Endovascular aortic valve and ascending aorta replacement

Currently there is no standard endovascular treatment option for ascending aortic aneurysms or dissection combined with aortic valve malformations. Our aim was to design a composite endovascular device consisting of a transcatheter aortic valve prosthesis and integrated thoracic aortic stent graft. The endovascular composite valve graft design is based on five integrated concepts: 1) individualization of prosthesis size according to the anatomy, 2) intraoperative coupling of both components, 3) free diastolic coronary perfusion, 4) distribution of the radial force to three anatomical structures, namely the aortic valve annulus (zone A), the sinotubular junction (zone B) and the distal ascending aorta (zone C) and 5) single stage implantation. The short distance between the coronary arteries and zone B and significant angulation between the planes of zones B and C must be considered in the composite valve graft designing process. The novel conduit device will enable simultaneous endovascular repair of aortic valve malformations and ascending aorta aneurysms or dissection. © 2016, Springer-Verlag Berlin Heidelberg.