Abstract:
OBJECTIVES:Our goal was to report the selection schemes, technical variations and long-term outcome of extra-anatomical bypass to correct complex, recurrent aortic coarctation and hypoplastic aortic arch. METHODS:Between 1989 and 2012, 53 patients (mean age 13.2 ± 4.3, median 11.6, range 9-23 years) with complex aortic coarctation (n = 33; long-segment hypoplastic aortic arch in 15), recurrent coarctation (n = 20; anastomosic pseudoaneurysm in 10), underwent correction using extra-anatomical bypass, either with (n = 18: femoral bypass = 13, left heart bypass = 5) or without (n = 35) extracorporeal circulation via a left lateral thoracotomy (n= 48) and combined median sternotomy and median laparotomy (n = 5). The decision to use extracorporeal circulation was based on the anatomical location of the coarctation, the length of the hypoplasia and a history of previous repair. Preoperatively, mean systolic blood pressure was 130 ± 30 mmHg at rest and 180 ± 40 mmHg during exercise, with a mean pressure gradient of 80 ± 11.6 (range 40-120) mmHg. RESULTS:Various extra-anatomical bypass strategies included left subclavian artery to descending aorta (n = 38), ascending aorta to left subclavian artery (n = 3), ascending aorta to descending aorta (n = 4), aortic arch to descending aorta (n = 3) and ascending aorta to abdominal aorta (n = 5). Graft size (median 18, range 10-26, mm) was chosen according to the diameter of the vessel proximal and distal to the planned graft. No operative deaths, paraplegia or abdominal malperfusion occurred. The mean reduction in systolic blood pressure was 60 ± 25 mmHg without pressure gradients. During a mean follow-up of 18.3 ± 3.7 years, there were no reoperations, graft complications or pseudoaneurysm formation on anastomotic sites. Seven (11.6%) patients are on antihypertensive medications. No patient presented with claudication nor did anyone experience orthostatic problems from the steal phenomenon. CONCLUSIONS:Extra-anatomical bypass is safe, an effective technique, and achieves satisfactory long-term results.
journal_name
Interact Cardiovasc Thorac Surgjournal_title
Interactive cardiovascular and thoracic surgeryauthors
Delmo Walter EM,Javier MFDM,Hetzer Rdoi
10.1093/icvts/ivx115subject
Has Abstractpub_date
2017-09-01 00:00:00pages
400-406issue
3eissn
1569-9293issn
1569-9285pii
3815698journal_volume
25pub_type
杂志文章abstract::Oesophageal cancer presents as advanced disease; in the majority of patients the symptoms are present for many months prior to diagnosis. Dysphagia has been described as the key to an early diagnosis of oesophageal cancer. This study aims to assess the public perception of the importance of this symptom. Ninety-six pa...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2010.247213
更新日期:2011-01-01 00:00:00
abstract:Objectives:Autologous pericardium, which is widely used in the field of cardiovascular surgery, is usually fixed with glutaraldehyde (GA) to improve handling and provide biomechanical stability. However, an optimal method of GA fixation of autologous pericardium is not known. The objective of this study was to evaluate...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivw356
更新日期:2017-03-01 00:00:00
abstract:OBJECTIVES:Minimally invasive surgical approaches for aortic valve replacement (AVR) are growing in popularity in an attempt to decrease morbidity from conventional surgery. We have adopted a technique that divides only the manubrium and spares the body of the sternum. We sought to determine whether patients benefit fr...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivu196
更新日期:2014-10-01 00:00:00
abstract::Surgery with chemotherapy has been the accepted procedure for treating pathological stage I small cell lung cancer. However, there is a question of whether all clinical stage I patients should undergo surgery or not because of discrepancies between clinical and pathological staging. We conducted a retrospective analys...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2004.101428
更新日期:2005-04-01 00:00:00
abstract::Perioperative graft failure following coronary artery bypass grafting (CABG) may result in acute myocardial ischaemia. Whether acute percutaneous coronary intervention, emergency reoperation or conservative intensive care treatment should be used is currently unknown. Between 2003 and 2009, 39 of the 5598 patients who...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivr127
更新日期:2012-04-01 00:00:00
abstract::Coronary vasospasm is a life threatening complication in the early postoperative period after coronary artery bypass grafting. We report a 45-year-old patient with normal preoperative ventricular function who could not be stabilized using established treatments such as: systemic application of glyceryl trinitrate, dil...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2004.103788
更新日期:2005-08-01 00:00:00
