Volume Changes in the Descending Aorta after Frozen Elephant Trunk and Conventional Hemi-Arch Repair after Acute Type A Aortic Dissection
The aim of this study was to compare the mortality rates, re-intervention rates, and volumetric changes in aortas following surgery, in terms of the true lumen and false lumen changes, using conventional hemi-arch repair (CET) and frozen elephant trunk (FET) techniques. During the period from 2015 t...
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| Format: | Article |
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MDPI AG
2022-10-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/12/10/2524 |
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| author | Abdulhakim Ibrahim Arash Motekallemi Ahmed Yahia Alexander Oberhuber Thorsten Eierhoff Sven Martens Elena Marchiori Andreas Rukosujew |
| author_facet | Abdulhakim Ibrahim Arash Motekallemi Ahmed Yahia Alexander Oberhuber Thorsten Eierhoff Sven Martens Elena Marchiori Andreas Rukosujew |
| author_sort | Abdulhakim Ibrahim |
| collection | DOAJ |
| description | The aim of this study was to compare the mortality rates, re-intervention rates, and volumetric changes in aortas following surgery, in terms of the true lumen and false lumen changes, using conventional hemi-arch repair (CET) and frozen elephant trunk (FET) techniques. During the period from 2015 to 2018, 66 patients underwent surgical treatment for acute aortic dissection (Debakey type 1). Demographic and procedure-related data were evaluated. We measured volumetric change before surgical treatment, at discharge, and at 12- and 24-month time points based on computed tomography angiography. The study cohort was divided into two groups (FET vs. CET). The mean age of the patients was 56.9 ± 9.4 years in the FET group versus 63.6 ± 11 years in the CET group (<i>p</i> = 0.063). The mean follow-up time was 24 ± 6 and 25 ± 5 months for the FET and CET groups, respectively. There were no significant differences between the two groups in terms of the medical histories of the cohorts. The results showed a significant increase in true lumen volume after the FET procedure (within 24 months postoperatively; <i>p</i> = 0.005), and no significant changes in total (<i>p</i> = 0.392) or false lumen (<i>p</i> = 0.659) volumes were noted. After the CET procedure, there were significant increases in total and false lumen volumes (<i>p</i> = 0.013, <i>p</i> = 0.042), while no significant change in true lumen was observed (<i>p</i> = 0.219). The volume increase in true lumen after the FET procedure was higher compared to the CET group at all postoperative time points (at discharge, 12 months, and 24 months) without significant evidence (<i>p</i> = 0.416, <i>p</i> = 0.422, <i>p</i> = 0.268). At two years, the volume increase in false lumen was significantly higher among the CET group compared to the FET group (<i>p</i> = 0.02). The Kaplan–Meier curve analysis showed that patients who underwent the CET procedure underwent significantly more re-interventions due to false lumen expansion of the descending aorta (<i>p</i> = 0.047). Present study results indicate that the true and false lumen changes in the aorta following the FET and CET procedures were different. FET led to a significant increase in true lumen volume, while false lumen volume remained stable; however, after the CET procedure, significant false lumen enlargement was noted at mid-term follow-up time points. The re-intervention rate after CET was higher due to false lumen expansion. |
| first_indexed | 2024-03-09T20:21:03Z |
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| id | doaj.art-199d95a2619145c19eb9f93c9313110a |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-09T20:21:03Z |
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| spelling | doaj.art-199d95a2619145c19eb9f93c9313110a2023-11-23T23:46:47ZengMDPI AGDiagnostics2075-44182022-10-011210252410.3390/diagnostics12102524Volume Changes in the Descending Aorta after Frozen Elephant Trunk and Conventional Hemi-Arch Repair after Acute Type A Aortic DissectionAbdulhakim Ibrahim0Arash Motekallemi1Ahmed Yahia2Alexander Oberhuber3Thorsten Eierhoff4Sven Martens5Elena Marchiori6Andreas Rukosujew7Department of Vascular and Endovascular Surgery, University Hospital Muenster, 48149 Muenster, GermanyDepartment of Cardiothoracic Surgery, University Hospital Muenster, 48149 Muenster, GermanyDepartment of Vascular and Endovascular Surgery, University Hospital Muenster, 48149 Muenster, GermanyDepartment of Vascular and Endovascular