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Aortic arch branches

Hiromitsu Kawasaki, Yoshihiro Nakayama, Yuichi Koga, Baku Takahashi, Hisashi Sato
A 54-year-old woman was referred for assessment of dysphagia and extrinsic compression of the esophagus detected by upper gastrointestinal endoscopy. Computed tomography revealed the rightsided aortic arch with mirror image branching and Kommerell's diverticulum. To relieve the esophageal compression, surgical intervention was indicated. Descending aortic replacement with a Dacron graft was performed through right thoracotomy under partial cardiopulmonary bypass. The patient was discharged without any complication, and her dysphagia disappeared...
May 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Naoki Kanemitsu, Takehiko Matsuo, Hiroaki Osada, Kazuo Yamanaka, Junichi Tazaki
We report a case of chronic dissecting thoracoabdominal aneurysm with intraoperative retrograde aortic dissection and rupture at proximal descending aorta, which was successfully treated by echoguided stent-graft insertion. An 82-year old male underwent thoracoabdominal aortic replacement for dilatation of infra-diaphragmatic aorta. Under F-F bypass, his thoracoabdominal aorta was replaced by a Dacron graft with 4-branches. After he weaned from F-F bypass, we found massive bleeding from proximal descending aorta...
May 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Yoshiki Endo, Yoshihito Irie, Kousuke Nishida, Tsuyoshi Fujimiya, Yoshiaki Katada
The patient was a 66 year-old male. Computed tomography (CT) angiography showed a huge aneurysm(120 mm) in the aortic arch and chronic type B aortic dissection(45 mm) in the descending aorta. Echocardiography showed patent ductus arteriosus( PDA). Because of pulmonary hypertension due to PDA, it was considered unacceptable to put him under general anesthesia twice. We performed thoracic endovascular aortic repair (TEVAR) via the ascending aorta and total arch replacement (TAR) simultaneously to prevent paraplegia...
May 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Kaiyun Gu, Zhe Zhang, Bin Gao, Yu Chang, Feng Wan
BACKGROUND: Peripheral ECMO is an effective cardiopulmonary support in clinical. The perfusion level could directly influence the performances and complications. However, there are few studies on the effects of the perfusion level on hemodynamics of peripheral ECMO. METHODS: The geometric model of cardiovascular system with peripheral ECMO was established. The blood assist index was used to classify the perfusion level of the ECMO. The flow pattern from the aorta to the femoral artery and their branches, blood flow rate from aorta to brain and limbs, flow interface, harmonic index of blood flow, wall shear stress and oscillatory shear index were chosen to evaluate the hemodynamic effects of peripheral ECMO...
May 9, 2018: Biomedical Engineering Online
Florian S Schoenhoff, David H Tian, Martin Misfeld, Konstantinos G Perreas, David Spielvogel, Friedrich W Mohr, Friedhelm Beyersdorf, Tristan D Yan, Thierry P Carrel
OBJECTIVES: Our objective was to evaluate the impact of reimplantation techniques of the supra-aortic branches in total arch replacement on the rates of permanent neurological deficit (PND) and survival. METHODS: We identified patients enrolled in the ARCH registry who underwent total arch replacement between 2000 and 2015 with either en bloc or separate reimplantation of the supra-aortic branches. RESULTS: A total of 3345 patients were included in the present analysis...
May 8, 2018: European Journal of Cardio-thoracic Surgery
Pouria Moshayedi, Gregory B Walker, Sina Tavakoli, Shashvat M Desai, Ashutosh P Jadhav
This report describes a case of duplicated origin of the right vertebral artery incidentally found in a young patient. Computed tomographic angiography and digital subtraction angiography showed a dominant branch derived from the right common carotid artery and an accessory branch that derived from the right subclavian artery, which aberrantly originated from the far left aortic arch, and adjoined the dominant branch at the C5 level. We discuss angiographic findings, clinical implications and embryological basis for this rare anomaly...
