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https://www.readbyqxmd.com/read/28319480/right-axillary-artery-cannulation-for-endovascular-repair-of-an-acute-type-a-aortic-dissection
#1
Corbin E Muetterties, Jeremy H Conklin, G William Moser, Grayson H Wheatley
We present the case of a 48-year-old woman with an acute type A aortic dissection that was treated with thoracic endovascular aortic repair at our institution. The patient was found to have a focal type A dissection with pericardial effusion but no tamponade physiology and no involvement of the aortic valve or root. We elected to treat the patient's type A aortic dissection with an endovascular stent because of the patient's favorable anatomy and no evidence of neurologic deficits or signs of distal malperfusion...
March 17, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28317163/the-value-of-diastolic-flow-reversal-in-the-descending-thoracic-aorta-as-a-determinant-of-invasively-measured-aortic-pulse-pressure
#2
Hack-Lyoung Kim, Yu Nui Kim, Hee-Jun Kim, Woo-Hyun Lim, Jae-Bin Seo, Sang-Hyun Kim, Myung-A Kim, Joo-Hee Zo
AIM: Although the diastolic flow reversal of the descending aorta has been recognized in patients with aortic regurgitation, its generation without this condition is still unknown. This study was performed to investigate whether flow patterns of the descending thoracic aorta, as measured by echocardiography, can represent invasively measured aortic pulse pressure (APP). METHODS: A total of 100 patients (age, 62.3±11.0 years; men, 62.0%) undergoing invasive coronary angiography (ICA) was analyzed...
March 19, 2017: Echocardiography
https://www.readbyqxmd.com/read/28315148/a-case-of-cardiac-tamponade-due-to-an-isolated-abscess-in-the-ascending-aorta-of-a-pregnant-woman-with-a-history-of-intravenous-substance-abuse
#3
Brandy Shattuck, John Livingstone
We describe the case of a 23-year-old white female, 10-12 weeks pregnant, with a history of intravenous drug use and a recently diagnosed pneumonia, who was found deceased in her bed after a night of sleep. Although postmortem serum toxicology tested positive for alprazolam, tetrahydrocannabinol, and morphine, the ultimate cause of death was determined to be cardiac tamponade secondary to an isolated abscess in the ascending aorta. The patient had several risk factors for aortic rupture and cardiac tamponade including intravenous drug use, pneumonia, and pregnancy...
March 17, 2017: Forensic Science, Medicine, and Pathology
https://www.readbyqxmd.com/read/28314643/acute-ascending-aortic-dissection-after-mdma-ecstasy-use-a-case-report
#4
Satoko Kanahara, Mostafa El-Refai, Nasser Lakkis, Rashed Tabbaa
Acute aortic dissection is rare among young patients in the absence of connective tissue disorders. One of the risk factors associated with aortic dissection among young patients is amphetamine use. We report a case of a 37-year-old female with a past medical history of hypertension presenting with syncope and altered mental status who was found to have an acute DeBakey Type I aortic dissection after ingestion of 3,4-methylenedioxymethamphetamine (MDMA), commonly known as ecstasy. This is the second case in the literature describing aortic dissection in relation to MDMA use...
November 15, 2016: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
https://www.readbyqxmd.com/read/28302996/spinal-cord-ischemia-secondary-to-epidural-metastasis-from-small-cell-lung-carcinoma
#5
Hirotoshi Yasui, Naoya Ozawa, Satoshi Mikami, Kenji Shimizu, Takahiro Hatta, Nami Makino, Mayu Fukushima, Satoshi Baba, Yasushi Makino
BACKGROUND Spinal cord ischemia is an uncommon event that is mainly caused by dissociation of the ascending aorta as a complication after aortic surgery. Spinal arteries can develop collateral circulation; therefore, the frequency of spinal infarction is about 1% of that in the brain. Few cases of spinal cord ischemia developing in the course of lung cancer have been reported. CASE REPORT We presented the case of a 56-year-old man with small cell lung carcinoma, cT4N2M1a (stage IV). He was treated with irradiation and 2 courses of platinum and etoposide combination chemotherapy...
