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https://www.readbyqxmd.com/read/28935306/suprasternal-aortic-valve-replacement-key-technology-and-techniques
#1
Andy C Kiser, Thomas G Caranasos, Mark D Peterson, Christopher E Buller, Michael A Borger
PURPOSE: Suprasternal transcatheter aortic valve replacement offers patients, with unsuitable femoral artery anatomy, an alternative to transapical, direct aortic, and subclavian approaches. DESCRIPTION: The Transit System (Aegis Surgical, Galway, Ireland) enables transcatheter aortic valve replacement directly into the ascending aorta or innominate artery through a small, suprasternal incision. The valve introducer sheath is inserted through a standard pursestring suture, which facilitates secure arterial closure...
October 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28930095/robust-and-practical-non-invasive-estimation-of-local-arterial-wave-speed-and-mean-blood-velocity-waveforms
#2
Remi Kowalski, Richard Beare, Marie Willemet, Jordi Alastruey, Joseph J Smolich, Michael M H Cheung, Jonathan P Mynard
Local arterial wave speed, a surrogate of vessel stiffness, can be estimated via the pressure-velocity (PU) and diameter-velocity (ln(D)U) loop methods. These assume negligible early-systolic reflected waves (RWes) and require measurement of cross-sectionally averaged velocity (U<sub>mean</sub>), which itself is a valuable quantity related to volumetric blood flow. However, RWes may not always be negligible and routine Doppler ultrasound typically provides maximum velocity waveforms or estimates of mean velocity subject to various errors (U<sub>raw</sub>)...
September 20, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/28925322/unusual-intramural-coronary-artery-with-vertical-course-complicating-an-arterial-switch-operation
#3
Lok Sinha, Richard A Jonas, Pranava Sinha
Intramural coronary arteries in patients with d-transposition of the great arteries (d-TGA) usually arise from the opposite sinus of Valsalva and traverse horizontally across the posterior/facing commissure before emerging externally from the appropriate sinus of Valsalva. Failure to make appropriate technical modifications during coronary transfer can result in an important risk of posttransfer ischemia. We report a case with an unusual course of an intramural left anterior descending (LAD) coronary artery in a patient with d-TGA, with origin at the mid ascending aorta and a vertical intramural course, increasing the susceptibility to injury during an arterial switch operation (ASO)...
January 1, 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28925047/voxel-by-voxel-4d-flow-mri-based-assessment-of-regional-reverse-flow-in-the-aorta
#4
Xin Shen, Susanne Schnell, Alex J Barker, Kenichiro Suwa, Lingzi Tashakkor, Kelly Jarvis, James C Carr, Jeremy D Collins, Shyam Prabhakaran, Michael Markl
BACKGROUND: Complex and reverse flow in the aorta has been implicated in aneurysm development and stroke via retrograde embolization. PURPOSE: To evaluate global and regional differences between standard 2D plane-based and volumetric voxel-based quantification of regional forward/reverse flow, and reverse flow fraction (RFF) in the aorta. STUDY TYPE: Retrospective. SUBJECTS: In all, 35 subjects: 10 healthy controls (age: 57 ± 7 years, nine male), nine patients without aortic valve regurgitation (AR) (age: 63 ± 10 years, seven male), six patients with mild AR (age: 66 ± 6 years, five male), and 10 with moderate or severe AR (age: 60 ± 16 years, eight male)...
September 18, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/28921052/in-vitro-evaluation-of-flow-patterns-and-turbulent-kinetic-energy-in-trans-catheter-aortic-valve-prostheses
#5
Daniel Giese, Kilian Weiss, Bettina Baeßler, Navid Madershahian, Yeong-Hoon Choi, David Maintz, Alexander C Bunck
OBJECTIVES: The objective of the current work was to evaluate flow and turbulent kinetic energy in different transcatheter aortic valve implants using highly undersampled time-resolved multi-point 3-directional phase-contrast measurements (4D Flow MRI) in an in vitro setup. MATERIALS AND METHODS: A pulsatile flow setup was used with a compliant tubing mimicking a stiff left ventricular outflow tract and ascending aorta. Five different implants were measured using a highly undersampled multi-point 4D Flow MRI sequence...
