scholarly journals Pedicled omental wrapping of ascending aortic graft following mediastinitis

2021 ◽  
Vol 7 (1) ◽  
pp. 66
Author(s):  
Yatin Arora ◽  
Velayoudam Devagourou ◽  
Ratnesh Kumar
2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 81-81
Author(s):  
Tetsu Nakamura ◽  
Sonoko Ishida ◽  
Hiroshi Hasegawa ◽  
Masashi Yamamoto ◽  
Shingo Kanaji ◽  
...  

Abstract Background Aortoesophageal fistula(AEF) had been a critical and life-threatening disease. The surgical strategy which consist of aortic graft replacement with omental wrapping, esophagectomy, and staged esophageal reconstruction achieve circulatory recovery, infection control and long term survival. The objective of this study is to evaluate surgical outcomes of pedicled jejunal transfer with microvascular augmentation as esophageal reconstruction for AEF. Methods 14 patients with aortoesophageal fistula who underwent aortic graft replacement and esophagectomy between 2010 and 2017 at Kobe University Hospital and affiliate hospitals were enrolled in this study. Patient characteristics, operative method and clinical outcomes were obtained by retrospective chart review. Results All 14 patients underwent aortic graft replacement with omental wrapping, esophagectomy and staged esophageal reconstruction. 10 patients (71.4%) successfully underwent staged esophageal reconstruction of pedicled jejunal transfer with microvascular augmentation and showed no leakage and no graft loss. Median survival time in the patients who underwent esophageal reconstruction was 20.3 months from initial operation. Nine of 10 patients were alive but one patient died of sepsis ten months after esophageal reconstruction. Conclusion Aortic graft replacement with omental wrapping and esophaegcotomy play crucial role in the treatment of AEF. Omentum is pedicled by right epiploic artery and vein to prepare good blood flow and sufficient volume of omental wraping and, consequently, stomach without right epiploic artery and vein becomes inappropriate for esophageal conduit. Pedicled jejunal transfer with microvascular augmentation contributes good post-operative outcome. The surgical strategy for AEF, which includes aortic graft replacement with omental wrapping, esophagectomy, and staged esophageal reconstruction by pedicled jejunal transfer microvascular augmentation is feasible and promising. Disclosure All authors have declared no conflicts of interest.


2012 ◽  
Vol 26 (3) ◽  
pp. 423.e1-423.e4 ◽  
Author(s):  
Russell W. Jamieson ◽  
Paul J. Burns ◽  
A. Raymond W. Dawson ◽  
Simon C.A. Fraser

2011 ◽  
Vol 14 (4) ◽  
pp. 237 ◽  
Author(s):  
Ferdinand Vogt ◽  
Anke Kowert ◽  
Andres Beiras-Fernandez ◽  
Martin Oberhoffer ◽  
Ingo Kaczmarek ◽  
...  

<p><b>Objective:</b> The use of homografts for aortic valve replacement (AVR) is an alternative to mechanical or biological valve prostheses, especially in younger patients. This retrospective comparative study evaluated our single-center long-term results, with a focus on the different origins of the homografts.</p><p><b>Methods:</b> Since 1992, 366 adult patients have undergone AVR with homografts at our center. We compared 320 homografts of aortic origin and 46 homografts of pulmonary origin. The grafts were implanted via either a subcoronary technique or the root replacement technique. We performed a multivariate analysis to identify independent factors that influence survival. Freedom from reintervention and survival rates were calculated as cumulative events according to the Kaplan-Meier method, and differences were tested with the log-rank test.</p><p><b>Results:</b> Overall mortality within 1 year was 6.5% (21/320) in the aortic graft group and 17.4% (8/46) in the pulmonary graft group. In the pulmonary graft group, 4 patients died from valve-related complications, 1 patient died after additional heterotopic heart transplantation, and 1 patient who entered with a primary higher risk died from a prosthesis infection. Two patients died from non-valve-related causes. During the long-term follow-up, the 15-year survival rate was 79.9% for patients in the aortic graft group and 68.7% for patients in the pulmonary graft group (<i>P</i> = .049). The rate of freedom from reoperation was 77.7% in the aortic graft group and 57.4% in the pulmonary graft group (<i>P</i> < .001). The reasons for homograft explantation were graft infections (aortic graft group, 5.0%; pulmonary graft group, 6.5%) and degeneration (aortic graft group, 7.5%; pulmonary graft group, 32.6%).</p><p><b>Conclusion:</b> Our study demonstrated superior rates of survival and freedom from reintervention after AVR with aortic homografts. Implantation with a pulmonary graft was associated with a higher risk of redo surgery, owing to earlier degenerative alterations.</p>


1995 ◽  
Vol 2 (3) ◽  
pp. 248-254 ◽  
Author(s):  
Bradley B. Hill ◽  
Richard Neville ◽  
Gordon L. Hyde ◽  
Chien-Suu Kuo ◽  
Edward B. Diethrich

2020 ◽  
Vol 68 (5) ◽  
Author(s):  
Gregorio Menzà ◽  
Fabrizio D'Ascenzo ◽  
Matteo Attisani ◽  
Michele La Torre ◽  
Fabio Verzini ◽  
...  
Keyword(s):  

2019 ◽  
Vol 58 (4) ◽  
pp. 477-478 ◽  
Author(s):  
Anne Lejay ◽  
Bernard Geny ◽  
Philippe Kolh ◽  
Nabil Chakfé

2019 ◽  
Vol 53 (7) ◽  
pp. 599-601
Author(s):  
Pagliariccio Gabriele ◽  
Gatta Emanuele ◽  
Carlo Grilli Cicilioni ◽  
Schiavon Sara ◽  
Carbonari Luciano

Introduction: A 90-year-old patient was admitted with a hemorrhagic shock from a huge ruptured abdominal aortic aneurysm with an unfavourable infrarenal aortic neck and a horseshoe kidney (HSK). Report: We decided on an open surgical approach: the HSK isthmus was sectioned with an Endo GIA 45 mm, and we performed a suprarenal aortic cross-clamping and an aortic graft reconstruction. Postoperatively, no urinary leakage was detected, and renal function showed no impairment. The patient died on the 10th postoperative day from pneumonia. Conclusion: We believe that the sectioning of the HSK isthmus with Endo GIA is a fast and simple maneouvre.


Sign in / Sign up

Export Citation Format

Share Document