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https://www.readbyqxmd.com/read/29780895/salvage-procedure-using-a-chimney-endograft-for-early-cerebral-ischaemia-after-hybrid-aortic-arch-repair-of-a-primary-aorto-bronchial-fistula
#1
M Cappelle, V Coppin, H Thieren, G Maleux, I Fourneau
Introduction: Hybrid aortic arch repair for the treatment of aorto-bronchial fistulas has been suggested as a safe alternative to open repair. However, surgical morbidity and mortality are still significant and re-intervention is sometimes inevitable. Report: Successful rescue by a hybrid approach is reported in a 76 year old woman who was transferred from another centre with recurrent episodes of left hemiplegia shortly after debranching of the supra-aortic vessels and thoracic aortic stent grafting for an aorto-bronchial fistula associated with a true aneurysm at the level of origin of the left subclavian artery...
2018: EJVES Short Reports
https://www.readbyqxmd.com/read/29780728/intimal-re-layering-technique-for-type-a-acute-aortic-dissection-reconstructing-the-intimal-layer-continuity-to-induce-remodeling-of-the-false-channel
#2
Eugenio Neri, Enrico Tucci, Giulio Tommasino, Giulia Guaccio, Carmelo Ricci, Pierleone Lucatelli, Marco Cini, Roberto Ceresa, Antonio Benvenuti, Luigi Muzzi
Background: Residual false channel is common after repair of type A acute aortic dissection (TAAAD). Starting from our recent series of TAAAD patients we carried out a retrospective analysis, regarding the failure of primary exclusion at the time of the initial operation. We classified the location of the principal entry tears perfusing the residual false channel. The proposed technique represents our attempt to correct the mechanism of false channel perfusion during primary repair. We describe a new technique designed to address some limitations of standard hemiarch aortic replacement...
2018: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29780725/total-aortic-repair-for-acute-type-a-aortic-dissection-a-new-paradigm
#3
George Matalanis, Shoane Ip
The currently accepted guidelines of open surgical repair for acute type A aortic dissection (ATAAD) include the resection of the primary entry tear, replacement of the ascending aorta and "hemi-arch" with an open distal anastomosis, and aortic valve resuspension and some form of obliteration of the aortic root false lumen. The principal aim being protection against aortic rupture, aortic regurgitation, and coronary ischemia and restoration of antegrade preferential true lumen perfusion. Proponents argue that this operation is tailored to be in the armamentarium of most cardiac surgeons and deliver the lowest early operative risk, while leaving the infrequent long-term sequelae to be dealt with electively by experienced aortic centres...
2018: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29780723/cerebral-perfusion-issues-in-type-a-aortic-dissection
#4
REVIEW
Davide Pacini, Giacomo Murana, Luca Di Marco, Marianna Berardi, Carlo Mariani, Giuditta Coppola, Mariafrancesca Fiorentino, Alessandro Leone, Roberto Di Bartolomeo
Stroke events are very common in acute type A aortic dissection. Cerebral malperfusion could manifest at presentation due to prolonged arch vessels hypoperfusion or develop after surgery for inadequate cerebral protection during arch repair. To reduce this detrimental complication there are several adjuncts that can be adopted for cerebral protection such as direct antegrade or retrograde cerebral perfusion (RCP) and use period of deep to moderate hypothermic circulatory arrest time; however, they are often insufficient as preoperative malperfusion already caused irreversible ischemic damages...
2018: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29780588/takeoff-orientation-of-the-major-aortic-arch-branches-irrespective-of-arch-type-ramifications-for-brachiocephalic-interventions-including-carotid-stenting
#5
Rajiv Tayal, M Zain Khakwani, Benjamin Lesar, Michael Sinclair, Afroditi Emporelli, Vadim Spektor, Marc Cohen, Najam Wasty
Background: Our previous work demonstrating great ease and predictability of cannulation of the major aortic arch branches with an upwardly pointing 3DR catheter, irrespective of aortic arch type, led us to hypothesize that centering or "cresting" of these vessels must occur along the superior most aspect of the aortic arch in a curvilinear fashion. Methods: We retrospectively analyzed 111 computed tomographic scans of the chest and thoracic aorta with intravenous contrast performed at our hospital between April 2011 and May 2012 utilizing TeraRecon image reconstruction software...
