Clinical Analysis Of Frozen Elephant Trunk For The Treatment Of Complited Type B Aortic Dissection

OBJECTIVE: To investigate the efficacy and treatment experience of frozen elephant trunk surgery for complited type B aortic dissection.METHODS: The early complications,economic benefits and long-term outcomes of 10 patients with complited TBAD who underwent frozen elephant trunk surgery from May 2016 to November 2018 in the Department of Cardiothoracic Surgery of the First Affiliated Hospital of Chongqing Medical University were retrospectively analyzed.Results: A total of 10 patients with complited TBAD were enrolled.Deep hypothemic circulation arrest,right axillary artery or right common carotid artery,selective anterograde cerebral perfusion,2 patients underwent frozen elephant trunk with left subclavian artery to left common carotid artery bypass and right subclavian artery vagal correction(to right common carotid artery),6 patients underwent frozen elephant trunk with left subclavian artery to left common carotid artery bypass.Frozen elephant trunk was performed in 2 cases.There were no deaths during and early after operation.One case had myocardial injury,one case had renalinsufficiency and two cases had acute renal failure.One case needed CRRT,seven cases had abnormal liver function,one case had ICU again after operation due to severe pulmonary infection,one case had tracheal intubation again,one case had electrolyte disturbance and ventricular fibrillation,and one case had delirium after operation.Three months after operation,CTA showed that the stent was stable,no displacement was found,the break of dissection was closed completely and no leakage occurred.One patient was reexamined for more than one month after operation and recovered well.The blood supply of left common carotid artery and left subclavian artery was good in all patients.All patients survived in good health,and the aorta around the stent was basically completely remodeled.One case was transferred to the local hospital for dialysis treatment because of renal failure.After 51 days of dialysis treatment,he was discharged from hospital for medication.One year after operation,he was in the stage of chronic renal insufficiency.Conclusion:Frozen elephant trunk surgery is safe and effective in the treatment of complited type B aortic dissection.When dissection involves aortic arch,insufficient landing area of stent,abnormal femoral and iliac arteries,connective tissue disease,it is a better choice than endovascular repair.