September 18, 2017: Magma
https://www.readbyqxmd.com/read/28917157/density-of-calcium-in-the-ascending-thoracic-aorta-and-risk-of-incident-cardiovascular-disease-events
#6
Isac C Thomas, Robyn L McClelland, Erin D Michos, Matthew A Allison, Nketi I Forbang, W T Longstreth, Wendy S Post, Nathan D Wong, Matthew J Budoff, Michael H Criqui
BACKGROUND AND AIMS: The volume and density of coronary artery calcium (CAC) both independently predict cardiovascular disease (CVD) beyond standard risk factors, with CAC density inversely associated with incident CVD after accounting for CAC volume. We tested the hypothesis that ascending thoracic aorta calcium (ATAC) volume and density predict incident CVD events independently of CAC. METHODS: The Multi-Ethnic Study of Atherosclerosis (MESA) is a prospective cohort study of participants without clinical CVD at baseline...
September 7, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/28916127/open-thoracic-and-thoraco-abdominal-aortic-repair-in-patients-with-connective-tissue-disease
#7
Paula R Keschenau, Drosos Kotelis, Jeroen Bisschop, Mohammad E Barbati, Jochen Grommes, Barend Mees, Alexander Gombert, Arnoud G Peppelenbosch, Geert Willem H Schurink, Johannes Kalder, Michael J Jacobs
OBJECTIVE/BACKGROUND: The aim is to present current results of open complex aortic repair in patients with connective tissue disease (CTD). METHODS: This was a retrospective cross-border, single centre study. From February 2000 to April 2016 72 aortic operations were performed on 65 patients with CTD (41 male, median age 41 years [range 19-70 years]). Fifty-six patients (86%) underwent at least one previous aortic repair (71 open, four endovascular), including 33 patients (51%) operated before at the site of the procedure reported here...
September 12, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28910688/aortic-fibromuscular-dysplasia-complicated-by-dissection-a-case-report-and-review-of-literature
#8
Takashi Tasaki, Kazuhito Hatanaka, Mari Kirishima, Shun Ohnishi, Yuko Goto, Ikumi Kitazono, Tsubasa Hiraki, Sohsuke Yamada, Michiyo Higashi, Akihide Tanimoto
Fibromuscular dysplasia (FMD) is an idiopathic, segmental, nonatherosclerotic, non-inflammatory vascular disease, which is often complicated by the occurrence of dissection. Although it is known to occur in all arteries, aortic involvement is relatively rare. To date, 33 cases of aortic FMD have been reported in available English literature, among which only three cases have been complicated by the occurrence of dissection. We describe the case of a 40-year-old woman diagnosed with aortic FMD complicated by the occurrence of a type A aortic dissection...
August 9, 2017: Cardiovascular Pathology: the Official Journal of the Society for Cardiovascular Pathology
https://www.readbyqxmd.com/read/28906534/management-of-a-complicated-redo-giant-dissecting-aortic-aneurysm
#9
Ibrahim Kara, Alper Erkin, MHalil Ibrahim Erkengel, Kiyasettin Asil
Giant aortic aneurysm is defined as an aneurysm of the aorta of greater than 10 cm in diameter. This rare condition is associated with a high risk of morbidity and mortality and it may lead to fatal complications such as rupture and/or dissection if not managed with proper surgical planning and expertise. Other than atherosclerosis, the main causes of giant ascending aortic aneurysms include Marfan and Ehlers-Danhlos syndromes. Herein we report on a young male patient who had had an aortic valve replacement five years earlier due to a bicuspid aortic valve leading to aortic failure, accompanied by aortic coarctation...
July 23, 2017: Cardiovascular Journal of Africa
https://www.readbyqxmd.com/read/28905979/-cyanosis-in-a-calf-with-a-double-outlet-right-ventricle
#10
Nicola Wiedemann, Nicolai Hildebrandt, Manfred Henrich, Estelle Henrich, Matthias Schneider
A 4-day-old female Holstein Friesian calf was presented for evaluation of cyanosis and dyspnea. On auscultation, severe bronchovesicular sounds and a systolic heart murmur of grade IV/VI above the tricuspid valve were found. On echocardiography, a marked dextroposition of the aorta (> 50% originating from the right ventricle), leading to both great arteries arising from the right ventricle - a so-called double-outlet right ventricle - was detected. Two ventricular septal defects were present, one in the perimembranous, subpulmonary region, the other non-committed in the muscular region...
