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The Bentall procedure is a type of cardiac surgery involving composite graft replacement of the aortic valve, aortic root, and ascending aorta, with re-implantation of the coronary arteries into the graft. This operation is used to treat combined disease of the aortic valve and ascending aorta, including lesions associated with Marfan syndrome.
Prior to the advent of endovascular aneurysm repair (EVAR), OAS was the only surgical treatment available for aortic aneurysms. The shift away from open aortic surgery towards endovascular surgery since 2003 has been driven by worse perioperative mortality associated with OAS, particularly in patients in relatively frail health. [2]
Endovascular aneurysm repair (EVAR) is a type of minimally-invasive endovascular surgery used to treat pathology of the aorta, most commonly an abdominal aortic aneurysm (AAA). When used to treat thoracic aortic disease, the procedure is then specifically termed TEVAR for "thoracic endovascular aortic/aneurysm repair."
For many years, the gold standard treatment for patients with aortic valve disease and aortic root aneurysms was to replace both the aortic valve and the ascending aorta with a composite graft. This also applies to patients with different levels of AI and annuloaortic ectasia, where the aortic valve may be largely preserved without any ...
Aortic aneurysm; Figure A shows a normal aorta. Figure B shows a thoracic aortic aneurysm (which is located behind the heart). Figure C shows an abdominal aortic aneurysm located below the arteries that supply blood to the kidneys. Specialty: Cardiology, Vascular surgery: Symptoms: abdominal pain and back pain: Complications: Hemorrhaging ...
There are two options: tubular ascending aortic replacement or replacement of the aortic root. Tubular ascending aortic replacement. The aorta is divided above the aortic valve and root. The avascular graft is then sutured to the aortic root. The form of the aortic valve may have been changed by this maneuver, it thus has to be carefully checked.
This was quickly followed by use of DHCA by Alfred Uihlein and other surgeons for treatment of large cerebral aneurysms, another neurosurgical procedure, for which DHCA is still used today. [23] In 1963, Christiaan Barnard and Velva Schrire were the first to use DHCA to repair an aortic aneurysm, cooling the patient to 10 °C. [13]
A more recently proposed mechanism is that the aorta can be compressed between bony structures (such as the manubrium, clavicle, and first rib) and the spine. In the ascending aorta (the portion of the aorta which is almost vertical), one mechanism of injury is torsion (a two-way twisting). [5] There are clinical predictors of an aortic injury. [6]
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