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Thoracic aneurysm

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https://www.readbyqxmd.com/read/29778614/thoracic-stent-grafting-through-transapical-approach-for-type-iii-endoleak-due-to-prosthetic-disconnection
#1
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
#2
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/29773431/preoperative-frailty-assessment-predicts-loss-of-independence-after-vascular-surgery
#3
Graham W Donald, Amir A Ghaffarian, Farid Isaac, Larry W Kraiss, Claire L Griffin, Brigitte K Smith, Mark R Sarfati, Julie L Beckstrom, Benjamin S Brooke
OBJECTIVE: Frailty, a clinical syndrome associated with loss of metabolic reserves, is prevalent among patients who present to vascular surgery clinics for evaluation. The Clinical Frailty Scale (CFS) is a rapid assessment method shown to be highly specific for identifying frail patients. In this study, we sought to evaluate whether the preoperative CFS score could be used to predict loss of independence after major vascular procedures. METHODS: We identified all patients living independently at home who were prospectively assessed using the CFS before undergoing an elective major vascular surgery procedure (admitted for >24 hours) at an academic medical center between December 2015 and December 2017...
May 14, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29772328/current-evidence-on-management-of-aortic-stent-graft-infection-a-systematic-review-and-meta-analysis
#4
REVIEW
Hai Lei Li, Yiu Che Chan, Stephen W Cheng
OBJECTIVE: Aortic stent-graft infection is rare, but remains one of the most challenging and threatening complications. This systematic review aimed to identify the clinical features, treatment and outcomes of endograft infection after abdominal endovascular aortic repair (EVAR) and thoracic endovascular aortic repair (TEVAR). METHODS: A systematic literature review of all published literature from January 1991 to September 2016 on stent-graft infection was performed under the instruction of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)...
May 14, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29767819/is-there-a-prospect-for-hybrid-aortic-arch-surgery
#5
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/29762936/bentall%C3%A2-s-procedure-in-pediatric-mixed-connective-tissue-disease-syndrome-management-of-pediatric-aortic-aneurysm-a-brief-review
#6
Krithika Ramaprabhu, Om Prakash, Noveen Davidson, Sanjay Bhalero, Satish Radhakrishnan, Robert Coelho
Mixed connective tissue disease (MCTD) syndrome in children may lead to large aortic aneurysms, which in turn pose a difficult surgical problem. Valve-sparing root replacement is not always a viable option as the disease process invariably affects the aortic valve leaflets. Among pediatric patients, the Ross procedure is contraindicated on account of weakness of the pulmonary root, while Bentall surgery is the 'gold standard' treatment of aortic aneurysm, with reproducible and excellent long-term results. The case is presented of a three-year-old girl with a large thoracic aortic aneurysm in whom Bentall's surgery was performed, with a good result...
September 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29755091/-coil-embolization-of-bronchial-artery-aneurysm-report-of-a-case
#7
Kenichi Hagiwara, Hiroshi Moriya, Yoshiyuki Sato
An 82-year-old male was admitted due to mild chest discomfort. Enhanced computed tomography showed a large bronchial artery aneurysm(BAA) of 26×27 mm at the left hilus. To avoid the rupture of BAA, coil embolization alone was performed. There has been no enlargement of BAA for these 4 years. In general, coil embolization only should be indicated in a patient with BAA with a stalk because of thoracic endovascular aortic repair (TEVAR) being off-label and low cost performance. TEVAR would be considered as a last resort only in case of enlarging BAA even after coil embolization...
May 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29755088/-hybrid-repair-of-distal-arch-aortic-aneurysm-total-aortic-arch-repair-with-the-lupiae-vascular-graft-and-thoracic-endovascular-aortic-repair-report-of-two-cases
#8
Nobu Yokoyama, Daigo Shinoda, Mitsunori Nakano, Manabu Shiraishi, Satoshi Itoh
Surgical treatment for distal arch aortic aneurysm is generally invasive, and there is no definitive approach for it. We report 2 cases of men who was admitted for the treatment of aortic aneurysm. First case is a 78-year-old man. Two saccular aneurysm were observed on distal aortic arch and descending aorta by contrast-enhanced computed tomography. Two staged-repair was performed with using the Lupiae vascular graft and thoracic endovascular aortic repair(TEVAR). The postoperative course was uneventful, and he was discharged on day 21 after 1st operation...
May 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29755087/-successful-echo-guided-deployment-of-stent-graft-for-intraoperative-retrograde-aortic-dissection-and-rupture-report-of-a-case
#9
Naoki Kanemitsu, Takehiko Matsuo, Hiroaki Osada, Kazuo Yamanaka, Junichi Tazaki
We report a case of chronic dissecting thoracoabdominal aneurysm with intraoperative retrograde aortic dissection and rupture at proximal descending aorta, which was successfully treated by echoguided stent-graft insertion. An 82-year old male underwent thoracoabdominal aortic replacement for dilatation of infra-diaphragmatic aorta. Under F-F bypass, his thoracoabdominal aorta was replaced by a Dacron graft with 4-branches. After he weaned from F-F bypass, we found massive bleeding from proximal descending aorta...
