Minimally invasive therapy for new-onset or residual aortic arch pathology after ascending aortic replacement
10.3760/cma.j.cn112434-20250103-00002
- VernacularTitle:微创技术在升主动脉置换术后主动脉弓部新发/残余病变中的应用经验
- Author:
Yi XIE
1
;
Peng YANG
;
Hongwei ZHANG
;
Chen LU
;
Yu LIU
;
Yu ZHANG
;
Qianlei LANG
;
Wenfan LI
;
Zhenyuan XU
;
Chenhao WANG
;
Zhenghua XIAO
;
Jia HU
Author Information
1. 四川大学华西医院心脏大血管外科，成都 610041
- Publication Type:Journal Article
- Keywords:
Aortic arch pathology;
Ascending aortic replacement;
Hybrid surgery;
Physician-modified endograft;
Novel unibody endograft;
Thoracic endovascular aortic re
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2025;41(6):366-371
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the outcomes of minimally invasive therapy for aortic arch pathology after ascending aortic replacement.Methods:A retrospective analysis was conducted at the Department of Cardiovascular Surgery, West China Hospital of Sichuan University from 2016 to 2024. After multidisciplinary discussion, these included patients were evaluated to be at high risk for traditional open surgery. Various minimally invasive repair techniques were employed, including Ⅳb hybrid technique, physician-modified endograft and novel unibody endograft. The study outcomes were technical success, in-hospital and follow-up mortality, stroke, endoleak, and the patency of the supra-aortic vessels.Results:A total of 40 patients(32 males and 8 females) with a median age of 60 years old were included in this study. The technique success rate was 100%, with no deaths or strokes reported. The patency of the supra-aortic vessels was 100%. 10 patients underwent Type Ⅳb hybrid surgery without any endoleaks occurring. Among the 22 patients who received physician-modified endograft, endoleaks were observed in 2 cases. One of these type Ⅰc endoleaks persisted and underwent reintervention. One patient underwent femoral artery replacement due to vascular injury. For the 8 patients who received novel unibody endograft, one case required reintervention due to persistent type Ⅰc endoleaks.Conclusion:With the development of different endovascular techniques and novel branched endograft, patients with aortic arch pathology who are at high risk for redo open surgery can achieve favorable outcomes with various minimal invasive techniques. However, long-term and large-sample follow-up studies are needed for further evaluation.
