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Aorta dissection

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https://www.readbyqxmd.com/read/28528045/endovascular-fenestration-for-distal-aortic-sealing-after-frozen-elephant-trunk-with-thoraflex
#1
Randolph H L Wong, Peter S Y Yu, Micky W T Kwok, Simon C Y Chow, Jacky Y K Ho, Malcolm J Underwood, Simon C H Yu
We describe a case of total arch replacement with frozen elephant trunk for chronic type B aortic dissecting aneurysm, which resulted in inadvertent landing of the frozen elephant trunk into the false lumen. A radiofrequency puncture system-assisted controlled endovascular fenestration of the dissection flap was performed at the upper abdominal aorta and subsequent thoracic endovascular stenting, successfully redirecting the blood flow from the false to the true lumen. Our case illustrated a possible way to seal distal reentry in chronic type B aortic dissection...
June 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28523430/long-term-durability-of-preserved-aortic-root-after-repair-of-acute-type-a-aortic-dissection
#2
Keiji Kamohara, Shugo Koga, Jun Takaki, Nozomi Yoshida, Kojiro Furukawa, Shigeki Morita
BACKGROUND: Optimal management of aortic root in type A aortic dissection (AAD) is controversial. To determine the most appropriate strategy, we studied the late outcomes after conservative repair of aortic root. METHODS: 234 AAD patients (mean age 68 ± 12 years) underwent surgical repair using supracommissural replacement (SCR) for aortic root reconstruction from 1989 to 2014. Ascending aortic replacement or hemi-arch replacement was performed in 180 patients (non-arch group), whereas total arch replacement (TAR) was performed in 54 patients...
May 18, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28520537/anomalous-origin-of-right-coronary-artery-from-left-coronary-sinus-13-cases-treated-with-the-reimplantation-technique
#3
Alain Cubero, Alejandro Crespo, Gadah Hamzeh, Andrés Cortes, Daniel Rivas, José Ignacio Aramendi
OBJECTIVES: Anomalous aortic origin of a coronary artery is uncommon but potentially clinically significant. Manifestations vary from asymptomatic patients to those who present with angina pectoris, myocardial infarction, heart failure, syncope, arrhythmias, and sudden death. We describe our experience with surgical reimplantation and results at midterm follow-up. METHODS: Between February 2003 and July 2016, a total of 13 patients with anomalous origin of the right coronary artery (RCA) from the left sinus underwent surgical reimplantation...
May 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28516101/early-spontaneous-resolution-of-an-iatrogenic-acute-type-a-aortic-dissection
#4
Mohammad A Zafar, Philip Y K Pang, Glen A Henry, Bulat A Ziganshin, Maryann Tranquilli, John A Elefteriades
Acute aortic dissection is a rare but devastating complication during cardiac catheterization. We present the case of an elderly female who incurred a Stanford Type A/DeBakey Type I acute aortic dissection extending into the arch vessels and descending aorta likely occurring during right coronary artery engagement for angioplasty. The patient was treated successfully by immediately sealing the entrance of the dissection via the placement of a stent and anti-impulse therapy. Follow-up computed tomography scan showed complete resolution of the dissection within one month...
December 2016: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/28516099/conservative-management-of-extensive-iatrogenic-aortic-dissection
#5
Derrick Y Tam, Amine Mazine, Asim N Cheema, Bobby Yanagawa
Iatrogenic aortic dissection (IAD) is a rare complication of percutaneous coronary interventions (PCI). There are no clear guidelines for IAD management, and limited data are available. Registry data and case series combined with extrapolations from our experience with spontaneous Type-A dissections suggest that very limited dissections are often managed conservatively with coronary stenting of the entry tear when possible, while more extensive dissections are managed surgically. We present a case report of a 50-year-old woman who underwent PCI for an ST-elevation myocardial infarction that resulted in an extensive IAD from the ostium of the right coronary artery to the aortic root, ascending aorta, and aortic arch...
