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Aorta surgery

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https://www.readbyqxmd.com/read/28647662/microsurgical-bypass-training-rat-model-part-1-technical-nuances-of-exposure-of-the-aorta-and-iliac-arteries
#1
Ali Tayebi Meybodi, Michael T Lawton, Pooneh Mokhtari, Sonia Yousef, Sirin Gandhi, Arnau Benet
BACKGROUND AND OBJECTIVE: Animal models using rodents are frequently used for the purpose of practicing microvascular anastomosis - an essential technique in cerebrovascular surgery. However, safely and efficiently exposing rat's target vessels is technically difficult. Such difficulty may lead to excessive hemorrhage and shorten animal survival. This limits the ability to perform multiple anastomoses on a single animal and may increase the overall training time and costs. We report our model for microsurgical bypass training in rodents in two consecutive articles...
June 21, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28647198/trends-in-open-abdominal-exposure-among-vascular-surgery-trainees
#2
Victoria Greenwood, Brian Shames, Adam Tanious, Murray L Shames, Jeffrey E Indes
BACKGROUND: This retrospective study evaluates the trends in open abdominal surgery cases among integrated vascular surgery residents compared with their 5 + 2 counterparts. METHODS: The Accreditation Council for Graduate Medical Education (ACGME) case logs between 2007 and 2016 were collected from a pool of 9861 residents and fellows from 371 institutions. Trainees were grouped into three categories: general surgery residency (GSR), integrated vascular surgery residency (IVSR), and vascular surgery fellowship in the United States...
June 21, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28642639/foregut-duplication-cysts-in-children
#3
Keshawadhana Balakrishnan, Frances Fonacier, Shilpa Sood, Natasha Bamji, Howard Bostwick, Gustavo Stringel
BACKGROUND AND OBJECTIVES: Duplications of the alimentary tract are rare anomalies. We report our experience with foregut duplication cysts including their clinical presentation, diagnostic modalities, and surgical management. METHODS: We report a 20-year retrospective review of all foregut duplication cysts managed at our institution. RESULTS: Twelve patients with 13 foregut duplication cysts were identified. The ages of the children at the time of surgery ranged from infancy to adolescence, with a mean age of 7...
April 2017: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/28642176/microsurgical-bypass-training-rat-model-part-2-anastomosis-configurations
#4
Ali Tayebi Meybodi, Michael T Lawton, Sonia Yousef, Pooneh Mokhtari, Sirin Gandhi, Arnau Benet
BACKGROUND: Mastery of microsurgical anastomosis is key to achieving good outcomes in cerebrovascular bypass procedures. Animal models (especially rodents) provide an optimal pre-clinical bypass training platform. However, the existing models for practicing different anastomosis configurations have several limitations. OBJECTIVE: We sought to optimize the use of the rat's abdominal aorta and common iliac arteries (CIA) for practicing the 3 main anastomosis configurations commonly used in cerebrovascular surgery...
June 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28642109/neoaortic-xenoprosthetic-grafts-for-treatment-of-mycotic-aneurysms-and-infected-aortic-grafts
#5
C Anibueze, V Sankaran, U Sadat, K Tan, Y G Wilson, R E Brightwell, M S Delbridge, P W Stather
OBJECTIVE: There is no international consensus regarding the optimum management of infected aortae (mycotic aneurysms, infected aortic grafts). Neoaortoiliac reconstruction has advantages over extra anatomical bypass grafting; however use of autologous vein is associated with venous hypertension and compartment syndrome, alternatively cadaveric homografts are associated with high rates of perianastomotic haemorrhage, limb occlusion and pseudoaneurysm. Arterial repair using xenoprosthetic patches is associated with lower infection rates compared to the use of prosthetic material...
June 19, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28641275/a-case-series-of-surgically-diagnosed-idiopathic-aortitis-in-a-canadian-centre-a-retrospective-study
#6
Diane L Murzin, Eric C Belanger, John P Veinot, Nataliya Milman
BACKGROUND: Idiopathic aortitis became recognized relatively recently, and the body of knowledge concerning this condition is scarce. We aimed to determine the frequency of idiopathic aortitis in aortic specimens, the clinical, laboratory and radiologic characteristics at diagnosis and during follow-up, and the approach to investigation, treatment and monitoring taken by the treating physicians. METHODS: We identified cases of aortitis diagnosed on pathological specimens of the aorta between Jan...
June 19, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28634593/carcinoid-heart-disease-starting-from-heart-failure
#7
Nicole Bertin, Serena Favretto, Francesco Pelizzo, Lucio Mos, Franco Pertoldi, Olga Vriz
Carcinoid syndrome is the constellation of symptoms mediated by humoral factors produced by some carcinoid tumors. It consists primarily of vasomotor symptoms, gastrointestinal hypermotility, hypotension, and bronchospasm, due to the production and release of vasoactive substances. Carcinoid heart disease occurs in more than 50% of patients with carcinoid syndrome; in some cases, it represents the initial manifestation of the disease. We report the case of a 75-year-old woman with a metastatic neuroendocrine tumor admitted to the emergency room for fatigue and heart failure...
