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We report 2 cases of spontaneous, unexpected leakage of the stent graft portion of the Thoraflex (Vascutek, Inchinnan, UK) frozen elephant trunk prosthesis that occurred during second stage surgical thoraco-abdominal aortic replacement. When the descending aortas including the distal portion of the frozen elephant trunk grafts were clamped, spontaneous leakage occurred in the proximal, untouched stent graft portion. This brief communication highlights the previously unreported potential risk of spontaneous leakage through the stent graft portion of the frozen elephant trunk prosthesis during a second stage repair of the thoraco-abdominal aorta.

Spontaneous leakage of the Thoraflex™ frozen elephant trunk prosthesis