2018: SAGE Open Medicine
https://www.readbyqxmd.com/read/29780069/successful-rescue-of-a-ruptured-tracheoinnominate-fistula-with-extracorporeal-membrane-oxygenation-endovascular-stents-and-debranching-surgical-bypass
#6
Yu-San Chien, Yen-Chun Chao, Kuo-Sheng Lee, Kung-Hong Hsu
We reported a case of ruptured tracheoinnominate fistula in a 14-year-old boy with history of repeated sternotomy. Tracheostomy was performed at age 2 years. Slide tracheoplasty was done at age 13 years. He presented to outpatient clinic with episodic hemosputum. Massive blood emanated from stoma during bronchoscopy evaluation. Venous-arterial extracorporeal membrane oxygenation was installed for resuscitation. A contrast-enhanced computed tomography (CT) and angiography confirmed the diagnosis. Immediate control of bleeding was achieved by an endovascular stent graft deployed at innominate artery...
May 18, 2018: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29778817/extent-of-aortic-replacement-in-type-a-dissection-current-answers-for-an-endless-debate
#7
REVIEW
Stephen D Waterford, Rita L Gardner, Marc R Moon
BACKGROUND: The proximal and distal extent of surgery for type A dissection is the subject of this review article. METHODS: In this report, we summarize select series that illumine the issue at hand and provide insight into the surgical approach at our institution to DeBakey type I aortic dissections. RESULTS: For proximal extent, we discuss preservation of the aortic valve in the presence of aortic insufficiency, as well as management of the aortic root in the setting of root dilation...
May 17, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29778614/thoracic-stent-grafting-through-transapical-approach-for-type-iii-endoleak-due-to-prosthetic-disconnection
#8
Isaac Martínez López, Manuela M Hernández Mateo, Luis C Maroto Castellanos, Javier Cobiella Carnicer, Isidre Vilacosta, Francisco J Serrano Hernando
TEVAR is a well-stablished treatment of descending thoracic aneurysms and increasingly complex endovascular procedures are being performed including aortic arch and ascending aorta. However, follow-up complications may be expected, which will enhance the need of alternative approaches such as transapical, in case of complex anatomies and reinterventions. We report the case of a man with prior history of ischemic cardiopathy and multiple endovascular aortic interventions with proximal landing in zone 1 and distal landing proximal to celiac trunk...
May 17, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29777669/repair-of-thoracic-and-thoracoabdominal-mycotic-aneurysms-and-infected-aortic-grafts-using-allograft
#9
Joel S Corvera, David Blitzer, Hannah Copeland, Daniel Murphy, Philip J Hess, Saila T Pillai, John W Fehrenbacher
BACKGROUND: Mycotic aneurysm of the thoracic or thoracoabdominal aorta and infection of thoracic or thoracoabdominal aortic grafts are challenging problems with high mortality. In-situ reconstruction with cryopreserved allograft(CPA) avoids placement of prosthetic material in an infected field and avoids suppressive antibiotics or autologous tissue coverage. METHODS: Fifty consecutive patients with infection of a thoracic or thoracoabdominal aortic graft or mycotic aneurysm underwent resection and replacement with CPA from 2006 to 2016...
May 16, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29775605/outcomes-of-planned-2-stage-hybrid-aortic-repair-with-dacron-replaced-proximal-landing-zone
#10
David N Ranney, Babatunde A Yerokun, Ehsan Benrashid, Muath Bishawi, Adam Williams, Richard L McCann, G Chad Hughes
BACKGROUND: Results of hybrid arch repair (HAR) utilizing native zone 0 proximal landing zone (PLZ) have been unsatisfactory in many series, especially in the setting of ascending aortic dilation (>4.0 cm). This study reports early and late outcomes of planned 2-stage HAR with open 1st stage proximal aortic replacement (PAR) followed by 2nd stage thoracic endovascular aortic repair (TEVAR) with PLZ within the Dacron replaced zone 0. METHODS: N=34 patients underwent planned 2-stage HAR between 1/2006-8/2017...
