Surgical Management of Aortic Pathology

Description:

This book follows the concept of perceiving the entire aorta as one functional organ assuming that all individual pathologies and local interventional procedures affect the up- and downstream segments with consequences for complications and disease progression. Thus any preventive or surgical strategy must recognize the aortic disease in its entirety. The book intends to cover the full spectrum of aortic pathologies, mechanisms and functional interplay. The latest available diagnostic tools and options for surgical treatment are presented by the foremost experts in their field in state-of-the-art reviews. The reader is provided with the most current and comprehensive insight into all fundamental and clinical aspects of aortic disease. All chapters are carefully complemented with figures and illustrations.

Table of contents:

1. A Brief History of Aortic Pathology and Surgery

Part I. Anatomy

2. The Surgical Anatomy of the Aortic Root

3. Morphology and Surgical Anatomy of the Aorta and Pulmonary Trunk

4. The Normal Aorta and Changes with Age

Part II. Mechanisms

5. Molecular Mechanisms of Aortic Valve Pathology

6. Functional and Morphological Interplay of the Aortic Valve, the Aortic Root, and the Left Ventricle

7. Interaction Between the Haemodynamics of Coronary Flow and Aortic Valve Pathologies

8. Left Ventricular Fibrosis in Patients with Aortic Stenosis

9. Novel Understanding on Thoracic Aortic Diseases from Bioengineering Concepts

10. Mechanics of the Thoracic Aortic Wall

11. Role of Biomechanical Stress in the Pathology of the Aorta

12. Insights into the Pathogenic Mechanisms of Acute Dissection

13. Triggers of Aortic Dissection

Part III. Principles

14. Medical Treatment of Thoracic Aortic Pathologies

15. Frailty in Aortic Surgery

16. Biomarkers of Acute Aortic Syndrome

17. Post-operative Management of Aortic Valve Disease

18. What the Surgeon Can Expect from the Pathologist and Vice Versa

19. Indications for Aortic Surgery and Use of Guidelines

20. Lessons Learnt from the International Registry of Acute Aortic Dissection (IRAD)

Part IV. Imaging

21. Trans(o)esophageal Echocardiography (TOE/TEE) in the Diagnosis of Aortic Pathologies

22. Left Ventricular Function and Aortic Valve Replacement

23. Imaging of the Thoracic Aorta

24. Cardiovascular Imaging in Aortic Diseases: Multimodality Approach in Clinical Practice

25. Multidetector Computed Tomography of the Aorta

26. Aortic Root Assessment with Computed Tomography in the Context of TAVR

27. Three-Dimensional Rotational Angiography

28. 4D Flow MR: Insights into Aortic Blood Flow Characteristics

29. Impact of Aortopathy and Aortic Valve Disease on 3D Blood Flow and Wall Shear Stress in the Thoracic Aorta: As Assessed by 4D Flow MRI

30. Emerging Tools to Assess the Risk of Rupture in AAA: Wall Stress and FDG PET

31. Exploring the Thoracic Aorta with Advanced Magnetic Resonance Imaging Beyond Routine Diameter Measurements

Part V. Congenital and Connective Tissue Aortopathy, Bicuspid Aortic Valve

32. Congenital Aortopathy

33. Aortic Connective Tissue Histopathology

34. Clinical Aspects of Heritable Connective Tissue Disorders

35. Bicuspid Aortic Valve: Timing of Surgery

36. Biscuspid Aortic Valve Repair

37. Morphology of the Ascending Aorta in Bicuspid Aortic Valve Disease

38. Genetics of Marfan Syndrome and Loeys-Dietz Syndrome

39. The Exostent Concept for the Marfan Syndrome

40. Aortic Dissection in Patients with Disorders of Connective Tissue

Part VI. Aortic Valve and Root

41. Diagnostic and Therapeutic Targets for Aortic Valve and Ascending Aorta Pathologies: Challenges and Opportunities

42. Concepts of Aortic Valve Repair

43. Surgical Repair of the Bicuspid Aortic Valve: Predictors of Failure

44. Native and Prosthetic Valve Endocarditis

45. Reconstruction of the Left Ventricular Outflow Tract for Aortic Root Abscess

46. Stented Bioprosthetic Valves

47. The Stentless Valve Concept

48. Challenges and Lessons from Preoccupation with the Stentless Aortic Valve Prosthesis Concept

49. Management of Aortic Prosthetic Leaks

50. Aortic Root Enlargement

51. Current Role and Techniques of the David Operation

52. The Yacoub Operation

53. Effect of Aortic Root Repair on Aortic Valve Function

54. The Ross Operation

Part VII. TAVI and New Technology

55. TAVI: A European Perspective

56. Transcatheter Aortic Valve Replacement in the USA

57. Transcatheter Aortic Valve Replacement: Management of High-Risk Patients and Complex Procedures

58. New Technology: The Sutureless Valve Prostheses

Part VIII. Ascending Aorta

59. Recommendations on Thresholds for Elective Surgery for Thoracic Ascending Aortic Aneurysms

60. Impact of Ascending Aorta Replacement on Ventricle Load and “Windkessel” Function

61. Surgical Strategies in Acute Type A Aortic Dissection

62. Acute Type A Dissection Repair

63. Management of Aortic Malperfusion Syndromes in Aortic Dissection

64. Cerebral Protection During Surgery of Acute Type A Aortic Dissection

65. Type-A Aortic Dissection After Previous Cardiac Surgery: Features and Optimal Management

66. The Elephant Trunk Concept in Type A Aortic Dissection

Part IX. Aortic Arch

67. Aortic Arch Surgery Under Warm Conditions (Moderate to Mild Hypothermia)

68. Infection of Ascending Aortic and Aortic Arch Prostheses

69. Elephant Trunk Technique(s)

70. Arch Surgery and Elephant Trunk Technique and Alternatives for Second Stage

71. Management of the Aortic Arch in the Modern Era

72. Debranching Concepts and Techniques for Arch Surgery

73. Total Endovascular Aortic Arch Replacement: Branched Arch Endografts

Part X. Descending Aorta

74. Blunt Thoracic Aortic Trauma

75. Surgical Anatomy of the Blood Supply to the Spinal Cord

76. Surgical Strategies in Acute and Chronic Type B Aortic Dissection

77. Current Open Treatment of Thoracoabdominal Aortic Aneurysms

78. Spinal Cord Protection in Thoracic Aortic Surgery

79. Monitoring Spinal Cord Function in Open and Endovascular Treatment of Thoracoabdominal Aortic Pathologies

80. Infected Aortic Grafts in the Descending Thoracic Aorta

81. Hybrid and Redo Strategies for Descending and Thoracoabdominal Aorta

Part XI. TEVAR

82. Endovascular Treatment of Aortic Diseases

83. Secondary Procedures After Primary Thoracic Endovascular Aortic Repair (TEVAR): Pathologies and Management

84. Stenting of the Descending Aorta

85. Complications of TEVAR