Four Different Pathologic Conditions of the Descending Aorta - One Hybrid Solution: Thoracic Endovascular Aortic Repair with Partial Debranching of the Aortic Arch. A Series of 6 Cases.

Abstract

Introduction: We report our experience of six patients admitted to our hospital during January - July 2023 with complex aortic conditions treated with a two-stage hybrid procedure, consisting of surgical debranching - bypass grafting - of the supra-aortic branches off-pump and stent graft placement for Thoracic Endovascular Aortic Repair (TEVAR). Clinical features: The clinical cases we present highlight the use of TEVAR in both chronic (Type B aortic dissections, pseudoaneurysms, and penetrating aortic ulcers) and acute conditions (traumatic aortic transections and ruptured aortic aneurysms). TEVAR is a less invasive surgical approach for management of these critical patients, having as benefits: smaller incisions, avoiding operative risks associated with the classical procedure, shorter recovery time after the intervention and lower hospitalization costs. Conclusions: TEVAR offers an alternative to open surgery, showing better immediate and mid-term results, as well as providing the chance to solve a variety of both chronic and acute cases that would be otherwise classified as too high risk for classic open surgery.