A simplified inversion technique for the frozen elephant trunk procedure using a four-branched graft

During the frozen elephant trunk (FET) procedure using a four-branched graft, making a distal anastomosis between the noninverted proximal graft and the distal stented aorta is quite challenging and takes time. Here, we introduce a simplified inversion technique for the FET procedure that uses a four-branched graft. This technique makes the distal anastomosis easy and secure, which would contribute to decreasing the circulatory arrest and ischemic time.