The efficacy and short-term results of hybrid thoracic endovascular repair into the ascending aorta for aortic arch pathologies

OBJECTIVES Conventional total aortic arch repair is a high-risk procedure, particularly for high-risk patients. Although endovascular treatment of aortic arch aneurysm is a recently induced procedure, only a few cases are indicated and outcomes are questionable. Here, we report on the early and shor...

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Published in:European journal of cardio-thoracic surgery 2014-02, Vol.45 (2), p.298-304
Main Authors: Shirakawa, Yukitoshi, Kuratani, Toru, Shimamura, Kazuo, Torikai, Kei, Sakamoto, Tomohiko, Shijo, Takayuki, Sawa, Yoshiki
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Aorta, Thoracic - surgery
Aortic Aneurysm, Thoracic - surgery
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation - adverse effects
Blood Vessel Prosthesis Implantation - instrumentation
Blood Vessel Prosthesis Implantation - methods
Endoleak - etiology
Endovascular Procedures - adverse effects
Endovascular Procedures - instrumentation
Endovascular Procedures - methods
Female
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Postoperative Complications - etiology
Retrospective Studies
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Summary:OBJECTIVES Conventional total aortic arch repair is a high-risk procedure, particularly for high-risk patients. Although endovascular treatment of aortic arch aneurysm is a recently induced procedure, only a few cases are indicated and outcomes are questionable. Here, we report on the early and short-term results of our surgical procedure, i.e. hybrid arch repair with supra-aortic debranching and endografting into the ascending aorta. METHODS Of the 514 patients who underwent arch repairs from 1997 to March 2012, 40 (28 males; mean age 74.4 years) were high-risk patients for whom hybrid arch repair of the ascending aortic landing zone was performed. Aortic pathologies included 31 degenerative aneurysms (including two ruptures), three type A dissections and four type B dissections. We performed supra-aortic debranching from the ascending aorta and endografting into the ascending aorta in 28 patients (including 10 patients with graft replacements and 3 patients with banding of the ascending aorta). For the 12 patients with an ascending aorta diameter of
ISSN:1010-7940
1873-734X
DOI:10.1093/ejcts/ezt391