Abstract Acute type A aortic dissection (ATAAD) still poses significant challenges and management dilemmas for cardiovascular surgeons worldwide. Despite the continuous improvement in diagnosis and management strategies for ATAAD, clinical outcomes remain poor and the optimal therapy is still debatable especially those with malperfusion syndrome (MPS). This review is based on the current literature and includes the results from the Aortic Registry of National Heart Institute of Malaysia (NHIM) database. It covers different aspects of ATAAD and concentrates on the outcome of surgical repair. The diagnosis is often delayed leading to variable outcomes. High index of suspicion and urgent treatment is required to tackle this dynamic disease which include the variation in presentation and clinical course. Different surgical techniques and perfusion strategies have been described to save patients. Complex techniques such as total arch replacement (TAR) with frozen elephant trunk and valve sparing root surgery may provide long-term benefit in selected patients, but require significant surgical expertise and experience.
{"title":"Current review of acute type A aortic dissection in Malaysia","authors":"Paneer Selvam Krishna Moorthy, Abdul Samad Sakijan, Deventhiran Permal, Intan Fariza Gaaffar, Aini Syakirin Kepli, Haidatul Insyirah Sahimi","doi":"10.1007/s12055-023-01608-2","DOIUrl":"https://doi.org/10.1007/s12055-023-01608-2","url":null,"abstract":"Abstract Acute type A aortic dissection (ATAAD) still poses significant challenges and management dilemmas for cardiovascular surgeons worldwide. Despite the continuous improvement in diagnosis and management strategies for ATAAD, clinical outcomes remain poor and the optimal therapy is still debatable especially those with malperfusion syndrome (MPS). This review is based on the current literature and includes the results from the Aortic Registry of National Heart Institute of Malaysia (NHIM) database. It covers different aspects of ATAAD and concentrates on the outcome of surgical repair. The diagnosis is often delayed leading to variable outcomes. High index of suspicion and urgent treatment is required to tackle this dynamic disease which include the variation in presentation and clinical course. Different surgical techniques and perfusion strategies have been described to save patients. Complex techniques such as total arch replacement (TAR) with frozen elephant trunk and valve sparing root surgery may provide long-term benefit in selected patients, but require significant surgical expertise and experience.","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"28 24","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134991936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-13DOI: 10.1007/s12055-023-01624-2
Giacomo Murana, Francesco Campanini, Valentina Orioli, Vinvenzo Pagano, Valeria Santamaria, Luca Di Marco, Roberto Di Bartolomeo, Davide Pacini
{"title":"Frozen elephant trunk in acute aortic dissection: a literature review","authors":"Giacomo Murana, Francesco Campanini, Valentina Orioli, Vinvenzo Pagano, Valeria Santamaria, Luca Di Marco, Roberto Di Bartolomeo, Davide Pacini","doi":"10.1007/s12055-023-01624-2","DOIUrl":"https://doi.org/10.1007/s12055-023-01624-2","url":null,"abstract":"","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"8 10","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136346338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-08DOI: 10.1007/s12055-023-01620-6
Vladimir M. Unguryan, Anton N. Kazantsev, Alexander V. Korotkikh, Sergey A. Ivanov, Yury V. Belov, Andrey D. Kaprin
{"title":"Isolated liver chemo perfusion for hepatic metastases from uveal melanoma: a report of 38 cases","authors":"Vladimir M. Unguryan, Anton N. Kazantsev, Alexander V. Korotkikh, Sergey A. Ivanov, Yury V. Belov, Andrey D. Kaprin","doi":"10.1007/s12055-023-01620-6","DOIUrl":"https://doi.org/10.1007/s12055-023-01620-6","url":null,"abstract":"","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"110 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135345455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Isolated cardiac cysticercosis of the right ventricle","authors":"Sarvesh Kumar, None Shiva, Vivek Tewarson, Mohammad Zeeshan Hakim, Kumar Rahul, Bhupendra Kumar, Sushil Kumar Singh","doi":"10.1007/s12055-023-01617-1","DOIUrl":"https://doi.org/10.1007/s12055-023-01617-1","url":null,"abstract":"","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"110 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135345454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-06DOI: 10.1007/s12055-023-01616-2
Henrik Agerup Kildahl, Evelyn Lauvstad Brenne, Håvard Dalen, Alexander Wahba
Abstract Embolism is a common complication in infective endocarditis which may lead to serious complications, such as stroke, intestinal ischemia, and peripheral embolization. A comprehensive literature search was performed and the registry at our centre, including 390 cases of infective endocarditis, diagnosed between 2010 and 2020, was investigated. Large registries show that 20–40% of patients with infective endocarditis (IE) are affected by embolism. In many instances, embolism is present already at the time of diagnosis. The rate of embolism during the hospital stay in our data was 11%. However, only 2% developed clinical embolism during or following surgery. According to recent guidelines, previous embolism, and the presence of vegetations > 10 mm present an indication for surgical treatment. Routine imaging revealed non-symptomatic cerebral embolism in 8.5% of surgical patients. However, it is not clear whether detection of non-symptomatic embolism and consecutive surgical treatment improves the prognosis of infective endocarditis.
{"title":"Systemic embolization in infective endocarditis","authors":"Henrik Agerup Kildahl, Evelyn Lauvstad Brenne, Håvard Dalen, Alexander Wahba","doi":"10.1007/s12055-023-01616-2","DOIUrl":"https://doi.org/10.1007/s12055-023-01616-2","url":null,"abstract":"Abstract Embolism is a common complication in infective endocarditis which may lead to serious complications, such as stroke, intestinal ischemia, and peripheral embolization. A comprehensive literature search was performed and the registry at our centre, including 390 cases of infective endocarditis, diagnosed between 2010 and 2020, was investigated. Large registries show that 20–40% of patients with infective endocarditis (IE) are affected by embolism. In many instances, embolism is present already at the time of diagnosis. The rate of embolism during the hospital stay in our data was 11%. However, only 2% developed clinical embolism during or following surgery. According to recent guidelines, previous embolism, and the presence of vegetations > 10 mm present an indication for surgical treatment. Routine imaging revealed non-symptomatic cerebral embolism in 8.5% of surgical patients. However, it is not clear whether detection of non-symptomatic embolism and consecutive surgical treatment improves the prognosis of infective endocarditis.","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135634657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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