AORTA最新文献

{"title":"Outcomes Post-Nick's Aortic Root Enlargement Technique: Single-Center Experience.","authors":"Amr Ashry,&nbsp;Sashini Iddawela,&nbsp;Vaibhav Mishra,&nbsp;William Wang,&nbsp;Heba M Mohammed,&nbsp;Amer Harky,&nbsp;Mohammed M Mostafa","doi":"10.1055/s-0042-1757800","DOIUrl":"https://doi.org/10.1055/s-0042-1757800","url":null,"abstract":"<p><strong>Background: </strong> Different techniques for aortic root enlargement (ARE) have been reported in the literature. Each technique comes with its own advantages and disadvantages. We report our outcomes of Nick's technique for ARE.</p><p><strong>Methods: </strong> A single-center retrospective data analysis of 31 patients was performed. Patients were operated between May 2015 and November 2017 at Assuit University Heart Hospital, Assuit, Egypt.</p><p><strong>Results: </strong> The median cardiopulmonary bypass time was 125 minutes (range: 90.0-160.0 minutes), with 90 minutes of cross-clamp (range: 60.0-110.0 minutes). Altogether 59% of the patients had mixed aortic valve diseases. Median intensive care unit and total hospital stay were 2 and 5 days, respectively. Patient-prosthesis mismatch was reported in one patient only (3.25%). Two patients died within 30 days. Median pressure gradient across the aortic valve was 20 mm Hg at 3 years of follow-up.</p><p><strong>Conclusion: </strong> The benefits of Nick's technique for ARE can be demonstrated in populations with younger patients and complicated pathology. Further research is required in larger patient populations.</p>","PeriodicalId":52392,"journal":{"name":"AORTA","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9767773/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10419541","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}

{"title":"The Secret behind Extreme Hypoxia Tolerance: A \"Slow-Growth\" Thoracoabdominal Aneurysm.","authors":"Carlo Olevano,&nbsp;Giuliano Gagliardi,&nbsp;Mollo Antonio,&nbsp;Santaniello Eugenio,&nbsp;Loris Flora,&nbsp;Emilio Di Lorenzo,&nbsp;Brenno Fiorani","doi":"10.1055/s-0042-1757796","DOIUrl":"https://doi.org/10.1055/s-0042-1757796","url":null,"abstract":"<p><p>A 61-year-old man presented to our institution complaining of back pain. Breathing was comfortable. An arterial blood gas showed extreme hypoxia causing chronic respiratory alkalosis. Further investigations revealed aneurysmal dilatation of the ascending aorta and the Crawford Type II thoracoabdominal aneurysm, with compression of both the left main bronchus and the right pulmonary artery. The patient was managed with a two-stage hybrid surgical approach comprising total arch replacement using the frozen elephant trunk technique followed by endovascular repair.</p>","PeriodicalId":52392,"journal":{"name":"AORTA","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9767754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10423504","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}

{"title":"Cerebrospinal Fluid Drainage for Prevention of Spinal Cord Ischemia in Thoracic Endovascular Aortic Surgery-Pros and Cons.","authors":"Hesham Ellauzi, Harendra Arora, John A Elefteriades, Mohammad A Zaffar, Rama Ellauzi, Wanda M Popescu","doi":"10.1055/s-0042-1757792","DOIUrl":"10.1055/s-0042-1757792","url":null,"abstract":"<p><p>Thoracic endovascular aortic repair (TEVAR) carries a risk of spinal cord ischemia (SCI) which exerts a devastating impact on patient's quality of life and life expectancy. Although routine prophylactic cerebrospinal fluid (CSF) drainage is not unequivocally supported by current data, several studies have demonstrated favorable outcomes. Patients at high risk for SCI following TEVAR likely will benefit from prophylactic CSF drains. However, the intervention is not risk free, and thorough risk/benefit analysis should be individualized to each patient.</p>","PeriodicalId":52392,"journal":{"name":"AORTA","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9767776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9163673","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}

{"title":"Replacement of a Calcified Aortic Valve in a Porcine Aortic Root with the Perceval Sutureless Bioprosthesis.","authors":"Giosuè Falcetta,&nbsp;Federico Del Re,&nbsp;Stefano Pratali,&nbsp;Uberto Bortolotti","doi":"10.1055/s-0042-1757795","DOIUrl":"https://doi.org/10.1055/s-0042-1757795","url":null,"abstract":"<p><p>We report a 79-year-old patient who had aortic valve replacement (AVR) using a porcine aortic root. Due to degeneration of the porcine aortic valve, he required reoperation during which a heavily calcified porcine root and aortic annulus prevented insertion of any traditional bioprosthesis. AVR was achieved using a sutureless bioprosthesis, combined with mitral valve replacement. The present case confirms the feasibility and advantages of using sutureless valve implantation in complex and high-risk redo procedures.</p>","PeriodicalId":52392,"journal":{"name":"AORTA","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9767758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10423502","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}

