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Aortic arch replacement

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https://www.readbyqxmd.com/read/28100966/total-arch-versus-hemiarch-replacement-for-type-a-acute-aortic-dissection-a-single-center-experience
#1
Antonio Lio, Francesca Nicolò, Emanuele Bovio, Andrea Serrao, Jacob Zeitani, Antonio Scafuri, Luigi Chiariello, Giovanni Ruvolo
We retrospectively evaluated early and intermediate outcomes of aortic arch surgery in patients with type A acute aortic dissection (AAD), investigating the effect of arch surgery extension on postoperative results. From January 2006 through July 2013, 201 patients with type A AAD underwent urgent corrective surgery at our institution. Of the 92 patients chosen for this study, 59 underwent hemiarch replacement (hemiarch group), and 33 underwent total arch replacement (total arch group) in conjunction with ascending aorta replacement...
December 2016: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28076961/total-arch-replacement-through-a-median-sternotomy-for-kommerell-s-diverticulum
#2
Yoshihiro Goto, Yutaka Koyama, Soh Hosoba, Shinji Ogawa, Shunsuke Fukaya, Yasuhide Okawa
Kommerell's diverticulum with a right aortic arch and aberrant left subclavian artery is a rare anomaly, and the optimal operative strategy has not yet been established. In particular, the approach to the diverticulum is controversial, with the greatest concern being whether or not to add a right thoracotomy to the median sternotomy for distal anastomosis. We successfully performed total arch replacement through a median sternotomy only, by referring to preoperative computed tomography. We think that if the aneurysm is in a shallow position from the tracheal bifurcation, total arch replacement is possible with a midline incision only...
January 1, 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/28043468/outcomes-of-truncus-arteriosus-repair-in-children-35-years-of-experience-from-a-single-institution
#3
Phillip S Naimo, Tyson A Fricke, Matthew S Yong, Yves d'Udekem, Andrew Kelly, Dorothy J Radford, Andrew Bullock, Robert G Weintraub, Christian P Brizard, Igor E Konstantinov
We evaluated the long-term outcomes following repair of truncus arteriosus (TA) from a single institution. We conducted a retrospective review of children (n = 171) who underwent TA repair between 1979 and 2014. Early mortality rate was 11.7% (20/171). There were 19 late deaths. Most deaths (74%, 29/39) occurred within the first year following surgery. The 1-year mortality rate in 1979-2004 was 18% (25/136) and decreased to 11% (4/35) in 2005-2014. The overall survival rate was 73.6% at 30 years. Multivariate analysis identified postoperative extracorporeal membrane oxygenation (P = 0...
July 2016: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28040765/classification-and-outcomes-of-extended-arch-repair-for-acute-type-a-aortic-dissection-a-systematic-review-and-meta-analysis
#4
REVIEW
Holly N Smith, Munir Boodhwani, Maral Ouzounian, Richard Saczkowski, Alexander J Gregory, Eric J Herget, Jehangir J Appoo
OBJECTIVES: Distal extent of repair in patients undergoing surgery for acute Type A aortic dissection (ATAAD) is controversial. Emerging hybrid techniques involving open and endovascular surgery have been reported in small numbers by select individual centres. A systematic review and meta-analysis was performed to investigate the outcomes following extended arch repair for ATAAD. A classification system is proposed of the different techniques to facilitate discussion and further investigation...
December 31, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28025311/operative-results-of-the-anterolateral-thoracotomy-with-partial-sternotomy-approach-for-chronic-type-b-aortic-dissection-involving-the-aortic-arch
#5
Gaku Uchino, Keiji Yunoki, Naoya Sakoda, Shigeru Hattori, Takuya Kawabata, Munehiro Saiki, Yasufumi Fujita, Kunikazu Hisamochi, Hideo Yoshida, Osamu Oba
OBJECTIVES: There are various treatment strategies for chronic-type B aortic dissection involving the aortic arch. Our aim was to review our surgical experience in the anterolateral thoracotomy with the partial sternotomy approach for chronic-type B aortic dissection involving the aortic arch. METHODS: From January 2000 to October 2015, 39 patients underwent the single-stage open surgery for chronic-type B aortic dissection involving the aortic arch using the anterolateral thoracotomy with partial sternotomy approach...
