Abstract：
UNASSIGNED: Type A acute aortic dissection (TA-AAD) is a great challenge for aortic surgeons. The establishment of a standardized surgical approach, particularly the determination of whether and when to address the aortic arch and the distal aorta in the same operation as the proximal aorta, is still unclear.
UNASSIGNED: Frozen elephant trunk (FET) has emerged as a valuable treatment for TA-AAD over the last decade. Here, we discuss the fundamentals and pitfalls of frozen elephant trunk procedures and present the latest innovations.
UNASSIGNED: FET has the potential to simplify arch reconstruction in patients with complex arch tears and rupture, optimize perfusion in the distal true lumen for those with a compressed true lumen and malperfusion, address distal reentry tears, and promote false lumen thrombosis and late aortic remodeling. Nevertheless, FET is still associated with non-negligible mortality and morbidity rates. Patient selection, surgical expertise, and postoperative care remain crucial determinants in ensuring successful outcomes. Recent innovations in FET surgery involve the development of techniques to minimize or avoid hypothermic circulatory arrest and new FET devices with different arch branch configurations aiming to facilitate subsequent aortic reinterventions. We believe that both these advancements have the potential to improve patient outcomes.
UNASSIGNED: Frozen elephant trunk (FET) has emerged as a valuable treatment for TA-AAD over the last decade. Here, we discuss the fundamentals and pitfalls of frozen elephant trunk procedures and present the latest innovations.
UNASSIGNED: FET has the potential to simplify arch reconstruction in patients with complex arch tears and rupture, optimize perfusion in the distal true lumen for those with a compressed true lumen and malperfusion, address distal reentry tears, and promote false lumen thrombosis and late aortic remodeling. Nevertheless, FET is still associated with non-negligible mortality and morbidity rates. Patient selection, surgical expertise, and postoperative care remain crucial determinants in ensuring successful outcomes. Recent innovations in FET surgery involve the development of techniques to minimize or avoid hypothermic circulatory arrest and new FET devices with different arch branch configurations aiming to facilitate subsequent aortic reinterventions. We believe that both these advancements have the potential to improve patient outcomes.
摘要：
■A型急性主动脉夹层（TA-AAD）对主动脉外科医生来说是一个巨大的挑战。建立规范的手术方式,特别是确定是否以及何时在与近端主动脉相同的手术中处理主动脉弓和远端主动脉，还不清楚。
冷冻象鼻（FET）在过去十年中已成为TA-AAD的一种有价值的治疗方法。在这里，我们讨论冷冻大象躯干程序的基本原理和陷阱，并介绍最新的创新。
■FET有可能简化患有复杂牙弓撕裂和破裂的患者的牙弓重建，对于那些压缩真腔和灌注不良的人，优化远端真腔的灌注，解决远端折返眼泪，并促进假腔血栓形成和晚期主动脉重构。然而，FET仍然与不可忽视的死亡率和发病率相关。患者选择,外科专业知识,术后护理仍然是确保成功结局的关键决定因素.FET手术的最新创新涉及技术的开发，以最大程度地减少或避免低温循环停滞，以及具有不同弓分支配置的新型FET设备，旨在促进随后的主动脉再介入。我们相信,这两种进展都有可能改善患者的预后.
冷冻象鼻（FET）在过去十年中已成为TA-AAD的一种有价值的治疗方法。在这里，我们讨论冷冻大象躯干程序的基本原理和陷阱，并介绍最新的创新。
■FET有可能简化患有复杂牙弓撕裂和破裂的患者的牙弓重建，对于那些压缩真腔和灌注不良的人，优化远端真腔的灌注，解决远端折返眼泪，并促进假腔血栓形成和晚期主动脉重构。然而，FET仍然与不可忽视的死亡率和发病率相关。患者选择,外科专业知识,术后护理仍然是确保成功结局的关键决定因素.FET手术的最新创新涉及技术的开发，以最大程度地减少或避免低温循环停滞，以及具有不同弓分支配置的新型FET设备，旨在促进随后的主动脉再介入。我们相信,这两种进展都有可能改善患者的预后.
