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Thoracic dissection

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https://www.readbyqxmd.com/read/28219557/total-endovascular-repair-of-post-dissection-aortic-arch-aneurysm-with-chimney-technique
#1
Wei-Tao Liang, Su Wang, Jian Zhou, Chen-Jun Han, Qiang Liu, Xiao-Yun Wu, Wang-Fu Zang
Open surgery remains the standard procedure for treatment of aortic arch pathologies. However, total endovascular repair can be a safe option for patients who are poor candidates for surgery because of compromised physiology. We report the case of a 63-year-old man with a post-dissection aortic arch aneurysm. We repaired the aneurysm using thoracic endovascular aortic repair (TEVAR) and used the chimney technique to reconstruct the supra-aortic branches. The patient is doing well after 12-month follow-up, demonstrating that TEVAR with the chimney technique can be used successfully for the treatment of post-dissection arch aneurysm...
March 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28219551/concomitant-endografting-of-a%C3%A2-type-b-aortic-dissection-during-transfemoral-aortic-valve-replacement
#2
Arman Kilic, Mary A Siki, Wilson Y Szeto, Joseph E Bavaria, Saif Anwaruddin, Nimesh D Desai
An 87-year-old woman with severe aortic stenosis underwent a transfemoral transcatheter aortic valve replacement (TAVR). Intraoperative transesophageal echocardiography demonstrated a well-seated valve with no paravalvular leak; however, a new acute type B aortic dissection was identified. Endografts were delivered through the TAVR sheath and deployed, effectively treating the dissection. The patient did well postoperatively, with imaging at 2 years demonstrating a well-functioning aortic valve and no migration or endoleak of the thoracic endografts...
March 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28219304/solitary-thoracic-intramedullary-spinal-neurofibroma-microsurgically-extirpated-via-recapping-t-saw-laminoplasty
#3
Mamer Soriano Rosario, Hideki Murakami, Satoshi Kato, Moriyuki Fujii, Noritaka Yonezawa, Hiroyuki Tsuchiya
We report the case of a 40-year-old female presenting with back pain that was complicated by a solitary intramedullary spinal cord mass at the T10-11 levels, confirmed by magnetic resonance imaging and computed tomography myelography. Microsurgical en bloc extirpation of the tumor approached through a recapping T-saw laminoplasty of T10 was done, and histopathology findings revealed a diagnosis of neurofibroma. Solitary spinal neurofibroma is one of the rarest tumors involving the spinal cord and is very adherent for the lack of a well-defined capsule, requiring careful dissection under microscope magnification for successful en bloc resection...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28216363/durable-outcomes-of-thoracic-endovascular-aortic-repair-with-zenith-tx1-and-tx2-devices
#4
Jocelyn M Beach, Yuki Kuramochi, Corey Brier, Eric E Roselli, Matthew J Eagleton
OBJECTIVE: Long-term data regarding the safety and durability of thoracic endovascular aortic repair (TEVAR) are limited. The study objective was to evaluate the long-term outcomes of TEVAR in high-risk patients with descending thoracic aortic pathology. METHODS: High-risk patients were treated with thoracic endografts (2001-2011) under a prospective, physician-sponsored, investigational device exemption trial. Three-dimensional reconstructions and measurements were performed on computed tomography scans acquired before discharge, at 1, 6, and 12 months, and then yearly thereafter...
February 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28216358/outcomes-of-thoracic-endovascular-aortic-repair-using-aortic-arch-chimney-stents-in-high-risk-patients
#5
Igor Voskresensky, Salvatore T Scali, Robert J Feezor, Javairiah Fatima, Kristina A Giles, Rosamaria Tricarico, Scott A Berceli, Adam W Beck
BACKGROUND: Aortic arch disease is a challenging clinical problem, especially in high-risk patients, in whom open repair can have morbidity and mortality rates of 30% to 40% and 2% to 20%, respectively. Aortic arch chimney (AAC) stents used during thoracic endovascular aortic repair (TEVAR) are a less invasive treatment strategy than open repair, but the current literature is inconclusive about the role of this technology. The focus of this analysis is on our experience with TEVAR and AAC stents...
