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Aortic arch dissection

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https://www.readbyqxmd.com/read/28345421/clinical-features-and-prognosis-of-patients-with-acute-aortic-dissection-in-china
#1
Lujing Zhao, Yanfen Chai, Zhigang Li
Objective To evaluate the clinical features, risk factors, and prognostic significance of different Stanford types of acute aortic dissection (AAD). Methods We retrospectively analyzed the clinical data and prognostic predictors in 105 patients with AAD (37 with Stanford type A and 68 with Stanford type B) at Tianjin Medical University General Hospital and Tianjin 4th Central Hospital from January 2014 to November 2015. Results Patients with Marfan syndrome and bicuspid aortic valve constituted 24.3% and 8...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28335136/retrospective-analysis-of-type-a-aortic-dissections-after-debranching-of-the-supra-aortic-trunks-and-stentgraft-of-the-aortic-arch-the-side-clamping-of-the-ascending-aorta-is-responsible
#2
Dorian Verscheure, Julien Gaudric, Quentin Pellenc, Arnaud Roussel, Laurent Chiche, Fabien Koskas
No abstract text is available yet for this article.
January 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28335135/evaluation-of-the-hybrid-treatment-of-the-aortic-arch-for-dissecting-aneurysm
#3
Elsa Faure, Ludovic Canaud, Charles Marty-Ane, Pierre Alric
No abstract text is available yet for this article.
January 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28329082/aortic-elongation-and-the-risk-for-dissection-the-t%C3%A3-bingen-aortic-pathoanatomy-taipan-project%C3%A2
#4
Tobias Krüger, Alexandre Oikonomou, David Schibilsky, Mario Lescan, Katharina Bregel, Luise Vöhringer, Wilke Schneider, Henning Lausberg, Gunnar Blumenstock, Fabian Bamberg, Christian Schlensak
OBJECTIVES: We measured aortic dimensions, particularly length parameters, using 3D imaging with the aim of refining the risk-morphology for Stanford type A aortic dissection (TAD). METHODS: Computer tomography angiography studies were analysed using the curved multiplanar reformats. At defined landmarks, the diameters and lengths of aortic segments were recorded. Three groups were compared retrospectively: patients actually suffering from a TAD (TAD-group; n  = 150), patients before suffering a TAD (preTAD-group n  = 15) and a healthy control group ( n  = 215)...
February 16, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28329032/early-and-mid-term-outcomes-of-endovascular-and-open-surgical-repair-of-non-dissected-aortic-arch-aneurysm%C3%A2
#5
Daijiro Hori, Homare Okamura, Takahiro Yamamoto, Satoshi Nishi, Koichi Yuri, Naoyuki Kimura, Atsushi Yamaguchi, Hideo Adachi
OBJECTIVES: With the introduction of endovascular stent graft technology, a variety of surgical options are available for patients with aortic aneurysms. We sought to evaluate early-term and mid-term outcomes of patients undergoing endovascular and open surgical repair for non-dissected aortic arch aneurysm. METHODS: Overall, 200 patients underwent treatment for isolated non-dissected aortic arch aneurysm between January 2008 and February 2016: 133 patients had open surgery and 67, endovascular repair...
February 22, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28298661/deep-hypothermic-circulatory-arrest-vs-antegrade-cerebral-perfusion-in-cerebral-protection-during-the-surgical-treatment-of-chronic-dissection-of-the-ascending-and-arch-aorta
#6
Oksana Vasilyevna Kamenskaya, Asya Stanislavovna Klinkova, Alexander Mikhailovich Chernyavsky, Vladimir Vladimirovich Lomivorotov, Ivan Olegovich Meshkov, Alexander Mikhailovich Karaskov
Circulatory arrest during aortic surgery presents a risk of neurological complications. The present study aimed to investigate the effectiveness of deep hypothermic circulatory arrest (DHCA) vs. antegrade cerebral perfusion (ACP) in cerebral protection during the surgical treatment of chronic dissection of the ascending and arch aorta and to assess the quality-of-life (QoL) in the long-term postoperative period with respect to the used cerebral protection method. In a prospective, randomized study, 58 patients with chronic type I aortic dissection who underwent ascending aorta and aortic arch replacement surgery were included...
