One-stage hybrid surgery for complex aortic disease

Objective: This study was to retrospectively analyze short- and medium-term efficacy of one-stage hybrid surgery in treating complex aortic disease. Methods: From February 2017 to March 2021, Retrospective analysis of 473 Cases of patients with aortic disease treated by endovascular surgery, of which 24 were complicated aortic diseases (defined as not being treated by Endovascular surgery alone), all of which were performed one-stop hybrid surgery in Anhui Provincial Hospital. Their clinical records and follow-up data were reviewed. Results: 11 cases underwent debranching technique and thoracic endovascular aortic repair(TEVAR), 4 cases underwent cardiac surgery combined with debranching technique plus TEVAR, 3 cases underwent cardiac surgery and TEVAR, 6 cases underwent left common carotid artery-left subclavian artery bypass and TEVAR. The incidences of pulmonary infection, pleural effusion, transient renal impairment, incision infection and cerebrovascular complications were 29.1%, 33.3%, 25%, 0 and 4.1%, respectively.One patient died of sudden cardiac arrest, a severe neurological deficit following cardiopulmonary resuscitation in the postoperative intensive care unit. The patients were followed up for 2 to 52 months,During follow-up, One patient suffered from sudden death with unknown cause at 25 months after surgery and the rest survived. Thrombosis was seen by CT in the false lumen of the thoracic stent segment in (22/24) patients; type Ⅰb endoleak occurred in (1/24) patient. Conclusions: One-stage aortic hybrid surgery suggests acceptable short- to medium-term efficacy in the treatment of complex aortic disease; it can avoid the damage caused by deep hypothermic circulatory arrest in traditional operations and promote the recovery of patients.