Hemi–aortic arch debranching for hybrid aortic arch repair by sequential transposition of the left common carotid and subclavian arteries

Canaud, Ludovic; Joyeux, Frédéric; Ziza, Vincent; Branchereau, Pascal; Marty-Ané, Charles; Alric, Pierre

doi:10.1016/j.jtcvs.2012.03.012

Cited by 16 publications

(17 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This finding confuses the comparison of operative mortality between reports and suggests studies which only report in-hospital mortality may significantly underestimate 30-day/in-hospital mortality. Nonetheless, the procedure-specific 30-day/in-hospital mortality rates in this study are comparable to prior reports of zone 1 hybrid arch repair (0%-15.6%), 11, 12, 17, 18 zone 0 hybrid arch repair (8.5%-29.6%), 9-12, 14, 17, 20 stented elephant trunk completion (4.5%-11%), 1, 2, 6, 7, 13 and total arch replacement with stented elephant trunk completion (17%). 7 …”

Section: Discussionsupporting

confidence: 87%

Results with an algorithmic approach to hybrid repair of the aortic arch

Andersen

Williams

Hanna

et al. 2013

Journal of Vascular Surgery

108

View full text Add to dashboard Cite

Objective Hybrid repair of the transverse aortic arch may allow for aortic arch repair with reduced morbidity in patients who are suboptimal candidates for conventional open surgery. Here, we present our results with an algorithmic approach to hybrid arch repair, based upon the extent of aortic disease and patient comorbidities. Methods Between August 2005 and January 2012, 87 patients underwent hybrid arch repair by three principal procedures: zone 1 endograft coverage with extra-anatomic left carotid revascularization (zone 1, n=19), zone 0 endograft coverage with aortic arch debranching (zone 0, n=48), or total arch replacement with staged stented elephant trunk completion (stented elephant trunk, n=20). Results The mean patient age was 64 years and the mean expected in-hospital mortality rate was 16.3% as calculated by the EuroSCORE II. 22% (n=19) of operations were non-elective. Sternotomy, cardiopulmonary bypass, and deep hypothermic circulatory arrest were required in 78% (n=68), 45% (n=39), and 31% (n=27) of patients, respectively, to allow for total arch replacement, arch debranching, or other concomitant cardiac procedures, including ascending ± hemi-arch replacement in 17% (n=8) of patients undergoing zone 0 repair. All stented elephant trunk procedures (n=20) and 19% (n=9) of zone 0 procedures were staged, with 41% (n=12) of patients undergoing staged repair during a single hospitalization. The 30-day/in-hospital rates of stroke and permanent paraplegia/paraparesis were 4.6% (n=4) and 1.2% (n=1), respectively. Three of 27 (11.1%) patients with native ascending aorta zone 0 proximal landing zone experienced retrograde type A dissection following endograft placement. The overall in-hospital mortality rate was 5.7% (n=5), however, 30-day/in-hospital mortality increased to 14.9% (n=13) due to eight 30-day out-of-hospital deaths. Native ascending aorta zone 0 endograft placement was found to be the only univariate predictor of 30-day/in-hospital mortality (odds ratio, 4.63; 95% confidence interval, 1.35-15.89; P=0.02). Over a mean follow-up of 28.5 ± 22.2 months, 13% (n=11) of patients required reintervention for type 1A (n=4), type 2 (n=6), or type 3 (n=1) endoleak. Kaplan-Meier estimates of survival at 1, 3, and 5 years were 73%, 60%, and 51%, respectivel. Conclusions Hybrid aortic arch repair can be tailored to patient anatomy and comorbid status to allow complete repair of aortic pathology, frequently in a single stage, with acceptable outcomes. However, endograft placement in the native ascending aorta is associated with high rates of retrograde type A dissection and 30-day/in-hospital mortality and should be approached with caution.

show abstract

Section: Discussionsupporting

confidence: 87%

Results with an algorithmic approach to hybrid repair of the aortic arch

Andersen

Williams

Hanna

et al. 2013

Journal of Vascular Surgery

108

View full text Add to dashboard Cite

show abstract

“…Debranching and revascularization in zone 1 were mainly performed through cervico-manubriotomy with sequential transposition of the LCCA and the LSA as we previously described. 8 For patients deemed unsuitable for sequential transposition because of proximal atherosclerotic lesions of the supra-aortic trunks, extra-anatomic revascularization of LCCA and LSA was performed with a carotid-carotid bypass, followed by a left carotid-subclavian transposition. Debranching and revascularization in zone 2: Revascularization of the LSA was performed each time it was possible without regard to vertebral circulation.…”

Section: Debranching Proceduresmentioning

confidence: 99%

Hybrid aortic arch repair for dissecting aneurysm

Faure

Canaud

Marty-Ané

et al. 2016

The Journal of Thoracic and Cardiovascular Surgery

Self Cite

View full text Add to dashboard Cite

show abstract

“…Canaud et al, from France, reported 11 cases treated with sequential transposition of left carotid and subclavian arteries via partial upper sternotomy and left cervical extension. 21 They had 90.9% technical success and no perioperative mortality. One patient had retrograde type A dissection requiring immediate surgical aortic root replacement with circulatory arrest.…”

Section: Arch Debranchingmentioning

confidence: 95%

Endovascular Stenting With Open Surgery for Reconstructions of the Ascending Aorta and the Aortic Arch: A Review of Indications and Results of Hybrid Techniques

Rana¹,

Gloviczki²,

Oderich³

2012

Perspectives in Vascular Surgery and Endovascular Therapy

View full text Add to dashboard Cite

Hybrid approaches for repair of aneurysms involving the ascending aorta and the aortic arch have been developed to avoid or reduce duration of cardiopulmonary bypass and circulatory arrest and to decrease operative time, blood loss, hospital stay, morbidity, and mortality. These include ascending aorta-based debranching or cervical extra-anatomical bypasses followed by stent-grafting. In patients with associated descending aortic aneurysms, the elephant trunk technique is used followed by stent-grafting of the descending thoracic aorta. A review of the literature of hybrid aortic arch reconstructions, published over past 7 years, reveals perioperative mortalities from 0% to 13%, stroke from 0% to 10%, and spinal cord injury in 0% to 13%. The outcomes are comparable to contemporary results from total open and total endovascular reconstructions in spite of the fact that the hybrid approach is generally taken in patients with high surgical risk for open repair and with prohibitive anatomy for total endovascular repair.

show abstract

Hemi–aortic arch debranching for hybrid aortic arch repair by sequential transposition of the left common carotid and subclavian arteries

Cited by 16 publications

References 10 publications

Results with an algorithmic approach to hybrid repair of the aortic arch

Results with an algorithmic approach to hybrid repair of the aortic arch

Hybrid aortic arch repair for dissecting aneurysm

Endovascular Stenting With Open Surgery for Reconstructions of the Ascending Aorta and the Aortic Arch: A Review of Indications and Results of Hybrid Techniques

Contact Info

Product

Resources

About