Novel hybrid treatment for extensive aortic arch aneurysms, a case report

Abstract Background The treatment for extensive aortic arch aneurysms involving the aortic arch and descending aorta is challenging for most cardiovascular surgeons. The surgical treatment is associated with a very high mortality rate. The optimal treatment has not been defined. Case presentation A 49-year-old male was hospitalized due to chest and upper back pain. Computed tomography angiography (CTA) demonstrated there was an extensive aortic arch aneurysm extending to the left common carotid artery and descending aorta. A novel single- stage hybrid surgery was performed on the patient through two steps: treatment of the aortic arch through median sternotomy and thoracic endovascular artery repair. The patient recovered uneventfully. Conclusions Our single-stage hybrid repair approach is safe, simple and effective. It provides an alternative treatment for extensive aortic arch aneurysms.

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Single-Stage Treatment of Aneurysm of the Distal Aortic Arch and Proximal Descending Aorta Using the Frozen Elephant Trunk Procedure. Case Report

PRILOZI ◽

10.2478/prilozi-2020-0047 ◽

2020 ◽

Vol 41 (3) ◽

pp. 65-70

Author(s):

Sasko Jovev ◽

Vasil Papestiev ◽

Marjan Shokarovski ◽

Stefanija Hadzievska ◽

Nadica Mehmedovic ◽

...

Keyword(s):

Aortic Arch ◽

Median Sternotomy ◽

Aortic Aneurysms ◽

Single Stage ◽

Frozen Elephant Trunk ◽

Organ Protection ◽

Elephant Trunk ◽

Descending Aorta ◽

Systemic Hypothermia ◽

Elephant Trunk Procedure

AbstractAneurysms of the thoracic aorta involving the distal arch and the proximal descending aorta have traditionally been treated with two open procedures. During the first stage, the aortic arch pathology has been addressed through a median sternotomy. Several weeks or months later, a second stage followed and included completing the repair of the descending aorta through a lateral thoracotomy.We, herein, report a single stage repair of an aneurysm involving the distal aortic arch and the proximal descending aorta using the frozen elephant trunk operative technique. Vascular hybrid stent graft prosthesis, specifically designed for treatment of extensive aortic aneurysms, has been used to replace the arch component and exclude the descending aorta component of the aneurysm through a median sternotomy, using bilateral antegrade cerebral perfusion and mild systemic hypothermia for intraoperative organ protection.

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Aneurysm Hybrid Treatment by Simultaneous Replacement of Ascending Aorta and Aortic Arch and Endoluminal Stenting of the Descending Aorta

The Heart Surgery Forum ◽

10.1532/hsf98.20051033 ◽

2006 ◽

Vol 9 (1) ◽

pp. E530-E532

Author(s):

Friedrich-Christian Riess ◽

Hans Krankenberg ◽

Thilo Tübler ◽

Matthias Danne

Keyword(s):

Aortic Arch ◽

Ascending Aorta ◽

Descending Aorta ◽

Hybrid Treatment

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Type B Interrupted Aorta in an Adult Patient

The Heart Surgery Forum ◽

10.1532/hsf98.2013309 ◽

2014 ◽

Vol 17 (2) ◽

pp. 80

Author(s):

Ahmet Ozkara ◽

Mehmet Ezelsoy ◽

Levent Onat ◽

Ilhan Sanisoglu

Keyword(s):

Cardiopulmonary Bypass ◽

Aortic Arch ◽

Collateral Circulation ◽

Neonatal Period ◽

Interrupted Aortic Arch ◽

Complete Loss ◽

Posterolateral Thoracotomy ◽

Type B ◽

Case Presentation ◽

Descending Aorta

Introduction: Interrupted aortic arch is a rare congenital malformation characterized by a complete loss of luminal continuity between the ascending and descending aorta. It is often diagnosed during the neonatal period.Case presentation: We presented a 51-year-old male patient with interrupted aortic arch type B who was treated successfully with posterolateral thoracotomy without using cardiopulmonary bypass.Conclusion: The prognosis for interrupted aortic arch depends on the associated congenital anomalies, but the outcome is usually very poor unless there is surgical treatment. Survival into adulthood depends on the development of collateral circulation.

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Single-stage endovascular management of complicated thoracic aorta coarctation concurrent with aortic arch aneurysm using a novel fenestration device

Journal of Thoracic Disease ◽

10.21037/jtd.2018.03.162 ◽

2018 ◽

Vol 10 (4) ◽

pp. 2474-2480 ◽

Cited By ~ 3

Author(s):

Jun Bai ◽

Yandong Liu ◽

Jie Jin ◽

Jun Li ◽

Xiangguo Ji ◽

...

Keyword(s):

Aortic Arch ◽

Thoracic Aorta ◽

Aortic Arch Aneurysm ◽

Single Stage ◽

Endovascular Management ◽

Arch Aneurysm

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Hybrid Procedure with Debranching from the Descending Aorta for Aortic Arch Aneurysm after Previous Open Repair

Annals of Vascular Surgery ◽

10.1016/j.avsg.2016.05.131 ◽

2017 ◽

Vol 38 ◽

pp. 319.e7-319.e10 ◽

Cited By ~ 1

Author(s):

Juergen Zanow ◽

Martin Breuer ◽

Eric Lopatta ◽

Christoph Schelenz ◽

Utz Settmacher

Keyword(s):

Aortic Arch ◽

Open Repair ◽

Hybrid Procedure ◽

Aortic Arch Aneurysm ◽

Descending Aorta ◽

Arch Aneurysm

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Antegrade transapical branch deployment for endovascular aortic-arch repair by in situ fenestration

European Journal of Cardio-Thoracic Surgery ◽

10.1093/ejcts/ezz223 ◽

2019 ◽

Author(s):

Takashi Murakami ◽

Noriaki Kishimoto ◽

Etsuji Sohgawa ◽

Toshihiko Shibata

Keyword(s):

Aortic Arch ◽

Carotid Arteries ◽

Stent Grafts ◽

Descending Aorta ◽

Bilateral Carotid ◽

Aortic Arch Repair ◽

Sheath Insertion ◽

Arch Aneurysm ◽

Transapical Access

Abstract A 76-year-old man presented with an aortic arch aneurysm and was considered a candidate for endovascular aortic arch repair by in situ fenestration. Alternative access routes were explored because of atherosclerotic disease of the descending aorta and bilateral carotid arteries. Transapical deployment of both an aortic and a branched stent grafts was successfully conducted without cerebral complications. The transapical access might have the potential to reduce the risks of complications related to large bore-sheath insertion to the carotid arteries.

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