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Aortic arch replacement

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https://www.readbyqxmd.com/read/28711965/efficacy-of-an-extracellular-matrix-in-systemic-loading-conditions-in-congenital-heart-surgery
#1
Adeel Ashfaq, Amit Iyengar, Oh Jin Kwon, Mohammad S Soroya, Son Nguyen, Ryan Ou, Brian Reemtsen
Extracellular matrices (ECM) are commonly used to repair congenital heart defects; however, there is a lack of literature pertaining to outcomes with ECM use in high-pressure conditions. Between 2011 and 2014, a total of 202 patients underwent congenital heart disease repair using the ECM placed in a systemic pressure condition. The operative sites included: defects in the ventricular septum, mitral valve, aortic valve, ascending aorta, and aortic arch. Patients were followed and evaluated for mortality and reoperations due to loss of ECM integrity...
July 15, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28705446/a-novel-sax-stent-method-in-treatment-of-ascending-aorta-and-aortic-arch-aneurysms-evaluated-by-finite-element-simulations
#2
M C Arokiaraj, M De Beule, G De Santis
OBJECTIVES: A novel stent method to simplify treatment of proximal ascending aorta and aortic arch aneurysms was developed and investigated by finite element analysis. Therapy of ascending aortic and aortic arch aneurysms is difficult and challenging and is associated with various complications. METHODS: A 55mm wide×120mm long stent was designed without the stent graft and the stent was deployed by an endovascular method in a virtual patient-specific aneurysm model...
February 2017: J Med Vasc
https://www.readbyqxmd.com/read/28698420/-intravascular-hemolysis-caused-by-stenosis-of-an-elephant-trunk-report-of-a-case
#3
Rikako Takamaru, Koji Kawahito, Kei Aizawa, Yoshio Misawa
Symptomatic intravascular hemolysis after prosthetic aortic graft replacement is rare. It is primarily attributed to mechanical injury of red blood cells caused by stenosis of the vascular graft. A 50-year-old man presented with hemolytic anemia, 5 years after total arch replacement with an elephant trunk for type A aortic dissection. The hemolysis was caused by graft stenosis of the elephant trunk. Endovascular treatment for the stenotic elephant trunk was successfully performed. The postoperative course was uneventful, and the hemolysis was resolved immediately after operation...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28693049/hybrid-repair-techniques-for-complex-aneurysms-and-dissections-involving-the-aortic-arch-and-thoracic-aorta
#4
Rami Tadros, Scott R Safir, Peter L Faries, Daniel K Han, Rajiv K Chander, James F McKinsey, Michael L Marin, Allan S Stewart, Sharif Ellozy
Aortic aneurysms involving the ascending aorta, aortic arch, and descending thoracic aorta have been a challenging entity to surgically treat for over 60 years. Despite the mortality of the disease, early open surgical procedures also had significant morbidity and mortality. The inherent risk in treating multiple anatomic segments simultaneously led to the innovation of the staged elephant trunk (ET) approach by Borst in 1983. To avoid the thoracotomy and associated complications related to the second stage of the procedure, an endovascular completion paradigm was begun by Volodos in 1991...
July 11, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28689951/spot-stenting-of-supra-aortic-branch-vessels-for-residual-type-a-dissection
#5
Ciro Ferrer, Raffaele Grande, Luigi Venturini, Valerio Scarano Catanzaro, Gabriele Maritati, Luca di Marzo
of this report is to describe the exclusion of the false lumen in a residual type A aortic dissection (TAAD) by the deployment of two covered stents: one in the right common carotid artery (RCCA) and one in the left subclavian artery (LSA). A 77-year-old female, already treated with ascending aorta replacement for acute TAAD, was referred to our center for a 97-mm post-dissection arch aneurysm. A computed tomography angiography (CTA) showed false lumen patency by reperfusion from secondary tears located at level of RCCA and LSA...
July 6, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28683997/is-less-more-or-is-more-less
#6
EDITORIAL
Leonard N Girardi, Lucas B Ohmes
Although aortic hemiarch replacement without the use of deep hypothermic circulatory arrest may be feasible in experienced centers, manipulation of the aortic arch and great vessels is of concern. Additional research is necessary before widespread adoption of this technique.
April 2017: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28683996/an-alternative-technique-for-hemiarch-replacement-without-using-deep-hypothermic-circulatory-arrest
#7
Michael Scott Halbreiner, Michael Yamashita, Ryan Plichta, Lars G Svensson
We describe an alternate technique to perform a replacement of the aortic hemiarch without the need for hypothermic circulatory arrest by axillary cannulation and arch vessel isolation. In 2015, 3 patients underwent hemiarch reconstructions for ascending aortic aneurysms that extended into the arch. Each was performed using right axillary cannulation, isolation and clamping of the innominate artery with isolation, and tangential clamping of the aorta distal to the innominate. There were no neurologic events and no perioperative morbidity or mortality...
