Frozen elephant trunk in acute aortic dissection: a literature review.

Background: Acute aortic dissection is a life-threatening condition that requires urgent surgical treatment. The frozen elephant trunk (FET) technique, including the Thoraflex hybrid prosthesis, has emerged as an effective strategy for treating complex aortic pathologies. With the widespread application of the FET technique, it continues to evolve, aiming to simplify procedures and reduce complications.

BioGlue is not associated with polypropylene suture breakage after aortic surgery.

Objective: We have encountered broken or damaged polypropylene sutures (Prolene) at the anastomotic sites during aortic reoperations. Because a surgical sealant, bovine serum albumin-glutaraldehyde (BioGlue), was used in previous aortic surgery in some of these cases, we undertook this study to evaluate whether the use of BioGlue was associated with breakage of polypropylene sutures at the aortic anastomosis.

Materials And Methods: The broken polypropylene sutures, anastomotic sites and aortic tissue at the location of suture breakage were visually inspected and evaluated intraoperatively.

Development of aortic arch surgery in Bologna and reflections on current strategy of cerebral protection.

Complications after open arch repair much decreased over time thanks to better methods of organ and cerebral protection. The crossroads was the introduction of antegrade cerebral perfusion as a method of cerebral protection. Other intraoperative techniques also contributed to facilitate arch reconstruction, such as performing circulatory arrest at higher core temperature, using hybrid grafts or endografts, and monitoring cerebral functions during the procedure.

Acute Aortic Syndrome Revisited: JACC State-of-the-Art Review.

The purpose of this paper is to describe all available evidence on the distinctive features of a group of 4 life-threatening acute aortic pathologies gathered under the name of acute aortic syndrome (AAS). The epidemiology, diagnostic strategy, and management of these patients has been updated. The authors propose a new and simple diagnostic algorithm to support clinical decision making in cases of suspected AAS, thereby minimizing diagnostic delays, misdiagnoses, and unnecessary advanced imaging.

Early outcome and mid-term survival after open arch repair using selective antegrade cerebral perfusion.

Objectives: The introduction of selective antegrade cerebral perfusion technique as method of cerebral protection improved the outcome of open arch surgery. The aim of this study was to report early outcomes using this technique.

Methods: Between 1997 and 2017, data were collected retrospectively for all patients who underwent surgical replacement of the aortic arch using selective antegrade cerebral perfusion ( = 938).

Sutureless aortic valves in elderly patients with aortic stenosis and intermediate-risk profile.

Aims: Sutureless valves became an alternative to standard bioprostheses, allowing surgeons to significantly reduce cross-clamping and extracorporeal circulation times, with a potential positive impact on major postoperative complications. The aim of this European multicentre study was to evaluate the safety and efficacy of sutureless valves in patients with an intermediate-risk profile undergoing aortic valve replacement (AVR).

Methods: We investigated early and mid-term outcomes of 518 elderly patients with aortic stenosis at intermediate-risk profile (mean STS Score 6.

Sutureless versus transcatheter aortic valves in elderly patients with aortic stenosis at intermediate risk: A multi-institutional study.

Objective: This multi-institutional study compares the long-term outcome of elderly patients with severe aortic stenosis and an intermediate risk profile undergoing sutureless versus transcatheter aortic valve implantation.

Methods: From 2008 to 2015, 967 elderly patients (>75 years) with intermediate risk (Society of Thoracic Surgeons score 4%-8%) and isolated aortic stenosis were included in the study (sutureless valve = 481; transcatheter aortic valve implantation = 486). After propensity score matching, 2 matched groups of 291 patients were obtained.

Postoperative and mid-term hemodynamic changes after replacement of the ascending aorta.

Objectives: To evaluate aortic distensibility and pulse waveform patterns associated with the ascending aortic aneurysm, and to analyze the postoperative and mid-term hemodynamic changes induced by prosthetic replacement of the ascending aorta.

Methods: Central blood pressure waves were recorded at the carotid artery level by means of a validated transcutaneous arterial tonometer in 30 patients undergoing prosthetic replacement of ascending aortic aneurysm and in 30 control patients. Measurements were obtained the day before surgery and 5 to 7 days and 16 to 20 months after surgery.

Results of frozen elephant trunk from the international E-vita Open registry.

Background: Over the years, frozen elephant trunk (FET) has become the treatment of choice for multisegmental thoracic aortic disease. This multicenter study presents the evolution of FET results using the E-vita Open hybrid graft with respect to institutional experience and time.

Methods: The data of International E-vita Open registry were studied according to the institutional experience of the participating centers (high- versus low-volume centers) and according to the evolution of FET treatment during time (1 period, 2005-2011 versus 2 period, 2012-2018).

The CatLet score: a new coronary angiographic scoring tool accommodating the variable coronary anatomy for the first time.

