fig6

Figure 6. Artist drawings of type I and II hybrid arch repairs (HAR) for chronic dissection. Type I: HAR involves debranching of the aortic arch vessels using a multi-branched Dacron graft sewn to either the native ascending aorta or, as shown in the drawing, a previously Dacron-replaced ascending aorta. This latter scenario is most commonly utilized in the setting of residual type B dissection after prior type A repair. Type II: HAR involves the replacement of the ascending aorta and, most commonly, a portion of the arch (to create proximal landing zone for the endografts) with distal anastomosis frequently in zones 1 or 2, along with debranching of the arch vessels.