title: The Bologna experience with the Thoraflex™ hybrid frozen elephant trunk device.
abstract: BACKGROUND
  We present our initial experience with the frozen elephant trunk using a Thoraflex™ hybrid device for the treatment of the complex thoracic aorta lesions.
  
  
  METHODS
  Between March 2013 and March 2014, ten patients underwent thoracic aorta surgery using the frozen elephant trunk approach with the Thoraflex hybrid device. Indications for surgery were: residual type A chronic dissection (eight patients), degenerative aneurysm (one patient) and type B chronic aortic dissection (one patient). Selective antegrade cerebral perfusion and moderate hypothermia were used in all cases.
  
  
  RESULTS
  In-hospital mortality was 0% and no patients presented with paraplegia, paraparesis or major neurological events. One patient experienced transient ischemic attack. Two patients underwent reoperation for bleeding. All postoperative angiography CT scans confirmed the desired results.
  
  
  CONCLUSIONS
  Our initial experience demonstrated excellent early results. The Thoraflex hybrid prosthesis with the four-branched arch graft increases the spectrum of techniques available for the surgeon in the treatment of complex diseases of the thoracic aorta.
authors.affiliation: Department of Cardiac Surgery, S Orsola-Malpighi Hospital, Via Massarenti 9, 40138 Bologna, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Di Bartolomeo
authors.forename: Luca
authors.initials: L
authors.lastname: Di Marco
authors.forename: Mariano
authors.initials: M
authors.lastname: Cefarelli
authors.forename: Alessandro
authors.initials: A
authors.lastname: Leone
authors.forename: Antonio
authors.initials: A
authors.lastname: Pantaleo
authors.forename: Marco
authors.initials: M
authors.lastname: Di Eusanio
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Barberio
authors.forename: Davide
authors.initials: D
authors.lastname: Pacini
mesh_terms: D000368:Aged; D000784:Aortic Dissection / Q000601:surgery; D001013:Aorta, Thoracic / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007558:Italy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged
keywords: aortic dissection; cerebral protection; endovascular prosthesis; hybrid surgery