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[PMID]:29384600
[Au] Autor:Kondov S; Siepe M; Beyersdorf F; von Samson-Himmelstjern P; Czerny M
[Ad] Endereço:Department of Cardiovascular Surgery, University Heart Center Freiburg, Faculty of Medicine, University of Freiburg, Germany.
[Ti] Título:Thoracoabdominal aortic replacement with a bovine pericardial tube graft for aortobronchial fistulation 10 years after TEVAR.
[So] Source:Multimed Man Cardiothorac Surg;2017, 2017 Dec 20.
[Is] ISSN:1813-9175
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Aortobronchial fistula after thoracic endovascular aortic repair is usually a late complication. It is associated with high mortality and its surgical management is technically challenging. This tutorial illustrates the steps involved in removing an infected stent graft and replacing it with a bovine pericardial tube graft.
[Mh] Termos MeSH primário: Aneurisma da Aorta Torácica/cirurgia
Doenças da Aorta/cirurgia
Implante de Prótese Vascular/efeitos adversos
Fístula Brônquica/cirurgia
Infecções Relacionadas à Prótese/cirurgia
Fístula Vascular/cirurgia
[Mh] Termos MeSH secundário: Animais
Doenças da Aorta/etiologia
Bioprótese
Prótese Vascular/efeitos adversos
Fístula Brônquica/etiologia
Bovinos
Remoção de Dispositivo
Procedimentos Endovasculares/efeitos adversos
Seres Humanos
Pericárdio/transplante
Infecções Relacionadas à Prótese/etiologia
Reoperação
Stents/efeitos adversos
Fístula Vascular/etiologia
[Pt] Tipo de publicação:VIDEO-AUDIO MEDIA
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1510/mmcts.2017.027


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[PMID]:28453793
[Au] Autor:Sabashnikov A; Heinen S; Deppe AC; Zeriouh M; Weymann A; Slottosch I; Eghbalzadeh K; Popov AF; Liakopoulos O; Rahmanian PB; Madershahian N; Kroener A; Choi YH; Kuhn-Régnier F; Simon AR; Wahlers T; Wippermann J
[Ad] Endereço:Department of Cardiothoracic Surgery, University Hospital of Cologne, Cologne, Germany.
[Ti] Título:Impact of gender on long-term outcomes after surgical repair for acute Stanford A aortic dissection: a propensity score matched analysis.
[So] Source:Interact Cardiovasc Thorac Surg;24(5):702-707, 2017 05 01.
[Is] ISSN:1569-9285
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: Previous research suggests that female gender is associated with increased mortality rates after surgery for Stanford A acute aortic dissection (AAD). However, women with AAD usually present with different clinical symptoms that may bias outcomes. Moreover, there is a lack of long-term results regarding overall mortality and freedom from major cerebrovascular events. We analysed the impact of gender on long-term outcomes after surgery for Stanford A AAD by comparing genders with similar risk profiles using propensity score matching. METHODS: A total of 240 patients operated for Stanford A AAD were included in this study. To control for selection bias and other confounders, propensity score matching was applied to gender groups. RESULTS: After propensity score matching, the gender groups were well balanced in terms of risk profiles. There were no statistically significant differences regarding duration of cardiopulmonary bypass ( P = 0.165) and duration of aortic cross-clamp time ( P = 0.111). Female patients received less fresh frozen plasma ( P = 0.021), had shorter stays in the intensive care unit ( P = 0.031), lower incidence of temporary neurological dysfunction ( P < 0.001) and lower incidence of dialysis ( P = 0.008). There were no significant differences regarding intraoperative mortality ( P = 1.000), 30-day mortality ( P = 0.271), long-term overall cumulative survival ( P = 0.954) and long-term freedom from cerebrovascular events ( P = 0.235) with up to a 9-year follow-up. CONCLUSIONS: Considering patients with similar risk profiles, female gender per se is not associated with worse long-term survival and freedom from stroke after surgical aortic repair. Moreover, female patients might even benefit from a smoother early postoperative course and lower incidence of early postoperative complications.
