Endovascular Arch Repair Using Inner Branch Stent-Graft With Transapical Access

Endovascular repair of aortic arch aneurysms has been considered in higher risk patients who are not ideally suited for open surgical or hybrid repair. A limitation of these devices is the 8- to 12-week delay for manufacturing, which does not allow treatment of symptomatic or rapidly expanding aneurysms. This report illustrates an urgent endovascular repair of an aortic arch aneurysm using a physician-modified endograft with 2 inner branches. Transapical access allowed better support and precision during device deployment, which was needed given the short proximal landing zone.