{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T22:15:10Z","timestamp":1787004910472,"version":"build-2736575974"},"reference-count":24,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thorac Cardiovasc Surg"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Background\u2003Total arch replacement with the frozen elephant trunk (FET) procedure has changed the landscape of therapy for aortic arch diseases. The optimal landing zone for a FET is controversial. We sought to share our early and midterm results of the FET procedure as well as compare the clinical outcomes of proximal and distal FET anastomosis.<\/jats:p>\n                  <jats:p>Methods\u2003A total of 100 patients who underwent total arch replacement using the FET technique were identified between November 2014 and August 2021. According to the FET anastomosis over the aortic arch, patients were classified into two groups (zone 0\/1 vs. zone 2\/3). In-hospital mortality, complications, and midterm outcomes were assessed based on patient characteristics.<\/jats:p>\n                  <jats:p>Results\u2003The overall in-hospital mortality was 8%. Major complications occurred in 32% of patients, including spinal cord injury (5%), stroke (7%), and acute kidney injury requiring dialysis (7%). Zone 2\/3 FET (odds ratio: 6.491, 95% confidence interval: 1.930\u201321.835, p\u2009=\u20090.003) was an independent predictor of the composite endpoint of major complications. The rate of complete false lumen thrombosis was comparable (64.3% vs. 71.4%, p\u2009=\u20090.567). All patients, patients with zone 0\/1 FET, and patients with zone 2\/3 FET had 3-year freedom from aorta-related events of 73.0, 70.2, and 75.0%, respectively. There were no significant differences (log-rank test, p\u2009=\u20090.500).<\/jats:p>\n                  <jats:p>Conclusion\u2003Compared with zone 2\/3, proximalization of FET using zone 0\/1 for anastomosis was associated with better early outcomes and comparable rates of midterm aorta-related events. To substantiate its use, more research on this approach is required.<\/jats:p>","DOI":"10.1055\/s-0042-1757631","type":"journal-article","created":{"date-parts":[[2022,10,10]],"date-time":"2022-10-10T19:38:11Z","timestamp":1665430691000},"page":"089-095","source":"Crossref","is-referenced-by-count":4,"title":["Proximalization of Frozen Elephant Trunk Procedure: Zone 0 or 1 versus Zone 2 or 3 Arch Repair"],"prefix":"10.1055","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9781-856X","authenticated-orcid":false,"given":"Kwok Fai Lucius","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Queen Mary Hospital, Hong Kong SAR, People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inderjeet","family":"Bhatia","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Queen Mary Hospital, Hong Kong SAR, People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tai Leung Daniel","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Queen Mary Hospital, Hong Kong SAR, People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wing Kuk Timmy","family":"Au","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Queen Mary Hospital, Hong Kong SAR, People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ka Lai Cally","family":"Ho","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Queen Mary Hospital, Hong Kong SAR, People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2022,10,10]]},"reference":[{"issue":"05","key":"ref1","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1093\/ejcts\/ezv085","article-title":"Current status and recommendations for use of the frozen elephant trunk technique: a position paper by the Vascular Domain of EACTS","volume":"47","author":"M Shrestha","year":"2015","journal-title":"Eur J Cardiothorac Surg"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"II98","DOI":"10.1177\/15266028020090S216","article-title":"First International Summit on Thoracic Aortic Endografting: roundtable on thoracic aortic dissection as an indication for endografting","volume":"9","author":"R S Mitchell","year":"2002","journal-title":"J Endovasc Ther"},{"issue":"04","key":"ref3","doi-asserted-by":"crossref","first-page":"738","DOI":"10.1093\/ejcts\/ezz082","article-title":"Simplified frozen elephant trunk technique for combined open and endovascular treatment of extensive aortic diseases","volume":"56","author":"C Detter","year":"2019","journal-title":"Eur J Cardiothorac Surg"},{"issue":"03","key":"ref4","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1093\/ejcts\/ezz103","article-title":"Open distal anastomosis in the frozen elephant trunk technique: initial experiences and preliminary results of arch zone 2 versus arch zone 3","volume":"56","author":"A Leone","year":"2019","journal-title":"Eur J Cardiothorac Surg"},{"issue":"02","key":"ref5","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1093\/icvts\/ivab086","article-title":"Frozen elephant trunk technique with different proximal landing zone for aortic dissection","volume":"33","author":"D S Panfilov","year":"2021","journal-title":"Interact Cardiovasc Thorac Surg"},{"issue":"19","key":"ref6","first-page":"30360-5","article-title":"Total arch repair with frozen elephant trunk using the \u2018zone 0 arch repair\u2019 strategy for type A acute aortic