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Thoracoabdominal aortic aneurysm

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https://www.readbyqxmd.com/read/29896044/open-replacement-of-the-thoracoabdominal-aorta-short-and-long-term-outcomes-at-a-single-institution
#1
Davide Carino, Young Erben, Mohammad A Zafar, Mrinal Singh, Adam J Brownstein, Maryann Tranquilli, John Rizzo, Bulat A Ziganshin, John A Elefteriades
Background  Despite much progress in the surgical and endovascular treatment of thoracoabdominal aortic diseases (TAADs), there is no consensus regarding the optimal approach to minimize operative mortality and end-organ dysfunction. We report our experience in the past 16 years treating TAAD by open surgery. Methods  A retrospective review of all TAAD patients who underwent an open repair since January 2000 was performed. The primary endpoints included early morbidity and mortality, and the secondary endpoints were overall death and rate of aortic reintervention...
June 2018: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/29896040/endovascular-treatment-of-various-aortic-pathologies-review-of-the-latest-data-and-technologies
#2
REVIEW
Koji Maeda, Takao Ohki, Yuji Kanaoka
The technologies and innovations applicable to endovascular treatment for complex aortic pathologies have progressed rapidly over the last two decades. Although the initial outcomes of an endovascular aortic repair have been excellent, as long-term data became available, complications including endoleaks, endograft migration, and endograft infection have become apparent and are of concern. Previously, the indication for endovascular therapy was restricted to descending thoracic aortic aneurysms and abdominal aortic aneurysms...
June 2018: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/29865944/advanced-technical-considerations-for-implanting-the-t-branch-off-the-shelf-multibranched-stent-graft-to-treat-thoracoabdominal-aneurysms
#3
Marcelo Ferreira, Diego Ferreira, Rodrigo Cunha, Guilherme Bicalho, Eduardo Rodrigues
PURPOSE: To demonstrate different techniques and device modifications that can expand the anatomic suitability of the off-the-shelf multibranched t-Branch for treatment of thoracoabdominal aortic aneurysm. TECHNIQUE: The t-Branch device is not customized for specific patient anatomy, and the most frequent limitations to its use are an inadequate sealing zone and renal artery anatomy. Experience with this device has prompted the development of several techniques that can be employed to maximize the suitability of this stent-graft...
June 1, 2018: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/29865943/accurate-orientation-of-the-t-branch-off-the-shelf-multibranched-endograft-after-deployment-in-urgent-cases
#4
Konstantinos Spanos, Myrto Theodorakopoulou, E Sebastian Debus, Fiona Rohlffs, Franziska Heidemann, Tilo Kölbel, Nikolaos Tsilimparis
PURPOSE: To evaluate the orientation of the standardized off-the-shelf multibranched t-Branch after implantation in urgent thoracoabdominal aortic aneurysm (TAAA) repairs, to characterize the impact of branch malorientation on procedural success, and to identify any predictive factors associated with malorientation. METHODS: A retrospective analysis was conducted of 42 consecutive patients (mean age 73.3±7 years; 25 men) with urgent TAAA presentation treated with the t-Branch from January 2014 to June 2017...
June 1, 2018: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/29850143/total-arch-replacement-and-frozen-elephant-trunk-for-type-a-aortic-dissection-after-bentall-procedure-in-marfan-syndrome
#5
Yu Chen, Wei-Guo Ma, Jun Zheng, Yong-Min Liu, Jun-Ming Zhu, Li-Zhong Sun
Background: We seek to report the long-term outcomes of the total arch replacement and frozen elephant trunk (TAR + FET) technique for type A aortic dissection (TAAD) following prior Bentall procedure in patients with Marfan syndrome (MFS). Methods: Between 2003 and 2015, we performed TAR + FET for 26 patients with MFS who developed TAAD following a prior Bentall procedure. Mean age at FET 36.9±9.7 years and 24 were males. TAAD was acute in 8 (30.8%, all new dissections from precious root aneurysm) and chronic in 18 (69...
April 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29804738/impact-of-previous-open-aortic-repair-on-the-outcome-of-thoracoabdominal-fenestrated-and-branched-endografts
#6
Enrico Gallitto, Gianluca Faggioli, Chiara Mascoli, Rodolfo Pini, Stefano Ancetti, Andrea Vacirca, Andrea Stella, Mauro Gargiulo
BACKGROUND: Thoracoabdominal aortic aneurysms (TAAAs) after previous aortic open surgical repair (OSR) are challenging clinical scenarios. Redo-OSR is technically demanding, and standard endovascular repair is unavailable due to visceral vessel involvement. Fenestrated and branched endografts (FB-EVAR) are effective options to treat TAAAs in high surgical risk patients but dedicated studies on the FB-EVAR outcomes in patients with TAAAs with previous OSR are not available. The aim of the study was to evaluate the impact of previous OSR on TAAAs FB-EVAR outcomes...
