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Selective Aortic Arch Perfusion

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https://www.readbyqxmd.com/read/29748059/experience-with-the-axillary-artery-as-an-arterial-cannulation-site-in-patients-with-acute-type-a-aortic-dissection
#1
Arpit Talwar, Elvina Wiadji, Manu N Mathur
BACKGROUND: The optimal arterial cannulation site in patients undergoing surgical management of acute type A aortic dissection (ATAAD) remains controversial. The axillary artery is rarely involved in the dissection process, provides antegrade flow in the descending aorta and minimises intraoperative malperfusion. The purpose of this study is to evaluate a single surgeon's experience of axillary artery cannulation for ATAAD repair. METHODS: All consecutive patients over a 15-year period having surgical repair of ATAAD were included in this study...
March 29, 2018: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29701386/simplified-technique-for-aortic-arch-replacement-in-patients-at-high-risk-for-frozen-elephant-trunk
#2
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
https://www.readbyqxmd.com/read/29695652/total-aortic-arch-replacement-after-thoracic-endovascular-aortic-repair-using-left-subclavian-arterial-perfusion
#3
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
https://www.readbyqxmd.com/read/29685718/distal-arch-aneurysm-repair-using-left-subclavian-artery-transposition-with-stented-elephant-trunk-in-the-hybrid-repair-era
#4
Rui-Dong Qi, Jun-Ming Zhu, Yong-Min Liu, Lei Chen, Cheng-Nan Li, Xiao-Yan Xing, Nan Zhang, Li-Zhong Sun
BACKGROUND: Hybrid aortic arch repair is an invasive approach to the surgical management of distal aortic arch aneurysm. The complications associated with hybrid aortic arch repair, such as stroke and endoleaks, are not uncommon and late reintervention is frequent. We retrospectively reviewed our experience of distal aortic arch aneurysm repair using the stented elephant trunk procedure with left subclavian artery (LSCA)-left common carotid artery (LCCA) transposition in the hybrid repair era...
March 27, 2018: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29649955/repair-of-tevar-associated-type-a-dissection-in-the-elderly-is-possible-with-reasonable-morbidity-and-mortality
#5
Angela Kornberger, Risteski Petar, Hazem El Beyrouti, Mahmud Khalil, Iris Burck, Nancy Halloum, Andres Beiras-Fernandez, Christian-Friedrich Vahl
BACKGROUND: Type A aortic dissection (AAD) is a devastating complication of thoracic endovascular repair (TEVAR). In elderly patients, surgery for AAD carries considerable morbidity and mortality. Repair of AAD after previous TEVAR is an even greater challenge as it usually requires the arch to be addressed and a preexisting stent graft to be included into the aortic repair. METHODS: A case series of 5 elderly patients who presented with acute AAD after previous TEVAR was reviewed...
January 1, 2018: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29629837/impact-of-hypertension-on-early-outcomes-and-long-term-survival-of-patients-undergoing-aortic-repair-with-stanford-a-dissection
#6
Julia Merkle, Anton Sabashnikov, Antje-Christin Deppe, Mohamed Zeriouh, Kaveh Eghbalzadeh, Carolyn Weber, Parwis Rahmanian, Elmar Kuhn, Navid Madershahian, Axel Kroener, Yeong-Hoon Choi, Ferdinand Kuhn-Régnier, Oliver Liakopoulos, Thorsten Wahlers
INTRODUCTION: Stanford A acute aortic dissection (AAD) is a life-threatening emergency, typically occurring in hypertensive patients, requiring immediate surgical repair. The aim of this study was to evaluate early outcomes and long-term survival of hypertensive patients in comparison to normotensive patients suffering from Stanford A AAD. METHODS: In our center, 240 patients with Stanford A AAD underwent aortic surgical repair from January 2006 to April 2015. After statistical and logistic regression analysis, Kaplan-Meier survival estimation was performed, with up to 9-year follow-up...
April 1, 2018: Perfusion
https://www.readbyqxmd.com/read/29617791/beating-heart-aortic-arch-surgery-in-neonates-and-infants
#7
Juan-Miguel Gil-Jaurena, María-Teresa González-López, Ana Pita, Ramón Pérez-Caballero, Mónica Herviás, Dorotea Blanco
OBJECTIVES: Aortic arch repair has been shifted from deep hypothermia plus circulatory arrest to cerebral perfusion at tepid temperatures. A step forward is a simultaneous brain-coronary perfusion, allowing beating-heart arch surgery. METHODS: A 'Y' cannula from the arterial line delivers oxygenated blood to brain and heart. The arch is repaired on a beating heart at 25°C. Intracardiac repair is performed after running cardioplegia through the root line. Fifty patients are classified into 3 groups: A, Norwood (8 neonates); B, aortic arch (14 children) and C, aortic arch plus intracardiac repair (28 patients)...
