Late complications and treatment options of aortic coarctation operated in childhood

2014 ◽  
Vol 155 (30) ◽  
pp. 1189-1195
Author(s):  
Csaba Dzsinich ◽  
Miklós Vaszily ◽  
Gábor Vallus ◽  
Máté Dzsinich ◽  
Péter Berek ◽  
...  
Keyword(s):  
Aortic Coarctation ◽  
Treatment Options ◽  
Late Complication ◽  
Late Complications ◽  
Intraoperative Bleeding ◽  
Graft Stenosis ◽  
Endovascular Interventions ◽  
Aortic Bypass ◽  
Hybrid Solution ◽  
Patch Plasty

Introduction: The prevalence of congenital aortic coarctation is 4 in 10 000 live birth. Aortic coarctation is typically located in the aortic isthmus, but it may occur at atypical sites. Treatment options include both surgical and endovascular interventions. In patients undergoing surgical or endovascular intervention late complications such as recoarctation or aortic aneurysm may develop. Aim: The aim of the authors was to analyse their own experience in late complication and treatment options of aortic coarctation operated in childhood. Method: Retrospective analysis of data of 32 patients treated between 1980 and 2014 for late complications 8–42 years after surgical treatment of aortic coarctation. Results: In 28 patients aneurysm formation after isthmic patch plasty was found. Two patients had aortobronchial fistula, 2 patients showed anastomosis disruption and 2 patients had graft stenosis. During operation hybrid solution was performed in 23 patients, isthmic aorto-aortic inlay graft interposition in 5 patients, aorto-aortic bypass in 2 patients, subclavio-aortic bypass in 2 patients, graft patch plasty in one patient and ilio-renal bypass in one patient. Complications included severe intraoperative bleeding in one patient and pneumothorax in one patient. No early or late mortality occurred. Conclusions: The authors conclude that life long control is mandatory in order to detect late complications in patients who underwent operation of aortic coarctation in childhood. Orv. Hetil., 2014, 155(30), 1189–1195.

scholarly journals Bridging thoracic endovascular aneurysm repair for a late rupture following aortic coarctation angioplasty

2015 ◽  
Vol 26 (5) ◽  
pp. 957-960
Author(s):  
Nelson F. G. Oliveira ◽  
João A. Castro ◽  
José D. Martins ◽  
Anita Quintas ◽  
Sérgio Laranjo ◽  
...  
Keyword(s):  
Case Report ◽  
Aortic Coarctation ◽  
Endovascular Aneurysm Repair ◽  
Late Complications ◽  
Descending Aorta ◽  
Endovascular Interventions ◽  
Definitive Repair ◽  
Life Threatening ◽  
Thoracic Endovascular Aneurysm Repair ◽  
Aneurysm Repair

AbstractIntroductionThoracic endovascular aneurysm repair has been employed to treat late complications after aortic coarctation correction. However, its use in children has seldomly been reported.Case reportWe present the case of a 15-year-old child who presented with a ruptured aneurysm of the descending aorta complicated later by an aortic-oesophageal fistula following aortic coarctation stenting that was managed with multiple bridging endovascular interventions until a definitive repair was performed.ConclusionThoracic endovascular aneurysm repair may be used successfully as a bridging intervention to a definitive repair in children with life-threatening aortic complications following aortic coarctation repair.

scholarly journals Patients´ experiences in a newly established clinic for late complications after colorectal and anal cancer treatment: a qualitative study

2022 ◽  
Author(s):  
Birthe Thing Oggesen ◽  
Momena Akbar ◽  
Marie Louise Sjødin Hamberg ◽  
Anne Kjaergaard Danielsen ◽  
Thordis Thomsen ◽  
...  
Keyword(s):  
Anal Cancer ◽  
Treatment Options ◽  
Late Complication ◽  
Safety Net ◽  
Structured Interview ◽  
Late Complications ◽  
Complete Relief ◽  
Daily Schedule ◽  
The Future ◽  
Receive Treatment

