Frozen elephant trunk infection: to defrost or to debranch?

Abstract Infections of frozen elephant trunk hybrid prosthesis (HP) are not well documented in the literature and their management is not standardized yet. We report herein the case of a 59-year-old patient who benefited from a Thoraflex™ HP aortic arch replacement for an acute type A aortic dissect...

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Bibliographic Details
Published in:European journal of cardio-thoracic surgery 2021-07, Vol.60 (1), p.191-193
Main Authors: Nader, Joseph, Chabry, Yuthiline, Nazih, Houda, Caus, Thierry
Format: Article
Language:English
Subjects:
Life Sciences
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Summary:Abstract Infections of frozen elephant trunk hybrid prosthesis (HP) are not well documented in the literature and their management is not standardized yet. We report herein the case of a 59-year-old patient who benefited from a Thoraflex™ HP aortic arch replacement for an acute type A aortic dissection. He presented a year later with a Staphylococcus aureus infection of the proximal part of this prosthesis. We performed a replacement of the proximal compound of the HP accompanied by a complete debranching of the 3 supra-aortic vessels with an inter-carotidal retro-oesophageal bypass. As we left in situ the endovascular graft within the descending aorta, a life-long antibiotic therapy was introduced. The postoperative follow-up was uneventful, and the patient discharged home 2 weeks after his surgery. As an alternative to a more radical redo surgery with major risk, a hybrid medical and surgical treatment of infected frozen elephant trunk could be considered.
ISSN:1010-7940
1873-734X
DOI:10.1093/ejcts/ezaa466