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294
Long-term outcomes for hybrid aortic arch repair
Andrew M Vekstein1, Christopher W Jensen1, E Hope Weissler2
1Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Duke University Medical Center, Durham, NC.
Journal of Vascular Surgery
|November 26, 2023
Summary
Hybrid arch repair (HAR) demonstrates excellent long-term survival and low reintervention rates for aortic arch pathology. Surgeon and institutional experience significantly improve outcomes, highlighting HAR
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Interventional Cardiology
Background:
- Hybrid arch repair (HAR) has become a standard treatment for aortic arch pathology.
- Long-term outcomes data for HAR are still emerging.
- An expanded classification scheme is used to analyze outcomes.
Purpose of the Study:
- To evaluate the long-term outcomes of hybrid arch repair (HAR).
- To assess overall and aortic-specific survival rates.
- To determine freedom from reintervention after HAR.
Main Methods:
- 163 patients underwent HAR between 2005 and 2022.
- Operative approaches included zone 0/1, type I, and type II/III HAR.
- 30-day and long-term outcomes were assessed, including survival and reintervention rates.
Main Results:
- The 5-year overall survival was 59%, and 5-year aortic-specific survival was 86%.
- Freedom from major reintervention was 92% at 5 years.
- Institutional experience significantly reduced 30-day mortality (14% to 1%) and stroke rates (6% to 3%).
Conclusions:
- HAR is associated with excellent operative outcomes and sustained protection from aortic events.
- High long-term aorta-specific survival and freedom from reintervention support HAR.
- Surgeon and institutional experience are critical for achieving superior HAR outcomes.
