Transposition of the supra-aortic vessels before stent grafting the aortic arch and descending aorta

Background: The presence of a bicuspid aortic valve (BAV) might be associated with a progressive dilatation of the aortic root and ascending aorta. However, involvement of the aortic arch and descending aorta has not yet been elucidated. Patients and methods: Magnetic resonance angiography (MRA) was used to assess the diameter of the ascending aorta, aortic arch, and descending aorta in 28 patients with bicuspid aortic valves (mean age 30 ± 9 years). Results: Patients with BAV, but without significant aortic stenosis or regurgitation (n = 10, mean age 27 ± 8 years, n.s. versus control) were compared with controls (n = 13, mean age 33 ± 10 years). In the BAV-patients, aortic root diameter was 35.1 ± 4.9 mm versus 28.9 ± 4.8 mm in the control group (p < 0.01). The diameter of the ascending aorta was also significantly increased at the level of the pulmonary artery (35.5 ± 5.6 mm versus 27.0 ± 4.8 mm, p < 0.001). BAV-patients with moderate or severe aortic regurgitation (n = 18, mean age 32 ± 9 years, n.s. versus control) had a significant dilatation of the aortic root, ascending aorta at the level of the pulmonary artery (41.7 ± 4.8 mm versus 27.0 ± 4.8 mm in control patients, p < 0.001) and, furthermore, significantly increased diameters of the aortic arch (27.1 ± 5.6 mm versus 21.5 ± 1.8 mm, p < 0.01) and descending aorta (21.8 ± 5.6 mm versus 17.0 ± 5.6 mm, p < 0.01). Conclusions: The whole thoracic aorta is abnormally dilated in patients with BAV, particularly in patients with moderate/severe aortic regurgitation. The maximum dilatation occurs in the ascending aorta at the level of the pulmonary artery. Thus, we suggest evaluation of the entire thoracic aorta in patients with BAV.

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Mid-term results after endovascular stent grafting of the descending aorta in high risk patients

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-2005-862125 ◽

2005 ◽

Vol 53 (S 01) ◽

Author(s):

M Brandt ◽

K Walluscheck ◽

S Kuchenbecker ◽

T Jahnke ◽

M Heller ◽

...

Keyword(s):

High Risk ◽

Endovascular Stent ◽

Descending Aorta ◽

Stent Grafting ◽

High Risk Patients ◽

Endovascular Stent Grafting ◽

Risk Patients ◽

Mid Term Results

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Aneurysm Hybrid Treatment by Simultaneous Replacement of Ascending Aorta and Aortic Arch and Endoluminal Stenting of the Descending Aorta

The Heart Surgery Forum ◽

10.1532/hsf98.20051033 ◽

2006 ◽

Vol 9 (1) ◽

pp. E530-E532

Author(s):

Friedrich-Christian Riess ◽

Hans Krankenberg ◽

Thilo Tübler ◽

Matthias Danne

Keyword(s):

Aortic Arch ◽

Ascending Aorta ◽

Descending Aorta ◽

Hybrid Treatment

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Type B Interrupted Aorta in an Adult Patient

The Heart Surgery Forum ◽

10.1532/hsf98.2013309 ◽

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

Introduction: 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.Case presentation: 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.Conclusion: 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.

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RF22 EXTRA-ANATOMIC BYPASS IN AN INFANT WITH SEVERE AORTIC ARCH AND THORACIC DESCENDING AORTA THROMBOSIS

Journal of Cardiovascular Medicine ◽

10.2459/01.jcm.0000550049.50754.51 ◽

2018 ◽

Vol 19 ◽

pp. e66

Author(s):

S. Hoxha ◽

G. Poretti ◽

C. sandrini ◽

L. barozzi ◽

A. murari ◽

...

