scholarly journals Extra-anatomic thoracic aortic bypass operations

Medicina ◽  
2008 ◽  
Vol 44 (5) ◽  
pp. 373
Author(s):  
Arūnas Valaika ◽  
Gediminas Norkūnas ◽  
Gintaras Kalinauskas ◽  
Giedrė Nogienė ◽  
Jurgis Verižnikovas ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Abdominal Aorta ◽  
Bypass Graft ◽  
Emergency Operation ◽  
Aortic Aneurysms ◽  
Major Surgery ◽  
Descending Aorta ◽  
Aorta Aneurysm ◽  
Aortic Bypass ◽  
Thoracic Aneurysms

Objective. When the patient condition contraindicates major surgery for descending thoracic aneurysms, the surgeon should consider using an ascending aorta to abdominal aorta bypass graft, leaving the diseased segment undisturbed. Our experience with eight patients is presented. Material and methods. Between 1988 and 2008, eight patients were treated for the following indications: reoperation for coarctation (two patients), complicated descending aortic aneurysms (five patients), and posttraumatic descending aorta dissection (one patient). The mean age of the patients was 44±8 years (range, 27–53 years). There were 6 (75%) males and 2 (25%) females. Emergency operations were performed in three patients (two with aortic recoarctation, one with posttraumatic aortic dissection). Two cases were reoperations (both after recoarctation). Descending aorta was ligated in seven cases. Distal anastomosis was connected with abdominal aorta in four cases and with iliac arteries in four patients. Results. Three early deaths occurred. Two patients died after emergency operation after recoarctation and posttraumatic aortic dissection, and one patient died after descending aorta aneurysm correction because of bleeding. Conclusions. In complex aortic coarctation, extra-anatomic bypass operation remains an effective procedure. The usage of these procedures in patients with descending aortic aneurysms remains complicated.

scholarly journals Giant Aortic Aneurysm in Child with Cutis Laxa Syndrome: Unusual Presentation, New Surgical Technique

2021 ◽  
Vol 24 (6) ◽  
pp. E1054-E1056
Author(s):  
Mazen Shamsaldeen Faden ◽  
Nada Ahmed Noaman ◽  
Osman Osama Osman Osama ◽  
Ahmed Abdelrahman Elassal ◽  
Arwa Mohammed Al-ghamdi ◽  
...  
Keyword(s):  
Final Diagnosis ◽  
Ascending Aorta ◽  
Accurate Diagnosis ◽  
Aortic Aneurysms ◽  
Cutis Laxa ◽  
Descending Aorta ◽  
Aorta Aneurysm ◽  
Thoracic Aortic Aneurysms ◽  
Valvular Insufficiency ◽  
New Surgical Technique

Ascending thoracic aortic aneurysms are rare in childhood and typically are seen in the setting of connective tissue defect syndromes. These aneurysms may lead to rupture, dissection, or valvular insufficiency, so root replacement is recommended. Here, we present a 17-month-old girl who presented with fever, cough, and pericardial effusion. Initially, we suspected this could be a COVID-19 case, so a nasopharyngeal swap was performed. An ascending aorta aneurysm involving the aortic arch was confirmed by echo, and urgent ascending aorta and arch replacement were done by utilizing the descending aorta as a new arch. The final diagnosis came with cutis laxa syndrome. In similar cases, good outcomes can be achieved with accurate diagnosis and appropriate surgical management.

Hybrid procedures for thoracoabdominal aortic pathologies

Vascular ◽  
2013 ◽  
Vol 21 (4) ◽  
pp. 205-214 ◽  
Author(s):  
Zhao Liu ◽  
Min Zhou ◽  
Chen Liu ◽  
Tong Qiao ◽  
Dian Huang ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Takayasu’S Arteritis ◽  
Bypass Graft ◽  
Aortic Aneurysms ◽  
Graft Occlusion ◽  
Takayasu's Arteritis ◽  
Hybrid Procedures ◽  
Coverage Area ◽  
Thoracoabdominal Aorta ◽  
Aortic Pathologies

We report our three-year experience with the visceral hybrid procedure for patients with thoracoabdominal aortic aneurysms, dissections and Takayasu's arteritis. We also evaluate and discuss the outcomes of hybrid procedures. Hybrid procedures include debranching of the visceral or renal arteries followed by endovascular repair of the disease. The surgical strategy was designed individually to reduce trauma and minimize stent coverage area. A series of 11 patients (9 men, mean age 52 years) were treated between June 2008 and September 2011. The pathologies were aneurysmal disease (thoracoabdominal aortic aneurysms) (5, 45.5%), aortic dissection (thoracoabdominal aortic dissection) (4, 36.4%) or true/false aneurysm formation after Takayasu's arteritis (2, 18.2%). Simultaneous approach (9, 81.8%) and staged approach (2, 18.2%) were performed. The mean follow-up was 13.5 months (range 1–36). The technical success was 100%. Stent grafts were implanted in the entire or part of the thoracoabdominal aorta. The overall mortality rate was 9.1% (1/11) with no aneurysm-related death. The permanent paraplegia and bypass graft occlusion rate was 0%. The overall morbidity was 36.4% with two endoleaks (2/11, 18.2%). In conclusion, hybrid procedures can minimize surgical invasiveness in treatments of thoracoabdominal aortic pathologies, and it is a safe method with acceptable morbidity and mortality.

