Early-to-midterm outcomes of aortic balloon occlusion technique versus hybrid procedure for aortic arch diseases.

Open in new tab Download slide Open in new tab Download slide OBJECTIVES The goal of this study was to compare the early-to-midterm outcomes of patients treated with the frozen elephant trunk procedure with aortic balloon occlusion (FET-ABO) versus hybrid repair for aortic arch diseases. METHODS Patients who underwent the FET-ABO (n  = 134) and the hybrid procedure (n  = 220) from 2017 to 2020 at our institution were analysed retrospectively. Early-to-midterm outcomes were compared using inverse probability weighting. Low-risk and high-risk subgroup analyses were performed according to the cut-off of the additive European System for Cardiac Operative Evaluation value of 6. RESULTS The present study demonstrated similar 30-day mortality (3.7% vs 8.6%; P  =   0.118) and adverse events between the FET-ABO and the hybrid groups. Fewer intraoperative red blood cell transfusions (0.54 ± 1.45 vs 1.26 ± 2.47 U; P  =   0.001), decreased total hospital costs (P  <   0.001) and considerable early-to-midterm survival [crude: hazard ratio (HR) 0.40, 95% confidence interval (CI) 0.17–0.91; P  =   0.030; adjusted: HR 0.35, 95% CI 0.13–0.91; P  =   0.032) were obtained with the FET-ABO compared to the hybrid procedure. The inverse probability weighting method substantiated the foregoing results. Adjusted subgroup analyses suggested that the FET-ABO procedure had a trend towards improved survival in low-risk patients (HR 0.17, 95% CI 0.03–0.93; P  =   0.041) and achieved outcomes comparable to those of the hybrid procedure in high-risk patients (HR 0.46, 95% CI 0.15–1.42; P  =   0.176). CONCLUSIONS The FET-ABO technique could be better promoted in hospitals lacking experience and equipment and could be more viable and cost-effective for selected patients compared with the hybrid procedure. [ABSTRACT FROM AUTHOR]