One-stage repair with separated cardiopulmonary bypass for coarctation of the aorta with left aortic arch and right thoracic descending aorta

2012 ◽  
Vol 60 (9) ◽  
pp. 575-577
Author(s):  
Masatoshi Shimada ◽  
Takaya Hoashi ◽  
Koji Kagisaki ◽  
Tatsuya Oda ◽  
Isao Shiraishi ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Aortic Arch ◽  
Coarctation Of The Aorta ◽  
Descending Aorta ◽  
One Stage

Type B Interrupted Aorta in an Adult Patient

2014 ◽  
Vol 17 (2) ◽  
pp. 80
Author(s):  
Ahmet Ozkara ◽  
Mehmet Ezelsoy ◽  
Levent Onat ◽  
Ilhan Sanisoglu
Keyword(s):  
Cardiopulmonary Bypass ◽  
Aortic Arch ◽  
Collateral Circulation ◽  
Neonatal Period ◽  
Interrupted Aortic Arch ◽  
Complete Loss ◽  
Posterolateral Thoracotomy ◽  
Type B ◽  
Case Presentation ◽  
Descending Aorta

<p><b>Introduction:</b> Interrupted aortic arch is a rare congenital malformation characterized by a complete loss of luminal continuity between the ascending and descending aorta. It is often diagnosed during the neonatal period.</p><p><b>Case presentation:</b> We presented a 51-year-old male patient with interrupted aortic arch type B who was treated successfully with posterolateral thoracotomy without using cardiopulmonary bypass.</p><p><b>Conclusion:</b> The prognosis for interrupted aortic arch depends on the associated congenital anomalies, but the outcome is usually very poor unless there is surgical treatment. Survival into adulthood depends on the development of collateral circulation.</p>

Transcatheter mechanical thrombectomy of neonatal occlusive aortic thrombus using an Amplatzer Piccolo PDA occluder

2021 ◽  
pp. 1-3
Author(s):  
Christopher Herron ◽  
Stuart Covi ◽  
Athina Pappas ◽  
Daisuke Kobayashi
Keyword(s):  
Aortic Arch ◽  
Critical Condition ◽  
Mechanical Thrombectomy ◽  
Coarctation Of The Aorta ◽  
Premature Neonate ◽  
Interrupted Aortic Arch ◽  
Thromboembolic Events ◽  
Descending Aorta ◽  
Aortic Thrombus

Abstract Neonatal aortic thrombus is a rare and critical condition that can present mimicking severe coarctation of the aorta or interrupted aortic arch. Transcatheter thrombectomy for this lesion has not been well described. We report a premature neonate with an occlusive proximal descending aorta thrombus, who underwent transcatheter mechanical thrombectomy using an Amplatzer Piccolo PDA occluder (Abbott, North Chicago, IL, USA). The procedure was successful with no subsequent distal thromboembolic events.

Abnormal histology of the aortic arch in coarctation of the aorta

1993 ◽  
Vol 3 (4) ◽  
pp. 412-416 ◽  
Author(s):  
Derk W. Wolterbeek ◽  
Arie P. Kappetein ◽  
Adriana C. Gittenberger–de Groot
Keyword(s):  
Neural Crest ◽  
Aortic Arch ◽  
Aortic Coarctation ◽  
Coarctation Of The Aorta ◽  
Lower Number ◽  
Descending Aorta ◽  
Aortic Isthmus ◽  
Cardiac Neural Crest ◽  
The Media

SummaryWe examined the number of elastic lamellae in the wall of the proximal aortic arch, aortic isthmus and descending aorta in patients with coarctation of the aorta. In the proximal aortic arch, the number of elastic lamellae was significantly lower in patients with coarctation compared to those with normal hearts without aortic anomalies and those with intracardiac defects but without aortic anomalies. The isthmus also showed a significantly lower number of elastic lamellae in the presence of preductal coarctation. In the descending aorta, the number of elastic lamellae was not significantly different between the different groups. There is doubt about the etiology of coarctation. Recent investigations showed that cells from the cardiac neural crest contribute to the formation of the arch arteries and the media of the arch. A developmental error of the neural crest might be responsible for the abnormal mural structures found in patients with aortic coarctation.

scholarly journals One-stage repair of aberrant left brachiocephalic artery and coarctation of the aorta in right aortic arch

2013 ◽  
Vol 17 (2) ◽  
pp. 444-446 ◽  
Author(s):  
Fabrizio Gandolfo ◽  
Sonia B. Albanese ◽  
Aurelio D.M. Secinaro ◽  
Adriano Carotti
Keyword(s):  
Aortic Arch ◽  
Coarctation Of The Aorta ◽  
Right Aortic Arch ◽  
Brachiocephalic Artery ◽  
One Stage

