Type A aortic dissection after abdominal aortic surgery

2020 ◽  
Vol 4 (1) ◽  
pp. 26
Author(s):  
MonishS Raut ◽  
MurtazaA Chishti ◽  
VijayMohan Hanjoora ◽  
Ashish Sharma
Keyword(s):  
Aortic Dissection ◽  
Aortic Surgery ◽  
Type A ◽  
Type A Aortic Dissection ◽  
Abdominal Aortic Surgery ◽  
Abdominal Aortic

scholarly journals STABILISE Technique via a Transapical Approach to Repair Residual Type A Aortic Dissection

Aorta ◽  
2021 ◽  
Author(s):  
Olivier Fouquet ◽  
Simon Dang Van ◽  
Myriam Ammi ◽  
Mickael Daligault ◽  
Christophe Baufreton ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Aortic Surgery ◽  
Type A ◽  
Thoracic Aortic Surgery ◽  
Elephant Trunk ◽  
Type A Aortic Dissection ◽  
Transcatheter Aortic Valve ◽  
Elephant Trunk Procedure ◽  
Valve Implantation ◽  
Transapical Approach

AbstractThe stent-assisted balloon-induced intimal disruption and relamination in aortic dissection or STABILISE concept is a novel endovascular strategy in Type A and Type B dissections. We report a case of Type A aortic dissection repair combining, first, an open thoracic aortic surgery with an elephant trunk procedure and, second, an endovascular treatment using the STABILISE technique via a combined transapical approach commonly used for transcatheter aortic valve implantation and a femoral pathway.

scholarly journals The use of an uncovered stent in type A aortic dissection during open aortic surgery

2018 ◽  
Vol 156 (6) ◽  
pp. e199-e200 ◽  
Author(s):  
Leopold Rupprecht ◽  
Piotr Kasprzak ◽  
Christof Schmid ◽  
Reinhard Kobuch ◽  
Karin Pfister
Keyword(s):  
Aortic Dissection ◽  
Aortic Surgery ◽  
Type A ◽  
Type A Aortic Dissection ◽  
Uncovered Stent

scholarly journals Giant Aortic Pseudoaneurysm with Stanford Type A Aortic Dissection after Aortic Valve Replacement

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Mertay Boran ◽  
Ali İhsan Parlar ◽  
Ertay Boran
Keyword(s):  
Aortic Valve ◽  
Aortic Dissection ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Aortic Surgery ◽  
Type A ◽  
Ascending Aorta ◽  
Aortic Aneurysms ◽  
Type A Aortic Dissection ◽  
Aortic Pseudoaneurysm

Giant pseudoaneurysm of the ascending aorta is a rare but dreadful complication occurring several months or years after aortic surgery. Thoracic aortic aneurysms tend to be asymptomatic and were previously often diagnosed only after a complication such as dissection or rupture. We present a rare case of giant ascending aneurysm with Stanford type A aortic dissection occurring 6 years after aortic valve replacement and also illustrate the potential dimensions the ascending aorta may reach by a pseudoaneurysm and dissection after AVR.

scholarly journals Severe Bronchospasm During Aortic Surgery for Type A Aortic Dissection

2021 ◽  
Vol 24 (3) ◽  
pp. E575-E577
Author(s):  
Zairong Lin ◽  
Kun-an Huang ◽  
Dongdong Chen ◽  
Qianzhen Li
Keyword(s):  
Cardiopulmonary Bypass ◽  
Aortic Dissection ◽  
Extracorporeal Membrane Oxygenation ◽  
Conventional Therapy ◽  
Aortic Surgery ◽  
Type A ◽  
Effective Therapy ◽  
Type A Aortic Dissection ◽  
Membrane Oxygenation

Severe bronchospasm during cardiopulmonary bypass is an unusual but potentially fatal event. No literature previously has reported such an event observed during surgery for type A aortic dissection. Herein, we report on a case of severe bronchospasm following cardiopulmonary bypass, during aortic surgery for type A aortic dissection. Bronchospasm did not respond to any conventional therapy, necessitating extracorporeal membrane oxygenation. Extracorporeal membrane oxygenation thus serves as an alternative and effective therapy for refractory bronchospasm.

Malperfusion in Acute Type A Aortic Dissection: Management Strategies

2021 ◽  
pp. 153857442110171
Author(s):  
Mona Jaffar-Karballai ◽  
Tien Thuy Tran ◽  
Oyinkan Oremakinde ◽  
Somama Zafar ◽  
Amer Harky
Keyword(s):  
Aortic Dissection ◽  
Aortic Surgery ◽  
Management Strategies ◽  
Type A ◽  
Acute Type ◽  
Type A Aortic Dissection ◽  
Post Surgery ◽  
Time Optimal ◽  
The Many ◽  
Almost All

Over the decades, it has been well established that malperfusion complicates a number of acute type A aortic dissection (ATAAD) patients. Of the many complications that arise from ATAAD is malperfusion, which is the result of true lumen compression secondary to the dissection, and it is one of the most dangerous complications. Left untreated, malperfusion can eventually compromise circulation to the vascular beds of almost all vital organs. Clinicians must consider the diagnosis of malperfusion promptly following a diagnosis of acute aortic dissection. The outcomes post-surgery for patients with ATAAD with concomitant malperfusion remains poor, despite mortality for aortic surgery improving over time. Optimal management for ATAAD with associated malperfusion has yet to be implemented, further research is warranted to improve the detection and management of this potentially fatal pathology. In this review, we explore the literature surrounding the complications of malperfusion in ATAAD and the various symptom presentations, investigations, and management strategies available.

