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KMID : 0364020100430050490
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Korean Journal of Thoracic and Cardiovascular Surgery
2010 Volume.43 No. 5 p.490 ~ p.498
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Early and Midterm Results of Hybrid Endovascular Repair for Thoracic Aortic Disease
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Youn Young-Nam
Hong Soon-Chang
Lee Sak
Chang Byung-Chul
Song Seung-Jun
Kim Kwan-Wook
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Abstract
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Background:A hybrid procedure using an open surgical extra-anatomic bypass of aortic arch vessels and thoracic endovascular aortic repair (TEVAR) is less invasive than open surgery, and provides a suitable proximal landing zone. Here we report our experience with a hybrid TEVAR procedure at a single center.
Methods:We retrospectively reviewed consecutive patients with thoracic aortic disease who received a hybrid TEVAR procedure between August 2008 and January 2010. Patients’ data were prospectively collected and mean follow-up was 10.8±5.5 months (range 3∼20).
Results:Nine patients (7 males and 2 females) with a mean age of 63.8±15.8 years (range 38∼84) underwent a hybrid procedure. Five patients had an arch or a proximal descending aortic aneurysm, two had a dissecting aneurysm of the descending aorta, and two had an aneurysm of the ascending arch and descending aorta. Mean expected mortality calculated by logistic EuroSCORE was 21%. Six patients underwent debranching and rerouting from ascending aorta to arch vessels, 2 had carotid-carotid bypass grafting, and 1 underwent carotid-axillary bypass grafting. Mean operation time was 221.4±84.0 min (range 94∼364). Deployment success of endovascular stent grafting was 100% with no endoleak on completion angiography. There was no mortality, and a small embolism in the branch of the right opthalmic artery in one patient. During follow-up, one intervention was required for the endoleak. Actuarial survival at 20 months was 100%.
Conclusions:Early and mid-term results are encouraging and suggest that hybrid TEVAR procedures are less invasive and safer and represent an effective technique for treating thoracic aortic disease.
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KEYWORD
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Aorta, surgery, Aorta, arch, Endovascular stent, Hybrid procedure
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