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Journal of Cardiovascular Surgery

Koen Deloose, Igor Martins, Caio Neves, Joren Callaert
Common femoral artery (CFA) atherosclerotic lesions currently remain one of the last limitations for adoption of endovascular repair as the first-line treatment. The bulky, eccentric, heavily calcified character of the CFA plaques, frequent involvement of the femoral bifurcation, easy surgical accessibility and last but not least, favorable long-term outcomes (1,2) still make CFA disease treatment part of the surgical domain. In the last 5 years, improvement of the endovascular equipment and technical skills of the operators have led to an increase in percutaneous CFA procedures...
November 12, 2018: Journal of Cardiovascular Surgery
Gustavo S Oderich, Emanuel R Tenorio
No abstract text is available yet for this article.
November 7, 2018: Journal of Cardiovascular Surgery
Ramon L Varcoe
No abstract text is available yet for this article.
November 7, 2018: Journal of Cardiovascular Surgery
Jonathan Bath, Maham Rahimi, Jose O Leite, Willythssa Pierre-Louis, Joseph Giglia
BACKGROUND: Although aortoiliac occlusive disease (AIOD) is preferentially treated endovascularly, some patients are still better served with an aortobifemoral bypass (ABF). For those patients, surgical treatment options include both standard open operations as well as laparoscopic ABF (LapABF). Several European centers perform LapABF with favorable results instead of open surgery, but this has not been widely embraced in the United States. We reviewed our ten-year experience with LapABF, evolving from a completely laparoscopic to a standardized laparoscopic-assisted approach...
November 7, 2018: Journal of Cardiovascular Surgery
Andrew Holden
The endovascular management of complex lower limb arterial occlusive disease is generally associated with poorer acute results, a higher incidence of provisional stenting and subsequent restenosis compared to more simple arterial lesions. Even more challenging results can be expected when two complex features are combined such as chronic total occlusion (CTO) and severe calcification. Intravascular lithotripsy (IVL) with the Shockwave system has recently been evaluated as a familiar angioplasty balloon based but effective technique for the management of arterial calcification...
October 31, 2018: Journal of Cardiovascular Surgery
Michel J Bosiers, Giuseppe Panuccio, Theodosios Bisdas, Arne Stachmann, Konstantinos P Donas, Giovanni Torsello, Martin Austermann
BACKGROUND: The iliac side branch device (IBD) is a valid method for the treatment of abdominal aorto-iliac aneurysms. However there is still a lack of evidence regarding the optimal length of the bridging stent graft (BSG) since aneurysmal degeneration of the hypogastric artery (HA) is an exclusion criterion. The aim of this study was to analyse the impact of longer BSG compared to the widely used 38mm stent-grafts in terms of reintervention rate and primary patency. METHODS: We retrospectively analyzed our prospectively collected database of all patients who underwent an endovascular aneurysm repair using an IBD in our center between April 2005 and May 2015...
October 29, 2018: Journal of Cardiovascular Surgery
Erwin Blessing, Ira Lugenbiel, Andrew Holden
Despite recent advances in endovascular therapy of lower extremity atherosclerotic disease, mainly driven through drug eluting balloon angioplasty, treatment of complex lesions remains challenging. Drug eluting balloons work less well in heavily calcified lesions and in particular long lesions often require bail-out stenting. Lesion preparation, as a stand-alone treatment or before delivering antiproliferative therapy or scaffolding, has gained increased recognition in recent years. Focal force or other specialty balloons are designed to prepare complex lesions to improve acute technical success and, ideally, long term patency of the vessel...
October 23, 2018: Journal of Cardiovascular Surgery
Moritz Mirna, Bernhard Wernly, Sarah Eder, Michael Lichtenauer, Erika Prinz, Wilfried Wintersteller, Christian Jung, Uta Hoppe, Matthias Hammerer
BACKGROUND: Aortic valve stenosis is the most common valvulopathy in developed countries. Transcatheter aortic valve implantation (TAVI) is a therapeutic alternative in symptomatic patients at high or prohibitive perioperative risk. Predilatation by balloon aortic valvuloplasty (BAV) under rapid ventricular pacing (RVP) has been a routine part of TAVI. However, both RVP and BAV carry substantial risks and an increasing number of interventional centers are performing TAVI without predilatation (direct TAVI)...
October 5, 2018: Journal of Cardiovascular Surgery
Emanuel R Tenorio, Matthew J Eagleton, Jussi M Kärkkäinen, Gustavo S Oderich
Spinal cord injury is the most devastating complication after aortic surgery. Rates of spinal cord injury vary from 0% up to 40%. Predictive factors include extent of coverage, hypogastric artery occlusion, prior aortic repair and perioperative hypotension. This article summarizes current strategies that are utilized to minimize risk of spinal cord injury including use of cerebrospinal fluid drainage, early limb reperfusion, staging and neuro-monitoring.
September 26, 2018: Journal of Cardiovascular Surgery
Emanuel R Tenorio, Aleem K Mirza, Jussi M Kärkkäinen, Gustavo S Oderich
Fenestrated and branched endovascular repair (F-BEVAR) has been increasingly used to treat patients with complex aortic aneurysms involving the renal-mesenteric arteries. As with any new procedure, there is a learning curve associated with mastering the technique. However, proficiency with deployment is only one aspect of the learning process, and ultimately, this curve is defined not by one quality parameter, but by patient selection, the performance of the entire team, the surgeons ability to adapt to unexpected events, and the durability of the repair...
