scholarly journals Aortic bypass surgery using synthetic conduits in a child with mycotic aneurysmal disease

2016 ◽  
Vol 98 (04) ◽  
pp. e59-e61
Author(s):  
A Sayed ◽  
M Mashaal ◽  
SA Soliman ◽  
H Elwan
Keyword(s):  
Aortic Surgery ◽  
Aortic Aneurysms ◽  
Antifungal Treatment ◽  
Main Concern ◽  
Synthetic Material ◽  
Surgical Interventions ◽  
Aortic Bypass ◽  
Thoracic And Abdominal

A six-year-old child developed multiple aortic aneurysms as a consequence of fungal infection following thoracic aortic surgery for coarctation. Several repairs of both the thoracic and abdominal aorta were carried out using synthetic material combined with long-term postoperative antifungal treatment. We describe the surgical interventions performed and follow-up. The choice of conduit continues to be the main concern; however, when other alternatives are not available, synthetic material combined with indefinite antifungal treatment can produce satisfactory medium-term results.

scholarly journals The Long-Term Follow-Up of Patients with Cystine Stones: A Single-Center Experience for 13 Years

2021 ◽  
Vol 10 (7) ◽  
pp. 1336
Author(s):  
Toshifumi Takahashi ◽  
Shinya Somiya ◽  
Katsuhiro Ito ◽  
Toru Kanno ◽  
Yoshihito Higashi ◽  
...  
Keyword(s):  
Surgical Intervention ◽  
Median Number ◽  
Small Sample ◽  
Age At Diagnosis ◽  
Surgical Interventions ◽  
Significant Difference ◽  
Long Term Follow Up ◽  
Cystine Stones

Introduction: Cystine stone development is relatively uncommon among patients with urolithiasis, and most studies have reported only on small sample sizes and short follow-up periods. We evaluated clinical courses and treatment outcomes of patients with cystine stones with long-term follow-up at our center. Methods: We retrospectively analyzed 22 patients diagnosed with cystine stones between January 1989 and May 2019. Results: The median follow-up was 160 (range 6–340) months, and the median patient age at diagnosis was 46 (range 12–82) years. All patients underwent surgical interventions at the first visit (4 extracorporeal shockwave lithotripsy, 5 ureteroscopy, and 13 percutaneous nephrolithotripsy). The median number of stone events and surgical interventions per year was 0.45 (range 0–2.6) and 0.19 (range 0–1.3) after initial surgical intervention. The median time to stone events and surgical intervention was 2 years and 3.25 years, respectively. There was a significant difference in time to stone events and second surgical intervention when patients were divided at 50 years of age at diagnosis (p = 0.02, 0.04, respectively). Conclusions: Only age at a diagnosis under 50 was significantly associated with recurrent stone events and intervention. Adequate follow-up and treatment are needed to manage patients with cystine stones safely.

How to Find Patients Who are 'Lost to Follow-up'

2010 ◽  
Vol 92 (3) ◽  
pp. 98-101 ◽  
Author(s):  
LC Biant ◽  
VK Eswaramoorthy ◽  
RE Field
Keyword(s):  
Surgical Interventions ◽  
Loss To Follow Up ◽  
Medical Interventions ◽  
Follow Up Studies ◽  
Long Term Follow Up ◽  
Lost To Follow Up

Long-term surveillance of patients is necessary to ascertain the outcome of medical interventions. The rate of 'loss to follow-up' is the largest controllable variable in long-term follow-up studies. Such surveillance programmes are of particular importance to surgical interventions as differences between techniques or implants may take years to become apparent.

scholarly journals Ross procedure and aortic valve repair: long-term echocardiographic outcomes, quality of life and physical activity of different aortic valve surgery procedures

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
F Bianco ◽  
M Colaneri ◽  
V Bucciarelli ◽  
FC Surace ◽  
FC Iezzi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Aortic Valve ◽  
Aortic Surgery ◽  
Ross Procedure ◽  
Valve Repair ◽  
Sf 36

