Long-term outcomes of total arch replacement with frozen elephant trunk procedure in more than 1,000 cases of acute type A aortic dissection in a single-center

P0200 

Abstract Submission 

Juntao Qiu (1), Kai Zhang (2), Cuntao Yu (3)

(1) N/A, China, (2) Fuwai Hospital, Beijing, Beijing, (3) Fuwai Hospital, National Centre for Cardiovascular Diseases, State Key Laboratory of Cardiovascular, Beijing, Beijing

Juntao Qiu    -  Contact Me
N/A

Kai Zhang    -  Contact Me
Fuwai Hospital

CUNTAO YU    -  Contact Me
Fuwai Hospital, National Centre for Cardiovascular Diseases, State Key Laboratory of Cardiovascular

Juntao Qiu    -  Contact Me
N/A

Objective: The most effective surgical method for acute type A aortic dissection(ATAAD) involving the aortic arch is controversial. This article was first to explore the long-term outcomes of ATAAD using total arch replacement with frozen elephant trunk procedure (TAR with FET) with the largest cases in one center.
Methods: From 2007 to 2018, 1427 cases of ATAAD underwent surgical treatment in Fuwai Hospital. Among them, patients who underwent TAR with FET were selected to obtain clinical data and conduct long-term follow-ups. The follow-up deadline is November 2023. Long-term clinical outcomes were summarized by survival, freedom from aortic reoperation, and activity of daily living.
Results: A total of 1090 patients underwent TAR with FET, 80.18% (874/1090) of male patients, average age 46.6 ± 10.2 years. 290 (26.6%) patients underwent the Bentall procedure in aortic root management. The average CPB time was 191.2 ± 63.7min, cross-clamp time was 105.1 ± 33.4min, hypothermic circulatory arrest time was 19.6 ± 7.2min, and operative mortality was 7.34% (80/1090). By the end of follow-up, All causes of death is166(including 80 operative deaths), average follow-up time is 6.15±3.97 years, the longest follow-up time is more than 16 years, 83.86% of patients (847/1010) have complete self-care ability and can engage in general physical work. Overall survival was 89.21%, 87.52%, and 81.7% at 3, 5 and 10 years respectively. The 5-year and 10-year freedom from aortic reoperation rates for discharged patients (1010 cases) were 95.55% and 92.97%, respectively.
Conclusion: TAR with FET had acceptable operative mortality and encouraging long-term outcomes for ATAAD. TAR with FET should be given priority to recommend for ATAAD in experienced center for better long-term outcomes.

Dissection