Techniques in hybrid repair of aortic arch and thoracoabdominal aortic pathologies

Since the mid-1900s, techniques in the repair of aortic arch and thoracoabdominal aortic pathologies have drastically evolved. Open aortic surgical repair was once the sole option for both simple and complex aneurysmal degeneration. Today, a number of minimally invasive and hybrid approaches are now available to assist both the surgeon and patient in tackling this challenging problem. In this review, we discuss the most current techniques in the repair of these complex pathologies as well as new advances. These include aortic arch and abdominal aortic debranching with endovascular repair, branched stent graft repair, parallel grafting techniques, fenestration techniques, and a hybrid approach to the aforementioned. In addition, we discuss comparative outcomes of these techniques spanning disciplines of both cardiac and vascular surgery. The most vital part of the treatment of complex aortic aneurysms is the tailoring of the treatment plan to each patient's unique anatomic and physiologic attributes.