Intraoperative aortoscopy during arch resection and stabilization of the “downstream aorta” with the frozen elephant trunk (FET) procedure using hybrid stent devices (Thoraflex in this video) is a new emerging adjunct diagnostic modality. Intraoperative direct visualization of the distal aortic bed prior to and after deployment of the hybrid stent device during the period of deep hypothermic circulatory arrest is necessary to confirm proper deployment and inspect the distal seal of the endo stent, as seen in this video. In the video, the atherosclerotic heavily diseased descending thoracic “downstream aorta” can also be clearly visualized.
A flexible illuminated fiber-optic endoscope with wide-bore aspiration channel (Ambu® aScope™ 4 Large, Ambu A/S, Ballerup, Denmark) with a working length of 60cm, a diameter of 6.3mm, and a channel width of 2.6mm was used in the procedure.
References
- Luthra S, Tsang GM. Concurrent stabilization of "downstream" aorta during acute type A aortic dissection repair.
- J Thorac Cardiovasc Surg. 2021 Jun 25:S0022-5223(21)00996-X. doi: 10.1016/j.jtcvs.2021.06.042. Epub ahead of print. PMID: 34226050.
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