Title :

Aortic treatment in connective tissue disease

Author(s) :

Ferraresi, Marco [Auteur]
Università cattolica del Sacro Cuore = Catholic University of the Sacred Heart [Roma] [Unicatt]
Watkins, Amelia Claire [Auteur]
Stanford University
Hertault, Adrien [Auteur]
Médicaments et biomatériaux à libération contrôlée: mécanismes et optimisation - Advanced Drug Delivery Systems - U 1008 [MBLC - ADDS]
Soler, Raphael [Auteur]
Hôpitaux Universitaires Paris Sud [AP-HP] [HUPS]
Azzaoui, Richard [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Fabre, Dominique [Auteur]
Hôpital Marie-Lannelongue
Sobocinski, Jonathan [Auteur]
Advanced Drug Delivery Systems (ADDS) - U1008
Haulon, Stephan [Auteur]
Hôpital Marie-Lannelongue

Journal title :

The Journal of cardiovascular surgery

Abbreviated title :

J Cardiovasc Surg (Torino)

Volume number :

60

Pages :

518-25

Publication date :

2018-06-26

ISSN :

1827-191X

Keyword(s) :

Connective tissue diseases
Vascular surgical procedures
Aortic treatment

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Connective tissue disease (CTD) represents a group of genetic conditions characterized by disruptive matrix remodeling. When this process involves aortic and vascular wall, patients with CTD have a high risk of developing ...
Show more >Connective tissue disease (CTD) represents a group of genetic conditions characterized by disruptive matrix remodeling. When this process involves aortic and vascular wall, patients with CTD have a high risk of developing arterial aneurysms, dissections and ruptures. Open surgical repair is still the gold standard therapy for patients with CTD with reasonable morbidity and mortality risk. The surgical treatment of CTD often requires multiple operations. In the endovascular era, fenestrated and branched stent grafts may play a role in reducing the complications of multiple open operations. Although the long-term results of endovascular treatment in the setting of CTD are unknown, it is generally accepted that endovascular treatment is restricted to selected patients with high surgical risk. In an emergency setting, endovascular intervention can serve as a lifesaving bridge to elective open aortic repair. Aortic centers performing a large volume of complex open and endovascular aortic repairs have started to combine these two techniques in a staged fashion. The goal is to reduce the morbidity and mortality associated with extensive aortic repairs in CTD patients. For this reason, recommend endovascular therapy when a "graft-to-graft" approach is possible. In this scenario, the surgeon who performs the open repair must take into consideration future interventions. Surgical repair in any aortic segment should allow creation of proximal and distal landing zones over 4 cm to secure the sealing of a future stent graft. Connective tissue disease should be treated with a multidisciplinary approach, in high volume centers. Endovascular treatment represents a potential option in patients at high risk for open repair. Staged hybrid procedures have emerged as a way to reduce spinal cord ischemia and avoid multiple open surgeries. The aim of this article is to discuss the management of aortic diseases in CTD, focusing on to the role of standard open surgery and emerging endovascular treatment, and to give an overview of the few series published regarding this topic with a small number of patients.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

CHU Lille
Inserm
Université de Lille

Collections :

• Advanced Drug Delivery Systems (ADDS) - U1008

Submission date :

2021-01-20T15:59:15Z
2024-02-23T09:41:25Z