Surgery, University Hospital Muenster, 48149 Muenster, GermanyDepartment of Vascular and Endovascular Surgery, University Hospital Muenster, 48149 Muenster, GermanyDepartment of Cardiothoracic Surgery, University Hospital Muenster, 48149 Muenster, GermanyDepartment of Vascular and Endovascular Surgery, University Hospital Muenster, 48149 Muenster, GermanyDepartment of Cardiothoracic Surgery, University Hospital Muenster, 48149 Muenster, GermanyThe aim of this study was to compare the mortality rates, re-intervention rates, and volumetric changes in aortas following surgery, in terms of the true lumen and false lumen changes, using conventional hemi-arch repair (CET) and frozen elephant trunk (FET) techniques. During the period from 2015 to 2018, 66 patients underwent surgical treatment for acute aortic dissection (Debakey type 1). Demographic and procedure-related data were evaluated. We measured volumetric change before surgical treatment, at discharge, and at 12- and 24-month time points based on computed tomography angiography. The study cohort was divided into two groups (FET vs. CET). The mean age of the patients was 56.9 ± 9.4 years in the FET group versus 63.6 ± 11 years in the CET group (<i>p</i> = 0.063). The mean follow-up time was 24 ± 6 and 25 ± 5 months for the FET and CET groups, respectively. There were no significant differences between the two groups in terms of the medical histories of the cohorts. The results showed a significant increase in true lumen volume after the FET procedure (within 24 months postoperatively; <i>p</i> = 0.005), and no significant changes in total (<i>p</i> = 0.392) or false lumen (<i>p</i> = 0.659) volumes were noted. After the CET procedure, there were significant increases in total and false lumen volumes (<i>p</i> = 0.013, <i>p</i> = 0.042), while no significant change in true lumen was observed (<i>p</i> = 0.219). The volume increase in true lumen after the FET procedure was higher compared to the CET group at all postoperative time points (at discharge, 12 months, and 24 months) without significant evidence (<i>p</i> = 0.416, <i>p</i> = 0.422, <i>p</i> = 0.268). At two years, the volume increase in false lumen was significantly higher among the CET group compared to the FET group (<i>p</i> = 0.02). The Kaplan–Meier curve analysis showed that patients who underwent the CET procedure underwent significantly more re-interventions due to false lumen expansion of the descending aorta (<i>p</i> = 0.047). Present study results indicate that the true and false lumen changes in the aorta following the FET and CET procedures were different. FET led to a significant increase in true lumen volume, while false lumen volume remained stable; however, after the CET procedure, significant false lumen enlargement was noted at mid-term follow-up time points. The re-intervention rate after CET was higher due to false lumen expansion.https://www.mdpi.com/2075-4418/12/10/2524aortic surgeryfrozen elephant trunkhemi-arch repairconventional aortic arch replacement |
| spellingShingle | Abdulhakim Ibrahim Arash Motekallemi Ahmed Yahia Alexander Oberhuber Thorsten Eierhoff Sven Martens Elena Marchiori Andreas Rukosujew Volume Changes in the Descending Aorta after Frozen Elephant Trunk and Conventional Hemi-Arch Repair after Acute Type A Aortic Dissection Diagnostics aortic surgery frozen elephant trunk hemi-arch repair conventional aortic arch replacement |
| title | Volume Changes in the Descending Aorta after Frozen Elephant Trunk and Conventional Hemi-Arch Repair after Acute Type A Aortic Dissection |
| title_full | Volume Changes in the Descending Aorta after Frozen Elephant Trunk and Conventional Hemi-Arch Repair after Acute Type A Aortic Dissection |
| title_fullStr | Volume Changes in the Descending Aorta after Frozen Elephant Trunk and Conventional Hemi-Arch Repair after Acute Type A Aortic Dissection |
| title_full_unstemmed | Volume Changes in the Descending Aorta after Frozen Elephant Trunk and Conventional Hemi-Arch Repair after Acute Type A Aortic Dissection |
| title_short | Volume Changes in the Descending Aorta after Frozen Elephant Trunk and Conventional Hemi-Arch Repair after Acute Type A Aortic Dissection |
| title_sort | volume changes in the descending aorta after frozen elephant trunk and conventional hemi arch repair after acute type a aortic dissection |
| topic | aortic surgery frozen elephant trunk hemi-arch repair conventional aortic arch replacement |
| url | https://www.mdpi.com/2075-4418/12/10/2524 |
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