Abstract: The management of aortic arch diseases remains a therapeutic challenge. Aortic dissection is the most common catastrophe of the aorta. Mortality of untreated acute dissection involving the ascending aorta or the aortic arch is about 1–2% per hour during the first 48 h. Endovascular treatment of aneurysms and aortic dissection involving the descending thoracic aorta has been shown to be an excellent alternative to open surgery. In order to achieve an adequate proximal landing zone for a stent graft in the aortic arch, it may be necessary to cover the origins of some or all of supra-aortic branches. Adjunctive open surgical extra-anatomical supra-aortic bypasses may be required to provide an adequate proximal landing zone, and such combined open and endovascular (hybrid) surgery is a valuable alternative for patients with aortic arch pathology.
The present article reports the case of an young patient, admitted at the emergency department, in whom an aortic dissection Stanford type A / DeBakey I type/ was diagnosed, which was originating right after the brachiocephalic trunk and was visible until both
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In such cases a minimally invasive alternative (not requiring aortic cross clamping, extracorporeal cardiopulmonary bypass or deep hypothermic circulatory arrest) is the carotid-carotid crossover subcutaneous bypass.
In our young cardiovascular center we have treated over 50 patients with aortic aneurysms and aortic dissections over the last three years with very encouraging clinical outcomes. The following case report describes one of our cases with hybrid minimally invasive surgery and endovascular approach for a patient suffering from life threatening acute aortic dissection Stanford type
Transcatheter aortic valve replacement or TAVR is the latest technology used principally for the treatment of aortic stenosis, a condition in which one of the major valves of the heart, the aortic valve, becomes tight and stiff, usually as a result of aging (3). Since many patients who need aortic valve replacement for aortic stenosis are too sick to undergo major valve replacement surgery, they are unable to get the treatment they need. With the transcatheter aortic valve, this issue is bypassed because this valve can be implanted in the heart by accessing the patient’s heart through an artery in the groin. The valve can be inserted through a wire that can be pushed to the heart, and the old valve is simply pushed to the side when the new valve is implanted. This technology has been in use in the US with Edwards’ Sapiens valve since 2011 and has saved the lives of many patients with aortic stenosis (4).
3. Overriding Aorta – Due to the alignment of the ventricular septum, and the VSD formation, the aorta is placed “directly above the aorta. Both the right and the left ventricles have access to the aorta causing an increase in outflow of blood through the aorta. Due to the pulmonary stenosis in the pulmonary arteries, the blood flow to the lungs will be obstructed causing the blood to be shunted back to the right ventricle and into the aorta; mixing the oxygenated blood with the deoxygenated blood going to the body tissues.
Although we haven't covered these systems in detail yet, which of the following systems would involve gas exchange of CO2 and O2?
Revascularization strategies including coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) are recommended as treatments for coronary artery disease. [8-11] CABG generally cost more ...
ECMO is an external cardiopulmonary bypass circuit that serves to temporarily replace the functions of the heart and lungs. This necessitates the surgical placement of a catheter into a central vein located near the heart and a second catheter that can be placed in either a different central vein (VV ECMO), which is used for respiratory support, or placed into artery (VA ECMO), used when the patient requires cardiac and respiratory support. These catheters are connected to the ECMO machine where the blood is pumped through an oxygenator where carbon dioxide is removed and oxygen instilled (http://nyp.org/services/carf/what-is-ecmo.html).
Transcatheter aortic valve replacement (TAVR) introduction to the clinical practice revolutionized the interventional cardiology ,it is a valuable option for a non –operable patient with sever aortic stenosis or high risk population however ,TAVR is associated with a risk of cerebral embolization and ischemic vascular events and possible neurological impairment the estimate of these complication is vary but it have been reported early and late after the procedure moreover the reported incidence of bleeding associated with TAVI is relatively high .with this given incident of complication required adequate antithrombotic therapy during and following procedure ,however despite the current guidelines recommendation the optimal antithrombotic is not very well established .
