Computed tomography-based anatomical suitability of an Endo-Bentall prosthesis for ascending aortic aneurysms.

Background: This study aimed to evaluate the suitability of a coronary-branched ascending aortic endograft, paired with aortic valve (AV) prosthesis (Endo-Bentall), for the endovascular repair of ascending aortic aneurysms.

Methods: Preoperative ≤1 mm computed tomography angiographies of consecutive patients managed with Bentall procedure or ascending aortic replacement and AV reconstruction/replacement, in a single institution (from January 1, 2008, to December 31, 2023), were retrospectively analyzed. Dedicate software was used to assess (1) vascular access, (2) proximal landing zone, (3) coronary artery anatomy, and (4) distal landing.

Multicentre frozen elephant trunk technique experience as redo surgery to treat residual type A aortic dissections following ascending aortic replacement.

Objectives: The goal of this project was to assess the efficacy of a reoperative frozen elephant trunk (FET) operation for treating residual type A aortic dissections.

Methods: Between April 2015 and October 2023, a total of 237 patients underwent elective redo surgical aortic arch replacement via the FET technique to treat residual type A aortic dissection in 11 European aortic centres. Data were pooled and analysed retrospectively.

Late diagnosis of Marfan syndrome is associated with unplanned aortic surgery and cardiovascular death.

Background: Marfan syndrome (MFS) guidelines recommend optimal pharmacologic therapy (OPT) and replacement of the ascending aorta (RAA) at 5.0 cm in diameter to prevent acute type A aortic dissection (ATAAD) and death. The effect of early MFS diagnosis and initiation of therapy on outcomes is not known.

Branched and fenestrated endovascular aortic arch repair in patients with native proximal aortic landing zone.

Objective: Fenestrated and branched thoracic endovascular repair (f/bTEVAR) have been successfully applied in patients with diverse aortic arch pathologies. The aim of this study is to present the early and mid-term outcomes of patients with native proximal aortic landing (NPAL) managed with f/bTEVAR.

Methods: A single-center retrospective analysis of patients with NPAL, managed with f/bTEVAR, between September 1, 2011, and June 30, 2022, was conducted.

A Retrospective Analysis of 10-year Experience on Branched and Fenestrated Endovascular Aortic Arch Repair.

Objective: This study aimed to present the early and mid-term outcomes of fenestrated/branched thoracic endovascular aortic repair (f/bTEVAR) for aortic arch pathologies.

Background: f/bTEVAR represents a less invasive treatment option for aortic arch diseases. Previous published series showed decreased early mortality and morbidity compared to open repair.

Analysing debranching techniques in Frozen Elephant Trunk procedures: a narrative literature review.

Background And Objective: Since 2003, the Frozen Elephant Trunk (FET) technique has attained rising popularity for treating extensive aortic arch pathologies such as acute and chronic aortic dissection, as well as thoracic aortic aneurysm. Conventionally, the FET procedure included a complete resection of the aortic arch and, subsequently, a distal aortic anastomosis of the prosthetic part of the hybrid graft in arch zone 3. Simultaneous to the introduction of the FET technique, the traditional Elephant Trunk technique was simplified by adding debranching techniques which allows for proximalization of the distal aortic anastomosis.

Endovascular Options for the Ascending Aorta and Aortic Arch: A Scoping Review.

The gold standard for aneurysmal repair of the ascending aorta and the aortic arch has been open surgery with an established track record of good results in suitable patients. In recent years, with innovations in the endovascular field alternative endovascular solutions for pathologies of the aortic arch and ascending aorta became available. At first reserved only for highly selected patients unfit for open surgery, endovascular aortic arch repair is now being offered to patients with suitable anatomy in high-volume referral centers after discussion in an interdisciplinary team.

Antegrade axillary arterial perfusion in 3D endoscopic minimally-invasive mitral valve surgery.

Background: Minimally-invasive (MIS) mitral valve (MV) surgery has become standard therapy in many cardiac surgery centers. While femoral arterial perfusion is the preferred cannulation strategy in MIS mitral valve surgery, retrograde arterial perfusion is known to be associated with an increased risk for cerebral atheroembolism, particularly in atherosclerosis patients. Therefore, antegrade perfusion may be beneficial in such cases.

Endovascular treatment of aortic aneurysms and dissections in patients with genetically triggered aortic diseases.

Connective tissue disease (CTD) syndromes involve the ascending, aortic arch, and thoracoabdominal aorta and are associated with higher risk of aortic aneurysm or dissection. Currently, vascular societies generally recommend open repair as the first option for aortic disease in patients with CTD. However, the implementation of endovascular techniques for patients with CTD with aortic pathologies seems to have increased in recent years, mainly in patients of high surgical risk or in urgent situations.

Risk factors for impaired neurological outcome after thoracic aortic surgery.

Background: We aimed to identify risk factors for an impaired postoperative neurological outcome after thoracic aortic surgery.

Methods: Data from all patients undergoing thoracic aortic surgery between 2010 and 2020 at our institution were collected and analyzed retrospectively. Logistic regression analysis was used to identify independent risk factors for permanent postoperative neurological deficit (ND) (stroke), which was defined as a ND lasting at least seven days.

Endovascular Treatment of Aortic Pathologies in Patients With Marfan Syndrome: Single-Center Experience.

Objectives: To study the outcome of endovascular treatment of aortic pathologies in patients with Marfan syndrome (MFS) at a single institution.