September 12, 2018: Journal of Cardiovascular Surgery
Emmanuel Katsogridakis, Laura Ballance, Oliver Cawley, George A Antoniou
INTRODUCTION: Endovascular methods have emerged as an appealing alternative to bypass for the treatment of patients not suitable for surgery. Drug eluting stents (DES) have been developed to address the limitations of angioplasty and stenting. There is a paucity of data in the literature on their performance for the treatment of patients with long femoro- popliteal segment lesions. We aimed to analyse the evidence supporting the use of DES in patients with complex femoro-popliteal disease...
August 29, 2018: Journal of Cardiovascular Surgery
Koji Maeda, Takao Ohki, Yuji Kanaoka, Takeshi Baba, Kota Shukuzawa, Reo Takizawa, Makiko Omori
BACKGROUND: Percutaneous endovascular aortic repair (PEVAR) is widespread for the treatment of abdominal aortic aneurysm (AAA). The purpose of this study is to present outcomes of PEVAR using simultaneous angiography via microsheath. METHODS: There were 100 punctures in 50 patients undergoing PEVAR for AAA. All cases used the ProGlide closure device (Abbot Vascular, Santa Clara, CA) for PEVAR, and another puncture with microsheath placed on the common femoral artery for a second insertion point of the ProGlide...
August 29, 2018: Journal of Cardiovascular Surgery
Yan K Gernhofer, Oscar O Braun, Michela Brambatti, Quan M Bui, Silva E Jorge, Barry H Greenberg, Eric Adler, Victor Pretorius
BACKGROUND: The optimal advanced heart failure (HF) therapy strategy for patients aged 60 or older with end-stage HF refractory to optimal medical therapy remains uncertain. This study compares outcomes of three advanced HF therapy strategies in this patient population. METHODS: A single-center retrospective study was conducted in 95 patients between the age of 60-73 years who had undergone isolated heart transplantation (HTx) or continuous flow left ventricular assist device (LVAD) implantation from 2010 to 2017...
August 29, 2018: Journal of Cardiovascular Surgery
Daniel Wendt, Sharaf-Eldin Shehada, Fanar Mourad, Rene Machulla, Ender Demircioglu, Philipp Marx, Aydin Demircioglu, Konstantinos Tsagakis, Matthias Thielmann, Heinz G Jakob, Mohamed El Gabry
BACKGROUND: Transit-time flow measurement (TTFM) should be routinely used in CABG surgery to verify graft function. Most recently, a 2D high-frequency-ultrasound (HF-US) epi-cardiac imaging probe has been released (MiraQTM, Medistim, Oslo, Norway), which allows to evaluate the cannulation/clamping site of the aorta morphologically and to evaluate the completed anastomosis. We aimed to evaluate the use of TTFM and HF-US on surgical strategy during CABG surgery. METHODS: A total of 65 consecutive patients undergoing CABG surgery were evaluated...
August 29, 2018: Journal of Cardiovascular Surgery
Anton Tomšič, Yasmine L Hiemstra, Thomas J van Brakel, Michel I Versteegh, Nina Ajmone Marsan, Robert J Klautz, Meindert Palmen
BACKGROUND: Chordal replacement techniques are progressively used to treat posterior mitral valve leaflet (PMVL) prolapse while leaflet resection remains commonly in use to address excessive leaflet tissue. For excessive tissue in height, shortening neochords can be used alternatively. Use of chordal replacement techniques has been suggested to result in lower diastolic transvalvular gradients, higher freedom from reoperation and improved left ventricular function. METHODS: From 1/2005 to 12/2016, 150 patients underwent valve repair for isolated PMVL prolapse with excessive tissue...
August 29, 2018: Journal of Cardiovascular Surgery
Vincenzo Vento, Raphael Soler, Dominique Fabre, Laurence Gavit, Emmanuelle Majus, Philippe Brenot, Mauro Gargiulo, Stéphan Haulon
Improvements in endovascular technologies and development of custom-made fenestrated and branched endografts currently allow clinicians to treat complex aortic lesions such as thoraco-abdominal and aortic arch aneurysms once treatable with open repair only. These advances are leading to an increase in the complexity of endovascular procedures which can cause long operation times and high levels of radiation exposure. This in turn places pressure on the vascular surgery community to display more superior interventional skills and radiological practices...
August 28, 2018: Journal of Cardiovascular Surgery
Stefano Gennai, Giuseppe M Saitta, Antonio Lauricella, Nicola Leone, Francesco Andreoli, Roberto Silingardi
BACKGROUND: To assess immediate and midterm outcomes of hemodynamically-unstable patients with ruptured abdominal aortic aneurysm (rAAA) treated with the Nellix endovascular sealing system (EVAS). METHODS: From June 2014 to June 2017, 21 hemodynamically-unstable rAAA patients with challenging anatomies were treated with EVAS. The mean AAA diameter and neck length measured 73±15mm and 14±10mm, respectively. All the patients presented an advance trauma life support (ATLS) hemorrhage class ≥1 confirming a compromised hemodynamic status...
August 28, 2018: Journal of Cardiovascular Surgery
Christos D Karkos, Ioannis Pliatsios, Theodosios Stamatopoulos, Maria A Mitka, Ioakeim T Giagtzidis, Konstantinos O Papazoglou
No abstract text is available yet for this article.
October 2018: Journal of Cardiovascular Surgery
Marco Manzi
No abstract text is available yet for this article.
October 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...
October 2018: Journal of Cardiovascular Surgery
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