title: Effect on false-lumen status of a combined vascular and endovascular approach for the treatment of acute type A aortic dissection.
abstract: OBJECTIVE
  The aim of the study is to evaluate midterm results with regard to false-lumen status of a combined vascular and endovascular approach for the treatment of acute type A aortic dissection.
  
  
  METHODS
  We performed ascending/hemiarch replacement during hypothermic circulatory arrest with additional open implantation of the Djumbodis Dissection System (non-self-expanding bare metal stent) to readapt the dissected layers in the arch and the proximal descending aorta in a consecutive series of 15 patients (mean age 61 years, 20% female) suffering from acute type A aortic dissections. The primary end point was the status of the false lumen at the level of the stent.
  
  
  RESULTS
  We observed three in-hospital deaths (20%). Complete thrombosis of the false lumen was observed in one patient (8%). In 25% of patients, partial thrombosis of the false lumen was observed. The remaining patients had continuing antegrade perfusion. Surgical conversion during a mean follow-up of 37 months was required in two patients (16%) due to continuing enlargement of the distal arch and the proximal descending aorta. No late deaths were observed.
  
  
  CONCLUSIONS
  Additional implantation of the Djumbodis Dissection System to readapt the dissected layers in the arch and the proximal descending aorta does not seem to have additive value as an adjunct to standard ascending/hemiarch replacement with regard to closure of the false lumen in the arch and the proximal descending aorta. The most limiting factor seems to be the non-self-expanding capability of the device.
authors.affiliation: Department of Cardiovascular Surgery, University Hospital Berne, Berne, Switzerland. martin.czerny@insel.ch
authors.forename: Martin
authors.initials: M
authors.lastname: Czerny
authors.forename: Sybilla
authors.initials: S
authors.lastname: Stöhr
authors.forename: Thierry
authors.initials: T
authors.lastname: Aymard
authors.forename: Gottfried H
authors.initials: GH
authors.lastname: Sodeck
authors.forename: Marek
authors.initials: M
authors.lastname: Ehrlich
authors.forename: Tomasz
authors.initials: T
authors.lastname: Dziodzio
authors.forename: Andrzej
authors.initials: A
authors.lastname: Juraszek
authors.forename: Thierry
authors.initials: T
authors.lastname: Carrel
mesh_terms: D000208:Acute Disease; D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D012086:Reoperation; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome