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https://www.readbyqxmd.com/read/28549026/the-use-of-rapid-deployment-valves-in-combined-aortic-and-mitral-valve-surgery-one-year-clinical-and-echocardiographic-outcomes
#1
Markus Schlömicher, Matthias Bechtel, Zulfugar Taghiyev, Yazan Al-Jabery, Peter Lukas Haldenwang, Vadim Moustafine, Justus Thomas Strauch
OBJECTIVE: Patients undergoing multiple valve surgery represent a high-risk group who could potentially benefit from a reduction of cross-clamp and cardiopulmonary bypass times because prolonged bypass and cross-clamp times are considered independent risk factors for increased morbidity and mortality after cardiac surgery. METHODS: Between July 2013 and November 2014, 16 patients underwent rapid deployment aortic valve replacement with the EDWARDS INTUITY valve system in the setting of concomitant mitral disease...
May 25, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28548474/aortic-aneurysm-endovascular-treatment-with-the-parallel-graft-technique-from-the-aortic-arch-to-the-iliac-axis
#2
Gian F Fadda, Mario Marino, Holta Kasemi, Costantino L DI Angelo, Carlo P Dionisi, Valeria Cammalleri, Carlo Setacci
BACKGROUND: The chimney technique has been developed for the treatment of complex aortic aneurysms. We analyzed the midterm to long-term outcomes of this approach from a single- centre experience. METHODS: From October 2008 to July 2016, 58 patients underwent endovascular aortic aneurysm repair using the chimney technique. Indications for treatment were thoracic aortic aneurysm (TAA) (n = 11), thoracoabdominal aortic aneurysm (TAAA) (n = 2), pararenal aortic aneurysm (PAAA) (n= 15), aortoiliac/isolated hypogastric artery aneurysm (n = 25), type I endoleak after previous TEVAR/EVAR (n=4), proximal pseudoaneurysm after AAA open repair (n = 1)...
May 26, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28548204/endovascular-treatment-for-ruptured-abdominal-aortic-aneurysm
#3
REVIEW
Stephen Badger, Rachel Forster, Paul H Blair, Peter Ellis, Frank Kee, Denis W Harkin
BACKGROUND: An abdominal aortic aneurysm (AAA) (pathological enlargement of the aorta) is a condition that can occur as a person ages. It is most commonly seen in men older than 65 years of age. Progressive aneurysm enlargement can lead to rupture and massive internal bleeding, which is fatal unless timely repair can be achieved. Despite improvements in perioperative care, mortality remains high (approximately 50%) after conventional open surgical repair. Endovascular aneurysm repair (EVAR), a minimally invasive technique, has been shown to reduce early morbidity and mortality as compared to conventional open surgery for planned AAA repair...
May 26, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28548006/management-of-endovascular-aortic-aneurysm-complications-via-retrograde-catheterization-through-the-distal-stent-graft-landing-zone
#4
Xicheng Zhang, Yuan Sun, Zhaolei Chen, Yuanhu Jing, Miao Xu
OBJECTIVE: A retrograde technique through the gap between the distal stent landing zone and the iliac artery wall has been applied to treat type II endoleak after endovascular aortic aneurysm repair (EVAR). In this study, we tried to investigate its efficacy in the management of type III endoleak and intraoperative accidental events. METHODS: We reported 2 complications of EVAR that were difficult to treat with conventional methods. One patient had a sustained type III endoleak after EVAR, and the right renal artery was accidentally sealed by a graft stent in the other patient during the operation...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28547126/endovascular-management-of-native-postcoarctation-thoracic-aortic-aneurysms
#5
Ziheng Wu, Xiangtao Zheng, Xin Fang, Yangyan He, Donglin Li, Chengfei Zheng, Hongkun Zhang
PURPOSE: Postcoarctation thoracic aortic aneurysm formation is one of the most serious complications for coarctation of aorta. Open surgery to repair these aneurysms is associated with high morbidity and mortality. Endovascular therapy is an attractive alternative to open surgery. We have studied the efficacy and safety of endovascular therapy for postcoarctation thoracic aortic aneurysms, and will share our findings and experience through this document. METHODS: The data was retrospectively collected on consecutive patients who were presented with postcoarctation thoracic aortic aneurysms at our medical center...
