ABSTRACT
BACKGROUND: Distal aortic complications from acute DeBakey I dissection repair are an important source of late morbidity and mortality. We present an early experience of using a novel single-branched thoracic aortic endograft in conjunction with open techniques to treat acute DeBakey I aortic dissection. METHODS: The patients in this series include five hyperacute dissections managed with a combined zone 2 partial arch replacement and placement of a zone 2 single subclavian branch endograft. RESULTS: There were no perioperative mortalities, strokes, or spinal cord ischemia in any patients at either stage of the procedure. At follow-up imaging, no patients had anterograde flow into the false lumen. All patients experienced false lumen thrombosis in the stented portion of the aorta. CONCLUSIONS: This combination of open repair techniques and the use of a novel branched endograft resulted in excellent early outcomes in this pioneer series. Further investigation of these techniques in a prospective fashion is warranted.
ABSTRACT
A 2010 Minnesota law required the Department of Human Services to develop a collaborative psychiatric consultation service for primary care practitioners and other health care professionals, with an initial focus on those who prescribe medications for children. Use of the service will be required for prescribers of certain psychotropic medications for children enrolled in fee-for-service Medical Assistance, the state's Medicaid program. This article discusses the impetus for the law, explains the new medication review requirements, and describes plans for the consultation service.