April 2, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29605960/moderate-hypothermic-circulatory-arrest-%C3%A2-28%C3%A2-c-with-selective-antegrade-cerebral-perfusion-for-total-arch-replacement-with-frozen-elephant-trunk-technique
#8
Ali El-Sayed Ahmad, Petar Risteski, Mahmut Ay, Nestoras Papadopoulos, Anton Moritz, Andreas Zierer
OBJECTIVES:  The optimal hypothermic level during circulatory arrest in aortic arch surgery remains controversial, particularly in frozen elephant trunk (FET) procedures. We describe herein our experience for total arch replacement with FET technique under moderate systemic hypothermic circulatory arrest (≥ 28°C) during selective antegrade cerebral perfusion. METHODS:  Between January 2009 and January 2016, 38 consecutive patients underwent elective total arch replacement for various aortic arch pathologies with FET technique using the E-vita Open hybrid prosthesis (Jotec GmbH, Hechingen, Germany)...
April 1, 2018: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/29590367/selective-visceral-perfusion-improves-renal-flow-and-hepatic-function-in-neonatal-aortic-arch-repair
#9
Joaquín Fernández-Doblas, Christian Ortega-Loubon, Joaquín Pérez-Andreu, Marcos Linés, Manuel Fernández-Molina, Raúl F Abella
OBJECTIVES: The aortic arch repair in the neonatal period is a complex procedure with significant morbidity. We define a useful double-perfusion technique and its effect on the function of abdominal organs in the postoperative course. METHODS: Nine patients with double perfusion (Group 1) were compared with 14 patients with antegrade cerebral perfusion (Group 2). The objective was to discern the incidence of postoperative acute kidney injury and impaired hepatic function, as well as tissue perfusion and myocardial function parameters...
March 26, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29508410/selective-cerebro-myocardial-perfusion-in-complex-neonatal-aortic-arch-pathology-midterm-results
#10
Stiljan Hoxha, Riccardo Giuseppe Abbasciano, Camilla Sandrini, Lucia Rossetti, Tiziano Menon, Luca Barozzi, Daniele Linardi, Alessio Rungatscher, Giuseppe Faggian, Giovanni Battista Luciani
Aortic arch repair in newborns and infants has traditionally been accomplished using a period of deep hypothermic circulatory arrest. To reduce neurologic and cardiac dysfunction related to circulatory arrest and myocardial ischemia during complex aortic arch surgery, an alternative and novel strategy for cerebro-myocardial protection was recently developed, where regional low-flow perfusion is combined with controlled and independent coronary perfusion. The aim of the present retrospective study was to assess short-term and mid-term results of selective and independent cerebro-myocardial perfusion in neonatal aortic arch surgery...
April 2018: Artificial Organs
https://www.readbyqxmd.com/read/29415372/one-stage-replacement-of-the-aorta-from-arch-to-thoracoabdominal-region
#11
Takashi Matsueda, Yuki Ikeno, Koki Yokawa, Yojiro Koda, Soichiro Henmi, Takeshi Inoue, Hiroshi Tanaka, Yutaka Okita
OBJECTIVES: We present our experience with one-stage replacement of thoracic aneurysm from the ascending aorta to the thoracoabdominal aorta. PATIENTS AND METHODS: Fourteen patients (10 male and 4 female; mean age 53.6 ± 12.4 years) with extended thoracic aortic aneurysms underwent graft replacement. The pathology of the diseased aorta was chronic aortic dissection in 13 patients and intraoperative retrograde aortic dissection in 1 patient. Five patients had Marfan syndrome...
February 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29398374/association-between-optic-nerve-head-blood-flow-measured-using-laser-speckle-flowgraphy-and-radial-arterial-pressure-during-aortic-arch-surgery
#12
Hironobu Hayashi, Masahiro Okamoto, Hideaki Kawanishi, Nobuoki Tabayashi, Toyoaki Matsuura, Shigeki Taniguchi, Masahiko Kawaguchi
OBJECTIVE: This study was designed to investigate the association between ocular blood flow measured using laser speckle flowgraphy (LSFG) and radial arterial pressure during aortic arch surgery. DESIGN: A prospective study. SETTING: A single university hospital. PARTICIPANTS: This study included 24 patients undergoing aortic arch surgery with cardiopulmonary bypass (CPB) using antegrade selective cerebral perfusion (SCP)...
April 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29334980/reoperation-for-a-giant-arch-anastomotic-pseudoaneurysm-eleven-years-after-total-arch-replacement-with-island-reconstruction
#13
Ryohei Matsuura, Yasushi Tsutsumi, Osamu Monta, Hisazumi Uenaka, Kenji Tanaka, Takaaki Samura, Hirokazu Ohashi
BACKGROUND: The long-term effects of some surgical treatment procedures of arch replacement for aortic dissection or aortic aneurysm are unknown. CASE PRESENTATION: The present study reports the case of a 68-year-old man admitted to our hospital for aortic arch anastomotic pseudoaneurysm with concomitant aortic root enlargement and coronary artery stenosis. Eleven years ago, at the age of 56 years, he underwent total arch replacement with island reconstruction for chronic aortic dissection...
