Results of the Gore Hybrid Vascular Graft in Challenging Aortic Branch Revascularization during Complex Aneurysm Repair

BACKGROUND: Prolonged organ ischemia during complex aortic surgery is associated with increased morbidity and mortality. A novel hybrid graft (Gore Hybrid Vascular Graft) as composite of expanded polytetrafluorethylene vascular prosthesis that has a section reinforced with nitinol was investigated for feasibility and effectiveness during aortic repair.

METHODS: Retrospective analysis of all consecutive patients treated with the hybrid vascular graft (HVG). Indication for graft implantation was surgeon's preference for branch revascularization in challenging aortic repair.

RESULTS: Within 26 months, 25 Gore HVGs and 17 conventional grafts were implanted in 12 patients (age, 73 years; range, 33-79 years, 8 men). Eleven patients were treated for thoracoabdominal aortic aneurysms and one for aortoiliac aneurysm (elective = 6, urgent = 6). Nine visceral debranching procedures, 2 Crawford procedures, and 1 repair of an internal iliac aneurysm were performed. The distribution of HVG use was left renal artery = 10, right renal artery = 9, superior mesenteric artery = 4, celiac trunk = 1, and internal iliac artery = 1. Time to restore visceral blood flow during visceral debranching was 7 ± 4 min for the Gore HVG vs. 12 ± 6 min for conventional grafts (P < 0.01).Technical success was achieved in all cases. At 12 months of median follow-up, cumulative patency of the HVGs was 96%.

CONCLUSIONS: The Gore HVG offers a new, simplified, and time-sparing technique for visceral anastomoses during complex aneurysm repair. However, long-term results are still lacking and need to be awaited.