April 28, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Chun-Ku Chen, Hsiao-Ping Chou, Chao-Yu Guo, Hsiao-Ting Chang, Ying-Yueh Chang, I-Ming Chen, Mei-Han Wu, Chun-Che Shih
OBJECTIVE: The variability in measuring the tortuosity of the thoracic aorta has not been previously studied. This study evaluated the interobserver and intraobserver variability of major methods used for measuring the tortuosity of the thoracic aorta in patients with aortic arch or descending thoracic aortic aneurysm. METHODS: This retrospective study enrolled 66 patients with aortic arch or descending thoracic aortic aneurysm who had undergone thoracic endovascular aortic repair...
April 25, 2018: Journal of Vascular Surgery
Marina Dias-Neto, Filipa Poleri, Sérgio Sampaio
INTRODUCTION: Type B aortic dissection (TBAD) affects mostly men with an estimated annual incidence between 2.9 and 4.0 per 100,000, and it appears to be increasing. DISSECT classification was published in 2013 aiming to reunite clinical and anatomical characteristics of interest to clinicians involved in TBAD management. In Portugal, the incidence of the condition, as well as its characteristics and outcomes, are not well documented. The aim of this paper is to describe the reality of a tertiary institution with a referral area of about 0,6 million habitants...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
Álvaro Laranjeira Santos, António Cruz Tomás, Jorge Pinheiro Santos, Daniela Varela-Afonso, José Fragata
INTRODUCTION: Surgical approach of multisegmental pathology of the thoracic aorta, namely aortic arch / descending aorta is challenging. The Frozen Elephant Trunk (FET) has good results, with acceptable risk. However, in the subgroup of patients (pts) older than 75 years and with important comorbidities, the surgical risk is very high. OBJECTIVES: Review short-term results of this original, simplified and potentially hybrid technique developed in our Department for this subgroup of patients...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
Taijiro Sueda, Shinya Takahashi, Keijiro Katayama
We present the case of an 86-year-old male with an aortic arch saccular aneurysm who underwent zone 1 thoracic endovascular aortic repair (TEVAR) with debranching from the right subclavian artery to the left carotid and left subclavian arteries. The patient developed a type Ia endoleak 1 month later. Postoperative contrast computed tomography (CT) showed a hematoma around the aneurysm, concerning for impending rupture. He thus underwent emergency endograft removal and replacement with a one-branched graft using selective cerebral perfusion via the left subclavian artery perfusion...
April 26, 2018: Annals of Thoracic and Cardiovascular Surgery
A E Zotikov, A S Ivandaev, V N Gontarenko, A V Kozhanova, I E Timina, V A Kul'bak
Nonspecific aortoarteritis (NAA) is an autoimmune disease characterized by the development of an inflammatory process in large arteries such as the aorta and its branches and pulmonary arteries. Operative interventions for lesions of the aortic arch branches may be divided into extra- and transthoracic. Involvement of all branches of the aortic arch requires transthoracic interventions to be performed. According to the findings of various authors, bicarotid bypass grafting is accompanied by a high incidence rate of complications and lethal outcomes...
2018: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
B N Kozlov, D S Panfilov, A S Priakhin
Described herein is a clinical case report concerning successful elimination of symptoms of oesophageal compression and the tracheobronchial tree in an adult female patient presenting with an incomplete vascular ring and the right-sided aortic arch with mirror-image branching of vessels.
2018: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
Ata Firouzi, Bahram Mohebbi, Ali Shafiei
Interrupted aortic arch (IAA) is a rare congenital malformation defined as complete discontinuity between ascending and descending parts of aorta. We present a case of IAA, which was referred to us due to dilatation of proximal and mid parts of his thoracic aorta accompanied by narrowing of aorta proximal to the branching of the left subclavian artery. Further evaluation revealed interruption of aorta at the proximal part of descending thoracic aorta by a transverse septum along with several collateral formations...
