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Transapical endovascular deployment of a stent-graft in the thoracic descending aorta

Utz Kappert1, Ahmed Ouda, Tamer Ghazy

  • 1Department of Cardiac Surgery, Dresden Heart Center, Dresden, Germany.

The Annals of Thoracic Surgery
|May 29, 2012
PubMed

Insights

A novel transapical approach successfully treated a large descending thoracic aortic aneurysm in a patient with challenging iliac anatomy. This technique offers a viable alternative for complex aortic aneurysm repair when standard endovascular methods are unsuitable.

Area of Science:

  • Cardiovascular Surgery
  • Vascular Surgery
  • Interventional Cardiology

Background:

  • Descending thoracic aortic aneurysms (DTAA) pose significant treatment challenges.
  • Standard endovascular aneurysm repair (EVAR) relies on suitable iliac access, which can be compromised by severe calcification or tortuosity.
  • Alternative access strategies are crucial for complex DTAA cases.

Observation:

  • A 74-year-old male presented with a large (60 mm) DTAA.
  • Severe calcification and kinking of iliac vessels precluded standard endovascular repair.
  • The patient had prior experience with transcatheter aortic valve implantation (TAVI).

Findings:

  • A transapical approach was employed for stent-graft deployment.
  • The stent-graft was successfully deployed through the cardiac apex.
  • No access-related complications occurred during the procedure.

Implications:

  • The transapical approach is a feasible alternative for DTAA repair in patients with inadequate iliac access.
  • This technique leverages expertise from transcatheter valve procedures.
  • Successful transapical stent-grafting offers a solution for complex aortic pathologies, potentially improving patient outcomes.

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