A 10-year study of surgical results of descending aorta aneurysm repair following chronic aortic dissection

2020 ◽  
Vol 72 (4) ◽  
pp. 1288-1297
Author(s):  
Jun Woo Cho ◽  
Suk Jung Choo ◽  
Chul Ho Lee ◽  
Ho Jin Kim ◽  
Joon Bum Kim ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Surgical Results ◽  
Descending Aorta ◽  
Aorta Aneurysm ◽  
Chronic Aortic Dissection ◽  
Aneurysm Repair

Severe obstructive calcifications affecting the descending and suprarenal abdominal aorta without coexisting peripheral atherosclerotic disease – coral reef aorta

VASA ◽  
2006 ◽  
Vol 35 (3) ◽  
pp. 206-208 ◽  
Author(s):  
Teebken ◽  
Pichlmaier ◽  
Kühn ◽  
Haverich
Keyword(s):  
Coral Reef ◽  
Abdominal Aorta ◽  
Bypass Graft ◽  
Retroperitoneal Approach ◽  
Rare Form ◽  
Iliac Arteries ◽  
Descending Aorta ◽  
Aortic Replacement ◽  
Thoracic And Abdominal ◽  
Common Iliac Arteries

The case of a 58-year-old woman with leg claudication due to a very rare form of atherosclerosis affecting the descending thoracic and abdominal aorta – known as coral reef aorta – without involvement of the femoro-distal vessels is reported. The patient was treated with a polyester bifurcation graft from the proximal descending aorta to both common iliac arteries via a left dorsal minithoracotomy and a second left retroperitoneal approach. This unusual approach was chosen instead of direct aortic replacement in order to prevent paraplegia. In case of future visceral or left renal malperfusion the diseased artery can be connected to the prosthesis directly or by the use of an additional bypass graft. This would not be the case with a conventional axillo-bifemoral graft.

Hemodynamics in Ascending and Abdominal Aorta Aneurysm Formation in the ApoE−/− Angiotensin II Mouse Model

2012 ◽  
Author(s):  
Bram Trachet ◽  
Marjolijn Renard ◽  
Joris Bols ◽  
Steven Staelens ◽  
Bart Loeys ◽  
...  
Keyword(s):  
Angiotensin Ii ◽  
Abdominal Aorta ◽  
Current Knowledge ◽  
Aortic Aneurysms ◽  
Abdominal Aorta Aneurysm ◽  
Aorta Aneurysm ◽  
Computational Biomechanics ◽  
Perfect Model ◽  
Life Threatening ◽  
Aneurysm Growth

Aortic aneurysm is a pathological dilatation of the aorta that can be life-threatening when it ruptures. Aneurysms occur throughout the entire aorta but there is a predisposition for the ascending and the abdominal aorta, an observation that cannot be fully explained by the current knowledge of the disease pathophysiology. ApoE −/− mice infused with angiotensin II have recently been reported to develop not only abdominal [1], but also ascending aortic aneurysms [2]. These animals thus provide the perfect model to compare aneurysm progression in both aortic locations and to investigate whether disturbed hemodynamics play a role in the initial phase of aneurysm growth. In this study, both imaging and computational biomechanics techniques were used to elucidate the flow field at the location of the aneurysm prior to onset of the disease.

MODELING OF ABDOMINAL AORTA ANEURYSM AND STUDY OF THE PATHOLOGY USING COMPUTATIONAL FLUID DYNAMICS METHOD

2011 ◽  
Vol 23 (04) ◽  
pp. 295-305 ◽  
Author(s):  
Raya Majdani Shabestari ◽  
Kamran Hassani ◽  
Farhad Izadi
Keyword(s):  
Abdominal Aorta ◽  
Three Dimensional ◽  
Aortic Aneurysms ◽  
Rupture Risk ◽  
Abdominal Aorta Aneurysm ◽  
Aorta Aneurysm ◽  
Aneurysm Wall ◽  
Aneurysm Diameter ◽  
Aneurysm Model ◽  
Dynamics Method

In this paper, we have constructed a three-dimensional abdominal aorta aneurysm model based on the CT-scan/angiography images. The inlet velocity is pulsatile and the simulation was done by means of finite volume analysis. The velocity and pressure contours were obtained for four different aneurysm sizes in three sections. The results indicate that the velocity decreases in aneurysm wall but pressure increases in that area. Furthermore, the increase of the aneurysm diameter increases the rupture risk due to high pressure in the wall. The shear stress is high in the start point and end of the aneurysm's curvature. Our study indicates that the aneurysm diameter is directly related to the pressure. High blood pressure could be a risk factor in artery rapture. Our model can serve as a useful tool for the study of the aortic aneurysms.

