Visceral aortic patch aneurysm after thoracoabdominal aortic repair: Conventional vs hybrid treatment

Objective: Visceral aortic patch (VAP) aneurysm repair following thoracoabdominal aortic aneurysm (TAAA) open treatment carries high morbidity and mortality rates. The aim of this study is to compare the outcomes of our series of patients who underwent redo VAP aneurysm open surgery (conventional group) with a selected group of high-risk patients who underwent, in the same time period from 2001-2007, an alternative hybrid surgical and endovascular approach (hybrid group). Methods: Conventional group: Twelve patients (11 males, median age 71.5 years, range, 65 to 77 years) underwent VAP aneurysm (median maximum diameter 62 mm, range, 52 to 75 mm) repair with re-inclusion technique via redo thoracophrenolaparotomy or bilateral subcostal laparotomy. Reimplantation of a single undersized VAP or separate revascularization of one or more visceral arteries was performed. Hybrid group: Seven patients (5 males, median age 70 years, range, 63 to 78 years) defined as at high risk for conventional surgery having American Society of Anesthesiology (ASA) class 3 or 4 associated with a preoperative forced expiratory volume in 1 second (FEV1) <50% or an ejection fraction