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"Hybrid" repair of aneurysms of the transverse aortic arch: midterm results.

Publication ,  Journal Article
Hughes, GC; Daneshmand, MA; Balsara, KR; Achneck, HA; Sileshi, B; Lee, SM; McCann, RL
Published in: Ann Thorac Surg
December 2009

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.

Duke Scholars

Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

December 2009

Volume

88

Issue

6

Start / End Page

1882 / 1887

Location

Netherlands

Related Subject Headings

  • Vascular Surgical Procedures
  • United States
  • Treatment Outcome
  • Time Factors
  • Thoracotomy
  • Survival Rate
  • Retrospective Studies
  • Respiratory System
  • Postoperative Complications
  • Middle Aged
 

Citation

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Hughes, G. C., Daneshmand, M. A., Balsara, K. R., Achneck, H. A., Sileshi, B., Lee, S. M., & McCann, R. L. (2009). "Hybrid" repair of aneurysms of the transverse aortic arch: midterm results. Ann Thorac Surg, 88(6), 1882–1887. https://doi.org/10.1016/j.athoracsur.2009.07.027
Hughes, G Chad, Mani A. Daneshmand, Keki R. Balsara, Hardean A. Achneck, Bantayehu Sileshi, Sean M. Lee, and Richard L. McCann. “"Hybrid" repair of aneurysms of the transverse aortic arch: midterm results.Ann Thorac Surg 88, no. 6 (December 2009): 1882–87. https://doi.org/10.1016/j.athoracsur.2009.07.027.
Hughes GC, Daneshmand MA, Balsara KR, Achneck HA, Sileshi B, Lee SM, et al. "Hybrid" repair of aneurysms of the transverse aortic arch: midterm results. Ann Thorac Surg. 2009 Dec;88(6):1882–7.
Hughes, G. Chad, et al. “"Hybrid" repair of aneurysms of the transverse aortic arch: midterm results.Ann Thorac Surg, vol. 88, no. 6, Dec. 2009, pp. 1882–87. Pubmed, doi:10.1016/j.athoracsur.2009.07.027.
Hughes GC, Daneshmand MA, Balsara KR, Achneck HA, Sileshi B, Lee SM, McCann RL. "Hybrid" repair of aneurysms of the transverse aortic arch: midterm results. Ann Thorac Surg. 2009 Dec;88(6):1882–1887.
Journal cover image

Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

December 2009

Volume

88

Issue

6

Start / End Page

1882 / 1887

Location

Netherlands

Related Subject Headings

  • Vascular Surgical Procedures
  • United States
  • Treatment Outcome
  • Time Factors
  • Thoracotomy
  • Survival Rate
  • Retrospective Studies
  • Respiratory System
  • Postoperative Complications
  • Middle Aged