scholarly journals 1-Year Follow-Up Study of Preemptive TEVAR for Residually Dissected Aortas after Proximal Open Repair of Acute Type A Aortic Dissection in High-Risk Patients for Late Re-Intervention

2019 ◽  
Vol 58 (6) ◽  
pp. e30
Author(s):  
Kiyofumi Morishita ◽  
Tosio Baba ◽  
Masami Shingaki ◽  
Tuyoshi Shibata ◽  
Kouhei Narayama
Keyword(s):  
High Risk ◽  
Aortic Dissection ◽  
Open Repair ◽  
Type A ◽  
Acute Type ◽  
Type A Aortic Dissection ◽  
High Risk Patients ◽  
Follow Up Study ◽  
Risk Patients

Catheter-based treatment of the dissected ascending aorta: a systematic review

2020 ◽  
Vol 59 (1) ◽  
pp. 80-91
Author(s):  
Changtian Wang ◽  
Ludwig Karl von Segesser ◽  
Francesco Maisano ◽  
Enrico Ferrari
Keyword(s):  
High Risk ◽  
Aortic Dissection ◽  
Endovascular Treatment ◽  
Open Surgery ◽  
Type A ◽  
Ascending Aorta ◽  
Type A Aortic Dissection ◽  
High Risk Patients ◽  
Risk Patients

Summary OBJECTIVES Type A aortic dissection requires immediate surgical repair. Despite improvements in surgery and anaesthesia, there is still a considerable risk when high-risk patients are concerned. Less invasive endovascular treatments are under evaluation. We investigated the current status of catheter-based treatment for type A aortic dissection with the entry tear located in the ascending aorta. METHODS A PubMed search was supplemented by searching through bibliographies and key articles. Demographics, risk score, stent graft detail, access route, mortality, cause of death, complications, reinterventions and follow-up data were extracted and analysed. RESULTS Thirty-one articles (7 retrospective reports; 24 case reports/series) were included in the study. In total, 104 patients (mean age 71 ± 14 years) received endovascular treatment for acute (63) or chronic (41) type A dissection. A history of a major cardiac or aortic operation was present in 29 patients. The mean EuroSCORE II was 30 ± 20 in 4 reports. A total of 114 stent grafts were implanted: ‘off-the-shelf’, 65/114; custom made, 12/114; and modified, 7/114. Hospital complications included intraprocedural conversion to open surgery (2/104), stroke (2/104), coronary stenting (2/104), early endoleak (9/104) and repeat aortic endovascular treatment for endoleak (5/104). Hospital mortality was 10% (intraoperative death 2/104). Mean duration of follow-up time was 21 ± 21 months (range 1–81 months); follow-up data were available for 86 patients: 10 patients died of non-aortic-related causes; reintervention for aortic disease (endovascular repair or open surgery) was performed in 8 patients. CONCLUSIONS Catheter-based ascending aorta repair for type A aortic dissection with the entry tear in the ascending aorta can be considered in carefully selected high-risk patients. Further analysis and specifically designed devices are required.

scholarly journals Endovascular treatment of acute type A aortic dissection in a nonagenarian: stabilization of a short covered stent using a bare-metal stent

2019 ◽  
Vol 29 (6) ◽  
pp. 978-980 ◽  
Author(s):  
Isaac Wamala ◽  
Roland Heck ◽  
Volkmar Falk ◽  
Semih Buz
Keyword(s):  
Aortic Dissection ◽  
Endovascular Treatment ◽  
Alternative Therapy ◽  
Type A ◽  
Bare Metal Stent ◽  
Covered Stent ◽  
Acute Type ◽  
Type A Aortic Dissection ◽  
Risk Patients

Abstract Endovascular treatment is a viable alternative therapy in high-risk patients with acute type A aortic dissection. However, the optimal endovascular treatment strategy is still evolving. Herein, we present a case of a 91-year-old man who successfully underwent repair of an ascending aortic dissection using a stent-in-stent technique. At 1-year follow-up, the stent demonstrated repair durability.

scholarly journals Fate of the preserved aortic root after treatment of acute type A aortic dissection: 23-year follow-up

2013 ◽  
Vol 146 (6) ◽  
pp. 1456-1460 ◽  
Author(s):  
Angelo M. Dell'Aquila ◽  
Giovanni Concistrè ◽  
Alina Gallo ◽  
Stefano Pansini ◽  
Alessandro Piccardo ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Aortic Root ◽  
Type A ◽  
Acute Type ◽  
Type A Aortic Dissection

scholarly journals Florida Sleeve is a Safe and Effective Technique for Valve Salvage in Acute Stanford Type A Aortic Dissection

2021 ◽  
Author(s):  
Mahmoud Alhussaini ◽  
Eric Jeng ◽  
Tomas Martin ◽  
Amber Filion ◽  
Thomas Beaver ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Dissection ◽  
Aortic Root ◽  
Type A ◽  
Long Term Results ◽  
Acute Type ◽  
Type A Aortic Dissection ◽  
Valve Sparing

