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https://www.readbyqxmd.com/read/29684119/aortic-stiffness-in-adolescent-turner-and-marfan-syndrome-patients
#1
Michal Schäfer, Lorna P Browne, Uyen Truong, James J Jaggers, Max B Mitchell, Ladonna Malone, Gareth Morgan, Kathryn Chatfield, Daniel McLennan, Harma Turbendian, Danial Vargas, Brian Fonseca, Michael DiMaria, Anar Shah, Margaret P Ivy, Alex J Barker, Kendall S Hunter, Neil Wilson, D Dunbar Ivy, David N Campbell
OBJECTIVES: Turner syndrome (TS) and Marfan syndrome (MFS) are partially characterized by aortopathies with a risk of developing severe aortic dilation, stiffness and consequent dissection and aneurysm formation. The incidence of a bicuspid aortic valve (BAV) is also increased in TS. We investigated aortic stiffness in teenage TS and MFS patients and evaluated to what degree stiffness in TS patients is augmented by the presence of a BAV. METHODS: Fifty-seven patients with TS (n = 37) and MFS (n = 20), as well as 22 controls with similar age and size distribution underwent evaluation of thoracic aortic stiffness using phase-contrast magnetic resonance imaging...
April 19, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29683463/a-closed-chest-model-to-induce-transverse-aortic-constriction-in-mice
#2
Lars Eichhorn, Christina Katharina Weisheit, Christopher Gestrich, Konrad Peukert, Georg Daniel Duerr, Muhammad Ajmal Ayub, Felix Erdfelder, Florian Stöckigt
Research on cardiac hypertrophy and heart failure is frequently based on pressure overload mouse models induced by TAC. The standard procedure is to perform a partial thoracotomy to visualize the transverse aortic arch. However, the surgical trauma caused by the thoracotomy in open-chest models changes the respiratory physiology as the ribs are dissected and left unattached after chest closure. To prevent this, we established a minimally invasive, closed chest approach via lateral thoracotomy. Herein we approach the aortic arch via the 2nd intercostal space without entering the chest cavities, leaving the mouse with a less traumatic injury to recover from...
April 5, 2018: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29683349/video-rethinking-mural-thickening-vasculitis-or-aortic-dissection
#3
Caitlin A Harrington, Alexander A Brescia, Brandon H Tieu, Cristina Fuss
OBJECTIVE: The objective of this video article is to provide education about the similarities and differences between vasculitis and rare, acute aortic pathologic findings so that an appropriate diagnosis can be made in a timely manner, especially for patients with life-threatening aortic pathologic findings. CONCLUSION: Although they are rare, acute aortic pathologic findings, such as aortic dissection and intramural hematoma, can have radiographic characteristics similar to those of vasculitis, which can make it challenging to discern between these vastly different diagnoses without the use of properly timed imaging studies...
May 2018: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/29682475/malperfusion-syndromes-in-type-a-aortic-dissection-what-we-have-learned-from-irad
#4
REVIEW
Paolo Berretta, Santi Trimarchi, Himanshu J Patel, Thomas G Gleason, Kim A Eagle, Marco Di Eusanio
Patients presenting with type A acute aortic dissection (TAAD) complicated by malperfusion syndromes represent one of the highest surgical risk cohorts for cardiovascular surgeons. In the setting of aortic dissection, end-organ ischemia may involve any of the major arterial side branches resulting in myocardial, cerebral, spinal cord, visceral and/or limb ischemia. In TAAD patients with malperfusion, notwithstanding continuous improvement in diagnostic and management strategies, surgical and clinical outcomes remain poor and the optimal therapy is controversial...
2018: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29682469/conservative-management-versus-endovascular-or-open-surgery-in-the-spectrum-of-type-b-aortic-dissection
#5
Xun Yuan, Andreas Mitsis, Mohammed Ghonem, Ilias Iakovakis, Christoph A Nienaber
Background: Type B aortic dissection is a life-threatening acute aortic condition often with acute ischemic signs or symptoms. With initial management focusing on alleviating malperfusion and pain, and avoiding propagation of dissection or rupture both systolic blood and pulse pressure should be reduced initially by an aggressive medical approach. In the setting of persistent signs of complications endovascular strategies have replaced open surgery and led to a fourfold increase in early survival and better long-term outcomes...
