Less invasive surgical treatment for aortic arch aneurysms in high-risk patients: A comparative study of hybrid thoracic endovascular aortic repair and conventional total arch replacement

Objective For aortic arch aneurysms, conventional total arch replacement has been the standard surgical option. In selected high-risk patients, we have attempted less invasive hybrid procedure involving supra-aortic bypass and endovascular stent-graft placement. We review the early and midterm outco...

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Veröffentlicht in:	The Journal of thoracic and cardiovascular surgery 2012-05, Vol.143 (5), p.1007-1013
Hauptverfasser:	Murashita, Takashi, MD, Matsuda, Hitoshi, MD, Domae, Keitaro, MD, Iba, Yutaka, MD, Tanaka, Hiroshi, MD, Sasaki, Hiroaki, MD, Ogino, Hitoshi, MD
Format:	Artikel
Sprache:	eng
Schlagworte:	Aged Aged, 80 and over Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Aortic Aneurysm, Thoracic - diagnostic imaging Aortic Aneurysm, Thoracic - mortality Aortic Aneurysm, Thoracic - surgery Aortography - methods Biological and medical sciences Blood and lymphatic vessels Blood Vessel Prosthesis Implantation - adverse effects Blood Vessel Prosthesis Implantation - mortality Cardiology. Vascular system Cardiothoracic Surgery Diseases of the aorta Endoleak - etiology Endoleak - surgery Endovascular Procedures - adverse effects Endovascular Procedures - mortality Female Hospital Mortality Humans Japan Kaplan-Meier Estimate Male Medical sciences Middle Aged Patient Selection Pneumology Reoperation Retrospective Studies Risk Assessment Risk Factors Time Factors Tomography, X-Ray Computed Treatment Outcome
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Zusammenfassung:	Objective For aortic arch aneurysms, conventional total arch replacement has been the standard surgical option. In selected high-risk patients, we have attempted less invasive hybrid procedure involving supra-aortic bypass and endovascular stent-graft placement. We review the early and midterm outcomes to clarify the impact of the hybrid procedure. Methods Between October 2007 and December 2010, 27 patients were treated with the hybrid procedure. During the same period, 191 patients underwent elective conventional total arch replacement. On retrospective analysis, the hybrid procedure was feasible in 103 patients (hybrid feasible) and not feasible in 88 patients (hybrid impossible). Patients undergoing the hybrid procedure attained significantly higher additive (11.6 ± 2.2 vs 9.5 ± 2.4, 10.3 ± 2.8, P
ISSN:	0022-5223 1097-685X
DOI:	10.1016/j.jtcvs.2011.06.024