Explant of an infected aortic arch fenestrated stent graft with extra-anatomic reconstruction

Fenestrated and branched endovascular aortic repair has increasingly been implemented to treat aortic arch pathology. Infection of these endografts is a rare complication-and one that has not yet been described for fenestrated and branched endovascular aortic repair of the arch. We present a 61-year-old man who presented with an infection of a fenestrated arch endograft secondary to an aortoesophageal fistula. He underwent staged surgical treatment using extra-anatomic bypasses. His postoperative course was complicated by prolonged hypoxemic respiratory failure and the development of end-stage renal disease. The patient was readmitted and died 93 days postoperatively because of surgical complications.