April 2017: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28683913/neuroprotection-strategies-in-aortic-surgery
#8
REVIEW
Edward J Bergeron, Matthew S Mosca, Muhammad Aftab, George Justison, Thomas Brett Reece
Neurologic injury is a potentially devastating complication of aortic surgery. The methods used in aortic surgery, including systemic cooling, initiation of circulatory arrest, and rewarming during the replacement of the aortic arch, are the most complex circulatory management and surgical procedures performed in modern-day surgery. Despite the plethora of published literature, neuroprotection in aortic surgery is largely based on observational studies and institutional-based practices. This article summarizes the current evidence and emerging strategies for neuroprotection in aortic arch operations...
August 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/28683908/aortic-arch-pathology-surgical-options-for-the-aortic-arch-replacement
#9
REVIEW
Giorgio Zanotti, Thomas Brett Reece, Muhammad Aftab
Aortic arch surgery remains one of the most technically challenging procedures in cardiac surgery. It demands consideration of myocardial, brain, spinal cord, and lower body protection and rigorous surgical technique. Novel surgical approaches and refinements in brain and end organ protection strategies, liberal use of antegrade cerebral perfusion and moderate hypothermia have made arch repair safer. As endovascular technology and open surgical techniques evolve, aortic surgeons will need to continue to learn and incorporate these methods into practice in order to improve outcomes...
August 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/28683905/acute-type-a-aortic-dissection
#10
REVIEW
Ramsey S Elsayed, Robbin G Cohen, Fernando Fleischman, Michael E Bowdish
Type A aortic dissection is a surgical emergency occurring when an intimal tear in the aorta creates a false lumen in the ascending aorta. Prompt diagnosis and surgical treatment are imperative to optimize outcomes. Surgical repair requires replacement of the ascending aorta with or without aortic root or aortic arch replacement. Surgical outcomes for this highly lethal diagnosis have improved, with contemporary survival to discharge at Centers of Excellence of 85% to 90%. Survival is related to prompt treatment, preexisting medical comorbidities, presence or absence of end organ malperfusion, extent of aortic repair required, and the development of postoperative complications...
August 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/28673709/patient-tailored-aortic-root-repair-in-adult-marfanoid-patients-surgical-considerations-and-outcomes
#11
Paul P Urbanski, Atanas Jankulowski, Aleksandra Morka, Vadim Irimie, Xiaochun Zhan, Michael Zacher, Anno Diegeler
OBJECTIVE: The aim of the study was to evaluate the operative and functional results after individual, patient-tailored aortic root repair in marfanoid patients. METHODS: Among 518 patients who underwent operation between 2002 and January 2016, using patient-tailored aortic root repair with isolated sinus replacement, 42 patients fulfilled the original Ghent criteria. None/trivial, mild, moderate, and severe insufficiency grades were present in 5, 16, 10, and 11 patients, respectively...
June 13, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28673705/reoperative-aortic-root-replacement-outcome-in-a-contemporary-series
#12
Jiro Esaki, Bradley G Leshnower, Jose N Binongo, Yi Lasanajak, LaRonica McPherson, Vinod H Thourani, Edward P Chen
OBJECTIVES: Reoperative aortic root replacement is a challenging procedure associated with significant mortality and morbidity. The purpose of this study was to investigate the outcomes of reoperative aortic root replacement when performed in a number of complex clinical settings and to identify risk factors for operative mortality and long-term survival. METHODS: From 2006 to 2015, 280 consecutive patients at an academic center underwent reoperative aortic root replacement after a variety of previous aortic or cardiac operations...
June 3, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28673110/valve-sparing-root-and-total-arch-replacement-for-cutis-laxa-aortopathy
#13
Anji T Yetman, James Hammel, Jennifer N Sanmann, Lois J Starr
Aortic aneurysms requiring surgery in early childhood are rare. Herein we describe the case of a three-year-old with massive aneurysmal aortic dilation secondary to the rare and often lethal genetic disorder, cutis laxa. Initial thoracic aortic aneurysm gene panel was negative. Parents of the child were not known to be consanguineous, but high-density SNP array revealed several regions of homozygosity. This prompted targeted sequence analysis that identified a novel homozygous missense mutation in the gene for cutis laxa, EFEMP2...
January 1, 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28671865/quality-of-life-after-surgery-for-stanford-type-a-aortic-dissection-influences-of-different-operative-strategies
#14
Tamer Ghazy, Mohamed Eraqi, Adrian Mahlmann, Helena Hegelmann, Klaus Matschke, Utz Kappert, Norbert Weiss
BACKGROUND: Outcome of surgery for acute Stanford type A aortic dissection extends beyond mortality and morbidity. More than one operative strategy is available but little is known regarding their influence on quality of life. This study analyzes the influence of defensive and aggressive operative strategies on the patients' midterm quality of life (QoL). METHODS: From July 2007 to July 2010, 95 patients underwent surgery for acute Stanford type A aortic dissection in our institution...
