Work

Staged open ascending aortic replacement and endovascular total arch repair using a three-inner-branch physician-modified endograft for chronic postdissection aneurysms

Year: 2026

Type: article

Abstract: This report describes a single-admission, two-stage hybrid approach for chronic postdissection aneurysmal degeneration of the ascending aorta and aortic arch. Stage 1 consists of open ascending aortic replacement without deep hypothermic circulatory arrest. Stage 2 uses a three-inner-branch physician-modified endograft with novel features for total arch repair, relying on the surgical graft from stage 1 as the proximal landing zone. To minimize cardiac pulsatility-induced motion, atriocaval occlusion was used, alongside a repurposed thoracic branch endoprosthesis side branch for secure innominate artery sealing. This less invasive strategy simplifies arch reconstruction and broadens treatment options for high-risk patients with postdissection multisegment aneurysms.

Source: Journal of Vascular Surgery Cases and Innovative Techniques

DOI: 10.1016/j.jvscit.2026.102527

Authors: William J. Yoon, Alexander P. Nissen

Institutions: Uppsala University, MedStar Washington Hospital Center, Georgetown University, MedStar Georgetown University Hospital

Language: English

Topic: Aortic Disease and Treatment Approaches

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,250