scholarly journals Mid-term Patency of the Great Saphenous Bypass to Aorta vs. Non-aortic Arteries in Stanford Type A Aortic Dissection Surgery With Concomitant CABG

2021 ◽  
Vol 8 ◽  
Author(s):  
Maozhou Wang ◽  
Songhao Jia ◽  
Xin Pu ◽  
Lizhong Sun ◽  
Ming Gong ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Aortic Dissection ◽  
Aortic Surgery ◽  
Type A ◽  
Rank Test ◽  
Type A Aortic Dissection ◽  
Aortic Bypass ◽  
Early Results ◽  
Significant Difference ◽  
Mid Term Results

Background: Stanford type A aortic dissection (STAAD) is often associated with coronary artery problems requiring coronary artery bypass grafting (CABG). However, the prognosis of different proximal graft locations remains unclear.Methods: From May 2015 to April 2020, 62 patients with acute STAAD who underwent aortic surgery concomitant with CABG were enrolled in our study. Aortic bypass was defined as connecting the proximal end of the vein bridge to the artificial aorta (SVG-AO); non-aortic bypass was defined as connecting the proximal end of the vein bridge to a non-aorta vessel, including left subclavian artery, left common carotid artery, and right brachiocephalic artery (non-SVG-AO). We compared early- and mid-term results between patients in the above two groups. Early results included death and bleeding, and mid-term results graft patency, aortic-related events, and bleeding. Grafts were evaluated by post-operative coronary computed tomography angiography. According to the Fitzgibbon classification, grade A (graft stenosis <50%) is considered a patent graft. Univariate and multivariate analyses were performed to assess differences between aortic and non-aortic bypass in STAAD.Results: SVG-AO and non-SVG-AO were performed in 15 and 47 patients, respectively. There was no significant difference in death (log-rank test, p = 0.426) or bleeding (p = 0.766) between the two groups in the short term. One year of follow-up was completed in 37 patients (eight in the SVG-AO group and 29 in the non-SVG-AO group), among which 14/15 (93.3%) grafts were patent in the SVG-AO group and 32/33 (97.0%) grafts in the non-SVG-AO at 1 week, without a significant difference (p = 0.532). At 3 months, 12/13 (92.3%) grafts were patent in the SVG-AO group and 16/32 (50.0%) grafts in the non-SVG-AO, with a significant difference (p = 0.015), and 12/13 (92.3%) grafts in the SVG-AO group and 15/32 (46.9%) grafts in the non-SVG-AO group were patents, with a significant difference. Multivariate analysis showed proximal aortic bypass and dual anticoagulation to be protective factors for the 1-year patency of grafts.Conclusion: In patients requiring aortic dissection surgery with concomitant CABG, no differencess' between SVG-AO and SVG-non-AO in early outcomes were detected, but SVG-AO may have higher mid-term patency.

Similar Midterm Clinical Outcomes and Aortic Remodeling in Bifurcated and Straight Aortic Stent Grafts Used to Treat Isolated Abdominal Aortic Dissection

2021 ◽  
pp. 152660282110612
Author(s):  
Tun Wang ◽  
Chang Shu ◽  
Quan-ming Li ◽  
Ming Li ◽  
Xin Li ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Type A ◽  
Type I ◽  
Stent Grafts ◽  
Type A Aortic Dissection ◽  
Abdominal Aortic ◽  
Abdominal Aortic Dissection ◽  
Aortic Remodeling ◽  
Bifurcated Graft

Purpose: The optimal treatment for isolated abdominal aortic dissection (IAAD) is currently unknown. We compared the effects of straight and bifurcated aortic stent grafts on postoperative aortic remodeling in patients with IAAD. Materials and Methods: From February 2012 to December 2019, 57 patients with IAAD were treated using endovascular methods, including either a bifurcated or a straight aortic stent graft. The clinical features, risk factors, computed tomography angiograms, midterm follow-up results, and aortic remodeling of these patients were reviewed and analyzed. Results: In total, 44 (77%) patients were treated with a bifurcated graft and 13 (23%) patients were treated with a straight graft. Patients treated with straight grafts had fewer common iliac arteries involved (38% vs 73%, p=0.023), the dissection length was shorter (76.3 ± 40.0 vs 116.2 ± 56.7 mm, p=0.011), and the preoperative aortic diameter (26.0 ± 5.6 vs 35.2 ± 12.1 mm) and the false lumen diameter (13.1 ± 5.2 vs 21.2 ± 11.3 mm) were smaller. During the procedure, there were 3 (5.3%) type I endoleaks, 1 (1.8%) surgical conversion and 1 (1.8%) partial renal artery coverage without perioperative mortality. Patients with straight grafts had shorter operative time (96.5 ± 24.4 vs 144.2 ± 49.0 minutes, p<0.0001). The median follow-up duration was 37.6 ± 21.0 (range = 3–89) months with 1 (1.8%) aortic-related death. Type A aortic dissection occurred in 1 (1.8%) patient. New descending aortic dissection occurred in 3 (5.3%) patients, and 1 patient advanced to type A aortic dissection 3 months later. Two (3.5%) patients had limb occlusion. There was no significant difference in aortic remodeling, survival, and freedom from all adverse events between the 2 treatment strategies. Conclusions: Endovascular treatment provides a safe, minimally invasive treatment for IAAD in midterm follow-up. Compression of the true lumen at the aortic bifurcation is the main concern after treatment with a bifurcated graft. Straight grafts are an excellent alternative for some patients, with the benefit of reduced procedural time, effective aortic remodeling, and excellent clinical prognosis. More experience is needed to offer clear recommendations for making treatment decisions as well as determine long-term effectiveness and durability.

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