May 25, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28546046/on-the-use-of-geometric-modeling-to-predict-aortic-aneurysm-rupture
#6
Sruthi L Muluk, Pallavi D Muluk, Judy Shum, Ender A Finol
BACKGROUND: Currently, the risk of abdominal aortic aneurysm (AAA) rupture is determined using the maximal diameter (Dmax) of the aorta. We sought in this study to identify a set of CT-based geometric parameters that would better predict the risk of rupture than Dmax. METHODS: We obtained CT Scans from 180 patients (90 ruptured AAA, 90 elective AAA repair) and then used automated software to calculate 1-dimensional, 2-dimensional, and 3-dimensional geometric parameters for each AAA...
May 22, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28546044/endovascular-repair-of-thoraco-abdominal-and-arch-aneurysms-in-patients-with-connective-tissue-disease-using-branched-and-fenestrated-devices
#7
Rachel E Clough, Teresa Martin-Gonzalez, Katrien Van Calster, Adrien Hertault, Rafaëlle Spear, Richard Azzaoui, Jonathan Sobocinski, Stéphan Haulon
INTRODUCTION: Prophylactic open surgery is the standard practice in patients with connective tissue and thoraco-abdominal (TAAA) and aortic arch disease. Branched and fenestrated devices offer a less invasive alternative but there are concerns regarding the durability of the repair and the effect of the stent graft on the fragile aortic wall. The aim of this study was to evaluate mid-term outcomes of fenestrated and/or branched endografting in patients with connective tissue disease. METHODS: All patients with connective tissue disease that underwent TAAA or arch aneurysm repair using a fenestrated and/or branched endograft in a single high volume centre between 2004 and 2015 were included...
May 22, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28546041/10-years-single-centre-results-of-abdominal-aortic-aneurysm-treatment-endovascular-vs-open-repair
#8
Payman Majd, Wael Ahmad, Ingrid Becker, Jan Sigge Brunkwall
OBJECTIVES: The purpose of the present study was to compare the long-term survival in matched cohorts of patients with infrarenal abdominal aortic aneurysm (AAA) undergoing an elective open repair (OR) or an endovascular aneurysm repair (EVAR). MATERIALS AND METHODS: Patients with a primary elective repair of an infrarenal aortic aneurysm between 1998 and 2006 were identified in a retrospective review of our single centre database. EVAR and OR patients were matched with respect to age, gender, renal disease, tobacco use, hypertension, chronic obstructive pulmonary disease and coronary artery disease...
May 22, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28544840/redo-tricuspid-valve-repair-with-leaflet-augmentation-using-the-left-atrial-wall
#9
Daisuke Endo, Kenji Kuwaki, Taira Yamamoto, Atsushi Amano
The case is reported of a 79-year-old female who received a patch augmentation of the tricuspid anterior and septal leaflets with a resected left atrial wall to address recurrent tricuspid regurgitation, including tricuspid valve tethering. The patient was admitted to the authors' hospital for chronic heart failure with paravalvular leakage after aortic valve replacement and recurrent severe tricuspid regurgitation. She had undergone two previous cardiac surgeries. Re-tricuspid repair required an augmentation of the tricuspid valve leaflets in addition to tricuspid annuloplasty...
January 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28544832/percutaneous-antegrade-trans-septal-closure-of-mitral-paravalvular-leak-without-creation-of-an-arteriovenous-wire-loop-in-patients-with-coexistent-mechanical-aortic-valve
#10
Teoman Kilic, Senol Coskun, Kurtulus Karauzum, Sadan Yavuz, Tayfun Sahin
BACKGROUND: Various approaches such as antegrade trans-septal, retrograde transfemoral and transapical techniques have been used to close mitral paravalvular leak (PVL) in patients with an aortic prosthesis. During the implementation of these techniques, an arteriovenous guidewire loop is often created for device delivery. However, passing through a mechanical aortic valve may cause hemodynamic compromise and prolong the procedure. To date, no studies have evaluated antegrade mitral PVL closure without the use of an arteriovenous wire loop in patients with a mechanical aortic prosthesis...