[Mh] Termos MeSH primário: Aneurisma Dissecante/cirurgia
Aneurisma da Aorta Torácica/cirurgia
Complicações Pós-Operatórias/epidemiologia
Pontuação de Propensão
Procedimentos Cirúrgicos Vasculares/métodos
[Mh] Termos MeSH secundário: Idoso
Feminino
Seguimentos
Alemanha/epidemiologia
Seres Humanos
Incidência
Masculino
Meia-Idade
Estudos Retrospectivos
Fatores de Risco
Distribuição por Sexo
Fatores Sexuais
Taxa de Sobrevida/tendências
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1093/icvts/ivw426


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[PMID]:29223273
[Au] Autor:van der Veer T; In 't Veen JCCM; den Dekker WK; Miedema J
[Ad] Endereço:Department of Pulmonology, Franciscus Gasthuis & Vlietland, Erasmus Medical Center, Rotterdam, the Netherlands. Electronic address: t.vanderveer@franciscus.nl.
[Ti] Título:A 79-Year-Old Woman With Dyspnea and Hypoxemia That Worsened in an Upright Position.
[So] Source:Chest;152(6):e139-e142, 2017 12.
[Is] ISSN:1931-3543
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:CASE PRESENTATION: A 79-year-old woman presented to the ED with complaints of gradually worsening exertional dyspnea, dizziness, and chest discomfort. For several weeks she had not been able to perform light household work. The patient's medical history mentioned pulmonary embolism following immobilization (2012), several fractures after trauma, an ischemic cerebral vascular accident (2014), and curative treatment for breast cancer (1995). Her current medication included esomeprazole, clopidogrel, simvastatin, calcium/vitamin D, amitriptyline, and acetaminophen.
[Mh] Termos MeSH primário: Anormalidades Múltiplas
Aneurisma da Aorta Torácica/complicações
Dispneia/etiologia
Forame Oval Patente/complicações
Hipóxia/etiologia
[Mh] Termos MeSH secundário: Idoso
Aneurisma da Aorta Torácica/diagnóstico
Cateterismo Cardíaco
Procedimentos Cirúrgicos Cardíacos/métodos
Diagnóstico Diferencial
Dispneia/diagnóstico
Ecocardiografia
Feminino
Forame Oval Patente/diagnóstico
Forame Oval Patente/cirurgia
Seres Humanos
Hipóxia/diagnóstico
Dispositivo para Oclusão Septal
Síndrome
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171211
[St] Status:MEDLINE


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[PMID]:29320978
[Au] Autor:Lim CS; Dhutia A; Riga C; Dharmadasa A; Gibbs RGJ; Hamady MS
[Ad] Endereço:1 Regional Vascular Unit, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom.
[Ti] Título:Two-Vessel Branched Stent Graft for Severely Angulated Aortic Arch Aneurysm in a Jehovah's Witness.
[So] Source:Vasc Endovascular Surg;52(2):154-158, 2018 Feb.
[Is] ISSN:1938-9116
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Aneurysmal disease involving the origins of supra aortic vessels often requires complex open and/or endovascular repair that is not only associated with significant risk of mortality and morbidity but also often with perioperative blood loss requiring transfusion. We report a successful repair of a large thoracic aortic aneurysm (TAA) involving the aortic arch with a custom-made Bolton Relay 2-vessel branched thoracic aortic endograft in a 42-year-old Jehovah's Witness who would otherwise be very unlikely to survive an open repair. Branched thoracic aortic endografting offers a potentially safe, minimally invasive, and effective alternative for TAA disease involving the supra-aortic arteries, especially in patients who are at high risk of open surgery.