April 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28633257/takayasu-arteritis-mimicking-type-a-intramural-hematoma
#8
Salvatore Torre, Paola Caramaschi, Giuseppe Faggian, Giovanni Battista Luciani
Takayasu arteritis is a panarteritis of unknown etiology involving the aorta and its main branches, with higher prevalence in women and peak of incidence in the second and third decades of life. Up to 30% of patients have coronary lesions and aortic valve involvement. Presentation mimicking aortic dissection is quite rare. Here described is the case of a young patient, presenting with an acute coronary syndrome associated with severe aortic regurgitation, who underwent emergent surgery with the suspicion of acute aortic dissection...
July 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28632534/administration-of-tetrahydrobiopterin-bh4-protects-the-renal-microcirculation-from-ischemia-and-reperfusion-injury
#9
Lokmane Rahmania, Diego Orbegozo, Fuhong Su, Fabio Silvio Taccone, Jean-Louis Vincent, Daniel De Backer
BACKGROUND: Abdominal aortic aneurysm surgery with suprarenal cross-clamping is often associated with renal injury. Although the mechanism underlying such injury is unclear, tissue ischemia and reperfusion, which induces endothelial dysfunction and decreases the availability of tetrahydrobiopterin (BH4), may play a role. We evaluated whether BH4 administration prevents renal ischemia/reperfusion injury in an animal model of aortic cross-clamping. METHODS: Nineteen anesthetized, mechanically ventilated, and invasively monitored adult sheep were randomized into 3 groups: sham animals (n = 5) that underwent surgical preparation but no aortic clamping; an ischemia/reperfusion group (n = 7), where the aorta was clamped above the renal arteries for 1 hour, and a BH4 group (n = 7), in which animals received 20 mg/kg of BH4 followed by aortic cross-clamp for 1 hour...
June 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28631316/recannulation-of-the-axillary-artery-in-aortic-and-complex-cardiac-surgery
#10
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/28621637/surgical-techniques-and-procedures-for-kidney-transplant-recipients-with-severe-atherosclerosis
#11
Koji Nanmoku, Yoshihiko Watarai, Shunji Narumi, Norihiko Goto, Takayuki Yamamoto, Makoto Tsujita, Takahisa Hiramitsu, Akio Katayama, Takaaki Kobayashi, Kazuharu Uchida
OBJECTIVES: Atherosclerosis is becoming a more common problem for dialysis patients. Therefore, transplant surgeons are faced with the need to develop surgical techniques and procedures for severe atherosclerosis. This study aimed to clarify the clinical features, the usefulness of examinations, and operative procedures for kidney transplant recipients with the complication of severe atherosclerosis. MATERIALS AND METHODS: Among 220 kidney transplant candidates, 13 patients (severe atherosclerosis group) were predicted complications due to arterial calcification in the bilateral iliac arterial system using a computed tomographic scan...
June 16, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28616352/aortic-polyaneurysmal-disease-case-report
#12
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/28616351/hybrid-aortic-repair-with-antegrade-supra-aortic-and-renovisceral-debranching-from-ascending-aorta
#13
José Antonio Del Castro-Madrazo, Margarita Rivas-Domínguez, Carlota Fernández-Prendes, Amer Zanabili Al-Sibbai, José Manuel Llaneza-Coto, Manuel Alonso-Pérez
Aortic dissection is a life threatening condition. Hybrid repair has been described for the treatment of complex aortic pathology such as thoracoabdominal aortic aneurysms (TAAA) and type A and B dissections, although open and total endovascular repair are also possible. Open surgery is still associated with substantial perioperative morbi-mortality rates, thus less invasive techniques such as endovascular repair and hybrid procedures can achieve good results in centers with experience. We present the case of a patient with a chronic type B dissection and TAAA degeneration that was treated in a single stage hybrid procedure with antegrade supra-aortic and renovisceral debranching from the ascending aorta and TEVAR...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28616347/intraoperative-care-for-aortic-surgery-using-circulatory-arrest
#14
REVIEW
Félix Ezequiel Fernández Suárez, David Fernández Del Valle, Adrián González Alvarez, Blanca Pérez-Lozano
The total circulatory arrest (CA) is necessary to achieve optimal surgical conditions in certain aortic pathologies, especially in those affecting the ascending aorta and aortic arch. During this procedure it is necessary to protect all the organs of ischemia, especially those of the central nervous system and for this purpose several strategies have been developed. The first and most important protective method is systemic hypothermia. The degree of hypothermia and the route of application have been evolving and currently tend to use moderate hypothermia (MH) (20...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28616346/emergent-aortic-surgery-in-octogenarians-is-the-advanced-age-a-contraindication