December 26, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28018832/limited-distal-arch-open-stenting-for-type-b-aortic-dissection-with-an-enlarged-ulcer-like-projection-complicated-by-abdominal-aortic-occlusion
#6
Mitsumasa Hata, Kenji Akiyama, Yukihiko Orime
A 79-year-old man underwent bifurcated graft replacement for abdominal aortic aneurysm, but the graft was totally occluded owing to an acute type B aortic dissection. We could not have access to the root for performing endovascular stenting for dissecting aneurysm. Furthermore, it was difficult to remove the aneurysm via a left thoracotomy because it was impossible to perfuse the lower body with blood from the femoral artery and also a left axillary arterial cannulation was unusable. Herein, we report a patient who was successfully treated with open surgical aortic stenting for an enlarged ulcer-like projection complicated by a type B aortic dissection...
December 2016: Thoracic and Cardiovascular Surgeon Reports
https://www.readbyqxmd.com/read/28017277/outcomes-after-surgery-for-acute-type-a-aortic-dissection-in-non-marfan-syndrome-patients-with-long-life-expectancy-a-24-year-follow-up
#7
Alessandro Piccardo, Tommaso Regesta, Alexandre Le Guyader, Nicola Di Lorenzo, François Bertin, Francis Pesteil, Elisabeth Cornu
BACKGROUND: Long-term survival and risk of reoperation in "non-Marfan syndrome" patients with a long life expectancy who undergo emergency surgery for acute type A aortic dissection (aTAAD) are not well known. AIM: To analyse survival, risk of reoperation and quality of life in this population. METHODS: From 1990 to 2010, all patients aged≤50 years and not affected by Marfan syndrome, who underwent emergency surgery for aTAAD at two institutions, were included in this analysis...
December 21, 2016: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/27996995/-acute-aortic-dissection-type-a-from-the-past-to-the-present
#8
Claudio F Russo, Giovanni Mariscalco, Pasquale Santé
Acute aortic dissection type A (AADA) is a disease that has a catastrophic impact on a patient's life. Although refinements in perioperative and surgical care have translated into improved outcomes for patients affected by AADA, hospital mortality after surgery still remains very high, ranging from 15% to 30%. The management of AADA is complex and dictated by the modality of presentation, extent and location of the disease. Attempts to formulate consensus statements and relevant guidelines have identified significant gaps in the AADA knowledge with reference to pathogenesis, appropriate management and configuration for clinical services...
November 2016: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/27964981/aortic-root-surgery-with-circulatory-arrest-predictors-of-prolonged-postoperative-hospital-stay
#9
Ourania Preventza, Joseph S Coselli, Andrea Garcia, Shahab Akvan, Sarang Kashyap, Katherine H Simpson, Matt D Price, Kim I de la Cruz, Konstantinos Spiliotopoulos, Lorraine D Cornwell, Faisal G Bakaeen, Shuab Omer, Denton A Cooley
OBJECTIVE: Little is known about the outcomes of aortic root operations that involve inducing hypothermic circulatory arrest for relatively extensive proximal aortic surgery. We attempted to identify predictors of postoperative hospital length of stay (LOS) and factors that affect postoperative recovery. METHODS: During 2006-2014, 247 of 265 patients (93.2%) with disease extending into the aortic arch survived aortic root operations (206 elective, 41 urgent/emergent) in which hypothermic circulatory arrest with moderate hypothermia was used...
November 16, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27964919/clinical-outcomes-of-the-david-v-valve-sparing-root-replacement-compared-with-bioprosthetic-valve-conduits-for-aortic-root-aneurysms
#10
Jiro Esaki, Bradley G Leshnower, Jose N Binongo, Yi Lasanajak, LaRonica McPherson, Michael E Halkos, Robert A Guyton, Edward P Chen
BACKGROUND: Valve-sparing root replacement (VSRR) is an established therapy for aortic root pathology. Limited insight exists when the results of VSRR are compared with those of conventional root replacement with use of a bioprosthetic composite conduit (BIO). This study compares the operative and midterm results of VSRR and BIO. METHODS: A retrospective review from 2002 to 2015 at a United States academic center identified 282 patients who underwent VSRR and 425 patients who underwent BIO...
