Aortic Surgery: Open Repair, Endovascular Innovations, and Hybrid Strategies

Surgical management of the thoracic and thoracoabdominal aorta continues to evolve through the parallel maturation of open surgical techniques and endovascular aortic repair (TEVAR/EVAR) technologies. This chapter provides a state-of-the-art review of operative approaches for aortic aneurysm, dissection, and complex aortic arch pathology, including the comparative evidence base for open versus endovascular strategies across different anatomical zones. Advances in fenestrated and branched endografts, cerebral protection strategies during arch surgery, and the role of hybrid procedures in high-risk patients are reviewed with reference to current guidelines and emerging trial data.