Thoracic Endovascular Aortic Repair for Pseudoaneurysm after Interrupted Aortic Arch Repair

Abstract

Here we describe the case of a 33-year-old woman who was diagnosed with interrupted aortic arch (IAA) type A and who underwent radical surgery in her infancy. She developed a 42-mm anastomotic pseudoaneurysm in the distal aortic arch. We decided to perform thoracic endovascular aortic repair because of the patient’s special request to avoid open surgery. We selected a reversed taper-type leg stent graft for the iliac artery and successfully implanted it without problems. However, the long-term outcomes of the stent graft in young people remain unclear, and careful regular follow-up for a long period is mandatory.

Aortic arch and frozen elephant trunk repair of a right-sided aortic arch with pseudoaneurysm rupture

“…Reviews of the operative strategies for pseudoaneurysm repair after congenital arch repair highlight the efficacy of each technique on a case by case basis. 10 , 11 , 12 , 13 , 14 Resection of the pseudoaneurysm from a right thoracotomy is technically feasible; however, we believed that given the size and location of the pseudoaneurysm, that approach would have been very challenging. Other repair strategies include total arch replacement, descending thoracic aortic replacement with subclavian artery–carotid artery transposition, and stent grafting with extra-anatomic bypass, which was performed in the present case.…”

The Importance of TEE Examination in Patients with Pseudoaneurysm of Arch of Aorta Post-TEVAR Procedure

“…Therefore, the final stent in position covered the entire arch of aorta with the arch vessels being supplied by the surgically placed graft in situ. [5][6][7] The patient was shifted to the intensive care unit following the procedure with the femoral sheaths. He was weaned from the ventilator and hemodynamically managed in the intensive care unit with special attention to avoid hypertension and sympathetic overdrive.…”

“…Therefore, the final stent in position covered the entire arch of aorta with the arch vessels being supplied by the surgically placed graft in situ. 5 6 7…”