December 2016: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/28516098/spontaneous-regression-of-a-large-iatrogenic-dissection-of-the-ascending-aorta
#6
Aurélien Roumy, Matthias Kirsch, René Prêtre, Lars Niclauss
A 74-year-old woman was admitted for right coronary angioplasty. During the procedure, she complained about chest pain, and contrast injection showed an iatrogenic dissection of the ascending aorta. A contrast computed tomography (CT) scan confirmed the diagnosis via visualization of a large non-circulating false lumen, which involved nearly the entire ascending aorta. The patient remained hemodynamically stable and asymptomatic while receiving medical therapy alone. Another CT scan performed 3 days later showed complete regression of the false lumen...
December 2016: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/28516095/david-v-procedure-in-a-patient-with-aortic-dilation-and-competent-quadricuspid-aortic-valve-are-genetics-to-blame
#7
Katherine R Hebeler, John J Squiers, Heike Baumgarten, J Michael DiMaio, William T Brinkman
Quadricuspid aortic valves (QAVs) are extremely rare. In this case study, we report a David-V valve-sparing aortic root replacement with reimplantation of a native QAV in a patient with aortic dilation, normal valve function, and a family history of aortic dissection. Microscopic pathological examination of the excised section of the aorta revealed scattered small foci of cystic medical degeneration throughout. A genetic predisposition for aortic dilation may be present in patients with QAV, even in the setting of a competent valve...
October 2016: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/28514894/successful-repair-of-acute-type-b-and-retrograde-type-a-aortic-dissection-with-kidney-ischemia
#8
Jeko M Madjarov, Michael G Katz, Hector Crespo-Soto, Svetozar Madzharov, Timothy Roush, Francis Robicsek
Acute dissection of thoracic aorta carries a risk of renal ischemia followed by the development of a kidney failure. The optimal surgical and nonsurgical management of these patients, timing of intervention, and the factors predicting renal recovery are not well delineated and remain controversial. We present a case of acute type B thoracic aortic dissection with left kidney ischemia. Evaluation of renal function was performed by the means of internationally accepted Risk, Injury, Failure, Loss of kidney function, End stage kidney disease and Acute Kidney Injury Network classifications for acute kidney injury, renal duplex sonography, and intravascular ultrasound that demonstrated left renal artery dissection with a flap completely compressing the true lumen...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28496084/-redissection-of-the-aortic-root-three-months-after-replacement-of-the-ascending-aorta-for-acute-stanford-type-a-dissection-report-of-a-case
#9
Takeshi Someya, Kiyotoshi Oishi, Toshizumi Shirai
We report a case of redissection of the aortic root after graft replacement for acute aortic dissection using BioGlue to approximate the false lumen. A 49-year-old man underwent graft replacement of the ascending aorta for acute aortic dissection. In this operation, BioGlue was applied to the false lumen of the aortic root. Three months later, computed tomography revealed an ulcer-like projection and an intramural hematoma in the aortic root. Aortic root replacement was performed, in which operative findings showed a new intimal tear and a patent false lumen contained with hematomas and a fragment of BioGlue...
May 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28496083/-retrograde-type-a-aortic-dissection-after-thoracic-endovascular-aortic-repair-report-of-a-case
#10
Sei Morizumi, Takafumi Inoue, Satoshi Nishi, Akihiro Yoshimoto, Masashi Fujisaki, Yoshihiro Suematsu
A 72-year-old man presented with aneurysms of the distal aortic arch and the distal descending aorta due to chronic type B aortic dissection. We first performed thoracic endovascular aortic repair (TEVAR) in the distal descending aorta, and the aneurysm was successfully excluded using a Gore Tag stentgraft. Seven days after TEVAR, computed tomography revealed retrograde type A aortic dissection occurring from the ascending aorta to the distal aortic arch. In emergency surgery, ascending aorta and total arch replacement were performed under selective cerebral perfusion with moderate hypothermia, and after coming off cardiopulmonary bypass, the distal aortic arch aneurysm was excluded using a Gore Tag stentgraft...
