title: An alternative approach to diffuse thoracic aortomegaly: on-pump hybrid total arch repair without circulatory arrest.
abstract: Diffuse thoracic aortomegaly has conventionally been managed with a two-stage elephant trunk procedure, requiring prolonged circulatory arrest, with an inherent risk of major morbidity and mortality. Recently, to improve outcomes, several hybrid arch procedures have been proposed using off-pump techniques. We have adopted an alternative, single-stage hybrid strategy using cardiopulmonary bypass without circulatory arrest to replace the ascending aorta and perform arch debranching and antegrade endovascular stent graft deployment. Unlike off-pump procedures, pathology of the aortic valve, root, and ascending aorta is addressed while avoiding the complications of stent graft placement in the native ascending aorta.
authors.affiliation: Libin Cardiovascular Institute of Alberta, Division of Cardiac Surgery, Department of Diagnostic Imaging, University of Calgary, Calgary, Alberta, Canada.
authors.forename: William D T
authors.initials: WD
authors.lastname: Kent
authors.forename: Jason K
authors.initials: JK
authors.lastname: Wong
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Herget
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Bavaria
authors.forename: Jehangir J
authors.initials: JJ
authors.lastname: Appoo
mesh_terms: D001013:Aorta, Thoracic / Q000002:abnormalities* / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D002315:Cardiopulmonary Bypass / Q000379:methods*; D000075202:Contraindications; D005500:Follow-Up Studies; D006324:Heart Arrest, Induced; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods*; D054079:Vascular Malformations / Q000601:surgery*