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Complex thoracic aortic aneurysm: a combined open and endovascular approach
A M Wolthuis1, S Houthoofd, H Deferm
1Department of Cardiovascular and Thoracic surgery, A.Z. Imelda Bonheiden, Belgium. amwolthuis@hotmail.com
Acta Chirurgica Belgica
|September 28, 2005
Summary
This study presents a two-stage repair for complex thoracic aortic aneurysms, combining open surgery with endovascular stenting. This approach offers an elegant solution for extensive aortic disease, though long-term outcomes require further investigation.
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Aortic Aneurysm Repair
Background:
- Complex thoracic aortic aneurysms present significant surgical challenges.
- Traditional open repair can be associated with high morbidity and mortality.
- The elephant trunk technique is used for extensive aortic arch aneurysms.
Observation:
- A 72-year-old male patient with comorbidities underwent a two-stage repair for a diffuse thoracic aortic aneurysm.
- The first stage involved open repair of the aortic valve, ascending aorta (Bentall procedure), and aortic arch using the elephant trunk technique.
- The second stage utilized endovascular stenting for the descending thoracic aorta.
Findings:
- This combined open and endovascular approach successfully managed a complex, extensive thoracic aortic aneurysm.
- The elephant trunk technique followed by endovascular repair is a viable strategy for "mega aortas."
- Few similar case reports exist, highlighting the novelty of this approach.
Implications:
- This hybrid strategy may offer an alternative for patients with extensive aortic disease unsuitable for purely open or endovascular repair.
- Further research is needed to compare long-term outcomes, including endoleaks and mortality, with traditional methods.
- This approach could expand treatment options for complex aortic aneurysms.