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Thoracic Aneurysms

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https://www.readbyqxmd.com/read/29927868/technological-advancements-in-echocardiographic-assessment-of-thoracic-aortic-dilatation-head-to-head-comparison-among-multidetector-computed-tomography-2-dimensional-and-3-dimensional-echocardiography-measurements
#1
Sarah Ghulam Ali, Laura Fusini, Alessia Dalla Cia, Gloria Tamborini, Paola Gripari, Manuela Muratori, Maria E Mancini, Andrea Annoni, Alberto Formenti, Mauro Pepi
PURPOSE: The aim of this study was to evaluate the feasibility and accuracy of 2-dimensional (2D) and 3-dimensional (3D) transthoracic echocardiography (2DTTE, 3DTTE) versus multidetector computed tomography (MDCT) in patients with ascending aortic (AA) dilation. MATERIALS AND METHODS: Fifty consecutive patients with AA dilation were evaluated by 2DTTE, X-plane (XP) 3DTTE, and MDCT. Aorta diameters were measured at aortic annulus, aortic root (SIN), sinotubular junction, AA, aortic arch before the prebrachiocephalic artery (PRE), and before left subclavian artery (INTRA)...
July 2018: Journal of Thoracic Imaging
https://www.readbyqxmd.com/read/29925964/mylk-pathogenic-variants-aortic-disease-presentation-pregnancy-risk-and-characterization-of-pathogenic-missense-variants
#2
Stephanie E Wallace, Ellen S Regalado, Limin Gong, Alexandra L Janda, Dong-Chuan Guo, Claudio F Russo, Richard J Kulmacz, Nadine Hanna, Guillaume Jondeau, Catherine Boileau, Pauline Arnaud, Kwanghyuk Lee, Suzanne M Leal, Matias Hannuksela, Bo Carlberg, Tami Johnston, Christian Antolik, Ellen M Hostetler, Roberto Colombo, Dianna M Milewicz
PURPOSE: Heritable thoracic aortic disease can result from null variants in MYLK, which encodes myosin light-chain kinase (MLCK). Data on which MYLK missense variants are pathogenic and information to guide aortic disease management are limited. METHODS: Clinical data from 60 cases with MYLK pathogenic variants were analyzed (five null and two missense variants), and the effect of missense variants on kinase activity was assessed. RESULTS: Twenty-three individuals (39%) experienced an aortic event (defined as aneurysm repair or dissection); the majority of these events (87%) were aortic dissections...
June 20, 2018: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/29925721/traumatic-basilar-artery-entrapment-without-longitudinal-clivus-fracture-a-case-report-and-review-of-the-literature
#3
Ayumu Yamaoka, Kei Miyata, Naofumi Bunya, Hirotoshi Mizuno, Hideto Irifune, Naoya Yama, Yukinori Akiyama, Takeshi Mikami, Masahiko Wanibuchi, Nobuhiro Mikuni
In blunt cerebrovascular injury, reported traumatic basilar artery occlusions have involved dissection of the basilar artery, distal embolization due to traumatic vertebral artery dissection, or entrapment of the basilar artery into the clivus fracture. To date, however, there are no reports of traumatic basilar artery entrapment without a clivus fracture. Here, we report the first case of traumatic basilar artery occlusion caused by entrapment into an originally existing bone defect. A 67-year-old man with a history of treatment for intracranial aneurysm suffered multiple traumatic injuries in a fall...
June 20, 2018: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/29923082/antegrade-thoracic-endovascular-aortic-repair-via-the-left-axillary-artery-in-a-patient-with-aortoiliac-occlusive-disease-leriche-syndrome
#4
Takeshi Kamada, Ryoichi Tanaka, Hajime Kin, Akihiko Abiko, Tomoyuki Iwase
We present the case of a 77-year-old man with a saccular descending thoracic aortic aneurysm who underwent successful antegrade thoracic endovascular aortic repair (TEVAR) via the left axillary artery. The patient had a history of axillo-bifemoral bypass grafting due to aortoiliac occlusive disease (Leriche syndrome), which precluded normal retrograde TEVAR. Upon successful procedure completion, no endoleak was noted on postoperative computed tomography. The patient was discharged from the hospital without any complications...
