Moderate Versus Deep Hypothermic Circulatory Arrest for Elective Aortic Transverse Hemiarch Reconstruction
Conclusions MHCA with antegrade cerebral perfusion yields excellent and equivalent outcomes to DHCA for elective aortic hemiarch reconstruction. MHCA significantly improves intraoperative times and, importantly, reduces transfusion requirements compared with DHCA with a retrograde cerebral perfusion strategy.
Eur J Vasc Endovasc Surg. 2021 Sep 7:S1078-5884(21)00537-2. doi: 10.1016/j.ejvs.2021.06.031. Online ahead of print.ABSTRACTOBJECTIVE: The aims of this study were to assess the incidence of major vascular events (MVE) and peripheral vascular events (PVE) in people with a small asymptomatic abdominal aortic aneurysm (AAA) and model the theoretical benefits and costs of an intensified low density lipoprotein cholesterol (LDL-C) lowering programme.METHODS: A total of 583 participants with AAAs measuring 30 - 54 mm were included in this study. The control of LDL-C and prescription of lipid lowering drugs were assessed by dividi...
Am J Physiol Cell Physiol. 2021 Sep 8. doi: 10.1152/ajpcell.00251.2021. Online ahead of print.ABSTRACTThrombospondins (TSPs) are multi-domain, secreted proteins that associate with cell-surfaces and extracellular matrix. In mammals, there is a large body of data on functional roles of various TSP family members in cardiovascular disease (CVD), including stroke, cardiac remodelling and fibrosis, atherosclerosis and aortic aneurysms. Coding single nucleotide polymorphisms (SNPs) of TSP1 or TSP4 are also associated with increased risk of several forms of CVD. Whereas interactions and functional effects of TSPs on a variety of...
Thoracoabdominal aortic aneurysm life-altering events, which include a combination of permanent dialysis, permanent spinal cord ischemia, stroke, and/or death, have devastating effects after complex endovascular repair. However, the occurrence of these life-altering events after endovascular abdominal aortic aneurysm repair (EVAR) and thoracic endovascular aortic repair (TEVAR) has not been studied. Therefore, we examined the effects of procedural and anatomic characteristics on a composite outcome of postoperative dialysis, stroke, paralysis, and/or mortality after any endovascular aortic repair.
Thoracic endovascular aortic repair (TEVAR) has been established as the treatment of choice for a range of thoracic aortic pathologies. Beta-blockers represent a possible perioperative treatment option to improve TEVAR outcomes due to their role in management of aortic aneurysm, dissection, and Marfan syndrome. We investigated the effect of preoperative beta-blocker usage on outcomes of TEVAR using the Vascular Quality Initiative database.
Conclusion: FB-EVAR is safe and effective for treatment of PRA and TAAAs with low rate of aortic-related mortality and aneurysm rupture on midterm follow-up.
CONCLUSIONS: When used by experienced teams under appropriate anatomical conditions, PMEGs are a safe and effective alternative to open surgery. However, further technical advancement and larger studies with long-term follow-up periods are warranted.PMID:34338495 | DOI:10.23736/S0021-9509.21.11877-4
Abstract BACKGROUND: Deep hypothermic circulatory arrest (DHCA) with retrograde cerebral perfusion (DHCA group) has traditionally been the cerebral protection strategy during transverse hemiarch aortic reconstruction. Recently, we have adopted moderate hypothermic (≥25°C) circulatory arrest (MHCA) with antegrade cerebral perfusion (MHCA group). We compared the outcomes for these two circulatory arrest management strategies. METHODS: From 2008 to 2012, in a concurrent series of 376 patients (DHCA, 301; MHCA, 75) undergoing transverse hemiarch for aortic aneurysm disease, inciden...