128 Frozen Elephant Trunk: An Overview of Hybrid Prostheses

Background Thoracic aortic pathologies are usually managed with different surgical and hybrid procedures, with total aortic arch replacement (TAR) being the main treatment for the disease implicating the aortic arch and the descending thoracic aorta (DTA). This can be performed in a single-procedure hybrid fashion using the frozen elephant trunk technique which utilises a hybrid aortic prosthesis (HP). This narrative review aims to provide an overview of the four major FET HPs, highlighting their design features, mechanical properties, configurations, and variants, and evaluating their clinical outcomes in the literature. Methods A comprehensive literature search was conducted using multiple electronic databases to identify and extract relevant data and information. Results Four FET devices were identified that can be considered the main option on the global market; Thoraflex Hybrid Plexus (THP), E-Vita, Cronus and Frozenix J Graft. Each hybrid prosthesis (HP) features unique design and features resulting in varying clinical outcomes. THP and E-Vita are the most widely used and investigated HPs, however, THP’s innovative design has translated to superior clinical outcomes. The use of Cronus and Frozenix is geographically confined to mainly manufacturers’ countries and therefore have not been thoroughly studied. Conclusion The FET technique for TAR can be considered an evolutionary step in the field of aortovascular surgery, allowing optimal treatment for complex aortic arch pathologies with favourable clinical outcomes. However, of the four main FET HPs on the global market, THP can be considered the primary choice due to its unique innovative design which has translated to superior clinical outcomes.