March 17, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28302143/altered-aortic-3d-hemodynamics-and-geometry-in-pediatric-marfan-syndrome-patients
#6
Roel L F van der Palen, Alex J Barker, Emilie Bollache, Julio Garcia, Michael J Rose, Pim van Ooij, Luciana T Young, Arno A W Roest, Michael Markl, Joshua D Robinson, Cynthia K Rigsby
BACKGROUND: Blood flow dynamics make it possible to better understand the development of aortopathy and cardiovascular events in patients with Marfan syndrome (MFS). Aortic 3D blood flow characteristics were investigated in relation to aortic geometry in children and adolescents with MFS. METHODS: Twenty-five MFS patients (age 15.6 ± 4.0 years; 11 females) and 21 healthy controls (age 16.0 ± 2.6 years; 12 females) underwent magnetic resonance angiography and 4D flow CMR for assessment of thoracic aortic size and 3D blood flow velocities...
March 17, 2017: Journal of Cardiovascular Magnetic Resonance
https://www.readbyqxmd.com/read/28301315/time-and-age-dependent-decrease-of-nt-probnp-after-septal-myectomy-in-hypertrophic-obstructive-cardiomyopathy
#7
Hao Cui, Xi Wu, Shuiyun Wang, Bing Tang, Changsheng Zhu, Haibo Chen, Xiaohui Zhou, Rong Wu, Qinjun Yu, Xiaohong Huang
BACKGROUND: NT-proBNP level is a predictive factor in hypertrophic cardiomyopathy patients, in which left ventricular outflow tract obstruction contributes to an increased NT-proBNP level. However, studies regarding the influence of septal myectomy on NT-proBNP level in hypertrophic obstructive cardiomyopathy are lacking. METHODS: One hundred and eighty-two patients who underwent septal myectomy in Fuwai Hospital from May 2011 to March 2016 and were included in the present study...
March 16, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28301100/comparison-of-mr-flow-quantification-in-peripheral-and-main-pulmonary-arteries-in-patients-after-right-ventricular-outflow-tract-surgery-a-retrospective-study
#8
Tobias Rutz, Christian Meierhofer, Susanne Naumann, Stefan Martinoff, Peter Ewert, Heiko C Stern, Sohrab Fratz
PURPOSE: To compare the quantification of pulmonary stroke volume (SV) by phase contrast magnetic resonance (PC-MR) in the main pulmonary artery (MPA) to the sum of SVs in both peripheral pulmonary arteries (PPA) in different right ventricular (RV) outflow pathologies. MATERIALS AND METHODS: Pulmonary SV was determined by PC-MR in the MPA and the PPA in healthy individuals (H, n = 54), patients after correction for tetralogy of Fallot with significant pulmonary regurgitation and without pulmonary or RV outflow tract stenosis (PR, n = 50), and in patients with RV outflow tract or pulmonary valve stenosis (PS, n = 50)...
March 16, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/28300009/prenatal-diagnosis-of-aortopulmonary-window-associated-with-aberrant-subclavian-artery
#9
Adetola F Louis-Jacques, Sarah Obican, Thieu Nguyen, Anthony Odibo
Aortopulmonary window is a rare cardiac developmental anomaly characterised by a communication between the ascending aorta and the pulmonary artery. Aortopulmonary window may be isolated or associated with cardiac defects such as ventricular septal defect, atrial septal defect, interrupted aortic arch, and tetralogy of Fallot. We report a case of aortopulmonary window associated with aberrant subclavian artery based on fetal two-dimensional echocardiogram. The mother was referred for fetal echocardiography because of multiple fetal anomalies...
March 16, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28298661/deep-hypothermic-circulatory-arrest-vs-antegrade-cerebral-perfusion-in-cerebral-protection-during-the-surgical-treatment-of-chronic-dissection-of-the-ascending-and-arch-aorta
#10
Oksana Vasilyevna Kamenskaya, Asya Stanislavovna Klinkova, Alexander Mikhailovich Chernyavsky, Vladimir Vladimirovich Lomivorotov, Ivan Olegovich Meshkov, Alexander Mikhailovich Karaskov
Circulatory arrest during aortic surgery presents a risk of neurological complications. The present study aimed to investigate the effectiveness of deep hypothermic circulatory arrest (DHCA) vs. antegrade cerebral perfusion (ACP) in cerebral protection during the surgical treatment of chronic dissection of the ascending and arch aorta and to assess the quality-of-life (QoL) in the long-term postoperative period with respect to the used cerebral protection method. In a prospective, randomized study, 58 patients with chronic type I aortic dissection who underwent ascending aorta and aortic arch replacement surgery were included...
