ASIAN CARDIOVASCULAR & THORACIC ANNALS最新文献

{"title":"How to treat type 1b endoleakage-extension, fEVAR, bEVAR, or open repair.","authors":"Ahmed F Khouqeer,&nbsp;Ginger M Etheridge,&nbsp;Joseph S Coselli,&nbsp;Vicente Orozco-Sevilla","doi":"10.1177/02184923221136705","DOIUrl":"10.1177/02184923221136705","url":null,"abstract":"<p><p>Thoracic endovascular aneurysm repair has been well described in the literature as a treatment for a wide range of thoracic aortic pathologies. As with any intervention, there remains a risk of an unfavorable outcome, including endoleak, a term used to describe unexpected blood flow between the stent-graft and the wall of the excluded aneurysm. Endoleaks cause pressurized enlargement of the aneurysmal sac and may lead to catastrophic outcomes such as rupture and death. Type 1b endoleak represents a distal landing zone that is compromised by retrograde blood flow. Moreover, there is a lack of data on type 1b endoleaks and its management options. With the increase in emerging endovascular techniques and technologies, endoleaks are more frequent. However, the management of endoleaks is not standardized among different centers. The purpose of this article is to provide an overview of type 1b endoleaks after thoracic endovascular aneurysm repair, current management options, and our experience.</p>","PeriodicalId":35950,"journal":{"name":"ASIAN CARDIOVASCULAR & THORACIC ANNALS","volume":"31 7","pages":"577-581"},"PeriodicalIF":0.7,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10183187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular solutions for abdominal aortic aneurysms: A comparative review of clinical outcomes with custom-made endografts.","authors":"Matti Jubouri,&nbsp;Kamran Hussain,&nbsp;Priyanshu Saha,&nbsp;Zaid M Alkhadire,&nbsp;Sven Zcp Tan,&nbsp;Damian M Bailey,&nbsp;Ian M Williams,&nbsp;Mohamad Bashir","doi":"10.1177/02184923221133956","DOIUrl":"https://doi.org/10.1177/02184923221133956","url":null,"abstract":"<p><strong>Background: </strong>The introduction of endovascular aortic repair has revolutionised the treatment of abdominal aortic aneurysms, replacing open surgical repair for the majority of elective cases due to its optimal morbidity and mortality. Several endovascular aortic repair stent grafts exist commercially, one of which is the Fenestrated Anaconda™ by Terumo Aortic which benefits from a very innovative design, unique custom-made approach and highly favourable results.</p><p><strong>Aims: </strong>The main scope of this narrative review is to provide a comprehensive overview of endovascular aortic repair clinical outcomes using the Fenestrated Anaconda™ stent-graft and comparing these with its market competitor, Zenith. This review will also examine the evidence in the literature on the Anaconda™'s custom-made approach.</p><p><strong>Methods: </strong>A comprehensive literature was conducted on several search engines including PubMed, Google Scholar, Ovid, Scopus and Embase to collate the evidence in the literature on clinical outcomes achieved with the Fenestrated Anaconda™ and Zenith including, but not limited to, survival, technical success, target vessel patency, endoleak, reintervention and aneurysm sac regression.</p><p><strong>Results: </strong>The Fenestrated Anaconda™ is associated with excellent results, including highly favourable survival, technical and clinical success and target vessel patency rates, very low need for reintervention or conversion, and minimal incidence of complications such as endoleak and endograft migration. The Fenestrated Anaconda™ also drives significant sac regression and aortic remodelling. In addition, its unique custom-made approach enables it to treat highly complex aortic anatomy as well as to 'rescue' failed competitor grafts.</p><p><strong>Conclusion: </strong>The Fenestrated Anaconda™ has proven that it is a very safe, highly applicable and extremely effective device used for complex aortic and/or iliac pathology based on its novel design and outstanding track record of clinical outcomes.