Abstract Funding Acknowledgements Type of funding sources: None. Background  To compare long-term outcomes of aortic valve repair (AVr) and pulmonary autograft replacement (Ross procedure) in terms of echocardiographic parameters, quality of life (QoL), physical activity (PA). Methods  In 2005-19, 129 patients (median age 22 [13, 33 IQR], 75% males) underwent aortic surgery in our Department: 40 were Ross (22 years [19, 51 IQR]), 67 AVr (17 years [1, 50 IQR]) and 22 aortic valve replacements (52 years [30, 80 IQR]). We focused on Ross and AVr. Retrospectively, relevant data were collected from medical records and phone re-calls. Physical activity (spontaneous and active) and QoL were assessed utilizing the IPAQ and SF-36 questionnaires. All patients underwent echocardiography pre/post-surgery and the follow-up lasted 12 ± 4 years. Results  At the baseline, Ross patients had more aortic stenosis than insufficiency (P = 0.045). At the follow-up, Ross procedures presented more right-ventricle and aortic annulus dilatation (P = 0.002 and P = 0.030, respectively), but higher left-ventricular global longitudinal strain (LV GLS: 18 ± 3.2 % vs. 16 ± 3.3, P = 0.0027). Conversely, AVr experienced more re-do operations (Log-rank P = 0.005). Ross reported better QoL (SF-36: 0.8 ± 0.07 vs. 19 ± 0.4, P-0.045) and were also more active in daily PA (IPAQ ≥ 2500 Mets: 63.8% vs. 6%; P = 0.006). Ross patients practiced more sports activities than AVr (P = 0.011). Conclusions  In a relatively small cohort of young and adults post aortic surgery patients, Ross procedures had better prognosis in terms of re-do operations; presented better ventricular function, as assessed by LV GLS. Ross patients had better long-term QoL and showed more spontaneous PA and involvement in sports activity.

Outcomes of open and endovascular repair of inflammatory abdominal aortic aneurysms

Vascular ◽  
2017 ◽  
Vol 26 (2) ◽  
pp. 203-208 ◽  
Author(s):  
África Duque Santos ◽  
Andrés Reyes Valdivia ◽  
María Asunción Romero Lozano ◽  
Enrique Aracil Sanus ◽  
Julia Ocaña Guaita ◽  
...  
Keyword(s):  
Open Surgery ◽  
Aortic Aneurysms ◽  
Endovascular Aortic Repair ◽  
Abdominal Aneurysm ◽  
Aortic Abdominal Aneurysm ◽  
Aortic Repair ◽  
Number Of Patients ◽  
Repair Group

Objective Reports on inflammatory aortic abdominal aneurysm treatment are scarce. Traditionally, open surgery has been validated as the gold standard of treatment; however, high technical skills are required. Endovascular aortic repair has been suggested as a less invasive treatment by some authors offering good results. The purpose of our study was to report our experience and outcomes in the treatment of inflammatory aortic abdominal aneurysm using both approaches. Material and methods A retrospective review and data collection of all patients treated for inflammatory aortic abdominal aneurysm between 2000 and 2015 was done in one academic center. Diagnosis of inflammatory aortic abdominal aneurysm was based on preoperative CT-scan imaging. Type of treatment, postoperative and long-term morbidity and mortality are described. Abdominal compressive symptoms (hydronephrosis) severity and relief after treatment are described. Results Thirty-four patients with intact inflammatory aortic abdominal aneurysm were included. Twenty-nine (85.3%) patients were treated by open means and the remaining five (14.7%) with endovascular aortic repair. Nearly 90% were considered high-risk patients. Median follow-up was 46 months (range 24–112). The two groups were comparable, except for the age and preoperative hydronephrosis. There was no statistical significance in blood transfusion requirements, intensive care hospitalization, 30-day and long-term mortality between the two groups. Preoperative hydronephrosis was diagnosed in four (13.8%) patients in the open surgery group and three (60%) patients in the endovascular aortic repair group. Improvement of hydronephrosis was recognized in three out of the four patients in the open repair group and two out of the three in the endovascular aortic repair group. Renal function remained stable in both groups during follow-up. Conclusions Open surgery remains a safe and valid option for the treatment of inflammatory aortic abdominal aneurysm. Although our study included a small number of patients with endovascular aortic repair treatment, results are promising. Further randomized controlled studies may be necessary to assess long-term effectiveness of endovascular aortic repair treatment in this disease.

Endovascular abdominal aortic aneurysm repair in patients with Marfan syndrome

Vascular ◽  
2019 ◽  
Vol 28 (1) ◽  
pp. 48-52
Author(s):  
Allan Marc Conway ◽  
Khalil Qato ◽  
Gautam Anand ◽  
Laurie Mondry ◽  
Gary Giangola ◽  
...  
Keyword(s):  
Marfan Syndrome ◽  
Open Repair ◽  
Aortic Surgery ◽  
Endovascular Aneurysm Repair ◽  
Aortic Aneurysms ◽  
Type I ◽  
Femoral Access ◽  
Abdominal Aortic ◽  
Aneurysm Repair

