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https://www.readbyqxmd.com/read/29786413/frozen-elephant-trunk-and-arch-endografts-for-chronic-thoracoabdominal-aortic-dissections
#1
Giovanni Tinelli, Marco Ferraresi, A Claire Watkins, Raphael Soler, Elie Fadel, Dominique Fabre, Stéphan Haulon
Chronic aortic dissecting aneurysms (TAAD) presenting after acute Stanford Type A or B dissection includes both arch and/or thoracoabdominal aortic aneurysms (TAAA). Approximately 60% of patients who survive surgical treatment of acute Type A aortic dissections will require another aortic procedure. Similarly, more than 70% of patients with chronic Type B aortic dissections will experience false lumen dilation at 5-year follow-up, often requiring intervention. Open or hybrid aortic repairs of complex TAAD involving the arch and the TAAA are very demanding procedures for both patients and clinicians...
May 22, 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29764707/mid-term-outcomes-from-a-multicenter-study-is-tevar-safe-for-ascending-aortic-dissection
#2
Qingsheng Lu, Lei Liu, Guangqi Chang, Xueming Chen, Hai Feng, Xuemin Zhang, Weiguo Fu, Zhihui Dong, Zaiping Jing
OBJECTIVES: This study aims to report mid-term follow-up outcomes of a series of TAAD patients treated with TEVAR in China. BACKGROUND: Thoracic endovascular aortic repair (TEVAR) has been used to treat type A aortic dissection (TAAD) for years. However, by comparing public reports, their outcomes which were based on different sample sizes show inconsistency. METHODS: Between January 2001 and December 2015, there were 56 patients with TAAD received TEVAR identified in 5 medical centers...
May 2, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29705370/clinical-outcomes-of-vasoring-connector-in-patients-with-acute-type-a-aortic-dissection
#3
I-Ming Chen, Po-Lin Chen, Shih-Hsien Weng, Chiao-Po Hsu, Chun-Che Shih, Hsiao-Huang Chang, Jeng Wei
BACKGROUND: Outcomes of acute type A aortic dissection (TAAD) repair may be improved when VasoRing connectors (VRC) are employed to facilitate aortic anastomosis. In the present study, we compared the results of acute TAAD repair using VRC and conventional suture technique. METHODS: A total of 68 patients who underwent acute TAAD repair by total arch replacement and antegrade frozen elephant trunk procedure at our institution were enrolled. Records of patients receiving aorta anastomosis with VRC (n = 33) and conventional suture (n =35) were retrospectively compared...
April 26, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29682475/malperfusion-syndromes-in-type-a-aortic-dissection-what-we-have-learned-from-irad
#4
REVIEW
Paolo Berretta, Santi Trimarchi, Himanshu J Patel, Thomas G Gleason, Kim A Eagle, Marco Di Eusanio
Patients presenting with type A acute aortic dissection (TAAD) complicated by malperfusion syndromes represent one of the highest surgical risk cohorts for cardiovascular surgeons. In the setting of aortic dissection, end-organ ischemia may involve any of the major arterial side branches resulting in myocardial, cerebral, spinal cord, visceral and/or limb ischemia. In TAAD patients with malperfusion, notwithstanding continuous improvement in diagnostic and management strategies, surgical and clinical outcomes remain poor and the optimal therapy is controversial...
2018: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29543232/targeted-genetic-analysis-in-a-large-cohort-of-familial-and-sporadic-cases-of-aneurysm-or-dissection-of-the-thoracic-aorta
#5
Ruwan Weerakkody, David Ross, David A Parry, Bulat Ziganshin, Jana Vandrovcova, Piyush Gampawar, Abdulshakur Abdullah, Jennifer Biggs, Julia Dumfarth, Yousef Ibrahim, Colin Bicknell, Mark Field, John Elefteriades, Nick Cheshire, Timothy J Aitman
PurposeThoracic aortic aneurysm/aortic dissection (TAAD) is a disorder with highly variable age of onset and phenotype. We sought to determine the prevalence of pathogenic variants in TAAD-associated genes in a mixed cohort of sporadic and familial TAAD patients and identify relevant genotype-phenotype relationships.MethodsWe used a targeted polymerase chain reaction and next-generation sequencing-based panel for genetic analysis of 15 TAAD-associated genes in 1,025 unrelated TAAD cases.ResultsWe identified 49 pathogenic or likely pathogenic (P/LP) variants in 47 cases (4...
