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Extensive pathologies of the aorta are a major challenge in terms of its surgical treatment. In principle, complex pathologies of the aorta are divided into type A aortic dissection according to the Stanford classification, and aneurysmatic changes involving the aortic arch. The first successful operations in the ascending aorta and the aortic arch were described by Denton Cooley, Michael DeBakey and Stanley Crawford (DeBakey et al. 1955, Cooley et al. 1956, Cooley et al. 1955). Several advancements made since this time have led to improvements in the surgical treatment of the ascending aorta (Bentall &De Bono 1968, Starr et al. 1963, David & Feindel 1992, Yacoub et al. 1998). Surgical procedures focused on dissections of the proximal portion of the descending aorta and the distal aortic arch have received increasing attention in the last few years and been subjected to several modifications. Especially the development of interventional radiological endovascular techniques that reduce the invasive nature of surgery as well as complication rates led to rapid advancements. In the following, a combined surgical and endovascular procedure for the treatment of complex aortic diseases will be presented. It is advancement on the methods used thus far. The development and performance of the method and results obtained by its application in patients at the Department of Cardiovascular Surgery, Hietzing Hospital -Vienna, as well as with reference to the European register will be summarised.

Combined Surgical and Endovascular Approach for the Treatment of Complex Thoracic Aortic Pathologies