Abstract Purpose Treatment of late complications is not systematically provided in Denmark. We therefore established a clinic to treat patients´ late complications. With this study we wanted to explore patients´ experiences with treatment and care in the clinic, including their recommendations for the future organization and structure of the clinic. Methods We conducted a qualitative semi-structured interview study with patients who had attended our late complication clinic after treatment for colorectal or anal cancer. Results We included 14 patients. We found two main categories: 1: benefitting from the late complication clinic and 2: preparation and delivery of the consultations. Patients benefitted from attending the late complication clinic and some experienced complete relief from symptoms. Others did not, but they gained hope that they might be able to receive treatment in the future. Patients wished for more information about late complications, preferring that the most common symptoms were described along with patient-friendly treatment options. The patients were satisfied with telephone consultations, as they were easy to fit into a daily schedule, and patients found it easy to express themselves openly. Conclusions Patients were satisfied with the late complication clinic as they felt it gave them a safety net. For the future, patients recommended provision of more information about late complications and possible treatments.

Alternative pulmonary artery reconstruction technique in the arterial switch operation

2021 ◽  
Author(s):  
Hisayuki Hongu ◽  
Masaaki Yamagishi ◽  
Yoshinobu Maeda ◽  
Keiichi Itatani ◽  
Masatoshi Shimada ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Arterial Switch Operation ◽  
Late Complication ◽  
Late Complications ◽  
Reconstruction Technique ◽  
Reconstruction Method ◽  
Arterial Switch ◽  
Switch Operation ◽  
Longitudinal Extension

Abstract OBJECTIVES Late complications of arterial switch operations (ASO) for transposition of the great arteries, such as neo-pulmonary artery (PA) stenosis and/or neoaortic regurgitation, have been reported. We developed an alternative reconstruction method called the longitudinal extension (LE) method to prevent PA bifurcation stenosis (PABS). METHODS We identified 48 patients diagnosed with transposition of the great arteries and performed ASO using the Lecompte manoeuvre for neo-PA reconstruction. In 9 consecutive patients (from 2014), the LE method was performed (LE). Before 2014, conventional techniques were performed in 39 patients (C). The median body weight and age in the LE and C groups were 3.0 and 3.1 kg and 12 and 26 days, respectively. In the LE group, 1 patient underwent bilateral PA banding before ASO. In C, PA banding and arch repair were performed in 1 patient each. Patients who received concomitant procedures were included. RESULTS The median follow-up in LE and C groups was 1.9 and 10.1 years, respectively. Early mortality/late death was not found in group LE and in 1 patient in group C. Only 1 case required ascending aorta sliding plasty in LE, and 8 patients needed PA augmentation for PABS in C. The median velocity of right/left PA was measured as 1.6/1.9 m/s in LE and 2.1/2.3 m/s in C, so it showed a lower value in LE. CONCLUSIONS Excellent mid-term results were obtained with the LE method. It was considered a useful procedure in preventing PABS, which is a primary late complication of ASO. Further follow-up and investigations are needed.

scholarly journals Does age at aortic coarctation repair have an impact on left ventricle size and function?

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
S Cardoso Torres ◽  
CX Resende ◽  
PG Diogo ◽  
P Araujo ◽  
RA Pinto ◽  
...  
Keyword(s):  
Aortic Coarctation ◽  
Surgical Repair ◽  
Myocardial Dysfunction ◽  
Global Longitudinal Strain ◽  
Negative Relationship ◽  
Late Complications ◽  
Left Ventricular ◽  
Funding Sources ◽  
The Mean ◽  
Clinical Records

