Boston - American Association for Thoracic Surgery

89 TH ANNUAL MEETING MAY 9–MAY 13, 2009BOSTON, MASSACHUSETTS3:45 p.m. SIMULTANEOUS SCIENTIFIC SESSION –ADULT CARDIAC SURGERYBallroom A–C, Hynes Convention CenterModerators: R. Duane DavisChuen-Neng Lee10. Have Hybrid Procedures Replaced Open Aortic Arch Reconstructionin High Risk Patients: A Comparative Study of Open Arch Debranchingwith Endovascular Stent Graft Placement and Conventional OpenTotal and Distal Aortic Arch ReconstructionRita K. Milewski, Wilson Y. Szeto, Alberto Pochettino, G. William Moser,Patrick Moeller, Joseph E. BavariaHospital of the University of Pennsylvania, Philadelphia, PA, USAInvited Discussant: Yutaka OkitaOBJECTIVE: Open total arch (OTA) and open distal arch plus proximal descendingaortic (ODAD) procedures can be performed electively with adjunct circulatoryand cerebral perfusion management. These procedures have been associated withsignificant, even prohibitive, morbidity and mortality in patients with multiplecomorbidities. Open aortic arch debranching with endovascular stent graft placementas a single stage procedure has emerged as a surgical option in this patientpopulation. This study evaluates the outcomes of a contemporary comparativeseries from one institution of open total arch, open total arch plus descendingaorta, and hybrid surgical procedures for extensive aortic arch pathology.METHODS: From July 2000 to September 2008, 1196 open arch procedures wereperformed: 694 elective hemiarch, 49 OTA, 42 ODAD and 350 emergent hemiarchand open descending procedures. From 2005 to 2008, 61 open (hybrid) endovascularprocedures were performed: 37 emergent Type A dissections and 24 elective openarch debranchings.86