scholarly journals Miniinvasive interventional bridge to major surgical repair of critical aortic coarctation in a newborn with severe multiorgan failure

2013 ◽  
Vol 3 ◽  
pp. 244-248 ◽  
Author(s):  
Ireneusz Haponiuk ◽  
Maciej Chojnicki ◽  
Mariusz Steffens ◽  
Radosław Jaworski ◽  
Aneta Szofer-Sendrowska ◽  
...  
Keyword(s):  
Aortic Coarctation ◽  
Surgical Repair ◽  
Multiorgan Failure

scholarly journals Does age at aortic coarctation repair have an impact on left ventricle size and function?

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
S Cardoso Torres ◽  
CX Resende ◽  
PG Diogo ◽  
P Araujo ◽  
RA Pinto ◽  
...  
Keyword(s):  
Aortic Coarctation ◽  
Surgical Repair ◽  
Myocardial Dysfunction ◽  
Global Longitudinal Strain ◽  
Negative Relationship ◽  
Late Complications ◽  
Left Ventricular ◽  
Funding Sources ◽  
The Mean ◽  
Clinical Records

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Adults with repaired aortic coarctation (CoA) require lifelong follow-up due to late complications, including left ventricular (LV) myocardial dysfunction. Age at the time of CoA repair is an important prognostic factor in these patients (pts). Purpose To evaluate LV size, ejection fraction (EF) and global longitudinal strain (GLS) values using 2D speckle tracking echocardiography (STE) in a population of adult pts with repaired CoA and to assess the relationship between these echocardiographic parameters and age at the time of CoA repair. Methods Retrospective analysis of adult pts with repaired CoA, followed in a Grown Up Congenital Heart Disease Centre. Pts with hemodynamically significant concomitant cardiac lesions were ruled out. Epidemiologic and clinical data were obtained from clinical records. Transthoracic echocardiograms were reviewed in order to assess GLS using 2DSTE (Echopac Software, GE). Results The study population consisted of 63 pts (61.9% male), with a mean age of 35.3 years at the time of the echocardiographic evaluation. The mean age at the time of the CoA repair was 117 months (95% CI 89.8-144.1 months). Surgical repair was performed in 46 pts (73%): resection with subclavian artery flap aortoplasty (n = 21); patch aortoplasty (n = 15) and head-to-head anastomosis (n = 10). In 10 pts there was no data regarding the type of surgical repair. Seven pts (11.1%) were submitted to percutaneous intervention (6 with aortic stent implantation and 1 with balloon aortic angioplasty). Mean LVEF was 63.4% (CI 95% 55.6 – 71.2%) and mean LV end-diastolic diameter (LVEDD) was 50mm (CI 95% 43-57mm). Mean GLS was - 17.3 (CI 95% 14.8- 19.8), which is inferior to the mean normal values reported for the software used. Age at the time of CoA repair had a statistically significant positive linear relationship with LVEDD (r= 0.282; p= 0.026) and a linear negative relationship with both GLS (r= -0,29; p= 0.022) and LVEF (r= -0.33; p= 0.05). Conclusion Older age at the time of CoA repair was associated with increased LVEDD and decreased GLS and LVEF. Also, GLS may be an important tool for the identification of subclinical LV dysfunction in adult pts with repaired CoA.

Neuropathic pain syndrome as an occult manifestation of injury of the spinal cord after surgical repair of aortic coarctation

2000 ◽  
Vol 10 (4) ◽  
pp. 413-415 ◽  
Author(s):  
Luc M Beauchesne ◽  
Angela Mailis ◽  
Gary D Webb
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Aortic Coarctation ◽  
Surgical Repair ◽  
Rare Complication ◽  
Pain Syndrome ◽  
Neuropathic Pain Syndrome ◽  
Cord Injury ◽  
Unusual Symptoms ◽  
Arterial Branch

AbstractInjury to the spinal cord injury with paraplegia, is a rare complication of surgical repair of aortic coarctation recognized immediately post-operatively. We present the case of a 41-year-old male undergoing surgery for restenosis at the site of a repair. Intra-operatively, he suffered inadvertent injury to an intercostal arterial branch during isolation of the aorta below the graft. Over the following months, he developed unusual symptoms involving the legs and genitourinary tract which, only after extensive investigations, were attributed to ischemic damage to the spinal cord related to the surgery. We suspect that similar syndromes reflecting injury to the spinal cord injury may be unrecognized following surgical repair of coarctation.

scholarly journals Cause of Death Following Surgery for Acute Type A Dissection

Aorta ◽  
2017 ◽  
Vol 05 (02) ◽  
pp. 33-41 ◽  
Author(s):  
R. Scott McClure ◽  
Maral Ouzounian ◽  
Munir Boodhwani ◽  
Ismail El-Hamamsy ◽  
Michael Chu ◽  
...  
Keyword(s):  
Cause Of Death ◽  
Surgical Repair ◽  
Multiorgan Failure ◽  
Type A ◽  
Acute Type ◽  
Neurologic Injury ◽  
Perioperative Mortality ◽  
Acute Type A Dissection ◽  
Modifiable Factors ◽  
Type A Dissection

