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https://www.readbyqxmd.com/read/28648757/prolonged-icu-length-of-stay-after-aaa-repair-analysis-of-time-trends-and-long-term-outcome
#1
H Gavali, K Mani, G Tegler, R Kawati, L Covaciu, A Wanhainen
OBJECTIVE: The aim of the study was to investigate the frequency and outcome of prolonged intensive care unit (ICU) length of stay (LOS) after abdominal aortic aneurysm (AAA) repair in the endovascular era. METHODS: All patients operated on for AAA between 1999 and 2013 at Uppsala University hospital were identified. Data were retrieved from the Swedish Vascular registry, the Swedish Intensive Care registry, the National Population registry, and case records. Prolonged ICU LOS was defined as ≥ 48 h during the primary hospital stay...
June 22, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28648650/planning-execution-and-follow-up-for-endovascular-aortic-aneurysm-repair-using-a-highly-restrictive-iodinated-contrast-protocol-in-patients-with-severe-renal-disease
#2
E Gallitto, G L Faggioli, M Gargiulo, A Freyrie, R Pini, C Mascoli, S Ancetti, V Vento, A Stella
BACKGROUND: The cumulative amount of iodinated-contrast-medium necessary for EVAR planning, operative procedure and subsequent follow-up is a threat for the onset of end stage renal disease in patients with pre-operative impaired kidney function. Purpose of this study is to describe a mini-invasive approach aimed to minimize the exposure of these patients to iodinated-contrast-medium and the subsequent risk of renal function worsening. METHODS: From 2012 to 2015, all patients with abdominal aortic aneurysm (AAA) at high-surgical risk and fit for standard endovascular repair (simple aortic-iliac anatomy: proximal and distal neck length ≥15mm, no severe angulation), underwent EVAR through the following "near-zero contrast" approach, if their glomerular filtration rate (GFR) was <30 mL/min: pre-operative planning was performed by non-contrast enhanced computed tomography (CT) and duplex-ultrasound (DU); the origin of renal/hypogastric arteries and aortic bifurcation was evaluated and matched with vertebral bone landmarks and the endograft deployed accordingly, using < 20cc of isotonic iodinate-contrast-medium and contrast-enhancement-DU (CEUS)...
June 22, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28648533/recurrent-laryngeal-nerve-injury-and-swallowing-dysfunction-in-neonatal-aortic-arch-repair
#3
Kamal K Pourmoghadam, William M DeCampli, Mark Ruzmetov, James Kosko, Sami Kishawi, Michael O'Brien, Amanda Cowden, Kurt Piggott, Harun Fakioglu
BACKGROUND: We evaluated the incidence, clinical effect, and recovery rate of vocal cord dysfunction (VCD) and swallowing dysfunction in neonates undergoing aortic arch repair. METHODS: We retrospectively evaluated 101 neonates who underwent aortic arch reconstruction from 2008 to 2015. Direct flexible laryngoscopy was performed in 89 patients before initiation of postoperative oral feeding after Norwood (n = 63) and non-Norwood (n = 26) arch reconstruction. We defined VCD as immobility of vocal cords or their lack of coaptation and poor mobility...
June 22, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28648482/comparison-of-intravascular-ultrasound-and-centerline-computed-tomography-determined-aortic-diameters-during-thoracic-endovascular-aortic-repair
#4
Sukgu M Han, Ramsey S Elsayed, Sung W Ham, Anuj Mahajan, Fernando Fleischman, Vincent L Rowe, Mark J Cunningham, Fred A Weaver
BACKGROUND: Accurate sizing of stent grafts during thoracic endovascular aortic repair (TEVAR) is critical for a successful outcome. Centerline measurements using three-dimensional reconstruction of preoperative computed tomography angiography (CTA) is the current standard for stent graft sizing. However, this technique is predicated on an idealized straightened aorta and does not account for the variability in the aortic diameter during the cardiac cycle or the overall status of the patient's volume...
