Visceral debranching in hybrid surgery of thoracoabdominal aortic aneurysms

Gusev A.A., Uspenskiy V.E., Gordeev M.L.

Scientific Research Division of Cardiothoracic Surgery, V.A. Almazov National Medical Research Centre of the RF Ministry of Public Health, Saint Petersburg, Russia

Presented herein is a review of the literature dedicated to the method of visceral debranching, i.e., switching of the visceral and renal branches of the abdominal aorta to its intact portion, using synthetic vascular prostheses as the first stage of hybrid surgical treatment of thoracoabdominal aortic aneurysms prior to endovascular aortic aneurysm repair. This is accompanied and followed by describing the history of the problem, operative technique, results of studies, as well as the data from registries and meta-analyses. Also discussed are the main complications of the method and measures of their prevention. We conclude that hybrid surgery of the thoracoabdominal portion of the aorta is a promising method in a particular cohort of patients, especially those at high surgical risk of "open" aortic surgery.

KEY WORDS: thoracic aortic aneurysm, blood vessel prosthesis, abdominal aorta, blood vessel prosthesis implantation, debranching, hybrid surgery.

P. 184

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