Document Detail

Is total debranching a safe procedure for extensive aortic-arch disease? A single experience of 27 cases.
MedLine Citation:
PMID:  21820909     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Thoracic, arch, and proximal descending thoracic aorta diseases are still considered an enormous challenge. The hybrid approach developed in recent years (supra-aortic trunks debranching and thoracic endovascular repair aortic repair; TEVAR) may improve the morbidity and mortality of the population at risk. The aim of this study was to analyze retrospectively our experience in the hybrid treatment of aortic-arch aneurysms and dissections.
METHOD: We carried out a retrospective review of 27 patients who required a surgical debranching of the supra-aortic trunks and a TEVAR in the management of the aortic arch and proximal descending thoracic aortic disease. The aortic lesions included 18 degenerative arch-aortic aneurysms, four complicated aortic dissections, two subclavian artery aneurysms, and three penetrating atherosclerotic ulcers. Technical success was achieved in all patients.
RESULTS: The 30-day mortality rate was 11.1% (3/27). Mean follow-up was 16.7 months (range, 1-56), and the survival rate was 77.8%. The endoleaks' rate was 3.7% (1/27), due to a stent-graft migration.
CONCLUSION: Hybrid approaches may represent an alternative option in the treatment of complex aortic lesions involving the arch and the proximal descending thoracic aorta in high-risk patients and emergency cases. However, the promising early results need to be confirmed by longer follow-up and larger comparative series.
Emanuele Ferrero; Michelangelo Ferri; Andrea Viazzo; Alessandro Robaldo; Edoardo Zingarelli; Fabrizio Sansone; Riccardo Casabona; Franco Nessi
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery     Volume:  41     ISSN:  1873-734X     ISO Abbreviation:  Eur J Cardiothorac Surg     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-03-01     Completed Date:  2012-05-01     Revised Date:  2013-06-28    
Medline Journal Info:
Nlm Unique ID:  8804069     Medline TA:  Eur J Cardiothorac Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  177-82     Citation Subset:  IM    
Vascular and Endovascular Surgery Unit, Mauriziano Umberto I Hospital, Largo Turati 62, 10128 Turin, Italy.
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MeSH Terms
Aged, 80 and over
Aneurysm, Dissecting / pathology,  surgery*
Aortic Aneurysm, Thoracic / pathology,  surgery*
Blood Vessel Prosthesis Implantation / adverse effects,  methods
Epidemiologic Methods
Middle Aged
Preoperative Period
Risk Factors
Treatment Outcome
Comment In:
Eur J Cardiothorac Surg. 2012 May;41(5):1212-3   [PMID:  22290907 ]
Eur J Cardiothorac Surg. 2012 Jan;41(1):183-4   [PMID:  21802310 ]

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