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Aorta dissection

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https://www.readbyqxmd.com/read/29155949/pseudoaneurysm-rupture-after-acute-type-a-dissection-repair-possible-reaction-to-bioglue
#1
Toshiro Kobayashi, Hiroshi Kurazumi, Masafumi Sato, Hidenori Gohra
A 45-year-old man with acute Type A aortic dissection underwent the ascending aorta replacement with BioGlue (CryoLife Europa, Guildford, Surrey, UK) for anastomotic reinforcement. Postoperatively, he developed descending aortic dilation, a giant mediastinal cyst, Henoch-Schonlein purpura and an anastomotic-site pseudoaneurysm rupture. A BioGlue-induced inflammatory reaction was likely, according to a positive patch test (delayed allergic reaction).
October 9, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29155941/new-graft-sizing-rings-for-aortic-valve-reimplantation-procedures
#2
Matija Jelenc, Blaž Jelenc, Ivan Kneževic, Tomislav Klokocovnik
OBJECTIVES: The objective was to design sizing rings that would enable proper sizing of the graft in reimplantation procedures and to perform leaflet repair before graft implantation. METHODS: The rings were designed in Autodesk Fusion 360 (San Rafael, CA, USA) and 3D printed using a commercial online 3D printing service. We designed incomplete rings with a low profile and complete rings with a high profile. The complete rings are best suited for reimplantation procedures, whereas low profile C rings are intended for isolated aortic valve repair, where the ascending aorta is not transected...
August 11, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29155940/stented-balloon-fenestration-before-entry-repair-using-the-frozen-elephant-trunk-technique-for-chronic-aortic-dissection
#3
Naomichi Uchida, Yoshitaka Yamane, Tomokuni Furukawa
Endovascular fenestration on the abdominal aorta is effective for preventing visceral malperfusion in aortic dissection. We report a case of stented balloon fenestration before residual entry repair using the frozen elephant trunk technique for chronic aneurysmal dissection after ascending aortic replacement for DeBakey I aortic dissection. We recognized poor communication between the true lumen and false lumen in the abdominal aorta, and visceral perfusion depended almost entirely on the proximal large entry...
October 9, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29155935/early-and-late-outcomes-of-open-repair-for-dissecting-aneurysms-of-the-descending-or-thoraco-abdominal-aorta
#4
Atsushi Omura, Kenji Minatoya, Jiro Matsuo, Yosuke Inoue, Yoshimasa Seike, Kyokun Uehara, Hiroaki Sasaki, Hitoshi Matsuda, Junjiro Kobayashi
OBJECTIVES: Although open repair is the standard surgical option for dissecting descending thoracic aneurysms (DTAs) and thoraco-abdominal aorta aneurysms (TAAAs), it remains a significant challenge with considerable perioperative morbidity and mortality. We retrospectively analysed early and late outcomes of open repair for these aortic aneurysms. METHODS: Early and late outcomes were investigated for 223 consecutive patients who underwent open repair for dissecting DTA or TAAA between January 2003 and December 2014 (mean age 55 ± 16 years)...
October 9, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29153807/thoracic-endovascular-aortic-repair-using-vascular-plug-for-chronic-type-iiib-aortic-dissection
#5
Up Huh, Seunghwan Song, Eunji Kim, Chang Won Kim
A 72-year-old man previously treated for an abdominal aortic aneurysm (AAA) was diagnosed with the 70-mm-sized type IIIb aortic dissection. Endovascular repair was considered, but there was no stent graft passing through the 8-mm iliac graft that was used for open repair of the AAA. We sealed the 5-mm-sized intimal tear site, using an Amplatzer Vascular Plug, which successfully repaired. The patient was discharged and had no complications. Serial follow-up computerized tomography scans showed that the vascular plug was positioned without migration, and the size of the aorta decreased...
