Right size matters! The ideal size of hybrid prosthesis in frozen elephant trunk

There is abundant of literature emerging to support the use of the frozen elephant trunk prosthesis, but there is still a lack of clear consensus on the sizing of the hybrid prosthesis. There is a general consensus that the stent should not be oversized in acute aortic dissection and chronic aortic dissection. Some surgeons consider that only the true lumen has to be measured while others argue that the entire diameter of the aorta has to be measured, and a few measure the aorta intraoperatively. In regards to thoracic aortic aneurysm, most surgeons oversize the stent-graft by 10% to 20%. A small device may not provide adequate sealing, whereas a larger device may cause new entry points distally. Hence, an appropriate device has to be selected for the optimal outcome.