Simultaneous Ascending Aortic Replacement and Thoracic Endovascular Aortic Repair (TEVAR) in Acute Aortic Syndrome

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Pir İ., Naddaf S., Çalık E., Ceviz M.

72nd Congress of the ESCVS, the European Society of CardioVascular and Endovascular Surgery, İstanbul, Türkiye, 25 - 28 Mayıs 2024, cilt.31, sa.1, ss.1-249, (Özet Bildiri)

  • Yayın Türü: Bildiri / Özet Bildiri
  • Cilt numarası: 31
  • Basıldığı Şehir: İstanbul
  • Basıldığı Ülke: Türkiye
  • Sayfa Sayıları: ss.1-249
  • Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
  • Atatürk Üniversitesi Adresli: Evet

Özet

1.39.15. Simultaneous Ascending Aortic Replacement and Thoracic Endovascular Aortic Repair (TEVAR) in Acute Aortic Syndrome Ibrahim Pir 1 , Saad Naddaf 1 , Eyüp Serhat Çalık 1 and Münacettin Ceviz 2 1 Department of Cardiovascular Surgery, Atatürk University Medical Faculty, Erzurum, Turkiye 2 Department of Cardiovascular Surgery, Buhara Hospital, Erzurum, Turkiye Backround: The term acute aortic syndrome (AAS) refers to a group of situations in which there is a danger of impending aortic rupture and treatment delays result in increased mortality. We aim to present the use of an endovascular and surgical hybrid approach to treat acute aortic syndrome. The method is a single-step procedure used to treat severe aortic disease withouth using hybrid operating room. Case Presentation: Five hours after beginning of acute and severe chest and back pain, a 62-year-old woman was referred to our department from cardiology. The patient was hemodynamically stable, hypertensive and had a history of Takayasu arteritis. Ascenden aort aneurysm, intramural hematoma (IMH) and a Stanford type B aortic dissection were found in computed tomography (CT). The patient was immediately operated on, under general anesthesia, and extracorporeal circulation was initiated with femoral cannulation. Then the patient underwent TCA. The ascending aortic aneurysmatic segment was removed. The TEVAR procedure was completed with direct view and the ruptured thoracic aortic segment was treated by opening the Medtronic captiva 30 × 30 × 200 mm stent graft over the hard wire as zero to the origin of the left subclavian artery. Then Ascending aortic replacement was completed. The patient’s post-procedure recovery was clinically uneventful. The patient was discharged on the seventh day after the operation. We Med. Sci. Forum 2025, 31, 1 177 of 249 demonstrate the efficacy and anatomical feasibility of combining open surgery with an endovascular method to treat ascenden aort aneurysm and aortic dissection of the thoracic aorta simultaneously. Endovascular intervention performed during open surgery makes the operation easier due to direct vision. Considering the complications and difficulties of thoraco-abdominal surgery, this hybrid approach appears to significantly reduce surgical morbidity and mortality. Keywords: Acute aortic sendrome; ascending aortic replacement; hybrid approach; TEVAR