2018: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29682123/a-case-of-traumatic-retrograde-type-a-aortic-dissection-accompanied-by-multiorgan-injuries
#6
Katsuaki Tsukioka, Tetsuya Kono, Kohei Takahashi, Hiromu Kehara, Shuichi Urashita, Kazunori Komatsu
A 75-year-old woman was involved in a traffic accident and suffered retrograde type A aortic dissection, multiple rib fractures, and grade II hepatic injury accompanied by intraperitoneal bleeding. We performed total arch replacement using an open stent graft with cardiopulmonary bypass and circulatory arrest. This procedure requires anticoagulation and hypothermia, which are principally contraindicated in severe trauma patients. However, this situation was resolved by managing the patient non-operatively for 7 days, confirming the stabilization of other injured organs, and then performing the surgery...
March 25, 2018: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29680298/experimental-evaluation-of-homemade-distal-stent-graft-fenestration-for-thoracic-endovascular-aortic-repair-of-type-a-dissection-by-a-transapical-approach
#7
Thomas Gandet, Anis Seghrouchni, Baris Ata Ozdemir, Guillaume Captier, Roland Demaria, Pierre Alric, Bernard Albat, Ludovic Canaud
OBJECTIVE: The use of off-the-shelf stent grafts for thoracic endovascular aortic repair of type A dissections is limited by variability in both the length of the ascending aorta and the location of the proximal intimal tear. This experimental study aimed to assess the feasibility of using a physician-modified thoracic aortic stent graft to treat acute type A dissection by a transapical cardiac approach. METHODS: The experiments were performed on six cadaveric human heart, ascending aorta, aortic arch, and descending aorta specimens...
April 18, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29676201/prognosis-and-monitoring-of-giant-cell-arteritis-and-associated-complications
#8
Tanaz A Kermani, Kenneth J Warrington
Giant cell arteritis (GCA) is the most common systemic vasculitis in people over the age of 50 years. Prospective imaging studies in GCA highlight the systemic nature of this vasculitis. Areas covered: This review summarizes literature using PubMed on complications of GCA and its treatment. Emphasis was placed on articles published within the past 5 years. Disease associated complications including vision loss from arteritic anterior ischemic optic neuropathy, large-artery stenoses and ischemia, and, aortic aneurysms and dissections...
April 20, 2018: Expert Review of Clinical Immunology
https://www.readbyqxmd.com/read/29675625/multidetector-ct-of-iatrogenic-and-self-inflicted-vascular-lesions-and-infections-at-the-groin
#9
REVIEW
Massimo Tonolini, Anna Maria Ierardi, Gianpaolo Carrafiello, Domenico Laganà
The number and complexity of endovascular procedures performed via either arterial or venous access are steadily increasing. Albeit associated with higher morbidity compared to the radial approach, the traditional common femoral artery remains the preferred access site in a variety of cardiac, aortic, oncologic and peripheral vascular procedures. Both transarterial and venous cannulation (for electrophysiology, intravenous laser ablation and central catheterisation) at the groin may result in potentially severe vascular access site complications (VASC)...
April 19, 2018: Insights Into Imaging
https://www.readbyqxmd.com/read/29675443/left-ventricular-intussusception-of-an-intimal-flap-in-an-aortic-dissection-stanford-type-a
#10
Tim Kaufeld, Malakh Shrestha, Axel Haverich, Andreas Martens
A 75-year-old woman was admitted to the emergency department with severe and sudden chest pain. Transthoracic echocardiogram showed an unusual case of aortic dissection Stanford Type A with complete circumferential detachment of the ascending aorta intima. An intussusception of the intima flap into the left ventricular outflow tract was also observed. This case presents a very rare surgical treatment involving root repair using tissue adhesives for a left ventricular intimal flap.
