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Thoracoabdominal aortic aneurysm

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https://www.readbyqxmd.com/read/28526092/transapical-aortic-perfusion-using-a-deep-hypothermic-procedure-to-prevent-dissecting-lung-injury-during-re-do-thoracoabdominal-aortic-aneurysm-surgery
#1
Yuya Kise, Yukio Kuniyoshi, Mizuki Ando, Hitoshi Inafuku, Takaaki Nagano, Satoshi Yamashiro
BACKGROUND: Avoiding various complications is a challenge during re-do thoracoabdominal aneurysm surgery. CASE PRESENTATION: A 56-year-old man had undergone surgery for type I aortic dissection four times. The residual thoracoabdominal aortic aneurysm that had severe adhesions to lung parenchyma was resected. Since the proximal anastomotic site was buried in lung parenchyma, deep hypothermia was essential to avoid lung dissection and to protect the spinal cord during the proximal anastomosis...
May 19, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28514896/-snare-ride-a-bailout-technique-to-catheterize-target-vessels-with-unfriendly-anatomy-in-branched-endovascular-aortic-repair
#2
Marcelo Ferreira, Athanasios Katsargyris, Eduardo Rodrigues, Diego Ferreira, Rodrigo Cunha, Guilherme Bicalho, Gustavo Oderich, Eric L G Verhoeven
PURPOSE: To describe a novel endovascular bailout technique for successful completion of target vessel stenting during branched stent-graft repair of thoracoabdominal aortic aneurysms (TAAA) after encountering difficulties with standard catheterization techniques. TECHNIQUE: Technical difficulties when using fenestrated and branched grafts should be expected, especially in difficult anatomy or when an off-the-shelf device (eg, standard 4-branch device) is used that does not perfectly "match" the anatomy...
May 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28513189/transcatheter-aortic-valve-implantation-the-transaortic-approach
#3
Simon Cy Chow, Gary Sh Cheung, Alex Pw Lee, Eugene B Wu, Jacky Yk Ho, Micky Wt Kwok, Peter Sy Yu, Innes Yp Wan, Malcolm J Underwood, Randolph Hl Wong
Background Transcatheter aortic valve implantation has been established as a safe and effective treatment option for patients at high or prohibitive surgical risk. However, some patients may not be suitable for the transfemoral approach due to severe iliofemoral disease or aneurysmal disease of the thoracoabdominal aorta. The aim of this case series was to evaluate the feasibility and clinical outcomes of the transaortic approach. Methods From May 2015 to June 2016, 5 patients (mean age 78.4 ± 3.9 years) with severe symptomatic aortic stenosis underwent transaortic transcatheter aortic valve implantation after a heart team discussion...
January 1, 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/28502540/trends-and-outcomes-in-endovascular-and-open-surgical-treatment-of-visceral-aneurysms
#4
Jason A Chin, Adele Heib, Cassius I Ochoa Chaar, Jonathan A Cardella, Kristine C Orion, Timur P Sarac
OBJECTIVE: Visceral artery aneurysms (VAAs) are rare but often repaired because of dire consequences of rupture. This is a population-based evaluation of chronologic trends in management, risk factors, and outcomes of endovascular and open therapy. METHODS: The 2003 to 2013 Agency for Healthcare Research and Quality (AHRQ) National Inpatient Sample (NIS) database was reviewed. Cases with primary diagnosis of VAA and undergoing endovascular or open repair were identified...
May 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28501656/perioperative-outcomes-of-open-versus-endovascular-repair-for-ruptured-thoracoabdominal-aneurysms
#5
Satinderjit S Locham, Joshua C Grimm, Isibor J Arhuidese, Besma Nejim, Tammam Obeid, James H Black, Mahmoud B Malas
OBJECTIVES: Open aneurysm repair (OAR) remains the gold standard for treating ruptured thoracoabdominal-aortic-aneurysms (TAAA). The aim of our study is to compare the 30-day post-operative outcomes among patients with ruptured TAAA undergoing OAR versus endovascular aneurysm repair. METHODS: Using the NSQIP database (2006-2015), we identified patients who underwent OAR and endovascular repair for a ruptured TAAA. Postoperative outcomes of interest included: mortality, renal failure, stroke, and cardiopulmonary complications...
