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Yi Zhou, Wei-Cheng Wang, Xiao-Ming Zhang, Cui Yang, Jing Zheng, Lin Yang, Ling Dong, Xiao Hu, Tao Zhu, Ya-Li Wang, Yan Yang
Background: Thoracic endovascular aortic repair (TEVAR) in the current era has gained widespread acceptance as the modality of choice for the treatment of complicated aortic dissection (AD). However, reports on clinical results of TEVAR treatment of AD patients are mainly comparisons and analyses of results between patients in the acute and chronic phases, few reports have described the postoperative aortic remodelling of patients with subacute AD after TEVAR. The aim of this study was to investigate aortic remodelling after TEVAR in acute and subacute Stanford type B AD patients...
May 2018: Quantitative Imaging in Medicine and Surgery
Michiko Honda, Akira Tsuchiya, Wataru Isono, Mikiko Takahashi, Akihisa Fujimoto, Masashi Kawamoto, Osamu Nishii
In order to diagnose endometrial cancer preoperatively, outpatient endometrial biopsy with a curette is frequently performed owing to its convenience. However, in some cases, gynecologists fail to diagnose endometrial cancer via outpatient endometrial biopsy because of the cancer's distribution in the uterus and its consistency. A 57-year-old Japanese woman (gravida 4 para 4) presented with a 6-month history of light but intermittent postmenopausal vaginal bleeding. A malignant uterine tumor was strongly suspected after imaging using ultrasound examination and magnetic resonance imaging; however, a precise pathological diagnosis was not achieved despite multiple outpatient endometrial biopsies with the aid of office hysteroscopy...
May 2018: Case Reports in Oncology
V Tchana-Sato, N Sakalihasan, J O Defraigne
Aortic dissection is a life-threatening condition due to a tear in the intimal layer of the aorta or bleeding within the aortic wall, resulting in the separation of the different layers of the aortic wall. Among the risk factors, age, hypertension, dyslipidemia and genetic disorders of the connective tissue have been identified. A prompt diagnosis and an adequate treatment are important in the management of affected patients. The type of treatment depends on the location and extension of the dissection. Open surgical repair is most commonly used for dissections involving the ascending aorta and the aortic arch, whereas endovascular intervention is indicated for descending aorta dissections that are complicated...
May 2018: Revue Médicale de Liège
Arminder S Jassar, Thoralf M Sundt
The outcome of surgery for acute aortic dissection is improving, but many debates remain as to the optimal treatment. These include the necessary extent of the operation proximally and distally, as well as the use of endovascular technologies.
June 20, 2018: General Thoracic and Cardiovascular Surgery
Stephanie E Wallace, Ellen S Regalado, Limin Gong, Alexandra L Janda, Dong-Chuan Guo, Claudio F Russo, Richard J Kulmacz, Nadine Hanna, Guillaume Jondeau, Catherine Boileau, Pauline Arnaud, Kwanghyuk Lee, Suzanne M Leal, Matias Hannuksela, Bo Carlberg, Tami Johnston, Christian Antolik, Ellen M Hostetler, Roberto Colombo, Dianna M Milewicz
PURPOSE: Heritable thoracic aortic disease can result from null variants in MYLK, which encodes myosin light-chain kinase (MLCK). Data on which MYLK missense variants are pathogenic and information to guide aortic disease management are limited. METHODS: Clinical data from 60 cases with MYLK pathogenic variants were analyzed (five null and two missense variants), and the effect of missense variants on kinase activity was assessed. RESULTS: Twenty-three individuals (39%) experienced an aortic event (defined as aneurysm repair or dissection); the majority of these events (87%) were aortic dissections...
June 20, 2018: Genetics in Medicine: Official Journal of the American College of Medical Genetics
Shun-Ichi Nihei, Hideaki Arai, Takayuki Uchida, Ayako Kanazawa, Takeru Endo, Ken Otsuji, Nobuya Harayama, Keiji Aibara, Masayuki Kamochi
A post-marketing surveillance study reported fatalities following tissue plasminogen activator administration in acute aortic dissection (AAD) with the symptoms of acute ischemic stroke (AIS) patients. Therefore, it is important to discriminate AAD from AIS. The present study aimed to investigate whether fibrinogen/fibrin degradation products (FDP) value can be useful in differential diagnosis between AAD and AIS. The study group comprised 20 AAD patients (10 men and 10 women; age 63.9 ± 13.6 years) and 159 AIS patients (91 men and 68 women; age 74...
2018: Journal of UOEH
D Wang, J T Qiu, C T Yu, X J Luo, W Gao, J L Wu, L Zhang
Objective: To investigate theperiodic changes in onset of aortic dissection. Methods: The clinical data of 1 121 patients with acute aortic dissection from Hebei province, treated at Fuwai hospital from January 1, 2010 to December 31, 2016, were collected and analyzed retrospectively. The regularity for the onset of aortic dissection was analyzed according to daytime (1:00 to 6:00, 7:00 to 12:00, 13:00 to 18:00, and 19:00 to 24:00), weekday, month, and quarter. Meanwhile,the differences in various type of aortic dissection patient were also compared...
