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At least 19 recordsLinked to original sources
PubMed1997

Ascending aorta to supraceliac abdominal aorta bypass for coarctation of the aorta in an adult.

We present herein a case of ascending aorta to supraceliac abdominal aorta bypass for coarctation of the aorta in a 46-year-old woman with a history of hypertension. Because of severe calcification of the coarctation segment, we performed an ascending aorta to supraceliac abdominal aorta bypass instead of a conventional resection and anastomosis of the coarctation segment. Following surgery, the patient's blood pressure normalized, and she was discharged on the 14th postoperative day without any complications. An ascending aorta to supraceliac abdominal aorta bypass for coarctation of the aorta in adults is thus considered to be safe and easy to perform.

Aorta↗
PubMed1997

Extensive replacement of the aorta from the ascending aorta to the supraceliac abdominal aorta during a one-stage operation.

A successful replacement of the aorta from the ascending aorta to the supraceliac abdominal aorta in one operation is herein reported. The patient was 66-year-old woman who had DeBakey type I chronic aortic dissection with a pre-disseminated intravascular coagulation (DIC) condition. The image diagnosis revealed a markedly enlarged false lumen with a narrow true lumen in the ascending aorta extending to the diaphragm level while below the diaphragm level, the aortic dilatation was mild. The operation was performed through both a thoracoabdominal incision and a median sternotomy to expose the whole thoracic aorta, and the aorta was replaced from the ascending aorta to the supraceliac abdominal aorta. Selective cerebral perfusion was used for cerebral protection and this was a useful adjunct since no time limitations were thus required during repair of the aortic arch. Although the patient developed several complications postoperatively, she eventually recovered and was discharged from the hospital without any neurological disorders.

Aged↗
PubMed2002

[Remodelling the aortic root by resection of the ascending aorta and non-coronary sinus in annular dilatation of the aorta and acute dissection of the descending aorta. 29 observations].

The first conservative surgical procedures of the native aortic valve in annular dilatation were performed by Yacoub and David [1, 2]. These so-called remodelling and inclusion procedures provided hope for a normal life without long-term anticoagulant therapy for patients with Marfan's syndrome, with protection from the complication of an acute dissection of the ascending aorta. The authors reported their experience in the Archives des Maladies du Coeur et des Vaisseaux in 1999, with excellent results [3]. However, a certain number of cases are encountered in which the Yacoub and David procedures cannot be performed because of the presence of a pseudo-bicuspid valve, isolated asymmetrical dilatation of the non-coronary sinus or acute dissection of the aorta without dilatation of the aortic root. In these forms, the authors have developed a technique of remodelling the aortic root with conservation of the native valve by resecting the ascending aorta and non-coronary sinus, rather than carrying out a Bentall procedure. Twenty-nine cases of this type have been treated in this way for three different indications: aneurysm of the ascending aorta with bicuspid aortic valve, aneurysm of the ascending aorta with aortic insufficiency and extension to the posterior sinus, and type A acute dissection of the aorta.

Adult↗
PubMed1985

Adequacy of ascending aorta-descending aorta shunt during cross-clamping of the thoracic aorta for prevention of spinal cord injury.

The effectiveness of various sized shunts placed between the ascending and the descending aorta to prevent paraplegia in dogs with the thoracic aorta cross-clamped for 1 hour was tested. Three tapered shunts sizes were used with tip dimensions of 3.8, 5.2, and 6.3 mm inner diameter, with cross-sectional areas of 11.34, 21.23, and 33.18 mm2, respectively, and with an equal midportion diameter of 10 mm (3/8 inch). These shunts carried 40%, 60%, and 72% respectively, of baseline descending aortic flow during the cross-clamping period. Flow distribution was measured with radioactive microspheres in the spinal cord (gray and white matter) and kidneys. All dogs without shunts (Group I) developed paraplegia, severe proximal circulatory embarrassment, and severe ischemia of the spinal cord (mainly gray matter) that was followed by marked hyperemia persisting up to 24 hours following the experiment. Mortality was 33%. Only animals treated with large shunts (Groups III and IV) avoided paraplegia and postischemic injury. An effective shunt was characterized as carrying 60% or more of baseline descending aortic flow, having a cross-sectional area at its tip equal to or larger than 29% of the descending aorta, and equaling at least 54% of its diameter. Porportionately, the size of the tridodecylmethylamonium-heparin shunts being used in human beings (even the largest 9 mm inner diameter) is significantly inadequate to maintain distal flows and pressures for the prevention of spinal cord injury. Four clinical options are discussed.

