High-Risk Left Main Angioplasty With Covered Stent in Marfan Patient With Hemi-Cabrol Surgery

Area of Science:

• Cardiovascular Surgery
• Interventional Cardiology
• Vascular Access

Background:

• The Cabrol procedure, a complex aortic graft technique, carries risks including graft stenosis.
• Graft stenosis can lead to significant patient morbidity and mortality.

Observation:

• A patient with Marfan syndrome and a history of aortic surgery presented with symptoms of coronary artery stenosis.
• Imaging identified severe stenosis at the Cabrol graft-left main artery anastomosis and the right coronary artery ostium.

Findings:

• Percutaneous coronary intervention (PCI) successfully treated the right coronary artery stenosis with a drug-eluting stent.
• PCI of the Cabrol graft was performed using a peripheral covered stent via brachial access, with no procedural complications.
• The patient remained asymptomatic at 2-year follow-up, with preserved graft function and no evidence of restenosis.

Implications:

• Percutaneous coronary intervention with a peripheral covered stent is a feasible and less-invasive option for treating Cabrol graft stenosis.
• This technique offers a promising alternative to repeat surgery, particularly for high-risk patients.
• Favorable long-term outcomes suggest this approach can improve quality of life and reduce complications associated with Cabrol graft stenosis.