Efficacy of total arch replacement with frozen elephant trunk for type B aortic dissection involving left subclavian artery-adjacent entry: a strategy for anatomically challenging cases.

Norimasa Haijima, Mikihiko Kudo, Satoru Murata, Takuya Ono, Hideyuki Shimizu

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Article in General thoracic and cardiovascular surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 authors.

Norimasa HaijimaDepartment of Cardiovascular Surgery, National Hospital Organization Saitama Hospital, 2-1 Suwa, Wako-shi, Saitama, 351-0102, Japan. haiji_71@hotmail.com.

Mikihiko KudoDepartment of Cardiovascular Surgery, National Hospital Organization Saitama Hospital, 2-1 Suwa, Wako-shi, Saitama, 351-0102, Japan.

Satoru MurataDepartment of Cardiovascular Surgery, National Hospital Organization Saitama Hospital, 2-1 Suwa, Wako-shi, Saitama, 351-0102, Japan.

Takuya OnoDepartment of Cardiovascular Surgery, National Hospital Organization Saitama Hospital, 2-1 Suwa, Wako-shi, Saitama, 351-0102, Japan.

Hideyuki ShimizuDepartment of Cardiovascular Surgery, Keio University Hospital, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.

Funding

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6 · The paper itself

Abstract

objectiveTo evaluate the feasibility and safety of total arch replacement with a frozen elephant trunk in patients with Stanford type B aortic dissection and an entry ≤ 10 mm distal to the left subclavian artery.

methodsWe retrospectively reviewed 40 consecutive patients who underwent either total arch replacement with a frozen elephant trunk (n = 30) or thoracic endovascular aortic repair (n = 10). The primary outcome was late all-cause mortality. Secondary outcomes included major complications, planned additional endovascular repair after total arch replacement with a frozen elephant trunk, false lumen thrombosis, and aortic remodeling.

resultsIn the thoracic endovascular aortic repair group, procedure-related complications occurred, including retrograde type A dissection and one death from aortic rupture. In the total arch replacement with a frozen elephant trunk group, all deaths were unrelated to the index procedure. Planned additional endovascular repair was more frequently performed after total arch replacement with a frozen elephant trunk.

conclusionsTotal arch replacement with a frozen elephant trunk is safe for anatomically challenging type B aortic dissection with an entry near the left subclavian artery and represents a viable treatment option in this setting.

Indexed as

Aorta, ThoracicAortic Aneurysm, ThoracicAortic DissectionBlood Vessel ProsthesisBlood Vessel Prosthesis ImplantationEndovascular ProceduresSubclavian ArteryAgedAortographyFeasibility StudiesFemaleHumansMaleMiddle AgedPostoperative ComplicationsProsthesis DesignFrozen elephant trunkLeft subclavian arteryStanford type b aortic dissectionThoracic endovascular aortic repairTotal arch replacement

Identifiers

PMID41182507

DOI10.1007/s11748-025-02219-x

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