1/1026. Transplant kidney protection during aortic aneurysm surgery.PURPOSE: Renal allografts are sensitive to ischemic insult. During aortic cross clamping prevention of ischemic damage to a kidney below an aneurysm is vital. Many maneuvers have been reported. We describe a simple technique of protecting the transplant kidney from ischemic damage during aortic surgery. MATERIALS AND methods: During vascular cross clamping a sterile ice slush was placed around the kidney for surface cooling, obviating the need for some of the complicated procedures previously reported. RESULTS: After removal of the ice slush and clamps, urine production resumed and creatinine levels remained unchanged. CONCLUSIONS: External cooling with ice slush provides adequate renal protection during aortic cross clamping and requires no special expertise or equipment.- - - - - - - - - - ranking = 1keywords = aneurysm (Clic here for more details about this article) |
2/1026. aortitis with multiple aneurysms mimicking infective endocarditis.aortitis usually produces aortic insufficiency by aortic root dilation. In rare cases the inflammation may involve the aortic valve cusps, causing valvular insufficiency. A patient in whom aortitis produced valvular masses, with aortic and peripheral arterial aneurysms, embolic episodes and aortic insufficiency is described. Valve replacement for suspected infective endocarditis was complicated by homograft dehiscence and multiple false aneurysms. Although immunosuppression was successful in decreasing the patient's vasculitis, he became infected and died of complications of aspergillus infection.- - - - - - - - - - ranking = 1.2keywords = aneurysm (Clic here for more details about this article) |
3/1026. Simultaneous operation for minimally invasive direct coronary artery bypass and abdominal aortic aneurysm repair.Simultaneous minimally invasive direct coronary artery bypass and abdominal aortic aneurysm repair were conducted in a 66-year-old man uneventful, requiring no transfusion. Surgery required 9 hours and 2 minutes. The tracheal tube was extubated in the operating room. Postoperative bleeding was 215 ml. The postoperative course was very smooth, with the patient able to walk on postoperative day 1. Postoperative coronary arteriogram and aortogram showed favorable results and the patient was discharged on day 23 after surgery.- - - - - - - - - - ranking = 1keywords = aneurysm (Clic here for more details about this article) |
4/1026. takayasu arteritis--a case report of aortic aneurysm.Aortic pseudo-aneurysm is a rare manifestation of takayasu arteritis. We present a 16-year-old girl who first complained of multiple arthritis, recurrent abdominal pain and malaise at the age of 15 years. The initial working diagnosis was juvenile rheumatoid arthritis. Follow-up abdominal ultrasonography for her hepatomegaly incidentally revealed an aortic aneurysm. Total aortography showed diffuse aortic narrowing and an infra-renal aortic pseudo-aneurysm. Vascular reconstruction with an interposition Dacron graft was performed with uneventful recovery. Early non-specific presentation of takayasu arteritis often results in delay of diagnosis. The presence of a vascular bruit in a young female with non-specific symptoms should point to a differential diagnosis of takayasu arteritis. We review the role of surgery in the management of this condition.- - - - - - - - - - ranking = 1.4keywords = aneurysm (Clic here for more details about this article) |
5/1026. Infrarenal endoluminal bifurcated stent graft infected with listeria monocytogenes.Prosthetic graft infection as a result of listeria monocytogenes is an extremely rare event that recently occurred in a 77-year-old man who underwent endoluminal stent grafting for infrarenal abdominal aortic aneurysm. The infected aortic endoluminal prosthesis was removed by means of en bloc resection of the aneurysm and contained endograft with in situ aortoiliac reconstruction. At the 10-month follow-up examination, the patient was well and had no signs of infection.- - - - - - - - - - ranking = 0.4keywords = aneurysm (Clic here for more details about this article) |
