Technical strategy for the endovascular management of ascending aortic pseudoaneurysm.
We present two cases of ascending aortic pseudoaneurysm exclusion with off-the-shelf aortic stent grafts. The right common carotid artery was used for access to facilitate graft delivery. Control of graft deployment was aided using a compliant right atrial occlusion balloon to lower cardiac output at the time of deployment. Transesophageal echocardiography facilitated the sizing and positioning of the right atrial balloon and was used to survey the heart and ascending aorta on successful exclusion of the pseudoaneurysm. These simple maneuvers made an uncommon procedure straight forward, predictable, and successful.
Department of Surgery, Greenville Hospital System University Medical Center, Greenville, SC 29615, USA. bhgray@ghs.org
Bruce H
BH
Gray
Eugene M
EM
Langan
Ginger
G
Manos
Leah
L
Bair
Steven Z
SZ
Lysak
D000368:Aged; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000601:surgery*; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation / Q000379:methods*; D002404:Catheterization; D017548:Echocardiography, Transesophageal; D057510:Endovascular Procedures / Q000295:instrumentation; D006801:Humans; D008297:Male; D011474:Prosthesis Design; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome