title: Minimally Invasive Techniques for Total Aortic Arch Reconstruction.
abstract: The cumulative experience with endovascular aortic repair in the descending thoracic and infrarenal aorta has led to increased interest in endovascular aortic arch reconstruction. Open total arch replacement is a robust operation that can be performed with excellent results. However, it requires cardiopulmonary bypass and circulatory arrest and, therefore, may not be tolerated by all patients. Minimally invasive techniques have been considered as an alternative and include hybrid arch debranching, parallel stent graft deployment in the chimney and snorkel configurations, and complete endovascular branched reconstruction with multi-branched devices. This review discusses the evolving use of endovascular techniques in the management of aortic arch pathology and considers their relevance in an era of safe and durable open aortic arch reconstruction.
authors.affiliation: McGovern Medical School at UTHealth and Memorial Hermann Heart & Vascular Institute, Houston, Texas.
authors.forename: Jason
authors.initials: J
authors.lastname: Faulds
authors.affiliation: McGovern Medical School at UTHealth and Memorial Hermann Heart & Vascular Institute, Houston, Texas.
authors.forename: Harleen K
authors.initials: HK
authors.lastname: Sandhu
authors.affiliation: McGovern Medical School at UTHealth and Memorial Hermann Heart & Vascular Institute, Houston, Texas.
authors.forename: Anthony L
authors.initials: AL
authors.lastname: Estrera
authors.affiliation: McGovern Medical School at UTHealth and Memorial Hermann Heart & Vascular Institute, Houston, Texas.
authors.forename: Hazim J
authors.initials: HJ
authors.lastname: Safi
mesh_terms: D001013:Aorta, Thoracic / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D057510:Endovascular Procedures / Q000379:methods*; D006801:Humans; D019651:Plastic Surgery Procedures / Q000379:methods*
keywords: aortic arch debranching; aortic arch reconstruction; endovascular aortic repair; hybrid endovascular construction