OBJECTIVES: Both aortic root remodelling and aortic valve (AV) reimplantation have been used for valve-sparing root replacement in patients with aortic root aneurysm with or without aortic regurgitation. There is no clear evidence to support one technique over the another. This study aimed to compare remodelling with basal ring annuloplasty versus reimplantation on a multicentre level with the use of propensity-score matching. METHODS: This was a retrospective international multicentre study of patients undergoing remodelling or reimplantation between 2010 and 2021. Twenty-three preoperative covariates (including root dimensions and valve characteristics) were used for propensity-score matching. Perioperative outcomes were analysed along with longer-term freedom from AV reoperation/reintervention and other major valve-related events. RESULTS: Throughout the study period, 297 patients underwent remodelling and 281 had reimplantation. Using propensity-score matching, 112 pairs were selected and further compared. We did not find a statistically significant difference in perioperative outcomes between the matched groups. Patients after remodelling had significantly higher reintervention risk than after reimplantation over the median follow-up of 6 years (P = 0.016). The remodelling technique (P = 0.02), need for decalcification (P = 0.03) and degree of immediate postoperative AV regurgitation (P < 0.001) were defined as independent risk factors for later AV reintervention. After exclusion of patients with worse than mild AV regurgitation immediately after repair, both techniques functioned comparably (P = 0.089). CONCLUSIONS: AV reimplantation was associated with better valve function in longer-term postoperatively than remodelling. If optimal immediate repair outcome was achieved, both techniques provided comparable AV function.

• MeSH
• Cardiac Valve Annuloplasty methods   MeSH
• Aortic Valve * surgery   MeSH
• Aortic Valve Insufficiency * surgery   MeSH
• Heart Valve Prosthesis Implantation methods   MeSH
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Reoperation statistics & numerical data   MeSH
• Replantation * methods   MeSH
• Retrospective Studies MeSH
• Aged MeSH
• Propensity Score * MeSH
• Treatment Outcome MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Multicenter Study MeSH
• Comparative Study MeSH

We hereby present a case report of airway compression due to descending aortic aneurysm occurred to 71-year-old female with 1-month progressive dyspnoea, haemoptysis, and cough without any fever. Her past medical history included repeated respiratory infections, chronic cough, an admission to the hospital 2 years ago due to left-side pneumonia. A dilatation of the ascending aorta and kinking of the descending aorta with compression of the left main stem bronchus was detected by the computed tomography. Stenting of the bronchial lumen had failed, and the patient was indicated for surgery, the descending aorta replacement had been performed. Left main stem bronchus compression of descending aorta kinking is a very rare pathology. Surgery was the only possible treatment.

Představujeme kazuistiku 71leté pacientky s kompresí levého hlavního bronchu aneurysmatem descendentní aorty, která se projevila progresivní dušností, kašlem a hemoptýzou bez přítomnosti teploty. Osobní anamnéza pacientky zahrnuje opakované respirační infekce, chronický kašel, hospitalizaci pro levostrannou pneumonii. Během CT vyšetření bylo zjištěno aneurysma ascendentní aorty, dilatace a kinking descendentní aorty s útlakem levého hlavního bronchu. Zavedení stentu do bronchiálního lumen nemělo úspěch, proto byl u pacientky indikován chirurgický výkon, kdy byla provedena náhrada descendentní aorty. Útlak hlavního bronchu aneurysmatem a kinkingem aorty je velice vzácnou patologií. Jedinou možností léčby byl chirurgický zákrok. © 2021, ČKS.

• Keywords
• komprese bronchu,
• MeSH
• Aortic Aneurysm * surgery   complications   MeSH
• Bronchi pathology   MeSH
• Cardiac Surgical Procedures MeSH
• Humans MeSH
• Aged MeSH
• Treatment Outcome MeSH
• Check Tag
• Humans MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Case Reports MeSH

Coronary artery aneurysm is a relatively rare disorder that is usually discovered as a secondary finding in patients undergoing coronary artery angiography. Coronary artery fistulas are relatively more frequent than rare aneurysms and are often associated with other cardiac abnormalities. The etiology of aneurysms is mostly atherosclerotic, and they are less frequently associated with other acquired or congenital diseases, such as Kawasaki disease, connective tissue diseases, septic emboli, arteritis, and iatrogenic disease. We report a 70-year-old woman with a rare combination of a coronary artery aneurysm associated with a coronary artery fistula, which drained into the pulmonary artery. The diagnosis of our patient was made by selective coronary angiography and confirmed by computed tomography angiography. The patient was treated surgically because of the symptomatic course of the disease.

• MeSH
• Pulmonary Artery diagnostic imaging   surgery   MeSH
• Coronary Aneurysm * complications   diagnostic imaging   surgery   MeSH
• Coronary Angiography MeSH
• Humans MeSH
• Coronary Artery Disease * complications   diagnostic imaging   surgery   MeSH
• Fistula * complications   diagnostic imaging   surgery   MeSH
• Aged MeSH
• Check Tag
• Humans MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Case Reports MeSH

Introduction. We are presenting a case report of an infected modular abdominal stent graft. Case Presentation. A 67-year-old male patient three years after Cook's modular abdominal aortic aneurysm (AAA) graft implantation for juxtarenal AAA with an implantation of a stent extension into the right common iliac artery for type Ib endoleak. The patient was admitted into our center in severe condition with suspected retroperitoneal bleeding. Computed tomography angiography (CTAG) confirmed retroperitoneal bleeding in the right common iliac artery. An urgent surgical revision was indicated; destructed arterial wall around the stent extension in the right common iliac artery was discovered. Due to the severe state of health of the patient, a resection of the infected stent and affected arterial wall was performed, followed by an iliac-femoral crossover bypass. The patient was transported to the intensive care unit with hepatic and renal failure, with maximal catecholamine support. Combined antibiotic treatment was started. The patient died five hours after the procedure. The cause of death was multiorgan failure caused by sepsis. Hemocultures and perioperative microbiological cultures showed the infection agent to be Staphylococcus aureus methicillin sensitive. Conclusion. Stent graft infection is a rare complication. Treatment is associated with high mortality and morbidity.

• Publication type
• Journal Article MeSH