</p>","PeriodicalId":35950,"journal":{"name":"ASIAN CARDIOVASCULAR & THORACIC ANNALS","volume":"31 7","pages":"565-576"},"PeriodicalIF":0.7,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10190309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"International RELAY^®, branched outcomes - designed to respect and repair the thoracic aorta: A comparative analysis between double and triple branched configurations.","authors":"Sidhant Singh,&nbsp;Abedalaziz O Surkhi,&nbsp;Callum Howard,&nbsp;Giovanni Mariscalco","doi":"10.1177/02184923231160697","DOIUrl":"https://doi.org/10.1177/02184923231160697","url":null,"abstract":"<p><strong>Background: </strong>Endovascular aortic arch repair (EAR) has emerged as an alternative to open surgical repair. A growing interest in endovascular repair techniques for aortic arch aneurysms and dissection has been met with a focus on the clinical efficacy of EAR devices. We present multicentre comparative data on the clinical outcomes associated with EAR using the double- and triple-branched configurations of the RELAY™ (Terumo Aortic, Scotland, UK) endograft.</p><p><strong>Methods: </strong>Multicentre data on EAR procedures, carried out from January 2019 to January 2022, using the double- and triple-branched RELAY™ endograft were collected prospectively. Follow-up data were collected at 30 days, 6 months, 12 months, and 24 months postoperative. Retrospective descriptive analysis, logistic regression, and Kaplan-Meier analysis were carried out on procedural and follow-up data.</p><p><strong>Results: </strong>A total of 131 patients were included in the series. In total, 103 and 28 patients were treated with the double-branched and triple-branched RELAY™ endograft, respectively. Over the 24-month follow-up period, zero mortality, cases of stroke, or reinterventions were recorded in the triple-branched group. Four mortalities, 19 disabling strokes, and 50 reinterventions were recorded in the double-branched group within 30 postoperative days. Target vessel patency was maintained in all patients in the triple-branched group, while vessel patency was maintained in 74.0% of patients in the double-branched group.</p><p><strong>Conclusion: </strong>Outcomes associated with the triple-branched group are consistent with those reported in the literature. Our data suggest that EAR with the RELAY™ endograft is associated with favourable clinical outcomes and clinical efficacy. Further comparative research into EAR devices is needed.</p>","PeriodicalId":35950,"journal":{"name":"ASIAN CARDIOVASCULAR & THORACIC ANNALS","volume":"31 7","pages":"624-632"},"PeriodicalIF":0.7,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10545102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular aortic arch repair: A comparison of outcomes and current trends.","authors":"Sven Zcp Tan,&nbsp;Matti Jubouri,&nbsp;Mohamad Bashir","doi":"10.1177/02184923221140756","DOIUrl":"https://doi.org/10.1177/02184923221140756","url":null,"abstract":"<p><strong>Objective: </strong>Application of thoracic endovascular aortic repair (TEVAR) to the aortic arch has been met with the development of purpose-made endoprostheses for on-label use in the aortic arch. An appraisal of the clinical efficacy of each major device is therefore useful towards informing clinical decision making for patients eligible for endovascular arch repair (EAR) rather than open surgical reconstruction.</p><p><strong>Methods: </strong>A literature review of publications outlining clinical experience with the RELAY™ Branched and Zenith™ devices was undertaken, and the results therefrom analysed to evaluate the clinical efficacies of each device.</p><p><strong>Results: </strong>Early- and long-term mortality rates associated with EAR appear favourable, especially compared against open surgical repair. EAR is also associated with good neurological outcomes and target vessel patency rates. However, EAR continues to be associated with substantial reintervention rates.</p><p><strong>Conclusions: </strong>At the present stage, EAR represents a promising alternative option to open surgical reconstruction in patients that meet its eligibility criteria. Though there remains a substantial learning curve associated with EAR, its favourable outcome profile is likely to increase its applicability in the future.