title: Role of the frozen elephant trunk procedure for chronic aortic dissection.
abstract: OBJECTIVE
  Considering the chronic and progressive nature of aortic dissection, operative planning must anticipate the need for later interventions. We have increasingly used a modified version of the frozen elephant trunk repair operation to treat these patients. We review the indications, considerations for planning, and important operative details for performing frozen elephant trunk repair for chronic aortic dissection.
  
  
  METHODS
  Frozen elephant trunk repair is performed using selective antegrade brain perfusion, direct placement of commercially available stent grafts with suture fixation in the aortic arch, and proximal aortic replacement. Details are reviewed.
  
  
  RESULTS
  We have published details related to the excellent results for the frozen elephant trunk procedure in patients with chronic dissection.
  
  
  CONCLUSIONS
  The modified frozen elephant trunk repair is particularly well suited for patients with chronic aortic dissection who often require multiple operations to address their extensive disease.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Heart and Vascular Institute, Aorta Center, Cleveland Clinic, Cleveland, OH, USA roselle@ccf.org.
authors.forename: Eric E
authors.initials: EE
authors.lastname: Roselli
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Heart and Vascular Institute, Aorta Center, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Faisal G
authors.initials: FG
authors.lastname: Bakaeen
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Heart and Vascular Institute, Aorta Center, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Douglas R
authors.initials: DR
authors.lastname: Johnston
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Heart and Vascular Institute, Aorta Center, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Edward G
authors.initials: EG
authors.lastname: Soltesz
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Heart and Vascular Institute, Aorta Center, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Michael Z
authors.initials: MZ
authors.lastname: Tong
mesh_terms: D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000601:surgery*; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D002908:Chronic Disease; D006801:Humans
keywords: Aortic arch; Chronic dissection; Circulatory arrest; Frozen elephant trunk; Hybrid aortic repair