Hybrid or open surgery for aortic arch diseases: Which one is better?_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHANG Yu , XIAO Zhenghua , ZHANG Eryong , YANG Peng , LU Chen , LIU Yu , NIU Hao , WANG Haiyue ,  HU Jia

Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, 610041, P.R.China;

Corresponding author：

HU Jia, Email: humanjia@msn.com

Keywords：

Aortic arch aneurysm; aortic dissection; hybrid technique; traditional open surgery; aortic endovascular repair; review

DOI：

10.7507/1007-4848.202008013

Video：

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Abstract Full text Figures/Tables Video References Cited by

The conventional total arch replacement (cTAR) with frozen elephant trunk implantation is commonly regarded as the gold standard for aortic pathologies involving ascending aorta and proximal aortic arch. By combining open supra-aortic vessels debranching and emerging endovascular technologies, hybrid arch repair (HAR) has been increasingly performed as a promising alternative in risky patients with comorbidities and frailties. Nevertheless, the advantages or disadvantages of hybrid arch procedures and cTAR in terms of survival and related outcomes remain controversial. This study is aimed to briefly review the role and results of HAR in the management of aortic arch pathology in comparison of contemporary cTAR.

Citation： ZHANG Yu, XIAO Zhenghua, ZHANG Eryong, YANG Peng, LU Chen, LIU Yu, NIU Hao, WANG Haiyue, HU Jia. Hybrid or open surgery for aortic arch diseases: Which one is better?. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2021, 28(8): 998-1004. doi: 10.7507/1007-4848.202008013 Copy