May 15, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29774793/surgical-considerations-in-interrupted-aortic-arch
#11
Damien J LaPar, Christopher W Baird
Interrupted aortic arch (IAA) is a rare congenital anomaly with several anatomical variants and is often associated with other intracardiac and/or extracardiac congenital anomalies. Historically, associated with high early mortality, outcomes for this anomaly have improved in recent eras with advances in perioperative and anesthesia management and refinements in surgical technique. This review provides a description of surgical anatomy, anatomical classifications, and associated congenital lesions as well as an examination of the perioperative and surgical management of IAA in the contemporary surgical era...
May 1, 2018: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29772586/custom-made-stent-grafts-for-the-treatment-of-pseudoaneurysms-after-childhood-coarctation-surgery
#12
Mario Lescan, Andreas Hornung, Michael Hofbeck, Christian Schlensak
BACKGROUND:  Post-coarctation of the aorta (CoA) pseudoaneurysms is a complication of open repair. Thoracic endovascular repair (TEVAR) is feasible but complicated by proximity to the supra-aortic trunks and severe arch angulation. METHODS:  We describe three cases of post-CoA pseudoaneurysms treated with custom-made Relay stent grafts (Vascutek, Scotland). RESULTS:  Technical and clinical success was achieved in all three cases with no mortality, morbidity, endoleaks, or complications...
May 17, 2018: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/29770485/elongated-transverse-aortic-arch-%C3%A4-n-subjects-without-turner-syndrome-a-preliminary-computed-tomography-study
#13
B Ece, H Yiğit, E Ergün, P N Koşar
INTRODUCTION: The purpose of the present study was to investigate the presence of an elongated transverse aortic arch (ETA), which has been reported to be specific for Turner syndrome, in a population without Turner syndrome. MATERIALS AND METHODS: A set of 1012 patients (713 men, 299 women) under 40 years old, who underwent thoracic CT examination in our radiology department between July 2016 and December 2016, were included in the study. CT scans were performed by 16-slice scanners...
May 17, 2018: Clinical Anatomy
https://www.readbyqxmd.com/read/29769419/heart-rate-reduction-with-ivabradine-in-the-early-phase-of-atherosclerosis-is-protective-in-the-endothelium-of-apoe-deficient-mice
#14
G Aquila, M B Morelli, F Vieceli Dalla Sega, F Fortini, P Nigro, C Caliceti, M Ferracin, M Negrini, A Pannuti, M Bonora, P Pinton, R Ferrari, P Rizzo
Ivabradine, a heart rate reducing agent, protects the vascular system by unidentified mechanisms. We sought to determine the effects of the treatment with ivabradine, started before plaque formation, on early transcriptional changes and endothelium lesions in regions of aorta subjected to disturbed blood flow. Six week-old apolipoprotein E-deficient (ApoE-/- ) mice, fed a low-fat diet, were treated with ivabradine to determine the effect on transcriptional changes (2-and 4-week treatment) and on lesions formation (19-week treatment) in the endothelium of the aortic arch...
February 2018: Journal of Physiology and Pharmacology: An Official Journal of the Polish Physiological Society
https://www.readbyqxmd.com/read/29769130/diagnostic-accuracy-of-low-dose-dual-source-cardiac-computed-tomography-as-compared-to-surgery-in-univentricular-heart-patients
#15
Narumol Chaosuwannakit, Pattarapong Makarawate
BACKGROUND: To evaluate the ability of low radiation dose dual-source computed tomography (DSCT) to depict the features of morphological univentricular heart and to define accuracy by comparing findings with surgery. METHODS: Low radiation dose dual-source cardiac computed tomography (CCT) of 33 cases of functional univentricular heart preliminary diagnosis by echocardiography compared with the results of surgery were retrospectively analyzed (aged 1 day to 4 years, median 5 months)...
