scholarly journals BioGlue cerebral embolism following acute type A aortic dissection repair

2021 ◽  
Author(s):  
Manabu Yamasaki ◽  
Kohei Abe ◽  
Ryota Nakamura ◽  
Rihito Tamaki ◽  
Hiroyasu Misumi
Keyword(s):  
Aortic Dissection ◽  
False Lumen ◽  
Surgical Techniques ◽  
Type A ◽  
Cerebral Embolism ◽  
Total Arch Replacement ◽  
Acute Type ◽  
Type A Aortic Dissection

The outcomes of surgery for Acute Stanford type A aortic dissection (ATAAD) have significantly improved in recent decades due to advances in surgical techniques and, surgical adhesives such as BioGlue. However, this convenient material can sometimes cause complications such as thrombotic embolism and pseudoaneurysm. Here, we present the case of a 61-year-old male with ATAAD who successfully underwent total arch replacement. Five days after the surgery, he collapsed due to right hemiplegia. We immediately performed cerebral thrombectomy and removed the thrombotic embolus caused by BioGlue, which was used to obliterate the false lumen of the dissected aorta during ATAAD repair.

scholarly journals Repair of Acute Type-A Aortic Dissection in the Present Era: Outcomes and Controversies

Aorta ◽  
2019 ◽  
Vol 07 (06) ◽  
pp. 155-162 ◽  
Author(s):  
Ellie Moeller ◽  
Marcos Nores ◽  
Sotiris C. Stamou
Keyword(s):  
Aortic Dissection ◽  
Operative Mortality ◽  
Cochrane Review ◽  
False Lumen ◽  
Surgical Techniques ◽  
Type A ◽  
Acute Type ◽  
Close Monitoring ◽  
Type A Aortic Dissection ◽  
The Past

AbstractAcute Type-A aortic dissection (AAAD) remains a surgical emergency with a relatively high operative mortality despite advances in medical and surgical management over the past three decades. In spite of the severity of disease, there is a paucity of studies reviewing key controversies surrounding AAAD repair and management. A systematic literature search was performed using Cochrane review and PubMed bibliography review. Abstracts were first reviewed for general pertinence and then articles were reviewed in full. Literature review indicates that use of moderate hypothermia and antegrade cerebral perfusion is a safe alternative to deep hypothermia. In hemodynamically stable patients, axillary cannulation may be substituted for femoral cannulation. With regard to the technical aspects of repair, preserving the aortic root whenever possible and performing the distal anastomosis with the open distal technique rather than with the clamp on is the preferred approach. In patients with a patent false lumen, close monitoring is indicated. As demonstrated by the literature, significant improvement of early and late mortality over the past years has occurred in patients presenting with AAAD. Repair of acute Type-A aortic dissection remains a challenge with high operative mortality; however, improvement of surgical techniques and management have resulted in improvement of early and late clinical outcomes.

scholarly journals Total arch replacement with an open stent graft for acute type A aortic dissection: fate of the false lumen

2009 ◽  
Vol 35 (1) ◽  
pp. 83-88 ◽  
Author(s):  
Naomichi Uchida ◽  
Hidenori Shibamura ◽  
Akira Katayama ◽  
Norimitsu Shimada ◽  
Miwa Sutoh
Keyword(s):  
Aortic Dissection ◽  
Stent Graft ◽  
False Lumen ◽  
Type A ◽  
Total Arch Replacement ◽  
Acute Type ◽  
Type A Aortic Dissection ◽  
Open Stent

Initial Management of Acute Type-A Aortic Dissection with a Thrombosed False Lumen: A Retrospective Cohort Study

Surgery Today ◽  
2004 ◽  
Vol 34 (8) ◽  
Author(s):  
Yoshihiko Kurimoto ◽  
Kiyofumi Morishita ◽  
Nobuyoshi Kawaharada ◽  
Johji Fukada ◽  
Yasufumi Asai ◽  
...  
Keyword(s):  
Cohort Study ◽  
Aortic Dissection ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
False Lumen ◽  
Type A ◽  
Acute Type ◽  
Initial Management ◽  
Type A Aortic Dissection

Do oral anticoagulants impact outcomes and false lumen patency after repair of acute type A aortic dissection?

2021 ◽  
Author(s):  
Igor Vendramin ◽  
Daniela Piani ◽  
Andrea Lechiancole ◽  
Nunzio Davide de Manna ◽  
Sandro Sponga ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Oral Anticoagulants ◽  
False Lumen ◽  
Type A ◽  
Acute Type ◽  
Type A Aortic Dissection

Surgical outcomes of total arch replacement with modified elephant trunk technique in type A aortic dissection: insights from single-center experience

2022 ◽  
pp. 021849232110701
Author(s):  
Jian Li ◽  
Yueyun Zhou ◽  
Wei Qin ◽  
Cunhua Su ◽  
Fuhua Huang ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Type A ◽  
Total Arch Replacement ◽  
Hospital Death ◽  
Acute Type ◽  
Elephant Trunk ◽  
Type A Aortic Dissection ◽  
Elephant Trunk Technique ◽  
Visceral Malperfusion ◽  
Cerebral Malperfusion

Background Total arch replacement with modified elephant trunk technique plays an important role in treating acute type A aortic dissection in China. We aim to summarize the therapeutic effects of this procedure in our center over a 17-year period. Methods Consecutive patients treated at our hospital due to type A aortic dissection from January 2004 to January 2021 were studied. Relevant data of these patients undergoing total arch replacement with modified elephant trunk technique were collected and analyzed. Results A total of 589 patients were included with a mean age of 53.1 ± 12.2 years. The mean of cardiopulmonary bypass, cross-clamping, and selected cerebral perfusion time were 199.6 ± 41.9, 119.0 ± 27.2, and 25.1 ± 5.0 min, respectively. In-hospital death occurred in 46 patients. Multivariate analysis identified four significant risk factors for in-hospital mortality: preexisting renal hypoperfusion (OR 5.43; 95% CI 1.31 – 22.44; P = 0.020), cerebral malperfusion (OR 11.87; 95% CI 4.13 – 34.12; P < 0.001), visceral malperfusion (OR 4.27; 95% CI 1.01 – 18.14; P = 0.049), and cross-clamp time ≥ 130 min (OR 3.26; 95% CI 1.72 – 6.19; P < 0.001). The 5, 10, and 15 years survival rates were 86.4%, 82.6%, and 70.2%, respectively. Conclusions Total arch replacement with modified elephant trunk technique is an effective treatment for acute type A aortic dissection with satisfactory perioperative results. Patients with preexisting renal hypoperfusion, cerebral malperfusion, visceral malperfusion, and long cross-clamp time are at a higher risk of in-hospital death.

scholarly journals Clinical significance of a false lumen pathway through the arch in acute type A aortic dissection and its influence on cervical branch compromise

2014 ◽  
Vol 48 (5) ◽  
pp. 671-678 ◽  
Author(s):  
Hiroshi Nagamine ◽  
Manami Miyazaki ◽  
Naohiro Wakabayashi ◽  
Hiroaki Sugita ◽  
Hiroiku Hara ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Clinical Significance ◽  
False Lumen ◽  
Type A ◽  
Acute Type ◽  
Type A Aortic Dissection
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