Intraoperative Aortoscopy for FET Hybrid Stent Deployment

Intraoperative Aortoscopy during arch resection and stabilization of the 'downstream aorta' with Frozen Elephant Trunk (FET) operation using hybrid stent devices (Thoraflex in this video) is a new emerging adjunct diagnostic modality. Intraoperative direct visualization of the distal aortic bed prior to and after deployment of the hybrid stent device during the period of deep hypothermic circulatory arrest is necessary to confirm proper deployment and inspect the distal seal of the endo stent as seen in this video. The atherosclerotic heavily diseased descending thoracic 'downstream aorta' can be also be clearly visalized.

A flexible illuminated fibre-optic endoscope with wide bore aspiration channel (Ambu® aScope™ 4 Large, Ambu A/S, Ballerup, Denmark) with a working length of 60cm, diameter of 6.3mm and a channel width of 2.6mm was used.