December 23, 2017: Archives of Iranian Medicine
Vamshi Krishna Kotha, Zlatko I Pozeg, Eric J Herget, Michael C Moon, Jehangir J Appoo
Conventional surgical techniques for acute Type A aortic dissection (ATAAD) generally fail to address residual dissection in the descending aorta. The persistence of a false lumen is associated with visceral malperfusion in the acute setting and adverse aortic remodeling in the chronic setting. Hybrid aortic arch repair techniques may improve perioperative and long-term mortality by expanding the true lumen and obliterating the false lumen. However, there is a limit to the extent of aortic coverage due to the concomitant risk of spinal cord ischemia...
August 2017: Aorta (Stamford, Conn.)
Ciro Ferrer, Carlo Coscarella, Piergiorgio Cao
BACKGROUND: In the light of current evidence, endovascular repair of aortic arch pathologies with custom-made devices should be considered a valid alternative to decrease operative mortality and morbidity associated with open or hybrid repair. Today, two double inner branch devices are available on market. We report our single-center experience with Bolton double branch stent graft in the treatment of aortic arch disease. METHODS: Between 2013 and 2016, 15 high-risk patients with arch pathology were treated in our center with a custom-made branched device...
April 11, 2018: Journal of Cardiovascular Surgery
Maria L Rodriguez, Gyaandeo Maharajh
Differential hypoxia and the arterial mixing zone are two important factors in managing peripheral veno-arterial extracorporeal membrane oxygenation (VA-ECMO). With the aim of improving perfusion to the aortic arch branches and coronaries, we describe our approach for VA-ECMO cannulation: bicaval drainage through the femoral vein and proximal retrograde ECMO flow using a multi-stage venous cannula inserted in the femoral artery and the tip placed at the proximal descending thoracic aorta. We report the use of this VA-ECMO approach on a 15-year-old female with combined cardiorespiratory failure and on a 12-year-old male with acute cardiac failure...
April 1, 2018: Perfusion
Nikolaos Tsilimparis, Christian Detter, Franziska Heidemann, Konstantinos Spanos, Fiona Rohlffs, Yskert von Kodolitsch, Sebastian E Debus, Tilo Kölbel
OBJECTIVES: DeBakey Type I aortic dissections are frequently treated by an ascending aortic tube graft or hemiarch replacement with the residual dissection remaining untreated. We investigated the outcomes of branched thoracic endovascular repair for post-dissection aneurysms of the aortic arch. METHODS: We conducted a retrospective, single-centre evaluation of 20 consecutive patients with a false-lumen aneurysm after a DeBakey I aortic dissection treated with branched thoracic endovascular repair...
March 28, 2018: European Journal of Cardio-thoracic Surgery
Se Hwan Kwon, So Youn Shin
Polysplenia syndrome is a rare condition (about 2.5:100,000 live births) wherein a person has two or more spleens with accompanying various thoracic and abdominal organ abnormalities. Polysplenia is usually associated with situs ambiguous, while polysplenia with situs inversus is very rare. Herein, we report a rare case of incidentally found polysplenia syndrome combined with situs inversus in a 59-year-old female who also had an interrupted inferior vena cava (IVC) with azygos continuation, patent ductus arteriosus (PDA), and variations in the aortic arch branches...
February 2018: Journal of Thoracic Disease
Justice O Agyei, Cynthia Alvarez, Azher Iqbal, Andrew A Fanous, Adnan H Siddiqui
BACKGROUND: A rare complication following a tracheotomy is common carotid artery (CCA) pseudoaneurysm. There are many treatment modalities for CCA pseudoaneurysm including surgical repair and single-artery balloon-covered stent-graft technique. We present successful treatment of a tracheotomy-related CCA pseudoaneurysm with the "kissing balloon" expandable stent-graft technique. CASE DESCRIPTION: We successfully implemented the "kissing balloon" expandable stent-graft technique for the treatment of a large, narrow-necked, bilobed CCA pseudoaneurysm that arose due to a tracheotomy complication...
March 27, 2018: World Neurosurgery
Adeline Schwein, Yannick Georg, Nabil Chakfé
No abstract text is available yet for this article.
March 23, 2018: European Journal of Vascular and Endovascular Surgery
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