scholarly journals Endovascular Exclusion of Aortobronchial Fistula and Distal Anastomotic Aneurysm after Extra-Anatomic Bypass for Aortic Coarctation

2017 ◽  
Vol 44 (1) ◽  
pp. 55-57 ◽  
Author(s):  
Antonio Bozzani ◽  
Vittorio Arici ◽  
Giuseppe Rodolico ◽  
Massimo Borri Brunetto ◽  
Angelo Argenteri
Keyword(s):  
High Risk ◽  
Aortic Coarctation ◽  
Medical Literature ◽  
Surgical Repair ◽  
Close Monitoring ◽  
Open Surgical Repair ◽  
Anastomotic Aneurysm ◽  
Aortobronchial Fistula ◽  
Late Sequela ◽  
History Of

The treatment of choice for aortic coarctation in adults remains open surgical repair. Aortobronchial fistula is a rare but potentially fatal late sequela of surgical correction of isthmic aortic coarctation via the interposition of a graft.The endovascular treatment of aortobronchial fistula is still under discussion because of its high risk for infection, especially if the patient has a history of cardiovascular prosthetic implantation. Patients need close monitoring, most notably those with secondary aortobronchial fistula. We discuss the case of a 65-year-old man who presented with the combined conditions, and we briefly review the relevant medical literature.

scholarly journals A rare case of pseudoaneurysm at the site of untreated coarctation of the aorta in an adult patient

2020 ◽  
Author(s):  
Takuma Mikami ◽  
Takeshi Kamada ◽  
Hiroki Uchiyama ◽  
Yosuke Kuroda ◽  
Ryo Harada ◽  
...  
Keyword(s):  
High Risk ◽  
Aortic Aneurysm ◽  
Aortic Coarctation ◽  
Poor Prognosis ◽  
Rare Case ◽  
Surgical Repair ◽  
Coarctation Of The Aorta ◽  
Pathological Findings ◽  
Open Surgical Repair ◽  
Risk Of Rupture

Abstract Here we report a rare case of pseudoaneurysm at the site of aortic coarctation. Aortic coarctation and a saccular aortic aneurysm protruding from the site of this coarctation were detected in a 50-year-old woman. Owing to the shape of the aneurysm and high risk of rupture, an open surgical repair was performed. The pathological findings of the removed aneurysm revealed a pseudoaneurysm consisting of only a thin adventitial wall. Adult uncorrected aortic coarctation has a poor prognosis. One of its causes may be the formation of such a pseudoaneurysm.

Primary venous aneurysms: A 20-year retrospective analysis

Vascular ◽  
2020 ◽  
Vol 28 (5) ◽  
pp. 577-582
Author(s):  
Samantha Gabriel ◽  
Naomi Eisenberg ◽  
Denise Kim ◽  
Arash Jaberi ◽  
Graham Roche-Nagle
Keyword(s):  
High Risk ◽  
Symptom Management ◽  
Inferior Vena ◽  
Surgical Repair ◽  
Vena Cava ◽  
Duplex Ultrasound ◽  
Time Frame ◽  
Risk Of Rupture ◽  
History Of ◽  
Medical Histories

Objective Primary venous aneurysms are unusual vascular occurrences. Our aim is to document our institution’s experience with this pathology; describing frequency, diagnosis, outcomes and medical histories of patients with primary venous aneurysms within a 20-year time frame. Methods A retrospective study at our institution using its radiology database was conducted. Results were isolated to primary venous aneurysms diagnosed between 1997 and 2017. Basic demographics and medical history were collected. Results We identified 32 patients with primary venous aneurysms. Eighteen were male and 14 were female. The average age of presentation was 54 years old, with a range of 17–86. None of these patients reported a family history of aneurysmal disease. The majority were incidental. Of these aneurysms, 3 were of the head and neck, 1 was contained in the thorax, 17 were intra-abdominal and 11 were peripheral. Diagnosis was made by computed tomography, duplex ultrasound, or magnetic resonance imaging. Conservative management was most frequently employed, but four patients underwent surgical repair. Three aneurysms required operation for symptom management (external jugular, subclavian, inferior vena cava), whereas one aneurysm of the popliteal vein was prophylactically managed, given the high risk for pulmonary embolism. Conclusions Primary venous aneurysms present infrequently. Despite their rarity, primary venous aneurysms have been reported to occur throughout the venous system. The majority of primary venous aneurysms in this series were found incidentally and can present both symptomatically or asymptomatically. The findings of our 20-year experience were consistent with the existing literature. Because the risk of rupture is negligible, the indications for surgical management remain for cosmesis, symptom management or high risk of thromboembolic events.