abstract::A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was: What is the role of mechanical valve prostheses in pulmonary valve replacement late after tetralogy of Fallot (TOF) repair? Altogether more than 30 papers were found using the reported search, of which ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章,评审
doi:10.1093/icvts/ivt541
更新日期:2014-05-01 00:00:00
abstract::We performed surgical repair of a giant left coronary ostial aneurysm after aortic root replacement using composite valve graft (modified Bentall procedure) in a patient with Marfan syndrome. Aneurysmal formation in the left main stem itself is very rare. In order to avoid mobilizing the coronary ostium from severe ad...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2008.183103
更新日期:2008-12-01 00:00:00
abstract::A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether treatment with magnesium in addition to an anti-arrhythmic is beneficial to patients who have gone into atrial fibrillation after cardiac surgery. Altogether 466 papers were identified using the ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2005.106419
更新日期:2005-06-01 00:00:00
abstract::Heart tumors are very rare neoplasms. Solitary fibrous tumors are mesenchymal neoplasms first described as pleura-based lesions. We are the first to describe the clinical symptoms, surgical technique for removal, histology, and exact location as well as medium-term follow-up of a solitary fibrous tumor in the heart. ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2005.108068
更新日期:2005-10-01 00:00:00
abstract::Penetrating cardiac injury is rare and frequently not survivable. Significant haemorrhage resulting in cardiac tamponade commonly ensues. Such cardiac tamponade is a clear clinical, radiological and sonographic indicator of significant underlying injury. In the absence of cardiac tamponade, diagnosis can be more chall...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivw342
更新日期:2017-02-01 00:00:00
abstract::The aim of this work was to question the necessity of repeated administration of warm blood cardioplegia in modern cardiac surgery. A consecutive series of 4014 patients underwent cardiosurgical procedures in the period from January 2001 to December 2006 in our centre, where modified Calafiore warm blood-cardioplegic ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2008.192757
更新日期:2009-05-01 00:00:00
abstract:OBJECTIVES:Atrial tachyarrhythmia, including atrial fibrillation (AF), atrial flutter (AFL) and intra-atrial reentrant tachycardia (IART), occur frequently in patients with congenital heart disease (CHD), who may undergo multiple surgical procedures throughout life. However, data on the effectiveness of concomitant arr...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivy181
更新日期:2018-12-01 00:00:00
abstract:OBJECTIVES:Mesenteric ischaemia (MesI) remains a rare but lethal complication following cardiac surgery. Previously identified risk factors for MesI mortality (age, poor left ventricular (LV) function, cardiopulmonary bypass time and blood loss) are non-specific and cannot necessarily be modified. This study aims to id...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivu139
更新日期:2014-09-01 00:00:00
abstract::This case report describes the repair of an aortoesophageal fistula caused by a previously placed aortic arch graft. A 62-year-old man underwent total aortic arch graft replacement one year ago. He was readmitted with hematemesis and a high fever. Examination by endoscopy revealed a perforation and two swollen lesions...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2010.257501
更新日期:2011-04-01 00:00:00
abstract::This study presents a novel way to perform the mini-maze procedure through the left atrial appendage. By this way, the usual additional incision of the intra-atrial groove is avoided, especially in patients receiving coronary artery bypass grafting (CABG) or aortic valve replacement without mitral valve disease. We re...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivu035
更新日期:2014-06-01 00:00:00
abstract:OBJECTIVES:The best surgical strategy for acute Stanford Type A aortic dissection (aTAAD) involving the arch remains controversial. Here, we report on the satisfactory results following aTAAD repair using a novel arch fenestrated stent graft. METHODS:From December 2014 to December 2015, 42 aTAAD patients (27 male and ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivx335
更新日期:2018-03-01 00:00:00
abstract:OBJECTIVES:The effect of antegrade pulmonary blood flow (APBF) has never been studied in the bidirectional Glenn (BDG) procedure performed late. METHODS:Records of 112 consecutive patients who had a BDG procedure during a 10-year period were reviewed retrospectively. The patients were divided into 2 groups based on wh...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivx325
更新日期:2018-03-01 00:00:00
