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Complications at the Proximal Landing Zone of Endovascular Stent Grafts Deployed in Surgically Replaced Ascending Aorta  Vamshi K. Kotha, MD, Eric J.

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Presentation on theme: "Complications at the Proximal Landing Zone of Endovascular Stent Grafts Deployed in Surgically Replaced Ascending Aorta  Vamshi K. Kotha, MD, Eric J."— Presentation transcript:

1 Complications at the Proximal Landing Zone of Endovascular Stent Grafts Deployed in Surgically Replaced Ascending Aorta  Vamshi K. Kotha, MD, Eric J. Herget, MD, Jehangir J. Appoo, MDCM  The Annals of Thoracic Surgery  Volume 102, Issue 5, Pages (November 2016) DOI: /j.athoracsur Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 Image depicts type I (left), II (middle), and III (right) hybrid aortic arch repair. (Reprinted with permission from Elsevier from Bavaria J, Vallabhajosyula P, Moeller P, Szeto W, Desai N, Pochettino A. Hybrid approaches in the treatment of aortic arch aneurysms:post-operative and midterm outcomes. J Thorac Endovasc Surg 2013;145(3 Suppl):S85-90.) The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 Oblique sagittal (candy cane) computed tomography multiplanar reconstruction images demonstrate protrusion of the proximal end of the stent graft into the ascending aortic lumen, termed bird beaking. The technique used for the measurement of the bird beak (left) length and (right) angle is depicted. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

4 Fig 3 Image depicts type II hybrid arch repair: Dacron (DuPont, Wilmington, DE) ascending aortic replacement, arch debranching, and antegrade stent graft placement in a patient with acute type A dissection. (Reprinted with permission from The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

5 Fig 4 Kaplan-Meier analysis of (A) survival and (B) complications at the proximal landing zone. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

6 Fig 5 Zone 2 hybrid arch repair in a patient with acute type A dissection. Note the surgical anastomosis is done just proximal to left subclavian artery (zone 2), and creation of a 2-cm to 4-cm segment of Dacron (DuPont, Wilmington, DE) graft for the proximal landing zone. (Reprinted with permission from The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions


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