scholarly journals P1494 Incidental finding of aortic aneurysm formation following 34 years of coarctation repair by dacron patch aortoplasty

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
E A Khalifa ◽  
S Helmy ◽  
S F Mohamed ◽  
M Alkuwari
Keyword(s):  
Aortic Aneurysm ◽  
Aortic Arch ◽  
Subclavian Artery ◽  
Aortic Coarctation ◽  
Surgical Repair ◽  
Left Ventricular ◽  
Coarctation Repair ◽  
History Of ◽  
Dacron Patch

Abstract Introduction Aneurysms are found following all types of surgical repair of aortic coarctation, especially after Dacron patch aortoplasty. We describe the finding of an aortic aneurysm in an asymptomatic 52-year-old male, who was managed by Dacron patch aortoplasty for native coarctation of the aorta 34 years earlier. Case report A 52-year male, smoker, hypertensive on medication He had previous history of surgical repair of aortic coarctation at age of 18 years . Repair was by Dacron patch aortoplasty. Since then, his regular follow up was unremarkable. Recently, he was referred for cardiac evaluation as a part of pre-employment general check-up. He was asymptomatic with no history of shortness of breath or chest pain. Physical examination revealed that the pulse in the left arm was reduced in volume in comparison to the right one. The heart sounds were essentially normal but a pericardial murmur was audible, perhaps reflecting residual collateral flow. Blood pressure was 156/83 mmHg in right arm and 142/81 in the left arm. Transthoracic echocardiography revealed mild left ventricular hypertrophy with normal global and regional contractility and an ejection fraction of 58%. Supra sternal window images showed dilatation of the three aortic arch branches. The distal portion of aortic arch just distal to origin of left subclavian artery was narrowed with a peak systolic gradient across of 34 mmHg. A cystic structure (1.7 cm x 1.9 cm) was visualized attached to the narrowed segment of the aorta, suggestive of a saccular aneurysm, (figures A&B&C). Computed tomography aortogram showed a narrow-necked aneurysm arising from the posterolateral aspect of the distal aortic arch (anticipated site of the coarctation repair graft anastomosis). A small laminated thrombus was also noted within. Aneurysm measured approximately 2.2 x 3.3 cm in its craniocaudal and anteroposterior dimensions respectively, with no evidence of aortic luminal compromise. (figures D&E&F). Management Aneurysmectomy was performed subsequently. Interposition polyester grafts were used to reconstruct the aortic arch and proximal descending aorta and to connect this aortic segment to the subclavian artery via a lateral thoracotomy. The postoperative course thereafter was uneventful. Conclusion: This is a rare insidious complication of Dacron patch aortoplasty that occurred after more than 3 decades, which highlights the importance of diagnostic imaging in the follow up of these patients Abstract P1494 Figure.

scholarly journals Pregnancy vs. Paycheck: A qualitative study of patient’s experience with employment during pregnancy at high risk for preterm birth

2020 ◽  
Author(s):  
Sarahn M. Wheeler ◽  
Kelley E. C. Massengale ◽  
Konyin Adewumi ◽  
Thelma A. Fitzgerald ◽  
Carrie B. Dombeck ◽  
...  
Keyword(s):  
Preterm Birth ◽  
High Risk ◽  
Prenatal Care ◽  
Pregnant Women ◽  
Structured Interview ◽  
Close Monitoring ◽  
Risk Pregnancy ◽  
Increased Risk ◽  
History Of ◽  
In Pregnancy

