Hybrid approaches in the treatment of aortic arch aneurysms: postoperative and midterm outcomes.

摘要: Background The combined open surgical and endovascular approach for the treatment of aortic arch aneurysms has emerged as a safe modality. This platform may have an especially important role in treating patients old age with greater comorbid burden. We describe our institutional experience hybrid approach, midterm outcomes. Methods From 2005 to present, 685 undergone thoracic repair (TEVAR); 104 had (open plus approach). Of these, 47 aneurysm or without proximal ascending aneurysm. All these median sternotomy vessel debranching antegrade retrograde TEVAR stent grafting arch. Results from prospectively maintained database are reported. Twenty-eight type I repair, 8 II 11 III repair. Those were excluded analysis. Stent graft deployment rate was 100% after debranching. Mean 71 ± 8 years. Fourteen percent cases involved redo sternotomy. Average cardiopulmonary bypass time 215 ± 64 minutes, crossclamp 70 ± 55 minutes circulatory arrest 19 ± 10 minutes. paraplegia 5.5% (n = 2), stroke 8% (n = 3). In-hospital mortality There no postoperative endoleaks. mean length stay 17.2 ± 14 days. follow-up 30 ± 21 months. Freedom all-cause 71%, 60%, 48% at 1, 3, 5 years, respectively. reoperation 2.7% (n = 1). No patient 1 3 endoleak latest follow-up. Conclusions involving zone 0 landing can be safely adopted good results cohort significant comorbidity. procedure performed endoleaks represent technical advancement field surgery.