TREATMENT: HYBRID ARCH
A hybrid arch repair involves both open and endovascular repair techniques to repair the diseased portion of the aorta. Open repair involves replacement of a portion of the aorta with a nylon graft. The endovascular procedure involves insertion of a small catheter into the descending portion of the aorta. The catheter has the endograft device attached to it, and once positioned in the aorta with X-ray guidance it is then deployed. The graft can be secured with the use of ‘ballooning’, where the surgeon expands a small balloon inside the ends of the graft to ensure it is firmly adhered to the healthy aortic wall, and the diseased section of the aorta is contained.
Intraoperative photograph of aortic arch debranching for Hybrid arch replacement.
Left: CT scan showing completed Hybrid arch repair with bypass grafts to head vessels and stent graft in ascending aorta, arch and descending aorta.
Right: Illustration showing completed Hybrid arch repair with bypass grafts to head vessels and stent graft in ascending aorta, arch and descending aorta.
Illustration of various novel approaches to hybrid arch therapy. Panel on right are representative of versions used in Calgary.