May 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28490606/comparison-of-10-murine-models-reveals-a-distinct-biomechanical-phenotype-in-thoracic-aortic-aneurysms
#11
C Bellini, M R Bersi, A W Caulk, J Ferruzzi, D M Milewicz, F Ramirez, D B Rifkin, G Tellides, H Yanagisawa, J D Humphrey
Thoracic aortic aneurysms are life-threatening lesions that afflict young and old individuals alike. They frequently associate with genetic mutations and are characterized by reduced elastic fibre integrity, dysfunctional smooth muscle cells, improperly remodelled collagen and pooled mucoid material. There is a pressing need to understand better the compromised structural integrity of the aorta that results from these genetic mutations and renders the wall vulnerable to dilatation, dissection or rupture. In this paper, we compare the biaxial mechanical properties of the ascending aorta from 10 murine models: wild-type controls, acute elastase-treated, and eight models with genetic mutations affecting extracellular matrix proteins, transmembrane receptors, cytoskeletal proteins, or intracellular signalling molecules...
May 2017: Journal of the Royal Society, Interface
https://www.readbyqxmd.com/read/28481992/iatrogenic-subintimal-aortic-dissection-that-disappeared-without-a-trace
#12
Kazumasa Orihashi, Kazuki Kihara, Masaki Yamamoto, Hideaki Nishimori
A case of an unusual iatrogenic aortic dissection is reported. A 77-year-old male patient in shock status due to acute type A aortic dissection underwent emergency surgery. Systemic perfusion was started via the femoral artery, but another dissection appeared in the descending aorta detected by transoesophageal echocardiography. However, the flap was unusually thin, and there was no change in the pre-existing thrombosed false lumen. These findings suggested subintimal development of dissection. After systemic perfusion was promptly switched to antegrade perfusion, the new dissection could no longer be detected...
May 6, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28479468/a-ten-year-experience-using-a-hybrid-endovascular-approach-to-treat-aberrant-subclavian-arterial-aneurysms
#13
Mathew Wooster, Martin Back, Danielle Sutzko, Hollie Gaeto, Paul Armstrong, Murray Shames
BACKGROUND: To describe a single center experience using combined extra-anatomic open arch branch revascularization with aortic arch endovascular exclusion for treatment of aberrant subclavian artery aneurysms. METHODS: All patients undergoing management of aberrant subclavian aneurysms were identified from a prospective patient registry. Means of revascularization included carotid-subclavian bypass or subclavian transposition and origin occlusion was performed by surgical ligation or endovascular embolization at surgeon discretion...
May 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28479427/inferior-mesenteric-artery-aneurysm-complicated-with-occluded-celiac-and-superior-mesenteric-artery-after-replacement-of-thoracoabdominal-aorta-for-chronic-dissected-thoracoabdominal-aortic-aneurysm
#14
Takashi Igarashi, Akihiro Yamamoto, Tsuyoshi Fujimiya, Shinya Takase, Hirono Satokawa, Hitoshi Yokoyama
We report a case of inferior mesenteric artery aneurysm after the replacement of the thoracoabdominal aorta for a chronic dissected thoracoabdominal aortic aneurysm in which the celiac artery and superior mesenteric artery were occluded. We performed the resection of the inferior mesenteric artery aneurysm and the revascularization of the superior mesenteric artery, inferior mesenteric artery, and the meandering artery. The patient's postoperative course was uneventful, without bowel ischemia. From the findings of intraoperative flow measurement of the visceral arteries, revascularization of the SMA was judged to be appropriate in this situation...
May 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28479185/neuroimaging-of-takayasu-arteritis-in-a-patient-with-ulcerative-rectocolitis
#15
Lucia Monti, Rosamaria Servillo, Irene Grazzini, Leila Khader, Maurizio Acampa, Alfonso Cerase
BACKGROUND: Takayasu arteritis (TA), also known as aortoarteritis and pulseless disease, is an autoimmune, idiopathic, large-vessel vasculitis that primarily affects the aorta and its major branches, the coronary arteries, and the pulmonary arteries. METHODS: This is a peculiar clinical and radiological pattern of TA in a young female Caucasian. Her medical history included diagnosis of ulcerative rectocolitis at the age of 14. Because of the occurrence of anemia and exacerbation of rectocolitis, she had started infliximab associated with low doses of cortisone and mesalazine...
