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Updated: Aug 17, 2026
Novel and Innovative Hybrid Technique for Type A Aortic Dissection
Published on: March 28, 2025
Hybrid endograft for one-step treatment of multisegment disease of the thoracic aorta
Ajay Chavan1, Matthias Karck, Christian Hagl
1Department of Radiology, Hannover Medical School, Hannover, Germany. chavan.ajay@klinikum-oldenburg.de
Insights
A novel hybrid endograft allows single-stage repair of complex thoracic aortic diseases, eliminating the need for multiple surgeries. This innovative approach treats conditions affecting both the proximal and descending aorta effectively.
Area of Science:
- Cardiovascular Surgery
- Medical Devices
- Thoracic Aorta Research
Background:
- Treating multisegment thoracic aortic pathology typically requires a two-step surgical approach.
- Existing methods present challenges for simultaneous repair of proximal and descending aortic conditions.
Purpose of the Study:
- To introduce and evaluate a hybrid endograft for single-stage surgical treatment of multisegment thoracic aortic diseases.
- To assess the safety and efficacy of the Chavan-Haverich endograft in a prospective patient cohort.
Main Methods:
- Prospective implantation of the Chavan-Haverich endograft in 22 patients with diverse thoracic aortic conditions.
- The endograft, a Dacron prosthesis with integrated stents, was deployed during circulatory arrest via median sternotomy.
- Simultaneous procedures like aortic valve replacement or bypass grafting were performed when necessary.
Main Results:
- Successful endograft implantation in 21 out of 22 patients.
- Observed complications included transient and lasting neurologic deficits, vocal cord paralysis, and one mortality.
- Positive outcomes included aneurysm thrombosis in atherosclerotic cases and false-lumen thrombosis in dissections, with no progressive aortic widening.
Conclusions:
- The Chavan-Haverich hybrid endograft facilitates a one-step treatment for complex thoracic aortic pathologies.
- This single-operation approach offers an alternative to multi-stage interventions for extensive aortic disease.
Purpose:
At present, a two-step surgical approach is necessary to treat patients with coexistent pathologic conditions involving the proximal and descending thoracic aorta. A hybrid endograft is described here that enables such treatment during a single operation.
Materials And Methods:
The Chavan-Haverich endograft consists of a Dacron vascular prosthesis with stainless-steel stents affixed at its distal end. After approval by the institutional review board, the endograft was prospectively implanted in 22 patients with multisegment thoracic aortic disease (13 men, nine women; median age, 64 years). Eleven patients had type A dissections (one acute, 10 chronic), four had a chronic type B dissection, and seven had atherosclerotic aneurysms of the ascending aorta or aortic arch as well as of the descending aorta. Of these patients, 11 additionally required aortic valve replacement or coronary artery bypass grafting. Via median sternotomy, the aortic arch was opened in circulatory arrest. After antegrade deployment of the stent-containing portion in the descending aorta, the proximal non-stent-containing endograft was used to reconstruct the aortic arch. Median follow-up was 14 months.
Results:
Endograft implantation was successful in all but one patient. Complications included neurologic deficits that were transient in one case and lasting in two, two cases of vocal cord paralysis, and one death. In all patients with atherosclerotic aneurysms who received the endograft (six of seven), aneurysm thrombosis was noted at follow-up. In aortic dissections, partial or complete false-lumen thrombosis to the level of the stents occurred in all patients. None of the patients showed a progressive widening of the descending aorta.
Conclusion:
The Chavan-Haverich endograft enables one-step treatment of multisegment pathologic conditions affecting the thoracic aorta that otherwise would require two or more operations.
