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Huo W, He M, Bao X, Lu Y, Tian W, Feng J, Zeng Z, Feng R. Minimally Invasive Endovascular Repair for Nondissected Ascending Aortic Disease: A Systematic Review. Emerg Med Int 2023; 2023:5592622. [PMID: 37767197 PMCID: PMC10522436 DOI: 10.1155/2023/5592622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 08/03/2023] [Accepted: 09/05/2023] [Indexed: 09/29/2023] Open
Abstract
Objective The aim of this study is to evaluate the efficacy of endovascular treatment for nondissected diseases of the ascending aorta. Data Sources. PubMed, Embase, and SciELO. Review Methods. In this study, we conducted a search on the PubMed, Embase, and SciELO databases for all cases of ascending aortic endovascular repair included in the literature published between January 2007 and July 2023, excluding type A aortic dissection. We reviewed 56 case reports and 7 observational studies included in this study, assessing the techniques, equipment, procedural steps, and results. We summarized the age, complications, follow-up time, and access route. Results This study includes 63 articles reporting 105 patients (mean age: 64.96 ± 17.08 years) who received endovascular repair for nondissected ascending aortic disease. The types of disease include aneurysm (N = 16), pseudoaneurysm (N = 71), penetrating aortic ulcer (N = 10), intramural hematoma (N = 2), thrombosis (N = 2), iatrogenic coarctation (N = 1), and rupture of the aorta (N = 3). The success rate of surgery is 99.05% (104/105). Complications include endoleak (10.48%, 11/105), stroke (5.71%, 6/105), postoperative infection (1.91%, 2/105), acute renal failure (0.95%, 1/105), aortic rupture (0.95%, 1/105), thrombosis (0.95%, 1/105), and splenic infarction (0.95%, 1/105). Five patients required conversion to open surgery, two patients underwent endovascular reintervention, and four of these five patients underwent surgery due to endoleak. Early mortality was 2.86% (3/105). Conclusion While the viability and results of endovascular repair for the treatment of ascending aortic disease are acknowledged in some circumstances, further research is needed to determine the safety and effectiveness of endovascular treatment for ascending aortic disease.
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Affiliation(s)
- Weixue Huo
- Department of Vascular Surgery, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Mengwei He
- Department of Vascular Surgery, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Xianhao Bao
- Department of Vascular Surgery, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Ye Lu
- Department of Vascular Surgery, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Wen Tian
- Department of Vascular Surgery, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Jiaxuan Feng
- Department of Vascular Surgery, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai, China
- Department of Vascular Surgery, Changhai Hospital, Navy Medical University, Shanghai, China
| | - Zhaoxiang Zeng
- Department of Vascular Surgery, Changhai Hospital, Navy Medical University, Shanghai, China
| | - Rui Feng
- Department of Vascular Surgery, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai, China
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2
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Wang C, Regar E, Lachat M, von Segesser LK, Maisano F, Ferrari E. Endovascular treatment of non-dissected ascending aorta disease: a systematic review. Eur J Cardiothorac Surg 2019; 53:317-324. [PMID: 28958041 DOI: 10.1093/ejcts/ezx308] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 07/19/2017] [Accepted: 07/30/2017] [Indexed: 12/20/2022] Open
Abstract
Severe ascending aorta disease includes aneurysms, pseudoaneurysms (ascending aorta pseudoaneurysms), penetrating aortic ulcers and Type A aortic dissections. Surgical replacement of the aortic root, ascending aorta or aortic arch is the common treatment for severe ascending aortic disease involving the root, the ascending aorta and/or the arch. Despite good surgical results, there is still a risk for morbidity and mortality following surgery for ascending aorta replacement when elderly patients or patients at high risk for surgery are concerned. Less invasive endovascular treatments for ascending aorta repair are under evaluation, and some reports appeared in the available literature in the last decade. However, clinical series or randomized studies are not yet available, and the use of these techniques is still questionable. In this study, we analysed the outcomes of reported cases of endovascular treatment for ascending aorta disease, excluding Type A aortic dissection. We reviewed reports published until February 2017, and we evaluated the employed technology, the devices, the procedural steps and the outcomes. A total of 26 articles reported 67 patients (mean age 65 ± 17 years) who received endovascular treatment for ascending aorta disease: aneurysms, ascending aorta pseudoaneurysms, penetrating aortic ulcers, intramural haematoma, thrombosis, iatrogenic coarctation and aortic rupture. Complications included endoleak (9 cases), stroke (3 cases), non-ST-elevation myocardial infarction (1 case) and splenic infarction (1 case). Three patients required conversion to open surgery, and 1 patient underwent endovascular reintervention. Early mortality was 2.9%. As an alternative treatment for ascending aorta disease in selected high-risk patients, the endovascular repair will gain popularity, but further analysis is required.
