Surgical resection of enlarged calcification formed by idiopathic localized constrictive pericarditis during total aortic arch replacement for aortic dissection

2019 ◽  
Vol 34 (6) ◽  
pp. 511-513
Author(s):  
Aiko Sonobe ◽  
Motoo Osaka ◽  
Bryan J. Mathis ◽  
Seigo Gomi ◽  
Hideyuki Kato ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Aortic Arch ◽  
Surgical Resection ◽  
Constrictive Pericarditis ◽  
Aortic Arch Replacement ◽  
Total Aortic Arch Replacement

scholarly journals Stroke in acute type A aortic dissection: the Nordic Consortium for Acute Type A Aortic Dissection (NORCAAD)

2020 ◽  
Vol 58 (5) ◽  
pp. 1027-1034 ◽  
Author(s):  
Raphaelle A Chemtob ◽  
Simon Fuglsang ◽  
Arnar Geirsson ◽  
Anders Ahlsson ◽  
Christian Olsson ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Aortic Arch ◽  
Type A ◽  
Pericardial Tamponade ◽  
Acute Type ◽  
Aortic Arch Replacement ◽  
Type A Aortic Dissection ◽  
Total Aortic Arch Replacement ◽  
Cerebral Malperfusion ◽  
Mortality Hazard Ratio

Abstract OBJECTIVES Stroke is a serious complication in patients with acute type A aortic dissection (ATAAD). Previous studies investigating stroke in ATAAD patients have been limited by small cohorts and have shown diverging results. We sought to identify risk factors for stroke and to evaluate the effect of stroke on outcomes in surgical ATAAD patients. METHODS The Nordic Consortium for Acute Type A Aortic Dissection database included patients operated for ATAAD at 8 Scandinavian Hospitals between 2005 and 2014. RESULTS Stroke occurred in 177 (15.7%) out of 1128 patients. Patients with stroke presented more frequently with cerebral malperfusion (20.6% vs 6.3%, P < 0.001), syncope (30.6% vs 17.6%, P < 0.001), cardiogenic shock (33.1% vs 20.7%, P < 0.001) and pericardial tamponade (25.9% vs 14.7%, P < 0.001) and more often underwent total aortic arch replacement (10.7% vs 4.7%, P = 0.016), compared to patients without stroke. In the 86 patients presenting with cerebral malperfusion, 38.4% developed stroke. Thirty-day and 5-year mortality in patients with and without stroke were 27.1% vs 13.6% and 42.9% vs 25.6%, respectively. Stroke was an independent predictor of early- [odds ratio 2.02, 95% confidence interval (CI) 1.34–3.05; P < 0.001] and midterm mortality (hazard ratio 1.68, 95% CI 1.27–2.23; P < 0.001). CONCLUSIONS Stroke in ATAAD patients is associated with increased early- and midterm mortality. Preoperative cerebral malperfusion and impaired haemodynamics, as well as total aortic arch replacement, were more frequent among patients who developed stroke. Importantly, a large proportion of patients presenting with cerebral malperfusion did not develop a permanent stroke, indicating that signs of cerebral malperfusion should not be considered a contraindication for surgery.

scholarly journals Complete resection of local advanced thymic carcinoma with total aortic arch replacement after chemotherapy: a case report

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Hidenori Kuno ◽  
Soichiro Funaki ◽  
Kenji Kimura ◽  
Kazuo Shimamura ◽  
Keiwa Kin ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Surgical Resection ◽  
Thymic Carcinoma ◽  
Complete Resection ◽  
Aortic Arch Replacement ◽  
Ct Guided ◽  
Extended Surgery ◽  
Total Aortic Arch Replacement ◽  
Increased Risk ◽  
Local Advanced

Abstract Background Although complete surgical resection of thymic carcinoma is a prognostic factor, it is not always an option for advanced tumors because of locoregional invasion. Extended surgery combined with a major blood vessel procedure remains controversial because of the increased risk of mortality. Case presentation Chest computed tomography (CT) uncovered an abnormal shadow in the mediastinum of a 74-year-old man. An irregularly shaped tumor obstructed the left innominate vein, and invasion of the aortic arch was suspected. A CT-guided percutaneous needle biopsy revealed squamous cell carcinoma of the thymus, which was considered unresectable. The patient underwent chemotherapy elsewhere, then was referred to us for surgical resection. We combined extended surgery with total aortic arch replacement under a cardiopulmonary bypass. Complete resection was achieved, and the patient remains alive without recurrence at 3 years after surgery Conclusion Resection including aortic arch replacement might be an option that can achieve complete resection of local advanced thymic carcinoma.

Modified Bentall operation with concomitant total aortic arch replacement for DeBakey type I aortic dissection: Report of a case

Surgery Today ◽  
1997 ◽  
Vol 27 (4) ◽  
pp. 373-375 ◽  
Author(s):  
Tomoe Katoh ◽  
Kensuke Esato ◽  
Akihito Mikamo ◽  
Kazuhiro Suzuki ◽  
Hidenori Gohra ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Aortic Arch ◽  
Type I ◽  
Aortic Arch Replacement ◽  
Bentall Operation ◽  
Total Aortic Arch Replacement
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