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Adults with repaired aortic coarctation (CoA) require lifelong follow-up due to late complications, including left ventricular (LV) myocardial dysfunction. Age at the time of CoA repair is an important prognostic factor in these patients (pts). Purpose To evaluate LV size, ejection fraction (EF) and global longitudinal strain (GLS) values using 2D speckle tracking echocardiography (STE) in a population of adult pts with repaired CoA and to assess the relationship between these echocardiographic parameters and age at the time of CoA repair. Methods Retrospective analysis of adult pts with repaired CoA, followed in a Grown Up Congenital Heart Disease Centre. Pts with hemodynamically significant concomitant cardiac lesions were ruled out. Epidemiologic and clinical data were obtained from clinical records. Transthoracic echocardiograms were reviewed in order to assess GLS using 2DSTE (Echopac Software, GE). Results The study population consisted of 63 pts (61.9% male), with a mean age of 35.3 years at the time of the echocardiographic evaluation. The mean age at the time of the CoA repair was 117 months (95% CI 89.8-144.1 months). Surgical repair was performed in 46 pts (73%): resection with subclavian artery flap aortoplasty (n = 21); patch aortoplasty (n = 15) and head-to-head anastomosis (n = 10). In 10 pts there was no data regarding the type of surgical repair. Seven pts (11.1%) were submitted to percutaneous intervention (6 with aortic stent implantation and 1 with balloon aortic angioplasty). Mean LVEF was 63.4% (CI 95% 55.6 – 71.2%) and mean LV end-diastolic diameter (LVEDD) was 50mm (CI 95% 43-57mm). Mean GLS was - 17.3 (CI 95% 14.8- 19.8), which is inferior to the mean normal values reported for the software used. Age at the time of CoA repair had a statistically significant positive linear relationship with LVEDD (r= 0.282; p= 0.026) and a linear negative relationship with both GLS (r= -0,29; p= 0.022) and LVEF (r= -0.33; p= 0.05). Conclusion Older age at the time of CoA repair was associated with increased LVEDD and decreased GLS and LVEF. Also, GLS may be an important tool for the identification of subclinical LV dysfunction in adult pts with repaired CoA.

scholarly journals Crossroads: advanced guidance through an aortic coarctation by fusion imaging in transfemoral TAVR after aorto-aortic bypass

2021 ◽  
Author(s):  
Martin Geyer ◽  
Alexander R. Tamm ◽  
Felix Kreidel ◽  
Andres Beiras-Fernandez ◽  
Thomas Münzel ◽  
...  
Keyword(s):  
Aortic Coarctation ◽  
Fusion Imaging ◽  
Aortic Bypass

scholarly journals A Comparison of Outcomes and Complications of Totally Implantable Access Port Through the Internal Jugular Vein Versus the Subclavian Vein

2014 ◽  
Vol 99 (2) ◽  
pp. 182-188 ◽  
Author(s):  
Yoshinobu Nagasawa ◽  
Tomoharu Shimizu ◽  
Hiromichi Sonoda ◽  
Eiji Mekata ◽  
Masato Wakabayashi ◽  
...  
Keyword(s):  
Internal Jugular Vein ◽  
Subclavian Vein ◽  
Jugular Vein ◽  
Statistical Significance ◽  
Late Complication ◽  
Insertion Site ◽  
Multivariate Logistic Regression Analysis ◽  
Late Complications ◽  
Complication Rates ◽  
Access Port

Abstract Totally implantable access ports (TIAPs) are generally used in oncology. Few studies have addressed complications associated with the insertion site. A total of 233 consecutive oncology patients were enrolled to receive TIAP inserts via internal jugular vein (IJV) or subclavian vein (SV). Data on clinicopathologic parameters and early/late complications were retrospectively collected. No differences were found early and late complication rates. Catheter injury was observed more frequently in the IJV group (2.9%) than in the SV group (1.0%) without statistical significance. Multivariate logistic regression analysis showed that age, switch to palliative use of TIAP, and the distribution of diseases (low risk in patients with colorectal cancer) were independent risk factors for determining complications. In conclusion, TIAP insertion site showed no impact on the early and late complication rates. Catheter injury appears to occur at the same frequency with both approaches. Therefore, medical doctors may choose their preferred puncture site when performing TIAP insertion.

scholarly journals Pancreatic window and open necrosectomy; a surgical alternative for walled-off pancreatic necrosis in a second level hospital in Mexico

2020 ◽  
Vol 8 (11) ◽  
pp. 4158
Author(s):  
Pedro A. Alvarado-Bahena ◽  
Enrique Chavez-Serna ◽  
Jonatan Salgado-Vives ◽  
Uraik F. Hernandez-Bustos ◽  
Dante A. Saldivar-Vera ◽  
...  
Keyword(s):  
Developing Countries ◽  
Acute Pancreatitis ◽  
Minimally Invasive ◽  
Pancreatic Necrosis ◽  
Late Complication ◽  
Late Complications ◽  
Open Approach ◽  
Invasive Procedures ◽  
Open Necrosectomy ◽  
Level Hospital

