Comprehensive perioperative blood management in patients undergoing elective bypass cardiac surgery: Benefit effect of health care education and systematic correction of iron deficiency and anemia on red blood cell transfusion.

Study Objective: The aim of this study was to investigate the efficacy of a two-step patient blood management (PBM) program in red blood cell (RBC) transfusion requirements among patients undergoing elective cardiopulmonary bypass (CPB) surgery.

Design: Prospective, non-randomized, two-step protocol design.

Setting: Cardiac surgery department of Clinique Pasteur, Toulouse, France.

Late results after mitral valve replacement with Mosaic bioprosthesis in patients aged 65 years or younger.

Objectives: Although in younger patients indications for biological prosthesis implantation in mitral valve replacement remain controversial, recently bioprostheses use increased considerably. We present late results obtained with the Medtronic Mosaic bioprosthesis in patients aged 65 years or younger.

Methods: Between 2007 and 2017, 67 mitral Mosaic bioprostheses were implanted in patients aged 65 years or younger (58.

Patient blood management in elective bypass cardiac surgery: A 2-step single-centre interventional trial to analyse the impact of an educational programme and erythropoiesis stimulation on red blood cell transfusion.

Unlabelled: Anaemia and iron deficiency are frequent in patients scheduled for cardiac surgery. Perioperative patient blood management (PBM) is widely recommended in current practice guidelines. The aim of this protocol is to analyse the effect of a global perioperative PBM programme on the red blood cell (RBC) transfusion ratio, morbidities and rehabilitation score in elective cardiac surgery.

Thirty-day outcome and vascular complications after transarterial aortic valve implantation using both Edwards Sapien and Medtronic CoreValve bioprostheses in a mixed population.

Aims: Transcatheter aortic valve implantation (TAVI) is performed through a transarterial approach with encouraging results in "one-type valve" registries. We report 30-day data from a mixed population of patients treated with either Medtronic CoreValve (MCV) or Edwards SAPIEN (ES) valves.

Methods And Results: Forty-five patients had TAVI via the transarterial approach (21 MCV and 24 ES).

Endovascular repair of traumatic rupture of the aortic isthmus: midterm results.

Objective: The endovascular management of aortic traumatic ruptures has been proposed as an alternative to classical surgical procedures. The aim of this work was to report the midterm results of the endovascular treatment of traumatic ruptures of the isthmic aorta.

Methods: Between January 1996 and July 2005, endovascular repair of blunt traumatic aortic ruptures was performed in 33 patients (mean age, 40 +/- 17 years).

Midterm results of endovascular treatment of atherosclerotic aneurysms of the descending thoracic aorta.

Objective: We sought to determine the midterm results of endovascular repair of atherosclerotic aneurysms of the thoracic descending aorta by using second-generation, commercially available stent grafts.

Methods: Between 1996 and 2005, 45 patients (mean age, 68 +/- 11 years) with aneurysms of the descending thoracic aorta underwent endovascular repair. Aortic dissections, penetrating ulcers, and traumatisms were excluded.

Acute traumatic aortic rupture: a comparison of surgical and stent-graft repair.

Objective: The study's objective was to comparatively evaluate surgery and stent-graft repair of acute or subacute traumatic aortic rupture.

Methods: A total of 76 patients (14-76 years old; mean, 37 years; male/female ratio, 63/11) with a traumatic aortic injury were admitted to our hospital between 1981 and 2003. Six patients died within 1 to 9 days of another associated severe traumatic lesion.

Midterm outcomes of thoracic aortic stent-grafts: complications and imaging techniques.

Purpose: To evaluate the midterm outcomes of thoracic aortic stent-grafting and the performance of computed tomographic angiography (CTA), radiography, and magnetic resonance angiography (MRA) in endograft surveillance.

Methods: Forty-seven patients with traumatic thoracic aortic ruptures (n=16), aneurysms (n=14), false aneurysms (n=3), penetrating ulcers (n=3), and dissections (n=11) treated with stent-grafts were monitored in follow-up using chest radiography and CTA in all patients and MRA in 23 patients. Two perpendicular maximal aortic diameters, the sum of these diameters, and the elliptical cross-sectional area were determined and compared to baseline for the entire group and in subgroup analyses according to lesion type.

Stent-graft treatment of penetrating thoracic aortic ulcers.

Purpose: To evaluate the efficacy of stent-graft placement for the treatment of penetrating thoracic aortic ulcers.

Methods: Ten patients (7 men; mean age 73.8 years, range 69-79) were treated for penetrating thoracic aortic ulcers using Talent or Excluder stent-grafts.

A useful endovascular technique for treating modular limb disconnection in a bifurcated stent-graft.

Purpose: To report a technique for treating a type III endoleak owing to disconnection of an iliac graft limb from a modular aortic stent-graft.

Technique: A hydrophilic guidewire is introduced via a homolateral femoral access and passed through the thrombosed iliac extension. Once the errant graft limb is recanalized, wire exchange for an extra stiff guidewire facilitates passage of an angioplasty balloon into the stent.