January 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28544831/aortic-root-surgery-in-marfan-syndrome-medium-term-outcome-in-a-single-center-experience
#11
Christine H Attenhofer Jost, Heidi M Connolly, Christopher G Scott, Naser M Ammash, Juan M Bowen, Hartzell V Schaff
BACKGROUND: The study aim was to analyze the authors' experience with aortic root surgery in Marfan syndrome (MFS), and to expand the surgical outcome data of patients meeting the Ghent criteria (Marfan registry). METHODS: Analyses were performed of data acquired from MFS patients (who met the Ghent criteria), including an aortic root surgery and Kaplan-Meier survival. RESULTS: Between April 2004 and February 2012, a total of 59 MFS patients (mean age at surgery 36 ± 13 years) underwent 67 operations for aortic root aneurysm (n = 52), aortic valve (AV) regurgitation (n = 15), acute aortic dissection (n = 2), and/or mitral valve (MV) regurgitation resulting from MV prolapse (n = 7)...
January 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28544826/preoperative-computed-tomography-scan-analysis-of-interleaflets-triangles-to-guide-aortic-root-repair-procedures
#12
Claudia Romagnoni, Andrea Mangini, Monica Contino, Rubina Rosa, Sonia Ippolito, Guido Gelpi, Carlo Antona
BACKGROUND: Stabilization of the ventriculo-aortic junction (VAJ) is gaining increasing interest in the context of aortic valve repair, since its dilation is a well-recognized risk factor for long-term repair failure. Interleaflets triangles are key elements of the VAJ, but cannot be completely visualized using echocardiography. A three-dimensional (3D) reconstruction of electrocardiogram-triggered computed tomography (CT) scan images allows an analysis of the real dimensions and anatomic characteristics of the subcommissural triangles...
January 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28544242/percutaneous-thoracic-aortic-aneurysm-repair-through-transcaval-aortic-access
#13
Zaher Fanari, Sumaya Hammami, Nilesh J Goswami, Jeffrey A Goldstein
Transcaval aortic access has been used for deployment of transcatheter aortic valves in patients in whom conventional arterial approaches are not feasible. This access can be vital in other situation when large bore access is needed. We described a case of 65-year-old man who had large thoracic descending aortic aneurysm with diffuse bilateral iliac disease precluding the arterial access required for the procedure. The patient underwent successful transcaval access with placement of 22-Fr balloon expandable sheath followed with successful deployments of 32 mm × 32 mm × 150 mm Valiant stent graft (Medtronic, Minneapolis, MN)...
May 22, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28543756/perventricular-device-closure-of-doubly-committed-sub-arterial-ventricular-septal-defects-via-a-left-infra-axillary-approach
#14
Sijie Zhou, Liyun Zhao, Taibing Fan, Bin Li, Weijie Liang, Haoju Dong, Shubo Song, Lin Liu
BACKGROUND: This study sought to evaluate the feasibility, safety, and efficacy of perventricular device closure of a doubly committed sub-arterial ventricular septal defect (dcVSD) through a left infra-axillary approach. METHOD: Forty-five patients, with a dcVSD of less than 8 mm in diameter, were enrolled in this study. The pericardium was exposed and opened through a left infra-axillary mini-incision. Two parallel purse-string sutures were placed on the right ventricle outflow tract and under transesophageal echocardiography guidance, a delivery sheath loaded with the device was inserted into the right ventricle and advanced through the defect into the left ventricle...
May 24, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28542808/ascending-aortic-rupture-through-a-penetrating-atherosclerotic-ulcer-a-rare-cause-of-sudden-unexpected-death
#15
Supawon Srettabunjong
Spontaneous rupture of the aorta through an atherosclerotic lesion without preexisting aortic aneurysm, dissection, or history of trauma is very rare. Without prompt aortic repair, all cases result in sudden death with a definitive diagnosis made only intraoperatively or during autopsy. The phenomenon has been uniformly found in individuals with hypertension. The author reports a sudden unexpected death caused by spontaneous rupture of the ascending aorta in a 57-year-old man with a history of hypertension...
