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New option for treating aortic arch diseases

Prospect of treatment option for hitherto inoperable patients
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(Vienna, 29 october, 2020) For the first time in Austria, an interdisciplinary aortic team from MedUni Vienna has successfully implanted a new type of stent graft in the aortic arch of two patients in the University Hospital Vienna, without having to open the ribcage. In the minimally invasive procedure, the aortic prosthesis, which supports and seals the blood vessel to safeguard the blood flow, is inserted via a small incision in the groin. In future, this conservative procedure might offer a treatment for patients who were previously considered to be inoperable.

If left untreated, diseases of the aorta, the body's main artery, carry the risk of rupture with severe bleeding or a vascular occlusion, such as a stroke. Such conditions mainly affect people over 50. Open surgery is often required to treat aortic disease and, especially for older patients, this is extremely stressful and carries a corresponding level of risk. Hitherto, the more conservative treatment, the less evasive procedure via the inguinal artery, was only suitable for certain areas of the aorta, such as the abdominal aorta.

Now, a new type of aortic prosthesis means that this minimally invasive procedure via the groin can also be used for aortic arch diseases. The aortic arch is directly adjacent to the heart and carries the blood supply to the arms and brain. For the first time in Austria, an interdisciplinary aortic team from MedUni Vienna has successfully implanted this new stent graft in the aortic arch of two patients in the University Hospital Vienna, without having to open the ribcage.

“Specially designed windows enabled us to conserve the branches of the brain artery while still covering the enlargement of the aorta. We managed to insert the stent graft via a small incision in the groin. The procedure went successfully for both patients and, because of the minimal surgical load, they were both allowed to go home after only a few days," says Martin Funovics from the Division of Cardiovascular and Interventional Radiology, who performed the procedure with the interdisciplinary aortic team.

This new treatment offers patients with aortic arch diseases, who were previously regarded as inoperable, the prospect of a possible treatment. This will predominantly apply to patients for whom the risk of open surgery was too great, because of their age or because of existing comorbidities. However, the new form of treatment is also an option for patients who, having had a successful operation, develop a new condition on a subsequent segment of the aorta.

"We are committed to simplifying the treatment of patients with aortic arch diseases going forward. This minimally invasive procedure provides us with new options for treating high-risk patients," reports Marlies Stelzmüller from the Division of Cardiac Surgery.

The procedures were performed in the University Hospital Vienna by the interdisciplinary aortic team from MedUni Vienna. Three divisions were involved in the operation: the Division of Cardiac Surgery (Marie-Elisabeth Stelzmüller and Marek Ehrlich), the Division of Cardiovascular and Interventional Radiology (Martin Funovics and Florian Wolf) and the Division of Cardiothoracic and Vascular Anesthesia and Intensive Care Medicine (Doris Hutschala and Nikolaus Heinrich).