March 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/28296135/assessment-of-trans-aortic-pressure-gradient-using-a-coronary-pressure-wire-in-patients-with-mechanical-aortic-and-mitral-valve-prostheses
#11
Nisharahmed Kherada, Juan Carlos Brenes, Annapoorna S Kini, George D Dangas
Accurate evaluation of trans-aortic valvular pressure gradients is challenging in cases where dual mechanical aortic and mitral valve prostheses are present. Non-invasive Doppler echocardiographic imaging has its limitations due to multiple geometric assumptions. Invasive measurement of trans-valvular gradients with cardiac catheterization can provide further information in patients with two mechanical valves, where simultaneous pressure measurements in the left ventricle and ascending aorta must be obtained...
March 15, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28294669/-visceral-complications-of-the-aortic-dissections-indications-and-technique-of-the-thoracoabdominal-refenestration
#12
Csaba Dzsinich, Jenő Szolnoky, Gábor Vallus, Gábor Darabos, Gabriella Nyiri, Dániel Teknős
Aortic dissection is a life threatening cardiovascular catastrophy. Its incidence estimated to 5-6 cases per 100,000 patients/year. The intimal tear happens at the ascending aorta in Type A, meanwhile at the aortic isthmus in Type B, but entry point may develop anywhere alongside the entire aorta. All types may affect a short aortic segment resulting in a localized false aneurysm, others separate the intimal layer at longer extension down to the visceral segment and far beyond to the femoral arteries. Dissection of orifices of side branches may lead to cerebral, upper extremity, spinal, visceral, renal and lower extremity malperfusion...
March 2017: Magyar Sebészet
https://www.readbyqxmd.com/read/28291606/geometry-and-growth-of-the-reconstructed-aorta-in-patients-with-hypoplastic-left-heart-syndrome-and-variants
#13
Christoph Haller, Devin Chetan, Arezou Saedi, Rachel Parker, Glen S Van Arsdell, Osami Honjo
OBJECTIVE: The interdigitating technique in aortic arch reconstruction in hypoplastic left heart syndrome and variants (HLHS) reduces the recoarctation rate. Little is known on aortic arch growth characteristics and resulting clinical impact. METHODS: A total of 139 patients with HLHS underwent staged palliation between 2007 and 2014; 73 patients underwent arch reconstruction. Dimensions of ascending aorta, transverse arch, interdigitating anastomosis, and descending aorta in pre-stage II and pre-Fontan angiograms were measured...
February 14, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28290181/acute-type-a-aortic-dissection-beyond-the-diameter
#14
Calogera Pisano, Carmela Rita Balistreri, Oreste Fabio Triolo, Vincenzo Argano, Giovanni Ruvolo
Aortic dissection is a life-threatening condition in which early diagnosis, treatment and close follow up are critical for survival. Between 60% and 70% of patients with acute aortic dissection are affected at the ascending aorta, classified as Stanford type A (TAD). Preventive surgery of the aorta in asymptomatic patients on the basis of aortic size alone remains controversial among patient populations without known risk factors for aortic dissection. In fact, many dissection patients do not appear to have markedly dilated aortas at the time of presentation...
November 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28288887/transapical-endovascular-repair-of-thoracic-aortic-pathology
#15
Takashi Murakami, Shinsuke Nishimura, Mitsuharu Hosono, Yoshitsugu Nakamura, Etsuji Sohgawa, Yukimasa Sakai, Toshihiko Shibata
BACKGROUND: Alternative access for thoracic endovascular aortic repair (TEVAR) has been explored for patients with unsuitable femoral and iliac access, but few cases of transapical access have been described. We report our experience with transapical access for various aortic pathologies. METHODS: We reviewed six cases undergoing transapical access for endovascular repair of thoracic aortic pathology between December 2013 and August 2015. Five patients had an aortic arch aneurysm and 1 patient presented with Stanford type A subacute aortic dissection...
