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Aortic valve replacement aortic aneurysm

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https://www.readbyqxmd.com/read/28387791/contemporary-results-of-hemiarch-replacement
#1
Ivancarmine Gambardella, Mario Gaudino, Christopher Lau, Monica Munjal, Antonino Di Franco, Lucas B Ohmes, Fawad Hameedi, Cristiano Spadaccio, Leonard N Girardi
OBJECTIVES: Our goal was to report on early and midterm outcomes of hemiarch replacement performed in a high-volume centre. METHODS: We extrapolated hemiarch replacements from our institutional aortic database. We also analysed the impact of aortic disease (dissection vs aneurysm) on the outcomes of de novo hemiarch replacement. RESULTS: A total of 756 patients underwent hemiarch replacement between 1997 and 2016. After elimination of cases involving the aortic root/valve and redo cases, we identified 426 cases of de novo -isolated hemiarch replacement (369 aneurysms and 57 dissections)...
April 6, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28366467/aortic-root-replacement-for-children-with-loeys-dietz-syndrome
#2
Nishant D Patel, Diane Alejo, Todd Crawford, Narutoshi Hibino, Harry C Dietz, Duke E Cameron, Luca A Vricella
BACKGROUND: Loeys-Dietz syndrome (LDS) is an aggressive aortopathy with a proclivity for aortic aneurysm rupture and dissection at smaller diameters than other connective tissue disorders. We reviewed our surgical experience of children with LDS to validate our guidelines for prophylactic aortic root replacement (ARR). METHODS: We reviewed all children (younger than 18 years) with a diagnosis of LDS who underwent ARR at our institution. The primary endpoint was mortality, and secondary endpoints included complications and the need for further interventions...
March 30, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28359490/how-could-these-mini-saccular-aneurysms-of-ascending-aorta-be-classified
#3
Anas Sarraj, Daniel-Edgardo Muñoz, Corazón-Mabel Calle Valda, Emilio Monguio, Guillermo Reyes
The wall of a true aneurysm is composed of all histologic layers of the aorta. A false aneurysm represents a small, contained rupture of aorta followed by bulging of the corresponding area that is usually sustained by a fibrous peel. Aortic dissection is defined as a separation of the lamellae of the aortic wall. Herein, we describe an unusual clinical presentation of aortic dissection in a 37-year-old male patient that presented severe aortic regurgitation and unusual bulges with linear intimal fissures in ascending aorta underwent mechanical aortic valve replacement and interposition of tubular vascular graft in ascending aorta...
April 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28355763/-late-reoperations-after-repaired-stanford-type-a-aortic-dissection
#4
F H Huang, L P Li, C H Su, W Qin, M Xu, L M Wang, Y S Jiang, Z B Qiu, L Q Xiao, C Zhang, H W Shi, X Chen
Objective: To summarize the experience of reoperations on patients who had late complications related to previous aortic surgery for Stanford type A dissection. Methods: From August 2008 to October 2016, 14 patients (10 male and 4 female patients) who underwent previous cardiac surgery for Stanford type A aortic dissection accepted reoperations on the late complications at Department of Thoracic and Cardiovascular Surgery, Nanjing Hospital Affiliated to Nanjing Medical University. The range of age was from 41 to 76 years, the mean age was (57±12) years...
April 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28329094/biological-solutions-to-aortic-root-replacement-valve-sparing-versus-bioprosthetic-conduit%C3%A2
#5
Mario Gaudino, Antonino Di Franco, Lucas B Ohmes, Luca Weltert, Christopher Lau, Ivancarmine Gambardella, Andrea Salica, Monica Munjal, Mohamed Elsayed, Leonard N Girardi, Ruggero De Paulis
OBJECTIVES: Valve-sparing operations and root replacement with a biologic composite conduit are viable options in aortic root aneurysm. This study was conceived to compare the early and mid-term results of these 2 procedures. METHODS: From September 2002 to November 2015, 749 consecutive patients underwent either a valve-sparing operation or a root replacement with a biologic composite conduit at 2 institutions. Propensity score matching was used to compare similar cohorts of patients in the overall population and in the ≤ 55 and ≥ 65-year age groups...
