Hybrid noncovered open stents in repair of DeBakey type 1 acute aortic dissections

Author:

Luthra Suvitesh12ORCID,Miskolczi Szabolcs1,Velissaris Theodore1,De Silva Ravi J3,Luehr Maximilian4,Kempfert Jörg5,Moon Michael C6

Affiliation:

1. Wessex Cardiothoracic Centre, Division of Cardiac Surgery, University Hospital Southampton , Southampton, UK

2. Academic Unit of Human Development and Health, University of Southampton , Southampton, UK

3. Division of Cardiac Surgery, Royal Papworth Hospital , Cambridge, UK

4. Department of Cardio-Thoracic Surgery, Heart Center of the University of Cologne , Cologne, Germany

5. Department of Cardiothoracic and Vascular Surgery, German Heart Center , Berlin, Germany

6. Division of Cardiac Surgery, Mazankowski Alberta Heart Institute , Alberta, Canada

Abstract

Abstract OBJECTIVES The indications for use, evidence base and experience with the novel noncovered open hybrid surgical stents for acute type A aortic dissection repair for concurrent stabilization of the ‘downstream’ aorta remains limited. We review the evidence base and the development of these stents. METHODS Data were collected from Pubmed/Medline literature search to develop and review the evidence base for safety and efficacy of non-covered surgical stents. Existing guidelines for use and developments were reviewed. RESULTS A single randomized control trial and 4 single-centre studies were included in the review with a total worldwide experience of 241 patients. The deployment was easy and did not add significantly to the primary operation. The mortality and new stroke ranged from 6.3–18.7%. Safe and complete deployment was accomplished in 92–100%. There was no device-related reintervention. There was a significant improvement in malperfusion in over 90% of the cases with varying degrees of remodelling (60–90%) of the downstream aorta. CONCLUSIONS Open noncovered stent grafts represent a major technical advancement as an adjunct procedure for acute dissection repairs, e.g. hemiarch repair. It has potential for wider use by non-aortic surgeons due to simplicity of technique. Limited safety and efficacy data confirm the device to be safe, feasible and reproducible with potential for wider adoption. However, long-term trial and registry data are required before recommendations for standard use outside of high-volume experienced aortic centres.

Publisher

Oxford University Press (OUP)

Cited by 1 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Die AMDS-Hybridprothese – ein neues Device zur Behandlung der akuten Typ-A-Dissektion;Zeitschrift für Herz-,Thorax- und Gefäßchirurgie;2024-09-13

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