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Acute aortic syndrome

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https://www.readbyqxmd.com/read/29780728/intimal-re-layering-technique-for-type-a-acute-aortic-dissection-reconstructing-the-intimal-layer-continuity-to-induce-remodeling-of-the-false-channel
#1
Eugenio Neri, Enrico Tucci, Giulio Tommasino, Giulia Guaccio, Carmelo Ricci, Pierleone Lucatelli, Marco Cini, Roberto Ceresa, Antonio Benvenuti, Luigi Muzzi
Background: Residual false channel is common after repair of type A acute aortic dissection (TAAAD). Starting from our recent series of TAAAD patients we carried out a retrospective analysis, regarding the failure of primary exclusion at the time of the initial operation. We classified the location of the principal entry tears perfusing the residual false channel. The proposed technique represents our attempt to correct the mechanism of false channel perfusion during primary repair. We describe a new technique designed to address some limitations of standard hemiarch aortic replacement...
2018: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29779910/long-term-follow-up-of-patients-with-acute-aortic-syndromes-relevance-of-both-aortic-and-non-aortic-events
#2
Anna Corsini, Davide Pacini, Luigi Lovato, Vincenzo Russo, Massimiliano Lorenzini, Alberto Foà, Ornella Leone, Samuele Nanni, Francesca Mingardi, Letizia Bacchi Reggiani, Giovanni Melandri, Roberto Di Bartolomeo, Claudio Rapezzi
BACKGROUND: The aim was to assess the long-term outcome of patients diagnosed with type A and type B acute aortic syndromes (AAS) and the mortality risk predictors. METHODS: A single centre retrospective observational study was performed on consecutive patients diagnosed with AAS and discharged between 2000 and 2016: 242 surgically treated type A, 87 uncomplicated, medically treated type B, and 80 complicated type B who received endovascular/surgical/hybrid treatment...
May 17, 2018: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29775606/ecmo-for-acute-respiratory-distress-syndrome-after-thoracoabdominal-aortic-aneurysm-repair
#3
Subhasis Chatterjee, William Mulvoy, Ourania A Preventza, Kim I de la Cruz, Scott A LeMaire, Joseph S Coselli
Acute respiratory distress syndrome (ARDS) after thoracoabdominal aortic aneurysm (TAAA) repair poses a formidable challenge. Despite conventional maneuvers in the operating room, perioperative ARDS may require extracorporeal membrane oxygenation (ECMO). We present 3 cases of successful ECMO for ARDS after TAAA repair and discuss management of anticoagulation and cerebrospinal fluid drains. Our experience suggests that ECMO is reasonable in selected patients after TAAA repair.
May 15, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29766010/single-stage-endovascular-treatment-of-a-penetrating-aortic-ulcer-with-a-concomitant-isolated-iliac-aneurysm
#4
Haidi Hu, Jianming Guo, Hualong Bai, Alan Dardik
Penetrating aortic ulcer (PAU) is an acute aortic syndrome that can proceed to life-threatening aortic dissection or even aortic rupture. Isolated iliac aneurysms are relatively rare and often asymptomatic due to their deep pelvic location but are frequently associated with high mortality with rupture. We report a case of a 68-year-old man with a symptomatic penetrating ulcer in the descending aorta and an asymptomatic right iliac aneurysm involving the common and internal iliac arteries. The patient was successfully treated by endovascular repair in a single-stage manner using stent grafts in the descending aorta and right common iliac artery after coil embolization of the right internal iliac artery...
December 2017: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/29749581/preconception-counseling-for-patients-with-thoracic-aortic-aneurysms
#5
REVIEW
Prashant Rao, Eric M Isselbacher
PURPOSE OF THE REVIEW: Acute aortic dissection is a potentially catastrophic cardiovascular emergency that is associated with a high mortality rate. Pregnancy, with its attendant hormonal and physiological changes, increases the risk of dissection in women with known thoracic aortic aneurysms. In this review, we highlight the importance of preconception counseling to help women with known thoracic aortic aneurysms better understand their risk of dissection and the heritable nature of thoracic aortic disease and its associated syndromes...
