title: Combined open and endovascular repair for aortic arch pathology.
abstract: 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.
authors.affiliation: Department of Cardiology, Gil Medical Center, Gachon University of Medicine and Science, Incheon, Korea.
authors.forename: Woong Chol
authors.initials: WC
authors.lastname: Kang
authors.forename: Eak Kyun
authors.initials: EK
authors.lastname: Shin
authors.forename: Tae Hoon
authors.initials: TH
authors.lastname: Ahn
authors.forename: Kyung Hoon
authors.initials: KH
authors.lastname: Lee
authors.forename: Chan Il
authors.initials: CI
authors.lastname: Moon
authors.forename: Seung Hwan
authors.initials: SH
authors.lastname: Han
authors.forename: Chul-Hyun
authors.initials: CH
authors.lastname: Park
authors.forename: Kook-Yang
authors.initials: KY
authors.lastname: Park
authors.forename: Jin Mo
authors.initials: JM
authors.lastname: Kang
authors.forename: Jung Ho
authors.initials: JH
authors.lastname: Kim