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Endograft repair for pseudoaneurysms and penetrating ulcers of the ascending aorta  Gabriele Piffaretti, MD, PhD, Mario Galli, MD, Chiara Lomazzi, MD,

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Presentation on theme: "Endograft repair for pseudoaneurysms and penetrating ulcers of the ascending aorta  Gabriele Piffaretti, MD, PhD, Mario Galli, MD, Chiara Lomazzi, MD,"— Presentation transcript:

1 Endograft repair for pseudoaneurysms and penetrating ulcers of the ascending aorta 
Gabriele Piffaretti, MD, PhD, Mario Galli, MD, Chiara Lomazzi, MD, Marco Franchin, MD, Patrizio Castelli, MD, Giovanni Mariscalco, MD, PhD, Santi Trimarchi, MD, PhD  The Journal of Thoracic and Cardiovascular Surgery  Volume 151, Issue 6, Pages (June 2016) DOI: /j.jtcvs Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

2 Figure 1 Preliminary computed angiography of a suture-line disruption AAP (patient #7) shows the following: (A) the variant of the supra-aortic vessels with a common origin of the brachiocephalic trunk and left common carotid artery; (B) the origin (arrow) of the AAP (marked as P) developed from a previous ascending aortic graft replacement (marked as A); (C) multiplanar reconstruction; (D) volume rendering reconstruction indicating the enormity of the pseudoaneurysm. BCT, Brachiocephalic trunk; LCCA, left common carotid artery; LSA, left subclavian artery; P, pseudoaneurysm; A, aorta. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

3 Figure 2 Postoperative computed tomography-angiography control of Figure 1 AAP: (A) regular patency of the supra-aortic vessels with the distal edge (arrow) of the custom-designed endograft deployed in proximity to the brachiocephalic trunk take-off point; (B) complete exclusion of the AAP (marked as P), and full expansion of the ascending endograft (marked with A); (C) multiplanar reconstruction; (D) volume rendering reconstruction at 24 months. P, Pseudoaneurysm; A, aorta. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

4 Figure 3 Intraoperative angiography of an AAP (patient #5) shows the following: (A) the neck located in zone 2 (lines); (B) the deployment of 2 short standard abdominal endografts; (C) final control angiogram with complete exclusion of the AAP and an absence of endoleaks; (D) preliminary CT-A of the same AAP; (E) 12-month follow-up CT-A of the stable exclusion of the AAP with no endoleaks, and the full expansion and integrity of the endografts; (F) volume rendering reconstruction at 24 months. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

5 Figure 4 Preoperative (A and B) CT-A of a penetrating aortic ulcer of the ascending aorta (patient #8); postoperative (C and D) CT-A control showing the presence of a type 3 endoleak. This patient had received a descending thoracic endovascular aortic repair before this ascending repair. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

6 Photo of an ascending aortic pseudoaneurysm treated (off-label) with 2 abdominal aortic cuffs.
The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

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