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State-of-the-Art in Aortic Surgery
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State-of-the-Art in Aortic Surgery

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "General Surgery".

Deadline for manuscript submissions: 15 July 2024 | Viewed by 2186

Special Issue Editor

Dr. Miriam Silaschi

E-Mail Website
Guest Editor
Department of Cardiac Surgery, University Hospital Bonn, Bonn, Germany
Interests: aortic disease; structural heart disease; heart team; interventional techniques

Special Issue Information

Dear Colleagues,

The surgical treatment of aortic disease has evolved significantly over the past decade, with a shift in focus from the treatment of acutely diseased aortic areas towards the lifetime management of aortic disease. This has lead to more radical strategies to treat aortic disease during the initial operation to avoid long-term complications.

Additionally, interventional techniques are increasingly performed and often combined with surgical treatment itself as “hybrid techniques”.

With this Special Issue, we welcome authors to submit papers on contemporary treatments of aortic disease, with a special focus on hybrid and interventional techniques and with special emphasis on heart team/vascular team approaches and the lifetime management of aortic disease.

Dr. Miriam Silaschi
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • hybrid techniques
  • aortic disease
  • interventional treatment
  • lifetime management of aortic disease
  • aortic dissection
  • frozen elephant trunk
  • connective tissue disease

Published Papers (2 papers)

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Research

11 pages, 1202 KiB  
Article
Impact of Intercostal Artery Reinsertion on Neurological Outcome after Thoracoabdominal Aortic Replacement: A 25-Year Single-Center Experience
by Florian Helms, Reza Poyanmehr, Heike Krüger, Bastian Schmack, Alexander Weymann, Aron-Frederik Popov, Arjang Ruhparwar, Andreas Martens and Ruslan Natanov
J. Clin. Med. 2024, 13(3), 832; https://doi.org/10.3390/jcm13030832 - 31 Jan 2024
Viewed by 454
Abstract
Background: Intercostal artery reinsertion (ICAR) during thoracoabdominal aortic replacement remains controversial. While some groups recommend the reinsertion of as many arteries as possible, others consider the sacrifice of multiple intercostals practicable. This study investigates the impact of intercostal artery reinsertion or sacrifice on [...] Read more.
Background: Intercostal artery reinsertion (ICAR) during thoracoabdominal aortic replacement remains controversial. While some groups recommend the reinsertion of as many arteries as possible, others consider the sacrifice of multiple intercostals practicable. This study investigates the impact of intercostal artery reinsertion or sacrifice on neurological outcomes and long-term survival after thoracoabdominal aortic repair. Methods: A total of 349 consecutive patients undergoing thoracoabdominal aortic replacement at our institution between 1996 and 2021 were analyzed in a retrospective single-center study. ICAR was performed in 213 patients, while all intercostal arteries were ligated and sacrificed in the remaining cases. The neurological outcome was analyzed regarding temporary and permanent paraplegia or paraparesis. Results: No statistically significant differences were observed between the ICAR and non ICAR groups regarding the cumulative endpoint of transient and permanent spinal cord-related complications (12.2% vs. 11.8%, p = 0.9). Operation, bypass, and cross-clamp times were significantly longer in the ICAR group. Likewise, prolonged mechanical ventilation was more often necessary in the ICAR group (26.4% vs. 16.9%, p = 0.03). Overall long-term survival was similar in both groups in the Kaplan–Meier analysis. Conclusion: Omitting ICAR during thoracoabdominal aortic replacement may reduce operation and cross-clamp times and thus minimize the duration of intraoperative spinal cord hypoperfusion. Full article
(This article belongs to the Special Issue State-of-the-Art in Aortic Surgery)
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16 pages, 3007 KiB  
Article
The Long-Term Outcome and Quality of Life after Replacement of the Ascending Aorta
by Marwan Hamiko, Katja Jahnel, Julia Rogaczewski, Myriam Schafigh, Miriam Silaschi, Andre Spaeth, Markus Velten, Wilhelm Roell, Ali El-Sayed Ahmad and Farhad Bakhtiary
J. Clin. Med. 2023, 12(13), 4498; https://doi.org/10.3390/jcm12134498 - 05 Jul 2023
Cited by 1 | Viewed by 1429
Abstract
(1) Background: Despite optimal surgical therapy, replacement of the ascending aorta leads to a significant reduction in the quality of life (QoL). However, an optimal result includes maintaining and improving the QoL. The aim of our study was to evaluate the long-term outcome [...] Read more.
(1) Background: Despite optimal surgical therapy, replacement of the ascending aorta leads to a significant reduction in the quality of life (QoL). However, an optimal result includes maintaining and improving the QoL. The aim of our study was to evaluate the long-term outcome and the QoL in patients with aneurysms in the ascending aorta; (2) Methods: Between 2014 and 2020, 121 consecutive patients who underwent replacement of the ascending aorta were included in this study. Acute aortic pathologies were excluded. A standard short form (SF)-36 questionnaire was sent to the 112 survivors. According to the surgical procedure, patients were divided into two groups (A: supracoronary replacement of the aorta, n = 35 and B: Wheat-, David- or Bentall-procedures, n = 86). The QoL was compared within these groups and to the normal population, including myocardial infarction (MI), coronary artery disease (CAD) and cancer (CAN) patients; (3) Results: 83 patients were males (68.6%) with a mean age of 62.0 ± 12.5 years. Early postoperative outcomes showed comparable results between groups A and B, with a higher re-thoracotomy rate in B (A: 0.0% vs. B: 22.1%, p = 0.002). The 30-day mortality was zero. Overall, mortality during the follow-up was 7.4%. The SF-36 showed a significant decay in both the Physical (PCS) and Mental Component Summary (MCS) in comparison to the normal population (PCS: 41.1 vs. 48.4, p < 0.001; MCS: 42.1 vs. 50.9, p < 0.001) but without significant difference between both groups. Compared to the MI and CAD patients, significantly higher PCS but lower MCS scores were detected (p < 0.05); (4) Conclusions: Replacement of the ascending aorta shows low risk regarding the operative and postoperative outcomes with satisfying long-term results in the QoL. The extent of the surgical procedure does not influence the postoperative QoL. Full article
(This article belongs to the Special Issue State-of-the-Art in Aortic Surgery)
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