Abstract
The authors describe the transapical deployment of a thoracic endograft to exclude a saphenous vein graft proximal anastomotic pseudoaneurysm following coronary artery bypass grafting (CABG) in a 63-year-old male with a prosthetic aortic valve. A standard thoracic endograft has been deployed via transapical access after percutaneous transluminal coronary angioplasty of the native vessel perfused by the patent CABG. The procedure was uneventful; an 8-month computed tomography scan showed complete exclusion of the pseudoaneurysm with patency of supra-aortic trunks.
Highlights
Ascending aorta and aortic arch aneurysms still represent one of the most complex conditions to be managed.Open surgery is the gold standard in high risk patients; surgical techniques have improved considerably over time, the need for cardiac arrest and extracorporeal circulation carries significant peri- and postoperative morbidity and mortality rates.On the other hand, thoracic endovascular aortic repair (TEVAR) has evolved rapidly as the standard treatment for lesions of the descending aorta, because of its high technical success rate and low operative risk
The technique is demonstrated in a 63-year-old male, with dilatative cardiomyopathy and a 32% ejection fraction, who underwent open chest surgery with prosthetic aortic valve replacement (Magna Ease 23 mm, Edwards Lifesciences, Irvine, CA), mitral valve repair
MN), and a double coronary artery bypass grafting (CABG) due to severe stenosis of the proximal tract of the left anterior descending (LAD) coronary artery involving the origin of D1
Summary
Ascending aorta and aortic arch aneurysms still represent one of the most complex conditions to be managed. Open surgery is the gold standard in high risk patients; surgical techniques have improved considerably over time, the need for cardiac arrest and extracorporeal circulation carries significant peri- and postoperative morbidity and mortality rates. Thoracic endovascular aortic repair (TEVAR) has evolved rapidly as the standard treatment for lesions of the descending aorta, because of its high technical success rate and low operative risk. New trials are testing the role of endoprosthesis dedicated to ascending aorta and aortic arch even if not yet available commercially.[2] At this time, endovascular solutions are applied only to compassionate cases in need of urgent repair; therapeutic options are based on alternative adaptation of available devices in a case-by-case fashion
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
