Mega-aorta in a young man

Cullhed, I; Lodin, Herman; Malers, E

doi:10.1016/0002-8703(60)90068-5

Cited by 5 publications

(3 citation statements)

References 9 publications

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“…MAS is rare and requires complex multistage repair of the ascending aorta, arch and TAAA. 2 , 3 , 4 Open repair of the ascending aorta and arch includes an frozen elephant trunk component (conventional or TEVAR). The residual extent II TAAA repair can be open or via a hybrid approach that includes abdominal aortic debranching, or total endovascular repair with branched endografts.…”

Section: Discussionmentioning

confidence: 99%

A multidisciplinary multistage complete mega aorta replacement and utilization of extracorporeal membrane oxygenation in thoracoabdominal aneurysm repair

Saldana-Ruiz¹,

Dhaliwal²,

Bodtke³

et al. 2023

Journal of Vascular Surgery Cases, Innovations and Techniques

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Section: Discussionmentioning

confidence: 99%

A multidisciplinary multistage complete mega aorta replacement and utilization of extracorporeal membrane oxygenation in thoracoabdominal aneurysm repair

Saldana-Ruiz¹,

Dhaliwal²,

Bodtke³

et al. 2023

Journal of Vascular Surgery Cases, Innovations and Techniques

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“…Mega-aorta syndrome is a relatively rare disease, with aneurysmal dilatation afflicting the ascending aorta, the aortic arch, the descending aorta and variable portions of the abdominal aorta. 1 This condition usually requires extensive surgical intervention, with poor prognosis if left untreated (39% 5-year survival in patients with untreated aneurysms). 2 Traditionally, open surgical treatment has been the standard treatment of this syndrome, although adjuvant endovascular therapy is increasingly being applied.…”

Section: Introductionmentioning

confidence: 99%

Interstage mortality in two‐stage elephant trunk surgery

et al. 2021

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Purpose Diffuse mega‐aorta is challenging. Prior studies have raised concerns regarding the safety of the open two‐stage elephant trunk (ET) approach for extensive thoracic aortic aneurysm (TAA), specifically in regard to interstage mortality. This study evaluates the safety of the two‐stage ET approach for management of extensive TAA. Methods Between 2003 and 2018, 152 patients underwent a Stage I ET procedure by a single surgeon (mean age 64.5 ± 14.8). Second stage ET procedure was planned in 60 patients (39.4%) and to‐date has been performed in 54 patients (90%). (in the remaining patients, the ET was prophylactic for the long‐term, with no plan for near‐term utilization). Results In‐hospital mortality after the Stage I procedure was 3.3% (5/152). In patients planned for Stage II, the median interstage interval was 5 weeks (range: 0–14). Of the remaining six patients with planned, but uncompleted Stage II procedures, five patients expired from various causes in the interval period (interstage mortality of 8.3%). There were no cases of aortic rupture in the interstage interval. Stage II was completed in 58 patients (including four unplanned) with a 30‐day mortality of 10.3% (6/58). Seven patients developed strokes after Stage II (12%), and three patients (5.1%) developed paraplegia. Conclusions The overall mortality, including Stage I, interstage interval, and Stage II was 18.6%. This substantial cumulative mortality for the open two‐staged ET approach for the treatment of extensive TAA appears commensurate with the severity of the widespread aortic disease in this patient group. Fear of interstage rupture should not preclude the aggressive Two‐Stage approach to the management of extensive TAA.

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“…The mega-aortic syndrome (MAS) is a relatively rare disease that causes the aneurismal transformation of the entire thoracic aorta and a variable extent of the abdominal aorta (1). As for thoraco-abdominal aortic aneurysms (TAAA), MAS is generally recognized to have a poor mid-term prognosis if untreated (2).…”

Section: Introductionmentioning

confidence: 99%

Hybrid three-stage repair of mega-aortic syndrome with the Lupiae technique: 10-year results

Esposito¹,

Cappabianca²,

Beghi³

et al. 2018

Ann. Cardiothorac. Surg.

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Three-stage hybrid repairs using the Lupiae technique can be safely performed in MAS type III patients. Short intervals between the stages should mitigate the risk of rupture during the waiting periods and may enhance patient compliance, but to achieve this, the burden and the complexity of the first stage must be carefully weighted. Our strategy improves the long-term survival of these patients compared to their natural history and is less invasive than an open repair. The adoption of Dacron landing zones appears to be associated with very low rates of reintervention due to endoleaks.

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Mega-aorta in a young man

Cited by 5 publications

References 9 publications

A multidisciplinary multistage complete mega aorta replacement and utilization of extracorporeal membrane oxygenation in thoracoabdominal aneurysm repair

A multidisciplinary multistage complete mega aorta replacement and utilization of extracorporeal membrane oxygenation in thoracoabdominal aneurysm repair

Interstage mortality in two‐stage elephant trunk surgery

Hybrid three-stage repair of mega-aortic syndrome with the Lupiae technique: 10-year results

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