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Hybrid Repair versus Conventional Open Repair Approaches for Aortic Arch Disease: a Comprehensive Review
Ribeiro, Tiago Santos; Gadelha Júnior, Hernani de Paiva; Santos, Magaly Arrais dos.
  • Ribeiro, Tiago Santos; Federal University of Rio Grande do Norte. Onofre Lopes University Hospital. Department of Integrated Medicine. Natal. BR
  • Gadelha Júnior, Hernani de Paiva; Federal University of Rio Grande do Norte. Onofre Lopes University Hospital. Department of Integrated Medicine. Natal. BR
  • Santos, Magaly Arrais dos; Dante Pazzanese Institute of Cardiology. São Paulo. BR
Rev. bras. cir. cardiovasc ; 36(2): 244-252, Mar.-Apr. 2021. graf., tab.
Article in English | LILACS, CONASS, SES-SP, SESSP-IDPCPROD, SES-SP | ID: biblio-1251100
ABSTRACT
Abstract

Objective:

To investigate whether hybrid repair has supremacy over conventional open repair in aortic arch diseases.

Methods:

A comprehensive search was undertaken in two major databases (PubMed and MEDLINE) to identify all studies comparing the two surgical techniques in five years, up to December 2018, that met the established criteria in this study. The search returned 310 papers, and 305 were selected after removing duplicates. The abstracts of the remaining articles were assessed, resulting in 15 studies that went to full-text analysis. After application of the inclusion and exclusion criteria, 8 papers remained for the final revision.

Results:

Eight studies met the criteria, with the inclusion of 1,837 patients. From a short-term perspective, hybrid repair and conventional open repair had similar outcomes in terms of postoperative mortality and acute neurological events. Hybrid repair was associated with less respiratory complications and risk of new intervention, as well as reduced hospital length of stay. Conventional open repair showed better mid- and long-term outcomes.

Conclusion:

Hybrid repair should be used in selected patients, with a high risk or very high-risk profile for conventional surgery. Finally, since most of the current data were obtained from limited to large samples, with narrow follow-up and had great heterogeneity, the best approach to the aortic arch is still variable. Therefore, the decision of the approach should be individualized and evaluated by the whole Heart Team, considering the expertise of the surgical team.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Aorta, Thoracic / Postoperative Complications / Retrospective Studies / Blood Vessel Prosthesis Implantation Type of study: Observational study / Prognostic study / Risk factors Limits: Humans Language: English Journal: Rev. bras. cir. cardiovasc Year: 2021 Type: Article Institution/Affiliation country: Dante Pazzanese Institute of Cardiology/BR / Federal University of Rio Grande do Norte/BR

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Full text: Available Index: LILACS (Americas) Main subject: Aorta, Thoracic / Postoperative Complications / Retrospective Studies / Blood Vessel Prosthesis Implantation Type of study: Observational study / Prognostic study / Risk factors Limits: Humans Language: English Journal: Rev. bras. cir. cardiovasc Year: 2021 Type: Article Institution/Affiliation country: Dante Pazzanese Institute of Cardiology/BR / Federal University of Rio Grande do Norte/BR