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Acute aortic syndrome

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https://www.readbyqxmd.com/read/29321037/acute-aortoiliac-occlusive-disease-during-percutaneous-transluminal-angioplasty-in-the-setting-of-st-elevation-myocardial-infarction-a-case-report
#1
Anthony H Kashou, Nabil Braiteh, Ali Zgheib, Hisham E Kashou
BACKGROUND: Aortoiliac occlusive disease, which is also referred to as Leriche syndrome, is a chronic atherosclerotic occlusive disease that occurs at the level of the aortic bifurcation. It is often thought to present with a triad of clinical symptoms: (1) intermittent lower extremity vascular claudication, (2) impotence, and (3) weak/absent femoral pulses. CASE PRESENTATION: We report a case of a 47-year-old Caucasian woman who presented with an acute inferior ST-elevation myocardial infarction...
January 11, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29320330/cardiovascular-manifestations-and-complications-of-loeys-dietz-syndrome-ct-and-mr-imaging-findings
#2
William W Loughborough, Kishore S Minhas, Jonathan C L Rodrigues, Stephen M Lyen, Helen E Burt, Nathan E Manghat, Marcus J Brooks, Graham Stuart, Mark C K Hamilton
Loeys-Dietz syndrome (LDS) is a recently described genetic connective tissue disorder with a wide spectrum of multisystem involvement. LDS is characterized by rapidly progressive aortic and peripheral arterial aneurysmal disease. LDS and the other inherited aortopathies such as Marfan syndrome have overlapping phenotypic features. However, LDS is characterized by a more aggressive vascular course; patient morbidity and mortality occur at an early age, with complications developing at relatively smaller aortic dimensions...
January 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/29310471/optimal-course-of-treatment-in-acute-cardiogenic-shock-complicating-myocardial-infarction
#3
Sebastian Nuding, Karl Werdan, Roland Prondzinsky
About 5% of patients with myocardial infarction suffer from cardiogenic shock as a complication, with a mortality of ≥30%. Primary percutaneous coronary intervention as soon as possible is the most successful therapeutic approach. Prognosis depends not only on the extent of infarction, but also - and even more - on organ hypoperfusion with consequent development of multiple organ dysfunction syndrome. Areas covered: This review covers diagnostic, monitoring and treatment concepts relevant for caring patients with cardiogenic shock complicating myocardial infarction...
January 9, 2018: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/29306454/transcoronary-gradients-of-hdl-associated-micrornas-in-unstable-coronary-artery-disease
#4
Sébastien A Choteau, Luisa F Cuesta Torres, Jennifer Y Barraclough, Alexander M M Elder, Gonzalo J Martínez, William Y Chen Fan, Sudichhya Shrestha, Kwok L Ong, Philip J Barter, David S Celermajer, Kerry-Anne Rye, Sanjay Patel, Fatiha Tabet
AIMS: MicroRNAs (miRNAs) are transported on high-density lipoproteins (HDLs) and HDL-associated miRNAs are involved in intercellular communication. We explored HDL-associated miRNAs concentration gradients across the coronary circulation in stable and unstable coronary artery disease patients and whether changes in the transcoronary gradient were associated with changes in HDL composition and size. METHODS: Acute coronary syndrome (ACS, n=17) patients, those with stable coronary artery disease (stable CAD, n=19) and control subjects without CAD (n=6) were studied...
February 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29303142/type-a-intramural-hematoma-in-a-patient-with-acute-coronary-syndrome-mimicking-acute-type-a-aortic-dissection
#5
Ö Gülmez, B Saritas, I Isiklar
Intramural hematoma (IMH) of ascending aorta is a rare but potentially lethal form of acute aortic syndrome (AAS). It is characterized by a hematoma within the media layer of the aorta secondary to rupture of the vasa vasorum in the absence of an intimal tear. However, the theory of "micro-tear" which cannot be easily detected has been raised. It may stabilize, regress, or progress to rupture or dissection. Similar to Type A aortic dissection (AD), patients with IMH of ascending aorta, as well as patients with persistent pain, are treated urgent surgery...
