Total Arch Replacement with a New Hybrid Device to Manage the Left Subclavian Artery in the Frozen Elephant Trunk Technique.

OBJECTIVES

Total arch replacement using the frozen elephant trunk technique remains the gold standard for a definite aortic arch repair. To facilitate surgical management of the left subclavian artery (LSA), a new hybrid frozen elephant trunk device was recently developed.

METHODS

A 62-year-old female patient presented with acute type A aortic dissection and underwent emergent aortic root and total arch replacement using the novel custom-made Evita Neo EDE hybrid arch device for frozen elephant trunk implantation. To facilitate the management of the LSA, a covered stent connected to the device was inserted into the LSA via guidewire prior to performing the distal anastomosis in zone two.

RESULTS

Postoperative computed tomographic angiography demonstrated excellent outcome and technical success with no signs of endoleak or device-related complications. The patient was discharged home 11 days after surgery in a stable clinical condition.

CONCLUSIONS

The new Neo EDE hybrid arch device for frozen elephant trunk implantation is easy to use and simplifies surgical management of the LSA without adding technical complexity.