1.	胡盛寿, 高润霖, 刘力生, 等. 《中国心血管病报告 2018》概要. 中国循环杂志, 2019, 34(3): 209-220.
2.	中国生物医学工程学会体外循环分会. 2017 与 2018 年中国心外科手术和体外循环数据白皮书. 中国体外循环杂志, 2019, 17(5): 257-260.
3.	Clare R, Jorgensen J, Brar SS. Open versus endovascular or hybrid thoracic aortic aneurysm repair. Curr Atheroscler Rep, 2016, 18(10): 60.
4.	Evangelista A, Isselbacher EM, Bossone E, et al. Insights from the international registry of acute aortic dissection: A 20-year experience of collaborative clinical research. Circulation, 2018, 137(17): 1846-1860.
5.	Czerny M, Schmidli J, Adler S, et al. Current options and recommendations for the treatment of thoracic aortic pathologies involving the aortic arch: An expert consensus document of the European Association for Cardio-Thoracic surgery (EACTS) and the European Society for Vascular Surgery (ESVS). Eur J Cardiothorac Surg, 2019, 55(1): 133-162.
6.	Rice RD, Sandhu HK, Leake SS, et al. Is total arch replacement associated with worse outcomes during repair of acute type a aortic dissection? Ann Thorac Surg, 2015, 100(6): 2159-2165.
7.	Shrestha M, Fleissner F, Ius F, et al. Total aortic arch replacement with frozen elephant trunk in acute type A aortic dissections: Are we pushing the limits too far? Eur J Cardiothorac Surg, 2015, 47(2): 361-366.
8.	Gong M, Ma WG, Guan XL, et al. Moderate hypothermic circulatory arrest in total arch repair for acute type A aortic dissection: Clinical safety and efficacy. J Thorac Dis, 2016, 8(5): 925-933.
9.	Erbel R, Aboyans V, Boileau C, et al. 2014 ESC guidelines on the diagnosis and treatment of aortic diseases: Document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. The Task Force for the Diagnosis and Treatment of Aortic Diseases of the European Society of Cardiology (ESC). Eur Heart J, 2014, 35(41): 2873-2926.
10.	Minatoya K, Inoue Y, Sasaki H, et al. Total arch replacement using a 4-branched graft with antegrade cerebral perfusion. J Thorac Cardiovasc Surg, 2019, 157(4): 1370-1378.
11.	Kremer J, Preisner F, Dib B, et al. Aortic arch replacement with frozen elephant trunk technique —A single-center study. J Cardiothorac Surg, 2019, 14(1): 147.
12.	Ma WG, Zhang W, Wang LF, et al. Type A aortic dissection with arch entry tear: Surgical experience in 104 patients over a 12-year period. J Thorac Cardiovasc Surg, 2016, 151(6): 1581-1592.
13.	Zhao HP, Zhu JM, Ma WG, et al. Total arch replacement with stented elephant trunk technique for acute type B aortic dissection involving the aortic arch. Ann Thorac Surg, 2012, 93(5): 1517-1522.
14.	Guan XL, Wang XL, Liu YY, et al. Changes in the hemostatic system of patients with acute aortic dissection undergoing aortic arch surgery. Ann Thorac Surg, 2016, 101(3): 945-951.
15.	邹磊, 章淬, 宋晓春, 等. 亚低温治疗对急性 Stanford A 型主动脉夹层患者围术期炎症反应及预后影响的随机对照试验. 中国胸心血管外科临床杂志, 2019, 26(3): 222-228.
16.	肖正华, 古君, 胡佳, 等. 基于炎症反应变化程度的主动脉夹层病程分期的初步探讨. 中国胸心血管外科临床杂志, 2014, 21(6): 721-724.
17.	Lin J, Tan Z, Yao H, et al. Retrograde inferior vena caval perfusion for total aortic arch replacement surgery (RIVP-TARS): Study protocol for a multicenter, randomized controlled trial. Trials, 2019, 20(1): 232.
18.	Li Y, Guo H, Wang L, et al. Application of aortic balloon occlusion in total aortic arch replacement with frozen elephant trunk on clinical endpoints for aortic dissection patients. Ann Thorac Cardiovasc Surg, 2020, 26(6): 332-341.
