Arminder Singh Jassar, MBBS, Michael A. Golden, MD, John G

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Balloon-Assisted Deployment Prevents Endograft Misalignment During Hybrid Aortic Arch Repair Arminder Singh Jassar, MBBS, Michael A. Golden, MD, John G. Augoustides, MD, FASE, William J. Vernick, MD, Joseph E. Bavaria, MD, Wilson Y. Szeto, MD The Annals of Thoracic Surgery Volume 91, Issue 6, Pages 1982-1984 (June 2011) DOI: 10.1016/j.athoracsur.2010.11.022 Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Preoperative computed tomographic scan depicting aortic arch aneurysm. The Annals of Thoracic Surgery 2011 91, 1982-1984DOI: (10.1016/j.athoracsur.2010.11.022) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 (A) Distal maldeployment of the Talent thoracic stent-graft (Medtronic Inc, Santa Rosa, CA) is seen after initial misalignment is corrected by graft pullback. Balloon has been inflated in the ascending aorta as a second device is prepared to be deployed. (B, C) Misaligned opening occurs as graft is unsheathed. (D, E) The balloon reorients the misaligned graft to the curve of the aorta. (F) This allows optimal graft deployment in the desired location. The Annals of Thoracic Surgery 2011 91, 1982-1984DOI: (10.1016/j.athoracsur.2010.11.022) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 (A) Intraoperative DynaCT and (B) 6-month follow-up computed tomographic scan demonstrate complete aneurysm exclusion and absence of endoleaks. (B) Take-off of the proximal aortic graft is also visible (arrow). The Annals of Thoracic Surgery 2011 91, 1982-1984DOI: (10.1016/j.athoracsur.2010.11.022) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions