Journal of Cardiovascular Development and Disease
Sequential Arch-Tear Eligibility for Uncovered Aortic Arch Stent in Acute DeBakey Type I Aortic Dissection
By Dario Petrone, Bruno Chiarello, Giulia BESSI and 7 others.
Abstract
Background
Because an uncovered arch scaffold does not provide a covered seal across an unresected arch tear, we evaluated a source-adjudicated sequential eligibility framework separating study-defined stop gates from residual-risk modifiers.
Methods
We retrospectively analyzed 266 patients with acute DeBakey type I dissection treated by hemiarch repair alone (No. = 160) or hemiarch plus AMDS (No. = 106). Blinded preoperative CT-scan re-review validated Gate 1 (visible arch tear), and operative-report review confirmed Gate 2 (tear directly observed at open inspection). Supra-aortic false-lumen communication was assessed only after both gates were negative.
