Echocardiographic Evaluation of Cardiac Remodeling after FET.

Background:  This study aimed to investigate if frozen elephant trunk (FET) implantation leads to negative cardiac remodeling in dissection and non-dissection patients and to determine whether there are differences when FET is implanted as an aortic redo procedure or initially.

Methods:  Between March 2013 and April 2022, 148 patients received FET without any concomitant procedures and therefore formed our cohort. One hundred and four were treated for dissecting and 44 for non-dissecting pathologies. Eighty-four received FET initially and 64 as an aortic redo procedure. Data were collected retrospectively using our center's dedicated aortic database as well as transthoracic echocardiographic reports of our cardiologists.

Results:  In the first weeks after FET implantation, dissection and non-dissection patients show a significant increase of mild valvular insufficiencies-a significant decrease of ejection fraction is only seen in dissection patients but these changes do not stay significant during later follow-up. Patients who receive FET as an aortic redo procedure tend to have significantly larger left ventricular (LV) end-diastolic diameters and higher LV masses, however, in longitudinal analysis, there were no long-term negative effects in patients who received FET initially or as aortic redo.

Conclusion:  In the first 2 years after implantation, FET has no echocardiographically measurable effect regarding negative cardiac remodeling in dissection and non-dissection patients, independent of the fact it is implanted initially or as an aortic redo procedure.