June 19, 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29922894/resuscitative-endovascular-balloon-occlusion-of-the-aorta-for-non-traumatic-intra-abdominal-hemorrhage
#5
Melanie R Hoehn, Natasha Z Hansraj, Amelia M Pasley, Megan Brenner, Samantha R Cox, Jason D Pasley, Jose J Diaz, Thomas Scalea
BACKGROUND: Hemorrhagic shock is the second leading cause of death in blunt trauma and a significant cause of mortality in non-trauma patients. The increased use of resuscitative endovascular balloon occlusion of the aorta (REBOA) as a bridge to definitive control for massive hemorrhage has provided promising results in the trauma population. We describe an extension of this procedure to our hemodynamically unstable non-trauma patients. METHODS: This is a retrospective review of patients requiring REBOA for end stage non-traumatic abdominal hemorrhage from our tertiary care facility...
June 19, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29922726/endovascular-treatment-of-thoracic-aortic-pseudoaneurysm-through-a-subclavian-approach-in-patient-with-aortoiliac-occlusive-disease-a-case-report
#6
Ezequiel Paredes-Mariñas, Carme Llort-Pont, Francisca Castro-Bolance, Vicente Riambau-Alonso
Introduction: Thoracic endovascular aortic repair (TEVAR) has become the preferred option for treatment of thoracic aortic pathology, but lack of vascular access options is a common contraindication to TEVAR. Case report: The authors report a case of a 67 year old male patient with multiple revascularisation procedures: bilateral axillofemoral bypass and thoracic aortofemoral bypass, both occluded. An anastomotic pseudoaneurysm of the thoracic aorta developed and detected on computed tomography angiography (CTA)...
2018: EJVES Short Reports
https://www.readbyqxmd.com/read/29921611/smggds-prevents-thoracic-aortic-aneurysm-formation-and-rupture-by-phenotypic-preservation-of-aortic-smooth-muscle-cells
#7
Masamichi Nogi, Kimio Satoh, Shinichiro Sunamura, Nobuhiro Kikuchi, Taijyu Satoh, Ryo Kurosawa, Junichi Omura, Md Elias Al-Mamun, Mohammad Abdul Hai Siddique, Kazuhiko Numano, Shun Kudo, Satoshi Miyata, Masatoshi Akiyama, Kiichiro Kumagai, Shunsuke Kawamoto, Yoshikatsu Saiki, Hiroaki Shimokawa
Background -Thoracic aortic aneurysm (TAA) and dissection (TAD) are fatal diseases, which cause aortic rupture and sudden death. The small GTP-binding protein GDP dissociation stimulator (SmgGDS) is a crucial mediator of the pleiotropic effects of statins. Previous studies revealed that reduced force generation in AoSMCs causes TAA and TAD. Methods -To examine the role of SmgGDS in TAA formation, we employed an angiotensin II (AngII, 1,000 ng/min/kg, 4 weeks)-induced TAA model. Results -33% Apoe-/- SmgGDS+/- mice died suddenly due to TAA rupture, whereas there was no TAA rupture in Apoe-/- control mice...
June 19, 2018: Circulation
https://www.readbyqxmd.com/read/29911202/bio-chemo-mechanics-of-thoracic-aortic-aneurysms
#8
Jessica E Wagenseil
Most thoracic aortic aneurysms (TAAs) occur in the ascending aorta. This review focuses on the unique bio-chemo-mechanical environment that makes the ascending aorta susceptible to TAA. The environment includes solid mechanics, fluid mechanics, cell phenotype, and extracellular matrix composition. Advances in solid mechanics include quantification of biaxial deformation and complex failure behavior of the TAA wall. Advances in fluid mechanics include imaging and modeling of hemodynamics that may lead to TAA formation...
March 2018: Current Opinion in Biomedical Engineering
https://www.readbyqxmd.com/read/29911003/bicuspid-aortic-valve-registry-of-the-italian-society-of-echocardiography-and-cardiovascular-imaging-registro-della-valvola-aortica-bicuspide-della-societ%C3%A3-italiana-di-ecocardiografia-e-cardiovascular-imaging-rationale-and-study-design
#9
Rodolfo Citro, Moreno Cecconi, Salvatore La Carrubba, Eduardo Bossone, Francesco Antonini-Canterin, Stefano Nistri, Fabio Chirillo, Ilaria Dentamaro, Michele Bellino, Alfredo Posteraro, Mauro Giorgi, Licia Petrella, Ines Monte, Vincenzo Manuppelli, Antonio Mantero, Scipione Carerj, Frank Benedetto, Paolo Colonna
Background: Bicuspid aortic valve (BAV) is the most common congenital heart disease, affecting 0.5%-2% of the general population. It is associated not only with notable valvular risk (aortic stenosis and/or regurgitation, endocarditis) but also with aortopathy with a wide spectrum of unpredictable clinical presentations, including aneurysmal dilation of the aortic root and/or ascending thoracic aorta, isthmic coarctation, aortic dissection, or wall rupture. Methods: The REgistro della Valvola Aortica Bicuspide della Società Italiana di ECocardiografia e CArdiovascular Imaging is a retrospective (from January 1, 2010)/prospective, multicenter, observational registry, expected to enroll 3000 patients with definitive diagnosis of BAV made by transthoracic and/or transesophageal echocardiography, computed tomography, cardiovascular magnetic resonance, or at surgery...