Objective: Valve-sparing root replacement is commonly used for management of aortic root aneurysms in elective setting, but its technical complexity hinders its broader adoption for acute Type-A Aortic Dissection (ATAAD). The Florida Sleeve (FS) procedure is a simplified form of valve sparing aortic root reconstruction that does not require coronary reimplantation. Here, we present our outcomes of the Florida Sleeve (FS) repair in patients with dilated roots in the setting of an ATAAD. Methods: We retrospectively reviewed 24 consecutive patients (2002-2018) treated with FS procedure for ATAAD. Demographic, operative, and postoperative outcomes were queried from our institutional database. Long term follow-up was obtained from clinic visits for local patients, and with telephone and telehealth measures otherwise. Results: Mean age was 49 ± 14 years with 19 (79%) males. Marfan syndrome was present in 4 (16.7%) patients and 14 (58.3) had ≥2+ aortic insufficiency (AI). Nine (37.2%) had preoperative mal-perfusion or shock. The FS was combined with hemi-arch replacement in 15 (62.5%) patients and a zone-2 arch replacement in 9 (37.5%) patients. There were 2 (8.3%) early postoperative mortalities. Median follow-up period was 46 months (range; 0.3-146). The median survival of the entire cohort was 143.4 months. One patient (4.2%) required redo aortic valve replacement for unrelated aortic valve endocarditis at 30 months postoperatively. Conclusion: FS is simplified and reproducible valve-sparing root repair. In appropriate patients, it can be applied safely in acute Stanford type-A aortic dissection with excellent early and long-term results.

Aortic Valve Function at Medium-term Follow-up after Resuspension During Repair of Acute Type A Aortic Dissection. Royal Brompton and Harefield Hospitals, Experience

2019 ◽  
Vol 3 (sup1) ◽  
pp. 66-66
Author(s):  
Alessia Gambaro ◽  
Marco Morosin ◽  
Micheal Murphy ◽  
John Pepper ◽  
Jullien Gaer ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Dissection ◽  
Type A ◽  
Acute Type ◽  
Medium Term ◽  
Type A Aortic Dissection ◽  
Valve Function

scholarly journals Early Spontaneous Resolution of an Iatrogenic Acute Type A Aortic Dissection

Aorta ◽  
2016 ◽  
Vol 04 (06) ◽  
pp. 235-239
Author(s):  
Mohammad Zafar ◽  
Philip Pang ◽  
Glen Henry ◽  
Bulat Ziganshin ◽  
Maryann Tranquilli ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Acute Aortic Dissection ◽  
Type A ◽  
Type I ◽  
Acute Type ◽  
Computed Tomography Scan ◽  
Descending Aorta ◽  
Type A Aortic Dissection ◽  
Tomography Scan

AbstractAcute aortic dissection is a rare but devastating complication during cardiac catheterization. We present the case of an elderly female who incurred a Stanford Type A/DeBakey Type I acute aortic dissection extending into the arch vessels and descending aorta likely occurring during right coronary artery engagement for angioplasty. The patient was treated successfully by immediately sealing the entrance of the dissection via the placement of a stent and anti-impulse therapy. Follow-up computed tomography scan showed complete resolution of the dissection within one month.

scholarly journals Extended-arch repair for acute type-A aortic dissection: perioperative and mid-term results

2019 ◽  
Vol 56 (4) ◽  
pp. 714-721 ◽  
Author(s):  
Akash Fichadiya ◽  
Alexander J Gregory ◽  
Vamshi K Kotha ◽  
Eric J Herget ◽  
Holly N Smith ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
False Lumen ◽  
Type A ◽  
Acute Type ◽  
Cross Sectional ◽  
Acute Setting ◽  
Type A Aortic Dissection ◽  
Surgical Complexity ◽  
Permanent Neurological Deficit

Abstract OBJECTIVES: Extended-arch techniques offer the potential to comprehensively treat acute type-A aortic dissection (ATAAD), but add surgical complexity compared to the standard hemiarch technique. This study describes both perioperative and mid-term outcomes following the introduction of an extended-arch technique for ATAAD. METHODS: Ours is a retrospective single-centre observational study of 95 consecutive patients with ATAAD from 2011 to 2016. The decision to perform extended-arch or hemiarch repair was individualized based on clinical and radiological features. Extended-arch repair was defined as replacement of the ascending aorta and arch with reimplantation of head vessels with or without distal endovascular extension. Clinical follow-up was 100% complete. Cross-sectional double-oblique measurements were performed for aortic remodelling analysis. RESULTS: Extended-arch (n = 28) and hemiarch (n = 67) repair resulted in a in-hospital mortality of 10% (n = 3) and 10%, (n = 7), and permanent neurological deficit rate of 7% and 12%, respectively. At a mean imaging follow-up duration of 2.7 ± 1.5 years, false lumen thrombosis was achieved in 57% and 9% of patients undergoing extended-arch and hemiarch repair, respectively. Rate of growth in the proximal descending aorta was 0.7 ± 2.3 mm/year in the extended-arch group vs 2.7 ± 3.9 mm/year in the hemiarch group. At a mean clinical follow-up time of 3.0 ± 1.6 years, open surgical aortic reoperation was 0% in the extended-arch group and 22% in the hemiarch group. CONCLUSIONS: Extended-arch repair of ATAAD can be introduced in the acute setting without increase in perioperative mortality or morbidity. At mid-term follow-up, extended-arch for ATAAD improves aortic remodelling and reduces the need for open surgical reoperation.

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