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https://www.readbyqxmd.com/read/28633258/stepwise-total-aortic-repairs-with-fenestrated-endografts-in-a-patient-with-loeys-dietz-syndrome
#1
Kenichi Hashizume, Hideyuki Shimizu, Masanori Honda, Shinya Inoue, Hidenobu Takaki, Kanako Hayashi, Hiroaki Kaneyama
Loeys-Dietz syndrome (LDS) is a rare connective tissue disorder (CTD) caused by mutations in the gene encoding transforming growth factor-β receptors Ⅰ and Ⅱ. Patients with LDS manifest spontaneous aneurysms and dissections of the aorta and peripheral artery. We report a successful treatment with a hybrid endovascular repair for a rapidly expanding thoracoabdominal aneurysm in a 41-year-old woman affected by LDS. To overcome the difficulties of anatomical and surgical repair, we applied an original strategy using surgeon-modified fenestrated endografts...
July 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28631316/recannulation-of-the-axillary-artery-in-aortic-and-complex-cardiac-surgery
#2
Philippa Jane Temple Bowers, Manu Narain Mathur
OBJECTIVES: Axillary artery cannulation has been used as an alternative site for cardiopulmonary bypass during surgery for aortic dissections and aneurysmal disease of the ascending aorta and arch. This study reports our experience with reusing the axillary artery for cardiopulmonary bypass during complex aortic and cardiac surgical procedures. METHODS: This was a retrospective review of a single surgeon's experience of recannulating the axillary artery for redo operations in complex aortic surgery...
June 19, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28631201/seven-esophageal-perforation-cases-after-aortic-replacement-stenting-for-thoracic-aortic-dissection-or-aneurysm
#3
Yoshihisa Yaguchi, Yoshimasa Kumata, Masahiro Horikawa, Takashi Kiyokawa, Tsuyoshi Inaba, Ryoji Fukushima
BACKGROUND: Esophageal perforation after aortic replacement/stenting for aortic dissection or aneurysm is a rare but severe complication. However, its cause, standard treatment, and prognosis are unclear. We analyzed the treatment and outcome retrospectively from seven cases experienced at our hospital. CASE PRESENTATION: The median age of the patients was 70 years (range, 41-86), and six of the seven cases were male. As the first treatment, aortic replacement techniques were performed in five, and thoracic endovascular aortic repair (TEVAR) procedure was performed in two...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28627863/endovascular-treatment-of-mycotic-aortic-aneurysms-a-paradigm-shift
#4
Karl Sörelius, Kevin Mani, Martin Björck, Anders Wanhainen
Treatment of mycotic aortic aneurysms (MAA) composes a particularly difficult challenge. Open repair (OR) has been considered the gold standard, despite lack of evidence supporting its superiority compared with the emerging alternative endovascular aortic repair (EVAR). This review discusses the pros and cons of EVAR for MAAs by dissecting the three largest publications on MAAs, and concludes that there has been a paradigm shift in treatment of MAAs for the benefit of EVAR.
June 19, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28625904/subarachnoid-hemorrhage-due-to-distal-superior-cerebellar-artery-dissection-in-neurofibromatosis-type-1
#5
Yuki Takeshima, Yuki Ohmori, Takashi Nakagawa, Yasuyuki Kaku, Jun-Ichi Kuratsu, Shigetoshi Yano
BACKGROUND: Neurofibromatosis type 1 (NF1) is a rare disease with an incidence of one in every 3000 births. Numerous studies have focused on the main function of NF1 as a tumor suppressor, while few have examined the cerebrovascular abnormalities observed in patients with NF1. It is worth noting that intracranial aneurysms are uncommon in this condition. CASE DESCRIPTION: We report a case of NF1 with a dissection of the distal segment of the superior cerebellar artery...
June 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28622069/spontaneous-coronary-artery-dissection-in-a-woman-with-a-past-medical-history-of-subarachnoid-hemorrhage-a-case-report
#6
Jean Bardon, Fabien Picard, Franck Barbou, Olivier Varenne, Benoît Vivien
Spontaneous coronary artery dissection (SCAD) is an uncommon disease. We report the case of a 50 year-old woman with a past medical history of aneurysmal subarachnoid hemorrhage, presenting with acute chest pain and diffuse ST segment elevation on ECG. Coronary angiogram revealed a SCAD of the left anterior descending coronary artery. The association between cerebral aneurysms and SCAD should trigger providers concern for fibromuscular dysplasia. We hereby report on a rare and atypical case involving the relationship between fibromuscular dysplasia and SCAD...