February 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28216355/innovative-postmarket-device-evaluation-using-a-quality-registry-to-monitor-thoracic-endovascular-aortic-repair-in-the-treatment-of-aortic-dissection
#6
Adam W Beck, Joseph V Lombardi, Dorothy B Abel, J Pablo Morales, Danica Marinac-Dabic, Grace Wang, Ali Azizzadeh, John Kern, Mark Fillinger, Rodney White, Jack L Cronenwett, Richard P Cambria
OBJECTIVE: United States Food and Drug Administration (FDA)-mandated postapproval studies have long been a mainstay of the continued evaluation of high-risk medical devices after initial marketing approval; however, these studies often present challenges related to patient/physician recruitment and retention. Retrospective single-center studies also do not fully represent the spectrum of real-world performance nor are they likely to have a sufficiently large enough sample size to detect important signals...
February 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28216353/left-subclavian-artery-revascularization-in-zone-2-thoracic-endovascular-aortic-repair-is-associated-with-lower-stroke-risk-across-all-aortic-diseases
#7
Rhiannon J Bradshaw, S Sadie Ahanchi, Obie Powell, Sebastian Larion, Colin Brandt, Michael C Soult, Jean M Panneton
BACKGROUND: The best management strategy for the left subclavian artery (LSA) in pathologic processes of the aorta requiring zone 2 thoracic endovascular aortic repair (TEVAR) remains controversial. We compared LSA coverage with or without revascularization as well as the different means of LSA revascularization. METHODS: A retrospective chart review was conducted of patients with any aortic diseases who underwent zone 2 TEVAR deployment from 2007 to 2014. Primary end points included 30-day stroke and 30-day spinal cord injury (SCI)...
February 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28212053/transthoracic-echocardiography-pitfalls-and-limitations-as-delineated-at-cardiac-ct-and-mr-imaging
#8
Sachin B Malik, Natalie Chen, Rex A Parker, Joe Y Hsu
Transthoracic echocardiography ( TTE transthoracic echocardiography ) is a critical tool in the field of clinical cardiology. It often serves as one of the first-line imaging modalities in the evaluation of cardiac disease owing to its low cost, portability, widespread availability, lack of ionizing radiation, and ability to evaluate both anatomy and function of the heart. Consequently, a large majority of patients undergoing a cardiac computed tomography (CT) or magnetic resonance (MR) imaging examination will have a TTE transthoracic echocardiography available for review...
February 17, 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28209770/are-patients-with-loeys-dietz-syndrome-misdiagnosed-with-beals-syndrome
#9
Rebecca Woolnough, Andrew Dhawan, Kimberly Dow, Jagdeep S Walia
Beals syndrome, also known as congenital contractural arachnodactyly (Online Mendelian Inheritance in Man: 121050), is an autosomal dominant disorder caused by a mutation in FBN2 that is typically characterized by congenital contractures and arachnodactyly. It shares a number of phenotypic features with Loeys-Dietz syndrome (Online Mendelian Inheritance in Man: 609192). Loeys-Dietz syndrome, initially described in 2005, is associated with mutations for the transforming growth factor β receptor and is characterized by findings of cerebral, thoracic, and abdominal arterial aneurysms...
February 16, 2017: Pediatrics
https://www.readbyqxmd.com/read/28207537/lymph-node-dissection-for-siewert-ii-esophagogastric-junction-adenocarcinoma-a-retrospective-study-of-3-surgical-procedures
#10
Xiao-Feng Duan, Jie Yue, Peng Tang, Xiao-Bin Shang, Hong-Jing Jiang, Zhen-Tao Yu
The present study was aimed to investigate the application of right thansthoracic Ivor-Lewis (IL), left transthoracic (LTT), and left thoracoabdominal (LTA) approach in Siewert type II adenocarcinoma of esophagogastric junction (AEG).The data of 196 patients with Siewert type II AEG received surgical resection in our cancer center between January 2014 and April 2016 was retrospectively analyzed. Finally, 136 patients met the inclusion criteria were enrolled in the study and divided into the IL (47 cases), LTT (51 cases), and LTA group (38 cases)...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28203176/a-case-of-gastric-cancer-with-situs-inversus-totalis
#11
Byoung Jo Suh
Situs inversus totalis (SIT) is a rare congenital anomaly that refers to a completely reversed location of the abdominal and thoracic organs. We report the case of 50-year-old man with gastric cancer and SIT who was diagnosed during a screening esophagogastroduodenoscopy. A chest X-ray, abdominopelvic computed tomography, and (18)F-fluoro2-deoxyglucose-D-glucose-positron emission tomography scans revealed SIT. We performed a radical subtotal gastrectomy with D2 lymph node dissection. Advanced surgical skill is required to perform a precise lymphadenectomy in a patient with SIT by visualizing the exact mirror image of the anatomy during the operation...