Background: Surgery confers the best chance of survival following acute Type A dissection (ATAD), yet perioperative mortality remains high. Although perioperative risk factors for mortality have been described, information on the actual causes of death is sparse. In this study, we aimed to characterize the inciting events causing death during surgical repair of ATAD. Methods: Nine centers participated in the study. We included all patients who died following surgical repair for ATAD between January 2007 and December 2013. An aortic surgeon at each site determined the primary cause of death from seven predetermined categories: cardiac, stroke, hemorrhage, other organ ischemia (peripheral, renal, or visceral), multiorgan failure, sepsis, or other causes. Additional characteristics and variables were analyzed to delineate potential modifiable factors for mortality. Results: Of the 692 surgeries for ATAD, there were 123 deaths (17.8% mortality rate). Mean age at death was 66 years. Events contributing to death were: cardiac (25%), stroke (22%), hemorrhage (21%), multiorgan failure (12%), other organ ischemia (11%), sepsis (4%), and other causes (5%). Neurologic injury at presentation was a predictor of stroke as the inciting cause of death (p = 0.04). Peripheral, renal, or visceral ischemia at presentation was highly predictive of death due to these presenting ischemic conditions (p = 0.004). We found no associations between cardiogenic shock, tamponade, or cardiopulmonary bypass duration and cardiac death. Conclusion: Operative mortality for ATAD remains high in Canada. Nearly 70% of deaths arise from cardiac failure, stroke, or hemorrhage. Therefore, novel surgical, hybrid, and endovascular strategies should target these three areas.

Use of covered Cheatham-Platinum stents in aortic coarctation and recoarctation

2004 ◽  
Vol 14 (1) ◽  
pp. 50-54 ◽  
Author(s):  
Shakeel A Qureshi ◽  
Maria Zubrzycka ◽  
Grazyna Brzezinska-Rajszys ◽  
Andrzej Kosciesza ◽  
Joanna Ksiazyk
Keyword(s):  
Aortic Coarctation ◽  
Surgical Repair ◽  
Balloon Dilation ◽  
Primary Treatment ◽  
Fourth Patient

We inserted covered Cheatham-Platinum stents in 4 patients, ranging in age from 12 to 19 years, who weighed between 45 and 94 kg. All the patients had aortic coarctation, with surgical repair having been attempted previously in one, and with balloon dilation having been performed as the primary treatment in two, resulting in formation of aneurysms. The fourth patient had not received any treatment. The gradients were reduced from 10 to 40 mmHg before insertion of the stent to 0 to 5 mmHg after stenting. No complications were encountered. All the patients are well at an interval of 3 to 14 months after stenting.

scholarly journals A rare case of pseudoaneurysm at the site of untreated coarctation of the aorta in an adult patient

2020 ◽  
Author(s):  
Takuma Mikami ◽  
Takeshi Kamada ◽  
Hiroki Uchiyama ◽  
Yosuke Kuroda ◽  
Ryo Harada ◽  
...  
Keyword(s):  
High Risk ◽  
Aortic Aneurysm ◽  
Aortic Coarctation ◽  
Poor Prognosis ◽  
Rare Case ◽  
Surgical Repair ◽  
Coarctation Of The Aorta ◽  
Pathological Findings ◽  
Open Surgical Repair ◽  
Risk Of Rupture

Abstract Here we report a rare case of pseudoaneurysm at the site of aortic coarctation. Aortic coarctation and a saccular aortic aneurysm protruding from the site of this coarctation were detected in a 50-year-old woman. Owing to the shape of the aneurysm and high risk of rupture, an open surgical repair was performed. The pathological findings of the removed aneurysm revealed a pseudoaneurysm consisting of only a thin adventitial wall. Adult uncorrected aortic coarctation has a poor prognosis. One of its causes may be the formation of such a pseudoaneurysm.

scholarly journals Endovascular Treatment of Late Thoracic Aortic Aneurysms after Surgical Repair of Congenital Aortic Coarctation in Childhood

PLoS ONE ◽  
2013 ◽  
Vol 8 (12) ◽  
pp. e83601 ◽  
Author(s):  
Robert Juszkat ◽  
Bartlomiej Perek ◽  
Bartosz Zabicki ◽  
Olga Trojnarska ◽  
Marek Jemielity ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Aortic Coarctation ◽  
Surgical Repair ◽  
Aortic Aneurysms ◽  
Thoracic Aortic Aneurysms

