Evidence map›Paper›PMID 38690556›Full record

ArticleEuropean heart journal. Case reports2024

The elephant's Achilles' heel: a case report of acute obstruction of frozen elephant trunk after proximal aortic dissection repair.

Stephan Nienaber, Xun Yuan, Susanna Price, Ulrich Rosendahl, Christoph A Nienaber

Open access · goldAbstract readCase Reports
In one paragraph

Article in European heart journal. Case reports, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.4field-weighted citation impact, top 38% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 2 countries.

Stephan NienaberUniversity of Cologne, Faculty of Medicine and University Hospital Cologne, Clinic III for Internal Medicine, Cologne, Germany.ORCID https://orcid.org/0000-0001-5779-7549
Xun YuanDepartment of Cardiology and Aortic Centre, Guy's and St. Thomas' Hospitals NHS Trust, Royal Brompton and Harefield Hospitals, London SW3 6NP, UK.ORCID https://orcid.org/0000-0001-6843-6466
Susanna PriceDepartment of Cardiology and Aortic Centre, Guy's and St. Thomas' Hospitals NHS Trust, Royal Brompton and Harefield Hospitals, London SW3 6NP, UK.ORCID https://orcid.org/0000-0002-6425-3360
Ulrich RosendahlDepartment of Cardiology and Aortic Centre, Guy's and St. Thomas' Hospitals NHS Trust, Royal Brompton and Harefield Hospitals, London SW3 6NP, UK.
Christoph A NienaberDepartment of Cardiology and Aortic Centre, Guy's and St. Thomas' Hospitals NHS Trust, Royal Brompton and Harefield Hospitals, London SW3 6NP, UK.ORCID https://orcid.org/0000-0001-9671-8030
St Thomas' Hospital · GBUniversity of Cologne · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The frozen elephant trunk (FET) technique as a hybrid combining surgical and endovascular repair is an emerging concept to treat complex aortic dissection. Early experience showed technical feasibility and promising clinical outcomes. However, unsuspected complications still arise. Case summary: A 25-year-old male presented to the emergency department with a 2-day history of chest pain. After exclusion of acute coronary syndrome, a computed tomography angiography (CTA) revealed Type A (DeBakey Type I) aortic dissection. The patient underwent median stenotomy for complete replacement of the ascending aorta, the aortic arch, and FET. Early after rewarming, the patient became unstable due to severe left ventricular dysfunction. Soon veno-arterial extracorporal membrane oxygenation (VA-ECMO) was required for circulatory support. The cause of deterioration remained unclear until repeated CTA showed acute obstruction of the FET. Invasive exploration confirmed a trans-FET gradient of 100 mmHg, successfully managed by repeated balloon inflation with resolution of both obstruction and gradient. The patient recovered completely without any sequela. Discussion: While the mechanism of acute obstruction after FET remains subject to speculation, the rescue intervention of ballooning the obliteration on VA-ECMO was life-saving. Intraoperative ultrasound and videoscopic inspection may be instrumental before chest closure to avoid such critical events.

Indexed as

Balloon dilatationCase reportFrozen elephant trunkPseudo-coarctationThoraflex Hybrid prosthesisType A aortic dissection

Identifiers

PMID38690556
PMCPMC11060110
OpenAlexW4394804973

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.