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Innominate artery

Andre S Madsen, John L Bruce, George V Oosthuizen, Wanda Bekker, Grant L Laing, Damian L Clarke
BACKGROUND: This paper reviews our experience with penetrating cervical venous trauma and aims to validate the selective non-operative management (SNOM) of these injuries. METHODS: This was a retrospective review of a prospectively maintained registry. All patients presenting alive with an injury to the internal jugular vein, subclavian vein or innominate vein following a PNI were reviewed for a 6-year period. RESULTS: Among 817 patients admitted for the management of PNI, 76 (9...
March 15, 2018: World Journal of Surgery
Aekaansh Verma, Mahdi Esmaily, Jessica Shang, Richard Figliola, Jeffrey A Feinstein, Tain-Yen Hsia, Alison L Marsden
BACKGROUND: First-stage single-ventricle palliation is challenging to manage, and significant interstage morbidity and mortality remain. Prior computational and in vitro studies of the assisted bidirectional Glenn (ABG), a novel first-stage procedure that has shown potential for early conversion to a more stable augmented Glenn physiology, demonstrated increased pulmonary flow and oxygen delivery while decreasing cardiac work, as compared to conventional stage-1 alternatives. This study aims to identify optimal shunt designs for the ABG to improve pulmonary flow while maintaining or decreasing superior vena caval (SVC) pressure...
March 2018: World Journal for Pediatric & Congenital Heart Surgery
Giulio Illuminati, Giulia Pizzardi, Rocco Pasqua, Francesca Frezzotti, Piergaspare Palumbo, Francesco Macrina, Francesco Calio
BACKGROUND: Tandem stenoses of the internal carotid artery (ICA) and proximal, ipsilateral common carotid artery (CCA) or innominate artery can be treated with a hybrid approach, combining conventional carotid endarterectomy (CEA) and retrograde stenting of the proximal stenosis, through surgical exposure of the carotid bifurcation. The purpose of this study was to evaluate the results of combining eversion CEA with retrograde CCA/innominate artery stenting. MATERIAL AND METHODS: From January 2015 to July 2017, 7 patients, 6 men of a mean age of 72 years (range 59-83 years) underwent simultaneous, retrograde stenting of the proximal CCA/innominate artery and an eversion CEA of the ipsilateral ICA, through surgical exposure of the carotid bifurcation, for severe tandem stenoses...
March 10, 2018: International Journal of Surgery
Yuki Horita
The objectives of central venous percutaneous transluminal angioplasty are to dilate the venous lesion and to extend the life of arteriovenous fistula for hemodialysis. It is reasonable to perform percutaneous transluminal angioplasty for central venous lesions if this interventional therapy is required to maintain stable dialysis therapy. However, the presence of large fresh thrombus at central venous lesion site represents a contraindication to percutaneous transluminal angioplasty unless the thrombus can first be removed by thrombectomy...
March 1, 2018: Journal of Vascular Access
Andrea H T Hoff, Ferdi Akca, Philippe W M Cuypers, Joost F Ter Woorst
We report the use of a bovine pericardial bifurcation prosthesis to repair a mycotic innominate artery aneurysm.
March 11, 2018: Journal of Cardiac Surgery
David Boulate, Dominique Fabre, Nathaniel B Langer, Elie Fadel
Surgical strategy and long-term outcomes of patients with rupture of the ascending aorta, aortic arch and supra-aortic vessels following blunt thoracic trauma have been rarely reported. We reviewed our institutional experience between 1995 and 2016. We identified 2 patients with an innominate artery ruptures, 2 with an aortic arch ruptures and 1 with an ascending aorta rupture; all were induced by the posterior displacement of the anterior chest wall. All patients underwent open surgical repair. Cardiopulmonary bypass with antegrade cerebral perfusion was required in 2 cases...
March 5, 2018: Interactive Cardiovascular and Thoracic Surgery
Andy C Kiser, Thomas G Caranasos, Mark D Peterson, David M Holzhey, Philipp Kiefer, L Wiley Nifong, Michael A Borger
OBJECTIVE: Recently, the PARTNER 2A trial reported results of transcatheter aortic valve replacement versus surgical aortic valve replacement in 2032 intermediate-risk patients at 2 years. Two hundred thirty-six patients (24%) required an access route other than transfemoral. Compared with transfemoral and surgical aortic valve replacement, nontransfemoral transcatheter aortic valve replacement was associated with a numerically higher rate of death and disabling stroke at 30 days. This underscores the need for a better alternative surgical approach for patients with marginal femoral access...