May 24, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29790721/techniques-and-outcomes-of-secondary-endovascular-repair-for-post-dissection-taa-taaa
#7
Pablo Marques De Marino, Kyriakos Oikonomou, Eric L Verhoeven, Athanasios Katsargyris
Post-dissection aortic aneurysms (PDAA) affect 20-40% of patients with aortic dissection. Open repair remains the first line therapy of PDAA, but is still associated with high mortality and morbidity rates. Endovascular repair is increasingly being used as a less invasive treatment option. Thoracic endovascular aneurysm repair (TEVAR) covering only the proximal entry tear has proven to be insufficient in most patients with chronic PDAA and has a limited role only for PDAA with distal sealing zone in the thoracic aorta...
May 23, 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29789217/outcomes-and-cost-of-open-versus-endovascular-repair-of-intact-thoracoabdominal-aortic-aneurysm
#8
Satinderjit Locham, Hanaa Dakour-Aridi, Besma Nejim, Jasninder Dhaliwal, Widian Alshwaily, Mahmoud Malas
OBJECTIVE: Many previous studies have evaluated the outcomes of open and endovascular repair of thoracoabdominal aortic aneurysms (TAAAs). However, little is known about the differences in cost of these procedures and the potential factors driving these differences. The aim of this study was to evaluate the outcomes and cost of open aortic repair (OAR) vs endovascular repair of intact TAAA. METHODS: All patients undergoing repair for intact TAAA were identified in the Premier Healthcare Database (July 2009-March 2015)...
May 19, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29786413/frozen-elephant-trunk-and-arch-endografts-for-chronic-thoracoabdominal-aortic-dissections
#9
Giovanni Tinelli, Marco Ferraresi, A Claire Watkins, Raphael Soler, Elie Fadel, Dominique Fabre, Stéphan Haulon
Chronic aortic dissecting aneurysms (TAAD) presenting after acute Stanford Type A or B dissection includes both arch and/or thoracoabdominal aortic aneurysms (TAAA). Approximately 60% of patients who survive surgical treatment of acute Type A aortic dissections will require another aortic procedure. Similarly, more than 70% of patients with chronic Type B aortic dissections will experience false lumen dilation at 5-year follow-up, often requiring intervention. Open or hybrid aortic repairs of complex TAAD involving the arch and the TAAA are very demanding procedures for both patients and clinicians...
May 22, 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29784568/assessment-of-failure-to-rescue-after-abdominal-aortic-aneurysm-repair-using-the-national-surgical-quality-improvement-program-procedure-targeted-data-set
#10
Hanaa Dakour-Aridi, Nawar Z Paracha, Satinderjit Locham, Besma Nejim, Mahmoud B Malas
OBJECTIVE: Open aortic repair (OAR) is associated with higher risk of mortality compared with endovascular aneurysm repair (EVAR). The aim of this study was to compare failure to rescue (FTR) after major predischarge complications in patients undergoing OAR and EVAR. METHODS: Patients who underwent OAR or EVAR in the American College of Surgeons National Surgical Quality Improvement Program between 2011 and 2015 were selected. Patients with ruptured aneurysm and those with type IV thoracoabdominal aneurysms were excluded...
May 18, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29780721/type-b-aortic-dissection-new-perspectives
#11
REVIEW
Marc A A M Schepens
Background: Stanford type B aortic dissection is one of the aortic catastrophes with a high mortality and morbidity that needs immediate or delayed treatment, either surgically or endovascularly. This comprehensive review article addresses the current status of open, endovascular and hybrid treatment options for type B aortic dissections with the focus on new therapeutic perspectives. Methods: Evaluation of currently available evidence based on randomized and registry data and personal experience...
2018: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29777669/repair-of-thoracic-and-thoracoabdominal-mycotic-aneurysms-and-infected-aortic-grafts-using-allograft
#12
Joel S Corvera, David Blitzer, Hannah Copeland, Daniel Murphy, Philip J Hess, Saila T Pillai, John W Fehrenbacher
BACKGROUND: Mycotic aneurysm of the thoracic or thoracoabdominal aorta and infection of thoracic or thoracoabdominal aortic grafts are challenging problems with high mortality. In-situ reconstruction with cryopreserved allograft(CPA) avoids placement of prosthetic material in an infected field and avoids suppressive antibiotics or autologous tissue coverage. METHODS: Fifty consecutive patients with infection of a thoracic or thoracoabdominal aortic graft or mycotic aneurysm underwent resection and replacement with CPA from 2006 to 2016...
