Search results for "aortic dissection"
showing 10 items of 109 documents
Mortality in patients with acute aortic dissection type A: analysis of pre- and intraoperative risk factors from the German Registry for Acute Aortic…
2015
Acute aortic dissection type A (AADA) is an emergency with excessive mortality if surgery is delayed. Knowledge about independent predictors of mortality on surgically treated AADA patients is scarce. Therefore, this study was conducted to identify pre- and intraoperative risk factors for death.Between July 2006 and June 2010, 2137 surgically treated patients with AADA were enrolled in a multicentre, prospective German Registry for Acute Aortic Dissection type A (GERAADA), presenting perioperative status, operative strategies, postoperative outcomes and AADA-related risk factors for death. Multiple logistic regression analysis was performed to identify the influence of different parameters …
Supracoronary ascending aortic replacement in patients with acute aortic dissection type A: What happens to the aortic root in the long run?
2013
ObjectiveOur objective was to determine long-term outcome predictors for patients with acute aortic dissection type A (AADA) and aortic root involvement.MethodsFrom 2001 through 2009, 119 of 152 patients operated on for AADA at a tertiary medical center underwent supracoronary ascending aortic replacement (52 women; mean age, 61 ± 15 years). Those with at least 1-year follow-up (n = 97) were retrospectively assessed for preoperative aortic root disease. Follow-up data were assessed for evidence of new-onset aortic root disease by computed tomography and echocardiography, and for reoperation for aortic root disease.ResultsMedian follow-up was 33.8 months (range, 0-112 months). Twenty-six (27…
Long-term results of simplified frozen elephant trunk technique in complicated acute type A aortic dissection: A case-control study.
2016
Aim To describe the long-term experience of a simplified frozen elephant trunk technique (sFETT) used in complicated acute type A aortic dissection (AAAD) treatment. Methods and results Between January 2001 and December 2012, 34 patients (mean age 59.9 ± 11.0 years) with complicated AAAD (DeBakey I) underwent an emergency surgery including sFETT. sFETT consisted in gluing the dissected aortic arch wall layers with gelatine-resorcinol adhesive and video-assisted antegrade open arch aortic stent-graft deployment in the arch or proximal descending aorta. In addition to sFETT, the aortic root was addressed with standard techniques. A 30-day mortality was 14.7% (five patients) due to bleeding (1…
Penn classification in acute aortic dissection patients
2016
Objective The objective of this study was to evaluate the effectiveness of the Penn classification in predicting in-hospital mortality after surgery in acute type A aortic dissection patients. Methods We evaluated 58 patients (42 men and 16 women; mean age 62.17 ± 10.6 years) who underwent emergency surgery for acute type A aortic dissection between September 2003 and June 2010 in our department. We investigated the correlation between the pre-operative malperfusion and in-hospital outcome after surgery. Results Twenty-eight patients (48%) were Penn class Aa (absence of branch vessel malperfusion or circulatory collapse), 11 (19%) were Penn class Ab (branch vessel malperfusion with ischaemi…
Vitamin D Receptor Activation Reduces Angiotensin-II–Induced Dissecting Abdominal Aortic Aneurysm in Apolipoprotein E–Knockout Mice
2015
Objective— Abdominal aortic aneurysm (AAA) is a vascular disorder characterized by chronic inflammation of the aortic wall. Low concentrations of vitamin D 3 are associated with AAA development; however, the potential direct effect of vitamin D 3 on AAA remains unknown. This study evaluates the effect of oral treatment with the vitamin D 3 receptor (VDR) ligand, calcitriol, on dissecting AAA induced by angiotensin-II (Ang-II) infusion in apoE −/− mice. Approach and Results— Oral treatment with calcitriol reduced Ang-II–induced dissecting AAA formation in apoE −/− mice, which was unrelated to systolic blood pressure or plasma cholesterol concentrations. Immunohistochemistry and reverse-tran…
Detection of a Dissecting Aortic Aneurysm by Renal Transplant Imaging
1997
After 2 years with a normal post-transplant course a 45-year-old man showed an elevated creatinine level (4.5 mg/dL). Transplantation had been neccessary because of progressive glomerulonephritis. Renal transplant imaging was obtained with 150 Mbq Tc-99m MAG3. The perfusion images showed radionuclide accumulation in the area of the upper abdominal aorta and delayed perfusion of the right iliac artery. Accumulation of Tc-99m MAG3 in the transplant was slow and no filling of the bladder could be observed. Immediately after imaging, the patient developed acute hemorrhagic shock. At emergency surgery, a long dissecting and ruptured aneurysm of the abdominal aorta was seen causing delayed and re…
Repair of TEVAR-Associated Type A Dissection in the Elderly Is Possible With Reasonable Morbidity and Mortality.
2018
Background: Type A aortic dissection (AAD) is a devastating complication of thoracic endovascular repair (TEVAR). In elderly patients, surgery for AAD carries considerable morbidity and mortality. Repair of AAD after previous TEVAR is an even greater challenge as it usually requires the arch to be addressed and a preexisting stent graft to be included into the aortic repair. Methods: A case series of 5 elderly patients who presented with acute AAD after previous TEVAR was reviewed. In 4 cases, there was retrograde AAD with involvement of the arch and stent graft. In 1 patient, intraoperative inspection showed no involvement of the arch. Three underwent ascending and subtotal arch replacemen…
Aortic intramural hemorrhage visualized by transesophageal echocardiography: Findings and prognostic implication
1994
Abstract Objectives. This study describes the transesophageal echocardiographic and follow-up findings in patients with aortic intramural hemorrhage. Background. Localized aortic intramural hemorrhage resulting in layered thickening of the aortic wall seems to represent a variant of acute aortic dissection without communication or a typical moving intimal flap. In autopsy studies this variant, attributed to a rupture of the van vasorum, has been described in 5% to 10% of patients with dissection. Methods. In a prospective transesophageal echocardiographic study in patients with aortic dissection performed between 1986 and 1991, the diagnosis of intramural hemorrhage was established in 15 of…
Periscope endograft technique to revascularize the left subclavian artery during thoracic endovascular aortic repair.
2013
To present early and midterm results of the periscope endograft (PG) technique to maintain left subclavian artery (LSA) blood flow in thoracic endovascular aortic repairs (TEVAR) involving zone 3.From April 2010 to January 2013, 14 consecutive high-risk patients (11 men; mean age 70±8 years, range 56-87) underwent TEVAR with the PG technique for 10 thoracic aortic aneurysms (TAA), 2 traumatic aortic ruptures, and 2 aortic dissections without a suitable landing zone (2 cm distal to the LSA). Five procedures were performed emergently for rupture (3 TAAs and the 2 trauma cases). Two patients had a periscope deployed in an aberrant right subclavian artery. The periscope endografts were sized 1 …
Endograft repair of spontaneous infrarenal abdominal aortic dissection
2005
A 71-year-old man with a history of hypertension and a recent myocardial infarction experienced a sudden periumbilical and back pain. Abdominal tenderness was found at physical examination, with no changes in electrocardiogram and serial enzyme determinations. Computed tomographic angiography (CTA) showed a normal thoracic aorta, an infrarenal aortic dissection extending into the left common iliac artery and a contralateral iliac occlusive disease (A, Cover). Although antihypertensive therapy was administered, the patient had persistent pain; subsequently, he underwent endovascular repair with a bifurcated stent graft (Talent, Medtronic Ave, Santa Rosa, Calif) introduced via the left femora…