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Coarctation Repair

Ugur Kaya, Abdurrahim Colak, Necip Becit, Munacettin Ceviz, Hikmet Kocak
Objective: In the present study, we aimed to retrospectively investigate the early and late results of different surgical treatment techniques applied in different age groups with coarctation of the aorta (CoA). Materials and Methods: Between January 2007 and February 2017, 26 patients (12 males, 14 females; mean age: 12.2±12.4 years; range: 29 days-34 years) who underwent surgery with the diagnosis of CoA were evaluated. Overall, 11 of these patients (42.3%) were in the infantile period, whereas 15 patients (57...
February 2018: Eurasian Journal of Medicine
Takayuki Shijo, Takashi Shirakawa, Masao Yoshitatsu, Keiji Iwata
Stent grafting for complex aortic anatomy remains a challenge. In particular, stent graft collapse (i.e. infolding) is possible when an excessive oversized device is needed. We describe a case of preoperative stent grafting simulation using a three-dimensional (3D) printed model for extensive aortic arch repair in a 69-year-old woman with multiple aneurysms combined with coarctation. The patient was scheduled to undergo staged hybrid repair. A stent graft larger than 28 mm in diameter was needed to deploy into a coarctation of 15 mm in diameter during the 2nd stage of the operation...
March 8, 2018: European Journal of Cardio-thoracic Surgery
Ineke Nederend, Eco J C de Geus, Lucia J M Kroft, Jos J M Westenberg, Nico A Blom, Arend D J Ten Harkel
BACKGROUND: Coarctation of the aorta (CoA) is one of the most common congenital heart defects. Due to improved surgical techniques, most patients live into adulthood. However, late complications including hypertension, recoarctation and arrhythmias are common. The autonomic nervous system (ANS) might play a role in the pathology. The aim of this study was to evaluate cardiac ANS activity and cardiac function in children after CoA repair and investigate the relationship between the two...
March 5, 2018: Annals of Thoracic Surgery
Melissa G Y Lee, Johnny Millar, Elizabeth Rose, Aleesha Jones, Dora Wood, Taryn L Luitingh, Diana Zannino, Johann Brink, Igor E Konstantinov, Christian P Brizard, Yves d'Udekem
OBJECTIVES: To determine the incidence of vocal cord paresis (VCP) after neonatal aortic arch repair/Norwood-type procedure, and the effectiveness of noninvasive laryngeal ultrasound in detecting VCP compared with gold standard invasive nasoendoscopy. METHODS: Fifty-two patients who underwent an arch repair (39 of 52; 75%) or Norwood-type procedure (13 of 52; 25%) via sternotomy between April 1, 2015, and April 30, 2017 underwent laryngeal ultrasound (50 of 52; 96%) and/or flexible fiber optic nasoendoscopy (39 of 52; 75%) at 48 to 72 hours after endotracheal extubation...
February 9, 2018: Journal of Thoracic and Cardiovascular Surgery
Yoshinori Kuroda, Tetsuro Uchida, Azumi Hamasaki, Atsushi Yamashita, Masahiro Mizumoto, Jun Hayashi, Ai Ishizawa, Kentaro Akabane, Mitsuaki Sadahiro
A 45 year-old-man who had undergone ventricular septal defect repair during childhood presented with hoarseness. He was diagnosed as having a distal aortic arch aneurysm by using computed tomography, and was referred to our hospital for surgical treatment. The operation was performed via a 4th intercostal thoracotomy in the right lateral position. The aortic aneurysm occupied the upper pleural cavity. The aortic arch was pressed up by the aortic aneurysm, so visual identification and clamping of the proximal aorta and the left subclavian artery were extremely difficult...
February 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Gareth J Morgan, Matteo Ciuffreda, Isabella Spadoni, Joseph DeGiovanni
AIM: To assess the acute results of the first human use of the Optimus covered stent in complex coarctation of the aorta. METHODS AND RESULTS: We successfully implanted the Optimus covered stent in eight cases in patients whose preprocedural anatomy looked challenging for currently available covered stents. Six of the patients had native coarctation with one recoarctation following surgical repair. There were no significant complications with reduction in the mean invasive gradient from 22 to 1 mm Hg...
