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Aorta dissection

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https://www.readbyqxmd.com/read/28214965/surgical-correction-of-aberrant-right-coronary-anomalies-stranding-an-aortic-commissure-with-and-without-unroofing
#1
Khaled Abdelhady, Samarth Durgam, Chawki Elzein, Michel N Ilbawi, David Rhoiney, Malek G Massad
The technique for successful surgical correction of an anomalous origin of the right coronary artery from the opposite aortic cusp with an aberrant course between the aorta and pulmonary artery is illustrated in a symptomatic 62-year-old woman. The intramural course of the right coronary artery traversed the tip of the commissure between the anterior and posterior leaflets, and its repair entailed unroofing of the intramural segment from inside the aortic intima. This technique required resuspension of the overlying commissure to maintain optimal aortic valve leaflet coaptation and prevent aortic insufficiency...
February 18, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28207465/two-rare-variants-of-left-vertebral-artery
#2
Rajani Singh
Though the variations of vertebral artery are clinically asymptomatic yet abnormalities are of diagnostic importance either prior to vascular surgery in the neck region or in patients of intravascular diseases such as arteriovenous malformations or cerebral aneurysms. Therefore, the aim of the study is to bring out 2 variations in the configuration of vertebral artery and their clinical implication. During dissection of thorax of 2 female cadavers, 2 different variants of configurations of left vertebral arteries were observed...
February 15, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28206818/sudden-death-due-to-aortic-dissection-in-early-pregnancy-a-case-report
#3
Akshith Rs Shetty, Y P Girish Chandra, S Praveen, Somusekhar Gajula
Forensic pathologists come across many deaths due to natural causes which are sudden. Sudden natural deaths in females who are pregnant warrant thorough investigation and a medico-legal autopsy to rule out any foul play. Here, we report a case of 21-year-old primigravida in her first trimester who suddenly complained of severe chest pain and was brought dead to the hospital with no history suggestive of prior natural disease. At autopsy, the death was attributed to dissection of ascending aorta.
January 1, 2017: Medico-legal Journal
https://www.readbyqxmd.com/read/28190713/transient-atrial-fibrillation-after-open-abdominal-aortic-revascularization-surgery-is-associated-with-increased-length-of-stay-mortality-and-readmission-rates
#4
Barbara A Blanco, Anai N Kothari, Pegge M Halandras, Robert H Blackwell, Dawn M Graunke, Paul C Kuo, Jae S Cho
BACKGROUND: It is well established that transient postoperative atrial fibrillation (TPAF) is associated with adverse postoperative outcomes after major cardiac and noncardiac operations. The purpose of this study was to elucidate the incidence, impact, and risk factors associated with the development of TPAF in patients undergoing revascularization surgery for occlusive diseases of the abdominal aorta and its branches (AAB). METHODS: By use of the Healthcare Cost and Utilization Project State Inpatient Database from Florida and California, patients who underwent open revascularization of AAB between 2006 and 2011 were identified...
February 9, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28188564/usefulness-of-the-echocardiographic-paravertebral-approach-for-the-diagnosis-of-descending-thoracic-aortic-dissection
#5
Shoko Yamaguchi, Hironori Murakami, Tomoko Kudo, Chiharu Otokozawa, Shunsuke Sasaki, Satoshi Yuda, Masanori Nojima
BACKGROUND: Transthoracic echocardiography (TTE) is not recommended as the first-line diagnostic modality for Stanford type B aortic dissection (type-B AD). PURPOSES: The aims of this study were to evaluate the usefulness and factors influencing for the diagnosis of type-B AD using the transthoracic echocardiographic paravertebral approach (PVA). METHODS: We compared the image acquisition rate of descending thoracic aorta (DTA) and the diagnostic rate of type-B AD using TTE versus PVA...
