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Aortic arch aneurysm

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https://www.readbyqxmd.com/read/28631316/recannulation-of-the-axillary-artery-in-aortic-and-complex-cardiac-surgery
#1
Philippa Jane Temple Bowers, Manu Narain Mathur
OBJECTIVES: Axillary artery cannulation has been used as an alternative site for cardiopulmonary bypass during surgery for aortic dissections and aneurysmal disease of the ascending aorta and arch. This study reports our experience with reusing the axillary artery for cardiopulmonary bypass during complex aortic and cardiac surgical procedures. METHODS: This was a retrospective review of a single surgeon's experience of recannulating the axillary artery for redo operations in complex aortic surgery...
June 19, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28626623/interdisciplinary-management-of-a-perforated-aneurysmal-arteria-lusoria-a-case-report
#2
Mina Rouman, Alexander Petrovitch, Eva-Maria Gey, Thomas Kuntze
Background  An aberrant right subclavian artery (RSA) or arteria lusoria is the most common congenital abnormality of the aortic arch with an incidence of 0.3 to 3.0%. Case Description  We report a case of a perforated aneurysmal aberrant RSA, managed using a hybrid approach. Conclusion  In emergency cases with acute bleeding, we recommend an endovascular approach to avoid the lethal sequel of arterial leakage. Whenever possible, the pulsatile blood flow to the right arm should be restored. Management should be tailored to the nature of the aneurysmal aberrant RSA, patient's comorbidities, and concomitant lesions...
January 2017: Thoracic and Cardiovascular Surgeon Reports
https://www.readbyqxmd.com/read/28616352/aortic-polyaneurysmal-disease-case-report
#3
Lucas Alvarez García, Paula Vidal Fernández, Miguel Felipe García Gimeno, Miguel Angel González Arranz, Maria Emma González González, Diego López García, Salvador Tagarro Villalba, Santiago Rodríguez Camarero
We report a 78-year-old man who presents progression of his aneurysmatic pathology with previous abdominal infrarenal aortic surgery 20 years later. The computed tomography (CT) scan showed proximal degeneration of the infrarenal aorta, left iliac aneurysm and a new descending thoracic aneurysm close to the aortic arch. The surgical treatment was staged in two times due to the evolution of the aneurysm measures. First, the thoracic and the infrarenal aneurysms were covered each one with endoprosthesis. Four years later the iliac disease was solved with a branched specific iliac endograft...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28616345/wrapping-of-the-ascending-aorta-revisited-is-there-any-role-left-for-conservative-treatment-of-ascending-aortic-aneurysm
#4
REVIEW
José María González-Santos, María Elena Arnáiz-García
Dilatation of the ascending aorta (AA) is a common finding in patients with aortic valve disease. The clinical practice guidelines recommend replacing the AA whenever the diameter exceeds 45 mm. However, no consensus has been reached regarding the approach when the aorta is only moderately dilated. Although the risk in aorta replacement is generally low, it may be higher when associated with other complex surgical procedures or it is carried out in elderly patients or patients with significant comorbidity. This would justify the use of alternative surgical techniques, which reduce surgical risk and guarantee a durable correction of the aortic pathology...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28616343/debranching-aortic-surgery
#5
REVIEW
Manuel Alonso Pérez, José Manuel Llaneza Coto, José Antonio Del Castro Madrazo, Carlota Fernández Prendes, Mario González Gay, Amer Zanabili Al-Sibbai
Conventional open surgery still remains as the gold standard of care for aortic arch and thoracoabdominal pathology. In centers of excellence, open repair of the arch has been performed with 5% immediate mortality and a low rate of complications; however overall mortality rates are around 15%, being up to 40% of all patients rejected for treatment due to their age or comorbidities. For thoracoabdominal aortic pathology, data reported from centers of excellence show immediate mortality rates from 5% to 19%, spinal cord ischemia from 2...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28602115/total-endovascular-treatment-of-aortic-arch-disease-using-an-arch-endograft-with-3-inner-branches
#6
Rafaëlle Spear, Rachel E Clough, Dominique Fabre, Blayne Roeder, Adrien Hertault, Teresa Martin Gonzalez, Richard Azzaoui, Jonathan Sobocinski, Stéphan Haulon
PURPOSE: To report early experience with a new endovascular graft developed for aortic arch aneurysm repair in patients unfit for open surgery. CASE REPORT: Three consecutive men (62, 74, and 69 years old) at high risk for open repair were treated for postdissection aortic arch aneurysms using a custom-made 3 inner branched endovascular graft. The 2 proximal branches are antegrade and perfuse the innominate artery and the left common carotid artery; the third branch is retrograde and perfuses the left subclavian artery...
