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Acute aortic syndrome

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https://www.readbyqxmd.com/read/28449426/-a-case-of-intramural-hematoma-of-the-esophagus-mimicking-acute-coronary-syndrome
#1
Dae Gon Ryu, Cheol Woong Choi, Dae Hwan Kang, Hyung Wook Kim, Dong Il Jeong, Wan Chul Kim, Jae Gyu Shin, Tae Won Lim
Intramural hematoma of the esophagus is a rare condition that can be spontaneous or secondary to trauma, toxic ingestion, or intervention. If it is the spontaneous type, it usually presents initially with epigastric pain, hematemesis or dysphagia. We present a case of intramural hematoma of the esophagus mimicking acute coronary syndrome. A 63-year-old man presented with severe acute chest pain. He has four coronary stents that were inserted five years ago, from a different hospital, and is on dual antiplatelet agents...
April 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/28427782/prospective-study-of-a-non-restrictive-decision-rule-for-acute-aortic-syndrome
#2
Judah Goldschmiedt, Jeffrey M Levsky, Eran Y Bellin, Esther Mizrachi, David Esses, Linda B Haramati
OBJECTIVES: To determine the impact of a non-restrictive clinical decision rule on CT utilization for Emergency Department patients suspected of having an acute aortic syndrome (AAS). METHODS: We prospectively assessed the performance of a previously described, collaboratively designed, non-restrictive clinical decision rule for AAS. Emergency Department patients with suspected AAS were stratified into low and high-risk groups based on decision rule results, from July 2013-August 2014...
April 6, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28413582/a-case-of-iatrogenic-aortic-intramural-hematoma
#3
Kamil Muhyieddeen, Arang Samim, Michah Roberts, Sundararajan Srikanth
Iatrogenic aortic dissection during percutaneous coronary intervention is a rare but serious complication. Both conservative and surgical approaches have been proposed as management strategies. We describe a case of an 87-year-old female who presented with an acute coronary syndrome complicated by the development of an ascending aortic dissection during percutaneous intervention, and we provide a brief review of the literature.
January 2017: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/28412719/combined-measurement-of-factor-xiii-and-d-dimer-is-helpful-for-differential-diagnosis-in-patients-with-suspected-pulmonary-embolism
#4
Ning Tang, Ziyong Sun, Dengju Li, Jun Yang, Shiyu Yin, Qing Guan
BACKGROUND: D-dimer has been used to rule out pulmonary embolism (PE). Based on previous reports of decreased concentrations of coagulation factor XIII (FXIII) in venous thromboembolism, and no change in FXIII concentration in patients with acute cardiovascular disease, we evaluated the benefit of simultaneously measuring D-dimer and FXIII concentrations for diagnosing PE. METHODS: In this prospective single-center study, we enrolled 209 patients initially suspected of having PE, and measured their D-dimer and FXIII concentrations...
April 17, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28407819/-association-between-fluid-overload-and-acute-renal-injury-after-congenital-heart-disease-surgery-in-infants
#5
De-Qiang Luo, Zi-Li Chen, Wei Dai, Feng Chen
OBJECTIVE: To study the association between fluid overload and acute kidney injury (AKI) after congenital heart disease surgery in infants. METHODS: A retrospective analysis was performed on 88 infants aged less than 6 months who underwent a radical surgery for congenital heart disease. The treatment outcomes were compared between the infants with AKI after surgery and those without. The effect of cumulative fluid overload on treatment outcomes 2 days after surgery was analyzed...
April 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/28394003/prevalence-of-abdominal-aortic-aneurysms-in-rural-urban-population-in-central-poland
#6
Tadeusz L Dereziński, Bartosz Fórmankiewicz, Arkadiusz Migdalski, Paweł Brazis, Grzegorz Jakubowski, Łukasz Woda, Arkadiusz Jawień
BACKGROUND: Abdominal aortic aneurysm (AAA) is a widening of the aorta below the renal arteries with a diameter equal or greater than 3 cm. The prevalence of AAA is estimated at 4-8% in men aged 65 years or older and 1-2% among women over 65 years. Participation in screening programs has decreased the number of aortic ruptures. METHODS: All men aged 60 years and older, and women aged 65 and older living in the rural/urban commune in Central Poland were invited to the participation in the study...
April 10, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28390915/predictors-of-stable-aortic-dimensions-in-medically-managed-acute-aortic-syndromes
#7
Arnoud V Kamman, Frederik Hw Jonker, Udo Sechtem, Kevin M Harris, Arturo Evangelista, Daniel G Montgomery, Himanshu J Patel, Kim A Eagle, Santi Trimarchi
PURPOSE: We aimed to identify predictors of stable aortic dimensions in medically managed type B aortic dissections (TBAD). METHODS: Medically managed TBAD patients from the International Registry of Acute Aortic Dissection (IRAD) with available aortic measurements at up to 24 months were included. Growth rate was calculated by dividing the largest descending diameter at the latest endpoint not influenced by intervention minus initial descending diameter, by the recorded time interval...