Pulmonary arteries carry blood from the heart to the lungs where the blood picks up oxygen. The oxygen rich blood is then returned to the heart via the pulmonary veins. Systemic arteries deliver blood to the rest of the body. The aorta is the main systemic artery and the largest artery of the body. It originates from the heart and branches out into smaller arteries which supply blood to the head region brachiocephalic artery, the heart itself coronary arteries, and the lower regions of the body.
...lood Vessel Stents.” 1-3). Bypass surgery is another option; a blood vessel from somewhere in the body is used to go around the blocked artery. This completely bypasses the blocked artery, so it no longer becomes an issue. Thrombolytic therapy is a method that involves injecting a medication into the artery that will dissolve the clot and allow blood to pass freely through the artery (“Peripheral Artery Disease.” 3).
The earliest beginnings of anatomy could be traced back to the Egyptians in 1600 B.C.E., when early examinations of sacrificial victims were taking place. From this time, scholars have found the earliest medical document, known as the Edwin Smith Papyrus, in which it described early anatomical observations made by the Egyptians, most likely due to their knowledge gained from mummification. The papyrus displayed organs such as the bladder, uterus, kidneys, liver, spleen, heart, and blood vessels.
Debate on the superiority of regional anesthesia to general anesthesia continues to date. Current literature does not support any difference in mortality between regional and general anesthesia. The largest randomized study to date highlighting this issue, the General Anesthesia Local Anesthesia (GALA) study group, demonstrated no significant difference amongst patients receiving local versus general anesthesia for carotid endarterectomy surgery45. Following that randomized clinical trial, a retrospective review of the American College of Surgeons National Quality Improvement Program (ACS-NSQIP) reported similar results46. In another report from the ACS-NSQIP focusing on endovascular aortic repair, a lack of difference in mortality amongst local anesthesia, spinal anesthesia or general anesthesia emerged47. Moreover, meta-analyses of regional anesthesia versus general anesthesia for total hip arthroplasty and total knee arthroplasty revealed no difference in mortality.48, 49
There are also several limitations to the solution. Most surgeries related to cardiovascular diseases success rate is very high but there is a chance of failing. If the surgery fails, very likely, the patient will die. During surgeries, there are risks. Some of the risks are bleeding, infection, stroke, kidney failure, or lung complications.
Throughout history, it seems that medicine and spirituality have been linked in many circumstances. In a study looking at the use of complementary and alternative therapies in cardiac patients, spiritual healing was one of many practices patient sought to utilize. In another study, 29% of participants chose to use prayer or premeditation as a way to cope with their chronic illness. In both studies, prayer or meditation was more likely to be used by individuals who had a large social network, as well as support from another person in the same health situation. Based on these studies, it seems that many individuals (not just cardiovascular patients) turn to their spirituality in times of health distress.
The commonest defect is a narrowing of the main artery from the heart aortic coarctation. A regular ultrasound examination of the heart ... ... middle of paper ... ... s are relatively limited. So far, researchers think it will be possible to increase the final height by 5-10 centimeters, depending on the duration of treatment.
America has come a long way since improvements in medical technology and treatment have been made. As time has progressed, modern medicine has continued to shape America and its medical practices, moving it towards becoming a much more medically advanced nation. Ranging from the birth of catheterization to the interventional era of development of surgeries, drugs, imaging, and care, the history of invasive and interventional cardiology is a field of modern medicine that has stepped up to another level, transformed the way medicine is utilized, and ultimately, changed the way America has saved lives.
The history of anatomy and physiology dates back to ancient Egyptian times when humans were mummified after death and bodies would be stripped of their internal organs during the embalming process. It was not until much later when Hippocrates II, known as the father of medicine, was the first to write about human anatomy. Shortly after that, the Alexandrian Medical School was established, where human dissection was allowed for the first time, which promoted research and new discoveries in the field. From there, many other influential researchers came up with theories regarding the cardiovascular and nervous systems, etc; however, the missing links in some of the earlier theories was found with the discovery of the microscope, which changed the focus of research and led to many advancements in the field.