Pan-aortic hybrid treatment of mega-aorta syndrome

J Vasc Surg. 2011 May;53(5):1398-401. doi: 10.1016/j.jvs.2010.11.115. Epub 2011 Feb 5.

Abstract

Hybrid procedures combining traditional open and newer endovascular techniques are increasingly used to treat complex aortic disease. We present a novel approach for total aortic replacement, including hybrid repair of the arch and thoracoabdominal aorta, in a patient with "mega-aorta syndrome." A two-stage approach using a valve-sparing aortic root replacement, total arch replacement (stage I elephant trunk), and left carotid-axillary bypass was used to treat the root, proximal-mid arch, and left subclavian aneurysmal pathology. This was followed by a hybrid distal arch/Extent II thoracoabdominal aneurysm repair 3 months later. After 15 months follow-up, the patient remains asymptomatic with an intact repair, no endoleak, and normal ventricular and aortic valve function. This case demonstrates a novel "pan-aortic" hybrid approach for repair of extensive thoracic aortic disease.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aneurysm / diagnostic imaging
  • Aneurysm / surgery*
  • Aorta, Thoracic / diagnostic imaging
  • Aorta, Thoracic / surgery*
  • Aortic Aneurysm, Thoracic / diagnostic imaging
  • Aortic Aneurysm, Thoracic / surgery*
  • Aortography / methods
  • Blood Vessel Prosthesis
  • Blood Vessel Prosthesis Implantation* / instrumentation
  • Brachiocephalic Trunk / surgery
  • Carotid Artery, Common / surgery
  • Endovascular Procedures*
  • Humans
  • Ligation
  • Male
  • Prosthesis Design
  • Stents
  • Subclavian Artery / diagnostic imaging
  • Subclavian Artery / surgery*
  • Syndrome
  • Tomography, X-Ray Computed
  • Treatment Outcome