Five-Year Outcomes of Hybrid Arch Frozen Elephant Trunk Repair With Novel Multibranched Hybrid Graft

Abstract

BackgroundThe objective of this study was to report the 5-year outcomes of hybrid arch frozen elephant trunk (FET) procedures with a multibranched hybrid graft. MethodsBetween 2014 and 2020, 50 consecutive patients (63 ± 15 years old; 34% women) underwent hybrid arch FET with Thoraflex hybrid graft (Terumo Aortic) at a single center. Indications included aortic aneurysm (n = 48 [96%]), acute aortic dissection (n = 10 [20%]), and chronic dissection (n = 20 [40%]). Follow-up was complete, and mean follow-up was 1455 ± 664 days. ResultsAll 50 patients experienced successful device implantation. The 30-day/in-hospital mortality was 2% (n = 1). Stroke and transient neurologic deficits occurred in 1 patient (2%) and 3 patients (6%). Two patients (4%) and 1 patient (2%) experienced transient and permanent spinal cord ischemia. FET thromboembolic complication was observed in 1 patient (2%). In follow-up, 6 patients died of aortic events, and there were 13 reinterventions in the downstream aorta, of which 46% (6/13) were planned second-stage operations. Survival rate at 1 year, 2 years, and 5 years was 96%, 92%, and 85%, and freedom from unplanned distal reintervention at 1 year, 2 years, and 5 years was 98%, 92%, and 81%. Computed tomography follow-up demonstrated positive distal aortic remodeling with aneurysmal regression and stabilized aortic dimensions in patients with aortic dissection. ConclusionsThe hybrid arch FET procedure with a novel hybrid graft is associated with good early and midterm outcomes. Longer term outcomes merit further investigation.