abstract::Infective endocarditis is a life threatening disease with high mortality and morbidity, including brain infarction concomitant with intracranial hemorrhage. Generally, patients with a recent intracranial hemorrhage are believed to be a contraindication to undergo cardiac surgery with cardiopulmonary bypass. However, s...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2006.146209
更新日期:2007-06-01 00:00:00
abstract::A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether it is better to preserve the aortic valve in patients with aortic root or ascending aortic aneurysms. Altogether 380 papers were found using the reported search, of which 23 represented the best ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章,评审
doi:10.1510/icvts.2008.186544
更新日期:2009-01-01 00:00:00
abstract:OBJECTIVES:To investigate the effects of body mass index (BMI) on early outcomes after revascularization using either on-pump or off-pump surgery. METHODS:Data for 3714 of 4314 patients who underwent surgical revascularization at our institution between 1999 and 2008 were analysed. Patients were divided into two group...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivu246
更新日期:2014-11-01 00:00:00
abstract::We report clinical outcomes following transcatheter aortic valve implantation (TAVI), using the CoreValve revalving system (18 Fr transfemoral or subclavian) or the Edwards Sapien valve (22 Fr transfemoral or 24 Fr transapical) as part of a Belgian prospective non-randomized multicentre registry. All 15 Belgian centre...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章,多中心研究
doi:10.1510/icvts.2010.253773
更新日期:2011-05-01 00:00:00
abstract::Anatomical variations of one or both thymic upper poles located behind the left innominate vein (LIV) are found in some patients; however, minimally invasive dissection of ectopic thymic tissues behind the LIV is technically complex. We describe a case of a dumbbell-shaped thymoma behind the LIV. The patient was succe...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivz165
更新日期:2019-11-01 00:00:00
abstract::In this case report, we report the application of frozen-and-thawed allogeneic platelet gel (PLT-gel) to treat a late driveline exit site infection in a 56-year old patient supported by a Heartware-HVAD left ventricular assist device. The treatment duration was 4 weeks and at the follow-up the skin around the exit sit...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivu195
更新日期:2014-09-01 00:00:00
abstract::The objective of this study was to identify and evaluate predictors of postoperative atrial fibrillation (POAF) in a large coronary artery bypass grafting (CABG) cohort. This was a single centre study of 7115 consecutive patients with preoperative sinus rhythm who underwent isolated CABG between January 1996 and Decem...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivr162
更新日期:2012-05-01 00:00:00
abstract:OBJECTIVES:The model for end-stage liver disease score (MELD = 3.8*LN[total bilirubin] + 9.6*LN[creatinine] + 11.2*[PT-INR] + 6.4) predicts mortality for tricuspid valve surgery. However, the MELD is problematic in patients undergoing warfarin therapy, as warfarin affects the international normalized ratio (INR). This ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivt014
更新日期:2013-05-01 00:00:00
abstract::False aortic aneurysm is an uncommon complication after oesophageal perforation and results in a high rate of mortality. A 63-year-old patient presented with acute chest pain. Biochemical tests (cardiac enzymes) and electrocardiogram were normal. A thoracic and abdominal CT scan was performed, and showed a foreign bod...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivs385
更新日期:2013-01-01 00:00:00
abstract:OBJECTIVES:Reliable suture line hemostasis should improve the outcome of aortic surgery. We examined the hemostatic effect and the tissue response of a novel elastomeric surgical sealant. METHODS:Using porcine internal carotid arteries, we performed 16 end-to-end anastomoses with four stitches of simple interrupted su...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2009.217620
更新日期:2010-02-01 00:00:00
abstract::A best evidence topic in cardiothoracic surgery was written according to a structured protocol. The question addressed was whether gabapentin, a commonly prescribed neuropathic analgesic and anticonvulsant, is safe and beneficial in patients with post-thoracotomy pain following thoracic surgery. Seventeen papers were ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章,评审
doi:10.1093/icvts/ivt301
更新日期:2013-10-01 00:00:00
abstract:OBJECTIVES:Cardiac surgical procedures carry a high risk of perioperative bleeding. Surgical sealants are often used to prevent suture line bleeding. PreveLeak™ is a surgical sealant composed of bovine serum albumin, a polyaldehyde cross-linker, and other components that forms a soft, flexible, water-tight, mechanical ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1093/icvts/ivv061
更新日期:2015-06-01 00:00:00