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https://www.readbyqxmd.com/read/28906534/management-of-a-complicated-redo-giant-dissecting-aortic-aneurysm
#1
Ibrahim Kara, Alper Erkin, MHalil Ibrahim Erkengel, Kiyasettin Asil
Giant aortic aneurysm is defined as an aneurysm of the aorta of greater than 10 cm in diameter. This rare condition is associated with a high risk of morbidity and mortality and it may lead to fatal complications such as rupture and/or dissection if not managed with proper surgical planning and expertise. Other than atherosclerosis, the main causes of giant ascending aortic aneurysms include Marfan and Ehlers-Danhlos syndromes. Herein we report on a young male patient who had had an aortic valve replacement five years earlier due to a bicuspid aortic valve leading to aortic failure, accompanied by aortic coarctation...
July 23, 2017: Cardiovascular Journal of Africa
https://www.readbyqxmd.com/read/28903936/aortic-valve-stenosis-alters-expression-of-regional-aortic-wall-shear-stress-new-insights-from-a-4-dimensional-flow-magnetic-resonance-imaging-study-of-571-subjects
#2
Pim van Ooij, Michael Markl, Jeremy D Collins, James C Carr, Cynthia Rigsby, Robert O Bonow, S Chris Malaisrie, Patrick M McCarthy, Paul W M Fedak, Alex J Barker
BACKGROUND: Wall shear stress (WSS) is a stimulus for vessel wall remodeling. Differences in ascending aorta (AAo) hemodynamics have been reported between bicuspid aortic valve (BAV) and tricuspid aortic valve patients with aortic dilatation, but the confounding impact of aortic valve stenosis (AS) is unknown. METHODS AND RESULTS: Five hundred seventy-one subjects underwent 4-dimensional flow magnetic resonance imaging in the thoracic aorta (210 right-left BAV cusp fusions, 60 right-noncoronary BAV cusp fusions, 245 tricuspid aortic valve patients with aortic dilatation, and 56 healthy controls)...
September 13, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28890987/impact-of-patient-specific-inflow-velocity-profile-on-hemodynamics-of-the-thoracic-aorta
#3
Pouya Youssefi, Alberto Gomez, Christopher Arthurs, Rajan Sharma, Marjan Jahangiri, Alberto Figueroa
Background-Computational fluid dynamics (CFD) provides a non-invasive method to functionally assess aortic hemodynamics. The thoracic aorta has an anatomically complex inlet comprising of the aortic valve, which is highly prone to different morphologies and pathologies. We investigated the effect of using patient-specific inflow velocity profiles compared to idealised profiles based on the patient's flow waveform. Methods-A healthy 31yo with a normally functioning tricuspid aortic valve (subject A), and a 52yo with a bicuspid aortic valve, aortic valvular stenosis and dilated ascending aorta (subject B) were studied...
September 11, 2017: Journal of Biomechanical Engineering
https://www.readbyqxmd.com/read/28886508/effects-of-clinico-pathological-risk-factors-on-in-vitro-mechanical-properties-of-human-dilated-ascending-aorta
#4
Anna Ferrara, Pasquale Totaro, Simone Morganti, Ferdinando Auricchio
Ascending aorta aneurysms (AsAA) are associated with a degeneration of the aortic wall tissue, which leads to changes in tissue mechanical properties. Risk factors for the development of the AsAA disease are recognized in patient age and gender, valve type, hypertension, diabetes mellitus, smoking history, and a prior diagnosis of Marfan syndrome. The present study aims to assess how such clinico-pathological factors can affect the mechanical properties of human dilated ascending aorta. Specimens of AsAA are excised from 68 patients who underwent elective AsAA surgical repair and stretched until rupture during the execution of uniaxial tensile tests...
August 31, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/28884233/in-vivo-strain-analysis-of-dilated-ascending-thoracic-aorta-by-ecg-gated-ct-angiographic-imaging
#5
Salvatore Pasta, Valentina Agnese, Marzio Di Giuseppe, Giovanni Gentile, Giuseppe M Raffa, Diego Bellavia, Michele Pilato
Accurate assessment of aortic extensibility is a requisite first step for elucidating the pathophysiology of an ascending thoracic aortic aneurysm (ATAA). This study aimed to develop a framework for the in vivo evaluation of the full-field distribution of the aortic wall strain by imaging analysis of electrocardiographic- (ECG) gated thoracic data of 34 patients with ATAA. Seven healthy controls (i.e., non-aneurysmal aorta) from patients who underwent ECG-gated CT angiography for coronary artery diseases were included for comparison...
