title: [Hybrid repair of the aortic arch. Santa Marta Hospital initial experience].
abstract: OBJECTIVE
  To retrospectively review the hybrid treatment of the aortic arch with supra-aortic debranching and endo- vascular stent-graft repair in a single institution.
  
  
  METHODS
  From 2007 to 2010, all patients submitted to aortic debranching procedures were entered into a prospective database analysis. For the present study, only patients with sealing zones 0 and 1, according to the Ishimaru classification, were included. Procedure-related morbimortality was analysed for the open and endovascular procedures.
  
  
  RESULTS
  During the study period, we electively performed 6 total aortic debranching and 4 partial aortic debranching procedures in 10 patients. According to the etiology the indications were: 6 aortic arch aneurysms, 2 post-dissection aneurysms, 1 false aneurysm and 1 type I endoleak following TEVAR. The proximal sealing zone was Ishimaru zone 0 in six patients and zone 1 in four patients. The TEVAR procedure was delayed in all patients with a completion success of 80% (1 patient died from ruptured aortic aneurysm; 1 patient denied the second procedure and was lost to follow-up). The 30d mortality rate was 10% (patient mentioned above). The main morbidity was: 1 axillar venous thrombosis, 1 case of subclinical myocardial infarction, 1 case of terminal renal insufficiency and 1 case of prolonged ventilation. No permanent cerebral or peripheral neurologic deficit was noted.
  
  
  CONCLUSIONS
  The hybrid repair of the aortic arch is a feasible and reproducible procedure, and our results are similar to the previously published series. Medium and long-term results are necessary to confirm whether the technique can be regarded as a safe alternative to open surgery in high-risk patients.
authors.affiliation: Serviços de Angiologia e Cirurgia Vascular e de Cirurgia Cardio-Torácica do Hospital Santa Marta, CHLC, Portugal.
authors.forename: Hugo
authors.initials: H
authors.lastname: Rodrigues
authors.forename: João Monteiro
authors.initials: JM
authors.lastname: Castro
authors.forename: Hugo
authors.initials: H
authors.lastname: Valentim
authors.forename: Alvaro
authors.initials: A
authors.lastname: Laranjeira
authors.forename: Maria Emília
authors.initials: ME
authors.lastname: Ferreira
authors.forename: João
authors.initials: J
authors.lastname: Albuquerque E Castro
authors.forename: José
authors.initials: J
authors.lastname: Fragata
authors.forename: Luís Mota
authors.initials: LM
authors.lastname: Capitão
mesh_terms: D000368:Aged; D017541:Aneurysm, False / Q000473:pathology / Q000601:surgery; D001013:Aorta, Thoracic / Q000473:pathology / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000473:pathology / Q000601:surgery*; D057867:Endoleak / Q000473:pathology / Q000601:surgery; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome