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Aortic arch dissection

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https://www.readbyqxmd.com/read/28547783/aortic-arch-origin-of-the-left-vertebral-artery-an-anatomical-and-radiological-study-with-significance-for-avoiding-complications-with-anterior-approaches-to-the-cervical-spine
#1
Gabrielle G Tardieu, Bryan Edwards, Fernando Alonso, Koichi Watanabe, Tsuyoshi Saga, Moriyoshi Nakamura, Mayuko Motomura, Raghu Sampath, Joe Iwanaga, Oded Goren, Stephen Monteith, Rod J Oskouian, Marios Loukas, R Shane Tubbs
INTRODUCTION: Complications from anterior approaches to the cervical spine are uncommon with normal anatomy. However, variant anatomy might predispose one to an increased incidence of injury during such procedures. We hypothesized that left vertebral arteries that arise from the aortic arch instead of the subclavian artery might take a more medial path in their ascent making them more susceptible to iatrogenic injury. MATERIALS AND METHODS: Fifty human adult cadavers were examined for left vertebral arteries having an aortic arch origin and these were dissected along their entire cervical course...
May 25, 2017: Clinical Anatomy
https://www.readbyqxmd.com/read/28546044/endovascular-repair-of-thoraco-abdominal-and-arch-aneurysms-in-patients-with-connective-tissue-disease-using-branched-and-fenestrated-devices
#2
Rachel E Clough, Teresa Martin-Gonzalez, Katrien Van Calster, Adrien Hertault, Rafaëlle Spear, Richard Azzaoui, Jonathan Sobocinski, Stéphan Haulon
INTRODUCTION: Prophylactic open surgery is the standard practice in patients with connective tissue and thoraco-abdominal (TAAA) and aortic arch disease. Branched and fenestrated devices offer a less invasive alternative but there are concerns regarding the durability of the repair and the effect of the stent graft on the fragile aortic wall. The aim of this study was to evaluate mid-term outcomes of fenestrated and/or branched endografting in patients with connective tissue disease. METHODS: All patients with connective tissue disease that underwent TAAA or arch aneurysm repair using a fenestrated and/or branched endograft in a single high volume centre between 2004 and 2015 were included...
May 22, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28544831/aortic-root-surgery-in-marfan-syndrome-medium-term-outcome-in-a-single-center-experience
#3
Christine H Attenhofer Jost, Heidi M Connolly, Christopher G Scott, Naser M Ammash, Juan M Bowen, Hartzell V Schaff
BACKGROUND: The study aim was to analyze the authors' experience with aortic root surgery in Marfan syndrome (MFS), and to expand the surgical outcome data of patients meeting the Ghent criteria (Marfan registry). METHODS: Analyses were performed of data acquired from MFS patients (who met the Ghent criteria), including an aortic root surgery and Kaplan-Meier survival. RESULTS: Between April 2004 and February 2012, a total of 59 MFS patients (mean age at surgery 36 ± 13 years) underwent 67 operations for aortic root aneurysm (n = 52), aortic valve (AV) regurgitation (n = 15), acute aortic dissection (n = 2), and/or mitral valve (MV) regurgitation resulting from MV prolapse (n = 7)...
January 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28541520/cardiovascular-surgery-in-loeys-dietz-syndrome-types-1-4
#4
Kirsten Krohg-Sørensen, Per Snorre Lingaas, Runar Lundblad, Egil Seem, Benedicte Paus, Odd R Geiran
OBJECTIVES: The first publication of Loeys-Dietz syndrome (LDS) described aortic rupture at young ages. Experience with new LDS types showed that the clinical course varies, and thresholds for prophylactic surgery are discussed. As this is an uncommon disease, experience needs to be shared. METHODS: Retrospective review of patients with LDS types 1-4 undergoing cardiovascular surgery during the years 1991-2016. RESULTS: Thirty-five patients (including 6 children with LDS2) underwent 57 operations...
