Conclusion
This systematic review
demonstrated an association between the FET procedure for total arch
replacement and perioperative coagulopathy, as represented by a need for
reoperation for bleeding and blood product transfusion. Being male and
of a younger age were identified as being protective against these
complications. Subgroup analysis revealed coagulopathy associated with
Thoraflex® Hybrid and Frozenix® was not heterogenous, while that of
E-vita® and Cronus® were subject to substantial heterogeneities in
reporting. However, it is worth deducing that while Thoraflex Hybrid
being used on a global scale and challenged by different clinical
indications (aneurysm and dissections (acute and chronic), and in
accordance to its apparent versatile performance, the outcomes of the
device indicate consistent and superior non-heterogenicity in comparison
to other available FET products in current surgical trend. Further
investigation into the effect of various graft-specific characteristics,
such as sizing, and human factors such as volume-outcome relationship on
rates of perioperative coagulopathy are warranted.