January 15, 2018: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29188429/spike-in-glucose-levels-after-reperfusion-during-aortic-surgery-assessment-by-continuous-blood-glucose-monitoring-using-artificial-endocrine-pancreas
#14
Koji Kawahito, Hirotaka Sato, Mamoru Kadosaki, Atsushi Egawa, Yoshio Misawa
OBJECTIVES: Although strict blood glucose control during cardiovascular surgery is essential to avoid postoperative complications, the various changes in glucose levels that occur during surgery have not been investigated in detail. In this study, we continuously monitored blood glucose changes during aortic surgery using the STG-55Ⓡ artificial endocrine pancreas (Nikkiso Inc., Tokyo). METHODS: Between December 2015 and 2016, we performed continuous blood glucose monitoring in 22 patients (14 men and 8 women, 72 ± 11 years old), who required hypothermic circulatory arrest during an ascending/aortic arch surgery, at the Jichi Medical University Hospital...
March 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29111297/mid-term-outcomes-of-repair-of-coarctation-of-aorta-with-hypoplastic-arch-extended-end-to-side-anastomosis-technique
#15
Eung Re Kim, Woong-Han Kim, Jinhae Nam, Kwangho Choi, Woo Sung Jang, Jae Gun Kwak
The optimal surgical repair technique for coarctation associated with aortic arch hypoplasia (CoA-AAH) in neonates and infants is controversial. This study evaluates our current strategy using extended end-to-side anastomosis under selective cerebral and myocardial perfusion in treating this group of patients. Through a retrospective review, we analyzed the outcome of 87 infants who underwent surgical repair of CoA-AAH from January 2004 to December 2015. Patients with functional single ventricle were excluded...
October 27, 2017: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29049830/acute-debakey-type-i-aortic-dissection-without-intimal-tear-in-the-arch-is-total-arch-replacement-the-right-choice
#16
Andrea Colli, Massimiliano Carrozzini, Annalisa Francescato, Marco Galuppo, Marina Comisso, Francesca Toto, Dario Gregori, Gino Gerosa
OBJECTIVES: Surgical management of acute DeBakey Type I aortic dissection without intimal tear in the aortic arch is controversial. This study compared short- and long-term outcomes of total arch replacement (TAR) versus limited ascending aorta/hemiarch replacement (no-TAR) in a consecutive series of patients. METHODS: Between January 1998 and December 2015, 220 consecutive patients were operated for DeBakey Type I acute aortic dissection; 135 cases did not exhibit an intimal entry tear in the aortic arch and were subsequently selected to comprise the primary study cohort...
January 1, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29038409/-total-arch-replacement-for-distal-arch-aneurysm-with-isolated-left-vertebral-artery-report-of-a-case
#17
Motonori Uchino, Masaru Yoshikai, Hisashi Sato, Jun Osaki
We herein present a case of distal aortic arch aneurysm with an isolated left vertebral artery(LVA). In surgery, after establishing cardiopulmonary bypass, the LVA was anastomosed to the left common carotid artery (LCCA) while under moderate hypothermia. Selective cerebral perfusion (SCP) was then initiated by inserting catheters into the brachiocephalic artery( BCA), the LCCA and the left subclavian artery (LSA). The aorta was transected between the BCA and the LCCA, and an open stent graft was deployed into the descending aorta during circulatory arrest...
October 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28863956/stent-graft-balloon-occlusion-with-selective-cerebral-perfusion-for-cardiac-surgery-after-proximal-aortic-arch-stent-grafting-a-case-report
#18
Takayuki Shijo, Akira Marumoto, Keiji Iwata
No abstract text is available yet for this article.
February 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28845874/-the-frozen-elephant-trunk-technique-for-the-treatment-of-complex-lesions-of-the-thoracic-aorta
#19
Luca Di Marco, Davide Pacini, Alessandro Leone, Antonio Pantaleo, Giacomo Murana, Roberto Di Bartolomeo
The treatment of patients with extensive disease of the thoracic aorta represents a formidable challenge for the cardiovascular surgeon. The beginning of thoracic aortic endovascular aortic arch repair has promoted the development of different hybrid approaches as the frozen elephant trunk (FET) strategy, which includes classic arch replacement and antegrade stenting of the descending thoracic aorta. It represents an interesting approach for patients with extensive disease of the thoracic aorta, and its application has significantly increased over recent years...
September 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28838515/surgical-repair-of-cervical-aortic-arch-with-brain-circulation-anomaly-through-clamshell-incision
#20
Toshihito Gomibuchi, Tatsuichiro Seto, Takateru Yamamoto, Ko Nakahara, Noburo Ohashi, Yoshinori Ohtsu, Yuko Wada, Daisuke Fukui, Kenji Okada
We report the successful surgical repair of a cervical aortic arch and diverticulum with a brain circulation anomaly through a clamshell incision. Because of the reliability of selective antegrade cerebral perfusion and superior exposure, we chose an approach through a clamshell incision. We describe the utility of this approach for treating a cervical aortic arch with a diverticulum.
September 2017: Annals of Thoracic Surgery
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