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At least 19 recordsLinked to original sources

Ascending aorta-abdominal aorta bypass: indications, technique, and report of 12 patients.

Use of the supraceliac segment of the abdominal aorta for ascending aorta-abdominal aorta bypass (AAAAB) offers a new technique for management of certain difficult surgical problems. Since 1973, we have performed AAAAB in 12 patients: 4 with recurrent coarctation of the thoracic aorta; 4 with coarctation of the thoracic aorta and associated cardiac lesions requiring a concomitant intracardiac procedure; 2 with recurrent aortoiliac occlusive disease (AIOD); 1 with interruption of the aortic arch requiring concomitant pulmonary artery banding; and 1 with coarctation of the abdominal aorta. In 3 of these patients (2 with recurrent AIOD and 1 with coarctation of the abdominal aorta) the distal anastomosis was made to the distal abdominal aorta or femoral arteries. Ten patients (83.3%) experienced satisfactory results; 2 patients (16.6%) died. The technique of AAAAB provides a practical solution to complex situations in which previous procedures preclude a standard operative approach, or when necessary concomitant procedures would otherwise require a two-stage operation.

Adolescent

Staphylococcal aortic pseudoaneurysm. Treatment employing ascending aorta-abdominal aorta bypass graft.

An adult patient developed infection of the anastomosis after resection of an isthmic coarctation, with subsequent formation of a pseudoaneurysm. He was treated successfully by an ascending aorta-abdominal aorta bypass graft. The graft was placed retrosternally and passed through the diaphragm into the retroperitoneal space. After surgery the patient developed systolic hypertension. A faint murmur was heard over the chest and abdomen, caused by the turbulent flow through the graft.

Adult

Ascending aorta-supraceliac abdominal aorta bypass: successful removal of an infected graft in the descending thoracic aorta.

An infected graft and a mycotic pseudoaneurysm were successfully resected by employing an ascending aortasupraceliac abdominal aorta bypass graft in a 19-year-old man. He had formerly undergone graft replacement surgery for traumatic aneurysm of the descending thoracic aorta, with the aid of a temporary external bypass graft. After this first operation, the patient had suffered from septicemia due to Psudomonas aeruginosa, which resulted in formation of mycotic pseudoaneurysms at the distal anastomotic site of the prosthetic graft and at both stumps of the formerly employed external bypass graft.

Adult

Renal revascularization in patients with severe atherosclerosis of the abdominal aorta or a previous operation on the abdominal aorta.

Renal revascularization has been performed in six patients in whom severe atherosclerosis or previous operative procedures on the abdominal aorta precluded the performance of a standard aortorenal bypass graft. Splenorenal anastomoses were performed in three patients, superior mesenterorenal anastomosis in one patient, long saphenous vein iliorenal anastomosis in one patient, and renal autotransplantation in one patient. Successful renal revascularization with preservation of renal function was accomplished in all patients. The natural history of severe atherosclerotic renovascular disease has demonstrated the relatively frequent occurrence of arterial thrombosis and renal failure in patients with solitary kidneys. Occasionally, the presence of severe aortic disease precludes the use of standard aortorenal bypass grafting. Fortunately, as reported herein, alternate methods of revascularization are available whereby renovascular hypertension can be corrected and renal function preserved, with minimal operative risk.

Adult

Hazards of straight catheter aortography in the tortuous abdominal aorta.

Twenty abdominal aortograms utilizing a straight-tipped catheter were evaluated for catheter tip motion during the injection of contrast media. The catheter tips were stable in 15 patients but showed downward recoil in the remaining 5 patients. These 5 patients had marked tortuosity of their abdominal aortae which was felt to be the etiology of the catheter tip instability. Based on this finding, the use of a straight-tipped catheter is to be discouraged in patients with extreme tortuosity of the abdominal aorta.

Aorta, Abdominal

Seat belt aorta: acute dissection and thrombosis of the abdominal aorta.

Aortic trauma mainly involves the thoracic aorta (95%), while the abdominal aorta is infrequently involved (5%). Of growing interest is the role of seat belts in abdominal aortic injuries. Although seat belts are known to cause injuries to the abdominal viscera, they rarely produce aortic trauma. We report here an acute dissection with thrombosis of the abdominal aorta leading to complete peripheral occlusion as a result of lap-type seat belt injury. The two previously reported cases of similar injuries which resulted in incomplete occlusion are reviewed. A hypothesis for the causal mechanism of these injuries is described. The authors also stress careful follow-up of all patients with seat belt injuries since other intra-abdominal vascular injuries may be present.

Accidents, Traffic

Coarctation of the abdominal aorta.

Coarctation of the abdominal aorta is an uncommon process but an important cause of systemic hypertension. Angiography is the investigation of choice to establish a diagnosis and document the extent of involvement. However, angiography does not provide an etiological diagnosis; and it may not be possible to distinguish an acquired coarctation from a congenital process. Three patients with coarctation of the abdominal aorta are presented.

