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Aortic arch aneurysm

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https://www.readbyqxmd.com/read/28905268/fluid-and-biomechanical-analysis-of-ascending-thoracic-aorta-aneurysm-with-concomitant-aortic-insufficiency
#1
F Condemi, S Campisi, M Viallon, T Troalen, G Xuexin, A J Barker, M Markl, P Croisille, O Trabelsi, C Cavinato, A Duprey, S Avril
We present a comprehensive and original framework for the biomechanical analysis of patients affected by ascending thoracic aorta aneurysm and aortic insufficiency. Our aim is to obtain crucial indications about the role played by deranged hemodynamics on the ATAAs risk of rupture. Computational fluid dynamics analysis was performed using patient-specific geometries and boundary conditions derived from 4D MRI. Blood flow helicity and wall shear stress descriptors were assessed. A bulge inflation test was carried out in vitro on the 4 ATAAs after surgical repair...
September 13, 2017: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/28890066/ascending-aorta-endovascular-repair-of-a-symptomatic-penetrating-atherosclerotic-ulcer-with-a-custom-made-endo-graft
#2
Theodoros Kratimenos, Nikolaos G Baikoussis, Dimitrios Tomais, Michalis Argiriou
BACKGROUND: Thoracic endovascular aortic repair (TEVAR) has become lately the procedure of choice in the treatment of most pathologies of descending thoracic aorta. Aortic arch aneurysms also came to be treated by TEVAR with various hybrid techniques or custom made scalloped/fenestrated stent-grafts. Zone 0; ascending TEVAR is more challenging than TEVAR of the descending thoracic aorta or aortic arch because of the more complex pathology, hemodynamics, and anatomy. Ascending TEVAR can be a lifesaving treatment in selected high surgical risk patients...
September 7, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28887263/changes-in-geometry-and-cardiac-deformation-of-the-thoracic-aorta-after-thoracic-endovascular-aortic-repair-tevar
#3
Kelsey Hirotsu, Ga-Young Suh, Jason T Lee, Michael D Dake, Dominik Fleischmann, Christopher P Cheng
BACKGROUND: TEVAR has dramatically expanded treatment options for patients with thoracic aortic pathology. The interaction between endografts and the dynamic anatomy of the thoracic aorta is not well characterized for repetitive physiologic stressors and subsequent issues related to long-term durability. Through 3D modeling we sought to quantify cardiac-induced aortic deformation before and after TEVAR to assess the impact of endografts on dynamic aortic anatomy. METHODS: Eight patients with acute (n = 4) or chronic (n = 3) Type B dissections, or chronic arch aneurysm (n = 1), underwent TEVAR with a single (n = 5) or multiple (n = 3) Gore C-TAG(s)...
September 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28885101/association-between-the-maximal-distance-of-atrial-septal-protrusion-and-cryptogenic-stroke
#4
Keisuke Tokunaga, Masahiro Yasaka, Takahiro Kuwashiro, Seiji Gotoh, Asako Nakamura, Go Takaguchi, Tetsuro Ago, Masahiro Kamouchi, Takanari Kitazono, Yasushi Okada
Background and purpose Previous studies have suggested that atrial septal aneurysm is a potential risk factor for cerebral embolism. However, the association between the level of atrial septal protrusion and cerebral embolism is still unclear. The purpose of the present study was to assess the association between the maximal distance of atrial septal protrusion and cryptogenic stroke. Methods A total of 588 consecutive acute ischemic stroke patients (70 ± 11 (mean ± SD) years, 401 men) who underwent transesophageal echocardiography were enrolled...
December 20, 2016: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28882865/prevalence-of-intracranial-aneurysms-in-patients-with-aortic-dissection
#5
W S Jung, J H Kim, S J Ahn, S-W Song, B M Kim, K-D Seo, S H Suh
BACKGROUND AND PURPOSE: There is an uncertainty about the association between intracranial aneurysms and aortic dissection. We aimed to determine the prevalence of intracranial aneurysms in patients with aortic dissection and evaluate the independent risk factors for the presence of intracranial aneurysms in these patients. MATERIALS AND METHODS: Seventy-one patients with a confirmed aortic dissection who underwent additional brain imaging were enrolled as the aortic dissection group, and 2118 healthy individuals with brain imaging, as controls...
