scholarly journals Implications of different definitions for aortic arch classification provided by contemporary guidelines on thoracic aortic repair

2021 ◽  
Author(s):  
Massimiliano M Marrocco-Trischitta ◽  
Mattia Glauber
Keyword(s):  
Aortic Arch ◽  
Aortic Wall ◽  
Clinical Information ◽  
Carotid Stenting ◽  
Aortic Disease ◽  
Thoracic Aortic Disease ◽  
Aortic Repair ◽  
Multicentre Trials ◽  
Aortic Arches ◽  
Definition Of

Abstract Contemporary guidelines on thoracic aortic repair provide inconsistent reporting standards for the definition of aortic arch classification in Types I, II and III. The different reported criteria cannot be used interchangeably, due to a very low level of concordance, and this finding has relevant implications for the comparisons between studies using different classifications, and between different datasets of multicentre trials, which are not consistently analyzed with the same criteria. Also, the reported definitions, which were originally proposed for predicting difficult carotid stenting and therefore were conceived for healthy aortic arches, can be influenced by the pathological derangements of the aortic wall, including aneurysms and dissections. In this respect, the Madhwal’s classification, which is based on the diameter of the left common carotid artery, appears to be the more suitable one for aortic arch classification in patients with thoracic aortic disease because it provides relevant clinical information along with an adequate reproducibility.

‘Bovine’ Aortic Arch – A Marker for Thoracic Aortic Disease

Cardiology ◽  
2012 ◽  
Vol 123 (2) ◽  
pp. 116-124 ◽  
Author(s):  
Matthew Hornick ◽  
Remo Moomiaie ◽  
Hamid Mojibian ◽  
Bulat Ziganshin ◽  
Zakaria Almuwaqqat ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Aortic Disease ◽  
Thoracic Aortic Disease ◽  
Bovine Aortic Arch

scholarly journals A Systematic Review and Meta-analysis of the Bovine Aortic Arch Variant as a Determinant of Thoracic Aortic Disease

2019 ◽  
Vol 58 (6) ◽  
pp. e593-e594
Author(s):  
Moad Alaidroos ◽  
Rodrigo M. Romarowski ◽  
Francesco Secchi ◽  
Paolo Righini ◽  
Giovanni Nano ◽  
...  
Keyword(s):  
Systematic Review ◽  
Aortic Arch ◽  
Meta Analysis ◽  
Aortic Disease ◽  
Thoracic Aortic Disease ◽  
Bovine Aortic Arch

scholarly journals HYBRID ENDOVASCULAR REPAIR FOR THORACIC AORTIC DISEASE INVOLVING AORTIC ARCH

2015 ◽  
Vol 65 (10) ◽  
pp. A1755
Author(s):  
Myeong Gun Kim ◽  
Woong Chol Kang ◽  
Pyung Chun Oh ◽  
Eak Kyun Shin ◽  
Yae Min Park ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Endovascular Repair ◽  
Aortic Disease ◽  
Thoracic Aortic Disease

One-Stage Hybrid Total Aortic Arch and Descending Thoracic Aortic Repair is a Safe and Secure Procedure With Less Postoperative Complications for Extended Aortic Arch Aneurysms

2021 ◽  
pp. 152660282110479
Author(s):  
Tomohiro Mizuno ◽  
Tsuyoshi Hachimaru ◽  
Tatsuki Fujiwara ◽  
Kiyotoshi Oishi ◽  
Masashi Takeshita ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Aortic Arch ◽  
Cox Regression ◽  
Aortic Disease ◽  
Neurological Deficits ◽  
Type Ii ◽  
Cox Regression Analysis ◽  
Aortic Repair ◽  
Aortic Arch Repair ◽  
Arch Aneurysm