November 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/29290079/buckberg-versus-calafiore-cardioplegia-in-patients-with-acute-coronary-syndromes
#6
Elmar W Kuhn, Oliver Liakopoulos, Ingo Slottosch, Antje Christin Deppe, Yeong-Hoon Choi, Navid Madershahian, Thorsten C W Wahlers
BACKGROUND:  Choice of cardioplegic solution plays a pivotal role in special subgroups of patients referred for on-pump cardiac surgery. This retrospective analysis aimed to assess the impact of intermittent warm (Calafiore, Cala) versus intermittent cold blood cardioplegia (Buckberg, Buck) in patients referred to coronary artery bypass graft (CABG) surgery due to acute coronary syndromes (ACS). METHODS:  From 2008 to 2015, all consecutive patients undergoing urgent on-pump CABG surgery due to ACS (n = 950) were retrospectively analyzed...
December 31, 2017: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/29279532/acute-type-a-aortic-dissection-with-iliac-malperfusion-in-a-patient-with-scimitar-syndrome
#7
Jae Hang Lee, Jin-Ho Choi, Eung-Joong Kim
We encountered a 35-year-old male patient with scimitar syndrome, acute type A aortic dissection, and severe iliac malperfusion. He presented with pain and weakness of the left lower extremity and underwent ascending aorta replacement through sternotomy and right anterior thoracotomy. Left iliac artery flow was recovered after the operation and the patient was discharged on the tenth day without any complication. The purpose of this report is to discuss the considerations in aortic surgery in patients with scimitar syndrome, and the surgical principles for treatment of aortic dissection with critical limb ischemia...
December 27, 2017: International Heart Journal
https://www.readbyqxmd.com/read/29276030/the-impact-of-prehospital-assessment-and-ems-transport-of-acute-aortic-syndrome-patients
#8
Akira Yamashita, Tetsuo Maeda, Yoshihito Kita, Satoru Sakagami, Yasuhiro Myojo, Yukihiro Wato, Yutaka Yoshita, Hideo Inaba
BACKGROUND: The quality of acute aortic syndrome (AAS) assessment by emergency medical service (EMS) and the incidence and prehospital factors associated with 1-month survival remain unclear. METHODS: We retrospectively analyzed the data collected for 94,468 patients with non-traumatic medical emergency excluding out-of-hospital cardiac arrest during the period of 2011-2014. RESULTS: Of these transported by EMS, 22,075 had any of the AAS-related symptoms, and 330 had an EMS-assessed risk for AAS; of these, 195 received an in-hospital AAS diagnosis...
December 5, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29247810/surgical-revascularization-of-the-celiac-artery-for-persistent-intestinal-ischemia-in-short-bowel-syndrome
#9
Arnaud Roussel, Alexandre Nuzzo, Quentin Pellenc, Yves Castier, Romain De Blic, Pierre Cerceau, Célia Boulitrop, Mathieu Coblence, Sonia Aguir, Pierre Mordant, Léon Maggiori, Audrey Huguet, Annie Sibert, Francisca Joly, Olivier Corcos
BACKGROUND AND OBJECTIVES: Without prompt superior mesenteric artery (SMA) revascularization, acute mesenteric ischemia (AMI) frequently leads to death or short bowel syndrome (SBS). In SBS patients, persistent or chronic intestinal ischemia (PII) of the remnant bowel can lead to recurrences of AMI. Since SMA revascularization is sometimes unfeasible, celiac artery (CA) revascularization may improve blood supply to the remnant bowel. The aim of this study was to describe and to assess our experience of the CA revascularization in case of SMA occlusion unsuitable for revascularization in the setting of PII in SBS patients...
December 13, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/29229360/peri-aortic-lymphoma-simulating-an-acute-aortic-syndrome
#10
Francesc Simó Alari, Flora Lacassin, Philippe Montane de la Roque, Israel Gutierrez
No abstract text is available yet for this article.
December 8, 2017: Cirugía Española
https://www.readbyqxmd.com/read/29221734/aortic-annulus-does-not-dilate-over-time-after-aortic-root-remodeling-with-or-without-annuloplasty
#11
Takashi Kunihara, Satoshi Arimura, Fumihiro Sata, Christian Giebels, Ulrich Schneider, Hans-Joachim Schäfers
OBJECTIVE: The lack of annular stabilization is the drawback of aortic root remodeling, and recently the addition of annuloplasty has been proposed. Limited data, however, exist on late annular size after remodeling. We studied annular size over time. METHODS: In 241 patients (53 ± 16 years) annular size was determined preoperatively (T0), before discharge (T1), and at least 2 years after remodeling (T2, 54 ± 27 months) with (n = 52) or without external suture annuloplasty...
