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Coarctation Repair

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https://www.readbyqxmd.com/read/28431733/neonatal-repair-of-persistent-fifth-aortic-arch-coarctation-and-interrupted-fourth-aortic-arch
#1
Enrico Cetrano, Angelo Polito, Matteo Trezzi, Adriano Carotti
Persistent left fifth aortic arch is a rare anomaly often associated with aortic coarctation. We report the case of a newborn presenting with signs of duct-dependent aortic coarctation. Echocardiography showed an interrupted fourth aortic arch, persistent left fifth aortic arch associated with aortic coarctation, and a restrictive arterial duct. Arch repair was accomplished using the fifth aortic arch as an in situ flap to enlarge the hypoplastic fourth aortic arch associated with coarctectomy and extended end-to-end anastomosis...
May 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28395657/avoidable-costs-of-stenting-for-aortic-coarctation-in-the-united-kingdom-an-economic-model
#2
Maximilian Salcher, Alistair Mcguire, Vivek Muthurangu, Marcus Kelm, Titus Kuehne, Huseyin Naci
BACKGROUND: Undesirable outcomes in health care are associated with patient harm and substantial excess costs. Coarctation of the aorta (CoA), one of the most common congenital heart diseases, can be repaired with stenting but requires monitoring and subsequent interventions to detect and treat disease recurrence and aortic wall injuries. Avoidable costs associated with stenting in patients with CoA are unknown. METHODS: We developed an economic model to calculate potentially avoidable costs in stenting treatment of CoA in the United Kingdom over 5 years...
April 10, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28391520/neonatal-repair-of-left-atrial-diverticulum-with-gigantic-thrombus-without-cardiopulmonary-bypass
#3
Akihiko Higashida, Takaya Hoashi, Heima Sakaguchi, Hajime Ichikawa
A 5-day-old neonate with coarctation of the aorta, hypoplastic aortic arch, large apical muscular ventricular septal defect, and patent ductus arteriosus developed pulmonary over-circulation and systemic hypoperfusion underwent bilateral pulmonary artery banding through median sternotomy as a part of hybrid stage I palliation. At operation, left atrial diverticulum with gigantic thrombus formation at the base of the left atrial appendage was incidentally detected by intraoperative direct echocardiography, and therefore, was successfully resected with the whole thrombus inside it without use of cardiopulmonary bypass...
April 8, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28373622/long-term-results-after-open-mitral-commissurotomy-for-a-one-month-old-infant-with-mitral-stenosis
#4
Takashi Kitaichi, Mikio Sugano, Hiroki Arase, Yohei Kawatani, Kanako Kameta, Hirotsugu Kurobe, Eiki Fujimoto, Akemi Ono, Yasunobu Hayabuchi, Hiroshi Fujita, Hitoshi Sogabe, Tetsuya Kitagawa
The strategy for an infant with congenital mitral stenosis should be determined by three important factors: left ventricular volume, the degree of the systemic outflow tract obstruction, and the type of mitral valve dysfunction. A successful staged biventricular repair in early infancy for a patient who had congenital mitral stenosis with short chordae, hypoplastic left ventricle and coarctation of the aorta, and the long-term results are described. There were the following important hemodynamic factors that led to the successful biventricular repair in the patient...
2017: Journal of Medical Investigation: JMI
https://www.readbyqxmd.com/read/28367436/severe-aortic-stenosis-and-severe-coarctation-of-the-aorta-a-hybrid-approach-to-treatment
#5
Daniel McLennan, Massimo Caputo, Demetris Taliotis
Hybrid surgery is becoming more popular in the treatment of children with congenital heart disease, particularly small infants and neonates. We report a case of a patient with aortic stenosis (AS) and coarctation of the aorta (CoA). CASE: a 1-month-old baby presented with severe AS and CoA. The decision was made to perform a hybrid surgical procedure. The patient underwent a lateral thoracotomy for repair of the CoA and carotid cutdown for aortic balloon valvuloplasty (AoVP).
