Thoracic or thoracoabdominal approaches to endovascular device removal and open aortic repair.

Background: Endovascular aortic repair is becoming increasingly common and diverse in its application despite ongoing uncertainty about long-term durability. Recent reports detail late conversion to open surgical repair to treat disease progression and repair failure. We describe our experience with using thoracic or thoracoabdominal approaches to endovascular device removal and open aortic repair after previous endovascular procedures.

Open repair of thoracoabdominal aortic aneurysm in the modern surgical era: contemporary outcomes in 509 patients.

Background: Recent technologic advances in endovascular devices have led to alternative approaches to thoracoabdominal aortic aneurysm (TAAA) repair; these innovative approaches must be compared with the "gold standard" of conventional open TAAA repair. To facilitate such comparisons, we evaluated contemporary outcomes of open TAAA repair.

Study Design: We retrospectively reviewed and analyzed data collected prospectively between May 2006 and October 2010 regarding 509 consecutive patients who underwent TAAA repair.

Early outcomes after aortic arch replacement by using the Y-graft technique.

Background: Aortic arch replacement remains among the most technically challenging cardiovascular operations, incurring considerable risk for perioperative death and stroke. The trifurcated graft technique, in which a double Y-graft is used to connect brachiocephalic branches to the main aortic graft, was recently developed to simplify arch reconstruction, reduce embolization, and minimize related cerebral ischemia. We examined early outcomes of aortic arch replacement performed by using single or double Y-graft variations of this technique.

Endovascular repair of a right-sided descending thoracic aortic aneurysm with a right-sided aortic arch and aberrant left subclavian artery.

Aneurysms involving a right-sided aortic arch and a right-sided descending thoracic aorta with an aberrant origin of the left subclavian artery are rare. We describe the successful surgical repair of this vascular anomaly by the combined use of a left carotid to subclavian artery bypass followed by endovascular stent-graft placement to exclude the aortic aneurysm. We also review the literature associated with this particular anatomic presentation.