September 7, 2017: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/28871348/characterization-of-complex-flow-patterns-in-the-ascending-aorta-in-patients-with-aortic-regurgitation-using-conventional-phase-contrast-velocity-mri
#6
Odd Bech-Hanssen, Frida Svensson, Christian L Polte, Åse A Johnsson, Sinsia A Gao, Kerstin M Lagerstrand
Ascending aorta (AA) flow displacement (FD) is a surrogate for increased wall shear stress. We prospectively studied the flow profile in the AA in patients with aortic regurgitation (AR), to identify predictors of FD and investigate whether magnetic resonance imaging (MRI) phase-contrast flow rate curves (PC-FRC) contain quantitative information related to FD. Forty patients with chronic moderate (n = 14) or severe (n = 26) AR (21 (53%) with bicuspid aortic valve) and 22 controls were investigated. FD was determined from phase-contrast velocity profiles and defined as the distance between the center of the lumen and the "center of velocity" of the peak systolic forward flow or the peak diastolic negative flow, normalized to the lumen radius...
September 4, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28864719/anatomical-and-clinical-predictors-of-valve-dysfunction-and-aortic-dilation-in-bicuspid-aortic-valve-disease
#7
Arturo Evangelista, Pastora Gallego, Francisco Calvo-Iglesias, Javier Bermejo, Juan Robledo-Carmona, Violeta Sánchez, Daniel Saura, Roman Arnold, Amelia Carro, Giuliana Maldonado, Augusto Sao-Avilés, Gisela Teixidó, Laura Galian, José Rodríguez-Palomares, David García-Dorado
OBJECTIVE: Bicuspid aortic valve (BAV) is associated with early valvular dysfunction and proximal aorta dilation with high heterogeneity. This study aimed to assess the determinants of these complications. METHODS: Eight hundred and fifty-two consecutive adults diagnosed of BAV referred from cardiac outpatient clinics to eight echocardiographic laboratories of tertiary hospitals were prospectively recruited. Exclusion criteria were aortic coarctation, other congenital disorders or intervention...
September 1, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28856517/bicuspid-aortic-valve-related-aortopathy
#8
REVIEW
Sina Stock, Salah A Mohamed, Hans-Hinrich Sievers
Bicuspid aortic valve related aortopathy is known to significantly increase the risk for catastrophic aortic events and, therefore, represents a considerable health burden. Albeit of ongoing research in this field including genetic, molecular, hemodynamic and morphologic aspects, bicuspid aortic valve related aortopathy still represents an imperfectly understood disorder. This lack in knowledge results in a lack of consistency considering different therapeutic approaches. Recent studies have provided new insights into the etiology and clinical impacts of bicuspid aortic valve related aortopathy in different clinical settings, leading to a growing body of opinion towards a more individualized surgical approach than currently provided by the guidelines...
August 30, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28833432/elasticity-of-ascending-aorta-and-left-ventricular-myocardial-functions-in-children-with-bicuspid-aortic-valve
#9
Filiz Ekici, Diyar Uslu, Selen Bozkurt
BACKGROUND: The aim of the study was to determine the aortic elasticity parameters (EPs) and myocardial function in children with bicuspid aortic valve (BAV). Additionally, we evaluated the effect of aortic leaflet phenotype (ALP) and aortic dilatation on elasticity parameters. METHODS: Sixty-two children diagnosed with isolated BAV (mean age 9.3 years old; patient group) and 63 healthy children (control group) have been evaluated for this study. Patient group was divided into three age subgroups: between 0-6, 7-11 and 12-17 age intervals...
August 22, 2017: Echocardiography
https://www.readbyqxmd.com/read/28828104/pulmonary-artery-dissection-complicating-aortic-dissection-in-a-patient-with-bicuspid-aortic-valve-and-aortic-coarctation
#10
Minhaj S Khaja, Richard L Hallett
We report a case of a type A aortic dissection with extension into the main pulmonary artery through a sinus of Valsalva fistula. Echocardiography and computed tomographic angiography of the chest were performed and bicuspid aortic valve, hemopericardium, and dilatation of the aortic root were found. A Stanford type A dissection was seen, extending to the distal transverse thoracic aorta, and there was a communication between the dissection at the left sinus of Valsalva and the main pulmonary artery, where a dissection flap was detected at computed tomographic angiography...
