A successful staged approach for treatment of concomitant mitral insufficiency and mycotic aneurysm.
Ontology highlight
ABSTRACT:
SUBMITTER: Zimmermann E
PROVIDER: S-EPMC8288813 | biostudies-literature | 2020 Mar
REPOSITORIES: biostudies-literature
Publications
A successful staged approach for treatment of concomitant mitral insufficiency and mycotic aneurysm.
Zimmermann Eric E Ogami Takuya T Dayal Rajeev R Avgerinos Dimitrios V DV
JTCVS techniques 20200113
Similar Datasets
Project description:ObjectivesMitral regurgitation (MR) is commonly experienced by patients with aortic insufficiency (AI), and in its mild form, it is considered benign. However, the progression of concomitant mild regurgitation after the aortic valve surgery (AVS) for AI is poorly characterized. The current study aimed to define the long-term outcomes of MR after surgery and identify the risk factors involved in deterioration.MethodsPatients presenting with moderate/severe AI and concomitant mild MR (n = 347) between January 2013 and December 2021 were enrolled. MR grade was assessed by transthoracic echocardiography during the follow-up, and deterioration is defined as an increase in grade to moderate or severe MR from the previous follow-up echocardiography. Analysis of risk factors for early mortality, MR deterioration, and long-term mortality was performed.ResultsA total of 278 patients (84.8%) among 328 survivors had at least one follow-up echocardiography, and complete follow-up occurred for 316 patients (96.3%). Mild MR improved to trivial or none in 194 patients (69.8%), progressed to persistent mild MR for 74 patients (26.6%), and deteriorated for 10 patients (3.6%). Preoperative atrial fibrillation [odds ratio (OR), 23.09; 95% confidence interval (CI), 4.35-122.54] and rheumatic AI (OR, 11.61; 95% CI, 1.26-106.85) were shown to be independent risk factors for MR deterioration by generalized linear mixed analysis.ConclusionProgression of concomitant mild MR is rare in patients with AI after AVS. However, rheumatic AI and preoperative atrial fibrillation increase the probability of MR deterioration. Careful follow-up for this cohort of patients is recommended.
| S-EPMC9894876 | biostudies-literature
Project description: Not available
| S-EPMC10562108 | biostudies-literature
Project description:The incidence of coronary artery aneurysm is between 1.4% and 4.9% based on autopsy or angiographic series. Mycotic coronary arteries aneurysms are very rare and represent less than 3% of all coronary aneurysms. We report the case of a patient who presented with multiple coronary mycotic aneurysms.
| S-EPMC11190475 | biostudies-literature
Project description:The authors describe a rare case of mycotic aneurysm (MA) associated with subarachnoid hemorrhage treated with aneurysm trapping. The literature on management and the surgical techniques are controversial due to lack of randomize trials.
| S-EPMC4726378 | biostudies-other
Project description:BackgroundRuptured intracranial mycotic aneurysms have high morbidity and mortality and present unique surgical challenges because of vessel friability.[1] Flow-preserving strategies are needed for more proximal lesions that cannot be treated with vessel sacrifice.Case descriptionA 33-year-old man with no medical history who presented with fevers and peripheral septic emboli was found to have infective cardiac valve vegetations. He reported headaches and left arm weakness; an irregular 7 × 8 × 9 mm bilobed middle cerebral artery mycotic aneurysm involving multiple M3 branches with subarachnoid hemorrhage was found on cranial imaging. Multifocal and small intraparenchymal hemorrhages from septic emboli were also seen. Clip trapping and revascularization were recommended. A right frontotemporal craniectomy was performed, preserving the superficial temporal artery. After extradural exposure, a hole was drilled in the middle fossa floor lateral to the foramen ovale. The Sylvian fissure was split and the larger M3 branch was isolated. An endoscopically harvested saphenous vein graft was anastomosed to the cervical external carotid artery, tunneled through the middle fossa floor, and anastomosed end-to-side to the larger M3. The aneurysm was clip trapped and the involved smaller M3 was transected and anastomosed end-toend to the superficial temporal artery. Indocyanine green videoangiography confirmed patency of both bypasses. Postoperatively, the patient received antibiotics and a mitral valve replacement. He was neurologically intact on 1-month and 2-year follow-up.ConclusionAlthough technically demanding, tailored revascularization and clipping of ruptured mycotic cerebral aneurysms are a viable treatment option for these complex lesions.