</p>","PeriodicalId":35950,"journal":{"name":"ASIAN CARDIOVASCULAR & THORACIC ANNALS","volume":"31 7","pages":"589-595"},"PeriodicalIF":0.7,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10563110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mitral valve surgery in octogenarians: Identifying factors that can guide clinical decision-making.","authors":"Dionysios Pavlopoulos,&nbsp;Konstantinos S Mylonas,&nbsp;Dimitrios Avgerinos,&nbsp;Konstantinos Petsios,&nbsp;George Samanidis,&nbsp;Sotirios Katsaridis,&nbsp;Konstantinos Perreas","doi":"10.1177/02184923231187681","DOIUrl":"https://doi.org/10.1177/02184923231187681","url":null,"abstract":"<p><strong>Background: </strong>Mitral valve surgery in octogenarians is a clinical challenge due to the impact of inherent, age-related comorbidities. Within the context of an aging population, the number of mitral surgery candidates over 80 has been gradually increasing. We sought to evaluate our institutional experience with mitral valve surgery in octogenarians to identify factors that may prove useful during the process of clinical decision-making.</p><p><strong>Methods: </strong>We retrospectively reviewed our institutional database for all patients over 80 years of age who underwent mitral valve surgery in our department from October 2002 up to February 2021. The primary endpoints of our study were 30-day all-cause mortality and long-term survival after the first postoperative month.</p><p><strong>Results: </strong>In total, 99 octogenarians underwent mitral valve surgery for various types of mitral pathology. In particular, 70 patients underwent mitral valve replacement with or without concomitant procedures and 29 underwent mitral valve repair with or without concomitant procedures. There was no difference between the two approaches in terms of 30-day mortality and long-term survival. Chronic kidney disease and total operative time were independent predicting factors for 30-day mortality. Etiology of mitral valve pathology and EuroSCORE II was independent predicting factors for long-term survival.</p><p><strong>Conclusions: </strong>The type of mitral valve surgery did not affect 30-day and long-term mortality rates in our study. Renal impairment and EuroSCORE II were independent predictors of 30-day mortality and long-term prognosis, respectively. Rheumatic valve disease was also associated with a poorer prognosis.</p>","PeriodicalId":35950,"journal":{"name":"ASIAN CARDIOVASCULAR & THORACIC ANNALS","volume":"31 6","pages":"498-505"},"PeriodicalIF":0.7,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10214562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Type IIa endoleak in thoraflex hybrid stent-graft for frozen elephant trunk operation.","authors":"Suvitesh Luthra,&nbsp;Geoffrey M Tsang","doi":"10.1177/02184923231186766","DOIUrl":"https://doi.org/10.1177/02184923231186766","url":null,"abstract":"A 55-year-old hypertensive woman presented 6 years ago with an uncomplicated Stanford type B acute aortic dissection (SVS/STS acute type B3,10) managed conservatively. Follow-up computed tomography scans showed progressive aneurysmal dilatation of zone 3 (63 mm) and zone 4–10 (47 mm) with retrograde extension into arch (non A–non B extension in Stanford type B, SVS/STS chronic type B2,10) (Figure 1). She underwent a frozen elephant trunk operation with 26/28F, 150 mm hybrid stent graft (Thoraflex THP2628X150B, Vascutek, Inchinnan, Scotland) with an uneventful recovery. Postoperative scan (day 7) confirmed false lumen obliteration around stent-graft, good placement and distal seal of endostent (Figure 1B). She represented 1 month later with breathlessness and anemia (haemoglobin 88 gm%). Computed tomography scan showed large zone 2/3 collection (Figure 1C, 1D) with contrast extravasation between the aortic wall and stent endograft with type IIa endoleak (retroleak from a large 3 intercostal artery) (Figure 2A, 2B). She was managed conservatively and remained stable. Subsequent serial scans showed no