Key result
Steeper FET stent-flap angles may cause postoperative dSINE due to distal edge mechanical stress.
Why the study?
The mechanisms underlying distal stent graft-induced new entry (dSINE) after frozen elephant trunk deployment remain unclear and multifactorial.
Case Report (n=1)
Mechanical stress from a steeper stent-flap angle may be a novel risk factor for distal stent graft-induced new entry after frozen elephant trunk deployment.
Hypothesis-generating for steeper stent-flap angle as dSINE risk after FET; prospective studies needed before technique changes.
The mechanisms behind developing distal stent graft-induced new entry (dSINE) are complex. Stent graft oversizing, spring-back force, and pathological aortic wall fragility have been the main risk factors associated with dSINE.1 Nonetheless, the dSINE development mechanisms are still unclear because it is related to multiple factors. We report a case of postoperative dSINE that may have been caused by a mechanical stress at the distal edge of the deployed frozen elephant trunk (FET) as a result of steeper stent-flap angle between the stent-covered aorta and nonstent-covered aorta after total arch repair (TAR) with FET deployment for type A acute aortic dissection (TAAD).
No takes yet. Share an insight, caveat, or question.
Wada et al. (2021) conducted a case report in Type A acute aortic dissection (TAAD) / distal stent graft-induced new entry (dSINE) (n=1). Total arch repair with frozen elephant trunk deployment was evaluated on Postoperative distal stent graft-induced new entry (dSINE). Mechanical stress at the distal edge of a deployed frozen elephant trunk, resulting from a steeper stent-flap angle, may cause postoperative distal stent graft-induced new entry.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: