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Aorta dissection

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https://www.readbyqxmd.com/read/29339694/aortic-%C3%AE-smooth-muscle-actin-expressions-in-aortic-disorders-and-coronary-artery-disease-an-immunohistochemical-study
#1
Shi Min Yuan, Ning Wu
OBJECTIVE: The is to report immunohistochemical observations of aortic α-smooth muscle actin (SMA) expressions in patients with aortic aneurysm, acute aortic dissection, and coronary artery disease and to discuss phenotypic switching of smooth muscle cells (SMCs) of these lesions. METHODS: Forty-nine consecutive patients scheduled for surgical treatment for acute type A aortic dissection (20 patients), aortic aneurysm (9 patients), and coronary artery disease (20 patients) were included...
January 2018: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/29336392/transesophageal-echocardiography-evaluation-of-the-aortic-arch-branches
#2
REVIEW
Thimmangouda A Patil, Santosh Kumar Ambli
Visualization of aortic arch branches by transesophageal echocardiography has been technically challenging. Visualizing these vessels helps in identifying the extent of dissection of the aorta, assessing the severity of carotid artery stenosis, presence of atheromatous plaques, patency of the left internal mammary artery graft, confirmation of subclavian artery cannulation, confirming holodiastolic flow reversal in the left subclavian artery by spectral Doppler imaging in case of severe aortic regurgitation, and confirming the optimal position of the intraaortic balloon perioperatively...
January 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29334863/totally-percutaneous-fenestration-via-the-cheese-wire-technique-to-facilitate-endovascular-aneurysm-repair-in-chronic-aortic-dissection
#3
Jordan R Stern, Danielle E Cafasso, Darren B Schneider, Andrew J Meltzer
Here, we describe a totally percutaneous technique for longitudinal fenestration of a chronic dissection flap in the setting of endovascular aneurysm repair (EVAR), where the septum would otherwise preclude proper endograft sealing. This technique is demonstrated in a 65-year-old man with a history of open surgical repair of a Stanford type A aortic dissection, with a type B component that was managed nonoperatively. The patient developed aneurysmal degeneration of the infrarenal aorta during follow-up, and his anatomy was well suited for EVAR with the exception of a chronic dissection flap dividing the proximal seal zone...
January 1, 2018: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29332573/torsades-de-pointes-in-patients-with-polymyalgia-rheumatica
#4
Pietro Enea Lazzerini, Iacopo Bertolozzi, Maurizio Acampa, Rosella Fulceri, Franco Laghi-Pasini, Pier Leopoldo Capecchi
Polymyalgia rheumatica (PMR) represents the most common inflammatory rheumatic disease of the elderly. It is characterized by synovitis of proximal joints and extra-articular synovial structures, along with chronic high-grade systemic inflammation. PMR is closely related to giant cell arteritis (GCA), a large-vessel vasculitis that involves the major branches of the aorta, particularly the extracranial branches of carotid artery including temporal arteries. It is currently believed that PMR and GCA may represent different manifestations of the same disease process...
January 10, 2018: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/29313372/optimization-of-three-dimensional-modeling-for-geometric-precision-and-efficiency-for-healthy-and-diseased-aortas
#5
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 9, 2018: Computer Methods in Biomechanics and Biomedical Engineering
https://www.readbyqxmd.com/read/29303142/type-a-intramural-hematoma-in-a-patient-with-acute-coronary-syndrome-mimicking-acute-type-a-aortic-dissection
#6
Ö Gülmez, B Saritas, I Isiklar
Intramural hematoma (IMH) of ascending aorta is a rare but potentially lethal form of acute aortic syndrome (AAS). It is characterized by a hematoma within the media layer of the aorta secondary to rupture of the vasa vasorum in the absence of an intimal tear. However, the theory of "micro-tear" which cannot be easily detected has been raised. It may stabilize, regress, or progress to rupture or dissection. Similar to Type A aortic dissection (AD), patients with IMH of ascending aorta, as well as patients with persistent pain, are treated urgent surgery...
November 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/29302461/warfarin-anticoagulation-in-acute-type-a-aortic-dissection-survivors-watas
#7
Yskert von Kodolitsch, Oliver Wilson, Helke Schüler, Axel Larena-Avellaneda, Tilo Kölbel, Sabine Wipper, Fiona Rohlffs, Christian Behrendt, E Sebastian Debus, Jens Brickwedel, Evaldas Girdauskas, Christian Detter, Alexander M Bernhardt, Jürgen Berger, Stefan Blankenberg, Hermann Reichenspurner, Tamer Ghazy, Klaus Matschke, Ralf-Thorsten Hoffmann, Norbert Weiss, Adrian Mahlmann
Background: Early survivors of acute type A aortic dissection (AAAD) remain at risk for late death and late aortic events. However, the frequency and long-term effects of warfarin anticoagulation on long-term outcome in post-surgical AAAD survivors have not been elucidated. Methods: Two tertiary care centers performed a retrospective observational cohort study of warfarin anticoagulation in AAAD in 243 persons with early survival of surgical repair (WATAS). Serial postoperative tomographic imaging was available in 106 persons...
December 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/29300989/importance-of-accurately-locating-the-entry-site-for-endovascular-treatment-of-retrograde-type-a-acute-aortic-dissection
#8
Paul P Urbanski, Ayman Sodah, Anna Matveeva, Vadim Irimie, Matthias Wagner, Arzou Agaev, Rainer Schmitt
OBJECTIVES: The aim of this study was to evaluate the diagnostic possibilities of accurately locating the entry site in acute retrograde Type A aortic dissection and the results of the corresponding endovascular treatments. METHODS: Among 100 patients who underwent surgery for the treatment of spontaneous acute Type A aortic dissection between 2012 and June 2017, all but 1 patient had preoperative computed tomographic angiography. A total of 8 retrograde extensions originated from the descending aorta, in which 6 of them were diagnosed correctly using radiological imaging...
January 2, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29290819/identification-of-type-iv-collagen-exposure-as-a-molecular-imaging-target-for-early-detection-of-thoracic-aortic-dissection
#9
Ke Xu, Chen Xu, Yanzhenzi Zhang, Feiran Qi, Bingran Yu, Ping Li, Lixin Jia, Yulin Li, Fu-Jian Xu, Jie Du
Thoracic aortic dissection (TAD) is an aggressive and life-threatening vascular disease and there is no effective means of early diagnosis of dissection. Type IV collagen (Col-IV) is a major component of the sub-endothelial basement membrane, which is initially exposed followed by endothelial injury as early-stage event of TAD. So, we want to build a noninvasive diagnostic method to detect early dissection by identifying the exposed Col-IV via MRI. METHODS: Col-IV-targeted magnetic resonance/ fluorescence dual probe (Col-IV-DOTA-Gd-rhodamine B; CDR) was synthesized by amide reaction and coordination reaction...
2018: Theranostics
https://www.readbyqxmd.com/read/29290421/patient-specific-three-dimensional-printing-for-kommerell-s-diverticulum
#10
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
https://www.readbyqxmd.com/read/29281610/aortic-replacement-in-cardiac-surgery
#11
REVIEW
Eric E Roselli
The number of aorta procedures performed annually in the United States has grown substantially during the past decade. Cleveland Clinic is a leader in research on the risk of aortic dissection in patients with a bicuspid or tricuspid aortic valve and associated aneurysm, which has led to changes in the recommendations of when to operate. Safety and efficacy data support more proactive treatment for most patients with thoracic aortic aneurysm and/or dissection with a growing emphasis on the need to provide life-long care to patients with aortic conditions...
December 2017: Cleveland Clinic Journal of Medicine
https://www.readbyqxmd.com/read/29279888/prevalence-of-systemic-atherosclerosis-burdens-and-overlapping-stroke-etiologies-and-their-associations-with-long-term-vascular-prognosis-in-stroke-with-intracranial-atherosclerotic-disease
#12
Takao Hoshino, Leila Sissani, Julien Labreuche, Gregory Ducrocq, Philippa C Lavallée, Elena Meseguer, Céline Guidoux, Lucie Cabrejo, Cristina Hobeanu, Fernando Gongora-Rivera, Pierre-Jean Touboul, Philippe Gabriel Steg, Pierre Amarenco
Importance: Patients who have experienced stroke with intracranial atherosclerotic disease (ICAD) may also have concomitant atherosclerosis in different arterial beds and other possible causes for ischemic stroke. However, little is known about the frequency and prognostic effect of such overlapping diseases. Objectives: To describe the prevalence of systemic atherosclerotic burdens and overlapping stroke etiologies and their contributions to long-term prognoses among patients who have experienced stroke with ICAD...
December 26, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/29279532/acute-type-a-aortic-dissection-with-iliac-malperfusion-in-a-patient-with-scimitar-syndrome
#13
Jae Hang Lee, Jin-Ho Choi, Eung-Joong Kim
We encountered a 35-year-old male patient with scimitar syndrome, acute type A aortic dissection, and severe iliac malperfusion. He presented with pain and weakness of the left lower extremity and underwent ascending aorta replacement through sternotomy and right anterior thoracotomy. Left iliac artery flow was recovered after the operation and the patient was discharged on the tenth day without any complication. The purpose of this report is to discuss the considerations in aortic surgery in patients with scimitar syndrome, and the surgical principles for treatment of aortic dissection with critical limb ischemia...
December 27, 2017: International Heart Journal
https://www.readbyqxmd.com/read/29276439/endovascular-treatment-of-distal-aortic-arch-aneurysm-associated-with-coarctation-of-aorta-in-a-jehovah-s-witness
#14
Luigi Di Tommaso, Vito A Mannacio, Ettorino Di Tommaso, Giovanni B Pinna, Immacolata Fontana, Gabriele Iannelli
Late aneurysm formation in the proximal aorta or distal aortic arch is a recognized sequela of untreated stenosis of the aortic isthmus and is associated with substantial risk of aortic rupture. We describe the case of a 44-year-old man with untreated coarctation of the aorta who presented with a prestenotic dissecting thoracic aortic aneurysm. He declined surgery because he was a Jehovah's Witness. Instead, we performed emergency endovascular aortic repair in which 2 stent-grafts were placed in the descending aorta...
