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Aorta dissection

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https://www.readbyqxmd.com/read/28802635/aorta-related-and-all-cause-mortality-in-patients-with-aortic-intramural-haematoma
#1
F S Schoenhoff, C Zanchin, M Czerny, V Makaloski, B Gahl, T Carrel, J Schmidli
OBJECTIVES: The prognosis of patients with intramural haematoma (IMH) of the aorta beyond the first year after diagnosis remains largely unknown. In particular, patients that do not undergo interventions are lost to follow-up. The aim was to assess medium-term outcome in IMH patients. METHODS: Post hoc analysis of 63 consecutive patients presenting with IMH between 1999 and 2013 was performed. Patients meeting imaging criteria at the first presentation were included even if follow-up imaging showed evidence of intimal disruption or false lumen flow...
August 9, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28795434/concomitant-antegrade-stent-grafting-of-the-descending-thoracic-aorta-during-transverse-hemiarch-reconstruction-for-acute-debakey-i-aortic-dissection-repair-improves-aortic-remodeling
#2
Ibrahim Sultan, Tyler J Wallen, Andreas Habertheuer, Mary Siki, George J Arnaoutakis, Joseph Bavaria, Wilson Y Szeto, Rita Milewski, Prashanth Vallabhajosyula
BACKGROUND AND AIM: Concomitant endovascular stent grafting of the descending thoracic aorta during open repair for acute DeBakey I aortic dissection can be performed in patients with extensive dissection and malperfusion. We analyzed the effects of this strategy on distal aortic remodeling. METHODS: From 2006-2014, acute DeBakey I dissection patients without primary aortic arch tear undergoing open distal hemiarch reconstruction (Standard group) versus those undergoing hemiarch with descending thoracic aorta (DTA) thoracic endovascular aortic repair (TEVAR group) were retrospectively reviewed...
August 9, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28790249/-triple-stage-endovascular-treatment-for-chronic-type-b-aortic-dissection-including-hybrid-procedure-report-of-a-case
#3
Takayuki Nishimoto, Yukihiro Bonkohara, Takashi Azuma, Masaki Iijima
A 66-year-old man developed an extended chronic type B dissection involving the thoraco-abdominal aorta with a large entry at the aortic arch and a patent false lumen. We performed triple-stage endovascular repair which included the vascular plug, endovascular aortic repair and hybrid thoracic endovascular aortic repair. His postoperative course was uneventful and the false lumen was finally thrombosed.
August 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28790239/-left-subclavian-artery-occlusion-by-using-amplatzer-vascular-plug-i-during-thoracic-endovascular-repair
#4
Akihisa Furuta, Masaaki Koide, Yoshifumi Kunii, Takuya Maeda
OBJECTIVE: The purpose of this study is to report the use of Amplatzer Vascular Plug (AVP) I for left subclavian artery (LSCA) occlusion during thoracic endovascular repair (TEVAR) with extra-anatomical bypass. METHODS: Retrospective review was undertaken in twelve patients who underwent transcatheter occlusion of the LSCA with AVP I as a part of TEVAR of thoracic aneurysm and aortic dissection at a single institution between Feb. 2014 and Jul. 2015. RESULT: Mean age was 72...
August 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28780762/valve-sparing-aortic-root-replacement-for-extremely-localized-circumferential-aortic-dissection-associated-with-intimo-intimal-intussusception
#5
Yujiro Ito, Yoshitsugu Nakamura, Miho Kuroda, Yuki Endo, Yusuke Nakanishi, Takaki Hori
Circumferential dissection is a rare clinical condition of aortic dissection, which is also known as intimo-intimal intussusception. In patients with type A aortic dissection with intimo-intimal intussusception, disruption and prolapse of the intimal flap into the left ventricle may occur and cause severe aortic regurgitation or blockage of the coronary artery ostium. A 43-year-old man presented with sudden dyspnea. Echocardiography revealed severe aortic insufficiency. Acute coronary syndrome was also suspected, but coronary angiography showed normal coronary arteries...
August 5, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28765187/non-atherosclerotic-aortic-mural-thrombus-a-rare-source-of-embolism
#6
Julian A Marin-Acevedo, Andree H Koop, Jose L Diaz-Gomez, Pramod K Guru
A 54-year-old man presented to the emergency department with acute left-sided chest pain and left upper quadrant abdominal pain. He had a significant history of squamous cell carcinoma of the lung previously treated with right pneumonectomy who ; is currently receiving adjuvant chemotherapy with cisplatin. Physical examination was remarkable for tachycardia, hypertension and mild abdominal tenderness. CT angiography revealed an aortic mural thrombus in the ascending aorta and aortic arch without dissection, aneurysm or tortuosity of the aorta...