January 2017: Case Reports in Oncology
https://www.readbyqxmd.com/read/28194664/phrenic-nerve-stimulation-during-neck-dissection-for-advanced-thyroid-cancer-involving-level-iv-is-it-worth-doing-it
#12
Carlos S Duque, Juan P Dueñas, Marcela Marulanda, Diana Pérez, Andres Londoňo, Soham Roy, Mai Al Khadem
During thyroidectomy and neck dissection surgery for advanced or recurrent metastatic thyroid cancer under intraoperative monitoring, we used the available technology to assess the feasibility of such an intervention to monitor those patients with phrenic nerves at risk. A retrospective review of patients operated on from January 2009 to December 2015 by a single surgeon (CSD) was conducted. Patients who had neck and mediastinal dissection, with or without total thyroidectomy, due to advanced or recurrent metastatic disease to the neck were selected...
February 13, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28190713/transient-atrial-fibrillation-after-open-abdominal-aortic-revascularization-surgery-is-associated-with-increased-length-of-stay-mortality-and-readmission-rates
#13
Barbara A Blanco, Anai N Kothari, Pegge M Halandras, Robert H Blackwell, Dawn M Graunke, Paul C Kuo, Jae S Cho
BACKGROUND: It is well established that transient postoperative atrial fibrillation (TPAF) is associated with adverse postoperative outcomes after major cardiac and noncardiac operations. The purpose of this study was to elucidate the incidence, impact, and risk factors associated with the development of TPAF in patients undergoing revascularization surgery for occlusive diseases of the abdominal aorta and its branches (AAB). METHODS: By use of the Healthcare Cost and Utilization Project State Inpatient Database from Florida and California, patients who underwent open revascularization of AAB between 2006 and 2011 were identified...
February 9, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28190547/surgical-outcomes-of-chronic-descending-dissections-type-i-versus-iii-debakey
#14
Ivancarmine Gambardella, Mario Gaudino, Christopher Lau, Monica Munjal, Mohamed Elsayed, Leonard N Girardi
BACKGROUND: We evaluated the results of open operation for the treatment of descending thoracic aneurysm (DTA) and thoracoabdominal aortic aneurysm (TAAA) in patients with DeBakey type I versus type III chronic aortic dissection. METHODS: We reviewed our institutional aortic database and compared the results of open repair in patients with type I versus type III chronic aortic dissection. Between 1997 and 2015, 726 patients underwent open DTA or TAAA repair at our institution...
February 9, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28190439/neurologic-complications-of-polytrauma
#15
R M Jha, L Shutter
Neurologic complications in polytrauma can be classified by etiology and clinical manifestations: neurovascular, delirium, and spinal or neuromuscular problems. Neurovascular complications include ischemic strokes, intracranial hemorrhage, or the development of traumatic arteriovenous fistulae. Delirium and encephalopathy have a reported incidence of 67-92% in mechanically ventilated polytrauma patients. Causes include sedation, analgesia/pain, medications, sleep deprivation, postoperative state, toxic ingestions, withdrawal syndromes, organ system dysfunction, electrolyte/metabolic abnormalities, and infections...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28188564/usefulness-of-the-echocardiographic-paravertebral-approach-for-the-diagnosis-of-descending-thoracic-aortic-dissection
#16
Shoko Yamaguchi, Hironori Murakami, Tomoko Kudo, Chiharu Otokozawa, Shunsuke Sasaki, Satoshi Yuda, Masanori Nojima
BACKGROUND: Transthoracic echocardiography (TTE) is not recommended as the first-line diagnostic modality for Stanford type B aortic dissection (type-B AD). PURPOSES: The aims of this study were to evaluate the usefulness and factors influencing for the diagnosis of type-B AD using the transthoracic echocardiographic paravertebral approach (PVA). METHODS: We compared the image acquisition rate of descending thoracic aorta (DTA) and the diagnostic rate of type-B AD using TTE versus PVA...
