Describing The Use of Two Hybrid Prostheses in The Staged Surgical Repair of Aortic Dissection

Abstract Background-Reconstruction of the thoracoabdominal aorta after dissection (Stanford Type A with extension into descending aorta) has limited surgical options. Described here is a novel technique for the staged surgical repair of the thoracoabdominal aorta after reconstruction of the ascending aorta with aortic arch using a hybrid prosthesis. Case presentation- The thoracoabdominal aorta is accessed via a lateral thoracotomy. After a left-left bypass to perfuse the descending aorta, the proximal end of the prosthesis is anastomosed to the proximal aorta and distal end of the new prosthesis is then inserted into the true lumen of the descending aorta and the stent is deployed. Conclusion-Using this technique, operative time is reduced with accurate reconstructions of the anatomy.

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Type B Interrupted Aorta in an Adult Patient

The Heart Surgery Forum ◽

10.1532/hsf98.2013309 ◽

2014 ◽

Vol 17 (2) ◽

pp. 80

Author(s):

Ahmet Ozkara ◽

Mehmet Ezelsoy ◽

Levent Onat ◽

Ilhan Sanisoglu

Keyword(s):

Cardiopulmonary Bypass ◽

Aortic Arch ◽

Collateral Circulation ◽

Neonatal Period ◽

Interrupted Aortic Arch ◽

Complete Loss ◽

Posterolateral Thoracotomy ◽

Type B ◽

Case Presentation ◽

Descending Aorta

Introduction: Interrupted aortic arch is a rare congenital malformation characterized by a complete loss of luminal continuity between the ascending and descending aorta. It is often diagnosed during the neonatal period.Case presentation: We presented a 51-year-old male patient with interrupted aortic arch type B who was treated successfully with posterolateral thoracotomy without using cardiopulmonary bypass.Conclusion: The prognosis for interrupted aortic arch depends on the associated congenital anomalies, but the outcome is usually very poor unless there is surgical treatment. Survival into adulthood depends on the development of collateral circulation.

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Embolization of the false lumen using IMPEDE-FX embolization plugs as part of treatment of an infrarenal post-dissection aneurysm: a case report

CVIR Endovascular ◽

10.1186/s42155-020-00183-6 ◽

2020 ◽

Vol 3 (1) ◽

Author(s):

Anne-Jet S. Jansen ◽

Paul M. van Schaik ◽

Jasper M. Martens ◽

Michel M. P. J. Reijnen

Keyword(s):

Case Report ◽

Mesenteric Artery ◽

Inferior Mesenteric Artery ◽

False Lumen ◽

True Lumen ◽

Case Presentation ◽

Type A Dissection ◽

Prospective Trials ◽

The Right ◽

Embolization Procedure

Abstract Background This case report demonstrates the value of IMPEDE-FX plugs in an embolization procedure of a false lumen of an infrarenal post-dissection aneurysm. Case presentation A 69-year-old patient was treated with mitral valve replacement, complicated by a Stanford type-A dissection. After 9 years he presented with an enlarging infrarenal post-dissection aneurysm. The false lumen was embolized using multiple IMPEDE-FX plugs as part of the treatment in addition to embolization of the inferior mesenteric artery and overstenting of the re-entry in the right iliac artery. At 15 months the CTA showed a fully thrombosed false lumen and remodeling of the true lumen. Conclusions The false lumen of an infrarenal post-dissection aneurysm can successfully be embolized using IMPEDE-FX embolization plugs as part of the treatment strategy. Prospective trials on patients with non-thrombosed false lumina are indicated.

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A case of pleuroperitoneal communication in which establishing a laparoscopic pneumoperitoneum was useful for the detection of a fistula

Surgical Case Reports ◽

10.1186/s40792-021-01147-1 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Takehiko Manabe ◽

Kenji Ono ◽

Soichi Oka ◽

Yuichiro Kawamura ◽

Toshihiro Osaki

Keyword(s):

