P014. A Multi-centre Study of Short and Mid-term Outcomes of the Ascyrus Medical Dissection Stent (AMDS) in the Treatment of Acute Type A Aortic Dissection
Bowdon
United Kingdom - Contact Me
Stuart is a consultant cardiac surgeon at South Tees Hospitals NHS Foundation Trust and honorary senior clinical lecturer. He undertook clinical training in cardiothoracic surgery across the North West of England and completed a post-CCT fellowship in advanced aortic surgery and TAVI at Toronto General Hospital. Stuart completed his PhD at the University of Manchester in 2013 on clinical prediction models in cardiovascular surgery. His research focus is on using big data and advanced analyses to improve cardiac surgery outcomes for patients. He has published widely on clinical risk prediction models, clinical outcome analyses, cardiopulmonary exercise testing and using large clinical registries. He is a member of the EACTS Research Taskforce, clinical lead for the Greater Manchester Health Informatics Collaborative and previously sat on the UK National Adult Cardiac Surgery Research Board.
Description
The Ascyrus Medical Dissection Stent (AMDS) is an uncovered aortic arch hybrid graft developed to promote true lumen expansion and enhance aortic remodelling in patients undergoing type A aortic dissection repair. The first implantation in the United Kingdom was performed in early 2021. The objective of this study was to report the short and mid-term outcomes in patients treated with the AMDS.
Methods
This was a multi-centre retrospective analysis of prospectively collected routine clinical data. All patients who presented with an acute type A aortic dissection and received an AMDS stent between January 2021 and September 2023 were included. Anonymised clinical data were transferred to the lead centre for analysis.
Results
A total of 46 patients across four centres were included. The majority (40, 87.0%) were operated as an emergency with six salvage procedures included. Most patients (33, 71.7%) were male and the mean age at operation was 64.4 (SD 12.0). The mean EuroSCORE II was 19.8 (SD 16.4) and 12 (26.1%) of patients presented with malperfusion. The in-hospital mortality rate was 21.7% (10/46) and 15.0% (6/40), overall and for non-salvage patients respectively. The mean duration of follow-up was 10 months with a maximum follow up of 30 months. There were no post-discharge deaths during follow-up with one patient requiring further aortic intervention. False lumen thrombosis was demonstrated on latest follow-up CT scan in 70% (23/33) of patients however there was evidence of descending aortic growth in 27.2% (9/32).
Conclusions
This study demonstrates that the AMDS can be used safely and effectively in patients with acute type A aortic dissection who present with or without malperfusion. No patients died during follow-up after discharge and positive remodelling of the false lumen was seen in the majority of patients. Further studies are required to demonstrate the long-term outcomes of the AMDS device and further define its role in the treatment of acute type A aortic dissection.
Authors
Stuart Grant (1), Mohamed Allam (2), Cha Rajakaruna (3), Eltayeb Mohamed Ahmed (4), David Zicho (5), Mazyar Kanani (2), Andrew Owens (2)
Institutions
(1) South Tees NHS Foundation Trust, Middlesbrough, NA, (2) South Tees Hospitals NHS Foundation Trust, Middlesbrough, NA, (3) Bristol Heart Institute, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK, Bristol, NA, (4) Bristol Heart Institute, Bristol, NA, (5) Hull University NHS Foundation Trust, Hull, NA