Subclavian flap aortoplasty for infant coarctation of the aorta

2021 ◽  
Keyword(s):  
Gold Standard ◽  
Aortic Coarctation ◽  
Standard Treatment ◽  
Coarctation Of The Aorta ◽  
Long Term Outcomes ◽  
Descending Aorta ◽  
Technical Aspects ◽  
Video Tutorial ◽  
End To End

Aortic resection with an extended end-to-end anastomosis is the surgical gold standard treatment for infant aortic coarctation and has excellent early and long-term outcomes. Subclavian flap aortoplasty is an alternative surgical technique that offers some advantages because there is no need to do extensive dissection and mobilization of the aortic arch and descending aorta as required in an extended end-to-end anastomosis. This video tutorial illustrates the technical aspects of subclavian flap aortoplasty in an infant.

scholarly journals Measurement of long-term outcomes in observational and randomised controlled trials

2007 ◽  
Vol 191 (S50) ◽  
pp. s78-s84 ◽  
Author(s):  
Richard Hodgson ◽  
Chris Bushe ◽  
Robert Hunter
Keyword(s):  
Gold Standard ◽  
Observational Studies ◽  
Randomised Controlled Trials ◽  
Face Validity ◽  
Controlled Trials ◽  
Experimental Paradigm ◽  
Pragmatic Trials ◽  
Long Term Outcomes ◽  
Randomised Controlled

BackgroundRandomised controlled trials (RCTs) are the gold standard for evaluating treatment efficacy. However, the outcomes of RCTs often lackclinical utility and usually do not address real-world effectivenessAimsTo review how traditional RCTs may be triangulatedwith other methodologies such as observational studies and pragmatic trials by highlighting recently reported studies, outcomes used and their respective meritsMethodLiterature review focusing on drug treatmentResultsRecently reported observational and some pragmatic studies show a degree of consistency in reported results and use outcomes that have face validity for cliniciansConclusionsNo single experimental paradigm or outcome provides the necessary data to optimise treatment of mental illness in the clinical setting

scholarly journals Clinical, Radiological, Pedobarographic, and Quality of Life Outcomes of the Ponseti Treatment for Clubfoot: A Prospective Study from Iran

2021 ◽  
Author(s):  
Kamyar Vahidi ◽  
Ahmad Shamabadi ◽  
Mohammad Hossein Nabian ◽  
Fardis Vosoughi ◽  
Ramin Zargarbashi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Standard Treatment ◽  
Daily Activities ◽  
Life Outcomes ◽  
Long Term Outcomes ◽  
First Metatarsal ◽  
Talipes Equinovarus ◽  
A Prospective Study

Abstract Background: Talipes equinovarus, also known as clubfoot, is a congenital anomaly that affects one newborn per 1000 live births. Its standard treatment strategy is the Ponseti casting management. This study aims to report the long-term outcomes of the Ponseti treatment in Iran.Methods: A prospective cohort study was enrolled to evaluate clinical outcomes, radiological results, pedobarographic measurements, and quality of life after the Ponseti treatment in patients with clubfoot who were followed for at least five years.Results: In this study, 25 clubfeet of 18 patients were included. Significant reductions in Pirani, Dimeglio, and CAP scores, improved ankle dorsiflexion, and acceptable pedobarographic indices were observed in this study. From the radiological evaluation indices, the calcaneal pitch and lateral talus-first metatarsal angles were significantly reduced. The quality of life of patients after five years of treatment was favorable, which was better in females. This study showed that the results of the Ponseti treatment remained acceptable after five years.Conclusions: The Ponseti management for clubfoot in the long term appears to maintain significant improvements. However, the rate of recurrence – albeit without disruption to daily activities - cannot be ignored.

Abnormal histology of the aortic arch in coarctation of the aorta

1993 ◽  
Vol 3 (4) ◽  
pp. 412-416 ◽  
Author(s):  
Derk W. Wolterbeek ◽  
Arie P. Kappetein ◽  
Adriana C. Gittenberger–de Groot
Keyword(s):  
Neural Crest ◽  
Aortic Arch ◽  
Aortic Coarctation ◽  
Coarctation Of The Aorta ◽  
Lower Number ◽  
Descending Aorta ◽  
Aortic Isthmus ◽  
Cardiac Neural Crest ◽  
The Media

SummaryWe examined the number of elastic lamellae in the wall of the proximal aortic arch, aortic isthmus and descending aorta in patients with coarctation of the aorta. In the proximal aortic arch, the number of elastic lamellae was significantly lower in patients with coarctation compared to those with normal hearts without aortic anomalies and those with intracardiac defects but without aortic anomalies. The isthmus also showed a significantly lower number of elastic lamellae in the presence of preductal coarctation. In the descending aorta, the number of elastic lamellae was not significantly different between the different groups. There is doubt about the etiology of coarctation. Recent investigations showed that cells from the cardiac neural crest contribute to the formation of the arch arteries and the media of the arch. A developmental error of the neural crest might be responsible for the abnormal mural structures found in patients with aortic coarctation.

scholarly journals Delayed Therapy of Descending Aortic Coarctation Results in Anterior Cerebral Rupture: A Case Report

2021 ◽  
Vol 9 ◽  
Author(s):  
Kele Qin ◽  
Jinfu Yang ◽  
Mi Tang ◽  
Chukwuemeka Daniel Iroegbu ◽  
Shijun Hu ◽  
...  
Keyword(s):  
Aortic Coarctation ◽  
Delayed Diagnosis ◽  
Coarctation Of The Aorta ◽  
Endovascular Stent ◽  
Case Presentation ◽  
Descending Aorta ◽  
Delay In Diagnosis ◽  
Upper And Lower Extremities ◽  
Blood Pressures ◽  
Percutaneous Transluminal

Background: Coarctation of the aorta (CoA) is the congenital constriction or narrowing of the aortic lumen. These constrictions are primarily located in the descending aorta causing significant discrepancies in systolic blood pressures of the upper and lower extremities. Thus, a delay in diagnosis and treatment may lead to severe and adverse consequences.Case presentation: Herein, we present a 13-year-old boy with anterior cerebral rupture following a delayed diagnosis for descending CoA. Percutaneous transluminal balloon dilatation and endovascular stent implantation were urgently and successfully performed alongside cerebral clipping of the vascular aneurysm.Conclusion: An early diagnosis is crucial for CoA's successful treatment and management to prevent complications, including anterior cerebral rupture.

Is Laparoscopic Roux-en-Y Gastric Bypass Still the Gold Standard Procedure for Indians? Mid- to Long-Term Outcomes from a Tertiary Care Center

2020 ◽  
Vol 30 (11) ◽  
pp. 4482-4493
Author(s):  
Shivanshu Misra ◽  
B. Deepa Nandhini ◽  
S. Christinajoice ◽  
S. Saravana Kumar ◽  
S. Prabhakaran ◽  
...  
Keyword(s):  
Gastric Bypass ◽  
Gold Standard ◽  
Care Center ◽  
Standard Procedure ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
Long Term Outcomes
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