Long-term Outcomes of Aortic Arch Replacement using Trifurcated Graft Technique
Presented During:
Thursday, April 25, 2024: 5:38PM - 7:00PM
Sheraton Times Square
Posted Room Name:
Central Park
Abstract No:
P0197
Submission Type:
Abstract Submission
Authors:
Yoonjin Kang (1), Ji Seong Kim (1), Jae Woong Choi (2), David Spielvogel (3), Kyung Hwan Kim (1)
Institutions:
(1) Seoul National University Hospital, Seoul, (2) Seoul National University Hospital, Seoul, Seoul, (3) Westchester Medical Center, Valhalla, NY
Submitting Author:
Yoonjin Kang
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Seoul National University Hospital
Seoul National University Hospital
Co-Author(s):
Ji Seong Kim
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Seoul National University Hospital
Seoul National University Hospital
Jae Woong Choi
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Seoul National University Hospital, Seoul
Seoul National University Hospital, Seoul
*David Spielvogel
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Westchester Medical Center
Westchester Medical Center
Kyung Hwan Kim
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Seoul National University Hospital
Seoul National University Hospital
Presenting Author:
Yoonjin Kang
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Seoul National University Hospital
Seoul National University Hospital
Abstract:
Objective: Selective antegrade cerebral perfusion using trifurcated graft technique during aortic arch replacement is associated with low rate of adverse neurologic outcomes. We described clinical outcomes of total arch replacement using Trifurcated Graft Technique (modified Spielvogel technique).
Methods: From January 2007 to September 2022, overall 143 patients underwent non-emergent total arch replacement using trifurcated graft technique. The trifurcated graft was used for hypothermic selective cerebral perfusion. Median follow-up duration was 63.3 months. Primary outcomes were overall survival and aortic re-intervention.
Results: There were hospital death in 10 (7.0%) and postoperative stroke in 8 (5.6%) patients. However, only one patient (0.7%) had disabling stroke. Reoperation due to bleeding was present in 13 (9.1%) patients. There was no graft infection or mediastinitis. Twenty-two (15.4%) patients underwent prolonged intubation. Cardiopulmonary bypass time, aorta cross clamp time, and Mean selective cerebral perfusion were 228.0±56.9, 154.5±41.8, 79.3±23.6 minutes. Overall survival at 1 and 5 years was 94.3% and 83.1%, respectively. Freedom from aortic re-intervention at 1 and 5 years was 94.1% and 89.0%, respectively. There were no occlusion of trifurcated graft during the follow-up.
Conclusions: Use of a trifurcation graft to the brachiocephalic vessels with modified Spielvogel technique is a reliable and safe method for aortic arch replacement, yielding acceptable postoperative and long-term outcomes.
Methods: From January 2007 to September 2022, overall 143 patients underwent non-emergent total arch replacement using trifurcated graft technique. The trifurcated graft was used for hypothermic selective cerebral perfusion. Median follow-up duration was 63.3 months. Primary outcomes were overall survival and aortic re-intervention.
Results: There were hospital death in 10 (7.0%) and postoperative stroke in 8 (5.6%) patients. However, only one patient (0.7%) had disabling stroke. Reoperation due to bleeding was present in 13 (9.1%) patients. There was no graft infection or mediastinitis. Twenty-two (15.4%) patients underwent prolonged intubation. Cardiopulmonary bypass time, aorta cross clamp time, and Mean selective cerebral perfusion were 228.0±56.9, 154.5±41.8, 79.3±23.6 minutes. Overall survival at 1 and 5 years was 94.3% and 83.1%, respectively. Freedom from aortic re-intervention at 1 and 5 years was 94.1% and 89.0%, respectively. There were no occlusion of trifurcated graft during the follow-up.
Conclusions: Use of a trifurcation graft to the brachiocephalic vessels with modified Spielvogel technique is a reliable and safe method for aortic arch replacement, yielding acceptable postoperative and long-term outcomes.
Aortic Symposium:
Aortic Arch
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