Virtual Conference

Tatsuya Nakao

New Tokyo Hospital, Japan

Title: Evaluation of aortic reinterventions after the Frozen Elephant Trunk(FET) procedure with Frozenix


Objective: The frozen elephant trunk(FET) procedure is intended to achieve one-stage treatment if appropriate or to be used as the first surgery for two-stage repair of various extended aortic pathologies. We assess the experience with zone 1 arch repair with Frozenix open stent graft and evaluate the need and outcomes of aortic reinterventions after the FET procedure.

Methods: Between July 2014 and July 2023, 335 consecutive patients underwent zone 1 aortic arch repair using the Frozenix Open Stent-graft(Japan Lifeline, JAPAN) for different thoracic aortic diseases, including aortic dissection or TAA. We evaluated the effect of FET on the downstream aorta by computed tomography. Primary endpoints are in-hospital deaths, complications and follow-up survival. Secondary endpoints include aortic re-intervention and aortic remodeling.

Results: During the follow-up period, positive or stable aortic remodeling was achieved in TAA and DTAA cases. Aortic re-intervention was performed in 52 patients(15.5%), including endovascular in 33 patients(hybrid in 1 patient) and open surgery in 19 in 19 patients. There was no difference in aortic pathologies and survival between patients with or without aortic re-intervention. No stroke or permanent SCI was observed after endovascular, and 1 SCI after open surgery(TAAA rep.)

Conclusion: Although re-intervention after the FET procedure was likely and common, morbidity and mortality are mrelatively low. We should close follow-up of all patients undergoing FET procedure without missing the chance of re-intervention.


Tatsuya Nakao became President at New Tokyo Hospital, Japan in June. 2023. He has been working as a foreign proctor of arch repair with Frozenix open stent-graft. He has been serving as an Editorial member of ACR(AME Case Reports).