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Affiliation(s)
- Changtian Wang
- Department of Cardiovascular Surgery, University Hospital of Zurich, Zurich, Switzerland.,Department of Cardiovascular Surgery, Nanjing Jinling Hospital, Nanjing, China
| | - Evelyn Regar
- Department of Cardiovascular Surgery, University Hospital of Zurich, Zurich, Switzerland
| | - Mario Lachat
- Department of Cardiovascular Surgery, University Hospital of Zurich, Zurich, Switzerland
| | - Ludwig K von Segesser
- Department of Surgery and Anesthesiology, Cardiovascular Research Unit, University Hospital of Lausanne, Lausanne, Switzerland
| | - Francesco Maisano
- Department of Cardiovascular Surgery, University Hospital of Zurich, Zurich, Switzerland
| | - Enrico Ferrari
- Department of Cardiovascular Surgery, Cardiocentro Ticino Foundation, Lugano, Switzerland
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Kolvenbach R, Karmeli R, Rabin A, Lica R. Endovascular Hybrid Repair of True Ascending Aortic Aneurysms Using Double Graft Wrapping to Prepare a Landing Zone for Ascending Aortic Stent-Graft Placement: A Cohort Study. J Endovasc Ther 2019; 26:658-664. [PMID: 31198085 DOI: 10.1177/1526602819856075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose: To describe a hybrid procedure that avoids cardiopulmonary bypass to treat patients with true ascending aortic aneurysms without a suitable proximal landing zone for endovascular repair. Material and Methods: Thirteen consecutive patients (mean age 75.9±6.5 years; 8 women) with true ascending aortic aneurysms were treated with the endovascular hybrid repair of true aortic aneurysms (EHTA) approach, which consists of a conventional sternotomy with double wrapping of the ascending aorta followed by staged stent-graft placement. Via sternotomy, a polypropylene mesh trimmed to downsize the aneurysm is placed around the dilated ascending aorta and sutured to the adventitia. A similarly trimmed polytetrafluoroethylene graft is placed loosely around the first wrap to avoid adhesions and secure the proximal landing zone. There is no need for cardiopulmonary bypass. A few days later, a standard thoracic stent-graft is deployed via either a transaxillary or transfemoral access; chimney or bypass grafts are used as needed to revascularize the supra-aortic vessels. Results: The ascending aortic diameter was reduced from a mean 5.7 cm (range 4.8-6.5) to 3.9 cm (range 3.2-4.3) after wrapping. The mean interval between surgery and stent-graft placement was 5 days. In this interval, 2 patients with significant reduction in the diameter of the ascending aorta elected to forego placement of a stent-graft. Of the 11 patients who underwent the full hybrid EHTA procedure, the ascending aortic stent-graft was combined with a chimney graft in the innominate artery in 4 cases. In 1 patient, a supra-aortic debranching procedure using a bifurcated Dacron graft to the innominate and left common carotid arteries was performed after wrapping with the polypropylene mesh. There was no mortality or neurological complication. A sternal wound infection required a prolonged hospital stay. At a mean follow-up of 13.8 months (range 3-24), there has been no death, type I endoleak, or sign of aneurysm enlargement on imaging. Conclusion: This technique permits complete endovascular exclusion of an ascending aortic aneurysm in a less invasive approach than standard open repair. Although this is only a small cohort of patients without long-term follow-up, it seems that this hybrid procedure is associated with low morbidity and mortality. It offers a beating-heart approach to treat true ascending aortic aneurysms in selected high-risk patients.