June 16, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28616351/hybrid-aortic-repair-with-antegrade-supra-aortic-and-renovisceral-debranching-from-ascending-aorta
#7
José Antonio Del Castro-Madrazo, Margarita Rivas-Domínguez, Carlota Fernández-Prendes, Amer Zanabili Al-Sibbai, José Manuel Llaneza-Coto, Manuel Alonso-Pérez
Aortic dissection is a life threatening condition. Hybrid repair has been described for the treatment of complex aortic pathology such as thoracoabdominal aortic aneurysms (TAAA) and type A and B dissections, although open and total endovascular repair are also possible. Open surgery is still associated with substantial perioperative morbi-mortality rates, thus less invasive techniques such as endovascular repair and hybrid procedures can achieve good results in centers with experience. We present the case of a patient with a chronic type B dissection and TAAA degeneration that was treated in a single stage hybrid procedure with antegrade supra-aortic and renovisceral debranching from the ascending aorta and TEVAR...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28616345/wrapping-of-the-ascending-aorta-revisited-is-there-any-role-left-for-conservative-treatment-of-ascending-aortic-aneurysm
#8
REVIEW
José María González-Santos, María Elena Arnáiz-García
Dilatation of the ascending aorta (AA) is a common finding in patients with aortic valve disease. The clinical practice guidelines recommend replacing the AA whenever the diameter exceeds 45 mm. However, no consensus has been reached regarding the approach when the aorta is only moderately dilated. Although the risk in aorta replacement is generally low, it may be higher when associated with other complex surgical procedures or it is carried out in elderly patients or patients with significant comorbidity. This would justify the use of alternative surgical techniques, which reduce surgical risk and guarantee a durable correction of the aortic pathology...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28616342/bicuspid-aortic-valve-syndrome-a-multidisciplinary-approach-for-a-complex-entity
#9
REVIEW
María Martín, Rebeca Lorca, José Rozado, Rubén Alvarez-Cabo, Juan Calvo, Isaac Pascual, Helena Cigarrán, Isabel Rodríguez, César Morís
Bicuspid aortic valve (BAV) or bicuspid aortopathy is the most common congenital heart disease. It can be clinically silent and it is often identified as an incidental finding in otherwise healthy, asymptomatic patients. However, it can be dysfunctioning at birth, even requiring neonatal intervention, or, in time, lead to aortic stenosis, aortic insufficiency, and endocarditis, and also be associated with aortic aneurysm and aortic dissection. Given its prevalence and significant complications, it is estimated that BAV is responsible for more deaths and morbidity than the combined effects of all the other congenital heart defects...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28616230/predictors-of-adamkiewicz-artery-and-anterior-spinal-artery-detection-through-computerized-tomographic-angiography
#10
Alexandre Campos Moraes Amato, Jose Rodrigues Parga Filho, Noedir Antonio Groppo Stolf
BACKGROUND: The detection of the Adamkiewicz artery and the anterior spinal artery has been associated with the ability to prevent adverse spinal cord outcomes after aortic surgical procedures. Yet, to our knowledge, no previous studies have attempted to use modern predictive models to identify the most important variables in determining artery detectability. AIMS: To develop a model to predict the odds of visualizing the Adamkiewicz artery or anterior spinal artery in patients undergoing computerized tomographic angiography...
2017: SAGE Open Medicine
https://www.readbyqxmd.com/read/28612909/implantation-of-stents-for-postsurgical-recoarctation-of-the-aorta-in-adolescents-and-adults
#11
Sylwia Sulik-Gajda, Roland Fiszer, Jacek Białkowski, Beata Chodór, Szymon Pawlak, Małgorzata Szkutnik
BACKGROUND: Results of stent implantation (SI) of postsurgical recoarctation of the aorta (ReCoA) are not frequently published. AIM: This study sought to retrospectively evaluate results of SI in ReCoA in older children and adults. METHODS: Twenty-eight SI were performed on 26 ReCoA patients with a median age of 23(10-65) years. Dependent upon availability, the following stents were applied -Palmaz, Cheatham Platinum (CP), Andrastents XL/XXL(AS), Covered CP (CVCP) stents and selfexpanding stents (Smart)...
June 14, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28612571/-correlation-between-serum-concentrations-of-catecholamines-and-oxygen-index-in-acute-aortic-dissection
#12
Hong Qian, Lei Du, Jing-Xiu Fan, Hui Yu, Er-Yong Zhang, Jia Hu
OBJECTIVES: To explore whether the serum concentration of adrenaline (AD) and noradrenaline (NA) elevate and its correlation with oxygenation index (OI) in the patients of acute aortic dissection (AAD). METHODS: From April 2013 to December 2013, clinical data were collected from three groups of patients (38 cases of AAD in Group A, 28 cases of ascending aortic aneurysm in Group B, and 22 cases of angina in Group C). All patients received the measurement of serum concentrations of AD, NA and endotoxin (ET)...
January 2017: Sichuan da Xue Xue Bao. Yi Xue Ban, Journal of Sichuan University. Medical Science Edition
https://www.readbyqxmd.com/read/28612004/extracranial-aneurysms-in-2-patients-with-autosomal-recessive-polycystic-kidney-disease
#13
Daniel S Elchediak, Anne Marie Cahill, Emma E Furth, Bernard S Kaplan, Erum A Hartung
Unlike autosomal dominant polycystic kidney disease (ADPKD), autosomal recessive polycystic kidney disease (ARPKD) is not generally known to be associated with vascular abnormalities. Only 4 cases of ARPKD patients with intracranial aneurysms have been reported previously. We present 2 ARPKD patients with extracranial vascular abnormalities: a young man with infrarenal aortic and iliac artery aneurysms complicated by dissection and a teenage girl with multiple splenic and gastric artery aneurysms and arterial vascular malformations...