April 2018: Journal of Cardiovascular Echography
https://www.readbyqxmd.com/read/29903350/acute-limited-intimal-tears-of-the-thoracic-aorta
#10
Anne S Chin, Martin J Willemink, Aya Kino, Virginia Hinostroza, Anna M Sailer, Michael P Fischbein, R Scott Mitchell, Gerald J Berry, D Craig Miller, Dominik Fleischmann
BACKGROUND: Limited intimal tears (LITs) of the aorta (Class 3 dissection variant) are the least common form of aortic pathology in patients presenting with acute aortic syndrome (AAS). LITs are difficult to detect on imaging and may be underappreciated. OBJECTIVES: This study sought to describe the frequency, pathology, treatment, and outcome of LITs compared with other AAS, and to demonstrate that LITs can be detected pre-operatively by contemporary imaging. METHODS: The authors retrospectively reviewed 497 patients admitted for 513 AAS events at a single academic aortic center between 2003 and 2012...
June 19, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29899987/-streptococcus-pyogenes-and-invasive-central-nervous-system-infection
#11
Ekamjeet Randhawa, John Woytanowski, Kedesha Sibliss, Ian Sheffer
Streptococcus pyogenes is a Gram-positive beta-hemolytic bacteria, also known as group A streptococci, that causes a range of infections. The most common presentation is acute pharyngitis; however, it is also implicated in skin and soft tissue infections, and less commonly bacteremia, osteomyelitis, pneumonia, otitis media and sinusitis. Group A streptococci infections of the central nervous system are exceedingly rare in the antibiotic era. The mechanism of infection is typically contiguous spread from existing infection or via direct inoculation...
2018: SAGE Open Medical Case Reports
https://www.readbyqxmd.com/read/29896041/redo-aortic-root-operations-in-patients-with-marfan-syndrome
#12
REVIEW
Vicente Orozco-Sevilla, Richard Whitlock, Ourania Preventza, Kim I de la Cruz, Joseph S Coselli
Aortic root aneurysm is the most common cardiovascular manifestation requiring surgical intervention in patients with Marfan syndrome (MFS), a heritable thoracic aortic disease. Elective replacement of the aortic root is the treatment of choice for patients with aneurysmal complications of the aortic root and ascending aorta. There are two basic approaches to aortic root replacement: valve-sparing (VS) and valve-replacing (VR) techniques. After successful aortic root replacement surgery, several patients with MFS may develop a late complication related to their aortic disease process, such as developing a pseudoaneurysm of the coronary artery reattachment buttons, aneurysmal expansion, or aortic dissection in the remaining native aorta...
June 2018: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/29896040/endovascular-treatment-of-various-aortic-pathologies-review-of-the-latest-data-and-technologies
#13
REVIEW
Koji Maeda, Takao Ohki, Yuji Kanaoka
The technologies and innovations applicable to endovascular treatment for complex aortic pathologies have progressed rapidly over the last two decades. Although the initial outcomes of an endovascular aortic repair have been excellent, as long-term data became available, complications including endoleaks, endograft migration, and endograft infection have become apparent and are of concern. Previously, the indication for endovascular therapy was restricted to descending thoracic aortic aneurysms and abdominal aortic aneurysms...
June 2018: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/29885430/spinal-cord-ischemia-following-elective-endovascular-repair-of-infrarenal-aortic-aneurysms-a-systematic-review
#14
REVIEW
Konstantinos G Moulakakis, Vangelis G Alexiou, Georgios Karaolanis, George S Sfyroeras, George Theoharopoulos, Andreas Lazaris, John Kakisis, George Geroulakos
AIM: Spinal cord ischemia (SCI) following endovascular abdominal aortic aneurysm (AAA) repair (EVAR) is a rare but devastating complication. The mechanism underlying the occurrence of SCI following EVAR seems to be multifactorial and is underreported and not fully elucidated. The aim of the study was to investigate the clinical outcomes in patients with this serious complication. MATERIAL-METHODS: A systematic review of the current literature, as per PRISMA statement guidelines, to evaluate the incidence of SCI following elective EVAR was performed...
