{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T00:15:07Z","timestamp":1793146507870,"version":"4.5.0"},"reference-count":17,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2024,10,31]],"date-time":"2024-10-31T00:00:00Z","timestamp":1730332800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Artur S\u0142omka"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: The frozen elephant trunk method combines the implantation of a Dacron prosthesis with a self-expanding stent graft, which allows for complex repairs of the aortic arch and thoracic aorta in one procedure. Despite the advantages of hybrid treatment for aortic arch aneurysms, in Poland, only a few such surgeries are performed annually compared to in Western countries. The aim of this study was to demonstrate the 8-year outcomes of treatment at the center where the Aortic Team operates, which is one of the centers in Poland with the most extensive experience in hybrid FET treatment. Methods: Patients who underwent frozen elephant trunk surgery for chronic and acute pathologies of the aortic arch and thoracic aorta between March 2016 and March 2024 were comprehensively analyzed retrospectively. Frozen elephant trunk procedures were performed under three consecutive clinical conditions: acute aortic dissection, chronic aortic dissection and redo surgery. Results: A total of 40 patients (median age: 60 years (53\u201366), 67.5% male) were admitted to our hospital and underwent an FET procedure. The median Euroscore II was 25.9% and the 30-day mortality was 7.5%. The 1-year and 5-year mortalities were the same, equal to 15%, with mortality cases observed only in the first and second groups of consecutive patients during the first two months of follow-up. Spinal cord injury was observed in 2.5% of patients. Conclusions: The FET technique can be successfully used to treat aortic aneurysms with optimal results and low complication rates. The surgery length, including the cardiopulmonary bypass and aortic cross-clamp times, decreased significantly with increasing experience.<\/jats:p>","DOI":"10.3390\/jcm13216544","type":"journal-article","created":{"date-parts":[[2024,11,1]],"date-time":"2024-11-01T11:53:43Z","timestamp":1730462023000},"page":"6544","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The Frozen Elephant Trunk Procedure\u20148 Years of Experience from Poland"],"prefix":"10.3390","volume":"13","author":[{"given":"Marian","family":"Burysz","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery, Regional Specialist Hospital, 86-300 Grudzi\u0105dz, Poland"},{"name":"Thoracic Research Centre, Collegium Medicum Nicolaus Copernicus University, Innovative Medical Forum, 85-094 Bydgoszcz, Poland"},{"name":"CAROL\u2014Cardiothoracic Anatomy Research Operative Lab, Department of Cardiovascular Surgery and Transplantology, Institute of Cardiology, Jagiellonian University Medical College, 31-008 Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grzegorz","family":"Horosin","sequence":"additional","affiliation":[{"name":"CAROL\u2014Cardiothoracic Anatomy Research Operative Lab, Department of Cardiovascular Surgery and Transplantology, Institute of Cardiology, Jagiellonian University Medical College, 31-008 Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7078-6000","authenticated-orcid":false,"given":"Wojciech","family":"Olejek","sequence":"additional","affiliation":[{"name":"Thoracic Research Centre, Collegium Medicum Nicolaus Copernicus University, Innovative Medical Forum, 85-094 Bydgoszcz, Poland"},{"name":"CAROL\u2014Cardiothoracic Anatomy Research Operative Lab, Department of Cardiovascular Surgery and Transplantology, Institute of Cardiology, Jagiellonian University Medical College, 31-008 Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5478-3245","authenticated-orcid":false,"given":"Mariusz","family":"Kowalewski","sequence":"additional","affiliation":[{"name":"Thoracic Research Centre, Collegium Medicum Nicolaus Copernicus University, Innovative Medical Forum, 85-094 Bydgoszcz, Poland"},{"name":"Department of Cardiac Surgery, Centre of Post-Graduate Medical Education, Central Clinical Hospital of the Ministry of Interior, 01-813 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krzysztof","family":"Bartu\u015b","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery and Transplantology, Institute of Cardiology, Jagiellonian University Medical College, 31-008 Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4137-2981","authenticated-orcid":false,"given":"Artur","family":"S\u0142omka","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toru\u0144, 85-094 Bydgoszcz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3736-8987","authenticated-orcid":false,"given":"Rados\u0142aw","family":"Litwinowicz","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Regional Specialist Hospital, 86-300 Grudzi\u0105dz, Poland"},{"name":"Thoracic Research Centre, Collegium Medicum Nicolaus Copernicus University, Innovative Medical Forum, 85-094 Bydgoszcz, Poland"},{"name":"CAROL\u2014Cardiothoracic Anatomy Research Operative Lab, Department of Cardiovascular Surgery and Transplantology, Institute of Cardiology, Jagiellonian University Medical College, 31-008 Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5329-5856","authenticated-orcid":false,"given":"Jakub","family":"Batko","sequence":"additional","affiliation":[{"name":"CAROL\u2014Cardiothoracic Anatomy Research Operative Lab, Department of Cardiovascular Surgery and Transplantology, Institute of Cardiology, Jagiellonian University Medical College, 31-008 Krakow, Poland"},{"name":"Department of Anatomy, Jagiellonian University Medical College, 31-008 Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"244","DOI":"10.4330\/wjc.v15.i5.244","article-title":"Current