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Thoracic dissection

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https://www.readbyqxmd.com/read/28540127/learning-curves-for-minimally-invasive-spine-surgeries-are-they-worth-it
#1
EDITORIAL
Nancy E Epstein
BACKGROUND: Minimally invasive surgery (MIS) spine procedures were developed to limit operative time, the extent of dissection, and reduce perioperative morbidity. Here, we asked what are the "learning curves" for these MIS spine procedures? METHODS: We reviewed studies in the literature that discussed the "learning curves" attributed to performing different MIS spine surgical procedures. Of interest, the majority were single-surgeon series. RESULTS: Very few articles assessed the learning curves for different MIS spine procedures...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28540077/role-of-molecular-imaging-with-positron-emission-tomographic-in-aortic-aneurysms
#2
REVIEW
Parmanand Singh, Zaid Almarzooq, Brian Salata, Richard B Devereux
Aortic aneurysms (AA) are often asymptomatic before the occurrence of acute, potentially fatal complications including dissection and/or rupture. Beyond aortic size, the ability to assess aortic wall characteristics and processes contributing to aneurysm development may allow improved selection of patients who may benefit from prophylactic surgical intervention. Current risk stratification for aneurysms relies upon routine noninvasive imaging of aortic size without assessing the underlying pathophysiologic processes, including features such as inflammation, which may be associated with aneurysm development and progression...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28539414/moderately-elevated-homocysteine-does-not-contribute-to-thoracic-aortic-aneurysm-in-mice
#3
Jasmin Roohi, Benjamin Kang, David Bernard, Djahida Bedja, Harry C Dietz, Lawrence C Brody
Background: Moderate hyperhomocysteinemia is an attractive target for intervention because it is present in 5-7% of the population and can be reversed by diet. This approach presupposes that hyperhomocysteinemia is directly involved in the disease process. Epidemiologic studies have indicated that moderately elevated homocysteine may contribute to thoracic aortic aneurysm (TAA) dilatation and dissection in humans. In vitro, elevated homocysteine disrupts the structure and function of extracellular matrix components, suggesting that moderate hyperhomocysteinemia may contribute to the development and/or progression of TAA...
May 24, 2017: Journal of Nutrition
https://www.readbyqxmd.com/read/28535766/a-novel-anatomic-severity-grading-score-for-acute-type-b-aortic-dissections-and-correlation-to-aortic-reinterventions-after-thoracic-endovascular-aortic-repair
#4
Shirui Chen, Sebastian Larion, Sadaf S Ahanchi, Chad P Ammar, Colin T Brandt, Jean M Panneton
BACKGROUND: We introduce a novel preoperative anatomic severity grading system for acute type B aortic dissections and validate the system in a cohort of patients who underwent thoracic endovascular aortic repair. METHODS: We identified a cohort of patients who received thoracic endovascular aortic repair (TEVAR) for acute type B aortic dissection from 2008 to 2014. We developed an anatomic severity grading score (ASG) to measure attributes of aortic anatomy that we hypothesized may affect difficulty or durability of repair...
May 23, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28528045/endovascular-fenestration-for-distal-aortic-sealing-after-frozen-elephant-trunk-with-thoraflex
#5
Randolph H L Wong, Peter S Y Yu, Micky W T Kwok, Simon C Y Chow, Jacky Y K Ho, Malcolm J Underwood, Simon C H Yu
We describe a case of total arch replacement with frozen elephant trunk for chronic type B aortic dissecting aneurysm, which resulted in inadvertent landing of the frozen elephant trunk into the false lumen. A radiofrequency puncture system-assisted controlled endovascular fenestration of the dissection flap was performed at the upper abdominal aorta and subsequent thoracic endovascular stenting, successfully redirecting the blood flow from the false to the true lumen. Our case illustrated a possible way to seal distal reentry in chronic type B aortic dissection...
