scholarly journals Aortic Arch False Lumen Embolisation in a Residual Chronic Type A Aortic Dissection

2019 ◽  
Vol 58 (4) ◽  
pp. 600-601
Author(s):  
Quentin Pellenc ◽  
Yves Castier
Keyword(s):  
Aortic Dissection ◽  
Aortic Arch ◽  
False Lumen ◽  
Type A ◽  
Chronic Type ◽  
Type A Aortic Dissection

scholarly journals Chronic Type A Aortic Dissection

Aorta ◽  
2016 ◽  
Vol 04 (01) ◽  
pp. 16-21 ◽  
Author(s):  
Conor Hynes ◽  
Michael Greenberg ◽  
Shawn Sarin ◽  
Gregory Trachiotis
Keyword(s):  
Aortic Dissection ◽  
Surgical Repair ◽  
False Lumen ◽  
Disease Process ◽  
Type A ◽  
Delayed Presentation ◽  
Chronic Type ◽  
Type A Aortic Dissection ◽  
First Line Therapy ◽  
Acute Dissection

AbstractStanford Type A aortic dissection is a rapidly progressing disease process that is often fatal without emergent surgical repair. A small proportion of Type A dissections go undiagnosed in the acute phase and are found upon delayed presentation of symptoms or incidentally. These chronic lesions may have a distinct natural history that may have a better prognosis and could potentially be managed differently then those presenting acutely. The method of repair depends on location and extent of the false lumen, as well as involvement of critical structures and branch arteries. Surgical repair techniques similar to those employed for acute dissection management are currently first-line therapy for chronic cases that involve the aortic valve, sinuses of Valsalva, coronary arteries, and supra-aortic branch arteries. In patients with high-risk for surgery, endovascular repairs have been successful, and active development of delivery systems and grafts will continue to enhance outcomes. We present two cases of chronic Type A aortic dissection and review the current literature.

scholarly journals One-stage aortic replacement for type A aortic dissection: using a Vasoring and a conventional elephant trunk graft

2019 ◽  
Vol 56 (1) ◽  
pp. 189-196
Author(s):  
Jeng Wei ◽  
Yung-Tsai Lee ◽  
Ching-Wen Wu
Keyword(s):  
Aortic Dissection ◽  
Aortic Arch ◽  
Vascular Graft ◽  
Open Surgery ◽  
Vascular Ring ◽  
False Lumen ◽  
Type A ◽  
Elephant Trunk ◽  
Type A Aortic Dissection ◽  
Aortic Replacement

AbstractOBJECTIVESWe used a vascular ring connector (Vasoring) and a conventional elephant trunk graft for complete repair in open surgery for type A aortic dissection. This report described the immediate and mid-term results of this new technique.METHODSWe used a rigid titanic ring as a stent in the vascular graft for rapid sutureless anastomosis in the reconstruction of type A aortic dissection.RESULTSA total of 65 consecutive patients with Stanford type A aortic dissection underwent open surgery performed by a single surgeon from November 2007 to February 2017. All patients underwent aortic reconstruction with vascular grafts and Vasorings (21 patients in the ascending aorta and 44 patients in the total aortic arch). For total aortic arch replacement, we implanted the conventional vascular graft in the proximal descending thoracic aorta as an elephant trunk graft. Concomitant procedures included the Bentall procedure (9 patients), the David operation (6 patients), coronary artery bypass grafting (9 patients), heart transplantation (1 patient), mitral valve replacement (2 patients) and endovascular aortic repair (1 patient). The mean duration of postoperative endotracheal intubation was 17.0 ± 11.8 h. The average blood loss was 520 ± 743 ml, and 25% of patients required no blood transfusion. The in-hospital mortality rate was 6%.CONCLUSIONSThe combined use of the vascular ring connector and the conventional elephant trunk graft may reduce bleeding and pump time, stop the blood flow in the false lumen and allow the 1-stage total arch replacement to be performed safely. The conventional elephant trunk graft is free from stent graft-induced new entry.