September 2017: Radiology case reports
https://www.readbyqxmd.com/read/28815188/painless-aortic-dissection-diagnostic-dilemma-with-fatal-outcomes-what-do-we-learn
#11
Saeeda Fatima, Konika Sharma
Aortic dissection is the most catastrophic clinical condition that involves the aorta. It has a high mortality as well as high rate of misdiagnosis due to frequent unusual presentation. Typically, it presents with acute chest, back, and tearing abdominal pain. However, it can present atypically with minimal or no pain, making diagnosis difficult. Physicians should always suspect acute aortic dissection in patients with certain clinical conditions like difficult-to-control hypertension, giant cell arteritis, bicuspid aortic valve, intracranial aneurysms, simple renal cysts, family history of aortic disease, and Marfan syndrome, especially when a patient presents with ischemic symptoms involving multiple organ without an obvious cause...
July 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28805011/bicuspid-and-unicuspid-aortic-valves-different-phenotypes-of-the-same-disease-insight-from-the-gentac-registry
#12
Joseph M Krepp, Mary J Roman, Richard B Devereux, Adrienne Bruce, Siddharth K Prakash, Shaine A Morris, Dianna M Milewicz, Kathryn W Holmes, William Ravekes, Ralph V Shohet, Reed E Pyeritz, Cheryl L Maslen, Barbara L Kroner, Kim A Eagle, Liliana Preiss, Federico M Asch
BACKGROUND: Unicuspid aortic valve (UAV) is a rare disorder, often difficult to distinguish from bicuspid aortic valve (BAV). BAV and UAV share valve pathology such as the presence of a raphe, leaflet fusion, aortic stenosis, aortic regurgitation, and/or ascending aortic dilatation, but a comprehensive echocardiographic comparison of patients with UAV and BAV has not been previously performed. METHODS: We investigated UAV and BAV patients at an early stage of disease included in GenTAC, a national registry of genetically related aortic aneurysms and associated cardiac conditions...
August 14, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28773988/investigation-on-the-regional-loss-factor-and-its-anisotropy-for-aortic-aneurysms
#13
Nastaran Shahmansouri, Mohammed Alreshidan, Alexander Emmott, Kevin Lachapelle, Ismaïl El-Hamamsy, Raymond Cartier, Richard L Leask, Rosaire Mongrain
An aortic aneurysm is a lethal arterial disease that mainly occurs in the thoracic and abdominal regions of the aorta. Thoracic aortic aneurysms are prevalent in the root/ascending parts of the aorta and can lead to aortic rupture resulting in the sudden death of patients. Understanding the biomechanical and histopathological changes associated with ascending thoracic aortic aneurysms (ATAAs), this study investigates the mechanical properties of the aorta during strip-biaxial tensile cycles. The loss factor-defined as the ratio of dissipated energy to the energy absorbed during a tensile cycle-the incremental modulus, and their anisotropy indexes were compared with the media fiber compositions for aneurysmal (n = 26) and control (n = 4) human ascending aortas...
October 26, 2016: Materials
https://www.readbyqxmd.com/read/28740678/bicuspid-aortic-root-spared-during-ascending-aorta-surgery-an-update-of-long-term-results
#14
EDITORIAL
Marco Russo, Guglielmo Saitto, Paolo Nardi, Fabio Bertoldo, Carlo Bassano, Antonio Scafuri, Antonio Pellegrino, Giovanni Ruvolo
BACKGROUND: Bicuspid aortic valve (BAV) aortopathy is well known in literature even if only few data exist regarding isolated supra-coronary aneurysm with normally functioning valve and root. Aim of this study is to clarify the long-term fate of bicuspid aortic root spared at the time of ascending aorta surgery. METHODS: We identified forty-seven patients (mean age, 57±11 y; range, 35-81 y, 31 males) who were treated by means of supracoronary aortic replacement in presence of normally functioning BAV and not significantly enlarged sinues of Valsalva...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28740468/evolution-of-precision-medicine-and-surgical-strategies-for-bicuspid-aortic-valve-associated-aortopathy
#15
Ali Fatehi Hassanabad, Alex J Barker, David Guzzardi, Michael Markl, Chris Malaisrie, Patrick M McCarthy, Paul W M Fedak
Bicuspid aortic valve (BAV) is a common congenital cardiac malformation affecting 1-2% of people. BAV results from fusion of two adjacent aortic valve cusps, and is associated with dilatation of the aorta, known as bicuspid valve associated aortopathy. Bicuspid valve aortopathy is progressive and associated with catastrophic clinical events, such as aortic dissection and rupture. Therefore, frequent monitoring and early intervention with prophylactic surgical resection of the proximal aorta is often recommended...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28730163/brain-strokes-related-to-aortic-aneurysma-the-analysis-of-three-cases
#16
Żanna Pastuszak, Adam Stępień, Joanna Kordowska, Agnieszka Rolewska, Dariusz Galbarczyk
Brain stroke connected with aortic blood flow disturbances is a rare disease and its incidence is difficult to assume. Nevertheless, 10-50% of patients with aortic dissection may not experience any pain. In case of 18-30% patients with aortic dissection neurological signs are first disease presentation and among them ischemic stroke is the most common. The most popular aortic dissection classification is with use of Stanford system. Type A involves the ascending aorta and type B is occurring distal to the subclavian artery...
