{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T16:43:19Z","timestamp":1790527399490,"version":"4.1.0"},"reference-count":17,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2019,8,29]],"date-time":"2019-08-29T00:00:00Z","timestamp":1567036800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p\/>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>The aim of the study was to compare the conventional frozen elephant trunk implantation technique with a modified implantation technique with an aortic anastomosis in zone 1 and extra-anatomic revascularization of the left subclavian artery during reperfusion.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>Between May 2014 and March 2018, 40 patients (26 male; mean age 60.2\u2009\u00b1\u200911.2\u2009years) underwent complete aortic arch replacement with the Thoraflex Hybrid prosthesis\u2122 (Vascutek, Inchinnan, Scotland) at our institution. Seventeen patients underwent conventional arch replacement (group 1) and 23 patients the modified procedure (group 2). Indication for arch replacement included all types of acute and chronic diseases.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Cardiopulmonary bypass time (213.1\u2009\u00b1\u200953.5 vs 243.8\u2009\u00b1\u200967.0\u2009min, P\u2009=\u20090.13) and aortic cross-clamp time (114.4\u2009\u00b1\u200940.7 vs 117.3\u2009\u00b1\u200956.6\u2009min, P\u2009=\u20090.86) did not differ significantly between group 1 and 2. There was a trend towards a shorter circulatory arrest time (50.72\u2009\u00b1\u20099.6 vs 44.7\u2009\u00b1\u200915.5\u2009min; P\u2009=\u20090.20) in group 2. Perioperative mortality was 10% (5.9% vs 13%; P\u2009=\u20090.62). Stroke occurred in 10% (5.9% vs 13%; P\u2009=\u20090.62) of patients. Spinal cord injury occurred in 7.5% of patients (11.8% vs 4.3% P\u2009=\u20090.57). Due to the a proximal aortic anastomosis, there was a significantly shorter coverage of the descending aorta with the prosthesis ending at vertebral level Th7.5 (6.75\u20138) in group 1 versus Th6.0 (5.0\u20136.0) in group 2 (P-value\u2009=\u20090.004).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Implantation of the frozen elephant trunk prosthesis in zone 1 allows for a more proximal aortic anastomosis that could make the procedure more feasible especially in patients with difficult anatomies or in an acute setting.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezz234","type":"journal-article","created":{"date-parts":[[2019,8,1]],"date-time":"2019-08-01T19:10:02Z","timestamp":1564686602000},"source":"Crossref","is-referenced-by-count":5,"title":["Comparison of the conventional frozen elephant trunk implantation technique with a modified implantation technique in zone 1"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9716-3655","authenticated-orcid":false,"given":"Roman","family":"Gottardi","sequence":"first","affiliation":[{"name":"Department of Cardiovascular and Endovascular Surgery, Paracelsus Medical University Salzburg, Salzburg, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6841-4208","authenticated-orcid":false,"given":"Andreas","family":"Voetsch","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular and Endovascular Surgery, Paracelsus Medical University Salzburg, Salzburg, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Krombholz-Reindl","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular and Endovascular Surgery, Paracelsus Medical University Salzburg, Salzburg, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Winkler","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular and Endovascular Surgery, Paracelsus Medical University Salzburg, Salzburg, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2119-1163","authenticated-orcid":false,"given":"Johannes","family":"Steindl","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular and Endovascular Surgery, Paracelsus Medical University Salzburg, Salzburg, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4966-6244","authenticated-orcid":false,"given":"Christian","family":"Dinges","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular and Endovascular Surgery, Paracelsus Medical University Salzburg, Salzburg, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Kirnbauer","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care, Paracelsus Medical University Salzburg, Salzburg, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Neuner","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care, Paracelsus Medical University Salzburg, Salzburg, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Berger","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Faculty of Medicine, University Heart Centre Freiburg, Albert Ludwigs University Freiburg, Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1514-7190","authenticated-orcid":false,"given":"Rainald","family":"Seitelberger","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular and Endovascular Surgery, Paracelsus Medical University Salzburg, Salzburg, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,8,29]]},"reference":[{"key":"2019091013152658500_ezz234-B1","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":"Shrestha","year":"2015","journal-title":"Eur J Cardiothorac Surg"},{"key":"2019091013152658500_ezz234-B2","doi-asserted-by":"crossref","first-page":"i15","DOI":"10.1093\/ejcts\/ezw303","article-title":"Technical details making 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A single center experience of 636 patients","volume":"93","author":"Misfeld","year":"2012","journal-title":"Ann Thorac Surg"},{"key":"2019091013152658500_ezz234-B11","first-page":"286","article-title":"Results of open thoracoabdominal aortic aneurysm repair","volume":"1","author":"LeMaire","year":"2012","journal-title":"Ann Cardiothorac Surg"},{"key":"2019091013152658500_ezz234-B12","doi-asserted-by":"crossref","first-page":"1679","DOI":"10.1016\/j.athoracsur.2006.05.037","article-title":"Perioperative management to improve neurologic outcome in thoracic or thoracoabdominal aortic stent-grafting","volume":"82","author":"Weigang","year":"2006","journal-title":"Ann Thorac Surg"},{"key":"2019091013152658500_ezz234-B13","first-page":"450","article-title":"Classification and outcomes of extended arch repair for acute Type A aortic dissection: a systematic review and meta-analysis","volume":"24","author":"Smith","year":"2017","journal-title":"Interact CardioVasc Thorac Surg"},{"key":"2019091013152658500_ezz234-B14","doi-asserted-by":"crossref","first-page":"1081","DOI":"10.1016\/j.ejcts.2009.12.007","article-title":"Symptomatic spinal cord malperfusion after stent-graft coverage of the entire descending aorta","volume":"37","author":"Gottardi","year":"2010","journal-title":"Eur J Cardiothorac Surg"},{"key":"2019091013152658500_ezz234-B15","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1016\/j.athoracsur.2011.08.032","article-title":"Selective left subclavian ligation in total aortic arch replacement","volume":"93","author":"Cui","year":"2012","journal-title":"Ann Thorac Surg"},{"key":"2019091013152658500_ezz234-B16","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/j.athoracsur.2011.09.005","article-title":"Invited commentary","volume":"93","author":"Gottardi","year":"2012","journal-title":"Ann Thorac Surg"},{"key":"2019091013152658500_ezz234-B17","doi-asserted-by":"crossref","DOI":"10.1093\/ejcts\/ezz037","article-title":"Multicentre experience with two frozen elephant trunk prostheses in the treatment of acute aortic dissection","author":"Berger","year":"2019","journal-title":"Eur J Cardiothorac Surg"}],"container-title":["European Journal of Cardio-Thoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ejcts\/advance-article-pdf\/doi\/10.1093\/ejcts\/ezz234\/29228603\/ezz234.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"}],"deposited":{"date-parts":[[2019,9,10]],"date-time":"2019-09-10T18:53:29Z","timestamp":1568141609000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ejcts\/advance-article\/doi\/10.1093\/ejcts\/ezz234\/5556412"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,8,29]]},"references-count":17,"URL":"https:\/\/doi.org\/10.1093\/ejcts\/ezz234","relation":{},"ISSN":["1010-7940","1873-734X"],"issn-type":[{"value":"1010-7940","type":"print"},{"value":"1873-734X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,8,29]]},"article-number":"ezz234"}}