Techniques and outcomes of total aortic arch repair with frozen elephant trunk for DeBakey I dissections

Total aortic arch replacement (Tar) with frozen elephant trunk (feT) technique (feT) has been increasingly used to treat a variety of aortic pathologies over the past two decades. Because feT can effectively treat the diseased arch and cover the proximal entry tear in the distal arch, it is a valuable option in the treatment of deBakey i aortic dissections. This report focuses on the techniques and outcomes of Tar with feT for acute/chronic aortic dissection. a review of pooled literature including 27 observational studies showed in-hospital mortality, permanent stroke, and spinal cord injury rates of 8.4%, 5.9% and 2.6% for acute aortic dissections, and 7.5%, 4.0% and 4.6% for chronic aortic dissections, respectively. in most of the studies, complete false lumen thrombosis rate was achieved in 80% of patients at the level of feT for acute and chronic aortic dissections. Mid-term outcomes are equally promising. for chronic aortic dissections, positive remodeling of the non-stented distal aortic segments is less frequent leading to secondary reinterventions within 3 to 5 years. however, most studies have not applied distal abdominal extensions of the repair using fenestrated and branched endografts. in the current endovascular era, Tar + feT should be considered as an alternative to conventional open surgical repair in centers of excellence.