Thoracic endovascular aortic repair of an ascending aortic pseudoaneurysm

A 74-year-old man with a history of two thoracic aortic repairs, including a modified Bentall procedure using a mechanical valve and total arch replacement, was referred to our hospital with the development of hoarseness. Computed tomography revealed an anastomotic pseudoaneurysm between the prosthetic grafts in the ascending aorta. Two aortic cuffs for abdominal aorta were deployed through the left axillary artery using a transcatheter aortic valve replacement guidewire placed at the supra-aortic mechanical valve during ventricular rapid pacing and were successfully covered with an inlet to the pseudoaneurysm on postoperative computed tomography. The postoperative course was favorable.