May 10, 2018: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29731027/prognostic-role-of-hypertensive-response-to-exercise-in-patients-with-repaired-coarctation-of-aorta
#6
Vidhushei Yogeswaran, Heidi M Connolly, Mohamad Al-Otaibi, Naser M Ammash, Carole A Warnes, Sameh M Said, Alexander C Egbe
BACKGROUND: This study aimed to determine the prevalence of hypertensive response to exercise (HRE) and its association with cardiovascular adverse events (CAEs) in patients with repaired coarctation of aorta (rCOA). METHODS: We retrospectively reviewed records of adult patients with rCOA who had cardiopulmonary exercise tests (CPETs) and follow-up from 1994 to 2014 at Mayo Clinic. Patients with residual COA, defined as aortic isthmus peak velocity >2.5 m/s, were excluded...
May 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29719804/unilateral-pulmonary-artery-agenesis-an-unusual-cause-of-unilateral-ards
#7
Lakshmi Saladi, Swati Roy, Gilda Diaz-Fuentes
Unilateral pulmonary artery agenesis (UPAA) is a rare malformation that can present as an isolated anomaly or may be associated with certain congenital cardiac anomalies, such as tetralogy of Fallot, atrial septal defect, coarctation of aorta, right aortic arch, truncus arteriosus and pulmonary atresia. Clinical presentation is non-specific which makes the diagnosis elusive; chronic dyspnea, hemoptysis or recurrent infections are the most common manifestations. Patients may remain asymptomatic until adulthood...
2018: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29716475/contemporary-management-and-outcome-after-lower-extremity-fasciotomy-in-non-trauma-related-vascular-surgery
#8
Charlotte Wesslén, Carl-Magnus Wahlgren
INTRODUCTION: Acute compartment syndrome (ACS) is a challenging and recognized complication to vascular surgery revascularization. The aim of this study was to investigate the current epidemiology, management, and early outcomes of fasciotomy in vascular surgery. METHODS: Retrospective cohort study of all patients undergoing lower extremity fasciotomy at a single university center between January 2008 and December 2014. Patient demographics, operative techniques, and outcomes were analyzed...
January 1, 2018: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29708034/aortic-centres-should-represent-the-standard-of-care-for-acute-aortic-syndrome
#9
Giovanni Mariscalco, Daniele Maselli, Marco Zanobini, Aamer Ahmed, Vito D Bruno, Umberto Benedetto, Riccardo Gherli, Tiziano Gherli, Francesco Nicolini
Background Existing evidence suggests that patients affected by acute aortic syndromes (AAS) may benefit from treatment at dedicated specialized aortic centres. The purpose of the present study was to perform a meta-analysis to evaluate the impact aortic service configuration has in clinical outcomes in AAS patients. Methods The design was a quantitative and qualitative review of observational studies. We searched PubMed/ MEDLINE, EMBASE, and Cochrane Library from inception to the end of December 2017 to identify eligible articles...
