'If you want to kill your dog, accuse him of having rabies.' (French proverb)

Q: What is the clinical evidence from this study?

Study design: Editorial. Population: Extensive aortic arch disease (n=27). Intervention: Hybrid aortic arch repair (total debranching) vs. Conventional open surgical repair. Primary outcome: Clinical and technical success rate.

Jean Bachet

doi:10.1016/j.ejcts.2011.06.014

December 12, 2011European Journal of Cardio-Thoracic SurgeryOpen Access

'If you want to kill your dog, accuse him of having rabies.' (French proverb)

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Why the study?

Is total debranching (hybrid aortic arch repair) a safe and effective alternative to conventional open surgery for extensive aortic arch disease?

Structured PICO

Is total debranching (hybrid aortic arch repair) a safe and effective alternative to conventional open surgery for extensive aortic arch disease?

P

Population

27 high-risk patients with extensive aortic arch disease undergoing hybrid aortic arch repair (total debranching).

I

Intervention

Hybrid aortic arch repair (total debranching)

C

Comparator

Conventional open surgical repair (historical/conceptual comparison)

O

Outcome

Clinical and technical success rate (clinical success defined by absence of perioperative aneurysm-related death and aneurysm expansion or rupture; technical success defined by no angiographic evidence of endoleaks, graft infection or thrombosis and no surgical conversion within 24 h postoperatively)composite

Limitations

No long-term data exist to ascertain the durability of this method.
Data remain limited.
The threshold beyond which patients are considered non-amenable to open surgery is never objectively defined.
Cost of hybrid procedures is about one-third higher than the cost of conventional surgery.
Lack of objective risk assessment (e.g., EuroSCORE or STS score) to define 'high-risk' patients
Questionable definitions of immediate technical and clinical success
Lack of long-term data to ascertain durability
Higher costs compared to conventional surgery

Implication

This editorial cautions against the uncritical adoption of hybrid aortic arch repair, highlighting that its short-term mortality rates may be inferior to contemporary conventional open surgical techniques.

Discussion

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Cite This Study

Jean Bachet (2011) conducted an editorial in Extensive aortic arch disease (n=27). Hybrid aortic arch repair (total debranching) vs. Conventional open surgical repair was evaluated on Clinical and technical success rate.

synapsesocial.com/papers/6a98753b3b58d06bb8581ba1 https://doi.org/10.1016/j.ejcts.2011.06.014

View Full Paper

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'If you want to kill your dog, accuse him of having rabies.' (French proverb)

Structured PICO

Limitations

Implication

Discussion

Cite This Study

'If you want to kill your dog, accuse him of having rabies.' (French proverb)

Structured PICO

Limitations

Implication

Discussion

Cite This Study

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