J Cardiovasc Surg
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Comparative Study
Increased risk of late aortic events after isolated aortic valve replacement in patients with bicuspid aortic valve insufficiency versus stenosis.
Bicuspid aortic valve (BAV) is a very heterogeneous disorder and risk of aortic events in BAV may be influenced by phenotype of the disease. Correlation has been proposed between aortic dilatation patterns and functional status of the BAV (i.e., stenosis versus insufficiency). The aim of our study was to evaluate the risk of late aortic events after isolated aortic valve replacement (AVR) in patients with BAV stenosis versus insufficiency. ⋯ BAV patients with isolated valve insufficiency are at increased risk of late aortic events, as compared with BAV stenosis patients at 15 years after AVR.
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We reported our 10-year experience with the Gore TAG thoracic endoprosthesis for treatment of thoracic aorta pathologies. ⋯ This single-center study demonstrates acceptable rates for operative mortality and major adverse events after endovascular repair of various thoracic aortic pathologies with both generations of Gore TAG device. However, a better knowledge in long-term results is necessary to define target populations.
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Endovascular treatment has become the preferred method of repair of abdominal and thoracic aortic aneurysms, and comes with a unique complication in the form of endoleaks (type I-IV). Type II endoleaks are the focus of this review. They are the most common form of endoleak detected in CT surveillance following endovascular repair. ⋯ Possible reasons for poor success rates will also be discussed. A general consensus on how to best manage these patients is yet to be reached. The aim of this review is to give an overview of type II endoleaks, their natural history and vessels most commonly involved, as well as different approaches to embolisation.
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The study aims to analyze retrospective results of extensive endovascular repair of the descending thoracic aorta with special attention to spinal cord malperfusion. ⋯ The coverage of the entire thoracic aorta is an effective procedure with high probability of success. Spinal cord malperfusion remains a serious complication especially in patients with prior aortic surgery but if collateral blood supply is maintained the occlusion of intercostal arteries do not determine paraplegia or paraparesis. In order to consider acute or chronic occlusion of subclavian, lumbar or hypogastric arteries so preventing spinal cord ischemia, strong preoperative evaluation including analysis of previous surgery for abdominal aortic aneurysm repair and avoidance of T12 aortic segment coverage if feasible is mandatory.
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Comparative Study
Total blood volume of Asian patients undergoing cardiac surgery is far from that predicted by conventional methods.
Current cardiopulmonary bypass (CPB) procedures use non-hematic fluids to prime bypass circuits, often resulting in marked hemodilution. Patients' total blood volume (TBV) is estimated prior to hemodilution. We aimed to evaluate differences between calculation of TBV by Nadler's formula, a classic reference book method, and an established formula calculated by the authors. ⋯ Total blood volume of Asian patients calculated by the authors differs markedly from that estimated by Nadler and classic reference book formulas, which suggests that more accurate calculation of TBV is needed for Asian cardiac patients requiring CPB, especially patients with valvular disease.