Aortic arch repair by "HENDO" technology clusters_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LUO Mingyao ^1,3 ,  SHU Chang ^1,2 , FANG Kun ¹ , YU Cuntao ¹ , QIAN Xiangyang ¹ , SUN Xiaogang ¹

1. State Key Laboratory of Cardiovascular Disease, Center of Vascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, P.R.China;
2. Department of Vascular Surgery, The Second Xiangya Hospital of Central South University, Changsha, 410008, P.R.China;
3. Department of Vascular Surgery, Fuwai Yunnan Cardiovascular Hospital, Affiliated Cardiovascular Hospital of Kunming Medical University, Kunming, 650220, P.R.China;

Corresponding?author：

SHU Chang, Email: changshu@vip.126.com

Keywords：

Aortic arch; hybrid; endovascular repair; open surgery

DOI：

10.7507/1007-4848.202002088

Video：

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Aortic arch disease is one of the research hotspots and treatment difficulties in the field of aorta, including aortic arch aneurysms, pseudoaneurysm, ulcer, dissection and intramural hematoma. By summarizing the clinical data of the vascular surgery center of Fuwai Hospital of Chinese Academy of Medical Sciences in the past five years and combining with the latest theories of the cutting-edge development of aortic surgery, the authors proposed the "HENDO" concept, including using hybrid technique (H), endovascular repair (Endo) and open surgery (O), properly to treat aortic arch pathologies individually. The authors advocated the establishment of HENDO team and cooperation mechanism in large aortic centers, to eliminate technical shortcomings of a single surgeon by fully mastering the three main technology clusters by teamwork. Accordingly, the best treatment for each patient can be administrated and the survival rate and quality of life can be improved eventually.

Citation： LUO Mingyao, SHU Chang, FANG Kun, YU Cuntao, QIAN Xiangyang, SUN Xiaogang. Aortic arch repair by "HENDO" technology clusters. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2020, 27(9): 987-991. doi: 10.7507/1007-4848.202002088 Copy

