European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Jul 2019
Intraoperative flow profiles of arterial and venous bypass grafts to the left coronary territory.
The different mechanical and vasodilatory properties of arteries and veins may influence their flow profiles when used for coronary artery bypass grafting (CABG). This may be of significance when assessing the cut-off values for adequate flow. However, conduit-related flow differences are less examined. ⋯ No statistically significant difference was observed for MGF and pulsatility index between arterial and venous conduits. However, arterial grafts have significantly higher diastolic filling and backwards flow than venous grafts. Furthermore, arterial grafts have a significantly higher MGF in ONCABG versus OPCABG.
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Eur J Cardiothorac Surg · Jun 2019
Case ReportsIncorrect frozen elephant trunk deployment into the false lumen of a patient with complicated type B acute dissection.
Total arch replacement with frozen elephant trunk (FET) is used for type B acute aortic dissection with insufficient proximal landing zone. Herein, we report incorrect deployment of FET into the false lumen. A 45-year-old man underwent femorofemoral bypass for complicated type B acute aortic dissection. ⋯ Progressive lactic acidosis occurred on postoperative day 2, and computed tomography showed incorrect deployment of the FET into the false lumen, causing true lumen stenosis and intestinal ischaemia. Despite extensive enterectomy and abdominal aorta fenestration for the improvement of true lumen perfusion, the patient died of multiorgan failure on postoperative day 7. Care is required to avoid incorrect deployment of FET when there is a large entry in the proximal descending aorta.
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Eur J Cardiothorac Surg · Jun 2019
Locational impact of luminal communication on aortic diameter changes and reintervention in acute type I aortic dissection.
The aim of this study is to evaluate the locational impact of a luminal communication on aortic diameter changes and reintervention after surgical repair of acute type I aortic dissection. ⋯ A luminal communication at the proximal descending thoracic aorta (segment 1) is a significant factor for an increasing aortic diameter and reintervention after surgical repair of acute type I aortic dissection.
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Eur J Cardiothorac Surg · Jun 2019
Assessment of geometrical remodelling of the aortic arch after hybrid treatment.
The aim of this study was to measure the morphological remodelling of the ascending aorta, aortic arch and thoracic aorta after aortic arch hybrid treatment including debranching and stent graft implantation. ⋯ Hybrid arch repair was associated with a significant elongation of the vessel and a significant increase in the curvature on the ascending aorta and the descending aorta and on the endograft proximal and the distal landing zones.
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Eur J Cardiothorac Surg · Jun 2019
Multicenter Study Comparative Study Observational StudyBiological or mechanical prostheses for isolated aortic valve replacement in patients aged 50-65 years: the ANDALVALVE study.
The decision about whether to use a biological or a mechanical prosthesis for aortic valve replacement remains controversial in patients between 50 and 65 years of age and has yet to be addressed in a Mediterranean population. This research aimed to analyse long-term survival and major morbidity rates (30-day mortality, stroke, any prosthetic reoperation and major bleeding) within this population. ⋯ NCT03239509.