BACKGROUND: Treatment of the aortic arch pathologies is technically challenging. In this study we assess early and late outcomes of hybrid aortic arch repairs that comprise extra-anatomic surgical procedures completed by thoracic endovascular interventions [thoracic endovascular aortic repair (TEVAR)]. METHODS: Since 2007, 21 patients (8 women and 13 men) with a median age of 48 years have undergone hybrid procedures for aortic arch pathologies. All of them were treated without cardio-pulmonary bypass. All survivors were followed up regularly and imaging examination were performed. A technical success, procedural complications as well as the early and late mortality and morbidity rates were evaluated. RESULTS: All patients survived surgery and TEVAR was technically successful in all of them. However, 2 individuals died (in-hospital mortality rate 9.5%) during in-hospital stay, both due to multi-organ failure (MOF). Additionally, one patient developed symptoms of cerebral stroke, another one of spinal cord ischemia. During the follow-up that ranged from 6 to 118 months and was completed by 100% of the survivors, one patient died 3 years after procedure because of sepsis (aorto-oesophageal fistula prior to intervention) and late vascular graft occlusions were noted in three cases. CONCLUSIONS: Hybrid procedures on the aortic arch that comprise surgical and endovascular interventions has become an attractive and safe therapeutic option with acceptable mortality and morbidity rate. They may be considered as a method of choice in treatment of the elderly and high-risk patients.
BACKGROUND: Treatment of the aortic arch pathologies is technically challenging. In this study we assess early and late outcomes of hybrid aortic arch repairs that comprise extra-anatomic surgical procedures completed by thoracic endovascular interventions [thoracic endovascular aortic repair (TEVAR)]. METHODS: Since 2007, 21 patients (8 women and 13 men) with a median age of 48 years have undergone hybrid procedures for aortic arch pathologies. All of them were treated without cardio-pulmonary bypass. All survivors were followed up regularly and imaging examination were performed. A technical success, procedural complications as well as the early and late mortality and morbidity rates were evaluated. RESULTS: All patients survived surgery and TEVAR was technically successful in all of them. However, 2 individuals died (in-hospital mortality rate 9.5%) during in-hospital stay, both due to multi-organ failure (MOF). Additionally, one patient developed symptoms of cerebral stroke, another one of spinal cord ischemia. During the follow-up that ranged from 6 to 118 months and was completed by 100% of the survivors, one patient died 3 years after procedure because of sepsis (aorto-oesophageal fistula prior to intervention) and late vascular graft occlusions were noted in three cases. CONCLUSIONS: Hybrid procedures on the aortic arch that comprise surgical and endovascular interventions has become an attractive and safe therapeutic option with acceptable mortality and morbidity rate. They may be considered as a method of choice in treatment of the elderly and high-risk patients.
Authors: R Scott Mitchell; Shin Ishimaru; Frank J Criado; Marek P Ehrlich; Krassi Ivancev; Mario Lachat; Martin Malina; James May; Karl-Heinz Orend; Hervé Rousseau; David M Williams Journal: J Endovasc Ther Date: 2005-02 Impact factor: 3.487
Authors: E C Gravereaux; P L Faries; J A Burks; V Latessa; D Spielvogel; L H Hollier; M L Marin Journal: J Vasc Surg Date: 2001-12 Impact factor: 4.268
Authors: Frank J Criado; Omran R Abul-Khoudoud; Gregory S Domer; Christine McKendrick; Mark Zuzga; Nancy S Clark; Kerry Monaghan; Marcos F Barnatan Journal: Ann Thorac Surg Date: 2005-09 Impact factor: 4.330
Authors: Ryan R Davies; Lee J Goldstein; Michael A Coady; Shawn L Tittle; John A Rizzo; Gary S Kopf; John A Elefteriades Journal: Ann Thorac Surg Date: 2002-01 Impact factor: 4.330
Authors: John A Cowan; Justin B Dimick; Peter K Henke; Thomas S Huber; James C Stanley; Gilbert R Upchurch Journal: J Vasc Surg Date: 2003-06 Impact factor: 4.268
Authors: Nikolaos C Schizas; Aikaterini P Dedeilia; Ilias Samiotis; Theodoros Kratimenos; Nikolaos G Baikoussis; Panagiotis G Dedeilias Journal: Indian J Thorac Cardiovasc Surg Date: 2021-03-19