Ascyrus Medical Dissection Stent In the treatment of acute type A Aortic dissection. A First-Hand Experience

Background: Acute type A aortic dissection is associated with a significant perioperative morbidity and mortality. Ascyrus Medical Dissection Stent (AMDS) is a novel bare stent graft developed to be used as an adjunct to standard surgical approach to promote true lumen expansion and therefor enhance aortic remodeling. Patients and Methods: From March 2021 to March 2022, four consecutive patients who presented with acute Debakey type I aortic dissection underwent emergent surgical repair with an inclusion (David) procedure and implantation of an AMDS. We analysed patient’s files prospectively and described the perioperative outcomes. Results: : All four device implantations were successful. Overall 30-day mortality was 0 %. Malperfusion that was present in two patients pre-operatively improved after AMDS implantation. At follow up, no aortic reinterventions were needed. No aortic injury related to the device was noted. Favourable changes in aortic true lumen and false lumen dimensions were found in most of our patients but the AMDS was compressed at the isthmus in one patient. Conclusion: AMDS is a reliable and secure device. However, its benefits remain unclear when it comes to a positive remodeling and seems less likelihood comparable to a frozen elephant trunk. The main reason seems to be an insufficient radial force of the AMDS.