The need for custom made frozen elephant trunk: when and where.

The frozen elephant trunk (FET) technique is an increasingly common procedure to treat complex extensive aortic disease both in elective and emergency setting. In a contemporary era, several prostheses are available to be used by surgeons performing such procedures, merging the advantages of endovascular and conventional surgery and preparing a more useful landing zone for second-stage downstream endovascular or open repair. Thoraflex hybrid (Terumo Aortic, Scotland) is a largely used hybrid vascular device merging a conventional surgical vascular graft made of gelatin-sealed woven polyester graft with a nitinol self-expanding stent graft.

Frozen Elephant Trunk Technique in Acute Type A Aortic Dissection: Is It for All?

Acute type A aortic dissection (ATAAD) is an indisputable emergency with very poor outcomes without surgical treatment. Although the aortic arch is often involved in the aortic dissection, its optimal management during surgical therapy remains uncertain. A conservative tear-oriented approach has traditionally been adopted, limiting the procedure to the ascending aorta (or hemiarch) replacement.

Surgical removal of an exceedingly rare papillary fibroelastoma of the aortic wall causing unstable angina.

Difficult diagnosis is due to rarity of the case. TT or TE echocardiography is sufficient to make a correct diagnosis. The risk of embolism or coronary ostia occlusion should guide the decision for surgery.

Caged-Ball Mitral Prosthesis Explanted After 50 Years.

We report a unique case of a Starr-Edwards prosthesis (model 6310, cloth covered) implanted in the mitral position by Christian Barnard that was successfully explanted and replaced after 50 years, the longest period free from valve dysfunction ever reported. Reoperation also included replacement of the native aortic valve combined with tricuspid valve annuloplasty. ().

A modified frozen elephant trunk hybrid device to facilitate supra-aortic trunk anastomosis.

Reimplantation of the supra-aortic vessels can be challenging with Thoraflex Hybrid. A device modification made the vessel lengths more appropriate and the position of the neo-vessels in the chest avoided malpositioning and kinking and facilitated sternum closure; this may improve operating times as well as allowing complete and continuous cerebral trivascular perfusion and corrects positioning of the intrathoracic vessels.

Impella 5.0 repositioning across the aortic valve without a guidewire using rapid ventricular pacing: A case report.

Background: Displacement of Impella 5.0 secondary to patient movement or transportation is a well-known complication. Typically, repositioning of an Impella across the aortic valve is attempted over a guidewire.

Brunner's gland hamartoma: a case report and review of literature.

Background: Brunner's hamartoma is a quite rare neoformation whose origin is not completely clear.

Methods: A case of a 69-year-old man with recurrent epigastric pain and an endoscopic finding of a duodenal mass is reported.

Results: The complete removal of hamartoma can give a complete remission of symptoms.

Mitral valve replacement and limited myectomy for hypertrophic obstructive cardiomyopathy: a 25-year follow-up.

Hypertrophic obstructive cardiomyopathy is a dynamic obstruction of the left ventricular outflow tract caused by septal hypertrophy and systolic anterior motion of the mitral valve. When the condition cannot be controlled by medical therapy the most frequently used surgical approach is left ventricular myotomy-myectomy. Mitral valve replacement (to correct another mechanism of obstruction) is another surgical option; however, its use for this condition is controversial.