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https://www.readbyqxmd.com/read/28433350/open-repair-of-chronic-thoracic-and-thoracoabdominal-aortic-dissection-using-deep-hypothermia-and-circulatory-arrest
#1
Joel Corvera, Hannah Copeland, David Blitzer, Adam Hicks, Joshua Manghelli, Philip Hess, John Fehrenbacher
BACKGROUND: Chronic dissection of the thoracic and thoracoabdominal aorta as sequela of a prior type A or B dissection is a challenging problem that requires close radiographic surveillance and prompt operative intervention in the presence of symptoms or aneurysm formation. Open repair of chronic thoracic and thoracoabdominal aortic dissection using deep hypothermia has been our preferred method to treat this complex pathology. The advantages of this technique include organ and spinal cord protection, the flexibility to extend the repair proximally into the arch, and the ability to limit ischemia to all vascular beds...
March 18, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28428528/-challenge-of-treating-thoracoabdominal-aortic-aneurysms-with-hybrid-thoracic-endovascular-aortic-repair
#2
Takashi Shuto, Shinji Miyamoto
The treatment of thoracoabdominal aortic aneurysms in great vessels is still challenging, as the early results of the operation are not very promising compared with other aortic operations, and the incidence of spinal cord ischemia is relatively high. In Japan, which is becoming a super-aging society, the method of performing minimally invasive operations remains a major issue. At our facility, we have been performing abdominal debranching thoracic endovascular aortic repair (TEVAR) to resolve these issues...
April 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28400556/precise-treatment-of-aortic-aneurysm-by-three-dimensional-printing-and-simulation-before-endovascular-intervention
#3
Ding Yuan, Han Luo, Hongliu Yang, Bin Huang, Jingqiang Zhu, Jichun Zhao
In this study, three-dimensional printing (3Dp) models and simulation surgeries (SSs) were applied in two challenging aortic cases. The first was an abdominal aortic aneurysm with a complex neck, and the second was a thoracic aortic dissection aneurysm (TADA) with an angled arch. In order to avoid unpredictable obstacles and difficulties, we made optimal surgical plans by using 3D models and virtual simulations. Based on preoperative evaluation system, the surgical plans seemed more reasonable and time-saving...
April 11, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28377913/acute-type-b-aortic-dissection-in-a-patient-with-previous-endovascular-abdominal-aortic-aneurysm-repair
#4
Sung Hun Park, Seung-Woon Rha
Endovascular aortic repair (EVAR) was relatively safe, and became a widely performed procedure. If aortic dissection (AD) occurred in patient with previous EVAR, it could cause fatal complications like endograft collapse. Surgical treatment was limited in this situation for comorbidities and complex anatomies. Here we report a rare case of acute type B AD developed following trans-radial coronary intervention in a patient with previous EVAR of abdominal aortic aneurysm, which was treated with thoracic EVAR.
March 2017: Vascular Specialist International
https://www.readbyqxmd.com/read/28376703/symptomatic-delayed-aortic-dissection-after-superior-mesenteric-artery-stenting-for-chronic-mesenteric-ischemia
#5
Cindy Huynh, Robert Schwartz
Chronic mesenteric ischemia most commonly occurs secondary to atherosclerotic disease of the mesenteric arteries. Patients are often older than 60 years and can present with postprandial abdominal pain, nausea, diarrhea, and significant weight loss. Symptomatic disease has traditionally been managed with open surgical repair, but endovascular strategies, such as percutaneous angioplasty and stenting, have emerged as the mainstays of therapy. Complications from stenting include plaque embolization, thrombosis, perforation, or dissection of the mesenteric arteries...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28369452/management-of-cerebral-malperfusion-in-surgical-repair-of-acute-type-a-aortic-dissection
#6
Tomokuni Furukawa, Naomichi Uchida, Shinya Takahashi, Yoshitaka Yamane, Shingo Mochizuki, Kazunori Yamada, Takaaki Mochizuki, Taijiro Sueda
OBJECTIVES: Cerebral malperfusion for patients with acute type A aortic dissection (AAAD) remains an unsolved problem. The present study aimed to evaluate our management of cerebral perfusion and identify predictors of perioperative cerebral malperfusion in patients undergoing surgical repair of AAAD. METHODS: Between January 2004 and December 2015, 137 consecutive patients with AAAD underwent aortic replacement at Tsuchiya General Hospital. The status of the dissected supra-aortic branch vessels (SABVs) was classified as patent or thrombosis by preoperative computed tomographic angiography...
March 20, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28359494/migration-of-an-atrial-septal-occluder-device-with-formation-of-abdominal-aortic-dissection
#7
Serkan Burç Deşer, Mustafa Kemal Demirağ
Atrial septal defects can be closed surgically or percutaneously. However, percutaneous closure of atrial septal defects carries some risks. Embolization of the atrial septal occluder is the major adverse event. Embolization of the device into the main pulmonary artery, left atrium, right ventricle, aortic arch, descending aorta, abdominal aorta, iliac bifurcation, and iliac arteries can be seen. We report the case of a 19-year-old man with migration of an Amplatzer (St Jude Medical, St Paul, MN) atrial septal occluder into the iliac bifurcation with the development of abdominal aortic dissection 1 month after successful percutaneous closure...
