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The AMDS hybrid prosthesis is a novel device for the treatment of acute DeBakey I aortic dissection in patients without an intimal tear in the arch. Composed of an uncovered nitinol braided stent with a proximal felt cuff, it is deployed antegrade during circulatory arrest. Whereas early results have been promising, here we present 4 cases of negative aortic remodeling that were rescued by total arch frozen elephant trunk technique. These cases highlight the importance of patient selection in considering the AMDS device and illustrate that rescue of negative aortic remodeling is possible.
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http://dx.doi.org/10.1016/j.athoracsur.2025.06.021 | DOI Listing |
JTCVS Open
August 2025
Department of Anaesthesia and Intensive Care Medicine, Royal Papworth Hospital, Cambridge Biomedical Campus, Cambridge, United Kingdom.
Objective: Postoperative intraluminal thrombosis after frozen elephant trunk replacement has been reported to occur with a frequency of 6% to 17% and is associated with poor outcomes. The purpose of this institutional review is to analyze thrombosis rate, predisposing patient and operative factors, and assess different anticoagulation regimens.
Methods: This retrospective cohort study includes 174 patients operated on over 10 years.
JTCVS Open
August 2025
State Key Laboratory of Cardiovascular Disease, Center of Vascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Objective: To evaluate the remodeling of the distal aorta and outcomes after aortic surgery for type A aortic dissection (TAAD) in patients with Marfan syndrome and investigate whether morphologic characteristics of the dissection can predict negative remodeling.
Methods: Between 2013 and 2021, we performed total arch with a frozen elephant trunk for 325 patients with Marfan syndrome with DeBakey type I aortic dissection. Mean age was 47.
Cureus
July 2025
Cardiovascular Surgery, Kushiro City General Hospital, Kushiro, JPN.
A 65-year-old man presented with Stanford type B aortic dissection complicated by rupture of the distal aortic arch, originating from the false lumen. Due to the short distance between the supra-aortic branches, the lack of peripheral access from malperfusion, and the invasiveness of combined arch and descending aortic replacement via left thoracotomy, emergency total arch replacement with a frozen elephant trunk was chosen to close the primary entry and control the rupture. However, intraoperative deployment of the prosthesis into the false lumen was suspected due to increasing bleeding and transesophageal echocardiographic findings.
View Article and Find Full Text PDFKyobu Geka
August 2025
Department of Cardiovascular Surgery, Hirakata Kosai Hospital, Hirakata, Japan.
An 82-year-old man was admitted to our hospital with chest pain as a chief complaint and diagnosed with a ruptured aortic aneurysm in the distal arch by contrast-enhanced computed tomography (CT). The patient underwent surgery using artificial heart-lung and selective cerebral extracorporeal circulation, and a semi-circumferential aortic arch incision was made around the anterior surface of the aortic arch. An open stent graft was inserted through the incision, trimmed to fit the size, and the aortic wall and the stent graft were fixed with 3-0 proline continuous sutures, and finally the incision was closed with 3-0 proline.
View Article and Find Full Text PDFKyobu Geka
August 2025
Department of Cardiovascular Surgery, Tsukazaki Hospital, Himeji, Japan.
We report a case of acute type A aortic dissection (ATAAD) with an isolated left vertebral artery (ILVA), and our successful surgical treatment with a fenestrated frozen elephant trunk (FET). A 56-year-old man was referred to our department for chest and back pain. Contrast enhanced computed tomography (CT) revealed ATAAD.
View Article and Find Full Text PDF