June 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28600637/transfemoral-snare-assisted-advancement-of-stent-graft-across-acutely-angulated-aortic-arch
#7
Sang Yub Lee, Dongho Hyun, Kwang Bo Park, Hong Suk Park, Young Soo Do
Delivery of stent grafts during thoracic endovascular aortic replacement can be challenging, especially in aortic arches with severe angulation. Several techniques have been recommended to achieve this. We introduce a simple technical method, transfemoral snare-assisted device advance, which was successful in a 72-year-old woman with an aneurysm in a severely angulated aortic arch and review various technical tips.
June 9, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28599977/fate-of-remnant-sinuses-of-valsalva-in-patients-with-bicuspid-and-trileaflet-valves-undergoing-aortic-valve-ascending-aorta-and-aortic-arch-replacement
#8
Rita Karianna Milewski, Andreas Habertheuer, Joseph E Bavaria, Mary Siki, Wilson Y Szeto, Eric Krause, Varun Korutla, Nimesh D Desai, Prashanth Vallabhajosyula
OBJECTIVE: In patients presenting with aortic valvulopathy with concomitant ascending aortic aneurysm, surgical management of the sinus of Valsalva segment remains undefined, especially for moderately dilated aortic roots. In patients with this pathology undergoing aortic valve replacement with supracoronary ascending aorta replacement, we assessed the fate of the remnant preserved sinus of Valsalva segment stratified by aortic valve morphology and pathology. METHODS: From 2002 to 2015, 428 patients underwent elective aortic valve replacement with supracoronary ascending aorta replacement...
April 28, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28597717/physician-modified-thoracic-stent-grafts-for-the-treatment-of-aortic-arch-lesions
#9
Ludovic Canaud, Toshio Baba, Thomas Gandet, Kouhei Narayama, Baris Ata Ozdemir, Tsuyoshi Shibata, Pierre Alric, Kiyofumi Morishita
PURPOSE: To evaluate outcomes of physician-modified thoracic stent-grafts for the treatment of aortic arch aneurysms. METHODS: A retrospective dual-center analysis was performed involving 36 patients (mean age 74.7±9 years, range 58-91; 27 men) with an aortic arch lesion who were treated between November 2013 and June 2016 using physician-modified thoracic stent-grafts. Half of the patients had a degenerative aneurysm; the remainder had type B dissection (n=9), traumatic transection (n=3), type Ia endoleak after previous endografting (n=5), or aortoesophageal fistula (n=1)...
June 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28597335/effect-of-endoskeleton-stent-graft-design-on-pulse-wave-velocity-in-patients-undergoing-endovascular-repair-of-the-aortic-arch
#10
Daijiro Hori, Kei Akiyoshi, Koichi Yuri, Satoshi Nishi, Takao Nonaka, Takahiro Yamamoto, Yusuke Imamura, Harunobu Matsumoto, Naoyuki Kimura, Atsushi Yamaguchi
PURPOSE: Pulse wave velocity (PWV), which measures vascular stiffness, is a powerful predictor of cardiovascular event. Treatment of aneurysms with endovascular prosthesis has been reported to increase PWV. The purpose of this study was to evaluate whether an endoskeleton stent graft design has less effect on PWV than the exoskeleton stent graft design. METHODS: Between July 2008 and September 2016, 74 patients underwent endovascular treatment of aortic arch aneurysm in our institution...
