HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Carlo Antona Paolo Vanelli Guido Gelpi Massimo Lemma Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Antona, C. Articles by Inglese, L. Search for Related Content PubMed PubMed Citation Articles by Antona, C. Articles by Inglese, L. Related Collections Great vessels

Ann Thorac Surg 2007;83:1158-1161
© 2007 The Society of Thoracic Surgeons

---

New Technology

Hybrid Technique for Total Arch Repair: Aortic Neck Reshaping for Endovascular-Graft Fixation

^a Department of Cardiovascular Surgery, Azienda Ospedaliera Polo Universitario "Luigi Sacco," Milan, Italy
^b Department of Radiology, Azienda Ospedaliera Polo Universitario "Luigi Sacco," Milan, Italy
^c Laboratorio di Emodinamica e Radiologia Cardiovascolare Istituto Policlinico San Donato, San Donato Milanese, Italy

Accepted for publication July 6, 2006.

^_* Address correspondence to Dr Vanelli, Department of Cardiovascular Surgery, Azienda Ospedaliera Polo Universitario "Luigi Sacco" Via G.B. Grassi, 74 20157 Milan, Italy (Email: p.vanelli{at}hsacco.it).

Purpose: Endovascular repairs of the aortic arch aneurysms require correct placement and an appropriate landing zone for fixation, which are not present in the majority of cases.

Description: We report a less invasive approach in 4 patients presenting an aortic arch aneurysm. We performed a hybrid procedure that is a combination of different techniques: a mid-sternotomy is performed, followed by transposition of the supra-aortic vessels, and neck reshaping with a proximal banding of the aortic arch. In particular, we banded the aorta to facilitate and optimize the endovascular fixation of the graft, reducing postoperative type-1 endoleaks.

Evaluation: The four procedures were uneventful with 1-day intensive care unit recovery. The postoperative and the 1-year follow-up CT scan did not reveal any endoleaks.

Conclusions: Hybrid technique, combined with banding of proximal aortic arch and endovascular grafting are an alternative technique to the conventional open aortic repair. A polyester cloth banding of the ascending and proximal aortic arch allow the neck reshaping of the aorta optimizing the fixation of the endovascular stent graft.

This article has been cited by other articles:

				P. J. Shah, A. L. Estrera, C. C. Miller III, T.-Y. Lee, A. D. Irani, R. Meada, and H. J. Safi Analysis of Ascending and Transverse Aortic Arch Repair in Octogenarians Ann. Thorac. Surg., September 1, 2008; 86(3): 774 - 779. [Abstract] [Full Text] [PDF]

				M. Karck and H. Kamiya Progress of the treatment for extended aortic aneurysms; is the frozen elephant trunk technique the next standard in the treatment of complex aortic disease including the arch? Eur. J. Cardiothorac. Surg., June 1, 2008; 33(6): 1007 - 1013. [Abstract] [Full Text] [PDF]

				M. Marzban Hybrid endovascular procedure for high risk elderly patients Interactive CardioVascular and Thoracic Surgery, June 1, 2008; 7(3): 429 - 429. [Full Text] [PDF]