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Acute aortic injury

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https://www.readbyqxmd.com/read/29344813/stroke-volume-variation-and-serum-creatinine-changes-during-abdominal-aortic-aneurysm-surgery-a-time-integrated-analysis
#1
Paolo Lentini, Luca Zanoli, Pasquale Fatuzzo, Faeq Husain-Syed, Rudi Stramanà, Diego Cognolato, Vincenzo Catena, Marco Baiocchi, Antonio Granata, Roberto Dell'Aquila
BACKGROUND: Patients undergoing abdominal aortic aneurysm (AAA) surgery with suprarenal clamping are at high risk for acute kidney injury (AKI) and major cardiac and cerebrovascular events (MACCE). We aimed to assess whether the stroke volume variation (SVV), a measure of hemodynamic instability, is associated with AKI in hypertensive patients undergoing elective AAA surgery with suprarenal clamping. METHODS: In a cohort of 51 hypertensive patients, we performed serial measurements of SVV (n = 459) and serum creatinine (sCr) (n = 255)...
January 17, 2018: Journal of Nephrology
https://www.readbyqxmd.com/read/29329828/frequency-and-prognostic-significance-of-acute-kidney-recovery-in-patients-who-underwent-transcatheter-aortic-valve-implantation
#2
Amir Azarbal, Kevin L Leadholm, Takamaru Ashikaga, Richard J Solomon, Harold L Dauerman
Acute kidney injury (AKI) after transcatheter aortic valve implantation (TAVI) is associated with increased mortality. As significant hemodynamic improvement may occur with relief of aortic stenosis, we hypothesized that TAVI patients may demonstrate the opposite phenomena: acute kidney recovery (AKR). We studied the incidence and predictors of AKR in post-TAVI patients. A total of 366 consecutive patients underwent TAVI (January 2012 to January 2017) at a single center. We defined AKR as a 25% improvement in glomerular filtration rate (GFR) at 48 hours after TAVI...
December 13, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29329731/multimodality-imaging-evaluation-before-transcatheter-aortic-valve-implantation-incidence-of-contrast-medium-induced-acute-kidney-injury-risk-factors-and-prognosis
#3
C Schneider, A Brumberg, F C Roller, J Rixe, P Roth, G A Krombach
AIM: To evaluate the incidence, risk factors, and prognostic implications of contrast medium-induced acute kidney injury (CI-AKI) in patients undergoing transcatheter aortic valve implantation (TAVI) evaluation. MATERIALS AND METHODS: Datasets from 98 out of 207 consecutive patients referred for multidetector computed tomography (MDCT) for TAVI evaluation were eligible for evaluation and were analysed retrospectively. The incidence of CI-AKI was correlated to outcome and to potential risk factors: kidney function (estimated glomerular filtration rate [eGFR]), heart failure, diabetes, amount of contrast medium, and duration of examination period...
January 10, 2018: Clinical Radiology
https://www.readbyqxmd.com/read/29327106/mdct-of-ductus-diverticulum-3d-cinematic-rendering-to-enhance-understanding-of-anatomic-configuration-and-avoid-misinterpretation-as-traumatic-aortic-injury
#4
Steven P Rowe, Pamela T Johnson, Elliot K Fishman
Acute aortic injuries are not common in the setting of severe blunt trauma, but lead to significant morbidity and mortality. High-quality MDCT with 2D MPRs and 3D rendering are essential to identify aortic trauma and distinguish anatomic variants and other forms of aortic pathology from an acute injury. Misinterpretation of mimics of acute aortic injury can lead to unnecessary arteriography and thoracic surgery. Since most traumatic injuries occur in the distal arch, radiologists must be cognizant of the range of appearances of variants related to the ductus diverticulum...
January 11, 2018: Emergency Radiology
https://www.readbyqxmd.com/read/29314570/transubclavian-approach-a-competitive-access-for-transcatheter-aortic-valve-implantation-as-compared-to-transfemoral
#5
Ignacio J Amat-Santos, Paol Rojas, Hipólito Gutiérrez, Silvio Vera, Javier Castrodeza, Javier Tobar, L Renier Goncalves-Ramirez, Manuel Carrasco, Pablo Catala, José A San Román
AIMS: Empirically, transfemoral (TF) approach is the first choice for transcatheter aortic valve implantation (TAVI). We aimed to investigate whether transubclavian (TSc) and TF approaches present comparable major outcomes according to current evidence. METHODS: We systematically searched PubMed, EMBASE, and Cochrane database for studies with symptomatic aortic stenosis patients who underwent TAVI through TF or TSc/axillary access from January/2006 to January/2017...
