Results of hybrid surgery for treatment of thoracic aortic aneurysm

Abstract

Introduction: Treatment of aortic aneurysms (AUS) is always a challenge for cardiologists. The incidence of aortic aneurysms is 5-10/100.000 people/ year, of which arch aneurysms account for 10% and have a risk of rupture and dissection leading to a high mortality rate similar to other aortic aneurysms. Aortic arch surgery is becoming more and more popular, and with the development of interventional techniques, the combination of transposition surgery of the arch branches and endovascular intervention called hybrid surgery (Hybrid Arch Repair- HAR) in the treatment of arch aneurysms is increasing, helping to increase treatment effectiveness without increasing complications for patients.

Method: Cross-sectional study, 14 patients with thoracic aortic aneurysm underwent hybrid surgery at the Cardiovascular Center, E Hospital from January 2020 to December 2023.

Result: In 14 patients, the average age was 66.2±8.4, with 92.9% of men. There were 5 cases of left common carotid-left subclavian artery transposition surgery to the right common carotid artery, 7 cases of total transposition surgery: brachiocephalic trunk (TABC), left common carotid-left subclavian artery to the ascending aorta, 2 cases of ascending segment replacement and transposition of all branches of the aorta. The average surgical time was 4.1±1.3 hours, the average mechanical ventilation time was 46.3±76.7 hours. The postoperative hospital stay was 15.1±7.1 days. The technical success rate was 92.9%. There were 2 deaths after surgery due to severe Covid pneumonia and sepsis.

Conclusion: Hybrid surgery for thoracic aortic aneurysm initially achieved good results, without affecting patients with low complication and mortality rates. However, a larger number of patients and long-term follow-up are needed to accurately assess the effectiveness.