title: Current status and recommendations for use of the frozen elephant trunk technique: a position paper by the Vascular Domain of EACTS.
abstract: The implementation of new surgical techniques offers chances but carries risks. Usually, several years pass before a critical appraisal and a balanced opinion of a new treatment method are available and rely on the evidence from the literature and expert's opinion. The frozen elephant trunk (FET) technique has been increasingly used to treat complex pathologies of the aortic arch and the descending aorta, but there still is an ongoing discussion within the surgical community about the optimal indications. This paper represents a common effort of the Vascular Domain of EACTS together with several surgeons with particular expertise in aortic surgery, and summarizes the current knowledge and the state of the art about the FET technique. The majority of the information about the FET technique has been extracted from 97 focused publications already available in the PubMed database (cohort studies, case reports, reviews, small series, meta-analyses and best evidence topics) published in English.
authors.affiliation: Department of Cardio-thoracic, Transplantion and Vascular Surgery, Hannover Medical School, Hannover, Germany.
authors.forename: Malakh
authors.initials: M
authors.lastname: Shrestha
authors.affiliation: Nogent sur Marne, Paris, France.
authors.forename: Jean
authors.initials: J
authors.lastname: Bachet
authors.affiliation: Division of Cardiovascular Surgery, Hospital of the University of Pennsylvania, PA, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Bavaria
authors.affiliation: Clinic for Cardiovascular Surgery, University Hospital Berne, Berne, Switzerland.
authors.forename: Thierry P
authors.initials: TP
authors.lastname: Carrel
authors.affiliation: Cardiac Surgery Department, European Hospital, Rome, Italy.
authors.forename: Ruggero
authors.initials: R
authors.lastname: De Paulis
authors.affiliation: Department of Cardiac Surgery, S. Orsola-Malpighi Hospital, Bologna, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Di Bartolomeo
authors.affiliation: Department of Cardiac Surgery, Heart Center Leipzig, Leipzig, Germany.
authors.forename: Christian D
authors.initials: CD
authors.lastname: Etz
authors.affiliation: Department of Cardiovascular Surgery, Hospital Hietzing, Vienna, Austria.
authors.forename: Martin
authors.initials: M
authors.lastname: Grabenwöger
authors.affiliation: Department of Cardiac Surgery, Medical University Innsbruck, Innsbruck, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Grimm
authors.affiliation: Department of Cardio-thoracic, Transplantion and Vascular Surgery, Hannover Medical School, Hannover, Germany.
authors.forename: Axel
authors.initials: A
authors.lastname: Haverich
authors.affiliation: Department of Thoracic & Cardiovascular Surgery, University of Essen West German Heart Center, Essen, Germany.
authors.forename: Heinz
authors.initials: H
authors.lastname: Jakob
authors.affiliation: Department of Cardio-thoracic, Transplantion and Vascular Surgery, Hannover Medical School, Hannover, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Martens
authors.affiliation: Department of Cardiovascular Surgery, Hospital Clinic, Barcelona, Spain Heart and Vascular Institute, Cleveland Clinic, Abu Dhabi, United Arab Emirates.
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Mestres
authors.affiliation: Department of Cardiac Surgery, S. Orsola-Malpighi Hospital, Bologna, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Pacini
authors.affiliation: Department of Vascular Surgery, Malmö University Hospital, Malmö, Sweden.
authors.forename: Tim
authors.initials: T
authors.lastname: Resch
authors.affiliation: AZ St. Jan, Brugge, Belgium.
authors.forename: Marc
authors.initials: M
authors.lastname: Schepens
authors.affiliation: Cardiovascular Clinic, Bad Neustadt, Germany.
authors.forename: Paul P
authors.initials: PP
authors.lastname: Urbanski
authors.affiliation: Department of Cardiovascular Surgery, University Hospital Zurich, Zurich, Switzerland University Heart Center Freiburg-Bad Krozingen, Freiburg, Germany martin.czerny@uniklinik-freiburg.de.
authors.forename: Martin
authors.initials: M
authors.lastname: Czerny
mesh_terms: D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000601:surgery*; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D006801:Humans; D017410:Practice Guidelines as Topic; D014057:Tomography, X-Ray Computed
keywords: Combined treatment; Frozen elephant trunk technique; Thoracic aortic pathology