May 23, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28540144/spondylitis-transmitted-from-infected-aortic-grafts-a-review
#16
REVIEW
Panayiotis D Megaloikonomos, Thekla Antoniadou, Leonidas Dimopoulos, Marcos Liontos, Vasilios Igoumenou, Georgios N Panagopoulos, Efthymia Giannitsioti, Andreas Lazaris, Andreas F Mavrogenis
Graft infection following aortic aneurysms repair is an uncommon but devastating complication; its incidence ranges from <1% to 6% (mean 4%), with an associated perioperative and overall mortality of 12% and 17.5-20%, respectively. The most common causative organisms are Staphylococcus aureus and Escherichia coli; causative bacteria typically arise from the skin or gastrointestinal tract. The pathogenetic mechanisms of aortic graft infections are mainly breaks in sterile technique during its implantation, superinfection during bacteremia from a variety of sources, severe intraperitoneal or retroperitoneal inflammation, inoculation of bacteria during postoperative percutaneous interventions to manage various types of endoleaks, and external injury of the vascular graft...
2017: J Bone Jt Infect
https://www.readbyqxmd.com/read/28540089/failed-tavi-in-tavi-implantation-tavi-dislocation-followed-by-ensuing-surgical-graft-resection
#17
Róbert Novotný, Jaroslav Hlubocký, Tomáš Kovárník, Petr Mitáš, Zuzana Hlubocka, Jan Rulíšek, Sevim Ismihan Gulmez, Shubjiwan Kaur Ghotra, Jaroslav Lindner
We are presenting a case report of failed valve-in-valve treatment of severe aortic stenosis. A control ultrasonography after TAVI implantation revealed a severe aortic regurgitation of the graft which was subsequently unresolved with postimplantation dilatation. Second TAVI was implanted with cranial dislocation to the aortic root. Patient underwent a CT examination to clarify the TAVI in TAVI position. Patient underwent a surgical resection of TAVI with implantation of biological aortic valve prosthesis. In situations where TAVI treatment fails or is complicated beyond the possibility of endovascular repair, surgical intervention despite its higher risks is the preferred choice...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28540074/imaging-for-surveillance-and-operative-management-for-endovascular-aortic-aneurysm-repairs
#18
REVIEW
Christopher Lau, Dmitriy N Feldman, Leonard N Girardi, Luke K Kim
Endovascular aortic aneurysm repairs rely heavily on radiologic imaging modalities for preoperative surveillance, intraoperative management, and postoperative follow-up. Ultrasonography, computed tomography (CT), magnetic resonance imaging (MRI) and angiography all have utility at different stages of management. Often one imaging modality compliments another by providing supplementary information. Data from the imaging exams must be synthesized into one coherent plan for managing patients with aortic aneurysms...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28538639/development-of-the-emergency-preservation-and-resuscitation-for-cardiac-arrest-from-trauma-epr-cat-clinical-trial
#19
Samuel A Tisherman, Hasan B Alam, Peter M Rhee, Thomas M Scalea, Tomas Drabek, Raquel M Forsythe, Patrick M Kochanek McCm
BACKGROUND: Patients who suffer a cardiac arrest from trauma rarely survive, even with aggressive resuscitation attempts, including an Emergency Department (ED) thoracotomy. Emergency Preservation and Resuscitation (EPR) was developed to utilize hypothermia to buy time to obtain hemostasis before irreversible organ damage occurs. Large animal studies have demonstrated that cooling to tympanic membrane temperature 10°C during exsanguination cardiac arrest can allow up to 2 hours of circulatory arrest and repair of simulated injuries with normal neurologic recovery...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28538630/the-evolution-of-care-improves-outcome-in-blunt-thoracic-aortic-injury-a-western-trauma-association-multicenter-study
#20
Steven R Shackford, Casey E Dunne, Riyad Karmy-Jones, William Long, Desarom Teso, Martin A Schreiber, Justin Watson, Cheri Watson, Robert C McIntyre, Lisa Ferrigno, Mark L Shapiro, Kevin Southerland, Julie A Dunn, Paul Reckard, Thomas M Scalea, Megan Brenner, William A Teeter
BACKGROUND: The management of blunt thoracic aortic injury (BTAI) has evolved radically in the last decade with changes in the processes of care and the introduction of thoracic endovascular repair (TEVAR). These changes have wrought improved outcome, but the direct effect of TEVAR on outcome remains in question as previous studies have lacked vigorous risk adjustment and long-term follow-up. To address these knowledge gaps, we compared the outcomes of TEVAR, open surgical repair, and nonoperative management for BTAI...
May 22, 2017: Journal of Trauma and Acute Care Surgery
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