Descending thoracic aortic aneurysms

Puchakayala, Madhusudan Rao; Lau, Wei C.

doi:10.1093/bjaceaccp/mkl002

Cited by 7 publications

(3 citation statements)

References 8 publications

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“…Effective proximal-to-distal aortic shunts have to carry 60% of baseline blood flow and maintain a mean pressure of 60-70 mmHg in the distal thoracic aorta. In cases of left heart bypass, flow rates of 25-40 ml Kg -1 min ?1 produced by centrifugal pump are enough to maintain satisfactory renal and spinal cord perfusion [ 6 ]. Intra-operative measurement of blood flow through an extra-anatomic graft may be advised to assure adequate distal aortic perfusion.…”

Section: Discussionmentioning

confidence: 99%

Reversal of paralysis and visceral ischemia after thoracic aortic ligation for infection via extra anatomic ascending aorta to infarenal aorta bypass graft

Awad

Elgharably

Buohliqah

et al. 2014

J Cardiothorac Surg

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Surgical management of acute aortic infection is challenging, including excision of the infected segment and reconstruction either through extra-anatomical bypass or in situ graft replacement with higher risk of re-infection. Here in, we present a case of delayed paralysis developed after an extra-anatomic (axillary-bifemoral) bypass of infected thoracic aorta in a 51 year old Caucasian male. Reversal of paralysis was successfully achieved via larger extra-anatomical ascending aorta to infra-renal aorta bypass and cerebrospinal fluid (CSF) drainage.Electronic supplementary materialThe online version of this article (doi:10.1186/s13019-014-0142-4) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Reversal of paralysis and visceral ischemia after thoracic aortic ligation for infection via extra anatomic ascending aorta to infarenal aorta bypass graft

Awad

Elgharably

Buohliqah

et al. 2014

J Cardiothorac Surg

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“…Intermittent clamp release has long been a practice during the repair of aortic aneurysms in order to provide intermittent blood flow to distal organs and reduce the effects of ischemia-reperfusion injury (31). Similarly, clinical practice with REBOA over the last ten years in Japan frequently involves intermittent balloon deflation (5).…”

Section: Endovascular Methods For Achieving Aortic Occlusionmentioning

confidence: 99%

Emerging Endovascular Therapies for Non-Compressible Torso Hemorrhage

Russo

Neff

Johnson

et al. 2016

Shock

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Management of non-compressible torso hemorrhage (NCTH) remains a challenge despite continued advancements in trauma resuscitation. Resuscitative thoracotomy with aortic cross-clamping and recent advances in endovascular aortic occlusion, including resuscitative endovascular occlusion of the aorta (REBOA), have finite durations of therapy due to the inherent physiologic stressors that accompany complete occlusion. Here we attempt to illuminate the current state of aortic occlusion for trauma resuscitation including: 1) explanation of the deleterious consequences of complete occlusion, 2) potential methods and limitations of existing technology to overcome these consequences, 3) a description of innovative methods to improve the resuscitation of NCTH. By explaining the complexity and potential deleterious effects of resuscitation augmented with aortic occlusion, our goal is to provide practitioners with a real-world perspective on current endovascular technology and to encourage the continued innovation required to overcome existing obstacles.

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“…When a distal perfusion technique is not provided and an aortic clamp is present, the perfusion of the vital tissues distal to the aortic clamp is provided by collateral vessels and depends upon the proximal perfusion pressure [62]. Thus, hypotension should be avoided as much as possible [62,66,67]. When the aortic clamp is released, the rapid decrease in vascular resistance produces hypotension.…”

Section: Hemodynamic Response To Cross-clampingmentioning

confidence: 99%