May 10, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28483620/clinical-outcomes-of-spinal-cord-ischemia-after-fenestrated-and-branched-endovascular-stent-grafting-during-total-endovascular-aortic-repair-for-thoracoabdominal-aortic-aneurysms
#6
Takeshi Baba, Takao Ohki, Yuji Kanaoka, Koji Maeda, Hiroki Ohta, Soichirou Fukushima, Naoki Toya, Masayuki Hara
PURPOSE: In this single-center study, we assessed the clinical outcomes of fenestrated-endovascular aortic repair (f-EVAR) and branched EVAR on morbidity and mortality during total endovascular aortic repair for thoracoabdominal aortic aneurysms (TAAAs). METHODS: Between July 2006 and June 2015, elective f-EVAR and multibranched EVAR (t-Branch) for TAAAs were performed in 99 patients at our institution [Crawford classification types I (7), II (13), III (6), IV (55), and V (18)]...
May 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28479427/inferior-mesenteric-artery-aneurysm-complicated-with-occluded-celiac-and-superior-mesenteric-artery-after-replacement-of-thoracoabdominal-aorta-for-chronic-dissected-thoracoabdominal-aortic-aneurysm
#7
Takashi Igarashi, Akihiro Yamamoto, Tsuyoshi Fujimiya, Shinya Takase, Hirono Satokawa, Hitoshi Yokoyama
We report a case of inferior mesenteric artery aneurysm after the replacement of the thoracoabdominal aorta for a chronic dissected thoracoabdominal aortic aneurysm in which the celiac artery and superior mesenteric artery were occluded. We performed the resection of the inferior mesenteric artery aneurysm and the revascularization of the superior mesenteric artery, inferior mesenteric artery, and the meandering artery. The patient's postoperative course was uneventful, without bowel ischemia. From the findings of intraoperative flow measurement of the visceral arteries, revascularization of the SMA was judged to be appropriate in this situation...
May 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28464191/adjunct-perfusion-branch-for-reduction-of-spinal-cord-ischemia-in-the-endovascular-repair-of-thoracoabdominal-aortic-aneurysms
#8
Marwan Youssef, Oroa Salem, Fritz Dünschede, Christian F Vahl, Bernhard Dorweiler
No abstract text is available yet for this article.
May 2, 2017: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/28458756/infected-aortic-and-iliac-aneurysms-clinical-manifestations-in-the-emergency-departments-of-two-hospitals-in-southern-taiwan-china
#9
Chang-Chih Tsai, Chien-Chin Hsu, Kuo-Tai Chen
BACKGROUND: Accurate diagnosis of infected aortic and iliac aneurysms is often delayed, hampering timely treatment and potentially resulting in a fatal consequence. The aim of this study was to discover useful clinical features that can help physicians to identify these patients. METHODS: We reviewed the discharge notes from two hospitals and identified all patients who had a diagnosis of infected aneurysms of the thoracoabdominal aorta and iliac arteries between July 2009 and December 2013...
2017: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28433350/open-repair-of-chronic-thoracic-and-thoracoabdominal-aortic-dissection-using-deep-hypothermia-and-circulatory-arrest
#10
Joel Corvera, Hannah Copeland, David Blitzer, Adam Hicks, Joshua Manghelli, Philip Hess, John Fehrenbacher
BACKGROUND: Chronic dissection of the thoracic and thoracoabdominal aorta as sequela of a prior type A or B dissection is a challenging problem that requires close radiographic surveillance and prompt operative intervention in the presence of symptoms or aneurysm formation. Open repair of chronic thoracic and thoracoabdominal aortic dissection using deep hypothermia has been our preferred method to treat this complex pathology. The advantages of this technique include organ and spinal cord protection, the flexibility to extend the repair proximally into the arch, and the ability to limit ischemia to all vascular beds...
