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https://www.readbyqxmd.com/read/28550176/mechanical-behavior-and-matrisome-gene-expression-in-aneurysm-prone-thoracic-aorta-of-newborn-lysyl-oxidase-knockout-mice
#1
Marius Catalin Staiculescu, Jungsil Kim, Robert P Mecham, Jessica Wagenseil
Mutations in lysyl oxidase (LOX) are associated with thoracic aortic aneurysm and dissection (TAAD). Mice that do not express Lox (Lox(-/-)) die soon after birth and have 60% and 40% reductions in elastin- and collagen-specific crosslinks, respectively. LOX inactivation could also change the expression of secreted factors, structural matrix, and matrix-associated proteins that constitute the aortic matrisome. We hypothesize that the absence of Lox will change the mechanical behavior of the aortic wall due to reduced elastin and collagen crosslinking and alter the expression levels of matrisome and smooth muscle cell (SMC) genes in a vascular location-specific manner...
May 26, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/28544830/assessment-of-contributors-of-aortopathy-and-subclinical-left-ventricular-dysfunction-in-normally-functioning-bicuspid-aortic-valves
#2
Kamil Tuluce, Selcen Yakar Tuluce, Ersin Cagri Simsek, Serdar Bayata, Cem Nazli
BACKGROUND: Left ventricular (LV) function and the dimensions of aortic valves from normally functioning bicuspid aortic valve (BAV) patients were compared with those of healthy control patients. A comparison between patients with antero-posterior BAV (BAV-AP) or right-left BAV (BAV-RL) was also performed, and the determinants of aortopathy and LV function were investigated. METHODS: Sixty-eight patients with aortic velocities <2 m/s and trivial or mild aortic regurgitation were included in the study...
January 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28543953/improved-technical-success-postnatal-outcomes-and-refined-predictors-of-outcome-for-fetal-aortic-valvuloplasty
#3
Kevin G Friedman, Lynn A Sleeper, Lindsay R Freud, Audrey C Marshall, Max E Godfrey, Monika Drogosz, Terra Lafranchi, Carol B Benson, Louise E Wilkins-Haug, Wayne Tworetzky
BACKGROUND: Fetal aortic valvuloplasty (FAV) may prevent progression of mid-gestation aortic stenosis (AS) to hypoplastic left heart syndrome (HLHS). METHODS: We evaluate outcomes in 123 fetuses that underwent FAV between 2000 and 2015. We analyze whether technical success and biventricular (Biv) outcome changed from the early era (2000-08) to a more recent era (2009-15) and identify pre-FAV predictors of Biv outcome. We developed CART models to predict the likelihood of Biv outcome...
May 22, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28543757/transcatheter-aortic-valve-replacement-for-a-bicuspid-aortic-valve-following-replacement-of-the-ascending-aorta
#4
Paolo Nardi, Marco Russo, Guglielmo Saitto, Gian Paolo Ussia, Giovanni Ruvolo
A normally functioning bicuspid aortic valve that is spared during replacement of the ascending aorta may ultimately require replacement due to structural deterioration. We report the use of trans-aortic valve replacement to replace a stenotic BAC 17 years following replacement of the ascending aorta.
May 21, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28542808/ascending-aortic-rupture-through-a-penetrating-atherosclerotic-ulcer-a-rare-cause-of-sudden-unexpected-death
#5
Supawon Srettabunjong
Spontaneous rupture of the aorta through an atherosclerotic lesion without preexisting aortic aneurysm, dissection, or history of trauma is very rare. Without prompt aortic repair, all cases result in sudden death with a definitive diagnosis made only intraoperatively or during autopsy. The phenomenon has been uniformly found in individuals with hypertension. The author reports a sudden unexpected death caused by spontaneous rupture of the ascending aorta in a 57-year-old man with a history of hypertension...
May 23, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28541520/cardiovascular-surgery-in-loeys-dietz-syndrome-types-1-4
#6
Kirsten Krohg-Sørensen, Per Snorre Lingaas, Runar Lundblad, Egil Seem, Benedicte Paus, Odd R Geiran
OBJECTIVES: The first publication of Loeys-Dietz syndrome (LDS) described aortic rupture at young ages. Experience with new LDS types showed that the clinical course varies, and thresholds for prophylactic surgery are discussed. As this is an uncommon disease, experience needs to be shared. METHODS: Retrospective review of patients with LDS types 1-4 undergoing cardiovascular surgery during the years 1991-2016. RESULTS: Thirty-five patients (including 6 children with LDS2) underwent 57 operations...
