The Thoracic and cardiovascular surgeon
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Thorac Cardiovasc Surg · Oct 2013
Hypothermic circulatory arrest using antegrade cerebral perfusion is safe for elective aortic arch surgery.
We hypothesized that hypothermic circulatory arrest (HCA) can be performed with a low operative risk and does not add to the morbidity in elective procedures. ⋯ HCA with open distal anastomosis for elective aortic repair can be performed with low operative mortality, even in the elderly, and seems not to add to the morbidity of the procedure.
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Thorac Cardiovasc Surg · Oct 2013
Can EuroSCORE II predict the mortality and length of intensive care unit stay after total aortic arch replacement with stented elephant trunk implantation for DeBakey type I aortic dissection?
EuroSCORE is a widely used objective risk scoring model. ⋯ Although EuroSCORE II is the newest risk model for cardiac surgery, it is not accurate when it is applied for thoracic aortic surgery. A new risk evaluating system specially designed for aortic surgery should be developed in the future.
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Thorac Cardiovasc Surg · Oct 2013
Multicenter StudyEvaluation of the thoracic aortic dissection treated by endografts covering a longer distance of aorta according to the location of the Adamkiewicz artery.
Presurgical locating the Adamkiewicz artery (AKA) will be very helpful for thoracic aortic endovascular repair. This study aimed to evaluate the effects of using longer endografts according to location of AKA on outcomes of endovascular treatment for thoracic aortic dissection. ⋯ Accurate preoperative knowledge of AKA is extremely useful for selecting a longer device to provide a better structural stability of affected aorta and promote false lumen thrombosis during a midterm follow-up phase.
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Thorac Cardiovasc Surg · Oct 2013
Case ReportsSuccessful management of a mycotic pseudoaneurysm involving an arch branch using an endovascular stent graft.
Mycotic aneurysms in the aortic arch are extremely rare and represent a challenging surgical problem. Although surgery is the standard treatment, application of endovascular repair has been extended, but this technique carries a concern regarding the interposition of an artificial graft in the infected lesion. We present the case of an infected pseudoaneurysm in the thoracic aorta which was successfully excluded by treatment with a stent graft.
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Thorac Cardiovasc Surg · Oct 2013
Case ReportsEndovascular repair of mycotic aneurysm of the descending thoracic aorta: diagnostic and therapeutic dilemmas-two case reports with 1-year follow-up.
A mycotic aneurysm of the thoracic aorta is a rare diagnosis with high mortality. We present two cases of endovascular reconstruction of mycotic descending thoracic aorta. Specific or nonspecific bacterial or other infectious agent in serial samples of blood, urine, cerebrospinal fluid, and pleural puncture was not detected in the first case, but we found in sputum sample Mycobacterium tuberculosis in the second patient. ⋯ Control computed tomographic scans 6 months after reconstruction showed no endoleak in both patients. Repair of mycotic descending thoracic aortic aneurysms by endoluminal stent graft is reasonable alternative to open surgical intervention. A broad-spectrum antibiotic therapy has a high significance in the treatment of patients with mycotic aneurysm.