Simplifying aortic arch surgery: open zone 2 arch with single branched thoracic endovascular aortic repair completion.

Abstract

Distal aortic complications from acute DeBakey I dissection repair are an important source of late morbidity and mortality. We present an early experience of using a novel single-branched thoracic aortic endograft in conjunction with open techniques to treat acute DeBakey I aortic dissection. The patients in this series include five hyperacute dissections managed with a combined zone 2 partial arch replacement and placement of a zone 2 single subclavian branch endograft. There were no perioperative mortalities, strokes, or spinal cord ischemia in any patients at either stage of the procedure. At follow-up imaging, no patients had anterograde flow into the false lumen. All patients experienced false lumen thrombosis in the stented portion of the aorta. This combination of open repair techniques and the use of a novel branched endograft resulted in excellent early outcomes in this pioneer series. Further investigation of these techniques in a prospective fashion is warranted.