[Mh] Termos MeSH primário: Aneurisma da Aorta Torácica/cirurgia
Perda Sanguínea Cirúrgica/prevenção & controle
Implante de Prótese Vascular/instrumentação
Prótese Vascular
Procedimentos Endovasculares/instrumentação
Testemunhas de Jeová
Religião e Medicina
Stents
[Mh] Termos MeSH secundário: Adulto
Angiografia Digital
Aneurisma da Aorta Torácica/diagnóstico por imagem
Aortografia/métodos
Transfusão de Sangue
Angiografia por Tomografia Computadorizada
Seres Humanos
Masculino
Desenho de Prótese
Resultado do Tratamento
Recusa do Paciente ao Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180112
[St] Status:MEDLINE
[do] DOI:10.1177/1538574417747426


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[PMID]:29237361
[Au] Autor:Rogers MP; Reskin SM; Ubert A; Black MC; Grubb KJ
[Ad] Endereço:1 Department of Cardiovascular and Thoracic Surgery, University of Louisville School of Medicine, Louisville, KY, USA.
[Ti] Título:Hybrid Endovascular Aortic Arch Reconstruction for Acute Aortic Dissection: An Endovascular Bridge Technique for Complex Anatomy.
[So] Source:Vasc Endovascular Surg;52(2):143-147, 2018 Feb.
[Is] ISSN:1938-9116
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Acute type A aortic dissections starting at the arch pose a challenge for cardiac surgeons. Open surgical repair requires deep hypothermic circulatory arrest for arch reconstruction and is associated with significant morbidity and mortality. Hybrid aortic repair techniques, with open arch debranching and thoracic endovascular aortic repair, have been employed in high-risk cases and challenging aortic pathology. Herein, we present a case of a 33-year-old African American male with a history of open thoracoabdominal aortic reconstruction and femoral-femoral artery bypass for a type B dissection who subsequently presented with new-onset chest pain and was found to have a retrograde type A dissection of a bovine arch with multiple dissection flaps and possible contrast extravasation on chest computed tomography. Endovascular reconstruction of the aortic arch using a hybrid technique was utilized and proved to be feasible and further should be considered when complex anatomy limits traditional surgical options.
[Mh] Termos MeSH primário: Aneurisma Dissecante/cirurgia
Aorta Torácica/cirurgia
Aneurisma da Aorta Torácica/cirurgia
Implante de Prótese Vascular/métodos
Procedimentos Endovasculares/métodos
[Mh] Termos MeSH secundário: Doença Aguda
Adulto
Aneurisma Dissecante/diagnóstico por imagem
Aneurisma Dissecante/fisiopatologia
Aorta Torácica/anormalidades
Aorta Torácica/diagnóstico por imagem
Aorta Torácica/fisiopatologia
Aneurisma da Aorta Torácica/diagnóstico por imagem
Aneurisma da Aorta Torácica/fisiopatologia
Aortografia/métodos
Implante de Prótese Vascular/instrumentação
Angiografia por Tomografia Computadorizada
Procedimentos Endovasculares/instrumentação
Hemodinâmica
Seres Humanos
Masculino
Resultado do Tratamento
Ultrassonografia de Intervenção
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171215
[St] Status:MEDLINE
[do] DOI:10.1177/1538574417747037


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Mady, Charles
Texto completo SciELO Brasil
[PMID]:29211214
[Au] Autor:Duncan JA; Dias RR; Dinato FJ; Fernandes F; Ramirez FJÁ; Mady C; Jatene FB
[Ad] Endereço:Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (InCor-HCFMUSP), São Paulo, SP, Brazil.
[Ti] Título:Hybrid Approach of Aortic Diseases: Zone 1 Delivery and Volumetric Analysis on the Descending Aorta.
[So] Source:Braz J Cardiovasc Surg;32(5):361-366, 2017 Sep-Oct.