Adolescent

[Incidence and clinical aspects of aneurysm rupture in the abdominal aorta].

On the basis of the section material of 25 years in Tartu a significant increase of the frequency of arteriosclerotic aneurysms of the aorta, especially of the abdominal aorta and its ruptures, could be established. At the same time the appearance of luetic aortic aneurysms decreased. Due to its variable symptomatology the diagnosis of the rupture of an aneurysm of the abdominal aorta is often not exactly diagnosed by the physician who is first in charge of the case. On the basis of a clinical material of 21 post-mortem examinations the diagnostics of the rupture of the aneurysm of the abdominal aorta is discussed, and the most important symptoms are emphasized. It is emphasized that an aneurysms of the abdominal aorta shall be recognized in every case allready before its rupture as the prognosis of the operation is relatively good in this stage. Since it must be reckoned with a continuous increase of the frequency of the arteriosclerotic lesions of the aorta the physician shall, too, always think of an aneurysm of the abdominal aorta when uncertain complaints of the abdomen and the back are present.

Aged

Occlusion of the abdominal aorta in a 29-year-old patient.

Following a period of two years with gradually increasing dyspnoe, the patient, a 29-year-old man, suddenly developed acute respiratory distress. On admission to hospital, blood pressure was 260/110, and there were no femoral pulses. Cine-angiography of the aorta revealed a total occlusion from the level of the first lumbar vertebra to the renal arteries. An extensive collateral circulation was visualized. Kidney function was normal. At operation, the aorta was as hard as stone, but the calibre was normal from the diaphragm down to the renal arteries. A dacron graft was inserted, end-to-side between the thoracic aorta and the abdominal aorta distal to the inferior mesenteric artery. Postoperatively, the systemic and ankle blood pressure became near normal. The aetiology of the aortic changes remains unknown. Several possibilities are considered, among them abdominal aortitis and cystic necrosis of the media. Coarctation of the abdominal aorta is less likely, as no narrowing of the aorta was seen at operation.

Adult

Transdiaphragmatic approach to the descending thoracic aorta for proximal control during surgery on the abdominal aorta.

A technic of mobilizing and clamping the lower descending thoracic aorta from the abdomen through the incision in the diaphragm is described. This technic is simple and may be useful when it is difficult to obtain proximal control of the abdominal aorta during surgery. In addition, certain surgical procedures on the upper abdominal aorta may be facilitated by the use of this technic.

Aorta, Abdominal

Spontaneous mycotic aneurysm of the abdominal aorta.

Aneurysms of the abdominal aorta may dissect, become infected, and rupture spontaneously. Since the mortality of infected mycotic aneurysm is high, a rapid diagnosis is a must. We describe a patient with a spontaneous mycotic aneurysm accurately diagnosed by computed tomography.

Aged

Distribution of intimal smooth muscle cell masses and their relationship to early atherosclerosis in the abdominal aortas of young swine.

In the abdominal aortas of young mash-fed swine, intimal cell masses (pads, cushions) are located predominantly away from blood vessel orifices. They are found scattered throughout the aorta but nevertheless have a definite pattern of distribution. In the distal one half of the abdominal aorta, they are more frequent in the ventral quandrant than in the dorsal or either lateral quadrant. In the proximal half, intimal cell masses are more frequent in the dorsal quadrant. When experimental atherosclerosis is induced in the abdominal aortas of young swine by either a hypercholesterolemic diet or by aortic ballooning followed by a hypercholesterolemic diet, the distribution of early lesions is similar. The lesions are found predominantly in quadrants where intimal cell masses were found to be most frequent in the control group of swine. The results suggest that most of the lesions, though not necessarily all, arose from pre-existing intimal cell masses beneath the aortic surface.

Animals

[Multiple renal arteries and their importance in surgery of aneurysm of the abdominal aorta].

Studies of 40 patients with aneurysms of the abdominal aorta, treated surgically, and 152 cadavers of adult persons enabled to state that atherosclerotic aneurysm of the abdominal aorta in vast majority of patients (in 38 of 40) affects its lower portion and is located at the level of the IIId -- Vth lumbar vertebrae. Also, there were found different variants of the anatomical structure of renal arteries and their relationship with the abdominal aorta aneurysms. It is the authors' opinion that a surgeon should be aware of this fact, while acoomplishing surgical procedures, and carefully estimate the value of an accessory vessel in the kidney blood supply, and also reimplant it in the allograft, if possible. It is believed, that if preservation of the mentioned arteries proved to be unfeasible, then either radical operation should be cancelled or the problem should be solved as to the need or rationality of radical operation simultaneously with nephrectomy in unilateral multitude of renal arteries.

Aorta, Abdominal