February 17, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28318632/endovascular-aneurysm-repair-evar-and-transcatheter-aortic-valve-replacement-tavr-associated-acute-kidney-injury
#6
REVIEW
Kenar D Jhaveri, Athanasios N Saratzis, Rimda J Wanchoo, Pantelis A Sarafidis
Acute kidney injury (AKI) after surgery or intervention is an important complication that may impact mortality, morbidity, and health care costs. Endovascular procedures are now performed routinely for a variety of pathologies that were traditionally treated with open surgery because randomized trials comparing endovascular and open surgery have shown at least equally good results and reduced complication and hospitalization rates with endovascular techniques. However, endovascular procedures have been associated with an increased risk for postoperative AKI, predominantly owing to contrast nephrotoxicity...
March 16, 2017: Kidney International
https://www.readbyqxmd.com/read/28315573/mortality-length-of-stay-and-cost-implications-of-procedural-bleeding-after-percutaneous-interventions-using-large-bore-catheters
#7
Björn Redfors, Brendan M Watson, Thomas McAndrew, Emilie Palisaitis, Dominic P Francese, Mehdi Razavi, Jordan Safirstein, Roxana Mehran, Ajay J Kirtane, Philippe Généreux
Importance: Bleeding complications after percutaneous transcatheter interventions that used large-bore catheters are frequent and associated with high mortality and morbidity. Objective: To describe the incidence of bleeding complications among patients undergoing contemporary endovascular interventions involving large-bore catheters and its association with in-hospital mortality, length of stay, and health care cost. Design, Setting, and Participants: This retrospective cohort study analyzed all 17 672 patients from the Healthcare Cost and Utilization Project's National Inpatient Sample database who were recorded as having undergone a transcatheter aortic valve replacement (n = 3223), an endovascular aneurysm repair (n = 12 633), or a percutaneous left ventricular assist device implant (n = 1816) between January 1, 2012, and December 31, 2013...
March 18, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28272209/dissection-of-the-interventricular-septum-echocardiographic-features
#8
Xiaoyan Gu, Yihua He, Shurong Luan, Ying Zhao, Lin Sun, Hongjia Zhang, J V Ian Nixon
Dissection of the interventricular septum (IVS) is an extremely rare entity. An institutional echocardiographic database was retrospectively reviewed; 13 patients with a diagnosis of IVS dissection were found and confirmed by cardiac surgery. The purposes of the study were: to determine the value of transthoracic echocardiography (TTE) in establishing the diagnosis of IVS dissection, and to detail the TTE features of IVS dissection.Thirteen patients with IVS dissection diagnosed by TTE, 8 males and 5 females were taken from 789,114 TTE studies performed between 1985 and 2014...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28262292/combined-aortic-root-replacement-and-mitral-valve-surgery-the-quest-to-preserve-both-valves
#9
Hoda Javadikasgari, Eric E Roselli, Muhammad Aftab, Rakesh M Suri, Milind Y Desai, Mitra Khosravi, Frank Cikach, Monica Isabella, Jay J Idrees, Sajjad Raza, Bassman Tappuni, Brian P Griffin, Lars G Svensson, A Marc Gillinov
OBJECTIVES: Coexisting aortic root and mitral valve pathology is increasingly recognized among patients undergoing surgery. We characterized the pathology and surgical outcomes of patients with combined aortic root and mitral disease. METHODS: From 1987 to 2016, 118 patients (age 52.40 ± 17.71 years) underwent concomitant aortic root and mitral procedures (excluding aortic stenosis, endocarditis, and reoperations). Aortic root pathologies included degenerative aneurysm (94%) and aortic dissection (6%)...
