Extension of the Personalized External Aortic Root Support (PEARS) Procedure to the Aortic Arch (PEAAS Procedure)

The Personalized External Aortic Root Support (PEARS) procedure is a contemporary strategy in the prophylactic management of aortic aneurysms, albeit formerly limited to the aortic root and ascending aorta. We describe an innovative surgical approach, termed the Personalized External Aortic Arch Support (PEAAS) procedure, that enables the ExoVasc PEARS prosthesis (eXstent, England) to be extended in cases of concomitant aortic arch dilatation. This modification applies external reinforcement principles to 'stabilize', and thus 'spare', the native aorta from the aortic valve to the distal aortic arch; utilized with favourable early outcomes in in Australasia. Advantages include the avoidance of circulatory arrest and cardiopulmonary bypass, with no interruption to cerebral perfusion. We consider that this novel technique could broaden the application of PEARS in selected patients to reduce the risk of aortic arch complications and the need for re-intervention.