June 24, 2018: Zhonghua Xin Xue Guan Bing za Zhi
Kathryn L Howe, John Harlock, Dominic Parry
Introduction: Type A aortic dissection can present with malperfusion syndrome. Lower limb ischaemia may resolve with repair of the dissection; however, the long duration of repair and/or persistent ischaemia may leave tissue at risk of necrosis with potential for substantial morbidity. Report: Here, the case of a 67 year old man who presented with a Type A aortic dissection with malperfusion of the lower extremities is described. The Vascular Surgery and Cardiac Surgery divisions were consulted simultaneously...
2018: EJVES Short Reports
Avnish Tripathi, Yinding Wang, Jeanette M Jerrell
Background: We investigated the treated prevalence of bicuspid aortic valve in a pediatric population with congenital heart disease and its incident complications. Materials and Methods: A 15-year retrospective data set was analyzed. Selection criteria included age ≤17 years, enrollees in the South Carolina State Medicaid program and diagnosed as having bicuspid aortic valve on one or more service visits. Results: The 15-year-treated prevalence of predominantly isolated bicuspid aortic valve was 2% (20/1000) of pediatric congenital heart disease cases, with a non-African American: African-American ratio of 3...
May 2018: Annals of Pediatric Cardiology
Masamichi Nogi, Kimio Satoh, Shinichiro Sunamura, Nobuhiro Kikuchi, Taijyu Satoh, Ryo Kurosawa, Junichi Omura, Md Elias Al-Mamun, Mohammad Abdul Hai Siddique, Kazuhiko Numano, Shun Kudo, Satoshi Miyata, Masatoshi Akiyama, Kiichiro Kumagai, Shunsuke Kawamoto, Yoshikatsu Saiki, Hiroaki Shimokawa
Background -Thoracic aortic aneurysm (TAA) and dissection (TAD) are fatal diseases, which cause aortic rupture and sudden death. The small GTP-binding protein GDP dissociation stimulator (SmgGDS) is a crucial mediator of the pleiotropic effects of statins. Previous studies revealed that reduced force generation in AoSMCs causes TAA and TAD. Methods -To examine the role of SmgGDS in TAA formation, we employed an angiotensin II (AngII, 1,000 ng/min/kg, 4 weeks)-induced TAA model. Results -33% Apoe-/- SmgGDS+/- mice died suddenly due to TAA rupture, whereas there was no TAA rupture in Apoe-/- control mice...
June 19, 2018: Circulation
Norman A Orabi, Leslie E Quint, Kuanwong Watcharotone, Bin Nan, David M Williams, Karen M Kim
The aim was to compare computed tomography (CT) features in acute and chronic aortic dissections (AADs and CADs) and determine if a certain combination of imaging features was reliably predictive of the acute versus chronic nature of disease in individual patients. Consecutive patients with aortic dissection and a chest CT scan were identified, and 120 CT scans corresponding to 105 patients were reviewed for a variety of imaging features. Statistical tests assessed for differences in the frequency of these features...
June 18, 2018: International Journal of Cardiovascular Imaging
Xiao-Nan He, Jin-Liang Zhan, Cheng Zhang, Yu Chen, Wei Gong, Wang Ji, Shao-Ping Nie
Objective: To investigate the impact of meteorological conditions and PM2.5 on the onset of acute aortic dissection in monsoonal climate. Methods: A linear regression analysis was performed in monsoonal climate epidemiological survey for a period of four years on the impact of meteorological factors (minimal temperature, mean temperature, maximal temperature, average daily surface temperature, day temperature range, relative humidity, mean wind speed, and atmospheric pressure) and PM2...
April 2018: Journal of Geriatric Cardiology: JGC
Yuwei Xiang, Bin Huang, Jichun Zhao, Hankui Hu, Ding Yuan, Yi Yang
This study was to analyze the outcomes of left subclavian artery (LSA) revascularization during thoracic endovascular repair (TEVAR) for type B aortic dissections (TBAD). From 2011 to 2017, TBAD patients who underwent LSA revascularization during TEVAR were enrolled. Technical success, endoleaks, mortality, complication, reintervention, and patency of target vessels were analyzed. 38 patients were included, 14 underwent carotid-subclavian bypass (CSB), and 24 underwent chimney graft (CG) implantation. Technical success rates were 92...