December 10, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27955909/cardiovascular-operations-for-loeys-dietz-syndrome-intermediate-term-results
#11
Nishant D Patel, Todd Crawford, J Trent Magruder, Diane E Alejo, Narutoshi Hibino, James Black, Harry C Dietz, Luca A Vricella, Duke E Cameron
OBJECTIVES: Early experience with Loeys-Dietz syndrome (LDS) suggested an aggressive aortopathy with high risk of aneurysm dissection and rupture at young ages and at smaller aortic diameters than in other connective tissue disorders. We reviewed our experience with LDS to re-examine our indications and outcomes of surgical management. METHODS: We reviewed all patients with a diagnosis of LDS who underwent cardiovascular surgery at our institution. The primary endpoint was mortality, and secondary endpoints included postoperative complications and need for reintervention...
November 16, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27939498/elective-primary-aortic-root-replacement-with-and-without-hemiarch-repair-in-patients-with-no-previous-cardiac-surgery
#12
Ourania Preventza, Joseph S Coselli, Matt D Price, Katherine H Simpson, Ouyang Yafei, Kim de la Cruz, Qianzi Zhang, Susan Green
OBJECTIVE: Excellent outcomes have been established for elective aortic root replacement (ARR). It is less clear whether extending the repair into the proximal aortic arch with hypothermic circulatory arrest increases risk. We examined the early outcomes of elective, primary ARR, with and without hemiarch replacement, in patients without previous cardiac surgery. METHODS: Over a 4-year period, 140 non-redo patients (median age, 54 years) underwent elective, primary ARR for root aneurysms; 119 patients (85%) had hemiarch replacement, and 21 (15%) had only ascending aortic replacement...
November 15, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27932024/postoperative-myocardial-infarction-in-acute-type-a-aortic-dissection-a-report-from-the-international-registry-of-acute-aortic-dissection
#13
Stephen D Waterford, Marco Di Eusanio, Marek P Ehrlich, T Brett Reece, Nimesh D Desai, Thoralf M Sundt, Truls Myrmel, Thomas G Gleason, Alberto Forteza, Carlo de Vincentiis, Anthony W DiScipio, Daniel G Montgomery, Kim A Eagle, Eric M Isselbacher, Anja Muehle, Aamir Shah, Daisy Chou, Christoph A Nienaber, Ali Khoynezhad
OBJECTIVE: Postoperative myocardial infarction remains a serious complication in cardiac surgery. The incidence and impact of this condition in acute type A aortic dissection are poorly understood. METHODS: A total of 1445 patients with acute type A aortic dissection who underwent surgery were enrolled in the International Registry of Acute Aortic Dissection from 1996 to 2013. Individuals with preoperative myocardial infarction at hospital presentation and a history of myocardial infarction were excluded...
November 14, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27900535/evaluation-of-cerebral-circulation-during-retrograde-perfusion-by-laser-speckle-flowgraphy
#14
Fumiaki Kimura, Hirotsugu Kanda, Yuki Toyama, Takayuki Kunisawa, Taiji Nagaoka, Akitoshi Yoshida, Hiroto Kitahara, Hiroyuki Kamiya
Laser speckle flowgraphy (LSFG) is an ophthalmologic equipment that qualitatively detects the blood flow of the optic nerve head, which is known to be related with cerebral microcirculation. LSFG can also measure the mean blur rate, which quantitatively calculates the blood flow. We aimed to assess the utility of LSFG in the evaluation of cerebral perfusion during aortic surgery under hypothermic circulatory arrest with retrograde and antegrade cerebral perfusion. Two patients underwent total arch replacement for aneurysm...
November 29, 2016: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27890843/total-endovascular-aortic-repair-in-a-patient-with-marfan-syndrome
#15
Mau Amako, Rafaëlle Spear, Rachel E Clough, Adrien Hertault, Richard Azzaoui, Teresa Martin-Gonzalez, Jonathan Sobocinski, Stéphan Haulon
BACKGROUND: The aim of this study is to describe a total endovascular aortic repair with branched and fenestrated endografts in a young patient with Marfan syndrome and a chronic aortic dissection. Open surgery is the gold standard to treat aortic dissections in patients with aortic disease and Marfan syndrome. METHODS: In 2000, a 38-year-old man with Marfan syndrome underwent open ascending aorta repair for an acute type A aortic dissection. One year later, a redo sternotomy was performed for aortic valve replacement...
