A 50-year-old man with an acute type B aortic dissection underwent thoracic endovascular aortic repair in 2019. The patient presented again with chest pain and left arm numbness. Computed tomography scan revealed aneurysm expansion and extensive thrombus within a floating stent graft. He underwent explantation of the stent graft, zone 2 total aortic arch replacement with frozen elephant trunk, and left axillary artery bypass. Simultaneously, he underwent retrograde thoracic endovascular aortic repair extension and controlled balloon septal rupture. Two years after surgery, he remains without complication.
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http://dx.doi.org/10.1016/j.atssr.2022.11.010 | DOI Listing |
Ann Thorac Surg Short Rep
September 2023
Section of Cardiac Surgery, Department of Cardiac Sciences, Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta, Canada.
Hybrid arch repair (HAR) combines surgical reconstruction of the ascending aorta and arch debranching with stent graft deployment into the descending thoracic aorta in an effort to reduce the morbidity associated with conventional open total arch replacement. We describe a case of delayed presentation for 2 thoracic aortic wall injuries caused by stent graft migration after type II HAR. This report highlights an important late complication of HAR and the need for careful device selection.
View Article and Find Full Text PDFAnn Thorac Surg Short Rep
December 2024
Division of Cardiothoracic Surgery, Department of Surgery, Duke University Hospital, Durham, North Carolina.
Background: This study sought to determine the safety of primary and staged biventricular repair in neonates with interrupted aortic arch (IAA), ventricular septal defect (VSD), and severe left ventricular outflow tract obstruction (LVOTO).
Methods: Patients with a fundamental diagnosis of IAA and VSD between 2015 and 2020 were extracted from The Society of Thoracic Surgeons National Database by using a Participant User File. The objective was to compare outcomes for neonates undergoing primary and staged Yasui and Ross operations.
Ann Thorac Surg Short Rep
December 2024
Division of Cardiovascular Surgery, Department of Surgery, University of Florida, Gainesville, Florida.
Coronary vasospasm involves constriction of the coronary arteries and has been described after manipulation of the coronary arteries (ie, after stenting or bypass grafting). This report details the case of a 57-year-old man who presented with an endoleak after thoracic endovascular aortic repair. He underwent a frozen elephant trunk procedure and postoperatively had diffuse coronary vasospasm, demonstrated on pre- and post-vasospasm cardiac catheterization.
View Article and Find Full Text PDFAnn Thorac Surg Short Rep
December 2024
Division of Cardiac Surgery, Inova Heart and Vascular Institute, Inova Health Systems, Falls Church, Virginia.
Background: DeBakey type I aortic dissections (AD) are most frequently treated with hemiarch repair. A subset of patients demonstrates persistent distal end-organ ischemia secondary to persistent true lumen (TL) compression. We describe the use of bare metal stent grafting across the residual arch dissection with the Zenith Dissection Endovascular Stent (ZDES, Cook Medical) in 7 patients with type I AD that was repaired in a hemiarch configuration with a compromised distal TL and organ malperfusion.
View Article and Find Full Text PDFAnn Thorac Surg Short Rep
December 2024
Department of Cardiothoracic and Vascular Surgery, McGovern Medical School at UTHealth Houston, Houston, Texas.
This report describes a patient with a thoracic aortic aneurysm who presented with chest pain and dyspnea. Preoperative studies revealed a massive cardiomediastinal silhouette. Within hours after the operation, a profound reduction in cardiomegaly was observed.
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