December 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/29276106/natural-history-of-the-proximal-aorta-in-patients-with-descending-thoracic-aortic-disease
#15
Paul C Tang, Paul D DiMusto, Nilto C De Oliveira, Brooks L Rademacher, Jennifer L Philip, Shahab A Akhter, Charles W Acher
OBJECTIVE: This study investigated the growth and behavior of the ascending aorta in patients with descending thoracic aortic disease. METHODS: We examined 200 patients with descending thoracic aortic disease including acute type B dissection (n = 95), chronic type B dissection (n = 38), intramural hematoma (n = 23), and thoracoabdominal aortic aneurysms (n = 44). Images from computed tomography and magnetic resonance imaging were evaluated after three-dimensional reconstruction to examine the growth rate in those with >1 year of imaging follow-up (n = 108)...
December 21, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29274600/evidence-of-intimal-tear-in-type-a-intramural-hematoma-of-the-aorta-a-case-series
#16
Gianfranco Filippone, Giovanni Caruana, Claudia Calia, Violetta Moscaritolo, Vincenzo Argano
INTRODUCTION: Aortic intramural hematoma (IMH) is described as "dissection without intimal tear" due to rupture of vasa vasorum, which results in bleeding within the tunica media in the absence of intimal disruption or blood flow communication. The aim of our study is to validate perioperative evidence of intimal entry tear in patients with IMH and to suggest that this entity may represent a part of a disease and not a separate disease. PRESENTATION OF CASES: We report two patients admitted to our institution with sudden onset thoracic pain...
December 12, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29258677/sixteen-year-experience-of-david-and-bentall-procedures-in-acute-type-a-aortic-dissection
#17
Bo Yang, Himanshu J Patel, Claire Sorek, Whitney E Hornsby, Xiaoting Wu, Sarah Ward, Marc Thomas, Anisa Driscoll, Victoria A Waidley, Elizabeth L Norton, Donald S Likosky, G Michael Deeb
BACKGROUND: To examine short-term and midterm outcomes after the David and Bentall procedures in patients with an acute type A aortic dissection. METHODS: Between 2001 and 2017, patients (n = 135) with acute type A aortic dissection underwent an aortic root replacement with either the David (n = 40) or Bentall (n = 95) procedure. Perioperative outcome, reoperation rate, aortic valve function, and long-term survival were evaluated. RESULTS: The median age of the entire cohort was 56 years...
December 16, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29250676/rare-variant-of-celiac-trunk-branching-pattern-associated-with-modifications-of-hepatic-arterial-vascularization
#18
Ecaterina Dăescu, Dorina Sztika, Alin Adrian Lăpădatu, Delia Elena Zăhoi
The routine dissection of a male body revealed multiple anatomical variations of the celiac trunk and hepatic artery vascularization. The origin of the celiac trunk was on the left side of the abdominal aorta, next to the T12-L1 intervertebral disk. The celiac trunk gave off five branches: the left inferior phrenic artery, the left gastric artery, the accessory right hepatic artery, the common hepatic artery and the splenic artery (the last two arteries had a common origin in a hepatosplenic trunk). A right branch detached off the left gastric artery and anastomosed with the hepatic artery proper...
2017: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/29249790/-ascending-aorta-replacement-and-extended-myectomy-for-acute-aortic-dissection-and-coexistent-hypertrophic-obstructive-cardiomyopathy-report-of-a-case
#19
Tomoyuki Suzuki, Masaki Hata, Kazuhiro Yamaya, Takeshi Saitou, Fumiya Haba, Masahiro Matsuno
Emergent ascending aortic replacement and extended myectomy were performed in a woman with acute aortic dissection who was aged 63 years. Preoperative transthoracic echocardiography performed in the intensive care unit showed only slight left ventricular outflow tract (LVOT) obstruction, but intraoperative transesophageal echocardiography after induction of anesthesia revealed pericardial effusion, systolic anterior motion(SAM), and associated mitral regurgitation(MR). Perioperative SAM and MR are sometimes facilitated under various hemodynamic conditions, but in this case, the left ventricular wall was thick and LVOT appeared to be obstructive by a hypertrophied septum...
December 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29249769/open-conversion-for-type-a-ascending-aortic-dissection-after-thoracic-endovascular-aortic-repair-by-the-chimney-graft-technique
#20
Hirofumi Kasahara, Yoshito Inoue, Takashi Hachiya
An 83-year-old man with aortic arch aneurysm underwent zone 0 thoracic endovascular aortic repair (TEVAR) by the chimney graft technique with two supra-aortic arch debranching grafts and developed subacute type A ascending aortic dissection. We performed emergency open conversion with circulatory arrest under deep hypothermia. The tip of the chimney graft (around the sino-tubular junction in the ascending aorta) was stiff, making it difficult to inspect the lumen and perform anastomosis. Deep hypothermic circulatory arrest and cutting the endograft stents to mobilize the graft were necessary for secure anastomosis...
December 18, 2017: Annals of Thoracic and Cardiovascular Surgery
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