Strategy for Porcelain Ascending Aorta in Cardiac Surgery

Osaka, Shunji; Tanaka, Masashi

doi:10.5761/atcs.ra.17-00181

Cited by 22 publications

(19 citation statements)

References 61 publications

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“…59 Nevertheless, EAS may lead to relocation of the aortic cannula to the distal arch, axillary-subclavian or femoral arteries or to the performance of off-pump surgery in selected patients. 60…”

Section: Arterial Cannulationmentioning

confidence: 99%

2019 EACTS/EACTA/EBCP guidelines on cardiopulmonary bypass in adult cardiac surgery

Kunst

Milojevic

Boer

et al. 2019

British Journal of Anaesthesia

127

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Special Article responsible in the event of any contradiction, discrepancy and/or ambiguity between the EACTS, EACTA and EBCP Guidelines and any other official recommendations or guidelines issued by the relevant public health authorities, in particular in relation to good use of healthcare or therapeutic strategies. Health professionals are encouraged to take the EACTS, EACTA and EBCP Guidelines fully into account when exercising their clinical judgement as well as in the determination and the implementation of preventive, diagnostic or therapeutic medical strategies; however, the EACTS, EACTA and EBCP Guidelines do not, in any way whatsoever, override the individual responsibility of health professionals to make appropriate and accurate decisions in consideration of each patient's health condition and, where appropriate and/or necessary, in consultation with that patient and the patient's care provider. Nor do the EACTS, EACTA and EBCP Guidelines exempt health professionals from giving full and careful consideration to the relevant official, updated recommendations or guidelines issued by the competent public health authorities, in order to manage each patient's case in light of the scientifically accepted data pursuant to their respective ethical and professional obligations. It is also the health professional's responsibility to verify the applicable rules and regulations relating to drugs and medical devices at the time of prescription. The article has been co-published with permission in the British Journal of Anaesthesia, the European Journal of Cardio-Thoracic Surgery and the Interactive CardioVascular and Thoracic Surgery.

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Section: Arterial Cannulationmentioning

confidence: 99%

2019 EACTS/EACTA/EBCP guidelines on cardiopulmonary bypass in adult cardiac surgery

Kunst

Milojevic

Boer

et al. 2019

British Journal of Anaesthesia

127

View full text Add to dashboard Cite

show abstract

“…Peripheral artery disease often coexists with significant carotid artery stenosis [12]. In severe form, such as porcelain aorta, it makes it impossible to even use minimally invasive surgical techniques [13]. In those cases, TA is the second choice for transcatheter heart valve delivery, but due to its invasive character, bleeding and other complications remain a relevant concern [14].…”

Section: Discussionmentioning

confidence: 99%

Twelve-month outcomes of transapical transcatheter aortic valve implantation in patients with severe aortic valve stenosis

Wiewiórka¹,

Sobczyński²,

Trębacz³

et al. 2021

pwki

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Introduction: Transapical access (TA) transcatheter aortic valve implantation (TAVI) (TA-TAVI) represents one of the possible routes in patients with severe aortic stenosis (AS) who are not suitable for transfemoral access.Aim: To assess early-and mid-term clinical outcomes after TA-TAVI. Material and methods: Patients with severe symptomatic AS undergoing TA-TAVI from November 2008 to December 2019 were enrolled. Clinical and procedural characteristics as well as clinical outcomes including all-cause mortality during 12-month follow-up were assessed.Results: Sixty-one consecutive patients underwent TA-TAVI for native AS. Patients were elderly with median age of 80.0 (76.0-84.0) years; 55.7% were males. Median baseline EuroSCORE I and STS scores were 18.2% (11.6-27.7) and 4.8% (3.3-8.2), respectively. The procedural success rate was 96.7%. In-hospital, 30-day and 12-month mortality rates were 9.8%; 18.0% and 24.6%, respectively. The main periprocedural and in-hospital complications were bleeding complications (14.8%). The following factors were associated with 12-month mortality: previous cerebrovascular event (CVE), glomerular filtration rate (GFR), aortic valve area (AVA), right ventricular systolic pressure (RVSP) and serum level of N-terminal prohormone of brain natriuretic peptide (NT-proBNP) (

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“…Atherosclerosis of the ascending aorta is a well-documented risk factor for stroke, clamp injury and embolic coronary events in patients undergoing cardiac surgery [ 4 ]. The incidence of ‘porcelain aorta’, or an aorta that is not amenable to bypass grafting due to severe atherosclerotic disease, ranges from 0.4% to 5.4% in patients undergoing CAB [ 5 , 6 ].…”

Section: Discussionmentioning

confidence: 99%

“…Another method for decreasing aortic manipulation is to cannulate the femoral, innominate or axillary artery for arterial perfusion rather than the ascending aorta [ 4 ]. Our patient’s significant atherosclerosis and history of aorto-bifemoral bypass grafting did not allow for an alternative arterial cannulation site.…”

Section: Discussionmentioning

confidence: 99%

Ascending aorta replacement with concomitant coronary and peripheral artery bypass grafting

Jackson

Williams

2021

Journal of Surgical Case Reports

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Atherosclerosis of the aorta is a well-known risk factor for peri-operative complications in patients undergoing cardiac surgery. Coronary and peripheral artery bypass procedures can be challenging when the native aorta is not amenable to bypass grafting due to severe calcification. We describe the successful management of a patient who underwent ascending aorta replacement with concomitant three-vessel coronary artery bypass, bilateral aorto-axillary bypass and left axillary-to-carotid bypass.

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Strategy for Porcelain Ascending Aorta in Cardiac Surgery

Cited by 22 publications

References 61 publications

2019 EACTS/EACTA/EBCP guidelines on cardiopulmonary bypass in adult cardiac surgery

2019 EACTS/EACTA/EBCP guidelines on cardiopulmonary bypass in adult cardiac surgery

Twelve-month outcomes of transapical transcatheter aortic valve implantation in patients with severe aortic valve stenosis

Ascending aorta replacement with concomitant coronary and peripheral artery bypass grafting

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