Penetrating atherosclerotic ulcer aneurysm of the innominate artery

VASA ◽  
2009 ◽  
Vol 38 (3) ◽  
pp. 263-266 ◽  
Author(s):  
Yuan ◽  
Tager
Keyword(s):  
Conservative Treatment ◽  
Thoracic Aorta ◽  
Open Surgery ◽  
Innominate Artery ◽  
Ruptured Aneurysm ◽  
Descending Thoracic Aorta ◽  
Penetrating Atherosclerotic Ulcer ◽  
Descending Aorta

Penetrating atherosclerotic ulcer of the aorta is uncommon, and usually develops in the descending thoracic aorta. Rarely this condition involves the branch vessels of the aorta. We report a case of ruptured aneurysm of the innominate artery resulting from penetrating atherosclerotic ulcer. Open surgery was the treatment of choice for the ruptured aneurysm, while conservative treatment was recommended for the associated penetrating atherosclerotic ulcers of the descending aorta.

scholarly journals Treating the patient with acute rupture of penetrating atherosclerotic ulcer of the thoracic aorta

2015 ◽  
Vol 96 (3) ◽  
pp. 377-380
Author(s):  
I R Yagafarov ◽  
R R Sayfullin ◽  
M M Iskhakov ◽  
N V Gazizov ◽  
M G Khatypov ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Thoracic Aorta ◽  
Spontaneous Rupture ◽  
Open Surgery ◽  
Intraoperative Complications ◽  
Long Term Results ◽  
Safe Procedure ◽  
Descending Thoracic Aorta ◽  
Prosthetic Repair ◽  
Penetrating Atherosclerotic Ulcer

Spontaneous rupture of the aorta - a violation of the integrity of the aortic wall which is not caused by an aneurysm, trauma, dissection or disintegrating tumor process, and is an acute life-threatening condition. According to some authors, the main cause of spontaneous rupture of the aorta is a penetrating atherosclerotic ulcer of the aorta, which is an ulceration of aortic atherosclerotic plaque leading to penetration of the internal elastic plate in media. We present a case of successful hybrid surgical treatment of patient with spontaneous rupture of the descending thoracic aorta with the formation of para-aortic hematoma and left-sided hemothorax. The patient underwent a hybrid operation - aortic arch and descending thoracic aorta prosthetic repair, subclavian bypass with left subclavian artery ligation, left-sided thoracotomy, and pleural cavity sanitation. No intraoperative complications were observed, the patient was taken off the ventilator on day 2. The control computed tomography performed on day 10, revealed correct and stable stent graft position with no signs of continued bleeding, endoleak. The patient was discharged in satisfactory condition on day 14. Due to the high hospital mortality of open surgery on the thoracic aorta in case of penetrating atherosclerotic ulcers, as well as the predominance of elderly patients with severe comorbidities that contraindicate open surgery using cardiopulmonary bypass, endovascular and hybrid technologies, which are minimally invasive and traumatic, come to the fore. Endovascular prosthetic repair in case of penetrating atherosclerotic ulcer of aortic arch and descending thoracic aorta is an effective and safe procedure in patients at high risk, showing encouraging long-term results.

Endovascular versus open treatment of degenerative aneurysms of the descending thoracic aorta: a single center experience

Vascular ◽  
2011 ◽  
Vol 19 (1) ◽  
pp. 8-14 ◽  
Author(s):  
Joachim Andrassy ◽  
Rolf Weidenhagen ◽  
Georgios Meimarakis ◽  
M Rentsch ◽  
K-W Jauch ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Thoracic Aorta ◽  
Open Surgery ◽  
Aortic Aneurysms ◽  
Descending Thoracic Aorta ◽  
Entire Cohort ◽  
Thoracic Aortic Aneurysms ◽  
Asymptomatic Patients ◽  
Open Treatment ◽  
One Year

Multiple reports could show a reduced risk for thoracic endovascular aortic repair (TEVAR) compared with open treatment. The aim of this study was to evaluate our twelve-year TEVAR experience for thoracic aortic aneurysms and compare these results with open repair. All patients who had received either open or endovascular surgery for a degenerative aortic aneurysm of the descending thoracic aorta in our center were evaluated retrospectively. N = 53 TEVAR patients (1997–2008) were included and their course was compared with an open-surgery group of n = 24 patients (1992–2002). The percentage of symptomatic patients was 43% (TEVAR) and 42% (open surgery). Endovascular treatment resulted in a significantly reduced 30-day (5.7% versus 25% P = 0.02) and one-year mortality (19% versus 42% P = 0.05) in the entire cohort. Symptomatic patients benefited the most from TEVAR (30-day mortality: 9% versus 40%, P = 0.06; one-year mortality: 27% versus 70%, P = 0.049) whereas the survival of our asymptomatic patients was not significantly different (30-day mortality: 3% versus 14%, P = 0.22; one-year mortality: 13% versus 21%, P = 0.65). Lastly, Kaplan–Meier analysis showed a significantly improved survival after TEVAR ( P = 0.05) and in particular for the symptomatic patients ( P = 0.003). In conclusion, endovascular treatment for patients with degenerative thoracic aortic aneurysms has significant advantages over open surgery.

A congenital fistula between the descending aorta and the right pulmonary vein in a neonate presenting with heart failure

2007 ◽  
Vol 17 (5) ◽  
pp. 563-564 ◽  
Author(s):  
Suhair O. Shebani ◽  
Mohammad D. Khan ◽  
Magdi A. Tofeig
Keyword(s):  
Heart Failure ◽  
Pulmonary Vein ◽  
Thoracic Aorta ◽  
Cardiac Failure ◽  
Cardiac Catheterisation ◽  
Newborn Baby ◽  
Descending Thoracic Aorta ◽  
Descending Aorta ◽  
The Right ◽  
Congenital Fistula

AbstractWe report a large congenital fistula connecting the descending thoracic aorta to the right upper pulmonary vein in a newborn baby presenting on the seventh day of life with cardiac failure and a continuous murmur heard posteriorly. The fistula was detected echocardiographically, and shown at cardiac catheterisation not to be suitable for percutaneous occlusion. The anatomy of the fistula was confirmed at surgery, when it was ligated successfully.

