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Early Morbidity and Mortality Within 30 days of hospitalization, morbidity and mortality after Bentall procedure are associated with complications stemming from cardiac arrhythmia, pneumonia, acute respiratory distress syndrome (ARDS), sepsis, graft infection, wound infection, neurologic/ cerebrovascular accident and stroke, hemorrhage/ bleeding, myocardial infarction, pericardial effusion ...
Open surgery typically involves exposure of the dilated portion of the aorta and insertion of a synthetic (Dacron or Gore-Tex) graft (tube). Once the graft is sewn into the proximal (toward the patient's head - and more specifically, towards their aortic valve) and distal (toward the patient's foot) portions of the aorta, the aneurysmal sac is ...
Dr. Juan C. Parodi introduced the minimally-invasive endovascular aneurysm repair (EVAR) to the world and performed the first successful endovascular repair of an abdominal aortic aneurysm on 7 September 1990 in Buenos Aires on a friend of Carlos Menem, the then President of Argentina. The first device was simple, according to Parodi: "It was a ...
Common features of both techniques of the replacement process are the clamping of the aorta and the use of a length of Dacron tube (also known as an "aortic graft"), typically 5 cm, to constrict the aortic root to the normal diameter, while the patient is cooled to 20°C and placed on life support. The procedure typically takes 4 to 6 hours in ...
The graft is then sutured to the cusp insertion lines. Some surgeons combine this procedure with an annuloplasty. [12] [21] For the procedure according to Tirone David, [17] the aortic valve is mobilized even further from the surrounding tissues. The avascular graft is then positioned around the valve, and the valve is fixed inside the graft ...
NHS England conducted a review of all 70 vascular surgery sites across England in 2018 as part of its Getting It Right First Time programme. The review specified that vascular hubs should perform at least 60 abdominal aortic aneurysm procedures and 40 carotid endarterectomies a year. 12 trusts missed both targets and many more missed one of them.
The tube visible at the bottom is the aortic cannula, which returns blood from the heart–lung machine. The tube above it (obscured by the surgeon on the right) is the venous cannula, which receives blood from the body. The patient's heart is stopped and the aorta is cross-clamped. The patient's head (not seen) is at the bottom.
The transaortic approach sees the catheter and valve inserted through the top of the right chest. Under general anesthesia, a small surgical incision is made alongside the right upper breastbone, followed by a small puncture of the aorta. The delivery system is then fed slowly to the correct position at the aortic valve.
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