Adrenal Glands↗
PubMed1989

[A new model of complete global brain ischemia produced by clamping the ascending aorta with aorta to right-atrium and aorta to femoral vein bypass formation in dogs].

The author made a new model of complete global brain ischemia (CGBI) in dogs, by clamping ascending aorta with aorta to right atrium and aorta to femoral vein bypass formation. In this study, dogs were kept under CGBI for 18 minutes with this method, and their hemodynamic changes and neurologic outcome after ischemia were evaluated. In all dogs, cardiovascular functions were well preserved without any hemodynamic support after CGBI. Although neurologic functions were severely damaged and all dogs were in vegetative state, all of them survived for at least 4 days after ischemia. With this method, it is possible to keep animals under CGBI long enough to cause severe neurologic damages without serious extracerebral complications. I conclude that, to evaluate the efficacy of treatments with neurologic outcome, this is the most appropriate model of complete global brain ischemia in dogs.

Animals↗
PubMed1979

Ascending aorta-supraceliac abdominal aorta bypass: successful removal of an infected graft in the descending thoracic aorta.

An infected graft and a mycotic pseudoaneurysm were successfully resected by employing an ascending aortasupraceliac abdominal aorta bypass graft in a 19-year-old man. He had formerly undergone graft replacement surgery for traumatic aneurysm of the descending thoracic aorta, with the aid of a temporary external bypass graft. After this first operation, the patient had suffered from septicemia due to Psudomonas aeruginosa, which resulted in formation of mycotic pseudoaneurysms at the distal anastomotic site of the prosthetic graft and at both stumps of the formerly employed external bypass graft.

Adult↗
PubMedDate not supplied

Surgical treatment of acute dissection of the aorta superimposed on pre-existing aneurysm of the ascending aorta. Total replacement of the ascending aorta with reimplantation of the coronary arteries. A report on five cases.

Five cases of acute dissection of the ascending aorta superimposed on a pre-existing aneurysm, including two with propagation of the dissection into the coronary arteries, were treated by total replacement of the ascending aorta utilizing a valve containing tube graft and reimplantation of the coronary arteries. Diverse techniques such as the use of an intermediate tube for reconnecting the coronary arteries, correction of the coronary dissection by reapproximation of the two layers or with bypass grafting, support of the distal aortic suture line with Teflon felt and fistulization of the periprosthetic space to the right atrium, greatly simplified the treatment of these lesions, permitting survival of four out of five patients, who are in excellent health one, four, and seven years respectively after surgery.

Adult↗
PubMed1988

Late results of ascending aorta-descending aorta bypass grafts for recurrent coarctation of aorta.

Ten patients between the ages of 10 and 17 years underwent ascending aorta-descending aorta bypass grafts for recurrent coarctation at the Oregon Health Sciences University from 1975 to 1984. The combined approach through a left thoracotomy and median sternotomy was used in all the patients. This operation was used when the segment of recoarctation was long, dense adhesions were present, collaterals were inadequate, or when a cardiac operation was necessary for an associated lesion. All the patients survived the operation, and the long-term results to date have been satisfactory.

Adolescent↗
PubMedDate not supplied

[Arterioventricular disorders in the transposition of the anterior aorta. 2 cases: with the aorta on the right and with the aorta on the left].

