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Aortic arch aneurysm

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https://www.readbyqxmd.com/read/27900535/evaluation-of-cerebral-circulation-during-retrograde-perfusion-by-laser-speckle-flowgraphy
#1
Fumiaki Kimura, Hirotsugu Kanda, Yuki Toyama, Takayuki Kunisawa, Taiji Nagaoka, Akitoshi Yoshida, Hiroto Kitahara, Hiroyuki Kamiya
Laser speckle flowgraphy (LSFG) is an ophthalmologic equipment that qualitatively detects the blood flow of the optic nerve head, which is known to be related with cerebral microcirculation. LSFG can also measure the mean blur rate, which quantitatively calculates the blood flow. We aimed to assess the utility of LSFG in the evaluation of cerebral perfusion during aortic surgery under hypothermic circulatory arrest with retrograde and antegrade cerebral perfusion. Two patients underwent total arch replacement for aneurysm...
November 29, 2016: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27890843/total-endovascular-aortic-repair-in-a-patient-with-marfan-syndrome
#2
Mau Amako, Rafaëlle Spear, Rachel E Clough, Adrien Hertault, Richard Azzaoui, Teresa Martin Gonzalez, Jonathan Sobocinski, Stéphan Haulon
OBJECTIVE: To describe a total endovascular aortic repair with branched and fenestrated endografts in a young patient with Marfan syndrome and a chronic aortic dissection. Open surgery is the gold standard to treat aortic dissections in patients with aortic disease and Marfan syndrome. METHODS: In 2000, a 38-year-old man with Marfan syndrome underwent open ascending aorta repair for an acute type A aortic dissection. One year later, a redo sternotomy was performed for aortic valve replacement...
November 24, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27884484/ross-hybrid-arch-and-frozen-elephant-trunk-reconstruction-for-late-complications-of-bicuspid-aortic-valve-and-aortopathy
#3
Matthew Valdis, Gaetano DeRose, Linrui Guo, Michael W A Chu
Young patients with bicuspid aortic valve disease and aortopathy remain a clinical challenge, with many requiring multiple corrective operations throughout their lifetimes. Innovative surgical approaches are often required to address complex aortic pathologic conditions but leave patients at risk for reintervention, lifelong anticoagulation, and suboptimal hemodynamics. We describe an active 44-year-old female triathlete with recurrent bicuspid aortic stenosis, a small aortic root, a hypoplastic aortic arch and complex distal arch, and a descending aortic aneurysm, who underwent a single-stage reconstruction with a combined Ross procedure, hybrid arch, and frozen elephant trunk reconstruction...
December 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/27876371/approaches-for-treatment-of-aortic-arch-aneurysm-a-numerical-study
#4
Asaph Nardi, Idit Avrahami
Aortic arch aneurysm is a complex pathology which requires coverage of one or more aortic arch vessels. In this study we explore the hemodynamic behavior of the aortic arch in aneurysmatic and treated cases with three currently available treatment approaches: Surgery Graft, hybrid Stent-Graft and chimney Stent Graft. The analysis included four models of the time-dependent fluid domains of aneurysmatic arch and of the surgery, hybrid and chimney endovascular techniques. Dimensions of the models are based on typical anatomy, and boundary conditions are based on typical physiological flow...
November 12, 2016: Journal of Biomechanics
https://www.readbyqxmd.com/read/27874962/analysis-of-risk-factors-of-type-a-aortic-dissection-taad-operation-of-frozen-elephant-trunk-and-total-arch-replacement
#5
W Shang, M Ma, Y-P Ge, N Liu, J-M Zhu, L-Z Sun
OBJECTIVE:  To investigate the incidence and risk factors of acute renal failure (ARF) after operation of frozen elephant trunk and total arch replacement for acute thoracic aortic aneurysm and dissection (TAAD) with mild hypothermic circulatory arrest (MHCA), and to analyze the long-term survival rate of the patients with ARF. PATIENTS AND METHODS: From February 2009 to March 2015, patients with acute TAAD accepted operation of frozen elephant trunk and total arch replacement were enrolled...
