TITLE

Distal aortic surgery following arch replacement with a frozen elephant trunk

AUTHOR(S)
Pichlmaier, Maximilian A.; Teebken, Omke E.; Khaladj, Nawid; Weidemann, Jürgen; Galanski, Michael; Haverich, Axel
PUB. DATE
September 2008
SOURCE
European Journal of Cardio-Thoracic Surgery;Sep2008, Vol. 34 Issue 3, p600
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Abstract: Objective: The frozen elephant trunk technique allows the repair of concomitant aortic arch and proximal descending aortic pathology in a single stage by using a hybrid prosthesis consisting of a vascular graft with a distal stented end. There are patients, however, who will require a second distal operation despite this new technique due to progression of their aortic disease. It has been unclear whether the presence of the stented segment of the hybrid prosthesis results in unexpected technical difficulties or possibly advantages for further vascular reconstruction. Methods: Six patients out of our initial cohort of 39 treated with a hybrid prosthesis from 2001 through 2006 have since required an additional distal aortic reconstruction. Two received endoluminal stent grafts, four had extensive open replacements. Results: There was no 30-day mortality, one patient died on day 133 having been discharged from hospital of an unrelated MRSA septicaemia. Complete thrombosis of the proximally covered aneurysm or the false lumen had occurred in all patients so that the replacements reached from the end of the stented portion of the hybrid prosthesis to the desired distal level. The operative approach proved to be facilitated by the hybrid prosthesis in terms of the necessary exposure and operative trauma. Postoperative recovery was uneventful as related to the hybrid prosthesis with few pulmonary complications and at least comparable to contemporary results for second stage elephant trunk procedures. Conclusions: The distal operative replacement of the aorta following a frozen elephant operation is safe and technically feasible. Early experience suggests that there is an advantage as compared to the conventional elephant technique in terms of intraoperative handling and postoperative recovery.
ACCESSION #
33887346

 

Related Articles

  • Improvement in Short-Term Pancreas Transplant Outcome by Targeted Antimicrobial Therapy and Refined Donor Selection. SCHNICKEL, GABRIEL T.; BUSUTTIL, RONALD W.; LIPSHUTZ, GERALD S. // American Surgeon;Oct2011, Vol. 77 Issue 10, p1407 

    Graft thrombosis and infectious complications are the main early causes of pancreatic allograft loss in recipients of whole vascularized pancreas transplants, resulting in loss rates up to 10 per cent in the first post transplant week. In this study we sought to determine if initiation of a...

  • Healing Pattern of Collagen-Impregnated and Preclotted Vascular Grafts in Dogs. Noishiki, Yasuharu; Chvapil, Milos // Vascular Surgery;Nov/Dec1987, Vol. 21 Issue 6, p401 

    To eliminate the need for preclotting dacron fabric vascular grafts, collagen-impregnated microvel double velour vascular grafts were used. Twelve mongrel dogs were implanted in the thoracic aorta with collagen-impregnated prostheses, in the form of a loop, 28 to 38 cm long and 8 mm in diameter....

  • Inhibition of neointimal hyperplasia in vascular grafts by sustained perivascular delivery of paclitaxel. Masaki, Takahisa; Rathi, Ramesh; Zentner, Gaylen; Leypoldt, John K.; Mohammad, Syed F.; Burns, Gregory L.; Li, Li; Zhuplatov, Sergey; Chirananthavat, Thanit; Kim, Seung-Jung; Kern, Steven; Holman, John; Kim, Sung Wan; Cheung, Alfred K. // Kidney International;Nov2004, Vol. 66 Issue 5, p2061 

    Inhibition of neointimal hyperplasia in vascular grafts by sustained perivascular delivery of paclitaxel.Background.Neointimal hyperplasia occurs commonly at the anastomoses of arteriovenous grafts for chronic hemodialysis, causing stenosis and occlusion. Antiproliferative drugs may be effective...

  • Synthetic Arterial Graft Conduits. Jackson, David R. // Vascular Surgery;Nov/Dec1984, Vol. 18 Issue 6, p354 

    This paper is presented to describe the different types of synthetic arterial graft conduits. Included are: woven and knitted dacron, externally-supported-polypropylene dacron, endothelial-cell-lined dacron, pyrolytic-carbon-coated dacron and collagen-impregnated dacron. It also includes PTFE...

  • Effect of Endothelial Seeding and Graft Material on the Patency Rate of Venous Grafts. Vo, Nghia M.; Arbogast, Loretta; Friedlander, Ed; Stanton, Paul E. // Vascular Surgery;May/Jun1989, Vol. 23 Issue 3, p208 

    Because prosthetic grafting to the venous system has a low patency rate, endothelial cell seeding has been used to enhance this rate. The effects of heterologous (porcine) or homologous (canine omental) endothelial seeding and of graft material (dacron or polytetrafluoroethylene--PTFE) on the...

  • Measurement of the Lumen Diameter in Vessels and Grafts: A New in Situ Method. Al-Ali, Jassem; Inacio, Jorge; Strömberg, Lennart; Swedenborg, Jesper // Vascular Surgery;Sep1991, Vol. 25 Issue 7, p521 

    A method and an equipment for measuring lumen diameters of vessels and vascular grafts in situ in experimental and clinical situations have been designed and tested on animals. The measurements were performed with a balloon catheter inserted in the lumen of the vessel. Saline was injected into...

  • Two-Year Results with Heparin-Bonded PTFE (Gore PROPATEN) Grafts for Femoropopliteal and Femorodistal Bypasses Are Encouraging. Bosier, Marc; Deloose, Koen; Verbist, Jürgen; Schroë, Herman; Lauwers, Geert; Lansink, Wouter; Peeters, Patrick // Vascular;Nov2005 Supplement, Vol. 13, pS66 

    The article discusses a study that assesses the performance of a new heparin-bonded expanded polytetrafluoroethylene (ePTFE) vascular graft. The purpose of using the ePTFE vascular graft is stated. Methods used in the study are mentioned. Diagrams are presented that show the overall primary and...

  • Development of Small-Diameter Vascular Grafts. Xinwen Wang; Lin, Peter; Qizhi Yao; Changyi Chen // World Journal of Surgery;Apr2007, Vol. 31 Issue 4, p682 

    Cardiovascular disease, including coronary artery and peripheral vascular pathologies, is the leading cause of mortality in the United States and Western countries. There is a pressing need to develop small-diameter vascular vessels for bypass surgery and other vascular reconstructive...

  • The effect of gamma irradiation on physical–mechanical properties and cytotoxicity of polyurethane–polydimethylsiloxane microfibrillar vascular grafts. Briganti, Enrica; Kayal, Tamer Al; Kull, Silvia; Losi, Paola; Spiller, Dario; Tonlorenzi, Sara; Berti, Debora; Soldani, Gaiorgio // Journal of Materials Science: Materials in Medicine;Apr2010, Vol. 21 Issue 4, p1311 

    Poly(ether) urethane (PEtU)–polydimethylsiloxane (PDMS) based materials have been processed by a spray, phase-inversion technique to produce microfibrillar small-diameter vascular grafts; however the effect of sterilization upon these grafts is still unknown. This study investigated the...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics