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Query: UMLS:C0162871 (abdominal aortic aneurysm)
 8,664 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

From July 1986 to January 1991, 123 patients with Wolff-Parkinson-White syndrome underwent operation for ablation of aberrant conduction pathways. There were 85 male and 38 female patients ranging in age from 11 months to 68 years. Associated anomalies included Ebstein's anomaly, sudden death syndrome, coronary artery disease, cardiomyopathy, abdominal aortic aneurysm, neurofibromatosis, other arrhythmias, or other complex congenital heart disease. Forty-one patients had multiple accessory pathways. Operative results showed a 7% initial failure rate, which dropped to 3% after reoperation. One patient had undergone previous operation for Wolff-Parkinson-White syndrome at another institution. Procedures performed concomitantly included mitral or tricuspid valve repair or replacement (6), right ventricular conduit replacement, subaortic resection, Fontan repair, corrected transposition repair, coronary artery bypass, and placement of an automatic internal cardioverter defibrillator. There was no operative mortality. Late follow-up is 27 +/- 16 months, and complications included mitral regurgitation and myocardial infarction. By comparison, in the last 12 months 124 patients with the Wolff-Parkinson-White syndrome underwent catheter ablation using radiofrequency current. There were 9 patients with multiple pathways. One hundred twelve patients (90%) had all accessory atrioventricular connections ablated and have remained free of symptomatic tachycardia. There have been 12 failures (10%), of which 5 have had operation and 7 are being treated medically. Mean follow-up is 7 +/- 5 months, and complications included circumflex coronary artery occlusion, excessive bleeding, valve perforation, and cerebral vascular accident.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Current treatment for Wolff-Parkinson-White syndrome: results and surgical implications. 189 33

From March 1978 through July 1985, 23 patients underwent implantation of 24 intraluminal ringed prostheses (IRP). There were 18 men and 5 women, with a mean age of 54.7 years, range 15-74 years. Eleven IRP were placed in the ascending aorta, two in the transverse arch, and 11 in the descending aorta. Pathology included acute aortic dissection in four patients, chronic dissection in four, and aortic aneurysm in 16. There were eight hospital deaths (35%). Causes of death included acute cardiac failure in seven patients, and ruptured abdominal aortic aneurysm in one. IRP complications requiring revision included right coronary artery occlusion in three of 11 patients (27%) with an IRP in the ascending aorta. Graft revision was also required in three of 11 IRP implanted in the descending aorta (27%), due to graft occlusion in one and graft stenosis in two. Of the six patients with IRP complications, there were three hospital deaths (50%). All 15 hospital survivors were followed for a mean of 68.5 months, range 5-112 months. There were four late deaths (26.7%). Causes of late death included hemoptysis in one, cardiomyopathy in one, and aortic redissection and rupture in two. We conclude that patients undergoing repair of aortic pathology with IRP have an important risk of early phase events, as technical problems can occur due to malposition and slippage of the securing rings.
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PMID:Events following implantation of an intraluminal ringed prosthesis in the ascending, transverse, and descending thoracic aorta. 225 97

Presented is the case of a 62-year-old man with refractory shock secondary to copper sulfate ingestion. The patient's history was complicated by the presence of peptic ulcer disease, myocardial disease, and a known abdominal aortic aneurysm. Despite the presence of such characteristic signs and symptoms as hemorrhagic gastroenteritis, hemolytic anemia, and refractory hypotension, the diagnosis of copper sulfate ingestion was delayed for several days after ingestion, when the family first volunteered that the patient had vomited blue-green material the day before his admission to the hospital. This delay contributed significantly to the patient's ultimate demise.
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PMID:Refractory shock secondary to copper sulfate ingestion. 374 May 85

To evaluate long-term survival in relation to preoperative risk factors, we reviewed 1112 patients undergoing abdominal aortic aneurysm (AAA) repair from 1970 to 1975. A 6-to 12-year follow-up was obtained on 1087 patients (97.7%) by chart review, death certificates, autopsy reports, and questionnaires returned by patients and referring physicians. Preoperatively 24% of patients had a history of prior myocardial infarction, 19.9% had a history of angina, and 40.4% were hypertensive. Emergency operation for ruptured aneurysm was performed in 6.5% and for expanding aneurysm in 3.4% of patients. The survival rate at 5 years was 67.5% and at 10 years was 40.7%. Cardiac-related problems were the most frequent cause of death (38%); 23% died of myocardial infarction and 15% from other heart disease or sudden death. Other causes included neoplasm (14.6%), other ruptured aneurysm (8.2%), and stroke (6.8%). Cause of death was unknown in 19.6%. A significant correlation of reduced survival time was noted in patients with advanced age and those with evidence of heart disease or hypertension. For patients without preoperative evidence of heart disease or hypertension, the 5-year mortality rate from myocardial infarction was 3.7%, compared with 11.7% for those with a positive history of hypertension and heart disease (p = 0.0001). For patients with no preoperative evidence of hypertension or heart disease, the length of survival after AAA repair was the same as that expected for the general population with the same age and sex composition. This study supports the contention that coronary angiography and prophylactic coronary bypass grafting should be performed selectively. Decisions regarding the need for coronary revascularization should be based on symptoms, noninvasive testing, and selective coronary angiography because aneurysmal disease alone is not shown in this study to increase the risk of death from myocardial disease. For patients with clinical findings of coronary artery disease, an aggressive diagnostic approach appears to be justified.
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PMID:Late survival after abdominal aortic aneurysm repair: influence of coronary artery disease. 648 77

