keyword
https://read.qxmd.com/read/38420648/should-we-operate-on-patients-with-acute-type-a-aortic-dissection-who-present-with-cardiopulmonary-resuscitation
#21
JOURNAL ARTICLE
Erik Beckmann, Andreas Martens, Heike Krueger, Wilhelm Korte, Pamila Shrestha, Tim Kaufeld, Malakh Shrestha
OBJECTIVES: Acute aortic dissection type A (AADA) is a life-threatening medical emergency. Emergent surgical repair is the gold standard but mortality remains high. Mortality is even higher in patients who arrive at the hospital in poor condition, especially after cardiopulmonary resuscitation (CPR). This study was designed to analyze the outcome of patients who underwent surgery for AADA and who require preoperative CPR. METHODS: Between 2000 and 2023, 810 patients underwent emergent surgery for AADA at our center...
February 28, 2024: European Journal of Cardio-thoracic Surgery
https://read.qxmd.com/read/38420535/aortic-remodeling-following-hybrid-arch-repair-with-zone-0-to-5-thoracic-endovascular-aortic-repairs-for-complex-arch-and-descending-thoracic-aortic-pathologies
#22
JOURNAL ARTICLE
Irbaz Hameed, Adham Ahmed, Stevan Pupovac, Naiem Nassiri, Roland Assi, Prashanth Vallabhajosyula
OBJECTIVE: For high-risk patients with aortic arch pathology, hybrid aortic arch repair with simultaneous or staged thoracic endovascular repair of the descending aorta may be a viable alternative to open repair. However, data on postintervention aortic remodeling remain limited. We report the short-term outcomes of remodeling of the thoracoabdominal aorta after hybrid arch repair + thoracic endovascular repair. METHODS: All patients undergoing hybrid arch repair with planned zones 0 to 5 thoracic endovascular repair from January 2020 to March 2022 were retrospectively reviewed...
February 2024: JTCVS open
https://read.qxmd.com/read/38414233/midterm-outcomes-of-multicenter-castor-single-branch-stent-graft-use-in-the-treatment-of-thoracic-aortic-diseases
#23
JOURNAL ARTICLE
Jianli Ren, Yonghui Chen, Erdemutu E, Ming Ma, Zongwei Liu, Jiechang Zhu, Shuaishuai Wang, Jiaxue Bi, Peng Li, Xiangchen Dai
PURPOSE: The aim of this study was to evaluate the midterm efficacy and safety of a single-branch Castor stent graft in the treatment of thoracic aortic disease. MATERIALS AND METHODS: Clinical data of 106 patients with thoracic aortic disease treated with Castor single-branch stent graft at 3 centers were collected between May 2018 and June 2023. The indicators included technical success, stent-related complication, reintervention, retrograde dissection, endoleak, distal stent graft-induced entry (dSINE), branch patency, and mortality...
February 27, 2024: Journal of Endovascular Therapy
https://read.qxmd.com/read/38404656/use-of-veno-venous-extracorporeal-membrane-oxygenation-for-stabilization-prior-to-redo-sternotomy-for-aortic-pseudoaneurysm-repair
#24
Anson Y Lee, Emily L Larson, Ifeanyi D Chinedozi, Jennifer S Lawton, Hamza Aziz
Background: Aortic pseudoaneurysms are particularly dangerous because of the risk of rupture and compression of mediastinal structures, including the trachea, and resultant respiratory distress. If respiratory distress progresses to respiratory failure, extracorporeal membrane oxygenation may be used to provide oxygenation prior to or during pseudoaneurysm repair. Case presentation: A 62-year-old male with a history of emergent aortic ascending and arch replacement for Stanford Type A dissection 10 months prior presented to his primary care physician with dyspnea...
January 3, 2024: Global Cardiology Science & Practice
https://read.qxmd.com/read/38403183/distal-repair-after-total-aortic-arch-replacement-with-frozen-elephant-trunk-in-patients-with-chronic-multilevel-thoracic-aortic-disease
#25
JOURNAL ARTICLE
Robert-James Doonan, Eshan Senanayake, Martin Claridge, Maciej Juszczak, Francesco Torella, Jorge Mascaro, Mark Field, Donald J Adam
OBJECTIVE: To examine the management of distal aortic disease after total arch replacement with the frozen elephant trunk (TAR + FET) in patients with chronic thoracic aortic disease. METHODS: Two centre retrospective study of consecutive patients treated between January 2010 and December 2019. Primary endpoint was 30 day/in hospital mortality. Secondary end point was mid-term survival. Data are presented as median (IQR). Chi squared or Fisher's exact test was used as appropriate...