June 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28526487/ultrasound-guided-thoracic-paravertebral-injection-in-dogs-a-cadaveric-study
#6
Diego A Portela, Luis Campoy, Pablo E Otero, Manuel Martin-Flores, Robin D Gleed
OBJECTIVE: To describe ultrasound-visualized anatomy and the spread characteristics of a dye injected in the thoracic paravertebral (TPV) space under ultrasound guidance. STUDY DESIGN: Anatomic cadaver study. ANIMALS: Seven dog cadavers. METHODS: One cadaver was used to observe, identify, and describe the relevant TPV anatomy. In the remaining six, the left fifth TPV space was randomly assigned to be injected with either a low volume (LV; 0...
February 16, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28523135/use-of-co2-in-video-assisted-thoracic-surgery-and-single-lumen-endotracheal-tube-a-new-less-invasive-approach
#7
REVIEW
Javier Gallego-Poveda, Nuno Carvalho Guerra, Catarina Carvalheiro, Hugo Ferreira, André Sena, Nádia Junqueira, Tiago Rodrigues Velho, Ângelo Nobre
Carbon dioxide (CO2) has been extensively used to allow laparoscopic procedures, due to its extensive advantages in obtaining a fairly innocuous pneumoperitoneum to allow visceral dissection. Its use in video assisted thoracic surgery (VATS) has seldom been described. We present our experience in more than 100 patients, operated for various thoracic pathologies, in whom we created a surgical pneumothorax to allow different surgeries to be undertaken.
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28523130/the-development-of-uniportal-video-assisted-thoracoscopic-surgery-in-s%C3%A3-o-paulo-from-diagnosis-to-lobectomy
#8
Alexandre de Oliveira, Thais Amarante P P Couto
BACKGROUND: The use of uniportal video-assisted thoracoscopic surgery (VATS) has been increasing worldwide. Our main goal was to describe the evolution of uniportal surgery in the biggest private hospital in Latin America that is located in São Paulo, Brazil. METHODS: This descriptive and retrospective study included patients who underwent uniportal VATS in the thoracic surgical department of Beneficencia Portuguesa Hospital, after being referred to our team to undergo the aforementioned procedure within the period from February 2012 to March 2016...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28514894/successful-repair-of-acute-type-b-and-retrograde-type-a-aortic-dissection-with-kidney-ischemia
#9
Jeko M Madjarov, Michael G Katz, Hector Crespo-Soto, Svetozar Madzharov, Timothy Roush, Francis Robicsek
Acute dissection of thoracic aorta carries a risk of renal ischemia followed by the development of a kidney failure. The optimal surgical and nonsurgical management of these patients, timing of intervention, and the factors predicting renal recovery are not well delineated and remain controversial. We present a case of acute type B thoracic aortic dissection with left kidney ischemia. Evaluation of renal function was performed by the means of internationally accepted Risk, Injury, Failure, Loss of kidney function, End stage kidney disease and Acute Kidney Injury Network classifications for acute kidney injury, renal duplex sonography, and intravascular ultrasound that demonstrated left renal artery dissection with a flap completely compressing the true lumen...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28511923/igg4-aortopathy-an-underappreciated-cause-of-non-infectious-thoracic-aortitis
#10
Victor Aguirre, Catherine Connolly, Robert Stuklis
IgG4 related thoracic aortitis is a recent addition to the differential diagnosis for inflammatory aortic disease - a condition which is often underappreciated until complications arise such as aneurysmal formation or aortic dissection. Currently, IgG4 aortitis remains a post-surgical diagnosis reliant on positive immunohistochemistry findings. Management is guided by the extent of disease involvement, which can be gauged by serum IgG4 levels and radiological findings. Options include surgical resection, corticosteroid therapy and steroid-sparing agents to prevent relapses...
April 19, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28510799/practical-surgical-techniques-for-lymphadenectomy-along-the-right-recurrent-laryngeal-nerve-during-thoracoscopic-esophagectomy-in-the-prone-position
#11
Taro Oshikiri, Tetsu Nakamura, Yukiko Miura, Hiroshi Hasegawa, Masashi Yamamoto, Shingo Kanaji, Kimihiro Yamashita, Yoshiko Matsuda, Takeru Matsuda, Yasuo Sumi, Satoshi Suzuki, Yoshihiro Kakeji
BACKGROUND: In esophageal squamous cell cancer (SCC), lymphadenectomy along the right recurrent laryngeal nerve (RLN) is important for disease control. The metastatic rate was 33% and the 5-year overall survival rate of these patients was 33.3%,1 but the risk of RLN palsy increases.2 We reported a reliable new method ('Pincers Maneuver')3 for lymphadenectomy along the right RLN during thoracoscopic esophagectomy in the prone position (TEP), and hereby present our video, aimed at providing a complete and safe dissection...