Tension hemothorax caused by a ruptured aneurysm of the descending thoracic aorta: Report of a case

Surgery Today ◽  
2000 ◽  
Vol 30 (6) ◽  
pp. 558-560 ◽  
Author(s):  
Yoshio Ootaki ◽  
Masayoshi Okada ◽  
Chojiro Yamashita ◽  
Takaki Sugimoto ◽  
Hidetaka Wakiyama
Keyword(s):  
Thoracic Aorta ◽  
Ruptured Aneurysm ◽  
Descending Thoracic Aorta

scholarly journals Bronchoesophageal fistula after endovascular repair of ruptured aneurysm of the descending thoracic aorta

2005 ◽  
Vol 41 (4) ◽  
pp. 712-714 ◽  
Author(s):  
Luigi Bonavina ◽  
Tommaso Lupattelli ◽  
Davide Bona ◽  
Santi Trimarchi ◽  
Giovanni Nano ◽  
...  
Keyword(s):  
Thoracic Aorta ◽  
Endovascular Repair ◽  
Ruptured Aneurysm ◽  
Descending Thoracic Aorta ◽  
Bronchoesophageal Fistula

Serial evaluation of the thoracic aorta in patients with a bicuspid aortic valve: A magnetic resonance angiography study

VASA ◽  
2010 ◽  
Vol 39 (2) ◽  
pp. 140-144 ◽  
Author(s):  
Tutarel ◽  
Meyer ◽  
Lotz ◽  
Westhoff-Bleck
Keyword(s):  
Aortic Valve ◽  
Thoracic Aorta ◽  
Bicuspid Aortic Valve ◽  
Aortic Root ◽  
Innominate Artery ◽  
Ascending Aorta ◽  
Current Data ◽  
Descending Aorta ◽  
Valve Function ◽  
A Prospective Study

Background: Bicuspid aortic valve (BAV) is associated with an arteriopathy leading to a progressive dilatation of the aortic root. Recent studies have shown that the whole thoracic aorta is affected by this arteriopathy. Longitudinal data regarding the progression of this arteriopathy in the whole thoracic aorta has not been reported before. Patients and methods: In this retrospective study 40 patients (mean age 28.5 ± 9.1 years) had 2 MR-angiographies (mean interval 37.1 ± 15.2 months). In 23 patients the aortic valve was regurgitant, in 1 stenotic, in 4 combined aortic stenosis / regurgitation was found, while in 12 the valve function was normal. Aortic diameters were measured at 6 different, standardized anatomical points. The influence of demographic and clinical parameters was assessed. Results: A significant increase of the diameter was observed at the aortic root (35.4 ± 5.6 mm → 39.1 ± 6.5 mm, p < 0.001), the ascending aorta (37.3 ± 8.0 mm → 39.5 ± 8.5 mm, p = 0.001), proximal to the innominate artery (29.4 ± 6.1 mm → 31.6 ± 6.8 mm, p = 0.008), and the descending aorta (20.2 ± 2.4 mm → 21.6 ± 4.2 mm, p = 0.03). There was no significant increase proximal (24.0 ± 5.7 mm → 24.6 ± 5.3 mm, p = 0.44) and distal to the left subclavian artery (21.4 ± 4.6 mm → 21.9 ± 4.5 mm, p = 0.19). These observations were independent of the presence of arterial hypertension, a previous operation, gender, and functional status of the aortic valve. Conclusions: The progressive dilatation of the aortic root and ascending aorta that can be observed in patients with BAV was not found in the more distal parts of the thoracic aorta with the exception of the descending aorta in this study. If the dilatation of the descending aorta bears any clinical significance can't be answered with the current data. A prospective study should be performed to confirm these results.

Late manifestation of a pseudoaneurysm in the descending thoracic aorta

VASA ◽  
2006 ◽  
Vol 35 (2) ◽  
pp. 112-114 ◽  
Author(s):  
Gurkan ◽  
Sunar ◽  
Canbaz ◽  
Duran
Keyword(s):  
Surgical Treatment ◽  
Thoracic Aorta ◽  
Aortic Rupture ◽  
Descending Thoracic Aorta ◽  
Catastrophic Event ◽  
Descending Aorta ◽  
Car Accident ◽  
Injured Patients ◽  
Deceleration Trauma ◽  
Late Manifestation

Rupture of the descending aorta following deceleration trauma is a catastrophic event because it has a high mortality. Prompt surgical treatment is generally considered to be mandatory. However, a few injured patients may leave the hospital with an undiagnosed aortic rupture which may give rise to a chronic pseudoaneurysm. In this report, a 28-year-old man is presented in whom a pseudoaneurysm of the descending thoracic aortic was diagnosed six months after a car accident.

scholarly journals Open surgery for descending thoracic aorta in an endovascular era

2019 ◽  
Vol 157 (6) ◽  
pp. 2168-2174 ◽  
Author(s):  
Takuya Fujikawa ◽  
Shin Yamamoto ◽  
Susumu Oshima ◽  
Kensuke Ozaki ◽  
Junichi Shimamura ◽  
...  
Keyword(s):  
Thoracic Aorta ◽  
Open Surgery ◽  
Descending Thoracic Aorta
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