Seco M, Edelman JJ, Boxtel BV, Forrest P, Byrom MJ, Wilson MK, Fraser J, Bannon PG, Vallely MP
J. Cardiothorac. Vasc. Anesth. 2015 Feb;29(1):185-195
PMID: 25620144
Clinical utility of magnetic resonance imaging in the follow-up of chronic aortic type B dissection
Sherrah AG, Vallely MP, Grieve SM, Jeremy RW, Hendel PN, Puranik R
Heart Lung Circ 2014 Jul;23(7):e157-9
PMID: 24735714
Abstract
Several imaging modalities are utilised in the assessment of disease progression in chronic aortic dissection. We present the case of a 66 year-old male who underwent ascending aorta repair for Stanford type A aortic dissection. On follow-up the persisting dissection of the descending thoracic aorta was observed to regress on magnetic resonance imaging (MRI). MRI has several advantages over computed tomography (CT) scanning and echocardiography in the follow-up phase of this disease.
Standardizing clinical end points in aortic arch surgery: a consensus statement from the International Aortic Arch Surgery Study Group
Yan TD, Tian DH, Lemaire SA, Hughes GC, Chen EP, Misfeld M, Griepp RB, Kazui T, Bannon PG, Coselli JS, Elefteriades JA, Kouchoukos NT, Underwood MJ, Mathew JP, Mohr FW, Oo A, Sundt TM, Bavaria JE, Di Bartolomeo R, Di Eusanio M, Trimarchi S,
Circulation 2014 Apr;129(15):1610-6
PMID: 24733540
Abstract
Outcomes of aortic arch replacement surgery after previous cardiac surgery
Davies RA, Black D, Bannon PG, Bayfield MS, Hendel PN, Hughes CF, Wilson MK, Vallely MP
ANZ J Surg 2013 Nov;83(11):827-32
PMID: 23782742
Abstract
BACKGROUND: Aortic arch replacement is a potentially high-risk operation and in the re-operative setting has been found to be a risk factor for poor outcome, yet there is a dearth of published data specifically on this topic. The aim of the study was to review our unit’s outcomes in this re-operative setting.
METHOD: Data were collated for all patients who underwent aortic arch replacement surgery after previous cardiac surgery from January 1988 to November 2011. The patients were divided based primarily on elective versus non-elective and also early (≤2005) and late (≥2006) series.
RESULTS: Twenty-seven eligible patients (22 male; median age: 53.0 years; elective: 14, non-elective: 13) were identified. There was a mean period of 14.5 years between the first operation and the subsequent aortic arch replacement. The overall 30-day mortality rate was 22.2% – 0% elective and 46.2% non-elective (P = 0.004). Overall permanent neurological dysfunction was 21.7% – 28.6% elective and 11.1% non-elective (P = 0.463). There were 11 early-series patients and 16 late-series patients. For early-series patients, 90.9% were non-elective versus 18.8% in the late-series patients. The 30-day mortality rate was 54.5% early series versus 0% late series.
CONCLUSION: Aortic arch replacement is high risk in the re-operative setting. These risks are even greater for non-elective procedures. This highlights the need for aggressive first-time surgery to reduce re-operative procedures and good long-term follow-up programmes to allow elective procedures if required.
