Open aortic arch surgery: the gold standard method
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Aortic arch pathologies are complex and treating them requires close team collaboration and technical skills to provide safe outcomes with low morbidity and mortality rates. Such challenges are facing both aortic and vascular surgeons. Open aortic arch repair has been the standard method of practice in all cases of aortic arch pathologies for the last four decades since the very first successful published case series by Griepp et al. during 1975. However, since then, repair of multi-segmented thoracic aortic pathologies has been explored through endovascular techniques; this is with or without open repair as a one-stage procedure especially in high-risk and elderly patients. Although the role of endovascular techniques in thoracoabdominal aorta is well established, its utilization as solo technique in aortic arch pathologies remains debatable. In this review, we highlight current evidences behind using open, endovascular, and hybrid procedures in aortic arch surgery.
KeywordsAortic surgery Aortic arch Hybrid aortic surgery
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Human and animal rights
This article does not contain any studies with human participants or animals performed by any of the authors.
Conflict of interest
The authors declare that they have no conflicts of interest.
- 7.Harky A, Fok M, Bashir M, Estrera AL. Brain protection in aortic arch aneurysm: antegrade or retrograde? Gen Thorac Cardiovascr Surg. 2018. https://doi.org/10.1007/s11748-017-0879-5.
- 10.Harky A, Bashir M, Mariscalco G. Aortic arch aneurysm surgery: what is the gold standard temperature in the absence of randomized data? Gen Thorac Cardiovasc Surg. 2017. https://doi.org/10.1007/s11748-017-0867-9.
- 15.Bashir M, Harky A, Bilal H. Is there a prospect for hybrid aortic arch surgery ? Gen Thorac Cardiovasc Surg. 2018. https://doi.org/10.1007/s11748-018-0940-z.
- 17.Tabayashi K, Ohmi M, Iguchi A, et al. Surgical treatment of the distal aortic arch aneurysm using selective cerebral perfusion. Keio Univ Int Symp Life Sci Med. 2001;7:134–41.Google Scholar
- 18.Englum BR, Andersen ND, Husain AM, Mathew JP, Hughes GC. Degree of hypothermia in aortic arch surgery - optimal temperature for cerebral and spinal protection: deep hypothermia remains the gold standard in the absence of randomized data. Ann Cardiothorac Surg. 2013;2:184–93.PubMedPubMedCentralGoogle Scholar
- 19.Harky A, Bashir M, Mariscalco G. Aortic arch aneurysm surgery: what is the gold standard temperature in the absence of randomized data? Gen Thorac Cardiovasc Surg. 2017. https://doi.org/10.1007/s11748-017-0867-9.
- 22.Okita Y, Miyata H, Motomura N, Takamoto S, Japan Cardiovascular Surgery Database Organization. A study of brain protection during total arch replacement comparing antegrade cerebral perfusion versus hypothermic circulatory arrest, with or without retrograde cerebral perfusion: Analysis based on the Japan Adult Cardiovascular Surgery Database. J Thorac Cardiovasc Surg. 2015;149:S65–73.CrossRefGoogle Scholar
- 30.Ueda Y, Miki S, Kusuhara K, Okita Y, Tahata T, Yamanaka K. Surgical treatment of aneurysm or dissection involving the ascending aorta and aortic arch, utilizing circulatory arrest and retrograde cerebral perfusion. J Cardiovasc Surg (Torino). 1990;31:553–8.Google Scholar
- 32.Lee TY, Safi HJ, Estrera AL. Cerebral perfusion in aortic arch surgery: antegrade, retrograde, or both? Texas Hear Inst J. 2011;38:674–7.Google Scholar
- 34.Usui A, Miyata H, Ueda Y, Motomura N, Takamoto S. Risk-adjusted and case-matched comparative study between antegrade and retrograde cerebral perfusion during aortic arch surgery: based on the Japan Adult Cardiovascular Surgery Database. Gen Thorac Cardiovasc Surg. 2012;60:132–9.CrossRefGoogle Scholar
- 35.Okita Y, Minatoya K, Tagusari O, Ando M, Nagatsuka K, Kitamura S. Prospective comparative study of brain protection in total aortic arch replacement: deep hypothermic circulatory arrest with retrograde cerebral perfusion or selective antegrade cerebral perfusion. Ann Thorac Surg. 2001;72:72–9.CrossRefGoogle Scholar
- 39.Hu Z, Wang Z, Ren Z, et al. Similar cerebral protective effectiveness of antegrade and retrograde cerebral perfusion combined with deep hypothermia circulatory arrest in aortic arch surgery: A meta-analysis and systematic review of 5060 patients. J Thorac Cardiovasc Surg. 2014;148:544–60.CrossRefGoogle Scholar