Multimodality imaging assessment for Thoraflex hybrid total arch replacement.

Area of Science:

• Cardiovascular Surgery
• Medical Devices
• Diagnostic Imaging

Background:

• Conventional treatment for extensive aortic pathologies requires staged surgical interventions.
• The Thoraflex device offers a potential solution for single-stage repair of ascending, arch, and descending thoracic aorta issues.

Purpose of the Study:

• To describe a multimodality hybrid approach for total aortic arch replacement using the Thoraflex device.
• To evaluate the efficacy of intraoperative imaging and assessment in ensuring successful repair.

Main Methods:

• Utilized a Thoraflex device for total arch replacement in a hybrid operating room.
• Employed 3-dimensional transesophageal echocardiography, Endo-EYE endoscopy, and on-table aortography for intraoperative assessment.
• Focused on verifying distal tear sealing, endograft deployment, and false lumen hemodynamics.

Main Results:

• The multimodality approach enabled assessment of distal aortic tear sealing and endograft patency.
• On-table functional assessment of false lumen hemodynamics was achieved.
• Early results of this hybrid approach are promising.

Conclusions:

• A hybrid, multimodality approach using the Thoraflex device facilitates single-stage treatment of complex aortic arch pathologies.
• Intraoperative imaging and functional assessment are crucial for ensuring the success of endovascular aortic repair.
• This technique shows potential for improved outcomes in treating extensive aortic diseases.