June 22, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28648481/outcomes-of-concomitant-renal-reconstruction-during-open-paravisceral-aortic-aneurysm-repair
#5
Mathew Wooster, Martin Back, Shivangi Patel, Adam Tanious, Paul Armstrong, Murray Shames
OBJECTIVE: The objective of this study was to review the outcomes of renal artery revascularizations during open aortic aneurysm repair. METHODS: Open abdominal aneurysm repairs performed from 2010 to 2015 at a single institution were reviewed, including type IV thoracoabdominal, suprarenal, and juxtarenal aneurysms. Direct renal reconstruction techniques included eversion endarterectomy, bypass, and vessel reimplantation based on the patient's anatomy. Renal loss was defined by artery occlusion...
June 22, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28648480/a-10-year-institutional-experience-with-open-branched-graft-reconstruction-of-aortic-aneurysms-in-connective-tissue-disorders-versus-degenerative-disease
#6
Caitlin W Hicks, Jennifer Lue, Natalia O Glebova, Bryan A Ehlert, James H Black
OBJECTIVE: Aortic reconstruction for complex thoracoabdominal aortic aneurysms (TAAAs) can be challenging, especially in patients with connective tissue disorders (CTDs) in whom tissue fragility is a major concern. Branched graft reconstruction is a more complex operation compared with inclusion patch repair of the aorta but is frequently necessary in patients with CTDs or other pathologies because of anatomic reasons. We describe our institutional experience with open branched graft reconstruction of aortic aneurysms and compare outcomes for patients with CTDs vs degenerative pathologies...
June 22, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28648334/catch-22-management-of-aortoesophageal-fistula-after-thoracic-endovascular-aortic-repair
#7
EDITORIAL
John S Ikonomidis
No abstract text is available yet for this article.
June 22, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28648010/-experience-of-sun-s-procedure-for-chronic-type-b-dissection-with-aortic-arch-involvement
#8
R D Qi, J M Zhu, L Chen, C N Li, Z Y Qiao, L J Cheng, Y P Ge, H O Hu, Y Xia, X Y Xing, T Zheng, Y M Liu, L Z Sun
Objective: To study the surgical treatment of chronic type B dissection with aortic arch involvement using Sun's procedure. Methods: Between February 2009 and December 2015, 29 patients [20 males, 9 females, with a mean age of (41±12) years, range 24-64 years] with type B dissection with aortic arch involvement underwent Sun's procedure. Sixteen patient had a history of hypertension. Marfan syndrome was observed in 9 cases, coronary artery disease in 3 cases, mitral regurgitation in 3 patients, cerebrovascular disease in one patient...
June 27, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28647641/impact-of-left-subclavian-artery-revascularization-prior-to-thoracic-endovascular-aortic-repair-on-post-operative-cerebrovascular-hemodynamics
#9
Arnoud V Kamman, Jonathan L Eliason, David M Williams, Bo Yang, Frans L Moll, Santi Trimarchi, Kim A Eagle, Himanshu J Patel
OBJECTIVES: The impact of left subclavian artery (LSA) revascularization prior to thoracic endovascular aortic repair (TEVAR) on cerebrovascular flow is not well described. We studied bilateral vertebral and carotid artery flow characteristics before and after TEVAR, to evaluate the hemodynamic effects of LSA revascularization. METHODS: Seventy-four patients with mixed etiologies (mean age 70.9±10.5 years) underwent LSA revascularization and TEVAR (2006-2016) and had available pre- and post-operative carotid Duplex study available...
June 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28647195/adapting-to-a-total-endovascular-approach-for-complex-aortic-aneurysm-repair-outcomes-after-fenestrated-and-branched-endovascular-aortic-repair
#10
Jacob Budtz-Lilly, Anders Wanhainen, Jacob Eriksson, Kevin Mani
OBJECTIVE: This study reports the feasibility of adopting a total endovascular approach for the treatment of complex abdominal aortic aneurysms (AAAs) at a European aortic center and compares the short- and midterm results against those from large and multicenter studies. METHODS: All patients treated endovascular aortic repair (EVAR) for juxta/pararenal AAAs or thoracoabdominal aortic aneurysms (TAAAs), both elective and acute, as well as reoperations, from 2010 to 2015 were included...
