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Gelpi G - - 2010
Hybrid aortic arch repair procedure was introduced to reduce invasiveness in high-risk patients with aortic arch pathology. The good results are expanding its application, but endoleak, particularly type I, remains its Achilles' heel. We describe our experience with hybrid treatment of aortic arch diseases focussing on techniques and results to ...
Werth Stephan Christian - - 2010
We report the case of a 69-year-old man presenting with a primary right lung cancer and a complete double aortic arch. An extended right pneumonectomy was successfully performed and the patient remained well at the one-year follow-up. We discuss the surgical approach and the technical considerations imposed by this rare ...
Agematsu Kota - - 2010
A 62-year-old man was brought to the emergency room of our hospital because of chest pain. Computed tomography revealed a right aortic arch and an aberrant left subclavian artery with Kommerell diverticulum and acute aortic dissection (Stanford type A). Total arch replacement was performed emergently through a median full sternotomy. ...
Erdoes Gabor - - 2010
We describe the case of a 23-year-old patient presenting for redo aortic arch surgery because of recoarctation and poststenotic aneurysm formation after patch aortoplasty in infancy. Using the hemi-clamshell approach, the entire aortic arch was replaced and the supraaortic branches were reimplanted. The applied surgical technique using hypothermic extracorporeal circulation ...
Sima L - - 2010
Gastroduodenal artery (GDA) aneurysm is a rare entity, comprising only 1.5% of all 3000 cases of visceral artery aneurysms that have been reported in literature. We report a case of a 55-year-old Caucasian man, diagnosed with right inguinal hernia. He was admitted to our department for surgical treatment. His medical ...
Oduncu Vecih - - 2010
Late stent thrombosis is very rare in bare metal stents. We report on a 72-year-old male patient who developed late thrombosis of a bare metal stent implanted in the left main coronary artery (LMCA). The patient presented with cardiogenic shock 350 days after the first stent implantation. Coronary angiography showed ...
Hickey Benjamin - - 2010
Penetrating aortic ulcers are frequently observed in the descending thoracic and abdominal aorta. They are uncommon in the aortic arch, and they are extremely rare in the major branches of the aorta. We present the case of a 71-year-old woman who presented with multiple penetrating aortic ulcers affecting both the ...
Bagur Rodrigo - - 2010
We present the case of an 80-year-old woman diagnosed with severe aortic stenosis and complex aortic atherosclerotic plaques who underwent transapical TAVI guided by transesophageal echocardiography and fluoroscopy with no catheter/wire manipulation across the aortic arch to avoid any systemic embolism.
Chen Xin - - 2010
The stented elephant trunk technique in aortic arch replacement combined with transaortic stented graft implantation into the descending aorta has been introduced as a means of eliminating the residual false lumen in the descending thoracic aorta and improving long-term outcomes of surgical intervention for Debakey I aortic dissection. This report ...
Ghosh Alakananda - - 2010
An 8-year-old boy developed a large aneurysm of the aortic arch after neonatal complete repair of interrupted aortic arch type B and closure of a perimembranous ventricular septal defect. To our knowledge, this unusual complication has not been previously reported in the English literature.
Yamashiro Satoshi - - 2010
The prevention of cerebral injury is an important consideration during the repair of an aortic arch aneurysm, and this is a major goal of cerebral protection techniques. We describe extended thoracic aortic aneurysms treated by use of our current surgical strategy. From January 2001 to June 2008, a total of ...
Kleinrok Andrzej - - 2010
Interrupted aortic arch is a rare and usually lethal malformation, representing approximately 1% of congenital heart disease. This presents as a missing segment of the aortic arch and is divided into three types: A-called extreme form of coarctation, and is characterized by disruption of aorta's continuity distal to the left ...
Hirata Yasutaka - - 2010
The neonatal repair of interrupted aortic arch and ventricular septal defect (IAA/VSD) presents a surgical challenge. Although one-stage repair has become well established, left ventricular outflow tract obstruction (LVOTO) continues to be an important factor affecting survival and reintervention rates after IAA/VSD repair. We investigated the relationship between the preoperative ...