February 23, 2024: European Journal of Vascular and Endovascular Surgery
https://read.qxmd.com/read/38398265/late-post-dissection-dynamic-intermittent-malperfusion-of-the-aortic-arch-in-association-with-a-rare-heterogenous-lox-gene-variation
#26
Barbara Leclercq, Julien Bertolino, Alexandre Rossillon, Vlad Gariboldi, Sarah El Harake, François Silhol, Michel Bartoli, Bernard Vaisse, Axel Bartoli, Gabrielle Sarlon-Bartoli
Late ischaemic consequences of type A aortic dissection are rare. We present a 6-year late complication of type A aortic dissection treated by Bentall surgery in a 41-year-old patient. The patient presented with several episodes of lipothymia associated with hypertensive attacks with anisotension, cervicalgia, hemicranial headache, abdominal pain and lower limb slipping initially on exertion and later at rest. On dynamic examination, we diagnosed an intermittent dynamic occlusion of the aortic arch and rare LOX gene variation, which is considered to be associated with aneurysm or dissection of the ascending aorta in young patients...
February 7, 2024: Journal of Clinical Medicine
https://read.qxmd.com/read/38391289/thoracic-aortic-aneurysms-a-single-center-s-10-years-experience-and-analysis-of-outcomes
#27
JOURNAL ARTICLE
Leonor Baldaia, Mariana Duque, Miguel Silva, Eduardo Silva, Celso Nunes, Vânia Constâncio, Luís Orelhas, Manuel Fonseca, Luís F Antunes
INTRODUCTION: Thoracic aortic aneurysms (TAAs) are an increasingly prevalent pathology with significant associated morbidity and mortality. Thoracic endovascular aortic repair (TEVAR) is the primary line of treatment. The purpose of this study was to analyse a single center's experience in the treatment of TAAs and identify possible risk factors for worse outcomes. METHODS: A retrospective review of our institutional database was done to identify all patients treated for TAAs in a 10-year period, from 1 January 2012 to 31 December 2022...
February 23, 2024: Vascular
https://read.qxmd.com/read/38390179/development-and-validation-of-a-prediction-model-for-postoperative-ischemic-stroke-following-total-arch-replacement-and-frozen-elephant-trunk-under-mild-hypothermia
#28
JOURNAL ARTICLE
Chao Deng, Hao Tang, Jingyu Li, Zhenxiong Li, Kangjun Shen, Zhiwei Zhang, Bo Jiang, Ling Tan
BACKGROUND: Early identification of postoperative ischemic stroke among patients with acute DeBakey type I aortic dissection (ADIAD) is of great significance to taking timely effective treatment. We aimed to develop and validate a prediction model for postoperative ischemic stroke in ADIAD patients who underwent total arch replacement (TAR) and frozen elephant trunk (FET) under mild hypothermia. METHODS: ADIAD patients who underwent TAR and FET between January 2017 and April 2023 were enrolled in our study...
February 29, 2024: Heliyon
https://read.qxmd.com/read/38389763/stanford-type-b-aortic-dissection-in-a-patient-with-aberrant-right-subclavian-artery
#29
Chellasamy Rajeev Thilak, Mohammed Idhrees, Mohammed Ibrahim, Arumugam Arunkumar, Bashi Velayudhan
An aberrant right subclavian artery is a rare aortic arch anomaly where the right subclavian artery arises from the proximal part of the descending thoracic aorta and distal to origin of left subclavian artery. It usually courses behind the esophagus. Type B aortic dissection along with aberrant right subclavian artery is not common. A middle-aged man presented with complaints of epigastric pain and on evaluation was found to have aberrant right subclavian artery with type B aortic dissection. A total arch replacement with frozen elephant trunk surgery and an extra-anatomic bypass of right subclavian artery were performed...
March 2024: Indian Journal of Thoracic and Cardiovascular Surgery
https://read.qxmd.com/read/38387723/cannabidiol-protects-against-acute-aortic-dissection-by-inhibiting-macrophage-infiltration-and-pmaip1-induced-vascular-smooth-muscle-cell-apoptosis
#30
JOURNAL ARTICLE
Yilong Guo, Yang Che, Xuelin Zhang, Zongna Ren, Yinan Chen, Liliang Guo, Lin Mao, Ren Wei, Xiang Gao, Tao Zhang, Li Wang, Wei Guo
Acute aortic dissection (AAD) progresses rapidly and is associated with high mortality; therefore, there remains an urgent need for pharmacological agents that can protect against AAD. Herein, we examined the therapeutic effects of cannabidiol (CBD) in AAD by establishing a suitable mouse model. In addition, we performed human AAD single-cell RNA sequencing and mouse AAD bulk RNA sequencing to elucidate the potential underlying mechanism of CBD. Pathological assays and in vitro studies were performed to verify the results of the bioinformatic analysis and explore the pharmacological function of CBD...
