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Yamanaka et al. Vessel Plus 2020;4:39 Vessel Plus
DOI: 10.20517/2574-1209.2020.46

Original Article Open Access

Usefulness of frozen elephant trunk technique for
distal aortic arch aneurysms

Kazuo Yamanaka , Takeshi Nishina , Yuji Sekine , Syun Sato , Masashi Yada , Yuichi Tara , Atushi
1
1
1
1
1
1
Iwakura , Masatoshi Fujita 3
2
1 Department of Cardiovascular Surgery, Nara Prefecture General Medical Center, Nara 630-8581, Japan.
2 Department of Cardiovascular Surgery, Tenri Hospital, Tenri 632-8552, Japan.
3 Department of Cardiovascular Medicine, Uji Hospital, Uji, Kyoto 611-0011, Japan.
Correspondence to: Dr. Kazuo Yamanaka, Executive Director, Cardiovascular Center, Nara Prefecture General Medical Center,
2-897-5 Shichijo-nishi, Nara 630-8581, Japan. E-mail: k-yamanaka@nara-hp.jp
How to cite this article: Yamanaka K, Nishina T, Sekine Y, Sato S, Yada M, Tara Y, Iwakura A, Fujita M. Usefulness of frozen elephant
trunk technique for distal aortic arch aneurysms. Vessel Plus 2020;4:39. http://dx.doi.org/10.20517/2574-1209.2020.46
Received: 2 Sep 2020 First Decision: 19 Oct 2020 Revised: 9 Nov 2020 Accepted: 18 Nov 2020 Published: 10 Dec 2020
Academic Editor: Antonio Nenna Copy Editor: Cai-Hong Wang Production Editor: Jing Yu

Received: First Decision: Revised: Accepted: Published: x
Abstract
Science Editor: Copy Editor: Production Editor: Jing Yu Aim: The effectual use of frozen elephant trunk (FET) has been for total aortic arch replacement (TAR) of acute
aortic dissection because of positive aortic remodeling. However, the use of FET in the non-dissecting aortic arch
aneurysm is still contr oversial. We aim to investigate the outcomes of TAR using the FET technique for distal aortic
arch aneurysms.

Methods: Between August 2014 and February 2020, 40 patients (35 males, mean age 77.0 years) underwent TAR
by using the FET technique with the J Graft Open Stent Graft for distal aortic arch aneurysms including 8 patients
with shaggy aorta. In 5 of 40 patients, coronary bypass grafting was concomitantly performed. We followed up for
29.0 months.

Results: The mortality were 0%. Stroke occurred in three patients (7.5%) one of whom had shaggy aorta,
paraparesis in one patient (2.5%) who recovered fully, and respiratory complication in two patients (5.0%). There
was no recurrent nerve palsy. During the follow-up period, death had no relationship with aortic disease.

Conclusion: We conclude the FET has the potential to improve TAR for distal aortic arch aneurysms.

Keywords: Aortic arch aneurysm, frozen elephant trunk, open stent, left recurrent nerve palsy, shaggy, total aortic
arch replacement

© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

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