Results of type II hybrid arch repair with zone 0 stent graft deployment for complex aortic arch pathology

Kent, William; Appoo, Jehangir J.; Bavaria, Joseph E.; Herget, Eric J.; Moeller, Patrick; Pochettino, Alberto; Wong, Jason

doi:10.1016/j.jtcvs.2014.06.070

Cited by 35 publications

(38 citation statements)

References 26 publications

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“…Therefore, hybrid aortic arch repair (HAR) with thoracic endovascular aortic repair (TEVAR) has been introduced in the last decade for patients with comorbidities and frailties. [7][8][9][10][11][12][13][14][15][16] The safety of hybrid TEVAR securing enough proximal landing zone and requiring supra-aortic rerouting bypass is still, however, controversial. We previously reported satisfactory midterm outcomes of CTAR (7-year survival ¼ 90.1%), compared with HAR with TEVAR, but the preoperative patient background in that report was significantly different because hybrid approaches had been used for high-risk patients.…”

Section: See Editorial Commentary Page 107mentioning

confidence: 99%

Objective analysis of midterm outcomes of conventional and hybrid aortic arch repair by propensity-score matching

Hiraoka

Chikazawa

Totsugawa

et al. 2017

The Journal of Thoracic and Cardiovascular Surgery

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Section: See Editorial Commentary Page 107mentioning

confidence: 99%

Objective analysis of midterm outcomes of conventional and hybrid aortic arch repair by propensity-score matching

Hiraoka

Chikazawa

Totsugawa

et al. 2017

The Journal of Thoracic and Cardiovascular Surgery

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“…Stroke will be more frequent whenever manipulation of the SAT and the aortic arch are performed, and also depending on the presence of previous lesions at that level. The reported incidence of this complication is very variable, reaching percentages as high as 12% (5,15) and it increases in those cases where sealing is attempted in zones 0 or 1. On the other hand, paraplegia rate seems to be lower than for classical open repair and it usually does not exceed 3% (15,16).…”

Section: Current Resultsmentioning

confidence: 99%

“…These procedures may be performed during one or two stages. The risk of complications seems to be lower, if they are performed in two steps (4,5). Moreover, in cases where the aneurysm affects the descending aorta, the recovery time between both surgeries would be shorter, and then, minimizing the mortality risk from rupture meanwhile.…”

Section: General Considerations For Aortic Arch Debranchingmentioning

confidence: 99%

“…With this general view of the surgical technique in mind, it would appear that debranching procedures are clearly advantageous compared not only with conventional open surgery, but, also with pure endovascular techniques, due to the fact that they use conventional endografts, which aside from being cheaper, they avoid delay in surgery by not having to wait for custom made devices and are ready to be used in a wide range of anatomies. However, the need for lateral clamping of the ascending aorta causes a potential injury to the artery which, mainly if it is associated to the stress forces generated by the endoprosthesis when it lands upon this aortic zone, can produce a retrograde type A dissection (3-5) in up to 6% of the cases, of which 42% are lethal (5). In addition, over time, these lesions may cause aneurysmal degeneration, eventually resulting in a type I endoleak.…”

Section: General Considerations For Aortic Arch Debranchingmentioning

confidence: 99%

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Debranching aortic surgery

et al. 2017

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Conventional open surgery still remains as the gold standard of care for aortic arch and thoracoabdominal pathology. In centers of excellence, open repair of the arch has been performed with 5% immediate mortality and a low rate of complications; however overall mortality rates are around 15%, being up to 40% of all patients rejected for treatment due to their age or comorbidities. For thoracoabdominal aortic pathology, data reported from centers of excellence show immediate mortality rates from 5% to 19%, spinal cord ischemia from 2.7% to 13.2%, and renal failure needing dialysis from 4.6% to 5.6%. For these reasons, different alternatives that use endovascular techniques, including debranching procedures, have been developed. The reported results for hybrid debranching procedures are controversial and difficult to interpret because series are retrospective, heterogenic and including a small number of patients. Clearly, an important selection bias exists: debranching procedures are performed in elderly patients with more comorbidities and with thoracoabdominal aortic aneurysms that have more complex and extensive disease. Considering this fact, debranching procedures still remain a useful alternative: for aortic arch pathology debranching techniques can avoid or reduce the time of extracorporeal circulation (ECC) or cardiac arrest which may be beneficial in high-risk patients that otherwise would be rejected for treatment. And compared to pure endovascular techniques, they can be used in emergency cases with applicability in a wide range of anatomies. For thoracoabdominal aortic aneurysms, they are mainly useful when other lesser invasive endovascular options are not feasible due to anatomical limitations or when they are not available in cases where delaying the intervention is not an option.

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“…For complex cases with severe aortic disease (dissection and aneurysm), thoracic endovascular aortic repair (TEVAR) is a less-invasive option to reduce complications [44][45][46]. Hybrid…”

Section: Aortic Diseasementioning

confidence: 99%

Clinical Applications of Three-Dimensional Printing in Cardiovascular Disease

Kurata

Koyama

Shirakawa

et al. 2018

Cardiovasc Imaging Asia

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Cardiovascular three-dimensional (3D) printing models have been focused as an emerging technology. Using 3D volume dataset with the high-quality image obtained from CT, MRI or echocardiography, 3D printing models are produced and can provide tangible spatial perception for cardiovascular anatomy and diseases to conventional two-dimensional diagnostic imaging. Recent studies have shown the expanding feasibility of 3D printing models from procedural planning and simulation for surgical or trans-catheter interventions to training, education and communication for medical professionals and patients, particularly in complex congenital heart disease, structural heart disease, and hybrid cardiovascular surgery. With 3D printing technology and material engineering, 3D printing models can replicate not only the morphology but also the function that allows advanced physiological evaluation, procedural simulation, and a platform to 3D bio-printing. This review summarizes cardiovascular 3D printing model workflow from data acquisition to production and discusses clinical applications of 3D printing models.

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Results of type II hybrid arch repair with zone 0 stent graft deployment for complex aortic arch pathology

Cited by 35 publications

References 26 publications

Objective analysis of midterm outcomes of conventional and hybrid aortic arch repair by propensity-score matching

Objective analysis of midterm outcomes of conventional and hybrid aortic arch repair by propensity-score matching

Debranching aortic surgery

Clinical Applications of Three-Dimensional Printing in Cardiovascular Disease

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