November 2016: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/27847062/preemptive-aneurysm-sac-embolization-for-thoracic-endovascular-aortic-repair-with-inadequate-proximal-landing-zone
#6
Jacky Y K Ho, Randolph H L Wong, Simon C Y Chow, Peter S Y Yu, Micky W T Kwok, Malcolm J Underwood, Simon C H Yu
Thoracic endovascular aortic repair (TEVAR) offers a less invasive treatment for aortic arch aneurysms. Clinical challenges arise when there is inadequate proximal landing for zone 1 TEVAR, such that a median sternotomy with total aortic debranching is required before stent deployment. The chimney technique was reported as an alternative approach to stent the arch branches and avoid sternotomy, but it was still associated with considerable chance of a type IA endoleak. We report a case of aortic arch aneurysm with an inadequate proximal landing for zone 1 TEVAR that was treated with debranching of head and neck vessels followed by TEVAR and preemptive and targeted coil embolization of the arch aneurysmal sac...
December 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27843111/a-comprehensive-review-of-in-situ-fenestration-of-aortic-endografts
#7
REVIEW
M Glorion, R Coscas, R G McWilliams, I Javerliat, O Goëau-Brissonniere, M Coggia
OBJECTIVE: Despite technical advances of fenestrated and branched endografts, endovascular exclusion of aneurysms involving renal, visceral, and/or supra-aortic branches remains a challenge. In situ fenestration (ISF) of standard endografts represents another endovascular means to maintain perfusion to such branches. This study aimed to review current indications, technical descriptions, and results of ISF. METHOD: A review of the English language literature was performed in Medline databases, Cochrane Database, Web of Science, and Scopus using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines...
November 11, 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27825691/long-term-outcomes-of-open-arch-repair-after-a-prior-aortic-operation-our-experience-in-154-patients
#8
Roberto Di Bartolomeo, Paolo Berretta, Antonio Pantaleo, Giacomo Murana, Mariano Cefarelli, Jacopo Alfonsi, Giuseppe Barberio, Alessandro Leone, Luca Di Marco, Davide Pacini
BACKGROUND: This study assessed the early and long-term results of arch operations performed after a prior aortic operation. METHODS: From 1994 to 2014, 154 consecutive patients (mean age, 59.7 years) underwent an aortic arch repair, after a previous aortic operation, at our institution. Antegrade selective cerebral perfusion was used in all cases. Chronic postdissection aortic aneurysm (87 [56.5%]) and degenerative aneurysm (43 [27.9%]) represented the most common indications for surgical intervention...
November 5, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27823595/status-of-branched-grafts-for-thoracic-aortic-arch-endovascular-repair
#9
REVIEW
W Anthony Lee
The aortic arch is one of the most anatomically complex segments of the thoracoabdominal aorta due the plurality of vital branch configurations, intrinsic and highly variable three-dimensional curvature, and involvement in a variety of thoracic aortic pathologies, such as aneurysmal degeneration, penetrating ulcer, and media wall dissection. Pathologies that extend the repair proximal to the left common carotid artery require more complex branch vessel management beyond a carotid-subclavian bypass. This article will review the current status of branched aortic arch endografts...
March 2016: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/27819806/pseudoaneurysm-as-a-late-complication-of-hybrid-aortic-arch-repair
#10
Cristian Rosu, Nicolas Beaulieu, Raymond Cartier, Philippe Demers
Hybrid aortic arch repair is increasingly used for the management of aortic arch aneurysm. Pseudoaneurysm is a newly described late complication of this procedure. A 57-year-old man underwent emergent supra-aortic debranching and aortic arch stent grafting after rupture of an arch aneurysm. Three years later, the patient presented with a pseudoaneurysm at the junction between the stent graft's proximal landing zone and the origin of the debranching graft. At reoperative repair, the proximal stent graft had eroded through the aortic wall at the junction of the endograft proximal landing zone and the proximal anastomosis of the debranching graft...
