1/98. Simultaneous selective cerebral perfusion and systemic circulatory arrest through the right axillary artery for aortic surgery.The duration of safe circulatory arrest for replacement of the ascending aorta for a type A dissection, without additional cerebral perfusion measures, is not clearly defined. If prolonged periods (> 60 minutes) are anticipated, retrograde cerebral perfusion or selective antegrade carotid perfusion may be required. The latter requires separate cannulas with subsequent snaring of the cerebral vessels, which may be time consuming and cumbersome. We propose an alternative method whereby the right axillary artery is cannulated for cardiopulmonary bypass and, when the desired hypothermic temperature is achieved, the flows are turned down to 500 mL/min. The origin of the innominate artery is then occluded establishing selective antegrade right carotid artery perfusion. The distal ascending or aortic arch anastomosis is then performed while the remainder of the body is under selective systemic circulatory arrest. The proximal aortic anastomosis is performed after the graft is clamped proximally and flows return to appropriate perfusion levels.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/98. Anomalous coronary artery, aortic dissection, and acute myocardial infarction.The combination of acute coronary occlusion and aortic dissection because of involvement of one or other coronary vessels in the dissection flap is uncommon. Furthermore, the occurrence of an anomalous coronary artery and its involvement in acute myocardial infarction is even more uncommon. We describe a patient with acute myocardial infarction in whom an acute aortic dissection involved the ostium of an anomalous circumflex artery.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/98. Ruptured iliac aneurysms.Iliac aneurysms are uncommon as compared with aneurysms of the abdominal aorta. Rupture is the most serious complication of aneurysms of both vessels. Considerable attention has been focused on the management of ruptured abdomonal aortic aneurysms, but ruptured iliac aneurysms have received little notice. The problems in the management of ten ruptured iliac aneurysms, seen over the last five years, together with the rarity of other reports of this condition, have stimulated this review.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/98. Fatal fungal infection complicating aortic dissection following coronary artery bypass grafting.The case of a 52-year-old man with severe coronary atheroma/ischaemic heart disease, who underwent successful triple vessel coronary artery bypass grafting is described. One month later this was complicated by aortic dissection arising at the aortic cannulation site. An emergency resection and Dacron graft placement were performed. Five weeks later he represented with haemoptysis. Despite inconclusive investigations the patient went on to suffer a massive fatal haemoptysis. autopsy revealed candida infection of the graft with a secondary aortobronchial fistula.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/98. Suprarenal mycotic aneurysm exclusion using a stent with a partial autologous covering.PURPOSE: To report a combined endovascular and open technique to manage a suprarenal mycotic aortic aneurysm using a stent-graft partially covered with a section of autologous artery. methods AND RESULTS: A 50-year-old was hospitalized for staphylococcal septicemia and severe back pain. A previously diagnosed 3-cm abdominal aortic aneurysm was found to have expanded 2 cm in 3 weeks. aortography documented some periaortic thickening and 2 mycotic aneurysms, one posterior at the level of the superior mesenteric artery and the second at the aortic bifurcation. After intensive antibiotic therapy, an endovascular approach to exclude the suprarenal mycotic aneurysm was undertaken in tandem with surgical excision of the infrarenal aneurysm. The harvested right common iliac artery was used to partially cover a Palmaz stent, which was deployed under direct vision just above the renal artery ostia so that the covered portion of the stent excluded the aneurysm. A right axillofemoral bypass with a femorofemoral bypass completed the revascularization. Postoperatively, the patient developed renal failure, ischemic colitis necessitating a left hemicolectomy, and paraplegia. Although the patient is paralyzed, the aneurysm remains excluded with patent visceral vessels at 12 months following surgery. No organisms were grown from excised aortic tissue, and no signs of recurrent infection have been seen. CONCLUSIONS: Stent-graft repair may be able to lessen the invasiveness and reduce the morbidity associated with treatment of mycotic aortic aneurysms.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
6/98. Leiomyosarcomas of great vessels.Sarcomas of the great vessels are rare. Altogether 400 such cases have been described in the aorta, the pulmonary artery, and inferior vena cava. The clinical symptoms are generally related to embolic phenomena, aneurysm formation, and widespread metastases, especially to bones. With improved diagnostic modalities more cases are diagnosed and treated surgically. Resection of the tumor may prolong the patient s life. In this paper authors present two cases of such rare sarcomas. In our first case a tumor has developed in the thoracic aorta with symptoms of imminent aortic dissection. The tumorous nature of the lesion was revealed only histologically, since neither the operation, nor macroscopic picture gave any clue to its tumorous nature. The second case was a male patient with a huge retroperitoneal tumor arising from the inferior vena cava, which was clinically suspected to be a carcinomaarising in the adrenal gland.- - - - - - - - - - ranking = 5keywords = vessel (Clic here for more details about this article) |
7/98. Glue aortoplasty repair of aortic dissection after coronary angioplasty.Aortic dissection complicating percutaneous transluminal coronary angioplasty is rare. We report the case of a 45-year-old man who after right coronary artery angioplasty with stenting, dissected that vessel to involve the aorta to the bifurcation. Surgical repair with gelatin-Resorcinol-formaldehyde (GRF) glue as opposed to prosthetic graft replacement of the ascending aorta was successful. The use of GRF glue is effective in the surgical treatment of aortic dissection after coronary angioplasty.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
8/98. Delayed aortic rupture caused by an implanted anterior spinal device. Case report.The authors describe a case of delayed aortic rupture following the application of a smooth-rod Kaneda (SRK) instrument. This is a rare but critical complication of anterior spinal fusion in which instrumentation is placed, and the authors wish to draw attention to the possible complications arising from such surgery. A few cases of this complication were reported in 1986. No reports have been published since then; perhaps because techniques and implant design have improved. In this case, a 53-year-old man suffered a T-11 fracture and related paraparesis, and he underwent decompression and anterior fusion in which an iliac bone graft was placed using an SRK device. Although his neurological deficit resolved postoperatively, nonunion of the grafted bone caused progressive kyphosis of the thoracolumbar spine. Twenty months after surgery, he complained of progressive gastrointestinal symptoms, and a delayed aortic rupture with a pseudoaneurysm was found surrounding the implant. The aortic pseudoaneurysm was replaced with an artificial vessel, and the SRK device was removed immediately. Delayed aortic rupture associated with anterior instrumentation is extremely rare but can occur. Even if the design of the implants can be improved, the placement of implants near the aorta and subsequent changes in the close anatomical relationship between the aorta and the implant eventually may result in this life-threatening complication. Careful follow-up examination and early removal of the implant, if necessary, are important.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
9/98. Arteriomegaly.Arteriomegaly describes tortuous, ectatic, irregular vessels with prolonged blood flow. Seven cases of this entity are outlined with representative case reports. The increased incidence of aneurysms, thrombosis and embolization is noted in this and other series. The possibility that tortuous vessels may be confused with aneurysms on examination is also discussed. Due to the prolongation of blood flow, adequate arteriographic evaluation may be quite difficult.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |
10/98. Successful repair of ascending aortic aneurysm due to Takayasu's arteritis.A 2-year-old girl with Takayasu's arteritis and an ascending aortic aneurysm underwent successful graft replacement. Although aneurysms of the great vessels are rarely encountered, this disease should be considered in the differential diagnosis of ascending aortic aneurysms in children.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
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