With the improvement of survival rates following cardiac transplantation, the probability of recipients developing extracardiac disease is increased. Three cases are reported of abdominal aortic aneurysm successfully operated on in cardiac allograft recipients 1 to 4 years after transplantation. Indications for transplantation were valvular, idiopathic and ischaemic cardiomyopathy. Post-transplant hypertension and hyperlipidaemia may have played a role in the rapid growth of the aneurysms. Cardiac function and the incidence of graft atherosclerosis were assessed before surgery by coronary angiography. All three patients were discharged from hospital. Abdominal aortic aneurysm resection may be a safe procedure in cardiac transplant patients. In view of the rapid increase in the size of the aneurysms in transplanted patients, careful screening should be performed during follow-up.
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PMID:Successful abdominal aortic aneurysm resection in long-term survivors of cardiac transplantation. 765 49

A clinical prognostic scoring system for patients with abdominal aortic aneurysm and audit of the sequelae of a sample population in Glasgow, are described. Randomly selected case notes of 500 patients, representing 41.6% (500 of 1202) of the total population treated in Glasgow hospitals with general surgical units (as opposed to vascular units) between 1980 and 1990, were examined for risk factors. These were then related to the operative and postoperative hospital mortality. Initial univariate analysis showed the outcome to be significantly influenced by the following factors: age (P = < 0.01), rupture (P = < 0.001), shock (P = < 0.001), myocardial disease (P = 0.08), cerebrovascular disease (P = 0.03), renal disease (P = 0.03) and size of the aneurysm (P = 0.06). Using multivariate analysis, the following independent risk factors were identified: age (P = 0.02), shock (P = < 0.001), myocardial disease (P = 0.02), cerebrovascular disease (P = 0.02) and renal disease (P = 0.003). Rounding of the regression coefficients created a simple risk score: risk score = (age in years)+(17 for shock)+(7 for myocardial disease)+(10 for cerebrovascular disease)+(14 for renal disease). Subsequent evaluation of the scoring system showed that the mortality rate increases in proportion to the score. Other findings are analysed and discussed.
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PMID:Glasgow aneurysm score. 804 22

We present here two cases of asymptomatic thoracoabdominal aortic aneurysms that were successfully operated on in heart transplant patients 8 and 23 months after transplantation. Thoracoabdominal aortic aneurysm was present prior to transplantation in one patient. In the other patient only the abdominal aortic aneurysm was found before transplantation. Indications for transplantation were ischemic and valvular cardiomyopathy. Surgical aortic aneurysm repair was performed with the standard technique. Both patients were discharged from the hospital. The possible contributing factors to the development and enlargement of aortic aneurysms and perioperative assessment are also discussed. Radiologic surveillance is warranted in any heart transplant recipient with abdominal or thoracoabdominal aortic aneurysms because of the more rapid aneurysm expansion.
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PMID:Thoracoabdominal aortic aneurysm repair in cardiac transplant recipients. 1112 65

The optimal surgical management of simultaneous abdominal aortic aneurysm and cardiac disease remains a major challenge in case of larger aneurysms and severe cardiac disease. In case of symptomatic aneurysms or impending rupture, a single-stage combined operation is the most widely accepted procedure. We report the successful use of closed-chest cardiopulmonary bypass, with femoral venous and axillary arterial peripheral cannulation, to support cardiac function on the beating heart during resection of a giant abdominal aortic aneurysm and ischaemic cardiomyopathy. One month later, the patient underwent a second-stage deferred cardiac operation, consisting of triple coronary bypass grafting, undersized mitral annuloplasty and epicardial left ventricular lead implantation for cardiac resynchronisation therapy.
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PMID:Femoro-axillary cardiopulmonary bypass for giant abdominal aortic aneurysm repair prior to staged cardiac operation for ischaemic cardiomyopathy. 1985 70

Ultrasonography in the hands of the internist can answer important clinical questions quickly at the point of patient care. This technique "enhances" the senses of the physicians and improves their ability to solve the problems of the patient. Point of care ultrasonography performed by clinicians has shown good accuracy in the diagnosis of diverse cardiac, abdominal and vascular pathologic conditions. It may also be useful for evaluation of thyroid, osteoarticular and soft tissue diseases. Furthermore, the use of ultrasound to guide invasive procedures (placement of venous catheters, thoracentesis, paracentesis) reduces the risk of complications. We present 5 cases to illustrate the usefulness of this technique in clinical practice: (i) peripartum cardiomyopathy; (ii) subclinical carotid artery atherosclerosis; (iii) asymptomatic abdominal aortic aneurysm; (iv) tendinitis of long head of biceps brachii and supraspinatus, and (v) spontaneous soleus muscle hematoma.
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PMID:Ultrasonography managed by internists: the stethoscope of 21st century? 2452 7