E-vita OPEN NEO in the treatment of acute or chronic aortic pathologies: first interim results of the NEOS study

Author:

Tsagakis Konstantinos1ORCID,Kempfert Joerg23,Zierer Andreas45,Martens Andreas6ORCID,Dohle Daniel-Sebastian7,Castiglioni Alessandro8,Wong Randolph Hung-Leung9,Widenka Kazimierz10,Liakopoulos Oliver11,Borger Michael A12,Oo Aung Ye13,Holubec Tomas14,Luehr Maximilian15,Legarra Calderón Juan José16,Grabenwöger Martin171819ORCID

Affiliation:

1. Department of Thoracic and Cardiovascular Surgery, West-German Heart and Vascular Center, University Hospital Essen , Essen, Germany

2. Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charité (DHZC) , Berlin, Germany

3. Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin , Berlin, Germany

4. Department of Cardiovascular and Thoracic Surgery, Faculty of Medicine, Johannes Kepler University Linz , Linz, Austria

5. Department of Cardiovascular and Thoracic Surgery, Wels-Grieskirchen Clinic , Wels, Austria

6. Clinic of Cardiac Surgery, University Hospital Oldenburg, Oldenburg, Germany

7. Department of Heart and Vascular Surgery, University Medical Center of the Johannes Gutenberg-University Mainz , Mainz, Germany

8. Department of Cardiac Surgery, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University , Milan, Italy

9. Division of Cardiothoracic Surgery, Department of Cardiothoracic Surgery, the Chinese University Hong Kong , Hong Kong

10. Department of Cardiac Surgery, District Hospital No. 2, University of Rzeszów , Rzeszów, Poland

11. Departemnt of Cardiac Surgery, Kerckhoff-Clinic, Campus Kerckhoff, University of Gießen , Bad Nauheim, Germany

12. University Department of Cardiac Surgery, Heart Center Leipzig , Leipzig, Germany

13. St Bartholomew’s Hospital, Barts Health NHS Trust , London, UK

14. Department of Cardiovascular Surgery, University Hospital Frankfurt, Goethe University , Frankfurt, Germany

15. Department of Cardiothoracic Surgery, Heart Center of the University of Cologne , Cologne, Germany

16. Department of Cardiovascular Surgery, University Hospital Álvaro Cunqueiro , Vigo, Spain

17. Department of Cardiovascular Surgery, Clinic Floridsdorf , Vienna, Austria

18. Institute of Cardiovascular Research, Karl Landsteiner Society , Vienna, Austria

19. Medical Faculty, Sigmund Freud Private University , Vienna, Austria

Abstract

Abstract OBJECTIVES The aim of this multicentre study was to demonstrate the safety and clinical performance of E-vita OPEN NEO Stent Graft System (Artivion, Inc.) in the treatment of aneurysm or dissection, both acute and chronic, in the ascending aorta, aortic arch and descending thoracic aorta. METHODS In this observational study of 12 centres performed in Europe and in Asia patients were enrolled between December 2020 and March 2022. All patients underwent frozen elephant trunk using E-vita OPEN NEO Stent Graft System. Primary end point was the rate of all-cause mortality at 30 days and secondary end points included further clinical and safety data are reported up to 3–6 months postoperatively. RESULTS A total of 100 patients (66.7% male; mean age, 57.7 years) were enrolled at 12 sites. A total of 99 patients underwent surgery using the E-vita OPEN NEO for acute or subacute type A aortic dissection (n = 37), chronic type A aortic dissection (n = 33) or thoracic aortic aneurysm (n = 29), while 1 patient did not undergo surgery. Device technical success at 24 h was achieved in 97.0%. At discharge, new disabling stroke occurred in 4.4%, while new paraplegia and new paraparesis was reported in 2.2% and 2.2%, respectively. Renal failure requiring permanent (>90 days) dialysis or hemofiltration at discharge was observed in 3.3% of patients. Between discharge and the 3–6 months visit, no patients experienced new disabling stroke, new paraplegia or new paraparesis. The 30-day mortality was 5.1% and the estimated 6-month survival rate was 91.6% (standard deviation: 2.9). CONCLUSIONS Total arch replacement with the E-vita OPEN NEO can be performed with excellent results in both the acute and chronic setting. This indicates that E-vita OPEN NEO can be used safely, including in the setting of acute type A aortic dissection.

Funder

JOTEC GmbH

Publisher

Oxford University Press (OUP)

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