The Early and Long-Term Outcomes of Total Arch Replacement Using the Frozen Elephant Trunk (FET) Technique for Chronic Aortic Aneurysms.

Background: The favorable long-term outcomes have been reported for total arch replacement using the frozen elephant trunk technique for acute aortic dissection. However, the data on chronic degenerative aortic aneurysms treated with this technique are limited compared with those for acute aortic dissection, and the long-term outcomes are not well understood. Here, we report early and long-term outcomes of total arch replacement using the frozen elephant trunk technique in patients with chronic aortic aneurysms.

Methods: We included 37 patients with chronic degenerative aortic aneurysms who underwent total arch replacement using the frozen elephant trunk technique between January 2015 and December 2022 at the National Defense Medical College Hospital, Tokorozawa, Japan. The primary endpoints were the 30-day and five-year survival rates. The secondary endpoints were major adverse cardiac and cerebrovascular events and acute renal failure.

Results:  The 30-day mortality rate was 13.5%, and the factors influencing this rate were postoperative cerebral infarction, acute renal failure, and prolonged ventilation. The factors influencing major adverse cardiac or cerebrovascular events and acute renal failure included a history of preoperative stroke. The five-year survival rate was 61.1%.

Conclusion: Total arch replacement using the frozen elephant trunk technique for degenerative aortic aneurysms at our institution yielded satisfactory early and long-term surgical outcomes.