June 21, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28647036/supra-aortic-interventions-for-endovascular-exclusion-of-the-entire-aortic-arch
#11
REVIEW
Terézia B Andrási, Marius Grossmann, Dieter Zenker, Bernhard C Danner, Friedrich A Schöndube
OBJECTIVE: Our aim was to analyze the outcomes of endovascular exclusion of the entire aortic arch (proximal landing in zone 0, distal landing in zone III or beyond, after Ishimaru) in which complete surgical debranching of the supra-aortic vessels (I), endovascular supra-aortic revascularization (chimney, fenestrated, or branched grafts) with partial surgical debranching (II), or total endovascular supra-aortic revascularization (III) was additionally performed. METHODS: Publications describing endovascular repair of the aortic arch (2000-2016) were systematically searched and reviewed...
July 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28646460/a-nationwide-survey-of-aortic-valve-surgery-in-japan-current-status-of-valve-preservation-in-cases-with-aortic-regurgitation
#12
REVIEW
Satoshi Arimura, Masahiro Seki, Kenichi Sasaki, Hideaki Takai, Minoru Matsuhama, Takashi Kunihara, Yutaka Okita, Shuichiro Takanashi, Tatsuhiko Komiya, Hitoshi Yaku, Hitoshi Okabayashi, Hirofumi Takemura, Hirokuni Arai, Masaru Sawazaki, Yoshiro Matsui, Norihiko Shiiya
OBJECTIVE: Although aortic valve-sparing operations are performed throughout Japan, the indications, specific repair techniques, and outcomes have not been reported in full. Thus, we conducted the first nationwide survey of aortic valve-sparing surgery. METHODS: We mailed a questionnaire to 508 institutions across Japan to obtain information on elective aortic valve and aortic root surgeries performed in 2014. Included in the mailing was a secondary questionnaire that sought further information from institutions reporting aortic valve-sparing surgeries...
June 23, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28645316/erratum-to-a-novel-anatomic-severity-grading-score-for-acute-type-b-aortic-dissections-and-correlation-to-aortic-reinterventions-after-thoracic-endovascular-aortic-repair
#13
Shirui Chen, Sebastian Larion, Sadaf S Ahanchi, Chad P Ammar, Colin T Brandt, Jean M Panneton
No abstract text is available yet for this article.
June 23, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28643474/long-term-failure-of-amplatzer-plugs-in-the-treatment-of-aortic-pathology
#14
Jeremy Song, Benjamin Ascherman, Kyle W Eudailey, Monir Mohar, Michael Argenziano, Hiroo Takayama, Isaac George
We present two cases of Amplatzer® device deployment that exhibited long-term failure necessitating surgical correction. The first case illustrates recanalization of a ruptured Valsalva aneurysm with worsening aortic insufficiency after percutaneous repair with the Amplatzer Vascular Plugs and Amplatzer duct occluder, while the second case illustrates recanalization after deployment of the Amplatzer septal occluder in a patient with a pseudoaneursym in a bovine aorta after type I aortic dissection repair. These two cases illustrate the potential long-term complications and limitations in durability with these devices...