Repair of acute type A dissection with distal malperfusion using a novel hybrid arch device

2020 ◽  
Keyword(s):  
Aortic Dissection ◽  
Aortic Arch ◽  
Circulatory Arrest ◽  
Spinal Cord Ischemia ◽  
False Lumen ◽  
Type A ◽  
Acute Type ◽  
Type A Aortic Dissection ◽  
Acute Type A Dissection ◽  
Feasible Option

Acute type A aortic dissection remains a high-risk surgical condition, and mortality among those presenting with malperfusion is up to 3-fold higher. Despite the added technical challenge of distal aortic arch interventions in the acute setting, it may be necessary to resolve distal malperfusion in patients with this disorder. The ideal arch intervention to address acute type A aortic dissection complicated by malperfusion should address the following objectives: (1) to relieve distal malperfusion by expanding the distal true lumen and depressurizing the false lumen; (2) to avoid compromising arch branches without requiring additional arch branch interventions; (3) to minimize the risk of spinal cord ischemia; and (4) to minimize the operative duration and circulatory arrest time. The use of an uncovered aortic arch stent that is delivered in an antegrade manner during circulatory arrest, concomitantly with hemiarch replacement, therefore represents an attractive solution in the management of acute type A aortic dissection complicated by malperfusion. This strategy does not require complex arch reconstruction and may thus be a feasible option among cardiac and vascular surgeons in lower volume aortic centers. Here we present a step-by-step approach to acute type A aortic dissection repair with hemiarch repair and delivery of an uncovered arch stent for a patient presenting with malperfusion.

False Lumen Catheterization in a Patient Who Has Type A Aortic Dissection That Mimics Acute Inferior Myocardial Infarction: A Case Report

2015 ◽  
Vol 18 (5) ◽  
pp. 208
Author(s):  
Erhan Kaya ◽  
Hakan Fotbolcu ◽  
Zeki Şimşek ◽  
Ömer Işık
Keyword(s):  
Myocardial Infarction ◽  
Case Report ◽  
Aortic Dissection ◽  
Cardiac Catheterization ◽  
False Lumen ◽  
Type A ◽  
Inferior Myocardial Infarction ◽  
Type A Aortic Dissection ◽  
Acute Inferior Myocardial Infarction ◽  
Catheterization Procedure

We report a 61-year-old patient who suffered from a type A aortic dissection that mimicked an acute inferior myocardial infarction. During a routine cardiac catheterization procedure, diagnostic catheters can be inserted accidentally into the false lumen. Invasive cardiologists should keep this complication in mind.

Cannulating a Dissecting Aorta Using Ultrasound-Epiaortic and Transesophageal Guidance

2011 ◽  
Vol 14 (6) ◽  
pp. 373 ◽  
Author(s):  
Saina Attaran ◽  
Maria Safar ◽  
Hesham Zayed Saleh ◽  
Mark Field ◽  
Manoj Kuduvalli ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Aortic Dissection ◽  
Acute Aortic Dissection ◽  
False Lumen ◽  
Type A ◽  
Ascending Aorta ◽  
Type A Aortic Dissection ◽  
Complete Rupture

<p>Management of acute Stanford type A aortic dissection remains a major surgical challenge. Directly cannulating the ascending aorta provides a rapid establishment of cardiopulmonary bypass but consists of risks such as complete rupture of the aorta, false lumen cannulation, subsequent malperfusion and propagation of the dissection.</p><p>We describe a technique of cannulating the ascending aorta in patients with acute aortic dissection that can be performed rapidly in hemodynamically unstable patients under ultrasound-epiaortic and transesophageal (TEE) guidance.</p>

Emergent Triple-Branched TEVAR and Redistribution of the Branches to the Supra-Aortic Target Vessels for Treatment of a Contained Ruptured Descending Aortic Aneurysm Associated With a Chronic Type A Aortic Dissection

2021 ◽  
pp. 152660282098527
Author(s):  
Jan Stana ◽  
Carlota Fernandes Prendes ◽  
Ramin Banafsche ◽  
Nikolaos Konstantinou ◽  
Barbara Rantner ◽  
...  
Keyword(s):  
False Lumen ◽  
Type A ◽  
Emergency Setting ◽  
Chronic Type ◽  
Type A Aortic Dissection ◽  
Custom Made ◽  
Descending Aortic Aneurysm ◽  
Type A Dissection ◽  
Open Surgical Approach

