Abstract
BackgroundDespite the marked improvement in the aortic dissection repair techniques, residual dissected aorta with a patent false lumen remains an issue. So, the aim of our study is to observe the effect of inserting the Thoraflex Hybrid Graft on the aortic diameters in patients with type A aortic dissection involving the arch and descending aorta. Patients with type I aortic dissection who had aortic dissection repair using the Thoraflex Hybrid Graft in University Hospitals Birmingham were studied. Radiological assessment with computed tomography of the aorta was done at the level of the diaphragm to measure the true lumen, false lumen and total aortic diameters. Significance of change of diameters at early post-operative as compared to the pre-operative period was analysed.ResultsEight cases were done in the acute setting, while 14 cases were done in the chronic setting. The ratio of true lumen to the total aortic diameter has significantly increased in the follow-up period as compared to the pre-operative period (P = 0.031). Whereas false lumen to total aortic diameter ratio has significantly decreased (P = 0.024). Subgroup analysis revealed that these changes were not significantly altered by whether the dissection was acute or chronic.ConclusionsThe Thoraflex Hybrid Graft will induce positive aortic remodelling with expansion of true lumen and will diminish the false lumen. But we could not find a significant difference between acute or chronic cases due to small sample size.
Highlights
Despite the marked improvement in the aortic dissection repair techniques, residual dissected aorta with a patent false lumen remains an issue
Available stented grafts used for the frozen elephant trunk (FET) include the E-VITA open plus, the Thoraflex Hybrid, Cronus and the J Graft
The Thoraflex Hybrid graft (Vascutek, Inchinnan, Scotland, United Kingdom (UK)) is expected to be more safe in dissection due to the interrupted stent pattern it has and less forces on the wall of the aorta, but it was observed that this graft
Summary
Despite the marked improvement in the aortic dissection repair techniques, residual dissected aorta with a patent false lumen remains an issue. The aim of our study is to observe the effect of inserting the Thoraflex Hybrid Graft on the aortic diameters in patients with type A aortic dissection involving the arch and descending aorta. Patients with type I aortic dissection who had aortic dissection repair using the Thoraflex Hybrid Graft in University Hospitals Birmingham were studied. Previous results from an international multicentre registry evaluating the aorta after E-vita stent graft for dissection concluded that this graft promotes thrombosis of the false lumen and positive remodelling in patients with aortic dissection [3]. In a study on 100 patients, single-centre data concluded that the Thoraflex stents favour the thrombosis of the false lumen for both acute and chronic dissections and they demonstrated positive remodelling of the aorta during follow-up [6]
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have