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Soler RJ, Fabre D, Watkins AC, Fadel E, Mercier O, Haulon S. Hybrid treatment of a giant thoracic aneurysm in a 38 year-old woman. J Vasc Surg 2018; 69:1591-1595. [PMID: 30583900 DOI: 10.1016/j.jvs.2018.09.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 09/28/2018] [Indexed: 10/27/2022]
Abstract
A 38-year-old woman, with no comorbidities, presented to an outside institution with a 10-cm aortic arch and descending thoracic aortic aneurysm. After an aborted attempt at hybrid repair, she underwent successful, staged repair with zone 1 thoracic endovascular aortic repair and open aneurysmal sac revision. The patient made an uneventful recovery with computed tomographic evidence of complete aneurysmal exclusion. This case demonstrates many of the techniques and issues in the evolving field of aortic arch repair.
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Affiliation(s)
- Raphael J Soler
- Aortic Center, Hôpital Marie Lannelongue, Université Paris Sud, Le Plessis-Robinson, France; Department of Vascular and Endovascular Surgery, Hôpital La Timone, Aix-Marseille Université, Marseille, France
| | - Dominique Fabre
- Aortic Center, Hôpital Marie Lannelongue, Université Paris Sud, Le Plessis-Robinson, France
| | - Amelia Claire Watkins
- Aortic Center, Hôpital Marie Lannelongue, Université Paris Sud, Le Plessis-Robinson, France; Department of Cardiothoracic Surgery, Stanford University, Stanford, Calif
| | - Elie Fadel
- Aortic Center, Hôpital Marie Lannelongue, Université Paris Sud, Le Plessis-Robinson, France
| | - Olaf Mercier
- Aortic Center, Hôpital Marie Lannelongue, Université Paris Sud, Le Plessis-Robinson, France
| | - Stéphan Haulon
- Aortic Center, Hôpital Marie Lannelongue, Université Paris Sud, Le Plessis-Robinson, France.
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Hattori S, Noguchi K, Gunji Y, Nagatsuka M, Yamabe T, Ogino H, Katayama I. Descending aortic banding for re-rupture of retrograde aortic dissection after emergency thoracic endovascular aortic repair. Gen Thorac Cardiovasc Surg 2018; 68:70-73. [PMID: 30244366 DOI: 10.1007/s11748-018-1016-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 09/15/2018] [Indexed: 11/30/2022]
Abstract
Conversion to open repair after thoracic endovascular aortic repair (TEVAR) for acute type B aortic dissection is rare, but inevitable. We present a case of an 86-year-old man with ruptured type B aortic dissection after TEVAR. He received a successful stent-graft implantation of the descending aorta without any type of endoleak. After the patient was transferred to the intensive care unit, he went into a shock state. Contrast-enhanced CT revealed a re-rupture of acute retrograde type B aortic dissection. The false lumen was patent and perforated to the left thorax. Left thoracotomy and descending aortic banding was performed. Descending aorta was encircled with a woven Dacron graft at the distal part of the rupture site to compress the patent false lumen. The bleeding was stopped, and the follow-up CT showed false lumen thrombosis. Descending aortic banding is one of the quick and effective open conversion techniques.
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Affiliation(s)
- Shigeru Hattori
- Department of Cardiovascular Surgery, Aortic Center, Shonan Kamakura General Hospital, 1370-1 Okamoto, Kamakura, Kanagawa, 247-8533, Japan.
| | - Kenichiro Noguchi
- Department of Cardiovascular Surgery, Aortic Center, Shonan Kamakura General Hospital, 1370-1 Okamoto, Kamakura, Kanagawa, 247-8533, Japan
| | - Yusuke Gunji
- Department of Cardiovascular Surgery, Aortic Center, Shonan Kamakura General Hospital, 1370-1 Okamoto, Kamakura, Kanagawa, 247-8533, Japan
| | - Motoki Nagatsuka
- Department of Cardiovascular Surgery, Aortic Center, Shonan Kamakura General Hospital, 1370-1 Okamoto, Kamakura, Kanagawa, 247-8533, Japan
| | - Tsuyoshi Yamabe
- Department of Cardiovascular Surgery, Aortic Center, Shonan Kamakura General Hospital, 1370-1 Okamoto, Kamakura, Kanagawa, 247-8533, Japan
| | - Hidemitsu Ogino
- Department of Cardiovascular Surgery, Aortic Center, Shonan Kamakura General Hospital, 1370-1 Okamoto, Kamakura, Kanagawa, 247-8533, Japan
| | - Ikuo Katayama
- Department of Cardiovascular Surgery, Aortic Center, Shonan Kamakura General Hospital, 1370-1 Okamoto, Kamakura, Kanagawa, 247-8533, Japan
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Khalil KH, Palma JH, Simonato M, Dias RR, Jatene F. When Aortic Stenting Alone Does Not Solve It: Mass Effect of Thoracic Aneurysms. Ann Vasc Surg 2016; 39:284.e11-284.e13. [PMID: 27521829 DOI: 10.1016/j.avsg.2016.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2016] [Revised: 03/15/2016] [Accepted: 04/18/2016] [Indexed: 10/21/2022]
Abstract
Thoracic aneurysms can potentially cause substantial compression of adjacent structures, creating substantial symptoms. We present a case of a 56-year-old woman with fatigue and dyspnea for 6 months. We discuss her initial endovascular treatment, which was insufficient to improve symptoms, and further surgical intervention was needed to solve the issue.
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Affiliation(s)
- Kalil Hussein Khalil
- Instituto do Coração, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Jose Honorio Palma
- Instituto do Coração, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
| | | | - Ricardo Ribeiro Dias
- Instituto do Coração, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Fabio Jatene
- Instituto do Coração, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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Open aortic surgery after thoracic endovascular aortic repair. Gen Thorac Cardiovasc Surg 2016; 64:441-9. [DOI: 10.1007/s11748-016-0658-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 05/13/2016] [Indexed: 01/10/2023]
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