Thoracic aneurysms: Endovascular procedures for debranching of ascending and isolated arch aneurysms

Open surgical repair of thoracic aortic arch aneurysm is a well-established technique for aneurysms involving the aorta arch or the aortic arch and ascending aorta. Open repair generally requires sternotomy, cardiopulmonary bypass, cardiac arrest, profound hypothermia, and circulatory arrest to complete the repair. Hybrid procedures using arch debranching techniques and thoracic endografting have been developed that can eliminate the need for cardiopulmonary bypass, cardiac arrest, profound hypothermia, and circulatory arrest and occasionally sternotomy also. We will describe the approach used at the Methodist DeBakey Heart & Vascular Center for hybrid repair of thoracic aortic arch aneurysm with and without ascending aortic involvement.