June 23, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28642793/repair-of-thoracoabdominal-aortic-aneurysm-with-thrombosed-infrarenal-component-a-modified-hybrid-technique-without-aortic-cross-clamping
#15
Hussam Abou-Al-Shaar, Khaled J Zaza, Muhammad Anees Sharif, Samer Koussayer
The authors report the successful repair of a Crawford type III thoracoabdominal aortic aneurysm (TAAA) with a thrombosed infrarenal component using a modified hybrid technique without aortic clamping in a high-risk patient. A 64-year-old male with a history of hypertension, diabetes, and severe chronic obstructive pulmonary disease presented with acute on chronic backache and bilateral short distance claudication. A computerized tomography scan demonstrated a large, nonleaking Crawford type III TAAA with thrombosed infrarenal component of the aneurysm...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28642292/frequency-and-magnitude-of-intermittent-hypoxia-modulate-endothelial-wound-healing-in-a-cell-culture-model-of-sleep-apnea
#16
Noelia Campillo, Bryan Falcones, Josep M Montserrat, David Gozal, Ana Obeso, Teresa Gallego-Martin, Daniel Navajas, Isaac Almendros, Ramon Farre
Intermittent hypoxia (IH) has been implicated in the cardiovascular consequences of obstructive sleep apnea (OSA). However, the lack of suitable experimental systems has precluded assessment as to whether IH is detrimental, protective or both for the endothelium. The aim of the work was to determine the effects of frequency and amplitude of IH oxygenation swings on aortic endothelial wound healing. Monolayers of human primary endothelial cells were wounded, and subjected to constant oxygenation (1%, 4%, 13% or 20% O2) or IH at different frequencies (0...
June 22, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28642109/neoaortic-xenoprosthetic-grafts-for-treatment-of-mycotic-aneurysms-and-infected-aortic-grafts
#17
C Anibueze, V Sankaran, U Sadat, K Tan, Y G Wilson, R E Brightwell, M S Delbridge, P W Stather
OBJECTIVE: There is no international consensus regarding the optimum management of infected aortae (mycotic aneurysms, infected aortic grafts). Neoaortoiliac reconstruction has advantages over extra anatomical bypass grafting; however use of autologous vein is associated with venous hypertension and compartment syndrome, alternatively cadaveric homografts are associated with high rates of perianastomotic haemorrhage, limb occlusion and pseudoaneurysm. Arterial repair using xenoprosthetic patches is associated with lower infection rates compared to the use of prosthetic material...
June 19, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28642087/contemporary-prevalence-in-hospital-outcomes-and-prognostic-determinants-of-triple-valve-surgery
#18
Lucas B Ohmes, Luke Kim, Dmitriy N Feldman, Christopher Lau, Monica Munjal, Antonino Di Franco, Fawad Hameedi, Ivancarmine Gambardella, Leonard N Girardi, Mario Gaudino
BACKGROUND: Triple valve surgery (TVS) remains a challenging procedure with limited existing literature. We aim to evaluate the prevalence, in-hospital outcomes, and prognostic determinants of TVS in the current era. MATERIALS AND METHODS: We reviewed the Nationwide Inpatient Sample database from 2003 to 2012 and included all patients who underwent aortic valve replacement (AVR) combined with mitral valve replacement (MVR) or repair (MVRep) and tricuspid valve replacement (TVR) or repair (TVRep)...
June 19, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28642065/severe-and-resistant-hypertension-in-an-older-woman-with-claudication
#19
Puneet Gupta, Robert Hagberg, Electra Kaloudis, Anika Lucas, Parth Shah, William B White
Coarctation of the aorta is an uncommon cause of treatment-resistant hypertension in adults. It is typically detected and treated in infancy or childhood with surgical or endovascular procedures. Most cases of recurrence of coarctation after repair occur in childhood or early adulthood; recurrence in older persons (>70 years) has rarely been reported. A 73-year-old woman was referred to us for the management of treatment-resistant hypertension accompanied by symptoms of claudication and headaches, which had resulted in multiple emergency room visits...
June 1, 2017: Journal of the American Society of Hypertension: JASH
https://www.readbyqxmd.com/read/28641275/a-case-series-of-surgically-diagnosed-idiopathic-aortitis-in-a-canadian-centre-a-retrospective-study
#20
Diane L Murzin, Eric C Belanger, John P Veinot, Nataliya Milman
BACKGROUND: Idiopathic aortitis became recognized relatively recently, and the body of knowledge concerning this condition is scarce. We aimed to determine the frequency of idiopathic aortitis in aortic specimens, the clinical, laboratory and radiologic characteristics at diagnosis and during follow-up, and the approach to investigation, treatment and monitoring taken by the treating physicians. METHODS: We identified cases of aortitis diagnosed on pathological specimens of the aorta between Jan...
June 19, 2017: CMAJ Open
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