Profound Aortopathy: A Rare Case of Massive Ascending and Descending Aortic Aneurysms, Type B Aortic Dissection, and Severe Aortic Valve Regurgitation.

Slides:

Advertisements

Similar presentations

Stent graft repair of descending aortic dissection in patients with Marfan syndrome: An effective alternative to open reoperation? Luca Botta, MD, Vincenzo.

Advertisements

Circ Cardiovasc Imaging

A new staged hybrid total arch repair procedure using a branched proximal elephant trunk technique with implantation of stent grafts to the ascending.

Visualization of vortex flow and shear stress in the aortic root during left ventricular assist device support Shohei Yoshida, MD, Satsuki Fukushima,

Enhanced computed tomography showing dissection-like features in an extracorporeal membrane oxygenation-supported patient with no cardiac output: Can.

An Option for Concomitant Management of Moderate Marfan Root Aneurysm at the Time of Mitral Valve Repair: A Role for Personalized External Aortic Root.

Acute aortic dissection with coronary ostium involvement and aortic valve regurgitation: Three-dimensional visualization with multislice computed tomography

Joyce Ji, MD, J. Trevor Posenau, MD, Kathryn J. Lindley, MD, Alan C

Reverse extra-anatomic aortic arch debranching procedure allowing thoracic endovascular aortic repair of a chronic ascending aortic aneurysm Ludovic.

Stephen P. Wiet, MD, William H. Pearce, MD, Walter J

Stent graft repair of descending aortic dissection in patients with Marfan syndrome: An effective alternative to open reoperation? Luca Botta, MD, Vincenzo.

Can Ramazan Öncel, İbrahim Başarıcı

Ourania Preventza, MD, James J. Livesay, MD, Denton A

Valve-sparing aortic root replacement in a patient with a rare connective tissue disorder: Arterial tortuosity syndrome Tomaso Bottio, MD, PhD, Gianluigi.

Leon M. Ptaszek, MD, PhD, Kibeom Kim, BA, Amy E. Spooner, MD, Thomas E

Acute type A aortic dissection mimicking a congenital supravalvular aortic membrane Ioannis Dimarakis, MRCS, Rashmi Yadav, FRCS, Sandeep Bahia, MBBS,

Virtual Vascular Endoscopy for Acute Aortic Dissection

Direct aortic transcatheter aortic valve implantation for pure aortic valve regurgitation after implantation of a left ventricular assist device René.

Zhang Jinzhou, MD, Wang Wen, MD, Zhu Hailong, MD, Wang Hongbing, MD

Valve-sparing procedure and Lecompte maneuver in patients with late aortic regurgitation and aortic aneurysm after the arterial switch operation Yih-Sharng.

Evolving experience with thoracic aortic stent graft repair

Aneurysmal circumflex coronary artery with fistulous connection to the coronary sinus Afksendiyos Kalangos, MD, PhD, DSc(Hon), Saziye Karaca, MD, Mustafa.

Markus Kondruweit, MD, Frank A

John S. Ikonomidis, MD, PhD, FRCS(C), Abe DeAnda, MD, D

Dehiscence of aortic valve commissure complicated by aortic regurgitation Toshihiro Fukui, MD, Tomoki Shimokawa, MD, Ken-u Fumimoto, MD, Susumu Mananbe,

Transcranial Doppler-guided selective antegrade cerebral perfusion during aortic debranching operation Ali Khoynezhad, MD, FACC, FACP, Rolando Celis,

Dilatation of the pulmonary autograft and native aorta after the Ross procedure: A comprehensive echocardiographic study Obaid Aljassim, MD, Gunnar Svensson,

Mark F. Conrad, MD, Robert S. Crawford, MD, Christopher J

Rupture of a Left Sinus of Valsalva Aneurysm With Coronary Compression: A Rare Cause of Ischemic Chest Pain Florim Cuculi, MD, Michele Rossi, MD, Kevin.

A new staged hybrid total arch repair procedure using a branched proximal elephant trunk technique with implantation of stent grafts to the ascending.

Tomaso Bottio, MD, PhD, Gino Gerosa, MD

Intraoperative occlusion of left coronary ostium after aortic repair detected by transesophageal echocardiography Kazumasa Orihashi, MD, Taiichi Takasaki,

Juxtaductal coarctation with type B dissection of the aorta: A new operative technique Anil Bhan, MCh, Saket Agarwal, MS, Rajesh Sharma, MCh, Pannangipalli.

Occlusion of an ascending aortic pseudoaneurysm with intraoperative echocardiography and a printed model Feng Li, MD, PhD, Ying Shan, MD, PhD, Yueli.