May 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29755086/-total-arch-replacement-with-concomitant-thoracic-endovascular-aortic-repair-via-the-ascending-aorta-for-extended-thoracic-aneurysm-report-of-a-case
#10
Yoshiki Endo, Yoshihito Irie, Kousuke Nishida, Tsuyoshi Fujimiya, Yoshiaki Katada
The patient was a 66 year-old male. Computed tomography (CT) angiography showed a huge aneurysm(120 mm) in the aortic arch and chronic type B aortic dissection(45 mm) in the descending aorta. Echocardiography showed patent ductus arteriosus( PDA). Because of pulmonary hypertension due to PDA, it was considered unacceptable to put him under general anesthesia twice. We performed thoracic endovascular aortic repair (TEVAR) via the ascending aorta and total arch replacement (TAR) simultaneously to prevent paraplegia...
May 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29754327/the-many-faces-of-igg4-related-disease-report-of-a-case-with-inaugural-recurrent-aortic-aneurism-ruptures-and-literature-review
#11
REVIEW
Mariana Luís, Luísa Brites, Bruno Fernandes, Diogo Jesus, Tânia Santiago, Sara Serra, João Rovisco, Lina Carvalho, José António P da Silva, Armando Malcata
Vascular involvement in IgG4-related disease (IgG4-RD), is a well-recognized feature and large vessel commitment, especially the aorta, can be the only manifestation of the disease. Being a newly recognized disease, its diagnosis and workup still represents a challenge in clinical practice. A 47-year-old-man with two aortic aneurysms ruptures, one at abdominal and the other at thoracic level, was referred to our rheumatology department. The initial analysis of the surgical specimen obtained 3 years earlier revealed a nonspecific aortitis...
May 12, 2018: Rheumatology International
https://www.readbyqxmd.com/read/29753564/left-atrium-and-pulmonary-artery-compression-due-to-aortic-aneurysm-causing-heart-failure-symptoms
#12
Antonio José Lagoeiro Jorge, Wolney de Andrade Martins, Victor M Moutinho, Juliano M Rezende, Patricia Y Alves, Humberto Villacorta, Pedro F Silveira, Antonio A Couto
Patients with thoracic aortic aneurysm (TAA) are mostly asymptomatic and TAA is rarely related to heart failure (HF). We report the case of an 80-year-old female patient, with type A TAA without dissection, with right pulmonary artery and left atrium compression, who presented with HF, preserved ejection fraction and acute pulmonary edema.
May 9, 2018: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29749581/preconception-counseling-for-patients-with-thoracic-aortic-aneurysms
#13
REVIEW
Prashant Rao, Eric M Isselbacher
PURPOSE OF THE REVIEW: Acute aortic dissection is a potentially catastrophic cardiovascular emergency that is associated with a high mortality rate. Pregnancy, with its attendant hormonal and physiological changes, increases the risk of dissection in women with known thoracic aortic aneurysms. In this review, we highlight the importance of preconception counseling to help women with known thoracic aortic aneurysms better understand their risk of dissection and the heritable nature of thoracic aortic disease and its associated syndromes...
May 10, 2018: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29748101/results-from-the-study-to-assess-outcomes-after-endovascular-repair-for-multiple-thoracic-aortic-diseases-summit
#14
Nikolaos Tsilimparis, Sebastian Debus, Min Chen, Qing Zhou, Mary-Margaret Seale, Tilo Kölbel
OBJECTIVE: Thoracic endovascular aortic repair (TEVAR) is currently the treatment of choice for most diseases of the descending thoracic aorta. Using data from the Study to Assess Outcomes After Endovascular Repair for Multiple Thoracic Aortic Diseases (SUMMIT) study we investigated the outcomes of TEVAR for different aortic diseases and risk factors associated with the outcomes. METHODS: The SUMMIT study included aggregated data of 521 TEVAR patients from five Cook-sponsored multicenter trials evaluating thoracic endografts of the Zenith platform (William Cook Europe, ApS, Bjaeverskov, Denmark)...
May 7, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29747952/awake-thoracic-endovascular-aneurysm-repair-for-aortic-rupture-a-case-series
#15
Jessica Forcillo, Yazan M Duwayri, William D Jordan, Bradley G Leshnower
Thoracic endovascular aortic repair (TEVAR) has been proven to be the optimal therapy for patients with a ruptured descending thoracic aortic pathology. In these emergent settings, TEVAR provides a rapid delivery of treatment to an unstable patient with a lethal disease. Typically, the greatest challenge is maintaining hemodynamic stability until the time of graft deployment. In this report, we describe our technique of performing awake TEVAR for ruptured descending thoracic aortic disease.