Abstract Background: Pregnant women with a history of preterm birth are at risk for recurrence, often requiring frequent prenatal visits for close monitoring and/or preventive therapies. Employment demands can limit uptake and adherence to recommended monitoring and preterm birth prevention therapies. Method: We conducted a qualitative descriptive study using in-depth interviews (IDIs) of pregnant women with a history of preterm birth. IDIs were conducted by trained qualitative interviewers following a semi-structured interview guide focused on uncovering barriers and facilitators to initiation of prenatal care, including relevant employment experiences, and soliciting potential interventions to improve prompt prenatal care initiation. The IDIs were analyzed via applied thematic analysis. Results: We described the interview findings that address women’s employment experiences. The current analysis includes 27 women who are majority self-described as non-Hispanic Black (74%) and publically insured (70%). Participants were employed in a range of professions; food services, childcare and retail were the most common occupations. Participants described multiple ways that being pregnant impacted their earning potential, ranging from voluntary work-hour reduction, involuntary duty hour reductions by employers, truncated promotions, and termination of employment. Participants also shared varying experiences with workplace accommodations to their work environment and job duties based on their pregnancy. Some of these accommodations were initiated by a collaborative employee/employer discussion, others were initiated by the employer’s perception of safe working conditions in pregnancy, and some accommodations were based on medical recommendations. Participants described supportive and unsupportive employer reactions to requests for accommodations. Conclusions: Our findings provide novel insights into women’s experiences balancing a pregnancy at increased risk for preterm birth with employment obligations. While many women reported positive experiences, the most striking insights came from women who described negative situations that ranged from challenging to potentially unlawful. Many of the findings suggest profound misunderstandings likely exist at the patient, employer and clinical provider level about the laws surrounding employment in pregnancy, safe employment responsibilities during pregnancy, and the range of creative accommodations that often allow for continued workplace productivity even during high risk pregnancy.

scholarly journals Successful open surgical repair of an infrarenal, abdominal aortic aneurysm (AAA) in a young Malawian female: A case report

2019 ◽  
Vol 31 (4) ◽  
pp. 256-258
Author(s):  
Geoffrey Manda
Keyword(s):  
Abdominal Pain ◽  
Spinal Surgery ◽  
Surgical Repair ◽  
Central Hospital ◽  
Open Surgical Repair ◽  
Infrarenal Abdominal Aortic Aneurysm ◽  
Lower Back ◽  
Abdominal Aortic ◽  
History Of ◽  
Queen Elizabeth Central Hospital

A 39-year-old woman presented to Queen Elizabeth Central Hospital in Blantyre, Malawi  with a 3-week history of worsening peri-umbilical abdominal pain radiating to the lower back associated with anorexia, nausea and vomiting. There was no history of trauma, diarrhoea, obstipation, fevers, or urinary symptoms. She reported history of ‘spinal surgery’ performed 6 years prior due to a herniated intervertebral lumbar disk.

scholarly journals Pregnancy vs. paycheck: a qualitative study of patient’s experience with employment during pregnancy at high risk for preterm birth

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Sarahn M. Wheeler ◽  
Kelley E. C. Massengale ◽  
Konyin Adewumi ◽  
Thelma A. Fitzgerald ◽  
Carrie B. Dombeck ◽  
...  
Keyword(s):  
Preterm Birth ◽  
High Risk ◽  
Prenatal Care ◽  
Pregnant Women ◽  
Structured Interview ◽  
Close Monitoring ◽  
Risk Pregnancy ◽  
Increased Risk ◽  
History Of ◽  
In Pregnancy

Abstract Background Pregnant women with a history of preterm birth are at risk for recurrence, often requiring frequent prenatal visits for close monitoring and/or preventive therapies. Employment demands can limit uptake and adherence to recommended monitoring and preterm birth prevention therapies. Method We conducted a qualitative descriptive study using in-depth interviews (IDIs) of pregnant women with a history of preterm birth. IDIs were conducted by trained qualitative interviewers following a semi-structured interview guide focused on uncovering barriers and facilitators to initiation of prenatal care, including relevant employment experiences, and soliciting potential interventions to improve prompt prenatal care initiation. The IDIs were analyzed via applied thematic analysis. Results We described the interview findings that address women’s employment experiences. The current analysis includes 27 women who are majority self-described as non-Hispanic Black (74%) and publically insured (70%). Participants were employed in a range of professions; food services, childcare and retail were the most common occupations. Participants described multiple ways that being pregnant impacted their earning potential, ranging from voluntary work-hour reduction, involuntary duty hour reductions by employers, truncated promotions, and termination of employment. Participants also shared varying experiences with workplace accommodations to their work environment and job duties based on their pregnancy. Some of these accommodations were initiated by a collaborative employee/employer discussion, others were initiated by the employer’s perception of safe working conditions in pregnancy, and some accommodations were based on medical recommendations. Participants described supportive and unsupportive employer reactions to requests for accommodations. Conclusions Our findings provide novel insights into women’s experiences balancing a pregnancy at increased risk for preterm birth with employment obligations. While many women reported positive experiences, the most striking insights came from women who described negative situations that ranged from challenging to potentially unlawful. Many of the findings suggest profound misunderstandings likely exist at the patient, employer and clinical provider level about the laws surrounding employment in pregnancy, safe employment responsibilities during pregnancy, and the range of creative accommodations that often allow for continued workplace productivity even during high risk pregnancy.

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