European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Jun 2019
Randomized Controlled TrialCan human myocardium be remotely preconditioned? The results of a randomized controlled trial.
No experimental study has shown that the myocardium of a remotely preconditioned patient is more resistant to a standardized ischaemic/hypoxic insult. ⋯ NCT01994707.
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Eur J Cardiothorac Surg · Jun 2019
Case ReportsIncorrect frozen elephant trunk deployment into the false lumen of a patient with complicated type B acute dissection.
Total arch replacement with frozen elephant trunk (FET) is used for type B acute aortic dissection with insufficient proximal landing zone. Herein, we report incorrect deployment of FET into the false lumen. A 45-year-old man underwent femorofemoral bypass for complicated type B acute aortic dissection. ⋯ Progressive lactic acidosis occurred on postoperative day 2, and computed tomography showed incorrect deployment of the FET into the false lumen, causing true lumen stenosis and intestinal ischaemia. Despite extensive enterectomy and abdominal aorta fenestration for the improvement of true lumen perfusion, the patient died of multiorgan failure on postoperative day 7. Care is required to avoid incorrect deployment of FET when there is a large entry in the proximal descending aorta.
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Eur J Cardiothorac Surg · Jun 2019
Assessment of geometrical remodelling of the aortic arch after hybrid treatment.
The aim of this study was to measure the morphological remodelling of the ascending aorta, aortic arch and thoracic aorta after aortic arch hybrid treatment including debranching and stent graft implantation. ⋯ Hybrid arch repair was associated with a significant elongation of the vessel and a significant increase in the curvature on the ascending aorta and the descending aorta and on the endograft proximal and the distal landing zones.
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Eur J Cardiothorac Surg · Jun 2019
Observational StudySilent cerebral infarction after thoracic endovascular aortic repair: a magnetic resonance imaging study.
Silent cerebral infarction is the most common brain injury incidentally detected on imaging and can be associated with increased risks of future stroke and cognitive decline. However, the incidence and risk factors of silent cerebral infarction after thoracic endovascular aortic repair (TEVAR) for aortic arch pathologies remain unclear. This study aimed to examine silent cerebral infarction following TEVAR using diffusion-weighted (DW) magnetic resonance imaging (MRI). ⋯ The incidence of silent cerebral infarction following TEVAR with supra-aortic debranching for aortic arch pathologies was 21%, and the severity of atheromatous change in the aortic arch, especially in the proximal landing zone, was positively associated with the development of silent cerebral infarction.