Mid-term results of elective repair of extensive thoracic aortic pathology by the Evita Open Plus hybrid endoprosthesis only.: Follow-up of the Evita Open Plus

Jean-Philippe Verhoye 1, 2, * Amedeo Anselmi 1, 2 Adrien Kaladji 1, 2 Erwan Flécher 1, 2 Antoine Lucas 1 Jean-François Heautot 3 Xavier Beneux 4 Olivier Fouquet 5
* Auteur correspondant
1 Service de chirurgie thoracique cardiaque et vasculaire [Rennes]
2 LTSI - Laboratoire Traitement du Signal et de l'Image
3 Service de radiologie et imagerie médicale [Rennes]
4 Service d'anesthésie réanimation chirurgicale
5 Service de chirurgie cardio-vasculaire et thoracique
Abstract : OBJECTIVES: To describe the early and mid-term clinical and instrumental results of the frozen elephant trunk (FET) procedure using the recent Evita Open Plus hybrid endoprosthesis for elective one-stage treatment of extensive thoracic aortic disease. METHODS: We reviewed 16 patients undergoing FET for post-dissection aneurysm (50%), true aneurysm (31%) or other aetiologies (19%), through median sternotomy and hypothermic circulatory arrest. An average 14 ± 7.6-month follow-up with regular contrast-enhanced control computed tomography scans was available. Four patients received preliminary carotid-subclavian bypass to improve spinal cord protection. Distal extension through endovascular deployment of stent-grafts into the descending aorta was performed during the same procedure in 3 patients. Concomitant procedures on the ascending aorta/root were done in 25% of cases. RESULTS: There were no cases of operative mortality. Cases of neither cerebral stroke nor postoperative paraplegia were observed. Two cases of transient paraparesis and 1 case of Brown-Séquard syndrome occurred. At follow-up, there were no cases of endoleak or endotension. One patient was reoperated for distal completion (thoracoabdominal aortic replacement). CONCLUSIONS: The FET using the Evita Open Plus device is a reliable and versatile treatment for one-step management of extensive disease of the aortic arch and the descending aorta. This strategy should be reserved for patients having limited preoperative comorbidities and good functional status.
Keywords : Aortic operation Endovascular procedures Hybrid surgery
Type de document :
Article dans une revue
European Journal of Cardio-Thoracic Surgery, Oxford University Press (OUP), 2014, 45 (5), pp.812-7. 〈10.1093/ejcts/ezt477〉
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Soumis le : mercredi 13 novembre 2013 - 10:19:07
Dernière modification le : mercredi 19 décembre 2018 - 15:02:05
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Jean-Philippe Verhoye, Amedeo Anselmi, Adrien Kaladji, Erwan Flécher, Antoine Lucas, et al.. Mid-term results of elective repair of extensive thoracic aortic pathology by the Evita Open Plus hybrid endoprosthesis only.: Follow-up of the Evita Open Plus. European Journal of Cardio-Thoracic Surgery, Oxford University Press (OUP), 2014, 45 (5), pp.812-7. 〈10.1093/ejcts/ezt477〉. 〈inserm-00903260〉

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