title: Early experience with the DJUMBODIS system: what did we observed, what can we expect? Part 1.
abstract: OBJECTIVE
  In order to remodel or to stabilize the dissected descending aorta following conventional replacement of proximal aorta for real type I acute dissection, the deployment of a bare-metal stent that expand the true lumen and compress the false lumen has been proposed. To date results have been insufficiently assessed through comparative studies. We conducted this study to compare midterm results according to the optional deployment of an antegradely inserted balloon inflated stainless steel stent at the level of the proximal descending aorta during conventional aortic surgery in real type I aortic dissections.
  
  
  METHODS
  Control study including a consecutive series of patients operated on conventionally for real type I aortic dissection involving descending aorta between 2006 and 2011. For stented patients, an optimal inflation volume was determined a priori according to the measured diameter of landing zone and a bare stent 90 or 140mm long was deployed antegradely during circulatory arrest. Endpoints were mid-term aortic event free survival and the evolution of the indexed (body surface area) diameter of descending aorta.
  
  
  RESULTS
  We included 19 and 26 patients in the stented and control group respectively. Aortic event free survival at 4 years was 57% and 43% (p=0.37) in the stented and control group respectively. The proximal descending aorta remained remodeled or stabilized during follow-up for 11 stented and only 9 control patients (p=0.05). After a mean follow up of 2 years, the mean indexed diameter of the upper third aorta was 4 mm wider in the control group due to false lumen enlargement (p=0.01).
  
  
  CONCLUSIONS
  Anatomic evolution is favorable in the stented group. Increment of comparative followup data is mandatory before considering a revision of conventional approach of TAAD to influence mid- term aortic event free survival.
authors.affiliation: Department of Cardiac Surgery, Amiens-Picardy University Hospital, Amiens, France; INSERM U 1088, Jules Verne University, Amiens, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Kaus
authors.forename: Audrey
authors.initials: A
authors.lastname: Houbert-Janssen
authors.forename: Jean Yves
authors.initials: JY
authors.lastname: Gaubert
authors.forename: Alessandro
authors.initials: A
authors.lastname: Piccardo
authors.forename: Aabir
authors.initials: A
authors.lastname: Petit
authors.forename: Henri
authors.initials: H
authors.lastname: Poulain
mesh_terms: D000368:Aged; D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000601:surgery*; D000792:Angiography; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D057510:Endovascular Procedures / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome