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Hybrid surgery is a treatment used to repair aneurysms or more complex aortic disease in patients considered too high risk for conventional surgery who do not have an endovascular alternative. The procedure often involves the part of the aorta that contains critical blood vessels extending to the head, arms or abdominal organs such as the kidneys, intestine and liver.
A combined approach allows your surgeon to first restore blood flow to critical blood vessels away from an aneurysm in an open surgical procedure. Then, your surgeon completes the repair of the damaged part of the aorta using a minimally invasive endovascular technique. Hybrid surgery has many advantages, including:
- It can be staged (done as separate procedures) which reduces risk
- It avoids opening the chest, thus reducing risk, particularly in patients with smoking history and COPD
Experts in Hybrid Repair at the UCLA Aortic Center
Experts at the UCLA Aortic Center are dedicated to providing high-risk patients with options for surgical repair. As world-renowned leaders in aortic aneurysms, our patients benefit from our vast experience in assessing and treating patients with aortic disease. In fact, UCLA surgeons were the first to perform a hybrid open surgery and endovascular repair in the 1990s. Our doctors have continued to refine this technique for the benefit of our patients. Meet our expert team.
Benefits of Hybrid Repair
Combining an endovascular approach with a less invasive open surgery provides high-risk patients with a shorter operation time and less time under anesthesia. Other benefits include:
- Avoidance of a heart lung machine
- Less blood loss during surgery
- Faster recovery period
- Avoidance of a thoracotomy (opening of the chest cavity)
- Reduced potential for organ damage.
Is Hybrid Repair Right for Me?
The hybrid approach was developed for high-risk patients who are not considered suitable for open surgery for their aortic disease. Patients considered for hybrid repair include:
- Older patients
- Patients with COPD or heart disease
- Patients with extensive aortic pathology
- Patients with both aortic occlusive disease and aneurysmal aortic disease
- Patients with previous aortic surgery
What to Expect during Hybrid Aortic Aneurysm Repair
A surgeon performs the hybrid procedure to repair the aorta in stages. The surgeon can perform these stages as a single procedure the same day or, more often, as separate procedures with an interval for recovery.
Here’s what to expect:
- You will be put under general anesthesia. You will be put on a breathing tube to help regulate your breathing. You will not feel any pain or remember the procedure.
- Your surgeon will create bypasses to critical vessels that are on or nearby the aneurysm. The surgeon will reattach these vessels to a healthy part of the aorta. This may require an incision in the abdomen or through the sternum, depending on the location of the aneurysm.
- After blood supply is reestablished to the affected blood vessels, the surgeon will close the incision.
- If done as a single procedure, the surgeon will proceed with the second stage.
- During the endovascular stage of the procedure, your surgeon will guide a catheter through a small incision to the damaged section of your aorta with the help of a special type of X-ray imaging called fluoroscopy.
- The catheter contains the compressed endograft for the aorta. When the catheter is in place, your surgeon can slide it out, position it and fasten it to your aorta.
- Your surgeon removes the catheter.
- Once closed, the small incision will heal within 1-2 weeks.
- You will have a follow-up CT scan as an outpatient within a few weeks, at six months and yearly to make sure the grafts are working properly.
Comprehensive Treatment Options at UCLA Aortic Center
Our doctors believe in patient-centered care. That’s why we take a personalized approach to diagnosis and treatment for aortic disease.