We show two cases of transposition of the great arteries with arterioventricular discordance and aorta at both sides (right and left). They were diagnosed by angiocardiography and verified afterwards in the anatomical analysis of the specimens. We discuss the necessary steps taken for the diagnosis in which we followed De la Cruz's rules. We emphasize that this anatomical group should be distinguished from the group of arterioventricular concordance. Both groups have the same connection. Against the opinions of other authors, we think that this connection signifies only the same physiology in both groups, but not the same anatomy. This anatomy would be originated by a different embriological fact (different spatial location of the truncal and conal ridges).

Angiocardiography↗
PubMed1977

Dynamic mechanical properties of atherosclerotic aorta. A correlation between the cholesterol ester content and the viscoelastic properties of atherosclerotic aorta.

The effect of cholesterol and cholesterol ester content of aortas on the dynamic mechanical properties of these tissues was studied in rabbits during development of atherosclerosis. The disease was induced by feeding a 1.5% cholesterol diet for six weeks. At two week intervals, an equal number of control and experimental animals were sacrificed and their aortas were collected. After grading the aortas for lesions, one-half of each aorta was used for the determination of cholesterol and cholesterol ester content while the other half was used for the determination of viscoelastic properties. The viscoelastic properties were determined in both the longitudinal and the tangentail direction of the aortas. The results showed that cholesterol feeding had no effect on the longitudinal dynamic Young's modulus of the aortas. On the other hand, the tangential dynamic Young's modulus of the aortas was found to be very much influenced by the cholesterol diet. After the first two weeks of cholesterol feeding, the tangential dynamic Young's modulus was found to be increased markedly with time. At the end of the 6-week period, the average value of the tangential Young's moduli was 4.0 X 10(6) dynes/cm2 in the cholesterol-fed group while in the control group it remained 2.7 X 10(6) dynes/cm2. This increase in the tangential Young's moduli showed a remarkable correlation with the increase in the cholesterol ester content of the aortas. The cholesterol est content of aortas, like the tangential Young's modulus, remained unaffected during the first two weeks of cholesterol feeding. But after the first two weeks, a rapid increase in the cholesterol ester content was observed which coincided with an almost identical increase in the tangential Young's modulus values. It is concluded that during the early stages of atherosclerosis, the cholesterol ester content of aortas exerts a significant influence on the tangential dynamic Young's modulus of aortas. The serum levels of cholesterol and cholesterol ester, although increased steadily with the cholesterol feeding, did not show any direct correlation with the viscoelastic properties of the aortas.

Animals↗
PubMed1994

Dissection of the descending thoracic aorta extending into the ascending aorta. A therapeutic challenge.

Proper management of dissections of the descending thoracic aorta with intimal disruption close to the left subclavian artery and retrograde extension of the dissection into the aortic arch or the ascending aorta is controversial, because the standard approach for ascending aortic aneurysms is surgical repair, which is difficult to achieve through a median sternotomy if the predominant aortic lesion is located in its descending part. Sixteen patients with descending thoracic aortic dissection, intimal disruption close to the subclavian artery, and extension of the dissection into the aortic arch or the ascending aorta are described here: Eleven patients underwent surgical repair including 9 emergency (82%) and 2 elective (18%) procedures. Retrograde aortic dissection included the aortic arch in 11 of 11 patients (100%) and the ascending aorta in 7 of 11 (63%). Pericardial effusion was present in 1 of 11 patients (9%) and mild aortic regurgitation was found in 1 of 11 (9%). Repair of the ascending aorta and arch with transaortic closure of the entrance tear in the descending thoracic aorta was performed in 4 of 11 patients (36%) via a median sternotomy. In 6 of 11 patients (55%) a lateral thoracotomy was used for repair of the descending thoracic aorta and closure of the entrance tear. Hospital mortality occurred in 1 of 11 patients (9%) and there was 1 late death. Paraplegia occurred in 1 of 11 patients (9%). Five patients with descending thoracic aortic dissection, intimal disruption close to the subclavian artery, and extension into the ascending aorta but without ascending aortic aneurysm (diameter 4.2 +/- 0.2 cm), pericardial effusion, or aortic incompetence were treated medically without early mortality. These results are compared with those achieved in 120 patients operated on during the same period for type A (89/120) and type B (31/120) aortic dissections. Considering the technical difficulties of simultaneous repair of dissections of the ascending and the descending thoracic aorta, we recommend that descending thoracic aortic dissection extending into the arch or the ascending aorta be managed in accordance with the site of the predominant lesion. Replacement of the arch with a varying portion of ascending aorta via a median sternotomy is recommended in patients with enlarged aortic diameter, pericardial effusion, and/or aortic insufficiency. Predominantly distal dissections with dilated descending thoracic aorta and/or distal complications are best approached via a lateral thoracotomy.

