Abstract:IntroductionAscending aortic pathology presents a unique challenge for treatment by thoracic endovascular aortic repair (TEVAR), because of lack of adequate endograft landing zones. This report describes a unique “reverse” extra-anatomical aortic arch debranching procedure performed to enable TEVAR of the ascending aorta.ReportA 71-year-old male presented with a large ascending aortic pseudoaneurysm secondary to previous arch repair anastomosis. This pathology was treated by TEVAR of the ascending aorta. To cr… Show more
“…The great preponderance of procedures in the 70to 79-year and the 80-to 89-year age groups were ascending aortic replacements with a hemiarch (70.1% and 93.9% for the 2 groups, respectively), but currently few endovascular options for isolated ascending aneurysm are on the horizon because of the unique anatomic and hemodynamic milieu of the proximal aorta. 6 ''Reverse'' extra-anatomic arch debranching followed by transapical endovascular stenting has been reported recently for the treatment of an ascending aortic aneurysm, 7 yet in its current form is reserved for prohibitive-risk patients only.…”
Elderly patients are at particular risk of morbidity and mortality from complex aortic operations. Novel interventions and better tools for risk assessment should be sought.
“…The great preponderance of procedures in the 70to 79-year and the 80-to 89-year age groups were ascending aortic replacements with a hemiarch (70.1% and 93.9% for the 2 groups, respectively), but currently few endovascular options for isolated ascending aneurysm are on the horizon because of the unique anatomic and hemodynamic milieu of the proximal aorta. 6 ''Reverse'' extra-anatomic arch debranching followed by transapical endovascular stenting has been reported recently for the treatment of an ascending aortic aneurysm, 7 yet in its current form is reserved for prohibitive-risk patients only.…”
Elderly patients are at particular risk of morbidity and mortality from complex aortic operations. Novel interventions and better tools for risk assessment should be sought.
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