May 24, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28540313/central-vascular-complications-following-elective-catheterization-using-transradial-percutaneous-coronary-intervention
#5
Julia Merkle, Christopher Hohmann, Anton Sabashnikov, Thorsten Wahlers, Jens Wippermann
Percutaneous coronary intervention is commonly used to treat coronary artery disease. Both transradial and transfemoral approaches are applied. In general, fewer complications are seen with the transradial approach compared to the transfemoral access, for which reason the transradial catheterization is frequently preferred. In this case presentation, we describe 2 cases of elective transradial coronary angiography both resulting in severe central vascular complications: perforation of the right subclavian artery with a mediastinal hematoma and dissection of the brachio-cephalic trunk and the aortic arch...
January 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28535731/transcervical-carotid-stent-placement-in-the-setting-of-a-hostile-neck-and-a-type-iii-aortic-arch
#6
Lauren A Huntress, Naiem Nassiri, Randy Shafritz, Saum A Rahimi
Previous radical neck dissection and neck irradiation pose considerable operative risks in patients requiring carotid endarterectomy for symptomatic carotid disease. Carotid stenting is an acceptable alternative for these patients but carries a higher risk of cerebrovascular accidents especially in patients with type III aortic arch anatomy. Herein, we present a technically challenging case of a patient with an irradiated neck and a history of radical neck dissection who presented with a symptomatic high-grade left internal carotid artery stenosis in the setting of a type III aortic arch...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28528045/endovascular-fenestration-for-distal-aortic-sealing-after-frozen-elephant-trunk-with-thoraflex
#7
Randolph H L Wong, Peter S Y Yu, Micky W T Kwok, Simon C Y Chow, Jacky Y K Ho, Malcolm J Underwood, Simon C H Yu
We describe a case of total arch replacement with frozen elephant trunk for chronic type B aortic dissecting aneurysm, which resulted in inadvertent landing of the frozen elephant trunk into the false lumen. A radiofrequency puncture system-assisted controlled endovascular fenestration of the dissection flap was performed at the upper abdominal aorta and subsequent thoracic endovascular stenting, successfully redirecting the blood flow from the false to the true lumen. Our case illustrated a possible way to seal distal reentry in chronic type B aortic dissection...
June 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28523430/long-term-durability-of-preserved-aortic-root-after-repair-of-acute-type-a-aortic-dissection
#8
Keiji Kamohara, Shugo Koga, Jun Takaki, Nozomi Yoshida, Kojiro Furukawa, Shigeki Morita
BACKGROUND: Optimal management of aortic root in type A aortic dissection (AAD) is controversial. To determine the most appropriate strategy, we studied the late outcomes after conservative repair of aortic root. METHODS: 234 AAD patients (mean age 68 ± 12 years) underwent surgical repair using supracommissural replacement (SCR) for aortic root reconstruction from 1989 to 2014. Ascending aortic replacement or hemi-arch replacement was performed in 180 patients (non-arch group), whereas total arch replacement (TAR) was performed in 54 patients...
May 18, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28523169/risk-factors-for-continuous-renal-replacement-therapy-after-surgical-repair-of-type-a-aortic-dissection
#9
Hai-Bo Wu, Wei-Guo Ma, Hong-Lei Zhao, Jun Zheng, Jian-Rong Li, Ou Liu, Li-Zhong Sun
BACKGROUND: To identify the risk factors for continuous renal replacement therapy (CRRT) following surgical repair of type A aortic dissection (TAAD) using the total arch replacement and frozen elephant trunk (TAR + FET) technique. METHODS: The study included 330 patients with TAAD repaired using TAR + FET between January 2014 and April 2015. Mean age was 47.1±10.2 years (range, 18-73 years) and 242 were male (73.3%). Univariate and multivariate analyses were used to identify the risk factors for CRRT...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28516101/early-spontaneous-resolution-of-an-iatrogenic-acute-type-a-aortic-dissection
#10
Mohammad A Zafar, Philip Y K Pang, Glen A Henry, Bulat A Ziganshin, Maryann Tranquilli, John A Elefteriades
Acute aortic dissection is a rare but devastating complication during cardiac catheterization. We present the case of an elderly female who incurred a Stanford Type A/DeBakey Type I acute aortic dissection extending into the arch vessels and descending aorta likely occurring during right coronary artery engagement for angioplasty. The patient was treated successfully by immediately sealing the entrance of the dissection via the placement of a stent and anti-impulse therapy. Follow-up computed tomography scan showed complete resolution of the dissection within one month...