June 2017: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/29675442/thoracic-endovascular-aortic-repair-for-aortoesophageal-fistula-after-covered-rupture-of-aortic-homograft-a-durable-option
#11
Michal Nozdrzykowski, Jens Garbade, Steffen Leinung, Andrej Schmidt, Friedrich-Wilhelm Mohr, Michael A Borger
A 63-year-old woman underwent replacement of the aortic root, ascending aorta, and partial arch due to Type A aortic dissection. Shortly thereafter, a replacement of the distal aortic arch and descending aorta was performed. Three years later, the patient developed an aortoesophageal fistula (AEF) resulting in re-replacement of the distal aortic arch and proximal descending aorta with a cryopreserved aortic homograft. Six weeks post-discharge, the patient was readmitted due to recurrent AEF. A thoracic endovascular stent graft was implanted to cover the aortic rupture, followed by correction of an esophageal lesion...
June 2017: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/29675440/multi-velocity-encoding-four-dimensional-flow-magnetic-resonance-imaging-in-the-assessment-of-chronic-aortic-dissection
#12
Andrew G Sherrah, Fraser M Callaghan, Rajesh Puranik, Richmond W Jeremy, Paul G Bannon, Michael P Vallely, Stuart M Grieve
Background: Chronic descending thoracic aortic dissection (CDTAD) following surgical repair of ascending aortic dissection requires long-term imaging surveillance. We investigated four-dimensional (4D)-flow magnetic resonance imaging (MRI) with a novel multi-velocity encoding (multi-VENC) technique as an emerging clinical method enabling the dynamic quantification of blood volume and velocity throughout the cardiac cycle. Methods: Patients with CDTAD (n = 10; mean age, 55...
June 2017: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/29675439/coronary-events-in-patients-presenting-for-repair-of-acute-type-a-aortic-dissection
#13
Paul C Tang, Shahab A Akhter, Satoru Osaki, Lucian Lozonschi, Takushi Kohmoto, Nilto C De Oliveira
Background: Preoperative coronary angiography is often not performed in acute Type A dissection. We examined differences in the incidence of pre-existing coronary disease and subsequent coronary events between patients undergoing acute Type A dissection repair and patients undergoing elective proximal aortic aneurysm repair. Methods: From 2000 to 2015, there were 154 acute Type A dissection repairs and 457 elective proximal aortic aneurysm repairs. We performed a retrospective review to evaluate preoperative coronary disease and postoperative coronary interventions such as percutaneous coronary intervention (PCI) and coronary bypass grafting (CABG)...
June 2017: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/29673638/outcome-after-surgery-for-aortic-dissection-type-a-in-morbidly-obese-patients
#14
Maximilian Kreibich, Bartosz Rylski, Joseph E Bavaria, Emanuela Branchetti, Daniel Dohle, Patrick Moeller, Prashanth Vallabhajosyula, Wilson Y Szeto, Nimesh D Desai
BACKGROUND: The number of obese patients is increasing and more obese patients are likely to present for surgical repair of aortic dissection Type A (ADA). We evaluated the effect of this procedure on mortality and morbidity of patients based on their body-mass-index (BMI; kg*m-2 ). METHODS: A total of 667 patients that underwent surgical repair of ADA between 2003 and 2017 were retrospectively analyzed. Patients were divided into four groups according to BMI: normal weight (18≤BMI<25; n=186), overweight (25≤BMI<30; n=238), obese (30≤BMI<35, n=144), and morbidly obese (BMI≥35; n=99)...
April 16, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29672685/surgical-and-early-outcomes-for-type-a-aortic-dissection-with-preoperative-renal-dysfunction-stratified-by-estimated-glomerular-filtration-rate
#15
Tianyu Zhou, Jun Li, Yongxin Sun, Jiawei Gu, Kai Zhu, Yulin Wang, Hao Lai, Chunsheng Wang
OBJECTIVES: The aim of this study was to analyse the effect of preoperative renal dysfunction on surgical and early outcomes for patients with Type A aortic dissection (AAD). METHODS: From January 2016 to December 2016, 140 patients with AAD who underwent surgical treatment at our institution were retrospectively analysed. According to the estimated glomerular filtration rate (eGFR), preoperative renal dysfunction was divided into 4 groups: normal (eGFR ≥90 ml/min/1...