February 10, 2017: Journal of Echocardiography
https://www.readbyqxmd.com/read/28185953/a-novel-smad3-mutation-caused-multiple-aneurysms-in-a-patient-without-osteoarthritis-symptoms
#6
Audrey Courtois, Wouter Coppieters, Vincent Bours, Jean-Olivier Defraigne, Alain Colige, Natzi Sakalihasan
Heterozygous mutations in the SMAD3 gene were recently described as the cause of a form of non-syndromic familial aortic thoracic aneurysm and dissection (FTAAD) transmitted as an autosomal dominant disorder and often associated with early-onset osteoarthritis. This new clinical entity, called aneurysms-osteoarthritis syndrome (AOS) or Loeys-Dietz syndrome 3 (LDS3), is characterized by aggressive arterial damages such as aneurysms, dissections and tortuosity throughout the arterial tree. We report, here, the case of a 45 year-old man presenting multiple visceral arteries and abdominal aortic aneurysms but without dissection of the thoracic aorta and without any sign of osteoarthritis...
February 6, 2017: European Journal of Medical Genetics
https://www.readbyqxmd.com/read/28184962/magnetic-resonance-imaging-4-d-flow-based-analysis-of-aortic-hemodynamics-in-turner-syndrome
#7
Raoul Arnold, Marie Neu, Daniel Hirtler, Charlotte Gimpel, Michael Markl, Julia Geiger
BACKGROUND: Cardiovascular surveillance is important in Turner syndrome because of the increased risk of aortic dilation and dissection with consecutively increased mortality. OBJECTIVE: To compare 4-D flow MRI for the characterization of aortic 3-D flow patterns, dimensions and vessel wall parameters in pediatric patients with Turner syndrome and age-matched controls. MATERIALS AND METHODS: We performed 4-D flow MRI measuring in vivo 3-D blood flow with coverage of the thoracic aorta in 25 patients with Turner syndrome and in 16 female healthy controls (age mean ± standard deviation were 16 ± 5 years and 17 ± 4 years, respectively)...
February 9, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28183174/the-petticoat-concept-for-endovascular-treatment-of-type-b-aortic-dissection
#8
Luca Bertoglio, Enrico Rinaldi, Germano Melissano, Roberto Chiesa
INTRODUCTION: A systematic literature search on outcomes of the PETTICOAT technique was aimed at verifying the feasibility and safety of the procedure, comparing clinical outcomes with standard stent-grafting of the proximal entry tear as well as describing the possible benefits in terms of aortic remodeling. EVIDENCE ACQUISITION: Potentially eligible papers were sought through a computerized search of MEDLINE and SCOPUS databases between January 2006 and June 2016...
February 9, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28181450/management-of-iatrogenic-aortal-dissection-as-a-complication-of-coronary-intervention-wait-and-watch
#9
Rajesh Dandale, Alexander Krapivsky, Feraydoon Niroomand
Iatrogenic aortic dissection (AD) is quite a rare complication during percutaneous coronary intervention (PCI). The exact mechanism of iatrogenic AD during PCI is unknown. A standard of care in the management of iatrogenic AD is still lacking. We describe a case of an 83-year-old man, with an aortocoronary bypass graft, who underwent complex PCI with rotational atherectomy catheterization with a radial approach for a chronic right coronary artery stenosis, complicated by AD. According to our experience, retrograde dissection into the aorta during PCI can be sealed with a coronary stent that covers the coronary ostium and should be treated conservatively in most circumstances, unless complication like extension of dissection into other vessels or pericardial effusion or hemodynamic instability occurs...
February 9, 2017: Future Cardiology
https://www.readbyqxmd.com/read/28180096/the-frozen-elephant-trunk-technique-european-association-for-cardio-thoracic-surgery-position-and-bologna-experience
#10
REVIEW
Luca Di Marco, Antonio Pantaleo, Alessandro Leone, Giacomo Murana, Roberto Di Bartolomeo, Davide Pacini
Complex lesions of the thoracic aorta are traditionally treated in 2 surgical steps with the elephant trunk technique. A relatively new approach is the frozen elephant trunk (FET) technique, which potentially allows combined lesions of the thoracic aorta to be treated in a 1-stage procedure combining endovascular treatment with conventional surgery using a hybrid prosthesis. These are very complex and time-consuming operations, and good results can be obtained only if appropriate strategies for myocardial, cerebral, and visceral protection are adopted...
