ArticleGeneral thoracic and cardiovascular surgery2025
Comparison between Zone 2 and Zone 3 distal anastomoses for aortic arch replacement in terms of invasiveness.
Article in General thoracic and cardiovascular surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Evaluation of vocal cord paralysis after total arch replacement using routine laryngeal endoscopy.General thoracic and cardiovascular surgery · 2026Article
- Zone 1 total arch replacement with frozen elephant trunk for type A dissection: early-to-mid-term outcomes.Journal of cardiothoracic surgery · 2026Observational
- Treatment of a Type II Endoleak from an Atypical Mediastinal Collateral Branch Following Total Arch Replacement with Frozen Elephant Trunk.Annals of vascular diseases · 2026Article
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesZone 2 anastomosis with total cervical branch reconstruction for acute type A aortic dissection and aortic arch aneurysms became possible after stent-graft introduction. This may be an easier procedure and reduce the risk of recurrent laryngeal nerve palsy. Therefore, this study aimed to compare the outcomes between Zone 2 and Zone 3 distal anastomoses.
methodsAfter evaluating the patient data in our institute between April 2016 and April 2022, the patients in whom distal anastomosis was performed at Zone 2 with a stent-graft were defined as the Zone 2 group (n = 70). The patients in whom distal anastomosis was performed at Zone 3 were defined as the Zone 3 group (n = 24).
resultsThe incidence of new-onset recurrent nerve palsy was one patient (1.4%) in the Zone 2 group and six patients (25.0%) in the Zone 3 group (p < 0.001). The lower body perfusion arrest time was 44.3 ± 9.1 min in the Zone 2 group and 52.9 ± 12.8 min in the Zone 3 group (p = 0.005). There were no significant differences in in-hospital mortality and morbidities. Multivariable analysis showed that only age was an independent predictor of overall mortality.
conclusionsPerforming distal anastomosis at Zone 2 with a frozen elephant trunk or stent-graft reduced the lower body perfusion arrest time and possibly prevented recurrent nerve palsy.
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