Walled-off pancreatic necrosis is defined as a necrotic collection with a defined wall, which generally occurs in 15% of patients in the fourth week after acute pancreatitis. Actually, open surgery is reserved for selected cases, with minimally invasive treatments such as image-assisted percutaneous drainage or endoscopic ultrasound being the procedures of choice. However, in developing countries the open approach continues to be an effective therapeutic alternative. We present the case of a 47-year-old male patient with no significant history who developed severe acute pancreatitis secondary to hypertriglyceridemia and who later developed walled-off pancreatic necrosis as a late complication. As a treatment, a debridement of the necrotic tissue with marsupialization was performed using the bradley III technique, secondary to the procedure, a pancreatic fistula was developed. After 8 weeks of hospitalization, in which he had a favourable response to surgical treatment, with spontaneous closure of the fistula without complications. Surgical management of late complications of acute pancreatitis remains controversial. Although minimally invasive procedures are the first option nowadays, in developing countries, open necrosectomy remains a good option for the treatment of these types of complications.

scholarly journals Late complication of the oral cavity and oropharynx after interstitial neutron therapy with sources of Cf-252

2021 ◽  
Vol 30 (2) ◽  
pp. 123-132
Author(s):  
V.V. Polkin ◽  
◽  
V.S. Medvedev ◽  
D.N. Derbugov ◽  
P.A. Isaev ◽  
...  
Keyword(s):  
Treatment Options ◽  
Late Complication ◽  
Radiotherapy Planning ◽  
Radiation Injuries ◽  
Management Options ◽  
Photon Irradiation ◽  
Patients With Cancer ◽  
Neutron Therapy ◽  
Lower Jaw ◽  
Radiation Ulcers

Radiotherapy is used to treat approximately 80% of patients with cancer of the head and neck. Despite enormous advances in radiotherapy planning and delivery, a significant number of pa-tients will experience radiation-associated toxicities. Many effective management options are available for acute radiotherapy-associated toxicities, but treatment options are much more lim-ited and of variable benefit among patients who develop late sequelae after radiotherapy. The present work is based on observations of 586 patients with oral and oropharynx cancer, for which interstitial neutron therapy was carried out in an independent version or in combination with re-mote radiation therapy. Radiation injuries occurred in 130 (22.2%) patients, in 92 (15.7%) they appeared in the form of radiation ulcers and in 38 (6.4%) – osteoradionecrosis of the lower jaw. The clinical picture and the course of radiation injuries after interstitial neutron therapy with sources of 252Cf did not differ significantly from radiation complications after photon irradiation.

scholarly journals Right lumbar abscess containing a gallstone—an unexpected late complication of laparoscopic cholecystectomy

2020 ◽  
Vol 2020 (7) ◽  
Author(s):  
André Marçal ◽  
Ricardo Vaz Pereira ◽  
Ana Monteiro ◽  
José Dias ◽  
António Oliveira ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Late Complication ◽  
Late Complications ◽  
Gallbladder Perforation ◽  
Past Medical History ◽  
Symptomatic Gallstones ◽  
History Of ◽  
Gallstone Spillage ◽  
Saline Lavage

Abstract During laparoscopic cholecystectomy, gallbladder perforation may occur leading to gallstone spillage and despite being rare, early or late complications may therefore develop. We report a case of a 79-year-old female, with a past medical history of a laparoscopic cholecystectomy 3 years earlier for symptomatic gallstones, admitted in the emergency department with a subcutaneous right lumbar abscess confirmed by computed tomography. Emergent abscess surgical drainage was performed and a gallstone was identified during saline lavage. Postoperative evolution was unremarkable and follow-up within a year was uneventful. Split gallstones due to gallbladder perforation during laparoscopic cholecystectomy should be retrieved in order to reduce future complications.

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