Objective The aim of this study was to determine the effect of a new method of cardiac assistant therapy with an extra-aortic balloon pump on the experimental dogs in which myocardial ischemia or infarction were induc...Objective The aim of this study was to determine the effect of a new method of cardiac assistant therapy with an extra-aortic balloon pump on the experimental dogs in which myocardial ischemia or infarction were induced,and to observe its effectiveness and feasibility. Methods Twelve animal models of myocardia,1 infarction were established with the method of left展开更多
BACKGROUND Very little is known about the role of extracorporeal membrane oxygenation(ECMO)for the management of patients undergoing major aortic surgery with particular reference to aortic dissection.AIM To review th...BACKGROUND Very little is known about the role of extracorporeal membrane oxygenation(ECMO)for the management of patients undergoing major aortic surgery with particular reference to aortic dissection.AIM To review the available literature to determine if there was any evidence.METHODS A systematic literature search through PubMed and EMBASE was undertaken according to specific key words.RESULTS The search resulted in 29 publications relevant to the subject:1 brief communication,1 surgical technique report,1 invited commentary,1 retrospective case review,1 observational study,4 retrospective reviews,13 case reports and 7 conference abstracts.A total of 194 patients were included in these publications of whom 77 survived.CONCLUSION Although there is no compelling evidence for or against the use of ECMO in major aortic surgery or dissection,it is enough to justify its use in this patient population despite current adverse attitude.展开更多
A 72-year-old woman was presented with intermittent claudication of bilateral lower extremities, refractory hypertension, and mild renal impairment. Computed tomographic angiography showed severe aortic stenosis cause...A 72-year-old woman was presented with intermittent claudication of bilateral lower extremities, refractory hypertension, and mild renal impairment. Computed tomographic angiography showed severe aortic stenosis caused by calcifications protruding into the aortic lumen proximal and distal to the visceral and renal branches, so-called coral reef aorta. An axillo-iliac bypass was performed. Postoperatively, the patient developed ileus and acute renal failure, presumably caused by a steal phenomenon to the lower extremities. Endovascular stenting of the aorta increased forward blood flow and dramatically improved the patient’s condition. This case study illustrates potential hemodynamic complications after extra-anatomical axillo-iliac bypass for coral reef aorta.展开更多
Background The conventional extra-anatomic bypass is originated from the axillary＇s artery and the graft size is often limited due to the small diameter of axillary＇s artery. ascending aorta can improve the graft si...Background The conventional extra-anatomic bypass is originated from the axillary＇s artery and the graft size is often limited due to the small diameter of axillary＇s artery. ascending aorta can improve the graft size and distal perfusion, Extra-anatomic bypass graft originating from need sternotomy which might have higher operative risks compared with axillo-femeral bypass. We summarize our experiences of extra-anatomic bypass from ascending aorta for atypical aortic coarctation. Methods Between January 2005 and February 2008, 5 women aged from 18 to 64 years underwent extra-anatomic bypass from ascending aorta to abdominal aorta or iliac artery bypass for treatment of atypical aortic coarctation. Preoperatively, all patients had hypertension and needed antihypertensive medications. Systolic blood pressure was 151 ± 9 mmHg. Ankle pressure index （API） 0.23 in left and 0.56± 0.23 in right. Average systolic pressure gradient of aortic stenosis was 76 were 0.60 ± 18 mmHg. Three patients underwent concomitant cardiac operation, including coronary artery bypass grafting, Benta11 procedure and atrial septal defect repair. Results There was no hospital and late mortality during 58 ＋ 15 months follow-up （range from 44 to 81 months）. Postoperative systolic blood pressure was reduced to 126 ± 11 mmHg at the time of discharge. All patients maintained normal blood pressure without medication during follow-up. API was improved to 1.12 ± 0.24 in left and 1.17 ± 0.25 in right （compared with preoperative data, P 〈0.05）. Follow-up computer tomography showed patency in all grafts. Conclusions Surgical treatment of atypical aortic coarctation with extra-anatomic bypass originating from ascending aorta alleviates hypertension and low limb ischemia. IS Chin J Cardiol 2011; 12（4） ： 207-2113展开更多
We report a 26-year-old man with critical aortic coarctation, severe bicuspid aortic valve stenosis, infective endocarditis and ascending aortic aneurysm. He underwent simultaneously in singlestage a Bentall’s proced...We report a 26-year-old man with critical aortic coarctation, severe bicuspid aortic valve stenosis, infective endocarditis and ascending aortic aneurysm. He underwent simultaneously in singlestage a Bentall’s procedure and an extra-anatomic ascending-descending aortic bypass grafting by 14-mm Dacron tube, through median sternotomy. The immediate postoperative outcome was favourable. The CT scan control for 7 years after surgery showed a good patency of the extra-anatomic bypass.展开更多
