Total Endovascular Treatment of an Aortic Arch Aneurysm in a Patient with a Mechanical Aortic Valve

Introduction: Endovascular repair of aortic arch aneurysms using an inner-branched device is a new treatment option for patients unfit for open surgery. There are many anatomical restrictions, such as the presence of a mechanical aortic valve that can contraindicate this complete endovascular approach. Report: A new delivery system to overcome this issue has been developed. This new system was used to treat an aortic arch aneurysm 77 mm in diameter in a 37-year-old patient with Marfan's syndrome. The patient was considered to be at major risk for open surgery because of severe respiratory insufficiency following a second sternotomy. Discussion: Total endovascular arch aneurysm repair is no longer contraindicated in patients with a mechanical aortic valve. (C) 2014 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.