TOTAL AORTIC ARCH REPLACEMENT WITH E-VITA OPEN PLUS™ HYBRID PROSTHESIS – INITIAL EXPERIENCE FROM A SINGLE SURGICAL CENTER

Authors

  • Nuno Lareiro Department of Anesthesiology, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal
  • Manuela Vieira Department of Anesthesiology, Centro Hospitalar Vila Nova de Gaia/Espinho, Portugal
  • Ana Panzina Department of Anesthesiology, Centro Hospitalar Vila Nova de Gaia/Espinho, Portugal
  • Tiago Milner Department of Cardiothoracic Surgery, Centro Hospitalar de Vila Nova de Gaia/Espinho, Portugal
  • Susana Lareiro Department of Cardiothoracic Surgery, Centro Hospitalar de Vila Nova de Gaia/Espinho, Portugal
  • Paulo Neves Department of Cardiothoracic Surgery, Centro Hospitalar de Vila Nova de Gaia/Espinho, Portugal
  • Paulo Ponce Department of Cardiothoracic Surgery, Centro Hospitalar de Vila Nova de Gaia/Espinho, Portugal
  • Luís Vouga Department of Cardiothoracic Surgery, Centro Hospitalar de Vila Nova de Gaia/Espinho, Portugal

DOI:

https://doi.org/10.48729/pjctvs.71

Abstract

Background: Complex pathology of the Thoracic Aorta constitutes a challenge, needing a complex and multidisciplinary approach. The hybrid stent graft prosthesis E-vita OPEN PLUS™ avoids a two-stage surgical approach in the surgical treatment of complex thoracic aortic disease. The E-vita Open Plus™ is estimated to generate cost savings compared with current two-stage repair from about 2 years after the procedure.


Methods: Between February 2017 and July 2019, a total of 6 patients, underwent one stage surgery for treatment of multisegmental thoracic aortic disease with hybrid stent graft prosthesis E-vita OPEN PLUS™ We collected the data from our records and compared them to the International E-vita Open Registry (IEOR), regarding ischemic and operative times as well as adverse events monitored during follow-up.


Results/Discussion: The average patient age was 56 years (range: 36-76 years). The average Cardiopulmonary Bypass, Aortic Cross Clamping and Circulatory Arrest times where 204, 86 and 63 minutes respectively. The recovery after procedure had fewer complications and the length stay was less than described in literature. There was no in-hospital mortality. In all patients there was a reduction of aneurysm sac size and positive aortic remodeling and all where asymptomatic in regard to cardiovascular symptoms.


Conclusions: The use of E-vita OPEN PLUS™ seems a safe and efficient option for patients with complex aortic arch pathology. In our experience, surgery allowed treatment of extensive thoracic aortic diseases with satisfactory short- and mid-term results.

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References

P. Geisbüsch, D. Kotelis, M. Müller–Eschner, A. Hyhlik-Dürr, and D. Böckler, “Complications after aortic arch hybrid repair,” J. Vasc. Surg., vol. 53, no. 4, pp. 935-941, Apr. 2011.

C. M. Bünger et al., “Hybrid aortic arch repair for complicated type B aortic dissection,” J. Vasc. Surg., vol. 58, no. 6, pp. 1490–1496, Dec. 2013.

M. Radhakrishnan et al., “E-Vita OPEN PLUS™ for Treating Complex Aneurysms and Dissections of the Thoracic Aorta: A NICE Medical Technology Guidance,” Appl. Health Econ. Health Policy, vol. 12, no. 5, pp. 485-495, 2014.

K. Tsagakis et al., “Arch replacement and downstream stent grafting in complex aortic dissection: first results of an international registry,” 2010.

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P. H. Groves, C. Pomfrett, and M. Marlow, “Review of the role of NICE in promoting the adoption of innovative cardiac technologies.,” Heart, vol. 104, no. 22, pp. 1817-1822, 2018.

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Published

25-04-2021

How to Cite

1.
Lareiro N, Vieira M, Panzina A, Milner T, Lareiro S, Neves P, Ponce P, Vouga L. TOTAL AORTIC ARCH REPLACEMENT WITH E-VITA OPEN PLUS™ HYBRID PROSTHESIS – INITIAL EXPERIENCE FROM A SINGLE SURGICAL CENTER. Rev Port Cir Cardiotorac Vasc [Internet]. 2021 Apr. 25 [cited 2024 May 21];27(1):17-22. Available from: https://pjctvs.com/index.php/journal/article/view/71

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