March 15, 2018: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/29523595/interleukin-3-stimulates-matrix-metalloproteinase-12-production-from-macrophages-promoting-thoracic-aortic-aneurysm-dissection
#6
Chang Liu, Congcong Zhang, Lixin Jia, Boya Chen, Luxin Liu, Jie Sun, Wenmei Zhang, Bin You, Yulin Li, Ping Li, Jie Du
Thoracic aortic aneurysm and dissection (TAAD) is due to degeneration of the aorta and causes a high mortality rate, while molecular mechanisms for the development of TAAD are still not completely understood. In the present study, 3-aminopropionitrile (BAPN) treatment was used to induce TAAD mouse model. Through transcriptome analysis, we found the expression levels of genes associated with interleukin-3 (IL-3) signaling pathway were up-regulated during TAAD development in mouse, which were validated by real-time PCR...
March 30, 2018: Clinical Science (1979-)
https://www.readbyqxmd.com/read/29519942/microrna-21-knockout-exacerbates-angiotensin-ii-induced-thoracic-aortic-aneurysm-and-dissection-in-mice-with-abnormal-transforming-growth-factor-%C3%AE-smad3-signaling
#7
Xiaofan Huang, Zhang Yue, Jia Wu, Jiuling Chen, Sihua Wang, Jie Wu, Linyun Ren, Anchen Zhang, Peng Deng, Ke Wang, Chuangyan Wu, Xiangchao Ding, Ping Ye, Jiahong Xia
OBJECTIVE: Thoracic aortic aneurysm and dissection (TAAD) are severe vascular conditions. Dysfunctional transforming growth factor-β (TGF-β) signaling in vascular smooth muscle cells and elevated angiotensin II (AngII) levels are implicated in the development of TAAD. In this study, we investigated whether these 2 factors lead to TAAD in a mouse model and explored the possibility of using microRNA-21 ( miR-21 ) for the treatment of TAAD. APPROACH AND RESULTS: TAAD was developed in Smad3 (mothers against decapentaplegic homolog 3) heterozygous (S3+/- ) mice infused with AngII...
May 2018: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/29515038/massive-aggrecan-and-versican-accumulation-in-thoracic-aortic-aneurysm-and-dissection
#8
Frank S Cikach, Christopher D Koch, Timothy J Mead, Josephine Galatioto, Belinda B Willard, Kelly B Emerton, Matthew J Eagleton, Eugene H Blackstone, Francesco Ramirez, Eric E Roselli, Suneel S Apte
Proteoglycan accumulation is a hallmark of medial degeneration in thoracic aortic aneurysm and dissection (TAAD). Here, we defined the aortic proteoglycanome using mass spectrometry, and based on the findings, investigated the large aggregating proteoglycans aggrecan and versican in human ascending TAAD and a mouse model of severe Marfan syndrome. The aortic proteoglycanome comprises 20 proteoglycans including aggrecan and versican. Antibodies against these proteoglycans intensely stained medial degeneration lesions in TAAD, contrasting with modest intralamellar staining in controls...
March 8, 2018: JCI Insight
https://www.readbyqxmd.com/read/29360940/from-genetics-to-response-to-injury-vascular-smooth-muscle-cells-in-aneurysms-and-dissections-of-the-ascending-aorta
#9
Jean-Baptiste Michel, Guillaume Jondeau, Dianna M Milewicz
Vascular smooth muscle cells (vSMCs) play a crucial role in both the pathogenesis of Aneurysms and Dissections of the ascending thoracic aorta (TAAD) in humans and in the associated adaptive compensatory responses, since thrombosis and inflammatory processes are absent in the majority of cases. Aneurysms and dissections share numerous characteristics, including aetiologies and histopathological alterations: vSMC disappearance, medial areas of mucoid degeneration, and extracellular matrix (ECM) breakdown. Three aetiologies predominate in TAAD in humans: (i) genetic causes in heritable familial forms, (ii) an association with bicuspid aortic valves, and (iii) a sporadic degenerative form linked to the aortic aging process...
March 15, 2018: Cardiovascular Research
https://www.readbyqxmd.com/read/29336903/one-year-experience-of-a-regional-service-model-of-teleconsultation-for-planning-and-treatment-of-complex-thoracoabdominal-aortic-disease
#10
Emiliano Chisci, Gianmarco de Donato, Aaron Fargion, Giorgio Ventoruzzo, Gianbattista Parlani, Carlo Setacci, Leonardo Ercolini, Stefano Michelagnoli
OBJECTIVE: The objective of this study was to report the methodology and 1-year experience of a regional service model of teleconsultation for planning and treatment of complex thoracoabdominal aortic disease (TAAD). METHODS: Complex TAADs without a feasible conventional surgical repair were prospectively evaluated by vascular surgeons of the same public health service (National Health System) located in a huge area of 22,994 km2 with 3.7 million inhabitants and 11 tertiary hospitals...
