Frozen Elephant Trunk: Technical Overview and Our Experience with a Patient-Tailored Approach

Area of Science:

• Cardiovascular Surgery
• Vascular Surgery
• Thoracic Surgery

Background:

• Hybrid prostheses have evolved for total aortic arch replacement.
• Diverse surgical techniques are needed for various aortic arch pathologies.

Purpose of the Study:

• To provide an overview of popular frozen elephant trunk surgical techniques.
• To present a tailored antegrade stent graft deployment technique for aortic arch pathology.

Main Methods:

• Overview of established frozen elephant trunk surgical techniques.
• Detailed description of a tailored approach using antegrade deployment of a Gore C-TAG endovascular stent graft sutured to a four-branched vascular prosthesis.
• Application of the technique in three cases of acute type A aortic dissection.

Main Results:

• The tailored technique was successfully applied to three patients with acute type A aortic dissection.
• The described method involves antegrade deployment of a Gore C-TAG endovascular stent graft.

Conclusions:

• The tailored frozen elephant trunk technique is effective for acute aortic dissection.
• This approach may be applicable to chronic dissections, aneurysms, and other aortic arch pathologies.
• The technique's tailored nature and material availability suggest broad utility in various operative scenarios.