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Acute aortic dissection

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https://www.readbyqxmd.com/read/28219577/method-of-hemorrhage-control-from-the-aorta-after-repair-of-a-dissected-aortic-aneurysm
#1
Joseph Galea, Alexander Manché
Patients with Marfan syndrome and presenting with acute aortic dissection have fragile aorta, causing bleeding problems in the anastomosis between the graft and the aorta. Hemostatic impairment following circulatory arrest and prolonged cardiopulmonary bypass contribute to these problems. We describe a technique to control persistent bleeding from the anastomosis in the aortopulmonary recess using two kissing inflated balloons at the tip of two Foley catheters to tamponade the bleeding sites.
March 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28219551/concomitant-endografting-of-a%C3%A2-type-b-aortic-dissection-during-transfemoral-aortic-valve-replacement
#2
Arman Kilic, Mary A Siki, Wilson Y Szeto, Joseph E Bavaria, Saif Anwaruddin, Nimesh D Desai
An 87-year-old woman with severe aortic stenosis underwent a transfemoral transcatheter aortic valve replacement (TAVR). Intraoperative transesophageal echocardiography demonstrated a well-seated valve with no paravalvular leak; however, a new acute type B aortic dissection was identified. Endografts were delivered through the TAVR sheath and deployed, effectively treating the dissection. The patient did well postoperatively, with imaging at 2 years demonstrating a well-functioning aortic valve and no migration or endoleak of the thoracic endografts...
March 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28217690/iatrogenic-acute-ascending-aortic-dissection-with-intramural-hematoma-during-coronary-artery-stenting-a-case-report
#3
Mohamad El-Haress, Hicham Daadaa, Shima Shahjouei, Firas El-Bitar, Hisham Bahmad
BACKGROUND: Iatrogenic acute ascending aortic dissection during percutaneous coronary intervention (PCI) is an exceptionally rare and life-threatening sequel that requires early and accurate diagnosis along with rapid management. No guidelines have yet been established to direct decisions on the different treatment options that can be employed in the setting of acute aortic dissections caused by PCI. However, similar cases have been treated either by intracoronary stenting and conservative management as in localized aortocoronary dissections or by surgical intervention in cases of extensive aortic dissections...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28216358/outcomes-of-thoracic-endovascular-aortic-repair-using-aortic-arch-chimney-stents-in-high-risk-patients
#4
Igor Voskresensky, Salvatore T Scali, Robert J Feezor, Javairiah Fatima, Kristina A Giles, Rosamaria Tricarico, Scott A Berceli, Adam W Beck
BACKGROUND: Aortic arch disease is a challenging clinical problem, especially in high-risk patients, in whom open repair can have morbidity and mortality rates of 30% to 40% and 2% to 20%, respectively. Aortic arch chimney (AAC) stents used during thoracic endovascular aortic repair (TEVAR) are a less invasive treatment strategy than open repair, but the current literature is inconclusive about the role of this technology. The focus of this analysis is on our experience with TEVAR and AAC stents...
February 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28216355/innovative-postmarket-device-evaluation-using-a-quality-registry-to-monitor-thoracic-endovascular-aortic-repair-in-the-treatment-of-aortic-dissection
#5
Adam W Beck, Joseph V Lombardi, Dorothy B Abel, J Pablo Morales, Danica Marinac-Dabic, Grace Wang, Ali Azizzadeh, John Kern, Mark Fillinger, Rodney White, Jack L Cronenwett, Richard P Cambria
OBJECTIVE: United States Food and Drug Administration (FDA)-mandated postapproval studies have long been a mainstay of the continued evaluation of high-risk medical devices after initial marketing approval; however, these studies often present challenges related to patient/physician recruitment and retention. Retrospective single-center studies also do not fully represent the spectrum of real-world performance nor are they likely to have a sufficiently large enough sample size to detect important signals...