May 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28259111/evidence-based-surgery-of-aortic-regurgitation-results-of-a-questionnaire-in-german-speaking-countries
#10
Christian Dinges, Johannes Steindl, Wolfgang Hitzl, Tobias Kiesslich, Rainald Seitelberger
Background evidence-based medicine (EBM) approaches have reached broad acceptance, both in conservative and surgical disciplines. The aim of this study is to clarify the role of EBM in a rare condition of aortic regurgitation (AR) with surgical indication. Methods A purpose-built Internet-based questionnaire was sent to 607 cardiovascular surgeons in Germany, Austria, and Switzerland. A virtual 64-year-old patient's medical history was presented, including two ultrasound images and one computed tomography scan, showing a 58-mm aortic root aneurysm and a severe trileaflet regurgitant aortic valve...
March 4, 2017: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/28238237/immediate-early-and-late-failure-after-transcatheter-aortic-valve-implantation-how-to-deal-with-the-inoperable
#11
Sabina PW Guenther, Maximilian A Pichlmaier, Erik Bagaev, Florian Herrmann, René Schramm, Steffen Massberg, Christian Hagl, Nawid Khaladj
BACKGROUND: Currently, the use of transcatheter aortic valve implantation (TAVI) is constantly increasing, whilst cardiosurgical back-up varies substantially. Besides immediate conversion to surgical aortic valve replacement (SAVR) for periprocedural complications, SAVR for TAV failure may be necessary within the early or late post-implant course. The etiology, incidence, risk-stratification, management and outcome for both scenarios are largely unclear. The study aim was to provide details of the authors' experience of SAVR after the failure of TAVI at a single institution...
September 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28198528/the-expression-of-inhibitor-of-nuclear-factor-kappa-b-kinase-epsilon-ikk%C3%AE%C2%B5-in-human-aortic-aneurysm
#12
Leiyang Zhang, Lei Wang, Wen Chen, Yueyue Xu, Liming Wang, Reinard Iskandar, Yifei Wang, Xin Chen
BACKGROUND: Aortic aneurysm (AA) is one of the most common causes of sudden death among elderly people. Although AA can be detected by non-invasive imaging techniques, there are no pharmacological treatments currently available to prevent progression at any stage of the disease. In this study we will explore the expression of IKKε in AA and its potential underlying molecular mechanism in AA. Material s and methods: Human aortic tissue was taken from 14 patients who underwent surgical repair of AA for the AA group and another 11 patients with normal aorta who underwent aortic valve replacement surgery for the control group...
February 15, 2017: Folia Morphologica (Warsz)
https://www.readbyqxmd.com/read/28194732/late-post-avr-progression-of-bicuspid-aortopathy-link-to-hemodynamics
#13
Shiho Naito, Tatiana Gross, Kushtrim Disha, Yskert von Kodolitsch, Hermann Reichenspurner, Evaldas Girdauskas
BACKGROUND AND AIM OF THE STUDY: The ascending aortic dilatation may progress after aortic valve replacement (AVR) in bicuspid aortic valve (BAV) patients. Our aim was to evaluate rheological flow patterns and histological characteristics of the aneurysmal aorta in BAV patients at the time of reoperative aortic surgery. MATERIALS AND METHODS: 13 patients (mean age: 42 ± 9 years, 10 (77%) male) with significant progression of proximal aortopathy after isolated AVR surgery for BAV disease (i...
February 13, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28168982/two-decades-of-experience-with-root-remodeling-and-valve-repair-for-bicuspid-aortic-valves
#14
Ulrich Schneider, Susanne K Feldner, Christopher Hofmann, Jakob Schöpe, Stefan Wagenpfeil, Christian Giebels, Hans-Joachim Schäfers
OBJECTIVE: Bicuspid aortic valve anatomy is associated with ascending aortic aneurysm in approximately 50% of individuals and may lead to severe aortic regurgitation with aortic dilatation. Both entities may be treated by valve repair and root remodeling. The objective was to review the cumulative experience of 20 years. METHODS: Between November 1995 and December 2015, 357 patients (324 male; age 10-80 years; mean, 49 ± 13 years) underwent combined bicuspid aortic valve repair and root remodeling...