Heitham T. Hassoun, MD, R. Scott Mitchell, MD, Michel S

Giant vein graft pseudoaneurysm with pulmonary hemorrhage

Diseases of the thoracic aorta in women

Anomalous pulmonary artery from the aorta via a patent ductus arteriosus: repair in a premature infant Khaled J Salaymeh, MD, Thomas R Kimball, MD, Peter.

Greater asymmetric wall shear stress in Sievers' type 1/LR compared with 0/LAT bicuspid aortic valves after valve-sparing aortic root replacement Elizabeth.

Aortic replacement for bicuspid aortic valve aortopathy: When and why?

Endovascular management of an acute type B aortic dissection in a patient with fibromuscular dysplasia Jeanette H. Man, BS, Abby Rothstein, MD, Parag.

Reoperative innominate arterial, ascending aortic, and root replacement for extensive fungal endocarditis Bradley G. Leshnower, MD, Thomas G. Gleason,

Patrick O. Myers, MD, Yacine Aggoun, MD, Cecile Tissot, MD

A Novel Approach for Emergency Repair of Intraoperative Type A Aortic Dissection Through a Left Thoracotomy Yuji Kawano, MD, Minoru Tabata, MD, MPH,

Sixty Years After Tetralogy of Fallot Correction

Aortic valve repair by sinotubular junctional remodeling to eliminate aortic regurgitation in donor cardiac allograft David J. Kaczorowski, MD, Y. Joseph.

Aortic coarctation in the adult: Management of complications and coexisting arterial abnormalities with hypothermic cardiopulmonary bypass and circulatory.

A reliable rabbit model for hyperkinetic pulmonary hypertension

Direct replacement of mycotic thoracoabdominal aneurysms

Intraoperative vacuum-assisted closure following in situ graft replacement for an infected thoracic aortic graft Katsuhiro Hosoyama, MD, Shunsuke Kawamoto,

Aortic dimensions in patients with bicuspid and tricuspid aortic valves Veronica Jackson, MD, Christian Olsson, MD, PhD, Per Eriksson, PhD, Anders Franco-Cereceda,

Aortic dissection coexistent with two saccular aneurysms

Nicole M. Bhave et al. JIMG 2018;11:

Advantages of the continuous telescopic inversion technique do not overcome the disadvantages of the “turn-up” technique of aortic anastomosis Takeshi.

Operative repair of iatrogenic innominate artery to left innominate vein arteriovenous fistula after pacemaker laser lead extraction Peter C. Chen, MD,

Sunil S. Rayan, MD, J. David Vega, MD, Jack S

Yijie Hu, MD, PhD, Qianjin Zhong, MD, PhD

Murphy’s law in cardiac surgery

Feasibility of the Inoue single-branched stent-graft implantation for thoracic aortic aneurysm or dissection involving the left subclavian artery: Short-

Branch graft patency after open repair of thoracoabdominal aortic aneurysms Nicholas T. Kouchoukos, MD, Alexander Kulik, MD, MPH, Catherine Castner, RN,

Aortic fenestration for chronic aortic dissection type B complicated by transient ischemic attacks of spinal cord Maraya Altuwaijri, MD, Konstantinos.

Type B aortic dissection after endovascular abdominal aortic aneurysm repair causing endograft collapse and severe malperfusion Vikram Iyer, MD, Mark.

Composite aortoplasty for recurrent coarctation after neonatal repair in Williams syndrome Jeni L Marks, MD, Max B Mitchell, MD, David N Campbell, MD,

Hiroshi Urayama, Hiroshi Ohtake, Yoh Watanabe

Hybrid Repair of an Aortic Arch Aneurysm Using Double Parallel Grafts Perfused by Retrograde Flow in Endovascular Repair Combined With Left Subclavian.

Type B Aortic Dissection After the Use of Tadalafil

Bicuspid Aortic Valves and Dilatation of the Ascending Aorta: Reply

Cardiac magnetic resonance imaging is more diagnostic than 2-dimensional echocardiography in determining the presence of bicuspid aortic valve S. Chris.