Thoracic Surgery ◽

Surgical Repair ◽

Abdominal Cavity ◽

Case Presentation ◽

X Ray ◽

Video Assisted Thoracic Surgery ◽

Video Assisted ◽

Pleuroperitoneal Communication ◽

Small Pore ◽

Chest X Ray

Abstract Background Pleuroperitoneal communication (PPC) is rarely observed, accounting for 1.6% of all patients who undergo continuous ambulatory peritoneal dialysis (CAPD). Although there have been several reports concerning the management of this condition, we have encountered several cases in which control failed. We herein report a valuable case of PPC in which laparoscopic pneumoperitoneum with video-assisted thoracic surgery (VATS) was useful for supporting the diagnosis and treatment. Case presentation The patient was a 58-year-old woman with chronic renal failure due to chronic renal inflammation who was referred to a nephrologist in our hospital to undergo an operation for the induction of CAPD. Post-operatively, she had respiratory failure, and chest X-ray and computed tomography (CT) showed right-sided hydrothorax that decreased when the injection of peritoneal dialysate was interrupted. Therefore, PPC was suspected, and she was referred to our department for surgical repair. We planned surgical treatment via video-assisted thoracic surgery. During the surgery, we failed to detect any lesions with thoracoscopy alone; we therefore added a laparoscopic port at her right-sided abdomen near the navel and infused CO2 gas into the abdominal cavity. On thoracoscopy, bubbles were observed emanating from a small pore at the central tendon of the diaphragm, which was considered to be the lesion responsible for the PPC. We closed it by suturing directly. Conclusions VATS with laparoscopic pneumoperitoneum should be considered as an effective method for inspecting tiny pores of the diaphragm, especially when the lesions responsible for PPC are difficult to detect.

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Left-Sided Bochdalek's Hernia in a Young Adult: A Case Report and Literature Review

The Surgery Journal ◽

10.1055/s-0041-1731443 ◽

2021 ◽

Vol 07 (03) ◽

pp. e124-e126

Author(s):

Mark Portelli ◽

Mark Bugeja ◽

Charles Cini

Keyword(s):

Computed Tomography ◽

Young Adult ◽

Rare Case ◽

Surgical Repair ◽

Bochdalek Hernia ◽

Case Presentation ◽

Atypical Case ◽

Accident And Emergency ◽

History Of ◽

Accident And Emergency Department

Abstract Purpose Bochdalek's hernia is a type of congenital diaphragmatic hernia occurring secondary to a defect in the posterior attachment of diaphragm. This condition commonly presents with respiratory insufficiency in infants. To date, there are less than 100 cases of Bochdalek's hernia presenting in adults published in the literature. The mainstay treatment of Bochdalek's hernia involves reduction of hernial contents back into the peritoneal cavity with a tensionless graft repair closing the diaphragmatic defect. Case Presentation We present an atypical case of the Bochdalek hernia presenting in a previously healthy 16-year-old male who presented to the Accident and Emergency department with a 2-day history of dysphagia and loss of breath. The Bochdalek hernia was confirmed on computed tomography (CT) imaging and the patient underwent surgical repair with Gore-Tex mesh. Conclusion The report shows a rare case of the Bochdalek hernia in a young adult, successfully managed with a laparotomy.

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Frozen elephant trunk infection: to defrost or to debranch?

European Journal of Cardio-Thoracic Surgery ◽

10.1093/ejcts/ezaa466 ◽

2020 ◽

Author(s):

Joseph Nader ◽

Yuthiline Chabry ◽

Houda Nazih ◽

Thierry Caus

Keyword(s):

Proximal Part ◽

Acute Type ◽

Frozen Elephant Trunk ◽

Elephant Trunk ◽

Aortic Arch Replacement ◽

Descending Aorta ◽

Type A Aortic Dissection ◽

Hybrid Prosthesis

Abstract Infections of frozen elephant trunk hybrid prosthesis (HP) are not well documented in the literature and their management is not standardized yet. We report herein the case of a 59-year-old patient who benefited from a Thoraflex™ HP aortic arch replacement for an acute type A aortic dissection. He presented a year later with a Staphylococcus aureus infection of the proximal part of this prosthesis. We performed a replacement of the proximal compound of the HP accompanied by a complete debranching of the 3 supra-aortic vessels with an inter-carotidal retro-oesophageal bypass. As we left in situ the endovascular graft within the descending aorta, a life-long antibiotic therapy was introduced. The postoperative follow-up was uneventful, and the patient discharged home 2 weeks after his surgery. As an alternative to a more radical redo surgery with major risk, a hybrid medical and surgical treatment of infected frozen elephant trunk could be considered.

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PENETRATING TRAUMA OF BRACHIOCEPHALIC ARTERY LESION WITH EMBOLIZATION OF FOREIGN BODY TO RIGHT AXILLARY ARTERY IN PEDIATRIC PATIENT: CASE PRESENTATION AND HIS MANAGEMENT.

10.22541/au.160594392.27795355/v1 ◽

2020 ◽

Author(s):

Luis Zerpa Acosta ◽

Jameel Al Ata ◽

Alfredo Sanchez Gamboa ◽

Elmahi Babikir ◽

Abdullah Al Zahrani ◽

...