Verin Anne-Laure - - 2010
Various malformations of the aortic arch and great vessels have been reported in the literature, which reflects the complexity of their embryologic development. Most of them are of incidental finding and remain asymptomatic but can be responsible for respiratory or digestive symptoms and be associated with congenital cardiac diseases. We ...
Malkawi Amir H - - 2010
To present a detailed description of aortic arch morphology in patients with aneurysm and dissection undergoing thoracic endovascular aortic repair (TEVAR). Morphological assessment of the aortic arch was performed in a consecutive series of patients undergoing TEVAR between November 2003 and April 2009. In the absence of standardized reporting criteria, ...
Solomon B - - 2010
Carotid artery stenting (CAS) remains a viable option for treating carotid artery lesions in high surgical risk patients. We retrospectively reviewed our experience in performing CAS in patients with complex aortic arch anatomy. The ''coronary technique'' uses an AL1 guiding catheter to engage the origin of the common carotid artery ...
Li Jian-Jun - - 2010
Acute total or subtotal occlusion of left main coronary artery (LMCA) is a catastrophic and mostly fatal event. Patients may present with cardiogenic shock and die whenever this event occurs. Survival is strongly dependent on the presence of collateral blood flow to the left coronary artery or a dominant right ...
Kanne Jeffrey P - - 2010
A number of congenital anomalies of the aortic arch complex can occur, ranging from asymptomatic normal variations in arch vessel branch pattern to symptomatic vascular rings, stenoses, and arch interruptions with a frequency ranging from 0.5% to 3.0%. A right aortic arch is present in 0.1% of the population and ...
Matalanis George - - 2011
The potential risks of deep hypothermic circulatory arrest in aortic arch surgery have been well documented. Antegrade cerebral perfusion may ameliorate brain injury but still involves variable periods of cerebral and visceral ischaemia. We describe a novel "branch-first continuous perfusion" technique which avoids both deep hypothermia and circulatory arrest. This ...
Nicolaou George - - 2010
Accurate positioning of thoracic endografts in the aortic arch and the proximal descending thoracic aorta can be difficult because of the tortuous arch anatomy and the hemodynamic forces therein. Adjunctive measures are necessary and include pharmacological interventions as well as rapid ventricular pacing and right-atrial-inflow occlusion. Endograft design advances have ...
Tshomba Yamume - - 2010
Retrograde type A dissection (RTAD) is not so uncommon after thoracic endovascular aortic repair of type B dissections, especially in the presence of connective tissue disorders. Risk of RTAD after thoracic endovascular aortic repair of nondissecting aneurysms has still to be clarified, mainly if proximal arch involvement requires hybrid repair ...
Sun LiZhong - - 2010
BACKGROUND: A conventional single-stage procedure, staged procedures, or debranching of the supraaortic vessels, followed by immediate transfemoral stenting of the aortic arch, have been introduced to treat chronic type B dissection with aortic arch involvement. The best method for surgical repair of chronic type B dissection with aortic arch involvement ...
Huber Christoph - - 2011
Objectives: One-stage repair of transposition of great arteries (TGA) and aortic arch obstruction (AAO) is currently advocated, but carries formidable surgical challenges. This report presents our experience and re-interventions for residual lesions over the last 10 years. Methods: Twenty-two patients (19.5±42.4 days; range 2-206; median 10 days, 3.5±0.6kg) diagnosed with ...
Tang Jingdong - - 2011
Using a defined angle T, which can be measured noninvasively using Doppler ultrasound, we aim to determine the location of the intimal breach in Stanford type B aortic dissection (AD) and estimate the risk of AD using that measurement. Our subjects included 86 healthy volunteers, 60 hypertensive patients, and 42 ...
Kalavrouziotis Dimitri - - 2011
A novel approach to the management of aortic arch aneurysm with an aberrant right subclavian artery (ARSA) is described. Construction of a Dacron graft with side arms adapted to the patient's arch anatomy allows for antegrade cerebral perfusion during circulatory arrest and revascularisation of the arch vessels. A long elephant-trunk ...
Tsagakis Konstantinos - - 2011
Arch replacement combined with antegrade stent grafting of the descending aorta represents a hybrid surgical approach for extensive thoracic aortic disease. This multicentre study evaluates the early results of this method in complex aortic dissection (AD). Retrospective data acquisition was achieved by institution of an international registry. A hybrid stent ...
