Hybrid Arch Debranching



About Thoracic Aortic Aneurysms

The aorta, the largest artery in the body, carries oxygen-rich blood away from the heart to all parts of the body. The section of the aorta that runs through the chest is called the thoracic aorta. Due to the serious risks of aortic aneurysms, timely diagnosis and treatment of a thoracic aneurysm are critical. Because the aorta is the body’s main supplier of blood, a ruptured aneurysm can cause life-threatening bleeding.

Thoracic aortic aneurysms are most often caused by atherosclerosis (plaque build-up in the arteries), but can also be brought on by connective tissue disorders. As you age, your risk of developing a thoracic aortic aneurysm increases. More men than women are diagnosed with thoracic aortic aneurysms, and are often affected with the condition at a younger age.

Thoracic aortic aneurysms often go unnoticed because patients rarely feel symptoms. While less than half of those with thoracic aortic aneurysms complain of symptoms, possible warning signs include:
•    Chest or back pain
•    Pain in the jaw, neck, and upper back
•    Coughing, hoarseness, difficulty breathing or swallowing

About Hybrid Arch Debranching

In the past, total arch replacement was considered to be one of the most risky cardiac procedures because the patient has to be put on a heart-lung machine and blood flow to the head and body are temporarily stopped (circulatory arrest) after the patient has been cooled to a very low temperature. Today, the Hybrid Arch Debranching approach has dramatically lowered the morbidity and risk of total arch replacement for aortic aneurysms. During the surgery, the aortic arch is ‘de-branched’ by sewing bypass grafts to the aortic arch blood vessels, and then an endograft is placed to seal off the aneurysm. With this operation, there is no need for the heart-lung machine and circulatory arrest.

The Hybrid Arch Debranching procedure is ideal for a patient who has multiple medical issues (such as diabetes or high blood pressure) in addition to a thoracic aortic aneurysm and is considered too high-risk for a traditional operation. The hybrid arch debranching surgery allows patients to undergo a bypass and endograft in the same procedure, reducing their hospital stay and improving their chances at long-term success. The University of Maryland’s multidisciplinary approach to patient care and state-of-the-art hybrid ORs offer high-risks patients with thoracic aneurysms new opportunity.



Teng Lee

Teng Lee, MD

Assistant Professor of Surgery, Lead Physician, Thoracic Aortic Surgery Program