Short- and mid-term results of hybrid and endovascular surgery for aortic arch disease

Introduction and objective: the objective of our study is to describe the mid-term results and complications of patients with aortic arch disease who underwent surgery of the aortic arch and supra-aortic branches in our center. Methods: retrospective, single center study. Consecutive patients with arch surgery and a diagnosis of thoracic aortic aneurysm (TAA) > 60 mm and aortic penetrating ulcer (PAU) from January 2017 through June 2022. We conducted a descriptive study including demographic variables, the mortality rate, and 30-day complications. Survival, readmissions and reinterventions were, then, analyzed using the Kaplan-Meier estimator. Results: a total of 20 patients underwent surgery: 14 underwent TAA surgery and 6 due to PAU; 2 required emergency surgery. Zone 0 was the most common proximal landing zone (50 %), followed by zone 1 (30 %). In 5 cases, SAT debranching and 5 carotid-subclavian bypasses were performed prior to TEVAR implantation. The technical success rate reached 95 %, 2 patients died at 30 days, one patient developed transient spinal cord ischemia and the other experienced a major neurological event. The median follow-up was 18 months (IQR, 7-37). All-cause mortality rate was 20 % (5% related to aortic disease).The 24-month estimated rate of readmission was 22.9 % and reoperation rate, 24.1 %. The most common cause for readmission was medical (15 %). Conclusions: the short- and mid-term results of hybrid and endovascular surgery for aortic arch disease are acceptable in terms of morbidity and mortality.