June 8, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28596039/assessment-of-aortic-wall-thrombus-predicts-outcomes-of-endovascular-repair-of-complex-aortic-aneurysms-using-fenestrated-and-branched-endografts
#11
Mauricio Ribeiro, Gustavo S Oderich, Thanila Macedo, Terri J Vrtiska, Jan Hofer, Julia Chini, Bernardo Mendes, Stephen Cha
OBJECTIVE: The goal of this study was to investigate the correlation between atherothrombotic aortic wall thrombus (AWT) and clinical outcomes in patients treated by fenestrated-branched endovascular aortic repair (F-BEVAR) and present a new classification system for assessment of AWT burden. METHODS: The clinical data of 301 patients treated for pararenal and thoracoabdominal aortic aneurysms (TAAAs) by F-BEVAR was reviewed. The study excluded 89 patients with extent I to III TAAA because of extensive laminated thrombus within the aneurysm sac...
June 5, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28595228/-delayed-hemolytic-anemia-associated-with-anti-jk3-antibody-following-cardiovascular-surgery-report-of-a-case
#12
Takayuki Nishimoto, Yukihiro Bonkohara, Masaki Iijima
We report a 73-year-old man who underwent total aortic arch replacement with an open stent graft for aortic arch aneurysm. The patient received blood transfusion intraoperatively without any signs of hemolysis. However, on post-operative day 16, he developed hemoglobinuria, and was found to have anemia, elevated serum lactate dehydrogenase, elevated total bilirubin, and decreased serum haptoglobin. Initially, the cause for these findings was unknown. Upon further testing, however, antibodies against the high frequency antigen, anti-Jk3 was identified...
June 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28591766/elective-frozen-elephant-trunk-procedure-using-the-e-vita-open-plus-prosthesis-in-94-patients-a-multicentre-french-registry
#13
Jean-Philippe Verhoye, Reda Belhaj Soulami, Olivier Fouquet, Vito Giovanni Ruggieri, Adrien Kaladji, Jacques Tomasi, Michel Sellin, Fadi Farhat, Amedeo Anselmi
OBJECTIVES: Our goal was to evaluate the operative outcomes of the frozen elephant trunk technique using the E-Vita Open Plus ® hybrid prosthesis in chronic aortic arch diseases and report clinical and radiological outcomes at the 1-year follow-up. METHODS: As determined from a prospective multicentre registry, 94 patients underwent frozen elephant trunk procedures using the E-Vita Open Plus hybrid device for the treatment of chronic aortic conditions, including 50% chronic aortic dissections, 40% degenerative aneurysms and 10% miscellaneous indications...
June 7, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28587739/aortic-valve-pathology-as-a-predictive-factor-for-acute-aortic-dissection
#14
Denis Berdajs, Selim Mosbahi, Enrico Ferrari, Dominique Charbonnier, Ludwig K von Segesser
BACKGROUND: In this study, the effect of aortic valve (AV) pathology on local hemodynamic conditions was evaluated as a potential trigger for the onset of acute type A and B aortic dissection. METHODS: A time- and pressure-related four-dimensional (4-D) computed fluid dynamic model of the aorta was established. In an experimental setup, AV stenosis and AV insufficiency were created. 4-D pressure-related geometry of the aortic root (AR) with valve insufficiency and valve stenosis were determined by high-fidelity (200 Hz) microsonometric crystals...
June 3, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28584942/combined-ct-fluoroscopic-and-ivus-guidance-for-percutaneous-treatment-of-a-postsurgical-pseudoaneurysm-following-repair-of-ascending-thoracic-aortic-aneurysm
#15
Anastasia Hadjivassiliou, Joel Gagnon, Michael Janusz, Darren Klass
Thoracic aortic pseudoaneurysms are a recognized complication following aortic arch replacement. The established first line treatment is surgical repair; however, this may not be feasible in all patients. Percutaneous treatment of ascending thoracic pseudoaneurysms has been described as an alternative for nonsurgical candidates. Utilization of multimodality imaging can prove invaluable in minimizing the risk of potentially fatal intra-procedural complications. We present a case of successful embolization using computer tomography-guided direct percutaneous puncture of the pseudoaneurysm, with concomitant endovascular treatment under fluoroscopic and intravascular ultrasound guidance in a patient with challenging vascular anatomy...