February 21, 2018: Congenital Heart Disease
Eisaku Nakamura, Kunihide Nakamura, Koji Furukawa, Hirohito Ishii, Katsuya Kawagoe
PURPOSE: Coarctation of the aorta (CoA) in adolescents and adults is relatively rare. Several operative techniques for CoA in adolescents and adults have been reported, but there is still no consensus. This study aims to highlight the use of individual patient characteristics to select optimal treatment strategies for CoA in adolescents and adults. METHODS: Surgical repair of CoA was performed in five patients (mean age: 34 ± 14 years, range: 13-58 years). All patients had primary CoA, and one had aneurysm above the CoA...
February 16, 2018: Annals of Thoracic and Cardiovascular Surgery
Hideto Ozawa, Takaya Hoashi, Kazuto Fujimoto, Hajime Ichikawa
An 11-month-old girl with an unbalanced atrioventricular septal defect, coarctation of the aorta and an interrupted inferior vena cava with hemiazygos continuation post-surgical status of coarctation repair and pulmonary artery banding underwent a Kawashima operation. Severe hypoxia occurred immediately after she was weaned from cardiopulmonary bypass, which was successfully resolved by the ligation of the hemiazygos vein. Postoperative enhanced computed tomography detected significant venovenous malformation from the hemiazygos vein to the left renal vein...
February 13, 2018: Interactive Cardiovascular and Thoracic Surgery
Michaela M Hell, Elizabeth Orchard, Stephen Westaby, Saul G Myerson
No abstract text is available yet for this article.
February 6, 2018: European Heart Journal
Akihiko Higashida, Takaya Hoashi, Masataka Kitano, Masatoshi Shimada, Tomohiro Nakata, Hideto Ozawa, Kenichi Kurosaki, Hajime Ichikawa
OBJECTIVES: To assess the feasibility of hybrid Stage I palliation consisting of bilateral pulmonary artery bandings and ductal stenting for patients with 2 ventricular cavities and hypoplastic left heart structures. METHODS: Eleven consecutive patients who underwent hybrid Stage I palliation between 2010 and 2017 were enrolled. The diagnoses were interrupted aortic arch/coarctation of the aorta, ventricular septal defect and significant left ventricular (LV) outflow tract obstruction in 5 patients, critical aortic stenosis and reduced LV contraction in 3 patients and hypoplastic left heart complex in 3 patients...
January 24, 2018: Interactive Cardiovascular and Thoracic Surgery
Jeffrey P Jacobs, John E Mayer, Sara K Pasquali, Kevin D Hill, David M Overman, James D St Louis, S Ram Kumar, Carl L Backer, Charles D Fraser, James S Tweddell, Marshall L Jacobs
The Society of Thoracic Surgeons Congenital Heart Surgery Database is a comprehensive clinical outcomes registry which captures almost all pediatric cardiac surgical operations in the United States. It is the platform for all activities of The Society of Thoracic Surgeons related to the analysis of outcomes and the improvement of quality in this subspecialty. This article summarizes current aggregate national outcomes in congenital and pediatric cardiac surgery and reviews related activities in the areas of quality measurement, performance improvement, and transparency...
January 11, 2018: Annals of Thoracic Surgery
Rabie Soliman, Dalia Saad
OBJECTIVE: The aim of the study was to assess the effect of dexmedetomidine on the incidence of paradoxical hypertension in patients undergoing aortic coarctation repair. DESIGN: Randomized observational study. SETTING: University hospital and cardiac center. PATIENTS: The study included 108 pediatric patients with isolated aortic coarctation. METHODS: The patients were classified into two groups (each = 54): Group D: the patients received dexmedetomidine as a loading dose of 0...
January 2018: Annals of Cardiac Anaesthesia
Benjamin Steven Frank, Tracy T Urban, Suhong Tong, Courtney Cassidy, Max B Mitchell, Christopher S Nichols, Jesse A Davidson
AIM: To determine endothelin-1 (ET-1) concentration before and after surgical coarctectomy and evaluate its association with left ventricular geometric change. METHODS: A prospective, cohort study of 24 patients aged 2 d to 10 years with coarctation of the aorta undergoing surgical repair. A sub-cohort of patients with age < 1 mo was classified as "neonates". Echocardiograms were performed just prior to surgery and in the immediate post-op period to assess left ventricle mass index and relative wall thickness (RWT)...
