Introduction
The adoption of thoracic aortic endovascular repair (TEVAR) has significantly improved treatment options for a variety of aortic pathologies, while decreasing morbidity and mortality compared to conventional open repairs. It has also allowed the use of hybrid techniques which combine surgical and endovascular graft placements. A number of these approaches have been described, but their popularity remains limited, in part due to the paucity of literature on their midterm and long-term outcomes. Here we present the case of a hybrid off-pump debranching and TEVAR with a 1-year follow-up. A discussion on the pearls and pitfalls of this technique is also provided.