March 18, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28433218/cardiac-arrhythmia-after-open-thoracoabdominal-aortic-aneurysm-repair
#11
Ahmet Dolapoglu, Irina V Volguina, Matt D Price, Susan Y Green, Joseph S Coselli, Scott A LeMaire
BACKGROUND: Cardiac arrhythmias commonly arise after cardiac surgery and are associated with poor prognosis. In thoracoabdominal aortic aneurysm (TAAA) repair, these complications are poorly understood. We assessed characteristics, incidence, outcomes, and potential predictors of postoperative arrhythmia (PA) after open TAAA repair. METHODS: From 2010 to 2014, 403 consecutive open TAAA replacement operations were performed in patients without preoperative cardiac rhythm abnormalities at a single tertiary center...
April 19, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28431720/hybrid-endovascular-repair%C3%A2-of%C3%A2-a-right-sided-thoracoabdominal-aortic%C3%A2-aneurysm
#12
Mamoru Hamuro, Tomoyuki Yamada, Kenji Yamamoto, Sakae Enomoto, Masahide Kawatou
A right-sided thoracoabdominal aortic aneurysm involving a right-sided aortic arch is extremely rare. Surgical treatment for a right-sided thoracoabdominal aortic aneurysm is challenging due to the anatomical complexity. We report a case of a right-sided thoracoabdominal aortic aneurysm with a right-sided aortic arch successfully treated by hybrid visceral debranching and endovascular repair.
May 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28428528/-challenge-of-treating-thoracoabdominal-aortic-aneurysms-with-hybrid-thoracic-endovascular-aortic-repair
#13
Takashi Shuto, Shinji Miyamoto
The treatment of thoracoabdominal aortic aneurysms in great vessels is still challenging, as the early results of the operation are not very promising compared with other aortic operations, and the incidence of spinal cord ischemia is relatively high. In Japan, which is becoming a super-aging society, the method of performing minimally invasive operations remains a major issue. At our facility, we have been performing abdominal debranching thoracic endovascular aortic repair (TEVAR) to resolve these issues...
April 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28428520/-prevention-of-spinal-cord-ischemia-during-thoracic-endovascular-aortic-repair
#14
Shinya Takahashi, Taijiro Sueda
Spinal cord ischemia(SCI) has been devastating complication of endovascular thoracic and thoracoabdominal aortic repair. Spinal cord blood supply arises from not only segmental artery, subclavian artery, hypogastric artery and these branches, but also perivertebral vasculature and paravertebral muscle and small arterial network, and risk factors of SCI were multifactorial. There are several adjuncts/strategies which are utilized to minimize the incidence of SCI: cerebrospinal fluid drainage, perioperative management of high mean arterial pressure, intraoperative evoked potential monitoring, and staged thoracoabdominal aortic repair...
April 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28423131/thoracoabdominal-aortic-aneurysm-in-a-hiv-positive-patient
#15
Márcio Luís Lucas, Ívia Binotto, Paulo Behar, Nilon Erling, Eduardo Lichtenfels, Newton Aerts
Advent of antiretroviral therapy has increased survival of patients with human immunodeficiency virus (HIV) infections, with the result that some of these patients now develop degenerative diseases, such as atherosclerotic aneurysms. Degenerative thoracoabdominal aortic aneurysm is rare in HIV patients. In this report, a 63-year-old male patient with HIV submitted to open repair of thoracoabdominal aortic aneurysm. The patient did not suffer any type of complication in the perioperative period and remained well in a 28-month follow-up period...
