scholarly journals Aortic arch and frozen elephant trunk repair of a right-sided aortic arch with pseudoaneurysm

2021 ◽  
Author(s):  
Aaron Clark ◽  
David Drullinsky ◽  
Suraj Parulkar ◽  
Christopher Mehta K
Keyword(s):  
Computed Tomography ◽  
Aortic Arch ◽  
Vascular Ring ◽  
Bypass Graft ◽  
Frozen Elephant Trunk ◽  
Elephant Trunk ◽  
Ligamentum Arteriosum ◽  
Aortic Pseudoaneurysm ◽  
Retroesophageal Subclavian Artery ◽  
History Of

A 53 year old male with a history of vascular ring repair secondary to a right sided aortic arch with retroesophageal subclavian artery and ligamentum arteriosum to the descending thoracic aorta presented to our institution with a large aortic pseudoaneurysm of the distal aortic arch. Computed tomography demonstrated a right sided aortic arch with a 5.8 cm pseudoaneurysm arising from the distal arch in the area of his previously divided ligamentum. The patient underwent a successful two-stage repair including a left carotid to subclavian bypass followed by total arch replacement with frozen elephant trunk. He recovered well postoperatively and computed tomography showed complete repair of the pseudoaneurysm with patent bypass graft.

scholarly journals Urgent Frozen Elephant Trunk for an Aortic Arch Pseudoaneurysm Secondary to Fractured Sternal Wire

2021 ◽  
Author(s):  
Filippos - Paschalis Rorris ◽  
Pantelis Tsipas ◽  
Konstantinos Velissarios ◽  
Theodoros Kratimenos ◽  
Lydia Kokotsaki ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Aortic Arch ◽  
Total Arch Replacement ◽  
Frozen Elephant Trunk ◽  
Elephant Trunk ◽  
Careful Planning ◽  
Rare Presentation ◽  
Aortic Pseudoaneurysm ◽  
Two Stages

Pseudoaneurysms of the aorta are rare complications of cardiac surgery, and sternal re-entry to address the pathology is particularly challenging. In this case, we describe a rare presentation of thoracic aortic pseudoaneurysm due to chronic erosion from a sternal wire, 10 years following the index operation. The patient was treated in two-stages, including carotid-subclavian bypass, followed by sternal re-entry with total arch replacement and frozen elephant trunk, employing cardiopulmonary bypass via femoral and axillary cannulation. Despite the high risks of rupture/haemorrhage associated with sternal re-entry, operative success for aortic pseudoaneurysms can be achieved with careful planning and safe bypass strategies.

Total Aortic Arch Replacement and Frozen Elephant Trunk

2020 ◽  
Author(s):  
Jacky Y.K. Ho ◽  
Simon C.Y. Chow ◽  
Micky W.T. Kwok ◽  
Takuya Fujikawa ◽  
Randolph H.L. Wong
Keyword(s):  
Aortic Arch ◽  
Frozen Elephant Trunk ◽  
Elephant Trunk ◽  
Aortic Arch Replacement ◽  
Total Aortic Arch Replacement

scholarly journals Risk Factor Analysis of Clinical Outcomes of Total Aortic Arch Replacement and Frozen Elephant Trunk With Aortic Balloon Occlusion

2021 ◽  
Author(s):  
Luchen Wang ◽  
Yunfeng Li ◽  
Yaojun Dun ◽  
Xiaogang Sun
Keyword(s):  
Hospital Stay ◽  
Aortic Arch ◽  
Circulatory Arrest ◽  
Balloon Occlusion ◽  
Conventional Group ◽  
Frozen Elephant Trunk ◽  
Elephant Trunk ◽  
Aortic Arch Replacement ◽  
Total Aortic Arch Replacement ◽  
Aortic Balloon Occlusion

Abstract Background: Total aortic arch replacement (TAR) with frozen elephant trunk (FET) requires hypothermic circulatory arrest (HCA) for 20 minutes, which increases the surgical risk. We invented an aortic balloon occlusion technique that requires 5 minutes of HCA on average to perform TAR with FET and investigated the possible merit of this new method in this study. Methods: This retrospective study included consecutive patients who underwent TAR and FET (consisting of 130 cases of aortic balloon occlusion group and 230 cases of conventional group) in Fuwai Hospital between August 2017 and February 2019. In addition to the postoperative complications, the alterations of blood routine tests, alanine transaminase (ALT) and aspartate transaminase (AST) during the in-hospital stay were also recorded. Results: The 30-day mortality rates were similar between the aortic balloon occlusion group (4.6%) and the conventional group (7.8%, P = 0.241). Multivariate analysis showed aortic balloon occlusion reduced postoperative acute kidney injury (23.1% vs 35.7%, P = 0.013) and hepatic injury (12.3% vs 27.8%, P = 0.001), and maintained similar cost to patients (25.5 vs 24.9 kUSD, P = 0.298). We also found that AST was high during intensive care unit (ICU) stay and recovered to normal before discharge, while ALT was not as high as AST in ICU but showed a rising tendency before discharge. The platelet count showed a rising tendency on postoperative day 3 and may exceed the preoperative value before discharge. Conclusions: The aortic balloon occlusion achieved the surgical goal of TAR with FET with an improved recovery process during the in-hospital stay.

scholarly journals Use of Contrast-Enhanced MR Angiography (CE-MRA) for the Diagnosis of a Vascular Ring Anomaly in a Dog

2012 ◽  
Vol 2012 ◽  
pp. 1-4
Author(s):  
Silke Hecht ◽  
April M. Durant ◽  
William H. Adams ◽  
Gordon A. Conklin
Keyword(s):  
Magnetic Resonance ◽  
Aortic Arch ◽  
Vascular Ring ◽  
Ligamentum Arteriosum ◽  
University Of Tennessee ◽  
Contrast Enhanced ◽  
Dry Food ◽  
Magnetic Resonance Imaging Mri ◽  
The Right ◽  
Band Crossing

A 4-month-old female mixed breed dog was presented to the University of Tennessee College of Veterinary Medicine with a history of regurgitation and cachexia. Thoracic radiographs revealed focal megaesophagus cranial to the heart base. Magnetic resonance imaging (MRI) was performed. True fast imaging with steady-state precession (TrueFISP), fast low angle shot (FLASH), and short tau inversion recovery (STIR) sequences were acquired prior to contrast medium administration. Contrast-enhanced magnetic resonance angiography (CE-MRA) demonstrated focal megaesophagus and position of the aortic arch to the right of the esophagus. A small ductus diverticulum and an indistinct linear soft tissue band crossing the esophagus were also noted. Surgical exploration confirmed MR diagnosis of a persistent right aortic arch (PRAA) with left ligamentum arteriosum. The dog improved following surgery but was unable to be transitioned to dry food. To our knowledge this is the first report describing the use of CE-MRA for preoperative diagnosis and guided surgical treatment of a vascular ring anomaly in a dog.

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