Surgical explanation of an infected aortic arch endograft: a two-stage approach

Thoracic Endovascular Aortic Repair has become the preferred treatment for various aortic pathologies due to its minimally invasive approach. While advancements, including branched devices, have expanded the scope of endovascular repair to the aortic arch and ascending aorta, they also present challenges, particularly in managing complications like infection. We report a rare case of a branched thoracic endograft explantation. A 67-year-old male was evaluated for hemoptysis caused by an infected branched endograft with an aorta-oesophageal fistula. The patient underwent a staged approach, including preoperative left common carotid artery to left subclavian artery bypass and explantation of the endograft under circulatory arrest. Reconstruction was achieved using a self-made bovine xenopericardial tube graft. Postoperative recovery was uneventful, and the patient was discharged in good condition 23 days post-surgery.