Hybrid thoraco-abdominal aortic repair via limited thoraco-phreno-laparotomy using Thoracoflo® Graft

The management of thoraco-abdominal aortic aneurysms remains challenging, particularly in patients considered unsuitable for conventional endovascular procedures due to unfavourable anatomy or unfit for traditional open surgical approaches due to comorbidities. In response to these limitations, a novel hybrid prosthesis has emerged as an alternative designed to reduce invasiveness, avoid aortic cross-clamping and avoid extracorporeal circulation. The Thoracoflo® (Terumo Aortic, Glasgow, UK) has been developed to bridge the gap between open and endovascular techniques, especially for patients with connective tissue disorders and individuals with complex anatomical challenges. In this paper, we present the use of the Thoracoflo device via a thoraco-phreno-laparotomy, offering an alternative to the previously employed medial laparotomy.