Endograft repair for pseudoaneurysms and penetrating ulcers of the ascending aorta Gabriele Piffaretti, MD, PhD, Mario Galli, MD, Chiara Lomazzi, MD,

How I Teach Hemi-Arch Replacement

Presentation transcript:

Profound Aortopathy: A Rare Case of Massive Ascending and Descending Aortic Aneurysms, Type B Aortic Dissection, and Severe Aortic Valve Regurgitation in an Adult Patient With Uncorrected Congenital Aortic Coarctation Rashad J. Belin, MD, PhD, Jessie Aw Zoretic, MD, James Carr, MD, Mark D. Huffman, MD, MPH, FAHA, FACC, Hyde Russell, MD, James Thomas, MD, FACC, FASE CASE DOI: 10.1016/j.case.2017.06.004 Copyright © 2017 American Society of Echocardiography Terms and Conditions

Figure 1 Surface-rendered CT angiogram revealing massive ascending and descending TAAs and the aortic coarctation just proximal to the descending TAA. CASE DOI: (10.1016/j.case.2017.06.004) Copyright © 2017 American Society of Echocardiography Terms and Conditions

Figure 2 ECG-gated thoracic aorta CT angiogram, sagittal view of the aortic root, ascending aorta, and descending TAAs; also shown are the dissection flaps. CASE DOI: (10.1016/j.case.2017.06.004) Copyright © 2017 American Society of Echocardiography Terms and Conditions

Figure 3 MRA, sagittal view revealing ascending and descending TAAs as well as dissection flaps within descending TAA. CASE DOI: (10.1016/j.case.2017.06.004) Copyright © 2017 American Society of Echocardiography Terms and Conditions

Figure 4 ECG-gated thoracic aorta CT angiogram, axial view of the ascending and descending TAA. Also shown is compression of the right pulmonary artery by the ascending TAA. CASE DOI: (10.1016/j.case.2017.06.004) Copyright © 2017 American Society of Echocardiography Terms and Conditions

Figure 5 ECG-gated thoracic aorta CT angiogram, coronal view illustrating aortic coarctation just proximal to the descending TAA. CASE DOI: (10.1016/j.case.2017.06.004) Copyright © 2017 American Society of Echocardiography Terms and Conditions

Figure 6 ECG-gated thoracic aorta CT angiogram, axial view illustrating descending TAA compressing the left pulmonary artery. CASE DOI: (10.1016/j.case.2017.06.004) Copyright © 2017 American Society of Echocardiography Terms and Conditions

Figure 7 ECG-gated thoracic aorta CT angiogram, sagittal view illustrating descending TAA compressing the left pulmonary artery. CASE DOI: (10.1016/j.case.2017.06.004) Copyright © 2017 American Society of Echocardiography Terms and Conditions

Figure 8 Continuous-wave Doppler revealing aortic valve regurgitant jet deceleration and very short pressure half-time consistent with severe aortic valve regurgitation. AR, Aortic regurgitation; Dec, deceleration; maxPG, maximum pressure gradient; PHT, pressure half time; Vmax, maximum velocity. CASE DOI: (10.1016/j.case.2017.06.004) Copyright © 2017 American Society of Echocardiography Terms and Conditions

Figure 9 Pulse-wave Doppler at suprasternal notch view showing holodiastolic flow reversal consistent with severe aortic valve regurgitation. CASE DOI: (10.1016/j.case.2017.06.004) Copyright © 2017 American Society of Echocardiography Terms and Conditions

Figure 10 Cardiac MRI/MRA 4D flow analysis prior to surgery. CASE DOI: (10.1016/j.case.2017.06.004) Copyright © 2017 American Society of Echocardiography Terms and Conditions

Figure 11 TEE revealing type B aortic dissection flap at 25 cm distal to the incisors. CASE DOI: (10.1016/j.case.2017.06.004) Copyright © 2017 American Society of Echocardiography Terms and Conditions

Figure 12 TEE, short-axis view of the aortic valve with color flow after surgery. CASE DOI: (10.1016/j.case.2017.06.004) Copyright © 2017 American Society of Echocardiography Terms and Conditions

Figure 13 TEE, long-axis view of the aortic valve and aortic graft with color flow after surgery. CASE DOI: (10.1016/j.case.2017.06.004) Copyright © 2017 American Society of Echocardiography Terms and Conditions

Figure 14 Cardiac MRI/MRA 4D flow analysis after the first surgery. CASE DOI: (10.1016/j.case.2017.06.004) Copyright © 2017 American Society of Echocardiography Terms and Conditions

Figure 15 Intraoperative photograph of massive descending thoracic aneurysm at the time of surgery. CASE DOI: (10.1016/j.case.2017.06.004) Copyright © 2017 American Society of Echocardiography Terms and Conditions

Figure 16 Cardiac MRI/MRA 4D flow analysis after the second surgery. CASE DOI: (10.1016/j.case.2017.06.004) Copyright © 2017 American Society of Echocardiography Terms and Conditions

CASE DOI: (10.1016/j.case.2017.06.004) Copyright © 2017 American Society of Echocardiography Terms and Conditions