A staged replacement of the entire aorta from the ascending arch to the hypogastric arteries using a hybrid approach.
Combined open and endovascular hybrid procedures can be used to treat complex aortic pathology. This article reports a five-stage hybrid repair for a complex thoracoabdominal aneurysm with dissection in a 57-year-old man. To our knowledge, this is the first reported case of replacement and exclusion of the entire native human aorta from the root to the iliac bifurcations using a combined open and endovascular approach without neurologic complication. Bilateral hypogastric and femoral circulation was preserved. Aggressive spinal protective measures, including spinal drainage, motor-evoked potentials, and prevention of intraoperative and perioperative hypotension, were used during this staged approach.
Jimenez
Juan Carlos
JC
Division of Vascular Surgery, University of California, Los Angeles, School of Medicine, Los Angeles, California, USA. jcjimene@gmail.com
Moore
Wesley S
WS
D000784:Aortic Dissection / Q000175:diagnosis / Q000601:surgery*; D017546:Angioscopy / Q000379:methods*; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D001027:Aortography; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D013908:Thoracotomy / Q000379:methods*; D014057:Tomography, X-Ray Computed