Abstract
Hybrid arch replacement is a well-accepted method for the treatment of lesions involving the aortic arch, though its benefits compared to classic surgical techniques remain controversial. Multiple surgical approaches have been analyzed in the literature for the treatment of such a challenging pathology. In this case report, we describe the surgical management of a 72-year-old man presenting with a complicated aortic arch rupture. The patient was treated urgently with a type I hybrid arch replacement in two stages, with total preservation of cerebral and systemic perfusion. Our case shows that hybrid arch methods are applicable even in emergency cases.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Data availability
The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.
References
Papakonstantinou NA, Antonopoulos CN, Baikoussis NG, Kakisis I, Geroulakos G. Aortic arch reconstruction: are hybrid debranching procedures a good choice? Heart Lung Circ. 2018;27:1345–9.
de Oliveira SL, de Castro BR, Navarro TP, et al. Hybrid treatment with complete transposition of supra-aortic trunks versus conventional surgery for the treatment of aortic arch aneurysm. Braz J Cardiovasc Surg. 2017;32:354–60.
Milewski RK, Szeto WY, Pochettino A, Moser GW, Moeller P, Bavaria JE. Have hybrid procedures replaced open aortic arch reconstruction in high-risk patients? A comparative study of elective open arch debranching with endovascular stent graft placement and conventional elective open total and distal aortic arch reconstruction. J Thorac Cardiovasc Surg. 2010;140:590–7.
Clough RE, Lotfi S, Powell J, Lee A, Taylor PR. Hybrid aortic arch repair. Ann Cardiothorac Surg. 2013;2:300–2.
Bavaria J, Vallabhajosyula P, Moeller P, Szeto W, Desai N, Pochettino A. Hybrid approaches in the treatment of aortic arch aneurysms: postoperative and midterm outcomes. J Thorac Cardiovasc Surg. 2013;145:S85–90.
Shrestha M, Bachet J, Bavaria J, et al. Current status and recommendations for use of the frozen elephant trunk technique: a position paper by the Vascular Domain of EACTS. Eur J Cardiothorac Surg. 2015;47:759–69.
Cao P, De Rango P, Czerny M, et al. Systematic review of clinical outcomes in hybrid procedures for aortic arch dissections and other arch diseases. J Thorac Cardiovasc Surg. 2012;144:1286–300, 1300.e1–2.
Preventza O, Liao JL, Olive JK, et al. Neurologic complications after the frozen elephant trunk procedure: a meta-analysis of more than 3000 patients. J Thorac Cardiovasc Surg. 2020;160:20–33.e4.
Buczkowski P, Puslecki M, Stefaniak S, et al. Off pump hybrid extra-anatomic techniques for aortic arch repair-own experience. J Thorac Dis. 2019;11:2305–14.
Funding
None.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Informed consent
Taken.
Ethics statement
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000.
Conflict of interest
The authors have no competing interests.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
The case has taken place at Evangelismos General Hospital, Athens, Greece
Rights and permissions
About this article
Cite this article
Schizas, N.C., Dedeilia, A.P., Samiotis, I. et al. Treatment of aortic arch rupture grade III with hybrid arch replacement: the key role of perfusion preservation. Indian J Thorac Cardiovasc Surg 37, 584–587 (2021). https://doi.org/10.1007/s12055-021-01168-3
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12055-021-01168-3