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Updated: Sep 21, 2025
06:26
Novel and Innovative Hybrid Technique for Type A Aortic Dissection
Published on: March 28, 2025
504
[Aortic arch debranching in hybrid thoracic aortic replacement]
A B Stepanenko1, E R Charchyan1, A P Gens1
1Petrovsky National Research Centre of Surgery, Moscow, Russia.
Khirurgiia
|June 3, 2022
Summary
Hybrid thoracic aortic repair with debranching offers insights into outcomes. While generally safe, total debranching carries a higher thrombosis risk, suggesting tailored approaches for complex aortic arch conditions.
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Thoracic Surgery
Background:
- Hybrid thoracic aortic repair involves debranching of supra-aortic vessels.
- This technique is utilized for various complex aortic conditions including dissections and aneurysms.
Purpose of the Study:
- To analyze the outcomes of aortic arch debranching in hybrid thoracic aortic replacement.
- To evaluate the risks and benefits associated with different debranching techniques.
Main Methods:
- A retrospective analysis of 107 patients undergoing hybrid thoracic aortic repair with debranching between 2015 and 2021.
- Patients underwent total, subtotal debranching, or subclavian-carotid anastomosis/bypass.
Main Results:
- A single mortality (0.9%) occurred due to thoracic aorta rupture.
- Subtotal debranching showed a moderate decrease in left vertebral artery blood flow without significant hemodynamic impact.
- Total and subtotal debranching presented a higher risk of potentially fatal branch thrombosis.
Conclusions:
- While hybrid repair with debranching is effective, careful consideration of thrombosis risk is necessary, especially with total debranching.
- Open reconstruction or fenestrated stent repair may be preferred for young patients needing subtotal aortic arch debranching.
- For high-risk patients, the Bavaria type II hybrid procedure is recommended; physiological approaches like Elephant Trunk and Frozen Elephant Trunk are favored.
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