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Coarctation Repair

Jan L Bruse, Abbas Khushnood, Kristin McLeod, Giovanni Biglino, Maxime Sermesant, Xavier Pennec, Andrew M Taylor, Tain-Yen Hsia, Silvia Schievano
OBJECTIVES: Even after successful aortic coarctation repair, there remains a significant incidence of late systemic hypertension and other morbidities. Independently of residual obstruction, aortic arch morphology alone may affect cardiac function and outcome. We sought to uncover the relationship of arch 3-dimensional shape features with functional data obtained from cardiac magnetic resonance scans. METHODS: Three-dimensional aortic arch shape models of 53 patients (mean age, 22...
September 22, 2016: Journal of Thoracic and Cardiovascular Surgery
Petros V Anagnostopoulos
No abstract text is available yet for this article.
September 14, 2016: Journal of Thoracic and Cardiovascular Surgery
Giovanni Alfonso Chiariello, Piergiorgio Bruno, Andrea Mazza, Marco Luciani, Franco Glieca, Massimo Massetti
No abstract text is available yet for this article.
September 19, 2016: Revista Española de Cardiología
Ai Sugimoto, Noritaka Ota, Masaya Murata, Kisaburo Sakamoto
We describe a case of complex left ventricular outflow tract obstruction, multiple muscular ventricular septal defects, aortic coarctation and a hypoplastic aortic arch, where staged biventricular repair was performed successfully using pulmonary root translocation.
September 13, 2016: Interactive Cardiovascular and Thoracic Surgery
Huifeng Zhang, Ming Ye, Gang Chen, Fang Liu, Lin Wu, Bing Jia
BACKGROUND: The hybrid technique combining balloon angioplasty for discrete coarctation (CoA) and surgical repair of a ventricular septal defect (VSD) is a novel treatment for patients with aortic CoA and VSD, but the efficacy of this approach is unknown. METHODS: We performed a retrospective analysis of 92 patients with short segment CoA and VSD who underwent complete repair between January 2004 and July 2014 in our center. Patients were divided into two groups according to the surgical approach employed: hybrid procedure (group A, n=39) and traditional midline surgical repair (group B, n=53)...
August 2016: Journal of Thoracic Disease
Inga Voges, Julian Kees, Michael Jerosch-Herold, Hannes Gottschalk, Jens Trentmann, Christopher Hart, Dominik D Gabbert, Eileen Pardun, Minh Pham, Ana C Andrade, Philip Wegner, Ines Kristo, Olav Jansen, Hans-Heiner Kramer, Carsten Rickers
BACKGROUND: The increased cardiovascular morbidity of adults with late repair of aortic coarctation (CoA) has been well documented. In contrast, successful CoA repair in early childhood has a generally good prognosis, though adverse vascular and ventricular characteristics may be abnormal, which could increase long-term risk. This study sought to perform a comprehensive analysis of aortic elasticity and left ventricular (LV) function in patients with aortic coarctation (CoA) using cardiovascular magnetic resonance (CMR)...
2016: Journal of Cardiovascular Magnetic Resonance
Brian Raffetto, Neil Rifenbark, Ashokkumar Jain
BACKGROUND: Traumatic axilloaxillary arteriovenous (AV) fistulas are rare occurrences, with the predominance of AV fistulas in this region occurring as an alternative surgical intervention in patients who are undergoing hemodialysis. CASE REPORT: We describe the case of a young man with this condition caused by a previous penetrating trauma who had a delayed diagnosis primarily because of the infrequency of the clinical presentation. This is one of a few documented cases of axilloaxillary AV fistulas in the setting of trauma...
September 6, 2016: Journal of Emergency Medicine
Nicola Maschietto, Luca Semplicini, Giulio Ceolotto, Arianna Cattelan, Helen Poser Dvm, Ilaria Iacopetti, Gabriele Gerardi, Giulia Maria De Benedictis, Tommaso Pilla, Daniele Bernardini, Luca Aresu, Stefania Rizzo, Cristina Basso, Andrea Semplicini, Ornella Milanesi
BACKGROUND: Stent implantation is the treatment of choice for adolescents and adults with aortic coarctation (CoAo). Despite excellent short-term results, 20%-40% of the patients develop arterial hypertension later in life, which was attributed to inappropriate response of the aortic baroreceptors to increased stiffness of the ascending aorta (ASAO), either congenital or induced by CoAo repair. In particular, it has been hypothesized that stent itself may cause or sustain hypertension...
