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3D aortic dissection

Emile S Farag, Pim van Ooij, R Nils Planken, Kayleigh C P Dukker, Frederiek de Heer, Berto J Bouma, Danielle Robbers-Visser, Maarten Groenink, Aart J Nederveen, Bas A J M de Mol, Jolanda Kluin, S Matthijs Boekholdt
BACKGROUND: Use of 4-dimensional flow magnetic resonance imaging (4D-flow MRI) derived wall shear stress (WSS) heat maps enables identification of regions in the ascending aorta with increased WSS. These regions are subject to dysregulation of the extracellular matrix and elastic fiber degeneration, which is associated with aortic dilatation and dissection. PURPOSE: To evaluate the effect of the presence of aortic valve stenosis and the aortic diameter on the peak WSS and surface area of increased WSS in the ascending aorta...
February 16, 2018: Journal of Magnetic Resonance Imaging: JMRI
Gerlinde Logghe, Bram Trachet, Lydia Aslanidou, Pablo Villaneuva-Perez, Julie De Backer, Nikolaos Stergiopulos, Marco Stampanoni, Hiroki Aoki, Patrick Segers
In order to show the advantage and potential of propagation-based phase-contrast synchrotron imaging in vascular pathology research, we analyzed aortic medial ruptures in BAPN/AngII-infused mice, a mouse model for aortic dissection. Ascending and thoraco-abdominal samples from n = 3 control animals and n = 10 BAPN/AngII-infused mice (after 3, 7 and 14 days of infusion, total of 24 samples) were scanned. A steep increase in the number of ruptures was already noted after 3 days of BAPN/AngII-infusion...
February 2, 2018: Scientific Reports
Christopher P Cheng, Yufei D Zhu, Ga-Young Suh
The study purpose is to optimize modeling parameters, specifically segmentation spacing and centerline extraction, to efficiently construct accurate 3D aortic models. Models are constructed by centerline extraction and orthogonal 2D segmentations. We examine the effect of segmentation interval spacing (2, 1, 0.5, 0.25 cm) and orthogonal segmentation and centerline extraction iteration (one, two, three iterations) for constructing models of Healthy, Tortuous, Aneurysmal, and Dissected human thoracic aortas...
January 2018: Computer Methods in Biomechanics and Biomedical Engineering
Xiaoning Sun, Hongqiang Zhang, Kai Zhu, Chunsheng Wang
BACKGROUND: Kommerell's diverticulum is a complex congenital malformation of aorta. Three-dimensional (3D) printing is an innovative manufacturing process that allows computer-assisted conversion of 3D imaging data into physical "printouts." The aim of this study was to explore the feasibility and impact of using patient-specific 3D-printed cardiac prototypes derived from computed tomography data on surgical decision-making and preoperative planning for Kommerell's diverticulum. METHODS: From April to August 2017, five patients with Kommerell's diverticulum were diagnosed and chosen for study...
December 26, 2017: International Journal of Cardiology
Jennifer L Philip, Nilto C De Oliveira, Shahab A Akhter, Brooks L Rademacher, Christopher B Goodavish, Paul D DiMusto, Paul C Tang
Background: Whether primary tear size impacts extent of type A dissection is unclear. Using statistical groupings based on dissection morphology, we examined its relationship to primary tear area. Methods: We retrospectively reviewed 108 patients who underwent acute ascending dissection repair from 2000-2016. Dissection morphology was characterized using 3-dimensional (3D) reconstructions of computed tomography (CT) scan images. Two-step cluster analysis was performed to group the dissections by examining the true lumen area as a fraction of the total aortic area at various levels...
September 2017: Journal of Thoracic Disease
Matija Jelenc, Blaž Jelenc, Ivan Kneževic, Tomislav Klokocovnik
OBJECTIVES: The objective was to design sizing rings that would enable proper sizing of the graft in reimplantation procedures and to perform leaflet repair before graft implantation. METHODS: The rings were designed in Autodesk Fusion 360 (San Rafael, CA, USA) and 3D printed using a commercial online 3D printing service. We designed incomplete rings with a low profile and complete rings with a high profile. The complete rings are best suited for reimplantation procedures, whereas low profile C rings are intended for isolated aortic valve repair, where the ascending aorta is not transected...
August 11, 2017: Interactive Cardiovascular and Thoracic Surgery
Nicholas S Burris, Benjamin A Hoff, Ella A Kazerooni, Brian D Ross
Thoracic aortic aneurysm is a common and lethal disease that requires regular imaging surveillance to determine timing of surgical repair and prevent major complications such as rupture. Current cross-sectional imaging surveillance techniques, largely based on computed tomography angiography, are focused on measurement of maximal aortic diameter, although this approach is limited to fixed anatomic positions and is prone to significant measurement error. Here we present preliminary results showing the feasibility of a novel technique for assessing change in aortic dimensions, termed vascular deformation mapping (VDM)...
