Postpartum dissection in bovine aorta with anomalous brachiocephalic vessels

2018 ◽  
Vol 27 (5) ◽  
pp. 400-403 ◽  
Author(s):  
Andrea De Martino ◽  
Giosuè Falcetta ◽  
Giovanni Scioti ◽  
Angela Pucci ◽  
Uberto Bortolotti
Keyword(s):  
Computed Tomography ◽  
Aortic Dissection ◽  
Aortic Arch ◽  
Acute Aortic Dissection ◽  
Left Vertebral Artery ◽  
Aortic Diseases ◽  
Histological Changes ◽  
Uncomplicated Pregnancy ◽  
Increased Risk ◽  
Bovine Aortic Arch

A 42-year-old woman, with no evidence of connective tissue disease, presented with acute aortic dissection after an uneventful vaginal delivery following an uncomplicated pregnancy. Emergency computed tomography angiography showed a bovine aortic arch with a separate origin of the left vertebral artery. At surgery, a tricuspid aortic valve was found and the aortic arch was successfully repaired with reimplantation of a button incorporating the origin of the brachiocephalic vessels. Acute aortic dissection throughout pregnancy is uncommon and favoured by hemodynamic, hormonal, and histological changes. Anomalies of the aortic arch branches might represent an increased risk of thoracic aortic diseases.

Successful carotid artery stenting in patients with aortic dissection

2020 ◽  
Keyword(s):  
Ischemic Stroke ◽  
Carotid Artery ◽  
Aortic Dissection ◽  
Cerebral Infarction ◽  
Acute Ischemic Stroke ◽  
Aortic Arch ◽  
Common Carotid Artery ◽  
Carotid Artery Stenting ◽  
Acute Aortic Dissection ◽  
Optimal Timing

Background: There are no guidelines for the optimal timing of surgery (emergency vs. delayed) for ascending aortic dissection with acute ischemic stroke. We retrospectively compared the prognoses and radiological and clinical findings for concomitant aortic dissection and ischemic stroke in a series of case reports. Case presentation: Three patients presented with left hemiparesis. Patient 1 underwent surgery for acute aortic dissection without treatment for acute ischemic stroke. In Patient 2, emergency stenting could not be performed due to cardiac tamponade and hypotension. Therefore, emergency acute aortic dissection surgery was performed. Patient 3 underwent emergency right common carotid artery stenting followed by surgery for acute aortic dissection. Brain perfusion computed tomography angiography (CTA) was performed to diagnose severe stenosis of the right common carotid artery or occlusion concomitant with acute aortic dissection involving the aortic arch with a cerebral perfusion mismatch in all the patients. Patient 3 had postoperative local cerebral infarction, whereas patients 1 and 2 (without stent insertion) had extensive postoperative cerebral infarction. Conclusion: Patient 3 showed a better prognosis than patients without stent treatment. We suggest that perfusion CTA of the aortic arch in suspected acute ischemic stroke can facilitate early diagnosis and prompt treatment in similar patients.

Bentall–de Bono procedure for acute aortic dissection

2021 ◽  
Keyword(s):  
Aortic Dissection ◽  
Aortic Root ◽  
Acute Aortic Dissection ◽  
Aortic Surgery ◽  
Acute Type ◽  
Aortic Diseases ◽  
Type A Aortic Dissection ◽  
Aortic Replacement ◽  
Ascending Aortic Replacement ◽  
Valve Sparing

We present a patient with an acute type A aortic dissection that involves the aortic root. The high mortality of patients with this condition is often associated with operations performed by surgeons with minimal experience dealing with aortic diseases. Therefore, less-experienced surgeons often opt for less complicated techniques like supracoronary ascending aortic replacement. However, according to the latest guidelines for the management of aortic diseases, the aortic root should be replaced when it is compromised by the dissection. The Bentall–de Bono technique treats the aortic root and demands less experience than valve-sparing aortic surgery.

