Postsurgical lobar torsion in an unusual setting

Hiramatsu, Masayuki; Shimoda, Kiyomi; Katsuragi, Naoya; Shiraishi, Yuji

doi:10.1016/j.jtcvs.2014.10.053

Cited by 2 publications

(2 citation statements)

References 4 publications

(7 reference statements)

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“…In all patients, the KE patterns were similar before and after intervention, but in patients 4 and 6 there was a change in the shape of the diastolic curve. Patient 4 had a surgical conversion of the extra cardiac conduit to a Y-graft from the hepatic veins to each pulmonary artery branch to better distribute the hepatic blood flow to the lungs [30, 31]. Before intervention, the curve had two diastolic peaks, but after surgery the early diastolic peak was higher and fused with the late diastolic peak.…”

Section: Resultsmentioning

confidence: 99%

Decreased Diastolic Ventricular Kinetic Energy in Young Patients with Fontan Circulation Demonstrated by Four-Dimensional Cardiac Magnetic Resonance Imaging

et al. 2017

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Four-dimensional (4D) flow magnetic resonance imaging (MRI) enables quantification of kinetic energy (KE) in intraventricular blood flow. This provides a novel way to understand the cardiovascular physiology of the Fontan circulation. In this study, we aimed to quantify the KE in functional single ventricles. 4D flow MRI was acquired in eleven patients with Fontan circulation (median age 12 years, range 3–29) and eight healthy volunteers (median age 26 years, range 23–36). Follow-up MRI after surgical or percutaneous intervention was performed in 3 patients. Intraventricular KE was calculated throughout the cardiac cycle and indexed to stroke volume (SV). The systolic/diastolic ratio of KE in Fontan patients was similar to the ratio of the controls’ left ventricle (LV) or right ventricle (RV) depending on the patients’ ventricular morphology (Cohen´s κ = 1.0). Peak systolic KE/SV did not differ in patients compared to the LV in controls (0.016 ± 0.006 mJ/ml vs 0.020 ± 0.004 mJ/ml, p = 0.09). Peak diastolic KE/SV in Fontan patients was lower than in the LV of the control group (0.028 ± 0.010 mJ/ml vs 0.057 ± 0.011 mJ/ml, p < 0.0001). The KE during diastole showed a plateau in patients with aortopulmonary collaterals. This is to our knowledge the first study that quantifies the intraventricular KE of Fontan patients. KE is dependent on the morphology of the ventricle, and diastolic KE indexed to SV in patients is decreased compared to controls. The lower KE in Fontan patients may be a result of impaired ventricular filling.Electronic supplementary materialThe online version of this article (doi:10.1007/s00246-016-1565-6) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Decreased Diastolic Ventricular Kinetic Energy in Young Patients with Fontan Circulation Demonstrated by Four-Dimensional Cardiac Magnetic Resonance Imaging

et al. 2017

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“…Hemiarch replacement (HAR) or ascending aorta replacement has been the most commonly performed surgical procedure for acute type A aortic dissection (AAAD) [ 1 – 3 ]. However, because this approach leaves the downstream aorta untouched, a patent false lumen promotes enlargement of the downstream aorta, increasing the risk of aortic rupture and reoperation [ 4 – 6 ]. A hybrid surgical approach, known as the total arch replacement with frozen elephant trunk (TAR-FET) technique, has recently received considerable interest.…”

Section: Introductionmentioning

confidence: 99%

Early and mid-term outcome of frozen elephant trunk using spinal cord protective perfusion strategy for acute type A aortic dissection

Hohri

Yamasaki

Matsuzaki

et al. 2020

Gen Thorac Cardiovasc Surg

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Objective This study aimed to evaluate the prevalence of spinal cord injury in total arch replacement with frozen elephant trunk for acute type A aortic dissection using our spinal cord protection technique. Methods Between January 2013 and December 2017, 33 patients underwent total arch replacement with frozen elephant trunk for acute type A aortic dissection (mean age 67.9 ± 13.3 years). Our spinal cord protection technique involved maintaining extracorporeal circulation through the left subclavian artery in all procedures, using aortic occlusion balloon during distal anastomosis, and inserting frozen elephant trunk above Th 8 with transesophageal echocardiographic guidance. Computed tomography was performed within 1–2 weeks, 12 months, and 36 months postoperatively. We compared the degree of thrombosis of the descending aorta between preoperation and early postoperative period by Fisher’s exact test. Moreover, we evaluated postoperative mortality and mobility (including spinal cord injury) at follow-up. Results The operative mortality within 30 days was 6.1%. Neither paraplegia nor paraparesis was noted. We observed significant thrombosis of the false lumen at the distal arch and aortic valve level of the descending aorta in postoperative early term period (p < 0.01). At mid-term follow-up (mean 33.9 months), survival probability and 3-year freedom from reoperation rates were 93.9 ± 4.1% and 95.0 ± 4.9%, respectively. Conclusions The frozen elephant trunk technique with our spinal protection strategy provides good postoperative outcomes. Our strategy can maintain spinal cord perfusion without complete ischemia time even during lower body ischemia time. Implementation of our spinal protection strategy will help prevent spinal cord injury and dilated downstream aorta.

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Postsurgical lobar torsion in an unusual setting

Cited by 2 publications

References 4 publications

Decreased Diastolic Ventricular Kinetic Energy in Young Patients with Fontan Circulation Demonstrated by Four-Dimensional Cardiac Magnetic Resonance Imaging

Decreased Diastolic Ventricular Kinetic Energy in Young Patients with Fontan Circulation Demonstrated by Four-Dimensional Cardiac Magnetic Resonance Imaging

Early and mid-term outcome of frozen elephant trunk using spinal cord protective perfusion strategy for acute type A aortic dissection

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