January 3, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29313164/treatment-of-nonocclusive-mesenteric-ischemia-with-type-b-aortic-dissection-using-intra-arterial-catheterization-after-trauma-surgery-case-report
#6
Sho Fujiwara, Yuki Sekine, Ryuichi Nishimura, Kazuya Tadasa, Shukichi Miyazaki
BACKGROUND: Nonocclusive mesenteric ischemia (NOMI) is a mesenteric arterial spasm and intestinal ischemia. This disease is a highly lethal disease because diagnosis and decision of appropriate treatments are often difficult. Operations cannot resolve the spasms and may worsen the situation. However, the safety and effectiveness of catheterization for NOMI with aortic dissection (AD) have not yet been elucidated. Here, we report a successful case of early diagnosis and treatment of NOMI with type B AD involving the superior mesenteric artery (SMA) using the intra-arterial infusion of a vasodilator via the SMA...
January 8, 2018: Surgical Case Reports
https://www.readbyqxmd.com/read/29312702/risk-factors-of-pre-operational-aortic-rupture-in-acute-and-subacute-stanford-type-a-aortic-dissection-patients
#7
Zhuo-Dong Li, Yang Liu, Jiang Zhu, Jun Wang, Fang-Lin Lu, Lin Han, Zhi-Yun Xu
Background: Aortic rupture is one of the main causes of early death in acute and subacute Stanford type A aortic dissection (ATAAD) patients. This study aimed to analyze potential risk factors for pre-operational aortic rupture in ATAAD patients. Methods: We retrospectively reviewed aortic dissection cases treated between May 2013 and May 2016 in Changhai Hospital, Shanghai. A total of 329 patients with ATAAD were included in the final analysis, and 31 patients died of aortic rupture before surgery...
December 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29298239/resuscitative-endovascular-balloon-occlusion-of-the-aorta-for-pelvic-blunt-trauma-and-life-threatening-hemorrhage-a-20-year-experience-in-a-level-i-trauma-center
#8
Audrey Pieper, Frédéric Thony, Julien Brun, Mathieu Rodière, Bastien Boussat, Catherine Arvieux, Jérôme Tonetti, Jean-François Payen, Pierre Bouzat
BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is increasingly used as a non-invasive clamp of the aorta after diverse post-traumatic injuries. Balloon inflation in zone 3 (from the lower renal artery to the aortic bifurcation) can be performed to stop on-going bleeding after severe pelvic trauma with life-threatening hemorrhage. The aim of our study was to describe our 20-year experience with REBOA in terms of efficacy and safety in patients with a suspicion of severe pelvic trauma and extreme hemorrhagic shock...
January 2, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29297076/effect-of-mechanically-expanded-vs-self-expanding-transcatheter-aortic-valve-replacement-on-mortality-and-major-adverse-clinical-events-in-high-risk-patients-with-aortic-stenosis-the-reprise-iii-randomized-clinical-trial
#9
Ted E Feldman, Michael J Reardon, Vivek Rajagopal, Raj R Makkar, Tanvir K Bajwa, Neal S Kleiman, Axel Linke, Dean J Kereiakes, Ron Waksman, Vinod H Thourani, Robert C Stoler, Gregory J Mishkel, David G Rizik, Vijay S Iyer, Thomas G Gleason, Didier Tchétché, Joshua D Rovin, Maurice Buchbinder, Ian T Meredith, Matthias Götberg, Henrik Bjursten, Christopher Meduri, Michael H Salinger, Dominic J Allocco, Keith D Dawkins
Importance: Transcatheter aortic valve replacement (TAVR) is established for selected patients with severe aortic stenosis. However, limitations such as suboptimal deployment, conduction disturbances, and paravalvular leak occur. Objective: To evaluate if a mechanically expanded valve (MEV) is noninferior to an approved self-expanding valve (SEV) in high-risk patients with aortic stenosis undergoing TAVR. Design, Setting, and Participants: The REPRISE III trial was conducted in 912 patients with high or extreme risk and severe, symptomatic aortic stenosis at 55 centers in North America, Europe, and Australia between September 22, 2014, and December 24, 2015, with final follow-up on March 8, 2017...
January 2, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29290079/buckberg-versus-calafiore-cardioplegia-in-patients-with-acute-coronary-syndromes
#10
Elmar W Kuhn, Oliver Liakopoulos, Ingo Slottosch, Antje Christin Deppe, Yeong-Hoon Choi, Navid Madershahian, Thorsten C W Wahlers
BACKGROUND:  Choice of cardioplegic solution plays a pivotal role in special subgroups of patients referred for on-pump cardiac surgery. This retrospective analysis aimed to assess the impact of intermittent warm (Calafiore, Cala) versus intermittent cold blood cardioplegia (Buckberg, Buck) in patients referred to coronary artery bypass graft (CABG) surgery due to acute coronary syndromes (ACS). METHODS:  From 2008 to 2015, all consecutive patients undergoing urgent on-pump CABG surgery due to ACS (n = 950) were retrospectively analyzed...