March 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/28294330/triple-branched-stent-graft-for-arch-repair-in-a-pregnant-woman-with-acute-debakey-type-i-aortic-dissection
#7
Qian Zhang, Xiaochun Ma, Zhengjun Wang, Chengwei Zou
A woman aged 36 years at 36 weeks of pregnancy sought medical attention at the Shandong Provincial Hospital affiliated to Shandong University, Shandong, China, after experiencing acute chest pain. The patient was diagnosed with chronic hypertension, severe pre-eclampsia, acute aortic dissection, aortic regurgitation, and heart failure. Computed tomography examination demonstrated a DeBakey type I aortic dissection that involved the origin of the innominate artery, the left common carotid artery, and the left subclavian artery...
March 12, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28288887/transapical-endovascular-repair-of-thoracic-aortic-pathology
#8
Takashi Murakami, Shinsuke Nishimura, Mitsuharu Hosono, Yoshitsugu Nakamura, Etsuji Sohgawa, Yukimasa Sakai, Toshihiko Shibata
BACKGROUND: Alternative access for thoracic endovascular aortic repair (TEVAR) has been explored for patients with unsuitable femoral and iliac access, but few cases of transapical access have been described. We report our experience with transapical access for various aortic pathologies. METHODS: We reviewed six cases undergoing transapical access for endovascular repair of thoracic aortic pathology between December 2013 and August 2015. Five patients had an aortic arch aneurysm and 1 patient presented with Stanford type A subacute aortic dissection...
March 10, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28280627/minimally-invasive-ivor-lewis-esophagectomy-for-esophageal-cancer-with-right-aortic-arch
#9
Jeremy Linson, Michael Latzko, Bestoun Ahmed, Ziad Awad
Right aortic arch (RAA) is a rare congenital vascular abnormality in which the aorta descends in the right thorax and encircles the esophagus. Historically, esophagectomy for patients for RAA is done through a left thoracotomy as exposure and mobilization of the esophagus is difficult through a right thoracotomy. A 73-year-old male was found to have an esophageal adenocarcinoma. Endoscopic ultrasound showed a T3N0 lesion in the lower third of the esophagus. PET CT demonstrated a circumferential lesion without evidence of distant disease or involved lymph nodes and a RAA which was not associated with congenital heart disease or symptoms...
February 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28242406/a-subcutaneous-mass-as-a-sign-of-thoracic-aortic-pseudoaneurysm
#10
Naoto Fukunaga, Kazufumi Yoshida, Kenta Nishiya, Tadaaki Koyama
A 39-year-old man on hemodialysis who received total aortic arch repair for dissection of Kommerrel diverticulum two months prior, visited an outpatient clinic. He presented with a sudden subcutaneous mass on the anterior chest wall one week earlier, that was painless, non-pulsatile, and with a normal skin color. Enhanced computed tomography revealed that the pseudoaneurysm originated from the proximal suture line. At surgery, an aortic intima was observed to be lacking at the native posterior aortic wall located at the proximal suture line with a 10-mm tear...
February 24, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28242400/endovascular-management-of-a-ruptured-aortic-arch-pseudoaneurysm-using-the-snorkel-technique-and-coil-embolization
#11
Tao Ma, Zhi-Hui Dong, Wei-Guo Fu, Bin Chen, Jun Hao Jiang, Yun Shi
We report a reoperation case of a ruptured infectious aortic arch pseudoaneurysm, which was stabilized with thoracic endovascular aortic repair (TEVAR) and snorkel bypass of the innominate artery (IA) and the left common carotid artery (LCCA). A 57-year old Chinese woman with multiple comorbidities and previous open repair for Stanford type A aortic dissection 5 years ago presented with a ruptured 10.7cm×7.3cm aortic arch pseudoaneurysm involving the origins of the LCCA and the left subclavian artery. The patient underwent emergent endovascular aortic repair with placement of a stent-grafts in both IA and LCA coursing parallel to the aortic arch endograft...