September 7, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28875285/current-status-of-cardiovascular-surgery-in-japan-2013-and-2014-a-report-based-on-the-japan-cardiovascular-surgery-database-5-thoracic-aortic-surgery
#6
REVIEW
Hideyuki Shimizu, Norimichi Hirahara, Noboru Motomura, Hiroaki Miyata, Shinichi Takamoto
BACKGROUND: Although open aortic repair (OAR) is still considered to be a standard treatment for thoracic aortic diseases, the indications for thoracic endovascular treatment (TEVAR)/hybrid aortic repair (HAR) have expanded in recent years. The purpose of this study was to review the current status of treatment of thoracic aortic diseases in Japan. METHODS: Data for 2013 and 2014 concerning surgery for diseases of the thoracic/thoracoabdominal aorta were extracted from the Japan Cardiovascular Surgery Database (JCVSD)...
September 5, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28868315/impact-of-thoracic-endovascular-repair-on-pulsatile-aortic-strain-in-acute-type-b-aortic-dissection-preliminary-results
#7
Foeke J H Nauta, Guido H W van Bogerijen, Michele Conti, Chiara Trentin, Frans L Moll, Joost A Van Herwaarden, Ferdinando Auricchio, Santi Trimarchi
BACKGROUND: The impact of thoracic endovascular aortic repair (TEVAR) on pulsatile aortic strain remains undetermined in patients with Type B aortic dissection (TBAD). Therefore, we quantified pulsatile aortic strain in TBAD patients and control subjects. METHODS: We retrospectively analyzed two TBAD patients from our database with cardiac-gated computed tomography angiography imaging available before and after TEVAR and two control subjects (67- and 76-year-old males)...
April 2017: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/28845874/-the-frozen-elephant-trunk-technique-for-the-treatment-of-complex-lesions-of-the-thoracic-aorta
#8
Luca Di Marco, Davide Pacini, Alessandro Leone, Antonio Pantaleo, Giacomo Murana, Roberto Di Bartolomeo
The treatment of patients with extensive disease of the thoracic aorta represents a formidable challenge for the cardiovascular surgeon. The beginning of thoracic aortic endovascular aortic arch repair has promoted the development of different hybrid approaches as the frozen elephant trunk (FET) strategy, which includes classic arch replacement and antegrade stenting of the descending thoracic aorta. It represents an interesting approach for patients with extensive disease of the thoracic aorta, and its application has significantly increased over recent years...
September 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28844469/a-systematic-review-of-primary-endovascular-repair-of-the-ascending-aorta
#9
REVIEW
Corbin E Muetterties, Rohan Menon, Grayson H Wheatley
OBJECTIVE: Endovascular repair of the ascending aorta is currently limited to patients at high surgical risk with aortic diseases originating above the sinotubular junction. A number of different endovascular technologies and approaches have been used, although no consensus exists regarding a standardized technique. To better understand real-world endovascular approaches to the ascending aorta, we performed a comprehensive review of the types of endovascular aortic stents and associated vascular access used in repair of the ascending aorta...
August 22, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28838513/hybrid-arch-frozen-elephant-trunk-for-persistent-endoleak-after-thoracic-endovascular-aortic-repair
#10
John H Landau, Luc A Dubois, Michael W A Chu
Aneurysms of the distal aortic arch and proximal descending thoracic aorta remain challenging to treat. Whereas thoracic endovascular aortic repair (TEVAR) with arch debranching has provided a more minimally invasive option for patients with such aneurysms, recurrent type Ia endoleaks can be difficult or impossible to treat with further endovascular intervention. We report the successful use of a hybrid arch and frozen elephant trunk graft for the treatment of a patient with a recurrent type Ia endoleak after TEVAR and arch debranching...