December 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29149323/should-the-dilated-ascending-aorta-be-repaired-at-the-time-of-bicuspid-aortic-valve-replacement
#6
Tsuyoshi Kaneko, Prem Shekar, Vladimir Ivkovic, Nicholas T Longford, Chuan-Chin Huang, Martin I Sigurdsson, Robert C Neely, Maroun Yammine, Julius I Ejilofor, Vanessa Montiero Vieira, Jasmine T Shahram, Karam M Habchi, Gregory W Malzberg, Peter S Martin, Jordan Bloom, Eric M Isselbacher, J Daniel Muehlschlegel, Thoralf M Sundt, Simon C Body
OBJECTIVES: Bicuspid aortic valve (BAV) is the most common congenital valvular abnormality and frequently presents with accelerated calcific aortic valve disease, requiring aortic valve replacement (AVR) and thoracic aortic aneurysm and dissection. Supporting evidence for Association Guidelines of aortic dimensions for aortic resection is sparse. We sought to determine whether concurrent repair of dilated or aneurysmal aortic disease during AVR in patients with BAV substantially improves morbidity and mortality outcomes...
November 14, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29147149/endovascular-treatment-of-infrarenal-isolated-abdominal-aortic-dissection-with-application-of-the-kissing-stents-technique-a-case-report-and-review-of-the-literature
#7
Georgios Sahsamanis, Georgios Vourliotakis, Konstantinos Maltezos, Georgios Plakas, Vasileios Tzilalis
Isolated abdominal aortic dissection (IAAD) is a rare form of aortic dissection involving usually the infrarenal part of the abdominal aorta. A 45-year-old male presented with lumbar pain and claudication. Computed tomography angiography (CTA) revealed an infrarenal IAAD extending to the left external iliac artery (EIA), causing ≥90% narrowing of the lumen. An endovascular approach was decided, with deployment of an aortic stent-graft and two balloon expandable stents in both common iliac arteries (IAs), applying the kissing stents technique...
September 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29142855/single-port-thoracoscopic-treatment-of-thoracic-duct-injury-after-thyroidectomy-with-neck-dissection
#8
Serkan Teksoz, Ezel Ersen, Akif Enes Arikan, Sina Ferahman, Kamil Kaynak, Gianlorenzo Dionigi, Yusuf Bukey
Chylous leakage is a complication of thyroidectomy accompanied by bilateral neck dissection with incidence of 0.5-6.2%. A 51-year-old female patient underwent total thyroidectomy, bilateral and central neck dissection for papillary thyroid carcinoma. In post-operative 4(th) day, left sided chylous leakage was observed as 1,500 cc/day through neck drain. Leakage did not cease after 1-month conservative treatment so single port thoracoscopic intervention was performed. Under general anesthesia, patient was placed in left lateral decubitus position...
October 2017: Gland Surgery
https://www.readbyqxmd.com/read/29138649/-clinical-and-electrocardiographic-aspect-of-pulmonary-embolism-masking-aortic-dissection-revealed-by-thoracic-ct-angiography
#9
Daniella Rakotoniaina Masinarivo, Jenny Larissa Rakotomanana
We here report the case of a 52-year old hypertensive, obese woman (BMI 32,46 kg/m(2)) with a past history of smoking and without evidence-based risk factors of venous thromboembolism, hospitalized for left chest pain radiating to the dorsolumbar region associated with dyspnoea. Clinical examination on hopitalization showed left blood pressure 100/60 mmHg, tachycardia 100/min, oxygen desaturation index at 88% with the patient breathing ambient air, normal cardiopulmonary auscultation, peripheral pulses palpable and no symptoms of phlebitis of the lower limbs...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/29137089/a-case-report-of-takayasu-arteritis-with-aortic-dissection-as-initial-presentation
#10
JiGuang Guo, GuoWu Zhang, Dan Tang, JianBin Zhang
RATIONALE: The initial symptoms and signs of Takayasu arteritis vary due to the heterogeneity of affected vessels. Moreover, the vascular lesions are difficult to detect at initial presentation, making diagnosis even more challenging. Although cases of aortic dissection with arteritis history have been reported, Takayasu arteritis in men with aortic dissection as initial presentation is very rare. PATIENT CONCERNS: A 37-year-old man presenting with persistent chest and back pain for 6 days was transferred to our hospital for further treatment...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29136134/asymptomatic-dissection-of-a-giant-aorta-ascendens-aneurysm-in-turner-syndrome
#11
Piotr Dobrowolski, Anna Klisiewicz, Ilona Michalowska, Mariusz Kusmierczyk, Piotr Hoffman
No abstract text is available yet for this article.