March 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29216679/the-role-of-extracorporeal-membrane-oxygenator-therapy-in-the-setting-of-type-a-aortic-dissection
#11
Ibrahim Sultan, Andreas Habertheuer, Tyler Wallen, Mary Siki, Wilson Szeto, Joseph E Bavaria, Matthew Williams, Prashanth Vallabhajosyula
BACKGROUND AND AIM: Patients presenting with type A aortic dissection (TAAD) present with a wide clinical spectrum ranging from hemodynamic stability to multiorgan malperfusion with cardiovascular collapse. Extracorporeal membrane oxygenator (ECMO) therapy is increasingly being utilized as salvage therapy in patients with acute cardiopulmonary failure and for post-cardiotomy shock. We sought to determine the utility of ECMO implementation post-TAAD repair. METHODS: The Pennsylvania Health Care Cost Containment Council (PHC4) database, maintained by an independently functioning state agency, was retrospectively reviewed from 2004 to 2014...
December 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/29123168/clinical-parameters-and-gut-microbiome-changes-before-and-after-surgery-in-thoracic-aortic-dissection-in-patients-with-gastrointestinal-complications
#12
Shuai Zheng, Shulin Shao, Zhiyu Qiao, Xue Chen, Chunmei Piao, Ying Yu, Feng Gao, Jie Zhang, Jie Du
Thoracic aortic dissection (TAAD) is one of the most common types of aortic diseases. Although surgery remains the main method of treatment, the high rate of postoperative gastrointestinal complications significantly influences the effects of surgery and the recovery process. Moreover, the mechanisms underlying this disease remain unclear. To address these problems, we examined changes in the gut microbiota in 40 thoracic aortic dissection patients with abdominal complications after surgery. Levels of white blood cells (WBC), neutrophile granulocytes (NE), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) were higher in all patients after surgery...
November 9, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29093243/-expression-of-mir-146b-in-peripheral-blood-serum-and-aortic-tissues-in-patients-with-acute-type-stanford-a-aortic-dissection-and-its-clinical-significance
#13
Jie Li, Qing Zhou, Xiaojun He, Yongqing Cheng, Dongjin Wang
To explore expression of miR-146b in peripheral blood serum and aortic wall tissues in patients with acute Stanford type A aortic dissection (TAAD), and to discuss the significance and underlying mechanisms.
 Methods: The subjects were divided into a control group (excluded relative aortic diseases) (n=23) and a TAAD group (n=27). The miR-146b levels of serum and aortic wall tissues were detected by quantitative real-time PCR (qRT-PCR). Serum miR-146b and aortic wall tissues miR-146b were compared among different risk TAAD groups...
October 28, 2017: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/28984667/ascending-aortic-aneurysm-is-an-inherited-disease-a-contemporary-literature-review-based-on-hill-s-criteria-of-specificity-strength-of-association-and-biological-coherence
#14
Mirza Mujadil Ahmad, Immad Arif Kiani, Khawaja Afzal Ammar, Mirza Nubair Ahmad, Bijoy K Khandheria, Timothy E Paterick, Renuka Jain, A Jamil Tajik
There is growing evidence of a differential etiological basis for thoracic aortic aneurysms (TAA), with ascending (As) TAAs being genetically mediated and descending (Des) TAAs more strongly related to acquired pathologies. A comprehensive literature review of this hypothesis has not been carried out. We carried out a systematic literature review based on the latest guidelines on TAA endorsed by the American Heart Association. The etiologies were classified as genetic and inherited, the studies were tabulated accordingly, and Hill's epidemiological criteria of causality were applied...
November 2017: Cardiology in Review
https://www.readbyqxmd.com/read/28955046/critical-role-of-adamts-4-in-the-development-of-sporadic-aortic-aneurysm-and-dissection-in-mice
#15
Pingping Ren, Michael Hughes, Swapna Krishnamoorthy, Sili Zou, Lin Zhang, Darrell Wu, Chen Zhang, John A Curci, Joseph S Coselli, Dianna M Milewicz, Scott A LeMaire, Ying H Shen
Sporadic aortic aneurysm and dissections (AADs) are common vascular diseases that carry a high mortality rate. ADAMTS-4 (a disintegrin-like and metalloproteinase with thrombospondin motifs-4) is a secreted proteinase involved in inflammation and matrix degradation. We previously showed ADAMTS-4 levels were increased in human sporadic descending thoracic AAD (TAAD) samples. Here, we provide evidence that ADAMTS-4 contributes to aortic destruction and sporadic AAD development. In a mouse model of sporadic AAD induced by a high-fat diet and angiotensin II infusion, ADAMTS-4 deficiency (Adamts-4-/-) significantly reduced challenge-induced aortic diameter enlargement, aneurysm formation, dissection and aortic rupture...
