Thoracic Endovascular Aortic Repair for Iatrogenic Injury of the Thoracic Aorta

2021 ◽  
pp. 152660282110659
Author(s):  
Peyton Tharp ◽  
Ryan W. King ◽  
Bruce M. Frankel ◽  
Mathew D. Wooster
Keyword(s):  
Thoracic Aorta ◽  
Pedicle Screws ◽  
Aortic Injury ◽  
Iatrogenic Injury ◽  
Descending Thoracic Aorta ◽  
Thoracic Pain ◽  
Spinal Reconstruction ◽  
Novel Approach ◽  
The Right ◽  
Scoliosis Deformity

Purpose: Address iatrogenic injury to the descending thoracic aorta by breached spinal screws through a novel approach of concomitant spinal screw removal and thoracic endovascular repair (TEVAR) placement. Case Report: A 36-year-old female with idiopathic scoliosis underwent T4 to L3 bilateral pedicle instrumentation with spinal fusion and correction of scoliosis deformity. Ten months post-operative, she continued to complain of mid-thoracic pain; computed tomography (CT) angiography revealed protrusion of the left T5 and T6 transpedicular screws into her descending thoracic aorta by 3 and 5 mm, respectively. She was taken to the odds ratio (OR) in a combination case with vascular and neurosurgery. Positioned in the right lateral decubitus position, TEVAR was successfully deployed while neurosurgery concurrently removed the invading spinal screws via posterior spinal exposure. Neurosurgery then completely revised the spinal hardware during the same operation. The patient progressed well throughout the remainder of her hospital stay and was discharged on postoperative day 4. Two-year angiography demonstrated a well-placed TEVAR with no extravasation or aortic abnormality. Conclusions: In the setting of iatrogenic aortic injury due to pedicle screws, concomitant TEVAR and spinal screw removal is a safe and feasible treatment option that allows for spinal reconstruction to occur without multiple trips to the operating room.

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.

Surgical Management of a Ballistic Trauma of the Right Ventricle and Descending Thoracic Aorta

2014 ◽  
Vol 28 (5) ◽  
pp. 1315.e1-1315.e4
Author(s):  
Caroline Carrières ◽  
Yannick Georg ◽  
Ismail Khelifa ◽  
Fabien Koskas
Keyword(s):  
Right Ventricle ◽  
Thoracic Aorta ◽  
Surgical Management ◽  
Descending Thoracic Aorta ◽  
The Right ◽  
Ballistic Trauma

A Case of Takaysu Arteritis Associated with Complete Obstruction of Descending Thoracic Aorta and Stenosis of the Right Coronary Artery

1997 ◽  
Vol 27 (2) ◽  
pp. 213
Author(s):  
Hong Seung Kim ◽  
Ju Yong Lee ◽  
Byoung Soo Yoo ◽  
Seung Chan Ahn ◽  
Jung Han Yoon ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Thoracic Aorta ◽  
Right Coronary Artery ◽  
Descending Thoracic Aorta ◽  
Complete Obstruction ◽  
The Right

Arteriosclerotic Aneurysm of the Descending Thoracic Aorta Presenting to the Right of the Spine

Radiology ◽  
1949 ◽  
Vol 53 (1) ◽  
pp. 93-96 ◽  
Author(s):  
Bernard S. Epstein ◽  
Robert L. Friedman
Keyword(s):  
Thoracic Aorta ◽  
Descending Thoracic Aorta ◽  
The Right

Changes in Coronary Flow Reserve following Stent Implantation in the Swine Descending Thoracic Aorta

2007 ◽  
Vol 14 (4) ◽  
pp. 544-550 ◽  
Author(s):  
Achilles A. Zacharoulis ◽  
Sophia M. Arapi ◽  
George A. Lazaros ◽  
Apostolos I. Karavidas ◽  
Apostolos A. Zacharoulis
Keyword(s):  
Thoracic Aorta ◽  
Coronary Flow Reserve ◽  
Stent Implantation ◽  
Coronary Flow ◽  
Aortic Diameter ◽  
Descending Thoracic Aorta ◽  
Stent Deployment ◽  
Flow Reserve ◽  
The Mean ◽  
The Right

Purpose: To evaluate coronary flow reserve (CFR) changes following stent implantation in the descending thoracic aorta (DTA) of a porcine model. Methods: Six pigs (3 males; 40 to 44 kg) were anesthetized and kept on mechanical ventilation. A 6-F guiding right Judkins catheter was advanced under fluoroscopy to the right coronary artery, and a pressure wire with a temperature sensor was placed within the vessel lumen at a distance of 4 cm from the ostium. CFR was estimated by the thermodilution method before and after maximal coronary vasodilation with 20 mg of intracoronary papaverine. Aortography was also performed to measure aortic diameter. Subsequently, a self-expanding vascular stent was deployed into the DTA just below the left subclavian artery (LSA), and CFR was measured again. All animals were maintained for 3 weeks; at the end of this period, a further CFR was calculated using the same procedure. Results: The mean aortic diameter below the LSA was 12.15±0.15 mm. Following stent deployment, the mean aortic diameter measured at the stented segment was 12.58±0.11 (p=0.001 versus baseline). The mean CFR value was 4.7062.00 before stent implantation, 2.6860.86 immediately after, and 4.0561.15 at 3 weeks after stenting. Accordingly, CFR values were significantly depressed immediately after stent placement compared with baseline (p=0.027). However, CFR values obtained 3 weeks following stent deployment were similar to the initial values (p=0.59). Conclusion: Stent deployment in the normal swine DTA produces a significant immediate decrease in CFR, which is attenuated 3 weeks later. The clinical impact of CFR changes following DTA endografting remain to be elucidated.