Objectives Marfan syndrome patients are at risk for aortic degeneration. Repair is traditionally performed with open surgery as this is deemed more durable. Endovascular aneurysm repair remains controversial. We report on the outcomes of Marfan syndrome patients with abdominal aortic aneurysms undergoing endovascular aneurysm repair. Methods The Vascular Quality Initiative registry identified 35,889 patients, including 29 with Marfan syndrome, treated with endovascular aneurysm repair from January 2003 to December 2017. Outcomes were analyzed per the Society for Vascular Surgery reporting standards. Results Median age was 70.0 years (IQR, 57.0–75.0), and 22 (75.9%) were male. Median aneurysm diameter was 5.3 cm (IQR, 4.9–6.3 cm), with an aortic neck length and diameter of 2.0 cm (IQR, 1.6–2.8 cm) and 2.5 cm (IQR, 2.2–2.8 cm), respectively. Twenty-one (72.4%) patients were asymptomatic, seven (24.1%) symptomatic, and one (3.4%) presented with rupture. Ten (34.5%) patients had prior aortic surgery. Six (20.7%) were unfit for open surgical repair. Length of stay was 2.0 days (IQR, 1.0–3.0 days). Percutaneous femoral access was performed in 15 (51.7%) patients with no complications. A type IA endoleak was present in one (3.4%), type IB in one (3.4%), and type II endoleak in two (6.9%) patients. There were no postoperative pulmonary, cardiac, or neurological complications. In-hospital mortality occurred in one (3.4%) patient who presented with a rupture and had been deemed unfit for open repair. A conversion to open repair was required. The patient expired on post-operative day 0. Early clinical success was achieved in 26 (89.7%) patients. Follow-up was available for 15 (51.7%) patients at a median time of 766 days (IQR, 653–937). There were no reinterventions or mortalities. Change in sac diameter was −0.6 cm (IQR, −1.1 to −0.2 cm), with no type I or III endoleaks. Discussion Endovascular aneurysm repair for patients with Marfan syndrome is feasible, and can be performed safely. Mid-term outcomes suggest this technique is durable. More robust long-term follow-up is needed.

The Italian Trial of Endovascular AAA Exclusion Using the Parodi Endograft

1997 ◽  
Vol 4 (3) ◽  
pp. 299-306 ◽  
Author(s):  
Gioacchino Coppi ◽  
Roberto Moratto ◽  
Roberto Silingardi ◽  
Nicola Tusini ◽  
Roberto Vecchioni ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysms ◽  
Aortic Aneurysms ◽  
Covered Stents ◽  
The Third ◽  
Abdominal Aortic ◽  
The Mean ◽  
Distal Fixation

Purpose: To report the outcome of the prospective 11-center Italian Parodi Trial using straight and tapered endografts for the endovascular exclusion of abdominal aortic aneurysms (AAA). Methods: From April 1994 to July 1995, 27 patients were evaluated and selected for endovascular AAA exclusion. The Parodi devices were delivered through femoral arteriotomies using 18 to 22F introducers and deployed by balloon expansion of the terminal stents. Results: Of 27 cases attempted, 24 endografts (15 tube, 9 aortomonoiliac) were implanted (1 deployment and 2 access failures [11.1%] were converted). Three endoleaks (12.5%) were treated intraoperatively with covered stents, two successfully, and the third sealed within 30 days. Three (12.5%) of the 24 treated patients died in-hospital of device- (n = 2) and procedure-related (n = 1) causes; the remaining 21 patients were discharged within 8 days. Of the 8 aortomonoiliac grafts in follow-up, only 1 (12.5%) failed in the mean 23-month (range 18 to 30) follow-up; however, 4 (31%) of 13 tube graft patients were converted to surgery within 18 months. Of the 16 (66.7%) surviving endografts at 2 years, 6 (38%) showed no change in the AAA diameter, while 10 (62%) had shrunk. Conclusions: The tube graft was applicable in only about 5% of cases, and accurate endograft sizing and distal fixation were problematic. The aortomonoiliac design was not appealing to surgeons but fared better in the long term. Given the advent of newer endograft models, the Italian Parodi Trial has been terminated.

Possible Long-Term Consequences of Middle Ear Effusion

1980 ◽  
Vol 89 (3_suppl) ◽  
pp. 246-248 ◽  
Author(s):  
Denzil N. Brooks
Keyword(s):  
Middle Ear ◽  
Hearing Aids ◽  
The Elderly ◽  
Middle Ear Effusion ◽  
Surgical Interventions ◽  
Impedance Testing ◽  
Auditory Impairment ◽  
Ear Effusion

Three studies will be reported in this paper and the suggestion made that there may be a connection between the findings. The first study concerns the middle ear status of 48 children treated in 1966/67 for middle ear effusion and followed up after ten years. Prior to treatment the median HL was 20 dB (SD = 13 dB) and at follow-up the median HL was 8 dB (SD = 5 dB). However, the otologic and tympanometric findings were less encouraging. Abnormal tympanic membranes (TM) were observed in almost half the children, the rate of abnormality relating to the number of surgical interventions made. However, the TM changes may be due either to the treatment or the disease itself. The second study concerns 104 children monitored by impedance testing over a ten-year period and tends to support the hypothesis that the effusion itself is the probable cause of the changes in the TM. The third study relates to applicants for hearing aids. Excluding those with clearly defined conditions such as otosclerosis, noise trauma and Meniére's disorder, etc, two clear groups emerged, one with uncontaminated sensorineural (SN) loss, the other with mainly SN loss but with a significant conductive overlay. Though the median hearing losses of the two groups are the same, the average age for the SN group (77; SD = 7 years) is 12 years greater than that of the “conductive” group (65; SD = 14 years). Few of the SN group can recall auditory dysfunction in childhood, but the majority of the conductive group have clear recall. It seems probable that middle ear disorders in childhood may give rise to auditory impairment in the elderly such that when combined with age-associated hearing loss the need for prosthetic aid arises at a much lower age.

