Case report demonstrates successful aortic arch repair without cardiopulmonary bypass in a high-risk patient, highlighting hybrid debranching and endovascular grafting as a viable alternative.
A 70-year-old patient presented a large saccular aneurysm involving the whole aortic arch. Because of a past history of left thoracotomy and a high co-morbidity profile, we opted for a combined strategy, consisting of an extra-anatomic bypass of the supra-aortic vessels, followed by the endovascular implantation of a covered thoracic stent-graft. Endovascular stent grafting of aortic arch aneurysm, after extra anatomic bypass of supra-aortic vessels, appears as an attractive alternative strategy for high surgical risk patients.
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Dambrin et al. (2004) studied this question.
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