Hybrid repair versus conventional open repair for thoracic aortic arch aneurysms

Elhelali, Ala; Hynes, Niamh; Devane, Declan; Sultan, Sherif; Kavanagh, Edel P; Morris, Liam; Veerasingam, Dave; Jordan, Fionnuala

doi:10.1002/14651858.cd012923.pub2

Cited by 9 publications

(7 citation statements)

References 132 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…An attempt to review literature for the Cochrane database to compare HAR with open arch repair in 2021 did not find a single randomized controlled trial or controlled clinical trial to be included in the study and was thus stopped ( 41 ). Conventional endograft and recent investigational devices have not yet received FDA approval to treat aortic arch pathologies.…”

Section: Discussionmentioning

confidence: 99%

Comprehensive review of hybrid aortic arch repair with focus on zone 0 TEVAR and our institutional experience

Singh

Pupovac

Assi

et al. 2022

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

Even with increasing operator experience and a better understanding of the disease and the operation, intervention for aortic arch pathologies continues to struggle with relatively higher mortality, reintervention, and neurologic complications. The hybrid aortic arch repair was introduced to simplify the procedure and improve the outcome. With recent industry-driven advances, hybrid repairs are not only offered to poor surgical candidates but have become mainstream. This review discusses the evolution of hybrid repair, terminology pertinent to this technique, and results. In addition, we aim to provide a pervasive review of hybrid aortic arch repairs with reference to relevant literature for a detailed understanding. We have also discussed our institutional experience with hybrid repairs.

show abstract

Section: Discussionmentioning

confidence: 99%

Comprehensive review of hybrid aortic arch repair with focus on zone 0 TEVAR and our institutional experience

Singh

Pupovac

Assi

et al. 2022

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

show abstract

“…The hybrid approach of treating aortic arch aneurysms consists of pre-made shunts from the ascending aorta to the brachiocephalic arteries – a technique of total switching of all vessels of the aortic arch – total arterial debranching; or switching of the left carotid and left subclavian artery from the brachiocephalic trunk – subtotal debranching; and/or carotid-subclavian bypass – the method of partial debranching. This technology has shown promising results over the past 10 years and has expanded the treatment of aortic arch pathology in patients considered unsuitable for open surgery [ 11 , 12 , 15 ]. Data from colleagues show that treatment of aortic pathology is still associated with 13% 30-day mortality, and the risk of complications in treating such pathology can reach 35% [ 16 – 18 ].…”

Section: Discussionmentioning

confidence: 99%

A single-center experience in the use of hybrid techniques for thoracic aortic pathology

et al. 2022

View full text Add to dashboard Cite

The hybrid method of treating thoracic aortic pathology is devoid of the disadvantages of traditional open surgery and, at the same time, has a broader range of applications than the endovascular method. From 2014 to 2019, we researched 122 patients with thoracic aortic pathology treated with the hybrid method (open surgery with thoracic endovascular aortic repair (TEVAR) at the National M. Amosov Institute of Cardiovascular Surgery National Academy of Medical Science of Ukraine. In the general group, 34 patients had a descending aortic aneurysm without dissection or rupture; 71 patients had an aortic dissection (10 – acute, 9 – subacute, 52 – chronic), penetrating aortic ulcer (PAU) – 7, thoracoabdominal aneurysm (Crawford I-II) – 4, isolated aortic arch aneurysm – 2, residual enlargement aorta after previous ascending aortic grafting causing type A acute aortic dissection (TAAD) – 3, primary aortic thrombosis – 1. Patients admitted as elective surgery candidates had switched aortic arch vessels (debranching) in the first stage and TEVAR in the second stage. For emergencies (aortic rupture with uncontrolled bleeding, malperfusion syndrome), TEVAR operation was performed first. Long-term results of treatment after three and six months are satisfactory. The hybrid technique of aortic arch treatment using modern minimally invasive technologies can eliminate the pathology in the most dangerous segment of the main artery of the body, providing a reasonable level of hospital mortality – 4.2%, and a small number of neurological complications.

show abstract

“…Aortic aneurysms are classified by Mitchell and Ishimaru based on the zone; however, isolated aortic arch aneurysms are rare and are usually associated with aneurysms in the ascending or descending aorta. 3 …”

Section: Discussionmentioning

confidence: 99%

“…The hybrid repair modality entails the debranching of the brachiocephalic, left common carotid, and left subclavian arteries with a synthetic bypass graft, followed by endovascular grafting through the aortic arch and the descending aorta. 3 Despite the low rates of mortality and morbidity associated with the hybrid procedure by comparison with OAR, concerns about retrograde aortic dissection after TEVAR and hybrid procedures have yet to be assuaged. 12 - 15 The estimated incidence of retrograde aortic dissection after the hybrid procedure for aortic arch diseases is reported to range between 1.33% and 3.5%, with 70% of the cases occurring during the first month and 29% after 30 days but mostly during the first year.…”

Section: Discussionmentioning

confidence: 99%

Late Retrograde Aortic Dissection after Hybrid Thoracic Endovascular Aortic Repair (TEVAR): A Case Report

Boroumand¹,

Ahmadi-Tafti²,

Davoodi³

et al. 2021

JTHC

View full text Add to dashboard Cite

Open total arch replacement is allied to high rates of mortality and morbidity; surgeons, therefore, tend to choose hybrid aortic arch repair as a less invasive operative procedure for the treatment of aortic arch aneurysms, especially in high-risk patients. However, studies on the early and late outcomes of patients undergoing hybrid aortic arch repair have revealed high rates of reintervention and reoperation compared with open total arch replacement. Here, we describe a male patient with late retrograde aortic dissection after hybrid thoracic endovascular aortic repair for aortic arch aneurysms. The patient returned 3 years after the procedure with signs of dyspnea on exertion and chest pain. Transthoracic echocardiography and computed tomography showed dissection of the ascending aorta, for which he underwent a redo Bentall procedure. The patient was weaned from cardiopulmonary bypass without any problem and discharged after 7 days.

show abstract

Hybrid repair versus conventional open repair for thoracic aortic arch aneurysms

Cited by 9 publications

References 132 publications

Comprehensive review of hybrid aortic arch repair with focus on zone 0 TEVAR and our institutional experience

Comprehensive review of hybrid aortic arch repair with focus on zone 0 TEVAR and our institutional experience

A single-center experience in the use of hybrid techniques for thoracic aortic pathology

Late Retrograde Aortic Dissection after Hybrid Thoracic Endovascular Aortic Repair (TEVAR): A Case Report

Contact Info

Product

Resources

About