{"title":"Intraoperative Finding of Anomalous Circumflex Artery Origin in the Dissected Right Coronary Ostium.","authors":"Makoto Mori,&nbsp;Andrea Amabile,&nbsp;Prashanth Vallabhajosyula","doi":"10.1055/s-0042-1750412","DOIUrl":"https://doi.org/10.1055/s-0042-1750412","url":null,"abstract":"<p><p>Anomalous origin of the left circumflex artery is a rare anatomical variant that may present a unique challenge in emergent aortic surgery.</p>","PeriodicalId":52392,"journal":{"name":"AORTA","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9767752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9170270","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}

{"title":"Fulminant Herpes Pneumonia Postaortic Surgery with Known Ankylosing Spondylitis.","authors":"Nicole Asemota,&nbsp;Ikenna David Ike,&nbsp;Aung Ye Oo,&nbsp;Ana Lopez-Marco","doi":"10.1055/s-0042-1757791","DOIUrl":"https://doi.org/10.1055/s-0042-1757791","url":null,"abstract":"<p><p>Herpes simplex virus (HSV) pneumonitis is rare after cardiac surgery. A 36-year-old gentleman with ankylosing spondylitis underwent emergency surgery for a complex aortic aneurysmal disease. Preoperative treatment of aortitis with antitumor necrosis factor and steroid medication and surgical stress including cardiopulmonary bypass potentially created an immunosuppressive state and reactivation of undiagnosed HSV. Rapid HSV pneumonia ensued, culminating in fulminant organ failure and mortality. HSV pneumonia should be considered postoperatively in patients with severe respiratory distress, especially if immunocompromised.</p>","PeriodicalId":52392,"journal":{"name":"AORTA","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9767785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10419538","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}

{"title":"Evaluating the Effectiveness of Stenting for Aortic Coarctation.","authors":"Constantinos Contrafouris,&nbsp;Constantine N Antonopoulos,&nbsp;Spyridon Rammos,&nbsp;Meletios Kanakis,&nbsp;Konstantinos Petsios,&nbsp;John D Kakisis,&nbsp;George Geroulakos","doi":"10.1055/s-0042-1750097","DOIUrl":"https://doi.org/10.1055/s-0042-1750097","url":null,"abstract":"<p><strong>Background: </strong> Coarctation of the aorta (CoA) is a congenital cardiovascular malformation involving narrowing of the thoracic aorta just distal to the left subclavian artery. The aim of our study was to evaluate the hemodynamic effects of endovascular treatment for CoA by using invasive aortic catheterization.</p><p><strong>Methods: </strong> All patients with CoA who underwent treatment by aortic stent implantation between September 1, 2003, and February 1, 2019, at the \"Onassis Cardiac Surgery Center,\" in Athens, Greece, were evaluated. Patients were treated with either bare (uncovered) Cheatham-Platinum (bCP) or covered Cheatham-Platinum (cCP) stent implantations. Invasive aortic pressure measurements were recorded before and after the endovascular intervention.</p><p><strong>Results: </strong> A total of 48, eight zig CP stents, comprising 24 bCP and 24 cCP stents were implanted in 47 patients. The mean aortic diameter (mm) at the CoA lesion increased from 9.7 ± 3.3 to 19.2 ± 2.9 mm (<i>p</i> <0.01) after the endovascular procedure. The invasive mean blood pressure (BP; mm Hg) from catheterization in the descending aorta increased (before = 114.2 ± 12.8 vs. after = 135.5 ± 28.1; <i>p</i> <0.01), while the invasive mean BP (mm Hg) from catheterization in the ascending aorta was decreased (before = 156.8 ± 25.0 vs. after = 138.4 ± 27.5; <i>p</i> <0.01) after the intervention. The mean aortic BP gradient decreased in both types of stents after intervention (BP gradient among patients with cCP stents = 30.9 +/- 23.6 mmHg and BP gradient among patients with bCP stents = 38.0 +/-23.1 mmHg). However, there was no statistically significant difference between the two types of stents; <i>p</i> = 0.36.</p><p><strong>Conclusions: </strong> Invasive aortic catheterization provided evidence that endovascular stenting with either bare or covered stents is efficient in treating patients with CoA.</p>","PeriodicalId":52392,"journal":{"name":"AORTA","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9767786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10419085","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}

