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https://www.readbyqxmd.com/read/28102102/impact-of-thoracic-endovascular-aortic-repair-on-pulsatile-circumferential-and-longitudinal-strain-in-patients-with-aneurysm
#1
Foeke J H Nauta, Guido H W van Bogerijen, Chiara Trentin, Michele Conti, Ferdinando Auricchio, Frans L Moll, Joost A van Herwaarden, Santi Trimarchi
PURPOSE: To quantify both pulsatile longitudinal and circumferential aortic strains before and after thoracic endovascular aortic repair (TEVAR), potentially clarifying TEVAR-related complications. METHODS: This retrospective study assessed the impact of TEVAR on pulsatile aortic strains through custom developed software and cardiac-gated computed tomography imaging of 8 thoracic aneurysm patients (mean age 71.0±8.2 years; 6 men) performed before TEVAR and during follow-up (median 0...
January 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28100876/primary-percutaneous-coronary-intervention-followed-by-valve-surgery-for-acute-coronary-syndrome-at-left-main-trunk-complicated-with-severe-aortic-stenosis
#2
Akira Shikuma, Jun Shiraishi, Kazunari Okawa, Masaki Yashige, Keisuke Shoji, Daisuke Ito, Masayoshi Kimura, Eigo Kishita, Yusuke Nakagawa, Masayuki Hyogo, Akiyuki Takahashi, Takahisa Sawada
An 89-year-old woman appeared to have acute coronary syndrome at the left main trunk (LMT) complicated with severe aortic stenosis, moderate-severe mitral regurgitation, depressed left ventricular (LV) function, and multivessel disease. Because of sustained hypotension even under intra-aortic balloon pumping support during emergency coronary angiograhy, we performed primary percutaneous coronary intervention solely for the LMT lesion using a bare metal stent, leading to recovery from the shock state. On the second hospital day, based on our heart-team consensus, we performed aortic valve replacement and coronary artery bypass grafting surgery, and added edge-to-edge repair (Alfieri stitch) of the mitral valve, resulting in complete revascularization and dramatically improved LV function...
January 17, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28097197/early-coronary-thrombosis-without-st-segment-elevation-following-repair-of-acute-aortic-dissection
#3
Davide Carino, Francesco Nicolini, Giorgio Romano, Matteo Ricci, Tiziano Gherli
Acute coronary thrombosis after emergent surgery for acute Type A aortic dissection is a rare event that can remain undiagnosed in absence of typical electrocardiogram readings. We report a case of left anterior descending artery thrombosis without ST-segment elevation three days after surgical repair, which was successfully treated with angioplasty and stenting.
August 2016: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/28088428/aortic-floating-thrombus-detected-by-computed-tomography-angiography-incidentally-five-cases-and-a-literature-review
#4
Shuyi Yang, Jie Yu, Wenjuan Zeng, Liang Yang, Lin Teng, Yue Cui, Heshui Shi
OBJECTIVE: To analyze the findings of aortic floating thrombus (AFT) on computed tomography angiography (CTA) for a definitive, timely diagnosis and to select a reasonable management course to improve prognosis. METHOD: We retrospectively analyzed imaging findings of 5 patients with AFT detected by CTA, including location, morphology, size, involved aortic segment, concomitant embolism, stent, and dynamic changes during the follow-up. RESULTS: Seven lesions were detected in the initial CTA studies of the 5 patients: 5 aortic intraluminal floating thrombi (3 patients) and 2 aortic in-stents floating thrombi (ASFTs; 2 patients)...
December 22, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28081162/beyond-pressure-gradients-the-effects-of-intervention-on-heart-power-in-aortic-coarctation
#5
Joao Filipe Fernandes, Leonid Goubergrits, Jan Brüning, Florian Hellmeier, Sarah Nordmeyer, Tiago Ferreira da Silva, Stephan Schubert, Felix Berger, Titus Kuehne, Marcus Kelm
BACKGROUND: In aortic coarctation, current guidelines recommend reducing pressure gradients that exceed given thresholds. From a physiological standpoint this should ideally improve the energy expenditure of the heart and thus prevent long term organ damage. OBJECTIVES: The aim was to assess the effects of interventional treatment on external and internal heart power (EHP, IHP) in patients with aortic coarctation and to explore the correlation of these parameters to pressure gradients obtained from heart catheterization...
2017: PloS One
https://www.readbyqxmd.com/read/28076617/radiation-exposure-in-endovascular-infra-renal-aortic-aneurysm-repair-and-factors-that-influence-it
#6
Rui Machado, Vitor Miguel Dias Ferreira, Luis Loureiro, João Gonçalves, Pedro Oliveira, Rui Almeida
Objective: The endovascular repair of aortic abdominal aneurysms exposes the patients and surgical team to ionizing radiation with risk of direct tissue damage and induction of gene mutation. This study aims to describe our standard of radiation exposure in endovascular aortic aneurysm repair and the factors that influence it. Methods: Retrospective analysis of a prospective database of patients with abdominal infra-renal aortic aneurysms submitted to endovascular repair...
November 2016: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28073669/reoperation-rates-after-open-and-endovascular-abdominal-aortic-aneurysm-repairs
#7
Conor F Hynes, Kendal M Endicott, Sina Iranmanesh, Richard L Amdur, Robyn Macsata
OBJECTIVE: This study compared reoperation rates associated with open abdominal aortic aneurysm (AAA) repair (OR) outcomes vs endovascular AAA repair (EVAR). METHODS: A retrospective review of the Veterans Affairs Surgical Quality Improvement Project data was performed with inclusion criteria defined as all patients who underwent AAA repair from October 1, 2007, to October 1, 2013. The primary outcome was the incidence of reoperations. Reoperations included subsequent OR or EVAR procedures performed on the abdominal aorta or iliac arteries, surgical treatment of temporally related bowel obstruction, as well as treatment of abdominal or groin wound complications ≤6 months and treatment of bowel or lower limb ischemia ≤10 days...
January 7, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28073666/standard-endovascular-aneurysm-repair-in-patients-with-wide-infrarenal-aneurysm-necks-is-associated-with-increased-risk-of-adverse-events
#8
Nelson F G Oliveira, Frederico M Bastos Gonçalves, Marie Josee Van Rijn, Quirina de Ruiter, Sanne Hoeks, Jean-Paul P M de Vries, Joost A van Herwaarden, Hence J M Verhagen
OBJECTIVE: Endovascular aneurysm repair (EVAR) has progressively expanded to treat more challenging anatomies. Although EVAR in patients with wide infrarenal necks has been reported with acceptable results, there is still controversy regarding the longer-term outcomes. Our aim is to determine the impact of infrarenal neck diameter on midterm outcome following EVAR with a single endograft with suprarenal fixation. METHODS: A retrospective case-control study was designed using data from a prospective multicenter database...
January 7, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28068871/predilation-technique-with-balloon-angioplasty-to-facilitate-percutaneous-groin-access-of-large-size-sheath-through-scar-tissue
#9
Felice Pecoraro, Mayur Krishnaswamy, Johnny Steuer, Gilbert Puippe, Nicola Mangialardi, Thomas Pfammatter, Zoran Rancic, Frank J Veith, Neal S Cayne, Mario Lachat
Purpose Percutaneous remote access for endovascular aortic repair is an advantageous alternative to open access. Previous surgery in the femoral region and the presence of synthetic vascular grafts in the femoral/iliac arteries represent major limitations to percutaneous remote access. The aim of this study was to evaluate an original technique used for enabling percutaneous remote access for thoracic or abdominal endovascular aortic repair in patients with scar tissue and/or a vascular graft in the groin. Methods Twenty-five consecutive patients with a thoracic (11/25; 44%) or an aortic aneurysm (14/25; 66%) and with a synthetic vascular graft in the groin (16/25; 64%) or a redo groin access (9/25; 36%) were managed through the percutaneous remote access...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28065240/endovascular-repair-for-acute-type-b-aortic-dissection
#10
Wei Ye, Chang-Wei Liu, Xiao-Jun Song, Yong-Jun Li, Bao Liu, Yue-Hong Zheng, Rong Zeng
Objective To report experience and result of endovascular repair for acute type B aortic dissection (ATBD). Methods Totally 125 ATBD patients receiving endovascular repair with stent-graft were enrolled in this study. Demographic data,operation details,perioperative findings,and follow-up results were retrospectively analyzed. Results All the 125 patients were successfully implanted with 135 stent-grafts. Thirteen cases were covered left subclavian artery,16 cases underwent left subclavian artery revascularization,and 10 cases underwent visceral artery revascularization...