February 20, 2024: Journal of Molecular and Cellular Cardiology
https://read.qxmd.com/read/38361588/obesity-and-acute-type-a-aortic-dissection-unraveling-surgical-outcomes-through-the-lens-of-the-upper-hemisternotomy-approach
#31
JOURNAL ARTICLE
Lin Xia, Yu Liu, Zhonglu Yang, Yuguang Ge, Lu Wang, Yejun Du, Hui Jiang
BACKGROUND: Acute type A aortic dissection (ATAAD) is a pressing cardiovascular emergency necessitating prompt surgical intervention. Obesity, a pervasive health concern, has been identified as a significant risk factor for ATAAD, introducing unique surgical challenges that can influence postoperative outcomes. This study aimed to investigate the outcomes of ATAAD surgery across various body mass index (BMI) categories, focusing on the implications of the upper hemisternotomy (UHS) approach...
2024: Frontiers in Cardiovascular Medicine
https://read.qxmd.com/read/38350554/early-outcomes-of-endovascular-repairs-of-the-aortic-arch-using-thoracic-branch-endoprosthesis
#32
JOURNAL ARTICLE
Haley J Pang, Andrew S Warren, Kirsten D Dansey, Christopher Burke, Scott DeRoo, Matthew P Sweet, Matthew Smith, Sara L Zettervall
OBJECTIVE: The only commercially available branched thoracic endoprosthesis (TBE) for treatment of the aortic arch was released in 2022. Limited data outside of clinical trial results have been reported. This study describes the demographics, anatomic details, and outcomes for patients treated for zone 0-2 using TBE outside of a clinical trial. METHODS: All patients treated using TBE for zone 0-2 were included. Patients treated as part of the clinical trial for zone 0-1 (6) were excluded...
February 11, 2024: Journal of Vascular Surgery
https://read.qxmd.com/read/38345901/cannula-placement-for-cerebral-protection-without-circulatory-arrest-in-patients-undergoing-hemiarch-aortic-aneurysm-repair
#33
JOURNAL ARTICLE
Joseph C Sweeney, Jaimin R Trivedi, Toyokazu Endo, Akhila Ankem, Siddharth V Pahwa, Mark S Slaughter, Brian L Ganzel
BACKGROUND: Aortic aneurysms involving the proximal aortic arch, which require hemiarch-type repair, typically require circulatory arrest with antegrade cerebral perfusion. Left carotid antegrade cerebral perfusion (LCP) via distal arch cannulation without circulatory arrest was used in this study's patient population. The goal was to assess the operative efficiency and clinical outcomes of using a distal arch cannulation technique that would not require any hypothermic circulatory arrest (HCA) time compared with more traditional brachiocephalic artery cannulation with right-sided unilateral antegrade cerebral perfusion (RCP) and HCA...
February 12, 2024: Texas Heart Institute Journal
https://read.qxmd.com/read/38341621/a-predictive-model-for-postoperative-adverse-outcomes-following-surgical-treatment-of-acute-type-a-aortic-dissection-based-on-machine-learning
#34
JOURNAL ARTICLE
Lin-Feng Xie, Yu-Ling Xie, Qing-Song Wu, Jian He, Xin-Fan Lin, Zhi-Huang Qiu, Liang-Wan Chen
Acute type A aortic dissection (AAAD) has a high probability of postoperative adverse outcomes (PAO) after emergency surgery, so exploring the risk factors for PAO during hospitalization is key to reducing postoperative mortality and improving prognosis. An artificial intelligence approach was used to build a predictive model of PAO by clinical data-driven machine learning to predict the incidence of PAO after total arch repair for AAAD. This study included 380 patients with AAAD. The clinical features that are associated with PAO were selected using the LASSO regression analysis...
February 11, 2024: Journal of Clinical Hypertension
https://read.qxmd.com/read/38335375/total-arch-replacement-via-single-upper-hemisternotomy-approach-for-aortic-aneurysm-in-syphilis-case-report
#35
JOURNAL ARTICLE
Lin Xia, Zhonglu Yang, Yu Liu, Yuguang Ge, Lu Wang, Hui Jiang
RATIONALE: Syphilitic aortic aneurysm is a relatively rare type of cardiovascular syphilis. A small number of patients with syphilitic aortic aneurysms will be accompanied by aortic regurgitation and coronary stenosis. Apart from aortic rupture or dissection, syphilitic aortic aneurysm often causes associated vascular disorders, including left common carotid artery, innominate artery, and celiac artery stenosis or obstruction. PATIENT CONCERNS: In this case, we observed left common carotid artery occlusion based on both ultrasound and intraoperative exploration...