September 13, 2017: Tierärztliche Praxis. Ausgabe G, Grosstiere/Nutztiere
https://www.readbyqxmd.com/read/28905268/fluid-and-biomechanical-analysis-of-ascending-thoracic-aorta-aneurysm-with-concomitant-aortic-insufficiency
#11
F Condemi, S Campisi, M Viallon, T Troalen, G Xuexin, A J Barker, M Markl, P Croisille, O Trabelsi, C Cavinato, A Duprey, S Avril
We present a comprehensive and original framework for the biomechanical analysis of patients affected by ascending thoracic aorta aneurysm and aortic insufficiency. Our aim is to obtain crucial indications about the role played by deranged hemodynamics on the ATAAs risk of rupture. Computational fluid dynamics analysis was performed using patient-specific geometries and boundary conditions derived from 4D MRI. Blood flow helicity and wall shear stress descriptors were assessed. A bulge inflation test was carried out in vitro on the 4 ATAAs after surgical repair...
September 13, 2017: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/28905233/gated-thoracic-magnetic-resonance-angiography-at-3t-noncontrast-versus-blood-pool-contrast
#12
Chengcheng Zhu, Henrik Haraldsson, Kimberly Kallianos, Liang Ge, Elaine Tseng, Travis Henry, David Saloner, Michael D Hope
Both noncontrast and contrast-enhanced approaches to gated thoracic magnetic resonance angiography (MRA) for aortic root evaluation have been reported at 3T. We compare qualitative and quantitative image quality measures for the two approaches, and assess the reproducibility of standard aortic measurements. Respiratory and cardiac gated MRA of the chest was performed at 3T in 45 patients: 23 after administration of iron-based blood pool contrast, and 22 without contrast. Image quality was assessed with a 5-point Likert scale, vessel lumen-to-muscle contrast ratios, and vessel wall sharpness...
September 13, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28904928/prenatal-sonographic-diagnosis-of-hypoplastic-left-heart-syndrome
#13
Raghu Teja Sadineni, B Santh Kumar, N B Chander, Durga Mahita Boppana
Hypoplastic left heart syndrome (HLHS) represents a variety of cardiac malformations that may result from errors in the early stages of cardiac development. HLHS includes a wide spectrum of cardiac malformations including hypoplasia of the left ventricle, ascending aorta, hypoplasia, or atresia of the aortic and mitral valves. Over the recent years, the improved resolution of advanced equipment with awareness and increased performance of second-trimester ultrasound examinations for the assessment of fetal anomalies have helped in understanding the spectrum and have expanded our knowledge of HLHS...
July 2017: International Journal of Applied and Basic Medical Research
https://www.readbyqxmd.com/read/28903936/aortic-valve-stenosis-alters-expression-of-regional-aortic-wall-shear-stress-new-insights-from-a-4-dimensional-flow-magnetic-resonance-imaging-study-of-571-subjects
#14
Pim van Ooij, Michael Markl, Jeremy D Collins, James C Carr, Cynthia Rigsby, Robert O Bonow, S Chris Malaisrie, Patrick M McCarthy, Paul W M Fedak, Alex J Barker
BACKGROUND: Wall shear stress (WSS) is a stimulus for vessel wall remodeling. Differences in ascending aorta (AAo) hemodynamics have been reported between bicuspid aortic valve (BAV) and tricuspid aortic valve patients with aortic dilatation, but the confounding impact of aortic valve stenosis (AS) is unknown. METHODS AND RESULTS: Five hundred seventy-one subjects underwent 4-dimensional flow magnetic resonance imaging in the thoracic aorta (210 right-left BAV cusp fusions, 60 right-noncoronary BAV cusp fusions, 245 tricuspid aortic valve patients with aortic dilatation, and 56 healthy controls)...
