Abstract
Complex pathology of the distal arch and proximal descending thoracic aorta is usually approached by stent endografting or in situ graft replacement. Oftentimes, these options are not feasible due to unfavorable anatomy, multiple previous procedures, active infection, or presence of concomitant cardiac disease. Thoracic aortic extra-anatomic bypass, as part of an open surgical strategy, is a useful and often the only curative option left for the treatment in these patients. Herein, we describe two cases that illustrate the utility of extra-anatomic thoracic aortic bypass for complex aortic disease.
Highlights
Both open in situ grafting and thoracic endovascular aortic repair (TEVAR) procedures are the first choice to treat complex aortic pathology such as aortopulmonary/esophageal fistulas, recurrent coarctation, aneurysms, and some infected vascular grafts
We describe two cases that illustrate the utility of extra-anatomic thoracic aortic bypass for complex aortic disease
We describe two clinical cases of thoracic ascending to descending aortic bypass used to treat unusual recurrent aortic problems that illustrate the usefulness of this strategy in complex aortic pathology
Summary
Both open in situ grafting and thoracic endovascular aortic repair (TEVAR) procedures are the first choice to treat complex aortic pathology such as aortopulmonary/esophageal fistulas, recurrent coarctation, aneurysms, and some infected vascular grafts. Complex pathology of the distal arch and proximal descending thoracic aorta is usually approached by stent endografting or in situ graft replacement. As part of an open surgical strategy, is a useful and often the only curative option left for the treatment in these patients.
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