June 22, 2017: Heart Surgery Forum
https://www.readbyqxmd.com/read/28648010/-experience-of-sun-s-procedure-for-chronic-type-b-dissection-with-aortic-arch-involvement
#15
R D Qi, J M Zhu, L Chen, C N Li, Z Y Qiao, L J Cheng, Y P Ge, H O Hu, Y Xia, X Y Xing, T Zheng, Y M Liu, L Z Sun
Objective: To study the surgical treatment of chronic type B dissection with aortic arch involvement using Sun's procedure. Methods: Between February 2009 and December 2015, 29 patients [20 males, 9 females, with a mean age of (41±12) years, range 24-64 years] with type B dissection with aortic arch involvement underwent Sun's procedure. Sixteen patient had a history of hypertension. Marfan syndrome was observed in 9 cases, coronary artery disease in 3 cases, mitral regurgitation in 3 patients, cerebrovascular disease in one patient...
June 27, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28637170/neuroprotective-effect-of-pressure-oriented-flow-regulation-and-ph-stat-management-in-selective-antegrade-brain-perfusion-during-total-aortic-arch-repair
#16
Hisato Ito, Toru Mizumoto, Yasuhiro Sawada, Kazuya Fujinaga, Hironori Tempaku, Yasunori Yamamoto, Katsuhiro Tsutsui, Hideto Shimpo
OBJECTIVES: The aim of this study was to assess the safety and effectiveness of our selective antegrade brain perfusion (SABP) strategy, which is characterized by moderate hypothermic and low-pressure management under pH-stat using a completely closed cardiopulmonary bypass circuit with a single centrifugal pump. METHODS: Forty-nine consecutive patients (median age, 74) underwent total aortic arch replacement using a 4-branched graft. SABP was conducted with individual cannulation in all arch vessels...
June 20, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28616348/predictive-risk-models-for-proximal-aortic-surgery
#17
REVIEW
Daniel Hernandez-Vaquero, Rocío Díaz, Isaac Pascual, Rubén Álvarez, Alberto Alperi, Jose Rozado, Carlos Morales, Jacobo Silva, César Morís
Predictive risk models help improve decision making, information to our patients and quality control comparing results between surgeons and between institutions. The use of these models promotes competitiveness and led to increasingly better results. All these virtues are of utmost importance when the surgical operation entails high-risk. Although proximal aortic surgery is less frequent than other cardiac surgery operations, this procedure itself is more challenging and technically demanding than other common cardiac surgery techniques...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28616345/wrapping-of-the-ascending-aorta-revisited-is-there-any-role-left-for-conservative-treatment-of-ascending-aortic-aneurysm
#18
REVIEW
José María González-Santos, María Elena Arnáiz-García
Dilatation of the ascending aorta (AA) is a common finding in patients with aortic valve disease. The clinical practice guidelines recommend replacing the AA whenever the diameter exceeds 45 mm. However, no consensus has been reached regarding the approach when the aorta is only moderately dilated. Although the risk in aorta replacement is generally low, it may be higher when associated with other complex surgical procedures or it is carried out in elderly patients or patients with significant comorbidity. This would justify the use of alternative surgical techniques, which reduce surgical risk and guarantee a durable correction of the aortic pathology...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28606609/retrograde-type-a-dissection-after-thoracic-endovascular-aortic-repair-surgical-strategy-and-literature-review
#19
Zhao An, Zhigang Song, Hao Tang, Lin Han, Zhiyun Xu
BACKGROUND: In this study, we investigated the surgical strategy for managing retrograde type A dissection (RTAD) after thoracic endovascular aortic repair (TEVAR) by reporting our experience and literature review. METHODS: From June 2011 to January 2014, nine patients with RTAD received surgical repair in our institution. The mean age of these patients was 49.3±10.7 years. Data on these RTAD patients was retrospectively collected for further analysis. Literature related to RTAD after TEVAR from 2006 to 2014 was reviewed using the following terms: thoracic endovascular aortic repair, retrograde type A dissection, stent induced new entry, and surgical repair...
May 29, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28606285/-the-application-of-short-stent-in-root-of-aorta-for-the-treatment-of-stanford-type-a-aortic-dissection
#20
X P Chen, Y P Zhao, Y F Ye, S Chen, G J Zhu, J Hu
Objective: To explore the effect of implanting short stent in root of aorta for the treatment of Stanford type A aortic dissection. Methods: Clinical data of 39 patients with Stanford type A aortic dissection who underwent surgical procedure at the Department of Cardiovascular Surgery of Luoyang Central Hospital Affiliated to Zhengzhou University, between January 2013 and December 2015 were retrospectively analyzed. There were 31 males and 8 females aged 27 to 75 (49.3±10.3) years. All patients received short stent implanting in aortic root, total arch replacement and stented elephant trunk implantation were performed at the same time...
June 13, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
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