{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:10:06Z","timestamp":1780445406045,"version":"3.54.1"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,2,22]],"date-time":"2022-02-22T00:00:00Z","timestamp":1645488000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The widespread adoption of the frozen elephant trunk (FET) technique for total arch reconstruction (TAR) in aortic arch aneurysm and dissection has led to the development of numerous commercial single-piece FET devices, each with its own unique design features. One such device, Thoraflex\u2122 Hybrid (Terumo Aortic, Glasgow, Scotland), has enjoyed widespread use since its introduction. We present and appraisal of its long-term clinical efficacy, based on international data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>Pre-, intra-, and postoperative data associated with Thoraflex\u2122 Hybrid implantations for aortic arch dissection, aneurysm, and penetrating atherosclerotic ulcer (PAU) up to April 2019 was gathered and is presented herein. Follow-up data at discharge, 3-, 6-, 12-, 24-, 36-, 48-, 60-, 72-, and 84- months post-implantation are included.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Data associated with 931 cases of Thoraflex\u2122 Hybrid implantation are included. Mean age at implantation was 63 \u00b1 12 years. 55% of patients included were male. Aortic dissection accounted for 48% (<jats:italic>n<\/jats:italic> = 464) of cases. Mean cardiopulmonary bypass and circulatory arrest durations were 202 +72 and 69 \u00b1 50 min, respectively. 30-day mortality was 0.6% (<jats:italic>n<\/jats:italic> = 6), while overall mortality was 14 (1.5%). Freedom from adverse events at 84 months was 95% (<jats:italic>n<\/jats:italic> = 869). Postoperative complications included neurological deficit, multi-organ failure, cardiorespiratory compromise, and infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Thoraflex\u2122 Hybrid's unique design is advantageous in comparison to market alternatives. Our data is consistent with that reported in literature and suggests Thoraflex\u2122 Hybrid is associated with favourable rates of mortality and morbidity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Thoraflex\u2122 Hybrid remains a central player in the aortic arch prosthesis market. Its use it widespread and is associated with favourable design features and clinical outcomes relative to market alternatives.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2022.842165","type":"journal-article","created":{"date-parts":[[2022,2,22]],"date-time":"2022-02-22T17:30:48Z","timestamp":1645551048000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":24,"title":["What Is the Long-Term Clinical Efficacy of the Thoraflex\u2122 Hybrid Prosthesis for Aortic Arch Repair?"],"prefix":"10.3389","volume":"9","author":[{"given":"Sven Z. C. 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