{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T10:51:00Z","timestamp":1789469460055,"version":"build-2803163510"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,5,30]],"date-time":"2022-05-30T00:00:00Z","timestamp":1653868800000},"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>Objective<\/jats:title><jats:p>The aim of this study was to evaluate the early and mid-term results after the frozen elephant trunk (FET) procedure for the treatment of complex arch and proximal descending aortic disease in a single-center institution.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From April 2015 to July 2021, 72 patients (25 women, 60.4 \u00b1 10.3 years) underwent Thoraflex\u2122 Hybrid implantation at our institution. The indications were thoracic aortic aneurysm (TAA) (<jats:italic>n<\/jats:italic> = 16, 22.2%), post-dissection aneurysm (<jats:italic>n<\/jats:italic> = 21, 29.2%), and acute aortic dissection (AAD) (<jats:italic>n<\/jats:italic> = 35, 48.6%). Antegrade cerebral perfusion under moderate hypothermia (28\u00b0C) was employed in all cases. Eighteen patients (25%) have already been operated due to heart or aortic disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall in-hospital mortality was 12.5% (9 patients). Rates of permanent neurological dysfunction and spinal cord injury were 9.7 and 5.5%, respectively. The in-hospital mortality rate among patients operated on AAD, TAA, and post-dissection aneurysm were 8.6, 6.2, and 23.8%, respectively. At a mean follow-up of 26 \u00b1 20 months, mortality was 9.7%. Furthermore, 23 patients (31.9%) required a subsequent procedure in distal aorta: endovascular stentgraft extension in 19 patients (26.4%) and open aortic surgery in 4 patients (5.5%). The mid-term survival of patients with type A aortic dissection was 97%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our experience with the Thoraflex Hybrid prosthesis demonstrates its surgical applicability for different types of aortic pathologies with promising outcomes during early and midterm follow-up. Our technique and perioperative management lead to comparable or even superior neurological outcomes and mortality in urgent cases considering other high-volume centers.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2022.924838","type":"journal-article","created":{"date-parts":[[2022,5,30]],"date-time":"2022-05-30T04:58:45Z","timestamp":1653886725000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":10,"title":["Single-Center Experience With the Thoraflex\u2122 Hybrid Prosthesis: Indications, Implantation Technique and Results"],"prefix":"10.3389","volume":"9","author":[{"given":"Konrad","family":"Wisniewski","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arash","family":"Motekallemi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelo 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