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Journal of Cardiovascular Surgery

Hervé Rousseau, Paul Revel-Mouroz, Bertrand Saint Lebes, Jean-Pierre Bossavy, Olivier Meyrignac, Fatima-Zohra Mokrane
INTRODUCTION: Endovascular treatment of aortic arch pathologies is challenging due to its complex anatomical architecture and the presence of vital collateral branches. This paper aims to provide an overview of the currently available and future endovascular options for these diseases, particularly regarding branched stent-grafts and the Mona-LSA device. EVIDENCE ACQUISITION AND EVIDENCE SYNTHESIS: After discussing the indications for revascularization of supra-aortic trunks in endovascular aortic repair, we present the principles, benefits and drawbacks of the main modern methods to overcome an insufficient proximal landing zone, ie...
July 9, 2018: Journal of Cardiovascular Surgery
Abhijeet Dhoble, Yelin Zhao, Pimprapa Vejpongsa, Catalin Loghin, Richard W Smalling, Anthony Estrera, Tom C Nguyen
BACKGROUND: The data on the trends and comparative outcomes after isolated and concomitant tricuspid valve repair/replacement (TVR) is scarce. METHODS: The International Classification of Diseases - 9th version was used to identify the patients who underwent TVR, using the National Inpatient Sample. Outcomes were evaluated using the analysis of variance and Chi-square test, and trends across the years were tested via Cochran-Armitage test. RESULTS: Of 6,868 patients who underwent TVR between 2005-14, 1,601 (23%) were isolated...
July 3, 2018: Journal of Cardiovascular Surgery
Marco Manzi
No abstract text is available yet for this article.
June 27, 2018: Journal of Cardiovascular Surgery
Roland Assi, Joseph E Bavaria, Nimesh Desai
Despite successful repair of acute type A aortic dissection (TAAD), the distal false lumen may remain patent resulting in progressive degeneration of the remaining distal aorta. This can lead to aneurysmal dilatation and risk of rupture. Open distal reoperation to replace the residually dissected thoraco-abdominal aorta may be accomplished with acceptable morbidity and mortality in experienced hands. This can be facilitated when the index operation for acute TAAD is tailored to exclude all primary tears and set the arch and descending aorta for a subsequent open, endovascular or hybrid procedure...
June 26, 2018: Journal of Cardiovascular Surgery
Athanasios Katsargyris, Pablo Marques De Marino, Eric L Verhoeven
To address target vessels in pararenal and thoracoabdominal aortic aneurysms with fenestrated and branched grafts, two solutions are available: fenestrations (holes in the graft) and directional side-branches. Fenestrations work well for target vessels that have a close to 90-degree take-off from the aorta, and when the main graft at the level of the target vessel is adjacent or close to the aortic wall. Directional side-branches work well when target vessels have a steeper take-off angle and when there is a larger gap to be bridged...
June 26, 2018: Journal of Cardiovascular Surgery
Fiona Rohlffs, Konstantinos Spanos, Nikolaos Tsilimparis, Eike S Debus, Tilo Kölbel
Endovascular strategies have been increasingly used for the treatment of chronic type B aortic dissection (cTBAD) offering better outcomes in terms of mortality and morbidity compared to open surgical repair. 1, 2 Aortic remodeling after standard TEVAR is less likely in cTBAD due to rigidity of the dissection membrane.3 Another limition of endovascular therapy is continued retrograde false lumen perfusion with back-flow from distal entry tears.4 Treatment strategies in cTBAD should aim at false lumen thrombosis...
June 26, 2018: Journal of Cardiovascular Surgery
Lazar B Davidovic, Stefan M Ducic, Aleksandra D Vujcic
No abstract text is available yet for this article.
June 26, 2018: Journal of Cardiovascular Surgery
Lazar B Davidovic, Ivan Tomic, Dragan M Markovic, Dusan M Kostic, Miroslav D Marković
No abstract text is available yet for this article.
June 26, 2018: Journal of Cardiovascular Surgery
Giovanni Tinelli, Marco Ferraresi, Amelia C Watkins, Adrien Hertault, Raphael Soler, Richard Azzaoui, Dominique Fabre, Jonathan Sobocinski, Stéphan Haulon
Connective Tissue Disease (CTD) represents a group of genetic conditions characterized by disruptive matrix remodeling. When this process involves aortic and vascular wall, patients with CTD have a high risk of developing arterial aneurysms, dissections and ruptures. Open surgical repair is still the gold standard therapy for patients with CTD with reasonable morbidity and mortality risk. The surgical treatment of CTD often requires multiple operations. In the endovascular era, fenestrated and branched stent grafts may play a role in reducing the complications of multiple open operations...
June 26, 2018: Journal of Cardiovascular Surgery
Ansar Z Vance, Daniel A Leung, Timothy W Clark
Pedal access has become an indispensable technique for endovascular therapy of complex lower extremity peripheral vascular disease. From an option as a single access in a patient lacking traditional access approaches to a critical maneuver in combined antegrade-retrograde approaches during the treatment of complex chronic total occlusions, pedal access is an essential tool for any endovascular physician treating peripheral arterial disease. Anticipatory planning is critical in the successful utilization of pedal access...
June 14, 2018: Journal of Cardiovascular Surgery
Enrico M Marone, Ferdinando Auricchio, Stefania Marconi, Michele Conti, Luigi F Rinaldi, Andrea Pietrabissa, Angelo Argenteri
BACKGROUND: The treatment of complex aortic diseases has known in the last years an extraordinary improvement, thanks to the development of new devices and techniques, especially concerning endovascular surgery. In this field, technological evolution has enabled vascular surgeons to overcome anatomical concerns and impairments that in the past made endovascular treatment unfeasible in many cases. However, the full exploitation of the devices offered by medical industry requires more and more powerful and accurate tools for case-by-case analysis and pre- operative planning...
June 11, 2018: Journal of Cardiovascular Surgery
Enrico Brocco, Sasa Ninkovic, Mariagrazia Marin, Christine Whisstock, Marino Bruseghin, Giovanni Boschetti, Raffaella Viti, William Forlini, Antonio Volpe
Diabetic foot is a complication of diabetes affecting 15% of diabetics in their lives. It is associated to diabetic neuropathy and peripheral vascular disease and its incidence has increased. The ulceration is the initial cause of a dramatic process leading, if not correctly treated, to amputations. Both neuropathy, neuro-ischemia and infections have a role in determining healing or worsening of the lesions and 85% of all amputations in diabetic patients are preceded by a foot ulceration deteriorating to a severe gangrene or infection...
May 29, 2018: Journal of Cardiovascular Surgery
Heinz G Jakob
No abstract text is available yet for this article.
May 29, 2018: Journal of Cardiovascular Surgery
Jun Li, Adham Karim, Mehdi Shishehbor
While the field of endovascular interventions has evolved in the last decade, technological advancements have rendered drug-coated balloons (DCBs) to be the first line therapy for femoropopliteal artery disease. As the knowledge continues to advance, the application of DCB to the infrapopliteal segments and its role in the setting of plaque modification atherectomy to minimize stent utilization will be further elucidated.
May 25, 2018: Journal of Cardiovascular Surgery
Konstantinos Tsagakis, Daniel Wendt, Alexandros M Dimitriou, Matthias Thielmann, Shehada Sharaf-Eldin, Mohamed El Gabry, Heinz G Jakob
BACKGROUND: Frozen elephant trunk (FET) is considered to be the treatment of choice in complex multi-segmental thoracic aortic disease involving the distal arch. Institutional results of FET technique are presented. METHODS: From 01.2005 to 10,2017 2018 286 patients underwent FET surgery in our department. Patients (age mean±SD 59±11 years) were operated for acute type I (55%) aortic dissection (AD), chronic AD (23%) and aneurysm (22%). Arch repair was performed with the E- vita open prosthesis under with selective cerebral perfusion and hypothermic circulatory arrest...
May 25, 2018: Journal of Cardiovascular Surgery
Michinao Tan, Kazushi Urasawa, Shunsuke Kitani, Yasumi Igarashi
No abstract text is available yet for this article.
May 25, 2018: Journal of Cardiovascular Surgery
Pablo Marques De Marino, Kyriakos Oikonomou, Eric L Verhoeven, Athanasios Katsargyris
Post-dissection aortic aneurysms (PDAA) affect 20-40% of patients with aortic dissection. Open repair remains the first line therapy of PDAA, but is still associated with high mortality and morbidity rates. Endovascular repair is increasingly being used as a less invasive treatment option. Thoracic endovascular aneurysm repair (TEVAR) covering only the proximal entry tear has proven to be insufficient in most patients with chronic PDAA and has a limited role only for PDAA with distal sealing zone in the thoracic aorta...
May 23, 2018: Journal of Cardiovascular Surgery
Marianne Brodmann, Eric Thérasse, Andrew Benko, Louis-Philippe Riel, Steven Dion, Philippe Généreux, Martin Brouillette
BACKGROUND: The aim of this study was to examine the safety and efficacy of the SoundBite™ Crossing System for the recanalization of infrainguinal chronic total occlusion (CTO) lesions. CTOs are frequent among patients with severe claudication or critical limb ischemia. Failure to recanalize CTOs remains common and is associated with poor prognosis. The SoundBite™ Crossing System (SoundBite Medical Solutions Inc., Montreal, Canada) is a newly developed device that uses a 0.018-inch wire (SoundBite™ Active Wire) to deliver acoustic shock waves to the distal tip of a steerable guidewire to facilitate directed penetration of the proximal cap and crossing of the occlusion...
May 23, 2018: Journal of Cardiovascular Surgery
Koen Deloose, Joren Callaert
BACKGROUND: Although evidence supports that the performance of drug coated balloons seems to be lesion complexity independent, it is quite clear that in long lesions, severe calcified lesions and chronic total occlusions, the bail out stent ratio is very high and that the "leaving nothing behind" strategy remains a dream in a lot of our daily cases. On the other side of the spectrum, "full metal jackets" of nitinol stents are creating even more problems. Stent fractures, intimal hyperplasia and reintervention difficulties complicate the recurrent vascular disease treatment...
May 23, 2018: Journal of Cardiovascular Surgery
Giovanni Tinelli, Marco Ferraresi, A Claire Watkins, Raphael Soler, Elie Fadel, Dominique Fabre, Stéphan Haulon
Chronic aortic dissecting aneurysms (TAAD) presenting after acute Stanford Type A or B dissection includes both arch and/or thoracoabdominal aortic aneurysms (TAAA). Approximately 60% of patients who survive surgical treatment of acute Type A aortic dissections will require another aortic procedure. Similarly, more than 70% of patients with chronic Type B aortic dissections will experience false lumen dilation at 5-year follow-up, often requiring intervention. Open or hybrid aortic repairs of complex TAAD involving the arch and the TAAA are very demanding procedures for both patients and clinicians...
May 22, 2018: Journal of Cardiovascular Surgery
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