ArticleCardiovascular diagnosis and therapy2026
Aortic remodeling after zone 0 simplified delivery frozen elephant trunk (SD-FET) technique in acute aortic dissection: one-year clinical and morphological results in a single centre.
Article in Cardiovascular diagnosis and therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The simplified delivery frozen elephant trunk (SD-FET) technique enables a one-step repair of type A acute aortic dissection (AAD) with stent proximalisation and very short normothermic circulatory arrest. This study reports early and 1-year clinical outcomes together with aortic remodelling in the residual dissected aorta. Methods: Thirty consecutive patients underwent SD-FET for AAD between 2018 and 2023. Preoperative, postoperative, 1-year follow-up computed tomography scans were analyzed. True lumen (TL), false lumen (FL), and total aortic diameters were measured in four segments (proximal descending, distal descending, coeliac trunk, infra-renal) using the centerline method. Aortic remodelling was classified as positive, stable, or negative. Early and mid-term outcomes were assessed, including mortality, neurologic complications, and aortic reinterventions. Results: Four patients (13%) died in-hospital, and four (13%) sustained postoperative stroke; no spinal cord injury occurred. During follow-up, one patient died of an aortic event and two required secondary reinterventions for downstream enlargement, yielding an overall 1-year freedom from reintervention of 92.5% [95% confidence interval (CI): 83-100%]. At the proximal descending aorta, TL increased and FL decreased significantly at 3 months and 1 year (P<0.001), with 92% of patients showing positive or stable remodelling. At the distal descending aorta and coeliac level, positive/stable remodelling was observed in 53% and 63% of cases, respectively, whereas infra-renal changes were limited. Conclusions: SD-FET simplifies total arch repair for AAD, reduces circulatory arrest under normothermia, and achieves acceptable early results. One-year clinical outcomes and remodelling are comparable to conventional FET, may supports its safety and efficacy, though larger cohorts and longer follow-up remain warranted.
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