June 2018: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/29707342/aortic-arch-repair-under-moderate-hypothermic-circulatory-arrest-with-or-without-antegrade-cerebral-perfusion-based-on-the-extent-of-repair
#10
Sung Jun Park, Bo Bae Jeon, Hee Jung Kim, Joon Bum Kim
Background: For aortic-arch repair, moderate hypothermic circulatory arrest (HCA) have shown favorable outcomes over conventional deep HCA when coupled with antegrade cerebral perfusion (ACP); however, recent studies have shown that ACP may not be essential when circulatory arrest time is less than 30 minutes. This study aims to evaluate the stratified arch repair strategy of moderate HCA with or without ACP based on the extent of procedure. Methods: Consecutive 138 patients (63 female; mean age, 60...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29703012/successful-treatment-of-left-main-shock-syndrome-induced-by-thrombosed-coronary-artery-dissection-a-case-report
#11
Xiaojun Bai, Weiping Zhang, Zuyi Yuan
RATIONALE: Left main shock syndrome (LMSS) induced by thrombosed coronary artery dissection is very rare and has a fatal prognosis. Optimal treatment strategy includes early reperfusion and hemodynamic support to prevent cardiogenic shock. However, it involves the extension of technical difficulties under different conditions. PATIENT CONCERNS: A 49-year-old woman developed symptoms of left main shock syndrome. The main clinical manifestations were retrosternal pain radiating to his back and left shoulder, heavy sweating, palpitation and brachypnea...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29701406/infrarenal-abdominal-penetrating-aortic-ulcer-an-atypical-location-of-a-rare-disease
#12
Nelson Camacho, Gonçalo Rodrigues, Rodolfo Abreu, Rita Ferreira, Joana Catarino, Ricardo Correia, Rita Bento, Maria Emília Ferreira
INTRODUCTION: Penetrating aortic ulcer (PAU) is classically included in acute aortic syndromes, together with aortic dissection and intramural hematoma. These three disorders are considered different stages of the same disease. PAU is the result of medial degeneration with disruption of the intima, mainly due to atherosclerotic risk factors. Most of them are located on descending thoracic aorta and only a few small series and case reports demonstrate location on infrarenal abdominal aorta...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29701402/endovascular-treatment-of-a-complicated-type-b-acute-aortic-dissection-with-3-d-ultrasound-control
#13
Roger Rodrigues, Javier Villaverde, Jorge Noya, Gabriel Anacleto, Óscar Gonçalves
INTRODUCTION: Acute type B aortic dissection (ATBAD), identified within 2 weeks of symptom onset, accounts for 25%-40% of all aortic dissections. Approximately 25% of patients presenting with ATBAD are complicated at admission by malperfusion syndrome or hemodynamic instability, resulting in a high risk of early death when untreated. METHODS: We present a case of a patient with a complicated type B dissection treated by an endovascular technique with control of the sealing zone with transesophageal Echocardiogram (TEE) and 3-D images...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29701357/frozen-elephant-trunk-with-e-vita-open-hybrid-prosthesis-for-surgical-correction-of-multisegmental-thoracic-aortic-pathology-review-of-results
#14
António Cruz Tomás, Álvaro Laranjeira Santos, Jorge Pinheiro Santos, Daniela Varela-Afonso, José Fragata
INTRODUCTION: The Frozen Elephant Trunk (FET) surgery allows correction of ascending, arch and proximal descending aortic pathology, using a hybrid prosthesis at the same time. It is a complex intervention and requires a multidisciplinary team that, besides scheduling and performing the surgery, accompanies the patient (pt) throughout the postoperative period. OBJECTIVES: To review short and medium term clinical results with this technique. METHODS: Between January 2010 and September 2017, we operated 34 patients (pts) using FET...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29697866/etiologies-and-predictors-of-30-day-readmissions-in-patients-undergoing-percutaneous-mechanical-circulatory-support-assisted-percutaneous-coronary-intervention-in-the-united-states-insights-from-the-nationwide-readmissions-database
#15
Chirag Bavishi, Alejandro Lemor, Vrinda Trivedi, Saurav Chatterjee, Pedro Moreno, John Lasala, Herbert D Aronow, J Dawn Abbott
BACKGROUND: Patients undergoing percutaneous mechanical circulatory support (pMCS)-assisted percutaneous coronary intervention (PCI) represent a high-risk group vulnerable to complications and readmissions. HYPOTHESIS: Thirty-day readmissions after pMCS-assisted PCI are common among patients with comorbidities and account for a significant amount of healthcare spending. METHODS: Patients undergoing PCI and pMCS (Impella, TandemHeart, or intra-aortic balloon pump) for any indication between January 1, 2012, and November 30, 2014, were selected from the Nationwide Readmissions Database...
April 26, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29688450/morphological-features-of-the-thoracic-aorta-and-supra-aortic-branches-in-patients-with-acute-type-a-aortic-dissection-in-china
#16
Jin-Lin Wu, Liang Zhang, Jun-Tao Qiu, Cun-Tao Yu
OBJECTIVES: This study aimed to investigate the morphological characteristics of the dissected thoracic aorta and brachiocephalic arteries within the Chinese population. METHODS: A retrospective analysis of computed tomography scans of 387 patients with acute Type A aortic dissection was carried out. The dimensions of the thoracic aorta at multiple levels and other imaging characteristics were studied. RESULTS: The patients with a maximum diameter ≥55 mm accounted for less than one-third of the population...