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28329462/preoperative-use-of-ct-angiography-in-infants-with-coarctation-of-the-aorta
#6
Kirsten Rose-Felker, Joshua D Robinson, Carl L Backer, Cynthia K Rigsby, Osama M Eltayeb, Michael C Mongé, Karen Rychlik, Christina L Sammet, Jeffrey G Gossett
BACKGROUND: Computed tomographic angiography (CTA) and echocardiography (echo) are used preoperatively in coarctation of the aorta to define arch hypoplasia and great vessel branching. We sought to determine differences in quantitative measurements, as well as surgical utility, between modalities. METHODS: Infants (less than six months) with both CTA and echo prior to coarctation repair from 2004 to 2013 were included. Measurements were compared and correlated with surgical approach...
March 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28300017/growth-of-left-ventricular-outflow-tract-and-predictors-of-future-re-intervention-after-repair-for-ventricular-septal-defect-and-aortic-arch-obstruction
#7
Abdulraouf Jijeh, Muna Ismail, Fahad Alhabshan
Ventricular septal defect and aortic arch obstruction are usually associated with a narrow left ventricular outflow tract. The aim of the present study was to analyse the growth and predictors of future obstruction of the left ventricular outflow tract after surgical repair. METHODS: We carried out a retrospective review of patients who underwent repair for ventricular septal defect and aortic arch obstruction - coarctation or interrupted aortic arch - between July, 2002 and June, 2013...
March 16, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28270208/aortic-length-measurements-for-pulse-wave-velocity-calculation-manual-2d-vs-automated-3d-centreline-extraction
#8
Arna van Engelen, Miguel Silva Vieira, Isma Rafiq, Marina Cecelja, Torben Schneider, Hubrecht de Bliek, C Alberto Figueroa, Tarique Hussain, Rene M Botnar, Jordi Alastruey
BACKGROUND: Pulse wave velocity (PWV) is a biomarker for the intrinsic stiffness of the aortic wall, and has been shown to be predictive for cardiovascular events. It can be assessed using cardiovascular magnetic resonance (CMR) from the delay between phase-contrast flow waveforms at two or more locations in the aorta, and the distance on CMR images between those locations. This study aimed to investigate the impact of different distance measurement methods on PWV. We present and evaluate an algorithm for automated centreline tracking in 3D images, and compare PWV calculations using distances derived from 3D images to those obtained from a conventional 2D oblique-sagittal image of the aorta...
March 8, 2017: Journal of Cardiovascular Magnetic Resonance
https://www.readbyqxmd.com/read/28265214/endovascular-exclusion-of-aortobronchial-fistula-and-distal-anastomotic-aneurysm-after-extra-anatomic-bypass-for-aortic-coarctation
#9
Antonio Bozzani, Vittorio Arici, Giuseppe Rodolico, Massimo Borri Brunetto, Angelo Argenteri
The treatment of choice for aortic coarctation in adults remains open surgical repair. Aortobronchial fistula is a rare but potentially fatal late sequela of surgical correction of isthmic aortic coarctation via the interposition of a graft. The endovascular treatment of aortobronchial fistula is still under discussion because of its high risk for infection, especially if the patient has a history of cardiovascular prosthetic implantation. Patients need close monitoring, most notably those with secondary aortobronchial fistula...
February 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28260541/aortic-arch-advancement-for-type-a-interrupted-aortic-arch-with-persistent-fifth-aortic-arch-type-b
#10
Ziyad M Binsalamah, Peter Chen, Emmett D McKenzie
Persistence of the fifth aortic arch is a very rare anomaly, but is clinically relevant when it is associated with coarctation. We report a case of a neonate with type A interrupted aortic arch and severe coarctation of a persistent fifth aortic arch, which was discovered after repair of a left congenital diaphragmatic hernia. The combination of anomalies was discovered intra-operatively following left thoracotomy, and was treated with aortic arch advancement. The postoperative course was uneventful.
