Abstract
Objectives: To analyze early and mid-term results after hybrid aortic arch repair (HAR). Methods: Between December 2008 and May 2012, 56 patients were admitted to our hospital for intent-to-treat of aortic arch pathological conditions. There were 44 men and 12 women, with a mean age of 75 ± 9 years. Complete debranching was performed in 20 patients, partial debranching in 8 patients, and isolated left subclavian artery revascularization in 28 patients. Debranching and thoracic endovascular aortic repair (TEVAR) was performed in a staged fashion in 10 patients. HAR could not be completed in 1 patient because he died of acute myocardial infarction prior to staged TEVAR. The proximal landing zone was Z0 in 13 patients, Z1 in14 patients, and Z2 in 28 patients. Japan score was 15 ± 15%. Results: The 30-day mortality was 5% (3/56). Respiratory failure developed in 8 patients, stroke in 2 patients, spinal cord ischemia in 2 patients, and aortic perforation in 1 patient. Eighteen of 55 patients (33%) had endoleaks immediately after HAR. In 46 patients with a follow-up period of more or 6 months, there were 6 endoleaks (13%). Three patients required secondary TEVARs. Actuarial survival estimates at 1 year and 3 years were 83 ± 7% and 77 ± 17%, respectively. Event-free survival curve were 76 ± 7% at 1 year, 72 ± 7% at 2 years, and 50 ± 14% at 3 years. Conclusions: HAR was associated with an excellent morbidity and mortality. However, there was a substantial incidence of complications including endoleaks during follow up. Thus, continued vigilant surveillance of patients is needed.
