Late reoperations after acute aortic dissection repair: Single-center experience

Luciani, Nicola; Geest, Raphaël De; Lauria, Giuseppe; Farina, Piero; Luciani, Marco; Glieca, Franco; Massetti, Massimo

doi:10.1177/0218492315584523

Cited by 28 publications

(13 citation statements)

References 20 publications

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“…Reoperation after the initial operation for the aortic dissection is required mainly for enlargement of the distal aorta, progressive aortic valve regurgitation, pseudoaneurysm at the aortic graft anastomosis, and graft infection. 1,2 Risk factors for the reoperation after the initial repairs include the use of gelatinresorcinol-formaldehyde glue, nonreplacement of the aortic root, a patent false lumen, and an unresected intimal tear. 2 Infected thrombus in the false lumen requiring an operation has rarely been reported.…”

Section: Discussionmentioning

confidence: 99%

Operation for infected thrombus in the false lumen after ascending aortic repair for acute aortic dissection

Ohki

Aoyama

Takazawa

et al. 2016

Cardiovascular and Thoracic Open

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Background: Aortic dissection requires operation for some reasons. Methods: We experienced a case for infected thrombus caused by Escherichia coli in the false lumen of the descending aorta 3 years after ascending aortic replacement for acute aortic dissection. Results: A deep sternal wound infection caused by Staphylococcus species after the initial surgery had been successfully treated with both administration of antibiotics for 8 weeks and omental transfer. Replacement of the descending aorta resulted in successful outcomes. Conclusion: A thrombosed false lumen with a low blood flow may be vulnerable to bacteremia.

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Section: Discussionmentioning

confidence: 99%

Operation for infected thrombus in the false lumen after ascending aortic repair for acute aortic dissection

Ohki

Aoyama

Takazawa

et al. 2016

Cardiovascular and Thoracic Open

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“…Anastomotic leakage can result in heart failure, pseudoaneurysm formation, persistent enlargement of the dissecting false lumen, and hemolytic anemia. Surgical repair is still the most effective method, despite its high surgical risk, technical di culty, and postoperative morbidity and mortality [1]. Transcatheter closure can be used as an alternative treatment because of its low trauma and e cacy.…”

Section: Introductionmentioning

confidence: 99%

“…The incidence of anastomotic leakage after aortic dissection surgery is 5-8% [1][2]. Anastomotic leakage can result in heart failure, pseudoaneurysm formation, persistent enlargement of the dissecting false lumen, and hemolytic anemia.…”

Section: Introductionmentioning

confidence: 99%

Transcatheter Closure of Anastomotic Leakage of Aortic Root after Aortic Surgery for Type A Dissection: Two Case Reports

Lin

Zhang²,

Zhou³

et al. 2021

Preprint

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Background: Anastomotic leakage of postoperative aortic dissection is an intractable complication with different clinical manifestations. It is important to detect and manage anastomotic leakage in a timely manner. This case report describes 2 patients who were admitted to the hospital with different clinical manifestations and were diagnosed with aortic root anastomotic leakage through imaging. Both patients received transcatheter closure treatment with definite early effects.Case presentation: Two middle-aged women with aortic root anastomotic leakage who were admitted with different clinical manifestations and received transcatheter closure.Conclusion: Paying attention to the clinical manifestations and imaging diagnosis of patients after aortic dissection surgery is important for early detection of disease progression. Transcatheter closure can be used as an alternative treatment who cannot tolerate secondary thoracotomy due to its small trauma and exact efficacy in the near and medium terms, but further follow-up is needed for long-term clinical outcomes.

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“…Aortic anastomotic leak (AAL) is not uncommon with a reported incidence of 5-8% (1,2). The main risk factors of AAL include calcification or degeneration of the aortic wall, surgical procedure type, unqualified surgical technique, infection, and underlying Marfan syndrome (3,4).…”

Section: Introductionmentioning

confidence: 99%

Trans-catheter closure of aortic anastomosis leak after aortic replacement: classifications and techniques

Zhao

et al. 2020

J Thorac Dis

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Background: Aortic anastomotic leak (AAL) is knotty complication after aortic replacement. We aimed to evaluate the feasibility and efficacy of the techniques of trans-catheter AAL closure as well as to evaluate the impact of the new classification on the interventional closure. Methods: From October 2015 to November 2017, 20 consecutive high surgical risk patients (mean age 47±12 years, 13 males) were referred to our center for trans-catheter closure AALs. Due to the variation of leak, we therefore developed a new-classification based on transesophageal echocardiography (TEE) and computed tomography angiography (CTA) assessments: type I: aorta-to-right atrium fistula, n=6; type II: pseudoaneurysm induced by a suture line dehiscence, n=4; type III: patency of the false lumen in aortic dissection, n=10. Outcomes were analyzed by assessing TEE and CTA in different types of AALs.Results: Successful closure was accomplished in 17 subjects (85%). The severity of AAL reduced significantly in 15 patients (88%); two patients required a second procedure. At follow-up, we found that in type I, the right atrium systolic pressure reduced (from 25.3±4.1 to 7.0±1.2 mmHg) with the improved NYHA (3.5±0.6 vs. 1.0±0.0), the diameter of pseudoaneurysm significantly decreased (5.0±1.8 to 2.0±1.8 mm) in type II, and complete thrombosis was achieved in all type III patients. Conclusions: Trans-catheter closure of AAL displays satisfactory results even in those defined as high-risk patients, and it could be considered be a viable alternative approach. New classification is helpful in decisionmaking.

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Late reoperations after acute aortic dissection repair: Single-center experience

Cited by 28 publications

References 20 publications

Operation for infected thrombus in the false lumen after ascending aortic repair for acute aortic dissection

Operation for infected thrombus in the false lumen after ascending aortic repair for acute aortic dissection

Transcatheter Closure of Anastomotic Leakage of Aortic Root after Aortic Surgery for Type A Dissection: Two Case Reports

Trans-catheter closure of aortic anastomosis leak after aortic replacement: classifications and techniques

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