A rare combination of post-ductal coarctation of the aorta and adjunct tortuous aneurysm: a neonate with Posterior fossa anomalies, Haemangiomas of the head and neck, Arterial, Cardiovascular, and Eye anomalies and ventral developmental defect syndrome

2022 ◽  
pp. 1-3
Author(s):  
Otohime Mori ◽  
Keiichi Fujiwara ◽  
Hisanori Sakazaki
Keyword(s):  
Cardiopulmonary Bypass ◽  
Aortic Aneurysm ◽  
Head And Neck ◽  
Aortic Arch ◽  
Posterior Fossa ◽  
Aortic Coarctation ◽  
Ductus Arteriosus ◽  
Coarctation Of The Aorta ◽  
Developmental Defect ◽  
Rare Combination

Abstract A 4-day-old girl with Posterior fossa anomalies, Haemangiomas of the head and neck, Arterial, Cardiovascular, and Eye anomalies and ventral developmental defect syndrome comprising a facial haemangioma, aortic coarctation at the aortic arch, torturous aortic aneurysm distal to coarctation, and ductus arteriosus originating proximal to the coarctation is presented. The aortic arch was successfully reconstructed without cardiopulmonary bypass, and she is currently doing well after 4 years and 8 months.

Wide Dissection and Intercostal Vessel Division Allows for Repair of Hypoplastic Aortic Arch Through Thoracotomy

2018 ◽  
Vol 9 (6) ◽  
pp. 659-664 ◽  
Author(s):  
Néstor F. Sandoval ◽  
Catalina Vargas Acevedo ◽  
Juan Bernardo Umaña ◽  
Ivonne Pineda ◽  
Albert Guerrero ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Postoperative Mortality ◽  
Coarctation Of The Aorta ◽  
Adverse Outcomes ◽  
Modified Technique ◽  
Exclusion Criteria ◽  
Descending Aorta ◽  
Significant Difference ◽  
Hypoplastic Aortic Arch ◽  
Lateral Thoracotomy

Background: The approach to coarctation of the aorta with hypoplastic aortic arch is controversial. We evaluated the outcomes in patients with coarctation of the aorta with or without hypoplastic aortic arch operated through a posterior left lateral thoracotomy. Methods: A retrospective cohort of patients with aortic coarctation, who underwent repair between January 2009 and October 2017, was analyzed. Preoperative, postoperative, and echocardiographic characteristics were reviewed. Statistical analysis examined survival, freedom from reintervention, and freedom from recoarctation. Results: In nine years, 389 patients who underwent surgical treatment for coarctation of the aorta were identified; after exclusion criteria and complete echocardiographic reports, 143 patients were analyzed, of which 29 patients had hypoplastic aortic arch. The modification in the extended end-to-end anastomosis technique was a wide dissection and mobilization of the descending aorta that was achieved due to the ligation and division of 3 to 5 intercostal vessels. In both groups, patients were close to one month of age and had a median weight of 3.6 and 3.4 kg for hypoplastic and nonhypoplastic arch, respectively. In postoperative events, there was no statistically significant difference between the groups ( P = .57 for renal failure, P = .057 for transient, nonpermanent neurologic events, P = .496 for sepsis), as for intensive care unit ( P = .502) and total in-hospital stay ( P = .929). There was one case of postoperative mortality in each group and both were associated with noncardiac comorbidities. Regarding survival (log-rank = 0.060), freedom from reintervention (log-rank = 0.073), and freedom from recoarctation (log-rank = 0.568), there was no statistically significant difference between the groups. Conclusion: We believe that it is the modified technique that allowed greater mobilization of the aorta and successful repair of hypoplastic arch through thoracotomy, without an increase in paraplegia or other adverse outcomes.

Off-pump ascending aorta or aortic arch to descending aorta bypass with a pericardial roll for the treatment of critically ill infants with interrupted aortic arch

2020 ◽  
Vol 30 (8) ◽  
pp. 1095-1102
Author(s):  
Didem M. Oztas ◽  
Mert Meric ◽  
Metin O. Beyaz ◽  
Senay Coban ◽  
Gizem Sari ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Aortic Arch ◽  
Critically Ill ◽  
Septal Defect ◽  
Single Ventricle ◽  
Interrupted Aortic Arch ◽  
Ascending Aorta ◽  
Descending Aorta ◽  
Off Pump ◽  
Aorta Bypass

