Purpose: To evaluate midterm outcomes of endovascular repair of types II and III thoracoabdominal aortic aneurysms (TAAA) using the Multilayer Flow Modulator (MFM) in patients unsuitable for open surgery or fenestrated stent-grafts.
Methods: In the prospective, multicenter, nonrandomized STRATO trial (EudraCT registration: 2009-013678-42; ClinicalTrials.gov identifier NCT01756911), 23 patients (mean age 75.
Background And Aim Of The Study: Transcatheter aortic valve implantation (TAVI) is a promising option to treat degenerated aortic valve bioprostheses, and may involve Valve-in-Valve (ViV) procedures. Unfortunately, the ViV technique may provide an inadequate relief of stenosis in small-diameter degenerated bioprostheses, especially in the 19 mm valve subgroup. The study aim was to determine the feasibility and reliability of reoperating 19 mm degenerated bioprostheses, using a minimally invasive sutureless valve implantation.
View Article and Find Full Text PDFBackground: Current treatment for extensive thoracoabdominal aortic aneurysms (TAAAs) involves high-risk surgical and endovascular repairs, with a hospital mortality exceeding 20%, and a postoperative paraplegia rate beyond 10.5%.
Objectives: The aim of this study was to present an estimation of the economic impacts of surgical and endovascular treatments of types II and III TAAAs in the US as well as the economic consequences of the elimination of spinal cord injury and mortality via an endovascular repair of extensive TAAAs (1).
Purpose: To evaluate endovascular repair of type II and III thoracoabdominal aortic aneurysms (TAAA) using the Multilayer Flow Modulator (MFM) in patients with contraindications for open surgery and fenestrated stent-grafts.
Methods: In this prospective, multicenter, nonrandomized trial (EudraCT registration: 2009-013678-42; ClinicalTrials.gov identifier NCT01756911), 23 patients (19 men; mean age 75.
Res Cardiovasc Med
February 2013
The preoperative and surgical management of a giant left ventricular pseudoaneurysm(LVP) associated with aortic valve replacement in a 76 year old male Jehovah's Witness patient is reported. The satisfactory recovery observed in this patient demonstrates the feasibility of this complex surgical procedure even in this particular patient population.
View Article and Find Full Text PDFBackground: Refusal of heterogenic blood products can be for religious reasons as in Jehovah's Witnesses or otherwise or as requested by an increasing number of patients. Furthermore blood reserves are under continuous demand with increasing costs. Therefore, transfusion avoidance strategies are desirable.
View Article and Find Full Text PDFPurpose: To describe a case of multiple thoracoabdominal aneurysms of tuberculous origin treated in an endovascular procedure with the Multilayer stent.
Case Report: A 16-year-old girl had been treated 4 years previously for a ruptured abdominal aortic aneurysm of tuberculous origin. Due to the presence of 4 rapidly evolving saccular aneurysms of the descending thoracic aorta and a fusiform aneurysm of the suprarenal aorta, an endovascular solution was chosen after the patient refused open surgery.
Interact Cardiovasc Thorac Surg
June 2011
Multilayer stents are already being used for the treatment of peripheral aneurysms. In France, they are currently under evaluation in the treatment of thoraco-abdominal aneurysms. We have used multilayer stents to treat aneurysmal evolution of thoraco-abdominal residual type B dissection.
View Article and Find Full Text PDFPurpose: Between January 1991 and October 2003, 200 Jehovah Witnesses adult patients underwent elective cardiac surgery. To asses the impact on continuing progress of blood saving protocols and the increasing operative risk of patients proposed to surgery, we have re-assessed our results in this specific population.
Methodology: Files of the first 100 patients operated upon between 1991 and 1998 were reviewed, and compared to the following 100 ones treated between 1998 to today.