1.	Jakob HG. Repair of aortic arch disease is undergoing a dramatic change within the next years. J Cardiovasc Surg (Torino), 2018, 59(4): 538-539.
2.	Bajona P, Quintana E. Total arch replacement: the last frontier? Eur J Cardiothorac Surg, 2016, 49(4): 1262-1263.
3.	舒暢. 主動脈弓部病變的 HENDO 方案. 第四屆中國血管大會, 2019 年 9 月 19 日, 天津.
4.	國家心血管病專家委員會血管外科專業委員會. 雜交技術治療累及弓部主動脈病變的中國專家共識. 中國循環雜志, 2020, 35(2): 4-9.
5.	Lin H, Du Y, Yu C, <italic>et al</italic>. Single stage hybrid repair for DeBakey type Ⅰ aortic dissection in high risk patients. Eur J Vasc Endovasc Surg, 2018, 56(3): 363-372.
6.	Lei G, Wang G, Liu Q, <italic>et al</italic>. 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.
7.	Zhang L, Yu C, Yang X, <italic>et al</italic>. Hybrid and frozen elephant trunk for total arch replacement in DeBakey typeⅠ dissection. J Thorac Cardiovasc Surg, 2019, 158(5): 1285-1292.
8.	王瑋璠, 徐旭, 王煒, 等. Stanford A 型主動脈夾層復合手術與主動脈弓置換支架“象鼻”手術的療效對比. 中華胸心血管外科雜志, 2019, 35(2): 99-101.
9.	Gandet T, Canaud L, Ozdemir BA, <italic>et al</italic>. Factors favoring retrograde aortic dissection after endovascular aortic arch repair. J Thorac Cardiovasc Surg, 2015, 150(1): 136-142.
10.	Shu C, Luo MY, Li QM, <italic>et al</italic>. Early results of left carotid chimney technique in endovascular repair of acute non-A-non-B aortic dissections. J Endovasc Ther, 2011, 18(4): 477-484.
11.	Li X, Li Q, Zhang W, et al. Early experience and technical aspects of physician-modified fenestration in thoracic endovascular aortic repair for aortic arch pathologies. J Inter Med Res, 2019, [Epub ahead of print].
12.	Huang H, Jiao Y, Zhang Y, <italic>et al</italic>. Implantation of unibody single-branched stent graft for patients with type B aortic dissections involving the left subclavian artery: 1-year follow-up outcomes. Cardiovasc Intervent Radiol, 2017, 40(11): 1678-1686.
13.	Criado FJ, Barnatan MF, Rizk Y, <italic>et al</italic>. Technical strategies to expand stent-graft applicability in the aortic arch and proximal descending thoracic aorta. J Endovasc Ther, 2002, 9(Suppl 2): Ⅱ32-Ⅱ38.
14.	Xiao HM, Li W, Wei G, <italic>et al</italic>. Comparison of supra-arch in situ fenestration and chimney techniques for aortic dissection involving the left subclavian artery. Vascular, 2019, 27(2): 153-160.
15.	Ferrer C, Cao P, Coscarella C, <italic>et al</italic>. Italian registry of double inner branch stent graft for arch pathology (the TRIUmPH Registry). J Vasc Surg, 2019, 70(3): 672-682.
16.	舒暢, 羅明堯, 李全明, 等. “煙囪”技術在累及主動脈弓部血管的動脈夾層腔內修復術中的應用. 中國普通外科雜志, 2010, 19(12): 1266-1270.
17.	羅明堯, 舒暢, 方坤, 等. CUFF 預開窗技術治療胸主動脈腔內修復術后近端內漏. 中國胸心血管外科臨床雜志, 2020, 27(1): 106-109.
18.	Zhu J, Zhao L, Dai X, <italic>et al</italic>. Fenestrated thoracic endovascular aortic repair using physician modified stent grafts for acute type B aortic dissection with unfavourable landing zone. Eur J Vasc Endovasc Surg, 2018, 55(2): 170-176.