December 2016: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/28516099/conservative-management-of-extensive-iatrogenic-aortic-dissection
#11
Derrick Y Tam, Amine Mazine, Asim N Cheema, Bobby Yanagawa
Iatrogenic aortic dissection (IAD) is a rare complication of percutaneous coronary interventions (PCI). There are no clear guidelines for IAD management, and limited data are available. Registry data and case series combined with extrapolations from our experience with spontaneous Type-A dissections suggest that very limited dissections are often managed conservatively with coronary stenting of the entry tear when possible, while more extensive dissections are managed surgically. We present a case report of a 50-year-old woman who underwent PCI for an ST-elevation myocardial infarction that resulted in an extensive IAD from the ostium of the right coronary artery to the aortic root, ascending aorta, and aortic arch...
December 2016: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/28502544/first-experience-with-the-double-chimney-technique-in-the-treatment-of-aortic-arch-diseases
#12
Tun Wang, Chang Shu, Quan-Ming Li, Ming Li, Xin Li, Hao He, Alan Dardik, Jian Qiu
OBJECTIVE: The objective of this study was to summarize our initial experience using the double chimney technique to treat aortic arch diseases. METHODS: From December 2009 to October 2016, 23 patients with aortic arch diseases, including 20 acute aortic dissections, 2 aortic arch aneurysms, and 1 type I endoleak after thoracic endovascular aortic repair (TEVAR), were treated using a double chimney technique. An emergent operation was performed in only one patient with an acute aortic dissection for severe left lower extremity ischemia...
May 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28496083/-retrograde-type-a-aortic-dissection-after-thoracic-endovascular-aortic-repair-report-of-a-case
#13
Sei Morizumi, Takafumi Inoue, Satoshi Nishi, Akihiro Yoshimoto, Masashi Fujisaki, Yoshihiro Suematsu
A 72-year-old man presented with aneurysms of the distal aortic arch and the distal descending aorta due to chronic type B aortic dissection. We first performed thoracic endovascular aortic repair (TEVAR) in the distal descending aorta, and the aneurysm was successfully excluded using a Gore Tag stentgraft. Seven days after TEVAR, computed tomography revealed retrograde type A aortic dissection occurring from the ascending aorta to the distal aortic arch. In emergency surgery, ascending aorta and total arch replacement were performed under selective cerebral perfusion with moderate hypothermia, and after coming off cardiopulmonary bypass, the distal aortic arch aneurysm was excluded using a Gore Tag stentgraft...
May 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28486683/comparison-of-endovascular-repair-with-branched-stent-graft-and-open-repair-for-aortic-arch-aneurysm%C3%A2
#14
Masahide Kawatou, Kenji Minakata, Kazuhisa Sakamoto, Taro Nakatsu, Junichi Tazaki, Hirooki Higami, Kyokun Uehara, Kazuhiro Yamazaki, Kanji Inoue, Takeshi Kimura, Ryuzo Sakata
OBJECTIVES: Although conventional open repair is our preference for patients with aortic arch aneurysms, we have often chosen thoracic endovascular aneurysm repair (TEVAR) with a handmade branched stent graft (bTEVAR) in high-risk patients. The aim of this study was to compare the midterm clinical outcomes of our bTEVAR technique to those of the open repair. METHODS: Between January 2007 and December 2014, we treated 129 patients with aortic arch aneurysm by means of either conventional open repair (OPEN, n  = 61) or bTEVAR ( n  = 68) at our institution...
May 8, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28482739/absent-right-common-carotid-artery-associated-with-aberrant-right-subclavian-artery
#15
Akira Uchino, Kazuhiko Uwabe, Iichiro Osawa
Rarely, the external and internal carotid arteries arise separately from the brachiocephalic trunk and right subclavian artery (SA) or the aortic arch and reflect the absence of a common carotid artery (CCA). We report a 45-year-old man with absent right CCA associated with aberrant right SA, an extremely rare combination, diagnosed by computed tomography (CT) angiography during follow-up for postoperative aortic dissection. Retrospective careful observation of preoperative postcontrast CT revealed the absent right CCA...
