SynthesisJournal of cardiac surgery2022
The great vessel freeze-out: A meta-analysis of conventional versus frozen elephant trunks in aortic arch surgery.
Synthesis in Journal of cardiac surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The great vessel freeze-out: A meta-analysis of conventional versus frozen elephant trunks in aortic arch surgery.Journal of cardiac surgery · 2022Pooled it
- Open, Hybrid and Endovascular Management of Aortic Arch Aneurysms: Recent Updates and Future Directions.Journal of clinical medicine · 2026Review
- Frozen elephant trunk: a narrative review of global and temporal trends.Journal of thoracic disease · 2026Review
- Early and 3-Year Outcomes of Frozen Elephant Trunk Procedure with Evolving E-vita Hybrid Grafts: A Retrospective Single-Centre Cohort Study over 11 Years.Journal of cardiovascular development and disease · 2025Article
- Complexity in aortic arch surgery and laws of diminishing return.Journal of thoracic disease · 2025Article
- Advances in aortic surgery.The British journal of cardiology · 2025Article
- Frozen elephant trunk technique using hybrid grafts: 15-year outcomes from a single-centre experience.European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery · 2024Article
- The Fate of Conventional Elephant Trunk in the Frozen Elephant Trunk Era.Aorta (Stamford, Conn.) · 2023Article
- Extra-anatomical left common carotid and subclavian artery bypass followed by aortic arch replacement with frozen elephant trunk.Journal of cardiothoracic surgery · 2023Article
- Frozen elephant trunk: the gold standard.Cardiovascular diagnosis and therapy · 2023Article
- Understanding outcomes of emergency aortic dissection repair during COVID-19 pandemic: What lessons have we learnt?Journal of cardiac surgery · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe optimal treatment strategy for complex aortic arch and proximal descending aortic pathologies remains controversial. Despite the frozen elephant trunk (FET) technique's increasing popularity, its use over the conventional elephant trunk (CET) remains a matter of physician preference and outcomes are varied.
methodsThis meta-analysis of available comparative studies of FET versus CET sought to examine differences in survival, reintervention, and adverse events. The following databases were searched from inception-May 2020: Ovid MEDLINE, Ovid EMBASE, and The Cochrane Library. Studies retrieved were then screened for eligibility against predefined inclusion/exclusion criteria with a protocol registered on Open Science Framework at https://osf.io/hrfze/.
resultsThe search identified 1911 citations, with five studies included. The resultant meta-analysis included 313 CET and 292 FET cases. FET had lower perioperative mortality (risk ratio [RR]: 0.50, 95% confidence interval [CI]: [0.42; 0.60], p < .001) and improved 1-year survival compared to CET (hazard ratio: 0.63, 95% CI: [0.42; 0.95], p = .03). There were no significant differences in rates of overall or open reinterventions following FET versus CET, but FET did yield a significantly higher rate of endovascular reintervention (RR: 2.32, 95% CI: [1.17; 4.61], p = .03). No significant differences were observed in the incidences of postoperative stroke, spinal cord injury, or renal failure between groups.
conclusionsThe FET technique yields superior rates of perioperative and medium-term survival with no significant increase in overall reinterventions. There was no significant difference in the rate of spinal cord injury between groups, providing further large-scale evidence that the FET is an acceptable, safe alternative to the CET.
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Registered trials
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