False lumen thrombosis after frozen elephant trunk procedure in acute and chronic aortic dissection

J Cardiovasc Surg (Torino). 2022 Apr;63(2):195-201. doi: 10.23736/S0021-9509.21.11800-2. Epub 2021 Nov 18.

Abstract

Background: The clinical significance of the false lumen (FL) thrombosis after the thoracic aortic surgery consists in the correlation with aortic remodeling. The aim of the study was to analyze the incidence of the FL thrombosis of the thoracoabdominal aorta after the frozen elephant trunk (FET) procedure in acute and chronic aortic dissection.

Methods: A total of 57 consecutive patients with type A and B aortic dissection (AD) underwent the FET procedure between March 2012 and December 2020 were included in a retrospective study. All of the patients were divided in two groups: acute (N.=18) and chronic (N.=39) AD. Early and 2-year outcomes were evaluated in both groups. Computed tomography scans were obtained along the entire aorta for the aortic status assessment.

Results: There were no statistically significant differences in early mortality and postoperative outcomes in both groups. The 2-year survival rate in acute and chronic AD was 74.7±10% vs. 71.4±7% (P=0.573), respectively. In the follow-up, the FL thrombosis rate, changes of the true lumen and total aortic diameters did not differ significantly between the analyzed groups of patients. The freedom from negative aortic remodeling was 62.2±26% in acute AD versus 76.2±11% in chronic AD (P=0.853). One (5.6%) and 4 (10.3%) distal aortic reinterventions were performed in acute and chronic AD, respectively.

Conclusions: False lumen thrombosis rate after the FET procedure did not differ significantly in acute and chronic AD.

MeSH terms

  • Aorta, Thoracic / diagnostic imaging
  • Aorta, Thoracic / surgery
  • Aortic Aneurysm, Thoracic* / complications
  • Aortic Aneurysm, Thoracic* / diagnostic imaging
  • Aortic Aneurysm, Thoracic* / surgery
  • Aortic Dissection* / complications
  • Aortic Dissection* / diagnostic imaging
  • Aortic Dissection* / surgery
  • Blood Vessel Prosthesis / adverse effects
  • Blood Vessel Prosthesis Implantation*
  • Humans
  • Retrospective Studies
  • Thrombosis* / diagnostic imaging
  • Thrombosis* / etiology
  • Thrombosis* / surgery
  • Treatment Outcome