#15
REVIEW
Mario Castaño, Javier Gualis, Jose M Martínez-Comendador, Elio Martín, Pasquale Maiorano, Laura Castillo
Surgery of both the ascending and descending aortic segments in the context of an acute aortic syndrome is one of the greatest challenges for the cardiac surgeon. In the case of surgery of the descending aorta, surgical risk increases due to the technical complexity, the required aggressive approach and because surgical indication is usually established as a result of complications and therefore involves, almost always, critically ill patients. The aging of the population is causing such surgery to be considered in an increasing number of octogenarians...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28612909/implantation-of-stents-for-postsurgical-recoarctation-of-the-aorta-in-adolescents-and-adults
#16
Sylwia Sulik-Gajda, Roland Fiszer, Jacek Białkowski, Beata Chodór, Szymon Pawlak, Małgorzata Szkutnik
BACKGROUND: Results of stent implantation (SI) of postsurgical recoarctation of the aorta (ReCoA) are not frequently published. AIM: This study sought to retrospectively evaluate results of SI in ReCoA in older children and adults. METHODS: Twenty-eight SI were performed on 26 ReCoA patients with a median age of 23(10-65) years. Dependent upon availability, the following stents were applied -Palmaz, Cheatham Platinum (CP), Andrastents XL/XXL(AS), Covered CP (CVCP) stents and selfexpanding stents (Smart)...
June 14, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28610543/does-diathermy-smoke-contaminate-processed-salvaged-blood-in-cardiac-surgery
#17
Katherine R Hulme, Jon van den Burg
INTRODUCTION: A cell salvage device is used in cardiac surgery with the aim of reducing allogeneic blood transfusion. Suction of blood from the operating field used for the device is often accompanied by diathermy smoke. There is limited published research to know if this blood is then contaminated with clinically significant levels of harmful chemicals from this smoke. Postoperative cardiac surgery patients are already physiologically vulnerable, making the optimization of salvaged blood worth considering...
June 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28608147/coarctation-index-predicts-recurrent-aortic-arch-obstruction-following-surgical-repair-of-coarctation-of-the-aorta-in-infants
#18
Gregory Adamson, Tara Karamlou, Phillip Moore, Luz Natal-Hernandez, Sarah Tabbutt, Shabnam Peyvandi
Recurrent aortic arch obstruction (RAAO) remains a major cause of morbidity following surgical neonatal repair of coarctation of the aorta (CoA). Elucidating predictors of RAAO can identify high-risk patients and guide postoperative management. The Coarctation index (CoA-I), defined as the ratio of the diameter of the narrowest aortic arch segment to the diameter of the descending aorta, has been used to help diagnose RAAO in neonates following the Norwood Procedure. We sought to assess the predictive value of the CoA-I on RAAO after CoA repair in infants with biventricular circulation...
June 12, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28606776/extraperitoneal-laparoscopic-radical-nephroureterectomy-and-lymph-node-dissection-in-modified-supine-position
#19
Pengchao Li, Jun Tao, Xiaheng Deng, Chao Qin, Yidong Cheng, Peng Li, Jiexiu Zhang, Yongke Cao, Xiao Yang, Chengdi Yang, Qiang Lu
Objective To explore the feasibilty of extraperitoneal laparoscopic radical nephroureterectomy (RNU) and lymph node dissection in modified supine position for managing urothelial carcinomas in renal pelvis or upper 2/3 ureter. Subjects / Patients and Methods Consecutively from January 2014 to October 2015, 15 patients with high-risk urothelial carcinoma in renal pelvis or upper 2/3 ureter underwent extraperitoneal laparoscopic radical nephroureterectomy (EL-RNU) and extraperitoneal laparoscopic lymph node dissection (EL-LND)...
June 9, 2017: Urology
https://www.readbyqxmd.com/read/28606285/-the-application-of-short-stent-in-root-of-aorta-for-the-treatment-of-stanford-type-a-aortic-dissection
#20
X P Chen, Y P Zhao, Y F Ye, S Chen, G J Zhu, J Hu
Objective: To explore the effect of implanting short stent in root of aorta for the treatment of Stanford type A aortic dissection. Methods: Clinical data of 39 patients with Stanford type A aortic dissection who underwent surgical procedure at the Department of Cardiovascular Surgery of Luoyang Central Hospital Affiliated to Zhengzhou University, between January 2013 and December 2015 were retrospectively analyzed. There were 31 males and 8 females aged 27 to 75 (49.3±10.3) years. All patients received short stent implanting in aortic root, total arch replacement and stented elephant trunk implantation were performed at the same time...
June 13, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
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