Aortic arch surgery, which requires deep hypothermic circulatory arrest, has morbidity and mortality rate up to 30% . Debranching of the supraaortic vessels combined with endovascular aortic repair (EVAR), so called hybrid procedures, have gained increasing acceptance as an alternative to open surgery. Unfortunately, aneurysm-related
remodelling of the supraaortic vessel anatomy and/or disease extension to these vessels can make bypass surgery challenging. To minimize or avoid manipulation-related
vascular complications and reduce clamping time during debranching, we have introduced a new non-sutured, Viabahn-based revascularisation technique of the
supraaortic vessels. This paper reports about our experience in 20 cases where Viabahn debranching was performed through a sternotomy.