January 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28400216/high-mortality-rates-after-both-open-surgical-and-endovascular-thoracic-aortic-interventions-in-patients-with-end-stage-renal-disease
#16
Nathan L Liang, Theodore H Yuo, Georges E Al-Khoury, Eric S Hager, Michel S Makaroun, Michael J Singh
BACKGROUND: Morbidity and mortality have improved with the evolution of endovascular techniques (thoracic endovascular aortic repair [TEVAR]) for thoracic aortic disease, but results after aortic intervention in patients with end-stage renal disease (ESRD) remain unclear. The objective of this study was to evaluate outcomes of open and endovascular descending thoracic aortic repair in dialysis-dependent patients. METHODS: We identified 352 patients with ESRD on dialysis undergoing open repair (n = 136) or TEVAR (n = 216) of the thoracic aorta from 2005 to 2008 using the United States Renal Data System database...
April 8, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28390774/surgeon-leadership-in-the-coding-billing-and-contractual-negotiations-for-fenestrated-endovascular-aortic-aneurysm-repair-increases-medical-center-contribution-margin-and-physician-reimbursement
#17
Francesco Aiello, Jonathan Durgin, Vijaya Daniel, Louis Messina, Danielle Doucet, Jessica Simons, James Jenkins, Andres Schanzer
BACKGROUND: Fenestrated endovascular aneurysm repair (FEVAR) allows endovascular treatment of thoracoabdominal and juxtarenal aneurysms previously outside the indications of use for standard devices. However, because of considerable device costs and increased procedure time, FEVAR is thought to result in financial losses for medical centers and physicians. We hypothesized that surgeon leadership in the coding, billing, and contractual negotiations for FEVAR procedures will increase medical center contribution margin (CM) and physician reimbursement...
April 5, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28389292/laparoscopic-transarterial-embolization-of-type-ii-endoleak-after-branched-fenestrated-thoracoabdominal-aortic-aneurysm-endovascular-repair
#18
Gian Franco Fadda, Holta Kasemi, Costantino Luca Di Angelo, Carlo De Nisco, Francesco Balestra, Antonio Cruccu, Mario Marino
Type II endoleak is the most frequent procedure-related complication during endovascular aneurysm exclusion. Actually there is little controversy in the management of type I and III endoleak, while type II endoleak still generates conflicting reports about their timing and type of treatment. Currently, the intervention is needed only in case of sac enlargement, but not in case of persistent endoleak alone. We report the case of a 77 year-old man treated with a custom-made branched/fenestrated endograft for a type III thoracoabdominal aortic aneurysm...
April 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28389286/decision-to-interrupt-second-stage-side-branch-completion-in-thoracoabdominal-branched-aortic-stent-grafting-to-prevent-spinal-cord-ischemia
#19
Joseph Touma, Bachir Benamara, Hicham Kobeiter, Pascal Desgranges
BACKGROUND: Spinal cord ischemia (SCI) is a severe complication of extended endovascular repair of thoracoabdominal aneurysms. We describe voluntary interruption of side-branch completion in staged branched endovascular aneurysm treatment due to uncertainty regarding SCI possible onset, based on intraoperative angiography findings. METHODS: We report a case of a staged endovascular treatment of thoracoabdominal aortic aneurysm in a 64-year-old patient using a branched endograft with an additional side branch that allows temporary sac perfusion to prevent SCI...
April 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28366305/off-the-shelf-multibranched-endograft-for-urgent-endovascular-repair-of-thoracoabdominal-aortic-aneurysms
#20
Enrico Gallitto, Mauro Gargiulo, Antonio Freyrie, Rodolfo Pini, Chiara Mascoli, Stefano Ancetti, Gianluca Faggioli, Andrea Stella
OBJECTIVE: The aim of this paper was to report early and midterm results of endovascular repair of urgent thoracoabdominal aortic aneurysms (TAAAs) by the off-the-shelf multibranched Zenith t-Branch endograft (Cook Medical, Bloomington, Ind). METHODS: Between January 2014 and April 2016, all patients with urgent TAAAs (asymptomatic with diameter >8 cm, symptomatic, or ruptured TAAAs) and aortoiliac anatomic feasibility underwent endovascular repair by t-Branch and were prospectively enrolled...
March 30, 2017: Journal of Vascular Surgery
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