May 24, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28539128/impaired-cardiac-output-during-exercise-in-adults-operated-for-ventricular-septal-defect-in-childhood-a-hitherto-unrecognised-pathophysiological-response
#7
Benjamin Asschenfeldt, Johan Heiberg, Steffen Ringgaard, Marie Maagaard, Andrew Redington, Vibeke E Hjortdal
BACKGROUND: Recent studies have demonstrated that surgical ventricular septal defect closure in childhood is associated with reduced functional capacity and disruption of the right ventricular force-frequency relationship during exercise. To further describe long-term cardiac function, we performed a non-invasive assessment of cardiac index during exercise in adults having undergone surgery for ventricular septal defect in early childhood. METHODS: A total of 20 patients (surgical age 2...
May 25, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28536892/patient-specific-stress-analyses-in-the-ascending-thoracic-aorta-using-a-finite-element-implementation-of-the-constrained-mixture-theory
#8
S Jamaleddin Mousavi, Stéphane Avril
It is now a rather common approach to perform patient-specific stress analyses of arterial walls using finite-element models reconstructed from gated medical images. However, this requires to compute for every Gauss point the deformation gradient between the current configuration and a stress-free reference configuration. It is technically difficult to define such a reference configuration, and there is actually no guarantee that a stress-free configuration is physically attainable due to the presence of internal stresses in unloaded soft tissues...
May 23, 2017: Biomechanics and Modeling in Mechanobiology
https://www.readbyqxmd.com/read/28535198/transcatheter-aortic-valve-implantation-for-recurrent-valsalva-sinus-re-dissection-and-severe-aortic-regurgitation-shortly-after-surgery-for-type-a-aortic-dissection
#9
Elena Caporali, Giovanni Pedrazzini, Stefanos Demertzis, Enrico Ferrari
Delayed aortic regurgitation following Valsalva sinus re-dissection is a well-known complication that can occur at any time after surgery for type-A aortic dissection without root replacement. We describe a case of acute type-A dissection in an 81-year-old lady successfully treated with aortic valve resuspension and ascending aorta replacement with a 28-mm vascular graft. A month later, the patient was readmitted for worsening heart failure and a transthoracic echocardiogram showed severe aortic regurgitation secondary to non-coronary Valsalva sinus re-dissection and non-coronary aortic valve leaflet prolapse also confirmed at computed tomography scan...
May 23, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28533581/bicuspid-aortic-valve-an-unusual-cause-of-aneurysm-of-left-coronary-sinus-of-valsalva
#10
Euden Bhutia, Dinesh Kumar, Binoy Shankar, Shakti Pad Das, Sunil Kishore
Bicuspid aortic valve is traditionally considered an innocuous congenital anomaly. Due to a better and widespread availability of non-invasive imaging techniques, it has come to the fore that 30% of these cases develop complications, viz., valve abnormality (aortic regurgitation and stenosis), and aneurysm of aortic root and ascending aorta. Sinus of Valsalva aneurysm is an uncommon complication of bicuspid aortic valve and more so those arising from the left coronary sinus are the rarest. These complications generally occur in the third or fourth decade of life...
May 2017: Iranian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28530132/development-of-a-high-fidelity-pressurized-porcine-beating-heart-simulator-for-cardiac-surgery-training
#11
Igo B Ribeiro, Janet M C Ngu, Gurinder Gill, Fraser D Rubens
BACKGROUND: Development of a high-fidelity cardiac surgery simulator (CSS) requires integration of a heart model with a mock cardiopulmonary bypass (CPB) circuit that can provide feedback to mimic the pathophysiology of cardiac surgery. However, the cost of commercially available simulators precludes regular use. We describe steps in the construction of a high-fidelity CSS that integrates a pulsatile paracorporeal ventricular-assist device (Pulse-VAD) and a commercially available CPB simulator...
May 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28528071/a-new-technique-for-graft-to-graft-anastomosis-to-reconstruct-the-aortic-arch
#12
Bashi V Velayudhan, A Mohammed Idhrees
When the ascending aorta and aortic arch must be replaced with a vascular graft, two separate grafts are often required to reconstruct a more anatomically configured aorta. We describe a method of graft tailoring that will result in a more natural shape of the neoaorta, avoiding kinking at the junction of the ascending aorta and the aortic arch.