February 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28216353/left-subclavian-artery-revascularization-in-zone-2-thoracic-endovascular-aortic-repair-is-associated-with-lower-stroke-risk-across-all-aortic-diseases
#6
Rhiannon J Bradshaw, S Sadie Ahanchi, Obie Powell, Sebastian Larion, Colin Brandt, Michael C Soult, Jean M Panneton
BACKGROUND: The best management strategy for the left subclavian artery (LSA) in pathologic processes of the aorta requiring zone 2 thoracic endovascular aortic repair (TEVAR) remains controversial. We compared LSA coverage with or without revascularization as well as the different means of LSA revascularization. METHODS: A retrospective chart review was conducted of patients with any aortic diseases who underwent zone 2 TEVAR deployment from 2007 to 2014. Primary end points included 30-day stroke and 30-day spinal cord injury (SCI)...
February 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28212053/transthoracic-echocardiography-pitfalls-and-limitations-as-delineated-at-cardiac-ct-and-mr-imaging
#7
Sachin B Malik, Natalie Chen, Rex A Parker, Joe Y Hsu
Transthoracic echocardiography ( TTE transthoracic echocardiography ) is a critical tool in the field of clinical cardiology. It often serves as one of the first-line imaging modalities in the evaluation of cardiac disease owing to its low cost, portability, widespread availability, lack of ionizing radiation, and ability to evaluate both anatomy and function of the heart. Consequently, a large majority of patients undergoing a cardiac computed tomography (CT) or magnetic resonance (MR) imaging examination will have a TTE transthoracic echocardiography available for review...
February 17, 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28188322/tennis-ball-sign-a-ct-sign-of-acute-aortic-dissection
#8
REVIEW
Hira Lal, Priyank Yadav, Anand Chellappan, Rajeev Singh
No abstract text is available yet for this article.
February 10, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28183174/the-petticoat-concept-for-endovascular-treatment-of-type-b-aortic-dissection
#9
Luca Bertoglio, Enrico Rinaldi, Germano Melissano, Roberto Chiesa
INTRODUCTION: A systematic literature search on outcomes of the PETTICOAT technique was aimed at verifying the feasibility and safety of the procedure, comparing clinical outcomes with standard stent-grafting of the proximal entry tear as well as describing the possible benefits in terms of aortic remodeling. EVIDENCE ACQUISITION: Potentially eligible papers were sought through a computerized search of MEDLINE and SCOPUS databases between January 2006 and June 2016...
February 9, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28180096/the-frozen-elephant-trunk-technique-european-association-for-cardio-thoracic-surgery-position-and-bologna-experience
#10
REVIEW
Luca Di Marco, Antonio Pantaleo, Alessandro Leone, Giacomo Murana, Roberto Di Bartolomeo, Davide Pacini
Complex lesions of the thoracic aorta are traditionally treated in 2 surgical steps with the elephant trunk technique. A relatively new approach is the frozen elephant trunk (FET) technique, which potentially allows combined lesions of the thoracic aorta to be treated in a 1-stage procedure combining endovascular treatment with conventional surgery using a hybrid prosthesis. These are very complex and time-consuming operations, and good results can be obtained only if appropriate strategies for myocardial, cerebral, and visceral protection are adopted...
February 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28173744/glutathione-system-participation-in-thoracic-aneurysms-from-patients-with-marfan-syndrome
#11
Alejandra María Zúñiga-Muñoz, Israel Pérez-Torres, Verónica Guarner-Lans, Elías Núñez-Garrido, Rodrigo Velázquez Espejel, Claudia Huesca-Gómez, Ricardo Gamboa-Ávila, María Elena Soto
Aortic dilatation in Marfan syndrome (MFS) is progressive. It is associated with oxidative stress and endothelial dysfunction that contribute to the early acute dissection of the vessel and can result in rupture of the aorta and sudden death. We evaluated the participation of the glutathione (GSH) system, which could be involved in the mechanisms that promote the formation and progression of the aortic aneurysms in MFS patients. Patients and methods: Aortic aneurysm tissue was obtained during chest surgery from eight control subjects and 14 MFS patients...