April 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28344762/protracted-refractory-pain-post-tevar-post-implantation-syndrome
#8
Peter Waweru, Hardeep Gill, Chris Abeid
Aortic dissection is a life-threatening condition and has one of the highest mortality rates of cardiovascular diseases. It remains a devastating disease; with multiple unanswered questions concerning treatment modalities. The role of thoracic endovascular aortic repair (TEVAR) in these patients; especially those with uncomplicated acute aortic Type B dissections (AAD-B) is especially controversial although it has been shown to have better long-term outcomes compared to medical therapy alone. For those who have TEVAR, up to 60% may develop an acute, transient systemic inflammatory response syndrome that remains vaguely defined...
October 2016: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28322037/analysis-of-klk1-polymorphism-rs5516-in-patients-with-abdominal-aortic-aneurysm-or-thoracic-aortic-dissection
#9
Yiming Zhang, Hongliang Huang, Yuliang Ma, Yifeng Sun, Guohua Wang, Liming Tang
No abstract text is available yet for this article.
March 20, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28319480/right-axillary-artery-cannulation-for-endovascular-repair-of-an-acute-type-a-aortic-dissection
#10
Corbin E Muetterties, Jeremy H Conklin, G William Moser, Grayson H Wheatley
We present the case of a 48-year-old woman with an acute type A aortic dissection that was treated with thoracic endovascular aortic repair at our institution. The patient was found to have a focal type A dissection with pericardial effusion but no tamponade physiology and no involvement of the aortic valve or root. We elected to treat the patient's type A aortic dissection with an endovascular stent because of the patient's favorable anatomy and no evidence of neurologic deficits or signs of distal malperfusion...
March 17, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28302917/hif1%C3%AE-in-aortic-aneurysms-and-beyond
#11
Tomoki Hashimoto, Victor Rizzo
Abdominal aortic aneurysm (AAA) is a permanent expansion of the vessel wall with a high prevalence in those 65 years of age and older. Aneurysms are prone to dissection and rupture that carry a mortality rate of over 85%. Currently, surgical repair is the only option to treat this disease. The need to intervene prior to these events has set off a flurry of basic studies in an effort to understand the cellular and molecular mechanisms that govern AAA formation, progression and rupture. In the present study, the role of myeloid cells in contributing to AAA development has been confirmed...
April 1, 2017: Clinical Science (1979-)
https://www.readbyqxmd.com/read/28286334/mechanical-strain-induced-expression-of-matrix-metalloproteinase-9-via-stretch-activated-channels-in-rat-abdominal-aortic-dissection
#12
ZhiHuang Qiu, LiangWan Chen, Hua Cao, Qiang Chen, Hua Peng
BACKGROUND The aim of the study was to investigate the expression of matrix metalloproteinase-9 (MMP-9) in rat abdominal aortic dissection (AD) induced by mechanical strain, so as to offer a better understanding of the possible mechanisms of AD. MATERIAL AND METHODS Experimental AD in rats was achieved by the injection of porcine pancreatic elastase. At days 0, 1, 3, 5, 7, 14, 21, and 30 after the establishment of AD model, serum MMP-9 levels were measured by enzyme-linked immunosorbent assay (ELISA). Four groups of vascular rings were stretched in vitro with a mechanical strength of 0 g, 1 g, 3 g, or 5 g for 30 min...
March 13, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28283881/a-case-of-double-inferior-vena-cava-with-renal-ovarian-and-iliac-vein-variation
#13
Taro Ito, Yayoi Ikeda
We encountered a rare case of an anatomic variant of inferior vena cava (IVC) duplication with renal, ovarian and iliac vein variation in an 81-year-old Japanese female cadaver during a student dissection course of anatomy at Aichi Gakuin University School of Dentistry. The two IVCs ran upwards bilaterally to the abdominal aorta. The left IVC joined with the left renal vein (RV) to form a common trunk that crossed anterior to the aorta and ended at the right IVC. We detected a vein [interiliac vein (IiV)] connecting the two IVCs at the level of the aortic bifurcation...
March 10, 2017: Anatomical Science International
https://www.readbyqxmd.com/read/28279721/the-petticoat-technique-for-complicated-acute-stanford-type-b-aortic-dissection-using-a-tapered-self-expanding-nitinol-device-as-distal-uncovered-stent
#14
Michele Antonello, Francesco Squizzato, Chiara Colacchio, Jacopo Taglialavoro, Franco Grego, Michele Piazza
BACKGROUND: Provisional Extension To Induce Complete Attachment (PETTICOAT) technique has shown good results in the treatment of acute type B aortic dissections (ABAD). Usually, uncovered tubular stainless steel stents are used to promote distal true lumen reattachment. METHODS: We describe the Petticoat technique using a conic self-expanding nitinol device as distal uncovered stent in five cases of complicated ABAD. We used as distal uncovered stent the single-flared E-XL (Jotec-GmbH)...
