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Aortic arch dissection

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https://www.readbyqxmd.com/read/28073667/enlargement-of-aortic-arch-vessels-after-surgical-repair-of-type-a-aortic-dissection
#1
Takashi Yamauchi, Suguru Kubota, Toshihiro Ohata, Kosei Hasegawa, Hideki Ueda
BACKGROUND: Information on the growth rate of the diameter of the residual dissected supra-aortic trunk after surgical repair of type A aortic dissection is limited. METHODS: We retrospectively reviewed 95 consecutive postsurgical patients with type A aortic dissection (acute, 91; chronic, 4) between 2005 and 2016 who were followed up with computed tomography. The diameter of the residual dissected supra-aortic trunk was measured by axial images and multiplanar reformatting, and the growth rate was calculated...
January 7, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28040765/classification-and-outcomes-of-extended-arch-repair-for-acute-type-a-aortic-dissection-a-systematic-review-and-meta-analysis
#2
REVIEW
Holly N Smith, Munir Boodhwani, Maral Ouzounian, Richard Saczkowski, Alexander J Gregory, Eric J Herget, Jehangir J Appoo
OBJECTIVES: Distal extent of repair in patients undergoing surgery for acute Type A aortic dissection (ATAAD) is controversial. Emerging hybrid techniques involving open and endovascular surgery have been reported in small numbers by select individual centres. A systematic review and meta-analysis was performed to investigate the outcomes following extended arch repair for ATAAD. A classification system is proposed of the different techniques to facilitate discussion and further investigation...
December 31, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28025311/operative-results-of-the-anterolateral-thoracotomy-with-partial-sternotomy-approach-for-chronic-type-b-aortic-dissection-involving-the-aortic-arch
#3
Gaku Uchino, Keiji Yunoki, Naoya Sakoda, Shigeru Hattori, Takuya Kawabata, Munehiro Saiki, Yasufumi Fujita, Kunikazu Hisamochi, Hideo Yoshida, Osamu Oba
OBJECTIVES: There are various treatment strategies for chronic-type B aortic dissection involving the aortic arch. Our aim was to review our surgical experience in the anterolateral thoracotomy with the partial sternotomy approach for chronic-type B aortic dissection involving the aortic arch. METHODS: From January 2000 to October 2015, 39 patients underwent the single-stage open surgery for chronic-type B aortic dissection involving the aortic arch using the anterolateral thoracotomy with partial sternotomy approach...
December 26, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28018832/limited-distal-arch-open-stenting-for-type-b-aortic-dissection-with-an-enlarged-ulcer-like-projection-complicated-by-abdominal-aortic-occlusion
#4
Mitsumasa Hata, Kenji Akiyama, Yukihiko Orime
A 79-year-old man underwent bifurcated graft replacement for abdominal aortic aneurysm, but the graft was totally occluded owing to an acute type B aortic dissection. We could not have access to the root for performing endovascular stenting for dissecting aneurysm. Furthermore, it was difficult to remove the aneurysm via a left thoracotomy because it was impossible to perfuse the lower body with blood from the femoral artery and also a left axillary arterial cannulation was unusable. Herein, we report a patient who was successfully treated with open surgical aortic stenting for an enlarged ulcer-like projection complicated by a type B aortic dissection...
December 2016: Thoracic and Cardiovascular Surgeon Reports
https://www.readbyqxmd.com/read/28018831/endovascular-and-operative-treatment-of-the-aortic-arch-in-a-high-risk-marfan-patient
#5
Marwan Hamiko, Matthias Endlich, Wolfgang Schiller, Armin Welz, Georg Nickenig, Chris Probst
In this case, we describe a combined endovascular and operative management for aortic arch repair in a 57-year-old Marfan patient with complex aortic arch geometry previously treated with several open surgeries for acute type A dissection. The patient, who was presented to our department with dorsal pain, deemed to be at high operative risk for another open aortic surgery due to massive aortic calcification. It is an unusual method of placing a custom-made stent-graft system in the false aortic lumen with operative and endovascular treatment of the supra-aortic vessels...
