First reported surgical explantation of infected thoracic branched endograft requiring complex arch and descending thoracic aortic repair

We present a 51-year-old woman with thoracic aortitis and rapidly enlarging descending thoracic aortic aneurysm in the setting of Clostridium septicum bacteraemia. After antibiotic treatment, she underwent left carotid-subclavian transposition and endovascular repair with thoracic branched endograft (TBE) with left carotid artery coverage. Three months postoperatively, she developed endograft infection, with a rapidly enlarging pseudoaneurysm at the proximal landing zone. She underwent TBE explant and descending thoracic aortic reconstruction. This report illustrates a rare complication and the first described surgical TBE explantation.