Pseudoaneurysm and aortobronchial fistula after surgical bypass for aortic coarctation: management with endovascular stent-graft.

Purpose: To report the endovascular repair of an aortobronchial fistula at the distal anastomosis of a complex thoracic graft.

Case Report: A 61-year-old man operated 18 years prior for aortic coarctation presented with hemoptysis. An aortobronchial fistula was suspected, but spiral computed tomography and angiography showed only a small pseudoaneurysm at the distal anastomosis without revealing the fistulous tract.

Macroporous polyester-covered stent in an experimental abdominal aortic aneurysm model.

Purpose: To validate a recently described animal model of abdominal aortic aneurysm (AAA) and to assess a new macroporous polyester-covered stent for endovascular AAA exclusion.

Methods: Twenty adult sheep had AAAs surgically created by replacing a segment of the infrarenal aorta with an autologous jugular venous graft. Three months later, surviving animals underwent percutaneous implantation of macroporous polyester-covered nitinol stents; 3 animals with untreated AAAs served as controls.

Aortoduodenal fistula after endovascular stent-graft of an abdominal aortic aneurysm.

Despite satisfying short- and middle-term effectiveness and feasibility, endovascular stent-grafting for abdominal aortic aneurysm is still under evaluation. We report a case of an aortoduodenal fistula after the use of this technique. Enlargement of the upper aneurysmal neck was followed by caudal migration of the major portion of the stent-graft, which resulted in kinking of the device in the aneurysmal sac.

Aortic stent grafting and side-branch embolization in an expanding chronic type B dissection.

Objective: This is a report of endovascular treatment of a case of type B thoracoabdominal aortic dissection in a patient with progressive dyspnea, dorsolumbar pain, and expanding aortic diameter over a 1-year period.

Methods: Pretreatment imaging evaluation showed that the false lumen supplied only the celiac trunk. Endovascular treatment combined (1) embolization of the first segment of the celiac trunk to avoid distal back-flow into the false lumen and (2) stent grafting to occlude the initial entry tear.

[Renal adenocarcinoma with retrohepatic vena cava thrombus: role of extracorporeal circulation in a retrospective series of 10 cases].

Introduction: Renal cell carcinoma is accompanied by tumour thrombus in the inferior vena cava (IVC) in 4 to 10% of cases. Since the use of cardiopulmonary bypass (CPB), surgery for extensive thrombus has been improved by reduction of blood loss, facilitating complete resection of the kidney and thrombus and possible repair of the inferior vena cava.

Objectives: To analyse a retrospective series of 10 cases and to compare the complications of CPB and conventional surgery by direct clamping.

[Diagnosis and endovascular treatment of thoracic aortic diseases].

Recent years have seen the emergence of non-invasive imaging techniques for the morphological assessment of the thoracic aorta. This evolution results in an important reduction of the role of diagnostic angiography. Simultaneously, thanks to a tremendous technologic development, endovascular treatment techniques concern nowadays some pathologic conditions of the descending aorta.

Delayed treatment of traumatic rupture of the thoracic aorta with endoluminal covered stent.

Background: Stent grafting is emerging as a new treatment for several pathological conditions involving the thoracic aorta. We studied the feasibility and safety of this technique for delayed treatment of ruptures of the aortic isthmus.

Methods And Results: Nine patients (14 to 76 years old; mean, 37 years; male/female ratio, 8/1) underwent stent grafting of the aortic isthmus in subacute (n=5) or chronic (n=4) aortic traumatic rupture after a motor accident.

[Intra-aortic covered endoprosthesis].

Because of the risk and complications related to surgery of the aorta, the development of new, less invasive endovascular techniques has resulted in a certain enthusiasm for these new treatments on the part of physicians and industry. The insertion of aortic stents allows the treatment of almost one half of aneurysm of the infrarenal abdominal aorta and descending aorta. The results appear to demonstrate the medium-term reliability and efficacy of these new techniques with a lower morbidity-mortality rate than that of conventional surgery.

Endovascular retrieval of two migrated venous stents by means of balloon catheters.

The usefulness of vascular stenting was demonstrated in both arterial and venous applications to restore patency and improve suboptimal results after percutaneous transluminal angioplasty. Dislodgment of venous stents with an embolization into the right cavities or the pulmonary artery, however, is one of the most feared complications of this procedure. Percutaneous removal of these migrated stents is an appealing method of replacing more invasive operative intervention with cardiopulmonary bypass, which may be very hazardous in these often severely ill patients.

[Long-term results of the surgical treatment of acute type A thoracic aortic dissection].

Out of a population of 110 patients operated as an emergency for acute Stanford type A dissection of the thoracic aorta between 1985 and 1994, there were 84 survivors. Seventy-nine were assessed after a mean follow-up period of 47.3 months.

[Heart valve diseases specific in rheumatoid polyarthritis. Apropos of 2 cases].

Rheumatoid nodules represent a rare cardiac valvular involvement in rheumatoid arthritis. Patients are usually asymptomatic. We report two cases of such involvement: one presented as a tumour implanted on the mitral valve, with systemic embolisation; the other presented as aortic regurgitation with acute heart failure.