Hybrid Three-Stage Repair of Mega Aorta With Lupiae Technique: Tips and Tricks

In this illustrated article, Esposito and colleagues outline the Lupiae technique for hybrid three-stage repair of mega aorta. The technique includes initial surgical replacement of the ascending aorta and proximal rerouting of the aortic arch vessels, followed by delayed surgical replacement of the infrarenal aorta with distal rerouting of the visceral and renal vessels, which then facilitates an endovascular approach for subsequent complete exclusion of the residual diseased aorta between the surgically shaped proximal and distal Dacron landing zone. The authors describe the outcomes for 27 patients treated with this approach, and they discuss tips for a safe and effective procedure.