Factors affecting left ventricular remodelling and mechanics in the long-term follow-up after successful repair of aortic coarctation

2005 ◽  
Vol 15 (2) ◽  
pp. 160-167 ◽  
Author(s):  
Roberto Crepaz ◽  
Roberto Cemin ◽  
Cristina Romeo ◽  
Edoardo Bonsante ◽  
Lino Gentili ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Aortic Coarctation ◽  
Surgical Repair ◽  
Left Ventricular ◽  
Left Ventricular Geometry ◽  
Ventricular Remodelling ◽  
Left Ventricular Remodelling ◽  
Ventricular Geometry ◽  
Blood Pressures ◽  
Successful Repair

Aims: To identify factors predisposing to abnormal left ventricular geometry and mechanics in 52 patients after successful repair of aortic coarctation. Methods and results: We evaluated left ventricular remodelling, systolic midwall mechanics, and isthmic gradient by echo-Doppler, systemic blood pressure at rest/exercise and by ambulatory blood pressure monitoring, and the aortic arch by magnetic resonance imaging. Echocardiographic findings were compared with those of 142 controls. The patients with aortic coarctation showed an increased indexed left ventricular end-diastolic volume, increased mass index, increased ratio of mass to volume and systolic chamber function. The contractility, estimated at midwall level, was increased in 21 percent of the patients. In 26 (50 percent) of the patients, we found abnormal left ventricular geometry, with 9 percent showing concentric remodelling, 33 percent eccentric hypertrophy, and 8 percent concentric hypertrophy. These patients were found to be older, underwent a later surgical repair, and to have higher systolic blood pressures at rest and exercise as well as during ambulatory monitoring. The relative mural thickness and mass index of the left ventricle showed a significant correlation with different variables on uni- and multivariate analysis. Age and diastolic blood pressure at rest are the only factors associated with abnormal left ventricular remodelling. Conclusions: Patients who have undergone a seemingly successful surgical repair of aortic coarctation may have persistently abnormal geometry with a hyperdynamic state of the left ventricle. This is more frequent in older patients, and in those with higher diastolic blood pressures.

scholarly journals P1494 Incidental finding of aortic aneurysm formation following 34 years of coarctation repair by dacron patch aortoplasty

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
E A Khalifa ◽  
S Helmy ◽  
S F Mohamed ◽  
M Alkuwari
Keyword(s):  
Aortic Aneurysm ◽  
Aortic Arch ◽  
Subclavian Artery ◽  
Aortic Coarctation ◽  
Surgical Repair ◽  
Left Ventricular ◽  
Coarctation Repair ◽  
History Of ◽  
Dacron Patch

Abstract Introduction Aneurysms are found following all types of surgical repair of aortic coarctation, especially after Dacron patch aortoplasty. We describe the finding of an aortic aneurysm in an asymptomatic 52-year-old male, who was managed by Dacron patch aortoplasty for native coarctation of the aorta 34 years earlier. Case report A 52-year male, smoker, hypertensive on medication He had previous history of surgical repair of aortic coarctation at age of 18 years . Repair was by Dacron patch aortoplasty. Since then, his regular follow up was unremarkable. Recently, he was referred for cardiac evaluation as a part of pre-employment general check-up. He was asymptomatic with no history of shortness of breath or chest pain. Physical examination revealed that the pulse in the left arm was reduced in volume in comparison to the right one. The heart sounds were essentially normal but a pericardial murmur was audible, perhaps reflecting residual collateral flow. Blood pressure was 156/83 mmHg in right arm and 142/81 in the left arm. Transthoracic echocardiography revealed mild left ventricular hypertrophy with normal global and regional contractility and an ejection fraction of 58%. Supra sternal window images showed dilatation of the three aortic arch branches. The distal portion of aortic arch just distal to origin of left subclavian artery was narrowed with a peak systolic gradient across of 34 mmHg. A cystic structure (1.7 cm x 1.9 cm) was visualized attached to the narrowed segment of the aorta, suggestive of a saccular aneurysm, (figures A&B&C). Computed tomography aortogram showed a narrow-necked aneurysm arising from the posterolateral aspect of the distal aortic arch (anticipated site of the coarctation repair graft anastomosis). A small laminated thrombus was also noted within. Aneurysm measured approximately 2.2 x 3.3 cm in its craniocaudal and anteroposterior dimensions respectively, with no evidence of aortic luminal compromise. (figures D&E&F). Management Aneurysmectomy was performed subsequently. Interposition polyester grafts were used to reconstruct the aortic arch and proximal descending aorta and to connect this aortic segment to the subclavian artery via a lateral thoracotomy. The postoperative course thereafter was uneventful. Conclusion: This is a rare insidious complication of Dacron patch aortoplasty that occurred after more than 3 decades, which highlights the importance of diagnostic imaging in the follow up of these patients Abstract P1494 Figure.

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