September 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/27804164/repair-of-ascending-aortic-aneurysms-following-cardiac-transplantation
#11
Shinichi Fukuhara, Elizabeth H Stephens, Jason P Glotzbach, Michael A Borger
Ascending aortic aneurysms arising from the native aorta following cardiac transplantation are rare. We report two patients who developed aneurysms of the native ascending aorta requiring surgical repair post-transplantation. Both patients underwent ascending and hemi-arch replacement and recovered uneventfully. Heart transplant patients with pre-existing aortic dilation/ectasia may display more rapid aneurysmal growth compared to non-transplant patients. Therefore close observation is warranted in these patients...
December 2016: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/27796533/preoperative-evaluation-and-endovascular-procedure-of-intraoperative-aneurysm-rupture-during-thoracic-endovascular-aortic-repair
#12
Bin-Shan Zha, Hua-Gang Zhu, Yu-Sheng Ye, Yong-Sheng Li, Zhi-Gong Zhang, Wen-Tao Xie
: Thoracic aortic aneurysms are now routinely repaired with endovascular repair if anatomically feasible because of advantages in safety and recovery. However, intraoperative aneurysm rupture is a severe complication which may have an adverse effect on the outcome of treatment. Comprehensive preoperative assessment and considerate treatment are keys to success of endovascular aneurysm repair, especially during unexpected circumstances. Few cases have reported on intraoperative aortic rupture, which were successfully managed by endovascular treatment...
October 28, 2016: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/27793556/unilateral-antegrade-cerebral-perfusion-and-moderate-hypothermia-assessing-safety-with-novel-biomarkers
#13
Bahadır Aytekin, Ertekin Utku Ünal, Aslı Demir, Uğur Aksu, Aytaç Çalışkan, Kübra Vardar, Fevzi Toraman, Ahmet Sarıtaş
BACKGROUND: Antegrade cerebral perfusion in aortic surgery is a well-established brain protection method. Open distal anastomosis during aortic surgery has some well-known advantages. Antegrade cerebral perfusion allows repair to some extent of the aortic arch, even in isolated ascending aortic aneurysm. The present study aims to investigate the adequacy of contralateral perfusion with novel oxidative stress parameters during unilateral antegrade cerebral perfusion. METHOD: The study included 30 consecutive patients undergoing thoracic aortic surgery with unilateral antegrade cerebral perfusion (uACP) under moderate hypothermia (28° C)...
September 13, 2016: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/27773575/efficacy-of-a-newly-modified-technique-for-distal-limited-open-stenting-in-octogenarians-with-aortic-arch-aneurysm
#14
Mitsumasa Hata, Yukihiko Orime, Shinji Wakui, Tetsuya Nakamura, Rei Hinoura, Atsushi Harada, Kenji Akiyama
OBJECTIVE: We assessed the efficacy of distal limited open stenting procedure in octogenarians with distal aortic arch aneurysm. METHODS: During the last 5 years, 24 patients underwent distal limited open stenting. Mean patient age was 81.6 ± 2.5 years, ranging from 80 to 90 years. The hemicircumference of the anterior surface of the arch around the left common carotid artery was obliquely incised, and a J-Graft Open Stent (Japan Lifeline Co, Ltd, Tokyo, Japan) was inserted into the descending aorta...
September 24, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27770195/early-outcomes-in-re-do-operation-after-acute-type-a-aortic-dissection-results-from-the-multicenter-reaad-database
#15
Angelo M Dell'Aquila, Francesco Pollari, Khalil Fattouch, Giuseppe Santarpino, Julia Hillebrand, Stefan Schneider, Jan Landwerht, Giuseppe Nasso, Renato Gregorini, Mauro Del Giglio, Elisa Mikus, Alberto Albertini, Heinz Deschka, Theodor Fischlein, Sven Martens, Alina Gallo, Giovanni Concistrè, Giuseppe Speziale, Tommaso Regesta
This study provides early results of re-operations after the prior surgical treatment of acute type A aortic dissection (AAD) and identifies risk factors for mortality. Between May 2003 and January 2014, 117 aortic re-operations after an initial operation for AAD (a mean time from the first procedure was 3.98 years, with a range of 0.1-20.87 years) were performed in 110 patients (a mean age of 59.8 ± 12.6 years) in seven European institutions. The re-operation was indicated due to a proximal aortic pathology in ninety cases: twenty aortic root aneurysms, seventeen root re-dissections, twenty-seven aortic valve insufficiencies and twenty-six proximal anastomotic pseudoaneurysms...
