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Aortic arch replacement

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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
#1
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
#2
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/29778817/extent-of-aortic-replacement-in-type-a-dissection-current-answers-for-an-endless-debate
#3
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/29777669/repair-of-thoracic-and-thoracoabdominal-mycotic-aneurysms-and-infected-aortic-grafts-using-allograft
#4
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
#5
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/29755089/-surgical-repair-of-kommerell-s-diverticulum-with-right-sided-aortic-arch-report-of-a-case
#6
Hiromitsu Kawasaki, Yoshihiro Nakayama, Yuichi Koga, Baku Takahashi, Hisashi Sato
A 54-year-old woman was referred for assessment of dysphagia and extrinsic compression of the esophagus detected by upper gastrointestinal endoscopy. Computed tomography revealed the rightsided aortic arch with mirror image branching and Kommerell's diverticulum. To relieve the esophageal compression, surgical intervention was indicated. Descending aortic replacement with a Dacron graft was performed through right thoracotomy under partial cardiopulmonary bypass. The patient was discharged without any complication, and her dysphagia disappeared...
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
#7
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
#8
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/29754182/assessment-of-aortic-stiffness-in-patients-with-ankylosing-spondylitis-using-cardiovascular-magnetic-resonance
#9
P Stefan Biesbroek, Sjoerd C Heslinga, Peter M van de Ven, Mike J L Peters, Raquel P Amier, Thelma C Konings, Christopher D Maroules, Colby Ayers, Parag H Joshi, Irene E van der Horst-Bruinsma, Vokko P van Halm, Albert C van Rossum, Michael T Nurmohamed, Robin Nijveldt
To evaluate aortic stiffness in patients with ankylosing spondylitis (AS) using cardiovascular magnetic resonance (CMR) and to assess its association with AS characteristics and left ventricular (LV) remodeling. In this prospective study, 14 consecutive AS patients were each matched to two controls without cardiovascular symptoms or known cardiovascular disease who underwent CMR imaging for the assessment of aortic arch pulse wave velocity (PWV) at 1.5 Tesla. To enhance comparability of the samples, matching was done with replacement resulting in 20 unique controls...
May 12, 2018: Clinical Rheumatology
https://www.readbyqxmd.com/read/29753501/low-rate-of-reoperations-after-acute-type-a-aortic-dissection-repair-from-the-nordic-consortium-registry
#10
Emily Pan, Tomas Gudbjartsson, Anders Ahlsson, Simon Fuglsang, Arnar Geirsson, Emma C Hansson, Vibeke Hjortdal, Anders Jeppsson, Kati Järvelä, Ari Mennander, Shahab Nozohoor, Christian Olsson, Anders Wickbom, Igor Zindovic, Jarmo Gunn
OBJECTIVES: To describe the relationship between the extent of primary aortic repair and the incidence of reoperations after surgery for type A aortic dissection. METHODS: A retrospective cohort of 1159 patients treated for type A aortic dissection at eight Nordic low- to medium-sized cardiothoracic centers from 2005 to 2014. Data were gathered from patient records and national registries. Patients were separately divided into 3 groups according to the distal anastomoses technique (ascending aorta [n = 791], hemiarch [n = 247], and total arch [n = 66]), and into 2 groups for proximal repair (aortic root replacement [n = 285] and supracoronary repair [n = 832])...
April 12, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29750927/frozen-elephant-trunk-for-acute-type-b-dissection-involving-the-distal-arch-in-the-hybrid-repair-era
#11
Rui-Dong Qi, Jun-Ming Zhu, Yong-Min Liu, Lei Chen, Cheng-Nan Li, Xiao-Yan Xing, Nan Zhang, Li-Zhong Sun
BACKGROUND: Hybrid repair of complicated acute type B aortic dissection(ATBAD) with aortic arch involvement is associated with a high rate of endoleak, stroke, and retrograde aortic dissection. Optimal management of this lesion remains uncertain. In this hybrid repair era, surgical results of ATBAD with distal aortic arch involvement using a frozen elephant trunk(FET) procedure with left subclavian artery(LSCA)-left common carotid artery(LCCA) transposition is reported. METHODS: From April 2011 to April 2016, 53 patients with complicated ATBAD with distal aortic arch involvement underwent a FET procedure with LSCA-LCCA transposition...
May 8, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29748059/experience-with-the-axillary-artery-as-an-arterial-cannulation-site-in-patients-with-acute-type-a-aortic-dissection
#12
Arpit Talwar, Elvina Wiadji, Manu N Mathur
BACKGROUND: The optimal arterial cannulation site in patients undergoing surgical management of acute type A aortic dissection (ATAAD) remains controversial. The axillary artery is rarely involved in the dissection process, provides antegrade flow in the descending aorta and minimises intraoperative malperfusion. The purpose of this study is to evaluate a single surgeon's experience of axillary artery cannulation for ATAAD repair. METHODS: All consecutive patients over a 15-year period having surgical repair of ATAAD were included in this study...
March 29, 2018: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29741604/impact-of-reimplantation-technique-of-supra-aortic-branches-in-total-arch-replacement-on-stroke-rate-and-survival-results-from-the-arch-registry
#13
Florian S Schoenhoff, David H Tian, Martin Misfeld, Konstantinos G Perreas, David Spielvogel, Friedrich W Mohr, Friedhelm Beyersdorf, Tristan D Yan, Thierry P Carrel
OBJECTIVES: Our objective was to evaluate the impact of reimplantation techniques of the supra-aortic branches in total arch replacement on the rates of permanent neurological deficit (PND) and survival. METHODS: We identified patients enrolled in the ARCH registry who underwent total arch replacement between 2000 and 2015 with either en bloc or separate reimplantation of the supra-aortic branches. RESULTS: A total of 3345 patients were included in the present analysis...