extravasation, stable size and thrombosis of the sac.","PeriodicalId":35950,"journal":{"name":"ASIAN CARDIOVASCULAR & THORACIC ANNALS","volume":"31 6","pages":"519-520"},"PeriodicalIF":0.7,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9858698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left bronchial compression after aortic arch reconstruction for coarctation of the aorta.","authors":"Kazuhiko Ishimaru,&nbsp;Shigemitsu Iwai","doi":"10.1177/02184923231186915","DOIUrl":"https://doi.org/10.1177/02184923231186915","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate the preoperative positional relationships between the blood vessels and the left bronchus during the development of left bronchial compression (LBC) after aortic arch reconstruction for coarctation of the aorta (CoA).</p><p><strong>Methods: </strong>We retrospectively reviewed data from 29 patients with CoA who underwent aortic arch reconstruction via median sternotomy between 2009 and 2019. The patients were divided into those who underwent aortic arch advancement (AAA) with (C group, six patients) or without (N group, 10 patients) postoperative LBC and those who underwent extended end-to-end anastomosis (E group, 13 patients). We determined the sterno-spinal axis (SSA) of the patients and evaluated the preoperative and postoperative positions of the vessels on the axial and three-dimensional multidetector row computed tomography (CT) angiographic images.</p><p><strong>Results: </strong>The distance between the ascending and descending aortas was significantly smaller in both C and N groups postoperatively than preoperatively. The distance between the descending aorta and SSA in the C group was markedly smaller compared with that in the other groups preoperatively and was increased postoperatively. Preoperatively, the distance from the left bronchus to the aortic arch in the C group was significantly larger than that in the other groups and was decreased postoperatively. The postoperative arch angle in the C group was significantly smaller than that in the other groups.</p><p><strong>Conclusion: </strong>A preoperative midline position of the descending aorta and highly displaced aortic arch in relation to the left bronchus on preoperative CT images could cause the postoperative LBC after AAA.</p>","PeriodicalId":35950,"journal":{"name":"ASIAN CARDIOVASCULAR & THORACIC ANNALS","volume":"31 6","pages":"483-490"},"PeriodicalIF":0.7,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10214570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative outcomes of percutaneous transvenous mitral commissurotomy between low and high Wilkins score.","authors":"Mohammad Alidoosti,&nbsp;Babak Sattartabar,&nbsp;Hamidreza Pourhoseini,&nbsp;Mojtaba Salarifar,&nbsp;Ebrahim Nematipour,&nbsp;Alimohammad Hajizeinali,&nbsp;Hassan Aghajani,&nbsp;Alireza Amirzadegan,&nbsp;Fateme Baharvand","doi":"10.1177/02184923231187052","DOIUrl":"https://doi.org/10.1177/02184923231187052","url":null,"abstract":"<p><strong>Background: </strong>Percutaneous transvenous mitral commissurotomy (PTMC) is one of the non-surgical methods for patients with significant mitral stenosis. It is less invasive, less complicating with better outcomes compared to surgery. The Wilkins score ≤8 is used to select patients for PTMC, but the results of several studies suggest that PTMC can also be successful in a higher Wilkins score. The aim of this study is to compare the outcomes of PTMC between two groups.</p><p><strong>Methods: </strong>In this retrospective study, patients who underwent PTMC between April 2011 and December 2019 were included. Patients were divided into two groups based on Wilkins score: 196 patients (57.64%) with a Wilkins score ≤8 (group I) and 134 patients (39.4%) with a Wilkins score >8 (group II).</p><p><strong>Results: </strong>There was no difference in demographic characteristics between two groups except for age (<i>p</i> = 0.04). Pre and post-interventional echocardiographic and catheterization measurements including left atrial pressure, pulmonary artery pressure, mitral valve area, mitral valve mean, and peak gradient were measured, and there was no difference between the two groups (<i>p</i> > 0.05). The most common complication was mitral regurgitation (MR). Serious complications such as stroke and arrhythmias were rare in both groups (<1%). There was no difference between MR, ASD (atrial septal defect) and serious complications between the two groups.