August 1, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28764607/recycling-and-reinforcing-intimomedial-flap-of-the-infrarenal-aorta-using-anterior-longitudinal-ligament-in-patients-with-acute-trauma-with-bowel-injuries
#7
Milan Jovanovic, Milan Radojkovic, Predrag Djordjevic, Dejan Rancic, Nemanja Jovanovic, Zoran Rancic
We present a patient with blunt abdominal trauma with severe acute right limb ischemia and clinical signs of diffuse peritonitis. Computed tomography angiography showed circumferential dissection of the infrarenal aorta with occlusion of the right common iliac artery. We opted for simultaneous abdomen exploration and open repair of injured aorta. Critical weakening of the aortic wall with imminent rupture was identified intraoperatively. Aortotomy cranially from bifurcation showed circumferential intimomedial dissection...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28761401/modified-port-access-technique-for-the-treatment-of-aortic-dissection-after-previous-cardiac-surgery
#8
Edvin Prifti, Aurel Demiraj, Roland Xhaxho
One of the most challenging conditions to manage after previous cardiac surgery is chronic dissection of the ascending aorta. We operated on a 54-year-old man who had aortic dissection in addition to large aortic dimensions very close to the sternum, severe aortic regurgitation, and a false lumen in the descending aorta. We used a combination of perfusion and myocardial protection techniques, arising from port-access technology, that enabled antegrade flow into the aorta, endoclamping of the ascending aorta, the administration of cardioplegic solution before opening the sternum, and left ventricular venting to prevent ventricular distention...
June 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28758558/acute-debakey-type-i-dissection-repair-using-frozen-elephant-trunk-the-cleveland-clinic-technique
#9
Muhammad Aftab, Ryan Plichta, Eric E Roselli
Over the past 3 decades, the standard surgical management for acute DeBakey type I aortic dissection has not significantly changed. Most patients undergo ascending aortic replacement with an interposition graft under hypothermic circulatory arrest with selective root replacement. Nevertheless, with the improvement in overall patient care, acute surgical outcomes continue to improve. The frozen elephant trunk (FET) technique was introduced as a modification to conventional elephant trunk to treat extensive degenerative and chronic dissecting aneurysms involving the aortic arch and the proximal descending aorta...
September 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28754428/mid-term-results-of-chimney-and-periscope-grafts-in-supra-aortic-branches-in-high-risk-patients
#10
F Pecoraro, M Lachat, N S Cayne, D Pakeliani, Z Rancic, G Puippe, F J Criado, T Pfammatter, F J Veith, B Krüger, T A Neff
PURPOSE: Report mid-term outcomes of thoracic endovascular aneurysm repair (TEVAR) with chimney and periscope grafts (CPG) in supra-aortic branches (SAB). METHODS: Retrospective analysis, from October 2009 to May 2014, of patients with aneurysms requiring TEVAR with zone 0/1/2 proximal landing in association with at least one CPG in the SAB. All patients were considered at high risk for conventional surgery. Peri-operative mortality and morbidity, retrograde type A dissection, maximum aortic transverse diameter (TD) and its post-operative evolution, endoleak, survival, freedom from cardiovascular re-interventions, and CPG freedom from occlusion during the follow-up were analysed...
July 25, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28753427/a-genetic-variant-associated-with-five-vascular-diseases-is-a-distal-regulator-of-endothelin-1-gene-expression
#11
Rajat M Gupta, Joseph Hadaya, Aditi Trehan, Seyedeh M Zekavat, Carolina Roselli, Derek Klarin, Connor A Emdin, Catharina R E Hilvering, Valerio Bianchi, Christian Mueller, Amit V Khera, Russell J H Ryan, Jesse M Engreitz, Robbyn Issner, Noam Shoresh, Charles B Epstein, Wouter de Laat, Jonathan D Brown, Renate B Schnabel, Bradley E Bernstein, Sekar Kathiresan
Genome-wide association studies (GWASs) implicate the PHACTR1 locus (6p24) in risk for five vascular diseases, including coronary artery disease, migraine headache, cervical artery dissection, fibromuscular dysplasia, and hypertension. Through genetic fine mapping, we prioritized rs9349379, a common SNP in the third intron of the PHACTR1 gene, as the putative causal variant. Epigenomic data from human tissue revealed an enhancer signature at rs9349379 exclusively in aorta, suggesting a regulatory function for this SNP in the vasculature...
July 27, 2017: Cell
https://www.readbyqxmd.com/read/28747077/sandwich-technique-for-endovascular-repair-of-acute-type-a-aortic-dissection
#12
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...
