Hybrid Aortic Arch Repair

Abstract

The surgical treatment of thoracic aneurysms or acute or chronic aortic dissections involving the aortic arch is still challenging despite significant advances in strategies and perioperative management. Even today, aortic arch surgery is associated with substantial risks for patients as reflected in the high mortality and morbidity rates. Conventional open repair techniques of the aortic arch are nowadays challenged by the introduction and wide adoption of hybrid endovascular prostheses, with the frozen elephant trunk (FET) procedure being the most important. This modern hybrid aortic arch repair combined with or without debranching of the supra-aortic vessels provides in certain pathologies a complete one-stage repair of the aortic arch and descending aorta. If necessary, the FET technique provides a secure landing zone for a subsequent thoracic endovascular aortic repair (TEVAR) of the remaining descending aorta. This chapter describes the indications and surgical technique of hybrid aortic arch repair and provides a summary of clinical outcomes and common complications.