Hybrid aortic arch and frozen elephant trunk reconstruction: bridging the gap between conventional and total endovascular arch repair.

Hybrid aortic arch and frozen elephant trunk reconstruction: bridging the gap between conventional and total endovascular arch repair. Expert Rev Cardiovasc Ther. 2018 Jan 18;: Authors: Bozso SJ, White A, Nagendran J, Moon MC, Chu MWA Abstract INTRODUCTION: Novel endovascular techniques hope to offer patients aortic arch repair with reduced morbidity compared to conventional arch surgery; however, current endovascular strategies remain challenged by the proximal seal zone, higher stroke rates, long-term durability and select anatomy. Hybrid arch repair offers patients a less invasive alternative that can treat more distal aorta than conventional arch repair yet still be performed via standard sternotomy. Areas Covered: This review will discuss the current evidence and future development of hybrid aortic arch and frozen elephant trunk reconstruction. Several approaches to hybrid arch repair are summarized, including the off-label use of thoracic endovascular stent-grafts and commercially manufactured hybrid grafts. Technical considerations and clinical outcomes with each approach will be addressed along with advantages and disadvantages. Expert Commentary: Hybrid arch repair will undergo continued refinement as our ability to provide a less-invasive alternative to conventional open arch repair grows. Evolution to allow for improved head vessel branch sizing, improved frozen elephant trunk deployment accuracy, monitoring to prevent par...
Source: Expert Review of Cardiovascular Therapy - Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research