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J Thorac Cardiovasc Surg. 2018 Nov;156(5):1787-1793. doi: 10.1016/j.jtcvs.2018.05.001. Epub 2018 May 17.

Stent-assisted, balloon-induced intimal disruption and relamination of aortic dissection in patients with Marfan syndrome: Midterm outcomes and aortic remodeling.

Author information

1
Department of Vascular Surgery, Hôpital Européen Georges Pompidou, AP-HP, Paris, France; PhyMedExp, University of Montpellier, INSERM, CNRS, France. Electronic address: elsafaure@hotmail.com.
2
Department of Vascular Surgery, Hôpital Européen Georges Pompidou, AP-HP, Paris, France.
3
Department of Vascular Surgery, Hôpital Européen Georges Pompidou, AP-HP, Paris, France; INSERM U970, Faculté de Médecine Paris-Descartes, Université Paris 5, Paris, France.

Erratum in

Abstract

OBJECTIVE:

The study objective was to assess the midterm outcomes and aortic remodeling in patients with Marfan syndrome with complicated acute type B aortic dissection treated with stent-assisted, balloon-induced intimal disruption and relamination.

METHODS:

We reviewed all patients treated with stent-assisted, balloon-induced intimal disruption and relamination for a complicated acute type B aortic dissection associated with Marfan syndrome according to the revised Ghent criteria.

RESULTS:

Between 2015 and November 2017, 7 patients with Marfan syndrome underwent stent-assisted, balloon-induced intimal disruption and relamination for a complicated acute type B aortic dissection. The median age of patients was 47 years (range, 23-70). Four patients had a history of aortic root replacement. Technical success was achieved in 100%. Three patients required an adjunctive procedure for renal artery stenting (n = 2) and iliac artery stenting (n = 1). There was no in-hospital death, 30-day postoperative stroke, spinal cord ischemia, ischemic colitis, or renal failure requiring dialysis. At a median follow-up of 15 months (range, 7-28), 1 patient required aortic arch replacement for aneurysmal degeneration associated with a type Ia endoleak at 2 years, giving a late reintervention rate of 14%. There was no other secondary endoleak. The primary visceral patency rate was 100%. There were no all-cause deaths reported. At last computed tomography scan, all patients had complete aortic remodeling of the treated thoracoabdominal aorta. Distally, at the nonstented infrarenal aortoiliac level, 6 patients had persistent false lumen flow with stable aorto-iliac diameter in 5. One patient had iliac diameter growth (27 mm diameter at last computed tomography scan).

CONCLUSIONS:

Stent-assisted, balloon-induced intimal disruption and relamination of aortic dissection in patients with Marfan syndrome is feasible, safe, and associated with an immediate and midterm persisting thoracoabdominal aortic remodeling.

KEYWORDS:

Marfan; STABILISE; TEVAR; bare-stent; dissection, aorta

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