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Yamanaka et al. Vessel Plus 2020;4:39 I http://dx.doi.org/10.20517/2574-1209.2020.46 Page 5 of 8

Table 4. Mortality and morbidity
Hospital mortality 0 (0.0%)
ICU stay 3.4 ± 5.2 days
Hospital stay 25.3 ± 29.6 days
Cerebral infarction 3 (7.5%)
Paraparesis 1 (2.5%)
Respiratory failure 2 (5.0%)
Recurrent nerve palsy 0 (0.0%)
distal embolism 0 (0.0%)
Re-operation for bleeding 0 (0.0%)

ICU: intensive care unit

Figure 3. Kaplan-Meier survival curve for overall survival in patients with total arch replacement with frozen elephant trunk. The cause
of death was not related to aortic disease. The survival rate at three years after the frozen elephant trunk was 94.3%

which had disappeared before discharge. The second patient developed paralysis on left side of body while
the third patient had small cerebral infarction due to right internal capsule. Paraparesis was reported in one
patient (2.5%) who recovered fully and discharged with normal gait. Respiratory complication was reported
in two patients (5.0%) who had acute respiratory distress syndrome required tracheotomy. No patients had
distal embolism nor new left recurrent nerve palsy.

Postoperative follow-up
All patients were followed up for 29.0 months (range 5-68 months), during which, four patients died.
The causes of death were pneumonia in two patients (postoperative 3 and 52 months) and cancer in two
patients (postoperative 7 and 58 months). The cause of death had no relationship with aortic disease. The
survival rate at three years after the FET was 94.3% [Figure 3].

DISCUSSION
“Open stent” graft implantation in Japan has become established worldwide as the FET technique since the
launch of commercially available products for the European and Chinese markets in the 2000s. In Japan,