Very Late Aortic Endograft Infection With Listeria monocytogenes in an Elderly Man.

Endograft infection with Listeria monocytogenes is a rare, potentially devastating complication of endovascular aortic aneurysm repair. To our knowledge, only 8 cases have been reported. We describe the case of a 72-year-old man who presented with L.

Hemodynamic outcomes after valve-in-valve transcatheter aortic valve replacement: a single-center experience.

Background: Valve-in-valve transcatheter aortic valve replacement (ViV-TAVR) has emerged as a safe, effective alternative to redo aortic valve surgery in high-risk patients with degenerated surgical bioprosthetic valves. However, ViV-TAVR has been associated high postprocedural valvular gradients, compared with TAVR for native-valve aortic stenosis.

Methods: We performed a retrospective study of all patients who underwent ViV-TAVR for a degenerated aortic valve bioprosthesis between January 1, 2013 and March 31, 2019 at our center.

Transcatheter aortic valve replacement after chest radiation: A propensity-matched analysis.

Background: Chest radiation therapy (CRT) for malignant thoracic neoplasms is associated with development of valvular heart disease years later. As previous radiation exposure can complicate surgical treatment, transcatheter aortic valve replacement (TAVR) has emerged as an alternative. However, outcomes data are lacking for TAVR patients with a history of CRT.

Transcatheter aortic valve implantation despite challenging vascular access.

We describe transcatheter aortic valve implantation in a patient who had severe peripheral artery disease. The patient's vascular condition required additional preliminary peripheral intervention to enable adequate vascular access. A 78-year-old man with severe aortic stenosis, substantial comorbidities, and severe heart failure symptoms was referred for aortic valve replacement.

Endovascular therapy in patients with genetically triggered thoracic aortic disease: applications and short- and mid-term outcomes.

Objectives: For patients with genetically triggered thoracic aortic disease, the morbidity and mortality associated with reoperation are high, making endovascular treatment an appealing option. We evaluated the short- and mid-term outcomes of different applications of endovascular intervention in such patients.

Methods: Between January 2003 and April 2013, 60 patients received endovascular or hybrid treatment for genetically triggered thoracic aortic disease.

Predicting early death after cardiovascular surgery by using the Texas Heart Institute Risk Scoring Technique (THIRST).

Preoperative risk-prediction models are an important tool in contemporary surgical practice. We developed a risk-scoring technique for predicting in-hospital death for cardiovascular surgery patients. From our institutional database, we obtained data on 21,120 patients admitted from 1995 through 2007.

Coarctation-associated aneurysms: a localized disease or diffuse aortopathy.

Background: We evaluated the occurrence and treatment of aortic aneurysms in coarctation patients.

Methods: During 1962 to 2011, 943 cases of coarctation were repaired. Aortic aneurysms were identified in 55 patients (5.

Combined clopidogrel and aspirin therapy in patients undergoing carotid endarterectomy is associated with an increased risk of postoperative bleeding.

This present study investigated the influence of combined preoperative clopidogrel and aspirin (ASA) administration on adverse postoperative outcomes and bleeding risk in patients undergoing carotid endarterectomy (CEA). A retrospective cohort study of all consecutive patients undergoing isolated CEA (n = 1488) between 1998 and 2005 was performed. Patients were classified into three groups: patients receiving combined preoperative clopidogrel/ASA therapy (n = 315), patients receiving preoperative ASA only (n = 639) and patients receiving no preoperative antiplatelet therapy (n = 518).

Contemporary relevancy of carotid-subclavian bypass defined by an experience spanning five decades.

Background: The contemporary impact of and indications for carotid-subclavian bypass (CSB) are essential considerations in decision making for brachiocephalic reconstruction.

Methods: We analyzed operative outcomes, long-term graft patency, and the extended epidemiological impact of the primary disease process in 287 consecutive patients (mean age, 60.6 years; 43.

Direct cannulation of the infrahepatic vena cava for emergent cardiopulmonary bypass support.

Cannulation for cardiopulmonary bypass, although seemingly routine, can pose technical challenges. In patients undergoing repeat sternotomy, for example, peripherally established cardiopulmonary bypass may be necessary to ensure safe entry into the chest; however, establishing bypass in this way can sometimes be complicated by patients' body habitus. We describe a technique for direct cannulation of the infrahepatic abdominal vena cava that was required for emergent cardiopulmonary bypass.

Popliteal vein aneurysm presenting as a popliteal mass.

Unlike most primary venous aneurysms, popliteal venous aneurysms can have devastating consequences, including pulmonary embolism and death. We present a case of popliteal venous aneurysm in a 27-year-old man who had local extremity symptoms and no thromboembolic complications. The fusiform 6- x 3-cm aneurysm was repaired surgically with an open tangential aneurysmectomy and lateral vein reconstruction.

Celiac artery aneurysm: a case report.

Aneurysm of the celiac artery is an uncommon clinical problem; fewer than 180 cases have been reported in the world medical literature. Most patients are symptomatic at the time of diagnosis. However, occasionally such aneurysms are detected incidentally during diagnostic imaging for other diseases.

Myocardial thievery: the coronary-subclavian steal syndrome.

Coronary-subclavian steal syndrome entails the reversal of blood flow in a previously constructed internal mammary artery coronary conduit, which produces myocardial ischemia. The most frequent cause of the syndrome is atherosclerotic disease in the ipsilateral, proximal subclavian artery. Although coronary-subclavian steal was initially reported to be rare, the increasing documentation of this phenomenon and its potentially catastrophic consequences in recent series suggests that the incidence of the problem has been underreported and that its clinical impact has been underestimated.

Off-pump repair of a giant pseudoaneurysm of a distal saphenous vein bypass graft.

Pseudoaneurysm of a saphenous vein bypass graft is a rare occurrence after coronary artery bypass grafting but may have lethal consequences. We treated a giant pseudoaneurysm of a saphenous vein graft to the right coronary artery in an 80-year-old male Jehovah's Witness who had undergone coronary artery bypass grafting 4 and a half years earlier. His history revealed a recurrent sternal wound infection.

Concomitant brachiocephalic and coronary artery disease: outcome and decision analysis.

Background: In patients with coronary artery disease, concomitant brachiocephalic disease may affect outcome and influence decision making regarding operative staging, technique, and choice of conduit.

Methods: Eighty consecutive patients (mean age, 59.3 years; 60.

Brachiocephalic reconstruction II: operative and endovascular management of single-vessel disease.

Objective: Although the surgical management of brachiocephalic disease is well established, evolving endovascular techniques present new options for treatment. We explored the potential benefits and drawbacks of these interventions in terms of outcome.

Methods: From 1966 to 2004, 391 consecutive patients (43.

Brachiocephalic reconstruction I: operative and long-term results for complex disease.

Objectives: Complex brachiocephalic disease involves multiple vessels and is frequently associated with multisystem atherosclerosis. We reviewed surgical outcome and examined the impact of this problem on decision making regarding operative staging, technique, and choice of conduit.

Methods: Between 1966 and 2000, 157 consecutive patients (mean age, 54.

Hypercoagulable state leading to paraplegia in a middle-aged man.

A 37-year-old man presented with an unusual thrombotic disorder characterized by acute paraplegia and the absence of palpable pulses due to extensive arterial thrombosis of the aorta and its distal branches. The patient had an extremely complicated course that necessitated multiple revascularization procedures over a 1.5-year period.