19.	Clough RE, Spear R, Van Calster K, <italic>et al</italic>. Case series of aortic arch disease treated with branched stent-grafts. Br J Surg, 2018, 105(4): 358-365.
20.	Spear R, Clough RE, Fabre D, <italic>et al</italic>. Total endovascular treatment of aortic arch disease using an arch endograft with 3 inner branches. J Endovasc Ther, 2017, 24(4): 534-538.
21.	Bosse C, K?lbel T, Mougin J, et al. Off-the-shelf multibranched endograft for total endovascular repair of the aortic arch. J Vasc Surg, 2020, [Epub ahead of print].
22.	Lindblad B, Bin Jabr A, Holst J, <italic>et al</italic>. Chimney grafts in aortic stent grafting: hazardous or useful technique? Systematic review of current data. Eur J Vasc Endovasc Surg, 2015, 50(6): 722-731.
23.	Wang T, Shu C, Li QM, <italic>et al</italic>. First experience with the double chimney technique in the treatment of aortic arch diseases. J Vasc Surg, 2017, 66(4): 1018-1027.
24.	Jayet J, Heim F, Coggia M, <italic>et al</italic>. An experimental study of laser in situ fenestration of current aortic endografts. Eur J Vasc Endovasc Surg, 2018, 56(1): 68-77.
25.	Beavan TE, Fatti L. Ligature of aortic arch in the neck. Br J Surg, 1947, 34(136): 414-416.
26.	De Bakey ME. Successful resection of aneurysm of distal aortic arch and replacement by graft. J Am Med Assoc, 1954, 155(16): 1398-1403.
27.	Svensson LG. Progress in ascending and aortic arch surgery: minimally invasive surgery, blood conservation, and neurological deficit prevention. Ann Thorac Surg, 2002, 74(5): S1786-S1789.
28.	Erbel R, Aboyans V, Boileau C, <italic>et al</italic>. 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.
29.	Patel HJ, Nguyen C, Diener AC, <italic>et al</italic>. Open arch reconstruction in the endovascular era: analysis of 721 patients over 17 years. J Thorac Cardiovasc Surg, 2011, 141(6): 1417-1423.
30.	Ikeno Y, Yokawa K, Matsueda T, <italic>et al</italic>. Long-term outcomes of total arch replacement using a 4-branched graft. J Thorac Cardiovasc Surg, 2019, 157(1): 75-85.
31.	Di Eusanio M, Berretta P, Cefarelli M, <italic>et al</italic>. Total arch replacement versus more conservative management in type A acute aortic dissection. Ann Thorac Surg, 2015, 100(1): 88-94.
32.	Rice RD, Sandhu HK, Leake SS, <italic>et al</italic>. Is total arch replacement associated with worse outcomes during repair of acute type A aortic dissection? Ann Thorac Surg, 2015, 100(6): 2159-2166.
33.	楊勇, 李小密, 李菲, 等. 主動脈弓置換術后急性腎損傷發生的危險因素分析. 中國胸心血管外科臨床雜志, 2011, 18(2): 109-113.
34.	Takagi H, Umemoto T, Alice Group. A meta-analysis of total arch replacement with frozen elephant trunk in acute type A aortic dissection. Vasc Endovascular Surg, 2016, 50(1): 33-46.