[Is] ISSN:1678-9741
[Cp] País de publicação:Brazil
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Conventional techniques of surgical correction of arch and descending aortic diseases remains as high-risk procedures. Endovascular treatments of abdominal and descending thoracic aorta have lower surgical risk. Evolution of both techniques - open debranching of the arch and endovascular approach of the descending aorta - may extend a less invasive endovascular treatment for a more extensive disease with necessity of proximal landing zone in the arch. OBJECTIVE: To evaluate descending thoracic aortic remodeling by means of volumetric analysis after hybrid approach of aortic arch debranching and stenting the descending aorta. METHODS: Retrospective review of seven consecutive patients treated between September 2014 and August 2016 for diseases of proximal descending aorta (aneurysms and dissections) by hybrid approach to deliver the endograft at zone 1. Computed tomography angiography were analyzed using a specific software to calculate descending thoracic aorta volumes pre- and postoperatively. RESULTS: Follow-up was done in 100% of patients with a median time of 321 days (range, 41-625 days). No deaths or permanent neurological complications were observed. There were no endoleaks or stent migrations. Freedom from reintervention was 100% at 300 days and 66% at 600 days. Median volume reduction was of 45.5 cm3, representing a median volume shrinkage by 9.3%. CONCLUSION: Hybrid approach of arch and descending thoracic aorta diseases is feasible and leads to a favorable aortic remodeling with significant volume reduction.
[Mh] Termos MeSH primário: Aneurisma Dissecante/cirurgia
Aorta Torácica/cirurgia
Aneurisma da Aorta Torácica/cirurgia
Implante de Prótese Vascular/métodos
Procedimentos Endovasculares/métodos
[Mh] Termos MeSH secundário: Idoso
Aneurisma Dissecante/diagnóstico por imagem
Aorta Torácica/diagnóstico por imagem
Aneurisma da Aorta Torácica/diagnóstico por imagem
Angiografia por Tomografia Computadorizada
Feminino
Seres Humanos
Masculino
Meia-Idade
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171207
[St] Status:MEDLINE


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Texto completo SciELO Brasil
[PMID]:29211213
[Au] Autor:Souza LO; Bernardes RC; Navarro TP; Procópio RJ; Reis FAR; Lima LCM; Silveira ELD
[Ad] Endereço:Hospital Márcio Cunha, Ipatinga, MG, Brazil.
[Ti] Título:Hybrid Treatment with Complete Transposition of Supra-Aortic Trunks versus Conventional Surgery for the Treatment of Aortic Arch Aneurysm.
[So] Source:Braz J Cardiovasc Surg;32(5):354-360, 2017 Sep-Oct.
[Is] ISSN:1678-9741
[Cp] País de publicação:Brazil
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: The disease of the aortic arch is traditionally approached by open surgical repair requiring cardiopulmonary bypass and circulatory arrest. This study performed a retrospective analysis comparing outcomes through primary hybrid patients submitted to aortic arch surgery without cardiopulmonary bypass with patients submitted to conventional open surgery. METHODS: 25 patients submitted to the aortic arch surgery were selected in the period 2003-2012 at the Madre Teresa Hospital in the city of Belo Horizonte, Brazil; 13 of these underwent hybrid technique without cardiopulmonary bypass and 12 underwent conventional open surgery. RESULTS: The mortality rate for the hybrid group was 23% and for the conventional surgery group was 17% (P=0.248). The postoperative complication rate was also similar in both groups, with no significant difference. CONCLUSION: Both techniques proved to be similar in mortality and morbidity. However, due to the small sample, more analytical studies with larger samples and long-term follow-up are needed to clarify this issue.
[Mh] Termos MeSH primário: Aneurisma da Aorta Torácica/cirurgia
Implante de Prótese Vascular/métodos
Procedimentos Endovasculares/métodos
[Mh] Termos MeSH secundário: Idoso
Estudos de Casos e Controles
Feminino
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Complicações Pós-Operatórias
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171207
[St] Status:MEDLINE


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[PMID]:29320620
[Au] Autor:Koncar IB; Dragas M; Sabljak P; Pesko P; Markovic M; Davidovic L
[Ti] Título:Aortoesophageal and aortobronchial fistula caused by Candida albicans after thoracic endovascular aortic repair.
[So] Source:Vojnosanit Pregl;73(9):684-7, 2016 Sep.