Emergency Stent-Graft Placement for Impending Rupture of the Descending Thoracic Aorta

2002 ◽  
Vol 9 (2_suppl) ◽  
pp. II-72-II-78 ◽  
Author(s):  
H. Joachim Nesser ◽  
Holger Eggebrecht ◽  
Dietrich Baumgart ◽  
Christian Ebner ◽  
Manfred Gschwendtner ◽  
...  
Keyword(s):  
Thoracic Aorta ◽  
Stent Graft ◽  
Aortic Rupture ◽  
Case Reports ◽  
Intramural Hematoma ◽  
Descending Thoracic Aorta ◽  
Thoracic Pain ◽  
Promising Alternative ◽  
Graft Placement ◽  
Impending Rupture

Purpose: To present initial experience with emergent stent-graft placement for impending rupture of the descending thoracic aorta. Case Reports: Intramural hematoma (IMH) of the descending thoracic aorta was diagnosed by transesophageal echocardiography and computed tomography in 3 patients with acute onset of severe thoracic pain. Because of signs of impending rupture, e.g., pleural effusion, sustained pain, or transadventitial bleeding, the patients underwent emergency stent-graft placement, which was successful in all cases. No procedure-related complications were observed. Follow-up to 18 months has revealed no evidence of endoleak, and all patients remain free of symptoms. Conclusions: Emergency stent-graft placement may be a promising alternative to conventional surgery in patients with impending aortic rupture due to IMH.

scholarly journals Endovascular treatment of the rupture of thoracic aortic aneurysm, manifested by a neurological «mask»

2021 ◽  
Vol 179 (6) ◽  
pp. 66-71
Author(s):  
A. N. Ryazanov ◽  
V. V. Soroka ◽  
S. P. Nokhrin ◽  
D. V. Kandyba ◽  
S. A. Platonov ◽  
...  
Keyword(s):  
Aortic Aneurysm ◽  
Thoracic Aorta ◽  
Pleural Cavity ◽  
Descending Thoracic Aorta ◽  
Suspected Pulmonary Embolism ◽  
Spiral Computed ◽  
Satisfactory Condition ◽  
Endovascular Methods ◽  
The Right

The article describes a case of successful treatment of the rupture of aortic aneurysm by the endovascular method. Patient P., 71 years old, was hospitalized in a multidisciplinary hospital with a diagnosis of acute cerebral circulation disorder. The patient was examined in the intensive care unit. Signs of neurological symptoms regressed. Spiral computed tomography of the chest organs was performed with suspected pulmonary embolism, the results of which revealed an aneurysm of the descending thoracic aorta, complicated by a rupture with the formation of a right-sided hemothorax. The patient underwent endoprosthesis of the thoracic aorta with stent graft. After 2 days, thoracoscopic sanitation, drainage of the right pleural cavity was performed. The postoperative period proceeded without peculiarities. The patient was discharged on the 12th day in satisfactory condition. At control examination in 1, 6, 12 months, the long-term steady positive result was noted. Endovascular methods minimize the risk of postoperative complications, contributing to a favorable outcome of the disease.

Total correction of tetralogy of Fallot without “routine”preoperative cardiac catheterization—management of 99 patients

1994 ◽  
Vol 4 (3) ◽  
pp. 262-266
Author(s):  
Ayse Sarioglu ◽  
Gülhis Batmaz ◽  
Mehmet Salih Bilal ◽  
Irfan Levent Saltik ◽  
Gül Saylam ◽  
...  
Keyword(s):  
Tetralogy Of Fallot ◽  
Thoracic Aorta ◽  
Cardiac Catheterization ◽  
Pulmonary Arteries ◽  
Systolic Pressure ◽  
Left Ventricular ◽  
Descending Thoracic Aorta ◽  
Total Correction ◽  
Echocardiographic Examination ◽  
The Right

SummaryBetween January 1989 and March 1993, total correction was performed in 99 patients with tetralogy of Fallot without submitting them to prior cardiac catheterization. The age of the patients ranged from 1.33 to 18 years (mean 5.33±3.77). After complete echocardiographic examination, the diameters of the right and left pulmonary arteries at the prebranching point and the descending thoracic aorta at the diaphragm were measured by cross-sectional echocardiography and the McGoon ratio was calculated. Total correction was performed in all patients with a McGoon ratio greater than 1.7. In none of the patients were the sizes of the pulmonary artery measured by echocardiography smaller than the measurements obtained during surgery. Transannular patching was performed in 76 patients. A conduit from the right ventricle to the pulmonary arteries was constructed in two patients with coronary arterial anomalies. Postrepair right ventricular to left ventricular systolic pressure ratios were between 0.25 and 0.85 (mean 0.54±0.13). There were two hospital deaths, neither being related to the diagnostic method used nor the criteria for surgery. We conclude that the diagnosis of tetralogy of Fallot together with measurements of pulmonary arteries and descending thoracic aorta can safely and reliably be achieved echocardiographically. The McGoon ratio can be adapted to echocardiography and total correction can be performed successfully based on echocardiographic examination.

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