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

Jan 17, 2023 •248 likes •331 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

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 • Fenestration • Branched stent graft UCSF UCSF 1
Arch Repair Arch Repair Gutter Multi-Layer Stent Courtesy of Thomas Larzon UCSF UCSF Arch Repair Arch Repair Kawaguchi et al, J Vasc Surg, 2008 UCSF UCSF 2
Arch Repair Arch Repair Images Courtesy of Dr John Anderson Images Courtesy of Dr John Anderson, MD UCSF UCSF Arch Repair Arch Repair Schneider DB, et al, 2003 UCSF UCSF 3
Arch Repair Arch Repair Schneider DB, et al, 2003 UCSF UCSF Arch Repair Arch Repair Kasprzak P, et al. Regensburg, Germany UCSF UCSF 4
Arch Repair 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 UCSF Arch Repair Arch Repair Thanks to Stephan Haulon, Lille, France UCSF UCSF 5
Arch Repair Arch Repair UCSF UCSF Arch Repair Arch Repair Other People’s Cases Other People’s Cases The Learning Curve • Cherrie Abraham Deaths • Stephan Haulon First 10 4 • Krassi Ivancev Second 10 1 • Eric Verhoeven Third 10 0 • Roy Greenberg Fourth 10 0 UCSF UCSF 6
Arch Repair 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 UCSF UCSF 7

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