September 7, 2016: Congenital Heart Disease
Bahaaldin Alsoufi, Courtney McCracken, Subhadra Shashidharan, Brian Kogon, William Border, Kirk Kanter
BACKGROUND: The two most common surgical strategies for the treatment of neonates born with single-ventricle anomalies associated with aortic arch obstruction are the Norwood operation and pulmonary artery banding plus coarctation repair (PAB+COA). We reviewed characteristics and outcomes of neonates who underwent those two surgical strategies at our institution. METHODS: Between 2002 and 2012, 94 neonates with a single ventricle and aortic arch obstruction (excluding hypoplastic left heart syndrome) underwent Norwood (n = 65) or PAB+COA (n = 29)...
September 1, 2016: Annals of Thoracic Surgery
Peng Huang, Jinwen Luo, Jian Liu, Xiaohui Yang, Xiaoming Peng, Pingbo Liu
OBJECTIVE: To evaluate the safety of surgical repair for neonatal aortic coarctation combined with ventricular septal defect.
 METHODS: Twenty-three aortic coarctation neonates received surgical treatment and their clinical data between April, 2013 and May, 2015 were analyzed retrospectively. All patients underwent coarctation repair + ventricular septal defect repair and mild hyperthermia cardiopulmonary bypass under the condition of general anesthesia. All patients were subjected to delayed sternal closure...
July 2016: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
Stephen C Brown, Benedicte Eyskens, Derize Boshoff, Bjorn Cools, Ruth Heying, Filip Rega, Bart Meyns, Marc Gewillig
OBJECTIVES: To determine the outcome of a bailout procedure using the right ventricle to re-assist the left ventricle in neonates after technically adequate coarctectomy but a failing borderline left heart. METHODS: The surgical procedure was performed on bypass. A 'reversed' 6-mm surgical shunt was inserted between the pulmonary trunk and the descending aorta together with bilateral branch pulmonary artery banding. RESULTS: Over a 10-year period, 89 neonates presented with coarctation and small left hearts...
August 19, 2016: Interactive Cardiovascular and Thoracic Surgery
Zhe-Zhe Peng, Ma-Zhong Zhang, Ying Sun, Jie Bai, Hong-Bin Gu, Pei-Pei Liu, Min Li, Mei-Hua Cai
OBJECTIVE: Anesthetic management for patients undergoing surgical repair of aortic coarctation (CoA) should include constant blood pressure monitoring of the right upper extremity and a lower extremity. The delayed or absent pulse in the lower limbs often leads to unsuccessful arterial cannulation in infants and the oscillometric technique used for blood pressure measurement. The aim of this study was to evaluate the agreement between the oscillometric method and intra-arterial technique for blood pressure monitoring in the lower limbs of infants undergoing CoA...
November 2016: Paediatric Anaesthesia
Zahra Khajali, Hamid Reza Sanati, Hamidreza Pouraliakbar, Bahram Mohebbi, Kamran Aeinfar, Reza Zolfaghari
Endovascular treatment offers a great advantage in the management of main arteries stenoses. However, simultaneous presence of a group of anomalies may complicate the situation. Here we present a case of 21-year old man with aortic coarctation. Radiographic imaging and angiography demonstrated aortic coarctation of the left-circumferential aortic arch, right-sided descending aorta and kommerell's diverticulum at the origin of right subclavian artery. These anomalies have rarely been reported to concurrently exist in the same case and the treatment is challenging...
August 12, 2016: Annals of Vascular Surgery
William T Mahle, Susan C Nicolson, Danielle Hollenbeck-Pringle, Michael G Gaies, Madolin K Witte, Eva K Lee, Michelle Goldsworthy, Paul C Stark, Kristin M Burns, Mark A Scheurer, David S Cooper, Ravi Thiagarajan, V Ben Sivarajan, Steven D Colan, Marcus S Schamberger, Lara S Shekerdemian
OBJECTIVE: To determine whether a collaborative learning strategy-derived clinical practice guideline can reduce the duration of endotracheal intubation following infant heart surgery. DESIGN: Prospective and retrospective data collected from the Pediatric Heart Network in the 12 months pre- and post-clinical practice guideline implementation at the four sites participating in the collaborative (active sites) compared with data from five Pediatric Heart Network centers not participating in collaborative learning (control sites)...
