{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T10:42:19Z","timestamp":1773830539401,"version":"3.50.1"},"reference-count":17,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T00:00:00Z","timestamp":1773792000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCDD"],"abstract":"<jats:p>Type A aortic dissection represents one of the most life-threatening cardiovascular emergencies, with management strategies evolving toward hybrid and endovascular approaches, particularly in high-risk patients. The Ascyrus Medical Dissection Stent (AMDS) is an emerging adjunctive technology designed to promote true lumen expansion and facilitate favorable aortic remodeling during open repair of acute Type A dissection. We present the first reported case of AMDS deployment in secondary Type A dissection following prior thoracic endovascular aortic repair (TEVAR). An 83-year-old female with extensive aortic history\u2014including TEVAR in 2012 for intramural hematoma with chimney stenting to the left subclavian artery and carotid\u2013subclavian bypass in 2013\u2014developed acute Type A dissection extending into the existing stent graft in 2024. Emergency surgical intervention included ascending aortic replacement, aortic arch repair with AMDS implantation, aortic valve resuspension, and left atrial appendage resection under cardiopulmonary bypass and hypothermic circulatory arrest. Postoperative imaging confirmed appropriate AMDS positioning, false lumen exclusion, and preservation of prior endograft integrity. The patient tolerated the procedure well and was discharged in stable condition with favorable early follow-up outcomes. This case demonstrates the potential role of hybrid surgical strategies and adjunctive endovascular devices in managing complex, multi-stage aortic disease.<\/jats:p>","DOI":"10.3390\/jcdd13030141","type":"journal-article","created":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T07:35:08Z","timestamp":1773819308000},"page":"141","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["First Reported Use of the AMDS Hybrid Prosthesis for Secondary Type A Aortic Dissection After Prior TEVAR"],"prefix":"10.3390","volume":"13","author":[{"given":"Gjoko","family":"Boshkoski","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery, Asklepios Clinic Harburg, 21075 Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dorgam","family":"Natour","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Asklepios Clinic Harburg, 21075 Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atanas","family":"Jankulovski","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Asklepios Clinic Harburg, 21075 Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Felderhoff","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Asklepios Clinic Harburg, 21075 Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aron. F.","family":"Popov","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Asklepios Clinic Harburg, 21075 Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1846","DOI":"10.1161\/CIRCULATIONAHA.117.031264","article-title":"Insights from the International Registry of Acute Aortic Dissection: A 20-Year Experience of Collaborative Clinical Research","volume":"137","author":"Evangelista","year":"2018","journal-title":"Circulation"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1001\/jama.283.7.897","article-title":"The International Registry of Acute Aortic Dissection (IRAD): New insights into an old disease","volume":"283","author":"Hagan","year":"2000","journal-title":"JAMA"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1148\/radiology.199.2.8668776","article-title":"Aortic dissection: A comparative study of diagnosis with spiral CT, multiplanar transesophageal echocardiography, and MR imaging","volume":"199","author":"Sommer","year":"1996","journal-title":"Radiology"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1016\/j.ejvs.2018.09.016","article-title":"Current options and recommendations for the treatment of thoracic aortic pathologies involving the aortic arch: An expert consensus document of the ESVS","volume":"57","author":"Czerny","year":"2019","journal-title":"Eur. J. Vasc. Endovasc. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1161\/CIRCINTERVENTIONS.113.000463","article-title":"Endovascular repair of type B aortic dissection: Long-term results of the randomized investigation of stent grafts in aortic dissection trial","volume":"6","author":"Nienaber","year":"2013","journal-title":"Circ. Cardiovasc. Interv."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1591","DOI":"10.1016\/j.jtcvs.2015.08.117","article-title":"Total aortic arch replacement: A comparative study of zone o hybrid arch exclusion versus traditional open repair","volume":"150","author":"Preventza","year":"2015","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"178","DOI":"10.21037\/acs-2020-fet-25","article-title":"Results of frozen elephant trunk from the international E-vita Open registry","volume":"9","author":"Tsagakis","year":"2020","journal-title":"Ann. Cardiothorac. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1016\/j.jtcvs.2024.07.059","article-title":"A novel hybrid prosthesis for open repair of acute DeBakey type I dissection with malperfusion: Early results from the PERSEVERE trial","volume":"170","author":"Szeto","year":"2025","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.jvs.2016.11.063","article-title":"Outcomes of thoracic endovascular aortic repair using aortic arch chimney stents in high-risk patients","volume":"66","author":"Voskresensky","year":"2017","journal-title":"J. Vasc. Surg."},{"key":"ref_10","first-page":"389","article-title":"Retrograde aortic dissection after thoracic endovascular aortic repair","volume":"260","author":"Canaud","year":"2014","journal-title":"Ann. Cardiothorac. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","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":"ref_12","doi-asserted-by":"crossref","first-page":"1286","DOI":"10.1016\/j.jtcvs.2015.01.044","article-title":"The elephant trunk is freezing: The Hannover experience","volume":"149","author":"Shrestha","year":"2015","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1161\/CIRCULATIONAHA.107.759076","article-title":"Retrograde type A aortic dissection after endovascular stent graft placement for treatment of type B dissection","volume":"119","author":"Dong","year":"2009","journal-title":"Circulation"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"S276","DOI":"10.1161\/CIRCULATIONAHA.108.835926","article-title":"Retrograde ascending aortic dissection during or after thoracic aortic stent graft placement: Insight from the European Registry on Endovascular Aortic Repair Complications","volume":"120","author":"Eggebrecht","year":"2009","journal-title":"Circulation"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2593","DOI":"10.3390\/jcm13092593","article-title":"The Ascyrus Medical Dissection Stent: A One-Fits-All Strategy for the Treatment of Acute Type A Aortic Dissection?","volume":"13","author":"Piks","year":"2024","journal-title":"J. Clin. Med."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Szeto, W.Y., Fukuhara, S., Fleischman, F., Sultan, I., Brinkman, W., Arnaoutakis, G., Takayama, H., Eudailey, K., Brinster, D., and Jassar, A. (Ann. Thorac. Surg., 2025). One-Year Results of Novel Aortic Arch Hybrid Prosthesis for Repair of Acute DeBakey Type I Dissection With Malperfusion: PERSEVERE Study, Ann. Thorac. Surg., Online ahead of print.","DOI":"10.1016\/j.athoracsur.2025.10.036"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1186\/1752-1947-7-223","article-title":"The CARE guidelines: Consensus-based clinical case reporting guideline development","volume":"7","author":"Gagnier","year":"2013","journal-title":"J. Med. Case Rep."}],"container-title":["Journal of Cardiovascular Development and Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2308-3425\/13\/3\/141\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T08:10:37Z","timestamp":1773821437000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2308-3425\/13\/3\/141"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,18]]},"references-count":17,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["jcdd13030141"],"URL":"https:\/\/doi.org\/10.3390\/jcdd13030141","relation":{},"ISSN":["2308-3425"],"issn-type":[{"value":"2308-3425","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,18]]}}}