Frozen elephant trunk (FET) has in recent times become a mainstay for
total arch replacement (TAR) in aortovascular surgery and is indicated
in order to treat a spectrum of complex aortic pathologies. However,
despite associated excellent post-operative results it is incredibly
important to recognise potential adverse complications such as negative
aortic remodelling, endoleak and distal stent-graft induced new entry so
that outcomes can be further improved. Below we provide commentary on a
recent article in the Journal of Cardiac Surgery discussing the topic.
Despite the fascinating outcomes of this systematic review and
meta-analysis the heterogeneity of the literature regarding these
adverse outcomes remains an issue which can only be solved with large
multi-centre trials directly comparing graft types as well as
indications for surgery.