October 2016: Pediatric Critical Care Medicine
Pratik Parikh, Haiqing Bai, Michael F Swartz, George M Alfieris, David A Dean
In order to identify differentially expressed genes that are specific to the ductus arteriosus, 18 candidate genes were evaluated in matched ductus arteriosus and aortic samples from infants with coarctation of the aorta. The cell specificity of the gene's promoters was assessed by performing transient transfection studies in primary cells derived from several patients. Segments of ductus arteriosus and aorta were isolated from infants requiring repair for coarctation of the aorta and used for mRNA quantitation and culturing of cells...
July 27, 2016: Experimental Biology and Medicine
Nilanjan Dutta, Rajarshi Ghosh, Neeraj Awasthy, Sumir Girotra, Sitaraman Radhakrishnan, Savitri Shrivastava, Parvathi Unninayar Iyer, Krishna Subramony Iyer
OBJECTIVES: Strategies for the optimal surgical management of coarctation of aorta with associated intracardiac defects continue to be debated upon. We describe a previously unreported surgical technique for the management of this combination of defects and present our early results. METHODS: Thirty-one patients (median age: 73 days and median weight: 3.9 kg) underwent repair of coarctation of aorta with associated cardiac defects, in a single-stage, through a midline sternotomy...
July 26, 2016: European Journal of Cardio-thoracic Surgery
Haki Jashari, Katarina Lannering, Pranvera Ibrahimi, Demir Djekic, Mats Mellander, Annika Rydberg, Michael Y Henein
INTRODUCTION: Surgical repair of coarctation of the aorta (CoA) is a safe procedure in children, however the condition is known for its potential recurrence and other related complications. The available evidence shows abnormal intrinsic properties of the aorta in CoA, thus suggesting additional effect, even after CoA repair, on left ventricular (LV) function. Accordingly, we sought to obtain a better understanding of LV myocardial mechanics in very early-corrected CoA using two-dimensional STE...
October 15, 2016: International Journal of Cardiology
Yvan Mivelaz, Mande T Leung, Mary Terri Zadorsky, Astrid M De Souza, James E Potts, George G S Sandor
Using noninvasive techniques, we sought to assess arterial stiffness, impedance, hydraulic power, and efficiency in children with postoperative tetralogy of Fallot (TOF), coarctation of the aorta (COA), and transposition of the great arteries (TGAs). Results were compared with those of healthy peers. Fifty-five children with repaired congenital heart disease (24 TOFs, 20 COAs, and 11 TGAs) were compared with 55 age-matched control subjects (CTRL). Echocardiographic Doppler imaging and carotid artery applanation tonometry were preformed to measure aortic flow, dimensions, and calculate pulse wave velocity, vascular impedance and arterial stiffness indexes, hydraulic power (mean and total), and hydraulic efficiency (HE) which were calculated using standard fluid dynamics equations...
August 15, 2016: American Journal of Cardiology
Danielle M Pineda, Samuel Tyagi, Matthew J Dougherty, Douglas A Troutman, Keith D Calligaro
Aortic graft infections are a rare occurrence, most commonly secondary to gram-positive organisms (Staphylococcus and Streptococcus species). We present 2 cases of thoracic aortic graft infections secondary to anaerobic bacteria, Propionibacterium species. The first case, a 40-year-old male, was found to have an anastomotic aneurysm at the distal anastomosis of a previous thoracoabdominal aneurysm repair. During the open repair of his anastomotic aneurysm, the original graft was not incorporated and cultures later speciated Propionibacterium acnes The second case is a 44-year-old male with a history of abdominal aortic coarctation that was repaired with a thoracic aorta to aortic bifurcation graft as a child who presented with flank pain and was found on imaging to have fluid around his bypass graft...
August 2016: Vascular and Endovascular Surgery
Tai Fuchigami, Masahiko Nishioka, Toru Akashige, Shotaro Higa, Kazuhiro Takahashi, Mami Nakayashiro, Taisuke Nabeshima, Arata Sashinami, Kenzo Sakurai, Kiyotaka Takefuta, Nobuhiro Nagata
OBJECTIVES: Bilateral pulmonary artery banding (bPAB) is utilized for some patients with a ventricular septal defect (VSD) and aortic coarctation (CoA) or interrupted aortic arch (IAA). We evaluated aortic valve (AoV) diameter and patient outcomes following bPAB. METHODS: Between August 2010 and September 2015, 10 consecutive patients with VSD and patent ductus arteriosus-dependent CoA or IAA underwent bPAB because of an AoV diameter of approximately <50% of the normal value (n = 6), severe subaortic stenosis and poor patient condition (n = 1, respectively), or low birthweight (n = 2)...
July 1, 2016: Interactive Cardiovascular and Thoracic Surgery
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