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acute arterial thrombosis after surgery on the aorta

Seiko Nakajima, Osamu Seguchi, Yoshihiro Murata, Tomoyuki Fujita, Hiroki Hata, Takafumi Yamane, Michinari Hieda, Takuya Watanabe, Takuma Sato, Haruki Sunami, Masanobu Yanase, Junjiro Kobayashi, Takeshi Nakatani
Despite continual improvements in ventricular assist device (VAD) therapy, various clinical issues are emerging. Importantly, various types of thromboembolic complications have been reported to date. Recently, we encountered a rare continuous-flow VAD-related thromboembolic event that resulted in acute myocardial infarction. A 26-year-old female who just underwent HeartMate II(®) VAD implantation suddenly developed widespread anterolateral myocardial infarction on postoperative day 16. Echocardiography and aortography revealed a large thrombus on the left coronary cusp of the aortic valve that almost completely occluded the left coronary ostium...
June 2014: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
Osamu Namura, Masakazu Sogawa, Fuyuki Asami, Takeshi Okamoto, Kazuhiko Hanzawa, Jun-ichi Hayashi
We present a case of floating thrombus originating from an almost normal thoracic aorta in a 54-year-old man who presented with acute arterial occlusion of his left leg. Transesophageal echocardiography (TEE), computed tomography, and magnetic resonance imaging showed two masses in an almost normal aorta after embolectomy for the acute arterial occlusion. Although the embolus was thrombus histologically, malignant tumors could not be ruled out. The masses did not decrease in size after 7 days of anticoagulant therapy, so they were extirpated under cardiopulmonary bypass (CPB) and TEE guidance...
September 2011: General Thoracic and Cardiovascular Surgery
N Haacke, J K Unger, C Haidenhein, M Russ, B Hiebl, S M Niehues
OBJECTIVE: In a porcine, aortic graft model we found 5 animals to develop and survive unnoticed, complete infrarenal aortic occlusion and 2 pigs with an acute occlusion but rather unspecific clinical symptoms. We investigated the pigs' vascular system to classify the anatomic capabilities to compensate for an acute abdominal aortic occlusion. DESIGN OF STUDY: Retrospective analysis of CT scans and clinical data to specify unexpected results in a case series of infrarenal occlusion in a porcine model...
2011: Clinical Hemorheology and Microcirculation
I I Zatevakhin, V N Zolkin, M Iu Gorbenko
Analysed herein are therapeutic outcomes in a total of 499 patients presenting with acute thrombosis of the aorta and lower-limb arteries and having previously no reconstructive operations on limb arteries on the affected side. Group I was composed of the patients who had during the first 24 hours of hospitalization undergone an emergency operation (n = 146), and Group II comprised those subjected to medical treatment only (n = 353). In Group I, the number of the patients who survived with a preserved extremity amounted to 91...
2010: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
Christoph A Nienaber, Hervé Rousseau, Holger Eggebrecht, Stephan Kische, Rossella Fattori, Tim C Rehders, Günther Kundt, Dierk Scheinert, Martin Czerny, Tilo Kleinfeldt, Burkhart Zipfel, Louis Labrousse, Hüseyin Ince
BACKGROUND: Thoracic endovascular aortic repair (TEVAR) represents a novel concept for type B aortic dissection. Although life-saving in acute emergencies, outcomes and survival of TEVAR in stable dissection are unknown. METHODS AND RESULTS: One hundred forty patients in stable clinical condition at least 2 weeks after index dissection were randomly subjected to elective stent-graft placement in addition to optimal medical therapy (n=72) or to optimal medical therapy alone (n=68) with surveillance (arterial pressure according to World Health Organization guidelines < or =120/80 mm Hg)...
December 22, 2009: Circulation
P Caridad Morata Barrado, E Blanco Cañibano, B García Fresnillo, M Guerra Requena
Aortic thrombus is rare in patients with essential thrombocytosis (ET), so the optimal treatment remains undefined. A 45-year-old man with history of ET, under chronic treatment with aspirin, presented to the emergency department complaining of acute onset in both the legs and abdominal pain. Physical examination revealed that both dorsalis pedis pulses were not palpable with cold and pale feet. His abdomen was soft and nondistended. The platelet count was 436 x 10(9)/L. The thoraco-abdominal computerized tomographic scanning revealed normal aortic diameter with supraceliac and infrarenal nonoccluding thrombus and infarction areas in spleen and left kidney...