May 8, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29720205/retrograde-type-a-dissection-in-a-24th-gestational-week-pregnant-patient-the-importance-of-interdisciplinary-interaction-to-a-successful-outcome
#14
Jerry Easo, Michael Horst, Bernhard Schmuck, Rohit Philip Thomas, Steffen Saupe, Malte Book, Alexander Weymann
BACKGROUND: Type A Dissection in pregnancy is a devastating medical condition with 2 lives at stake and unclear strategy at early gestational stages. We describe a successful outcome, clearly dependent on the coordination of all involved disciplines. CASE PRESENTATION: This case history describes a 28 year old female with a 24th week pregnancy gravida 2 para 0 with a DeBakey Type I aortic dissection, diagnosed via ultrasound. Surgery was perfomed on the day of diagnosis...
May 2, 2018: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29720088/three-dimensional-thoracic-aorta-principal-strain-analysis-from-routine-ecg-gated-computerized-tomography-feasibility-in-patients-undergoing-transcatheter-aortic-valve-replacement
#15
Alessandro Satriano, Zachary Guenther, James A White, Naeem Merchant, Elena S Di Martino, Faisal Al-Qoofi, Carmen P Lydell, Nowell M Fine
BACKGROUND: Functional impairment of the aorta is a recognized complication of aortic and aortic valve disease. Aortic strain measurement provides effective quantification of mechanical aortic function, and 3-dimenional (3D) approaches may be desirable for serial evaluation. Computerized tomographic angiography (CTA) is routinely performed for various clinical indications, and offers the unique potential to study 3D aortic deformation. We sought to investigate the feasibility of performing 3D aortic strain analysis in a candidate population of patients undergoing transcatheter aortic valve replacement (TAVR)...
May 2, 2018: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29705370/clinical-outcomes-of-vasoring-connector-in-patients-with-acute-type-a-aortic-dissection
#16
I-Ming Chen, Po-Lin Chen, Shih-Hsien Weng, Chiao-Po Hsu, Chun-Che Shih, Hsiao-Huang Chang, Jeng Wei
BACKGROUND: Outcomes of acute type A aortic dissection (TAAD) repair may be improved when VasoRing connectors (VRC) are employed to facilitate aortic anastomosis. In the present study, we compared the results of acute TAAD repair using VRC and conventional suture technique. METHODS: A total of 68 patients who underwent acute TAAD repair by total arch replacement and antegrade frozen elephant trunk procedure at our institution were enrolled. Records of patients receiving aorta anastomosis with VRC (n = 33) and conventional suture (n =35) were retrospectively compared...
April 26, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29701390/ascending-aorta-aneurysms-in-octogenarians
#17
Jorge Pinheiro Santos, Álvaro Laranjeira, António Cruz Tomás, Daniela Varela-Afonso, José Fragata
INTRODUCTION: Older age is often regarded as a relative contraindication for open surgery for aortic aneurysms. These individuals often have a greater comorbidity burden that predispose them for development of postoperative complications. The aim of our study is to evaluate the surgical outcomes of selected octogenarians after open aortic surgery. METHODS: We performed a retrospective observational study. We collected data from patients operated on by our team between January of 2012 to September of 2017...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29701386/simplified-technique-for-aortic-arch-replacement-in-patients-at-high-risk-for-frozen-elephant-trunk
#18
Álvaro Laranjeira Santos, António Cruz Tomás, Jorge Pinheiro Santos, Daniela Varela-Afonso, José Fragata
INTRODUCTION: Surgical approach of multisegmental pathology of the thoracic aorta, namely aortic arch / descending aorta is challenging. The Frozen Elephant Trunk (FET) has good results, with acceptable risk. However, in the subgroup of patients (pts) older than 75 years and with important comorbidities, the surgical risk is very high. OBJECTIVES: Review short-term results of this original, simplified and potentially hybrid technique developed in our Department for this subgroup of patients...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29701358/carotid-stenosis-in-cardiac-surgery-patients
#19
Pedro Pinto Sousa, Gabriela Teixeira, João Gonçalves, Carlos Veiga, Pedro Sá Pinto, Pedro Brandão, Alexandra Canedo, Luis Vouga, Rui Almeida
INTRODUCTION: Ischemic stroke is a potential perioperative complication after an open heart surgery (OHS). Whether a carotid stenosis or occlusion is associated with an increased risk of perioperative stroke in patients or just a risk factor has been a concern of intense debate in the literature. METHODS: We retrospectively analyzed patients submitted to OHS between January and December2016 with known asymptomatic carotid disease. The data from 85 consecutive patients undergoing coronary artery bypass grafting, valve replacement, or both was collected...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29699874/aortic-arch-reconstruction-are-hybrid-debranching-procedures-a-good-choice
#20
REVIEW
Nikolaos A Papakonstantinou, Constantine N Antonopoulos, Nikolaos G Baikoussis, Ioannis Kakisis, Georgios Geroulakos
INTRODUCTION: Conventional open total arch replacement is the treatment of choice for surgical aortic arch pathologies. However, it is an invasive procedure, requiring cardiopulmonary bypass and deep hypothermic circulatory arrest leading to significant morbidity and mortality rates. Hybrid aortic arch debranching procedures without (type I) or with (type II) ascending aorta replacement seek to limit operative, bypass, and circulatory arrest times by making the arch repair procedure simpler and shorter...
March 30, 2018: Heart, Lung & Circulation
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