February 10, 2017: Journal of Echocardiography
https://www.readbyqxmd.com/read/28187501/anatomical-study-of-the-brachial-plexus-in-the-common-marmoset-callithrix-jacchus
#17
Kenji Emura, Takamitsu Arakawa, Toshio Terashima
To elucidate the forelimb phylogeny of primates, anatomical analysis of the brachial plexus in platyrrhines is beneficial. In the present study, six brachial plexuses and the surrounding arteries of four common marmosets were dissected. In five specimens, the brachial plexus consisted of five ventral rami from the fifth cervical nerve (C5) to the first thoracic nerve (T1). In one specimen, the ventral ramus of the fourth cervical nerve joined with the brachial plexus. In five specimens, the upper trunk was composed of C5 and the sixth cervical nerve (C6)...
February 10, 2017: Anatomical Record: Advances in Integrative Anatomy and Evolutionary Biology
https://www.readbyqxmd.com/read/28185953/a-novel-smad3-mutation-caused-multiple-aneurysms-in-a-patient-without-osteoarthritis-symptoms
#18
Audrey Courtois, Wouter Coppieters, Vincent Bours, Jean-Olivier Defraigne, Alain Colige, Natzi Sakalihasan
Heterozygous mutations in the SMAD3 gene were recently described as the cause of a form of non-syndromic familial aortic thoracic aneurysm and dissection (FTAAD) transmitted as an autosomal dominant disorder and often associated with early-onset osteoarthritis. This new clinical entity, called aneurysms-osteoarthritis syndrome (AOS) or Loeys-Dietz syndrome 3 (LDS3), is characterized by aggressive arterial damages such as aneurysms, dissections and tortuosity throughout the arterial tree. We report, here, the case of a 45 year-old man presenting multiple visceral arteries and abdominal aortic aneurysms but without dissection of the thoracic aorta and without any sign of osteoarthritis...
February 6, 2017: European Journal of Medical Genetics
https://www.readbyqxmd.com/read/28184962/magnetic-resonance-imaging-4-d-flow-based-analysis-of-aortic-hemodynamics-in-turner-syndrome
#19
Raoul Arnold, Marie Neu, Daniel Hirtler, Charlotte Gimpel, Michael Markl, Julia Geiger
BACKGROUND: Cardiovascular surveillance is important in Turner syndrome because of the increased risk of aortic dilation and dissection with consecutively increased mortality. OBJECTIVE: To compare 4-D flow MRI for the characterization of aortic 3-D flow patterns, dimensions and vessel wall parameters in pediatric patients with Turner syndrome and age-matched controls. MATERIALS AND METHODS: We performed 4-D flow MRI measuring in vivo 3-D blood flow with coverage of the thoracic aorta in 25 patients with Turner syndrome and in 16 female healthy controls (age mean ± standard deviation were 16 ± 5 years and 17 ± 4 years, respectively)...
February 9, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28183174/the-petticoat-concept-for-endovascular-treatment-of-type-b-aortic-dissection
#20
Luca Bertoglio, Enrico Rinaldi, Germano Melissano, Roberto Chiesa
INTRODUCTION: A systematic literature search on outcomes of the PETTICOAT technique was aimed at verifying the feasibility and safety of the procedure, comparing clinical outcomes with standard stent-grafting of the proximal entry tear as well as describing the possible benefits in terms of aortic remodeling. EVIDENCE ACQUISITION: Potentially eligible papers were sought through a computerized search of MEDLINE and SCOPUS databases between January 2006 and June 2016...
February 9, 2017: Journal of Cardiovascular Surgery
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