[HSF] aortic arch aneurysm

Sat Oct 17 21:42:55 EDT 2009

STENT

Tom

-----Original Message-----
From: Michael Firstenberg <msfirst at gmail.com>
To: OpenHeart-L at lists.hsforum.com
Sent: Fri, Oct 16, 2009 6:53 pm
Subject: Re: [HSF] aortic arch aneurysm

that is my question - hypothetical 24 yr/old, otherwise healthy, standard aortic trauma - no other major comorbidities...... 

1) stent 
2) open (repair method of choice) 
3) medical management 

-m 

On Oct 16, 2009, at 6:46 PM, tdmartin2000 at aol.com wrote: 

> 
> Depends on what you call long term. We will be reporting over 400 > thoracic endografts at the Society of Vascular Surgery soon and will > have short term results (longest one out is about 10 yrs. It appears > that they will be good long term (10-15yrs) but we can't say what > the 20 yr results will be. 
> 
> 
> 
> Tom 
> 
> 
> -----Original Message----- 
> From: Zhandong Zhou <zzhoumd at pol.net> 
> To: OpenHeart-L at lists.hsforum.com <OpenHeart-L at lists.hsforum.com> 
> Sent: Fri, Oct 16, 2009 9:16 am 
> Subject: Re: [HSF] aortic arch aneurysm 
> 
> 
> 
> How is the long term result? 
> 
> Zhandong Zhou, MD 
> St. Joseph Hospital 
> Syracuse, New York 
> Tel: 315 423 7192 
> 
> On Oct 16, 2009, at 6:24 AM, tdmartin2000 at aol.com wrote: 
> 
>> 
>> What about them? With the grafts available we can treat down to >> 18mm > fairly easily and even before we were able to use "home->> made" > devices using abdominal components. Everyone is worried >> about long > term f/u but they need that anyway. If everything >> looks good at 2 > yrs we go every other yr scans and some we might >> even consider > longer periods. Let's just say they come back with >> a problem- most > can be fixed with an endo procedure and if not >> and you have to do a > thoracotomy- well, you haven't lost much >> have you. 
>> 
>> We will have branced grafts on research protocols within 6 to 8 > >> months and are already doing homemade fenestration grafts. My > >> prediction is that almost all descending and thoracoabdominal > >> aneurysms will be repaired with endo techniques within 5 to 7 yrs. 
>> 
>> 
>> 
>> Tom Martin 
>> 
>> 
>> -----Original Message----- 
>> From: Michael Firstenberg <msfirst at gmail.com> 
>> To: OpenHeart-L at lists.hsforum.com <OpenHeart-L at lists.hsforum.com> 
>> Sent: Thu, Oct 15, 2009 7:13 am 
>> Subject: Re: [HSF] aortic arch aneurysm 
>> 
>> 
>> 
>> What about young patients 
>> Particularly those with normal or small aortas? 
>> 
>> -michael/iPhone 
>> 
>> On Oct 15, 2009, at 6:59 AM, tdmartin2000 at aol.com wrote: 
>> 
>>> 
>>> No question- endograft is the way to go. 
>>> 
>>> 
>>> 
>>> Tom Martin 
>>> 
>>> U of Florida 
>>> 
>>> Gainesville 
>>> 
>>> 
>>> -----Original Message----- 
>>> From: Douville, Chuck <ecdouville at orclinic.com> 
>>> To: OpenHeart-L <OpenHeart-L at hsforum.com> 
>>> Sent: Tue, Oct 13, 2009 11:38 pm 
>>> Subject: [HSF] aortic arch aneurysm 
>>> 
>>> 
>>> 
>>> 
>>> Colleagues, this woman is 49. She had vague chest pain and a >> >>> history > of 
>>> ypertension and tobacco use. A ct was done and shows her aortic >> >>> arch > to maximum 
>>> .9 cm at the ligamentum arteriosum with extensive calcification in >>> >> > the aortic 
>>> all. Upon further questioning, she gives a history of a high > >> >>> velocity motor 
>>> ehicle accident (60 miles per hour) as a restrained driver; she >>> was >> > not ejected 
>>> rom the car. 
>>> he is asymptomatic but is clearly twice the size of her normal > >>> >> aorta and I 
>>> annot be certain it has been there for 30 years, although it seems >>> >> > likely.. 
>>> ould anyone not operate on this patient? If yes, would you use a > >>> >> stent graft on 
>>> uch a young woman? I have attached a Jpeg file; if it does not > >>> >> come through, 
>>> will ask Prasanna to kindly post it for review. 
>>> 
>>> hanks chuckdouville 
>>> 
>>> 
>>> 
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