Single-stage hybrid total arch replacement for extended arch aneurysms

Outcomes of single-stage total arch replacement via clamshell incision

BACKGROUND Treatment of complex aortic pathologies involving the transverse arch with extensive involvement of the descending aorta remains a surgical challenge. Since clamshell incision provides superior exposure of the entire thoracic aorta, we evaluated the use of this technique for single-stage total arch replacement by arch vessel reconstruction. METHODS The arch-first technique combined...

Fast – Track Total Arch Replacement

Single Stage Aortic Arch Replacement without Circulatory Arrest.

A 78-year-old man with a Kommerell diverticulum and aberrant right subclavian artery was admitted for thoracic pain and severe malnutrition due to esophageal compression. We performed an atypical surgical procedure including extra-anatomical debranching and direct aortic repair, trying to avoid deep hypothermic circulatory arrest and shorten the cardiopulmonary bypass time.

Total endograft replacement of aortic arch.

Total endovascular replacement of the aortic arch is a complex procedure that is often favoured when the pathology anatomy precludes a standard median sternotomy. Here we present the case of endograft repair in a 79 year old male with 6.5 cm arch aneurysm and 5.4 cm descending thoracoabdominal aneurysm. Following bilateral carotid-subclavian bypasses, a long 7 Fr sheath was advanced into the de...

Total arch replacement using antegrade cerebral perfusion for distal aortic arch aneurysm.

Total aortic arch replacement remains a complex surgical procedure, best practiced in high-volume aortic centers. The following report details the surgical procedure for total arch replacement with selective antegrade cerebral perfusion (SACP) for distal arch aneurysm. Following moderate hypothermic circulatory arrest and SACP, the distal arch, and then the proximal arch, is reconstructed, foll...