Midterm Outcomes of the Dissected Aorta Repair Through Stent Implantation Trial.

The Annals of Thoracic Surgery
Sabin J BozsoMichael C Moon

Abstract

The intimal flap at the distal aortic anastomosis after standard aortic dissection repair creates distal anastomotic new entry, leading to false lumen (FL) pressurization and true lumen (TL) collapse and resulting in increased mortality, malperfusion, aortic growth, and reinterventions. The Ascyrus Medical Dissection Stent (AMDS; Ascyrus Medical, Boca Raton, FL) is a hybrid prosthesis that seals and depressurizes the FL at the distal anastomosis while expanding and pressurizing the TL. The Dissected Aorta Repair Through Stent Implantation trial is a prospective, nonrandomized, international type A dissection trial where patients with acute DeBakey I dissections were enrolled between March 2017 and January 2019. Forty-seven patients were enrolled (median age, 62.5; 67.4% men) with a median follow-up of 631 days. All patients underwent emergent surgical repair with successful AMDS implantation. One patient was excluded because of use in iatrogenic dissection. Overall mortality at 30 days and 1 year was 13.0% (6/46) and 19.6% (9/46), whereas new strokes occurred in 6.5% (3/46). Over 95% of vessel malperfusions resolved because of AMDS-induced TL expansion, including 3 patients with preoperative paralysis. Positive remodeling of th...Continue Reading

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Citations

Aug 25, 2020·The Annals of Thoracic Surgery·William T Brinkman
Apr 7, 2021·Surgical Technology International·Leonard PittsJörg Kempfert
Jul 7, 2021·The Journal of Thoracic and Cardiovascular Surgery·Suvitesh Luthra, Geoffrey M Tsang

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