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Complications after aortic arch hybrid repair
Philipp Geisbüsch1, Drosos Kotelis, Matthias Müller-Eschner
1Department of Vascular and Endovascular Surgery, Ruprecht-Karls University Heidelberg, Heidelberg, Germany. Philipp.Geisbuesch@med.uni-heidelberg.de
Journal of Vascular Surgery
|January 11, 2011
Summary
Hybrid aortic arch repair (HAR) in high-risk patients has significant complications and mortality. Careful patient selection and performance in high-volume centers are crucial for better outcomes.
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Thoracic Surgery
Background:
- Hybrid aortic arch repair (HAR) combines endovascular and open surgical techniques.
- It is often considered for high-risk patients unsuitable for conventional repair.
Purpose of the Study:
- To analyze early and midterm complications following hybrid aortic arch repair (HAR).
- To identify predictors of mortality and reintervention after HAR.
Main Methods:
- Retrospective analysis of 47 patients undergoing HAR between 1997 and 2009.
- Included analysis of debranching techniques and emergency procedure rates.
Main Results:
- In-hospital mortality was 19%, with higher rates after complete debranching.
- Complications included cardiodcirculatory (15%), pulmonary (26%), and renal issues (11%).
- Stroke rate was 6.3%, paraplegia 6%, and reintervention rate 27.6%.
Conclusions:
- HAR is associated with significant morbidity, mortality, and reintervention rates in high-risk patients.
- Judicious patient selection and performance in high-volume centers with surgical cooperation are recommended.
- Indications should be limited to patients unsuitable for conventional repair or in emergency situations.
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