title: Multimodality imaging assessment for Thoraflex hybrid total arch replacement.
abstract: Conventionally, aortic pathologies involving the ascending, arch, and descending thoracic aorta are treated by a staged operation. The Thoraflex device is a composite 4-branched graft with a distal endovascular stent, which allows one-stage treatment of these pathologies. We describe our multimodality hybrid approach for total arch replacement using the Thoraflex device with the adjunct of intraoperative 3-dimensional transesophageal echocardiography, Endo-EYE endoscopy, and on-table aortography in a hybrid operating room. These multimodality assessments can ascertain adequate sealing of a distal aortic tear and proper opening of the endograft, and provide on-table functional assessment of false lumen hemodynamics. Early results are promising.
authors.affiliation: Division of Cardiothoracic Surgery, Department of Surgery, Prince of Wales Hospital, Hong Kong.
authors.forename: Randolph Hl
authors.initials: RH
authors.lastname: Wong
authors.affiliation: Division of Cardiothoracic Surgery, Department of Surgery, Prince of Wales Hospital, Hong Kong.
authors.forename: Jacky Yk
authors.initials: JY
authors.lastname: Ho
authors.affiliation: Division of Cardiothoracic Surgery, Department of Surgery, Prince of Wales Hospital, Hong Kong mjunderwood@surgery.cuhk.edu.hk.
authors.forename: Malcolm J
authors.initials: MJ
authors.lastname: Underwood
mesh_terms: D000368:Aged; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging* / Q000601:surgery*; D001027:Aortography; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation / Q000379:methods*; D018618:Echocardiography, Doppler, Color; D019560:Echocardiography, Three-Dimensional; D017548:Echocardiography, Transesophageal; D057510:Endovascular Procedures / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D015607:Stents; D016896:Treatment Outcome
keywords: Aneurysm; aortic aneurysm; blood vessel prosthesis implantation; dissecting; endovascular procedures; multimodal imaging; thoracic