Purpose: To demonstrate the feasibility of urgent endovascular treatment of a chronic type A dissection and contained rupture of the false lumen using a noncustomized triple-branched arch endograft, which necessitated reassignment of the branches to the supra-aortic vessels. Case Report:: A 57-year-old patient with a contained rupture of the descending thoracic aorta, in the setting of a chronic type A dissection and a maximum aortic diameter of 85 mm, was converted to endovascular repair after failure of an open surgical approach. A custom-made triple-branched arch endograft designed for another patient was employed, with concomitant occlusion of the false lumen using a Candy Plug occluder. To adjust the graft’s configuration to the patient’s anatomy, the supra-aortic vessels were not assigned to the originally planned branches. The 12-month follow-up angiography demonstrated a satisfactory result. Conclusion: A noncustomized triple-branched arch endograft can be used in an emergency setting to treat chronic type A dissection, reassigning the branches to the supra-aortic vessels as needed.

scholarly journals Aortic Aneurysm and Dissection in Pregnancy: Report of a Rare Case in a Marfan with Bicuspid Aortic Valve

2020 ◽  
Vol 5 (04) ◽  
pp. 331-334
Author(s):  
Paolo Masiello ◽  
Rocco Leone ◽  
Rossella Maria Benvenga ◽  
Severino Iesu
Keyword(s):  
Aortic Valve ◽  
Aortic Dissection ◽  
Aortic Arch ◽  
Bicuspid Aortic Valve ◽  
Rare Case ◽  
Unplanned Pregnancy ◽  
Type A ◽  
Cardiac Biomarkers ◽  
High Morbidity ◽  
Type A Aortic Dissection

Abstract Background Type A aortic dissection is an emergency with high morbidity and mortality when surgery is not performed. Few cases are described in the literature about aortic dissection during pregnancy. A correlation between pregnancy and aortic dissection is mainly reported in patients with family history and connective tissue disorders, such as Marfan’s syndrome (MS), Loeys–Dietz’s syndrome, and Ehlers–Danlos’s syndromes, and patients with bicuspid aortic valve (BAV); exceptional cases are also described in patients without risk factors. Case presentation A 22-year-old young woman with MS, ascending aorta dilation, and BAV became pregnant. During labor, she experienced a short-term chest pain with spontaneous resolution. The electrocardiogram (ECG) and cardiac biomarkers were negative for acute coronary artery disease, but no transthoracic echocardiogram (TTE) was performed. A caesarean section was performed without complications. After 1 month, a routine TTE showed a chronic ascending aortic dissection involving the aortic arch and supra-aortic vessels. Due to a normally functioning aortic valve, the David operation was performed (sparing aortic valve) with the replacement of the aortic arch and supra-aortic vessels. Conclusions Aortic dissection is a rare cardiovascular complication that can occur during pregnancy and is associated with very high-risk mortality. We have reported a rare case of undiagnosed type A aortic dissection involving the aortic arch during unplanned pregnancy in patients with BAV and MS, subsequently treated with the David surgery and replacement of ascending aortic arch and supra-aortic vessels. A closer clinical and instrumental follow-up is necessary in this particular group of patients at risk. Awareness of all physicians involved is mandatory.

scholarly journals Enlargement of aortic arch vessels after surgical repair of type A aortic dissection

2017 ◽  
Vol 65 (3) ◽  
pp. 669-675 ◽  
Author(s):  
Takashi Yamauchi ◽  
Suguru Kubota ◽  
Toshihiro Ohata ◽  
Kosei Hasegawa ◽  
Hideki Ueda
Keyword(s):  
Aortic Dissection ◽  
Aortic Arch ◽  
Surgical Repair ◽  
Type A ◽  
Type A Aortic Dissection

Initial Management of Acute Type-A Aortic Dissection with a Thrombosed False Lumen: A Retrospective Cohort Study

Surgery Today ◽  
2004 ◽  
Vol 34 (8) ◽  
Author(s):  
Yoshihiko Kurimoto ◽  
Kiyofumi Morishita ◽  
Nobuyoshi Kawaharada ◽  
Johji Fukada ◽  
Yasufumi Asai ◽  
...  
Keyword(s):  
Cohort Study ◽  
Aortic Dissection ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
False Lumen ◽  
Type A ◽  
Acute Type ◽  
Initial Management ◽  
Type A Aortic Dissection
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