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1.
JACC Case Rep ; 3(2): 267-268, 2021 Feb.
Article in English | MEDLINE | ID: mdl-34317514

ABSTRACT

We present an exceptional case of a quadricuspid aortic valve associated with a left atrial myxoma. Both are rare conditions, and this association has not been reported yet. These conditions can be silent but may lead to several complications. This case highlights importance of a careful echocardiographic evaluation for early management. (Level of Difficulty: Beginner.).

3.
Vasc Health Risk Manag ; 11: 211-7, 2015.
Article in English | MEDLINE | ID: mdl-25848302

ABSTRACT

OBJECTIVE: The objective of this study is to explore the feasibility and efficacy of a new technique for sutureless vascular anastomosis, using glued prosthesis, as a sole anastomosis fixation method in rabbits. METHODS: Ten rabbits were randomly selected to conduct the experiment. Five rabbits underwent direct anastomosis of infrarenal abdominal aorta, with glued prosthesis. In five other rabbits, reconstruction was done by sutured anastomosis. All animals were immediately examined by echo-Doppler for patency of anastomosis. The burst pressure of the glued anastomosis was measured and compared with that of a sutured artery. The animals were euthanized, and tissue samples were taken for histological examination immediately after the experiment. RESULTS: Compared to conventional anastomoses, sutureless vascular anastomoses required shorter time of creation and significantly reduced blood loss (P<5%). There was no significant difference on the average blood flow through the anastomosis between two groups at the end of surgery. All anastomoses with glued prosthesis, examined by echo-Doppler, were patent at the anastomotic site, except one, which was stenosed immediately after surgery. In the control group, except one with stenosis, all conventional anastomoses were patent. Mean burst pressure at the anastomotic site for sutureless anastomoses was lower than in control group. Macroscopically, the BioGlue did not demonstrate any adhesion to the surrounding tissue as it was covered by the vascular prosthesis. Histological examination showed low-grade inflammatory reaction in glued anastomoses versus no inflammatory reaction at the sutured anastomoses. CONCLUSION: This technique may provide a feasible and successful alternative in vascular surgery. However, further long-term studies are necessary to elucidate the break pressure and degree of inflammation at the anastomotic site.


Subject(s)
Aorta, Abdominal/surgery , Blood Vessel Prosthesis Implantation/instrumentation , Blood Vessel Prosthesis Implantation/methods , Blood Vessel Prosthesis , Proteins/pharmacology , Tissue Adhesives/pharmacology , Animals , Aorta, Abdominal/diagnostic imaging , Aorta, Abdominal/physiopathology , Blood Loss, Surgical , Blood Vessel Prosthesis Implantation/adverse effects , Feasibility Studies , Female , Graft Occlusion, Vascular/etiology , Graft Occlusion, Vascular/physiopathology , Male , Models, Animal , Operative Time , Rabbits , Regional Blood Flow , Stress, Mechanical , Time Factors , Ultrasonography, Doppler , Vascular Patency
4.
Ann Surg Innov Res ; 8(1): 8, 2014.
Article in English | MEDLINE | ID: mdl-25493096

ABSTRACT

BACKGROUND: In recent years, several methods and new techniques have been studied and proposed for establishment of sutureless vascular anastomoses, streaming use of sutureless vascular surgery in the future. PRESENTATION OF THE HYPOTHESIS: The new vascular connector (NVC) is a hypothetical design of a vascular device, proposed for creation and maintenance of sutureless vascular anastomosis. Implication of NVC would introduce a new device and technique in establishment of sutureless vascular anastomosis in which surgical approach is minimized and so post-operation disorders. It would eliminate need for suture; shorten clampage and operation time, consequently reducing stress for both, the surgeon and the patient. It enables the creation of vascular anastomosis fast, simple, safe, reliable, with satisfactory patency and stability of anastomosis. TESTING THE HYPOTHESIS: Efficacy of NVC needs to be evaluated in further studies, in order to be confirmed for clinical use. The effectiveness of NVC should be verified firstly in vitro and in vivo tests; and by animal experiments. The likelihood of its negative influence in thrombogenicity should be well evaluated. IMPLICATIONS OF THE HYPOTHESIS: Implication of the new vascular connector (NVC) would be of interest to both patients and the surgeon due to the following main achievements: 1) enables the creation of vascular anastomosis fast and simple, 2) significant shortening of clampage time of blood vessels and operation time-this assumption would be followed by reduced risk of operative and post-operative complications and length of hospital stay or admission to Intensive care unit, 3) safe and reliable, 4) compatible with any blood vessel and standard vascular graft, 5) using the NVC we will reduce in minimum need for replaced blood volume, 6) reduces the cost of treatment. It is anticipated that the NVC would provide shorter operation time and least operative and post-operative complications in creation of sutureless vascular anastomosis.