September 2017: Tomography: a Journal for Imaging Research
Eric E Roselli, Saad M Hasan, Jay J Idrees, Muhammad Aftab, Matthew J Eagleton, Venu Menon, Lars G Svensson
OBJECTIVES: The objectives are to (i) report characteristics and outcomes of patients with inoperable acute type A aortic dissection, (ii) describe proximal aortic morphology and (iii) identify potential for endovascular treatment of the entry tear. METHODS: Fifty-three (7.7%) of 686 patients with acute type A dissection between 2005 and 2015 were deemed inoperable. Chart review and active follow-up were performed for clinical characteristics and outcomes. Specific attention was directed at determining the reasons for inoperability...
October 1, 2017: Interactive Cardiovascular and Thoracic Surgery
Kelsey Hirotsu, Ga-Young Suh, Jason T Lee, Michael D Dake, Dominik Fleischmann, Christopher P Cheng
BACKGROUND: Thoracic endovascular aortic repair (TEVAR) has dramatically expanded treatment options for patients with thoracic aortic pathology. The interaction between endografts and the dynamic anatomy of the thoracic aorta is not well characterized for repetitive physiologic stressors and subsequent issues related to long-term durability. Through three-dimensional (3D) modeling we sought to quantify cardiac-induced aortic deformation before and after TEVAR to assess the impact of endografts on dynamic aortic anatomy...
September 5, 2017: Annals of Vascular Surgery
A Osswald, C Karmonik, J R Anderson, F Rengier, M Karck, J Engelke, K Kallenbach, D Kotelis, S Partovi, D Böckler, A Ruhparwar
OBJECTIVE: Retrograde aortic type A dissection (RTAD) is a known complication in patients with aortic type B dissection. The purpose of this computational fluid dynamics (CFD) study was to identify haemodynamic risk factors for the occurrence of RTAD. METHODS: Computed tomographic angiography (CTA) images of 10 patients with type B dissections, who subsequently developed a RTAD, were retrospectively analysed together with patients constituting a control group (n = 10) where no further vascular events after the initial type B dissection occurred...
July 14, 2017: European Journal of Vascular and Endovascular Surgery
William E Moody, Luke Pickup, Emma Plunkett, John Fryearson, Paul F Clift, R Katie Morris, Peter J Thompson, Sara Thorne, Lucy E Hudsmith
BACKGROUND: Pregnancy is associated with an increased risk of aortic pathology. We sought to assess the feasibility of performing non-contrast 3D steady-state free-precession (SSFP) magnetic resonance angiography (MRA) in pregnant subjects with inherited aortopathy. METHODS: Fifteen pregnant subjects (age 27±4yr) with positive genotyping for aortopathy (Marfan, Loeys-Dietz, Ehlers-Danlos) and/or a family history of aortic dissection underwent non-contrast 3D-SSFP MRA at 1...
June 2, 2017: International Journal of Cardiology
Ding Yuan, Han Luo, Hongliu Yang, Bin Huang, Jingqiang Zhu, Jichun Zhao
In this study, three-dimensional printing (3Dp) models and simulation surgeries (SSs) were applied in two challenging aortic cases. The first was an abdominal aortic aneurysm with a complex neck, and the second was a thoracic aortic dissection aneurysm (TADA) with an angled arch. In order to avoid unpredictable obstacles and difficulties, we made optimal surgical plans by using 3D models and virtual simulations. Based on preoperative evaluation system, the surgical plans seemed more reasonable and time-saving...
April 11, 2017: Scientific Reports
Dong Lu, Cheng-Li Li, Wei-Fu Lv, Ming Ni, Ke-Xue Deng, Chun-Ze Zhou, Jing-Kun Xiao, Zhen-Feng Zhang, Xing-Ming Zhang
The aim of the present study was to compare multislice computed tomography angiography (MSCTA) and digital subtraction angiography (DSA) in the diagnosis of aortic dissection. In total, 49 patients with aortic lesions received enhanced computed tomography scanning, and three-dimensional (3D) images were reconstructed by volume rendering (VR), maximum intensity projection (MIP), multiplanar reformation (MPR) and curved planar reconstruction (CPR). The display rate of the entry tear site, intimal flap, true and false lumen from each reconstruction method was calculated...
February 2017: Experimental and Therapeutic Medicine
Yu Xu, Yukun Peng, Rongmei Qu, Guorong Zheng, Feiyan Feng, Yan Feng, Linying He, Shanli He, Zeyu Li, Chang Liu, Zhaoming Xiao, Jun Ouyang, Jingxing Dai
It is difficult for anatomists to dissect the human cardiac conduction system (CCS) on specimens as well as for cardiovascular clinicians to locate the CCS during cardiac operations. Here, we demonstrate a new method for locating the CCS using a 3D model of its nutritious arteries. First, we perfused the coronary arteries with contrast material and then acquired a set of data of thin computer tomography (CT) scans. Then, we generated a 3D model of the coronary artery and distinguished the arteries that supply the CCS...