January 1, 2017: Neuroradiology Journal
https://www.readbyqxmd.com/read/28479468/a-ten-year-experience-using-a-hybrid-endovascular-approach-to-treat-aberrant-subclavian-arterial-aneurysms
#16
Mathew Wooster, Martin Back, Danielle Sutzko, Hollie Gaeto, Paul Armstrong, Murray Shames
BACKGROUND: To describe a single center experience using combined extra-anatomic open arch branch revascularization with aortic arch endovascular exclusion for treatment of aberrant subclavian artery aneurysms. METHODS: All patients undergoing management of aberrant subclavian aneurysms were identified from a prospective patient registry. Means of revascularization included carotid-subclavian bypass or subclavian transposition and origin occlusion was performed by surgical ligation or endovascular embolization at surgeon discretion...
May 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28474978/angiographic-analysis-of-vascular-integrity-after-percutaneous-closure-using-prostar-xl-device-during-transcatheter-aortic-valve-implantation
#17
Fabien Lareyre, Juliette Raffort, Carine Dommerc, Mohamed Benhammamia, François Bourlon, Yacoub Habib, Claude Mialhe
INTRODUCTION: Percutaneous closure devices are commonly used to achieve hemostasis during endovascular procedures including transcatheter aortic valve implantation (TAVI). The aim of our study was to investigate the quality of the percutaneous femoral arterial closure by Prostar XL device using a systematic peroperative angiographic control at the end of TAVI procedure. MATERIALS AND METHODS: Two hundred seventeen consecutive patients (mean age: 84 [6.5]; 112 women and 105 men) undergoing TAVI with percutaneous transfemoral access were prospectively registered in our center...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28473436/dba-2j-haplotype-on-distal-chromosome-2-reduces-mertk-expression-restricts-efferocytosis-and-increases-susceptibility-to-atherosclerosis
#18
Yukako Kayashima, Natalia Makhanova, Nobuyo Maeda
OBJECTIVE: Arch atherosclerosis 4 (Aath4) is a quantitative trait locus for atherosclerotic plaque formation in the inner curve of the aortic arch previously identified in an F2 cross of Apoe(-/-) mice on DBA/2J and 129S6 backgrounds. Mertk, coding for a ligand-activated transmembrane tyrosine kinase, is a candidate gene within the same chromosomal region. Our objective was to determine whether strain differences in Mertk influence plaque formation. APPROACH AND RESULTS: To dissect the strain effects of Mertk on atherosclerosis, we first established a congenic mouse line (Aath4a(DBA/DBA) ) in which a 5' region of Aath4 of DBA/2J, including Mertk, was backcrossed onto a 129S6-Apoe(-/-) background...
May 4, 2017: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/28468757/relationship-between-fibrillin-1-genotype-and-severity-of-cardiovascular-involvement-in-marfan-syndrome
#19
Romy Franken, Gisela Teixido-Tura, Maria Brion, Alberto Forteza, Jose Rodriguez-Palomares, Laura Gutierrez, David Garcia Dorado, Gerard Pals, Barbara Jm Mulder, Artur Evangelista
BACKGROUND: The effect of FBN1 mutation type on the severity of cardiovascular manifestations in patients with Marfan syndrome (MFS) has been reported with disparity results. OBJECTIVES: This study aims to determine the impact of the FBN1 mutation type on aortic diameters, aortic dilation rates and on cardiovascular events (ie, aortic dissection and cardiovascular mortality). METHODS: MFS patients with a pathogenic FBN1 mutation followed at two specialised units were included...
May 3, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28449459/endovascular-repair-of-residual-intimal-tear-or-distal-new-entry-after-frozen-elephant-trunk-for-type-a-aortic-dissection
#20
Xu-Dong Pan, Bin Li, Wei-Guo Ma, Jun Zheng, Yong-Min Liu, Jun-Ming Zhu, Lian-Jun Huang, Li-Zhong Sun
BACKGROUND: In patients with type A dissection, residual dissection and new distal entry tears following the frozen elephant trunk (FET) procedure adversely affect long-term prognosis. Management include open and endovascular repair, while clinical experience is limited. We evaluate the efficacy of thoracic endovascular aortic repair (TEVAR) in management of residual intimal tear or distal new entry tear following FET in patients with type A aortic dissection (TAAD). METHODS: Between May 2003 and April 2013, we performed FET and total arch replacement for 1,003 patients with TAAD...
March 2017: Journal of Thoracic Disease
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