5.
Heart Lung Circ ; 23(10): e226-8, 2014 Oct.
Article in English | MEDLINE | ID: mdl-24931065

ABSTRACT

We report the case of 54 year-old man who presented with an injury of the brachiocephalic artery secondary to a violent blunt chest trauma. The patient underwent urgent open surgical repair. The procedure was achieved on on-pump beating heart approach. The subsequent course was uneventful.


Subject(s)
Aneurysm, False/surgery , Brachiocephalic Trunk/injuries , Coronary Artery Bypass/methods , Wounds, Nonpenetrating/surgery , Aneurysm, False/etiology , Brachiocephalic Trunk/surgery , Humans , Male , Middle Aged , Myocardial Contraction , Sternotomy , Vascular Grafting , Wounds, Nonpenetrating/complications
6.
Interact Cardiovasc Thorac Surg ; 15(2): 294-6, 2012 Aug.
Article in English | MEDLINE | ID: mdl-22566511

ABSTRACT

Heart wounds are frequently fatal. The haemorrhage from a right ventricle-gunshot wound in a male patient was successfully controlled using a novel haemostatic vacuum device. This case report shows how this simple, quick and efficient method can be used to control critical bleedings.


Subject(s)
Heart Injuries/surgery , Hemostatic Techniques/instrumentation , Wounds, Gunshot/surgery , Aged, 80 and over , Cardiac Tamponade/etiology , Cardiac Tamponade/surgery , Equipment Design , Fatal Outcome , Heart Injuries/diagnosis , Heart Injuries/etiology , Heart Ventricles/injuries , Humans , Male , Sternotomy , Suicide, Attempted , Suture Techniques , Treatment Outcome , Vacuum , Wounds, Gunshot/diagnosis , Wounds, Gunshot/etiology
7.
Eur J Cardiothorac Surg ; 42(1): 178-9, 2012 Jul.
Article in English | MEDLINE | ID: mdl-22334630

ABSTRACT

The extraction by cervicotomy of substernal goitres may be impossible and sometimes requires the enlargement of the thoracic inlet with at least a sternal-split. We present the extraction of a posterior mediastinal substernal goitre with the application of an innovative vacuum-based suction device, previously used for the control of bleeding from the heart and great vessels in clinical and experimental conditions.


Subject(s)
Goiter, Substernal/surgery , Thyroidectomy/instrumentation , Aged , Humans , Male , Thyroidectomy/methods , Vacuum
8.
J Interv Cardiol ; 25(1): 95-101, 2012 Feb.
Article in English | MEDLINE | ID: mdl-21981588

ABSTRACT

BACKGROUND AND AIM OF THE STUDY: Postoperative pericardial effusion is frequent and can be complicated by cardiac tamponade. Although the different drainage techniques are well described in the setting of medical effusion, there is not a standard postoperative effusion treatment. The aim of this work was to assess the feasibility and effectiveness of the percutaneous pericardial drainage. METHODS: This a retrospective study involving 197 patients from 1990 to 2008. Drainage was performed by subxiphoid puncture (91.9%) or left parasternal puncture (8.1%) between 3 and 690 days following a cardiac procedure via median sternotomy. Effusion thickness was at least 10 mm in the subcostal echocardiography view. RESULTS: No deaths directly related to the procedure were observed. Complete and enduring drainage was achieved in 158 patients (80.2%). The procedure failed for 22 patients (11.2%) because no fluid was drained in 14 cases (7.1%) and a right ventricular puncture in 8 cases (4.1%). Recurrence of the effusion, which occurred for 17 patients (8.6%), was more frequent if an effusion of more than 5 mm persisted after the first drainage (P = 0.024) and if the drainage was performed outside the operating room because of emergency (P = 0.046). Risk factors for mortality were recurrence of the effusion (P = 0.04) and drainage performed outside the operating room (P = 0.007). CONCLUSIONS: Percutaneous pericardial drainage is effective to treat postoperative pericardial effusion. When the effusion is thicker than 10 mm and accessible, it can be the initial strategy and surgical drainage can serve as an alternate strategy in case of failure and complications of this procedure.


