Dissection of Arch Branches Alone an Indication for Aggressive Arch Management in Type A Dissection?

Publication date: Available online 9 August 2019Source: The Annals of Thoracic SurgeryAuthor(s): Elizabeth L. Norton, Xiaoting Wu, Linda Farhat, Karen M. Kim, Himanshu J. Patel, G Michael Deeb, Bo YangAbstractBackgroundIt is controversial if extension of aortic dissection into arch branches should be an indication for replacement of the arch and its branches in acute type A aortic dissection (ATAAD).MethodsFrom 2008-April 2018, 399 patients underwent open repair for an ATAAD, 190 patients had known innominate and/or left common carotid artery dissection without malperfusion syndrome, including: no arch procedure (n=1)/hemiarch replacement (n=109) and zone 1/2/3 arch replacement (n=80) with replacement of 1-4 arch branch vessels.ResultsThe median age was 58-years-old. Preoperative comorbidities were similar between groups except for the hemiarch group having more coronary artery disease (22% vs. 3%, p=0.0002). Both groups underwent similar aortic root procedures and other concomitant procedures with equivalent cardiopulmonary bypass and aortic cross-clamp times. The zone 1/2/3 group had longer hypothermic circulatory arrest times with greater use of antegrade cerebral perfusion (all p
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research

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In conclusion, T2D impairs vascular function by dysregulated autophagy. Therefore, autophagy could be a potential target for overcoming diabetic microvascular complications. To What Degree Does Loss of Skeletal Muscle with Age Contribute to Immunosenescence? https://www.fightaging.org/archives/2019/11/to-what-degree-does-loss-of-skeletal-muscle-with-age-contribute-to-immunosenescence/ Sarcopenia, the progressive loss of muscle mass and strength, is characteristic of aging. A perhaps surprisingly large fraction of the losses can be averted by strength training, but there are nonetheless inexorable process...
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CONCLUSION: The study group in the aortic valve surgery that administered myocardial protection indexed for the left ventricular mass index and showed a statistically significant lower incidence for post-operative low cardiac output syndrome compared to the control group. PMID: 31749412 [PubMed - as supplied by publisher]
Source: Perfusion - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Perfusion Source Type: research
Fight Aging! publishes news and commentary relevant to the goal of ending all age-related disease, to be achieved by bringing the mechanisms of aging under the control of modern medicine. This weekly newsletter is sent to thousands of interested subscribers. To subscribe or unsubscribe from the newsletter, please visit: https://www.fightaging.org/newsletter/ Longevity Industry Consulting Services Reason, the founder of Fight Aging! and Repair Biotechnologies, offers strategic consulting services to investors, entrepreneurs, and others interested in the longevity industry and its complexities. To find out m...
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Source: The Journal of Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Source Type: research
ConclusionsAscending aortic stent placement for ascending aortic disease is feasible and is associated with favorable aortic remodeling. Despite persistent perfusion to the false lumen in a subset of patients, there is minimal aortic dilation at short-term follow-up with excellent survival.
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
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In this issue of the Journal, Ghoreishi and colleagues1 have performed a tour de force in attempting to analyze 5 major factors potentially associated with stroke after type A aortic dissection repair. The etiology of stroke after aortic surgery is an entanglement of numerous complex factors that place patients at risk for both ischemic and embolic neurologic insults. Decisions about the extent of surgical repair, cannulation site, cerebral perfusion strategy, and degree of hypothermia are all interrelated.
Source: The Journal of Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Commentary Source Type: research
We describe the debranching-first technique and proximal arch replacement for a huge innominate artery aneurysm and discuss the surgical strategy for cannulation, perfusion and organ protection. PMID: 31203765 [PubMed - as supplied by publisher]
Source: Perfusion - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Perfusion Source Type: research
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Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research
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