| Endovascular fenestration in aortic dissection with acute malperfusion syndrome: Immediate and late follow-up. | |
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MedLine Citation:
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PMID: 21683839 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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OBJECTIVE: To evaluate the immediate and long-term results of fenestration in aortic dissection with acute malperfusion syndrome. METHODS: Between 1999 and 2007, 35 patients (31 men; age, 57 ± 11 years) with aortic dissection (19 with type A and 16 with type B) were treated by fenestration for malperfusion syndrome (27 renal, 27 bowel, and 14 lower limb) due to dynamic compression. Fenestration was performed with 2 rigid guidewires inserted in one 8F sheath (45 cm long). The mean interval between aortic dissection and fenestration was 5 days (28 patients within 3 days and 7 patients between 9 and 41 days). RESULTS: Fenestration (100% technical success rate) with an additional endovascular procedure (29 peripheral stents and 1 thoracic stent graft) resulted in angiographic success in 97% of the patients. Bowel surgery was performed in 7 patients. Mortality within the first month (12/35) was related to bowel ischemia (n = 5), neurologic complications (n = 3), type A surgery (n = 2), and late treatment (n = 2). At a mean follow-up of 48 ± 30 months, 4 of the remaining 23 patients had died and 2 had withdrawn from the study. The diameter of the aorta, as measured using computed tomography/magnetic resonance imaging, remained stable in 12 of the remaining 17 patients and had increased in 5 (1 with Marfan syndrome and 4 with multiple arterial ectasia). CONCLUSIONS: In emergencies, fenestration saved 69% of the patients with acute malperfusion syndrome in complicated aortic dissection. During the follow-up period, the aortic diameter remained stable in most of the surviving patients. |
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Authors:
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Marco Midulla; Armelle Renaud; Thomas Martinelli; Mohammad Koussa; Claire Mounier-Vehier; Alain Prat; Jean-Paul Beregi |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Journal of thoracic and cardiovascular surgery Volume: 142 ISSN: 1097-685X ISO Abbreviation: J. Thorac. Cardiovasc. Surg. Publication Date: 2011 Jul |
Date Detail:
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Created Date: 2011-06-20 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0376343 Medline TA: J Thorac Cardiovasc Surg Country: United States |
Other Details:
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Languages: eng Pagination: 66-72 Citation Subset: AIM; IM |
Copyright Information:
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Copyright © 2011 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved. |
Affiliation:
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Department of CardioVascular Imaging and Intervention, Hôpital Cardiologique, CHRU de Lille, France. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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