The clinical case of a 37 years old female with the previous diagnosis of human immunodeficiency virus infection (HIV), under medical control, is reported, in whom an extensive and large thoracoabdominal aortic aneurysm was diagnosed (type II of the Stanley Crawford's classification), completely asymptomatic. The patient underwent surgical management, consisting in the resection of the aneurysm and prosthetic replacement, utilizing the "simplified technique", that was once again extremely well succeeded in this most demanding situation. The clinical and pathological features of this infection and the potential involvement in the pathogenesis of this uncommon aneurysm are discussed, according to the data published in the literature. Furthermore, the main aspects of the surgical management are described and discussed, facing the diverse technical alternatives nowadays used in clinical practice.
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Circ Cardiovasc Interv
December 2024
Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA. (M.S., S.L., E.A.S.).
Background: Intravascular ultrasound (IVUS) use in aortic endovascular interventions, including thoracic endovascular aneurysm repair (TEVAR) and endovascular aneurysm repair (EVAR), may have similar benefits to those seen in coronary and peripheral interventions, but limited utilization and outcome data exist.
Methods: Centers for Medicare and Medicaid Services claims data were used to identify patients undergoing TEVAR and EVAR from 2016 to 2023. Utilization trends were stratified by region, urbanicity, distressed communities index, community versus academic center, Medicare versus dual enrollment status, indication, urgency, and presence of dissection with malperfusion.
Ann Vasc Dis
December 2024
Department of Cardiovascular Surgery, St Marianna University School of Medicine, Kawasaki, Kanagawa, Japan.
Myasthenia gravis (MG) is an autoimmune neuromuscular junction disorder that rarely coexists with infectious thoracoabdominal aortic aneurysms (TAAA) requiring open repair. A 57-year-old patient with MG underwent elective thoracoabdominal aortic replacement. He was diagnosed with MG (Osserman classification II A).
View Article and Find Full Text PDFJ Endovasc Ther
December 2024
Department of Vascular and Endovascular Surgery, Klinik Ottakring, Wiener Gesundheitsverbund, Wien, Austria.
Objective: This study offers a retrospective assessment of a single-center experience using cerebrospinal fluid catheters to reduce the risk of perioperative spinal cord injury in patients undergoing single-staged complex endovascular juxtarenal or thoracoabdominal aortic aneurysm repair.
Results: A total of 97 patients were included. On average, 70.
Eur J Cardiothorac Surg
December 2024
Department of Cardiac Surgery, Rostock Heart Center, University Medical Center Rostock, Schillingallee 35, 18057, Rostock, Germany.
Objectives: Neuroprotective measures have been established in open thoraco-abdominal aortic aneurysm repair to reduce the incidence of postoperative paraplegia. Distal aortic perfusion (DaP) is meant to increase blood flow to the abdominal organs and the spinal cord. Cerebrospinal fluid (CSF) drainage is part of peri- and postoperative clinical routine.
View Article and Find Full Text PDFInsights Imaging
December 2024
Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn, Germany.
Objectives: Recently, epicardial adipose tissue (EAT) assessed by CT was identified as an independent mortality predictor in patients with various cardiac diseases. Our goal was to develop a deep learning pipeline for robust automatic EAT assessment in CT.
Methods: Contrast-enhanced ECG-gated cardiac and thoraco-abdominal spiral CT imaging from 1502 patients undergoing transcatheter aortic valve replacement (TAVR) was included.
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