September 27, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28901506/whole-exome-sequencing-identifies-fbn1-mutations-in-two-patients-with-early%C3%A2-onset-type-b-aortic-dissection
#16
Qian Han, Wenwen Zhang, Changjian Liu, Min Zhou, Feng Ran, Long Yi, Xitai Sun, Zhao Liu
The etiology of thoracic aortic aneurysm and dissection (TAAD) is complex and heterogeneous. Emerging evidence has demonstrated that genetic causes may be a consideration in early‑onset TAAD. Owing to overlapping clinical phenotypes and the genetic heterogeneity of TAAD, it is challenging for clinicians to make a molecular diagnosis of TAAD, particularly in those who present with non‑specific syndromic features. In order to identify the causative mutation in two young patients with acute type B aortic dissection without syndromic features, whole exome sequencing (WES) was performed in the present study...
November 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/28868310/genes-associated-with-thoracic-aortic-aneurysm-and-dissection-an-update-and-clinical-implications
#17
REVIEW
Adam J Brownstein, Bulat A Ziganshin, Helena Kuivaniemi, Simon C Body, Allen E Bale, John A Elefteriades
Thoracic aortic aneurysm (TAA) is a lethal disease, with a natural history of enlarging progressively until dissection or rupture occurs. Since the discovery almost 20 years ago that ascending TAAs are highly familial, our understanding of the genetics of thoracic aortic aneurysm and dissection (TAAD) has increased exponentially. At least 29 genes have been shown to be associated with the development of TAAD, the majority of which encode proteins involved in the extracellular matrix, smooth muscle cell contraction or metabolism, or the transforming growth factor-β signaling pathway...
February 2017: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/28855619/identification-of-novel-clinically-relevant-variants-in-70-southern-chinese-patients-with-thoracic-aortic-aneurysm-and-dissection-by-next-generation-sequencing
#18
Miaoxian Fang, Changjiang Yu, Siyao Chen, Weiping Xiong, Xin Li, Rong Zeng, Jian Zhuang, Ruixin Fan
Thoracic Aortic Aneurysm and Dissection (TAAD) is a life-threatening pathology and remains challenging worldwide. Up to 40% of TAAD are hereditary with complex heterogeneous genetic backgrounds. Recently, next-generation sequencing (NGS) has been successfully applied to identify genetic variants in an efficient and cost-effective manner. In our study, NGS coupled with DNA target-capture array was used to screen 11 known causative genes of TAAD in 70 patients from Southern China. All the identified variants were confirmed by Sanger sequencing...
August 30, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28797584/long-term-outcomes-of-frozen-elephant-trunk-for-type-a-aortic-dissection-in-patients-with-marfan-syndrome
#19
Wei-Guo Ma, Wei Zhang, Jun-Ming Zhu, Bulat A Ziganshin, Ai-Hua Zhi, Jun Zheng, Yong-Min Liu, John A Elefteriades, Li-Zhong Sun
OBJECTIVE: The use of the frozen elephant trunk (FET) technique for repair of type A aortic dissection (TAAD) in Marfan syndrome (MFS) is controversial. We seek to evaluate the efficacy of FET and total arch replacement (TAR) for TAAD in patients with MFS. METHODS: The early and long-term outcomes were analyzed for 106 patients with MFS (mean age, 34.5 ± 9.7 years) undergoing FET + TAR for TAAD. RESULTS: Operative mortality was 6.6% (7 of 106)...
June 16, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28747077/sandwich-technique-for-endovascular-repair-of-acute-type-a-aortic-dissection
#20
Feng Gao, Qian Zeng, Fangming Lin, Xiaohu Ge
OVERVIEW: To describe a new endovascular procedure for acute type A aortic dissection (TAAD) repair. METHODS: Between 2013 and 2016, 12 patients (average age 54±9.6 years; 10 men) with acute TAAD (mean EURO score 11.4%±3.2%, range 5-17) and unfit for surgery underwent thoracic endovascular aortic repair (TEVAR) with 2 periscope grafts to preserve blood supply to supra-aortic branches plus bypass grafting as needed. If the ascending aorta was dilated to >40 mm, sternotomy was performed to wrap the ascending aorta and reduce its diameter to accommodate the aortic stent-grafts...
October 2017: Journal of Endovascular Therapy
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