Transcatheter Mustard Revision Using Endovascular Graft Prostheses

We describe the use of percutaneously inserted, transcatheter endovascular graft prostheses to exclude large Mustard baffle leaks in a high-surgical-risk patient. We used 3-dimensional–printed models to determine feasibility and to plan the procedure. Telescoping thoracic and abdominal graft extensions were placed in the inferior and superior limbs of the systemic venous pathways. An atrial septal defect occluder device was also used to close a separate leak not covered by the endovascular graft prostheses. This approach may be useful in patients with complex, large intraatrial baffles that require repair of baffle leaks not amenable to device closure.