November 10, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29136132/aortic-events-and-reoperations-after-elective-arch-surgery-incidence-surgical-strategies-and-outcomes
#12
Maximilian Luehr, Sven Peterss, Andreas Zierer, Davide Pacini, Christian D Etz, Malakh Lal Shrestha, Konstantinos Tsagakis, Bartosz Rylski, Giampiero Esposito, Klaus Kallenbach, Ruggero De Paulis, Paul P Urbanski
OBJECTIVES: The true incidence of aortic events (AEs) and reoperations (REDO) following elective total aortic arch replacement remains unknown. The aim of this study was to review the incidence of AEs and surgical REDO, and its respective outcomes after 1232 elective arch repairs at 11 European aortic centres. METHODS: Retrospective chart review (in the absence of prospective data collection) was performed for statistical analysis. Follow-up was conducted during routine clinical examination or in a telephone interview with patients and/or their respective physicians...
November 9, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29129854/update-on-the-therapeutic-strategy-of-type-b-aortic-dissection
#13
Shuichiro Kaji
Stanford type B aortic dissection (TBAD) is a life-threatening disease. Current therapeutic guidelines recommend medical therapy with aggressive blood pressure lowering for patients with acute TBAD unless they have fatal complications. Although patients with uncomplicated TBAD have relatively low early mortality, aorta-related adverse events during the chronic phase worsen the long-term clinical outcome. Recent advances in thoracic endovascular aortic repair (TEVAR) can improve clinical outcomes in patients with both complicated and uncomplicated TBAD...
November 10, 2017: Journal of Atherosclerosis and Thrombosis
https://www.readbyqxmd.com/read/29129424/laparoscopic-ligation-of-cisterna-chyli-for-refractory-chylothorax-a-case-series-and-review-of-the-literature
#14
Ilitch Diaz-Gutierrez, Madhuri Vasudev Rao, Rafael Santiago Andrade
OBJECTIVES: We describe an alternative surgical technique for the treatment of chylothorax in patients who have had failure of or are not candidates for transthoracic ligation or embolization by interventional radiology. METHODS: We describe our experience with laparoscopic ligation of the cisterna chyli in 3 such patients and compare our results with published literature. We used a 5-port approach as for foregut surgery. We retracted the liver, transected the gastrohepatic ligament, and retracted the stomach to the left...
September 30, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29129420/surgical-strategy-for-the-treatment-of-aortoesophageal-fistula
#15
Takahiro Yamazato, Tetsu Nakamura, Noriyuki Abe, Koki Yokawa, Yuki Ikeno, Yojiro Koda, Soichiro Henmi, Hidekazu Nakai, Yasuko Gotake, Takashi Matsueda, Takeshi Inoue, Hiroshi Tanaka, Yoshihiro Kakeji, Yutaka Okita
OBJECTIVE: To present a surgical strategy for aortoesophageal fistula (AEF). METHODS: From October 1999 to May 2017, 27 patients with AEF were treated at Kobe University Hospital. After 9 patients with malignancies or fish bone penetration were excluded, 18 patients who had AEF secondary to aortic lesions were investigated. The mean age was 67.2 ± 10.4 years, and the male/female ratio was 16:2. Twelve patients had a nondissection thoracic aneurysm, and 6 patients had a chronic aortic dissection...
