{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T16:43:20Z","timestamp":1790527400024,"version":"4.1.0"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2020,11,3]],"date-time":"2020-11-03T00:00:00Z","timestamp":1604361600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Vascutek Ltd"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,1,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p\/>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>Our goal was to study the immediate outcome after an emergency frozen elephant trunk procedure with a Thoraflex\u2122 Hybrid prosthesis (THP) in patients included in the EPI-Flex national registry and operated on in 21 French centres.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>All patients operated on in France between April 2016 and April 2019 for acute aortic syndromes and who had an frozen elephant trunk procedure with a THP were included in the study. The main end point was in-hospital mortality. The secondary end point was neuromorbidity, including paraplegia. The evolution of the main end point was monitored using a variable life-adjusted display graph with cumulative sum derivatives in order to stop inclusions in case the observed mortality became out of range compared to an expected mortality between 15% and 20%.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Enrolment ended on the scheduled date and included 109 patients. Most cases (54%) were performed at 3 centres, where more than 10 THP each were implanted (10\u201326). The observed mortality in the large-volume centres (22%) was comparable to that observed in the low-volume centres (20%). The individually risk-adjusted cumulative sum revealed that observed in-hospital mortality was statistically in line with that predicted by the log EuroSCORE. Analysis of the secondary end point revealed 8% cases of paraplegia, all of which appeared after treatment of the thoracic type A aortic dissection.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>In France, THP for emergency frozen elephant trunk surgery outside high-volume centres did not result in excessive in-hospital deaths. However, a word of caution must be expressed regarding the prevention of medullar ischaemia even in emergency aortic surgery.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezaa325","type":"journal-article","created":{"date-parts":[[2020,8,6]],"date-time":"2020-08-06T19:16:51Z","timestamp":1596741411000},"page":"458-466","source":"Crossref","is-referenced-by-count":12,"title":["The frozen elephant trunk technique in an emergency: THORAFLEX French National Registry offers new insights"],"prefix":"10.1093","volume":"59","author":[{"given":"Yuthiline","family":"Chabry","sequence":"first","affiliation":[{"name":"Federation of Heart, Lung and Vessels, University Hospital Amiens-Picardie, Amiens, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean","family":"Porterie","sequence":"additional","affiliation":[{"name":"Department of Cardiac and Vascular Surgery, University Hospital Rangueil, Toulouse, 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