The Efficacy of a Total Debranching TEVAR (td TEVAR) for the Re-operation of Aortic Arch Aneurysm

Kyohei Ueno, Megumu Kanno, Hirofumi Midorikawa, Gaku Takinami, Rie Kageyama, Haruna Seki

Department of Cardiovasculer Surgery, Southern TOHOKU General Hospital, Koriyama, Japan

Date, time and location: 2018.05.26 13:30, Congress Hall, 2F–A

Abstract

TEVAR combined with all neck branch reconstruction(total debranching TEVAR ; tdTEVAR) is applied to aortic arch aneurysm for minimally invasive procedure and improvement of treatment results. We report the initial and long-term results of td TEVAR for the re-operation of aortic arch aneurysm. TdTEVAR for the re-operation was applied in 5 cases by September, 2017. The Reasons for the re-operation were a dilation of arch aneurysm after ascending aorta replacement in 4 cases and a localized dissection of proximal landing zone after zone 2 TEVAR in 1 case. We reconstructed the neck branches under cardio-pulmonary bypass(CPB). At that time, we kept in mind to anastomosis with artificial graft at just above sinus of valsalva with single aortic clamp. In hospital mortality and CPB related complication were 0% and there were each 1 case of paraparesis and left upper limb ischemia. Our strategy of tdTEVAR provided durable results in patients treated for the re-operation of aortic arch aneurysm.