Background: Jehovah's Witnesses who require cardiac surgery represent a challenge to the physician because of their refusal to accept blood transfusions. Because coronary artery bypass grafting (CABG) is performed by most surgeons under cardiopulmonary bypass (CPB), which has potentially deleterious effects on hemostasis, we used a new concept called minimal extracorporeal circulation (MECC). MECC includes heparin-coated tubing, a centrifugal pump, and an oxygenator.
View Article and Find Full Text PDFMigration of an Antheor caval filter into the pulmonary artery was observed in a 66-year old male patient referred for multifocal pulmonary embolism in a context of heparin-induced thrombocytopenia. The inferior vena cava was of small diameter (18 mm). The filter was removed under cardio-pulmonary bypass and total heparinization, despite the proven thrombocytopenia.
View Article and Find Full Text PDFFrom April 1985 to September 1991, 88 patients were operated for a total of 100 thoracobrachial outlet syndromes. The patients were placed in the dorsal supine position, turned 30 degrees towards the contralateral side. The arm was suspended in slight abduction.
View Article and Find Full Text PDFPhlebologie
October 1992
Factors which the duration of time off work after surgical treatment of venous insufficiency of the legs were studied in 3000 patients undergoing surgery in our institution between 1985 and 1990. Three variables significantly influenced return to work at 2 weeks (RW2w). The first was socio-professional group.
View Article and Find Full Text PDFPhlebologie
September 1989
Coronary surgery represents an increasing economic burden to society. This is aggravated a great deal by the fact that these patients do not return to work and are often placed in permanent postoperative disability. Comparative analysis of return-to-work rates after coronary by-pass, according to the social benefits system, clearly demonstrates the magnitude of the possible savings.
View Article and Find Full Text PDFFrom September 1985 to December 1986, 100 patients undergoing percutaneous placement of a transvenous "LGM" caval filter were included in a multicenter prospective trial. Peripheral venograms completed by pulmonary arteriography or scintigraphy were obtained for all patients. Eighty-five patients had experienced pulmonary embolism, 59 had iliocaval thrombosis, while 40 had venous thrombosis confined to the lower limbs.
View Article and Find Full Text PDFThe authors report seven cases of abdominal aortic aneurysm rupturing into the inferior vena cava system. Symptoms were protean, but included local clinical manifestations and general findings due to the high-flow arteriovenous fistula. In spite of different types of clinical presentation, the correct preoperative diagnosis was made when a continuous bruit with systolic accentuation was heard over the abdomen.
View Article and Find Full Text PDFImpotence can be caused by leakage of venous blood from the penis during erection. Of 135 patients studied with erectile dysfunction, 40 had venous leakage, and these patients were classified into three groups according to findings on cavernosograms. Thirty-one patients were treated with implantation of balloons and coils.
View Article and Find Full Text PDFThree cases of aorto-iliocaval fistula are reported. Two cases were diagnosed during operation, an emergency laparotomy being indicated by the picture of hemodynamic shock unimproved by intravenous fluids, and without reduction in number of circulating red cells, associated with a painful abdominal aorta aneurysm. Recovery occurred after surgical closure of fistula and grafting of the aneurysm.
View Article and Find Full Text PDFJ Thorac Cardiovasc Surg
April 1986
Between October, 1973, and October, 1983, 18 patients with cancer of the kidney or adrenal gland that had invaded the vena cava, and in 11 cases had reached the heart, were operated on by seven surgical teams. The surgical excision in all patients was performed with extracorporeal circulation, circulatory arrest and deep hypothermia. No deaths occurred.
View Article and Find Full Text PDFThe authors study the haemodynamics of the endovenous electrodes of cardiac stimulators (EE) in the light of clinical and plethysmographic investigations. Seven venous thromboses were observed out of 2,000 implantations of stimulators (0.35%).
View Article and Find Full Text PDFBetween 1975 and 1983, 441 choledochoscopy were performed in a series of 451 consecutive patients undergoing surgical common biliary duct exploration for choledocholithiasis. In 127 patients (27.8%), no stones were found.
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