A hybrid aortic re-arching technique.

Abstract

Hybrid repair of aortic arch aneurysms involves technically challenging de-branching procedures requiring construction of graft anastomoses to the left subclavian and innominate arteries. Exposure of the intrathoracic segment of the aortic arch branches may be difficult, particularly that of the left subclavian artery, frequently requiring a left carotid to subclavian artery bypass before the de-branching procedure.1 We present a simplified method of aortic arch revascularization, termed re-arching, where the bypass grafts are tunneled from the ascending aorta to the axillary arteries bilaterally.