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Recorded video case

INTERDISCIPLINARY PROJECT: “3D PRINTING” AND AORTIC DISEASE FROZEN ELEPHANT TRUNK USING THE NEW E-VITA OPEN PLUS NEO (JOTEC R), AORTIC VALVE REPLACEMENT, MITRAL VALVE ANULOPLASTY, LEFT SUBCLAVIAN REVASCULARIZATION USING LEFT MAMMARY ARTERY

Clinical Summery

  • 1st February 2017, underwent an ascending aorta replacement, debranching of the Innominate artery and left common carotid artery for the acute aortic dissection
  • The patient presented pseudoaneurysm at level of aortic root, a residual dissection of the aortic arch and of the descending thoracic aorta and a moderate-severe aortic and mitral valve insufficiency
  • Depression of LV function

Surgical Tecnique

  • Aortic Valve Replacement with Stentless biological prosthesis Medtronic Freestyle n 25
  • Mitral Annuloplasty using Memo 4D n 28
  • Ascending aorta and aortic arch replacement with debranching of the Innominate artery and left common carotid artery
  • Frozen Elephant Trunk using E-vita Open plus NEO n 26
  • Unfavorable anatomy for LSA revascularization
  • Left subclavian artery revascularization using Left Mammary Artery

Thanks so much

Dr. Loris Salvador , Dr. Nicola Lamascese, Dr. Alessandro Favaro, Dr. Michele Gallo, dr. Daniele Zoni, Dr. Cheti Benazzato (anesthesiologist) , Mrs. Noemi D’Amato (perfusionist) , Mrs. Cristina Rabaglio (nurse), Mrs. Laura Chiarello (nurse)

Dr. Carlo Campana (3d printing engineer),

Mr. Luciano Ghiotto (3d printing specialist),

Dr. Leonardo Costa (biomedical engineer)

SISMA spa, StefanPlast, Valle Autotrasporti, ULSS8 Berica

 

xx

February 24, 2021 2 Comments
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Live case

Aortic Arch Stenting

Dr. Eric E. Roselli, Director of the Aorta Center, discusses Aortic Arch Stenting: The Cleveland Clinic Technique at the 2019 CLE Care of Aortic Dissection Symposium.

Sign up to learn more about the Comprehensive Lifelong Expeditious (CLE) Care of Aortic Disease™ Symposium, September 17 – 18, 2021, www.ccfcme.org/aorticdisease21

Visit the Cleveland Clinic Aorta Center, https://my.clevelandclinic.org/departments/heart/depts/aorta-center

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Recorded case
Video Thumbnail - click for more.

Case using Najuta stent graft (fenestrated) to preserve 3 branch vessels

This video is the recorded case of the treatment of the aortic aneurysm by a fenestrated stent graft, Kawasumi Najuta stent graft system to preserve all branch vessels, performed in Japan.
Recorded video case

TEVAR WITH PROXIMAL SCALLOP CUSTOM MADE STENT-GRAFT FOR CHRONIC POST-TRAUMATIC ANEURYSMS OF THE AORTIC ISTHMUS

This is a case of 46 years old man with a grade II blunt traumatic aortic lesion 21 years ago, without any treatment and follow up.
Today 85 mm aortic isthmus pseudoaneurysm. Obesity, moderate-severe dyspnea, refusing sternotomy for FET.
Strategy: Custom-made scalloped stent-graft (Terumo Aortic Bolton Relay 30-26-180 mm) for Zone 1 (left common carotid artery). Waiting for the stent graft customization (3 weeks), car-subcl bypass and plug in the subclavian artery (allowing more accurate fusion imaging during TEVAR: redo fusion). Dynamic four-dimensional CT (4D CT) was performed pre- (showing the left main bronchus dynamic compression by the sac) and post- operatively (showing the free flow and first stent working during the cardiac cycle). TEVAR under fusion imaging technique, rapid pacing. Cone-bone CT scan showed a good aortic lesion exclusion, confirmed at 1 month 4D CT scan.

September 14, 2020 No Comments
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Technical note

35 Years of Progress in Aortic Surgery

Over the past 35 years, there has been extensive progress in aortic surgery for people with Marfan, Loeys Dietz, and other genetic aortic condition. Dr. Joseph Coselli, Professor, Vice-Chair, Department of Surgery & Chief, Cardiothoracic Surgery, Baylor College of Medicine, and a member of The Marfan Foundation Professional Advisory Board, discussed the advances and the options currently available for these patients. The presentation was made at The Marfan Foundation’s 35th Annual Conference in Houston, Texas,  on July 13, 2019

September 18, 2019 No Comments
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Recorded video case

Endovascular Aortic Arch replacement with Kawasumi Najuta Thoracic Stent Graft System

Endovascular treatment with custom made Najuta device of a 61mm saccular aortic arch aneurysm after carotid-carotid-subclavian by pass.
Previous surgical correction of 81 mm pararenal aortic aneurysm with extraperitoneal approach.

May 10, 2019 1 Comment
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Case report

Ministernotomy for ascending aorta and aortic arch replacement with left carotid artery, right carotid artery and left axillary artery debranching.

Clinical Summary
– 28 year old male
– Traumatic aortic injury (TAI)
– Endovascular treatment
Complications
– Aortic arch and brachiocephalic trunk dissection
– Right carotid artery and left sublcavian artery occlusion
– Stroke
– Orthostatic Hypotension (Extracranial Steal Syndromes from Disease of the Aortic Branches?)
Surgery Technique
– Femoro-femoral and right axillary artery cannulation
– The aorta was accessed through a Ministernotomy

February 7, 2019 No Comments
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Case report

Aortic dissection treatment with the new Medtronic Navion

Male patient, 68 y.o. presented chronic type a aortic dissection with descending aneurysm 57 mm in axial diameter (20 mm increment during 20 months period)

was treated with carotid-carotid-subclavian by pass. subsequent arch replacement with ascending to innominate artery by pass.
finally controlled flap rupture after deployment of thoracic endograft with very good result at CTA, obtaining complete exclusion of the false lumen (type ll endoleak arising from intercostal arteries)

January 11, 2019 No Comments
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Recorded video case

Kommerell’s diverticulum in right-sided aortic arch treatment

This video case-report show a case of debranching-TEVAR in our hybrid room on fusion imaging and final procedure CBCT, with a CT scan at 2 years follow up.

September 18, 2018 2 Comments
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Recorded video case

Total endovascular treatment of the aortic arch after type A dissection with chimney and sandwich technique

This is a very advanced case of a total endovascular repair of a post-type A dissection aneurysm of the aortic arch with chimney endografts for the brachiocephalic trunk and the LCCA and a periscope in Sandwich technique for the LSA. See the procedure in chapters for the different steps under: https://vascupedia.com/video/total-endovascular-treatment-of-the-aortic-arch-after-type-a-dissection-with-chimney-and-sandwich-technique/

June 11, 2018 10 Comments
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