Subject(s)
Drainage/methods , Pericardial Effusion/therapy , Adolescent , Adult , Aged , Aged, 80 and over , Cardiac Surgical Procedures/adverse effects , Female , Humans , Male , Middle Aged , Pericardial Effusion/etiology , Pericardial Effusion/mortality , Postoperative Complications , Recurrence , Retrospective Studies , Risk Factors , Treatment Outcome , Young Adult
9.
Clin Chem Lab Med ; 49(5): 897-901, 2011 May.
Article in English | MEDLINE | ID: mdl-21288172

ABSTRACT

BACKGROUND: The aim of this work has been to study the association between plasma asymmetric dimethylarginine (ADMA) concentrations and carotid stenosis in a group of 64 patients undergoing carotid endarterectomy (CEA). METHODS: Arginine, ADMA and symmetric dimethylarginine (SDMA) were measured using capillary electrophoresis with UV detection. An evaluation of plasma concentrations of total cysteine (tCys) and total homocysteine (tHcy) was also performed. RESULTS: Pearson's analysis show a positive correlation between ADMA and carotid stenosis (r=0.37, p=0.003), which is also confirmed after stepwise multiple linear regression analysis. ADMA plasma concentrations were significantly associated with tHcy (r=0.40, p=0.001) and to a lesser extent, even if not significantly, with tCys (r=0.23, p=0.07). CONCLUSIONS: Our data suggest that plasma ADMA is involved in carotid narrowing after CEA intervention. This suggests that this molecule may have an important role in the events that lead to stenosis.


Subject(s)
Arginine/analogs & derivatives , Carotid Artery Diseases/blood , Carotid Artery Diseases/surgery , Endarterectomy, Carotid , Aged , Arginine/blood , Cohort Studies , Cysteine/blood , Female , Homocysteine/blood , Humans , Male , Middle Aged , Regression Analysis
10.
Eur J Cardiothorac Surg ; 39(6): 1070-2, 2011 Jun.
Article in English | MEDLINE | ID: mdl-21075003

ABSTRACT

Bleeding is one of the major problems during surgery as well as in cases of accidental vascular injury. Control of bleeding can be life threatening in two surgical circumstances: when the wound is difficult to expose, and when the tissue too fragile to suture. Following more than 100 animal tests, we developed an innovative vacuum-based suction device, which enables us to address this challenge. We set up a proof-of-concept protocol in humans and report here our first clinical experience.


Subject(s)
Blood Loss, Surgical/prevention & control , Hemostasis, Surgical/methods , Animals , Aorta/injuries , Coronary Artery Bypass/adverse effects , Heart Atria/injuries , Hemostasis, Surgical/instrumentation , Humans , Prospective Studies , Sheep , Suction/instrumentation , Vacuum , Wound Healing
11.
PLoS One ; 5(5): e10476, 2010 May 04.
Article in English | MEDLINE | ID: mdl-20454563

ABSTRACT

Powering future generations of implanted medical devices will require cumbersome transcutaneous energy transfer or harvesting energy from the human body. No functional solution that harvests power from the body is currently available, despite attempts to use the Seebeck thermoelectric effect, vibrations or body movements. Glucose fuel cells appear more promising, since they produce electrical energy from glucose and dioxygen, two substrates present in physiological fluids. The most powerful ones, Glucose BioFuel Cells (GBFCs), are based on enzymes electrically wired by redox mediators. However, GBFCs cannot be implanted in animals, mainly because the enzymes they rely on either require low pH or are inhibited by chloride or urate anions, present in the Extra Cellular Fluid (ECF). Here we present the first functional implantable GBFC, working in the retroperitoneal space of freely moving rats. The breakthrough relies on the design of a new family of GBFCs, characterized by an innovative and simple mechanical confinement of various enzymes and redox mediators: enzymes are no longer covalently bound to the surface of the electron collectors, which enables use of a wide variety of enzymes and redox mediators, augments the quantity of active enzymes, and simplifies GBFC construction. Our most efficient GBFC was based on composite graphite discs containing glucose oxidase and ubiquinone at the anode, polyphenol oxidase (PPO) and quinone at the cathode. PPO reduces dioxygen into water, at pH 7 and in the presence of chloride ions and urates at physiological concentrations. This GBFC, with electrodes of 0.133 mL, produced a peak specific power of 24.4 microW mL(-1), which is better than pacemakers' requirements and paves the way for the development of a new generation of implantable artificial organs, covering a wide range of medical applications.


