초록접수 현황
| 14F-195 | 구연 발표 |
Mid-term Outcome of Total Arch Replacement and Frozen Elephant Trunk in Acute DeBakey Type I Aortic Dissection
송석원, 김태훈, 임선희
연세대학교 의과대학 강남세브란스병원 흉부외과학교실
Background : Frozen elephant trunk (FET) procedure for acute DeBakey type I aortic dissection (AIAD) is thought to yield result favorable in aortic remodeling, but still remains controversial. The aim of this study is to evaluate the mid-term outcome of FET compared to total arch replacement (TAR) for AIAD.
Methods : A total of 44 patients with AIAD underwent FET (n = 20), or TAR (n = 24) from 2011 to 2013. The indications for FET were complicated descending thoracic aorta (DTA) dissection or aneurysm. Between the FET and TAR groups, the morpholgical changes of true and false lumen at 3 different levels (proximal, mid DTA, and abdominal aorta) were compared to assess the aorta remodeling.
Results : Three (12.5%) patients died in the FET group, and 3 (15%) in the TAR group (p > 0.05). In mid-term follow-up (mean, 38 months), the overall survival (p = 0.85) and re-intervention free survival (p = 0.78) after 3 years showed no difference between the two groups. Complete thrombosis in the false lumen was occurred in 11 (65%) patients in the FET group, and 13 (62%) in the TAR group (p > 0.05). True lumen collapse was significantly improved in the FET group (p = 0.017).
Conclusion : Although a significant true lumen expansion was found in the FET group, there was no benefit towards favorable aortic remodeling or reintervention-free survival according to our mid-term follow-up data. This result suggests that except in selective cases, FET procedure should not be considered as a routine procedure for AIAD.
Methods : A total of 44 patients with AIAD underwent FET (n = 20), or TAR (n = 24) from 2011 to 2013. The indications for FET were complicated descending thoracic aorta (DTA) dissection or aneurysm. Between the FET and TAR groups, the morpholgical changes of true and false lumen at 3 different levels (proximal, mid DTA, and abdominal aorta) were compared to assess the aorta remodeling.
Results : Three (12.5%) patients died in the FET group, and 3 (15%) in the TAR group (p > 0.05). In mid-term follow-up (mean, 38 months), the overall survival (p = 0.85) and re-intervention free survival (p = 0.78) after 3 years showed no difference between the two groups. Complete thrombosis in the false lumen was occurred in 11 (65%) patients in the FET group, and 13 (62%) in the TAR group (p > 0.05). True lumen collapse was significantly improved in the FET group (p = 0.017).
Conclusion : Although a significant true lumen expansion was found in the FET group, there was no benefit towards favorable aortic remodeling or reintervention-free survival according to our mid-term follow-up data. This result suggests that except in selective cases, FET procedure should not be considered as a routine procedure for AIAD.
책임저자: 송석원
연세대학교 의과대학 강남세브란스병원 흉부외과학교실
연락처 : 송석원, Tel: 02-2019-3380 , E-mail : sevraphd@yuhs.ac