scholarly journals Long Term Outcomes of Freestyle Stentless Aortic Bioprosthesis: A Single Center Experience

2020 ◽  
Vol 23 (1) ◽  
pp. E034-E038
Author(s):  
Mehmet Ezelsoy ◽  
Kerem Oral ◽  
Kemal Tolga Saracoglu ◽  
Ayten Saracoglu ◽  
Zehra Bayramoglu ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Root ◽  
Artery Bypass ◽  
Clinical Results ◽  
Aortic Aneurysms ◽  
Aortic Cross Clamp Time ◽  
Replacement Procedure ◽  
Structural Valve Deterioration

Background: The study is presenting our long-term clinical results after freestyle stentless aortic root bioprosthesis replacement in patients with severe aortic insufficiency with ascending aortic aneurysm. Methods: Seventy-seven patients with ascending aortic aneurysms and aortic valve insufficiency underwent a total root replacement procedure using a stentless “Freestyle” valve (Medtronic Inc., Minneapolis, Minnesota). There were 50 (64.9%) men and 27 (35.1%) women. Mean age was 68.7 ± 11.1 years. The surgical procedure used a complete root replacement. Concomitant procedures included coronary artery bypass grafting in 15 (19.5%) patients. Results: The mean cardiopulmonary bypass time was 130.3 ± 26.4 minutes and total aortic cross clamp time was 99.5 ± 23.6 minutes. Hospital mortality was 2.6%. The median follow-up time was 11.2 years. The 5- and 10-years freedom from aortic valve reoperation were 97.4 ± 1.2% and 93.4 ± 4.9%, respectively. During 10 years follow up, there were 14 late deaths; 4 deaths were cardiac, and 10 deaths were noncardiac. Valve-related deaths were attributable to thromboembolism in 1 patient, endocarditis in 2 patients, and congestive heart failure in 1 patient. Conclusion: The freestyle stentless aortic root bioprosthesis offered good clinical outcomes, in terms of survival and structural valve deterioration. The Freestyle valve is a viable option for use in patients undergoing bioprosthetic aortic valve replacement and expected desire for long-term durability.

Long-term computed tomography follow-up after open surgical repair of abdominal aortic aneurysms

2006 ◽  
Vol 47 (6) ◽  
pp. 549-553 ◽  
Author(s):  
M. Mantoni ◽  
K. Neergaard ◽  
J. K. Christoffersen ◽  
T. L. Lambine ◽  
N. BÆkgaard
Keyword(s):  
Computed Tomography ◽  
Surgical Repair ◽  
Abdominal Aortic Aneurysms ◽  
Aortic Aneurysms ◽  
Open Surgical Repair ◽  
Abdominal Aortic

Uncovered Chimney Stent Graft for Renal Arteries With the Nellix Endovascular Aneurysm Sealing Technique

2017 ◽  
Vol 52 (2) ◽  
pp. 148-153 ◽  
Author(s):  
Luca Garriboli ◽  
Antonio Maria Jannello
Keyword(s):  
Aortic Aneurysms ◽  
Type I ◽  
Abdominal Aortic ◽  
Vessel Patency ◽  
Type I Endoleak ◽  
Procedural Costs ◽  
Endovascular Approach ◽  
Access Complications

Purpose: To describe the application of uncovered chimney stent grafts with the Nellix endovascular aneurysm sealing technique (ChEVAS) for juxtarenal abdominal aortic aneurysms (JAAAs). Case Report: Two patients with JAAA and multiple comorbidities were considered unfit for open surgery and were selected for an endovascular approach. Fenestrated and branched endografts were too expensive, and a chimney endovascular approach was considered inappropriate for the relatively high incidence of proximal type I endoleak and graft migration. ChEVAS was performed successfully with the novel addition of uncovered chimney stents to further reduce costs and possibly improve target vessel patency. JAAA exclusion and visceral vessel patency was confirmed at 18-month follow-up. Conclusion: ChEVAS with bare chimney stents is technically less complex, potentially reduces access complications and procedural costs, and may improve long-term patency compared to alternative techniques. Results at 18 months seem promising, but strict follow-up is necessary as the long-term durability is unknown.

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