AbstractAim:Standard surgical treatment of the interrupted aortic arch with the use of cardiopulmonary bypass is risky especially in critically ill babies. In this manuscript, we present the results of off-pump pericardial roll bypass for the treatment of aortic interruption.Material and methods:The technique was applied in nine critically ill infants between July 2011 and December 2019. Data were reviewed retrospectively. There were four girls and five boys. The types of the interruption were type B in six cases and type A in three babies. Additional cardiovascular anomalies were ventricular septal defect in all, atrial septal defect or patent foramen ovale in all, single-ventricle pathologies in two and bicuspid aortic valve in three cases. All the patients were in critical situations such as intubated, having symptoms of infection, congestive heart failure or ischaemia and malperfusion leading visceral organ dysfunction.Results:All patients underwent off-pump ascending aorta or aortic arch to descending aorta bypass with a pericardial roll. Post-operative early mortality occurred in one patient with severe mitral regurgitation due to cardio-septic shock. One patient who had single-ventricle pathology underwent bidirectional Glenn and was lost on the post-operative 26th day due to sepsis 2 years after operation. Two patients presented with dilatation of the pericardial tube 18 and 24 months after the operations and one underwent reconstruction of the neo-arch. The remaining patients are asymptomatic, active and within normal limits of body and mental growth.Conclusion:Treatment of interrupted aortic arch with a bypass with an autologous pericardial roll treated with gluteraldehyde without cardiopulmonary bypass seems a safe and reliable technique especially for the treatment of critically ill infants.

Revised technique of cardiopulmonary bypass in one-stage repair of interrupted aortic arch complex

1993 ◽  
Vol 55 (5) ◽  
pp. 1166-1171 ◽  
Author(s):  
Hisataka Yasui ◽  
Hideaki Kado ◽  
Kunihiro Yonenaga ◽  
Shihori Kawasaki ◽  
Yuichi Shiokawa ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Aortic Arch ◽  
Interrupted Aortic Arch ◽  
One Stage

scholarly journals Early Results of a Novel Single-Stage Hybrid Aortic Arch Replacement Technique to Reduce Bypass and Circulatory Arrest Duration

2020 ◽  
Vol 23 (2) ◽  
pp. E107-E113
Author(s):  
Castigliano Murthy Bhamidipati ◽  
Jay D Pal
Keyword(s):  
Cardiopulmonary Bypass ◽  
Aortic Dissection ◽  
Aortic Arch ◽  
Stent Graft ◽  
Circulatory Arrest ◽  
True Lumen ◽  
Elephant Trunk ◽  
Aortic Arch Replacement ◽  
Descending Aorta ◽  
The Mean

ABSTRACT Objective: Hybrid repair procedures of the aortic arch have been utilized to reduce surgical risks and apply this therapy to patients who would not traditionally be candidates for open surgical repair.  We present a variation on the frozen elephant trunk technique to further reduce cardiopulmonary bypass and circulatory arrest duration. Methods: After initiation of cardiopulmonary bypass and during systemic cooling, a wire is advanced from the femoral artery into the aortic arch.  In the case of aortic dissection, intravascular ultrasound is used to confirm true lumen placement.  Under circulatory arrest, the proximal aortic arch is resected and the wire externalized.  Antegrade deployment of a stent graft is performed into the aortic arch and proximal descending aorta.  The ascending aortic graft is sewn to the cut end of the aorta, incorporating the stent graft.  The graft is cannulated and cardiopulmonary bypass reinitiated.  The remainder of the arch replacement is performed during re-warming. Results: Twenty two patients underwent this novel hybrid arch replacement procedure for aortic pseudoaneurysm, aortic dissection, or aneurysm.  In comparison to the frozen elephant trunk procedure, where a dacron graft is inserted into the descending aorta, and later fixed with an endograft, this technique allows for immediate distal fixation.  In the case of aortic dissection, there is immediate expansion of the true lumen with distal seal, potentially obviating the need for additional procedures.  Mean duration of follow up is 12 months (range 1 – 14 months).  The mean duration of cardiopulmonary bypass was 109.32 ±3.14 minutes.  The mean duration of circulatory arrest was 18.00 ±1.33 minutes at a mean temperature of 23.64 ±0.58 degrees Celsius.  There were no mortalities, no permanent disabling strokes, and no renal failure (requiring dialysis). Conclusions: This novel hybrid technique for aortic arch replacement is safe, significantly reduces cardiopulmonary bypass and circulatory arrest times, and is performed readily without need for fluoroscopy.  In patients with thoracoabdominal aneurysms, the stent graft can be used as an elephant trunk for further thoracoabdominal aneurysm repair or branched thoracic endovascular aortic repair procedures.  

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