Document Detail


Hybrid aortic arch repair procedure: reinforcement of the aorta for a safe and durable landing zone.
MedLine Citation:
PMID:  20870433     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Hybrid aortic arch repair procedure was introduced to reduce invasiveness in high-risk patients with aortic arch pathology. The good results are expanding its application, but endoleak, particularly type I, remains its Achilles' heel.
DESIGN: We describe our experience with hybrid treatment of aortic arch diseases focussing on techniques and results to avoid type I endoleak.
MATERIALS AND METHODS: A total of 15 high-risk patients with zone 0-2 aortic arch pathology underwent supra-aortic debranching on ascending aorta and proximal aortic arch reinforcement with a Dacron prosthesis. Metachronously, the procedure was completed with endovascular stent grafting (ESG).
RESULTS: Median age was 70 years with a mean European System for Cardiac Operative Risk Evaluation (EuroSCORE) of 12.7±6.8. One patient died between aortic debranching and ESG. Mean time between surgical debranching and ESG was 32±27.7 days. No major neurological events occurred. Mean length of the landing zone for ESG was 3.8±0.8 cm. Computed tomography (CT) angiography scan performed soon after operation, and at 3, 6, and 12 months did not show any type I endoleak.
CONCLUSIONS: Supra-aortic debranching on ascending aorta with proximal aortic arch reinforcement is a useful step to ensure a safe landing zone for ESG, reducing risk early to midterm of endoleak. Longer term follow-up is required to confirm the viability of this technique.
Authors:
G Gelpi; P Vanelli; A Mangini; P Danna; M Contino; C Antona
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Publication Detail:
Type:  Journal Article     Date:  2010-09-25
Journal Detail:
Title:  European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery     Volume:  40     ISSN:  1532-2165     ISO Abbreviation:  Eur J Vasc Endovasc Surg     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-29     Completed Date:  2011-01-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9512728     Medline TA:  Eur J Vasc Endovasc Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  709-14     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.
Affiliation:
Cardiovascular Surgery Division of L. Sacco Hospital, University of Milan, Via GB Grassi 74, 20175 Milan, Italy. gelpi.guido@hsacco.it
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MeSH Terms
Descriptor/Qualifier:
Aged
Aorta, Thoracic / radiography,  surgery*
Aortic Diseases / mortality,  radiography,  surgery*
Aortography / methods
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation / adverse effects,  instrumentation,  methods*,  mortality
Endoleak / etiology,  prevention & control
Endovascular Procedures* / adverse effects,  instrumentation,  mortality
Female
Humans
Italy
Kaplan-Meier Estimate
Male
Middle Aged
Polyethylene Terephthalates
Prosthesis Design
Retrospective Studies
Stents
Time Factors
Tomography, X-Ray Computed
Treatment Outcome
Chemical
Reg. No./Substance:
0/Polyethylene Terephthalates

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