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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
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
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
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
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 preoperative planning...
October 2018: Journal of Cardiovascular Surgery
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