In addition to the routine implementation of the established techniques of replacement of the aortic valve and the aorta with valve-bearing vascular prostheses, reconstructive, valve-preserving procedures have recently been increasingly used.
The range of operations includes the treatment of patients with dilatations and chronic tears of the large vessels.
In addition to the routine implementation of the established techniques of replacement of the aortic valve and the aorta with valve-bearing vascular prostheses, more recently reconstructive, valve-preserving procedures have been increasingly used.
Surgical therapy of complex diseases of the aorta with hybrid stent prostheses
The frequency of aortic diseases is constantly increasing due to rising life expectancy and has tripled within the last 20 years from approximately 3 to 11 per 100 000 inhabitants.
The main problem in the therapy of complex thoracic aortic diseases requiring simultaneous or multiple interventions on the ascending aorta, the arcuate region and the descending section of the aorta is the extent of the surgical intervention required. With the introduction of hybrid endoprostheses, previous therapeutic procedures were simplified by combining classic vascular reconstruction with the insertion of a self-expanding vascular support (stent). With this so-called "frozen elephant trunk technique", the entire aorta of the thorax is replaced in a single session during circulatory arrest while protecting the brain and spinal cord function by means of such a hybrid prosthesis - consisting of a tubular plastic prosthesis with a stent component for the descending section and a conventional vascular prosthesis for the aortic arch.
Through the concept of combined surgical-minimal-invasive intervention, both the objective of simultaneous procedures and risk reduction can be achieved in patients, most of whom are elderly and suffer from multiple diseases. The performance of the procedure in the hybrid operating room also enables the multidimensional imaging required for the procedure and the prompt result and quality control