June 6, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29883307/thoracic-aortic-aneurysm-how-to-counsel-when-to-refer
#15
REVIEW
Frank Cikach, Milind Y Desai, Eric E Roselli, Vidyasagar Kalahasti
Thoracic aortic aneurysm (TAA) is usually clinically silent and progresses slowly until a tipping point is reached, after which the aortic diameter can expand more rapidly and the condition can potentially end in aortic dissection or rupture. Causes include bicuspid aortic valve and genetic syndromes (Marfan, Loeys-Dietz, and Ehlers-Danlos syndromes) and familial associations, but many cases are idiopathic. Clinicians should therefore be alert for clues on chest imaging, and consider screening in first-degree relatives of patients known to have aortic disease...
June 2018: Cleveland Clinic Journal of Medicine
https://www.readbyqxmd.com/read/29880113/multimodality-imaging-of-thoracic-aortic-diseases-in-adults
#16
REVIEW
Nicole M Bhave, Christoph A Nienaber, Rachel E Clough, Kim A Eagle
In diagnosing and following patients with acute aortic syndromes and thoracic aortic aneurysms, high-quality imaging of the thoracic aorta is indispensable. Mainstay modalities for thoracic aortic imaging are echocardiography, computed tomographic angiography, and magnetic resonance angiography. For any given clinical scenario, the imaging modality and protocol chosen will have a significant impact on sensitivity and specificity for the aortic diagnosis of concern. Imaging can also provide important ancillary information regarding myocardial performance, aortic valve morphology and function, and end-organ perfusion...
June 2018: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29877279/ruptured-thoracic-aortic-aneurysm-imaging-pulmonary-embolism
#17
Yuichi Baba, Toru Kubo, Naohito Yamasaki, Hiroaki Kitaoka
No abstract text is available yet for this article.
June 6, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29876507/angiotensin-transforming-growth-factor-%C3%AE-and-aortic-dilatation-in-marfan-syndrome-of-mice-and-humans
#18
Christopher Yu, Richmond W Jeremy
Marfan syndrome is consequent upon mutations in FBN1 , which encodes the extracellular matrix microfibrillar protein fibrillin-1. The phenotype is characterised by development of thoracic aortic aneurysm. Current understanding of the pathogenesis of aneurysms in Marfan syndrome focuses upon abnormal vascular smooth muscle cell signalling through the transforming growth factor beta (TGFβ) pathway. Angiotensin II (Ang II) can directly induce aortic dilatation and also influence TGFβ synthesis and signalling...
March 2018: IJC Heart & Vasculature
https://www.readbyqxmd.com/read/29875232/iris-anomalies-and-the-incidence-of-acta2-mutation
#19
Kenneth J Taubenslag, Hannah L Scanga, Jennifer Huey, Jennifer Lee, Anagha Medsinge, Christin L Sylvester, Kenneth P Cheng, Ken K Nischal
BACKGROUND: Central cysts of the iris pigment epithelium, or iris flocculi, are frequently reported in the literature in association with thoracic aortic aneurysm and dissection due to smooth muscle alpha-actin 2 ( ACTA2 ) mutations. Children with ACTA2 mutations may also present with congenital mydriasis. We report our experience regarding the frequency of ACTA2 mutation in children with the above iris anomalies. METHODS: This is a retrospective, consecutive case series of all children presenting for iris flocculi or congenital mydriasis at a single tertiary centre from October 2012 to December 2016...
June 6, 2018: British Journal of Ophthalmology
https://www.readbyqxmd.com/read/29866073/right-sided-infective-endocarditis-with-coronary-sinus-vegetation
#20
Guang Song, Jing Zhang, Xintong Zhang, Huan Yang, Wanying Huang, Ming Du, Ke Zhou, Weidong Ren
BACKGROUND: Infective endocarditis (IE) is a rare disease with high mortality. Right-sided IE accounts for 5-10% of cases of IE. The tricuspid valve is most commonly affected, oppositely in coronary sinus (CS). The diagnoses, treatments and outcomes of CS vegetation has not been summarized yet. CASE PRESENTATION: We present a 71-year-old man complained of cough and fever. Transthoracic echocardiography revealed the aneurysmal dilated CS with the band medium-echo mobile structure...
June 4, 2018: BMC Cardiovascular Disorders
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