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Related Concept Videos

Aneurysm III: Interprofessional Care01:26

Aneurysm III: Interprofessional Care

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Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
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Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
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A nurse managing a patient with aortic regurgitation begins with a comprehensive assessment, including a review of the patient's medical history, family history, and lifestyle factors. During the cardiac examination, the nurse listens for heart sounds and checks for signs of valve abnormalities. The nurse also observes for symptoms such as dyspnea, orthopnea, and paroxysmal nocturnal dyspnea and assesses the patient's endurance and daily activity tolerance.Based on the findings, the nurse...
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Related Experiment Video

Updated: Apr 25, 2026

Novel and Innovative Hybrid Technique for Type A Aortic Dissection
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Open fenestration for complicated acute aortic B dissection.

Santi Trimarchi1, Sara Segreti1, Viviana Grassi1

  • 11 Thoracic Aortic Research Center, Cardiovascular Surgery, Policlinico San Donato IRCCS, Milan, Italy ; 2 Section of Vascular Surgery, Department of Surgery and Morphological Sciences, Circolo University Hospital, University of Insubria School of Medicine, Varese, Italy.

Annals of Cardiothoracic Surgery
|August 19, 2014
PubMed
Summary
This summary is machine-generated.

Acute type B aortic dissection (ABAD) can cause organ ischemia. Open fenestration surgery effectively resolves malperfusion, offering a less invasive alternative to total aortic replacement for complicated ABAD cases.

Keywords:
Acute type B aortic dissectionmalperfusionopen fenestration

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Area of Science:

  • Cardiovascular Surgery
  • Vascular Surgery
  • Thoracic Surgery

Background:

  • Acute type B aortic dissection (ABAD) is a critical cardiovascular emergency.
  • Complications like visceral, renal, and limb ischemia significantly increase mortality in ABAD patients.
  • Malperfusion syndromes complicate up to 30% of ABAD cases.

Purpose of the Study:

  • To evaluate the efficacy of open fenestration in treating ischemic complications of ABAD.
  • To present open fenestration as a viable alternative to endovascular repair or total aortic replacement.

Main Methods:

  • Open surgical fenestration procedure to create a single aortic lumen.
  • Suprarenal or infrarenal fenestration placement to restore organ perfusion.
  • Comparison of open fenestration with total aortic replacement and endovascular techniques.

Main Results:

  • Open fenestration effectively resolves malperfusion in ABAD.
  • The procedure is less invasive than total aortic replacement, avoiding extracorporeal support.
  • Preservation of intercostal arteries reduces the risk of paraplegia.

Conclusions:

  • Surgical aortic fenestration is an effective and durable treatment for ischemic complications in ABAD.
  • It is particularly beneficial for patients without aortic dilatation.
  • Open fenestration serves as a crucial alternative when endovascular management is contraindicated or fails.