</p><p><strong>Conclusion: </strong>This study shows that the Wilkins score with a cutoff value of 8 is not suitable for patient selection and novel criteria including both mitral valve features and other variables affecting the PTMC outcomes is needed.</p>","PeriodicalId":35950,"journal":{"name":"ASIAN CARDIOVASCULAR & THORACIC ANNALS","volume":"31 6","pages":"491-497"},"PeriodicalIF":0.7,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10233528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronary bronchial fistula - A rare incidental finding.","authors":"Sourabh Goswami,&nbsp;Surender Deora,&nbsp;Rengarajan Rajagopal,&nbsp;Smily Sharma","doi":"10.1177/02184923231187842","DOIUrl":"https://doi.org/10.1177/02184923231187842","url":null,"abstract":"<p><p>Coronary fistulas are unusual finding in coronary angiography (CAG) with coronary bronchial fistula (CBF) being a rarer one. Here, we represent a case of CBF which was diagnosed incidentally on CAG. These anomalous connections can be percutaneously treated.</p>","PeriodicalId":35950,"journal":{"name":"ASIAN CARDIOVASCULAR & THORACIC ANNALS","volume":"31 6","pages":"521-523"},"PeriodicalIF":0.7,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9847514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of nodal staging by 18F-FDG-PET/CT in limited disease small-cell lung cancer.","authors":"Jan Hockmann,&nbsp;Hubertus Hautzel,&nbsp;Kaid Darwiche,&nbsp;Wilfried Eberhard,&nbsp;Martin Stuschke,&nbsp;Clemens Aigner,&nbsp;Ken Herrmann,&nbsp;Till Plönes","doi":"10.1177/02184923231187279","DOIUrl":"https://doi.org/10.1177/02184923231187279","url":null,"abstract":"<p><strong>Background: </strong>Small-cell lung cancer (SCLC) is highly aggressive with a nearly incurable disease in most cases. The most important prognostic factor is the status of the mediastinal lymph nodes. Only a small proportion of patients can be diagnosed at early stages and directed to curative multimodal treatment. Therefore, accuracy of nodal staging by (18F)-Fluoro-2-deoxyglucose (FDG) positron emission tomography (PET) computed tomography (18F-FDG-PET/CT) in (very) limited disease SCLC, although not well investigated, is highly important.</p><p><strong>Methods: </strong>Treatment naive, non-bulky patients treated or diagnosed with SCLC between June 2012 and April 2020 with complete data including FDG-PET/CT and invasive mediastinal staging were retrospectively analyzed (<i>n</i> = 19). Sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV) and accuracy of mediastinal lymph node staging of 18F-FDG-PET/CT was calculated.</p><p><strong>Results: </strong>The FDG-PET/CT showed a sensitivity of 91%, and the specificity was calculated as 87.5%. In this cohort, the disease prevalence in lymph nodes was 58% (<i>n</i> = 11). Positive predictive value was 91%, NPV 88% and accuracy calculated at 89%. One patient was upstaged from single-level N2 to multilevel N2. In one patient, upstaging in invasive staging was performed from N2 to N3, and one patient was downstaged from N1 to N0.</p><p><strong>Conclusions: </strong>FDG-PET/CT is a valuable tool for the detection of distant metastases, but in mediastinal staging of SCLC some limitations might remain. Invasive methods remain the gold standard. Therefore, the mediastinal lymph nodal status of patients with SCLC screened for multimodal treatment should be further evaluated by additional invasive techniques to verify the exact N-staging and to optimize treatment stratification.</p>","PeriodicalId":35950,"journal":{"name":"ASIAN CARDIOVASCULAR & THORACIC ANNALS","volume":"31 6","pages":"506-511"},"PeriodicalIF":0.7,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10363929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10227576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}