Key result
Traditional open repair remains the gold standard for total aortic arch pathology, as current evidence shows no definitive superiority of zone 0 hybrid repair over open repair regarding mortality.
Why the study?
Does zone 0 hybrid arch exclusion improve outcomes compared to open total arch replacement in patients with aortic arch pathology?
Does zone 0 hybrid arch exclusion improve outcomes compared to open total arch replacement in patients with aortic arch pathology?
Traditional open repair remains the gold standard for total aortic arch pathology, while zone 0 hybrid repair offers an alternative for high-risk patients, though definitive superiority is not established.
Maintains open repair as standard for operable patients; leaves open zone 0 hybrid role pending randomized data.
Open total aortic arch replacement is one of the most technically demanding operations in cardiothoracic surgery, requiring operator expertise and intraoperative and postoperative teamwork. Despite current advancements in the field of open aortic surgery with regard to intraoperative brain protection and postoperative care, the morbidity and mortality associated with open total arch operations varies. Endovascular and hybrid procedures involving the use of zone 0 as a landing zone allow fair comparison between open total arch and hybrid operations. Hybrid procedures involving all of the other landing zones [1-4] should not be compared with open total arch replacement, as the extent of the pathology is different.
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Preventza et al. (2018) conducted a review in Aortic arch pathology. Zone 0 hybrid arch exclusion vs. Open total arch replacement was evaluated. Traditional open repair remains the gold standard for total aortic arch pathology, as current evidence shows no definitive superiority of zone 0 hybrid repair over open repair regarding mortality.
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