February 8, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/28168983/changes-in-operative-strategy-for-patients-enrolled-in-the-international-registry-of-acute-aortic-dissection-interventional-cohort-program
#12
Neil Parikh, Santi Trimarchi, Thomas G Gleason, Arnoud V Kamman, Marco di Eusanio, Truls Myrmel, Amit Korach, Hersh Maniar, Takeyoshi Ota, Ali Khoynezhad, Daniel G Montgomery, Nimesh D Desai, Kim A Eagle, Christoph A Nienaber, Eric M Isselbacher, Joseph Bavaria, Thoralf M Sundt, Himanshu J Patel
OBJECTIVE: Advancements in cardiothoracic surgery prompted investigation into changes in operative management for acute type A aortic dissections over time. METHODS: One thousand seven hundred thirty-two patients undergoing surgery for type A aortic dissection were identified from the International Registry of Acute Aortic Dissection Interventional Cohort Database. Patients were divided into time tertiles (T) (T1: 1996-2003, T2: 2004-2010, and T3: 2011-2016). RESULTS: Frequency of valve sparing procures increased (T1: 3...
January 9, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28168982/two-decades-of-experience-with-root-remodeling-and-valve-repair-for-bicuspid-aortic-valves
#13
Ulrich Schneider, Susanne K Feldner, Christopher Hofmann, Jakob Schöpe, Stefan Wagenpfeil, Christian Giebels, Hans-Joachim Schäfers
OBJECTIVE: Bicuspid aortic valve anatomy is associated with ascending aortic aneurysm in approximately 50% of individuals and may lead to severe aortic regurgitation with aortic dilatation. Both entities may be treated by valve repair and root remodeling. The objective was to review the cumulative experience of 20 years. METHODS: Between November 1995 and December 2015, 357 patients (324 male; age 10-80 years; mean, 49 ± 13 years) underwent combined bicuspid aortic valve repair and root remodeling...
January 10, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28162223/impact-of-subclinical-vascular-complications-detected-by-systematic-postprocedural-multidetector-computed-tomography-after-transcatheter-aortic-valve-implantation-using-balloon-expandable-edwards-sapien-xt-heart-valve
#14
Yuki Kakefuda, Kentaro Hayashida, Yoshitake Yamada, Fumiaki Yashima, Taku Inohara, Ryo Yanagisawa, Makoto Tanaka, Takahide Arai, Takashi Kawakami, Yuichiro Maekawa, Hikaru Tsuruta, Yuji Itabashi, Mitsushige Murata, Motoaki Sano, Kazuma Okamoto, Akihiro Yoshitake, Hideyuki Shimizu, Masahiro Jinzaki, Keiichi Fukuda
Complications after transcatheter aortic valve implantation (TAVI) remain an important issue. This study aimed to evaluate the impact of systematic postprocedural multidetector computed tomography (MDCT) to detect subclinical complications after TAVI. From October 2013 to August 2015, a total of 135 patients who underwent transfemoral TAVI (n = 116) or transapical TAVI (n = 19) with Sapien XT and MDCT preprocedure and postprocedure were enrolled. Postprocedural MDCT findings were compared with the preprocedural MDCT findings...
January 5, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28149590/one-stage-hybrid-surgery-for-acute-stanford-type-a-aortic-dissection-with-david-operation-aortic-arch-debranching-and-endovascular-graft-a-case-report
#15
Lulu Liu, Chaoyi Qin, Jianglong Hou, Da Zhu, Bengui Zhang, Hao Ma, Yingqiang Guo
Acute Stanford type A aortic dissection requires an extremely complex surgical strategy and presents high risk of complications. Although many different procedures were reported to treat this aortic dissection, high mortality rate and incidences of complications still exist. This study presents a 59-year-old lady with acute Stanford type A aortic dissection, which originated from the aortic root to proximal part of right external iliac artery and involved the brachiocephalic trunk, left carotid artery, celiac trunk, and left renal artery...
