Endo-Bentall Procedure Using A Fenestrated Endovascular Valved Conduit To Repair An Aorto-atrial Fistula
Bradley G. Leshnower, MD, Alexander P. Nissen, MD, Yazan M. Duwayri, MD, William J. Nicholson, MD, Adam B. Greenbaum, MD, Vasilis C. Babaliaros, MD.
Emory University School of Medicine, Atlanta, GA, USA.
BACKGROUND: Endovascular treatment of aortic root pathology poses significant challenges due to the presence of the coronary ostia and the lack of a dedicated device. This video demonstrates the use of a modular off-the shelf solution using a commercially available thoracic aortic stent graft and transcatheter heart valve to repair an aorto-atrial fistula in a patient at prohibitive risk for open repair
METHODS: Using peripheral cardiopulmonary bypass support, a physician modified thoracic stent graft with two fenestrations for the coronary arteries was deployed inside a pre-existing surgical aortic valve. A transcatheter aortic valve was subsequently deployed and the coronary arteries were stented.
RESULTS: The patient tolerated the procedure well. Postoperative echocardiographic imaging and computed tomography confirmed closure of the aorto-atrial fistula. The patient was discharged from the hospital.
CONCLUSIONS: This video demonstrates the 1st successful performance of a minimally invasive endovascular aortic root repair using off-the shelf, commercially available devices.
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