June 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28528047/sclerosing-aortic-and-coronary-arteritis-due-to-igg4-related-disease
#13
Mikael Barbu, Ulf Lindström, Claes Nordborg, Andreas Martinsson, Christian Dworeck, Anders Jeppsson
We present the case of a 55-year-old woman admitted for a coronary artery bypass operation because of three-vessel coronary artery disease based on angiographic findings and clinical symptoms. Unexpected intraoperative findings with diffuse tissue thickening of the ascending aorta and coronary arteries indicated an alternate pathogenesis rather than coronary artery atherosclerosis. Histopathologic findings and clinical evaluation could confirm IgG4-related disease (IgG4-RD). IgG4-RD is a newly recognized fibroinflammatory condition that can present in a variety of organs and is characterized by common histopathologic features...
June 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28526040/catching-a-floating-thrombus-a-case-report-on-the-treatment-of-a-large-thrombus-in-the-ascending-aorta
#14
Gijs Eduard de Maat, Giorgio Vigano, Massimo Alessandro Mariani, Ehsan Natour
BACKGROUND: The ascending aorta is an uncommon site for non-infective thrombus. In non-aneurysmal and non-atherosclerotic vessels this condition becomes extremely rare, while it represents a source of potential cerebral and peripheral embolic events. Currently, there is no consensus in the guidelines on how to treat a free floating thrombus in ascending aorta, therefore we present our decision making process and therapeutic strategy. CASE PRESENTATION: A healthy 48-year-old man was hospital admitted with acute abdominal pain...
May 19, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28523430/long-term-durability-of-preserved-aortic-root-after-repair-of-acute-type-a-aortic-dissection
#15
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/28521602/dynamic-alterations-in-cerebral-celiac-and-renal-flows-resulting-from-ascending-aorta-subclavian-artery-and-femoral-artery-cannulations-of-extracorporeal-devices
#16
Sahin Iscan, Habib Cakir, Bortecin Eygi, Ismail Yurekli, Koksal Donmez, Pınar Unde Ayvat, Derya Sarıkaya Pekel, Mert Kestelli
INTRODUCTION: The aim of this study was to assess the relationships among cardiac output, extracorporeal blood flow, cannulation site, right (RCa) and left carotid (LCa), celiac (Ca) and renal artery (Ra) flows during extracorporeal circulation. METHODS: A mock circulatory circuit was assembled, based on a compliant anatomical aortic model. The ascending aorta, right subclavian and femoral artery cannulations were created and flow was provided by a centrifugal pump (Cp); cardiac output was provided by a roller pump (Rp)...
May 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28516212/anatomical-visualization-of-neural-course-and-distribution-of-anterior-ascending-aortic-plexus
#17
Tomokazu Kawashima, Fumi Sato
The aim of this study was to document the detailed anatomy of neural course and distribution on the anterior ascending aorta, to identify the high and low density areas of the anterior ascending aortic plexus for further understandings in cardiovascular surgery. The embalmed hearts of 42 elderly individuals were submacroscopically and microscopically examined, after excluding any that were macroscopically abnormal. With its origins in the anterior ascending aortic plexus, the right coronary plexus substantially innervated the right coronary artery, the right atrium and ventricle, and the sinus node...
May 17, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28516099/conservative-management-of-extensive-iatrogenic-aortic-dissection
#18
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
#19
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/28515742/the-use-of-intraoperative-epiaortic-ultrasonography-in-monitoring-patients-over-75-years-old-treated-with-aortic-valve-replacement
#20
Tomasz Niklewski, Michał Zembala, Dariusz Puszczewicz, Paweł Nadziakiewicz, Wojciech Karolak, Marian Zembala
INTRODUCTION: Epiaortic ultrasound scanning (EAS) extended the use of ultrasound to the intraoperative diagnosis of aortic pathology. Surgical palpation of the ascending aorta underestimates the presence and severity of atherosclerotic plaques. Epiaortic ultrasound scanning has been used as an adjunct to transesophageal echocardiography (TEE) or as a primary direct diagnostic tool for imaging the ascending aorta as well as the aortic arch, which gained prominence as part of a multipronged intraoperative strategy to reduce atherosclerotic emboli...
March 2017: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
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