April 24, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29685679/extra-thoracic-supra-aortic-bypass-surgery-is-safe-in-thoracic-endovascular-aortic-repair-and-arterial-occlusive-disease-treatment
#17
Alexander Gombert, Lea van Issum, Mohammad E Barbati, Jochen Grommes, Andras Keszei, Drosos Kotelis, Houman Jalaie, Andreas Greiner, Michael J Jacobs, Johannes Kalder
OBJECTIVE: The safety and feasibility of supra-aortic debranching as part of endovascular aortic surgery or as a treatment option for arterial occlusive disease (AOD) remains controversial. The aim of this study was to assess the clinical outcome of this surgery. METHODS: This single centre, retrospective study included 107 patients (mean age 69.2 years, 38.4% women) who underwent supra-aortic bypass surgery (carotid-subclavian bypass, carotid-carotid bypass, and carotid-carotid-subclavian bypass) because of thoracic or thoraco-abdominal endovascular aortic repair (57%; 61/107) or as AOD treatment (42...
April 20, 2018: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29682475/malperfusion-syndromes-in-type-a-aortic-dissection-what-we-have-learned-from-irad
#18
REVIEW
Paolo Berretta, Santi Trimarchi, Himanshu J Patel, Thomas G Gleason, Kim A Eagle, Marco Di Eusanio
Patients presenting with type A acute aortic dissection (TAAD) complicated by malperfusion syndromes represent one of the highest surgical risk cohorts for cardiovascular surgeons. In the setting of aortic dissection, end-organ ischemia may involve any of the major arterial side branches resulting in myocardial, cerebral, spinal cord, visceral and/or limb ischemia. In TAAD patients with malperfusion, notwithstanding continuous improvement in diagnostic and management strategies, surgical and clinical outcomes remain poor and the optimal therapy is controversial...
2018: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29670772/left-circumflex-artery-rupture-with-left-atrial-tamponade-and-functional-mitral-stenosis
#19
Weiting Huang, Khaled Mohamed Emadeldin Moheb Hammad, Victor Tar Toong Chao, Khung Keong Yeo
The growth in percutaneous transluminal devices has enabled operators to tackle more complex, native, and post-bypass surgery anatomy. However, complications such as coronary artery dissection, coronary perforation, retrograde aortic dissection, arrhythmias, and acute coronary syndrome still occur with resulting mortality rates of up to 4.2% in complex interventions. Perforation of the circumflex artery is of particular interest in view of its position and relation to the surrounding cardiac structures. This is a site of potential fluid collection, and as the left atrium is fixed to the parietal pericardium at the entry of the pulmonary veins, fluid in the oblique sinus can accumulate enough pressure to compress the left atrium and the coronary sinus...
2018: Case Reports in Cardiology
https://www.readbyqxmd.com/read/29657734/treatment-of-a-patient-with-acute-aortic-dissection-using-extracorporeal-cardiopulmonary-resuscitation-after-an-out-of-hospital-cardiac-arrest-a-case-report
#20
Takahiro Yukawa, Kazuhiro Sugiyama, Kazuki Miyazaki, Takahiro Tanabe, Susumu Ishikawa, Yuichi Hamabe
Case: Circulatory support using veno-arterial extracorporeal membrane oxygenation for aortic disease is conventionally contraindicated. In this case, a 66-year-old man experienced cardiopulmonary arrest caused by acute aortic dissection. When exercising in the gym, he experienced chest discomfort, so the staff immediately called an ambulance. While in the ambulance, he experienced cardiopulmonary arrest. His initial electrocardiogram showed ventricular fibrillation. At the emergency department, we immediately performed extracorporeal cardiopulmonary resuscitation...
April 2018: Acute Medicine & Surgery
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