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Affiliation(s)
- Ralf Kolvenbach
- Department of Vascular Surgery and Endovascular Therapy, Augusta Hospital, Catholic Hospital Group, Düsseldorf, Germany
| | | | | | - Raluca Lica
- Department of Vascular Surgery and Endovascular Therapy, Augusta Hospital, Catholic Hospital Group, Düsseldorf, Germany
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4
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Computational simulation of TEVAR in the ascending aorta for optimal endograft selection: A patient-specific case study. Comput Biol Med 2018; 103:140-147. [DOI: 10.1016/j.compbiomed.2018.10.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 10/14/2018] [Accepted: 10/14/2018] [Indexed: 01/16/2023]
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5
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Lin J, Parikh N, Udgiri N, Wang S, Miller DF, Li C, Panneton J, Nutley M, Zhang Z, Huang Y, Lu J, Zhang J, Wang L, Guidoin R. Laser Fenestration of Aortic Stent-Grafts Followed by Noncompliant vs Cutting Balloon Dilation: A Scanning Electron Microscopy Study. J Endovasc Ther 2018; 25:397-407. [DOI: 10.1177/1526602818772311] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Purpose: To examine the effects of in situ laser fenestration and subsequent balloon dilation (noncompliant vs cutting) on the graft fabric of 4 aortic stent-graft models. Method: In an in vitro setup, the Zenith TX2, Talent, Endurant, and Anaconda aortic stent-grafts (all made of polyester graft material) were subjected to laser fenestration with a 2.3-mm-diameter probe at low and high energy in a physiologic saline solution followed by balloon dilation of the hole. For the first series of tests, 6-mm-diameter noncompliant balloons were used and replaced for the second series by 6-mm-diameter cutting balloons. Each procedure was performed 5 times (5 fenestrations per balloon type). The fenestrations were examined visually and with light and scanning electron microscopy. Results: Each fenestration demonstrated various degrees of fraying and/or tearing regardless of the device. The monofilament twill weave of the Talent endograft tore in the warp direction up to 7.09±0.46 mm at high energy compared with 2.41±0.26 mm for the Endurant multifilament device. The fenestrations of the 3 endografts with multifilament weave (Zenith, Anaconda, and Endurant) showed more fraying; fenestration areas in the multifilament Endurant were >10 mm2 at low and high energy. The fenestrations were free of melted fibers, but minor blackening of the filaments was observed in all devices. Overall, the cutting balloons resulted in worse tearing and damage. Of note, the edges of the dilated laser-formed fenestrations of the Talent and the Endurant grafts demonstrated evidence of additional shredded yarns. Conclusion: In situ fenestration does not cause any melting of the polyester; however, the observed structural damage to the fabric construction must be carefully considered. Cutting balloons caused various levels of tearing compared to the noncompliant balloons and cannot be recommended for use in this application. Rather, noncompliant balloons should be employed, but only with endografts constructed from multifilament yarns. The use of in situ fenestration must be restricted to urgent and emergent cases until long-term durability can be determined.
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Affiliation(s)
- Jing Lin
- Key Laboratory of Textile Science & Technology, Ministry of Education and College of Textiles, Donghua University, Shanghai, China
| | - Niraj Parikh
- Division of Vascular Surgery, Eastern Virginia Medical School, Sentara Heart Hospital, Norfolk, VA, USA
| | - Naval Udgiri
- Division of Vascular Surgery, Eastern Virginia Medical School, Sentara Heart Hospital, Norfolk, VA, USA
| | - Shaoxia Wang
- Key Laboratory of Textile Science & Technology, Ministry of Education and College of Textiles, Donghua University, Shanghai, China
| | - Daniel F. Miller
- Division of Vascular Surgery, Eastern Virginia Medical School, Sentara Heart Hospital, Norfolk, VA, USA
| | - Chaojing Li
- Key Laboratory of Textile Science & Technology, Ministry of Education and College of Textiles, Donghua University, Shanghai, China
- Department of Surgery, Faculty of Medicine, Université Laval and Axe Médecine Régénératrice, Centre de Recherche du CHU, Québec City, Quebec, Canada
| | - Jean Panneton
- Division of Vascular Surgery, Eastern Virginia Medical School, Sentara Heart Hospital, Norfolk, VA, USA
| | - Mark Nutley
- Division of Vascular Surgery and Department of Diagnostic Imaging, University of Calgary, Peter Lougheed Centre, Calgary, Alberta, Canada
| | - Ze Zhang
- Department of Surgery, Faculty of Medicine, Université Laval and Axe Médecine Régénératrice, Centre de Recherche du CHU, Québec City, Quebec, Canada
| | - Yunfan Huang
- Key Laboratory of Textile Science & Technology, Ministry of Education and College of Textiles, Donghua University, Shanghai, China
| | - Jun Lu
- Key Laboratory of Textile Science & Technology, Ministry of Education and College of Textiles, Donghua University, Shanghai, China
| | - Jingyi Zhang
- Key Laboratory of Textile Science & Technology, Ministry of Education and College of Textiles, Donghua University, Shanghai, China
