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.