| S-EPMC9479689 | biostudies-literature
Project description:An infected mycotic aneurysm due to Streptococcus constellatus subsp. constellatus has not previously been reported. We report on this condition in an 87-year-old woman who had aggravating abdominal pain and a large fusiform aneurysm over the thoracic-abdominal aorta with mural thrombus. Isolates from two sets of blood cultures and the debrided tissue were identified as S. constellatus subsp. constellatus by their biochemical reaction profiles, compatible 16S rRNA gene sequencing results, and sequencing results for the partial groESL gene and the 16S-23S intergenic spacer region.
| S-EPMC387616 | biostudies-literature
Project description:A 10-year-old castrated male mixed-breed dog exhibited vomiting, lethargy and anorexia. An abdominal ultrasound examination revealed a focal dilation of the abdominal aorta. The dog died 2 days after examination, and necropsy revealed a ruptured aneurysm at the abdominal aorta between the kidneys. Histological examination revealed severe granulomatous and necrotizing pan-arteritis with fungal organisms. Graphium species was identified through DNA sequence analysis of the PCR product from formalin-fixed paraffin-embedded samples. To our knowledge, this is the first report of aortic aneurysm caused by Graphium species in a dog. Sequence was submitted to the DNA Data Bank of Japan with the accession number LC007972.
| S-EPMC4638297 | biostudies-literature
Project description:PurposeTo determine whether treatment of symptomatic convergence insufficiency (CI) has an effect on Academic Behavior Survey (ABS) scores.MethodsThe ABS is a six-item survey developed by the Convergence Insufficiency Treatment Trial Group that quantifies the frequency of adverse school behaviors and parental concern about school performance on an ordinal scale from 0 (never) to 4 (always) with total scores ranging from 0 to 24. The ABS was administered at baseline and after 12 weeks of treatment to the parents of 218 children aged 9 to 17 years with symptomatic CI, who were enrolled in the Convergence Insufficiency Treatment Trial and randomized into (1) home-based pencil push-ups; (2) home-based computer vergence/accommodative therapy and pencil push-ups; (3) office-based vergence/accommodative therapy with home reinforcement; and (4) office-based placebo therapy with home reinforcement. Participants were classified as successful (n = 42), improved (n = 60), or non-responder (n = 116) at the completion of 12 weeks of treatment using a composite measure of the symptom score, nearpoint of convergence, and positive fusional vergence. Analysis of covariance methods were used to compare the mean change in ABS between response to treatment groups while controlling for the ABS score at baseline.ResultsThe mean ABS score for the entire group at baseline was 12.85 (SD = 6.3). The mean ABS score decreased (improved) in those categorized as successful, improved, and non-responder by 4.0, 2.9, and 1.3 points, respectively. The improvement in the ABS score was significantly related to treatment outcome (p < 0.0001), with the ABS score being significantly lower (better) for children who were successful or improved after treatment as compared to children who were non-responders (p = 0.002 and 0.043, respectively).ConclusionsA successful or improved outcome after CI treatment was associated with a reduction in the frequency of adverse academic behaviors and parental concern associated with reading and school work as reported by parents.
| S-EPMC3261761 | biostudies-literature
Project description: Not available
| S-EPMC5779145 | biostudies-literature
Project description:Open surgery is the elective treatment for mycotic aneurysms of the aorta. This surgery consists of resection of the aneurysm, debridement and revascularization with an in situ or extra-anatomic bypass. Even when surgery has been successful, the morbi-mortality is raised and the endovascular treatment has become an alternative for specific patients. When mycotic aneurysms involved the visceral arteries, more complex techniques are necessary such as fenestrated endovascular aortic repair or chimmeny endovascular aortic repair and the most frequent complications of this are endoleaks and oclussion the visceral arteries. We present a case of a pacient with a paravisceral abdominal mycotic aneurysms that was result with 2 chimney technique (in the right renal and superior mesenteric arteries) and a single Nellix EVAS (Endologix, Irvine, Calif) of 12 cm long without evidence of endoleaks in the follow-up.
| S-EPMC5545147 | biostudies-other