Purpose Hybrid aortic arch repair (HAR) has been implemented for extended aortic arch and descending thoracic aortic disease since 2012 in our institution. This study aimed to estimate the early and mid-term efficacy and safety of HAR. Materials and Methods From 2007 to 2019, 56 patients underwent HAR for extended aortic arch disease, and 75 patients underwent total arch replacement (TAR) for arch-limited disease. HAR comprises 3 procedures: replacement of the aorta, reconstruction of all arch vessels, and thoracic endovascular aortic repair (TEVAR) from zone 0 to the descending aorta after cardiopulmonary bypass is off in 1 stage. The type II-1 HAR procedure, in which the ascending aorta and aortic arch distal to the brachiocephalic artery are replaced, was the most frequently selected procedure (40/56 patients). The outcomes of the type II-1 HAR procedure were compared with those of TAR using the Cox regression analysis. Results The median follow-up period was 36 months. In HAR, the operative mortality, in-hospital mortality, and postoperative permanent neurological deficits were not observed. The paraplegia rate was 1.8%. TEVAR-related complications occurred in 3 patients. Among the patients with non-ruptured atherosclerotic aortic arch aneurysm (31 type II-1 HAR patients and 36 TAR patients, the postoperative respiratory support time in those who underwent type II-1 HAR was quicker than in those who underwent TAR (p<0.01). The rate of 6 year freedom from all-cause death in type II-1 HAR (83.1%) was numerically higher than that in TAR (74.7%), and the rate of 6 year freedom from surgery-related complications in type II-1 HAR (90.3%) was numerically lower than that in TAR (96.9%) due to the occurrence of TEVAR-related complications, and the rate of 6 year freedom from reintervention to the descending thoracic aorta in type II-1 HAR (100%) seemed to be better than that in TAR (83.7%). However, Cox regression analysis did not reveal any statistical difference between the 2 procedures. Conclusions HAR, especially the type II-1 procedure, can treat extended aortic arch disease with acceptable survival outcomes. The development of TEVAR technology will further improve the outcomes of HAR in the future.

scholarly journals Atypical aortic arch branching variants: A novel marker for thoracic aortic disease

2015 ◽  
Vol 149 (6) ◽  
pp. 1586-1592 ◽  
Author(s):  
Julia Dumfarth ◽  
Alan S. Chou ◽  
Bulat A. Ziganshin ◽  
Rohan Bhandari ◽  
Sven Peterss ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Aortic Disease ◽  
Thoracic Aortic Disease

scholarly journals Aortic arch tortuosity, a novel biomarker for thoracic aortic disease, is increased in adults with bicuspid aortic valve

2019 ◽  
Vol 284 ◽  
pp. 84-89 ◽  
Author(s):  
Bader Aldeen Alhafez ◽  
Van Thi Thanh Truong ◽  
Daniel Ocazionez ◽  
Sahand Sohrabi ◽  
Harleen Sandhu ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Arch ◽  
Bicuspid Aortic Valve ◽  
Aortic Disease ◽  
Thoracic Aortic Disease

scholarly journals Current options and recommendations for the use of thoracic endovascular aortic repair in acute and chronic thoracic aortic disease: an expert consensus document of the European Society for Cardiology (ESC) Working Group of Cardiovascular Surgery, the ESC Working Group on Aorta and Peripheral Vascular Diseases, the European Association of Percutaneous Cardiovascular Interventions (EAPCI) of the ESC and the European Association for Cardio-Thoracic Surgery (EACTS)

2020 ◽  
Vol 59 (1) ◽  
pp. 65-73 ◽  
Author(s):  
Martin Czerny ◽  
Davide Pacini ◽  
Victor Aboyans ◽  
Nawwar Al-Attar ◽  
Holger Eggebrecht ◽  
...  
Keyword(s):  
Working Group ◽  
European Association ◽  
Aortic Disease ◽  
Thoracic Endovascular Aortic Repair ◽  
Endovascular Aortic Repair ◽  
Current Evidence ◽  
Heart Team ◽  
Acute Type ◽  
Thoracic Aortic Disease ◽  
Aortic Repair

