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Review
. 2018 May;7(3):328-344.
doi: 10.21037/acs.2018.05.05.

Open repair techniques in the aortic arch are still superior

Jean Bachet  1
Affiliations
Review

Open repair techniques in the aortic arch are still superior

Jean Bachet. Ann Cardiothorac Surg. 2018 May.

Abstract

Conventional arch replacement can be carried out in a great majority of patients. Hybrid procedures are often as invasive and technically difficult as conventional ones. Moreover, their immediate results are, in many reported experiences, not better and their long-term results less favourable than the ones observed with conventional methods. So, yes, the open conventional arch replacement is still "the gold standard".

Keywords: Aortic arch; endoluminal stent grafting; hybrid procedures; open repair; supra-aortic vessels debranching.

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Conflict of interest statement

Conflicts of Interest: The author has no conflicts of interest to declare.

Figures

Figure 1
Figure 1
The right axillary artery cannulation.
Figure 2
Figure 2
The innominate artery cannulation.
Figure 3
Figure 3
The traditional distal anastomosis performed in an open manner. (A) The suture can be reinforced by the use of Teflon felt or sealants; (B) the suture is performed with everting U-shaped pledgeted sutures.
Figure 4
Figure 4
The “Elephant Trunk” technique.
Figure 5
Figure 5
Two commercially available hybrid prostheses. (A) The E-vita Jotec prosthesis; (B) the Thoraflex prosthesis.
Figure 6
Figure 6
The “En bloc” re-implantation technique.
Figure 7
Figure 7
The separate re-implantation technique. (A) A commercially available multibranched prosthesis; (B) the sequential “Separate” reimplantation technique according to Kazui; (C) the final result.
Figure 8
Figure 8
Some examples of extra-anatomic bypasses between the supra-aortic vessels.
Figure 9
Figure 9
The hybrid technique with the “Lupiae” prosthesis.
Figure 10
Figure 10
The multiple bypasses and anastomoses in some cases of hybrid procedures.
Video
Video
Open repair techniques in the aortic arch are still superior.
See this image and copyright information in PMC

References

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