Article Abstract

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

Authors: Nimesh D. Desai, Ashley Hoedt, Grace Wang, Wilson Y. Szeto, Prasthanth Vallabhajosyula, Mary Reinke, Joseph E. Bavaria


Background: 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.
Methods: 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
Results: 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.
Conclusions: 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.


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