Total Arch Aortic Reconstruction with Thoraflex Hybrid: Initial Single-Institutional Experience
Presented During:
Thursday, April 25, 2024: 5:38PM - 7:00PM
Sheraton Times Square
Posted Room Name:
Central Park
Abstract No:
P0349
Submission Type:
Abstract Submission
Authors:
Michael Kirsch (1), Adam Carroll (1), Muhammad Aftab (1), T. Brett Reece (1)
Institutions:
(1) University of Colorado Anschutz, Denver, CO
Submitting Author:
Michael Kirsch
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University of Colorado Anschutz
University of Colorado Anschutz
Co-Author(s):
Adam Carroll
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University of Colorado Anschutz
University of Colorado Anschutz
*Muhammad Aftab
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University of Colorado Anschutz
University of Colorado Anschutz
*T. Brett Reece
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University of Colorado Anschutz
University of Colorado Anschutz
Presenting Author:
Michael Kirsch
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Abstract:
Objective: Comfort with total arch replacement has increased with the evolution of hybrid techniques. The frozen elephant trunk (FET) technique, has traditionally relied upon distinct open and endovascular grafts, joined intraoperatively. The ThoraflexTM Hybrid was FDA approved in May 2022 as the first commercially available hybrid device for FET. We sought to describe our institutional experience performing total arch replacement since its approval.
Methods: We performed a retrospective review of prospectively collected clinical data from all patients undergoing elective aortic arch reconstruction with a total arch replacement at a single tertiary care center from May 2022 to October 2023. Data were retrieved from the electronic medical record.
Results: Thirty-four patients met the inclusion criteria and underwent elective aortic arch reconstruction with total arch replacement during the study period. Twenty-two (64.7%) underwent traditional frozen elephant trunk (FET) replacement, while 12 (35.3%) underwent replacement using the Thoraflex. Sixteen (72.7%) FET and 9 (75.0%) Thoraflex patients were male (p = 0.508), with a median age of 56.7 (IQR 51.0–63.8) and 62.6 (IQR 55.6–71.8) years, respectively (p = 0.597). Nine (40.9%) of traditional FET patients had a prior aortic intervention, compared with 9 (75.0%) of Thoraflex patients, p = 0.184. There were no significant differences in demographics or comorbidities between patients undergoing FET and non-FET aortic arch replacement, including diabetes, hypertension, tobacco use, chronic lung disease, peripheral artery disease, previous stroke, coronary artery disease, or previous cardiac intervention.
There were no differences in median cardiopulmonary bypass time (p = 0.242), aortic cross clamp time (p = 0.135) or circulatory arrest time (p = 0.364) by type of aortic arch replacement. There were no differences in postoperative length of stay (p = 0.669) or ICU length of stay (p = 0.112). There were no differences in postoperative ICU morbidity, including new dialysis requirement, venous thromboembolus, paralysis, stroke, prolonged mechanical ventilation, surgical site infection, postoperative atrial fibrillation, or operative mortality.
Complete outcome data are shown in Table 1.
Conclusions: Elective total arch replacement for aortic arch pathology is not associated with differences in operative and postoperative outcomes based upon technique of replacement.
Methods: We performed a retrospective review of prospectively collected clinical data from all patients undergoing elective aortic arch reconstruction with a total arch replacement at a single tertiary care center from May 2022 to October 2023. Data were retrieved from the electronic medical record.
Results: Thirty-four patients met the inclusion criteria and underwent elective aortic arch reconstruction with total arch replacement during the study period. Twenty-two (64.7%) underwent traditional frozen elephant trunk (FET) replacement, while 12 (35.3%) underwent replacement using the Thoraflex. Sixteen (72.7%) FET and 9 (75.0%) Thoraflex patients were male (p = 0.508), with a median age of 56.7 (IQR 51.0–63.8) and 62.6 (IQR 55.6–71.8) years, respectively (p = 0.597). Nine (40.9%) of traditional FET patients had a prior aortic intervention, compared with 9 (75.0%) of Thoraflex patients, p = 0.184. There were no significant differences in demographics or comorbidities between patients undergoing FET and non-FET aortic arch replacement, including diabetes, hypertension, tobacco use, chronic lung disease, peripheral artery disease, previous stroke, coronary artery disease, or previous cardiac intervention.
There were no differences in median cardiopulmonary bypass time (p = 0.242), aortic cross clamp time (p = 0.135) or circulatory arrest time (p = 0.364) by type of aortic arch replacement. There were no differences in postoperative length of stay (p = 0.669) or ICU length of stay (p = 0.112). There were no differences in postoperative ICU morbidity, including new dialysis requirement, venous thromboembolus, paralysis, stroke, prolonged mechanical ventilation, surgical site infection, postoperative atrial fibrillation, or operative mortality.
Complete outcome data are shown in Table 1.
Conclusions: Elective total arch replacement for aortic arch pathology is not associated with differences in operative and postoperative outcomes based upon technique of replacement.
Aortic Symposium:
Aortic Arch
Image or Table
