Echocardiographic evaluation of cardiac remodeling in dissection and non-dissection patients after frozen elephant trunk implantation

P0119 

Abstract Submission 

Tim Berger (1), Domenic Meissl (1), Maximilian Kreibich (1), Martin Czerny (1), Joseph Kletzer (1), Matthias Eschenhagen (2), Bartosz Rylski (1), Roman Gottardi (1)

(1) Department of Cardiovascular Surgery, University Hospital Freiburg Heart Centre, Freiburg, Germany,, Freiburg, Germany, (2) Department of Cardiovascular Surgery, University Hospital Freiburg Heart Centre, Freiburg, GermanN/A, Freiburg, Germany

Tim Berger    -  Contact Me
Department of Cardiovascular Surgery, University Hospital Freiburg Heart Centre, Freiburg, Germany,

Domenic Meissl    -  Contact Me
Department of Cardiovascular Surgery, University Hospital Freiburg Heart Centre, Freiburg, Germany,

Maximilian Kreibich    -  Contact Me
Department of Cardiovascular Surgery, University Hospital Freiburg Heart Centre, Freiburg, Germany,

*Martin Czerny    -  Contact Me
Department of Cardiovascular Surgery, University Hospital Freiburg Heart Centre, Freiburg, Germany,

Joseph Kletzer    -  Contact Me
Department of Cardiovascular Surgery, University Hospital Freiburg Heart Centre, Freiburg, Germany,

Matthias Eschenhagen    -  Contact Me
Department of Cardiovascular Surgery, University Hospital Freiburg Heart Centre, Freiburg, GermanN/A

Bartosz Rylski    -  Contact Me
Department of Cardiovascular Surgery, University Hospital Freiburg Heart Centre, Freiburg, Germany,

Roman Gottardi    -  Contact Me
Department of Cardiovascular Surgery, University Hospital Freiburg Heart Centre, Freiburg, Germany,

Tim Berger    -  Contact Me
N/A

Objectives: To investigate if FET implantation leads to negative cardiac remodeling in dissection and non-dissection patients and to determine whether there are differences when FET is implanted as an aortic re-do procedure or initially.

Methods: Between March 2013 and April 2022 three hundred twenty-five patients underwent aortic arch replacement surgery using the FET technique at the XXX. To reduce bias regarding the frozen elephant trunk´s effect on cardiac remodeling preoperative moderate and severe valve stenosis or regurgitation as well as concomitant valve, root or cardiac procedures were excluded. Therefore, one-hundred-forty-eight (consisting of 104 dissection and 44 non-dissection) patients formed our cohort. Data was collected retrospectively using our centre´s dedicated aortic database. Echocardiographic data was extracted from transthoracic echocardiographic reports done by the in-house cardiologists before and after surgery as well as during follow-up

Results: Dissection patients show in the immediate postoperative phase after FET implantation a significant decrease of ejection fraction and increase of mild valvular insufficiencies. After the first postoperative year following FET implantation, non-dissection patients show a significant increase of ejection fraction and a decrease of septal diameter. Patients who receive FET as an aortic redo procedure tend to have significant larger left ventricular enddiastolic diameters and higher left ventricular masses – even after correction for body surface area. During longitudinal analysis there were no long-term negative effects, neither in patients who received FET initially, nor in patients who received it as an aortic redo procedure.

Conclusions: With strict treatment of cardiovascular risk factors including blood pressure control to normal values, the implantation of a FET hybrid prosthesis has no negative effect on cardiac remodeling. FET also has no measurable effect regarding negative cardiac remodeling independently of the fact if it is implanted initially or as aortic redo procedure in the first two years after implantation.

Aortic Arch