Open descending aortic replacement after Thoraflex™ hybrid graft implantation.

The Thoraflex™ device is a composite 4-branched graft with a distal endovascular stent that allows either a one-stage treatment or an endovascular second-stage treatment of multisegment aortic pathologies. Reports on open second-stage treatment after the Thoraflex™ device implantation are sparse especially regarding the technical aspects. We described our surgical procedure of open second-stage descending thoracic aortic replacement after Thoraflex™ implantation with a special focus on the anastomosis technique to a stent graft. We found excellent haemostasis and a good postoperative outcome using our approach of the stent graft to graft anastomosis.