IYSC01. Early and Long-term Outcomes of Hybrid Technique for Thoracic Aortic Pathologies Involving Aortic Arch

Abstract

We report our single-center experience with hybrid technique for aortic arch diseases and the early and long-term outcomes in these patients. From January 2006 to August 2018, 379 patients (mean age 54 ± 11 years; 347 males) with aortic arch diseases underwent hybrid repair composed of supra-aortic debranch and thoracic endovascular aortic repair. Computed tomography scanning was performed at 1, 3, 6 months and annually thereafter. The hybrid operation was technically successful in 98.7% of the patients (374/379). Perioperative complications included death in 6.1% (23/379), stroke in 5.0% (19/379), paraplegia in 2.1% (8/379), aortic rupture in 2.6% (10/379), and reintervention in 0.8% (3/379) patients. After a mean follow-up of 46 months (range, 0-156 months), the overall mortality was 13.5% (51/379), with Kaplan-Meier survival estimate of 91.2 ± 1.5%, 88.3 ± 1.7%, 85.9 ± 2.0% and 81.5 ± 2.7% at 1, 3, 5, and 10 years, respectively (Fig 1). During the follow-up, the incidences of complication were as follows: endoleaks occurred in 17.6% of patients (62/353), aortic rupture in 5.1% (18/353), stokes in 2.3% (8/353), reintervention in 4.2% (15/353), and vascular graft infection in 1.4% (5/353). The estimated freedom from extra-anatomic bypass occlusion at 1, 5, and 10 years was 98.8 ± 0.6%, 96.4 ± 1.1% and 90.4 ± 3.4%, respectively (Fig 2). the hybrid technique is an acceptable option for aortic arch diseases. The long-term outcomes demonstrate high rates of survival and graft patency.Fig 2Cumulative freedom from extra-anatomic bypass. SD, standard deviation.View Large Image Figure ViewerDownload Hi-res image Download (PPT)