Re-hybrid thoracic stent graft implantation with total aortic arch debranching in urgent procedure: case report

INTRODUCTION: Implementation of emergency endovascular aortic repair provides an opportunity to treat complicated acute syndromes involving descending aorta. CASE REPORT: A 40-year-old man with a history coarctation surgical as child and anastomosis aneurysm double stent graft implantation hemi-arch transposition was urgently admitted intensifying shortness breath hoarseness. computed tomography study confirmed blood leak into sac in proximal landing zones implanted grafts (Type I endoleak). Therefore, he qualified for hybrid surgery. First, the ascending aorta brachiocephalic trunk anastomosed 12 mm vascular prosthesis from upper mini-sternotomy. In next step, normothermic extracorporeal circulation necessary prevent cerebral circulation. Finally, GORE (Gore Medical, Flagstaff, AZ, USA) zone directly behind site The hospital course uncomplicated, patient discharged home 5 days after procedure. CONCLUSIONS: Complicated pathologies requiring emergent interventions can be treated by approach utilizing multistep techniques achieving optimal results.