December 31, 2017: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/29283977/divergent-effects-of-hypertonic-fluid-resuscitation-on-renal-pathophysiological-and-structural-parameters-in-rat-model-of-lower-body-ischemia-reperfusion-induced-sterile-inflammation
#11
Bulent Ergin, Coert J Zuurbier, Aysegul Kapucu, Can Ince
The pathogenesis of acute kidney injury (AKI) is characterized by the deterioration of tissue perfusion and oxygenation and enhanced inflammation. The purpose of this study was to investigate whether or not the hemodynamic and inflammatory effects of hypertonic saline (HS) protect the kidney by promoting renal microcirculatory oxygenation and possible deleterious effects of HS due to its high sodium content on renal functional and structural injury following ischemia/reperfusion. Mechanically ventilated and anesthetized rats were randomly divided into four groups (n = 6 per group): a sham-operated control group; a group subjected to renal ischemia for 45 min by supra-aortic occlusion followed by 2 h of reperfusion (I/R); and I/R group treated with a continuous i...
December 27, 2017: Shock
https://www.readbyqxmd.com/read/29280925/ontemporary-utilization-of-resuscitative-thoracotomy-results-from-the-aast-aortic-occlusion-for-resuscitation-in-trauma-and-acute-care-surgery-aorta-multicenter-registry
#12
Joseph DuBose, Timothy Fabian, Tiffany Bee, Laura J Moore, John B Holcomb, Megan Brenner, David Skarupa, Kenji Inaba, Todd E Rasmussen, David Turay, Thomas M Scalea
INTRODUCTION: Several reviews of Resuscitative thoracotomy (RT) use over the last 5 decades have been conducted, most recently the evidence-based practice management guideline (PMG) of the Eastern Association for the Surgery of Trauma (EAST). The present study was designed to examine contemporary RT utilization and outcomes compared to historical data (n = 10,238) from the EAST PMG review from published series 1974 - 2013. METHODS: The AAST AORTA registry was utilized to identify patients undergoing RT in the ED from Nov 2013 to Dec 2016...
December 26, 2017: Shock
https://www.readbyqxmd.com/read/29275829/risk-modeling-to-optimize-patient-selection-for-management-of-the-descending-thoracic-aortic-aneurysm
#13
Akiko Tanaka, Harleen K Sandhu, Wande B Pratt, Rana Afifi, Charles C Miller, Kristofer Charlton-Ouw, Maria E Codreanu, Naveed U Saqib, Ali Azizzadeh, Hazim J Safi, Anthony L Estrera
BACKGROUND: A single-institutional study comparing early and long-term outcomes of thoracic endovascular aortic repair (TEVAR) and open surgical repair (OSR) was performed to determine the appropriate treatment option for descending thoracic aortic aneurysm (DTAA). METHODS: Between 2005 and 2014, 438 DTAA patients were treated (TEVAR, 88; OSR, 350). Acute dissection and traumatic injury were excluded. Perioperative and follow-up data were reviewed. Stratified analyses were conducted to identify patients most likely to benefit from TEVAR...
December 21, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29251358/acute-kidney-injury-post-transcatheter-aortic-valve-replacement
#14
REVIEW
Pradhum Ram, Kenechukwu Mezue, Gregg Pressman, Janani Rangaswami
Transcatheter aortic valve replacement (TAVR) is a treatment option in high-risk patients with severe aortic stenosis who are not surgical candidates. In light of emerging evidence, it is being increasingly performed even in intermediate-risk patients in recent years. Patients who develop acute kidney injury (AKI) following TAVR are known to have worse outcomes. The objective of this concise review was to identify the prevalence and the impact of AKI following TAVR on patient outcomes by including the most recent literature in our search...
December 18, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/29249501/predictors-of-survival-in-octogenarians-after-mitral-valve-surgery-for-degenerative-disease-the-mitral-surgery-in-octogenarians-study
#15
Pierpaolo Chivasso, Vito D Bruno, Shakil Farid, Pietro Giorgio Malvindi, Amit Modi, Umberto Benedetto, Franco Ciulli, Yasir Abu-Omar, Massimo Caputo, Gianni D Angelini, Steve Livesey, Hunaid A Vohra
OBJECTIVES: An increasing number of octogenarians are referred to undergo mitral valve surgery for degenerative disease, and percutaneous approaches are being increasingly used in this subgroup of patients. We sought to determine the survival and its predictors after Mitral valve Surgery in Octogenarians (MiSO) in a multicenter UK study of high-volume specialized centers. METHODS: Pooled data from 3 centers were collected retrospectively. To identify the predictors of short-term composite outcome of 30 days mortality, acute kidney injury, and cerebrovascular accident, a multivariable logistic regression model was developed...