May 16, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28507574/blood-groups-and-acute-aortic-dissection-type-iii
#12
Nikola Fatic, Aleksandar Nikolic, Mihailo Vukmirovic, Nemanja Radojevic, Nenad Zornic, Igor Banzic, Nikola Ilic, Dusan Kostic, Bogdan Pajovic
INTRODUCTION: Acute aortic type III dissection is one of the most catastrophic events, with in-hospital mortality ranging between 10% and 12%. The majority of patients are treated medically, but complicated dissections, which represent 15% to 20% of cases, require surgical or thoracic endovascular aortic repair (TEVAR). For the best outcomes adequate blood transfusion support is required. Interest in the relationship between blood type and vascular disease has been established. The aim of our study is to evaluate distribution of blood groups among patients with acute aortic type III dissection and to identify any kind of relationship between blood type and patient's survival...
April 1, 2017: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/28503799/lymph-node-dissection-for-siewert-ii-esophagogastric-junction-adenocarcinoma-a-retrospective-study-of-136-cases
#13
Xiaofeng Duan, Xiaobin Shang, Peng Tang, Hongjing Jiang, Zhentao Yu
BACKGROUND: To compare the lymph node dissection with the right transthoracic Ivor-Lewis (IL) procedure to that with the left transthoracic (LT) approach for Siewert type II adenocarcinoma of the esophagogastric (AEG) junction. METHODS: In this study, 136 patients with Siewert type II AEG who met the inclusion criteria underwent surgical resection were divided into the IL (47 cases) and LT (89 cases) groups. The number and frequency of the dissected lymph nodes in each station were compared between the two groups...
May 14, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28502544/first-experience-with-the-double-chimney-technique-in-the-treatment-of-aortic-arch-diseases
#14
Tun Wang, Chang Shu, Quan-Ming Li, Ming Li, Xin Li, Hao He, Alan Dardik, Jian Qiu
OBJECTIVE: The objective of this study was to summarize our initial experience using the double chimney technique to treat aortic arch diseases. METHODS: From December 2009 to October 2016, 23 patients with aortic arch diseases, including 20 acute aortic dissections, 2 aortic arch aneurysms, and 1 type I endoleak after thoracic endovascular aortic repair (TEVAR), were treated using a double chimney technique. An emergent operation was performed in only one patient with an acute aortic dissection for severe left lower extremity ischemia...
May 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28499667/insight-into-the-incidence-of-acute-aortic-dissection-in-the-german-region-of-berlin-and-brandenburg
#15
S D Kurz, V Falk, J Kempfert, M Gieb, T M Ruschinski, M Kukucka, M Tsokos, H Grubitzsch, H Herbst, J Semmler, C Buschmann
BACKGROUND: Stanford acute type A aortic dissection (ATAAD) is a potentially lethal condition. Epidemiology studies show a statistical incidence in Europe of approximately 2-16 cases/100,000 inhabitants/year. In Germany, the estimated incidence (here subsumed under "thoracic aortic dissection" with 4.63 cases/100,000 inhabitants/year) is mainly extracted from medical death certificates by the German Federal Statistical Office. The prehospital incidence of ATAAD deaths is largely unknown...
May 6, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28497016/small-refinements-in-breast-reconstruction-a-technique-for-inframammary-fold-creation
#16
Arthur Ismagilov, Anna Vanesyan, Ilnur Kamaletdinov
BACKGROUND: In breast reconstructive surgery, the inframammary fold (IMF) is an essential component of breast identity. The lack of the IMF following previous mastectomy requires restoration. We have developed a new IMF reconstruction technique using the posterior sheet (PS) of the expander capsule. This article presents our 10-year experience of performing this original technique during two-stage breast reconstruction. METHODS: Preoperatively, the midline, lateral, and medial borders (MBs) of the implant pocket and the new IMF line were marked...
