Abstract
Operating on extended arch aneurysms that contain severe atherosclerotic plaques is difficult. In such cases, the incidence of intraoperative multiple embolization is very high. We applied single-stage hybrid arch repair, which involved ascending aorta replacement and debranching of arch vessels, consecutively with endovascular repair for two patients. This technique was developed to prevent embolization of atherosclerotic plaques during cardiopulmonary bypass, and abrasion of the plaques during thoracic endovascular repair. Both patients recovered without embolic complications.
Highlights
Thoracic endovascular aortic repair (TEVAR) is widely used for extensive arch aneurysm repair, it has some anatomical restrictions
We developed a new method of single-stage hybrid total arch repair
We report our modification of this technique of selective perfusion at the initiation of CPB, in which we used selective cannulation to avoid brain embolism caused by turbulent flow during CPB
Summary
Thoracic endovascular aortic repair (TEVAR) is widely used for extensive arch aneurysm repair, it has some anatomical restrictions. Keywords ► arch aneurysm ► shaggy aorta ► hybrid operation Operating on extended arch aneurysms that contain severe atherosclerotic plaques is difficult.
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