November 20, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29249231/hemoglobinuric-acute-kidney-injury-in-a-patient-with-a-kinked-prosthetic-aortic-graft%C3%A2
#16
Hema V Sheelvanth, Khaleel A Sayeed, William A Whittier
Acute kidney injury (AKI) due to intravascular hemolysis has been well described in paroxysmal nocturnal hemoglobinuria (PNH) and in cardiac valvular dysfunction. However, reported cases of hemoglobinuric AKI from prosthetic aortic grafts are sparse. We present a case of microangiopathic hemolytic anemia and hemoglobinuric AKI presenting 9 days after repair of an ascending aortic dissection with a prosthetic graft. After an unremarkable recovery following the initial procedure, the patient presented on postoperative day 9 with dyspnea, fatigue, and cola-colored urine...
December 18, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/29230707/acute-kidney-injury-after-abdominal-aortic-aneurysm-repair-current-epidemiology-and-potential-prevention
#17
Liesa Zabrocki, Frank Marquardt, Klaus Albrecht, Stefan Herget-Rosenthal
PURPOSE: Acute kidney injury (AKI) is a severe complication after infrarenal abdominal aortic aneurysm (iAAA) repair. Little data are available whether endovascular aneurysm (EVAR) or open aortic repair (OAR) differs with respect to AKI frequency and severity, consecutive development of chronic kidney disease (CKD) and potentially preventable and modifiable risk factors of AKI. PATIENTS AND METHODS: We assessed AKI rates, AKI stages and CKD applying current, complete definitions from the kidney disease improving global outcomes initiative in propensity-score-matched cohorts of all patients with elective and urgent iAAA repair at our institution from 2007 to 2011...
December 11, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/29230568/ankle-brachial-pressure-index-as-a-predictor-of-the-2-year-outcome-after-transcatheter-aortic-valve-replacement-data-from-the-japanese-ocean-tavi-registry
#18
Masahiro Yamawaki, Motoharu Araki, Tsutomu Ito, Yosuke Honda, Takahiro Tokuda, Yoshiaki Ito, Hiroshi Ueno, Kazuki Mizutani, Minoru Tabata, Akihiro Higashimori, Norio Tada, Kensuke Takagi, Futoshi Yamanaka, Toru Naganuma, Yusuke Watanabe, Masanori Yamamoto, Shinichi Shirai, Kentaro Hayashida
Peripheral artery disease plays a pivotal role for access site selection in transcatheter aortic valve replacement (TAVR). Abnormal ankle-brachial index (ABI) is a generalized mortality marker in many cardiovascular scenarios. However, the long-term outcomes in high-risk TAVR populations remain unclear. We investigated the association between low ABI and 2-year outcome after TAVR. Of 1613 patients enrolled in the OCEAN-TAVI registry, 1458 (90.4%) who underwent ABI before TAVR were divided into groups: patients with (1) ABI ≥ 0...
December 11, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/29229143/myocardial-functional-changes-in-transfemoral-versus-transapical-aortic-valve-replacement
#19
Niraj Asthana, Aditya Mantha, Eric H Yang, William Suh, Olcay Aksoy, Richard J Shemin, Gabriel Vorobiof, Peyman Benharash
BACKGROUND: Transcatheter aortic valve replacement (TAVR) has greatly expanded the treatment options available for patients with severe aortic stenosis at high surgical risk. MATERIALS AND METHODS: We compared changes in myocardial function in TAVR with a transfemoral (TF) versus a transapical (TA) approach at a major tertiary hospital from 2012-2016. Traditional echocardiographic measures of cardiac structure and function were tracked, alongside the use of two-dimensional speckle tracking echocardiography to measure myocardial strain and strain rates...
January 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29226380/acute-severe-mitral-regurgitation-after-blunt-chest-trauma
#20
Petar Saric, Benjamin D Ravaee, Toral R Patel, Brian D Hoit
Myocardial contusion and aortic injury are well-known cardiac complications of blunt chest trauma, but valvular injury is rare. Traumatic valve injuries most commonly involve the aortic valve, with isolated mitral valve injury being quite rare. We report a case of acute severe mitral regurgitation due to ruptured chordae tendineae requiring surgical repair following a motor vehicle accident.
December 11, 2017: Echocardiography
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