April 2018: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29738368/anti-apoptotic-effect-of-%C3%AE-1-blockers-in-ascending-thoracic-aortic-smooth-muscle-cells-the-role-of-hsp70-expression
#16
Ioannis K Rizos, James N Tsoporis, Ioannis K Toumpoulis, Vasileios Salpeas, Shehla Izhar, Angelos G Rigopoulos, Eleftherios A Sakadakis, Thomas G Parker
Heat shock proteins (HSP) play an important role in the cellular adaptation to stress, a requisite for cell survival. The aortic wall appears to be a target for increased expression of HSP during surgical stress. We aimed to define the expression and function of aortic HSP70 in 31 patients with normal ascending thoracic aortic diameter who underwent aortic valve replacement due to aortic valve stenosis (AVS) and in 35 patients with dilated ascending thoracic aorta who underwent replacement of an ascending thoracic aortic aneurysm (ATAA)...
May 3, 2018: Journal of Cardiovascular Pharmacology
https://www.readbyqxmd.com/read/29737479/locomotor-treadmill-training-promotes-soleus-trophism-by-mammalian-target-of-rapamycin-pathway-in-paraplegic-rats
#17
Caroline Cunha do Espírito Santo, Daniela Dal Secco, Anamaria Meireles, Gabriel Ribeiro de Freitas, Franciane Bobinski, Mauricio Peña Cunha, Ana Lúcia Severo Rodrigues, Alessandra Swarowsky, Adair Roberto Soares Santos, Jocemar Ilha
Assisted-treadmill training, may be helpful in promoting muscle mass preservation after incomplete spinal cord injury (SCI). However, biological mechanism involved in this process is still not fully understood. This study investigated the effects of locomotor treadmill training on muscle trophism mediated by protein kinase B (Akt)/mammalian target of rapamycin (mTOR)/p70 ribosomal protein S6 kinase (p70S6K) in paraplegic rats. Adult female Wistar rats underwent an incomplete thoracic SCI induced by compression using an aneurysm clip...
May 8, 2018: Neurochemical Research
https://www.readbyqxmd.com/read/29733113/endovascular-repair-of-aortic-arch-intramural-hematoma-and-penetrating-ulcers-with-810-nm-in-situ-laser-assisted-fenestration-preliminary-results-of-a-single-center
#18
Guang Liu, Jinbao Qin, Chaoyi Cui, Zhen Zhao, Kaichuang Ye, Huihua Shi, Xiaobing Liu, Minyi Yin, Guanglin Yang, Sheng Huang, Min Lu, Xintian Huang, Mier Jiang, Weimin Li, Xinwu Lu
PURPOSE: The aim of the present study was to report the clinical outcomes of the use of 810 nm in situ laser-generated fenestration (ISLF) for the treatment of aortic aneurysms (AAs) and intramural hematomas (IMHs) located in the aortic arch. STUDY DESIGN AND METHODS: Between April 2014 and September 2017, 23 patients (15 men, mean age 66.0 years) with AAs (n = 12) or IMHs (n = 11) underwent thoracic endovascular aortic repair (TEVAR) with 810 nm ISLF of the arch...
May 7, 2018: Lasers in Surgery and Medicine
https://www.readbyqxmd.com/read/29730347/extra-anatomic-bypass-of-a-complex-adult-coarctation-how-i-do-it
#19
EDITORIAL
Eric N Feins, Arminder S Jassar, Luis F Tapias, Eric M Isselbacher, Thoralf M Sundt
Complex adult coarctations associated with arch hypoplasia and aneurysms require a range of surgical approaches depending upon anatomy. Extra-anatomic bypass is an important strategy that enables the surgeon to avoid the risks of extensive dissection/mobilization. Extra-anatomic bypass can be accomplished from the ascending to lower descending thoracic aorta via an intra-pericardial route lateral to the right atrium and posterior to the IVC; however, this approach incompletely addresses post-stenotic aneurysmal disease...
May 3, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29730345/hemiarch-reconstruction-vs-clamped-aortic-anastomosis-for-concomitant-ascending-aortic-aneurysm
#20
Ibrahim Sultan, Valentino Bianco, Ibrahim Yajzi, Arman Kilic, Keith Dufendach, Arturo Cardounel, Andrew D Althouse, Ahmad Masri, Forozan Navid, Thomas G Gleason
BACKGROUND: Deep hypothermic circulatory arrest (DHCA) is often avoided in patients with concomitant ascending aortic pathology when treating other cardiac disease to avoid increased risk of morbidity and mortality. We hypothesized that the use of DHCA with retrograde cerebral perfusion (RCP) does not add incremental risk to ascending aortic replacement alone in the setting of concomitant cardiac surgery. METHODS: 408 ascending aortic ± hemiarch replacements and aortic (root)/mitral/tricuspid valve(s), CABG, or MAZE procedures were performed for concomitant cardiac disease...
May 3, 2018: Annals of Thoracic Surgery
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