Elephant trunk法とfrozen elephant trunk法の比較・検討

Comparative Study of Elephant Trunk and Frozen Elephant Trunk Techniques

当科では，上行大動脈にエントリーを認めないStanford A型急性大動脈解離には全弓部大動脈置換術を施行する方針である．2019年4月から従来のelephant trunk（ET）法からFrozenix（日本ライフライン社，東京）を用いたfrozen elephant trunk（FET）法に変更した．本稿では，ET法とFET法の手術成績を比較・検討した．

Twenty-six patients underwent total arch replacement for Stanford type A aortic dissection, including that with elephant trunk technique （ET group, n＝10） or with frozen elephant trunk technique （FET group, n＝16）. We compared preoperative and intraoperative findings, postoperative results and distal aortic arch remodeling between the two groups. In FET group, anesthesia time, operation time, cardiopulmonary bypass time, cardiac arrest time and circulatory arrest time were significantly shorter than ET group. Also, intra-operative blood transfusion amount was significantly smaller than ET group. In FET group, the ratio of true lumen area and thrombosis rate of false lumen at the distal arch level were significantly higher than ET group. Other postoperative results were almost similar between the two groups.