Mini open stent grafting with half sternotomy for aortic arch aneurysm

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Vascular Surgery

Background:

• Open stent grafting is an alternative to graft replacement and thoracic endovascular aortic repair for aortic arch aneurysms.
• A novel approach, mini-open stent grafting (mini-OSG), utilizing a half sternotomy, was developed to reduce patient recovery time.
• This report details seven cases of mini-OSG for aortic aneurysm and dissection.

Purpose of the Study:

• To evaluate the feasibility and early outcomes of mini-open stent grafting (mini-OSG) for aortic arch pathologies.
• To assess the safety and efficacy of a less invasive approach compared to traditional methods.

Main Methods:

• Seven patients underwent mini-OSG for aortic arch aneurysm or dissection.
• Procedures involved conventional cardiopulmonary bypass and stent graft insertion via aortotomy during circulatory arrest.
• Data collected included operation time, blood loss, postoperative ventilation duration, and follow-up outcomes.

Main Results:

• The mean patient age was 66 years.
• No mortality was observed in the series.
• Mean operation time was 387 minutes, with a mean blood loss of 587 ml. Patients were weaned from ventilation at 7.1 hours postoperatively.
• Follow-up (2-20 months) revealed no pseudoaneurysm or endoleakage.

Conclusions:

• Mini-open stent grafting (mini-OSG) appears to be a less invasive option for treating aortic arch aneurysms and dissections.
• The technique demonstrated promising early safety and efficacy.
• Further extensive studies and rigorous follow-up are recommended to confirm these findings.