Subject(s)
Bioelectric Energy Sources , Glucose/metabolism , Implants, Experimental , Animals , Catechol Oxidase/metabolism , Electrodes , Glucose Oxidase/metabolism , Hydrogen-Ion Concentration , Male , Oxidation-Reduction , Prosthesis Implantation , Rats , Rats, Wistar , Time Factors , Ubiquinone/metabolism , Urea/metabolism , Urease/metabolism
12.
Interact Cardiovasc Thorac Surg ; 8(2): 287-9, 2009 Feb.
Article in English | MEDLINE | ID: mdl-19004862

ABSTRACT

The advent of endovascular prostheses to treat descending thoracic aortic lesions offers an alternative approach in patients who are poor candidates for surgery. We present a case of a type B descending thoracic aortic dissection with rapid aneurysmal evolution in a woman with a giant-cell arteritis, treated by endovascular repair: 26 months after, we observed the anterior dislocation of the distal segment of the stent. The dislocation required a second treatment in order to avoid the aortic wall rupture and to restore the axis of the prosthesis. This report emphasizes the difficulty of the endovascular repair in the giant-cell arteritis, because of the vascular fragility confirmed by the rapid aneurysmal evolution after the type B dissection and the appearance of the stenting complication.


Subject(s)
Aortic Aneurysm, Thoracic/surgery , Aortic Dissection/surgery , Blood Vessel Prosthesis Implantation , Foreign-Body Migration/etiology , Giant Cell Arteritis/complications , Stents , Aged , Aortic Dissection/diagnostic imaging , Aortic Dissection/etiology , Aortic Aneurysm, Thoracic/diagnostic imaging , Aortic Aneurysm, Thoracic/etiology , Aortography/methods , Blood Vessel Prosthesis Implantation/adverse effects , Blood Vessel Prosthesis Implantation/instrumentation , Female , Foreign-Body Migration/diagnostic imaging , Foreign-Body Migration/surgery , Giant Cell Arteritis/diagnostic imaging , Giant Cell Arteritis/drug therapy , Humans , Immunosuppressive Agents/therapeutic use , Reoperation , Tomography, X-Ray Computed , Treatment Outcome
13.
Can J Cardiol ; 24(10): 781-5, 2008 Oct.
Article in French | MEDLINE | ID: mdl-18841258

ABSTRACT

BACKGROUND: There are almost three million octogenarians living in France, many of whom present with a coronaropathy. Moreover, it appears that life expectancy at 80 years of age is still important. OBJECTIVE: To evaluate the results of coronary surgery among these patients. METHODS: Eighty-eight consecutive octogenarians who had an isolated coronary artery bypass surgery between 1996 and 2002 were compared with 165 patients 60 to 70 years of age; the two groups had been paired according to the main risk factors. Patients were contacted by telephone and then received a quality-of-life-related questionnaire. RESULTS: Operative mortality was 2.3% in the octogenarian versus 1.2% in the 60- to 70-year-old group (P not significant). There was more low cardiac output syndrome, postoperative acute renal failure and transfusion in octogenarians. Long-term survival (average duration of follow-up was 3.8 years) was higher in the 60- to 70-year-old group: 89.7% versus 77.9% (P=0.025). Four independent risk factors of long-term increased mortality were found: age, diabetes, history of stroke and postoperative blood transfusion. Finally, the long-term survival in the octogenarians who had this surgery was higher than in the octogenarians of the general French population to a significant degree, with a quality of life considered to be satisfactory. CONCLUSION: For selected octogenarians, an isolated coronary surgery can be proposed, with short- and long-term results comparable with those of a younger population.