Keyword(s):

Aortic Arch ◽

Descending Aorta

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Faculty Opinions recommendation of Hybrid endovascular aortic arch repair using branched endoprosthesis: the second-generation "branched" open stent-grafting technique.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1162765.624362 ◽

2009 ◽

Author(s):

John Augoustides ◽

Michael Andritsos

Keyword(s):

Aortic Arch ◽

Second Generation ◽

Stent Grafting ◽

Grafting Technique ◽

Aortic Arch Repair ◽

Open Stent Grafting ◽

Open Stent

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GROWTH AND RE-INTERVENTION OF RESIDUAL AORTIC ARCH AND DESCENDING AORTA AFTER TYPE A DISSECTION REPAIR

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(19)32730-5 ◽

2019 ◽

Vol 73 (9) ◽

pp. 2124

Author(s):

Domenico Calcaterra ◽

Truls Myrmel ◽

Alan Braverman ◽

Takeyoshi Ota ◽

Reed Pyeritz ◽

...

Keyword(s):

Aortic Arch ◽

Type A ◽

Descending Aorta ◽

Type A Dissection

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WITHDRAWN: A Case Report of Blunt Aortic Arch Injury Treated by Immediate Stent-Grafting

European Journal of Vascular and Endovascular Surgery ◽

10.1053/ejvs.2002.1898 ◽

2003 ◽

Author(s):

Y. Kurimotoa ◽

K. Morishitab ◽

N. Kawaharadab ◽

J. Fukadab ◽

Y. Asaia ◽

...

Keyword(s):

Case Report ◽

Aortic Arch ◽

Stent Grafting

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Abstract 3051: Long Term Results Of Open Endovascular Repair For Aortic Dissections

Circulation ◽

10.1161/circ.116.suppl_16.ii_683-c ◽

2007 ◽

Vol 116 (suppl_16) ◽

Author(s):

Kazuo Shimamura ◽

Toru Kuratani ◽

Goro Mastumiya ◽

Yoshiyuki Shirakawa ◽

Mugiho Takeuchi ◽

...

Keyword(s):

Aortic Arch ◽

Endovascular Repair ◽

Long Term Results ◽

Stent Grafting ◽

Grafting Technique ◽

Aortic Dissections ◽

Open Stent Grafting ◽

Open Stent ◽

Intimal Tear

Background . Complete resection of the intimal tear in aortic arch is one of the most complicated tasks in the treatment of aortic dissections. We introduced open stent grafting technique to complete this task with technical easiness. In this study we evaluated the long term efficacy of this procedure from our 12 years experience. Patients and Method. Form January 1994 to December 2004, 59 aortic dissections with intimal tear in aortic arch or proximal descending aorta were operated with open stent grafting technique (age 61.7yrs, 41 type A and 18 type B). Thirty three (55.9%) were in emergency status. All these cases were morphologically excluded from the indication of transluminal endovascular repair. Under deep hypothermic circulatory arrest with antegrade cerebral perfusion, the hybrid prosthesis was inserted into descending aorta through the transected proximal aortic arch in order to achieve intimal tear exclusion. Results. Complete exclusion of the aortic arch intimal tear was achieved in all cases. Operative mortality within 30 days was 3.4%. Major postoperative complications included 4(6.8%) cerebral infarctions, 2 (3.4%) paraplegia, 2 (3.4%) transient paraparesis. Median follow up was 71.2 months (maximum 153 months). One patient (1.7%) showed type I endoleak from the distal end. In 6 patients (10.2%) additional endovascular repair for other thoracic lesions were performed, and only one case with Marfan syndrome required open surgical repair for thoracoabdominal aorta because of expansion of the remaining thoracic dissection. CT scan showed shrinkage of the false channel in 78.6% of the patients. There were no rupture of the remaining dissected aorta and the freedom from aortic related death was 94.7%, 94.7%, and 88.8% at 1,5, and 8 years respectively. Conclusion. This study suggested that open stent grafting is a safe and effective technique with good long-term results. This procedure could be an alternative and standard method to repair aortic dissections with aortic arch intimal tear.

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