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ascending aorta

P X Kuan, P W Tan, A T Jobli, A R Norsila
INTRODUCTION: Differences in systolic blood pressure reading between arms are common but could signal trouble if the discrepancy is significant. Early detection of aortic dissection could invariably determine patient's survivability. Hence, a high index of suspicion with prompt diagnostic imaging is vital for accurate diagnosis. CASE PRESENTATION: A previously healthy 35-year-old lady was referred from district hospital for hypertensive cardiomyopathy complicated by acute pulmonary oedema...
August 2016: Medical Journal of Malaysia
Ahmad Masri, Vidyasagar Kalahasti, Lars G Svensson, Eric E Roselli, Douglas Johnston, Donald Hammer, Paul Schoenhagen, Brian P Griffin, Milind Y Desai
BACKGROUND: -In patients with a dilated proximal ascending aorta and trileaflet aortic valve (TAV), we sought to assess a) factors independently associated with increased long-term mortality and b) the incremental prognostic utility of indexing aortic root to patient height. METHODS: -We studied consecutive patients with a dilated aortic root (≥4 cm) that underwent echocardiography and gated contrast-enhanced thoracic aortic computed tomography or magnetic resonance angiography between 2003-2007...
October 21, 2016: Circulation
Sossio Perrotta
No abstract text is available yet for this article.
October 20, 2016: Journal of Cardiac Surgery
Hiroaki Osada, Hiroyuki Nakajima, Katsuaki Meshii, Motoaki Ohnaka
A 75-year-old man who had undergone ascending aorta replacement for acute Type A aortic dissection presented with a recurring high fever. Transesophageal echocardiography revealed that a vegetation had formed on the re-dissected intimal flap of the noncoronary sinus of Valsalva. This didactic case suggests that antibiotic prophylactic measures be considered for aortic dissection flaps as for irregular valves susceptible to infective endocarditis.
February 2016: Aorta (Stamford, Conn.)
Atsushi Nakagomi, Sho Okada, Toshihiro Shoji, Yoshio Kobayashi
Our aim was to assess the discrepancy in the blood pressure amplification (BPA) value defined as the aortic-to-brachial increase in systolic BP (SBP) between invasive and noninvasive brachial cuff-based methods. In 45 patients undergoing cardiac catheterization, BP in the brachial artery and ascending aorta were measured with an invasive catheter and a brachial cuff-based oscillometric device. To calculate aortic SBP, brachial waveforms were calibrated by the brachial systolic and diastolic BP (DBP) (C1 calibration) or by the brachial mean BP and DBP (C2 calibration)...
October 20, 2016: Hypertension Research: Official Journal of the Japanese Society of Hypertension
Yuji Kanaoka, Takao Ohki, Koji Maeda, Takeshi Baba
PURPOSE: To evaluate risk factors for early (<30 days) type I endoleak following thoracic endovascular aortic repair (TEVAR). METHODS: A retrospective study was conducted of 439 consecutive patients (mean age 74.0±10.0 years; 333 men) who underwent TEVAR at a single center between June 2006 and June 2013. Pathologies included 237 aortic arch aneurysms and 202 descending thoracic aortic aneurysms (dTAA). Maximum TAA diameter was 63.6±13.7 mm. Among the distal aortic arch aneurysms, 124 required coverage of the left subclavian artery (LSA), while the remaining 113 arch aneurysms had debranching (n=40), the chimney technique (n=52), and a branched stent-graft (n=13)...
October 19, 2016: Journal of Endovascular Therapy
Kayako Isohashi, Eku Shimosegawa, Sadahiro Naka, Yasukazu Kanai, Genki Horitsugi, Ikuko Mochida, Keiko Matsunaga, Tadashi Watabe, Hiroki Kato, Mitsuaki Tatsumi, Jun Hatazawa
BACKGROUND: In boron neutron capture therapy (BNCT), positron emission tomography (PET) with 4-borono-2-(18)F-fluoro-phenylalanine (FBPA) is the only method to estimate an accumulation of (10)B to target tumor and surrounding normal tissue after administering (10)B carrier of L-paraboronophenylalanine and to search the indication of BNCT for individual patient. Absolute concentration of (10)B in tumor has been estimated by multiplying (10)B concentration in blood during BNCT by tumor to blood radioactivity (T/B) ratio derived from FBPA PET...
