State-of-the-art of hybrid procedures for the aortic arch: a meta-analysis.

Questions have risen regarding procedural indications, techniques, and outcomes for hybrid arch procedures. We performed a meta-analysis to benchmark this innovative approach. Studies and case reports involving hybrid aortic arch procedures listed through May 2008 were reviewed (n = 718). End points were 30-day mortality, stroke, paraplegia, and endoleak rates. A total of 15 studies with 463 patients were included in the meta-analysis. Overall 30-day mortality was 8.3%. Endoleak rate was 9.2%, stroke was 4.4%, and paraplegia was 3.9%. Treated on-pump or off-pump did not affect any of the endpoints. Results compare favorably with standard operative repair. Long-term follow-up is needed. Copyright 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.