Repair of Arch Aneurysm With Frozen Elephant Trunk for DeBakey Type I Dissection Previously Treated With a Hybrid Arch Bare-Metal Stent.

The AMDS hybrid prosthesis is a novel device for the treatment of acute DeBakey I aortic dissection in patients without an intimal tear in the arch. Composed of an uncovered nitinol braided stent with a proximal felt cuff, it is deployed antegrade during circulatory arrest. Whereas early results have been promising, here we present 4 cases of negative aortic remodeling that were rescued by total arch frozen elephant trunk technique. These cases highlight the importance of patient selection in considering the AMDS device and illustrate that rescue of negative aortic remodeling is possible.