Aortic Arch repair Tim Chuter, MD Professor of Surgery - - PowerPoint PPT Presentation

▶

Jan 17, 2023 248 likes •333 views

Arch Repair Aortic Arch repair Tim Chuter, MD Professor of Surgery In-Residence, UCSF UCSF UCSF Arch Repair Arch Repair CHIMPS Options Chimneys, Periscopes, Snorkels Hypothermic circulatory arrest Debranching Snorkel

SLIDE 1

1

UCSF

Aortic Arch repair

Tim Chuter, MD

Professor of Surgery In-Residence, UCSF

UCSF Arch Repair UCSF Arch Repair

Options

Hypothermic circulatory arrest
Debranching
Snorkel
Fenestration
Branched stent graft

UCSF Arch Repair

CHIMPS

Chimneys, Periscopes, Snorkels

SLIDE 2

2

UCSF Arch Repair

Gutter

Courtesy of Thomas Larzon UCSF Arch Repair

Multi-Layer Stent

UCSF Arch Repair UCSF Arch Repair Kawaguchi et al, J Vasc Surg, 2008

SLIDE 3

3

UCSF Arch Repair

Images Courtesy of Dr John Anderson, MD

UCSF Arch Repair

Images Courtesy of Dr John Anderson

UCSF Arch Repair UCSF Arch Repair

Schneider DB, et al, 2003

SLIDE 4

4

UCSF Arch Repair UCSF Arch Repair

Schneider DB, et al, 2003

UCSF Arch Repair Kasprzak P, et al. Regensburg, Germany UCSF Arch Repair

SLIDE 5

5

UCSF Arch Repair

Problems with transcervical delivery

Relative sizes of aorta (delivery system) and

right carotid artery

Competition for space
No runway
Occlusion of flow to the brain

UCSF Arch Repair UCSF Arch Repair UCSF Arch Repair Thanks to Stephan Haulon, Lille, France

SLIDE 6

6

UCSF Arch Repair UCSF Arch Repair UCSF Arch Repair

Other People’s Cases

Cherrie Abraham
Stephan Haulon
Krassi Ivancev
Eric Verhoeven
Roy Greenberg

UCSF Arch Repair

Other People’s Cases

The Learning Curve Deaths First 10 4 Second 10 1 Third 10 Fourth 10

SLIDE 7

7

UCSF Arch Repair UCSF Arch Repair

Conclusions

Branches vs. Fenestrations vs. Snorkel vs.

Debranching

2-branch technique ready for more

widespread application

3-branch version coming
Dissections vs. Arch aneurysm