June 18, 2018: Scientific Reports
James C Iannuzzi, Sahael M Stapleton, Yanik J Bababekov, David Chang, Robert T Lancaster, Mark F Conrad, Richard P Cambria, Virendra I Patel
BACKGROUND: In uncomplicated type B aortic dissection (UTBAD), the "gold standard" has been nonoperative treatment with medical therapy, although this has been questioned by studies demonstrating improved outcomes in those treated with thoracic endovascular aortic repair (TEVAR). This study assessed long-term survival after acute UTBAD comparing medical therapy, open repair, and TEVAR. METHODS: The California Office of Statewide Hospital Planning Development database was analyzed from 2000 to 2010 for adult patients with acute UTBAD...
June 15, 2018: Journal of Vascular Surgery
Mark A Davison, Derek M Norton, Andrew M Popoff, Christopher W Seder, Robert J March
A Dacron wrap aortoplasty has been described as an adjunct to reduction ascending aortoplasty for the repair of Type A aortic dissections. We report a case of an uncomplicated hemiarch repair with wrap aortoplasty of the distal anastomosis which resulted in severe acute hemolysis. Despite only minimal focal graft deformation on imaging, the patient was found to have a flow gradient across the distal anastomosis, which was reduced by > 50% following release of the outer graft wrap. To our knowledge, only 29 additional cases of hemolytic anemia following aortic dissection repair have been described in the English literature...
June 1, 2018: Vascular Medicine
Daniele De Viti, Francesco Santoro, Pasquale Raimondo, Natale Daniele Brunetti, Cataldo Memmola
We report a late clinical presentation of an aorto-right ventricular fistula (RVF) extending from the right sinus of Valsalva into the RV outflow tract with significant left-to-right shunt and severe pulmonary hypertension. A three-dimensional transesophageal echocardiogram and a chest-computed tomography scans were performed to better characterize the abnormality. Aorto- RVF can be either congenital or acquired, secondary to endocarditis, Valsalva aneurysm rupture, chest trauma, or aortic dissection.
April 2018: Journal of Cardiovascular Echography
Rodolfo Citro, Moreno Cecconi, Salvatore La Carrubba, Eduardo Bossone, Francesco Antonini-Canterin, Stefano Nistri, Fabio Chirillo, Ilaria Dentamaro, Michele Bellino, Alfredo Posteraro, Mauro Giorgi, Licia Petrella, Ines Monte, Vincenzo Manuppelli, Antonio Mantero, Scipione Carerj, Frank Benedetto, Paolo Colonna
Background: Bicuspid aortic valve (BAV) is the most common congenital heart disease, affecting 0.5%-2% of the general population. It is associated not only with notable valvular risk (aortic stenosis and/or regurgitation, endocarditis) but also with aortopathy with a wide spectrum of unpredictable clinical presentations, including aneurysmal dilation of the aortic root and/or ascending thoracic aorta, isthmic coarctation, aortic dissection, or wall rupture. Methods: The REgistro della Valvola Aortica Bicuspide della Società Italiana di ECocardiografia e CArdiovascular Imaging is a retrospective (from January 1, 2010)/prospective, multicenter, observational registry, expected to enroll 3000 patients with definitive diagnosis of BAV made by transthoracic and/or transesophageal echocardiography, computed tomography, cardiovascular magnetic resonance, or at surgery...
April 2018: Journal of Cardiovascular Echography
Joshua M Spin, Daniel Y Li, Lars Maegdefessel, Philip S Tsao
Aortic aneurysms represent a major public health burden, and currently have no medical treatment options. The pathophysiology behind these aneurysms is complex and variable, depending on location and underlying cause, and generally involves progressive dysfunction of all elements of the aortic wall. Changes in smooth muscle behavior, endothelial signaling, extracellular matrix remodeling, and to a variable extent inflammatory signaling and cells, all contribute to the dilation of the aorta, ultimately resulting in high mortality and morbidity events including dissection and rupture...
June 14, 2018: Vascular Pharmacology
Mingfang Liao, Sili Zou, Yan Bao, Jie Jin, Junlin Yang, Yandong Liu, Mark Green, Futang Yang, Lefeng Qu
Aortic dissection (AD) is the circumferential or transversal tear of the aorta wall that allows blood to infiltrate the layers. MicroRNA (miR) analyses have demonstrated a correlation between miR-320 family and AD. The underlying mechanism is yet unclear. The matrix metalloproteinases (MMPs) are a group of proteolytic enzymes that could catalyze the degeneration of the extracellular matrix and the destruction of the vasculature. In this study, we investigated whether miR-320 presented a role in regulating the production of MMPs in aortic dissection...
June 13, 2018: Experimental Cell Research
Robert R Ehrman, Mark J Favot, Adrienne Malik
Acute aortic dissection presents a diagnostic challenge for Emergency Physicians. Use of recently published "high-risk" features to identify patients as truly high-risk may lead to over-testing. This article is protected by copyright. All rights reserved.
June 14, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
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