Complicated Acute Type A Aortic Dissection and Severe Aortic Atherosclerosis Predict Early Mortality After Frozen Elephant Trunk Procedure 

Frozen elephant trunk (FET) is an established surgical option for the single-stage treatment of acute type A aortic dissection. The authors studied 222 patients who underwent FET and compared outcomes and reintervention rates. The authors found significantly improved 30-day mortality with a zone 2 repair technique (7 percent) compared to a zone 3 repair technique (18 percent). Early mortality was driven by the presence of complicated dissection, including the presence of malperfusion syndrome, rupture, the need for presurgical intubation, or the need for cardiopulmonary resuscitation. Secondary distal aortic interventions were frequently performed after FET (37.4 percent); however, this did not adversely affect five-year survival. The authors also discuss the importance of patient selection for FET vs more expeditious procedures in type A dissections, since this could affect both short- and long-term outcomes, although further investigation in this area is necessary.