June 5, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28583734/thoracic-endovascular-aortic-repair-with-branched-inoue-stent-graft-for-arch-aortic-aneurysms
#16
Junichi Tazaki, Kanji Inoue, Hirooki Higami, Nobuya Higashitani, Masanao Toma, Naritatsu Saito, Masahide Kawatou, Takeshi Kimura
BACKGROUND: Thoracic endovascular aortic repair (TEVAR) for thoracic aortic aneurysms (TAAs) is in rapid expansion due to its minimal invasiveness. However, TEVAR for an arch aneurysm with a straight stent graft needs surgical reconstruction for supra-aortic vessels. A branched stent graft pioneered by Inoue (branched Inoue Stent Graft [ISG]) has been expected to resolve this problem, but its utility remains to be established in the real clinical setting. This study evaluated the long-term clinical outcome of branched ISGs for TAAs...
June 2, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28582524/acute-non-a-non-b-aortic-dissection-incidence-treatment-and-outcome
#17
Bartosz Rylski, Marta Pérez, Friedhelm Beyersdorf, Diana Reser, Fabian A Kari, Matthias Siepe, Martin Czerny
OBJECTIVES: Our aim was to report outcome of patients with acute non-A non-B aortic dissection involving the aortic arch but not the ascending aorta. METHODS: Dissection extension and entry location were analysed in patients with acute aortic dissection admitted between 2001 and 2016 at a tertiary centre. Non-A non-B dissection was classified as descending-entry type with entry distal to the left subclavian artery and dissection extending into the aortic arch, and arch-entry type with entry between the innominate and left subclavian arteries...
June 3, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28553761/innominate-artery-aneurysm-how-to-solve-it
#18
Xiao-Long Wang, Xin-Liang Guan, Wen-Jian Jiang, Ou Liu, Hong-Jia Zhang
We herein describe our *These authors contributed equally to this work. experience with a congenital innominate artery aneurysm (IAA) that was managed with a simple surgical procedure. A 44-year-old woman was admitted for chest distress. Computed tomography angiography showed a 3.6-cm IAA arising from the aortic arch and compressing the trachea. A median sternotomy was performed with the patient under general anesthesia, and the IAA was found to involve the origin of the innominate artery and the bifurcation of the right subclavian artery and common carotid artery; however, the aorta was intact...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28552320/rupture-of-a-complex-aortic-arch-aneurysm-hybrid-repair
#19
G Pagliariccio, E Gatta
No abstract text is available yet for this article.
May 25, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28548474/aortic-aneurysm-endovascular-treatment-with-the-parallel-graft-technique-from-the-aortic-arch-to-the-iliac-axis
#20
Gian F Fadda, Mario Marino, Holta Kasemi, Costantino L DI Angelo, Carlo P Dionisi, Valeria Cammalleri, Carlo Setacci
BACKGROUND: The chimney technique has been developed for the treatment of complex aortic aneurysms. We analyzed the midterm to long-term outcomes of this approach from a single- centre experience. METHODS: From October 2008 to July 2016, 58 patients underwent endovascular aortic aneurysm repair using the chimney technique. Indications for treatment were thoracic aortic aneurysm (TAA) (n = 11), thoracoabdominal aortic aneurysm (TAAA) (n = 2), pararenal aortic aneurysm (PAAA) (n= 15), aortoiliac/isolated hypogastric artery aneurysm (n = 25), type I endoleak after previous TEVAR/EVAR (n=4), proximal pseudoaneurysm after AAA open repair (n = 1)...
May 26, 2017: Journal of Cardiovascular Surgery
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