19.	Chen LW, Wu XJ, Lu L, et al. Total arch repair for acute type A aortic dissection with 2 modified techniques: Open single-branched stent graft placement and reinforcement of the dissected arch vessel stump with stent graft. Circulation, 2011, 123(22): 2536-2541.
20.	Aftab M, Plichta R, Roselli EE. Acute DeBakey typeⅠdissection repair using frozen elephant trunk: The cleveland clinic technique. Semin Cardiothorac Vasc Anesth, 2017, 21(3): 200-205.
21.	Liu K, Zhu C, Zheng X, et al. A new aortic arch inclusion technique with frozen elephant trunk for type A aortic dissection. Ann Surg, 2020, 271(5): 978-983.
22.	An Z, Song Z, Tang H, et al. Retrograde type A dissection after thoracic endovascular aortic repair: Surgical strategy and literature review. Heart Lung Circ, 2018, 27(5): 629-634.
23.	Czerny M, Eggebrecht H, Rousseau H, et al. Distal stent graft-induced new entry after TEVAR or FET: Insights into a new disease from EuREC. Ann Thorac Surg, 2020, 110(5): 1494-1500.
24.	国家心血管病专家委员会血管外科专业委员会. 杂交技术治疗累及弓部主动脉病变的中国专家共识. 中国循环杂志, 2020, 35(2): 124-129.
25.	Plichta RP, Hughes GC. Thoracic endovascular aortic repair for the ascending aorta: Experience and pitfalls. J Vis Surg, 2018, 4: 92.
26.	Tokuda Y, Oshima H, Narita Y, et al. Hybrid versus open repair of aortic arch aneurysms: Comparison of postoperative and mid-term outcomes with a propensity score-matching analysis. Eur J Cardiothorac Surg, 2016, 49(1): 149-156.
27.	Lei G, Wang G, Liu Q, et al. Single-stage hybrid aortic arch repair is associated with a lower incidence of postoperative acute kidney injury than conventional aortic surgery. J Cardiothorac Vasc Anesth, 2019, 33(12): 3294-3300.
28.	Vallabhajosyula P, Szeto W, Desai N, et al. TypeⅠand TypeⅡhybrid aortic arch replacement: Postoperative and mid-term outcome analysis. Ann Cardiothorac Surg, 2013, 2(3): 280-287.
29.	Joo HC, Youn YN, Kwon JH, et al. Late complications after hybrid aortic arch repair. J Vasc Surg, 2019, 70(4): 1023-1030.
30.	Li Q, Ma WG, Zheng J, et al. Distal stent graft-induced new entry after TEVAR of type B aortic dissection: Experience in 15 years. Ann Thorac Surg, 2019, 107(3): 718-724.
31.	Rudarakanchana N, Jenkins MP. Hybrid and total endovascular repair of the aortic arch. Br J Surg, 2018, 105(4): 315-327.
32.	Perera AH, Rudarakanchana N, Monzon L, et al. Cerebral embolization, silent cerebral infarction and neurocognitive decline after thoracic endovascular aortic repair. Br J Surg, 2018, 105(4): 366-378.
33.	Dias NV, Sonesson B, Kristmundsson T, et al. Short-term outcome of spinal cord ischemia after endovascular repair of thoracoabdominal aortic aneurysms. Eur J Vasc Endovasc Surg, 2015, 49(4): 403-409.
34.	Bisdas T, Panuccio G, Sugimoto M, et al. Risk factors for spinal cord ischemia after endovascular repair of thoracoabdominal aortic aneurysms. J Vasc Surg, 2015, 61(6): 1408-1416.
35.	Miao L, Song L, Sun SK, et al. Meta-analysis of open surgical repair versus hybrid arch repair for aortic arch aneurysm. Interact Cardiovasc Thorac Surg, 2017, 24(1): 34-40.
36.	Yip HC, Chan YC, Qing KX, et al. Retrograde type A dissection following hybrid supra-aortic endovascular surgery in high-risk patients unfit for conventional open repair. J Cardiovasc Surg (Torino), 2018, 59(2): 243-251.
37.	Ma T, Dong ZH, Fu WG, et al. Incidence and risk factors for retrograde type A dissection and stent graft-induced new entry after thoracic endovascular aortic repair. J Vasc Surg, 2018, 67(4): 1026-1033.
