Total Arch Replacement with a New Hybrid Device to Manage the Left Subclavian Artery in the Frozen Elephant Trunk Technique

采用新型混合装置进行全弓置换术,以在冷冻象鼻术中处理左锁骨下动脉

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Abstract

OBJECTIVES: Total arch replacement using the frozen elephant trunk technique remains the gold standard for a definite aortic arch repair. To facilitate surgical management of the left subclavian artery (LSA), a new hybrid frozen elephant trunk device was recently developed. METHODS: A 62-year-old female patient presented with acute type A aortic dissection and underwent emergent aortic root and total arch replacement using the novel custom-made Evita Neo EDE hybrid arch device for frozen elephant trunk implantation. To facilitate the management of the LSA, a covered stent connected to the device was inserted into the LSA via guidewire prior to performing the distal anastomosis in zone two. RESULTS: Postoperative computed tomographic angiography demonstrated excellent outcome and technical success with no signs of endoleak or device-related complications. The patient was discharged home 11 days after surgery in a stable clinical condition. CONCLUSIONS: The new Neo EDE hybrid arch device for frozen elephant trunk implantation is easy to use and simplifies surgical management of the LSA without adding technical complexity.

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