This site is not optimized for Internet Explorer 8 (or older).

Please upgrade to a newer version of Internet Explorer or use an alternate browser such as Chrome or Firefox.

Results of Frozen Elephant Trunk From the International E-vita Open Registry

Monday, June 22, 2020

Submitted by


Source Name: The Annals of Cardiothoracic Surgery


Konstantinos Tsagakis, Davide Pacini, Martin Grabenwöger, Michael A. Borger, Nora Goebel, Wolfgang Hemmer, Alvaro Laranjeira Santos, Thanos Sioris, Kazimierz Widenka, Petar Risteski, Jorge Mascaro, Igor Rudez, Andreas Zierer, Carlos A. Mestres, Arjang Ruhparwar, Roberto Di Bartolomeo, Heinz Jakob

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.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 (1st period, 2005–2011 versus 2nd period, 2012–2018). Overall, 1,165 patients were enrolled in the study with a wide variety of multisegmental thoracic aortic pathologies and aortic emergencies. Participating centers determined their own surgical protocol.The overall 30-day mortality was 12%. Short- and long-term survival were higher in high- versus low-volume centers (P=0.048 and P=0.013, respectively). In the 2nd time period, cerebral complications were reduced significantly (P=0.015). Incidence of permanent spinal cord-related symptoms was reduced to 3% in the 2nd time period, but did not reach statistical significance. Hypothermic circulatory arrest time (P<0.001) and incidence of postoperative temporary renal replacement therapy (P=0.008) were significantly reduced in the 2nd time period. Ten-year survival and freedom from aortic-related death rates were 46.6% and 85.7%, respectively, for the entire group. The freedom from distal aortic re-interventions for a new or progressive residual aortic disease was 76.0%. In conclusion, this study shows that the evolution of FET arch repair techniques with the E-vita Open graft and increasing institutional experience were associated with improved results. Progression of residual aortic disease makes close follow-up with aortic imaging mandatory in such patients.

Add comment

Log in or register to post comments