| | - Lu Wang
- Key Laboratory of Textile Science & Technology, Ministry of Education and College of Textiles, Donghua University, Shanghai, China
| | - Robert Guidoin
- Department of Surgery, Faculty of Medicine, Université Laval and Axe Médecine Régénératrice, Centre de Recherche du CHU, Québec City, Quebec, Canada
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6
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A systematic review of primary endovascular repair of the ascending aorta. J Vasc Surg 2018; 67:332-342. [DOI: 10.1016/j.jvs.2017.06.099] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 06/19/2017] [Indexed: 11/21/2022]
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7
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Sattah AP, Secrist MH, Sarin S. Complications and Perioperative Management of Patients Undergoing Thoracic Endovascular Aortic Repair. J Intensive Care Med 2017; 33:394-406. [PMID: 28946776 DOI: 10.1177/0885066617730571] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Endovascular treatments have become increasingly common for patients with a variety of thoracic aortic pathologies. Although considered less invasive than traditional open surgical approaches, they are nonetheless complex procedures. Patients undergo manipulation of an often calcified aorta near the origin of the carotid and subclavian vessels and have stents placed in a curved vessel adjacent to a perpetually beating heart. These stents can obstruct blood flow to the spinal cord, induce an inflammatory response, and in rare cases erode into the adjacent trachea or esophagus. Renal complications range from contrast-induced nephropathy to hypotension and ischemia to dissection. Emboli can lead to strokes and mesenteric ischemia. These patients have complex medical histories, and skilled perioperative management is critical to achieving the best clinical outcomes. Here, we review the medical management of the most common complications in these patients including stroke, spinal cord ischemia, renal injury, retrograde dissections, aortoesophageal and aortobronchial fistulas, postimplantation syndrome, mesenteric ischemia, and endograft failure.
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Affiliation(s)
- Anna P Sattah
- 1 School of Arts and Sciences, Duke University, Durham, NC, USA.,2 School of Medicine and Department of Surgery, University of Virginia, Charlottesville, VA, USA.,3 Department of Anesthesia and Critical Care, George Washington University Medical Center, Washington, DC, USA.,4 Holy Cross Hospital, Silver Spring, MD, USA
| | - Michael H Secrist
- 5 College of Humanities, Brigham Young University, Provo, UT, USA.,6 Doctor of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.,7 Department of Interventional Radiology, University of California, Irvine, CA, USA.,8 Department of Radiology, George Washington University Medical Center, Washington, DC, USA
| | - Shawn Sarin
- 2 School of Medicine and Department of Surgery, University of Virginia, Charlottesville, VA, USA.,9 Kasturba Medical College, Karnataka, India.,10 Northeast Ohio Medical Universities, Rootstown, OH, USA.,11 Department of Interventional Radiology, National Institutes of Health, Stapleton, New York City, NY, USA.,12 Department of Interventional Radiology, George Washington University Medical Center, Washington, DC, USA
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8
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Gao F, Zeng Q, Lin F, Ge X. Sandwich Technique for Endovascular Repair of Acute Type A Aortic Dissection. J Endovasc Ther 2017; 24:647-653. [PMID: 28747077 DOI: 10.1177/1526602817721674] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Overview: To describe a new endovascular procedure for acute type A aortic dissection (TAAD) repair. Methods: Between 2013 and 2016, 12 patients (average age 54±9.6 years; 10 men) with acute TAAD (mean EURO score 11.4%±3.2%, range 5–17) and unfit for surgery underwent thoracic endovascular aortic repair (TEVAR) with 2 periscope grafts to preserve blood supply to supra-aortic branches plus bypass grafting as needed. If the ascending aorta was dilated to >40 mm, sternotomy was performed to wrap the ascending aorta and reduce its diameter to accommodate the aortic stent-grafts. Results: All patients were successfully treated. Seven patients required bypass grafting, and most of the patients had periscope grafts to the innominate/right common carotid artery and left common carotid artery; only 3 patients had the left subclavian artery preserved. All patients exhibited good hemodynamics and normal pressures after the procedure. The mean procedure time and blood loss were 4.5±1.0 hours and 217±111.5 mL, respectively. Two patients treated emergently died shortly after surgery from multiorgan failure. The average follow-up duration was 17±14.5 months (range 2–42) in the 10 survivors. The remaining patients recovered and none experienced stent-graft thrombosis, stroke, or peripheral artery embolism during follow-up. Conclusion: A procedure that combines sandwich/periscope grafting with TEVAR, wrapping of the aorta, and supra-arch bypass grafting can be used to treat patients with acute TAAD.
