采用冰冻象鼻技术修复曾接受杂交主动脉弓裸金属支架治疗的DeBakey I型主动脉夹层的主动脉弓动脉瘤

Repair of Arch Aneurysm With Frozen Elephant Trunk for DeBakey Type I Dissection Previously Treated With a Hybrid Arch Bare-Metal Stent.

作者信息

Kelly John J, Brown Chase R, Eisenga John B, White Abigail, Kreibich Maximilian, Ahlbrecht Axel, Czerny Martin, Brinkman William T, Moon Michael C, Szeto Wilson Y

机构信息

Division of Cardiovascular Surgery, University of Pennsylvania, Philadelphia, Pennsylvania.

Department of Cardiothoracic Surgery, Baylor Scott and White, The Heart Hospital, Plano, Texas.

出版信息

Ann Thorac Surg. 2025 Jul 2. doi: 10.1016/j.athoracsur.2025.06.021.

DOI:10.1016/j.athoracsur.2025.06.021

PMID:40609665

Abstract

The AMDS hybrid prosthesis is a novel device for the treatment of acute DeBakey I aortic dissection in patients without an intimal tear in the arch. Composed of an uncovered nitinol braided stent with a proximal felt cuff, it is deployed antegrade during circulatory arrest. Whereas early results have been promising, here we present 4 cases of negative aortic remodeling that were rescued by total arch frozen elephant trunk technique. These cases highlight the importance of patient selection in considering the AMDS device and illustrate that rescue of negative aortic remodeling is possible.

摘要

AMDS混合假体是一种用于治疗无主动脉弓内膜撕裂患者的急性DeBakey I型主动脉夹层的新型装置。它由一个带有近端毡套的裸镍钛诺编织支架组成，在循环停止期间顺行植入。尽管早期结果很有前景，但我们在此展示4例通过全主动脉弓冰冻象鼻技术挽救的主动脉重塑不良病例。这些病例强调了在考虑使用AMDS装置时患者选择的重要性，并表明挽救主动脉重塑不良是可能的。