38.	Chung C, Fremed D, Han D, et al. Update on the use of abdominal and thoracic endografts for treating aortic aneurysms. Expert Rev Med Devices, 2016, 13(3): 287-295.
39.	Zhang HW, Fan KJ, Liang HM, et al. Chimney and sandwich stent grafts for hybrid repair of type A dissection late after a Bentall for Marfan syndrome. J Thorac Cardiovasc Surg, 2016, 152(4): 1191-1193.
40.	Zhang HW, Huang Y, Yang P, et al. Urgent retrograde two-stage hybrid repair of a complicated blunt traumatic aortic injury. J Vasc Surg, 2019, 70(5): 1669-1672.
41.	Huang CY, Weng SH, Weng CF, et al. Factors predictive of distal stent graft-induced new entry after hybrid arch elephant trunk repair with stainless steel-based device in aortic dissection. J Thorac Cardiovasc Surg, 2013, 146(3): 623-630.
42.	Burdess A, Mani K, Tegler G, et al. Stent-graft induced new entry tears after type B aortic dissection: How to treat and how to prevent? J Cardiovasc Surg (Torino), 2018, 59(6): 789-796.
43.	Martin G, Riga C, Gibbs R, et al. Short- and long-term results of hybrid arch and proximal descending thoracic aortic repair: A benchmark for new technologies. J Endovasc Ther, 2016, 23(5): 783-790.
44.	Hiraoka A, Chikazawa G, Totsugawa T, et al. Objective analysis of midterm outcomes of conventional and hybrid aortic arch repair by propensity-score matching. J Thorac Cardiovasc Surg, 2017, 154(1): 100-106.
45.	Zhang L, Yu C, Yang X, et al. Hybrid and frozen elephant trunk for total arch replacement in DeBakey typeⅠdissection. J Thorac Cardiovasc Surg, 2019, 158(5): 1285-1292.
46.	Chakos A, Jbara D, Yan TD, et al. Long-term survival and related outcomes for hybrid versus traditional arch repair—A meta-analysis. Ann Cardiothorac Surg, 2018, 7(3): 319-327.
47.	Shi F, Wang Z. Acute aortic dissection surgery: Hybrid debranching versus total arch replacement. J Cardiothorac Vasc Anesth, 2020, 34(6): 1487-1493.
48.	Soares TR, Melo R, Amorim P, et al. Clinical outcomes of aortic arch hybrid repair in a real-world single-center experience. J Vasc Surg, 2020, 72(3): 813-821.
49.	邱家伟, 赵锐, 王德等. Ⅱ型杂交全主动脉弓修复术治疗不同年龄段 Stanford A 型主动脉夹层的临床疗效分析. 中国胸心血管外科临床杂志, 2020, 27(9): 1010-1014.
50.	Preventza O, Garcia A, Cooley DA, et al. Total aortic arch replacement: A comparative study of zone 0 hybrid arch exclusion versus traditional open repair. J Thorac Cardiovasc Surg, 2015, 150(6): 1591-1598.
51.	Benedetto U, Melina G, Angeloni E, et al. Current results of open total arch replacement versus hybrid thoracic endovascular aortic repair for aortic arch aneurysm: A meta-analysis of comparative studies. J Thorac Cardiovasc Surg, 2013, 145(1): 305-306.
52.	Ma M, Feng X, Wang J, et al. Acute typeⅠaortic dissection: A propensity-matched comparison of elephant trunk and arch debranching repairs. Interact Cardiovasc Thorac Surg, 2018, 26(2): 183-189.
53.	Papakonstantinou NA, Antonopoulos CN, Baikoussis NG, et al. Aortic arch reconstruction: Are hybrid debranching procedures a good choice? Heart Lung Circ, 2018, 27(11): 1335-1349.
54.	Moulakakis KG, Mylonas SN, Markatis F, et al. A systematic review and meta-analysis of hybrid aortic arch replacement. Ann Cardiothorac Surg, 2013, 2(3): 247-260.
55.	罗明尧, 舒畅, 方坤, 等. “HENDO”技术体系治疗主动脉弓部疾病. 中国胸心血管外科临床杂志, 2020, 27(9): 987-991.

1. 胡盛寿, 高润霖, 刘力生, 等. 《中国心血管病报告 2018》概要. 中国循环杂志, 2019, 34(3): 209-220.
2. 中国生物医学工程学会体外循环分会. 2017 与 2018 年中国心外科手术和体外循环数据白皮书. 中国体外循环杂志, 2019, 17(5): 257-260.
3. Clare R, Jorgensen J, Brar SS. Open versus endovascular or hybrid thoracic aortic aneurysm repair. Curr Atheroscler Rep, 2016, 18(10): 60.
4. Evangelista A, Isselbacher EM, Bossone E, et al. Insights from the international registry of acute aortic dissection: A 20-year experience of collaborative clinical research. Circulation, 2018, 137(17): 1846-1860.
5. Czerny M, Schmidli J, Adler S, et al. Current options and recommendations for the treatment of thoracic aortic pathologies involving the aortic arch: An expert consensus document of the European Association for Cardio-Thoracic surgery (EACTS) and the European Society for Vascular Surgery (ESVS). Eur J Cardiothorac Surg, 2019, 55(1): 133-162.
6. Rice RD, Sandhu HK, Leake SS, et al. Is total arch replacement associated with worse outcomes during repair of acute type a aortic dissection? Ann Thorac Surg, 2015, 100(6): 2159-2165.
7. Shrestha M, Fleissner F, Ius F, et al. Total aortic arch replacement with frozen elephant trunk in acute type A aortic dissections: Are we pushing the limits too far? Eur J Cardiothorac Surg, 2015, 47(2): 361-366.
8. Gong M, Ma WG, Guan XL, et al. Moderate hypothermic circulatory arrest in total arch repair for acute type A aortic dissection: Clinical safety and efficacy. J Thorac Dis, 2016, 8(5): 925-933.
9. Erbel R, Aboyans V, Boileau C, et al. 2014 ESC guidelines on the diagnosis and treatment of aortic diseases: Document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. The Task Force for the Diagnosis and Treatment of Aortic Diseases of the European Society of Cardiology (ESC). Eur Heart J, 2014, 35(41): 2873-2926.
10. Minatoya K, Inoue Y, Sasaki H, et al. Total arch replacement using a 4-branched graft with antegrade cerebral perfusion. J Thorac Cardiovasc Surg, 2019, 157(4): 1370-1378.
11. Kremer J, Preisner F, Dib B, et al. Aortic arch replacement with frozen elephant trunk technique —A single-center study. J Cardiothorac Surg, 2019, 14(1): 147.
12. Ma WG, Zhang W, Wang LF, et al. Type A aortic dissection with arch entry tear: Surgical experience in 104 patients over a 12-year period. J Thorac Cardiovasc Surg, 2016, 151(6): 1581-1592.
13. Zhao HP, Zhu JM, Ma WG, et al. Total arch replacement with stented elephant trunk technique for acute type B aortic dissection involving the aortic arch. Ann Thorac Surg, 2012, 93(5): 1517-1522.
14. Guan XL, Wang XL, Liu YY, et al. Changes in the hemostatic system of patients with acute aortic dissection undergoing aortic arch surgery. Ann Thorac Surg, 2016, 101(3): 945-951.
15. 邹磊, 章淬, 宋晓春, 等. 亚低温治疗对急性 Stanford A 型主动脉夹层患者围术期炎症反应及预后影响的随机对照试验. 中国胸心血管外科临床杂志, 2019, 26(3): 222-228.
16. 肖正华, 古君, 胡佳, 等. 基于炎症反应变化程度的主动脉夹层病程分期的初步探讨. 中国胸心血管外科临床杂志, 2014, 21(6): 721-724.
17. Lin J, Tan Z, Yao H, et al. Retrograde inferior vena caval perfusion for total aortic arch replacement surgery (RIVP-TARS): Study protocol for a multicenter, randomized controlled trial. Trials, 2019, 20(1): 232.
18. Li Y, Guo H, Wang L, et al. Application of aortic balloon occlusion in total aortic arch replacement with frozen elephant trunk on clinical endpoints for aortic dissection patients. Ann Thorac Cardiovasc Surg, 2020, 26(6): 332-341.
19. Chen LW, Wu XJ, Lu L, et al. Total arch repair for acute type A aortic dissection with 2 modified techniques: Open single-branched stent graft placement and reinforcement of the dissected arch vessel stump with stent graft. Circulation, 2011, 123(22): 2536-2541.
20. Aftab M, Plichta R, Roselli EE. Acute DeBakey typeⅠdissection repair using frozen elephant trunk: The cleveland clinic technique. Semin Cardiothorac Vasc Anesth, 2017, 21(3): 200-205.
21. Liu K, Zhu C, Zheng X, et al. A new aortic arch inclusion technique with frozen elephant trunk for type A aortic dissection. Ann Surg, 2020, 271(5): 978-983.
22. An Z, Song Z, Tang H, et al. Retrograde type A dissection after thoracic endovascular aortic repair: Surgical strategy and literature review. Heart Lung Circ, 2018, 27(5): 629-634.
23. Czerny M, Eggebrecht H, Rousseau H, et al. Distal stent graft-induced new entry after TEVAR or FET: Insights into a new disease from EuREC. Ann Thorac Surg, 2020, 110(5): 1494-1500.
24. 国家心血管病专家委员会血管外科专业委员会. 杂交技术治疗累及弓部主动脉病变的中国专家共识. 中国循环杂志, 2020, 35(2): 124-129.
25. Plichta RP, Hughes GC. Thoracic endovascular aortic repair for the ascending aorta: Experience and pitfalls. J Vis Surg, 2018, 4: 92.
26. Tokuda Y, Oshima H, Narita Y, et al. Hybrid versus open repair of aortic arch aneurysms: Comparison of postoperative and mid-term outcomes with a propensity score-matching analysis. Eur J Cardiothorac Surg, 2016, 49(1): 149-156.
27. Lei G, Wang G, Liu Q, et al. Single-stage hybrid aortic arch repair is associated with a lower incidence of postoperative acute kidney injury than conventional aortic surgery. J Cardiothorac Vasc Anesth, 2019, 33(12): 3294-3300.
