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Type 1 hybrid arch repair - a simplified strategy for complex aortic arch pathologies
Payel Sarkar1, Subhendhu Adhikari1, Hari Govind Varma1
1Department of Cardiac Surgery, Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata, India
Multimedia Manual of Cardiothoracic Surgery : MMCTS
|January 7, 2026
Summary
Hybrid arch repair offers a successful alternative for treating large aortic aneurysms. This technique combines open debranching with thoracic endovascular aortic repair, reducing risks for complex patients.
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Endovascular Therapy
Background:
- Aortic aneurysms, particularly large distal arch and proximal descending thoracic types, pose significant surgical challenges.
- Conventional open repair necessitates cardiopulmonary bypass and circulatory arrest, increasing peri-operative risks in elderly or comorbid patients.
Purpose of the Study:
- To present a case of successful management of a large distal arch and proximal descending thoracic aortic saccular aneurysm.
- To highlight the efficacy of type I hybrid arch repair as an alternative to conventional open surgery.
Main Methods:
- The study employed a type I hybrid arch repair, involving off-pump debranching of supra-aortic vessels.
- Thoracic endovascular aortic repair (TEVAR) was utilized to exclude the aneurysmal segment.
Main Results:
- The hybrid arch repair successfully managed the large saccular aneurysm.
- This approach avoided circulatory arrest, reduced operative time, and minimized complications compared to open repair.
Conclusions:
- Type I hybrid arch repair is a viable and effective option for complex aortic aneurysms in the distal arch and proximal descending aorta.
- This technique offers a less invasive approach with reduced risks, suitable for high-risk patient populations.
