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

IntroductionEndovascular 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.ReportA 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.DiscussionTotal endovascular arch aneurysm repair is no longer contraindicated in patients with a mechanical aortic valve