Aim: To evaluate long-term results and the causes of complications in congenital obstructive pathology of the aortic arch.
Material And Methods: Retrospective study enrolled 62 patients aged 55 ± 14 days who underwent aortic arch surgery under cardiopulmonary bypass. It was compared two methods of aortic archplasty: use of xenopericardial material in group 1 and Rajasinghe's autoplastic method in group 2.
Results: Follow-up was 42 ± 14 months. In the long-term recoarctation occurred in 7 (13.7%) cases including 6 (18.75%) patients in group 1 and one (3.3%) patient in group 2. Residual hypertension was observed in 12 (23.5%) cases including 10 (37%) patients in group 1 and 2 (8.3%) patients in group 2. Six (50%) patients receive antihypertensive therapy, 5 (41.6%) patients who receive antihypertensive drugs have persistent increase of blood pressure without evidence of anatomic aortic obstruction. Hypertensive response to functional tests was observed in one patient.
Conclusions: Aortic arch reconstruction using autoplasty is associated with lower risk of recoarctationand residual hypertension compared with xenopericardial patch application.
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http://dx.doi.org/10.17116/hirurgia2015818-21 | DOI Listing |
J Vasc Surg Cases Innov Tech
April 2025
Department of Surgery, University of Rochester School of Medicine, Rochester, NY.
Type B aortic dissection (TBAD) represents a serious medical emergency with up to a 50% associated 5-year mortality caused by thoracic aorta, dissection-associated aneurysmal (DAA) degeneration, and rupture. Unfortunately, conventional size-related diagnostic methods cannot distinguish high-risk DAAs that benefit from surgical intervention from stable DAAs. Our goal is to use DAA stiffness measured with magnetic resonance elastography (MRE) as a biomarker to distinguish high-risk DAAs from stable DAAs.
View Article and Find Full Text PDFJ Vasc Surg Cases Innov Tech
April 2025
Atrium Health, Sanger Heart and Vascular Institute, Division of Vascular Surgery, Charlotte, NC.
We report a case of mesenteric ischemia after thoracic endovascular aortic repair (TEVAR) for chronic type B aortic dissection performed at a different institution. Computed tomography angiography findings indicated that the previous TEVAR had been deployed distally into the false lumen. To mitigate this, a large fenestration was created between the false lumen and true lumen.
View Article and Find Full Text PDFRes Pract Thromb Haemost
January 2025
Division of Vascular Surgery, St. Michael's Hospital, Toronto, Ontario, Canada.
Background: Abdominal aortic aneurysm (AAA) is characterized by the proteolytic breakdown of the extracellular matrix, leading to dilatation of the aorta and increased risk of rupture. Biomarkers that can predict major adverse aortic events (MAAEs) are needed to risk stratify patients for more rigorous medical treatment and potential earlier surgical intervention.
Objectives: The primary objective was to identify the association between baseline levels of these biomarkers and MAAEs over a period of 5 years.
J Endovasc Ther
January 2025
Aortic Center, Hôpital Marie-Lannelongue, Groupe Hospitalier Paris Saint Joseph, Université Paris-Saclay, INSERM UMR_S 999, Le Plessis Robinson, France.
Introduction: Management of patients with large aortic arch aneurysms who are considered high risk for frozen elephant trunk technique have been challenging, especially when they have a dilated ascending aorta (AA) that precludes total endovascular branched repair (arch BEVAR). A viable option in our armamentarium is wrapping of the AA (AW), and zone 0 Ishimaru TEVAR.
Methods: Retrospective analysis of our aortic database from 2013 to 2024 to select high-risk patients with aortic arch aneurysm that had an AW and TEVAR.
J Vasc Surg Cases Innov Tech
April 2025
Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Case Western Reserve University School of Medicine, University Hospitals Harrington Heart and Vascular Institute, Cleveland, OH.
Transaortic endarterectomy (TE) is an effective and durable method of restoring patency in the aorta afflicted with atherosclerotic disease, which most commonly affects the infrarenal aorta and common iliac artery. When the suprarenal aorta is involved, the disease is usually confined to the orifices of the visceral vessels without obstruction of the aortic lumen. In rare cases, dense, calcified, exophytic, and amorphous lesions causing severe luminal obstruction, termed coral reef atherosclerosis (CRA) of the suprarenal aorta, may occur.
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