Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Next-Generation Frozen Elephant Trunk Technique in the Era of Precision Medicine

  • Suk-Won Song (Department of Thoracic and Cardiovascular Surgery, Ewha Womans University Aorta and Vascular Hospital, Ewha Womans University Medical Center) ;
  • Ha Lee (Department of Thoracic and Cardiovascular Surgery, Ewha Womans University Aorta and Vascular Hospital, Ewha Womans University Medical Center) ;
  • Myeong Su Kim (Department of Thoracic and Cardiovascular Surgery, Ewha Womans University Aorta and Vascular Hospital, Ewha Womans University Medical Center) ;
  • Randolph Hung Leung Wong (Division of Cardiothoracic Surgery, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong) ;
  • Jacky Yan Kit Ho (Division of Cardiothoracic Surgery, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong) ;
  • Wilson Y. Szeto (Division of Cardiovascular Surgery, Department of Surgery, Perelman School of Medicine, University of Pennsylvania) ;
  • Heinz Jakob (Department of Cardiothoracic Surgery, West German Heart and Vascular Center, University Hospital Essen)
  • Received : 2024.08.23
  • Accepted : 2024.08.28
  • Published : 2024.09.05
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Abstract

The frozen elephant trunk (FET) technique can be applied to extensive aortic pathology, including lesions in the aortic arch and proximal descending thoracic aorta. FET is useful for tear-oriented surgery in dissections, managing malperfusion syndrome, and promoting positive aortic remodeling. Despite these benefits, complications such as distal stent-induced new entry and spinal cord ischemia can pose serious problems with the FET technique. To prevent these complications, careful sizing and planning of the FET are crucial. Additionally, since the FET technique involves total arch replacement, meticulous surgical skills are essential, particularly for young surgeons. In this article, we propose several techniques to simplify surgical procedures, which may lead to better outcomes for patients with extensive aortic pathology. In the era of precision medicine, the next-generation FET device could facilitate the treatment of complex aortic diseases through a patient-tailored approach.

Keywords

References

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