Background: The SYNTAX score for decision makings or outcome predictions in coronary artery disease does not account for the variations in the coronary anatomy, which is a clear fallacy for patients with less typical anatomy than suggested by the SYNTAX score. The current study aimed to derive a new coronary angiographic scoring system accommodating the variability in the coronary anatomy.

Methods: The 17-myocardial segment model and laws of competitive blood supply and flow conservation were utilized to derive this new scoring system.

The CatLet score and outcome prediction in acute myocardial infarction for patients undergoing primary percutaneous intervention: A proof-of-concept study.

Background: The Coronary Artery Tree description and Lesion EvaluaTion (CatLet) score accommodating the variability in coronary anatomy is a recently developed and comprehensive angiographic scoring system aimed at assisting in risk-stratification of patients with coronary artery disease. However, a validation of this angiographic scoring system is lacking.

Methods: The CatLet score was calculated retrospectively in 308 consecutively enrolled patients with acute myocardial infarction (AMI) undergoing primary percutaneous coronary intervention.

Minimally Invasive Aortic Valve Replacement with Sutureless Valves: Results From an International Prospective Registry.

Objective: To report the early and mid-term results of patients who underwent minimally invasive aortic valve replacement (MI-AVR) with a sutureless prosthesis from an international prospective registry.

Methods: Between March 2011 and September 2018, among 957 patients included in the prospective observational SURE-AVR (Sorin Universal REgistry on Aortic Valve Replacement) registry, 480 patients underwent MI-AVR with self-expandable Perceval aortic bioprosthesis (LivaNova PLC, London, UK) in 29 international institutions through either minithoracotomy ( = 266) or ministernotomy ( = 214). Postoperative, follow-up, and echocardiographic outcomes were analyzed for all patients.

Comparison of Two Strategies for Aortic Valve-Sparing Root Replacement.

Background: Since its introduction in 1992, multiple variations of the aortic valve-sparing David procedure technique have been described. Here, we present the short- and midterm outcomes of 2 centers using the straight tube graft (David-I) and the Valsalva prosthesis in patients who underwent isolated David procedure.

Methods: Between March 2002 and October 2015, 232 patients underwent the David procedure at 2 European centers.

Surgical aortic valve replacement with new-generation bioprostheses: Sutureless versus rapid-deployment.

Objectives: The aim of this retrospective multicenter study was to compare early clinical and hemodynamic outcomes of Perceval-S sutureless (Livanova, London, United Kingdom) and Intuity rapid-deployment (Edwards Lifesciences, Irvine, Calif) bioprostheses.

Methods: Data from patients who underwent isolated or combined aortic valve replacement with Perceval-S and with Intuity bioprostheses at 18 cardiac surgical institutions were analyzed. Propensity matching was performed to identify similar patient cohorts.

Total aortic arch replacement with frozen elephant trunk technique: Results from two European institutes.

Objective: We report on a large series of patients treated at the S. Orsola Hospital, University of Bologna (Bologna, Italy) and Hannover Medical School (Hannover, Germany), with the aim to evaluate the early and midterm results.

Methods: Between January 2007 and March 2017, 437 patients underwent total aortic arch replacement with the frozen elephant trunk technique.

The Decision-Making Process in Acute Type A Aortic Dissection: When to Replace the Aortic Arch.

The decision-making process is crucial for the surgery of acute type A aortic dissection (AAAD). Often surgeons have to face different challenges, taking prompt decisions in emergency setting, during the pre- and intraoperative phase. Choosing if operate or not a patients with AAAD as well as the management of the dissected aortic arch can be challenging.

Less invasive ventricular enhancement (LIVE) as potential therapy for ischaemic cardiomyopathy end-stage heart failure.

Background: Surgical ventricular reshaping (SVR) is a treatment option for patients with severe ischaemic heart failure (HF). Recently, a new minimally invasive, hybrid technique named "less invasive ventricular enhancement" (LIVE), has been developed adopting the Reviven™ Myocardial Anchoring System (BioVentrix Inc., San Ramon, CA, USA).

The frozen elephant trunk surgery: a systematic review analysis.

The frozen elephant trunk might be considered one of the most appreciated innovations during the last decades to treat complex thoracic aortic lesions. Many useful tips have been progressively introduced to standardize the procedures and, nowadays, the improved post-operative outcomes contributed to spread the procedure. The following article will provide a comprehensive review analysis of the Frozen Elephant Trunk (FET) technique, throughout the current available devices, possible surgical indications and primary post-operative complications.

Aortic remodeling in acute type A aortic dissection after frozen elephant trunk implantation.

Survivors at first intervention after acute type A aortic dissection often necessitate additional interventions to avoid dilation and rupture of the remaining thoraco-abdominal aorta. During the first-stage arch procedure, the attempt to treat the descending thoracic aorta with a stent graft could attenuate this phenomenon and reduce the need for further open or endovascular reinterventions. In this short review article, the frozen elephant trunk technique was tested as influencing factor of aortic remodeling during follow-up analysis.