March 6, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28255109/unusual-repair-of-aortic-coarctation-transcatheter-intervention-implications
#11
Adam J Carlisle, Anand D Shah, David Appel, Brian E Kogon
A 56-year old male was evaluated for exertional dyspnea. He had previously undergone mechanical aortic valve replacement and aortic coarctation repair. Following uncomplicated coronary angiography using Judkins left and right catheters, aortography revealed that the loud murmur was related to an unusual, extra-anatomic surgical repair: transverse aorta to descending aorta bypass. Recognition of an extra-anatomic surgical bypass of coarctation is important, as this repair would leave a continuous murmur on exam...
March 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28219544/the-society-of-thoracic-surgeons-congenital-heart-surgery-database-2017-update-on-outcomes-and-quality
#12
Jeffrey P Jacobs, John E Mayer, Constantine Mavroudis, Sean M O'Brien, Erle H Austin, Sara K Pasquali, Kevin D Hill, David M Overman, James D St Louis, Tara Karamlou, Christian Pizarro, Jennifer C Hirsch-Romano, Donna McDonald, Jane M Han, Susan Becker, Christo I Tchervenkov, Francois Lacour-Gayet, Carl L Backer, Charles D Fraser, James S Tweddell, Martin J Elliott, Hal Walters, Richard A Jonas, Richard L Prager, David M Shahian, Marshall L Jacobs
The Society of Thoracic Surgeons Congenital Heart Surgery Database is the largest congenital and pediatric cardiac surgical clinical data registry in the world. 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 report 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...
March 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28124406/recombinant-porcine-factor-viii-for-high-risk-surgery-in-paediatric-congenital-haemophilia-a-with-high-titre-inhibitor
#13
S E Croteau, Y L Abajas, A S Wolberg, B I Nielsen, G R Marx, C W Baird, E J Neufeld, P E Monahan
INTRODUCTION: High-titre factor VIII (FVIII) inhibitors complicate peri-operative haemostasis. Recombinant porcine FVIII (r-pFVIII) may provide an alternative haemostatic agent for high-risk procedures and allow FVIII activity monitoring. AIM: Devise an effective haemostatic plan for repair of a progressively symptomatic aortic coarctation in a 5-year-old male with immune tolerance induction (ITI) refractory high-titre FVIII inhibitors. METHODS: Preprocedure human FVIII inhibitor titre was 58 Bethesda Units mL(-1) (BU) and cross-reacted to neutralize porcine FVIII at 30 BU...
March 2017: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/28115510/abnormal-wave-reflections-and-left-ventricular-hypertrophy-late-after-coarctation-of-the-aorta-repair
#14
Michael A Quail, Rebekah Short, Bejal Pandya, Jennifer A Steeden, Abbas Khushnood, Andrew M Taylor, Patrick Segers, Vivek Muthurangu
Patients with repaired coarctation of the aorta are thought to have increased afterload due to abnormalities in vessel structure and function. We have developed a novel cardiovascular magnetic resonance protocol that allows assessment of central hemodynamics, including central aortic systolic blood pressure, resistance, total arterial compliance, pulse wave velocity, and wave reflections. The main study aims were to (1) characterize group differences in central aortic systolic blood pressure and peripheral systolic blood pressure, (2) comprehensively evaluate afterload (including wave reflections) in the 2 groups, and (3) identify possible biomarkers among covariates associated with elevated left ventricular mass (LVM)...
March 2017: Hypertension
https://www.readbyqxmd.com/read/28109381/endovascular-technique-for-repair-of-descending-thoracic-aortic-aneurysm-after-coarctation-operation
#15
Heike Baumgarten, John J Squiers, William T Brinkman, Javier Vasquez
The incidence of aneurysm after open surgical repair of coarctation is 11% to 24%. If the condition is left untreated, fatal rupture may occur. Thoracic endovascular aortic repair (TEVAR) has been reported as a feasible and safe alternative to open surgical repeated procedures in this context. However, TEVAR might be challenging because of the proximity of the pathologic condition to the supraaortic vessels and the ongoing presence of the coarctation. We report a unique case of a 48-year old man undergoing TEVAR because of aortic aneurysm after previous surgical coarctation treatment and successful closure of the coarctation with a vascular plug device...
