Reduction in aneurysm size during the months after an endovascular graft placement generally is considered one of the criteria of success. We report the case of a patient with an abdominal aortic aneurysm rupture occurring 9 months after a bifurcated endovascular graft placement despite a greater than 45% reduction in size noted on contrast-enhanced computed tomography scan performed at 7 months. Biomaterial modifications of the stent and of the Dacron explanted stent-graft are analyzed.

et al.. Percutaneous repair or medical treatment for secondary mitral regurgitation: outcomes at 2 years Methods and results. AimsThe MITRA-FR trial showed that among symptomatic patients with severe secondary mitral regurgitation, percutaneous repair did not reduce the risk of death or hospitalization for heart failure at 12 months compared with guideline-directed medical treatment alone.At 37 centres, we randomly assigned 304 symptomatic heart failure patients with severe secondary mitral regurgitation (effective regurgitant orifice area >20 mm 2 or regurgitant volume >30 mL), and left ventricular ejection fraction between 15% and 40% to undergo percutaneous valve repair plus medical treatment (intervention group, n = 152) or medical treatment alone (control group, n = 152). The primary efficacy outcome was the composite of all-cause death and unplanned hospitalization for heart failure at 12 months. At 24 months, all-cause death and unplanned hospitalization for heart failure occurred in 63.8% of patients (97/152) in the intervention group and 67.1% (102/152) in the control group [hazard ratio (HR) 1.01, 95% confidence interval (CI) 0.77-1.34]. All-cause *Corresponding author. Hôpital Cardiovasculaire Louis Pradel, Chirurgie Cardio-Vasculaire et Transplantation Cardiaque, mortality occurred in 34.9% of patients (53/152) in the intervention group and 34.2% (52/152) in the control group (HR 1.02, 95% CI 0.70-1.50). Unplanned hospitalization for heart failure occurred in 55.9% of patients (85/152) in the intervention group and 61.8% (94/152) in the control group (HR 0.97, 95% CI 0.72-1.

Continuous movements in the grafted aorta and blood pressure impose permanent stress to the stent frame and the polyester fabric resulting in morphological changes in the body middle ring of grafts. The clinical implications of the suture breakages are unknown although they may be related to distal secondary leakage in tube grafts.

It is essential to take into account the saturation index to optimally choose a woven textile for the construction of an endoprosthesis since this property of the textile may contribute to explain the macroscopic lesions observed. We did not observe significant polymer degradation by filament dynamometry but further studies are needed to confirm these data.

In this study, we have identified a specific mechanism of late (9-20 years) longitudinal rupture of knitted polyester prostheses consisting of degradation of the polyester filaments along the remeshing and guide lines that run the length of the graft.