dissection","volume":"S0022-5223","author":"H Yamamoto","year":"2019","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"03","key":"ref7","doi-asserted-by":"crossref","first-page":"170","DOI":"10.21037\/acs.2020.03.09","article-title":"Open total arch replacement with trifurcated graft and frozen elephant trunk","volume":"9","author":"E Beckmann","year":"2020","journal-title":"Ann Cardiothorac Surg"},{"issue":"03","key":"ref8","doi-asserted-by":"crossref","first-page":"178","DOI":"10.21037\/acs-2020-fet-25","article-title":"Results of frozen elephant trunk from the international E-vita Open registry","volume":"9","author":"K Tsagakis","year":"2020","journal-title":"Ann Cardiothorac Surg"},{"issue":"03","key":"ref9","doi-asserted-by":"crossref","first-page":"189","DOI":"10.21037\/acs-2020-fet-22","article-title":"Hybrid arch frozen elephant trunk repair: evidence from the Canadian Thoracic Aortic Collaborative","volume":"9","author":"M Ouzounian","year":"2020","journal-title":"Ann Cardiothorac Surg"},{"issue":"05","key":"ref10","doi-asserted-by":"crossref","first-page":"1285","DOI":"10.1016\/j.jtcvs.2019.01.020","article-title":"Hybrid and frozen elephant trunk for total arch replacement in DeBakey type I dissection","volume":"158","author":"L Zhang","year":"2019","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"03","key":"ref11","doi-asserted-by":"crossref","first-page":"152","DOI":"10.21037\/acs.2020.03.13","article-title":"Frozen elephant trunk with Frozenix prosthesis","volume":"9","author":"Y Okita","year":"2020","journal-title":"Ann Cardiothorac Surg"},{"issue":"03","key":"ref12","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1053\/j.semtcvs.2020.11.016","article-title":"Total aortic arch replacement and frozen elephant trunk","volume":"33","author":"J YK Ho","year":"2021","journal-title":"Semin Thorac Cardiovasc Surg"},{"issue":"03","key":"ref13","doi-asserted-by":"crossref","first-page":"144","DOI":"10.21037\/acs.2020.03.08","article-title":"Long-term outcomes of the frozen elephant trunk procedure: a systematic review","volume":"9","author":"D H Tian","year":"2020","journal-title":"Ann Cardiothorac Surg"},{"issue":"02","key":"ref14","first-page":"329","article-title":"Long-term experience with the E-vita Open hybrid graft in complex thoracic aortic disease","volume":"51","author":"H Jakob","year":"2017","journal-title":"Eur J Cardiothorac Surg"},{"issue":"01","key":"ref15","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1016\/j.jtcvs.2019.10.031","article-title":"Neurologic complications after the frozen elephant trunk procedure: a meta-analysis of more than 3000 patients","volume":"160","author":"O Preventza","year":"2020","journal-title":"J Thorac Cardiovasc 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Technol"},{"issue":"05","key":"ref19","first-page":"669","article-title":"Safety and pitfalls in frozen elephant trunk implantation","volume":"2","author":"A Damberg","year":"2013","journal-title":"Ann Cardiothorac Surg"},{"issue":"05","key":"ref20","first-page":"612","article-title":"Overall Essen's experience with the E-vita open hybrid stent graft system and evolution of the surgical technique","volume":"2","author":"K Tsagakis","year":"2013","journal-title":"Ann Cardiothorac Surg"},{"issue":"05","key":"ref21","doi-asserted-by":"crossref","first-page":"e003172","DOI":"10.1161\/JAHA.115.003172","article-title":"False lumen status in patients with acute aortic dissection: a systematic review and meta-analysis","volume":"5","author":"D Li","year":"2016","journal-title":"J Am Heart Assoc"},{"issue":"05","key":"ref22","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1093\/ejcts\/ezx218","article-title":"Single-centre experience with the frozen elephant trunk technique in 251 patients over 15\u2009years","volume":"52","author":"M Shrestha","year":"2017","journal-title":"Eur J Cardiothorac Surg"},{"issue":"02","key":"ref23","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1093\/ejcts\/ezy031","article-title":"True-lumen and false-lumen diameter changes in the downstream aorta after frozen elephant trunk implantation","volume":"54","author":"T Berger","year":"2018","journal-title":"Eur J Cardiothorac Surg"},{"issue":"01","key":"ref24","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1093\/ejcts\/ezab063","article-title":"Is total aortic arch replacement with the frozen elephant trunk procedure reasonable in elderly patients?","volume":"60","author":"E Beckmann","year":"2021","journal-title":"Eur J Cardiothorac Surg"}],"container-title":["The Thoracic and Cardiovascular Surgeon"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0042-1757631.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T07:21:32Z","timestamp":1730791292000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0042-1757631"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,10]]},"references-count":24,"journal-issue":{"issue":"02","published-online":{"date-parts":[[2024,3,5]]},"published-print":{"date-parts":[[2024,3]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0042-1757631","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0171-6425","1439-1902"],"issn-type":[{"value":"0171-6425","type":"print"},{"value":"1439-1902","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,10]]}}}