February 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28066610/the-application-of-autologous-pulmonary-artery-in-surgical-correction-of-complicated-aortic-arch-anomaly
#16
Shusheng Wen, Jianzheng Cen, Jimei Chen, Gang Xu, Biaochuan He, Yun Teng, Jian Zhuang
BACKGROUND: In the patients with longer-segment aortic arch hypoplasia or interruption with ventricular septal defect, surgery with homograft vessel or autologous pericardial patch to augment descending aortic arch will not result in adverse reactions caused by end-to-end anastomosis. In this study, we retrospectively analyzed primary experience of surgical correction of complicated aortic arch anomaly with autologous main pulmonary artery. METHODS: From July 2010 to March 2016, the twenty-one cases of aortic arch complex anomalies were reconstructed with autologous main pulmonary artery...
November 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28045418/primary-coarctation-related-isthmus-aneurysm-in-an-adult
#17
Jose María González-Santos, María Elena Arnáiz-García, María José Dalmau-Sorlí, Javier Rodríguez-Collado, Javier López Rodríguez
A 56-year-old female patient was transferred due to the presence of a left supraclavicular pulsatile mass. Further work-up was performed to confirm diagnosis. Angiography and computed tomography were also performed. The anatomy of the thoracic aorta suggested an unknown and untreated aortic coarctation. A second aortic narrowing was identified at the aortic arch, a result of elongation of the aorta. Endovascular approach was not possible, due to complexity of the aortic anatomy, and tortuosity. Open surgical repair was successfully performed...
December 2016: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28038838/-interventional-cardiac-catheterization-in-congenital-heart-disease
#18
François Godart, Ali Houeijeh
Interventional cardiac catheterization has a major place in the management of congenital heart disease. Since the Rashkind atrioseptostomy in mid-1960s, many techniques have been developed. For some, it is necessary to close a cardiac or extracardiac shunt using occluder (double disc system, plug, coil…): closure of atrial septal defect, ventricular septal defect or patent arterial duct. For others, it is necessary to treat a valvular or vascular stenosis using a balloon catheter: dilatation of the pulmonary or the aortic valve, dilatation of aortic coarctation...
December 27, 2016: La Presse Médicale
https://www.readbyqxmd.com/read/28035639/mycobacterium-infection-from-a-cardiopulmonary-bypass-heater-cooler-unit-in-a-patient-with-steroid-induced-immunosuppression
#19
Yi Cai, Kevin Landolfo, Johnathan R Renew
PURPOSE: To present a case of mycobacterium infection transmitted through a heater-cooler unit during cardiac bypass surgery. CLINICAL FEATURES: A 63-yr-old woman with a past medical history of aortic coarctation repair in 1963 and a mechanical aortic valve replacement in 2010 was prescribed antibiotics and steroids at an outpatient care facility in September 2015 for symptoms of an upper respiratory tract infection. Four months later, she developed malaise and intermittent fever with anemia and acute kidney dysfunction...
May 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28011739/surgical-management-of-aortic-coarctation-in-adolescents-and-adults
#20
Kanhua Yin, Zhiqi Zhang, Yi Lin, Changfa Guo, Yongxin Sun, Ziwei Tian, Qiuchen Xie, Chunsheng Wang
OBJECTIVES: Coarctation of the aorta (CoA) in adolescents and adults is often complicated by other cardiac or aortic problems and may carry additional surgical difficulties. Limited studies have reported the surgical outcomes of CoA repair in this particular patient population. We reviewed our contemporary experience of open surgical management of CoA in adolescents and adults. METHODS: From 2008 to 2016, a total of 60 adolescents and adults (mean age, 32 years) underwent CoA repair at our centre...
December 22, 2016: Interactive Cardiovascular and Thoracic Surgery
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