October 2009: International Journal of Hematology
S A Beye, O Kane, T N Tchikangoua, A Ndiaye, P A Dieng, G Ciss, P S Ba, M Ndiaye
The aim of this study was to evaluate the anaesthetic assumption of responsibility of the surgery of the aneurism of under renal abdominal aorta. It was a retrospective study over two years (April 2005 - April 2007). Seven patients were operated, the mean age was 69,4 years. An operational pre evaluation was carried out among all patients including/understanding an interrogation, a clinical examination and a clinical assessment. All the patients profited from a general anaesthesia with controlled ventilation...
2009: Le Mali Médical
I Nevelsteen, J Duchateau, P De Vleeschauwer, J De Leersnijder
INTRODUCTION: Endovascular repair of abdominal aortic aneurysms (EVAR) has proven to be an attractive and successful alternative to traditional open surgery in properly selected patients. As in open surgery, ischaemic colitis remains a feared complication, but the incidence and causes are not properly documented. OBJECTIVE: To present a case of endovascular aneurysm repair complicated by postoperative unilateral graft limb occlusion and ischaemic colitis. CASE REPORT: A 76-year-old woman presented with diffuse abdominal pain in the presence of an infrarenal abdominal aorta aneurysm of 5...
September 2006: Acta Chirurgica Belgica
T Schachner, K Vertacnik, J Nagiller, G Laufer, J Bonatti
AIM: We report our results on mortality, morbidity and long time events after composite graft replacement of the aortic root and ascending aorta/aortic arch and factors associated with them. METHODS: Seventy-four patients, aged 52 years (15-73) underwent modified ''button'' Bentall operation. The indication for operation was acute dissection in 29 (39%) patients, chronic dissection in 3 (4%), aortic regurgitation after previous replacement of the ascending aorta because of aortic dissection in 2 (3%) and non dissecting aneurysm in 40 (54%)...
October 2005: Journal of Cardiovascular Surgery
Xiao-Xi Li, Sheng-Ming Wang, Wei Chen, Wen-Quan Zhuang, Zhuan-Hong Wu, Guang-Qi Chang, Song-Qi Li, Jian-Yong Yang, Yong-Jie Lin
Between October 2000 and January 2002, 9 consecutive male patients with subacute or chronic aortic dissection underwent stent-graft placement. The indication for surgery was continuous pain or aneurysm development. One patient had a type A dissecting aortic aneurysm with a primary tear in the ascending thoracic aorta; the other 8 had type B dissection. Placement of an endovascular stent-graft was technically successful in 8 patients, and one underwent an open procedure for abdominal aortic fenestration. The entry site was sealed and the false lumen disappeared in 8 cases, and thrombosis of the false lumen was obtained...
June 2004: Asian Cardiovascular & Thoracic Annals
O Hartung, Y S Alimi, T Lonjon, P Barthares, L Cador, C Juhan
OBJECTIVE: Descending thoracic aorta to femoral artery bypass (DTAFB) has demonstrated usefulness in the treatment of aorto-iliac occlusive disease but related morbidity and mortality are not negligible. We wanted to determine the feasibility of thoracoscopic DTAFB and to report our clinical experience. MATERIAL AND METHODS: An experimental study was performed on 8 pigs in helicoidal position under general anesthesia with right selective ventilation ). Three trocars were inserted and the descending aorta was dissected )...
October 2003: Journal des Maladies Vasculaires
V Bresan, K Irlbacher, R Bittner, R Meyer, R Dietz, M Möckel
A 73-year old woman presented with mild paraparesis and hypesthesia of the legs. Furthermore, she complained dizziness, fainting and dyspnea. There was a history of peripheral artery disease, diabetes mellitus, arterial hypertension and chronic atrial fibrillation. Five years ago she had breast cancer with removal of the left mamma and additional radiation therapy. Cardiac catheterization at that time demonstrated no significant coronary stenoses. A contrast-enhanced CT-scan excluded lumbal spinal metastases...
