Combined open and endovascular repair for aortic arch pathology.
OBJECTIVE
We describe our experience with combined open and endovascular repair in patients who have aortic arch pathology.


METHODS
This study is a retrospective analysis of 7 patients who underwent combined open and endovascular repair for aortic arch pathology. Medical records and radiographic information were reviewed.


RESULTS
A total of 7 consecutive patients (5 men, 71.4%) underwent thoracic stent graft implantation. The mean age was 59.9±16.7 years. The indication for endovascular repair was aneurysmal degeneration in 5 patients, and rupture or impending rupture in 2 patients. In all 7 cases, supra-aortic transposition of the great vessels was performed successfully. Stent graft implantation was achieved in all cases. Surgical exposure of the access vessel was necessary in 2 patients. A total of 9 stent grafts were implanted (3 stent grafts in one patient). The Seal thoracic and the Valiant endovascular stent graft were implanted in 6 patients and 1 patient, respectively. There were no post-procedure deaths or neurologic complications. In 2 patients, bleeding and injury of access vessel were noted after the procedure. Postoperative endoleak was noted in 1 patient. One patient died at 10 months after the procedure due to a newly developed ascending aortic dissection. No patients required secondary intervention during the follow-up period. The aortic diameter decreased in 4 patients. In 3 patients, including 1 patient with endoleak, there was no change in aortic diameter.


CONCLUSIONS
Our experience suggests that combined open and endovascular repair for aortic arch pathology is safe and effective, with few complications.
Kang
Woong Chol
WC
Department of Cardiology, Gil Medical Center, Gachon University of Medicine and Science, Incheon, Korea.
Shin
Eak Kyun
EK
Ahn
Tae Hoon
TH
Lee
Kyung Hoon
KH
Moon
Chan Il
CI
Han
Seung Hwan
SH
Park
Chul-Hyun
CH
Park
Kook-Yang
KY
Kang
Jin Mo
JM
Kim
Jung Ho
JH