Aneurysms and dissections of aortic arch and thoracoabdominal aorta: Single centre experience with hybrid treatment

"Aim. In the last decade, several "off-label" indications for thoracic endovascular aortic repair (TEVAR), have modified the way that most surgeons approach thoracic aortic disease. Among these is the so-called hybrid (open and endo) repair. Methods. From 1998 through 2012, 231 aortic arch repairs and 467 thoraco-abdominal aortic repairs were performed at our centre. From 2001 we categorized, according to Ishimaru's classification, a total of 167 aortic arch aneurysms (66.5% atherosclerotic and 33.5% dissecting) as zone 0 (48), zone 1 (37), or zone 2 (82) and, according to Crawford's classification, a total of 52 thoraco-abdominal aortic aneurysms (57% atherosclerotic and 43% dissecting) as type I (20), type II (six), type III (10), type IV (six) or aneurysms of the visceral aortic patch (10) who underwent hybrid repair by means of aortic arch \/ visceral aortic debranching followed by TEVAR. The most of these patients were selected for hybrid repair having increased surgical risk defined as age > 75 yrs, and\/or EF < 20%, and\/or FEV1