December 5, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29171206/extrinsic-compression-of-the-left-main-coronary-artery-by-a-huge-aortic-arch-aneurysm-mimicking-acute-coronary-syndrome
#12
Jeoung Sook Shin, So Yeon Choi, Sang Hyun Lim, Jun Ho Jung, Doo Kyoung Kang, Seung Jea Tahk
No abstract text is available yet for this article.
November 22, 2017: Korean Circulation Journal
https://www.readbyqxmd.com/read/29166938/a-case-of-blunt-thoracic-aortic-injury-requiring-ecmo-for-acute-malperfusion-before-tevar
#13
Daiki Wada, Koichi Hayakawa, Shuji Kanayama, Shuhei Maruyama, Hiromu Iwamura, Noriyuki Miyama, Fukuki Saito, Yasushi Nakamori, Yasuyuki Kuwagata
BACKGROUND: Blunt thoracic aortic injury (BTAI) is associated with a high mortality rate and the paradigm of treating patients with BTAI currently favours thoracic endovascular aneurysm repair (TEVAR) if possible. In BTAI, lethal malperfusion caused by a pseudoaneurysm has rarely been reported. We present the first report of a successful case in which a pseudoaneurysm causing the infrequent occurrence of lethal malperfusion and subsequent acute severe ischaemia in the distal portion of the thoracic descending aorta was overcome by veno-arterial extracorporeal membrane oxygenation (VA ECMO) as a bridging therapy until the initiation of TEVAR...
November 22, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29125616/acute-type-a-aortic-dissection-involving-the-iliac-and-left-renal-arteries-misdiagnosed-as-myocardial-infarction
#14
Paul Nkemtendong Tolefac, Anastase Dzudie, Sidick Mouliom, Leopold Aminde, Romuald Hentchoya, Martin H Abanda, Charles Mve Mvondo, Vanina D Wanko, Henry N Luma
Acute aortic dissection is the most frequent and deadly presentation of acute aortic syndromes. Its incidence is estimated at three to four cases per 100 000 persons per year. Its clinical presentation may be misleading, with misdiagnosis ranging between 14.1 and 38% in many series. A late diagnosis or absence of early and appropriate management is associated with mortality rates as high as 50 and 80% by the third day and second week, respectively, especially in proximal lesions. We report on the case of a 53-year-old man who presented with type A aortic dissection, misdiagnosed as acute myocardial infarction, who later died on day 12 of hospitalisation...
November 3, 2017: Cardiovascular Journal of Africa
https://www.readbyqxmd.com/read/29123447/endovascular-stent-graft-repair-of-localized-acute-aortic-intramural-hematoma-a-case-report-and-literature-review
#15
Ugur Kaya, Abdurrahim Colak, Necip Becit, Munacettin Ceviz, Hikmet Kocak
Aortic intramural hematoma (IMH) is a variant of acute aortic syndrome, which can be life-threatening. Ascending aorta IMHs, particularly accompanied by penetrating aortic ulcer (PAU), can cause dissection, rupture, and cardiac tamponade. Therefore, early surgical treatment is recommended for IMHs of the ascending aorta. Herein, we present the case of a 60-year-old male patient who was on warfarin sodium treatment and in whom an IMH localized to the arcus aorta was detected incidentally via computed tomography, with the suspicion of pulmonary embolism, and an endovascular stent graft was inserted into the arcus aorta...
October 2017: Eurasian Journal of Medicine
https://www.readbyqxmd.com/read/29106452/acute-aortic-syndromes-diagnosis-and-management-an-update
#16
Eduardo Bossone, Troy M LaBounty, Kim A Eagle
Acute aortic syndromes (AAS) encompass a constellation of life-threatening medical conditions including classic acute aortic dissection (AAD), intramural haematoma, and penetrating atherosclerotic aortic ulcer. Given the non-specific symptoms and physical signs, a high clinical index of suspicion is necessary to detect the disease before irreversible lethal complications occur. In order to reduce the diagnostic time delay, a comprehensive flowchart for decision-making based on pre-test sensitivity of AAS has been designed by the European Society of Cardiology guidelines on aortic diseases and should be thus applied in the emergency scenario...