[Is] ISSN:0042-8450
[Cp] País de publicação:Serbia
[La] Idioma:eng
[Ab] Resumo:Introduction: Endovascular stent-graft placement has emerged as a minimally invasive alternative to open surgery for the treatment of aortic aneurysms and dissections. There are few reports of stent graft infections and aortoenteric fistula after endovascular thoracic aortic aneurysm repair, and the first multicentric study (Italian survey) showed the incidence of about 2%. Case report: We presented a 69-year-old male patient admitted to our hospital 9 months after thoracic endovascular aortic repair, due to severe chest pain in the left hemithorax and arm refractory to analgesic therapy. Multislice computed tomography (MSCT) showed a collection between the stent graft and the esophagus with thin layers of gas while gastroendoscopy showed visible blood jet 28 cm from incisive teeth. Surgical treatment was performed in collaboration of two teams (esophageal and vascular surgical team). After explantation of the stent graft and in situ reconstruction by using Dacron graft subsequent esophagectomy and graft omentoplasty were made. After almost four weeks patient developed hemoptisia as a sign of aorto bronchial fistula. Treatment with implantation of another aortic cuff of 26 mm was performed. The patient was discharged to the regional center with negative blood culture, normal inflammatory parameters and respiratory function. Three months later the patient suffered deterioration with the severe weight loss and pneumonia caused by Candida albicans and unfortunately died. The survival time from the surgical treatment of aortoesophageal fistula was 4 months Conclusion: Even if endovascular repair of thoracic aortic diseases improves early results, risk of infection should not be forgotten. Postoperative respiratory deterioration and finally hemoptisia could be the symptoms of another fistula.
[Mh] Termos MeSH primário: Aneurisma da Aorta Torácica/cirurgia
Implante de Prótese Vascular/efeitos adversos
Prótese Vascular/efeitos adversos
Fístula Brônquica/microbiologia
Candida albicans/isolamento & purificação
Candidíase/microbiologia
Procedimentos Endovasculares/efeitos adversos
Fístula Esofágica/microbiologia
Infecções Relacionadas à Prótese/microbiologia
Stents/efeitos adversos
Fístula Vascular/microbiologia
[Mh] Termos MeSH secundário: Idoso
Aortografia/métodos
Implante de Prótese Vascular/instrumentação
Fístula Brônquica/diagnóstico por imagem
Fístula Brônquica/cirurgia
Candidíase/diagnóstico
Candidíase/cirurgia
Angiografia por Tomografia Computadorizada
Remoção de Dispositivo
Procedimentos Endovasculares/instrumentação
Fístula Esofágica/diagnóstico por imagem
Fístula Esofágica/cirurgia
Esofagectomia
Evolução Fatal
Seres Humanos
Masculino
Tomografia Computadorizada Multidetectores
Infecções Relacionadas à Prótese/diagnóstico por imagem
Infecções Relacionadas à Prótese/cirurgia
Fatores de Tempo
Resultado do Tratamento
Fístula Vascular/diagnóstico por imagem
Fístula Vascular/cirurgia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180213
[Lr] Data última revisão:
180213
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180111
[St] Status:MEDLINE
[do] DOI:10.2298/VSP141209074K


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[PMID]:29381979
[Au] Autor:Jud P; Gary T; Hafner F; Tiesenhausen K; Ott T; Oswald WK; Brodmann M
[Ad] Endereço:Division of Angiology, Department of Internal Medicine.
[Ti] Título:Multiple arterial thromboses due to cystic medial degeneration Erdheim-Gsell: A case report.
