The XXXX trunk is freezing: The Hannover experience.

@entity1 @entity64 @entity449 @entity7105 @entity439
BACKGROUND: The " @entity7105 trunk" (ET) technique traditionally has been performed to treat complex aortic diseases involving the aortic arch and the descending aorta. Despite the fact that, in recent years, the "frozen @entity7105 trunk" (FET) technique has been used increasingly for such pathologies, discussion is still ongoing in the surgical community regarding which of the 2 techniques is better. We compared our results using the classic ET versus the FET technique. METHODS: From August 2001 to March 2013, a total of 277 @entity1 underwent total aortic arch replacement and either ET (group A) or FET (group B) implantation. In group A, 97 @entity1 (59 @entity1 ; age 59.7    12.7 years; 44.3% with @entity439 ; 55.6% with dissection [48.45% acute]) underwent an ET procedure; 21.64% were reoperations. In group B, 180 @entity1 underwent an FET procedure (126 @entity1 ; age 59.8    13.2 years; 34.4% with @entity439 ; 63.3% with dissection [35% acute]); 30% were reoperations. RESULTS: In group A, in-hospital mortality was 24.7%; @entity64 rate was 12.4%. During follow-up, 27.8% underwent a second-stage procedure. In group B, in-hospital mortality was 12.2%; @entity64  rate was 13.3%. During follow-up, 27.7% @entity1 underwent further interventions in the downstream aorta. CONCLUSIONS: In selected @entity1 with combined aortic arch and descending @entity449 limited to the proximal descending aorta, the FET approach potentially allows for single-stage therapy, whereas a second-stage operation is inevitable with the classic ET approach. Moreover, owing to the availability of prefabricated, easy-to-use, FET, hybrid prostheses that result in significantly better outcomes in @entity1 who have acute aortic dissection, type A, and if necessary, and provide an ideal "landing zone" for future endovascular completion, the classic ET procedure is "freezing," in the sense that it is being replaced by the FET approach.