Yamashiro Satoshi - - 2010
We describe total arch replacement after ascending aortic replacement for acute type II dissecting aneurysm with associated anomaly of the left vertebral artery. A female patient was recommended at 10 years of age after the initial operation because of an enlargement of the distal ascending aorta. Magnetic resonance angiography revealed ...
Troisi N - - 2010
AIM: Aim of this study was to retrospectively analyze the experience of a single center in the hybrid treatment of aortic arch aneurysms. METHODS: From January 2005 to August 2008 a hybrid treatment for complex aortic aneurysms (aortic arch, thoracoabdominal aorta or thoracic and abdominal segments at the same time) ...
Chamogeorgakis T P - - 2010
AIM: Prolonged cardio-pulmonary bypass (CPB) time, usually necessary for reoperations, is known to increase mortality in coronary bypass procedures and aortic reoperations. We investigated if prolonged CPB time and arch reconstruction in reoperations of the thoracic aorta affect in-hospital outcome. METHODS: Twenty-nine patients underwent reoperations on the thoracic aorta. The ...
Momma Kazuo - - 2010
Cardiovascular anomalies are present in 80% of neonates with 22q11.2 deletion syndrome. Three genes in chromosome 22q11.2 (TBX1, CRKL, and ERK2) have been identified whose haploinsufficiency causes dysfunction of the neural crest cell and anterior heart field and anomalies of 22q11.2 deletion syndrome. The most common diseases are conotruncal anomalies, ...
Nagashima Mitsugi - - 2010
We report the surgical case of an eight-year-old girl who had a very rare combination of ventricular septal defect and abnormal aortic arch anatomy: right cervical aortic arch, left descending aorta and Kommerell's diverticulum from which the left subclavian artery arose with anomalous subaortic left brachiocephalic vein. She was confirmed ...
Ito Yuzuru - - 2010
We describe a diabetic patient successfully treated for an acute mycotic aortic arch pseudoaneurysm with primary aldosteronism. The patient first complained of severe pain in the left upper extremity and left back with high C reactive protein (CRP) and high-grade fever. It was suspected that acute aortic dissection had developed ...
Krüger Tobias - - 2011
Thoracic mobile aortic mural thrombus (TAMT) of the aortic arch is a rare condition. We report 3 cases of symptomatic TAMT treated with systemic alteplase (tissue plasminogen activator [t-PA]) thrombolysis. The first patient was symptomatic with repetitive thromboembolism to the left brachial artery. She was treated with repetitive thrombolysis after ...
Geirsson Arnar - - 2010
Acute type A dissection is one of the most lethal conditions that surgeons encounter. Advances in surgical techniques and perioperative management have resulted in acceptable short- and long-term outcomes. Traditionally, the surgical approach involves a conservative extent of aortic arch resection. Recently, some groups have advocated a more aggressive approach ...
Baker-Smith Carissa M - - 2010
Aortic valve atresia with interruption of the aortic arch is an extremely rare anomaly; only eleven cases of this anomaly have been reported to date. In the absence of additional sources of blood flow to the ascending aorta, aortic valve atresia with interruption of the aortic arch is fatal. We ...
Elefteriades John A - - 2010
Straight deep hypothermic circulatory arrest (DHCA) is a technique available for brain preservation during deep hypothermic arrest in aortic arch replacement. In this article, the author discusses the practice of straight DHCA in his institute and the advantage of this technique over other brain preservation techniques.
Nardella J - - 2010
Endovascular repair of thoracic aorta pathology is emerging as the preferred treatment strategy in high risk patients. Hybrid techniques with debranching of the supra-aortic vessels extend indications for endovascular repair of the aortic arch and descending aorta. After a brief case-presentation, we describe these procedures, outline the indications and discuss ...
Chen Liang-Wan - - 2010
In total arch replacement for acute type A aortic dissection, the left subclavian artery anastomosis and the distal anastomosis at the descending aorta are often remarkably difficult because of the deep surgical field. We developed a single-branched stent graft that was constructed by adding a side arm stent-graft to a ...