September 13, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28902822/assessing-the-effect-of-endoprosthetic-repair-of-the-thoracic-portion-on-aortic-remodelling-after-surgical-correction-for-debakey-type-i-dissection
#15
V V Bazylev, M G Shmatkov, D A Zakharov, Z A Morozov
OBJECTIVE: The purpose of the study was to evaluate the influence of endoprosthetic repair of the aortic thoracic portion on remodelling of the descending aorta in patients after the surgical stage of correction for DeBakey type I aortic dissection. PATIENTS AND METHODS: The authors retrospectively analysed a group of 12 patients (9 men and 3 women) subjected to endoprosthetic repair of the aortic thoracic portion after previously performed surgical correction of the ascending aorta and its braches...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28902813/-surgical-decision-making-during-treatment-of-a-patient-with-multifocal-atherosclerosis-based-on-intraoperative-epiaortic-scanning
#16
A V Marchenko, P A Mialiuk, A S Vronskiĭ
The article deals with a clinical case report regarding surgical management of a patient presenting with multifocal atherosclerosis. Taking into consideration critical stenoses of the anterior interventricular artery (80%) and circumflex artery (80%), as well as subocclusion of the left internal carotid artery and stenosis of the right internal carotid artery (60%), there were high risks for intraoperative cerebral circulation impairment. It was decided to perform a two-stage operation on the coronary and carotid beds...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28902094/reference-values-for-fluorine-18-fluorodeoxyglucose-and-fluorine-18-sodium-fluoride-uptake-in-human-arteries-a-prospective-evaluation-of-89-healthy-adults
#17
Björn A Blomberg, Anders Thomassen, Pim A de Jong, Marnix G E H Lam, Søren Hess, Michael H Olsen, Willem P T M Mali, Abass Alavi, Poul F Høilund-Carlsen
OBJECTIVE: Reference values of fluorine-18-fluorodeoxyglucose (F-FDG) and fluorine-18-sodium fluoride (F-NaF) uptake in human arteries are unknown. The aim of this study was to determine age-specific and sex-specific reference values of arterial F-FDG and F-NaF uptake. PARTICIPANTS AND METHODS: Uptake of F-FDG and F-NaF was determined in the ascending aorta, aortic arch, and descending thoracic aorta. In addition, F-FDG uptake was determined in the carotid arteries and F-NaF uptake was determined in the coronary arteries...
September 8, 2017: Nuclear Medicine Communications
https://www.readbyqxmd.com/read/28894059/-re-operation-for-saccular-aneurysm-after-ascending-aortic-replacement-with-homograft-report-of-a-case
#18
Masahiro Ikeda, Toshihisa Asakura, Kazuhiko Uwabe, Kozo Morita, Atsushi Iguchi, Hiroshi Niinami
A 62-years-old female had undergone ascending aortic replacement with homograft for graft infection and mediastinitis after initial replacement of ascending aorta due to acute type A dissection. Ten years after homograft replacement, follow up computed tomography showed acute growing saccular aneurysm of the homograft without infectious symptoms. We urgently performed Bentall procedure and hemiarch replacement successfully. Pathological diagnosis was true aneurysm of the homograft. She was discharged from hospital without any complication and has been quite uneventful 7 years after surgery...
September 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28894057/-successful-treatment-of-ascending-aortic-graft-infection-with-a-rifampicin-soaked-vascular-prosthesis-and-continuous-irrigation
#19
Koji Hashizume, Shinichiro Taniguchi, Ichiro Matsumaru, Shun Nakaji, Mizuki Sumi, Kiyoyuki Eishi
A 68-year-old woman underwent replacement of the ascending aorta for acute type A aortic dissection. She was then diagnosed with postoperative methicillin-resistant Staphylococcus aureus (MRSA) infection, and the infected aortic graft was replaced with a rifampicin-soaked vascular prosthesis, which was followed by continuous irrigation using a 0.1% povidone-iodine solution. The postoperative course was uneventful, and she has been doing well for 5 years with no recurrence of infection. Prosthetic graft replacement using a rifampicin-soaked graft followed by continuous irrigation with povidone-iodine is useful for treatment of an MRSA-infected prosthetic vascular graft...
September 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28894052/-three-surgical-cases-of-quadricuspid-aortic-valve
#20
Yoshikazu Motohashi, Takahiro Katsumata, Tatsuya Suzuki, Ryo Shimada, Hayato Konishi, Shinji Fukuhara, Sachiko Kanki, Masahiro Daimon, Hideki Ozawa, Shintaro Nemoto
Quadricuspid aortic valve is a rare congenital disease. We experienced 3 surgical cases of quadricuspid aortic valve. Patient 1 was a 72-year-old man who was noted to have a quadricuspid aortic valve associated with aortic regurgitation and an ascending aortic aneurysm(51 mm in diameter). He underwent replacement of the aortic valve and the ascending aorta. Patient 2 was a 71-year-old man with severe aortic stenosis, regurgitation, and coronary triple vessel disease. He underwent aortic valve replacement and coronary artery bypass grafting...
September 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
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