A 77 years old man with a history of coronary artery bypass surgery including a left internal thoracic artery graft had undergone thoracic endovascular aortic repair (TEVAR) for penetrating aortic ulcer at an external hospital. The left subclavian artery (LSA) had been covered (figure 1A). The patient was admitted to our institution 4 months after TEVAR for shortness of breath and worsening of left ventricular ejection fraction. After multidisciplinary discussion we decided to fenestrate the previously implanted graft percutaneously.
2. Heart Center Leipzig at the University of Leipzig, Department of Internal Medicine/Cardiology, Leipzig, Germany
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