April 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28389290/symptomatic-intragraft-thrombus-following-endovascular-repair-of-blunt-thoracic-aortic-injury
#8
Sherwin Abdoli, Sung Wan Ham, Alison G Wilcox, Fernando Fleischman, Lydia Lam
INTRODUCTION: Thoracic endovascular aortic repair (TEVAR) can be complicated by graft collapse, endoleaks, and stent migration. The incidence of these complications and other outcomes is poorly understood in young trauma victims who receive endovascular aortic repair of blunt thoracic aortic injury. REPORT: A 29 year-old pedestrian was struck by a vehicle resulting in polytrauma including blunt thoracic aortic injury (BTAI) with transection distal to the left subclavian artery origin...
April 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28371362/pregnancy-related-acute-aortic-dissection-in-marfan-syndrome-a-review-of-the-literature
#9
REVIEW
Katherine Smith, Bernard Gros
A well-established association exists between acute aortic dissection and pregnancy, particularly in women with Marfan syndrome. However, there is debate regarding appropriate management guidelines. In particular, there are differing opinions regarding when prophylactic aortic root repair should be recommended as well as the efficacy of beta blockers in this clinical scenario. The current study evaluated 10 years of published literature (2005-2015) in the PubMed/Medline database. Fifty articles, describing 72 cases of women who presented with aortic dissection in the antepartum or postpartum period were identified...
April 2, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28355763/-late-reoperations-after-repaired-stanford-type-a-aortic-dissection
#10
F H Huang, L P Li, C H Su, W Qin, M Xu, L M Wang, Y S Jiang, Z B Qiu, L Q Xiao, C Zhang, H W Shi, X Chen
Objective: To summarize the experience of reoperations on patients who had late complications related to previous aortic surgery for Stanford type A dissection. Methods: From August 2008 to October 2016, 14 patients (10 male and 4 female patients) who underwent previous cardiac surgery for Stanford type A aortic dissection accepted reoperations on the late complications at Department of Thoracic and Cardiovascular Surgery, Nanjing Hospital Affiliated to Nanjing Medical University. The range of age was from 41 to 76 years, the mean age was (57±12) years...
April 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28355760/-treatment-strategies-of-complex-lesions-in-patients-with-acute-stanford-type-a-dissection-of-important-branches-involvement
#11
G M Zhang, J M Xia, Y Sun, L H Fan, Y Y Duan, S H Yu, B S Duan, B Li, S Mei, L Zhou, H B Huang, J Y Li, Q Z Guo, J M Zhu
Acute Stanford type A aortic dissection with important branches involved is more complex, could lead to organ malperfusion syndrome even organ failure. The understanding of pathological anatomy, classification, staging, and the pathophysiological change has increasingly mature, but not complete. In addition, the treatment strategy for complex lesions is diversified, some questions may not reach consensus. Fully understanding of the anatomical and pathophysiology is very important for surgeons to choose reasonable treatment strategy...
April 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28345421/clinical-features-and-prognosis-of-patients-with-acute-aortic-dissection-in-china
#12
Lujing Zhao, Yanfen Chai, Zhigang Li
Objective To evaluate the clinical features, risk factors, and prognostic significance of different Stanford types of acute aortic dissection (AAD). Methods We retrospectively analyzed the clinical data and prognostic predictors in 105 patients with AAD (37 with Stanford type A and 68 with Stanford type B) at Tianjin Medical University General Hospital and Tianjin 4th Central Hospital from January 2014 to November 2015. Results Patients with Marfan syndrome and bicuspid aortic valve constituted 24.3% and 8...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28344762/protracted-refractory-pain-post-tevar-post-implantation-syndrome
#13
Peter Waweru, Hardeep Gill, Chris Abeid
Aortic dissection is a life-threatening condition and has one of the highest mortality rates of cardiovascular diseases. It remains a devastating disease; with multiple unanswered questions concerning treatment modalities. The role of thoracic endovascular aortic repair (TEVAR) in these patients; especially those with uncomplicated acute aortic Type B dissections (AAD-B) is especially controversial although it has been shown to have better long-term outcomes compared to medical therapy alone. For those who have TEVAR, up to 60% may develop an acute, transient systemic inflammatory response syndrome that remains vaguely defined...
October 2016: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28341511/open-and-endovascular-abdominal-aortic-injury-repair-outcomes-in-polytrauma-patients
#14
Anand Dayama, Aksim Rivera, Odunayo Olorunfemi, Ahmed Mahmoud, Catherine A Fontecha, John McNelis
INTRODUCTION: The management of patients with abdominal aortic injury (AAI) remains challenging. Open repair of AAI is still the standard of care although it is associated with high mortality. In past few years, endovascular surgery has evolved as a less invasive alternative to open surgery in emergency settings. The objective of this study was to compare outcomes after open repair versus endovascular repair of AAI in polytrauma patients. METHODS: The National Trauma Data Bank, from 2008 to 2012, was queried to identify trauma patients undergoing open and endovascular repair of AAI using International Classification of Diseases, ninth Edition, and Clinical Modification codes...
