The aorta is the major artery that transports blood from the heart to the rest of the body. The sections of the aorta are named according to its trajectory from the heart: the “ascending aorta”, the “arch” and the “descending aorta”. An aortic aneurysm is a condition affecting the aorta where there is a weakening of the muscles within the aortic walls, causing it to widen and expand. An aortic dissection is a life-threatening condition in which a small tear causes the walls of the aorta to split apart. Both these conditions may require urgent surgery to prevent rupture of the walls.
Surgery on the aortic arch is a highly complex operation. It is an open-heart operation that involves cooling the body to hypothermic temperatures, deliberately stopping the heart pumping (circulatory arrest) and connecting it to a cardio-pulmonary bypass machine. The damaged aorta is then reconstructed using a synthetic tube or graft.
Depending on the location of the damaged aorta and the patient’s state of health, a hybrid surgical approach may be possible. By definition, this involves a condensed portion of open-heart surgery, followed by a less invasive repair utilizing an endovascular approach. Both stages can be performed during the same operation, or may be separated by a short period of recovery. Owing to the need for imaging devices that can visualize the blood vessels, hybrid aortic arch procedures can only be performed in specially-equipped hospitals. The two main hybrid procedures: