Abstract
BACKGROUND: There is limited experience and knowledge of the use of the fenestrated frozen elephant trunk (FET) technique in acute type A aortic dissection (ATAAD). This study's aims were to assess the clinical outcomes of the fenestrated FET technique for ATAAD and to identify its best practices and pitfalls. METHODS: This study included 101 patients who underwent emergency surgical aortic repair for ATAAD at our hospital between October 2018 and April 2023. We analyzed the perioperative and postoperative outcomes of those treated with the fenestrated FET technique (n = 65). RESULTS: The rate of postoperative thrombosed false lumen at the distal aortic arch after the fenestrated FET technique was 87%. In most cases, the location of the distal end of the FET was T6 or T7. The rate of distal stent-induced new entry was 8%. The operation time, aorta cross-clamp time, and extracorporeal circulation time were shorter in patients in whom the fenestrated FET technique was performed than in those treated with conventional total arch replacement. Eight patients had secondary aortic events in the follow-up period and were able to be treated by endovascular techniques. CONCLUSIONS: The fenestrated FET technique offers the advantage of low invasiveness during emergent aortic repair. It also provides an option for secondary therapy in cases of late aortic events. Overall, this technique has potential to improve both early and late outcomes of therapy for ATAAD.