May 16, 2018: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29767819/is-there-a-prospect-for-hybrid-aortic-arch-surgery
#16
REVIEW
Mohamad Bashir, Amer Harky, Haris Bilal
The surge of endovascular repair of aortic aneurysm in current modern aortic surgery practice has been the key for surgical management of elective cases of thoracic aortic aneurysms. This has paved way for the combined hybrid approach to be amongst the armamentarium for the management of aortic arch disease. The pivotal understanding of the aortic arch natural history coupled with device technology advancement allowed surgeons insight into delivery of hybrid surgery with acceptable morbidity and mortality results...
May 16, 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29766008/diagnostic-utility-of-chest-radiography-in-predicting-long-standing-systemic-arterial-hypertension
#17
Hakan Sahin, Paul Stark
Purpose: To investigate the association between aortic arch width on frontal chest radiography and systemic hypertension. Methods: A total of 200 consecutive patients were included. Relationships between aortic arch width measurement on chest radiography and blood pressure measurement were investigated using Student's t -tests and Fisher's exact tests. Results: Twenty-five patients were normotensive (< 130/90 mmHg), and 175 were hypertensive...
December 2017: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/29765495/effect-of-the-antioxidant-lipoic-acid-in-aortic-phenotype-in-a-marfan-syndrome-mouse-model
#18
Maria C Guido, Victor Debbas, Vera M Salemi, Elaine R Tavares, Thayna Meirelles, Thaís L S Araujo, Patricia Nolasco, Julio C A Ferreira-Filho, Celso K Takimura, Lygia V Pereira, Francisco R Laurindo
Marfan syndrome (MFS) cardiovascular manifestations such as aortic aneurysms and cardiomyopathy carry substantial morbidity/mortality. We investigated the effects of lipoic acid, an antioxidant, on ROS production and aortic remodeling in a MFS mgΔloxPneo mouse model. MFS and WT (wild-type) 1-month-old mice were allocated to 3 groups: untreated, treated with losartan, and treated with lipoic acid. At 6 months old, echocardiography, ROS production, and morphological analysis of aortas were performed. Aortic ROS generation in 6-month-old MFS animals was higher at advanced stages of disease in MFS...
2018: Oxidative Medicine and Cellular Longevity
https://www.readbyqxmd.com/read/29761081/enhanced-aortic-pressure-wave-reflection-in-patients-with-aortic-coarctation-after-aortic-arch-repair
#19
REVIEW
Tomoaki Murakami
Background: In patients with aortic coarctation after successful aortic arch repair, it is well known that early-onset cardiovascular diseases can develop. Summary: We studied the pressure waveform in patients after aortic arch repair focusing on a pressure wave reflection. In patients after aortic arch repair, the repaired portion generates a new reflected pressure wave. As a result, the newly generated pressure wave causes aortic pressure augmentation, loss of pressure amplification, and left ventricular hypertrophy with fibrosis...
March 2018: Pulse (Basel, Switzerland)
https://www.readbyqxmd.com/read/29759739/aortic-valve-bypass-surgery-in-severe-aortic-valve-stenosis-insights-from-cardiac-and-brain-magnetic-resonance-imaging
#20
Cesare Mantini, Massimo Caulo, Daniele Marinelli, Piero Chiacchiaretta, Armando Tartaro, Antonio Raffaele Cotroneo, Gabriele Di Giammarco
OBJECTIVE: To investigate and describe the distribution of aortic and cerebral blood flow (CBF) in patients with severe valvular aortic stenosis (AS) before and after aortic valve bypass (AVB) surgery. METHODS: We enrolled 10 consecutive patients who underwent AVB surgery for severe AS. Cardiovascular magnetic resonance imaging (CMR) and brain magnetic resonance imaging were performed as baseline before surgery and twice after surgery. Quantitative flow measurements were obtained using 1...
April 13, 2018: Journal of Thoracic and Cardiovascular Surgery
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