Subject(s)
Coronary Artery Bypass/methods , Coronary Disease/mortality , Coronary Disease/surgery , Quality of Life , Age Factors , Aged , Aged, 80 and over , Coronary Disease/psychology , Female , Follow-Up Studies , France/epidemiology , Humans , Male , Middle Aged , Retrospective Studies , Risk Factors , Survival Rate/trends , Time Factors
14.
Can J Cardiol ; 24(10): e73-4, 2008 Oct.
Article in English | MEDLINE | ID: mdl-18841264

ABSTRACT

Behçet's disease is an autoimmune, multisystem disease presenting with recurrent oral and genital ulceration as well as ocular involvement. Aneurysmal degeneration of coronary arteries remains a rare phenomenon in Behçet's disease. The case of a patient with Behçet's disease who presented with severe stenosis of the left anterior descending artery associated with a giant aneurysm of the proximal segment is described. Surgical revascularization was proposed, followed by percutaneous embolization of the aneurysm.


Subject(s)
Behcet Syndrome/complications , Coronary Aneurysm/complications , Coronary Stenosis/etiology , Adult , Behcet Syndrome/diagnostic imaging , Coronary Aneurysm/diagnostic imaging , Coronary Aneurysm/therapy , Coronary Angiography , Coronary Stenosis/diagnostic imaging , Coronary Stenosis/surgery , Diagnosis, Differential , Embolization, Therapeutic , Humans , Male , Myocardial Revascularization , Severity of Illness Index , Tomography, X-Ray Computed
15.
J Card Surg ; 23(6): 741-2, 2008.
Article in English | MEDLINE | ID: mdl-18462338

ABSTRACT

We report the case of 31-year-old man who was admitted for cerebellar ischemia. The echocardiography showed an intraventricular mass, mobile with the cardiac activity compatible with a thrombus or a myxoma. He successfully underwent a video-assisted removal of the mass, through the mitral valve.


Subject(s)
Brain Ischemia/diagnostic imaging , Cardiac Surgical Procedures/instrumentation , Heart Neoplasms/surgery , Heart Ventricles/surgery , Mitral Valve/surgery , Thoracic Surgery, Video-Assisted , Adult , Brain Ischemia/pathology , Brain Ischemia/surgery , Cardiac Surgical Procedures/methods , Heart Neoplasms/diagnostic imaging , Heart Neoplasms/pathology , Heart Ventricles/diagnostic imaging , Heart Ventricles/pathology , Humans , Male , Mitral Valve/pathology , Myxoma/surgery , Thoracic Surgery, Video-Assisted/methods , Ultrasonography
16.
Ann Vasc Surg ; 20(6): 731-5, 2006 Nov.
Article in English | MEDLINE | ID: mdl-16830208

ABSTRACT

Tracheoinnominate artery fistula is an uncommon but life-threatening complication usually requiring emergency ligation of the artery. The recent introduction of stent-grafts offers a new therapeutic option for emergency management of hemorrhage. Stent-grafts can be used for definitive treatment or as a bridge to surgery. The purpose of this report is to describe a case of hemoptysis due to a tracheoinnominate artery fistula that occurred after a single orotracheal intubation for general anesthesia and was treated by placement of a covered stent followed 12 hours later by surgical revascularization of the innominate artery using a cryopreserved arterial allograft.


Subject(s)
Angioplasty , Arteries/transplantation , Brachiocephalic Trunk/surgery , Respiratory Tract Fistula/surgery , Stents , Tracheal Diseases/surgery , Vascular Fistula/surgery , Brachiocephalic Trunk/diagnostic imaging , Cryopreservation , Female , Hemoptysis/etiology , Hemoptysis/surgery , Humans , Intubation, Intratracheal/adverse effects , Middle Aged , Respiratory Tract Fistula/diagnostic imaging , Respiratory Tract Fistula/etiology , Tomography, X-Ray Computed , Trachea/injuries , Tracheal Diseases/diagnostic imaging , Tracheal Diseases/etiology , Transplantation, Homologous , Treatment Outcome , Vascular Fistula/diagnostic imaging , Vascular Fistula/etiology
18.
Clin Chem Lab Med ; 43(10): 1015-9, 2005.
Article in English | MEDLINE | ID: mdl-16197291

ABSTRACT

The aim of this work was to study the association between plasma thiol levels and percentage carotid narrowing in a group of 68 patients who underwent a carotid endarterectomy, pertained as a risk factor for vascular and cardiovascular disease. Total plasma thiols were measured by capillary electrophoresis laser-induced fluorescence. The mean values of the hematological parameters studied were within normal limits and 25% of the patients were hyperhomocysteinemic (homocysteine >15 micromol/L). Pearson's correlation between carotid narrowing degree and the most common risk factors for atherosclerosis showed a positive relationship only between carotid narrowing degree and cysteine levels (r=0.252; p<0.05). Stepwise multiple linear regression with carotid narrowing degree as the dependent variable, and cysteine, homocysteine, age, triglyceride and low-density lipoprotein-cholesterol as independent variables confirmed that cysteine was significantly associated with these variables. By regrouping the population according to cysteine and homocysteine concentration percentiles, we found positive correlation between these parameters and median values of carotid narrowing degree. Our study provides experimental evidence to confirm that plasma homocysteine and cysteine are involved in carotid narrowing after carotid endarterectomy intervention, suggesting that cysteine may be involved in the deleterious molecular mechanisms active in carotid stenosis.


