Arakelyan V.S., Papitashvili V.G., Kidakoev R.Z., Khon V.L., Dzutsev V.R.Hybrid surgery for thoracic aortic pathology: development prospects

Authors: Arakelyan V.S., Papitashvili V.G., Kidakoev R.Z., Khon V.L., Dzutsev V.R.

Company: 1 Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation
2 Republican Clinical Hospital, Vladikavkaz, Alania

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Type:  Original articles


DOI: https://doi.org/10.24022/1997-3187-2023-17-3-367-374

For citation: Arakelyan V.S., Papitashvili V.G., Kidakoev R.Z.-G., Khon V.L., Dzutsev V.R. Hybrid surgery for thoracic aortic pathology: development prospects. Creative Cardiology. 2023; 17 (3): 367–74 (in Russ.). DOI: 10.24022/1997-3187-2023-17-3-367-374

Received / Accepted:  09.09.2023 / 29.09.2023

Keywords: aortic aneurysm hybrid aortic surgery endoprosthetics stent graft debranching

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Abstract

Objective. To present the experience of treating thoracic aortic aneurysms using a hybrid approach and to assess the prospects for its development.

Material and methods. From 2018 to 2022, 53 hybrid interventions were performed on the basis of the Department of arterial Pathology for various reasons of pathology of the arch and descending part of the aorta. During this period, the following hybrid operations were performed: various options for switching the branches of the aortic arch with endoprosthetics (n=44), operations using the frozen elephant trunk technology (n=4), abdominal aortic plastic surgery by the type of unicanalization, followed by the installation of a stent graft in the descending aorta (n=5).

Results. In the early postoperative period, there were no fatal outcomes in the group of patients with switching of the branches of the aortic arch and unichanalization of the abdominal aorta with subsequent endoprosthetics. One fatal case among patients operated using the “frozen elephant trunk” technology due to the progression of existing renal insufficiency, the addition of multiple organ dysfunction. Long-term survival in patients after debranching was 92.6%, for patients after the operation “frozen elephant trunk”, as well as after reconstructive intervention on the abdominal aorta with subsequent installation of a stent graft in the descending aorta was 100%.

Conclusion. Hybrid surgery is a modern direction in the treatment of pathology of the thoracic aorta with acceptable results in the near and long-term period of surgery.

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About Authors

  • Valeriy S. Arakelyan, Dr. Med. Sci., Professor, Head of Department; ORCID
  • Vasiliy G. Papitashvili, Cand. Med. Sci., Leading Researcher, Head of Department; ORCID
  • Rustam Z.-G. Kidakoev, Postgraduate, Cardiovascular Surgeon; ORCID
  • Vladislav L. Khon, Cand. Med. Sci., Cardiovascular Surgeon; ORCID
  • Vitaliy R. Dzutsev, Cand. Med. Sci., Cardiovascular Surgeon

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery