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Thorac Cardiovasc Surg
DOI: 10.1055/s-0044-1790590
Original Cardiovascular

Echocardiographic Evaluation of Cardiac Remodeling after FET

Domenic Meissl
1   Department of Cardiovascular Surgery, University Heart Center Freiburg Bad Krozingen, Baden-Wprttemberg, Germany
,
Maximilian Kreibich
1   Department of Cardiovascular Surgery, University Heart Center Freiburg Bad Krozingen, Baden-Wprttemberg, Germany
,
Martin Czerny
1   Department of Cardiovascular Surgery, University Heart Center Freiburg Bad Krozingen, Baden-Wprttemberg, Germany
,
Joseph Kletzer
1   Department of Cardiovascular Surgery, University Heart Center Freiburg Bad Krozingen, Baden-Wprttemberg, Germany
,
Matthias Eschenhagen
1   Department of Cardiovascular Surgery, University Heart Center Freiburg Bad Krozingen, Baden-Wprttemberg, Germany
,
Stoyan Kondov
1   Department of Cardiovascular Surgery, University Heart Center Freiburg Bad Krozingen, Baden-Wprttemberg, Germany
,
Bartosz Rylski
1   Department of Cardiovascular Surgery, University Heart Center Freiburg Bad Krozingen, Baden-Wprttemberg, Germany
,
Roman Gottardi
1   Department of Cardiovascular Surgery, University Heart Center Freiburg Bad Krozingen, Baden-Wprttemberg, Germany
,
Tim Berger 
1   Department of Cardiovascular Surgery, University Heart Center Freiburg Bad Krozingen, Baden-Wprttemberg, Germany
› Author Affiliations Funding This work was supported by the Berta-Ottenstein-Programme for Advanced Clinician Scientists, Faculty of Medicine, University of Freiburg.
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Abstract

Background This study aimed to investigate if frozen elephant trunk (FET) implantation leads to negative cardiac remodeling in dissection and non-dissection patients and to determine whether there are differences when FET is implanted as an aortic redo procedure or initially.

Methods Between March 2013 and April 2022, 148 patients received FET without any concomitant procedures and therefore formed our cohort. One hundred and four were treated for dissecting and 44 for non-dissecting pathologies. Eighty-four received FET initially and 64 as an aortic redo procedure. Data were collected retrospectively using our center's dedicated aortic database as well as transthoracic echocardiographic reports of our cardiologists.

Results In the first weeks after FET implantation, dissection and non-dissection patients show a significant increase of mild valvular insufficiencies—a significant decrease of ejection fraction is only seen in dissection patients but these changes do not stay significant during later follow-up. Patients who receive FET as an aortic redo procedure tend to have significantly larger left ventricular (LV) end-diastolic diameters and higher LV masses, however, in longitudinal analysis, there were no long-term negative effects in patients who received FET initially or as aortic redo.

Conclusion In the first 2 years after implantation, FET has no echocardiographically measurable effect regarding negative cardiac remodeling in dissection and non-dissection patients, independent of the fact it is implanted initially or as an aortic redo procedure.

Keywords

cardiac remodeling - frozen elephant trunk - total aortic arch replacement - echocardiographic evaluation

Ethics Approval Statement

IRB approval was obtained on February 4, 2021 (No. 20-1302) by the institutional review board of the University of Freiburg and the need for informed consent was waived due to retrospective analysis.


Supplementary Material



Publication History

Received: 20 January 2024

Accepted: 20 August 2024

Article published online:
19 September 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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