March 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28341359/prognostic-value-of-the-clinical-syntax-score-on-2-year-outcomes-in-patients-with-acute-coronary-syndrome-who-underwent-percutaneous-coronary-intervention
#15
Chen He, Ying Song, Chuang-Shi Wang, Yi Yao, Xiao-Fang Tang, Xue-Yan Zhao, Run-Lin Gao, Yue-Jin Yang, Bo Xu, Jin-Qing Yuan
This prospective, single-center, observational study evaluated prognostic value of clinical SYNTAX score (CSS) on 2-year outcomes in patients with acute coronary syndrome (ACS) who underwent percutaneous coronary intervention (PCI). The SYNTAX score (SS) is a scoring system based on the complexity and severity of coronary lesions and is thought to be a prognostic tool to predict long-term outcomes. However, SS was a sole angiographic grading tool only with no consideration for clinical factors. There are few studies investigating the prognostic value of CSS in patients with ACS who underwent PCI...
March 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28332098/acute-aortic-syndromes-update-in-current-medical-management
#16
REVIEW
Jacqueline H Morris, Doran Mix, Scott J Cameron
Advances in medical therapy and non-surgical percutaneous options to manage the specter of acute aortic syndromes have improved both patient morbidity and mortality. There are key features in the patient history and initial exam which physicians should be attuned to in order to diagnose acute aortic syndromes such as aortic dissection, penetrating aortic ulcer, and intramural hematoma. Once recognized, early initiation of the appropriate pharmacologic therapy is important, and further appreciating the limitations of such therapy before considering a surgical approach is critical to improve patient outcomes...
April 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28330636/acute-coronary-syndrome-resulting-from-systolic-compression-of-left-main-coronary-artery-secondary-to-aortic-subvalvular-aneurysm
#17
Partha Sardar, Evbu Enakpene, James C Fang, Frederick G P Welt
No abstract text is available yet for this article.
April 10, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28330439/impact-of-preoperative-anemia-and-postoperative-hemoglobin-drop-on-the-incidence-of-acute-kidney-injury-and-in-hospital-mortality-in-patients-with-type-b-acute-aortic-syndromes-undergoing-thoracic-endovascular-aortic-repair
#18
Riccardo Gorla, Konstantinos Tsagakis, Michael Horacek, Amir-Abbas Mahabadi, Philipp Kahlert, Heinz Jakob, Eduardo Bossone, Raimund Erbel, Rolf Alexander Jánosi
BACKGROUND: The impact of preoperative anemia and postoperative hemoglobin (Hb) drop on the incidence of acute kidney injury (AKI) after thoracic endovascular aortic repair (TEVAR) for type B acute aortic syndromes (AAS) as well as their prognostic value is unknown. METHODS: This retrospective study included 144 patients with type B AAS undergoing TEVAR at our center. Preoperative anemia was classified as no/mild (Hb ≥ 12.0 g/dL in men; ≥11.3 g/dL in women), moderate (Hb 10...
April 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28325709/early-referral-to-coronary-artery-bypass-grafting-following-acute-coronary-syndrome-trends-and-outcomes-from-the-acute-coronary-syndrome-israeli-survey-acsis-2000-2010
#19
Robert Klempfner, Yaron D Barac, Arwa Younis, Eran Kopel, Anan Younis, Goldkorn Ronen, Elad Maor, Yaron Arbel, David Rott, Ilan Goldenberg, Dan Aravot
BACKGROUND: Limited information exists on whether changes in medical practices over the study decades have affected the outcomes of acute coronary syndrome (ACS) patients who undergo early coronary artery bypass surgery (CABG) during index hospitalisation. METHODS: Data on trends for early CABG referral and associated outcomes were obtained among 11,485 ACS patients enrolled in the biennial Acute Coronary Syndrome Israeli Surveys (ACSIS) 2000-2010. RESULTS: Among 11,485 patients, 566 (5%) were referred to early CABG...
March 1, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28320990/comorbidities-and-complications-in-nonagenarians-undergoing-coronary-angiography-and-intervention
#20
Mohamed Gayed, Nour Yadak, Waad Qamhia, Yunis Daralammouri, Marc-Alexander Ohlow
Elderly people represent the fastest growing portion of cardiovascular patients. We aimed to analyze the clinical presentation, risk factors, co-morbidities, complications, and mortality in patients 90 years or more who underwent coronary angiography and intervention.We retrospectively studied 108 (0.25% of 43,385) consecutive patients ≥ 90 years undergoing cardiac catheterization and/or intervention in a tertiary specialist hospital between 2003 and 2014.Most patients (68.5%) were introduced on an emergency basis, especially with acute coronary syndrome (ACS) (63...
March 21, 2017: International Heart Journal
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