A novel modification of frozen elephant trunk technique: unique protocol from one institution.

OBJECTIVE: We aim to present a novel surgical technique of Frozen Elephant Trunk (FET) to treat complex thoracic aortic diseases in one stage and report its short-term outcomes. PATIENTS AND METHODS: Between December 2019 and 30 April 2021, twenty-five patients underwent FET operation at Viet Duc University Hospital. The mean age of the patients was 55.9 (±9.9, range 33-72) years. Eighteen (72%) of the patients were men. Thoracic aortic aneurysm was presented in three (12%) patients. Among seventeen (68%) of the patients undergoing the aortic dissection, eleven (44%) were treated acute type A aortic dissection. Type A intramural hematoma was presented in three (12%) patients. Four (16%) of the patients had undergone previous aortic operations, four (16%) of them had Marphan syndrome and two (11.1%) of them had stage 3 chronic kidney disease. All patients underwent FET procedure by unique protocol. Brain protection was achieved by antegrade bilateral selective cerebral perfusion and moderate hypothermia (28°C) in all cases; besides cerebral tissue oximetry monitoring was used to control brain oxygenation. RESULTS: There were no perioperative deaths, and all patients are still alive during mild-term follow-up period. Sixteen (88.9%) patients received isolated FET, while a Bentall procedure during FET was performed in two (8%) patients and right coronary artery bypass was in one (4%) case. The duration of cardiopulmonary bypass, cross-clamping, circulatory arrest, and total operation were 176.7 (±48.1, range 102-330), 106 (±39.8, range 63-205), 32.7 (±9.6, range 20-58), and 365.6 (±53.6, range 270-480) min, respectively. There was no bleeding following surgery. Prolonged ventilation required tracheotomy was documented in two (8%) patients, hemodialysis caused acute renal failure was in five (20%) patients, cerebral shock was in one (4%) patient, and type 1A endoleak in 2 (8%) patients. CONCLUSIONS: Our modification of FET technique was feasible, effective, and safe, with good postoperative outcomes.

Cytological, linkage and insecticide studies on a genetic sexing line in Anopheles stephensi Liston.

T(Y-D1)35 is a genetic sexing line in Anopheles stephensi (2n = 6; XX female, XY male) based on the translocation of the dieldrin resistance gene to the male determining chromosome. A cytological analysis demonstrated the presence of a 3 chromosome multiple translocation in which part of the Y chromosome formed the differential segment. An analysis of egg karyotypes enabled the segregation behaviour of the complex to be determined and only alternate and adjacent I segregations could be demonstrated. The breakpoint of the translocation in chromosome 3 was located using polytene salivary gland preparations. Linkage studies using chromosome three markers revealed contrasting effects of the translocation on recombination in this chromosome. An insecticide treatment method, based on the exposure of newly emerged adults, was developed enabling large numbers of individuals to be treated for the production of only males.