May 16, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29775606/ecmo-for-acute-respiratory-distress-syndrome-after-thoracoabdominal-aortic-aneurysm-repair
#13
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/29756196/endovascular-treatment-of-thoracoabdominal-aortic-aneurysm-in-loeys-dietz-syndrome
#14
Tomasz Jakimowicz, Michał Macech, Piotr Hammer, Tadeusz Grochowiecki, Sławomir Nazarewski
No abstract text is available yet for this article.
2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29755087/-successful-echo-guided-deployment-of-stent-graft-for-intraoperative-retrograde-aortic-dissection-and-rupture-report-of-a-case
#15
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
https://www.readbyqxmd.com/read/29725663/recovery-of-lost-motor-evoked-potentials-in-open-thoracoabdominal-aortic-aneurysm-repair-using-intercostal-artery-bypass
#16
Alexander Gombert, Jochen Grommes, Danny Hilkman, Drosos Kotelis, Werner H Mess, Michael J Jacobs
Ischemia of the spinal cord remains a disastrous complication in thoracoabdominal aortic aneurysm (TAAA) surgery. We report a case of open type I TAAA repair during which no motor evoked potentials were detectable for >1 hour after aortic cross-clamping. The creation of three intercostal artery bypasses restored spinal cord perfusion. As the patient showed only moderate clinical signs of spinal cord ischemia afterward, we underline the role of neuromonitoring to guide intercostal artery bypass implantation during TAAA surgery as the combined use of neuromonitoring and intercostal artery bypass implantation may prevent paraplegia in specific TAAA cases...
March 2018: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29709533/patience-is-a-virtue-expectant-management-of-chylothorax-after-thoracoabdominal-aortic-aneurysm-repair-usually-works
#17
EDITORIAL
Jeffrey E Keenan, Nicholas D Andersen
In their series of 11 postoperative chylothorax events after open thoracoabdominal aortic aneurysm repair, Wu and colleagues demonstrate this rare (incidence <1%) but potentially serious complication can usually be treated nonoperatively. In cases of high-output chylothorax or chylothorax refractory to medical management, surgical thoracic duct ligation may be required.
April 27, 2018: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29705087/long-term-outcomes-after-repair-of-symptomatic-abdominal-aortic-aneurysms
#18
Venita Chandra, Karen Trang, Whitt Virgin-Downey, Ronald L Dalman, Matthew W Mell
OBJECTIVES: Previous studies have reported increased perioperative mortality of nonruptured symptomatic abdominal aortic aneurysms (Sx-AAA) compared with asymptomatic elective AAA (E-AAA) repairs, but no long-term-outcomes have been reported. We sought to compare long-term outcomes of Sx-AAA and E-AAA after repair at a single academic institution. METHODS: Patients receiving AAA repair for Sx-AAA and E-AAA from 1995 through 2015 were included. Ruptured AAA and suprarenal or thoracoabdominal AAA were excluded...
April 25, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29701423/reversal-of-acute-spinal-cord-injury-in-the-immediate-post-operative-period-after-thoracoabdominal-aneurysm-repair-with-csf-drainage
#19
Marisa Silva, Ana Ferro
INTRODUCTION: Spinal cord injury after thoracoabdominal aortic aneurysm surgery is a devastating and unpredictable complication (1). With surgical manipulation, particularly with aortic clamping, cerebrospinal fluid (CSF) pressure may rise, and its pressure exceeds the spinal arterial pressure, spinal perfusion may be reduced, leading to neurological dysfunction. METHODS AND RESULTS: This clinical case reports to a 70-year-old male patient with an early onset of post-operative paraesthesia of the lower limbs in the immediate post-operative period of thoracoabdominal aortic aneurysm repair...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29701395/elective-2nd-stage-tevar-to-complete-frozen-elephant-trunk-in-the-surgical-correction-of-complex-multisegmental-pathology-of-the-thoracic-aorta
#20
Álvaro Laranjeira Santos, António Cruz Tomás, Daniela Varela-Afonso, Jorge Pinheiro Santos, José Fragata
INTRODUCTION: Classical conventional surgery to treat multi-segmental thoracic aortic disease in two operative stages, sternotomy and left thoracotomy, is associated with significant mortality and complications. The Frozen Elephant Trunk (FET) associated with an endovascular procedure (TEVAR) allows an extensible and simplified surgical approach of the descending and thoracoabdominal aorta without increasing the risk. METHODS: Retrospective study of 8 patients (pts), 5 males, mean age 67...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
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