scholarly journals Expanding Perigraft Seroma after A scending Aorta Replacement

2021 ◽  
Author(s):  
Shinji Kanemitsu ◽  
Shunsuke Sakamoto ◽  
Satoshi Teranishi ◽  
Toru Mizumoto
Keyword(s):  
Fibrin Glue ◽  
Thoracic Aorta ◽  
Aortic Surgery ◽  
Final Diagnosis ◽  
Prosthetic Graft ◽  
Acute Type ◽  
Acute Type A Dissection ◽  
Perigraft Seroma ◽  
Aorta Replacement ◽  
Type A Dissection

Abstract BackgroundPerigraft seroma is a persistent and sterile fluid confined within a fibrous pseudomembrane surrounding a graft that develops after graft replacement. Development of perigraft seroma is an uncommon complication that occurs after the surgical repair of the thoracic aorta using woven polyester grafts. mechanism underlying perigraft seroma formation remains unclear.Case presentationHerein, we describe the case of 77-year-old man who underwent repeat sternotomy for the treatment of large perigraft seroma 1 year after ascending aorta replacement for acute type A dissection. After removing a cloudy yellow fluid, we covered the prosthetic graft with fibrin glue and wrapped it with a new graft. Bacterial culture and laboratory examination of the fluid confirmed the final diagnosis of perigraft seroma, and there was no evidence of recurrence. The area in which fluid accumulated around the graft shrunk 1 year after surgery.ConclusionsThe cause of a expanding perigraft after repair of the thoracic aorta remains unknown. Physicians should be aware that chronic expanding mediastinal seroma with Dacron grafts is one of the rare postoperative complications of thoracic aortic surgery. Applying fibrin glue to the graft surface might effectively prevent the recurrence of perigraft seroma.

scholarly journals Outcomes of Acute Type A Dissection Repair Before and After Implementation of a Multidisciplinary Thoracic Aortic Surgery Program

2014 ◽  
Vol 63 (17) ◽  
pp. 1796-1803 ◽  
Author(s):  
Nicholas D. Andersen ◽  
Asvin M. Ganapathi ◽  
Jennifer M. Hanna ◽  
Judson B. Williams ◽  
Jeffrey G. Gaca ◽  
...  
Keyword(s):  
Aortic Surgery ◽  
Type A ◽  
Acute Type ◽  
Thoracic Aortic Surgery ◽  
Acute Type A Dissection ◽  
Before And After ◽  
Type A Dissection

A dreadful sign of aortic dissection: Aortic intimo-intimal intussusception with prominent intimal flap prolapsing into the left ventricular apex

VASA ◽  
2009 ◽  
Vol 38 (2) ◽  
pp. 181-184 ◽  
Author(s):  
Ozer ◽  
Davutoglu ◽  
Burma ◽  
Sucu ◽  
Sarı
Keyword(s):  
Aortic Dissection ◽  
Clinical Presentation ◽  
Left Ventricular ◽  
Left Ventricular Cavity ◽  
Acute Type ◽  
Clinical Form ◽  
Intimal Flap ◽  
Acute Type A Dissection ◽  
Type A Dissection ◽  
Intimal Intussusception

Intimo-intimal intussusception is an unusual clinical form of aortic dissection resulting from circumferential detachment of the intima. Clinical presentation varies according to the level of detached intima in the aorta. We present a case of acute type A dissection with prominent prolapse of the circumferential detachment intimal flap into the left ventricular cavity extended to the apex.

Reoperations after repaired acute type A dissection

2010 ◽  
Vol 58 (S 01) ◽  
Author(s):  
R Kobuch ◽  
S Hirt ◽  
L Rupprecht ◽  
M Hilker ◽  
C Schmid
Keyword(s):  
Type A ◽  
Acute Type ◽  
Acute Type A Dissection ◽  
Type A Dissection

scholarly journals Complex Reoperation for Late Complications After Acute Type A Aortic Dissection Surgery

Aorta ◽  
2015 ◽  
Vol 03 (06) ◽  
pp. 195-198
Author(s):  
Guillermo Stöger ◽  
Matías Ríos ◽  
Roberto Battellini ◽  
Daniel Bracco ◽  
Vadim Kotowicz
Keyword(s):  
Aortic Root ◽  
Past History ◽  
Type A ◽  
Late Complications ◽  
Type I ◽  
Acute Type ◽  
Acute Type A Dissection ◽  
Type I Endoleak ◽  
Type A Dissection ◽  
Branched Graft

AbstractThe correct management of acute Type A dissection continues to be a challenge. The primary goal is to save the patient´s life. However, the decision regarding the surgical approach determines possible later complications. We present the case of a 59-year-old female patient with a past history of emergent surgery for acute Type A dissection treated by supracoronary ascending and aortic valve replacement 19 years previously. Later, in a second endovascular approach, the descending aorta was treated by a thoracic endoprosthesis. During follow-up a dilated aortic root and a Type I endoleak were observed, and complex reoperation was required. We performed a total aortic arch replacement with a 4-branched graft and a complete aortic root replacement using the Cabrol technique for the reinsertion of the coronary arteries. The mechanical aortic normally functioning valve was preserved. The patient was discharged 30 days postoperatively.

scholarly journals Cause of Death Following Surgery for Acute Type A Dissection

Aorta ◽  
2017 ◽  
Vol 05 (02) ◽  
pp. 33-41 ◽  
Author(s):  
R. Scott McClure ◽  
Maral Ouzounian ◽  
Munir Boodhwani ◽  
Ismail El-Hamamsy ◽  
Michael Chu ◽  
...  
Keyword(s):  
Cause Of Death ◽  
Surgical Repair ◽  
Multiorgan Failure ◽  
Type A ◽  
Acute Type ◽  
Neurologic Injury ◽  
Perioperative Mortality ◽  
Acute Type A Dissection ◽  
Modifiable Factors ◽  
Type A Dissection

Background: Surgery confers the best chance of survival following acute Type A dissection (ATAD), yet perioperative mortality remains high. Although perioperative risk factors for mortality have been described, information on the actual causes of death is sparse. In this study, we aimed to characterize the inciting events causing death during surgical repair of ATAD. Methods: Nine centers participated in the study. We included all patients who died following surgical repair for ATAD between January 2007 and December 2013. An aortic surgeon at each site determined the primary cause of death from seven predetermined categories: cardiac, stroke, hemorrhage, other organ ischemia (peripheral, renal, or visceral), multiorgan failure, sepsis, or other causes. Additional characteristics and variables were analyzed to delineate potential modifiable factors for mortality. Results: Of the 692 surgeries for ATAD, there were 123 deaths (17.8% mortality rate). Mean age at death was 66 years. Events contributing to death were: cardiac (25%), stroke (22%), hemorrhage (21%), multiorgan failure (12%), other organ ischemia (11%), sepsis (4%), and other causes (5%). Neurologic injury at presentation was a predictor of stroke as the inciting cause of death (p = 0.04). Peripheral, renal, or visceral ischemia at presentation was highly predictive of death due to these presenting ischemic conditions (p = 0.004). We found no associations between cardiogenic shock, tamponade, or cardiopulmonary bypass duration and cardiac death. Conclusion: Operative mortality for ATAD remains high in Canada. Nearly 70% of deaths arise from cardiac failure, stroke, or hemorrhage. Therefore, novel surgical, hybrid, and endovascular strategies should target these three areas.

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