scholarly journals Simultaneous Endovascular Approach for Aortic Arch Aneurysm Associated with Aortic Valve Stenosis. What Have We Learned?

2015 ◽  
Vol 06 (02) ◽  
pp. 81-84
Author(s):  
Joël Lapeze ◽  
Guy Durand de Gevigney ◽  
Didier Revel ◽  
Olivier Jegaden
2020 ◽  
Vol 22 (Supplement_N) ◽  
pp. N142-N145
Author(s):  
Alice Benedetti ◽  
Alvise Del Monte ◽  
Maurizio Rubino ◽  
Daniela Mancuso

Abstract A 36-year-old woman at 31 weeks’ gestation presented with exertional dyspnoea and palpitations. She had a history of bicuspid aortic valve treated with surgical aortic valvotomy for severe stenosis, followed by ascending aorta replacement for type A acute aortic dissection and Bentall operation with a mechanical valve for severe aortic regurgitation. Eight years after the last surgery, magnetic resonance angiography showed aortic arch aneurysm (49 mm) with a small intimal flap. Thereafter, the patient was lost to follow-up until the current admission. She was hemodynamically stable on presentation and physical examination was unremarkable apart from a mechanical second heart sound. The electrocardiogram showed sinus rhythm with left bundle branch block (Panel A). Transthoracic echocardiography revealed severe left ventricular dilation (EDV 90 ml/m2) with mild dysfunction (EF 50%), normal prosthetic aortic valve function, and aortic arch dilation (50 mm) (Panel B and C). After a multidisciplinary evaluation, elective cesarean section was performed at 34 weeks’ gestation. A post-delivery aortic computed tomography angiography revealed aortic arch aneurysm (52 mm) with intimal flap and two pseudoaneurysms of the anterior aortic wall causing sternal erosion (Panel D, E, F and G). Subsequently, the patient underwent ascending aorta and aortic arch replacement by Frozen Elephant Trunk technique with a 24 x130 mm prosthesis between the aortic root and the descending aorta. The postoperative course was uneventful, and the patient was discharged to a cardiac rehabilitation centre.


2008 ◽  
Vol 16 (3) ◽  
pp. 266-267 ◽  
Author(s):  
Anuj Bansal ◽  
Sandeep Arora ◽  
Darren Traub ◽  
David Haybron

2019 ◽  
Vol 47 (9) ◽  
pp. 558-560
Author(s):  
Cuiting Zhao ◽  
Yang Sun ◽  
Yonghuai Wang ◽  
Guangyuan Li ◽  
Pingping Meng ◽  
...  

Author(s):  
V. I. Kravchenko ◽  
I. M. Kravchenko ◽  
I. I. Zhekov ◽  
V. D. Lybavka ◽  
V. V. Lazoryshynets

The ascending aorta and aortic arch aneurysm surgical correction is the most difficult problem of cardiovascular surgery due to the necessity of management of the main disease and adequate protection of the brain and visceral organs. The aim. To present the methods and results of protection of the central nervous system and visceral organs during the correction of the ascending aorta and aortic arch aneurysm or isolated aortic arch aneurism. Materials and methods. During 1994–2018, we operated 419 patients with the ascending aorta and aortic arch aneurysm (or isolated aortic arch aneurism). Diagnosis of aneurysms was based on clinical data, transthoracic and transesophageal echocardiography, computed tomography, X-ray examination, aortography. All operations were performed under general anesthesia, through the median sternotomy using cardiopulmonary bypass. Valve-sparing technique with aortic valve resuspension/aortic valve plasty and semi-arch/arch replacement was used in 288/9 (68.7%) patients. Bentall operation with semi-arch/arch replacement was used in 86/9 (20.5%) patients. Other operations accounted for 45 (10.7%) patients. Results. The history of the development of aortic aneurysms treatment options is briefly overviewed in the paper. Diagnostic methods are mentioned, but the main method today is computed tomography. Initial status of the patients was severe. All operations were performed through median sternotomy using cardiopulmonary bypass. The following techniques were used for surgical treatment of aneurysms: 1) valve-sparing technique with aortic valve resuspension/ plasty and semi-arc/arch replacement was used in 288/9 (68.7%) patients. In this group there were 8 Yacoub operations, 6 David operations. In 7 patients, plication of one of the leaflets was performed in case of aortic valve prolapse. 3 patients underwent strengthening of the free edge of the leaflets and 4 patients underwent plasty by the patch in case of leaflet fenestrations; 2) Bentall operation with semi-arch/arch replacement was used in 86/9 (20.5%); 3) others: isolated arch in 15 (3.6%); Wheat operation + arch in 9 (1.0%); aortic arch plasty in 4 (1.0%); Elephant trunk (conventional Elephant trunk) + TEVAR was used in 17 (4.1%) patients. The brain protection was performed differently at each of the two stages in our surgical experience. The best result was achieved at the last stage. The number of postoperative complications decreased from 34.4% to 8.4% and hospital mortality from 17.2% to 5.3%, respectively. Also, a modern endovascular method – hybrid operations Elephant trunk + TEVAR – was used in 17 (4.1%) patients with good immediate result. Conclusions. 1. At type A aortic dissection (DeBakey type I) the operation of choice is supracoronary ascending aortic replacement with a semi-arch (arch) replacement of the aorta. 2. Accumulation of surgical experience, team training, improvement of methods of protection of the brain and visceral organs allowed to reduce the number of postoperative complications from 34.4% to 8.4% and hospital mortality from 17.2% to 5.3%.


2021 ◽  
Vol 77 (18) ◽  
pp. 2515
Author(s):  
Nicole Girlyn T. Pang ◽  
Gwen R. Marcellana ◽  
Maria Janelle M. Fajardo ◽  
Terence M. Cuezon ◽  
Ferdinand V. Alzate ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document