Harrer Marieluise M Heart Center Hietzing, General Hospital Hietzing, Vienna, Austria. - - 2010
Near-infrared spectroscopy (NIRS) complements online monitoring of cerebral oxygenation during aortic arch surgery. Its addition targets at an increase of safety of a complex procedure employing bilateral antegrade cerebral perfusion (BACP) and circulatory arrest under tepid blood temperatures. We report the outcome of NIRS-guided aortic arch surgery using BACP with ...
Ferro Carlo - - 2011
The purpose of this report is to describe deployment of the Relay NBS Thoracic Stent Graft with the Plus Delivery System (Bolton Medical, Sunrise, FL) in a flexible resin arch model with a 15-mm radius curve as well as our preliminary clinical results. The Relay NBS graft with the Plus ...
Henaine Roland - - 2010
We outline the case of an 18-year-old male patient with a congenital nonoperated interruption of the aortic arch. A right thoracotomy without cardiopulmonary bypass facilitated repair through an extra-anatomic bypass between the ascending and the supradiaphragmatic descending aorta. Results for the immediate and 2-year radiologic and clinical check-up were satisfactory. ...
Ohsawa Ryo - - 2011
During the elective course of human dissection at the University of Toyama in 2007, we encountered a rare case of double aortic arch accompanied by sub- and pre-aortic left brachiocephalic veins (LBV), and anomalous origin and course of the left vertebral artery in a Japanese elderly female. The double aortic ...
Donas Konstantinos P - - 2010
We report our clinical experience with the use of a sutureless telescoping anastomosis, initially described as the VORTEC (Viabahn Open Rebranching TEChnique) revascularization technique, for debranching of supra-aortic vessels. Between May 2005 and December 2008, 20 patients (15 men) with an aortic arch lesion underwent trans-sternal debranching with sutureless telescoping ...
Kellenberger Christian J - - 2010
Although anomalies of the aortic arch and its branches are relatively uncommon malformations, they are often associated with congenital heart disease. Isolated lesions may be clinically significant when the airways are compromised by a vascular ring. In this article, the development and imaging appearance of the aortic arch system and ...
Tsagakis Konstantinos - - 2010
During hypothermic circulatory arrest (HCA), a briefly visible descending aorta is exposed, enabling direct vision to the surgeon. This study evaluated the impact of angioscopy on arch and descending aortic surgery for type A aortic dissection (AD). From December 2007 to March 2009, a flexible bronchovideoscope was used in 21 ...
Mortensen Kristian Havmand - - 2010
BACKGROUND: Ectatic aortopathy and arterial abnormalities cause excess morbidity and mortality in Turner syndrome, where a state of vasculopathy seemingly extends into the major head and neck branch arteries. OBJECTIVE: We investigated the prevalence of abnormalities of the major intrathoracic arteries, their interaction with arterial dimensions, and their association with ...
Adams Corey - - 2010
We report a case of a 52-year-old male who presented with acute leg ischemia and underwent successful femoral embolectomy and fasciotomies. Investigations revealed a pedunculated mass in the aortic arch, floating under the innominate and left common carotid arteries. Urgent resection was performed through a longitudinal aortotomy with deep hypothermic ...
Casteleyn Christophe - - 2010
Although the murine thoracic aorta and its main branches are widely studied to gain more insight into the pathogenesis of human vascular diseases, detailed anatomical data on the murine aorta are sparse. Moreover, comparative studies between mice and men focusing on the topography and geometry of the heart and aorta ...
Uchida Naomichi - - 2010
This study describes the long-term safety and effectiveness of extended aortic arch replacement with the frozen elephant trunk technique from our 12 years of experience. Between September 1997 and September 2008, 156 patients (mean age 67.9 years) with different pathologies from the aortic arch to the extended descending aorta in ...
Antoniou G A - - 2010
BACKGROUND: Aortic arch disease has conventionally been the domain of open surgical repair. Hybrid open and endovascular repair has evolved as an alternative, less invasive, treatment option with promising results. A systematic literature review and analysis of the reported outcomes was undertaken. METHODS: An Internet-based literature search using MEDLINE was ...
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