April 2017: Gland Surgery
https://www.readbyqxmd.com/read/28496083/-retrograde-type-a-aortic-dissection-after-thoracic-endovascular-aortic-repair-report-of-a-case
#17
Sei Morizumi, Takafumi Inoue, Satoshi Nishi, Akihiro Yoshimoto, Masashi Fujisaki, Yoshihiro Suematsu
A 72-year-old man presented with aneurysms of the distal aortic arch and the distal descending aorta due to chronic type B aortic dissection. We first performed thoracic endovascular aortic repair (TEVAR) in the distal descending aorta, and the aneurysm was successfully excluded using a Gore Tag stentgraft. Seven days after TEVAR, computed tomography revealed retrograde type A aortic dissection occurring from the ascending aorta to the distal aortic arch. In emergency surgery, ascending aorta and total arch replacement were performed under selective cerebral perfusion with moderate hypothermia, and after coming off cardiopulmonary bypass, the distal aortic arch aneurysm was excluded using a Gore Tag stentgraft...
May 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28490606/comparison-of-10-murine-models-reveals-a-distinct-biomechanical-phenotype-in-thoracic-aortic-aneurysms
#18
C Bellini, M R Bersi, A W Caulk, J Ferruzzi, D M Milewicz, F Ramirez, D B Rifkin, G Tellides, H Yanagisawa, J D Humphrey
Thoracic aortic aneurysms are life-threatening lesions that afflict young and old individuals alike. They frequently associate with genetic mutations and are characterized by reduced elastic fibre integrity, dysfunctional smooth muscle cells, improperly remodelled collagen and pooled mucoid material. There is a pressing need to understand better the compromised structural integrity of the aorta that results from these genetic mutations and renders the wall vulnerable to dilatation, dissection or rupture. In this paper, we compare the biaxial mechanical properties of the ascending aorta from 10 murine models: wild-type controls, acute elastase-treated, and eight models with genetic mutations affecting extracellular matrix proteins, transmembrane receptors, cytoskeletal proteins, or intracellular signalling molecules...
May 2017: Journal of the Royal Society, Interface
https://www.readbyqxmd.com/read/28490232/the-candy-plug-technique-technical-aspects-and-early-results-of-a-new-endovascular-method-for-false-lumen-occlusion-in-chronic-aortic-dissection
#19
Fiona Rohlffs, Nikolaos Tsilimparis, Beatrice Fiorucci, Franziska Heidemann, Eike Sebastian Debus, Tilo Kölbel
PURPOSE: To describe the technical aspects and early results of the Candy-Plug technique for endovascular false lumen occlusion in chronic aortic dissection. METHODS: A retrospective single-center study analyzing 18 consecutive patients (mean age 63 years, range 44-76; 16 men) with thoracic false lumen aneurysm in chronic aortic dissection. All patients underwent thoracic endovascular aortic repair with false lumen occlusion using the Candy-Plug technique. Primary endpoints consisted of technical success (successful deployment) and clinical success (no false lumen backflow)...
May 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28486683/comparison-of-endovascular-repair-with-branched-stent-graft-and-open-repair-for-aortic-arch-aneurysm%C3%A2
#20
Masahide Kawatou, Kenji Minakata, Kazuhisa Sakamoto, Taro Nakatsu, Junichi Tazaki, Hirooki Higami, Kyokun Uehara, Kazuhiro Yamazaki, Kanji Inoue, Takeshi Kimura, Ryuzo Sakata
OBJECTIVES: Although conventional open repair is our preference for patients with aortic arch aneurysms, we have often chosen thoracic endovascular aneurysm repair (TEVAR) with a handmade branched stent graft (bTEVAR) in high-risk patients. The aim of this study was to compare the midterm clinical outcomes of our bTEVAR technique to those of the open repair. METHODS: Between January 2007 and December 2014, we treated 129 patients with aortic arch aneurysm by means of either conventional open repair (OPEN, n  = 61) or bTEVAR ( n  = 68) at our institution...
May 8, 2017: Interactive Cardiovascular and Thoracic Surgery
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