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Journal of Cardiothoracic Surgery
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Redo aortic arch repair using trifurcated hybrid prosthesis after failed Ascyrus medical dissection stent treatment

Authors: Al-Obaidi, Mustafa; Salem, Razan; Walther, Thomas; Holubec, Tomas;

Redo aortic arch repair using trifurcated hybrid prosthesis after failed Ascyrus medical dissection stent treatment

Abstract

Abstract Background The management of acute type A aortic dissection (ATAAD) using the Ascyrus Medical Dissection Stent (AMDS) can lead to complications due to the persistence of the false lumen (FL). This case report presents two instances of failed AMDS treatment for ATAAD, highlighting the novel use of a trifurcated hybrid prosthesis for redo aortic arch repair using a minimally invasive frozen elephant trunk (FET) technique. Case Presentation Case 1: A 57-year-old male, previously treated with AMDS for ATAAD, presented with an enlarging aortic arch and persistent FL two years post-surgery caused by re-entry in the distal aortic arch. Redo surgery using the FET technique with an E-vita OPEN NEO Trifurcated hybrid prosthesis resulted in successful repair and partial FL thrombosis. Case 2: A 51-year-old male with prior AMDS treatment for ATAAD presented with severe aortic valve regurgitation and a maintained FL perfusion due to a residual re-entry in the proximal region of the descending aorta. Redo surgery using the FET technique with the same hybrid prosthesis led to successful repair and good recovery, confirmed by follow-up imaging. Conclusions The use of the E-vita OPEN NEO Trifurcated hybrid prosthesis in the FET technique offers a promising solution for redo aortic arch repair in cases of failed AMDS treatment for ATAAD. This approach can improve patient outcomes by addressing complications associated with persistent FL and enhancing long-term survival.

Keywords

Male, Reoperation, RD1-811, Aortic Aneurysm, Thoracic, Case Report, Aorta, Thoracic, Middle Aged, Acute type a aortic dissection (ATAAD) ; Stents [MeSH] ; Aortic Dissection/surgery [MeSH] ; Humans [MeSH] ; Middle Aged [MeSH] ; Aortic Aneurysm, Thoracic/surgery [MeSH] ; E-vita OPEN NEO trifurcated hybrid prosthesis ; Reoperation [MeSH] ; Aorta, Thoracic/surgery [MeSH] ; Frozen elephant trunk (FET) technique ; Blood Vessel Prosthesis [MeSH] ; Male [MeSH] ; Blood Vessel Prosthesis Implantation/instrumentation [MeSH] ; Ascyrus medical dissection stent (AMDS) ; Minimal invasive surgery ; Case Report ; Blood Vessel Prosthesis Implantation/methods [MeSH] ; Prosthesis Design [MeSH], Prosthesis Design, Frozen elephant trunk (FET) technique, E-vita OPEN NEO trifurcated hybrid prosthesis, Blood Vessel Prosthesis, Aortic Dissection, Blood Vessel Prosthesis Implantation, Minimal invasive surgery, Anesthesiology, Ascyrus medical dissection stent (AMDS), Humans, Surgery, RD78.3-87.3, Stents, Acute type a aortic dissection (ATAAD)

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
1
Average
Average
Average
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