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Repair of a Chronic DeBakey Type II Aortic Dissection With Aortic Valve Insufficiency.

Ann Thorac Surg Short Rep

June 2023

Department of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, West Virginia.

Ascending aortic aneurysms with aortic insufficiency caused by chronic DeBakey type II dissections have been difficult to repair. A 70-year-old woman presented with heart failure, severe aortic insufficiency, and a large ascending aortic aneurysm. She had a trileaflet valve and a healed chronic proximal intimal flap.

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Arteriovenous fistula (AVF) is a surgical connection between an artery and a vein created in patients with end-stage renal disease needing dialysis. A major concern with AVF is maturation failure which results, while creating a new AVF, a troublesome process for the patients. Thus, maturation of AVF is important which is achieved by outflow tract outward remodeling.

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Background: In patients with acute acute type A aortic dissection (ATAAD) requiring emergency surgery, the use of aortic root repair or replacement remains a topic of controversy. The purpose of this study was to evaluate the early and mid-term clinical outcomes after aortic root repair or replacement, and to provide a theoretical basis for such patients.

Methods: The study included 442 consecutive patients with ATAAD who underwent aortic root repair [n=227, repair group (RG)] or the Bentall procedure [n=215, Bentall group (BG)] at our hospital between December 2018 and December 2021.

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Introduction And Importance: Spontaneous coronary artery dissection is a rare cause of acute coronary syndromes not related to atherosclerosis. It involves the sudden tearing of the coronary artery wall, separating the inner intimal lining from the outer vessel wall, typically affecting a single coronary vessel. In 20% of cases, the cause of spontaneous coronary artery dissection is unknown.

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Although its role has been debated, temporal artery biopsy (TAB) remains the gold standard for the diagnosis of cranial giant cell arteritis (GCA). The specificity of TAB is excellent and the sensitivity, albeit lower, is comparable with other diagnostic modalities used for the diagnosis of GCA. This outpatient procedure has a low rate of complications and is well integrated in the majority of healthcare systems.

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