Extra-anatomic left subclavian artery bypass patency in frozen elephant trunk surgeryCentral MessagePerspective
Objective: To explore the advantages and consequences of using an extra-anatomic Dacron bypass in frozen elephant trunk surgery for fast and secure left subclavian artery (LSA) reimplantation. Methods: Between June 2017 and June 2023, 195 patients were treated using an LSA bypass. All postoperative...
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Elsevier
2025-04-01
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| Series: | JTCVS Techniques |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666250725000641 |
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| author | Leon Mattern Philipp Pfeiffer, MD Karen Wittemann Edoardo Zancanaro, MD Chris Probst, MD Ahmed Ghazy, MD Hendrik Treede, MD, PhD Daniel-Sebastian Dohle, MD, PhD |
| author_facet | Leon Mattern Philipp Pfeiffer, MD Karen Wittemann Edoardo Zancanaro, MD Chris Probst, MD Ahmed Ghazy, MD Hendrik Treede, MD, PhD Daniel-Sebastian Dohle, MD, PhD |
| author_sort | Leon Mattern |
| collection | DOAJ |
| description | Objective: To explore the advantages and consequences of using an extra-anatomic Dacron bypass in frozen elephant trunk surgery for fast and secure left subclavian artery (LSA) reimplantation. Methods: Between June 2017 and June 2023, 195 patients were treated using an LSA bypass. All postoperative imaging was reviewed to assess the patency of the bypass grafts. If the LSA bypass was not patent, symptoms of complications and their management were evaluated. Time-to-event analysis was performed to assess bypass patency and time to thrombosis. Results: Out of 195 LSA bypasses, 183 remained patent during follow-up, for a 5-year patency rate of 91.4%. Prolonged cardiopulmonary bypass duration was associated with poorer graft patency. Eight of the 12 patients with a thrombosed LSA bypass were asymptomatic. The most common complication of thrombosed bypass was subclavian steal syndrome. Surgical revision was necessary in 2 of the 4 symptomatic patients. All cases of thrombosed LSA bypass occurred within the first 15 months. Conclusions: LSA bypass in frozen elephant trunk surgery is a fast and safe technique for supra-aortic artery reimplantation. Bypass thrombosis is rare and often does not require surgical intervention. |
| format | Article |
| id | doaj-art-5151ab2d7b60477f8b0b46e4a03cafce |
| institution | Kabale University |
| issn | 2666-2507 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JTCVS Techniques |
| spelling | doaj-art-5151ab2d7b60477f8b0b46e4a03cafce2025-08-20T04:01:01ZengElsevierJTCVS Techniques2666-25072025-04-01301710.1016/j.xjtc.2025.01.025Extra-anatomic left subclavian artery bypass patency in frozen elephant trunk surgeryCentral MessagePerspectiveLeon Mattern0Philipp Pfeiffer, MD1Karen Wittemann2Edoardo Zancanaro, MD3Chris Probst, MD4Ahmed Ghazy, MD5Hendrik Treede, MD, PhD6Daniel-Sebastian Dohle, MD, PhD7Address for reprints: Leon Mattern, Department of Cardiac and Vascular Surgery, University Medical Center Mainz, Langenbeckstraße 1, Mainz, 55131, Germany.; Department of Cardiac and Vascular Surgery, University Medical Center Mainz, Mainz, GermanyDepartment of Cardiac and Vascular Surgery, University Medical Center Mainz, Mainz, GermanyDepartment of Cardiac and Vascular Surgery, University Medical Center Mainz, Mainz, GermanyDepartment of Cardiac and Vascular Surgery, University Medical Center Mainz, Mainz, GermanyDepartment of Cardiac and Vascular Surgery, University Medical Center Mainz, Mainz, GermanyDepartment of Cardiac and Vascular Surgery, University Medical Center Mainz, Mainz, GermanyDepartment of Cardiac and Vascular Surgery, University Medical Center Mainz, Mainz, GermanyDepartment of Cardiac and Vascular Surgery, University Medical Center Mainz, Mainz, GermanyObjective: To explore the advantages and consequences of using an extra-anatomic Dacron bypass in frozen elephant trunk surgery for fast and secure left subclavian artery (LSA) reimplantation. Methods: Between June 2017 and June 2023, 195 patients were treated using an LSA bypass. All postoperative imaging was reviewed to assess the patency of the bypass grafts. If the LSA bypass was not patent, symptoms of complications and their management were evaluated. Time-to-event analysis was performed to assess bypass patency and time to thrombosis. Results: Out of 195 LSA bypasses, 183 remained patent during follow-up, for a 5-year patency rate of 91.4%. Prolonged cardiopulmonary bypass duration was associated with poorer graft patency. Eight of the 12 patients with a thrombosed LSA bypass were asymptomatic. The most common complication of thrombosed bypass was subclavian steal syndrome. Surgical revision was necessary in 2 of the 4 symptomatic patients. All cases of thrombosed LSA bypass occurred within the first 15 months. Conclusions: LSA bypass in frozen elephant trunk surgery is a fast and safe technique for supra-aortic artery reimplantation. Bypass thrombosis is rare and often does not require surgical intervention.http://www.sciencedirect.com/science/article/pii/S2666250725000641frozen elephant trunkaortic arch surgeryleft subclavian artery bypassischemic burden |
| spellingShingle | Leon Mattern Philipp Pfeiffer, MD Karen Wittemann Edoardo Zancanaro, MD Chris Probst, MD Ahmed Ghazy, MD Hendrik Treede, MD, PhD Daniel-Sebastian Dohle, MD, PhD Extra-anatomic left subclavian artery bypass patency in frozen elephant trunk surgeryCentral MessagePerspective JTCVS Techniques frozen elephant trunk aortic arch surgery left subclavian artery bypass ischemic burden |
| title | Extra-anatomic left subclavian artery bypass patency in frozen elephant trunk surgeryCentral MessagePerspective |
| title_full | Extra-anatomic left subclavian artery bypass patency in frozen elephant trunk surgeryCentral MessagePerspective |
| title_fullStr | Extra-anatomic left subclavian artery bypass patency in frozen elephant trunk surgeryCentral MessagePerspective |
| title_full_unstemmed | Extra-anatomic left subclavian artery bypass patency in frozen elephant trunk surgeryCentral MessagePerspective |
| title_short | Extra-anatomic left subclavian artery bypass patency in frozen elephant trunk surgeryCentral MessagePerspective |
| title_sort | extra anatomic left subclavian artery bypass patency in frozen elephant trunk surgerycentral messageperspective |
| topic | frozen elephant trunk aortic arch surgery left subclavian artery bypass ischemic burden |
| url | http://www.sciencedirect.com/science/article/pii/S2666250725000641 |
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