Nonsurgical Repair of the Ascending Aorta: Why Less Is More
نویسندگان
چکیده
Objective: Advanced endovascular options for acute and chronic pathology of the ascending aorta are emerging; however, several problems with stent grafts placed in have been identified patients unsuitable surgical repair, such as migration erosion at interface. Method: Among six cases analysed this report, three were treated a graft to manage dissection proximal aorta; dimensions those varied between 34 45 mm diameter, from 77 100 length. Three patients, matched by age, sex their nature pathology, subjected focal closure single communicating entry use an occluding device (Amplatzer ASD PFO occluders 14 18 disc diameter) similar Charlson comorbidity score. Results: Both conceptually different nonsurgical management strategies technically feasible; grafts, early or delayed full re-dissection was documented contrast complete seal, induced remodelling long-term survival after successful placing coils occluder devices. Moreover, aortic root motion not impaired occlusion communication occluder, while free impeded placement. Conclusions: The intriguing observation our small series that portends risk either (post-procedural) tissues landing site biological interface 12 16 months procedure, phenomenon seen devices up 5 years follow-up. Obviously, approach avoids wall result minimal interaction interface, diseased wall. Potential explanations may be related reduced placement aorta, whereas preserved occluder. causality however fully understood, besides stiffness radial force graft, other factors inflammatory reactions tissue local adhesions within chest also play role. With failing portend success, they still role temporizing solution elective conversion. Larger datasets registries needed further explore evolving field interventions aorta.
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ژورنال
عنوان ژورنال: Journal of Clinical Medicine
سال: 2023
ISSN: ['2077-0383']
DOI: https://doi.org/10.3390/jcm12144771