Page 4 - Virtual Vascular Vol 9
P. 4

There is however and advanced End-

                                                                                                                                                                               ovascular option for repairing arch

                                                                                                                                                                               aneurysms.



                                                                                                                                                                               A custom-made stent graft with
                                                                                                                                                       1                       three inner side branches can be

                                                                                                                                                                               manufactured.  Each of these dia-
                                                                                                                                                   2                           mond shaped recesses leads to an


                                                                                                                                                                               inner side branch



                                                                                                                                                                               The Endograft is introduced via

                                                                                                                                                   3                           the groin on a stiff guidewire going
                                                                                                                                                                               through the aortic valve.  A balloon

                                                                                                                                                                               placed in the right atrium is used to

                                                                                                                                                                               occlude the IVC blood return tempo-

                                                                                                                                                                               rarily to drop the aortic blood pres-
                                                                                                                                                                               sure.




                                                                                                                                                                               The stent graft is released into the

                                                                                                                                                                               ascending aorta.  Blood flow is main-
                                                                                                                                                                               tained via these recesses and the

                                                                                                                                                                               branches are bridged with addition-

                                                                                                                                                                               al stent components introduced via
            79-year old man with multiple co-morbidities presented with a large saccular
       A  aneurysm in the aortic arch.  He was deemed unfit for open repair which would                                                                                        cutdowns in both neck and for the

       require cardiopulmonary bypass.                                                                                                                                         left subclavian branch via the femoral
                                                                                                                                                                               artery.











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