November 24, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27885195/evaluation-and-influence-of-brachiocephalic-branch-re-entry-in-patients-with-type-a-acute-aortic-dissection
#16
Shota Yasuda, Kiyotaka Imoto, Keiji Uchida, Norihisa Karube, Tomoyuki Minami, Motohiko Goda, Shinichi Suzuki, Munetaka Masuda
BACKGROUND: Stanford type A acute aortic dissection (A-AAD) extends to the brachiocephalic branches in some patients. After ascending aortic replacement, a remaining re-entry tear in the distal brachiocephalic branches may act as an entry and result in a patent false lumen in the aortic arch. However, the effect of brachiocephalic branch re-entry concomitant with A-AAD remains unknown.Methods and Results:Eighty-five patients with A-AAD who underwent ascending aortic replacement in which both preoperative and postoperative multiple-detector computed tomography (MDCT) scans could be evaluated were retrospectively studied...
December 22, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/27874962/analysis-of-risk-factors-of-type-a-aortic-dissection-taad-operation-of-frozen-elephant-trunk-and-total-arch-replacement
#17
W Shang, M Ma, Y-P Ge, N Liu, J-M Zhu, L-Z Sun
OBJECTIVE:  To investigate the incidence and risk factors of acute renal failure (ARF) after operation of frozen elephant trunk and total arch replacement for acute thoracic aortic aneurysm and dissection (TAAD) with mild hypothermic circulatory arrest (MHCA), and to analyze the long-term survival rate of the patients with ARF. PATIENTS AND METHODS: From February 2009 to March 2015, patients with acute TAAD accepted operation of frozen elephant trunk and total arch replacement were enrolled...
November 2016: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/27863729/outcomes-of-anterolateral-thoracotomy-with-or-without-partial-sternotomy-for-kommerell-diverticulum
#18
Gaku Uchino, Keiji Yunoki, Shigeru Hattori, Naoya Sakoda, Takuya Kawabata, Munehiro Saiki, Yasufumi Fujita, Kunikazu Hisamochi, Hideo Yoshida
BACKGROUND: Kommerell diverticulum is a rare aortic arch anomaly. The indications for operative intervention and surgical strategy are still controversial. The standard surgical procedure at our institution is total aortic arch plus descending aortic replacement using anterolateral thoracotomy with partial sternotomy. The aberrant subclavian artery is reconstructed anatomically or extraanatomically. METHODS: From 2002 to 2014, 6 patients (1 woman), aged 55 to 78 years, underwent graft replacement through an anterolateral thoracotomy or anterolateral thoracotomy with a partial sternotomy approach for Kommerell diverticulum...
November 15, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27847081/complete-resection-of-thymic-sarcomatoid-carcinoma-through-total-aortic-arch-replacement
#19
Soichi Oka, Akihiro Taira, Shuichi Shinohara, Taiji Kuwata, Masaru Takenaka, Yasuhiro Chikaishi, Ayako Hirai, Hidetaka Uramoto, Yosuke Nishimura, Fumihiro Tanaka
Sarcomatoid carcinoma of the thymus is extremely rare. An operation remains the only effective treatment for this disease. We report a case of complete resection of thymic sarcomatoid carcinoma through a total aortic arch replacement and left upper lobectomy at our institution. Our aggressive operation was very effective, and the patient has experienced no recurrence in the 3 years since his operation.
December 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27845304/partial-aortic-root-remodeling-for-root-reconstruction-in-patients-with-acute-type-a-dissection
#20
Fuhua Huang, Liangpeng Li, Wei Qin, Cunhua Su, Liming Wang, Liqiong Xiao, Xin Chen
In the present study, we reported our experience with partial aortic root remodeling for root reconstruction in patients with acute type A dissection, which involves in non-coronary sinus and/or the right coronary sinus with just one trimmed Dacron graft. Between February 2001 and May 2010, we performed partial aortic root remodeling in 40 patients, who underwent emergency surgical intervention. The dissected sinuses were excised leaving a 3-5 mm rim of the aortic wall from the attached aortic valve cusps. A short piece (4-5 cm) of collagen coated woven polyester vascular prosthesis was trimmed with one or two "tongues" to reconstruct the non-coronary sinus and/or the right coronary sinus, but without using separated patches...
September 2016: Journal of Biomedical Research
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