6/1026. Abdominal aortic aneurysm repair in patients with renal allografts.Aortic reconstruction is being reported in an increasing number of patients after renal transplantation as a result of improved renal graft survival and life expectancy. Aortic surgery in these patients places the pelvic allograft at risk for ischemic damage. We present two separate modalities that have been successfully used in protecting the renal transplant from prolonged warm ischemia during abdominal aortic aneurysm (AAA) repair in two cases. One technique involves an aortofemoral shunt using the perirenal aorta for proximal cannulation and the other technique utilizes an indwelling shunt through the prosthetic graft. Both patients had an uneventful recovery with no evidence of renal dysfunction and their renal function has been stable on long-term follow-up. These cases illustrate two useful alternatives in providing pulsatile perfusion to a transplanted kidney in the iliac fossa during AAA repair. They have been used successfully as simpler alternatives to temporary axillofemoral bypass or extracorporeal pump oxygenation in preventing postoperative renal dysfunction.- - - - - - - - - - ranking = 1keywords = aneurysm (Clic here for more details about this article) |
7/1026. Inflammatory abdominal aortic aneurysm and bilateral complete ureteral obstruction: treatment by endovascular graft and bilateral ureteric stenting.Inflammatory abdominal aortic aneurysms may present a challenge to the surgeon, especially because of associated retroperitoneal fibrosis and possible ureteral complications. We present a case of inflammatory abdominal aortic aneurysm with bilateral ureteral entrapment and complete anuria, successfully treated by endovascular grafting and temporary ureteral stenting.- - - - - - - - - - ranking = 1.2keywords = aneurysm (Clic here for more details about this article) |
8/1026. In situ repair of a secondary aortoappendiceal fistula with a rifampin-bonded Dacron graft.Secondary aortoenteric fistulas remain challenging diagnostic and therapeutic problems. Although the duodenum is most frequently involved, other intestinal segments are possible sites for fistulization. We report here a case of graft-appendiceal fistula revealed by recurrent gastrointestinal bleeding 11 years after abdominal aortic aneurysm replacement. The preoperative diagnosis was not achieved by endoscopy or imaging assessment. Despite recommended principles of total graft excision and extraanatomic bypass, appendectomy and in situ rifampin-bonded graft reconstruction were performed because of the advanced age and poor arterial runoff. The postoperative course was uneventful and the patient remains well 17 months after operation.- - - - - - - - - - ranking = 0.2keywords = aneurysm (Clic here for more details about this article) |
9/1026. Single-stage surgery for distal aortic arch aneurysm and infrarenal abdominal aortic aneurysm through anterolateral approach.A 58-year-old man with a distal aortic arch aneurysm (DAA) associated with an infrarenal abdominal aortic aneurysm (AAA) successfully underwent a single-stage replacement of the aneurysms. A left anterolateral thoracotomy was used for replacement of the DAA, which was performed using profound hypothermic circulatory arrest and continuous retrograde cerebral perfusion. An extraperitoneal approach in conjunction with a lateral abdominal incision was employed for replacement of the AAA. The combination of an anterolateral thoracotomy and a lateral abdominal incision is useful in combined surgery for DAA and AAA.- - - - - - - - - - ranking = 2.2keywords = aneurysm (Clic here for more details about this article) |
10/1026. Subacute ischaemic proctitis: a rare condition requiring extensive rectal surgery.Subacute ischaemic proctitis is a rare condition. We describe the case of a 60-year-old male patient who developed, after aortic aneurysm repair, a transient ischaemic colitis that totally healed without sequelae. He eventually developed symptoms of severe proctitis. Investigations identified a stenosis of the mid rectum, while the upper rectum was inflammatory. On angiogram, there was a poor blood flow through the Riolan's arcade and a stenosis of the proximal aorto-graft anastomosis. diagnosis of subacute ischaemic proctitis due to poor blood supply through the internal iliac arteries was made. Anti-inflammatory drugs and dilations were inefficient. A subtotal proctectomy with low colorectal anastomosis was required. On pathological specimen, the lesions were strongly suggestive of an ischaemic process. The patient had an excellent recovery and was asymptomatic 8 months after the operation.- - - - - - - - - - ranking = 0.2keywords = aneurysm (Clic here for more details about this article) |
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