First-in-Human Explantation for Infection of the Novel Thoracic Branched Endograft

Background: The Gore TAG thoracic branched endoprosthesis (W.L. Gore & Associates) is the only branched thoracic stent graft available in the U.S. First-in-Human/Early Reports Summary: A 67-year-old man underwent thoracic branched endograft (TBE) placement with the Gore TAG device for a contained rupture of the distal aortic arch and thoracic aorta. Imaging showed a mycotic aneurysm that eroded into the left lower lobe, causing hemoptysis. He was transferred to a quaternary care aortic center. Discussion: To remove the TBE, a left common carotid–to–subclavian artery bypass was performed. The patient was cannulated and placed in hypothermic circulatory arrest. The aneurysm was explored, and both stent components were explanted. The aorta was reconstructed with anastomoses in zones 2 and 5. Two additional washouts were required, but the patient had an uncomplicated course and was discharged on postoperative day 18. Novelty: To our knowledge, this is the first reported case of explantation of an infected TBE. Take-Home Message: Explantation of an infected TBE is feasible with multidisciplinary care at an experienced aortic center.

Duke Scholars

Author Brian F Gilmore Surgery, Vascular and Endovascular Surgery