Cannulation and perfusion strategies during hybrid stent-grafting for aortic arch repair

Aim: To evaluate the short-term outcomes of hybrid stent-grafting for aortic rapier in patients admitted at the Federal Center for Cardiovascular Surgery named after S.G. Sukhanov, Perm.

Methods: 34 patients underwent hybrid stent-grafting at the Federal Center for Cardiovascular Surgery named after S.G. Sukhanov in the period from January 2018 to August 2023. The mean age of patients was 56±14 years. Twenty-four (71%) patients were males 24. Three patients (9%) were present with a positive history of stroke. Six patients (18%) suffered from coronary artery disease and nine (26%) patients had diabetes mellitus. All patients were divided into 4 groups depending on the aortic disease: 17 (50%) patients with arch aneurysm and ascending aorta aneurysm and without it were included in Group 1, 10 (29%) patients with DeBakey type III dissection were enrolled in Group 2, 4 (12%) patients with acute DeBakey type I aortic dissection – Group 3 and 3 (9%) patients with hemodynamically corrected type I aortic dissection.

Results: The in-hospital period ranged from 13 to 28 days. In-hospital mortality was 6% (n=2). One patient experienced ischemic stroke in the early postoperative period resolving within the first 24 hours. All patients underwent a control computed tomography, confirming the absence of endoleaks. There were no cases of stent-graft translocation.

Conclusion: Hybrid stent-grafting in patients with ascending aortic arch and descending aorta pathologies allows reconstructing almost the entire thoracic aorta in a single stage. In case the thoracoabdominal segment is involved, it significantly facilitates the second one.

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