The management of vascular trauma in pediatric patients presents numerous challenges, especially in an austere environment. We present the case of a 3-year-old girl who sustained multiple fragmentation injuries to the right chest and right upper extremity as a result of combat activity in Iraq. This resulted in an occult pseudoaneurysm of the innominate artery identified during exploration of her right chest for a persistent air leak from the right side of the chest. Computed tomography angiography delineated the injury, which was surgically repaired. This report demonstrates the type of challenging cases encountered in a combat zone and illustrates the need for a national database of such injuries in pediatric patients to better inform surgical decision making.
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http://dx.doi.org/10.1016/j.athoracsur.2013.07.115 | DOI Listing |
Gen Thorac Cardiovasc Surg
January 2025
Department of Cardiovascular Surgery, Nerima Hikarigaoka Hospital, 1-5-2, Hikarigaoka, Nerima-ku, Tokyo, Japan.
Objective: Branched prostheses are used to treat aortic arch with dissection. However, changes in the neck vessel geometry and diameter after dissection are not well known. We aimed to evaluate neck vessels geometry and changes in diameter with dissection.
View Article and Find Full Text PDFLife (Basel)
January 2025
Clinical Laboratory of Radiology and Medical Imaging, "Sf. Apostol Andrei" County Emergency Hospital, 900591 Constanta, Romania.
Aortic arch anomalies represent a range of congenital vascular malformations resulting from disruptions in the typical embryological development of the aortic arch and its branches. These anomalies, which vary widely in their presentation, can lead to significant clinical symptoms depending on their structure and position. We report the case of a 75-year-old male with intermittent hypertension, palpitations, and episodic warmth in the upper body.
View Article and Find Full Text PDFJ Cardiovasc Dev Dis
January 2025
Emergency Department, Leszek Giec Upper-Silesian Medical Centre of the Medical University of Silesia in Katowice, 40-635 Katowice, Poland.
Paradoxical embolism occurs when a clot originates in the venous system and traverses through a pulmonary or intracardiac shunt into the systemic circulation, with a mortality rate of around 18%. The risk factors for arterial embolism and venous thrombosis are similar, but different disease entities can lead to a hypercoagulable state of the blood, including antithrombin III (AT III) deficiency. We report the case of a 43-year-old man with a massive central pulmonary embolism with a rider embolus and concomitant aortic arch embolism with involvement of the brachiocephalic trunk, bilateral subclavian and axillary arteries, and the right vertebral artery, followed by a secondary ischaemic stroke.
View Article and Find Full Text PDFJACC Case Rep
January 2025
Chinese Institutes for Medical Research and Anzhen Hospital, Capital Medical University, Beijing, China.
Although open repair remains the mainstream treatment for aortic arch dissection, its surgical complexity and perioperative complications are significant. We developed a novel stentgraft system for less-invasive endovascular aortic arch repair. We successfully performed a total percutaneous transfemoral endovascular repair of aortic arch dissection using a novel off-the-shelf endograft system.
View Article and Find Full Text PDFPort J Card Thorac Vasc Surg
October 2024
Department of Vascular and Endovascular Surgery, St Francis Hospital & Heart Center, Roslyn, NY, USA.
The optimal management of acute type A aortic dissection (ATAAD) remains a controversial subject. While some surgeons opt for a hemiarch approach to minimize bypass and cross-clamping time, others prefer partial or total arch replacement to prevent the need for additional operations. The advent of hybrid approaches offers a variety of options to the aortic surgeon in treating ATAAD.
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