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The Experiences of TEVAR after Frozenix-Open Stent Graft (F-OSG) Placement for TAA Surgery～Availability of Hybrid TEVAR～


  • #HS 01-O-3
  • Hybrid Surgery. SESSION-1
  • Oral

The Experiences of TEVAR after Frozenix-Open Stent Graft (F-OSG) Placement for TAA Surgery～Availability of Hybrid TEVAR～

Tatsuya Nakao

Asian Soceity for Cardiovascular and Thoracic Surgery, Cardiothoracic Surgery Network, Matsudo, Japan

Date, time and location: 2018.05.26 13:30, Congress Hall, 2F–A

Abstract

Objective: F-OSG has been commercially available as the frozen elephant trunk (FET) hybrid prosthesis from July 2014 in Japan. The objective of this report is to elucidate the feasibility and efficacy of the FET procedure with F-OSG for treatment of extended aortic arch disease to extended descending aorta for dissections as well as TAAs.

METHODS: Between July 2014 and July 2017, 88 patients (mean age 70.0 years, male/female 68/20) with different pathologies from the aortic arch to the extended descending aorta in 47 dissections (acute /chronic A=26/4, acute/chronic/subacute B=1/6/10) and 41 thoracic arteriosclerotic aneurysms (TAAs) had the FET technique with F-OSG performed upon them.

RESULTS: Operative mortality within 30 days was 4.5%(4 cases) due to broad CI(12d), LOS(0d), MOF(1d), TAAA rupture(13d). Late mortality was 4.5%(4 cases) due to pneumonia(6M), DIC(9M), unknown(4M), TAAA rupture(10M). During the mean follow up period of 9.7 months, the survival rate was 89.0 % at 1year. In 11 patients(pts) with stent-graft-related event, the 2nd stage TEVAR (Hybrid TEVAR) were performed. The causes of 11 pts were Mega aorta in 1 pt, dilatation of des.Ao in 4 pts, re-dissection of des.Ao in 2pts, type 1b endleak(EL)+migration in 3 pts, type 2 EL(Lt SCA) in 1 pt. 9 of 11 pts were treated succcesfully by 2nd stage TEVAR.1 pt with mega-aorta extending from the ascending-aorta to the TAAA was successfully treated by staged operations and 1 pt with type 2 EL was treated by des.Ao replacement. Residual 9pts were treated  A follow-up computed tomographic image was available for 95.8% (84/88) of pts. In 39 pts with TAAs and 45 pts with dissections, Regarding the size of aneurysm and false lumen, increased/unchanged/shrank were 1/27/11 in 39 pts with TAAs and 6/24/15 in 45 pts with dissection.

CONCLUSION: We must follow up the fate of the false lumen and aneurysm sizes carefully in mid～late term period. We consider 2nd stage TEVAR (Hybrid TEVAR) can be a effective treatment for dissection and aneurysm cases that are estimated to grow from now on.

 


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