May 2017: Case Reports in Nephrology and Dialysis
https://www.readbyqxmd.com/read/28607545/the-genetics-of-aortopathies-in-clinical-cardiology
#14
REVIEW
Amit Goyal, Ali R Keramati, Matthew J Czarny, Jon R Resar, Arya Mani
Aortopathies pose a significant healthcare burden due to excess early mortality, increasing incidence, and underdiagnosis. Understanding the underlying genetic causes, early diagnosis, timely surveillance, prophylactic repair, and family screening are keys to addressing these diseases. Next-generation sequencing continues to expand our understanding of the genetic causes of heritable aortopathies, rapidly clarifying their underlying molecular pathophysiology and suggesting new potential therapeutic targets...
2017: Clinical Medicine Insights. Cardiology
https://www.readbyqxmd.com/read/28606412/diagnosing-acute-aortic-dissection-with-aneurysmal-degeneration-with-point-of-care-ultrasound
#15
John Bernett, Robert Strony
No abstract text is available yet for this article.
May 30, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28606255/-incidence-and-risk-factors-of-recurrence-after-endovascular-treatment-of-vertebrobasilar-dissecting-aneurysms
#16
Y Z Zang, Z G Wang, C W Wang, Y Zhang, X Ding, X F Wang
Objective: To evaluate the incidence and risk factors of recurrence after endovascular treatment of vertebrobasilar dissecting aneurysms (VBDAs). Methods: Retrospective analysis was used for the clinical information of 40 cases of vertebrobasilar dissecting aneurysms treated with endovascular methods in our department between January 2007 and December 2015.According to whether recurrence occurred, the patients were divided into recurrence group (10 patients) and non-recurrence group (30 patients). The data of the patients' age, sex, hypertension history, smoking history, aneurismal size, presenting symptoms, degree of embolization, GCS scores, aneurismal localization and treatment methods were analyzed to evaluate the risk factors for recurrence after endovascular treatment...
June 6, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28606160/consumption-coagulopathy-in-acute-aortic-dissection-principles-of-management
#17
Yuyong Liu, Lu Han, Jiachen Li, Ming Gong, Hongjia Zhang, Xinliang Guan
BACKGROUND: The effect of acute aortic dissection itself on coagulopathy or surgery-related coagulopathy has never been specifically studied. The aim of the present study was to perioperatively describe consumption coagulopathy in patients with acute aortic dissection. METHODS: Sixty-six patients with acute type A aortic dissection were enrolled in this study from January 2015 to September 2016. Thirty-six patients with thoracic aortic aneurysms were used as a control group during the same period...
June 12, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28605479/collapsed-stent-graft-and-severe-malperfusion-2%C3%A2-years-after-endovascular-aortic-repair
#18
Yoshihiro Goto, Soh Hosoba, Shinji Ogawa, Yoshihisa Kinoshita
Late collapsing of a stent graft is an extremely rare event, with one existing report describing this phenomenon. A 65-year-old man with a history of endovascular aortic repair for an abdominal aortic aneurysm presented with paraplegia and bilateral lower limb ischaemia. Contrast-enhanced computed tomography showed a dissection of the descending thoracic aorta and a collapsed stent graft, resulting in bilateral lower limb ischaemia. Subsequent axillo-bifemoral bypass resolved his lower extremity functions. The patient required haemodialysis due to acute kidney failure...
June 10, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28604473/perioperative-anesthetic-management-for-cesarean-delivery-in-a-parturient-with-type-iv-loeys-dietz-syndrome-a-case-report
#19
Ravish Kapoor, David G Mann, Emad B Mossad
Loeys-Dietz syndrome (LDS) is a rare connective tissue disorder predisposing to aortic and arterial aneurysms. Presentations are classified into subtypes based on gene mutations. Pregnancy in patients with LDS is considered very high risk due to the potential for aortic dissection and uterine rupture. We report successful management of an elective cesarean delivery in a 16-year-old patient with LDS type IV using epidural anesthesia. Perioperative considerations and multidisciplinary management specific to taking care of parturients with LDS are discussed...
June 8, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28603157/anatomical-and-radiological-analyses-of-l-shaped-kidney-with-vascular-anomalies
#20
Joe Iwanaga, Koichi Watanabe, Tsuyoshi Saga, Nobuhiro Tahara, Yoko Tabira, Ayano Sakuragi, Keiko Kaji, Kiyoshi Takahashi, Koh-Ichi Yamaki
L-shaped kidney is a congenital anomaly. The disorder results in the kidney appearing very similar in shape to horseshoe kidney (also a congenital anomaly), but either the right or left kidney is located at a position lower than the other kidney. In this report, we describe a woman with L-shaped kidney, identified during anatomical dissection, and compare the findings with clinical data obtained before her death. We discuss the embryology of L-shaped kidney based on detailed anatomical data on the kidney and its vascular system obtained by means of gross anatomical, radiological, and histological examinations...
June 12, 2017: Kurume Medical Journal
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