The Frozen Elephant Trunk Induces Late Morphological Changes in the Aortic Angle

P0334 

Abstract Submission 

Takanobu Kimura (1), Hiroshi Tsuneyoshi (2)

(1) Shizuoka general hospital, Shizuoka,Japan, (2) Shizuoka General Hospital, Shizuoka,Japan

Takanobu Kimura    -  Contact Me
Shizuoka general hospital

Hiroshi Tsuneyoshi    -  Contact Me
Shizuoka General Hospital

Takanobu Kimura    -  Contact Me
N/A

Objective:
The spring back force of the frozen elephant trunk (FET) often leads to stent-induced new entry (SINE). However, limited knowledge exists regarding the morphological alterations in the aortic angle resulting from this spring-back force.
Methods:
Among 107 cases using the Frozenix ®(Japan lifeline©, Japan) from July 2014 to October 2023 at our institution, 32 cases underwent follow-up using 3D-CT. We assessed changes in the aortic angle between the proximal and distal edge of the FET from preoperative to 1-year postoperative follow-up.
Results:
The definition of the aortic angle, an example, and a graphical representation of the changes in the aortic angle are shown in the figure. The mean age of the cohort was 74.1 years, with 14 cases of aortic dissection and 18 cases of aortic aneurysm. The aortic angle increased in all patients postoperatively. The mean aortic angles at preoperative, discharge, 6 months, and 1 year were 78.9°, 99.3°, 106.2°, and 114.1°, respectively. The mean angle change at discharge compared to preoperative was 129.9%. The angle change was more pronounced in the aortic dissection group than in the aortic aneurysm group (153.1° for aortic dissection vs. 111.8° for aortic aneurysm, p=0.048). Distal SINE occurred in 2 cases demonstrating relatively substantial angular changes (135.3% and 146.3%, respectively). One case occurred immediately after the surgery, while the other manifested one year after surgery when the aortic angle significantly changed from 109° to 132°.
Conclusions:
The spring-back force induced by the FET results in substantial changes in the aortic angle. Particularly in cases of aortic dissection, these changes are prominently evident immediately after the operation. Meticulous follow-up should be needed to detect SINE associated with angle changes.

Aortic Arch