January 10, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28149605/the-timing-of-elective-ascending-aortic-aneurysm-replacement-for-non-syndromic-patients-and-the-implication-of-bicuspid-aortic-valve-related-aortopathy
#15
EDITORIAL
Ali Khoynezhad
No abstract text is available yet for this article.
December 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28097199/long-term-survival-after-composite-mechanical-aortic-root-replacement
#16
Khaled E Al-Ebrahim, Husain H Jabbad, Ahmad H Alqari
This report describes the long-term follow-up of the repair of a giant ascending aneurysm using a composite graft with a mechanical valve.
August 2016: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/28097190/chronic-type-a-aortic-dissection-and-giant-aortic-root-aneurysm-after-aortic-valve-replacement
#17
Andrés Enríquez Puga, Sara Castaño Rodríguez, Blanca Mateos Pañero, Beatriz Castaño Moreira, Luis Fernando López Almodóvar
We describe the case of a 61-year-old male with a giant aortic root aneurysm associated with chronic aortic Type A dissection. The patient had been operated on 16 years before due to aortic annuloectasia with mechanical valve replacement. The patient underwent revision aortic surgery with a Bentall-De Bono operation with Svensson modification, using a #21 On-X Valsalva mechanical valve conduit. The postoperative course was uneventful.
June 2016: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/28097185/immediate-improvement-in-severe-mitral-regurgitation-after-aortic-valve-replacement-for-severe-aortic-insufficiency
#18
Ahmad Zeeshan, Mojun Zhu, John A Elefteriades
A 57-year-old male with ascending aortic aneurysm, severe aortic regurgitation, and severe mitral regurgitation (MR) underwent ascending aortic replacement and aortic valve replacement. MR in this patient with normal mitral valve morphology was considered secondary to aortic valve incompetency. Consequently, a surgical approach to restore aortic valve function was adopted with successful MR resolution. This case report demonstrates the possibility of reversing early functional mitral regurgitation without surgically approaching the mitral valve...
June 2016: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/28079661/femoral-neuropathy-following-spontaneous-retroperitoneal-hemorrhage-after-cardiac-surgery-a-case-report
#19
Dinah J White, F T Lytle
A woman underwent ascending aortic aneurysm repair, aortic root and valve replacement, and coronary artery bypass grafting. Her postoperative course was complicated by stroke and status epilepticus. With supportive care and antiepileptics, her neurologic status improved. Intravenous heparin and aspirin were initiated. On postoperative day 13, she developed a large retroperitoneal hematoma with femoral neuropathy. Because her hematoma was not amenable to percutaneous drainage or surgical evacuation, and considering her comorbidities, a conservative approach was elected...
April 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28057275/anatomic-suitability-for-transcaval-access%C3%A2-based-on-computed-tomography
#20
REVIEW
Robert J Lederman, Adam B Greenbaum, Toby Rogers, Jaffar M Khan, Melissa Fusari, Marcus Y Chen
Transcaval access has been used successfully for over 200 transcatheter aortic valve replacements, large-bore percutaneous left ventricular assist devices, and thoracic endovascular aortic aneurysm repairs. This review teaches how to plan transcaval access and closure based on computed tomography. The main planning goals are to: 1) identify calcium-free crossing targets in the abdominal aorta along with optimal fluoroscopic projection angles and level with respect to lumbar vertebrae; 2) identify obstacles such as interposed bowel or pedunculated aortic atheroma; 3) plan covered stent bailout; and 4) identify jeopardized vascular branches such as renal arteries that might be obstructed by bailout covered stents if employed...
January 9, 2017: JACC. Cardiovascular Interventions
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