1. Jakob HG. Repair of aortic arch disease is undergoing a dramatic change within the next years. J Cardiovasc Surg (Torino), 2018, 59(4): 538-539.
2. Bajona P, Quintana E. Total arch replacement: the last frontier? Eur J Cardiothorac Surg, 2016, 49(4): 1262-1263.
3. 舒暢. 主動脈弓部病變的 HENDO 方案. 第四屆中國血管大會, 2019 年 9 月 19 日, 天津.
4. 國家心血管病專家委員會血管外科專業委員會. 雜交技術治療累及弓部主動脈病變的中國專家共識. 中國循環雜志, 2020, 35(2): 4-9.
5. Lin H, Du Y, Yu C, <italic>et al</italic>. Single stage hybrid repair for DeBakey type Ⅰ aortic dissection in high risk patients. Eur J Vasc Endovasc Surg, 2018, 56(3): 363-372.
6. Lei G, Wang G, Liu Q, <italic>et al</italic>. 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.
7. Zhang L, Yu C, Yang X, <italic>et al</italic>. Hybrid and frozen elephant trunk for total arch replacement in DeBakey typeⅠ dissection. J Thorac Cardiovasc Surg, 2019, 158(5): 1285-1292.
8. 王瑋璠, 徐旭, 王煒, 等. Stanford A 型主動脈夾層復合手術與主動脈弓置換支架“象鼻”手術的療效對比. 中華胸心血管外科雜志, 2019, 35(2): 99-101.
9. Gandet T, Canaud L, Ozdemir BA, <italic>et al</italic>. Factors favoring retrograde aortic dissection after endovascular aortic arch repair. J Thorac Cardiovasc Surg, 2015, 150(1): 136-142.
10. Shu C, Luo MY, Li QM, <italic>et al</italic>. Early results of left carotid chimney technique in endovascular repair of acute non-A-non-B aortic dissections. J Endovasc Ther, 2011, 18(4): 477-484.
11. Li X, Li Q, Zhang W, et al. Early experience and technical aspects of physician-modified fenestration in thoracic endovascular aortic repair for aortic arch pathologies. J Inter Med Res, 2019, [Epub ahead of print].
12. Huang H, Jiao Y, Zhang Y, <italic>et al</italic>. Implantation of unibody single-branched stent graft for patients with type B aortic dissections involving the left subclavian artery: 1-year follow-up outcomes. Cardiovasc Intervent Radiol, 2017, 40(11): 1678-1686.
13. Criado FJ, Barnatan MF, Rizk Y, <italic>et al</italic>. Technical strategies to expand stent-graft applicability in the aortic arch and proximal descending thoracic aorta. J Endovasc Ther, 2002, 9(Suppl 2): Ⅱ32-Ⅱ38.
14. Xiao HM, Li W, Wei G, <italic>et al</italic>. Comparison of supra-arch in situ fenestration and chimney techniques for aortic dissection involving the left subclavian artery. Vascular, 2019, 27(2): 153-160.
15. Ferrer C, Cao P, Coscarella C, <italic>et al</italic>. Italian registry of double inner branch stent graft for arch pathology (the TRIUmPH Registry). J Vasc Surg, 2019, 70(3): 672-682.
16. 舒暢, 羅明堯, 李全明, 等. “煙囪”技術在累及主動脈弓部血管的動脈夾層腔內修復術中的應用. 中國普通外科雜志, 2010, 19(12): 1266-1270.
17. 羅明堯, 舒暢, 方坤, 等. CUFF 預開窗技術治療胸主動脈腔內修復術后近端內漏. 中國胸心血管外科臨床雜志, 2020, 27(1): 106-109.
18. Zhu J, Zhao L, Dai X, <italic>et al</italic>. Fenestrated thoracic endovascular aortic repair using physician modified stent grafts for acute type B aortic dissection with unfavourable landing zone. Eur J Vasc Endovasc Surg, 2018, 55(2): 170-176.
19. Clough RE, Spear R, Van Calster K, <italic>et al</italic>. Case series of aortic arch disease treated with branched stent-grafts. Br J Surg, 2018, 105(4): 358-365.
20. Spear R, Clough RE, Fabre D, <italic>et al</italic>. Total endovascular treatment of aortic arch disease using an arch endograft with 3 inner branches. J Endovasc Ther, 2017, 24(4): 534-538.
21. Bosse C, K?lbel T, Mougin J, et al. Off-the-shelf multibranched endograft for total endovascular repair of the aortic arch. J Vasc Surg, 2020, [Epub ahead of print].
22. Lindblad B, Bin Jabr A, Holst J, <italic>et al</italic>. Chimney grafts in aortic stent grafting: hazardous or useful technique? Systematic review of current data. Eur J Vasc Endovasc Surg, 2015, 50(6): 722-731.
23. Wang T, Shu C, Li QM, <italic>et al</italic>. First experience with the double chimney technique in the treatment of aortic arch diseases. J Vasc Surg, 2017, 66(4): 1018-1027.
24. Jayet J, Heim F, Coggia M, <italic>et al</italic>. An experimental study of laser in situ fenestration of current aortic endografts. Eur J Vasc Endovasc Surg, 2018, 56(1): 68-77.
25. Beavan TE, Fatti L. Ligature of aortic arch in the neck. Br J Surg, 1947, 34(136): 414-416.
26. De Bakey ME. Successful resection of aneurysm of distal aortic arch and replacement by graft. J Am Med Assoc, 1954, 155(16): 1398-1403.
27. Svensson LG. Progress in ascending and aortic arch surgery: minimally invasive surgery, blood conservation, and neurological deficit prevention. Ann Thorac Surg, 2002, 74(5): S1786-S1789.
28. Erbel R, Aboyans V, Boileau C, <italic>et al</italic>. 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.
29. Patel HJ, Nguyen C, Diener AC, <italic>et al</italic>. Open arch reconstruction in the endovascular era: analysis of 721 patients over 17 years. J Thorac Cardiovasc Surg, 2011, 141(6): 1417-1423.
30. Ikeno Y, Yokawa K, Matsueda T, <italic>et al</italic>. Long-term outcomes of total arch replacement using a 4-branched graft. J Thorac Cardiovasc Surg, 2019, 157(1): 75-85.
31. Di Eusanio M, Berretta P, Cefarelli M, <italic>et al</italic>. Total arch replacement versus more conservative management in type A acute aortic dissection. Ann Thorac Surg, 2015, 100(1): 88-94.
32. Rice RD, Sandhu HK, Leake SS, <italic>et al</italic>. Is total arch replacement associated with worse outcomes during repair of acute type A aortic dissection? Ann Thorac Surg, 2015, 100(6): 2159-2166.
33. 楊勇, 李小密, 李菲, 等. 主動脈弓置換術后急性腎損傷發生的危險因素分析. 中國胸心血管外科臨床雜志, 2011, 18(2): 109-113.
34. Takagi H, Umemoto T, Alice Group. A meta-analysis of total arch replacement with frozen elephant trunk in acute type A aortic dissection. Vasc Endovascular Surg, 2016, 50(1): 33-46.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Aortic arch repair by "HENDO" technology clusters

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