Emergency Endovascular Total Arch Exclusion With an Off-the-Shelf Bimodular Device

2021 ◽  
pp. 155698452110503
Author(s):  
Giorgia Cibin ◽  
Augusto D’Onofrio ◽  
Michele Antonello ◽  
Piero Battocchio ◽  
Gino Gerosa
Keyword(s):  
Aortic Dissection ◽  
Aortic Arch ◽  
Acute Aortic Dissection ◽  
History Of Surgery ◽  
Perioperative Outcome ◽  
Cerebrovascular Events ◽  
Brachiocephalic Trunk ◽  
High Surgical Risk ◽  
History Of ◽  
Endovascular Approach

A patient with a history of surgery for type A acute aortic dissection was readmitted for aortic arch and descending aortic dissection with rupture at the isthmus and periaortic hematoma. Due to the high surgical risk, the aortic team chose an endovascular approach, and the patient successfully underwent emergency total arch exclusion with an off-the-shelf, bimodular, single-branch device. The main module was deployed in the aortic arch and in the brachiocephalic trunk, and the second module was deployed in the ascending aorta. Despite the good perioperative outcome with no cerebrovascular events, the patient died 20 days later because of sudden iliac rupture.

scholarly journals Type B aortic dissection repair using a Thoraflex hybrid prosthesis in a setting of aberrant left vertebral artery

2020 ◽  
Vol 2020 (7) ◽  
Author(s):  
Saifullah Mohamed ◽  
Akshay J Patel ◽  
Yassir Iqbal ◽  
Khurum Mazhar ◽  
Uday Dandekar ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Vertebral Artery ◽  
Left Vertebral Artery ◽  
Type B ◽  
Frozen Elephant Trunk ◽  
Type B Aortic Dissection ◽  
Elephant Trunk ◽  
Aortic Replacement ◽  
Increased Risk ◽  
Hybrid Prosthesis

Abstract Type B aortic dissection (TBAD) is often managed conservatively with intervention reserved for complicated cases. Strategies for complicated and uncomplicated TBAD can involve optimal medical therapy, thoracic endovascular aortic replacement and open surgical repair of TBAD with replacement of the affected segment of aorta and reimplantation of aortic branches. The frozen elephant trunk technique has been reported to be a successful surgical strategy in patients with complicated TBAD, particularly in patients who possess unfavourable aortic arch anatomy for endovascular stenting or at increased risk of retrograde Type A aortic dissection. The Thoraflex is a commercially available aortic graft, manufactured by Vascutek®. We describe a successful case of addressing complicated TBAD with rare variant aortic anatomy using a Thoraflex hybrid frozen elephant trunk graft and reimplantation of the aberrant left vertebral artery to the perfusion limb of the Thoraflex graft.

scholarly journals Non-contrast computed tomography of type A acute aortic dissection in patients with out-of-hospital cardiopulmonary arrest: a case series

2019 ◽  
Vol 3 (4) ◽  
pp. 1-5 ◽  
Author(s):  
Shinsuke Takeuchi ◽  
Yoshihiro Yamaguchi ◽  
Hideaki Yoshino
Keyword(s):  
Computed Tomography ◽  
Aortic Dissection ◽  
Causes Of Death ◽  
Acute Aortic Dissection ◽  
Cardiopulmonary Arrest ◽  
Case Series ◽  
Type A ◽  
Autopsy Imaging ◽  
Conventional Autopsy ◽  
Contrast Ct

Abstract Background The prognosis of patients admitted for acute aortic dissection (AAD) has remarkably improved. However, we must also consider out-of-hospital cardiopulmonary arrest (OHCPA) patients while assessing the prognosis. In recent years, autopsy imaging has become more common as an alternative to conventional autopsy. Therefore, we reviewed our OHCPA patients with type A AAD using acute phase non-contrast computed tomography (CT). Case summary Here, we report a case series of three patients who developed OHCPA and were diagnosed with type A AAD using non-contrast CT. Although the direct causes of death varied in each case, we could easily determine the direct causes of death from clinical course of the condition and from non-contrast CT. Discussion Although non-contrast CT does not completely replace autopsy, if its convenience and non-invasiveness make it possible for more patients to undergo the procedure, the real prognosis (including morbidity and mortality) may be better understood. Therefore, we considered it significant to use non-contrast CT for investigating the cause of sudden death.

Aortic root remodelling with aortic annuloplasty and aortic arch replacement one year after surgical treatment of acute aortic dissection

2017 ◽  
pp. 1213-1213
Author(s):  
Szymon M. Kocańda ◽  
Jakub Zieliński ◽  
Edyta Kaczmarska-Dyrda ◽  
Ilona Michałowska ◽  
Mariusz Kuśmierczyk
Keyword(s):  
Surgical Treatment ◽  
Aortic Dissection ◽  
Aortic Arch ◽  
Aortic Root ◽  
Acute Aortic Dissection ◽  
Aortic Arch Replacement ◽  
One Year
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