Adolescent↗
PubMed2000

Posterior pericardial approach for ascending aorta-to-descending aorta bypass through a median sternotomy.

BACKGROUND: Bypass grafting for repeat operation or complex forms of descending aortic disease is an alternative approach to decrease potential complications of anatomic repair. METHODS: Between December 1985 and February 1998, 17 patients (13 men, 4 women; mean age, 47.6 +/- 18.5 years) underwent ascending aorta-to-descending aorta bypass through a median sternotomy and posterior pericardial approach. Indications for operation were coarctation or recoarctation of aorta in 8 patients, Takayasu's aortitis in 2, prosthetic aortic valve stenosis associated with coarctation of aorta, complex descending aortic arch aneurysm, reoperation for chronic descending aortic dissection, long-segment stenosis of descending aorta, acquired coarctation after repair of traumatic transection of descending aorta, severe aortic atherosclerosis, and false aneurysm of descending aorta after repair of coarctation in 1 patient each. Concomitant procedures were performed in 12 patients. RESULTS: No early or late mortality has occurred. Follow-up was 100% complete and extended to 12 years (mean, 2.7 +/- 3.3 years). No late graft-related complications have occurred; 1 patient had successful repair of perivalvular leak after mitral valve replacement, and 1 patient had replacement of lower descending and abdominal aorta. CONCLUSIONS: Exposure of the descending aorta through the posterior pericardium for ascending aorta-descending aorta bypass is a safe alternative and particularly useful when simultaneous intracardiac repair is necessary.

Adolescent↗
PubMed1984

Comparative effects of verapamil and sodium nitroprusside on contraction and 45Ca uptake in the smooth muscle of rabbit aorta, rat aorta and guinea-pig taenia coli.

The effects of verapamil and sodium nitroprusside on muscle tension and 45Ca uptake activated in different ways were compared in rabbit aorta, rat aorta and guinea-pig taenia coli. In rabbit aorta, K-induced contraction was specifically inhibited by verapamil and noradrenaline-induced contraction by sodium nitroprusside. In rat aorta, both K-induced and noradrenaline-induced contractions were inhibited by verapamil or by sodium nitroprusside also. In taenia, both K- and histamine-induced sustained contractions were inhibited by verapamil but not by sodium nitroprusside. The effect of verapamil was competitively antagonized by external Ca, while that of sodium nitroprusside was not. High K, noradrenaline and histamine increased the rate of 45Ca uptake in aortae and taenia. In rabbit aorta the increment in response to high K was specifically inhibited by verapamil and the increment induced by noradrenaline was specifically inhibited by sodium nitroprusside. In rat aorta, increments induced by both high K and noradrenaline were inhibited by verapamil and by sodium nitroprusside. In taenia, the increments induced by high K and by histamine were inhibited by verapamil but not by sodium nitroprusside. These results suggest different characteristics of Ca entry systems in these smooth muscles. In rabbit aorta, there seem to be two Ca channels, one of which is activated by high K and inhibited by verapamil, while the other is activated by noradrenaline and inhibited by sodium nitroprusside. In rat aorta, both K- and noradrenaline-activated Ca pathways are sensitive to both verapamil and sodium nitroprusside whereas, in taenia, both K- and histamine-activated Ca pathways are sensitive only to verapamil.

Animals↗