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Affiliation(s)
- Feng Gao
- Department of Cardiovascular Surgery, Xiangya Haikou Hospital of Central South University, Haikou Municipal Hospital, Haikou Vascular Disease Research Institute, Haikou City, China
| | - Qian Zeng
- Department of Cardiovascular Surgery, Xiangya Haikou Hospital of Central South University, Haikou Municipal Hospital, Haikou Vascular Disease Research Institute, Haikou City, China
| | - Fangming Lin
- Department of Cardiovascular Surgery, Xiangya Haikou Hospital of Central South University, Haikou Municipal Hospital, Haikou Vascular Disease Research Institute, Haikou City, China
| | - Xiaohu Ge
- Department of Vascular Surgery, Municipal Hospital of XinJiang Province, China
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9
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Leung Wai Sang S, Bavaria JE, Giri JS, Wickramasinghe R, Desai N. Transfemoral Valve-in-Valve Sapien 3 in a Patient with an Ascending Aortic Aneurysm. J Card Surg 2016; 31:318-20. [DOI: 10.1111/jocs.12724] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | | | - Jay S. Giri
- Medicine; University of Pennsylvania; Philadelphia Pennsylvania
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10
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Feng G, Qian Z, Jun G, Fangming L. Hybrid Repair of an Aortic Arch Aneurysm Using Double Parallel Grafts Perfused by Retrograde Flow in Endovascular Repair Combined With Left Subclavian Artery Surgical Bypass. Ann Thorac Surg 2016; 100:1888-91. [PMID: 26522534 DOI: 10.1016/j.athoracsur.2014.12.089] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Revised: 11/26/2014] [Accepted: 12/16/2014] [Indexed: 11/26/2022]
Abstract
Despite its invasive nature, open surgical repair is still the first choice to treat aortic arch aneurysms. With the advancement of endovascular technology, thoracic endovascular aortic repair (TEVAR) has gained popularity in treating aortic aneurysms; however, blood flow preservation of the supra-arch branches remains a complicated challenge. This case report describes a hybrid procedure that successfully treated a patient with aortic arch aneurysm by combining the parallel grafts perfused by retrograde flow in the TEVAR procedure and a carotid-subclavian artery bypass.
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Affiliation(s)
- Gao Feng
- Department of Cardiovascular Surgery, XiangYa HaiKou Hospital of Central South University, HaiKou Municipal Hospital, and HaiKou Vascular Disease Research Institute, HaiKou, China.
| | - Zeng Qian
- Department of Cardiovascular Surgery, XiangYa HaiKou Hospital of Central South University, HaiKou Municipal Hospital, and HaiKou Vascular Disease Research Institute, HaiKou, China
| | - Guan Jun
- Department of Cardiovascular Surgery, XiangYa HaiKou Hospital of Central South University, HaiKou Municipal Hospital, and HaiKou Vascular Disease Research Institute, HaiKou, China
| | - Lin Fangming
- Department of Cardiovascular Surgery, XiangYa HaiKou Hospital of Central South University, HaiKou Municipal Hospital, and HaiKou Vascular Disease Research Institute, HaiKou, China
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11
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Allen KB, Davis JR, Cohen DJ. Critical aortic stenosis and acute ascending aortic penetrating ulcer managed utilizing transapical TAVR and TEVAR. Catheter Cardiovasc Interv 2015; 86:768-72. [PMID: 25640823 DOI: 10.1002/ccd.25816] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 01/03/2015] [Indexed: 11/11/2022]
Abstract
Thoracic endovascular aortic repair (TEVAR) of acute ascending aortic pathology is feasible; however, the unique features of this aortic segment in addition to access challenges restricts its use to a select, high-risk subset of patients. With the advent of TAVR, large device delivery using transapical access has become a well-defined technique. We report a patient with critical aortic stenosis and an acute ascending aortic penetrating ulcer with tamponade managed successfully utilizing transapical TAVR and TEVAR. To our knowledge, this is the first reported case of a hybrid single-stage TAVR and ascending aortic TEVAR using transapical access.
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Affiliation(s)
- Keith B Allen
- Department of Cardiothoracic Surgery, St. Luke's Mid America Heart Institute, Kansas City, Missouri
| | - J Russell Davis
- Department of Cardiothoracic Surgery, St. Luke's Mid America Heart Institute, Kansas City, Missouri
| | - David J Cohen
- Department of Cardiology, St. Luke's Mid America Heart Institute, Kansas City, Missouri
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12
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Thoracic Aorta Stent Grafting through Transapical Access. Ann Vasc Surg 2015; 29:362.e5-9. [DOI: 10.1016/j.avsg.2014.09.018] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2014] [Revised: 09/09/2014] [Accepted: 09/14/2014] [Indexed: 11/20/2022]
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13
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Kölbel T. Commentary: transapical access and periscope grafts as a lifesaving procedure in a complicated arch lesion. J Endovasc Ther 2013; 20:18-9. [PMID: 23391076 DOI: 10.1583/12-4082c.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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