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Coarctation Repair

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https://www.readbyqxmd.com/read/29780722/coarctation-repair-redo-challenges-in-the-adults-what-to-do
#1
REVIEW
Erik Beckmann, Arminder S Jassar
Aortic coarctation is one of the most common congenital cardiac pathologies. Repair of native aortic coarctation is nowadays a common and safe procedure. However, late complications, including re-coarctation and aneurysm formation, are not uncommon. The incidence of these complications is dependent on the type of the initial operation. Both endovascular and conventional open repair play important roles in the treatment of late complications after previous coarctation repair. This article will review the incidence of late complications after coarctation repair and will discuss the treatment options for redo coarctation repair in adult patients...
2018: Journal of visualized surgery
https://www.readbyqxmd.com/read/29772586/custom-made-stent-grafts-for-the-treatment-of-pseudoaneurysms-after-childhood-coarctation-surgery
#2
Mario Lescan, Andreas Hornung, Michael Hofbeck, Christian Schlensak
BACKGROUND:  Post-coarctation of the aorta (CoA) pseudoaneurysms is a complication of open repair. Thoracic endovascular repair (TEVAR) is feasible but complicated by proximity to the supra-aortic trunks and severe arch angulation. METHODS:  We describe three cases of post-CoA pseudoaneurysms treated with custom-made Relay stent grafts (Vascutek, Scotland). RESULTS:  Technical and clinical success was achieved in all three cases with no mortality, morbidity, endoleaks, or complications...
May 17, 2018: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/29761081/enhanced-aortic-pressure-wave-reflection-in-patients-with-aortic-coarctation-after-aortic-arch-repair
#3
REVIEW
Tomoaki Murakami
Background: In patients with aortic coarctation after successful aortic arch repair, it is well known that early-onset cardiovascular diseases can develop. Summary: We studied the pressure waveform in patients after aortic arch repair focusing on a pressure wave reflection. In patients after aortic arch repair, the repaired portion generates a new reflected pressure wave. As a result, the newly generated pressure wave causes aortic pressure augmentation, loss of pressure amplification, and left ventricular hypertrophy with fibrosis...
March 2018: Pulse (Basel, Switzerland)
https://www.readbyqxmd.com/read/29753817/arch-augmentation-via-median-sternotomy-for-coarctation-of-aorta-with-proximal-arch-hypoplasia
#4
W Hampton Gray, Winfield J Wells, Vaughn A Starnes, S Ram Kumar
BACKGROUND: Coarctation of the aorta can be associated with hypoplasia of the proximal transverse aortic arch. One approach to manage this condition is via left thoracotomy and extended end-to-end anastomosis with the expectation that the proximal arch will grow over time. Our preferred approach is to augment the aorta via midline sternotomy. We hypothesized that this approach is safe, durable and allows reliable growth of the aorta. METHODS: We identified the records of patients with biventricular anatomy who had coarctation of the aorta, hypoplasia of the proximal transverse arch, and no other cardiac lesion that would mandate cardiopulmonary bypass use and midline sternotomy...
May 10, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29733824/preoperative-aortic-arch-size-and-late-outcome-following-coarctation-repair-via-lateral-thoracotomy
#5
Preeti Ramachandran, Philip R Khoury, Robert H Beekman, Erik C Michelfelder, Peter B Manning, James S Tweddell, James F Cnota
BACKGROUND: The approach (lateral thoracotomy vs median sternotomy) to repair coarctation of aorta is frequently based on arch dimensions from the preoperative echocardiogram. Few studies have assessed the relationship between preoperative arch dimensions and late postoperative outcome. This study aims to define how preoperative arch dimensions relate to late outcomes and identify long term predictors of successful surgery. METHODS: We performed a retrospective review of 102 neonates and infants undergoing isolated coarctation repair via lateral thoracotomy between 2003-2012...
May 4, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29731787/mycotic-aneurysm-a-lesser-known-complication-of-coarctation-repair-in-a-child-managed-by-endovascular-aneurysm-repair
#6
M Tomar, R Parakh, A Bhan
We report a 12-year-old child diagnosed with mycotic aneurysm at the site of coarctation of aorta (CoA) repair. Surgical intervention, though very high risk, is the mainstay of management. In selected cases endovascular stenting is being reported in adults. Here we report the use of an endovascular stent in a child.
October 2017: Images in Paediatric Cardiology
https://www.readbyqxmd.com/read/29731027/prognostic-role-of-hypertensive-response-to-exercise-in-patients-with-repaired-coarctation-of-aorta
#7
Vidhushei Yogeswaran, Heidi M Connolly, Mohamad Al-Otaibi, Naser M Ammash, Carole A Warnes, Sameh M Said, Alexander C Egbe
BACKGROUND: This study aimed to determine the prevalence of hypertensive response to exercise (HRE) and its association with cardiovascular adverse events (CAEs) in patients with repaired coarctation of aorta (rCOA). METHODS: We retrospectively reviewed records of adult patients with rCOA who had cardiopulmonary exercise tests (CPETs) and follow-up from 1994 to 2014 at Mayo Clinic. Patients with residual COA, defined as aortic isthmus peak velocity >2.5 m/s, were excluded...