Keyword(s):

Pediatric Patients ◽

Surgical Repair ◽

Axillary Artery ◽

Median Sternotomy ◽

Penetrating Trauma ◽

Innominate Artery ◽

Penetrating Injuries ◽

Patient Case ◽

Case Presentation ◽

Great Vessels

ABSTRACT: BACKGROUND: Penetrating injuries of the intrathoracic great vessels are well recognized although uncommon in pediatric patients, management in pediatric patients presents challenges. Surgical repair by median sternotomy is the exposure of choice for accessing innominate artery injuries, but endovascular intervention in being increasingly introduced in the hemodynamically stable

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Quadriceps reconstruction with suture anchor and Achilles allograft combination in quadriceps tendon re-rupture after primary surgical repair: A novel technique

Joint Diseases and Related Surgery ◽

10.52312/jdrs.2021.14 ◽

2021 ◽

Author(s):

Erhan Okay ◽

Mehmet Cenk Turgut ◽

Abbas Tokyay

Keyword(s):

Suture Anchor ◽

Surgical Repair ◽

Primary Repair ◽

Full Range ◽

Knee Extensor ◽

Quadriceps Tendon ◽

Extensor Mechanism ◽

Surgical Options ◽

Knee Extensor Mechanism

Quadriceps ruptures are one of the pathological conditions of the knee extensor mechanism, accounting for 3% of all tendon injuries. These injuries cause substantial disability of the extensor mechanism. Primary repair is the treatment of choice in acute presentation. In the setting of chronic conditions, the treatment becomes more challenging. Available surgical options include lengthening procedures, and reconstruction with auto graft or allografts. The traditional Scuderi and Codivilla techniques are challenging to perform in degenerative or traumatic retracted ruptures. There is no standard effective treatment in these patients, which yields the best clinical and biomechanical outcomes. An 18 - year-old male patient with quadriceps re-rupture after a primary repair was managed with allograft reconstruction using suture anchors. At six years of follow-up, the patient gained a full range of motion with excellent clinical outcomes. He returned to his previous work. In conclusion, quadriceps reconstruction using suture anchor and Achilles allograft combination is a feasible technique in neglected cases who present with quadriceps tendon re-rupture after primary surgical repair.

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Ascending aorta graft pseudoaneurysm and aortobronchial fistula caused by a fractured sternal wire: a case report

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-021-01737-y ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Ahmad Ali Amirghofran ◽

Elahe Nirooei ◽

Mohammad Ali Ostovan

Keyword(s):

Unusual Case ◽

Preventive Measures ◽

Prosthetic Graft ◽

Ascending Aorta ◽

Dacron Graft ◽

Thoracoabdominal Aorta ◽

Case Presentation ◽

Pseudoaneurysm Formation ◽

Aortobronchial Fistula ◽

History Of

Abstract Background Pseudoaneurysm of ascending aorta is a rare but serious complication of cardiovascular surgeries and it infrequently occurs in the normal prosthetic graft materials. We share our experience with an unusual case of ascending aorta Dacron graft pseudoaneurysm caused by a fractured sternal wire. Case presentation A 34-year-old man, known case of Marfan syndrome, with history of two prior aortic surgeries for aneurysm of ascending aorta, arch and thoracoabdominal aorta, presented with hemoptysis. The hemoptysis originated from an aortobronchial fistula secondary to a huge ascending aorta Dacron graft pseudoaneurysm. The graft erosion and subsequent pseudoaneurysm was caused by a fractured sternal wire. Surgical repair of the pseudoaneurysm was performed successfully and a Gore-tex patch was placed behind the sternum over the graft to prevent further direct contact of the wire and the graft. Conclusion Sternal wires can damage the adjacent vascular grafts and lead to fatal complications such as pseudoaneurysm formation. Thus, preventive measures such as using sternal bands and placing a covering layer between the sternal wires and aortic grafts are recommended in patients with dilated or replaced ascending aorta.

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Subarachnoid Fluid Lactate and Paraplegia after Descending Aorta Aneurysmectomy: Two Compared Case Reports

Case Reports in Anesthesiology ◽

10.1155/2013/925739 ◽

2013 ◽

Vol 2013 ◽

pp. 1-4

Author(s):

Enrico Giustiniano ◽

Silvia Eleonora Malossini ◽

Francesco Pellegrino ◽

Franco Cancellieri

Keyword(s):

Cerebrospinal Fluid ◽

Surgical Procedures ◽

Case Reports ◽

Lactate Concentration ◽

Postoperative Outcome ◽

The Other ◽

Thoracoabdominal Aorta ◽

Descending Aorta ◽

Helpful Tool ◽

Cord Injury

We report a comparison of two cases regarding subjects who underwent thoracoabdominal aorta aneurysmectomy. During the procedure we monitored cerebrospinal fluid lactate concentration. One patient experienced postoperative paraplegia and his cerebrospinal fluid lactate concentration was much higher than that in the other case, whose postoperative outcome was uneventful. Consequently we consider that monitoring the lactate concentration in cerebrospinal fluid during thoracic aorta surgical procedures may be a helpful tool to predict the ischemic spine-cord injury allowing for trying to recover it precociously.

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