Stanford B 型急性大動脈解離に対するfrozen elephant trunk 併用上行弓部置換術

Recently, advanced technique and device of thoracic endovascular aortic repair （TEVAR） enabled surgical intervention for type B acute aortic dissection （BAD）. However, BAD have often serious complications；cerebral infarction, spinal cord infarction, multi-organ ischemia or necrosis, and retrograde type A acute aortic dissection. TEVAR is performed for complicated BAD for the aim of life saving in such a failure case of conservative treatment. Here we reported our surgical experience of total arch replacement using frozen elephant trunk （FET） by median sternotomy, for BAD with failed conservative treatment. There are 3 advantages；brain protection using selective cerebral perfusion, main entry closure using FET, and prevention of retrograde type A acute aortic dissection following prosthetic graft replacement. We examined how to select a FET product size and described operative procedures.