目的探讨带膜支架腔内修复联合解剖外旁路术对 Stanford A 型主动脉夹层的临床效果。方法通过建立各种解剖外旁路来重建无名动脉、左颈总动脉或左锁骨下动脉以延长锚定区,然后一期或分期行带膜支架主动脉腔内修复术;可采取颈动脉入路或...目的探讨带膜支架腔内修复联合解剖外旁路术对 Stanford A 型主动脉夹层的临床效果。方法通过建立各种解剖外旁路来重建无名动脉、左颈总动脉或左锁骨下动脉以延长锚定区,然后一期或分期行带膜支架主动脉腔内修复术;可采取颈动脉入路或股动脉入路来完成主动脉腔内修复术。结果全组34例中升主动脉夹层8例,主动脉弓部夹层26例,除1例术中死亡外,其余33例均成功接受带膜支架主动脉腔内修复术。30d 病死率为8.8%(3/34),内漏发生率为11.8%(4/34),脑梗死发生率为5.9%(2/34)。随访6～70个月,平均24.5个月,2例失访。结果显示假腔内完全血栓形成16例,部分血栓形成13例。结论带膜支架腔内修复联合解剖外旁路术为 Stanford A 型主动脉夹层提供了一种新的治疗方法,具有微创、安全性较高,并发症较少的特点,但应注意适应证的选择。展开更多
文摘Objective The aim of this study was to determine the effect of a new method of cardiac assistant therapy with an extra-aortic balloon pump on the experimental dogs in which myocardial ischemia or infarction were induced,and to observe its effectiveness and feasibility. Methods Twelve animal models of myocardia,1 infarction were established with the method of left
文摘BACKGROUND Very little is known about the role of extracorporeal membrane oxygenation(ECMO)for the management of patients undergoing major aortic surgery with particular reference to aortic dissection.AIM To review the available literature to determine if there was any evidence.METHODS A systematic literature search through PubMed and EMBASE was undertaken according to specific key words.RESULTS The search resulted in 29 publications relevant to the subject:1 brief communication,1 surgical technique report,1 invited commentary,1 retrospective case review,1 observational study,4 retrospective reviews,13 case reports and 7 conference abstracts.A total of 194 patients were included in these publications of whom 77 survived.CONCLUSION Although there is no compelling evidence for or against the use of ECMO in major aortic surgery or dissection,it is enough to justify its use in this patient population despite current adverse attitude.
文摘A 72-year-old woman was presented with intermittent claudication of bilateral lower extremities, refractory hypertension, and mild renal impairment. Computed tomographic angiography showed severe aortic stenosis caused by calcifications protruding into the aortic lumen proximal and distal to the visceral and renal branches, so-called coral reef aorta. An axillo-iliac bypass was performed. Postoperatively, the patient developed ileus and acute renal failure, presumably caused by a steal phenomenon to the lower extremities. Endovascular stenting of the aorta increased forward blood flow and dramatically improved the patient’s condition. This case study illustrates potential hemodynamic complications after extra-anatomical axillo-iliac bypass for coral reef aorta.
文摘Background The conventional extra-anatomic bypass is originated from the axillary＇s artery and the graft size is often limited due to the small diameter of axillary＇s artery. ascending aorta can improve the graft size and distal perfusion, Extra-anatomic bypass graft originating from need sternotomy which might have higher operative risks compared with axillo-femeral bypass. We summarize our experiences of extra-anatomic bypass from ascending aorta for atypical aortic coarctation. Methods Between January 2005 and February 2008, 5 women aged from 18 to 64 years underwent extra-anatomic bypass from ascending aorta to abdominal aorta or iliac artery bypass for treatment of atypical aortic coarctation. Preoperatively, all patients had hypertension and needed antihypertensive medications. Systolic blood pressure was 151 ± 9 mmHg. Ankle pressure index （API） 0.23 in left and 0.56± 0.23 in right. Average systolic pressure gradient of aortic stenosis was 76 were 0.60 ± 18 mmHg. Three patients underwent concomitant cardiac operation, including coronary artery bypass grafting, Benta11 procedure and atrial septal defect repair. Results There was no hospital and late mortality during 58 ＋ 15 months follow-up （range from 44 to 81 months）. Postoperative systolic blood pressure was reduced to 126 ± 11 mmHg at the time of discharge. All patients maintained normal blood pressure without medication during follow-up. API was improved to 1.12 ± 0.24 in left and 1.17 ± 0.25 in right （compared with preoperative data, P 〈0.05）. Follow-up computer tomography showed patency in all grafts. Conclusions Surgical treatment of atypical aortic coarctation with extra-anatomic bypass originating from ascending aorta alleviates hypertension and low limb ischemia. IS Chin J Cardiol 2011; 12（4） ： 207-2113
文摘We report a 26-year-old man with critical aortic coarctation, severe bicuspid aortic valve stenosis, infective endocarditis and ascending aortic aneurysm. He underwent simultaneously in singlestage a Bentall’s procedure and an extra-anatomic ascending-descending aortic bypass grafting by 14-mm Dacron tube, through median sternotomy. The immediate postoperative outcome was favourable. The CT scan control for 7 years after surgery showed a good patency of the extra-anatomic bypass.
文摘目的探讨带膜支架腔内修复联合解剖外旁路术对 Stanford A 型主动脉夹层的临床效果。方法通过建立各种解剖外旁路来重建无名动脉、左颈总动脉或左锁骨下动脉以延长锚定区,然后一期或分期行带膜支架主动脉腔内修复术;可采取颈动脉入路或股动脉入路来完成主动脉腔内修复术。结果全组34例中升主动脉夹层8例,主动脉弓部夹层26例,除1例术中死亡外,其余33例均成功接受带膜支架主动脉腔内修复术。30d 病死率为8.8%(3/34),内漏发生率为11.8%(4/34),脑梗死发生率为5.9%(2/34)。随访6～70个月,平均24.5个月,2例失访。结果显示假腔内完全血栓形成16例,部分血栓形成13例。结论带膜支架腔内修复联合解剖外旁路术为 Stanford A 型主动脉夹层提供了一种新的治疗方法,具有微创、安全性较高,并发症较少的特点,但应注意适应证的选择。
