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Aortoplasty and Stent Implantation for the Dacron-Jotec Junction Stenosis: First-in-Human Case Report
David Garcia-Romero1, Alfonso R Mitre2, Daniel Molina-Seguil3
1Department of Cardiology, Hospital Álvaro Cunqueiro, University Hospital of Vigo, Vigo, Spain; Department of Cardiology, National Institute of Cardiology Ignacio Chávez, Mexico City, Mexico.
Background:
Endovascular aortic repair using hybrid prostheses, such as the Jotec E-vita Open Neo prosthesis, is essential for aortic arch pathology. Anastomotic stenosis following this procedure is a rare complication that requires specialized management.
Case Summary:
A 42-year-old man presented with symptomatic severe stenosis between the Dacron graft and the E-vita Open Neo prosthesis after Frozen Elephant Trunk repair. Management included balloon aortoplasty followed by implantation of a 45-mm NuMED CP stent using the balloon-assisted tracking technique. The peak-to-peak gradient was reduced from 85 to 8.5 mm Hg. The patient was discharged 5 days later without complications.
Discussion:
The balloon-expandable CP stent provided effective luminal re-expansion and durable hemodynamic improvement, demonstrating its value as a mechanical solution for complex postsurgical anastomotic stenosis.
Take-Home Messages:
Aortoplasty with implantation of a noncovered mechanical stent is a feasible and effective endovascular option to treat complex anastomotic stenosis at the Dacron-Jotec junction after hybrid aortic arch repair.