December 2016: EJNMMI Research
Sarah Schalekamp-Timmermans, Jerome Cornette, Albert Hofman, Willem A Helbing, Vincent W V Jaddoe, Eric A P Steegers, Bero O Verburg
BACKGROUND: There are sex differences in the risk of development of cardiovascular disease (CVD). According to the developmental origins of health and disease paradigm (DOHaD), CVD originates in fetal life. This study examines fetal sex differences in cardiovascular development in utero. METHODS: In 1028 pregnant women, we assessed fetal circulation using pulsed wave Doppler examinations between 28 and 34 weeks gestation. To test associations between fetal sex and fetal circulation measurements, linear regression models were used adjusting for fetal size, gestational age, and fetal heart rate...
2016: Biology of Sex Differences
Karina Di Gregoli, Nur Najmi Mohamad Anuar, Rosaria Bianco, Stephen J White, Andrew C Newby, Sarah J George, Jason L Johnson
RATIONALE: Atherosclerosis and aneurysms are leading causes of mortality worldwide. MicroRNAs (miRs) are key determinants of gene and protein expression, and atypical miR expression has been associated with a number of cardiovascular diseases; although their contributory role to atherosclerotic plaque and abdominal aortic aneurysm (AAA) stability are poorly understood. OBJECTIVE: To investigate whether miR-181b regulates TIMP-3 expression and affects atherosclerosis and aneurysms Methods and Results: Here, we demonstrate that miR-181b was over-expressed in symptomatic human atherosclerotic plaques and abdominal aortic aneurysms, and correlated with decreased expression of predicted miR-181b targets, TIMP-3 and elastin...
October 18, 2016: Circulation Research
Courtney N Gleason, Deanna L Kerkhof, Elizabeth A Cilia, Maria A Lanyi, Jonathan Finnoff, Dai Sugimoto, Gianmichel D Corrado
OBJECTIVE: The traditional history and physical (H&P) is a poor screening modality to identify athletes at risk for sudden cardiac death. Although better than H&P alone, electrocardiograms (ECG) have also been found to have high false-positive rates. A limited portable ECG by a frontline physician (PEFP) performed during preparticipation physical examination (PPE) allows for direct measurements of the heart to more accurately identify athletes with structural abnormalities. Therefore, it is worthwhile to assess the feasibility of incorporating limited PEFP as part of PPEs...
October 13, 2016: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
Jiu-Chang Zhong, Zhen-Zhou Zhang, Ran Xu, Lai-Jiang Chen, Shu-Jie Guo, Ying-Le Xu, Gavin Oudit, Hai-Yan Jin, Bei Song, Qing Chang, Ping-Jin Gao, Ji-Guang Wang
OBJECTIVE: The Apelin/APJ system has recently been implicated in pathologies of hypertension. However, little was elucidated upon effects of Apelin on vascular adventitial remodeling progression. Here, we examined regulatory roles of Apelin in pressure overload-induced adventitial remodeling and fibrosis in hypertensive rats. DESIGN AND METHOD: The male Sprague-Dawley rats were performed with transverse aortic constriction (TAC). The rats with TAC were randomized to daily deliver either pyroglutamyl Apelin-13 (50 μg/kg) or saline for 4 weeks...
September 2016: Journal of Hypertension
Hyosoon An, Gi Beom Kim, Jae Suk Baek, Young Ah Lee, Bo Sang Kwon, Eun Jung Bae, Chung Il Noh
OBJECTIVE: Aortic dilatation and dissection are complications in some Turner syndrome (TS) patients. To better understand vascular nature of aorta before adult, we evaluated several elastic properties of the aorta in adolescent with TS in comparison to healthy controls. DESIGN AND METHOD: Various indices of the vascular function of ascending aorta were assessed prospectively in TS (n = 28), with a mean age of 14.9 ± 3.3 years and age-matched control (n = 18) groups with the transthoracic echocardiography...
September 2016: Journal of Hypertension
Chen-Huan Chen
Blood pressure (BP) is conventionally measured with a pressure cuff over an upper arm and a cutoff of 140/90 mmHg in the office is the current criteria for diagnosing hypertension. Recently, out of office BP has been suggested as the reference standard for the management of hypertension, due to its better prognostic value over office BP.However, the above BP parameters are all measured at brachial arteries and may be different from the central blood pressure (CBP) measured in the ascending aorta or carotid arteries...
