The authors analyze the technical aspects of aortic prosthesis in 37 patients with atherosclerotic, high occlusions of the aorta. The upper occlusion limit in this abnormality is shown to have two X-ray variants. Thoracophrenolumbotomy is considered to be the best access for proximal anastomosis in aortic prosthesis. The traditional operation technique for this abnormality has some disadvantages, the main limit of which is the necessity of shifting a patient from place to place for proximal and distal anastomoses. This makes the operation in these severe patients longer. The authors have proposed a novel procedure for aortic prosthesis by employing a special roller. The latter eliminates the necessity of shifting the patient from place to place during surgery, cuts surgical time by more than 2 hours, allows one to follow asepsis more carefully.
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Innovations (Phila)
December 2024
Department of Neurosciences and Rehabilitation, Cardiac Surgery Unit, University of Ferrara, Italy.
Objective: Both the en bloc island technique and the branched graft technique (BGT) present advantages but also limitations in aortic arch surgery. Here is the first presentation of an innovative prosthesis for aortic arch replacement, conceived to overcome the disadvantages of both techniques.
Methods: The novel ISLAND graft is a tubular Dacron or hybrid prosthesis with an additional extended Dacron graft ("bubble") on the superior aspect, for en bloc island graft anastomosis.
BMC Cardiovasc Disord
January 2025
Department of Thoracic and Cardiovascular Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.
Background: The aim of this study was to investigate whether the hybrid technique yields superior outcomes in comparison with the total arch replacement combined with frozen elephant trunk (TAR + FET) for acute aortic dissection (AAD) involving the aortic arch.
Methods: This retrospective cohort study using propensity-score matching included patients with AAD involving the aortic arch admitted to Nanjing First Hospital and Shanghai General Hospital from January 2015 to June 2020. The in-hospital and mid-term outcomes were compared between patients who received hybrid treatment (n = 136) and those who received TAR + FET (n = 415).
Multimed Man Cardiothorac Surg
January 2025
Department of Cardiothoracic Surgery, Faculty of Medicine, Mansoura University Mansoura, Egypt.
The Ross procedure continues to be the best procedure to address unrepairable aortic valve pathology, especially in young adults. The Achilles heel of this procedure has been aortic root dilation and the potential need for a reoperation that may be associated with slightly increased risks in addition to the need for intervention on the pulmonary outflow tract. Modifying the Ross procedure by autograft inclusion inside a Dacron graft seems to have the potential advantage of stabilizing the autograft diameter, which may be associated with improved durability and decrease the need for future intervention.
View Article and Find Full Text PDFJ Cardiovasc Dev Dis
January 2025
Division of Cardiac Surgery, Department of Surgery, University of Alberta, Edmonton, AB T6G 2R3, Canada.
Objectives: Acute type A aortic dissection (ATAAD) is a life-threatening condition that requires emergent surgical intervention. Numerous surgical approaches exist for ATAAD, and controversy remains regarding the optimal arch interventions for ATAAD patients. Aortic Arch Interventions: Approaches to ATAAD repair include hemiarch repair or extended arch repairs, including the hemiarch with a hybrid stent implantation, such as the AMDS hybrid Prosthesis, total arch replacement (TAR), and the use of an elephant trunk and frozen elephant trunk.
View Article and Find Full Text PDFJ Cardiovasc Dev Dis
December 2024
Interventional Cardiology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.
Transcatheter aortic valve replacement (TAVR) in patients with severe aortic stenosis and raphe-type bicuspid aortic valve (BAV) is still associated with poor outcomes in terms of increased risk of paravalvular regurgitation, stroke, and permanent pacemaker implantation. There is no definitive consensus on the optimal sizing method for prosthesis selection in this setting. The LIRA method is a supra-annular tailored sizing method specifically designed for bicuspid anatomy that might increase accuracy of prosthesis choice in BAV patients and improve TAVR outcomes.
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