December 2016: Thoracic and Cardiovascular Surgeon Reports
https://www.readbyqxmd.com/read/28017277/outcomes-after-surgery-for-acute-type-a-aortic-dissection-in-non-marfan-syndrome-patients-with-long-life-expectancy-a-24-year-follow-up
#6
Alessandro Piccardo, Tommaso Regesta, Alexandre Le Guyader, Nicola Di Lorenzo, François Bertin, Francis Pesteil, Elisabeth Cornu
BACKGROUND: Long-term survival and risk of reoperation in "non-Marfan syndrome" patients with a long life expectancy who undergo emergency surgery for acute type A aortic dissection (aTAAD) are not well known. AIM: To analyse survival, risk of reoperation and quality of life in this population. METHODS: From 1990 to 2010, all patients aged≤50 years and not affected by Marfan syndrome, who underwent emergency surgery for aTAAD at two institutions, were included in this analysis...
December 21, 2016: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/27996995/-acute-aortic-dissection-type-a-from-the-past-to-the-present
#7
Claudio F Russo, Giovanni Mariscalco, Pasquale Santé
Acute aortic dissection type A (AADA) is a disease that has a catastrophic impact on a patient's life. Although refinements in perioperative and surgical care have translated into improved outcomes for patients affected by AADA, hospital mortality after surgery still remains very high, ranging from 15% to 30%. The management of AADA is complex and dictated by the modality of presentation, extent and location of the disease. Attempts to formulate consensus statements and relevant guidelines have identified significant gaps in the AADA knowledge with reference to pathogenesis, appropriate management and configuration for clinical services...
November 2016: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/27964919/clinical-outcomes-of-the-david-v-valve-sparing-root-replacement-compared-with-bioprosthetic-valve-conduits-for-aortic-root-aneurysms
#8
Jiro Esaki, Bradley G Leshnower, Jose N Binongo, Yi Lasanajak, LaRonica McPherson, Michael E Halkos, Robert A Guyton, Edward P Chen
BACKGROUND: Valve-sparing root replacement (VSRR) is an established therapy for aortic root pathology. Limited insight exists when the results of VSRR are compared with those of conventional root replacement with use of a bioprosthetic composite conduit (BIO). This study compares the operative and midterm results of VSRR and BIO. METHODS: A retrospective review from 2002 to 2015 at a United States academic center identified 282 patients who underwent VSRR and 425 patients who underwent BIO...
December 10, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27955909/cardiovascular-operations-for-loeys-dietz-syndrome-intermediate-term-results
#9
Nishant D Patel, Todd Crawford, J Trent Magruder, Diane E Alejo, Narutoshi Hibino, James Black, Harry C Dietz, Luca A Vricella, Duke E Cameron
OBJECTIVES: Early experience with Loeys-Dietz syndrome (LDS) suggested an aggressive aortopathy with high risk of aneurysm dissection and rupture at young ages and at smaller aortic diameters than in other connective tissue disorders. We reviewed our experience with LDS to re-examine our indications and outcomes of surgical management. METHODS: We reviewed all patients with a diagnosis of LDS who underwent cardiovascular surgery at our institution. The primary endpoint was mortality, and secondary endpoints included postoperative complications and need for reintervention...
November 16, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27932024/postoperative-myocardial-infarction-in-acute-type-a-aortic-dissection-a-report-from-the-international-registry-of-acute-aortic-dissection
#10
Stephen D Waterford, Marco Di Eusanio, Marek P Ehrlich, T Brett Reece, Nimesh D Desai, Thoralf M Sundt, Truls Myrmel, Thomas G Gleason, Alberto Forteza, Carlo de Vincentiis, Anthony W DiScipio, Daniel G Montgomery, Kim A Eagle, Eric M Isselbacher, Anja Muehle, Aamir Shah, Daisy Chou, Christoph A Nienaber, Ali Khoynezhad
OBJECTIVE: Postoperative myocardial infarction remains a serious complication in cardiac surgery. The incidence and impact of this condition in acute type A aortic dissection are poorly understood. METHODS: A total of 1445 patients with acute type A aortic dissection who underwent surgery were enrolled in the International Registry of Acute Aortic Dissection from 1996 to 2013. Individuals with preoperative myocardial infarction at hospital presentation and a history of myocardial infarction were excluded...