28. Vallabhajosyula P, Szeto W, Desai N, et al. TypeⅠand TypeⅡhybrid aortic arch replacement: Postoperative and mid-term outcome analysis. Ann Cardiothorac Surg, 2013, 2(3): 280-287.
29. Joo HC, Youn YN, Kwon JH, et al. Late complications after hybrid aortic arch repair. J Vasc Surg, 2019, 70(4): 1023-1030.
30. Li Q, Ma WG, Zheng J, et al. Distal stent graft-induced new entry after TEVAR of type B aortic dissection: Experience in 15 years. Ann Thorac Surg, 2019, 107(3): 718-724.
31. Rudarakanchana N, Jenkins MP. Hybrid and total endovascular repair of the aortic arch. Br J Surg, 2018, 105(4): 315-327.
32. Perera AH, Rudarakanchana N, Monzon L, et al. Cerebral embolization, silent cerebral infarction and neurocognitive decline after thoracic endovascular aortic repair. Br J Surg, 2018, 105(4): 366-378.
33. Dias NV, Sonesson B, Kristmundsson T, et al. Short-term outcome of spinal cord ischemia after endovascular repair of thoracoabdominal aortic aneurysms. Eur J Vasc Endovasc Surg, 2015, 49(4): 403-409.
34. Bisdas T, Panuccio G, Sugimoto M, et al. Risk factors for spinal cord ischemia after endovascular repair of thoracoabdominal aortic aneurysms. J Vasc Surg, 2015, 61(6): 1408-1416.
35. Miao L, Song L, Sun SK, et al. Meta-analysis of open surgical repair versus hybrid arch repair for aortic arch aneurysm. Interact Cardiovasc Thorac Surg, 2017, 24(1): 34-40.
36. Yip HC, Chan YC, Qing KX, et al. Retrograde type A dissection following hybrid supra-aortic endovascular surgery in high-risk patients unfit for conventional open repair. J Cardiovasc Surg (Torino), 2018, 59(2): 243-251.
37. Ma T, Dong ZH, Fu WG, et al. Incidence and risk factors for retrograde type A dissection and stent graft-induced new entry after thoracic endovascular aortic repair. J Vasc Surg, 2018, 67(4): 1026-1033.
38. Chung C, Fremed D, Han D, et al. Update on the use of abdominal and thoracic endografts for treating aortic aneurysms. Expert Rev Med Devices, 2016, 13(3): 287-295.
39. Zhang HW, Fan KJ, Liang HM, et al. Chimney and sandwich stent grafts for hybrid repair of type A dissection late after a Bentall for Marfan syndrome. J Thorac Cardiovasc Surg, 2016, 152(4): 1191-1193.
40. Zhang HW, Huang Y, Yang P, et al. Urgent retrograde two-stage hybrid repair of a complicated blunt traumatic aortic injury. J Vasc Surg, 2019, 70(5): 1669-1672.
41. Huang CY, Weng SH, Weng CF, et al. Factors predictive of distal stent graft-induced new entry after hybrid arch elephant trunk repair with stainless steel-based device in aortic dissection. J Thorac Cardiovasc Surg, 2013, 146(3): 623-630.
42. Burdess A, Mani K, Tegler G, et al. Stent-graft induced new entry tears after type B aortic dissection: How to treat and how to prevent? J Cardiovasc Surg (Torino), 2018, 59(6): 789-796.
43. Martin G, Riga C, Gibbs R, et al. Short- and long-term results of hybrid arch and proximal descending thoracic aortic repair: A benchmark for new technologies. J Endovasc Ther, 2016, 23(5): 783-790.
44. Hiraoka A, Chikazawa G, Totsugawa T, et al. Objective analysis of midterm outcomes of conventional and hybrid aortic arch repair by propensity-score matching. J Thorac Cardiovasc Surg, 2017, 154(1): 100-106.
45. Zhang L, Yu C, Yang X, et al. Hybrid and frozen elephant trunk for total arch replacement in DeBakey typeⅠdissection. J Thorac Cardiovasc Surg, 2019, 158(5): 1285-1292.
46. Chakos A, Jbara D, Yan TD, et al. Long-term survival and related outcomes for hybrid versus traditional arch repair—A meta-analysis. Ann Cardiothorac Surg, 2018, 7(3): 319-327.
47. Shi F, Wang Z. Acute aortic dissection surgery: Hybrid debranching versus total arch replacement. J Cardiothorac Vasc Anesth, 2020, 34(6): 1487-1493.
48. Soares TR, Melo R, Amorim P, et al. Clinical outcomes of aortic arch hybrid repair in a real-world single-center experience. J Vasc Surg, 2020, 72(3): 813-821.
49. 邱家伟, 赵锐, 王德等. Ⅱ型杂交全主动脉弓修复术治疗不同年龄段 Stanford A 型主动脉夹层的临床疗效分析. 中国胸心血管外科临床杂志, 2020, 27(9): 1010-1014.
50. Preventza O, Garcia A, Cooley DA, et al. Total aortic arch replacement: A comparative study of zone 0 hybrid arch exclusion versus traditional open repair. J Thorac Cardiovasc Surg, 2015, 150(6): 1591-1598.
51. Benedetto U, Melina G, Angeloni E, et al. Current results of open total arch replacement versus hybrid thoracic endovascular aortic repair for aortic arch aneurysm: A meta-analysis of comparative studies. J Thorac Cardiovasc Surg, 2013, 145(1): 305-306.
52. Ma M, Feng X, Wang J, et al. Acute typeⅠaortic dissection: A propensity-matched comparison of elephant trunk and arch debranching repairs. Interact Cardiovasc Thorac Surg, 2018, 26(2): 183-189.
53. Papakonstantinou NA, Antonopoulos CN, Baikoussis NG, et al. Aortic arch reconstruction: Are hybrid debranching procedures a good choice? Heart Lung Circ, 2018, 27(11): 1335-1349.
54. Moulakakis KG, Mylonas SN, Markatis F, et al. A systematic review and meta-analysis of hybrid aortic arch replacement. Ann Cardiothorac Surg, 2013, 2(3): 247-260.
55. 罗明尧, 舒畅, 方坤, 等. “HENDO”技术体系治疗主动脉弓部疾病. 中国胸心血管外科临床杂志, 2020, 27(9): 987-991.

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