September 2016: Journal of Hypertension
Junichiro Hashimoto
The central aorta constitutes the main trunk of the systemic arterial tree. It dilates passively with cardiac ejection during systole and then constricts with its recoil function during diastole, thereby regulating blood pressure and blood flow. The central pulsatile hemodynamics affects local hemodynamics within as well as downstream of the aorta (e.g., end organs).The aorta progressively stiffens and dilates with advancing age, and such age-dependent change is accelerated by hypertension. According to the law of Laplace, wall stress depends on the diameter and pressure of the blood vessel...
September 2016: Journal of Hypertension
Jae-Kwan Song
The successful clinical introduction of various non-invasive imaging modalities has contributed to the establishment of 'acute aortic syndrome', a relatively new clinical syndrome incorporating several disease entities with similar clinical features (at the time of clinical presentation). Aortic dissection (AD) with intimal flap and two aortic channels (true and false lumens) is the most important disease entity in acute aortic syndrome. Clinical characteristics of AD have been established, with standardized treatment strategies depending on the affected site of the aorta...
September 2016: Journal of Hypertension
Yosuke Takahashi, Yasuyuki Sasaki, Yasuyuki Bito, Manabu Motoki, Takashi Murakami, Toshihiko Shibata
We herein report two cases of perigraft effusion mimicking graft infection after debranching thoracic endovascular repair for an anastomotic pseudoaneurysm of the distal ascending aorta. Both patients presented with a bulging tumor on the sternum. Enhanced computed tomography showed no endoleak, but extension of periprosthetic graft fluid to a subcutaneous sternal wound was present. We suspected a deep sternal wound infection; however, cultures of débrided tissues were negative. After drainage of the subcutaneous fluid or negative pressure wound therapy, both patients were doing well without recurrence of effusion...
October 14, 2016: Journal of Vascular Surgery
Rongjie Zhang, Jian Zhou, Jiaxuan Feng, Zhiqing Zhao, Junjun Liu, Zhenjiang Li, Rui Feng, Zaiping Jing
BACKGROUND: How to choose the proximal landing zone in endovascular interventions for a patient with a patent retrograde false lumen in dissection of the ascending aorta and aortic arch remains unclear. This study sought to report the safety and efficiency of inducing thrombosis of the retrograde false lumen to enhance a proximal landing zone to treat retrograde type A aortic dissection. METHODS: This study included 9 patients with retrograde type A aortic dissection treated with a 2-stage operation strategy between January 2015 and January 2016...
September 22, 2016: Journal of Thoracic and Cardiovascular Surgery
Rei-Yeuh Chang, Chien-Chang Chen, Wei-Pang Hsu, Pei-Ching Hsiao, Han-Lin Tsai, Ping-Gune Hsiao, Jiann-Der Wu, How-Ran Guo
BACKGROUND: Avulsion of the aortic valve commissure as a cause of acute aortic valve regurgitation is mostly due to trauma, infective endocarditis, or ascending aortic dissection. Nontraumatic avulsion of the aortic valve commissure is very rare. We reviewed the literature and analyzed potential risk factors of nontraumatic avulsion. CASE PRESENTATION: An 80-year-old male with hypertension was seen in the emergency department with acute onset dyspnea. Echocardiogram revealed left ventricular hypertrophy with adequate systolic function, prolapse of the noncoronary cusp, and incomplete coaptation of the right coronary and noncoronary cusps with severe aortic valve regurgitation...
October 2016: Medicine (Baltimore)
Sang Min Park, Haemin Jeong, Kyung-Soon Hong, Christopher Kim
BACKGROUND: In a patient underwent aortic valve replacement (AVR) due to bicuspid aortic valve (BAV) insufficiency without marked dilation of ascending aorta, the development of delayed-typed aneurysmal complication of ascending aorta has been often reported because the dilated aorta tends to grow insidiously with age. CASE SUMMARY: A 58-year-old man who underwent AVR with mechanical valve due to severe aortic regurgitation secondary to BAV 7 years previously presented with exertional chest discomfort for 1 year...
October 2016: Medicine (Baltimore)
Justin T Tretter, Diane E Spicer, Shumpei Mori, Sathish Chikkabyrappa, Andrew N Redington, Robert H Anderson
A comprehensive understanding of the normal and abnormal aortic root is paramount if we are to improve not only our assessment of the aortic root and its components but also the surgical approach to reconstructing this complex structure when congenitally malformed. Most anatomic and imaging-based classifications of the normal root recognize and describe the basic components, which include the shape and size of the three aortic sinuses and their three valvar leaflets, as well as the sinutubular junction and proximal ascending aorta...
October 11, 2016: Journal of the American Society of Echocardiography
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