Renovascular hypertension: results in adulthood of renal autotransplantation performed in children.

Background: This study describes the long-term results of renal autotransplantation for renovascular hypertension performed in children who are now 21 years of age or older.

Methods: Sixteen children (4 boys, 12 girls) with a mean age of 11.2 years at the time of the procedure underwent ex-vivo surgery at the university hospital of Saint-Etienne between 1992 and 2008.

How to manage hypertension with atherosclerotic renal artery stenosis?

The management of atherosclerotic renal artery stenosis (ARAS) in patients with hypertension has been the topic of great controversy. Major contemporary clinical trials such as the Cardiovascular Outcomes for Renal Artery lesions (CORAL) and Angioplasty and Stenting for Renal Atherosclerotic lesions (ASTRAL) have failed to show significant benefit of revascularization over medical management in controlling blood pressure and preserving renal function. We present here the implications and limitations of these trials and formulate recommendations for management of ARAS.

Editor's Choice - Ex vivo Renal Artery Repair with Kidney Autotransplantation for Renal Artery Branch Aneurysms: Long-term Results of Sixty-seven Procedures.

Objective/background: To evaluate the long-term outcome of renal revascularization by ex vivo renal artery reconstruction and autotransplantation for renal artery branch aneurysms (RABAs).

Methods: Between 1991 and 2015, 67 ex vivo renal artery reconstructions with kidney autotransplantation were performed in 55 adults (mean age 47 years) and 10 children to repair 87 RABAs. The main underlying disease was fibromuscular dysplasia in 34 patients.

Common hepatic artery as inflow in kidney transplantation.

Kidney transplantation originating from the hepatic artery has not previously been reported. Herein, we report a third kidney transplantation with the common hepatic artery as inflow. A 62-year-old male with chronic renal failure due to polycystic kidney disease was proposed to a third kidney transplantation.

European consensus on the diagnosis and management of fibromuscular dysplasia.

The main objectives of this expert consensus are to raise awareness about fibromuscular dysplasia, which is more frequent and more often systemic than previously thought and can sometimes have devastating consequences; to provide up-to-date recommendations for the diagnosis, evaluation, and management of the disease; and to identify research priorities. The emphasis has been put on recommendations for daily practice. The main topics covered include definition, classification, diagnosis, and management of fibromuscular dysplasia in adult patients with symptomatic involvement of the renal arteries, supra-aortic trunks, and digestive and peripheral arteries.

Carotid artery surgery: high-risk patients or high-risk centers?

Background: Carotid angioplasty and stenting has been proposed as an alternative to carotid endarterectomy (CEA) in patients deemed as at high risk for this surgical procedure. To date, definitely accepted criteria to identify "high-risk" patients for CEA do not exist. Our objective was to assess the relevance of numerous supposed high-risk factors in our experience, as well as their possible effect on our early postoperative results.

Early and late results of ex vivo repair and autotransplantation in solitary kidneys.

Introduction: Autotransplantation of a solitary kidney provides an excellent opportunity to study the immediate and long-term consequences of intra-operative renal ischaemia. The purpose of this report is to describe a series of nine patients who underwent ex vivo repair and autotransplantation on solitary kidneys.

Patients And Methods: The series included six females and three males with a mean age of 36 years.

Redo aortic valve surgery with endovascular control of the internal thoracic artery graft.

Background And Aim Of The Study: Redo aortic valve surgery (AVS) in patients with patent pedicled internal thoracic artery (ITA) grafts remains a challenging procedure because of the possibility of injury to the grafts and difficulties in optimal myocardial protection. This procedure is associated with a significant mortality and morbidity. Different approaches to myocardial protection and ITA graft dissection and control have been described.

Incidental visceral and renal artery stenosis in patients undergoing coronary angiography.

Purpose: The study aimed to examine the association between incidentally discovered mesenteric artery stenosis, renal artery stenosis (RAS) and coronary artery disease in patients undergoing coronary angiography.

Materials And Methods: We performed a prospective analysis of consecutive patients undergoing routine cardiac catheterisation. Abdominal aortograms in lateral and antero-posterior view were obtained to assess arterial stenosis of the coeliac axis, superior mesenteric artery and renal arteries.

Aneurysmal extension to the iliac bifurcation increases the risk of complications and secondary procedures after endovascular repair of abdominal aortic aneurysms.

Background: To compare the outcome of endovascular aneurysm repair (EVAR) of abdominal aortic aneurysm (AAA) in patients with and without associated common iliac artery aneurysm (CIAA) extending to the iliac bifurcation.

Methods: Review of 157 patients who underwent endovascular aneurysm repair between 1999 and 2007. Group 1 included 133 patients with and without CIAA and suitable distal common iliac neck (type A, B, C, or D).

Infrarenal iterative aortic surgery: early and late morbi-mortality observed in 61 patients.

The aim of this study was to analyze the early and late results of iterative aortic surgery after bypass of infrarenal aorta. Results from Clermont-Ferrand and Saint-Etienne hospitals have been collected. Between January 1993 and December 2001, 61 patients (59 men and two women, mean age 65 years) underwent a partial or complete second aortic reconstruction through a direct approach.

Pseudoaneurysms postangioplasty of the renal artery: case reports and review of the literature.