Graft endoclamping with brachio-femoral wire conduit for elephant trunk retrieval in open thoraco-abdominal aortic repair

2020 ◽  
Author(s):  
Emanuele Gatta ◽  
Paolo Berretta ◽  
Luciano Carbonari ◽  
Marco Di Eusanio
Keyword(s):  
Abdominal Aorta ◽  
Aortic Disease ◽  
Proximal Anastomosis ◽  
Elephant Trunk ◽  
Aortic Arch Replacement ◽  
Descending Aorta ◽  
Aorta Aneurysm ◽  
Second Stage ◽  
Aortic Repair ◽  
Abdominal Aortic

Abstract Staged repair involving aortic arch replacement with elephant trunk (ET) technique and thoraco-abdominal aorta (TAA) replacement is the treatment of choice for patients with extensive aortic disease. The ET graft serves as a proximal platform for subsequent distal aortic repair as it allows one to avoid hazardous dissection of the distal arch and facilitate proximal anastomosis. However, in patients with large proximal descending aorta aneurysm, identifying and retrieving the ET during the second-stage TAA intervention can be challenging because of an unclampable aorta. Here, we present our brachio-femoral wire conduit technique for a safe ET clamping and retrieval during second-stage TAA procedures.

scholarly journals Aneurysmectomy for Crawford’s Type-I Thoracoabdominal Aortic Aneurysm using Gelatin Impregnated Woven Vascular Prosthesis under Mild Hypothermic Extracorporeal Circulation: A Video Presentation

2020 ◽  
Vol 4 (02) ◽  
pp. 136-139
Author(s):  
Ujjwal K. Chowdhury ◽  
Sukhjeet Singh ◽  
Niwin George ◽  
Poonam Malhotra Kapoor ◽  
Srikant Sharma ◽  
...  
Keyword(s):  
Aortic Aneurysm ◽  
Thoracic Aorta ◽  
Abdominal Aorta ◽  
Thoracoabdominal Aortic Aneurysm ◽  
Renal Arteries ◽  
Aortic Aneurysms ◽  
Type I ◽  
Descending Thoracic Aorta ◽  
Descending Aorta ◽  
Type Iv

AbstractBased on the risk of ischemic injury to the spinal cord and the risk of renal failure and mortality, Crawford and colleagues classified thoracoabdominal aortic aneurysms into four extents. Type I thoracoabdominal aortic aneurysms involved the descending thoracic aorta proximal to the level of 6th rib to above the renal arteries; type II extends from the proximal descending thoracic aorta above the level of T6 to below the renal arteries; type III extends from below the level of T6 in the descending aorta and a variable extent in the abdominal aorta; type IV thoracoabdominal aortic aneurysm involved the abdominal aorta without involvement of the descending aorta.

scholarly journals Ascending Aortic Length and Its Association With Type A Aortic Dissection

2021 ◽  
Author(s):  
Daniella Eliathamby ◽  
Mariana Gutierrez ◽  
Aileen Liu ◽  
Maral Ouzounian ◽  
Thomas L. Forbes ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Innominate Artery ◽  
Type A ◽  
Ascending Aorta ◽  
Aortic Aneurysms ◽  
Control Group ◽  
Acute Type ◽  
Type A Aortic Dissection ◽  
Acute Dissection ◽  
Thoracic Aneurysms

Background The aim of this study was to determine the role of ascending aortic length and diameter in type A aortic dissection. Methods and Results Computed tomography scans from patients with acute type A dissections (n=51), patients with proximal thoracic aortic aneurysms (n=121), and controls with normal aortas (n=200) were analyzed from aortic annulus to the innominate artery using multiplanar reconstruction. In the control group, ascending aortic length correlated with diameter ( r 2 =0.35, P <0.001), age ( r 2 =0.17, P <0.001), and sex ( P <0.001). As a result of immediate changes in aortic morphology at the time of acute dissection, predissection lengths and diameters were estimated based on models from published literature. Ascending aortic length was longer in patients immediately following acute dissection (median, 109.7 mm; interquartile range [IQR], 101.0–115.1 mm), patients in the estimated predissection group (median, 104.2 mm; IQR, 96.0–109.3 mm), and patients in the aneurysm group (median, 107.0 mm; IQR, 99.6–118.7 mm) in comparison to controls (median, 83.2 mm; IQR, 74.5–90.7 mm) ( P <0.001 all comparisons). The diameter of the ascending aorta was largest in the aneurysm group (median, 52.0 mm; IQR, 45.9–58.0 mm), followed by the dissection group (median, 50.3 mm; IQR, 46.6–57.5 mm), and not significantly different between controls and the estimated predissection group (median, 33.4 mm [IQR, 30.7–36.7 mm] versus 35.2 mm [IQR, 32.6–40.3 mm], P =0.09). After adjustment for diameter, age, and sex, the estimated predissection aortic lengths were 16 mm longer than those in the controls and 12 mm longer than in patients with nondissected thoracic aneurysms. Conclusions The length of the ascending aorta, after adjustment for age, sex, and aortic diameter, may be useful in discriminating patients with type A dissection from normal controls and patients with nondissected thoracic aneurysms.

Sign in / Sign up

Export Citation Format

Share Document