June 30, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29103932/incidence-and-prognostic-factors-related-to-major-adverse-cerebrovascular-events-in-patients-with-complex-aortic-diseases-treated-by-the-chimney-technique
#17
Michel J Bosiers, Kenneth Tran, Jason T Lee, Konstantinos P Donas, Frank J Veith, Giovanni Torsello, Felice Pecoraro, Konstantinos Stavroulakis
OBJECTIVE: Endovascular aneurysm repair (EVAR) with the chimney technique (ch-EVAR) has been used for the treatment of aortic aneurysms as an alternative approach to fenestrated endografting or open repair. Nonetheless, the need for an upper extremity arterial access may contribute to a higher risk for periprocedural cerebrovascular events. This study reports on the perioperative cerebral and major adverse cardiac and cerebrovascular events (MACCE) after ch-EVAR. METHODS: The PERICLES registry (PERformance of the chImney technique for the treatment of Complex aortic pathoLogiES) is an international, retrospective multicenter study evaluating the performance of ch-EVAR for the treatment of complex aortic pathologies...
November 2, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29100589/effect-of-access-site-choice-on-acute-kidney-injury-after-percutaneous-coronary-intervention
#18
Maitri S Pancholy, Kimberly Skelding, Thomas Scott, James Blankenship, Samir B Pancholy
Acute kidney injury (AKI) after percutaneous coronary intervention (PCI) is associated with worse outcomes. Consecutive patients undergoing PCI between 2005 and 2013 were retrospectively analyzed. Patients undergoing PCI using transfemoral access (TFA) were categorized as the TFA Group, and those using transradial access (TRA) were categorized as the TRA Group. Post-PCI AKI was defined as an increase in serum creatinine >0.5 mg/dl or >25% increase from baseline 48 to 72 hours after the procedure. Independent predictors of post-PCI AKI were identified using inverse probability weighted multivariable analysis...
September 20, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29092914/influence-of-socioeconomic-factors-on-pregnancy-outcome-in-women-with-structural-heart-disease
#19
Iris M van Hagen, Sara Baart, Rebekah Fong Soe Khioe, Karen Sliwa-Hahnle, Nasser Taha, Malgorzata Lelonek, Luigi Tavazzi, Aldo Pietro Maggioni, Mark R Johnson, Nikolaos Maniadakis, Richard Fordham, Roger Hall, Jolien W Roos-Hesselink
OBJECTIVE: Cardiac disease is the leading cause of indirect maternal mortality. The aim of this study was to analyse to what extent socioeconomic factors influence the outcome of pregnancy in women with heart disease. METHODS: The Registry of Pregnancy and Cardiac disease is a global prospective registry. For this analysis, countries that enrolled ≥10 patients were included. A combined cardiac endpoint included maternal cardiac death, arrhythmia requiring treatment, heart failure, thromboembolic event, aortic dissection, endocarditis, acute coronary syndrome, hospitalisation for cardiac reason or intervention...
November 1, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29073930/functional-evaluation-of-sublingual-microcirculation-indicates-successful-weaning-from-va-ecmo-in-cardiogenic-shock
#20
Sakir Akin, Dinis Dos Reis Miranda, Kadir Caliskan, Osama I Soliman, Goksel Guven, Ard Struijs, Robert J van Thiel, Lucia S Jewbali, Alexandre Lima, Diederik Gommers, Felix Zijlstra, Can Ince
BACKGROUND: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is increasingly adopted for the treatment of cardiogenic shock (CS). However, a marker of successful weaning remains largely unknown. Our hypothesis was that successful weaning is associated with sustained microcirculatory function during ECMO flow reduction. Therefore, we sought to test the usefulness of microcirculatory imaging in the same sublingual spot, using incident dark field (IDF) imaging in assessing successful weaning from VA-ECMO and compare IDF imaging with echocardiographic parameters...
October 26, 2017: Critical Care: the Official Journal of the Critical Care Forum
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