May 4, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28476875/traditional-cardiovascular-risk-factors-and-their-relation-to-future-surgery-for-valvular-heart-disease-or-ascending-aortic-disease-a%C3%A2-case-referent-study
#16
Johan Ljungberg, Bengt Johansson, Karl Gunnar Engström, Elin Albertsson, Paul Holmer, Margareta Norberg, Ingvar A Bergdahl, Stefan Söderberg
BACKGROUND: Risk factors for developing heart valve and ascending aortic disease are based mainly on retrospective data. To elucidate these factors in a prospective manner, we have performed a nested case-referent study using data from large, population-based surveys. METHODS AND RESULTS: A total of 777 patients operated for heart valve disease or disease of the ascending aorta had previously participated in population-based health surveys in Northern Sweden. Median time (interquartile range) from survey to surgery was 10...
May 5, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28475566/aortic-remodeling-following-sun-s-procedure-for-acute-type-a-aortic-dissection
#17
Jiawen Luo, Xianming Fu, Yangzhao Zhou, Hao Tang, Guobao Song, Tao Tang, Xiaobo Liao, Xinmin Zhou
BACKGROUND Sun's procedure is a surgical technique widely used in type A aortic dissection. The purpose of this study was to analyze clinical outcomes and morphologic changes in true and false lumen by computed tomography (CT) angiography after Sun's procedure. MATERIAL AND METHODS We retrospectively reviewed 51 patients who underwent Sun's procedure for acute Stanford type A aortic dissection extending down to iliac bifurcation between January 2013 and December 2014. The images of preoperative, one-month, three-month, and six-month follow-up were analyzed by CT angiography to measure the area and diameter of true and false lumen...
May 5, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28468950/er-stress-dependent-microparticles-derived-from-smooth-muscle-cells-promote-endothelial-dysfunction-during-thoracic-aortic-aneurysm-and-dissection
#18
Lixin Jia, Wen-Mei Zhang, Tao-Tao Li, Yan Liu, Chun-Mei Piao, You-Cai Ma, Yu Lu, Yuan Wang, Ting-Ting Liu, Yong-Fen Qi, Jie Du
Vascular smooth muscle cells (SMCs) degeneration is one of the key features of thoracic aortic aneurysm and dissection (TAAD). We and others showed that elevated endoplasmic reticulum (ER) stress causes SMCs loss and TAAD formation, however, mechanism whereby how SMCs dysfunction contributes to intimal damage, leading to TAAD remained to be explored. In the present study, In vitro assay showed elevated mechanical stretch (18% elongation, 3600 cycles/hr) stimulated ER stress response and microparticles (MPs) production from both SMCs and endothelial cells (ECs) in a time-dependent manner...
May 3, 2017: Clinical Science (1979-)
https://www.readbyqxmd.com/read/28468757/relationship-between-fibrillin-1-genotype-and-severity-of-cardiovascular-involvement-in-marfan-syndrome
#19
Romy Franken, Gisela Teixido-Tura, Maria Brion, Alberto Forteza, Jose Rodriguez-Palomares, Laura Gutierrez, David Garcia Dorado, Gerard Pals, Barbara Jm Mulder, Artur Evangelista
BACKGROUND: The effect of FBN1 mutation type on the severity of cardiovascular manifestations in patients with Marfan syndrome (MFS) has been reported with disparity results. OBJECTIVES: This study aims to determine the impact of the FBN1 mutation type on aortic diameters, aortic dilation rates and on cardiovascular events (ie, aortic dissection and cardiovascular mortality). METHODS: MFS patients with a pathogenic FBN1 mutation followed at two specialised units were included...
May 3, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28466967/anatomical-variations-of-the-renal-arterial-vasculature-an-australian-perspective
#20
Daniel T Tardo, Christopher Briggs, Gerard Ahern, Alexander Pitman, Sankar Sinha
INTRODUCTION: Variations of the renal arteries have been studied and published across various population groups, but similar information for the ethnically diverse nation of Australia is lacking. This study describes the pattern of renal artery anomalies in a section of the Australian population based on computed tomography (CT) angiograms of the abdomen and cadaveric dissection. METHODS: The renal arterial vasculature of 594 kidneys from 300 subjects (28 cadavers, 272 CT) was studied...
May 3, 2017: Journal of Medical Imaging and Radiation Oncology
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