February 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28174405/-thoracic-endovascular-aortic-repair-for-a-descending-thoracic-aneurysm-associated-with-pseudocoarctation-of-the-aorta-report-of-a-case
#11
Hiroaki Aida, Satoru Kagaya, Kazuo Abe
A 77-year-old man with a descending thoracic aneurysm associated with pseudocoarctation of the aorta underwent thoracic endovascular aortic repair (TEVAR). Computed tomography demonstrated kinking of the descending thoracic aorta. The aneurysm was located distal to a kinking and constricting aortic isthmus. TEVAR was performed because of the patient's comorbidity such as valvular heart diseases and postradiation status for the thoracic Hodgkin disease. TEVAR was successful but small aortic dissection was occurred distal to the stentgraft...
February 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28173744/glutathione-system-participation-in-thoracic-aneurysms-from-patients-with-marfan-syndrome
#12
Alejandra María Zúñiga-Muñoz, Israel Pérez-Torres, Verónica Guarner-Lans, Elías Núñez-Garrido, Rodrigo Velázquez Espejel, Claudia Huesca-Gómez, Ricardo Gamboa-Ávila, María Elena Soto
Aortic dilatation in Marfan syndrome (MFS) is progressive. It is associated with oxidative stress and endothelial dysfunction that contribute to the early acute dissection of the vessel and can result in rupture of the aorta and sudden death. We evaluated the participation of the glutathione (GSH) system, which could be involved in the mechanisms that promote the formation and progression of the aortic aneurysms in MFS patients. Patients and methods: Aortic aneurysm tissue was obtained during chest surgery from eight control subjects and 14 MFS patients...
February 8, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/28165556/complicated-thoraco-abdominal-aortic-dissection-presenting-with-lower-limb-ischemia-in-a-patient-with-bovine-arch-and-arteria-lusoria
#13
G-R Joliat, C Dubuis, S Déglise
We report the case of a 58-year-old man who presented with thoraco-abdominal pain and right lower limb ischemia due to type B aortic dissection. Moreover, the patient was discovered to have several concomitant aortic arch anomalies (bovine arch, arteria lusoria, and left vertebral artery arising from the aortic arch). Taking into account this complex anatomy, emergent femoral exploration with fenestration and thrombectomy was performed. The blood flow to the right lower limb was restored. A few days later the aortic dissection spread proximally, and the aortic arch dilatation enlarged...
January 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28161919/cysts-of-the-iris-pigment-epithelium-what-is-new-and-interesting-the-2016-jose-rizal-international-medal-lecture
#14
REVIEW
Jerry A Shields, Carol L Shields
PURPOSE: Cysts of the iris pigment epithelium (IPE) can involve the pupillary margin, midzone, or peripheral location or can be free-floating in the aqueous or vitreous or lodged in the anterior chamber angle. Avariant of IPE cyst, known as iris flocculi, can be a marker for systemic thoracic aneurysm. DESIGN: Review of IPE cysts and description of new observations of the lesions. METHODS: Review of IPE cysts. RESULTS: Lesions in 672 eyes were classified as of the pupillary margin (n = 49; 7%), midzone (n = 188; 28%), peripheral (n = 424; 63%), or dislodged/free-floating (n = 11; 2%)...
January 2017: Asia-Pacific Journal of Ophthalmology
https://www.readbyqxmd.com/read/28161685/bilateral-approach-for-thoracoscopic-esophagectomy-with-lymph-node-dissection-in-the-dorsal-area-of-the-thoracic-aorta-in-patients-with-esophageal-cancer-a-report-of-two-cases
#15
Yu Onodera, Toru Nakano, Takahiro Heishi, Tadashi Sakurai, Yusuke Taniyama, Chiaki Sato, Noriaki Ohuchi, Takashi Kamei
INTRODUCTION: The incidence of lymph node metastasis in the dorsal area of the thoracic aorta (DTA) is relatively low in patients with esophageal cancer. It is difficult to approach the DTA using surgical procedures, such as an open thoracotomy and thoracoscopy in the left decubitus position. CASE PRESENTATION: Case 1: A 70-year-old man with esophageal cancer underwent thoracoscopic esophagectomy with mediastinal lymph node dissection via a right thoracoscopic approach, followed by lymphadenectomy in the DTA via left thoracoscopy in the prone position...