[So] Source:Medicine (Baltimore);96(47):e8782, 2017 Nov.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Cystic medial degeneration Erdheim-Gsell is a vascular pathology mainly of the large vessels, which is mostly associated with Marfan syndrome or Ehlers-Danlos syndrome. The clinical findings of this entity are aneurysms of the aorta or large peripheral arteries which usually present in an acute setting due to rupture of an aneurysm. PATIENT CONCERNS: We present a case of a 43-year-old Caucasian male with histologically proven cystic medial degeneration of the lower limb vessels mimicking peripheral artery occlusive disease. Despite antiplatelet and anticoagulant treatment, the patient suffered multiple vascular stenosis and occlusions. DIAGNOSES: Multiple arterial stenoses and thromboses leading to peripheral artery occlusive disease caused by cystic medial degeneration Erdheim-Gsell. INTERVENTIONS: Multiple surgical and endovascular interventions including bypass graft and intra-arterial thrombolysis as well as oral antiplatelet and anticoagulant therapy. OUTCOME: Despite dual antiplatelet therapy, anticoagulant therapy with rivaroxaban and multiple surgical and endovascular interventions, the patient developed recurrent arterial thromboses. The patient did not suffer further thrombotic events since clopidogrel and phenprocoumon were administered. LESSONS: Clinical presentation of cystic medial degeneration Erdheim-Gsell mimicking peripheral artery occlusive disease is very unusual. Due to the fragile vessel wall, patients with cystic medial degeneration might have a higher risk to develop arterial thromboses, even under antiplatelet therapy or anticoagulant treatment.
[Mh] Termos MeSH primário: Aneurisma da Aorta Torácica/complicações
Arteriopatias Oclusivas/etiologia
Cistos/complicações
Trombose/etiologia
[Mh] Termos MeSH secundário: Adulto
Seres Humanos
Masculino
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180208
[Lr] Data última revisão:
180208
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008782


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[PMID]:29332920
[Au] Autor:Zhao C; Zhu Z; Zheng X; Liu K
[Ad] Endereço:Department of Cardiovascular Surgery, 2nd Hospital of Bethune, Jilin University, Changchun.
[Ti] Título:Aorto-Cutaneous Fistula after Surgical Treatment of Stanford Type A Aortic Dissection.
[So] Source:Int Heart J;59(1):223-225, 2018 Jan 27.
[Is] ISSN:1349-3299
[Cp] País de publicação:Japan
[La] Idioma:eng
[Ab] Resumo:An aorto-cutaneous fistula is a rare complication that occurs after aortic surgery. Due to its rarity, postoperative complications are not normally highlighted in most standard teaching. We report here a case of aorto-cutaneous fistula after surgical treatment of a Stanford type A aortic dissection (AD) in a 67-year-old Chinese male. The patient presented with severe right heart dysfunction and a mass was found in the upper-middle of his chest, which started bleeding in the next years. On admission, preoperative aortic computed tomography angiography (CTA) showed a huge hematoma located in the anterior superior mediastinum and a shunt between the embedding cavity of the aortic root and right atrium. An emergent procedure was performed. Intraoperatively, we found two leaks approximately 2 mm from the anastomosis of the greater curvature of the ascending aortic graft and stented graft after the hematoma was cleared and we confirmed the shunt had a large amount of blood flow after a right atrium incision. After the surgery, the patient was diagnosed with a cerebral hemorrhage, and his family decided to refuse therapy on the third postoperative day (p.o.d.).
[Mh] Termos MeSH primário: Aneurisma Dissecante/cirurgia
Aneurisma da Aorta Torácica/cirurgia
Implante de Prótese Vascular/efeitos adversos
Fístula Cutânea/etiologia
Complicações Pós-Operatórias
Stents/efeitos adversos
Fístula Vascular/etiologia
[Mh] Termos MeSH secundário: Idoso
Aneurisma Dissecante/diagnóstico
Aneurisma da Aorta Torácica/diagnóstico
Angiografia por Tomografia Computadorizada
Fístula Cutânea/diagnóstico
Fístula Cutânea/cirurgia
Ecocardiografia Doppler em Cores
Seres Humanos
Masculino
Reoperação
Fístula Vascular/diagnóstico
Fístula Vascular/cirurgia
Procedimentos Cirúrgicos Vasculares/métodos
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180206
[Lr] Data última revisão:
180206
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180116
[St] Status:MEDLINE
[do] DOI:10.1536/ihj.17-109



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