Endovascular aortic repair with multilayer graft for aortic dissection – results from Nextcardio

Victor S.Costache1, Cristina Goia1, Dan Dorobantu2, Sherif Sultan3, Andreea Costache1, Alexandru Voican1, Nicolae Florescu1

Background. The multilayer flow modulator (MFM) has shown promising results in the treatment of complex aortic pathologies, especially when branch arteries are involved, including a few reported cases of dissection. We present our single center experience and results with this technique.

Methods. Patiens with complex type A or B  dissections were selected for MFM repair as per devce indications of use and were followed prospectively.

Results. A total of 13 consecutive patiens with aortic dissection, were treated with an MFM endoposthesis in our institution. Two cases are illustrated in Figure 1 and 2 (left – preop, right –postop). Patient and procedure related data are shown in table. Indications included: type B dissection (n=10), residual type B after A surgical correction (n=2) and one acute type A after surgical correction requiring intervention for malperfusion. One patient required drainage for pericardial effusion and one had distal aortic and bilateral iliac thrombosis, due to femoral access complication which required urgent revascularization by axillary-femoral bypass.

There were early two reinterventions in the same patient, detailed above resulting in a reintervention free survival of 85% at 3 years. Initial procedural success was 100% with no branch occlusions during follow-up.

Conclusions. MFM endovascular grafts are a safe option in the treatment of complex aortic dissections, with low mortality and good procedural successs. Further studies and longer followup are needed to establish the role of MFM devices in the management of aortic dissection.

Funding

The author(s) disclosed receipt of the following financial sup- port for the research, authorship, and/or publication of this article: This paper/research is supported by the Competitiveness Operational Programme 2014–2020, financed from European Regional Development Fund and by the Romanian Government under the project “                         Next generation computer aided research in cardiovascular disease management –NextCARDIO”, project code: COP P_37_701.

ianuarie 16th, 2018|Publicatii, Rezultate|