March 7, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28275590/protocol-for-evaluating-the-cardio-ankle-vascular-index-to-predict-cardiovascular-events-in-japan-a-prospective-multicenter-cohort-study
#15
REVIEW
Toru Miyoshi, Hiroshi Ito, Shigeo Horinaka, Kohji Shirai, Jitsuo Higaki, Hajime Orimio
INTRODUCTION: The cardio-ankle vascular index (CAVI) was developed in Japan and is a blood pressure-independent index of arterial stiffness from the origin of the aorta to the ankle. In recent years, it has been studied by many researchers worldwide, and it is strongly anticipated that it will play a role as a predictive factor for arteriosclerotic diseases. The objective of this study was to examine the benefits of using CAVI as a predictor of cardiovascular events in high-risk patients...
January 2017: Pulse (Basel, Switzerland)
https://www.readbyqxmd.com/read/28262748/diagnostic-implication-of-fibrin-degradation-products-and-d-dimer-in-aortic-dissection
#16
Jian Dong, Xianli Duan, Rui Feng, Zhiqing Zhao, Xiang Feng, Qingsheng Lu, Qing Jing, Jian Zhou, Junmin Bao, Zaiping Jing
Fibrin degradation products (FDP) and D-dimer have been considered to be involved in many vascular diseases. In this study we aimed to explore the diagnostic implication of FDP and D-dimer in aortic dissection patients. 202 aortic dissection patients were collected as the case group, 150 patients with other cardiovascular diseases, including myocardial infarction (MI, n = 45), pulmonary infarction (n = 51) and abdominal aortic aneurysm (n = 54) were collected as non-dissection group, and 27 healthy people were in the blank control group...
March 6, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28259576/female-sex-independently-predicts-mortality-after-thoracic-endovascular-aortic-repair-for-intact-descending-thoracic-aortic-aneurysms
#17
Sarah E Deery, Katie E Shean, Grace J Wang, James H Black, Gilbert R Upchurch, Kristina A Giles, Virendra I Patel, Marc L Schermerhorn
OBJECTIVE: Whereas sex differences in the pathogenesis, presentation, and outcomes of repair for abdominal aortic aneurysms are well studied, less is known about sex differences after thoracic endovascular aortic repair (TEVAR). The goal of this study was to evaluate the association between sex and morbidity and mortality after TEVAR. METHODS: A retrospective review of all TEVARs in the Society for Vascular Surgery Vascular Quality Initiative (VQI) registry from 2011 to 2015 was conducted, excluding those with dissection, trauma, and rupture...
March 1, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28238929/comparison-between-open-and-endovascular-repair-for-the-treatment-of-juxtarenal-abdominal-aortic-aneurysms-a-single-center-experience-with-midterm-results
#18
Koji Maeda, Takao Ohki, Yuji Kanaoka, Takeshi Baba, Kenjirou Kaneko, Kota Shukuzawa
PURPOSE: To evaluate the optimal treatment for juxtarenal abdominal aortic aneurysm (JAAA) we compared outcomes of open surgical repair (OSR) with endovascular aortic repair (EVAR) utilizing a variety of fenestrated and snorkel EVARs. METHODS: We evaluated overall survival, aneurysm-related death, re-intervention and renal impairment in 152 JAAAs retrospectively, excluding cases of aortic dissection and rupture. Cox models were used to assess survival and assessed postoperative dialysis rates following surgery...
February 23, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28237617/safe-dissection-of-high-paraaortic-lymph-nodes-superior-to-the-renal-vein-in-ovarian-primary-peritoneal-or-fallopian-tube-cancer-by-the-komiyama-s-maneuver-a-modification-of-kocher-s-maneuver
#19
Shinichi Komiyama, Megumi Manrai, Rena Takahashi, Chiaki Takeya
OBJECTIVE: High paraaortic lymph nodes superior to the renal vein are often involved by metastasis from advanced ovarian cancer, but are difficult to dissect. We developed a novel surgical technique for removing these nodes. METHODS: The ascending colon is displaced from the right paracolic gutter. A retroperitoneal incision is made cranially from the ileocecal region along Monk's white line (fusion fascia) dorsal to the ascending colon. Incising the fusion fascia toward the root of the right renal vein from inside Gerota's fascia allows separation of the right kidney and mobilization of the ascending colon, partly exposing the inferior vena cava...
February 22, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28230898/manifestations-and-medicolegal-significance-of-loeys-dietz-syndrome
#20
Roger W Byard
Loeys-Dietz syndrome is a recently described autosomal dominant disorder with underlying vasculopathy characterized by aortic and other vascular aneurysmal dissection/rupture. A 61-year-old man is reported who died suddenly and unexpectedly and at autopsy was found to have a ruptured abdominal aortic aneurysm. Additional findings included dolichostenomelia, high-arched palate, and pectus excavatum. There was a strong family history of Loeys-Dietz syndrome, although the decedent had never been tested. Death was, therefore, due to a ruptured abdominal aortic aneurysm in a case of probable Loeys-Dietz syndrome...
February 23, 2017: Journal of Forensic Sciences
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