Cor Vasa 2014, 56(6):e523-e526 | DOI: 10.1016/j.crvasa.2014.07.004

Hybrid repair of aortic arch aneurysm

František Sabola, Boris Bilýa,*, Adrian Kolesára, Panagiotis Artemioua, Ľubomír Špakb, Ján Luczya
a Klinika srdcovej chirurgie, VÚSCH, a. s., Lekárska fakulta Univerzity Pavla Jozefa Šafárika, Košice, Slovenská republika
b Klinika angiológie, VÚSCH, a. s., Lekárska fakulta Univerzity Pavla Jozefa Šafárika, Košice, Slovenská republika

Aneurysms of the transverse aortic arch requiring surgery most often affect elderly patients with multiple co-morbidities and represent a significant challenge to both patient and surgeon. The hybrid approach developed in recent years (debranching followed by endovascular repair) may improve the morbidity and mortality of the population risk. We present a case-report of 72-year-old man with aortic arch aneurysm arising at the origin of the left subclavian artery involving whole caudal segment of an aortic arch with concomitant single vessel coronary disease. The hybrid procedure was carried out in two stages, first (open surgical approach) performing an extra-anatomic bypass - debranching combining with concomitant coronary artery bypass procedure without heart-lung machine and following day deploying the aortic endograft. Postoperative period was uneventful. On the 15th day after hybrid procedure, the patient was discharged in a stabilized condition for ambulatory care. This approach may be an alternative to standard open procedures in high-risk patients with promising midterm results.

Keywords: Aortic arch aneurysm; Aortic arch debranching; Hybrid repair

Received: July 2, 2014; Revised: July 23, 2014; Accepted: July 26, 2014; Published: December 1, 2014  Show citation

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Sabol F, Bilý B, Kolesár A, Artemiou P, Špak Ľ, Luczy J. Hybrid repair of aortic arch aneurysm. Cor Vasa. 2014;56(6):e523-526. doi: 10.1016/j.crvasa.2014.07.004.
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References

  1. W.D. Clouse, J.W. Hallett, H.V. Schaff, et al., Improved prognosis of thoracic aortic aneurysms. A population-based study, Journal of the American Medical Association 280 (1998) 1926-1929. Go to original source... Go to PubMed...
  2. T. Juvonen, M.A. Ergin, J.D. Galla, et al., Prospective study of the natural history of thoracic aortic aneurysms, Annals of Thoracic Surgery 63 (1997) 1533-1545. Go to original source... Go to PubMed...
  3. R.R. Davies, L.J. Goldstein, M.A. Coady, et al., Yearly rupture or dissection rates for thoracic aortic aneurysms: simple prediction based on size, Annals of Thoracic Surgery 73 (2002) 17-28. Go to original source... Go to PubMed...
  4. M. Czerny, D. Zimpfer, T. Fleck, et al., Initial results after combined repair of aortic arch aneurysms by sequential transposition of the supra aortic branches and consecutive endovascular stent-graft placement, Annals of Thoracic Surgery 78 (2004) 1256-1260. Go to original source... Go to PubMed...
  5. M. Kato, K. Ohnishi, M. Kaneko, et al., A new graft implanting method of descending thoracic aortic aneurysm or dissection with a stent graft, Circulation 94 (Suppl 2) (1996) 188-193.
  6. L.G. Svensson, E.S. Crawford, K.R. Hess, et al., Deep hypothermia with circulatory arrest. Determinants of stroke and early mortality in 656 patients, Journal of Thoracic and Cardiovascular Surgery 106 (1993) 19-31. Go to original source... Go to PubMed...
  7. W.A. Cooper, I.G. Duarte, V.H. Thourani, et al., Hypothermic circulatory arrest causes multisystem vascular endothelial dysfunction and apoptosis, Annals of Thoracic Surgery 69 (2000) 696-703. Go to original source... Go to PubMed...
  8. J. Vojáček, M. Lojík, T. Daněk, et al., Nové možnosti léčby výdutí oblouku aorty hybridním přístupem, Cor et Vasa 50 (2008) 241. Go to original source...
  9. M. Czerny, J. Schmidli, T. Carrel, M. Grimm, Hybrid aortic arch repair, Annals of Cardiothoracic Surgery 2 (2013) 372-377.
  10. M. Urban, L. Blaha, M. Wierzgoň, et al., Hybridní terapie aterosklerotických vředů aorty bez použití mimotělního oběhu, Cor et Vasa 50 (2008) 167-169. Go to original source...
  11. G.J. Koullias, G.H. Wheatley III, State-of-the-art of hybrid procedures for the aortic arch: a meta-analysis, Annals of Thoracic Surgery 90 (2010) 689-697. Go to original source... Go to PubMed...
  12. T.M Sundt, T.A. Orszulak, D.J. Cook, H.V. Schaff, Improving results of open arch replacement, Annals of Thoracic Surgery 86 (2008) 787-796. Go to original source... Go to PubMed...
  13. K. Shimamura, T. Kuratamni, G. Matsumiya, et al., Long-term results of the open stent-grafting technique for extended aortic arch disease, Journal of Thoracic and Cardiovascular Surgery 135 (2008) 1261-1269. Go to original source... Go to PubMed...
  14. P. Vallabhajosyula, W. Szento, N. Desai, J.E. Bavaria, Type I and Type II hybrid aortic arch replacement: postoperative and mid-term outcome analysis. Annals of Cardiothoracic Surgery 2 (2013) 280-287.




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