July 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28743241/complete-ophthalmoplegia-complete-ptosis-and-dilated-pupil-due-to-internal-carotid-artery-dissection-as-the-first-manifestation-of-takayasu-arteritis
#13
H M M T B Herath, S P Pahalagamage, D Withana, Sunethra Senanayake
BACKGROUND: Takayasu arteritis is a rare, chronic large vessel vasculitis involving the aorta and its primary branches. As the disease progresses, the active inflammation of large vessels leads to dilation, narrowing and occlusion of the arteries. Arterial dissection is due to separation of the layers of the arterial wall resulting in a false lumen, where blood seeps into the vessel wall. Neurological sequelae of intracranial arterial dissection results from cerebral ischemia due to thromboembolism and hypo perfusion...
July 25, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28742740/penetrating-aortic-ulcer-leading-to-aortic-dissection
#14
Smith Giri, Prajwol Dhakal, Inyong Hwang, Krishmita Siwakoti, Shadwan Alsafwah
Rarely, penetrating atherosclerotic ulcers can rupture into the wall of the aorta, resulting in acute aortic dissection. This article describes a woman with an incidental diagnosis of type A aortic dissection secondary to a penetrating atherosclerotic ulcer of the ascending aorta. Although surgical repair of the aortic root was recommended, the patient refused treatment and left against medical advice.
August 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
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/28736120/aneurysmal-degeneration-of-type-b-aortic-dissections-after-thoracic-endovascular-aortic-repair-a-systematic-review
#16
REVIEW
Marissa Famularo, Karol Meyermann, Joseph V Lombardi
BACKGROUND: Promising results of thoracic endovascular aortic repair (TEVAR) in patients with complicated type B aortic dissection (TBAD) have been well documented. However, whereas early results have led many to hypothesize a benefit of TEVAR in uncomplicated patients, the natural history of TEVAR after the treatment of TBAD has yet to mature. In this review, we evaluated the available data to investigate whether longer term TEVAR warrants enthusiasm for all comers with TBAD. METHODS: A systematic review of the literature was performed searching specifically for studies assessing medium- and long-term outcomes after TEVAR for the treatment of TBAD...
July 20, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28734429/ascending-aorta-stenting-after-off-pump-aortic-wrapping-in-stanford-a-retrograde-aortic-dissection
#17
Dorian Verscheure, Ramzi Ramadan, Alexandre Azmoun, Julien Guihaire, Claude Angel, Philippe Brenot, Philippe Deleuze
We report 4 cases of off-pump ascending aorta wrapping combined with ascending aorta stenting in retrograde Stanford A acute aortic dissection (SAAD). Since 2008, 18 patients have undergone wrapping of the ascending aorta at our institution. Four patients had a persistent circulating false lumen in the ascending aorta after wrapping, with a threat to the aortic root. We chose an endovascular approach with ascending aorta stenting. Follow-up computed tomography showed a reapplication of the intimal flap in the reinforced aorta...
August 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28730163/brain-strokes-related-to-aortic-aneurysma-the-analysis-of-three-cases
#18
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/28727149/aortic-microcalcification-associates-with-elastin-fragmentation-in-marfan-syndrome
#19
Shaynah A Wanga, Stijntje Hibender, Yanto Ridwan, Cindy van Roomen, Mariska Vos, Ingeborg van der Made, Nicole van Vliet, Romy Franken, Luigi Amjg van Riel, Maarten Groenink, Aeilko H Zwinderman, Barbara Jm Mulder, Carlie Jm de Vries, Jeroen Essers, Vivian de Waard
Marfan syndrome (MFS) is a connective tissue disorder, in which aortic rupture is the major cause of death. MFS patients with an aortic diameter below the advised limit for prophylactic surgery (<5cm) may unexpectedly experience an aortic dissection or rupture, despite yearly monitoring. Hence, there is a clear need for improved prognostic markers to predict such aortic events. We hypothesize that elastin fragments play a causal role in aortic calcification in MFS and that microcalcification serves as a marker for aortic disease severity...
July 20, 2017: Journal of Pathology
https://www.readbyqxmd.com/read/28716062/the-effects-of-acute-and-elective-cardiac-surgery-on-the-anxiety-traits-of-patients-with-marfan-syndrome
#20
Kálmán Benke, Bence Ágg, Miklós Pólos, Alex Ali Sayour, Tamás Radovits, Elektra Bartha, Péter Nagy, Balázs Rákóczi, Ákos Koller, Viola Szokolai, Julianna Hedberg, Béla Merkely, Zsolt B Nagy, Zoltán Szabolcs
BACKGROUND: Marfan syndrome is a genetic disease, presenting with dysfunction of connective tissues leading to lesions in the cardiovascular and skeletal muscle system. Within these symptoms, the most typical is weakness of the connective tissue in the aorta, manifesting as aortic dilatation (aneurysm). This could, in turn, become annuloaortic ectasia, or life-threatening dissection. As a result, life-saving and preventative cardiac surgical interventions are frequent among Marfan syndrome patients...
July 17, 2017: BMC Psychiatry
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