February 24, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28230898/manifestations-and-medicolegal-significance-of-loeys-dietz-syndrome
#12
Roger W Byard
Loeys-Dietz syndrome is a recently described autosomal dominant disorder with underlying vasculopathy characterized by aortic and other vascular aneurysmal dissection/rupture. A 61-year-old man is reported who died suddenly and unexpectedly and at autopsy was found to have a ruptured abdominal aortic aneurysm. Additional findings included dolichostenomelia, high-arched palate, and pectus excavatum. There was a strong family history of Loeys-Dietz syndrome, although the decedent had never been tested. Death was, therefore, due to a ruptured abdominal aortic aneurysm in a case of probable Loeys-Dietz syndrome...
February 23, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28219557/total-endovascular-repair-of-post-dissection-aortic-arch-aneurysm-with-chimney-technique
#13
Wei-Tao Liang, Su Wang, Jian Zhou, Chen-Jun Han, Qiang Liu, Xiao-Yun Wu, Wang-Fu Zang
Open surgery remains the standard procedure for treatment of aortic arch pathologies. However, total endovascular repair can be a safe option for patients who are poor candidates for surgery because of compromised physiology. We report the case of a 63-year-old man with a post-dissection aortic arch aneurysm. We repaired the aneurysm using thoracic endovascular aortic repair (TEVAR) and used the chimney technique to reconstruct the supra-aortic branches. The patient is doing well after 12-month follow-up, demonstrating that TEVAR with the chimney technique can be used successfully for the treatment of post-dissection arch aneurysm...
March 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28216358/outcomes-of-thoracic-endovascular-aortic-repair-using-aortic-arch-chimney-stents-in-high-risk-patients
#14
Igor Voskresensky, Salvatore T Scali, Robert J Feezor, Javairiah Fatima, Kristina A Giles, Rosamaria Tricarico, Scott A Berceli, Adam W Beck
BACKGROUND: Aortic arch disease is a challenging clinical problem, especially in high-risk patients, in whom open repair can have morbidity and mortality rates of 30% to 40% and 2% to 20%, respectively. Aortic arch chimney (AAC) stents used during thoracic endovascular aortic repair (TEVAR) are a less invasive treatment strategy than open repair, but the current literature is inconclusive about the role of this technology. The focus of this analysis is on our experience with TEVAR and AAC stents...
February 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28215930/ultrasound-guided-resuscitative-endovascular-balloon-occlusion-of-the-aorta-in-the-resuscitation-area
#15
Takayuki Ogura, Alan Kawarai Lefor, Mitsunobu Nakamura, Kenji Fujizuka, Kousuke Shiroto, Minoru Nakano
BACKGROUND: In trauma resuscitation with resuscitative endovascular balloon occlusion of the aorta (REBOA), urgent and accurate placement of the catheter in the resuscitation area without fluoroscopy can shorten the time from admission to REBOA, allowing rapid, temporary control of bleeding. DISCUSSION: The experience-based protocol in our center for ultrasound-guided REBOA in the resuscitation area without fluoroscopy is as follows: the femoral artery is punctured and a guidewire inserted; sonography is used to verify that the guidewire is in the abdominal aorta; the position of the balloon is confirmed with ultrasound after estimating the distance to the clavicle, and the pressure in the radial artery and sheath is used to monitor correct positioning; connect the pressure transducer to the catheter sheath for continuous monitoring of the blood pressure in the sheath, and inflate the balloon until the blood pressure tracing at the sheath has disappeared; check the pulse in the left radial artery, and withdraw the catheter slightly if the pulse in the radial artery is not palpable or is decreased (if this pulse is not palpable or decreased, the balloon is in the aortic arch)...