December 26, 2017: World Journal of Cardiology
Andreas Paschalis, Ioannis Dimarakis
We present a case of asymptomatic residual coarctation following combined resection and isthmusplasty with implantation of the left internal thoracic artery distal to the repair 30 years ago.
January 10, 2018: Cardiology in the Young
Zaccaria Ricci, Simona Benegni, Cristiana Garisto, Isabella Favia, Roberta Haiberger, Luca Di Chiara
BACKGROUND: Endotoxemia in pediatric cardiac surgical patients is poorly understood. The endotoxin activity assay (EAA) levels were examined in neonates undergoing cardiac surgery in order to assess their reference levels and their association with other pre-, intra-, and postoperative risk factors for gut hypoperfusion. We finally observed if refeeding was associated with modification of endotoxin levels. METHODS: In a prospective cohort study, neonates undergoing surgery for correction or palliation were enrolled...
January 2018: World Journal for Pediatric & Congenital Heart Surgery
Yukiko Mizutani, Norio Tada, Takahiko Masuda, Masaki Hata
Coarctation of the aorta (CoA) is a relatively common congenital heart anomaly, and bicuspid aortic valve (BAV) is a common congenital heart disease that coexists with CoA. In larger children and adults with CoA, transcatheter intervention has gained acceptance, but for surgical high-risk patients with aortic stenosis, the use of transcatheter aortic valve implantation (TAVI) has been established. Recently, although favorable data have been reported for TAVI when treating BAV, simultaneous transcatheter intervention for CoA and BAV will prove to be a challenge because of the unique anatomy involved requires multiple procedural steps and also has problems of site access...
July 2017: Journal of Heart Valve Disease
Claudio Capelli, Emilie Sauvage, Giuliano Giusti, Giorgia M Bosi, Hopewell Ntsinjana, Mario Carminati, Graham Derrick, Jan Marek, Sachin Khambadkone, Andrew M Taylor, Silvia Schievano
Patient-specific computational models have been extensively developed over the last decades and applied to investigate a wide range of cardiovascular problems. However, translation of these technologies into clinical applications, such as planning of medical procedures, has been limited to a few single case reports. Hence, the use of patient-specific models is still far from becoming a standard of care in clinical practice. The aim of this study is to describe our experience with a modelling framework that allows patient-specific simulations to be used for prediction of clinical outcomes...
February 6, 2018: Interface Focus
Evan G Starr, John R Doty
We report the case of a 43-year-old woman with severe coronary artery disease, coarctation of the aorta and dextrocardia. Concomitant repair was achieved by coronary artery bypass grafting and ascending-descending bypass of the proximal descending thoracic aorta.
December 20, 2017: Interactive Cardiovascular and Thoracic Surgery
Akihito Matsushita, Yu Tsunoda, Takashi Hattori, Wahei Mihara
A 71 year old male who had undergone extra-anatomic bypass grafting between the ascending aorta and the thoraco-abdominal aorta at 41 years of age for aortic coarctation was admitted with back pain and dyspnea. A 16 mm Cooley double velour knitted polyethylene terephthalate (PET) graft was used in the initial operation in 1983. Computed tomography showed disruption of the initial PET graft perforating the right atrium, and a pseudoaneurysm at the distal anastomosis. The patient was in acute cardiac failure because of left to right shunting...
2018: EJVES Short Reports
Luigi Di Tommaso, Vito A Mannacio, Ettorino Di Tommaso, Giovanni B Pinna, Immacolata Fontana, Gabriele Iannelli
Late aneurysm formation in the proximal aorta or distal aortic arch is a recognized sequela of untreated stenosis of the aortic isthmus and is associated with substantial risk of aortic rupture. We describe the case of a 44-year-old man with untreated coarctation of the aorta who presented with a prestenotic dissecting thoracic aortic aneurysm. He declined surgery because he was a Jehovah's Witness. Instead, we performed emergency endovascular aortic repair in which 2 stent-grafts were placed in the descending aorta...
December 2017: Texas Heart Institute Journal
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