Abstract Since its clinical implementation in the late nineties, thoracic endovascular aortic repair (TEVAR) has become the standard treatment of several acute and chronic diseases of the thoracic aorta. While TEVAR has been embraced by many, this disruptive technology has also stimulated the continuing evolution of open surgery, which became even more important as late TEVAR failures do need open surgical correction justifying the need to unite both treatment options under one umbrella. This fact shows the importance of—in analogy to the heart team—aortic centre formation and centralization of care, which stimulates continuing development and improves outcome . The next frontier to be explored is the most proximal component of the aorta—the aortic root, in particular in acute type A aortic dissection—which remains the main challenge for the years to come. The aim of this document is to provide the reader with a synopsis of current evidence regarding the use or non-use of TEVAR in acute and chronic thoracic aortic disease, to share latest recommendations for a modified terminology and for reporting standards and finally to provide a glimpse into future developments.

scholarly journals A review of endovascular treatment of thoracic aorta disease

2018 ◽  
Vol 100 (8) ◽  
pp. 662-668 ◽  
Author(s):  
GJS Tan ◽  
PLZ Khoo ◽  
KMJ Chan
Keyword(s):  
Thoracic Aorta ◽  
Open Repair ◽  
Aortic Disease ◽  
Thoracic Endovascular Aortic Repair ◽  
Aortic Aneurysms ◽  
Endovascular Aortic Repair ◽  
Aortic Diseases ◽  
Thoracic Aortic Disease ◽  
Thoracic Aortic Aneurysms ◽  
Aortic Repair

Introduction The development of thoracic endovascular aortic repair has altered the approach and reduced the risk of treating the majority of descending thoracic aortic conditions. Primarily developed for the exclusion of thoracic aortic aneurysms, it is now used in place of open repair surgery for most descending thoracic aortic diseases, and has also been used to treat aortic arch diseases in selected cases. Methods A literature search was conducted of Medline and Embase databases from January 2007 to February 2017, using the key words ‘aortic disease’, ‘thoracic aorta’ and ‘endovascular repair’; 205 articles were identified, of which 25 studies were selected for review based on their relevance. Findings The key findings of the indications, techniques, outcomes, complications and comparisons with open surgical repair were extracted from the published studies and are summarised in this review. Thoracic endovascular aortic repair is the preferred choice of intervention for patients with descending thoracic aortic disease. With time, it has improved to be safer and has the potential to expand aortic treatment choices in future.

scholarly journals Perioperative Hemodynamic Management and Pharmacotherapeutics of Patients Undergoing Thoracic Endovascular Aortic Repair

2014 ◽  
Vol 2014 ◽  
pp. 1-6
Author(s):  
Anja Muehle ◽  
Isil Uzun ◽  
Ziba Jalali ◽  
Ali Khoynezhad
Keyword(s):  
Blood Pressure ◽  
Aortic Disease ◽  
Thoracic Endovascular Aortic Repair ◽  
Endovascular Aortic Repair ◽  
Long Term Results ◽  
Safe Procedure ◽  
Thoracic Aortic Disease ◽  
Hemodynamic Management ◽  
Aortic Repair ◽  
Alternative Treatment Option

Thoracic endovascular aortic repair (TEVAR) has become an attractive alternative treatment option for many patients with specific thoracic aortic disease. New devices and advanced image-guided procedures are continuously expanding the indications and improve neurological outcomes. Hemodynamic management of these patients is a critical aspect in reducing neurological deficit and it is different compared to patients undergoing open thoracic aortic operations. There are two different phases of blood pressure management for patients with thoracic aortic disease. Before and during the critical steps of TEVAR anti-impulsive therapy facilitates safe positioning and stent deployment. After stent grafts are deployed, controlled hypertensive blood pressure levels are achieved to avoid spinal cord ischemia. This precise blood pressure strategy is essential to ensure a safe procedure and good long-term results.

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