February 17, 2018: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Marina Dias-Neto, José F Ramos, José F Teixeira
Injuries of the supra-aortic trunk after blunt chest trauma are rare. This is a case report of a blunt traumatic lesion of the innominate artery (IA) origin that exhibited aortic arch involvement with a focus on imaging and treatment. A 41-year-old fisherman presented an IA injury secondary to a high-impact blunt chest trauma. Upon physical examination, vital signs were stable and upper extremity pulses were present. In addition to several bone fractures (costal ribs, clavicle, scapula, temporal, maxillary, and sphenoid), computed tomography angiography revealed dissection/pseudoaneurysm of the IA sparing the bifurcation...
January 1, 2018: Vascular and Endovascular Surgery
Sameer Hirji, Jehangir J Appoo, Mollie Ferris, Jason Wong, Eric Herget
Residual Type B aortic dissection following open surgical repair of a Type A thoracic aortic dissection- can sometimes be complicated by collateral blood supplies, which can impact existing flow patterns, and result in progressive aneurysmal dilatation of the thoracic false lumens. We report a unique case that describes the clinical presentation of an infrarenal to innominate artery collateral blood flow that complicated a chronic residual type B dissection, which was timely diagnosed using multi-modality imaging, and successfully managed through an innovative minimally-invasive endovascular treatment strategy (without thoracotomy) with no neurological sequela...
February 8, 2018: Annals of Thoracic Surgery
Changtian Wang, Mario Lachat, Evelyn Regar, Ludwig Karl von Segesser, Francesco Maisano, Enrico Ferrari
OBJECTIVES: To treat aortic valve disease and concomitant root disease with transcatheter techniques, 'composite graft' implants are required. Our goal was to assess the suitability of the porcine aortic root for transcatheter root repair tests. METHODS: Eight pig hearts explanted from domestic pigs used in experimental surgery were compared to data from the literature on human hearts. The measured diameters included those of the annulus, sinuses of Valsalva, coronary ostia, sinotubular junction, ascending aorta, innominate artery and aortic arch...
February 2, 2018: Interactive Cardiovascular and Thoracic Surgery
Eric E Roselli, Jay J Idrees, Douglas R Johnston, Matthew J Eagleton, Milind Y Desai, Lars G Svensson
OBJECTIVE: Endovascular stent-grafting provides an alternative treatment option for high-risk patients with ascending aortic disease. The feasibility of this approach has been demonstrated before. We assess the updated experience with ascending thoracic endovascular aortic repair and propose a modification of the landing zone classification based on the outcomes. METHODS: From 2006 to 2016, 39 patients deemed very high risk for open replacement underwent endovascular repair of ascending aorta for acute type A dissection (12, 31%), intramural hematoma (2, 5%), pseudoaneurysm (22, 56%), and chronic dissection suture line entry tear (3, 8%)...
November 22, 2017: Journal of Thoracic and Cardiovascular Surgery
Woon Heo, Suk-Won Song, Kwang-Hun Lee, Shin-Young Lee, Tae-Hoon Kim, Min-Young Baek, Kyung-Jong Yoo
OBJECTIVES: This study aimed to evaluate the impact of remnant re-entries in arch branches on postoperative change in the aortic arch and descending aortic diameters and the rate of major adverse aortic events. METHODS: Between January 2010 and December 2016, 249 patients underwent surgery for acute Type I aortic dissection. Patients who underwent total arch replacement, had Marfan syndrome or had intramural haematoma were excluded. Seventy-two patients with predischarge and follow-up computed tomography scans were enrolled...
January 29, 2018: European Journal of Cardio-thoracic Surgery
Onkar B Auti, Varun Shetty, Vinay Belaval, Vimal Raj
Levoatrial cardinal vein (LACV) is anomalous connection between left atrium or pulmonary veins and systemic veins such as innominate vein or superior vena cava. This persistence of splanchnic circulation occurs when there is left-sided obstructive cardiac lesions such as hypoplastic left heart or mitral atresia. In this report we present three cases of LACV with well-developed left heart, without any obstructive lesions. All our cases presented with pulmonary arterial hypertension (PAH) and had associated intracardiac shunt such as ventricular/atrial septal defect and supracardiac partial anomalous pulmonary venous connection...
October 2017: Indian Journal of Radiology & Imaging
Boris N Kozlov, Dmitri S Panfilov, Igor V Ponomarenko, Andrey G Miroshnichenko, Aleksandra A Nenakhova, Alexander I Maksimov, Vladimir M Shipulin
OBJECTIVES: The aim of the study was to access the extended occlusion of the intercostal arteries by a stent graft in the development of postoperative spinal cord injury during aortic arch surgery using the frozen elephant trunk technique. METHODS: A total of 37 consecutive patients underwent total aortic arch surgery using the frozen elephant trunk technique between March 2012 and July 2017. The mean age of the patients was 54.7 ± 10.5 years. Type A and Type B aortic dissections were the indications for surgery...
January 17, 2018: Interactive Cardiovascular and Thoracic Surgery
Yong K Kwon, Nathaly Llore, Stuart S Kaufman, Cal S Matsumoto, Thomas M Fishbein, Raffaele Girlanda
Intestinal transplantation in children has evolved with more isolated small intestine transplants being performed compared to combined liver-intestine transplants. Consequently, surgical techniques have changed, frequently requiring the use of vascular homografts of small caliber to revascularize the isolated small intestine, the impact of which on outcomes is unknown. Among 106 pediatric intestine and multivisceral transplants performed at our center since 2003, 33 recipients of an isolated small intestine graft were included in this study...
March 2018: Pediatric Transplantation
Josh A Sibille, Joel P Harding, Jocelyn K Ballast, Mohammad Hooshmand, Jeko M Madjarov, Frank R Arko
A 60-year-old woman involved in a motor vehicle collision presented with a traumatic pseudoaneurysm of the innominate artery origin in addition to multiple concomitant injuries. She was classified as a high-risk candidate for open repair. An experimental thoracic branched graft device was used for coverage of the injury with the addition of a right carotid-to-left carotid-to-left subclavian artery bypass. Follow-up imaging showed resolution of the pseudoaneurysm and patency of her bypass grafts. This is the first described use of the Mona LSA Branch Thoracic Stent Graft System (Medtronic, Minneapolis, Minn) in the innominate artery...
March 2017: Journal of Vascular Surgery Cases and Innovative Techniques
Ourania Preventza, Matt D Price, Konstantinos Spiliotopoulos, Hiruni S Amarasekara, Lorraine D Cornwell, Shuab Omer, Kim I de la Cruz, Qianzi Zhang, Susan Y Green, Scott A LeMaire, Todd K Rosengart, Joseph S Coselli
OBJECTIVE: The preferred arterial cannulation site for elective proximal aortic procedures requiring circulatory arrest varies, and different sites have been tried. We evaluated the relationships between arterial cannulation site and adverse outcomes, including stroke, in patients undergoing elective aortic arch surgery. METHODS: We reviewed the records of 938 patients who underwent elective hemiarch or total arch surgery with circulatory arrest between 2006 and 2016...
December 19, 2017: Journal of Thoracic and Cardiovascular Surgery
Prakash Doddapattar, Manish Jain, Nirav Dhanesha, Steven R Lentz, Anil K Chauhan
OBJECTIVE: Fibronectin containing extra domain A (Fn-EDA) is an endogenous ligand of TLR4 (toll-like receptor 4) and is abundant in the extracellular matrix of advanced atherosclerotic lesions in human and mice. Irrespective of sex, deletion of Fn-EDA reduces early atherosclerosis in apolipoprotein E-deficient (Apoe-/-) mice. However, the contribution of Fn-EDA in advanced atherosclerosis remains poorly characterized. We determined the contribution of Fn-EDA in advanced atherosclerotic lesions of aged (1-year-old) Apoe-/- mice...
January 11, 2018: Arteriosclerosis, Thrombosis, and Vascular Biology
Ahmad Zaheer Qureshi
Context Hemorrhage is one of the potentially fatal complications of tracheostomy. A rare but lethal cause of tracheostomy related bleeding is hemorrhage from the innominate artery. This occurs following tracheo-innominate artery fistula (TIF) formation, which is associated with a mortality rate of more than 85%. Here, we report the case of an individual with tetraplegia and a tracheostomy who died as a result of innominate artery hemorrhage. This case highlights the possible causes and interventions associated with this complication, and provides insight into tracheostomy related bleeding in patients with spinal cord injury (SCI)...
January 11, 2018: Journal of Spinal Cord Medicine
Matthew C Schwartz, Kamal Pourmoghadam, Michael O'Brien, Craig E Fleishman, William DeCampli
A right aortic arch with an isolated left innominate artery from the left patent ductus arteriosus is a rare arch anomaly, and establishing continuity between the innominate artery and aorta can be challenging. We describe repair of this lesion in a three-week-old male using an autologous pedicle flap of ascending aorta as well as a homograft patch as the roof to recreate continuity between the aorta and left innominate artery.
January 2018: World Journal for Pediatric & Congenital Heart Surgery
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