knowledge and contemporary management of non-A non-B aortic dissections","volume":"15","author":"Christodoulou","year":"2023","journal-title":"World J. Cardiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"E334","DOI":"10.1161\/CIR.0000000000001106","article-title":"2022 ACC\/AHA Guideline for the Diagnosis and Management of Aortic Disease: A Report of the American Heart Association\/American College of Cardiology Joint Committee on Clinical Practice Guidelines","volume":"146","author":"Isselbacher","year":"2022","journal-title":"Circulation"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1550","DOI":"10.1016\/S0022-5223(03)00045-X","article-title":"The frozen elephant trunk technique: A new treatment for thoracic aortic aneurysms","volume":"125","author":"Karck","year":"2003","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"708","DOI":"10.21037\/cdt-22-330","article-title":"The frozen elephant trunk procedure: Indications, outcomes and future directions","volume":"12","author":"Acharya","year":"2022","journal-title":"Cardiovasc. Diagn. Ther."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1007","DOI":"10.1016\/j.ejcts.2008.02.030","article-title":"Progress of the treatment for extended aortic aneurysms; is the frozen elephant trunk technique the next standard in the treatment of complex aortic disease including the arch?","volume":"33","author":"Karck","year":"2008","journal-title":"Eur. J. Cardio-Thorac. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Shen, K., Tan, L., Tang, H., Zhou, X., Xiao, J., Xie, D., Li, J., and Chen, Y. (2022). Total Arch Replacement With Frozen Elephant Trunk Using a NEW \u201cBrain-Heart-First\u201d Strategy for Acute DeBakey Type I Aortic Dissection Can Be Performed Under Mild Hypothermia (\u226530\u00b0C) With Satisfactory Outcomes. Front. Cardiovasc. Med., 9.","DOI":"10.3389\/fcvm.2022.806822"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"257","DOI":"10.5114\/kitp.2014.45673","article-title":"CARDIAC SURGERY The use of a new hybrid stent graft for the repair of extensive thoracic aortic aneurysms with the frozen elephant trunk method\u2014First Polish experiences","volume":"3","author":"Zembala","year":"2014","journal-title":"Pol. J. Cardio-Thorac. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"878","DOI":"10.1093\/icvts\/ivab375","article-title":"Non-A non-B acute aortic dissection with entry tear in the aortic arch","volume":"34","author":"Kosiorowska","year":"2022","journal-title":"Interact. Cardiovasc. Thorac. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1177\/15385744211002493","article-title":"\u201cProximalization is Advancement\u201d\u2014Zone 3 Frozen Elephant Trunk vs Zone 2 Frozen Elephant Trunk: A Literature Review","volume":"55","author":"Choudhury","year":"2021","journal-title":"Vasc. Endovasc. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Arnold, Z., Geisler, D., Aschacher, T., Winkler, B., Lenz, V., Crailsheim, I., Folkmann, S., Harrer, M., Moidl, R., and Grabenw\u00f6ger, M. (2023). Long-Term Results with 187 Frozen Elephant Trunk Procedures. J. Clin. Med., 12.","DOI":"10.3390\/jcm12124143"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Wisniewski, K., Motekallemi, A., Dell\u2019Aquila, A.M., Oberhuber, A., Schaefers, J.F., Ibrahim, A., Martens, S., and Rukosujew, A. (2022). Single-Center Experience with the ThoraflexTM Hybrid Prosthesis: Indications, Implantation Technique and Results. Front. Cardiovasc. Med., 9.","DOI":"10.3389\/fcvm.2022.924838"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"500","DOI":"10.21037\/acs-2023-scp-16","article-title":"Spinal cord injury after frozen elephant trunk procedures\u2014Prevention and management","volume":"12","author":"Murana","year":"2023","journal-title":"Ann. Cardiothorac. Surg."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Porterie, J., Hostalrich, A., Dagenais, F., Marcheix, B., Chaufour, X., and Ricco, J.-B. (2023). Hybrid Treatment of Complex Diseases of the Aortic Arch and Descending Thoracic Aorta by Frozen Elephant Trunk Technique. J. Clin. Med., 12.","DOI":"10.3390\/jcm12175693"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Kayali, F., Qutaishat, S., Jubouri, M., Chikhal, R., Tan, S.Z.C.P., and Bashir, M. (2022). Kinking of Frozen Elephant Trunk Hybrid Prostheses: Incidence, Mechanism, and Management. Front. Cardiovasc. Med., 9.","DOI":"10.3389\/fcvm.2022.912071"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1104","DOI":"10.21037\/cdt-23-300","article-title":"Evidence-based frozen elephant trunk practice: A narrative review","volume":"13","author":"Kayali","year":"2023","journal-title":"Cardiovasc. Diagn. Ther."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"262","DOI":"10.21037\/cdt-22-73","article-title":"Normothermic frozen elephant trunk: Our experience and literature review","volume":"12","author":"Malvindi","year":"2022","journal-title":"Cardiovasc. Diagn. Ther."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"65","DOI":"10.5114\/kitp.2024.138374","article-title":"Hybrid treatment of penetrating aortic trauma","volume":"21","author":"Burysz","year":"2024","journal-title":"Pol. J. Cardio-Thorac. Surg."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/21\/6544\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:24:59Z","timestamp":1760113499000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/21\/6544"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,31]]},"references-count":17,"journal-issue":{"issue":"21","published-online":{"date-parts":[[2024,11]]}},"alternative-id":["jcm13216544"],"URL":"https:\/\/doi.org\/10.3390\/jcm13216544","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,31]]}}}