Physician-modified low-profile Endo-Bentall device for treating complex aortic diseases involving the aortic root

With the goal of expanding applicability and functionality, we propose two modifications to the Endo-Betall device, originally described by Ghoreishi et al: (1) a stent-free segment (by removing the first stent ring) within the thoracic stent graft portion of the Endo-Bentall device; and (2) vertical gold marker placement tagged to fenestrations. Removing the first stent ring can be a strategy to decrease the overall Endo-Bentall device profile, allowing for better maneuverability and less traumatic engagement with the aortic wall. Vertical gold markers act as visual guides during the procedure, ensuring the precise alignment of coronary fenestrations with coronary ostia.