November 14, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27890843/total-endovascular-aortic-repair-in-a-patient-with-marfan-syndrome
#11
Mau Amako, Rafaëlle Spear, Rachel E Clough, Adrien Hertault, Richard Azzaoui, Teresa Martin-Gonzalez, Jonathan Sobocinski, Stéphan Haulon
BACKGROUND: The aim of this study is to describe a total endovascular aortic repair with branched and fenestrated endografts in a young patient with Marfan syndrome and a chronic aortic dissection. Open surgery is the gold standard to treat aortic dissections in patients with aortic disease and Marfan syndrome. METHODS: In 2000, a 38-year-old man with Marfan syndrome underwent open ascending aorta repair for an acute type A aortic dissection. One year later, a redo sternotomy was performed for aortic valve replacement...
November 24, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27885195/evaluation-and-influence-of-brachiocephalic-branch-re-entry-in-patients-with-type-a-acute-aortic-dissection
#12
Shota Yasuda, Kiyotaka Imoto, Keiji Uchida, Norihisa Karube, Tomoyuki Minami, Motohiko Goda, Shinichi Suzuki, Munetaka Masuda
BACKGROUND: Stanford type A acute aortic dissection (A-AAD) extends to the brachiocephalic branches in some patients. After ascending aortic replacement, a remaining re-entry tear in the distal brachiocephalic branches may act as an entry and result in a patent false lumen in the aortic arch. However, the effect of brachiocephalic branch re-entry concomitant with A-AAD remains unknown.Methods and Results:Eighty-five patients with A-AAD who underwent ascending aortic replacement in which both preoperative and postoperative multiple-detector computed tomography (MDCT) scans could be evaluated were retrospectively studied...
December 22, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/27883977/age-related-changes-of-thoracic-aorta-geometry-used-to-predict-the-risk-for-acute-type-b-dissection
#13
Damian Craiem, Salma El Batti, Mariano E Casciaro, Elie Mousseaux, Marie-Emmanuelle Sirieix, Alain Simon, Jean-Marc Alsac
AIMS: Risk models that use a single aortic diameter threshold have failed to successfully predict acute type B aortic dissection (TBAD). We sought to identify meaningful age-indexed anatomical variables to predict TBAD risk. METHODS AND RESULTS: A geometric deformable model, consisting of virtual elastic balloons that inflate inside a vessel lumen, was developed to quantify thoracic aorta geometry. In the presence of TBAD, true and total artery lumen morphology were assessed...
February 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27882488/quantification-of-motion-of-the-thoracic-aorta-after-ascending-aortic-repair-of-type-a-dissection
#14
Ga-Young Suh, Dominik Fleischmann, Ramin E Beygui, Christopher P Cheng
PURPOSE: To quantify cardiac and respiratory deformations of the thoracic aorta after ascending aortic graft repair. METHODS: Eight patients were scanned with cardiac-resolved computed tomography angiography during inspiratory/expiratory breath-holds. Aortic centerlines and lumen were extracted to compute the arclength, curvature, angulation, and cross-section shape. RESULTS: From systole to diastole, the angle of graft [Formula: see text] arch increased by 2...
November 23, 2016: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/27881689/acute-type-a-aortic-dissection-treated-using-a-tubular-stent-graft-in-the-ascending-aorta-and-a-multibranched-stent-graft-in-the-aortic-arch
#15
Tilo Kölbel, Christian Detter, Sebastian W Carpenter, Fiona Rohlffs, Yskert von Kodolitsch, Sabine Wipper, Herrmann Reichenspurner, E Sebastian Debus, Nikolaos Tsilimparis
PURPOSE: To describe the combined use of a tubular stent-graft for the ascending aorta and an inner-branched arch stent-graft for patients with acute type A aortic dissection. TECHNIQUE: The technique to deploy these modular, custom-made stent-grafts is demonstrated in 2 patients with acute DeBakey type I aortic dissections and significant comorbidities precluding open surgery. Both emergent procedures were made possible by the availability of suitable devices manufactured for elective repair in other patients...