December 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28146465/successful-use-of-idarucizumab-as-a-reversal-agent-for-dabigatran-in-a-patient-with-acute-dissected-aortic-aneurysm
#16
Anna Tomaszuk-Kazberuk, Paulina Łopatowska, Elżbieta Młodawska, Joanne van Ryn, Paul A Reilly, Charles V Pollack
No abstract text is available yet for this article.
January 31, 2017: Polskie Archiwum Medycyny Wewnętrznej
https://www.readbyqxmd.com/read/28134010/noteworthy-cardiac-surgical-literature-2016
#17
Muhammad Aftab, Joseph C Cleveland, T Brett Reece
Cardiac surgical care of patients continued to evolve rapidly in 2016. In this article, 3 topics of considerable change are discussed based on recent publications. The first topic reviews the potential risks and benefits of newly instituted low-risk percutaneous aortic valve replacement. The second topic reviews the increasing utilization of more extensive arch replacements in acute type A dissection. The final topic reviews current trends and justification for changes in patterns of use of cardioplegia options...
January 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28131431/the-standardized-concept-of-moderate-to-mild-%C3%A2-28%C3%A2-c-systemic-hypothermia-during-selective-antegrade-cerebral-perfusion-for%C3%A2-all-comers-in-aortic-arch-surgery-single-center-experience-in-587-consecutive-patients-over-a-15-year-period
#18
Ali El-Sayed Ahmad, Nestoras Papadopoulos, Petar Risteski, Anton Moritz, Andreas Zierer
BACKGROUND: Whether selective antegrade cerebral perfusion (ACP) during moderate-to-mild systemic hypothermia (≥28°C) is applicable to aortic arch surgery without restrictions including the emergency setting of an acute type A aortic dissection or extensive total arch procedures such as elephant and frozen elephant trunk techniques is an ongoing subject of controversy. METHODS: Between January 2000 and January 2015, 587 consecutive all-comers underwent aortic arch surgery at our institution uniformly applying selective ACP (unilateral: n = 393 [67%]; bilateral: n = 194 [33%]) during moderate-to-mild systemic hypothermia (28...
January 25, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28119405/impact-of-gender-on-long-term-outcomes-after-surgical-repair-for-acute-stanford-a-aortic-dissection-a-propensity-score-matched-analysis%C3%A2
#19
Anton Sabashnikov, Stephanie Heinen, Antje Christin Deppe, Mohamed Zeriouh, Alexander Weymann, Ingo Slottosch, Kaveh Eghbalzadeh, Aron-Frederik Popov, Oliver Liakopoulos, Parwis B Rahmanian, Navid Madershahian, Axel Kroener, Yeong-Hoon Choi, Ferdinand Kuhn-Régnier, André R Simon, Thorsten Wahlers, Jens Wippermann
OBJECTIVES: Previous research suggests that female gender is associated with increased mortality rates after surgery for Stanford A acute aortic dissection (AAD). However, women with AAD usually present with different clinical symptoms that may bias outcomes. Moreover, there is a lack of long-term results regarding overall mortality and freedom from major cerebrovascular events. We analysed the impact of gender on long-term outcomes after surgery for Stanford A AAD by comparing genders with similar risk profiles using propensity score matching...
January 23, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28115748/acute-aorta-overview-of-acute-ct-findings-and-endovascular-treatment-options
#20
Marie Cerna, Martin Kocher, Rohit Philip Thomas
Acute aortic pathologies include acute aortic syndrome (aortic dissection, intramural hematoma, penetrating aortic ulcer), impending rupture, aortic aneurysm rupture and aortic trauma. Acute aortic syndrome, aortic aneurysm rupture and aortic trauma are life-threatening conditions requiring prompt diagnosis and treatment. The basic imaging modality for "acute aorta" is CT angiography with typical findings for these aortic pathologies. Based on the CT, it is possible to classify aortic diseases and anatomical classifications are essential for the planning of treatment...
January 2, 2017: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
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