April 17, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29672613/intravascular-ultrasound-assisted-sizing-in-thoracic-endovascular-aortic-repair-improves-aortic-remodeling-in-type-b-aortic-dissection
#16
Julia Lortz, Konstantinos Tsagakis, Christos Rammos, Michael Horacek, Thomas Schlosser, Heinz Jakob, Tienush Rassaf, Rolf Alexander Jánosi
The precise sizing of the stent graft in thoracic endovascular aortic repair (TEVAR) affects aortic remodeling and hence, further outcome. Covering the proximal entry tear is essential for successful treatment of Type B aortic dissection. Intravascular ultrasound (IVUS) enables real-time aortic diameter assessment, and is especially useful when computed tomography (CT) image quality is poor. IVUS, however, is not routinely utilized due to cost inefficiency. We investigated the impact of IVUS-assisted stent graft sizing on aortic remodeling in TEVAR...
2018: PloS One
https://www.readbyqxmd.com/read/29670772/left-circumflex-artery-rupture-with-left-atrial-tamponade-and-functional-mitral-stenosis
#17
Weiting Huang, Khaled Mohamed Emadeldin Moheb Hammad, Victor Tar Toong Chao, Khung Keong Yeo
The growth in percutaneous transluminal devices has enabled operators to tackle more complex, native, and post-bypass surgery anatomy. However, complications such as coronary artery dissection, coronary perforation, retrograde aortic dissection, arrhythmias, and acute coronary syndrome still occur with resulting mortality rates of up to 4.2% in complex interventions. Perforation of the circumflex artery is of particular interest in view of its position and relation to the surrounding cardiac structures. This is a site of potential fluid collection, and as the left atrium is fixed to the parietal pericardium at the entry of the pulmonary veins, fluid in the oblique sinus can accumulate enough pressure to compress the left atrium and the coronary sinus...
2018: Case Reports in Cardiology
https://www.readbyqxmd.com/read/29669321/lncrna-expression-profile-of-human-thoracic-aortic-dissection-by-high-throughput-sequencing
#18
Jie Sun, Guojun Chen, Yuanwen Jing, Xiang He, Jianting Dong, Junmeng Zheng, Meisheng Zou, Hairui Li, Shifei Wang, Yili Sun, Wangjun Liao, Yulin Liao, Li Feng, Jianping Bin
BACKGROUND/AIMS: In this study, the long non-coding RNA (lncRNA) expression profile in human thoracic aortic dissection (TAD), a highly lethal cardiovascular disease, was investigated. METHODS: Human TAD (n=3) and normal aortic tissues (NA) (n=3) were examined by high-throughput sequencing. Bioinformatics analyses were performed to predict the roles of aberrantly expressed lncRNAs. Quantitative real-time polymerase chain reaction (qRT-PCR) was applied to validate the results...
April 13, 2018: Cellular Physiology and Biochemistry
https://www.readbyqxmd.com/read/29668804/morphology-of-the-diaphragm-muscle-in-southern-tamandua-tamandua-tetradactyla-and-its-importance-in-cases-of-traumatic-hernia
#19
Érica F S Azevedo, Daniela R Costa E Silva, Tamires V S Natividade, Elane G Giese, Ana Rita DE Lima, Paola C Soares, Érika Branco
The wall of the diaphragm can be affected by changes caused by physical trauma, allowing the passage of viscera between the abdominal cavity and thoracic cavity, thus reducing the space for pulmonary expansion, leading to the formation of hernia and possible death. Thus, we aimed to characterize, size and determine the topography of the diaphragmatic muscle in the Southern Tamandua, since clinical and surgical activities in wild animals have become a reality more and more present in veterinary medicine. We used six adult animals, x-rayed and dissected, followed by collection of fragments of muscular portions for histological analysis...
April 16, 2018: Anais da Academia Brasileira de Ciências
https://www.readbyqxmd.com/read/29666717/aortic-dissection-presenting-as-septic-shock-a-case-report-and-literature-review
#20
Jing Feng, Rui Liu, Sai Ma, Changkui Cao, Wei Zhang, Yang Zhao, Shinan Nie
Acute aortic dissection is a life-threatening clinical emergency, which mostly occurs in aged patients and presents with sharp chest pain. In this paper, we reported a case of acute aortic dissection, which induced septic shock in a young woman, without typical chest pain. The septic shock was possibly due to the bacterial translocation caused by aortic dissection-induced intestinal ischemia and intestinal epithelial barrier dysfunction. Our case appeared as the first case report of aortic dissection presenting as septic shock...
2018: Case Reports in Emergency Medicine
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