Methods: Consecutive MFS patients who underwent endovascular repair or hybrid procedures for aortic pathologies from January 2010 to May 2020 were identified. Several endovascular and hybrid strategies have been used.

Modified use of a 4-branched frozen elephant trunk prosthesis for treatment of a right-sided aortic arch aneurysm with an aberrant left subclavian artery.

Right aortic arch aneurysm originating from a Kommerell's diverticulum associated with an aberrant left subclavian artery is a rare congenital entity. We report a case of an asymptomatic 60-year-old female with right aortic arch aneurysm with an aberrant left subclavian artery, treated with a modified frozen elephant trunk technique using a 4-branched prosthesis, with the perfusion branch as an extra-anatomical bypass to the aberrant left subclavian artery. This case demonstrates short-term safety and efficacy of this technique.

Management of Ascending Aorta and Aortic Arch: Similarities and Differences Among Cardiovascular Guidelines.

Background: Ascending aorta and aortic arch diseases have an increasing interest among cardiovascular specialists regarding diagnosis and management. Innovations in endovascular surgery and evolution of open surgery have extended the indications for treatment in patients previously considered unfit for surgery. The aim of this systematic review of the literature was to present and analyze current cardiovascular guidelines for overlap and differences in their recommendations regarding ascending aorta and aortic arch diseases and the assessment of evidence.

Laser Lead Extraction During Venoarterial ECMO support.

The treatment of valvular endocarditis in patients with cardiac implantable electrophysiological device (CIED) includes valvular surgery and lead extraction. This can be challenging in patients with severely reduced left ventricular ejection fraction (LVEF). Reduced LVEF in combination with sepsis and cardioplegic cardiac arrest can make weaning from cardiopulmonary bypass difficult.

Early outcomes of patients with Marfan syndrome and acute aortic type A dissection.

Background: Acute aortic Stanford type A dissection remains a frequent and life-limiting event for patients with Marfan syndrome. Outcome results in this high-risk group are limited.

Methods: The German Registry for Acute Aortic Dissection Type A collected the data of 56 centers between July 2006 and June 2015.

Intraoperative quality assessment of tissue perfusion with indocyanine green (ICG) in a porcine model of mesenteric ischemia.

Background: Mesenteric ischemia is a severe and potentially lethal event. Assessment of intestine perfusion is eminently depending on the skills, and the experience of the surgeon. Thus, the therapy is biased by the right evaluation.

Endovascular Repair of Postdissection Thoracoabdominal Aortic Aneurysm in Patients With Vascular Ehlers-Danlos Syndrome.

Purpose: To report endovascular repair of postdissection thoracoabdominal aortic aneurysm (TAAA) in 2 patients with vascular Ehlers-Danlos syndrome (vEDS).

Case Reports: . A 56-year-old vEDS male patient with a 50-mm type III TAAA [history of aortic root repair, hemiarch replacement, and thoracic endovascular aortic repair (TEVAR) for acute type A aortic dissection (TAAD) 7 years ago] was treated by a 2-stage procedure; first, cervical debranching of the left subclavian artery and second TEVAR and t-branch.

European registry of type A aortic dissection (ERTAAD) - rationale, design and definition criteria.

Background: Acute Stanford type A aortic dissection (TAAD) is a life-threatening condition. Surgery is usually performed as a salvage procedure and is associated with significant postoperative early mortality and morbidity. Understanding the patient's conditions and treatment strategies which are associated with these adverse events is essential for an appropriate management of acute TAAD.

German Aortic Root Repair Registry-Insights From the First 400 Consecutive Patients.

Background: The objective was to provide initial data from our prospective valve-sparing aortic root replacement (V-SARR) registry and reasons for conversion to prosthetic aortic valve replacement.

Methods: Six centers established an intention-to-treat-design V-SARR-registry (the German Aortic Root Repair Registry; first patient in October 2016); the main inclusion criterion was being scheduled for V-SARR as plan A. Clinical information, operative details, intraoperative valve/root measurements, and clinical and transthoracic echocardiography follow-up-data are documented.

Outcome of the frozen elephant trunk procedure as a redo operation.

Objectives: The goal of this study was to determine the outcome of patients undergoing an elective frozen elephant trunk (FET) procedure as a redo operation following previous cardiac surgery.

Methods: One hundred and eighteen consecutive patients underwent FET procedures between October 2010 and October 2019 at our centre. Patients were registered in a dedicated database and analysed retrospectively.

Validation of quantitative assessment of indocyanine green fluorescent imaging in a one-vessel model.

Objectives: Evaluation of intestinal perfusion remains subjective and depends on the surgeon´s individual experience. Intraoperative quality assessment of tissue perfusion with indocyanine green (ICG) fluorescence using a near-infrared camera system has been described in different ways and for different indications. The aim of the present study was to evaluate fluorescent imaging (FI) in the quantitative assessment of intestinal perfusion in a gastric tube model in pigs and to compare the results to results obtained with florescent microspheres (FM), the gold standard for tissue perfusion.

Prediction of mortality rate in acute type A dissection: the German Registry for Acute Type A Aortic Dissection score.

Objectives: The goal was to develop a scoring system to predict the 30-day mortality rate for patients undergoing surgery for acute type A aortic dissection on the basis of the German Registry for Acute Type A Aortic Dissection (GERAADA) data set and to provide a Web-based application for standard use.

Methods: A total of 2537 patients enrolled in GERAADA who underwent surgery between 2006 and 2015 were analysed. Variable selection was performed using the R-package FAMoS.