Subject(s)
Carotid Artery Diseases/blood , Carotid Artery Diseases/pathology , Sulfhydryl Compounds/blood , Aged , Endarterectomy, Carotid , Female , Humans , Male , Middle Aged , Risk Factors
19.
J Vasc Surg ; 42(1): 153-8, 2005 Jul.
Article in English | MEDLINE | ID: mdl-16012465

ABSTRACT

Coxiella burnetii, the etiologic agent of Q fever, is mainly responsible for endocarditis with negative blood culture results, but only a few cases of C. burnetii infections of aortic aneurysms have been published. We report three cases of abdominal aortic aneurysms treated in patients with Q fever infection with simultaneous endocarditis (n = 1) and previous history of cardiac valve replacement for endocarditis (n = 1). A coeliac aortic aneurysm was diagnosed in one patient treated for acute Q fever with persistent serologic results showing chronic infection despite adequate antibiotic therapy and without endocarditis. Resection of the aneurysm cured the chronic infection, and C. burnetii was identified by culture of the aneurysmal wall. In the two other cases, chronic infection of C. burnetii was diagnosed by serologic examination after surgery for an abdominal aortic aneurysm. One patient with negative blood culture results had amaurosis fugax due to endocarditis and required aortic valve replacement; recurrent fever without evidence of valve dysfunction or infection developed in one patient who had had prosthetic cardiac valve replacement 6 months earlier for endocarditis. Aortic aneurysms were treated with in situ prosthetic grafts and long-term antibiotic therapy. At a mean follow-up of 12 years, no septic aortic complications occurred, and serologic test results have remained negative. The presence of an aortic aneurysm and cardiac valve disease seems to be a predisposing factor for chronic C. burnetii infection. Diagnosis particularly relies on the physician's awareness of this condition and is confirmed by serologic examination. Aortic aneurysm resection is mandatory to cure the chronic infection and must be associated with long-term antibiotic therapy.


Subject(s)
Aneurysm, Infected/microbiology , Aortic Aneurysm, Abdominal/complications , Endocarditis, Bacterial/complications , Q Fever/complications , Aged , Aneurysm, Infected/surgery , Aortic Aneurysm, Abdominal/pathology , Aortic Aneurysm, Abdominal/surgery , Blood Vessel Prosthesis Implantation , Chronic Disease , Doxycycline/therapeutic use , Drug Therapy, Combination , Endocarditis, Bacterial/microbiology , Endocarditis, Bacterial/surgery , Female , Heart Valve Prosthesis Implantation , Humans , Iliac Artery/pathology , Male , Middle Aged , Q Fever/drug therapy , Rifampin/therapeutic use
20.
J Vasc Surg ; 41(4): 708-11, 2005 Apr.
Article in English | MEDLINE | ID: mdl-15874937

ABSTRACT

We report a type B aortic dissection treated with stenting of the descending thoracic aorta that subsequently developed an ischemic necrosis of the esophagus with a posterior mediastinum abscess. The surgical treatment consisted of an extra-anatomic bypass to revascularize the supra-aortic trunks and the distal abdominal aorta through a middle sternal laparotomy, the resection of the thoracic aorta, and the drainage of the mediastinal abscess. Despite this aggressive surgical approach and an initial favorable postoperative course, the patient suddenly died 3 weeks later, likely from a rupture of the aortic stump.


Subject(s)
Angioplasty/adverse effects , Aortic Aneurysm, Thoracic/surgery , Aortic Dissection/surgery , Blood Vessel Prosthesis Implantation/adverse effects , Esophageal Fistula/etiology , Esophageal Fistula/diagnosis , Esophageal Fistula/surgery , Fatal Outcome , Humans , Male , Middle Aged , Stents
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