January 19, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28159859/surgical-indication-for-chronic-aortic-dissection-in-descending-thoracic-and-thoracoabdominal-aorta
#16
Tatsuya Oda, Kenji Minatoya, Hiroaki Sasaki, Hiroshi Tanaka, Yoshimasa Seike, Tatsuya Itonaga, Yosuke Inoue, Masahiro Higashi, Kunihiro Nishimura, Junjiro Kobayashi
BACKGROUND: To address the lack of information about the size of ruptures associated with chronic dissection in the descending and thoracoabdominal aorta, we evaluated the natural history of this pathology. METHODS AND RESULTS: We analyzed data from 571 patients (mean age, 69.4±11.6 years) with unrepaired chronic aortic dissection in the descending or thoracoabdominal aorta with a maximal aortic diameter of ≥3.5 cm from 2007 to 2014. This was a cross-sectional study...
February 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28155679/the-risk-of-stanford-type-a-aortic-dissection-with-different-tear-size-and-location-a-numerical-study
#17
Yue Shi, Minjia Zhu, Yu Chang, Huanyu Qiao, Yongmin Liu
BACKGROUND: This study is to investigate the influence of hemodynamics on Stanford type-A aortic dissection with different tear size and location, to provide some support for the relationships between the risks (rupture, reverse tearing and further tearing) and tear size and location for clinical treatment. METHODS: Four numerical models of Stanford type-A aortic dissection were established, with different size and location of the tears. The ratio of the area between the entry and re-entry tears(RA) is various within the model; while, the size and the location of the re-entry in the distal descending aorta are fixed...
December 28, 2016: Biomedical Engineering Online
https://www.readbyqxmd.com/read/28153878/nlrp3-nucleotide-oligomerization-domain-like-receptor-family-pyrin-domain-containing-3-caspase-1-inflammasome-degrades-contractile-proteins-implications-for-aortic-biomechanical-dysfunction-and-aneurysm-and-dissection-formation
#18
Darrell Wu, Pingping Ren, Yanqiu Zheng, Lin Zhang, Gaiping Xu, Wanmu Xie, Eric E Lloyd, Sui Zhang, Qianzi Zhang, John A Curci, Joseph S Coselli, Dianna M Milewicz, Ying H Shen, Scott A LeMaire
OBJECTIVE: Increasing evidence suggests that contractile dysfunction in smooth muscle cells (SMCs) plays a critical role in aortic biomechanical dysfunction and aortic aneurysm and dissection (AAD) development. However, the mechanisms underlying SMC contractile dysfunction in sporadic AAD are poorly understood. In this study, we examined the role of the NLRP3 (nucleotide oligomerization domain-like receptor family, pyrin domain containing 3)-caspase-1 inflammasome, a key inflammatory cascade, in SMC contractile dysfunction in AAD...
February 2, 2017: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/28149606/who-is-at-risk-of-dissection-or-rupture-in-moderately-dilated-ascending-aorta
#19
EDITORIAL
Pyung Chun Oh, Woong Chol Kang
No abstract text is available yet for this article.
December 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28134482/modelling-of-aortic-aneurysm-and-aortic-dissection-through-3d-printing
#20
Daniel Ho, Andrew Squelch, Zhonghua Sun
INTRODUCTION: The aim of this study was to assess if the complex anatomy of aortic aneurysm and aortic dissection can be accurately reproduced from a contrast-enhanced computed tomography (CT) scan into a three-dimensional (3D) printed model. METHODS: Contrast-enhanced cardiac CT scans from two patients were post-processed and produced as 3D printed thoracic aorta models of aortic aneurysm and aortic dissection. The transverse diameter was measured at five anatomical landmarks for both models, compared across three stages: the original contrast-enhanced CT images, the stereolithography (STL) format computerised model prepared for 3D printing and the contrast-enhanced CT of the 3D printed model...
January 30, 2017: Journal of Medical Radiation Sciences
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