title: Comparison of hybrid endovascular and open surgical repair for proximal aortic arch diseases.
abstract: To compare the outcomes of hybrid endovascular and open surgical repair for proximal aortic arch diseases.
  
  
  
  A total of 55 consecutive patients with aortic arch aneurysm or aortic dissection involving any of zone 0 to 1 (39 male, age 63.4 ± 14.3 years) underwent a hybrid endovascular repair (n=35) or open surgical repair (n=20) from 2006 to 2014 were analyzed retrospectively. Perioperative and late outcomes were compared.
  
  
  
  Baseline characteristics were similar between the two groups, except age and EuroSCORE II, which were higher in the hybrid group. Perioperative mortality or stroke was not significantly different between the two groups, however, tended to be lower in the hybrid repair group than in the open repair group (11.4% vs. 30.0%, p=0.144). Incidences of other morbidities did not differ. During follow-up, over-all survival was similar between the hybrid and the open repair was similar (87.3% vs. 79.7% at 1 year and 83.8% vs. 72.4% at 3 years; p=0.319). However, reintervention-free survival was significantly lower for hybrid repair compared with open repair (83.8% vs. 100% at 1 year and 65.7% vs. 100% at 3 years; p=0.022).
  
  
  
  Hybrid repair of proximal aortic disease showed comparable perioperative and late outcomes compared with open surgical repair despite a higher reintervention rate during follow-up. Therefore, hybrid repair may be considered as an acceptable treatment alternative to surgery especially in patients at high surgical risk.
authors.affiliation: Cardiology, Gil Medical Center, Gachon University, Incheon, Republic of Korea.
authors.forename: Woong Chol
authors.initials: WC
authors.lastname: Kang
authors.affiliation: Cardiology, Severance Cardiovascular Hospital, Yonsei University, Seoul, Republic of Korea. Electronic address: ygko@yuhs.ac.
authors.forename: Young-Guk
authors.initials: YG
authors.lastname: Ko
authors.affiliation: Cardiology, Gil Medical Center, Gachon University, Incheon, Republic of Korea.
authors.forename: Eak Kyun
authors.initials: EK
authors.lastname: Shin
authors.affiliation: Cardiothoracic Surgery, Gil Medical Center, Gachon University, Incheon, Republic of Korea.
authors.forename: Chul-Hyun
authors.initials: CH
authors.lastname: Park
authors.affiliation: Cardiology, Severance Cardiovascular Hospital, Yonsei University, Seoul, Republic of Korea.
authors.forename: Donghoon
authors.initials: D
authors.lastname: Choi
authors.affiliation: Cardiothoracic Surgery, Severance Cardiovascular Hospital, Yonsei University, Seoul, Republic of Korea.
authors.forename: Young Nam
authors.initials: YN
authors.lastname: Youn
authors.affiliation: Radiology, Severance Cardiovascular Hospital, Yonsei University, Seoul, Republic of Korea.
authors.forename: Do Yun
authors.initials: DY
authors.lastname: Lee
mesh_terms: D000368:Aged; D000784:Aortic Dissection / Q000601:surgery*; D001013:Aorta, Thoracic / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012086:Reoperation; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome
keywords: Hybrid endovascular repair; Open surgical repair; Proximal aortic arch diseases