Single-Stage Hybrid Arch Repair for Patients with Shaggy Aorta

Abstract

Operating on extended arch aneurysms that contain severe atherosclerotic plaques is difficult. In such cases, the incidence of intraoperative multiple embolization is very high. We applied single-stage hybrid arch repair, which involved ascending aorta replacement and debranching of arch vessels, consecutively with endovascular repair for two patients. This technique was developed to prevent embolization of atherosclerotic plaques during cardiopulmonary bypass, and abrasion of the plaques during thoracic endovascular repair. Both patients recovered without embolic complications.

The Shaggy Aorta Syndrome: An Updated Review

“…14,18,21,51,71 Singlestage hybrid arch repair, which involved ascending aorta replacement and debranching of arch vessels, consecutively with endovascular repair could represent a valid option in patients with SA. 72 In ascending aortic aneurysm, complicated with atherosclerotic lesions of the descending aorta, a hybrid approach using frozen elephant trunk technique could be a valid treatment to reduce the embolism risk. 54 Uchida et al 28 reported a modified arch-first technique in a patient with arch aneurysm complicated by SA, involving arch replacement with a beating heart after reconstruction of supra-aortic vessels while maintaining normal blood pressure.…”