Management of thoracoabdominal aortic aneurysms

Conventional treatment of thoracoabdominal aortic aneurysms (TAAAs) consists of graft replacement with reattachment of the main aortic branches. Over the past 20 years a multimodal approach has gradually evolved to reduce the trauma of surgery by maximizing organ protection, allowing experienced surgical Centers to have better outcomes than previously reported. However, mortality and morbidity associated to TAAA open repair remain significant. Hybrid repair, consisting of open aortic debranching and revascularization followed by endovascular exclusion of the aneurysm, may extend the indications of TAAA repair to high-risk patients that cannot benefit from surgery, however results are still under evaluation. Aim of this paper is to illustrate the management and results of thoracoabdominal aortic aneurysms surgery with open techniques of organ protection and hybrid approach in our Center.