Hemolytic anaemia due to graft kinking progression and aortic stenosis exacerbation after aortic arch replacement: A case report.

Introduction: Hemolytic anaemia from graft kinking is a rare complication after aortic surgery, typically treated by graft replacement. This case highlights hemolytic anaemia caused by the interaction of aortic stenosis and a kinked graft, successfully managed with transcatheter aortic valve replacement (TAVR).

Presentation Of Case: A 75-year-old male developed hemolytic anaemia 2 years after total aortic arch replacement for a saccular aneurysm, with a worsening graft kink and aortic stenosis.

What is the Optimal Proximal Landing Zone of the Stent Graft in Treatment of Aortic Type B Dissection?

Purpose: Retrograde type A aortic dissection (RTAD) represents a serious complication of endovascular treatment for type B aortic dissection (TBAD). To avoid RTAD, it is recommended to land the proximal end of the stent graft in a non-dissected aortic segment. In this study, we investigated whether landing in the dissection area increased the number of events at the proximal site.

Total arch replacement with frozen elephant trunk technique for Kommerell's diverticulum with a right-sided aortic arch and aberrant left subclavian artery.

Background: Kommerell's diverticulum with a right-sided aortic arch and aberrant left subclavian artery is uncommon. We perforemed a single-stage procedure with the frozen elephant trunk technique.

Case Presentation: A 62-year-old man underwent aortic dissection a year ago, and computerized tomographic angiography performed at that time revealed a right aortic arch, Kommerell's diverticulum (42 mm), and an aberrant left subclavian artery.

A case of early reperfusion of celiac artery for type A acute aortic dissection with malperfusion.

Malperfusion of the celiac artery alone, with acute aortic dissection, rarely requires early intervention. A 57-year-old woman had thrombosed type A acute aortic dissection with celiac malperfusion, for which total arch replacement was performed after percutaneous balloon angioplasty of the celiac artery. The endovascular treatment minimized extensive hepatic infarction, which saved the patient's life.

Entry Site Is Associated With Aortic Enlargement After Pre-emptive Endovascular Repair for Uncomplicated Type B Aortic Dissection.

Objectives: We aimed to examine the mid-term results corresponding to the entry site in patients who underwent pre-emptive thoracic endovascular aortic aneurysm repair (TEVAR) for uncomplicated type B aortic dissection (TBAD).

Methods: We included 27 patients who underwent pre-emptive TEVAR for uncomplicated TBAD between September 2014 and December 2019. We divided the patients into 2 groups depending on the proximal landing zone (zone 2 group, zone ≥3 group) and retrospectively analyzed the risk of all-cause and aorta-related mortality, aortic events (rupture, open conversion, and secondary intervention), and aortic enlargement (≥5 mm).

Perivascular radiolucent line during recanalization of superficial femoral artery.

During the recanalization of chronic total occlusions in the superficial femoral artery, severe calcification adds technical difficulty in guidewire crossing due to poor ultrasound visualization and uncontrollable guidewire manipulation. Herein, we present the case of a 70-year-old man with chronic total occlusion of the superficial femoral artery to report the indicating aspirated air in the subintimal space, which could be noted after a failed subintimal angioplasty. The helped a safe guidewire tail crossing by making the vascular wall visible.

Tracheo-innominate artery fistula with continuous bleeding successfully treated through the suprasternal approach: a case report.

Background: Tracheo-innominate artery fistula (TIF) is a rare but fatal complication occurring after tracheotomy. Brachiocephalic trunk transection, one of the surgical treatments for TIF, is mostly associated with a full or partial median sternotomy. We describe a case of TIF with continuous bleeding, which was successfully treated with brachiocephalic trunk transection through a collar incision without the need for median sternotomy.

Priming and replenishment in cardiopulmonary bypass with hydroxyethyl starch 130/0.4 decreases fluid overbalance without renal dysfunction or bleeding in adult valve surgery.

The best priming and replenishment solution in cardiopulmonary bypass remains unknown, and the efficacy and drawbacks of artificial colloid are controversial. We retrospectively compared consecutive patients undergoing elective adult valve surgery in cases wherein cardiopulmonary bypass was primed and replenished with hydroxyethyl starch 130/0.4 (n = 12) or crystalloid solution (n = 11).

De-airing an open stent graft to potentially reduce spinal cord injury.

We have occasionally observed a bubble leaving the suture line of an open stent graft; hence, we hypothesized that de-airing an open stent graft could potentially reduce spinal cord injury. Postoperative computed tomography often showed residual air in thoracic aortic aneurysms, confirmed by the presence of a certain amount of air in an open stent graft in a dry lab. We filled CO in the sterilized package of an open stent graft and subsequently filled it with saline, which absorbed the CO and entered into the gap of the graft.

Exophytic Atheroma Mimicking Papillary Fibroelastoma Adjacent to the Aortic Valve.

Follow-up echocardiography in a 69-year-old man with alcoholic cardiomyopathy showed a mass above the aortic valve near the left coronary ostium. Transesophageal echocardiography and computed tomography suggested a papillary fibroelastoma with a high risk of embolism. At operation we found an exophytic atheroma adjacent to the left coronary artery orifice.

Cuff leakage, not paravalvular leakage, in the Carpentier Edwards PERIMOUNT Magna Ease aortic bioprosthesis.

Though the Carpentier Edwards PERIMOUNT Magna Ease valve is a bioprosthesis with documented excellent haemodynamics and easy implantability, this valve has a gap between the cobalt-chromium-nickel alloy stent and silicone sewing ring. This gap, which is widest just below each of the three commissural struts, lacks silicone and leaves the two-layer polytetrafluoroethylene fabric unsupported and unprotected. If the needle of a valve suture is placed in this structurally weak area of the sewing ring, the resultant fabric tear may result in a true cuff leakage, not the usual paravalvular leakage.

An easy and useful exposure technique using a malleable u-shaped retractor for proximal anastomosis in abdominal aortic replacement.

During surgery for an abdominal aortic aneurysm, various problems can occur at the proximal anastomosis. Adequate exposure must be secured, and the proximal anastomosis must be sutured firmly. We have used a malleable U-shaped retractor to easily secure exposure of the proximal anastomosis.