{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T15:50:17Z","timestamp":1753890617926,"version":"3.41.2"},"reference-count":14,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,9,26]],"date-time":"2024-09-26T00:00:00Z","timestamp":1727308800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Acute Type A aortic dissection (ATAAD) with supra-aortic branch (SAB) malperfusion remains a formidable clinical challenge, often resulting in high mortality and complex treatment dilemmas. The introduction of the AMDS represents a significant innovation, designed to stabilize the aortic arch, and manage malperfusion effectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This case study evaluates the utility of AMDS in the treatment of a 63-year-old male with hypertension, who presented with severe, acute chest pain. Diagnosed with a DeBakey type I ATAAD involving SAB, the patient underwent cardiopulmonary bypass, aortic root replacement, aortic arch repair with AMDS implantation, and subsequent endovascular stenting for severe left common carotid artery malperfusion that developed postoperatively. The AMDS was instrumental in facilitating crucial aortic arch reconstruction and addressing the initial severe malperfusion. Despite postoperative cerebral malperfusion, targeted endovascular stenting resulted in a rapid and substantial neurological recovery. The patient was discharged to a rehabilitation facility on postoperative day 20, free of neurological deficits.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The use of AMDS in managing ATAAD with SAB involvement is transformative, enabling less invasive surgical techniques and offering immediate, effective correction of malperfusion. This case underscores the essential role of integrating advanced endovascular strategies to enhance outcomes in high-risk aortic surgeries, marking a pivotal advancement in the therapeutic approach to complex aortic dissections<jats:bold>.<\/jats:bold><\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2024.1429287","type":"journal-article","created":{"date-parts":[[2024,9,26]],"date-time":"2024-09-26T04:46:58Z","timestamp":1727326018000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Surmounting the summit: tackling cerebral malperfusion in AMDS-treated acute deBakey I dissections. A case report"],"prefix":"10.3389","volume":"11","author":[{"given":"Nunzio Davide","family":"de Manna","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Florian","family":"Helms","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ezin","family":"Deniz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Till Frederik","family":"Kaireit","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omar","family":"Abu-Fares","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bastian","family":"Schmack","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arjang","family":"Ruhparwar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Weymann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aron Frederik","family":"Popov","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2024,9,26]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1093\/ejcts\/ezy313","article-title":"Current options and recommendations for the treatment of thoracic aortic pathologies involving the aortic arch: an expert consensus docu- ment of the European association for cardio-thoracic surgery (EACTS) and the European society for vascular surgery (ESVS)","volume":"55","author":"Czerny","year":"2019","journal-title":"Eur J Cardiothorac Surg"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1713","DOI":"10.1016\/j.jtcvs.2019.11.003","article-title":"Surgery for type A aortic dissection in patients with cerebral malperfusion: results from the international registry of acute aortic dissection","volume":"161","author":"Sultan","year":"2021","journal-title":"J Thorac Cardiovasc Surg"},{"key":"B3","doi-asserted-by":"publisher","first-page":"691","DOI":"10.1053\/j.semtcvs.2019.05.036","article-title":"The decision-making process in acute type A aortic dissection: when to replace the aortic arch","volume":"31","author":"Leone","year":"2019","journal-title":"Semin Thorac Cardiovasc Surg"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1768","DOI":"10.1016\/j.athoracsur.2019.04.121","article-title":"Single-stage management of dynamic malperfusion using a novel arch remodeling hybrid graft","volume":"108","author":"Bozso","year":"2019","journal-title":"Ann Thorac Surg"},{"key":"B5","doi-asserted-by":"publisher","first-page":"ezac581","DOI":"10.1093\/ejcts\/ezac581","article-title":"Treatment of acute type A aortic dissection with the ascyrus medical dissection stent in a consecutive series of 57 cases","volume":"63","author":"Luehr","year":"2023","journal-title":"Eur J Cardiothorac Surg"},{"key":"B6","first-page":"95","article-title":"New hybrid prosthesis for acute type A aortic dissection","volume":"36","author":"Montagner","year":"2020","journal-title":"Surg Technol Int"},{"key":"B7","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1016\/j.xjon.2022.06.014","article-title":"Safety and arch complications after hemiarch versus total arch replacement with stented elephant trunk in acute type 1 dissection: is a stent graft always beneficial?","volume":"11","author":"Hayashi","year":"2022","journal-title":"JTCVS Open"},{"key":"B8","doi-asserted-by":"publisher","first-page":"463","DOI":"10.1016\/j.athoracsur.2020.05.090","article-title":"Midterm outcomes of the dissected aorta repair through stent implantation trial","volume":"111","author":"Bozso","year":"2021","journal-title":"Ann Thorac Surg"},{"key":"B9","doi-asserted-by":"publisher","first-page":"276","DOI":"10.1093\/icvts\/ivab085","article-title":"Initial experience with the new type A arch dissection stent: restoration of supra-aortic vessel perfusion","volume":"33","author":"Montagner","year":"2021","journal-title":"Interact Cardiovasc Thorac Surg"},{"key":"B10","doi-asserted-by":"publisher","first-page":"892516","DOI":"10.3389\/fcvm.2022.892516","article-title":"Early results of a novel hybrid prosthesis for treatment of acute aortic dissection type A with distal anastomosis line beyond aortic arch zone zero","volume":"9","author":"Mehdiani","year":"2022","journal-title":"Front Cardiovasc Med"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1763","DOI":"10.1016\/j.jtcvs.2018.09.120","article-title":"Dissected aorta repair through stent implantation trial: canadian results","volume":"157","author":"Bozso","year":"2019","journal-title":"J Thorac Cardiovasc Surg"},{"key":"B12","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1016\/j.jtcvs.2019.10.031","article-title":"Neurologic complications after the frozen elephant trunk procedure: a meta-analysis of more than 3000 patients","volume":"160","author":"Preventza","year":"2020","journal-title":"J Thorac Cardiovasc Surg"},{"key":"B13","doi-asserted-by":"publisher","first-page":"1661","DOI":"10.1016\/j.jtcvs.2022.08.040","article-title":"Three-year outcomes of the dissected aorta repair through stent implantation trial","volume":"167","author":"Bozso","year":"2024","journal-title":"J Thorac Cardiovasc Surg"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1324","DOI":"10.1016\/j.jtcvs.2018.10.134","article-title":"Malperfusion in acute type A aortic dissection: an update from the nordic consortium for acute type A aortic dissection","volume":"157","author":"Zindovic","year":"2019","journal-title":"J Thorac Cardiovasc Surg"}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2024.1429287\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,26]],"date-time":"2024-09-26T04:47:00Z","timestamp":1727326020000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2024.1429287\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,26]]},"references-count":14,"alternative-id":["10.3389\/fcvm.2024.1429287"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2024.1429287","relation":{},"ISSN":["2297-055X"],"issn-type":[{"type":"electronic","value":"2297-055X"}],"subject":[],"published":{"date-parts":[[2024,9,26]]},"article-number":"1429287"}}