March 2003: Zeitschrift Für Kardiologie
C Wiesenack, G Kerschbaum, A Keyser, R Kobuch, K Taeger
We are reporting a case of an acute thromboembolic obstruction of the aortic bifurcation in a 66-year-old patient undergoing coronary artery bypass grafting with extracorporeal circulation. After declamping of the aorta, the arterial pressure measured in the femoral artery suddenly dropped, whereas the pressure measured in the aortic cannula and in both radial arteries stayed normal. Transoesophageal echocardiography was performed to exclude an acute aortic dissection. While the patient always had a constant sinus rhythm, an angiography following the end of surgery, showed a complete obstruction of the abdominal aorta...
January 2001: Der Anaesthesist
Iu V Belov, A B Stepanenko
The trial included 894 patients in postoperative period with thrombosis of reconstructed arteries, who had undergone since 1975 1100 repeated reconstructive operations. Vast experience of reoperations on the vessels allowed to summarize various types of reoperations, to systematize them and to propose new classification. Surgical policy was determined by the causes of acute thrombosis and the time of its duration. Evaluation of the results of repeated reconstructions has revealed, that patency of the by-passes in the aorto-femoro-popliteal area in long-term postoperative period is significantly lower than after surgery on renal arteries and brachiocephalic branches...
1998: Khirurgiia
D Melliere, D Berrahal, J P Becquemin, P Desgranges, A Cavillon
OBJECTIVE: The aim of this study was to evaluate screening, prevention and treatment of false anastomotic aneurysms (FAA). METHOD: A retrospective analysis of 95 FAA observed in 72 patients (67 males, 5 females, age range 48 to 93 years was conducted. Mean delay to onset was 7.5 years. RESULTS: Diagnosis was made on the basis of imaging evidence using, since 1978, duplex-scan: 8/15 FAA of the aorta, 4/5 FAA of the iliac arteries and 35/75 FAA of the femoral arteries...
1996: Journal des Maladies Vasculaires
B F Johnson, G Thomas, K N Wiley, M Greaves, F E Preston, M Fox, A T Raftery
The principal causes of failure of a pancreas transplant are rejection and vascular thrombosis. There is an unusually high attrition rate for pancreas transplants, but study models have been difficult to develop. In a rat model that allows study of acute rejection to the exclusion of nonspecific effects of transplant surgery on the pancreas, in vitro synthesis of prostacyclin (PGI2) and thromboxane A2 (TXA2) by transplanted pancreas and the blood vessels transplanted with it was measured using an RIA for their stable hydrolysis products 6-keto-prostaglandin F1 alpha and thromboxane B2 (TXB2)...
December 1993: Transplantation
T Jeannot, J M Védrinne, B B Xuan, J M Chevalier, J Motin
This case report demonstrates the value of transoesophageal echocardiography (TOE) in comparison with transthoracic echocardiography as it allows a better view of the thoracic aorta, the auricles, the interauricular septum and the cardiac valves, especially in the intubated and ventilated patients. A 84-year-old woman was admitted to the ICU for hypoxia after carotid-subclavian bypass surgery for acute ischaemia of the left upper limb. The TOE showed a dilated right heart and a patent foramen ovale, compatible with pulmonary embolism as well as two thrombi in the aortic arch...
1994: Annales Françaises D'anesthèsie et de Rèanimation
C Fava, M Grosso, D Malara, C Barile
The possible ways of treating renal artery embolisms are reviewed with an examination of their advantages and defects. Surgical treatment has a fairly high mortality rate but quickly cures any type of vascular occlusion and will cure any concomitant problems such as arterial stenosis. Medical treatment with anticoagulant or thrombolytic drugs offers a lower short term mortality rate and is effective even on narrow blood vessels but the response varies according to the type of thromboembolic damage and the way the drugs are administered...
July 1987: La Radiologia Medica
T Ikezawa
To assess the diagnostic value of myoglobin between elective surgery and acute arterial occlusion, serum and urine myoglobin (S-Mb, U-Mb) levels were measured before and for 7 consecutive days following arterial reconstructive surgery in 7 patients with abdominal aortic aneurysm or arteriosclerosis obliterans (elective surgery group), and in 20 patients with acute arterial occlusion due to embolism or thrombosis. They were divided into three groups based on symptoms and other features: mild, moderate, and severe groups...
February 1991: Rinsho Byori. the Japanese Journal of Clinical Pathology
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