ArticleInterdisciplinary cardiovascular and thoracic surgery2025
Mid-term morphological changes in Frozenix.
Article in Interdisciplinary cardiovascular and thoracic surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Delayed aortic arch deformity associated with a frozen elephant trunk after total arch replacement.Journal of cardiothoracic surgery · 2026Article
- Frozen elephant trunk for acute type A aortic dissection: long-term outcomes over two decades.European heart journal · 2026Article
- Mid-to-long-term outcomes of the frozen elephant trunk procedure in aortic pathology: a systematic review and meta-analysis.Annals of cardiothoracic surgery · 2025Article
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThe frozen elephant trunk is widely used for aortic arch aneurysms and DeBakey type I and III aortic dissections. However, radial force and spring-back of the stent can cause morphological changes, contributing to stent-induced new entry. This study aimed to evaluate postoperative morphological changes of frozen elephant trunk and provide biomechanical insights.
methodsThis retrospective study included 107 patients who underwent Frozenix placement between April 2014 and December 2023. Clinical outcomes and morphological changes of frozen elephant trunk were assessed. Morphological changes were evaluated by measuring the distal diameter and stent angle, defined as the angle between the lines perpendicular to the proximal and distal ends of the stent, via computed tomography, including angiographic imaging.
resultsThirty-day mortality was 3%. The median follow-up duration was 24 months, and the incidence of all-cause mortality was 9.69 events per 100 patient years. Stent-induced new entry occurred in seven patients (7%). The distal diameter was enlarged in all 95 evaluated patients; 59 (62%) exceeded the stent size. In these patients, the mean distal diameter reached 105% of the original stent size. Dissections demonstrated greater distal diameter expansion than thoracic aortic aneurysms. The stent angle, assessed in 33 patients, increased in all cases, with progressive changes observed over 3 years.
conclusionsPostoperative enlargement of the distal diameter beyond the original stent size and progressive changes in stent angle should be taken into account when selecting the size of the frozen elephant trunk and planning the surgical strategy. Long-term computed tomography follow-up is also warranted.
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