2017: Open Medicine (Warsaw, Poland)
https://www.readbyqxmd.com/read/28694784/4d-flow-analysis-of-bav-related-fluid-dynamic-alterations-evidences-of-wall-shear-stress-alterations-in-absence-of-clinically-relevant-aortic-anatomical-remodeling
#17
Filippo Piatti, Francesco Sturla, Malenka M Bissell, Selene Pirola, Massimo Lombardi, Igor Nesteruk, Alessandro Della Corte, Alberto C L Redaelli, Emiliano Votta
Bicuspid aortic valve (BAV) is the most common congenital cardiac disease and is a foremost risk factor for aortopathies. Despite the genetic basis of BAV and of the associated aortopathies, BAV-related alterations in aortic fluid-dynamics, and particularly in wall shear stresses (WSSs), likely play a role in the progression of aortopathy, and may contribute to its pathogenesis. To test whether WSS may trigger aortopathy, in this study we used 4D Flow sequences of phase-contrast cardiac magnetic resonance imaging (CMR) to quantitatively compare the in vivo fluid dynamics in the thoracic aorta of two groups of subjects: (i) five prospectively enrolled young patients with normo-functional BAV and with no aortic dilation and (ii) ten age-matched healthy volunteers...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28683903/genetic-disorders-of-the-thoracic-aorta-and-indications-for-surgery
#18
REVIEW
Jack C J Sun
Genetic disorders of the aorta are rare but can lead to life-threatening thoracic aortic aneurysms. Although the genetic causes of many of these connective tissue diseases are well defined, others such as familial thoracic aortic aneurysm and bicuspid aortic valve aortopathy are not. The natural history of genetic thoracic aortic aneurysms is not well understood or predictable, and surgical guidelines for treatment remain imprecise. Future research should strive to provide in-depth and detailed genetic profiling to drive clinical management, including medical and surgical therapies...
August 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/28671863/rethinking-the-paradigm-modern-approach-to-proximal-aortic-reconstruction-demonstrates-excellent-outcomes
#19
Jonathan M Hemli, Edward R R DeLaney, Kush R Dholakia, Dror Perk, Nirav C Patel, S Jacob Scheinerman, Derek R Brinster
BACKGROUND: Techniques for aortic surgery continue to evolve. A real-world snapshot of patients undergoing elective surgery for aneurysm in the modern era is helpful to assist in deciding the appropriate timing for intervention. We herein describe our experience with 100 consecutive patients who underwent primary elective surgery for aneurysm of the proximal thoracic aorta over a two-year period at a single institution. METHODS: The majority of our patients were male, mean age 61...
June 20, 2017: Heart Surgery Forum
https://www.readbyqxmd.com/read/28666329/increased-blood-levels-of-transforming-growth-factor-%C3%AE-in-patients-with-aortic-dilatation
#20
Carmen Rueda-Martínez, Oscar Lamas, Fernando Carrasco-Chinchilla, Juan Robledo-Carmona, Carlos Porras, Gemma Sánchez-Espín, Manuel Jiménez Navarro, Borja Fernández
OBJECTIVES: Recent studies have shown that patients with syndromic thoracic aortic aneurysm, particularly patients with bicuspid aortic valve, have increased blood levels of transforming growth factor β1 (TGF-β1), indicating this molecule as a prognostic biomarker. However, it is not known whether TGF-β1 is also elevated in the blood of patients with tricuspid aortic valve and aortic dilatation. METHODS: We analysed the plasma levels of TGF-β1 in 52 patients with tricuspid or bicuspid aortic valve and with normal or dilated ascending aorta who underwent cardiac surgery in our hospital...
June 28, 2017: Interactive Cardiovascular and Thoracic Surgery
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