February 17, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28180096/the-frozen-elephant-trunk-technique-european-association-for-cardio-thoracic-surgery-position-and-bologna-experience
#16
REVIEW
Luca Di Marco, Antonio Pantaleo, Alessandro Leone, Giacomo Murana, Roberto Di Bartolomeo, Davide Pacini
Complex lesions of the thoracic aorta are traditionally treated in 2 surgical steps with the elephant trunk technique. A relatively new approach is the frozen elephant trunk (FET) technique, which potentially allows combined lesions of the thoracic aorta to be treated in a 1-stage procedure combining endovascular treatment with conventional surgery using a hybrid prosthesis. These are very complex and time-consuming operations, and good results can be obtained only if appropriate strategies for myocardial, cerebral, and visceral protection are adopted...
February 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28168983/changes-in-operative-strategy-for-patients-enrolled-in-the-international-registry-of-acute-aortic-dissection-interventional-cohort-program
#17
Neil Parikh, Santi Trimarchi, Thomas G Gleason, Arnoud V Kamman, Marco di Eusanio, Truls Myrmel, Amit Korach, Hersh Maniar, Takeyoshi Ota, Ali Khoynezhad, Daniel G Montgomery, Nimesh D Desai, Kim A Eagle, Christoph A Nienaber, Eric M Isselbacher, Joseph Bavaria, Thoralf M Sundt, Himanshu J Patel
OBJECTIVE: Advancements in cardiothoracic surgery prompted investigation into changes in operative management for acute type A aortic dissections over time. METHODS: One thousand seven hundred thirty-two patients undergoing surgery for type A aortic dissection were identified from the International Registry of Acute Aortic Dissection Interventional Cohort Database. Patients were divided into time tertiles (T) (T1: 1996-2003, T2: 2004-2010, and T3: 2011-2016). RESULTS: Frequency of valve sparing procures increased (T1: 3...
January 9, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28165556/complicated-thoraco-abdominal-aortic-dissection-presenting-with-lower-limb-ischemia-in-a-patient-with-bovine-arch-and-arteria-lusoria
#18
G-R Joliat, C Dubuis, S Déglise
We report the case of a 58-year-old man who presented with thoraco-abdominal pain and right lower limb ischemia due to type B aortic dissection. Moreover, the patient was discovered to have several concomitant aortic arch anomalies (bovine arch, arteria lusoria, and left vertebral artery arising from the aortic arch). Taking into account this complex anatomy, emergent femoral exploration with fenestration and thrombectomy was performed. The blood flow to the right lower limb was restored. A few days later the aortic dissection spread proximally, and the aortic arch dilatation enlarged...
January 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28149590/one-stage-hybrid-surgery-for-acute-stanford-type-a-aortic-dissection-with-david-operation-aortic-arch-debranching-and-endovascular-graft-a-case-report
#19
Lulu Liu, Chaoyi Qin, Jianglong Hou, Da Zhu, Bengui Zhang, Hao Ma, Yingqiang Guo
Acute Stanford type A aortic dissection requires an extremely complex surgical strategy and presents high risk of complications. Although many different procedures were reported to treat this aortic dissection, high mortality rate and incidences of complications still exist. This study presents a 59-year-old lady with acute Stanford type A aortic dissection, which originated from the aortic root to proximal part of right external iliac artery and involved the brachiocephalic trunk, left carotid artery, celiac trunk, and left renal artery...
December 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28134010/noteworthy-literature-published-in-2016-for-cardiac-surgery
#20
Muhammad Aftab, Joseph C Cleveland, T Brett Reece
Cardiac surgical care of patients continued to evolve rapidly in 2016. In this article, 3 topics of considerable change are discussed based on recent publications. The first topic reviews the potential risks and benefits of newly instituted low-risk percutaneous aortic valve replacement. The second topic reviews the increasing utilization of more extensive arch replacements in acute type A dissection. The final topic reviews current trends and justification for changes in patterns of use of cardioplegia options...
March 2017: Seminars in Cardiothoracic and Vascular Anesthesia
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