Frozen elephant trunk with straight vascular prosthesis.

We present a recapitulation of 15 years of experience starting with conception, inception, development, and clinical implementation and application of the E-vita open hybrid graft. Concomitantly, we delve into surgical techniques that shaped our clinical results. Introduced in February 2005, the novel "Essen I Prosthesis", was first-in-human surgically implanted. Follow on to this success, and within six months, eight further applications were performed. Once, the CE mark was attained, the prosthesis was branded as E-vita Open Prosthesis. In 2008, the blood-tight modification was introduced, and with time and clinical practice and application, the device's indications were expanded. Hence, the focus remained on managing complex thoracic aneurysmal disease and in particular acute and chronic type I aortic dissections. With the surge of our surgical experience and the integration of various surgical modifications, 30-days mortality was reduced to 12%, while morbidities such as stroke and spinal cord injury were reduced to 7% and 3%, respectively. The rate of re-intervention on distal aorta was significantly reduced; an attestation to the prosthesis's effectuated performance which contrasted proximal aortic repairs. With new additional device variations on the horizon, a wider range of patient-specific treatment options can now be offered. 2020 Annals of Cardiothoracic Surgery. All rights reserved.