September 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28838101/valve-sparing-david-i-procedure-in-acute-aortic-type-a-dissection-a-20-year-experience-with-more-than-100-patients
#11
Erik Beckmann, Andreas Martens, Jana Pertz, Tim Kaufeld, Julia Umminger, Jasmin S Hanke, Jan D Schmitto, Serghei Cebotari, Axel Haverich, Malakh Lal Shrestha
OBJECTIVES: The aortic valve-sparing David procedure has been applied to the elective treatment of patients with aortic aneurysms with excellent results. The use of this technique in patients with acute aortic dissection type A (AADA) is still a matter of debate. We present our long-term experience with 109 patients with AADA who had the valve-sparing David I procedure. METHODS: Between July 1993 and October 2015, 109 patients with AADA had the valve-sparing David I procedure at our centre...
August 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28826996/long-term-outcome-of-endovascular-treatment-for-mycotic-aortic-aneurysm
#12
C-M Luo, C-Y Chan, Y-S Chen, S-S Wang, N-H Chi, I-H Wu
OBJECTIVE/BACKGROUND: Endovascular repair (EVAR) of mycotic aortic aneurysm (MAA) has become an alternative treatment for high risk patients. The aim of this study was to evaluate long-term survival and outcomes. METHODS: Retrospective analysis of 40 consecutive patients with MAAs undergoing EVAR and subsequent intravenous antibiotic treatment between September 2009 and April 2015. Follow-up was truncated on 30 April 2015. Uni- and multivariate logistic regression were used to assess risk factors of adverse outcomes...
August 18, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28790248/-concomitant-operations-for-thoracic-aortic-aneurysm-and-myasthenia-gravis-report-of-a-case
#13
Hayato Konishi, Takahiro Katsumata, Yoshikazu Motohashi, Hiroaki Uchida, Eiki Woo, Tomoyasu Sasaki, Shigetoshi Mieno, Hideki Ozawa, Masahiro Daimon, Shintaro Nemoto
A 77-year-old man, who had been under medical treatment for myasthenia gravis without thymoma, was diagnosed with aortic arch aneurysm. He underwent total aortic arch replacement and total resection of the thymus through median sternotomy. His symptoms relating to myasthenia gravis dramatically disappeared after the surgery. The serum anti-acetyl chorine receptor antibody decreased from 2.7 to 0.7 nmol/l (N<0.2) with the reduction of oral predonisolone from 12.5 to 5 mg/day at 4 years after the surgery. The concomitant operations significantly improved his quality of life...
August 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28765187/non-atherosclerotic-aortic-mural-thrombus-a-rare-source-of-embolism
#14
Julian A Marin-Acevedo, Andree H Koop, Jose L Diaz-Gomez, Pramod K Guru
A 54-year-old man presented to the emergency department with acute left-sided chest pain and left upper quadrant abdominal pain. He had a significant history of squamous cell carcinoma of the lung previously treated with right pneumonectomy who ; is currently receiving adjuvant chemotherapy with cisplatin. Physical examination was remarkable for tachycardia, hypertension and mild abdominal tenderness. CT angiography revealed an aortic mural thrombus in the ascending aorta and aortic arch without dissection, aneurysm or tortuosity of the aorta...
August 1, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28760465/elective-aortic-arch-repair-factors-influencing-neurologic-outcome-in-791-patients
#15
Mariano Cefarelli, Giacomo Murana, Giuseppina G Surace, Sebastiano Castrovinci, Giuliano Jafrancesco, Johannes Christiaan Kelder, Patrick Klein, Uday Sonker, Wim J Morshuis, Robin H Heijmen
BACKGROUND: The aim of this study was to determine perioperative factors influencing neurologic outcome in a single-center cohort of patients undergoing elective aortic arch operations. METHODS: From January 2005 to June 2015, 791 consecutive patients received open aortic arch operations with either antegrade selective cerebral perfusion (ASCP) (636 patients [80.4%]) or deep hypothermic circulatory arrest (DHCA) (155 patients [19.6%]). Main indications were degenerative aneurysm (85%) and chronic postdissection aneurysm (9...
