Publications by authors named "Alexander Calderone"

4 Publications

  • Page 1 of 1

Frozen Elephant Trunk Repair for Acute Type A Dissection in Right Aortic Arch.

Ann Thorac Surg 2021 Sep 15. Epub 2021 Sep 15.

Department of Cardiac Surgery, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada. Electronic address:

A 68-year-old woman with right aortic arch and aberrant left subclavian artery was urgently operated for type A aortic dissection. Surgical management included total arch repair with frozen elephant trunk technique and left subclavian artery re-implantation. Post-operative course was complicated by severe renal failure, delirium and pneumonia. She was re-operated 3 weeks later due to an expanding proximal aortic anastomosis pseudoaneurysm. Right aortic arch is a rare vascular anomaly requiring thoughtful preoperative planning for adequate myocardial, cerebral and spinal protection. Frozen elephant trunk facilitates management of extensive dissection, relieves malperfusion and may alleviate the need for subsequent operations.
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September 2021

Femoral Vein Pulsatility: What Does It Mean?

J Cardiothorac Vasc Anesth 2021 Aug 26;35(8):2521-2527. Epub 2021 Mar 26.

Department of Anesthesiology, Department of Medicine, Division of Intensive Care Medicine, Institut universitaire de cardiologie et de pneumologie de Québec - Université Laval, Quebec, Canada.

In this report, the clinical evolution of a 72-year-old patient transferred to the surgical intensive care unit after cardiac surgery is described. The presence of a pulsatile Doppler signal of the common femoral vein was noted after surgery. On postoperative day 5, diuretics in addition to a combination of inhaled epoprostenol and milrinone were associated with normalization of femoral vein pulsatility. The observations seen in peripheral venous flow reinforce the hypothesis that pulsatility of the common femoral vein represents an associated echocardiographic sign of right ventricular dysfunction and may be used to monitor systemic venous congestion. Pulsatility in the venous system may be improved by reducing volume overload and improving right ventricular function.
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August 2021

Endoscopic pyloromyotomy in minimally invasive esophagectomy: a novel approach.

Surg Endosc 2021 May 4. Epub 2021 May 4.

Division of Thoracic and Upper Gastrointestinal Surgery, McGill University Health Centre, Montreal, QC, Canada.

Background: Pyloric drainage procedures, namely pyloromyotomy or pyloroplasty, have long been considered an integral aspect of esophagectomy. However, the requirement of pyloric drainage in the era of minimally invasive esophagectomy (MIE) has been brought into question. This is in part because of the technical challenges of performing the pyloric drainage laparoscopically, leading many surgical teams to explore other options or to abandon this procedure entirely. We have developed a novel, technically facile, endoscopic approach to pyloromyotomy, and sought to assess the efficacy of this new approach compared to the standard surgical pyloromyotomy.

Methods: Patients who underwent MIE for cancer from 01/2010 to 12/2019 were identified from a prospectively maintained institutional database and were divided into two groups according to the pyloric drainage procedure: endoscopic or surgical pyloric drainage. 30-day outcomes (complications, length of stay, readmissions) and pyloric drainage-related outcomes [conduit distension/width, nasogastric tube (NGT) duration and re-insertion, gastric stasis] were compared between groups.

Results: 94 patients were identified of these 52 patients underwent endoscopic PM and 42 patients underwent surgical PM. The groups were similar with respect to age, gender and comorbidities. There were more Ivor-Lewis esophagectomies in the endoscopic PM group than the surgical PM group [45 (86%), 15 (36%) p < 0.001]. There was no significant difference in the rate of complications and readmissions. Gastric stasis requiring NGT re-insertion was rare in the endoscopic PM group and did not differ significantly from the surgical PM group (1.9-4.7% p = 0.58).

Conclusions: Endoscopic pyloromyotomy using a novel approach is a safe, quick and reproducible technique with comparable results to a surgical PM in the setting of MIE.
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May 2021