Open aortic arch surgery: the gold standard method

Area of Science:

• Cardiovascular Surgery
• Vascular Surgery
• Thoracic Surgery

Background:

• Aortic arch pathologies present complex surgical challenges requiring multidisciplinary collaboration.
• Open aortic arch repair has been the standard for over 40 years.
• Endovascular techniques are increasingly explored for thoracic aortic pathologies, particularly in high-risk patients.

Purpose of the Study:

• To review and highlight current evidence for open, endovascular, and hybrid procedures in aortic arch surgery.
• To compare the efficacy and safety of different treatment modalities for aortic arch pathologies.
• To inform surgical decision-making in the management of complex aortic arch conditions.

Main Methods:

• Comprehensive literature review of studies on aortic arch repair techniques.
• Analysis of evidence regarding open, endovascular, and hybrid approaches.
• Evaluation of outcomes, morbidity, and mortality rates associated with each technique.

Main Results:

• Open repair remains a cornerstone but carries significant risks.
• Endovascular techniques show promise, but their role as a solo technique in the aortic arch is still debated.
• Hybrid procedures offer a combined approach, potentially mitigating risks for select patient groups.

Conclusions:

• The optimal treatment strategy for aortic arch pathologies depends on patient-specific factors and disease complexity.
• Further research is needed to establish the definitive role of endovascular and hybrid techniques in aortic arch repair.
• A collaborative, evidence-based approach is crucial for managing aortic arch diseases safely and effectively.