October 21, 2016: Heart and Vessels
https://www.readbyqxmd.com/read/27767064/angiopoietin-2-attenuates-angiotensin-ii-induced-aortic-aneurysm-and-atherosclerosis-in-apolipoprotein-e-deficient-mice
#16
Hongyou Yu, Corey S Moran, Alexandra F Trollope, Lynn Woodward, Robert Kinobe, Catherine M Rush, Jonathan Golledge
Angiogenesis and inflammation are implicated in aortic aneurysm and atherosclerosis and regulated by angiopoietin-2 (Angpt2). The effect of Angpt2 administration on experimental aortic aneurysm and atherosclerosis was examined. Six-month-old male apolipoprotein E deficient (ApoE(-/-)) mice were infused with angiotensin II (AngII) and administered subcutaneous human Fc-protein (control) or recombinant Angpt2 (rAngpt2) over 14 days. Administration of rAngpt2 significantly inhibited AngII-induced aortic dilatation and rupture of the suprarenal aorta (SRA), and development of atherosclerosis within the aortic arch...
October 21, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27766268/type-b-aortic-dissection-repair-using-a-thoraflex-hybrid-prosthesis-in-a-complex-aortic-arch-anatomy
#17
Moussa Abi Ghanem, Mario Gomez-Sanchez, Xavier Chaufour, Bertrand Marcheix
Thoracic endovascular aortic repair (TEVAR) is recognized as an attractive option to treat complicated Type B aortic dissection. Nevertheless, TEVAR is not always technically possible. We report the case of a 53-year-old male with complicated Type B aortic dissection, in the setting of a complex anomalous aortic arch anatomy with an aneurysmal aberrant right subclavian artery. He was successfully treated by the frozen elephant trunk technique using the Thoraflex hybrid graft.
February 2016: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/27765887/total-aortic-arch-replacement-advantages-of-varied-techniques
#18
REVIEW
Ryan C Shelstad, Justin G Reeves, Katsuhiro Yamanaka, T Brett Reece
We review the operative techniques of aortic arch replacement. Aortic arch replacement presents several formidable challenges, as it requires arresting the circulation to the body and replacement of the brachiocephalic vessels with special consideration for protecting the central nervous system. Perfusion strategies, selective antegrade cerebral perfusion, and operative graft selection are key elements in aortic arch replacement surgery. Standard approaches include the island technique, the branched graft technique, and the "Spielvogel" trifurcated graft technique-each having its own advantages...
December 2016: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27760812/analysis-of-risk-factors-for-early-type-i-endoleaks-after-thoracic-endovascular-aneurysm-repair
#19
Yuji Kanaoka, Takao Ohki, Koji Maeda, Takeshi Baba
PURPOSE: To evaluate risk factors for early (<30 days) type I endoleak following thoracic endovascular aortic repair (TEVAR). METHODS: A retrospective study was conducted of 439 consecutive patients (mean age 74.0±10.0 years; 333 men) who underwent TEVAR at a single center between June 2006 and June 2013. Pathologies included 237 aortic arch aneurysms and 202 descending thoracic aortic aneurysms (dTAA). Maximum TAA diameter was 63.6±13.7 mm. Among the distal aortic arch aneurysms, 124 required coverage of the left subclavian artery (LSA), while the remaining 113 arch aneurysms had debranching (n=40), the chimney technique (n=52), and a branched stent-graft (n=13)...
October 19, 2016: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/27753844/ed-02-1-acute-aortic-syndrome
#20
Jae-Kwan Song
The successful clinical introduction of various non-invasive imaging modalities has contributed to the establishment of 'acute aortic syndrome', a relatively new clinical syndrome incorporating several disease entities with similar clinical features (at the time of clinical presentation). Aortic dissection (AD) with intimal flap and two aortic channels (true and false lumens) is the most important disease entity in acute aortic syndrome. Clinical characteristics of AD have been established, with standardized treatment strategies depending on the affected site of the aorta...
September 2016: Journal of Hypertension
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