February 9, 2024: Medicine (Baltimore)
https://read.qxmd.com/read/38331207/posterior-false-lumen-and-paraplegia-following-fet-procedure-in-acute-type-a-aortic-dissection
#36
JOURNAL ARTICLE
Jinhua Wei, Zhan Hu, Wei Wang, Runyu Ding, Zujun Chen, Xin Yuan, Fei Xu
BACKGROUND: Postoperative paraplegia is the major concern for frozen elephant trunk (FET) procedure in acute type A aortic dissection (ATAAD) patients. It is crucial to determine patients with high risk of paraplegia before implementing FET procedure. METHODS: From January 2013 to December 2018, 544 ATAAD patients undergoing FET procedure were included in this study. The segment number of posterior false lumen (PFL) between T9-L2 levels was calculated. In-hospital outcomes and long-term survival were investigated based on the number of PFL...
February 6, 2024: Annals of Thoracic Surgery
https://read.qxmd.com/read/38329523/a-thyroidea-ima-artery-variation-providing-collateral-circulation-to-the-mediastinum
#37
JOURNAL ARTICLE
Taylor Benedict, Sharon Kuo, Natasha A J Adams, Therese Ach, Robin Michaels, Alexandra J Zachwieja
The thyroidea ima artery (TIA) is a highly variable arterial deviation of the blood supply to the thyroid gland with critical implications for surgical neck procedures such as tracheostomy. Though relatively common in the population at large (~ 4%), most TIA variations are related to the origin of the artery and whether it emerges from the common sites of the brachiocephalic trunk, aortic arch, and right common carotid artery, or another more unique vessel-as opposed to its dispersion pattern. TIA variants generally supply the thyroid gland, occasionally co-occurring with absent thyroid arteries...
February 8, 2024: Surgical and Radiologic Anatomy: SRA
https://read.qxmd.com/read/38322094/insertion-multi-parachute-suturing-and-knotting-ims-k-technique-for-aortic-surgery
#38
JOURNAL ARTICLE
Yoshinori Nakahara, Retsu Tateishi, Fumiya Haba, Syunya Ono, Takeyuki Kanemura
Successful surgical interventions for aortic surgery, such as hemiarch repair and total arch replacement, pivot on the foundation of optimal anastomosis. We propose an alternative approach to anastomosis. The "insertion multi-parachute suturing and knotting" (IMS-K) technique entails the deployment of two parachute sutures, which can be effectively employed for both proximal and distal anastomoses. The first suture is applied loosely to the posterior half of the anastomosis and subsequently parachuted down, tightening the suture with a nerve hook...
February 2024: Curēus
https://read.qxmd.com/read/38317061/endovascular-aortic-arch-repair-under-monitored-anaesthesia-care-maximizing-microinvasiveness
#39
JOURNAL ARTICLE
Augusto D'Onofrio, Michele Piazza, Giulio Andreatta, Irene Cao, Valentina Lombardi, Demetrio Pittarello, Franco Grego, Michele Antonello, Gino Gerosa
Patients with aortic arch pathologies after surgery for type-A acute aortic dissection represent a challenging population since open surgery is associated with a non-negligible rate of mortality and complications. Microinvasive endovascular aortic arch repair Arch-Thoracic EndoVascular Aortic Repair (Ar-TEVAR) has shown promising results in high-risk patients. Ar-TEVAR is usually performed under general anaesthesia. We report the case of an 83-year-old man with a history of ascending aorta replacement for type-A acute aortic dissection who was referred for an anastomotic pseudoaneurysm...
February 1, 2024: European Journal of Cardio-thoracic Surgery
https://read.qxmd.com/read/38315001/is-deep-hypothermic-cardiac-arrest-mandatory-in-aortic-arch-surgeries
#40
Jignesh Kothari, Ishan Gohil, Kinneresh Baria
Cannulation strategies in aortic arch surgeries are a matter of immense discussion. Majority of time deep hypothermic circulatory arrest (DHCA) is the way out, but it does come with its set of demerits. Here we demonstrate a case with aortic arch dissection dealt with dual cannulation strategy in axillary and femoral artery without need for DHCA and ensuring complete neuroprotection of brain and spinal cord without hinderance of time factor. Inception of new ideas like this may decrease the need for DHCA and hence its drawbacks, thus decreasing the morbidity and mortality associated...
February 5, 2024: Brazilian Journal of Cardiovascular Surgery
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