Aortectomy for Thoracic Aneurysm

Alexander, John C.

doi:10.1001/jama.1944.02850530017005

Cited by 43 publications

(7 citation statements)

References 22 publications

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“…Most of the first attempts at excising aortic lesions involved cases of coarctation. In 1944, Alexander and Byron 18 successfully removed a descending aortic aneurysm associated with coarctation but did not try to restore aortic continuity. Other pioneers during this period included Crafoord and Nylin, 19 who performed an end-to-end anastomosis to restore aortic continuity after resecting a coarctation of the thoracic aorta; Shumacker, 20 who completely excised a small aneurysm along with the coarcted segment and then anastomosed the aortic ends primarily; Swan et al, 21 who used an aortic homograft to bridge the defect that remained after a similar excision; and Gross, 22 who used preserved homografts to treat aortic coarctation.…”

Section: Modern Direct Repairmentioning

confidence: 99%

Aortic Surgery

Cooley

2012

Semin Cardiothorac Vasc Anesth

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Aortic aneurysms have been recognized since at least the 2nd century. However, little progress in their treatment was made until the early 1800s, when surgical ligation of these lesions sometimes proved successful. Until the mid 20th century, the most widespread approach was indirect treatment to provide palliation and prevent rupture. Such treatment involved introducing foreign materials into the aneurysm to promote blood coagulation or wrapping the aneurysm with plastic film to stimulate periarterial fibrosis. In 1888, Rudolph Matas introduced endoaneurysmorrhaphy, in which the diseased portion of the aorta was removed and a tunnel was constructed through the remaining healthy portion. This approach was widely used until the 1950s, when the advent of synthetic grafts allowed modern, direct repair. Emphasis began to be placed on excising aortic aneurysms and restoring pulsatile distal flow. In the 1980s, however, most surgeons reverted to the endoaneurysmorrhaphy technique-this time relining rather than removing the diseased portion of the aorta-thus bringing the history of aortic aneurysm surgery full circle. Today, an increasing number of aortic repairs are being achieved with endovascular methods, which offer new hope to patients at high risk for traditional aortic surgery.

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Section: Modern Direct Repairmentioning

confidence: 99%

Aortic Surgery

Cooley

2012

Semin Cardiothorac Vasc Anesth

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“…In the same year Alexander and Byron (1944) reported the successful excision of a saccular aneurysm of the descending aorta. The aneurysm probably arose at the site of a coarctation: 7.5 cm.…”

Section: The Radical Approachmentioning

confidence: 99%

Excision of Saccular Aneurysm of the Thoracic Aorta: A Report of Five Cases

Bickford¹,

Glennie²

1960

Thorax

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The history of the surgery of aortic aneurysm is long, yet it is only in recent years that any progress has been made. Some landmarks may be noted. In 1864, Moore and Murchison described the method of intrasaccular wiring of an abdominal aortic aneurysm which was unsuccessful in this case because of infection introduced at the same time. This method was modified by Blakemore and King (1938), who used an electric current to promote clotting by heating the wire, and by Linton (1952), who stressed the need to insert a sufficient length of wire; Colt (1925) Ochsner (1944, 1952) excised and sutured the base of a small saccular aneurysm of the descending aorta which had been encountered unexpectedly during an operation for a supposed mediastinal tumour. This operation was a complete success, and was the basis for further advances.In the same year Alexander and Byron (1944) reported the successful excision of a saccular aneurysm of the descending aorta. The aneurysm probably arose at the site of a coarctation: 7.5 cm. of the aorta was removed with the aneurysm, and as the collateral circulation was well developed no attempt was made to restore the continuity of the aorta. The patient, a young man, survived for two

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“…COA takes up for 5-7% of all congenital heart disease (1), and 17% of COA are accompanied by aorta aneurysm (2). The surgical treatment for COA has been introduced since 1940s and Alexander et al (3) first reported aortectomy for COA. In 1948, Harris et al (4) performed excision and End-to-End suture of aorta for coarctation and aneurysm of the aorta.…”

Section: Introductionmentioning

confidence: 99%

Single-stage endovascular management of complicated thoracic aorta coarctation concurrent with aortic arch aneurysm using a novel fenestration device

et al. 2018

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To present a case with aorta coarctation complicated by aortic arch aneurysm which is clinical rare and entails a high risk of rupture. Here we reported a 46-year-old female patient diagnosed with aortic arch aneurysm combined with coarctation. The computed tomography angiography shows that an irregular aneurysm was located at the aortic arch site with its maximal diameter 86.55 mm and the right end of aneurysm was located 10 mm away from the ostium of left common carotid artery (LCCA). The aneurysm body invaded the left subclavian artery, and at the distal end of aneurysm a coarctation had been observed with a minimum diameter reaching 2.7 mm. We performed percutaneous balloon angioplasty, thoracic endovascular aortic repair to exclude the aneurysm, and simultaneously used a novel in situ fenestration device (Quick-Fenestrater) to revascularize the covered LCCA. This is first case of using a novel fenestration device single-stage endovascular treatment of complicated thoracic aorta coarctation concurrent with aortic arch aneurysm. Combined endovascular techniques can elevate the success rate of reconstruct complicated aorta aneurysm concurrent with coarctation and reduce complications. Under the guidance of QuickFenestrater, in situ fenestration could be performed with safety and a high success frequency.

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Aortectomy for Thoracic Aneurysm

Cited by 43 publications

References 22 publications

Aortic Surgery

Aortic Surgery

Excision of Saccular Aneurysm of the Thoracic Aorta: A Report of Five Cases

Single-stage endovascular management of complicated thoracic aorta coarctation concurrent with aortic arch aneurysm using a novel fenestration device

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