March 10, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28288587/the-value-of-arterial-pressure-waveform-cardiac-output-measurements-in-the-radial-and-femoral-artery-in-major-cardiac-surgery-patients
#16
A van Drumpt, J van Bommel, S Hoeks, F Grüne, T Wolvetang, J Bekkers, M Ter Horst
BACKGROUND: A relatively new uncalibrated arterial pressure waveform cardiac output (CO) measurement technique is the Pulsioflex-ProAQT® system. Aim of this study was to validate this system in cardiac surgery patients with a specific focus on the evaluation of a difference in the radial versus the femoral arterial access, the value of the auto-calibration modus and the ability to show fluid-induced changes. METHODS: In twenty-five patients scheduled for ascending aorta, aortic arch replacement, or both we measured CO simultaneously by transpulmonary thermodilution (COtd) and by using the ProAQT® system connected to the radial (COpR), as well as the femoral artery catheter (COpF)...
March 14, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28286061/tnf-alpha-antagonist-and-vascular-inflammation-in-patients-with-psoriasis-vulgaris-a-randomized-placebo-controlled-study
#17
Robert Bissonnette, François Harel, James G Krueger, Marie-Claude Guertin, Malorie Chabot-Blanchet, Juana Gonzalez, Catherine Maari, Isabelle Delorme, Charles W Lynde, Jean-Claude Tardif
BACKGROUND: Vascular inflammation is increased in patients with psoriasis. PURPOSE: This randomized, double-blind, multicenter study evaluated the effects of the tumor necrosis factor alpha (TNF-α) antagonist adalimumab on vascular inflammation in patients with psoriasis. METHOD: 107 patients were randomized (1:1) to receive adalimumab for 52 weeks OR placebo for 16 weeks followed by adalimumab for 52 weeks. Vascular inflammation was assessed with positron emission tomography-computed tomography...
March 9, 2017: Journal of Investigative Dermatology
https://www.readbyqxmd.com/read/28283881/a-case-of-double-inferior-vena-cava-with-renal-ovarian-and-iliac-vein-variation
#18
Taro Ito, Yayoi Ikeda
We encountered a rare case of an anatomic variant of inferior vena cava (IVC) duplication with renal, ovarian and iliac vein variation in an 81-year-old Japanese female cadaver during a student dissection course of anatomy at Aichi Gakuin University School of Dentistry. The two IVCs ran upwards bilaterally to the abdominal aorta. The left IVC joined with the left renal vein (RV) to form a common trunk that crossed anterior to the aorta and ended at the right IVC. We detected a vein [interiliac vein (IiV)] connecting the two IVCs at the level of the aortic bifurcation...
March 10, 2017: Anatomical Science International
https://www.readbyqxmd.com/read/28280084/anomalous-origin-of-the-circumflex-coronary-artery-presenting-with-ventricular-fibrillation-cardiac-arrest
#19
Amer Harky, Mohamad Bashir, Megan Garner, TainYen Hsia
We report a case of an incidental finding of an anomalous left circumflex coronary artery arising from the right pulmonary artery that effectuated a ventricular fibrillation cardiac arrest in a woman aged 34 years. This rarity was detected during routine work-up to delineate the cause of this arrhythmia. Our patient had a background of double-outlet right ventricle and a ventricular septal defect, which was repaired with a Dacron patch and a left ventricle patch over to the aorta at age 14 months. Angiographic study at the time of her presentation showed anomalous origin of the left circumflex artery originating from the right pulmonary artery; this was discussed in multispecialty team meeting and surgical intervention was recommended; eventually, surgery was performed with reimplantation of the anomalous circumflex artery into the ascending aorta...
March 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28276071/cfd-and-bernoulli-based-pressure-drop-estimates-a-comparison-using-patient-anatomies-from-heart-and-aortic-valve-segmentation-of-ct-images
#20
Jürgen Weese, Angela Lungu, Jochen Peters, Frank M Weber, Irina Waechter-Stehle, D Rodney Hose
PURPOSE: An aortic valve stenosis is an abnormal narrowing of the aortic valve (AV). It impedes blood flow and is often quantified by the geometric orifice area of the AV (AVA) and the pressure drop (PD). Using the Bernoulli equation, a relation between the PD and the effective orifice area (EOA) represented by the area of the vena contracta (VC) downstream of the AV can be derived. We investigate the relation between the AVA and the EOA using patient anatomies derived from cardiac computed tomography (CT) angiography images and computational fluid dynamic (CFD) simulations...
March 9, 2017: Medical Physics
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