December 20, 2016: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
https://www.readbyqxmd.com/read/28062548/modified-frozen-elephant-trunk-for-acute-type-a-aortic-dissection-a-comparative-study-with-standard-repair-technique
#11
Peter Matt, Prerana Banerjee, Martin Grapow, Florian Rueter, Ulrich Schurr, Martin Siegemund, Jens Fassl, Oliver Reuthebuch, Friedrich Eckstein
OBJECTIVES: We hypothesized that antegrade open stent graft implantation in the descending aorta during acute type A aortic dissection surgery is safe and improves patient outcome compared with the standard repair technique. METHODS: Hundred and forty-one consecutive patients underwent surgery for acute type A aortic dissection at our institution from 2010 to 2016. Of those, 104 patients underwent ascending aorta and hemiarch repair under hypothermic circulatory arrest with antegrade cerebral perfusion (standard group)...
January 5, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28058986/midterm-results-of-proximal-aneurysm-sealing-with-the-ovation-stent-graft-according-to-on-vs-off-label-use
#12
Gianmarco de Donato, Francesco Setacci, Luciano Bresadola, Patrizio Castelli, Roberto Chiesa, Nicola Mangialardi, Giovanni Nano, Carlo Setacci
PURPOSE: To compare the use of the Ovation stent-graft according to the ≥7-mm neck length specified by the original instructions for use (IFU) vs those treated off-label (OL) for necks <7 mm long. METHODS: A multicenter retrospective registry (TriVascular Ovation Italian Study) database of all patients who underwent endovascular aneurysm repair with the Ovation endograft at 13 centers in Italy was interrogated to identify patients with a minimum computed tomography (CT) follow-up of 24 months, retrieving records on 89 patients (mean age 76...
January 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28057275/anatomic-suitability-for-transcaval-access%C3%A2-based-on-computed-tomography
#13
REVIEW
Robert J Lederman, Adam B Greenbaum, Toby Rogers, Jaffar M Khan, Melissa Fusari, Marcus Y Chen
Transcaval access has been used successfully for over 200 transcatheter aortic valve replacements, large-bore percutaneous left ventricular assist devices, and thoracic endovascular aortic aneurysm repairs. This review teaches how to plan transcaval access and closure based on computed tomography. The main planning goals are to: 1) identify calcium-free crossing targets in the abdominal aorta along with optimal fluoroscopic projection angles and level with respect to lumbar vertebrae; 2) identify obstacles such as interposed bowel or pedunculated aortic atheroma; 3) plan covered stent bailout; and 4) identify jeopardized vascular branches such as renal arteries that might be obstructed by bailout covered stents if employed...
January 9, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28056759/should-we-be-concerned-about-the-inflammatory-response-to-endovascular-procedures
#14
Djordje Radak, Nenad Djukic, Slobodan Tanaskovic, Milan Obradovic, Desanka Cenic-Milosevic, Esma R Isenovic
Endovascular surgery represents a minimally invasive procedure for the treatment of occlusive and aneurysmal arterial disease. However, it is followed by inflammatory response, with a rise in specific inflammatory biomarkers, such as C-reactive protein, serum amyloid A and fibrinogen. Shear stress during balloon inflation and vascular injury represents triggering events for the inflammatory process, stimulating the production of proinflammatory molecules and activation of circulating monocytes. The current literature indicates that stent implantation induces more prominent inflammatory reaction...
January 5, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28056476/-advanced-systemic-sclerosis-endovascular-reconstruction-of-the-aortic-bifurcation-for-limb-salvage
#15
Florian Stein, Lars Kamper, Konstantinos Meletiadis, Ulrich Kusenack, Patrick Haage
History and admission findings A 69-year-old patient was initially hospitalized because of a 1.5 cm ulceration at the back of the right foot which had existed for the last year and become increasingly swollen and painful. Medical history revealed PmScl-positive systemic sclerosis presenting with a massive calcinosis cutis, advanced pulmonary fibrosis and peripheral artery disease. Examinations Inflammatory markers were normal. MR-Angiography of the lower extremities revealed a multi-segmental high-grade stenosis of the aortic bifurcation due to extensively calcified plaques...
