Document Detail


"Hybrid" repair of aneurysms of the transverse aortic arch: midterm results.
MedLine Citation:
PMID:  19932255     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Aneurysms of the transverse aortic arch, especially those involving the mid to distal arch, are technically challenging to repair with conventional open techniques. We present our results with a combined open/endovascular approach ("hybrid repair") in such patients. METHODS: From August 11, 2005, to September 18, 2008, 28 patients underwent hybrid arch repair. For patients (n = 9) with distal arch aneurysms but 2 cm or more of proximal landing zone (PLZ) distal to the innominate artery, right to left carotid-carotid bypass was performed to create a PLZ by covering the left carotid origin. For patients (n = 12) with mid arch aneurysms but 2 cm or more of PLZ in the ascending aorta, proximal ascending aorta-based arch debranching was performed. For patients (n = 7) with arch aneurysms with no adequate PLZ ("mega aorta") but adequate distal landing zone, a stage 1 elephant trunk procedure was performed to create a PLZ. For the first two groups, endovascular aneurysm exclusion and debranching were performed concomitantly, whereas the procedures were staged for the group undergoing an initial elephant trunk procedure. RESULTS: Mean patient age was 64 +/- 13 years. Primary technical success rate was 100%. Thirty-day/in-hospital rates of death, stroke, and permanent paraplegia/paresis were 0%, 0%, and 3.6% (n = 1), respectively. At a mean follow-up of 14 +/- 11 months, there have been no late aortic-related events. Two patients (7%) required secondary endovascular reintervention for a type 1 endovascular leak. No patient has a type 1 or 3 endovascular leak at latest follow-up. CONCLUSIONS: Hybrid repair of transverse aortic arch aneurysms appears safe and effective at midterm follow-up and may represent a technical advance in the treatment of this pathology.
Authors:
G Chad Hughes; Mani A Daneshmand; Keki R Balsara; Hardean A Achneck; Bantayehu Sileshi; Sean M Lee; Richard L McCann
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  88     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-11-25     Completed Date:  2010-01-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  1882-7; discussion 1887-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, Duke University Medical Center, Durham, North Carolina 27710, USA. gchad.hughes@duke.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Aortic Aneurysm, Thoracic / mortality,  surgery*
Endoscopy / methods*
Female
Follow-Up Studies
Humans
Incidence
Male
Middle Aged
Postoperative Complications / epidemiology
Retrospective Studies
Survival Rate / trends
Thoracotomy / methods*
Time Factors
Treatment Outcome
United States / epidemiology
Vascular Surgical Procedures / methods*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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