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Date Published: 02/05/2024
Abstract Views: 78
Views PDF: 21
DOI: https://doi.org/10.47972/vjcts.v46i.1119
Issue
Vol. 46
Section
Research Article
How to Cite
Phung, D. H. S., Le, H. Q., & Nguyen, H. U. (2024). Results of using thoraflextm hybrid prothesis for the treatment of complex aortic disease at Viet Duc University Hospital. The Vietnam Journal of Cardiovascular and Thoracic Surgery, 46, 22 - 30. https://doi.org/10.47972/vjcts.v46i.1119

Results of using thoraflextm hybrid prothesis for the treatment of complex aortic disease at Viet Duc University Hospital

Duy Hong Son Phung, Hong Quan Le, Huu Uoc Nguyen

Main Article Content

Abstract

Background: The aim of this study was to introduce and evaluate the early results after the frozen elephant trunk (FET) procedure with ThoraflexTM Hybrid prothesis for the treatment of complex aortic disease at Viet Duc University Hospital.


Methods: This is a retrospective descriptive study of all acceptable patients after the frozen elephant trunk (FET) procedure with ThoraflexTM Hybrid prothesis at Viet Duc University Hospital from January 2021 to May 2023.


Results: There were 21 patients with a male rate of 85.7% and an average age 58.2±10 years old (range 40–73). History of patients with hypertension: 19 (90.5%); post-dissection aortic aneurysm: 2 (9.5%) patients. By cause, the number of patients with thoracic aortic aneurysm was 03 (14.3%), acute aortic dissection type A was 16 (76.1%), and aortic dissection type B was 02 (9.5%). In which there were 16 cases of emergency surgery (76.1%). Replacement of the aortic arch was performed under moderate hypothermic (280 °C on average) circulatory arrest and bilateral selective antegrade cerebral perfusion with permanent monitoring of cerebral tissue oxygenation by the MASIMO machine. Average cardio-pulmonary bypass time, aortic cross clamp time, distal hypothermic circulatory arrest time, and operating time were 137,5±22,9 minutes; 86,3±17,6 minutes; 25,2±8,9 minutes; and 7,7±10,3 hours. The average ventilation time, length of intensive care unit stay, and hospital stay were 7,2±9,7 days, 18,8±20,7 days, and 19,9 ± 6,5 days. There was one patient with post-operative cerebrospinal fluid drainage. No patient had bleeding complications, recurrent nerve palsy, reoperation, or in-hospital mortality.


Conclusion: The initial results after the frozen elephant trunk procedure with ThoraflexTM Hybrid prothesis for the treatment of complex aortic disease at Viet Duc University Hospital were safe, good, and feasible.

Article Details

Keywords

thoracic aortic disease, frozen elephant trunk, ThoraflexTM Hybrid, aortic dissection, aortic aneurysm

References

1. Borst HG, Walterbusch G, Schaps D. Extensive Aortic Replacement using “Elephant Trunk” Prosthesis. Thorac Cardiovasc Surg. 1983;31(1):37-40. doi:10.1055/s-2007-1020290
2. Tan SZCP, Mohammed I, Bashir M. Frozen Elephant Trunk Sizing: A 30,000-Feet Perspective with Thoraflex Hybrid Stent Graft. AORTA. 2022;10(4):182-190. doi:10.1055/s-0042-1756667
3. Tan SZCP, Jubouri M, Mohammed I, Bashir M. What Is the Long-Term Clinical Efficacy of the ThoraflexTM Hybrid Prosthesis for Aortic Arch Repair? Front Cardiovasc Med. 2022;9:842165. doi:10.3389/fcvm.2022.842165
4. Di Marco L, Pantaleo A, Leone A, Murana G, Di Bartolomeo R, Pacini D. The Frozen Elephant Trunk Technique: European Association for Cardio-Thoracic Surgery Position and Bologna Experience. Korean J Thorac Cardiovasc Surg. 2017;50(1):1-7. doi:10.5090/kjtcs.2017.50.1.1
5. Czerny M, Schmidli J, Adler S, et al. Current options and recommendations for the treatment of thoracic aortic pathologies involving the aortic arch: an expert consensus document of the European Association for Cardio-Thoracic surgery (EACTS) and the European Society for Vascular Surgery (ESVS). Eur J Cardiothorac Surg. 2019;55(1):133-162. doi:10.1093/ejcts/ezy313
6. Shrestha M, Pichlmaier M, Martens A, Hagl C, Khaladj N, Haverich A. Total aortic arch replacement with a novel four-branched frozen elephant trunk graft: first-in-man results†. Eur J Cardiothorac Surg. 2013;43(2):406-410. doi:10.1093/ejcts/ezs296
7. TERUMO AORTIC ANNOUNCES US FDA APPROVAL FOR THORAFLEX HYBRID. Terumo Aortic. Published April 20, 2022. Accessed June 11, 2023. https://terumoaortic.com/fda-approval-for-thoraflex-hybrid-device/
8. Wisniewski K, Motekallemi A, Dell’Aquila AM, et al. Single-Center Experience With the ThoraflexTM Hybrid Prosthesis: Indications, Implantation Technique and Results. Front Cardiovasc Med. 2022;9. Accessed July 2, 2023. https://www.frontiersin.org/articles/10.3389/fcvm.2022.924838
9. K T, A O, A W, et al. The frozen elephant trunk technique: impact of proximalization and the four-sites perfusion technique. Eur J Cardio-Thorac Surg Off J Eur Assoc Cardio-Thorac Surg. 2021;61(1). doi:10.1093/ejcts/ezab295
10. Malvindi PG, Scrascia G, Vitale N. Is unilateral antegrade cerebral perfusion equivalent to bilateral cerebral perfusion for patients undergoing aortic arch surgery? Interact Cardiovasc Thorac Surg. 2008;7(5):891-897. doi:10.1510/icvts.2008.184184
11. Eusanio MD, Schepens MAAM, Morshuis WJ, et al. Separate grafts or en bloc anastomosis for arch vessels reimplantation to the aortic arch. Ann Thorac Surg. 2004;77(6):2021-2028. doi:10.1016/j.athoracsur.2003.10.094
12. Piperata A, d’Ostrevy N, Busuttil O, Pernot M. How to minimize the circulatory arrest time by using the Thoraflex Hybrid prosthesis: the ‘release and perfuse’ technique. Eur J Cardiothorac Surg. 2022;61(1):235-237. doi:10.1093/ejcts/ezab374