May 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29731016/hypertensive-response-with-exercise-to-reveal-increased-cardiovascular-risk-in-adults-with-aortic-coarctation-repair-value-and-caution
#8
EDITORIAL
Philip J Millar, Erwin N Oechslin
No abstract text is available yet for this article.
May 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29695645/non-invasive-measurement-of-cardiac-output-in-children-with-repaired-coarctation-of-the-aorta-using-electrical-cardiometry-compared-to-transthoracic-doppler-echocardiography
#9
Luis Altamirano-Diaz, Eva Welisch, Adam A Dempsey, Teresa Sohee Park, Michael Grattan, Kambiz Norozi
Objective
 To evaluate the equivalence of the ICON® electrical cardiometry (EC) haemodynamic monitor to measure cardiac output (CO) relative to transthoracic Doppler echocardiography (TTE) in paediatric patients with repaired coarctation of the aorta (CoA). 
 
 Approach
 A group of n=28 CoA patients and n=27 matched controls were enrolled. EC and TTE were performed synchronously on each participant and CO measurements compared using linear regression and Bland-Altman analysis...
April 26, 2018: Physiological Measurement
https://www.readbyqxmd.com/read/29691159/a-cross-sectional-study-of-the-prevalence-of-exercise-induced-hypertension-in-childhood-following-repair-of-coarctation-of-the-aorta
#10
Taryn L Luitingh, Melissa G Y Lee, Bryn Jones, Remi Kowalski, Sofia Weskamp Aguero, Jane Koleff, Diana Zannino, Michael M H Cheung, Yves d'Udekem
BACKGROUND: Exercise-testing may be a more tolerable method of detecting hypertension in children after coarctation repair compared to gold-standard 24-hour ambulatory blood pressure (BP) monitoring (ABPM). This study aims to determine the prevalence of exercise-induced hypertension and end-organ damage in children after coarctation repair, and the effectiveness of exercise-testing compared to 24-hour ABPM in this population. METHODS: Exercise-testing (Bruce protocol), transthoracic echocardiogram, 24-hour ABPM, and pulse wave velocity were performed in 41 patients aged 8 to 18 years with previous coarctation repair...
March 27, 2018: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29688517/complex-coarctation-of-the-aorta-requiring-a-third-redo-operation
#11
Damian Gimpel, David J McCormack, A El-Gamel
Coarctation of the aorta can require multiple redo surgeries. It is extremely pertinent to plan for this and ensure that each operation is performed with future repair in mind. We present a rare case and the subsequent management of competitive flow in coarctation of the aorta requiring a fourth operation for repair.
April 24, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29667078/impact-of-different-coarctation-therapies-on-aortic-stiffness-phase-contrast-mri-study
#12
Michal Schäfer, Gareth J Morgan, Max B Mitchell, Michael Ross, Alex J Barker, Kendall S Hunter, Brian Fonseca, Michael DiMaria, Daniel Vargas, D Dunbar Ivy, Neil Wilson, Lorna P Browne
Coarctation of the aorta has been associated with increased thoracic aortic stiffness in adolescents and young adults. However, the effects of different therapeutic strategies on aortic stiffness in a young population is unknown. This study aimed to non-invasively assess aortic stiffness between different repair or intervention strategies in patients with coarctation of the aorta. Forty-nine coarctation patients who underwent either surgery (n = 26), balloon angioplasty (n = 14), or stent implantation (n = 12), and 26 age- and size-matched normotensive healthy controls underwent evaluation of thoracic aortic stiffness and flow hemodynamics via phase-contrast cardiac magnetic resonance...
April 17, 2018: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/29531485/surgical-management-of-aortic-coarctation-from-infant-to-adult
#13
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
https://www.readbyqxmd.com/read/29528405/stent-grafting-simulation-using-a-three-dimensional-printed-model-for-extensive-aortic-arch-repair-combined-with-coarctation
#14
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
https://www.readbyqxmd.com/read/29518385/cardiac-autonomic-nervous-system-activity-and-cardiac-function-in-children-after-coarctation-repair
#15
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. Most patients live into adulthood as a result of improved surgical techniques; however, late complications, including hypertension, recoarctation, and arrhythmias, are common. The autonomic nervous system (ANS) might play a role in the pathology. This study evaluated cardiac ANS activity and cardiac function in children after CoA repair and investigated the relationship between the two. METHODS: The study participants were 31 children after CoA repair and 62 healthy controls aged between 8 and 18 years...
March 5, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29510943/laryngeal-ultrasound-detects-a-high-incidence-of-vocal-cord-paresis-after-aortic-arch-repair-in-neonates-and-young-children
#16
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
https://www.readbyqxmd.com/read/29483464/-surgical-experience-of-distal-aortic-arch-aneurysm-suspected-to-be-associated-with-pre-existing-coarctation-of-the-aorta
#17
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
https://www.readbyqxmd.com/read/29468813/optimus-covered-stent-advanced-covered-stent-technology-for-complex-congenital-heart-disease
#18
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
https://www.readbyqxmd.com/read/29459569/selection-of-a-surgical-treatment-approach-for-aortic-coarctation-in-adolescents-and-adults
#19
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...
April 20, 2018: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29447368/venovenous-malformation-developed-prior-to-a-kawashima-operation-in-a-patient-with-an-interrupted-inferior-vena-cava
#20
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
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