March 23, 2017: Scientific Reports
Tobias Krüger, Alexandre Oikonomou, David Schibilsky, Mario Lescan, Katharina Bregel, Luise Vöhringer, Wilke Schneider, Henning Lausberg, Gunnar Blumenstock, Fabian Bamberg, Christian Schlensak
OBJECTIVES: We measured aortic dimensions, particularly length parameters, using 3D imaging with the aim of refining the risk-morphology for Stanford type A aortic dissection (TAD). METHODS: Computer tomography angiography studies were analysed using the curved multiplanar reformats. At defined landmarks, the diameters and lengths of aortic segments were recorded. Three groups were compared retrospectively: patients actually suffering from a TAD (TAD-group; n  = 150), patients before suffering a TAD (preTAD-group n  = 15) and a healthy control group ( n  = 215)...
June 1, 2017: European Journal of Cardio-thoracic Surgery
Julia Geiger, Daniel Hirtler, Kristina Gottfried, Ozair Rahman, Emilie Bollache, Alex J Barker, Michael Markl, Brigitte Stiller
BACKGROUND: The aim of this 4D flow cardiovascular magnetic resonance (CMR) follow-up study was to investigate longitudinal changes in aortic hemodynamics in adolescent patients with Marfan syndrome (MFS). METHODS: 4D flow CMR for the assessment of in-vivo 3D blood flow with full coverage of the thoracic aorta was performed twice (baseline scan t1/follow-up scan t2) in 19 adolescent MFS patients (age at t1: 12.7 ± 3.6 years, t2: 16.2 ± 4.3 years) with a mean follow-up duration of 3...
March 22, 2017: Journal of Cardiovascular Magnetic Resonance
Roel L F van der Palen, Alex J Barker, Emilie Bollache, Julio Garcia, Michael J Rose, Pim van Ooij, Luciana T Young, Arno A W Roest, Michael Markl, Joshua D Robinson, Cynthia K Rigsby
BACKGROUND: Blood flow dynamics make it possible to better understand the development of aortopathy and cardiovascular events in patients with Marfan syndrome (MFS). Aortic 3D blood flow characteristics were investigated in relation to aortic geometry in children and adolescents with MFS. METHODS: Twenty-five MFS patients (age 15.6 ± 4.0 years; 11 females) and 21 healthy controls (age 16.0 ± 2.6 years; 12 females) underwent magnetic resonance angiography and 4D flow CMR for assessment of thoracic aortic size and 3D blood flow velocities...
March 17, 2017: Journal of Cardiovascular Magnetic Resonance
Daniel Ho, Andrew Squelch, Zhonghua Sun
INTRODUCTION: The aim of this study was to assess if the complex anatomy of aortic aneurysm and aortic dissection can be accurately reproduced from a contrast-enhanced computed tomography (CT) scan into a three-dimensional (3D) printed model. METHODS: Contrast-enhanced cardiac CT scans from two patients were post-processed and produced as 3D printed thoracic aorta models of aortic aneurysm and aortic dissection. The transverse diameter was measured at five anatomical landmarks for both models, compared across three stages: the original contrast-enhanced CT images, the stereolithography (STL) format computerised model prepared for 3D printing and the contrast-enhanced CT of the 3D printed model...
March 2017: Journal of Medical Radiation Sciences
A Dundie, G Hayes, P Scrivani, L Campoy, D Fletcher, K Ash, E Oxford, N S Moïse
A 10 week old female intact Staffordshire terrier was presented with a total of five congenital cardio-thoracic vascular anomalies consisting of a patent ductus arteriosus (PDA) with an aneurysmic dilation, pulmonic stenosis, persistent right aortic arch, aberrant left subclavian artery and persistent left cranial vena cava. These abnormalities were identified with a combination of echocardiogram and computed tomography angiography (CTA). The abnormalities were associated with esophageal entrapment, regurgitation, and volume overload of the left heart with left atrial and ventricular enlargement...
April 2017: Journal of Veterinary Cardiology: the Official Journal of the European Society of Veterinary Cardiology
Takeshi Oda, Hiroshi Yasunaga, Yasuyuki Zaima, Akiko Arimura, Shinichi Imai, Ryo Kanamoto, Hayato Fukuda, Eiji Nakamura, Hideki Tashiro, Shigeaki Aoyagi
Felt strips are widely used for reinforcement of the aortic stump in surgery for aortic dissection (AD). Postoperative hemolytic anemia (HA) due to an inverted internal felt strip at the aortic stump fixation for AD is extremely rare. A 70-year-old woman underwent ascending aorta replacement for acute type A AD, where both proximal and distal anastomotic sites were reinforced with Teflon felt strips. A week later, macroscopic hematuria and HA emerged. Three-dimensional transesophageal echocardiography (3D-TEE) demonstrated that the proximal inner felt strip turned up and protruded into the aortic inner lumen...
April 2017: Journal of Medical Ultrasonics
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