{"title":"Penetrating Aortic Injury due to Broken Ribs and Preventive Measures.","authors":"Youichi Yanagawa,&nbsp;Hiroki Nagasawa,&nbsp;Kouhei Ishikawa,&nbsp;Shunki Hirayama,&nbsp;Akira Itoi,&nbsp;Atsuhiko Mogami","doi":"10.1055/s-0042-1757946","DOIUrl":"https://doi.org/10.1055/s-0042-1757946","url":null,"abstract":"<p><p>We herein report two cases of patients that underwent prophylactic operations to prevent aortic injuries in association with fractured ribs. Penetrating aortic injuries induced by fractured ribs remain fatal. Prophylactic operations appear effective. However, the indication for such operations should be clarified further in the future.</p>","PeriodicalId":52392,"journal":{"name":"AORTA","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9767755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10478878","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}

{"title":"Applications of Three-Dimensional Printing in the Management of Complex Aortic Diseases.","authors":"Paolo Magagna,&nbsp;Andrea Xodo,&nbsp;Mirko Menegolo,&nbsp;Carlo Campana,&nbsp;Luciano Ghiotto,&nbsp;Loris Salvador,&nbsp;Franco Grego","doi":"10.1055/s-0042-1750410","DOIUrl":"https://doi.org/10.1055/s-0042-1750410","url":null,"abstract":"<p><p>The use of three-dimensional (3D) printing is gaining considerable success in many medical fields, including surgery; however, the spread of this innovation in cardiac and vascular surgery is still limited. This article reports our pilot experience with this technology, applied as an additional tool for 20 patients treated for complex vascular or cardiac surgical diseases. We have analyzed the feasibility of a \"3D printing and aortic diseases project,\" which helps to obtain a more complete approach to these conditions. 3D models have been used as a resource to improve preoperative planning and simulation, both for open and endovascular procedures; furthermore, real 3D aortic models were used to develop doctor-patients communication, allowing better knowledge and awareness of their disease and of the planned surgical procedure. A 3D printing project seems feasible and applicable as an adjunctive tool in the diagnostic-therapeutic path of complex aortic diseases, with the need for future studies to verify the results.</p>","PeriodicalId":52392,"journal":{"name":"AORTA","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9767784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10419086","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}

{"title":"Retroperitoneal Compared to Transperitoneal Approach for Open Abdominal Aortic Aneurysm Repair Is Associated with Reduced Systemic Inflammation and Postoperative Morbidity.","authors":"Damian M Bailey,&nbsp;George A Rose,&nbsp;Daniel O'Donovan,&nbsp;Dafydd Locker,&nbsp;Ian R Appadurai,&nbsp;Richard G Davies,&nbsp;Richard J Whiston,&nbsp;Mohamad Bashir,&nbsp;Michael H Lewis,&nbsp;Ian M Williams","doi":"10.1055/s-0042-1749173","DOIUrl":"https://doi.org/10.1055/s-0042-1749173","url":null,"abstract":"<p><strong>Background: </strong> In the United Kingdom, the most common surgical approach for repair of open abdominal aortic aneurysms (AAAs) is transperitoneal (TP). However, retroperitoneal (RP) approach is favored in those with more complex vascular anatomy often requiring a cross-clamp on the aorta superior to the renal arteries. This study compared these approaches in patients matched on all major demographic, comorbid, anatomic, and physiological variables.</p><p><strong>Methods: </strong> Fifty-seven patients (TP: <i>n</i> = 24; RP: <i>n</i> = 33) unsuitable for endovascular aneurysm repair underwent preoperative cardiopulmonary exercise testing prior to open AAA repair. The surgical approach undertaken was dictated by individual surgeon preference. Postoperative mortality, complications, and length of hospital stay (LoS) were recorded. Patients were further stratified according to infrarenal (IR) or suprarenal/supraceliac (SR/SC) surgical clamping. Systemic inflammation (C-reactive protein) and renal function (serum creatinine and estimated glomerular filtration rate) were recorded.</p><p><strong>Results: </strong> Twenty-three (96%) of TP patients only required an IR clamp compared with 12 (36%) in the RP group. Postoperative systemic inflammation was lower in RP patients (<i>p</i> = 0.002 vs. TP) and fewer reported pulmonary/gastrointestinal complications whereas renal impairment was more marked in those receiving SR/SC clamps (<i>p</i> < 0.001 vs. IR clamp). RP patients were defined by lower LoS (<i>p</i> = 0.001), while mid-/long-term mortality was low/comparable with TP, resulting in considerable cost savings.</p><p><strong>Conclusion: </strong> Despite the demands of more complicated vascular anatomy, the clinical and economic benefits highlighted by these findings justify the more routine adoption of the RP approach for complex AAA repair.</p>","PeriodicalId":52392,"journal":{"name":"AORTA","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9767756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10478877","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}