Pseudoaneurysms postangioplasty of the renal artery are a life-threatening complication but are poorly known due to their rarity. The aim of this report is to study this complication through three personal case reports and 10 cases found in a literature review. The data analysis led us to highlight important aspects about four main elements: initial procedure events, time to presentation, symptoms leading to diagnosis, and treatment.

Takayasu arteritis in children.

Takayasu arteritis (TA) is a large vessel vasculitis that usually affects young female patients during the second and third decades of life, but has been reported in children as young as 24 months of age. Aim of this report was to describe four children (two girls) with TA, as well as summarizing main published studies. The mean age at presentation of our cases was 11 years (range 8-15).

Bypass to the perigeniculate collateral arteries: mid-term results.

Purpose: The purpose of this report is to present mid-term results of infrainguinal revascularizations using either the highest genicular artery or medial sural artery as the distal anastomosis site.

Material And Methods: Between 1996 and 2005, a total of 59 bypass procedures to perigeniculate collateral arteries were performed in 57 patients (14 women, 43 men) with a mean age of 74. Fifty five patients presented with critical ischemia (tissue loss in 28 and rest pain in 27).

Beating-heart approach and moderately delayed surgical management of postinfarction ventricular septal rupture: an advisable approach to improve results?

Early repair of postinfarction ventricular septal rupture is usually associated with significant mortality and morbidity. Assessing conditions to moderately delay the surgical intervention and reduce cardioplegic arrest may be an interesting approach to improve hospital results. Results of five non-selected patients in whom surgery was moderately delayed and performed according a policy of reducing the cardioplegic-induced ischemia were reviewed.

Enterovirus in arteriosclerosis: a pilot study.

Background: Various pathogens have been suspected to play a role in the initiation or amplification of the atherosclerotic lesions. Both experimental and epidemiological arguments plead for a possible role of enterovirus in this process.

Objective: To determine the prevalence of enterovirus genome in atherosclerotic plaques, in comparison with Chlamydia pneumoniae, human cytomegalovirus (hCMV) and herpes simplex virus.

Mid-term results of endovascular treatment for descending thoracic aorta diseases in high-surgical risk patients.

We report the initial experience of two cardiovascular surgery centers in the treatment of descending thoracic aorta lesions with covered stent grafts in high-surgical risk patients. From April 1999 to November 2004, 54 patients, mean age 64 years (range 16-83), were treated by stent graft for a lesion of the descending aorta (degenerative aneurysms n = 22, aortic dissections n = 12, chronic post traumatic aneurysms n = 5, anastomotic false aneurysms n = 2, penetrating ulcers n = 4, intramural hematomas n = 5, traumatic rupture n = 4), with 42.6% treated on an emergency basis.

Surgery of the abdominal aorta and its branches in children: late follow-up.

Background: The aim of this study was to evaluate the late results in adult patients who underwent surgery of the abdominal aorta as children.

Methods: During a 17-year period, eight children underwent surgery for lesions of the abdominal aorta. There were 6 boys and 2 girls, with an average age of 10 years.

Incidental disclosure of asymptomatic coronary embolic occlusion related to mitral valve papillary fibroelastoma: an unusual finding and a review of the literature.

Cardiac papillary fibroelastoma (CPF) located on mitral and aortic valves are known to produce systemic embolism mainly represented by strokes, whereas myocardial infarction and sudden death usually result from specific locations around LVOT. Coronary artery embolic occlusion originating from a mitral location has not yet been reported. The case is reported of a 42-year-old man referred for surgical treatment of a mitral valve papillary fibroelastoma disclosed after transitory and completely regressive left hemicorporeal deficiency and previous myocardial infarct.

Giant coronary artery aneurysm mimicking a compressive cardiac tumor Imaging features and operative strategy.

Giant atheromatous coronary aneurysms mimicking a cardiac tumor remain exceptional. We report the case of a patient who experienced a severe inferior myocardial infarction related to a giant thrombosed coronary aneurysm masquerading a cardiac tumor and compressing right cardiac cavities with mechanical detrimental consequences on tricuspid, mitral and aortic valvular competence. The contribution of imaging was essential to assess diagnosis, understand the physiopathogeny of myocardial and valvular consequences and plan the optimal surgical strategy.

Off-pump myocardial revascularization in a diabetic patient with severe hemophilia B and impaired left ventricular function: hematological and operative strategies.

Coronary surgery with diabetes and severe hemophilia B is a challenging situation requiring specific and adequate therapeutic considerations. We herein report the case of a 52-year-old diabetic patient with severe factor IX deficiency and impaired ventricular function, who was scheduled for myocardial revascularization because of exertional angina and recurrent myocardial infarctions following infusions of factor IX concentrate. The patient underwent a successful off-pump direct myocardial revascularization with neither hemorrhagic nor thrombotic complications.

Risk factors for systemic emboli in infective endocarditis.

A retrospective study was undertaken to analyse the risk factors for systemic emboli in infective endocarditis. Patients (n = 80; 70% males; mean age 65 years; range 20-91 years) with infective endocarditis, as defined by the Duke criteria and diagnosed using transoesophageal echocardiography during the period January 1995 to March 2001, were included. The average time between the start of the illness and the beginning of antibiotic treatment was 55 days (range 0-405 days).