Abstract
Aortic arch repair with frozen elephant trunk is increasingly offered to patients with extensive thoracic aortic disease. Given the magnitude of such a procedure, reported postoperative mortality and morbidity have to be considered adequate but not negligible. To further improve postoperative outcomes we developed a hybrid approach allowing frozen elephant trunk to be performed without hypothermia and circulatory arrest. After an initial experience in patients with chronic aneurysms, we successfully adopted the same approach in a patient with type 1 acute aortic dissection. Transfemoral stent-graft deployment, balloon clamping, and an always antegrade aortic perfusion are key elements of the approach presented here.
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