September 20, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29127469/the-right-intercostobronchial-trunk-anatomical-study-in-respect-of-posterior-intercostal-artery-origin-and-its-clinical-application
#16
Lidija Kocbek, Mateja Rakuša
PURPOSE: The right bronchial artery usually arises from the descending thoracic aorta as a common trunk with the right intercostal artery and forms the right intercostobronchial trunk. Both, the third right posterior intercostal artery and the right intercostobronchial trunk, are described as the most constant vessels. The focus of the study was to determine the characteristics of the right intercostobronchial trunk regarding the origins of the posterior intercostal arteries from the thoracic aorta...
November 10, 2017: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/29123882/a-case-of-circumferential-type-a-aortic-dissection-with-intimal-intussusception-diagnosed-using-repeat-transthoracic-echocardiography-examination
#17
Toshinobu Yamagishi, Masahiro Kashiura, Kazuya Nakata, Kazuki Miyazaki, Takahiro Yukawa, Takahiro Tanabe, Kazuhiro Sugiyama, Akiko Akashi, Yuichi Hamabe
Case: Sometimes it is difficult to diagnose circumferential aortic dissection with enhanced computed tomography alone. A 58-year-old woman presented with sudden-onset chest discomfort and loss of consciousness. Transthoracic echocardiogram showed mild aortic regurgitation. Enhanced computed tomography scans showed no obvious intimal tear or flap at the proximal ascending aorta, but an intimal flap was observed from the aortic arch to both common iliac arteries. Stanford type B dissection was tentatively diagnosed...
July 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29123849/a-case-report-of-systemic-embolic-events-associated-with-atrial-fibrillation
#18
Hidehiko Nakano, Hiroshi Yamagami, Hisashi Ofuchi
Case: An 82-year-old woman who had atrial fibrillation was found unconscious and was brought to the emergency department by ambulance. Her Glasgow Coma Scale score was 3, and an electrocardiogram showed ST segment elevation in V3 and V4. Cardiac ultrasonography showed left ventricular asynergy in the anterior wall, septum, and apex. Although dissection of the aorta was suspected, contrast computed tomography showed multiple arterial thromboses, including bilateral common carotid arteries and poor contrast in the left ventricle...
January 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29123447/endovascular-stent-graft-repair-of-localized-acute-aortic-intramural-hematoma-a-case-report-and-literature-review
#19
Ugur Kaya, Abdurrahim Colak, Necip Becit, Munacettin Ceviz, Hikmet Kocak
Aortic intramural hematoma (IMH) is a variant of acute aortic syndrome, which can be life-threatening. Ascending aorta IMHs, particularly accompanied by penetrating aortic ulcer (PAU), can cause dissection, rupture, and cardiac tamponade. Therefore, early surgical treatment is recommended for IMHs of the ascending aorta. Herein, we present the case of a 60-year-old male patient who was on warfarin sodium treatment and in whom an IMH localized to the arcus aorta was detected incidentally via computed tomography, with the suspicion of pulmonary embolism, and an endovascular stent graft was inserted into the arcus aorta...
October 2017: Eurasian Journal of Medicine
https://www.readbyqxmd.com/read/29121846/retrograde-ascending-dissection-after-thoracic-endovascular-aortic-repair-combined-with-the-chimney-technique-and-successful-open-repair-using-the-frozen-elephant-trunk-technique
#20
Koji Hirano, Toshiya Tokui, Bun Nakamura, Ryosai Inoue, Masahiro Inagaki, Yasumi Maze, Noriyuki Kato
The chimney technique can be combined with thoracic endovascular aortic repair (TEVAR) to both obtain an appropriate landing zone and maintain blood flow of the arch vessels. However, surgical repair becomes more complicated if retrograde type A aortic dissection occurs after TEVAR with the chimney technique. We herein report a case involving a 73-year-old woman who developed a retrograde ascending dissection 3 months after TEVAR for acute type B aortic dissection. To ensure an adequate proximal sealing distance, the proximal edge of the stent graft was located at the zone 2 level and an additional bare stent was placed at the left subclavian artery (the chimney technique) at the time of TEVAR...
January 1, 2017: Vascular and Endovascular Surgery
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