January 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28045241/evidence-for-and-risks-of-endovascular-treatment-of-asymptomatic-acute-type-b-aortic-dissection
#16
Rachel E Clough, Christoph A Nienaber
Acute aortic dissection is a challenging disease to manage. Type B aortic dissection has traditionally been divided temporally into acute and chronic cases but more recently this classification has been modified to include a sub-acute phase. Computed tomography is the imaging technique used most frequently in diagnosis and management. Active management of blood pressure is essential and should include beta-blockade unless contra-indicated. In-hospital outcomes are generally acceptable in patients with medically managed acute uncomplicated type B aortic dissection, with up to 90% of patients surviving to hospital discharge but by 5-years up to 50% of patients are dead with a significant proportion dying from aortic rupture...
January 3, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28043994/long-term-results-following-emergency-stent-graft-repair-for-traumatic-rupture-of-the-aortic-isthmus%C3%A2
#17
Cecile Martin, Frederic Thony, Mathieu Rodiere, Pierre Bouzat, Pierre Lavagne, Michel Durand, Olivier Chavanon
OBJECTIVES: Endovascular repair of traumatic injury of the aortic isthmus is a safe technique that has shown good short-term results. However, the future of these stent grafts remains unexamined, especially in relation to young patients. METHOD: Between January 2000 and December 2014, 60 patients were treated with endovascular aortic stent graft for injury of the aortic isthmus. Follow-up was done by computed tomography scans with intravenous contrast or magnetic resonance imaging associated with a chest X-ray in order to control the stent graft...
January 2, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28043989/impact-of-thoracic-endovascular-aortic-repair-on-radial-strain-in-an-ex-vivo-porcine-model
#18
Foeke J H Nauta, Hector W L de Beaufort, Michele Conti, Stefania Marconi, Arnoud V Kamman, Anna Ferrara, Joost A van Herwaarden, Frans L Moll, Ferdinando Auricchio, Santi Trimarchi
OBJECTIVES: To quantify the impact of thoracic endovascular aortic repair (TEVAR) on radial aortic strain with the aim of elucidating stent-graft-induced stiffening and complications. METHODS: Twenty fresh thoracic porcine aortas were connected to a mock circulatory loop driven by a centrifugal flow pump. A high-definition camera captured diameters at five different pressure levels (100, 120, 140, 160, and 180 mmHg), before and after TEVAR. Three oversizing groups were created: 0-9% (n = 7), 10-19% (n = 6), and 20-29% (n = 6)...
January 2, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28043783/pulmonary-homograft-stenosis-in-the-ross-procedure-incidence-clinical-impact-and-predictors-in-long-term-follow-up
#19
Laura Pardo González, Martin Ruiz Ortiz, Mónica Delgado, Dolores Mesa, Rafael Villalba, Sara Rodriguez, Francisco J Hidalgo, Pedro Alados, Jaime Casares, Jose Suarez de Lezo
BACKGROUND: The Ross procedure is used in the treatment of selected patients with aortic valve disease. Pulmonary graft stenosis can appear in the long-term follow-up after the Ross intervention, but the factors involved and its clinical implications are not fully known. AIM: To describe the incidence, clinical impact and predictors of homograft stenosis and reintervention after the Ross procedure in a prospective series in a tertiary referral hospital. METHODS: From 1997 to 2009, 107 patients underwent the Ross procedure (mean age: 30±11 years; 69% men; 21 aged<18 years), and were followed for echocardiographic homograft stenosis (peak gradient>36mmHg) and surgical or percutaneous homograft reintervention...
December 30, 2016: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/28043449/stentless-vs-stented-aortic-valve-bioprostheses-in-the-small-aortic-root
#20
Laurens W Wollersheim, Wilson W Li, Abdullah Kaya, Berto J Bouma, Antoine H Driessen, Wim J van Boven, Jan van der Meulen, Bas A de Mol
In patients with a small aortic root undergoing aortic valve replacement (AVR), the Freedom SOLO bioprosthesis may be the ideal prosthesis because of its stentless design and supra-annular implantation. This study investigated if the stentless Freedom SOLO has an advantage when compared with a stented bioprosthesis in patients with a small aortic root. From April 2005-July 2014, 269 consecutive patients underwent AVR with either a Freedom SOLO (n = 76) or Mitroflow (n = 193) bioprosthesis size 19mm or 21mm, respectively...
July 2016: Seminars in Thoracic and Cardiovascular Surgery
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