Transluminal stenting in type A acute aortic dissection: does the Djumbodis system have any impact on false lumen evolution?

Abstract

Background: We reviewed our experience with the transluminal placement of the Djumbodis system in the aortic arch and isthmus in patients with type A acute aortic dissection to assess its impact on true and false aortic lumen evolution.

Methods: Between January 2005 and September 2009, 50 patients underwent surgery for type A acute aortic dissection. Twenty-eight patients (group A) were operated on by implanting the Djumbodis prosthesis, and 22 patients (group B) without the prosthesis. Contrast-enhanced computed tomography and magnetic resonance imaging controls were performed on survivors at or soon after discharge and at follow-up.

Results: Preoperative and operative data and complication rates were not significantly different between the two groups. Three in-hospital deaths occurred within 30 days, 1 in each group due to aortic rupture. At 1- and 4-year follow-up, actuarial survival was 82% ± 7% versus 90% ± 6% and 73% ± 9% versus 84% ± 9%, in group A and B, respectively (p = 0.35). Three reoperations were performed, 2 in group A and 1 in group B (p = 0.66). At follow-up, there was no significant difference between groups regarding the ratio between true lumen and aortic diameters and false lumen patency rates at the aortic arch, isthmus, and descending aorta level.

Conclusions: Placement of the Djumbodis prosthesis does not confer any additional surgical benefit and does not seem to contribute to reducing the incidence of postoperative false lumen patency in patients operated on for type A acute aortic dissection in comparison with conventional surgery.