Hybrid treatment in a patient with acute aortic syndrome and an aberrant right subclavian artery.

A 57-year-old man was admitted to our department with recent onset of chest pain. Computed tomography (CT) scans revealed an acute aortic syndrome manifested by a penetrating atherosclerotic ulcer and contained rupture at the level of origin of an aberrant right subclavian artery. A combined vascular and endovascular approach was selected.

Prevention of sternal wound complications after sternotomy: results of a large prospective randomized multicentre trial.

Objectives: A prospective randomized multicentre trial was performed to analyse the efficacy of a vest (Posthorax support vest®) to prevent sternal wound infection after cardiac surgery, and to identify risk factors.

Methods: From September 2007 to March 2010, 2539 patients undergoing cardiac surgery via median sternotomy were prospectively randomized into those who received a Posthorax® vest and those who did not. Patients were instructed to wear the vest postoperatively for 24 h a day for at least 6 weeks; the duration of follow-up was 90 days.

Repair of stent graft-induced retrograde type A aortic dissection using the E-vita open prosthesis.

Objectives: Stent graft-induced retrograde type A dissection is a life-threatening complication after endovascular treatment of acute aortic type B dissections.

Methods: From August 2005 to February 2011, retrograde aortic dissection occurred in 4 of 29 patients (13.8%) undergoing thoracic endovascular aortic repair (TEVAR) for acute complicated aortic type B dissection.

Frozen elephant trunk technique for acute type A aortic dissection.

We present a case of a 59-year old male with a Stanford type A aortic dissection (DeBakey type I) extending from the sinotubular junction to the abdominal aorta. The patient was treated by a combined surgical and endovascular repair (frozen elephant trunk technique) using a specially designed hybrid prosthesis (E-vita open, Jotec GmbH). This onstage hybrid procedure enables simultaneous treatment of the ascending aorta, the aortic arch and the descending aorta.

Multicenter early experience with extended aortic repair in acute aortic dissection: is simultaneous descending stent grafting justified?

Objective: In acute type A aortic dissection, the extension of repair to downstream aorta has been controversially discussed. We present the early results of a multicenter study using a hybrid stent graft prosthesis.

Methods: Between January 2005 and January 2010, the data from 191 patients after combined proximal aortic replacement and antegrade stent grafting were collected in the database of the International E-vita open Registry.