CTICasesOversown Side Graft for Impella Access
Imaging findings
Chest radiograph shows an incomplete border sign in the right upper chest. CT shows a large, blind-ending, oversown vascular graft extending from the ascending aorta into the anterior chest wall. The graft was used to facilitate trans-aortic insertion of an Impella device.
Key takeaways
During CABG or other open-heart procedures, a large side graft may be sewn to the ascending aorta to allow insertion of a ventricular assist device (VAD) like the Impella. After VAD removal, the graft is oversown and left in place, presenting as a mass-like opacity with an incomplete border sign on chest radiograph.
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