July 28, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28758558/acute-debakey-type-i-dissection-repair-using-frozen-elephant-trunk-the-cleveland-clinic-technique
#16
Muhammad Aftab, Ryan Plichta, Eric E Roselli
Over the past 3 decades, the standard surgical management for acute DeBakey type I aortic dissection has not significantly changed. Most patients undergo ascending aortic replacement with an interposition graft under hypothermic circulatory arrest with selective root replacement. Nevertheless, with the improvement in overall patient care, acute surgical outcomes continue to improve. The frozen elephant trunk (FET) technique was introduced as a modification to conventional elephant trunk to treat extensive degenerative and chronic dissecting aneurysms involving the aortic arch and the proximal descending aorta...
September 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28756426/handle-with-care-a-ductus-arteriosus-aneurysm-in-an-elderly-patient
#17
Sebastiano Gili, Fulvio Orzan, Fabrizio D'Ascenzo, Antonio Montefusco, Pierluigi Omedé
A ductus arteriosus aneurysm (DAA) was corrected with an 18 mm Amplatzer patent foramen ovale occluder. DAA is a rare finding, with sporadic cases reported (the vast majority in children and infants). In the elderly, it poses serious therapeutic challenges, as the risk of rupture is counterbalanced by the high risk of its correction, which requires surgery or placement of an endovascular prosthesis in a critical region such as the aortic arch.
August 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28754428/mid-term-results-of-chimney-and-periscope-grafts-in-supra-aortic-branches-in-high-risk-patients
#18
F Pecoraro, M Lachat, N S Cayne, D Pakeliani, Z Rancic, G Puippe, F J Criado, T Pfammatter, F J Veith, B Krüger, T A Neff
PURPOSE: Report mid-term outcomes of thoracic endovascular aneurysm repair (TEVAR) with chimney and periscope grafts (CPG) in supra-aortic branches (SAB). METHODS: Retrospective analysis, from October 2009 to May 2014, of patients with aneurysms requiring TEVAR with zone 0/1/2 proximal landing in association with at least one CPG in the SAB. All patients were considered at high risk for conventional surgery. Peri-operative mortality and morbidity, retrograde type A dissection, maximum aortic transverse diameter (TD) and its post-operative evolution, endoleak, survival, freedom from cardiovascular re-interventions, and CPG freedom from occlusion during the follow-up were analysed...
July 25, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28740717/hybrid-repair-of-aortic-arch-aneurysms-a-comprehensive-review
#19
REVIEW
Steve Xydas, Christos G Mihos, Roy F Williams, Angelo LaPietra, Maurice Mawad, S Howard Wittels, Orlando Santana
Open total arch replacement (TAR) has become safer with refinements in cerebral protection techniques. The frequent extension of aortic arch aneurysms into the descending thoracic aorta customarily requires a two-staged conventional elephant trunk procedure, carrying relatively high mortality and morbidity risks and high rates of rupture in the interval between the two open surgeries. The technical demands and invasive nature of TAR has therefore precluded many high-risk patients from being surgical candidates for aneurysm repair...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28740694/successful-management-of-a-giant-dissecting-aortic-aneurysm-in-a-patient-with-behcet-s-disease
#20
Zhiqi Zhang, Kanhua Yin, Yi Lin, Changfa Guo, Yongxin Sun, Chunsheng Wang
Thoracic aortic aneurysm with subsequent dissection is a very rare but dangerous complication of Behcet's disease, which is a systemic syndrome that can involve blood vessels of all sizes. Surgical experience in dealing with this complication in patients with Behcet's disease has been limited. We report a 20-year-old patient with Behcet's disease who presented with a giant dissecting thoracic aortic aneurysm. The patient was successfully treated with an aortic root and arch replacement using a frozen elephant trunk technique...
June 2017: Journal of Thoracic Disease
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