November 23, 2016: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/27874962/analysis-of-risk-factors-of-type-a-aortic-dissection-taad-operation-of-frozen-elephant-trunk-and-total-arch-replacement
#16
W Shang, M Ma, Y-P Ge, N Liu, J-M Zhu, L-Z Sun
OBJECTIVE:  To investigate the incidence and risk factors of acute renal failure (ARF) after operation of frozen elephant trunk and total arch replacement for acute thoracic aortic aneurysm and dissection (TAAD) with mild hypothermic circulatory arrest (MHCA), and to analyze the long-term survival rate of the patients with ARF. PATIENTS AND METHODS: From February 2009 to March 2015, patients with acute TAAD accepted operation of frozen elephant trunk and total arch replacement were enrolled...
November 2016: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/27866026/survival-and-cardiovascular-events-after-coarctation-repair-in-long-term-follow-up-coafu-predictive-value-of-clinical-variables
#17
P Bambul Heck, J Pabst von Ohain, H Kaemmerer, P Ewert, A Hager
OBJECTIVE: Long-term sequelae and events after coarctation repair are well described. However, the predictive value of variables from clinical follow-up investigation for late events and survival has rarely been investigated. METHODS: All patients who participated in the prospective cross-sectional COALA Study in 2000 with a structural clinical investigation including blood pressure measurement and symptom-limited exercise test were contacted for reevaluation of survival, current clinical status and major cardiovascular events...
February 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27845304/partial-aortic-root-remodeling-for-root-reconstruction-in-patients-with-acute-type-a-dissection
#18
Fuhua Huang, Liangpeng Li, Wei Qin, Cunhua Su, Liming Wang, Liqiong Xiao, Xin Chen
In the present study, we reported our experience with partial aortic root remodeling for root reconstruction in patients with acute type A dissection, which involves in non-coronary sinus and/or the right coronary sinus with just one trimmed Dacron graft. Between February 2001 and May 2010, we performed partial aortic root remodeling in 40 patients, who underwent emergency surgical intervention. The dissected sinuses were excised leaving a 3-5 mm rim of the aortic wall from the attached aortic valve cusps. A short piece (4-5 cm) of collagen coated woven polyester vascular prosthesis was trimmed with one or two "tongues" to reconstruct the non-coronary sinus and/or the right coronary sinus, but without using separated patches...
September 2016: Journal of Biomedical Research
https://www.readbyqxmd.com/read/27824871/aortic-and-cardiac-structure-and-function-using-high-resolution-echocardiography-and-optical-coherence-tomography-in-a-mouse-model-of-marfan-syndrome
#19
Ling Lee, Jason Z Cui, Michelle Cua, Mitra Esfandiarei, Xiaoye Sheng, Winsey Audrey Chui, Michael Haoying Xu, Marinko V Sarunic, Mirza Faisal Beg, Cornelius van Breemen, George G S Sandor, Glen F Tibbits
Marfan syndrome (MFS) is an autosomal-dominant disorder of connective tissue caused by mutations in the fibrillin-1 (FBN1) gene. Mortality is often due to aortic dissection and rupture. We investigated the structural and functional properties of the heart and aorta in a [Fbn1C1039G/+] MFS mouse using high-resolution ultrasound (echo) and optical coherence tomography (OCT). Echo was performed on 6- and 12-month old wild type (WT) and MFS mice (n = 8). In vivo pulse wave velocity (PWV), aortic root diameter, ejection fraction, stroke volume, left ventricular (LV) wall thickness, LV mass and mitral valve early and atrial velocities (E/A) ratio were measured by high resolution echocardiography...
2016: PloS One
https://www.readbyqxmd.com/read/27823595/status-of-branched-grafts-for-thoracic-aortic-arch-endovascular-repair
#20
REVIEW
W Anthony Lee
The aortic arch is one of the most anatomically complex segments of the thoracoabdominal aorta due the plurality of vital branch configurations, intrinsic and highly variable three-dimensional curvature, and involvement in a variety of thoracic aortic pathologies, such as aneurysmal degeneration, penetrating ulcer, and media wall dissection. Pathologies that extend the repair proximal to the left common carotid artery require more complex branch vessel management beyond a carotid-subclavian bypass. This article will review the current status of branched aortic arch endografts...
March 2016: Seminars in Vascular Surgery
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