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Aortic dilatation

Michael C Mongé, Osama M Eltayeb, John M Costello, Joyce T Johnson, Andrada R Popescu, Cynthia K Rigsby, Carl L Backer
BACKGROUND: Controversy remains regarding the optimal surgical approach for children with supravalvular aortic stenosis (SVAS). METHODS: Since 1997 we have used Brom three-patch aortoplasty for patients with SVAS. We prefer computed tomography (CT) imaging for preoperative evaluation rather than cardiac catheterization as it avoids the well-known morbidity of general anesthesia. The purpose of this study was to present our intermediate-term results of this strategy...
March 2018: World Journal for Pediatric & Congenital Heart Surgery
Francesco Nappi, Antonio Nenna, Domenico Larobina, Angelo Rosario Carotenuto, Mohamed Jarraya, Cristiano Spadaccio, Massimiliano Fraldi, Massimo Chello, Christophe Acar, Thierry Carrel
OBJECTIVES: Reinforcements for the pulmonary autograft (PA) in the Ross operation have been introduced to avoid the drawback of conduit expansion and failure. With the aid of an in silico simulation, the biomechanical boundaries applied to a healthy PA during the operation were studied to tailor the best implant technique to prevent reoperation. METHODS: Follow-up echocardiograms of 66 Ross procedures were reviewed. Changes in the dimensions and geometry of reinforced and non-reinforced PAs were evaluated...
March 12, 2018: Interactive Cardiovascular and Thoracic Surgery
Kyokun Uehara, Hitoshi Matsuda, Jiro Matsuo, Yosuke Inoue, Atsushi Omura, Yoshimasa Seike, Hiroaki Sasaki, Junjiro Kobayashi
AIM: To evaluate the surgical outcomes and midterm results of patients under 50 years old with acute type A aortic dissection (AAAD). METHODS: The study population included 51 patients who underwent AAAD repair between 2003 and 2016. Of these 51 patients, 46 (90.1%) were males and 14 (27.5%) had connective tissue disorders. Twenty-five patients (49.0%) had a body mass index >25.0 kg/m2 and two patients were pregnant. Total arch replacement was performed in 39 patients (76...
March 13, 2018: Journal of Cardiac Surgery
Ugur Kaya, Abdurrahim Colak, Necip Becit, Munacettin Ceviz, Hikmet Kocak
Objective: In the present study, we aimed to retrospectively investigate the early and late results of different surgical treatment techniques applied in different age groups with coarctation of the aorta (CoA). Materials and Methods: Between January 2007 and February 2017, 26 patients (12 males, 14 females; mean age: 12.2±12.4 years; range: 29 days-34 years) who underwent surgery with the diagnosis of CoA were evaluated. Overall, 11 of these patients (42.3%) were in the infantile period, whereas 15 patients (57...
February 2018: Eurasian Journal of Medicine
G Hong Ong, D K Benjamin Leong
Middle-aortic syndrome is a surgically curable cause of childhood hypertension. Open surgery is traditionally offered but with the advance of medical technology, endovascular approached is available in many country. Failure to control BP in open surgery is as low as 4.1% compares to 13% in endovascular approaches. However, mortality is 4% in open surgery almost 2 times higher than 2.3% in endovascular approach. This article presents a case of 10 years old child treated successfully without complication with endovascular balloon dilatation, as a first case of such disease in East Malaysia...
February 2018: Medical Journal of Malaysia
Michael Gottlieb, Brit Long, Alex Koyfman
INTRODUCTION: Aortic stenosis is a common condition among older adults that can be associated with dangerous outcomes, due to both the disease itself and its influence on other conditions. OBJECTIVE: This review provides an evidence-based summary of the current emergency department (ED) evaluation and management of aortic stenosis. DISCUSSION: Aortic stenosis refers to significant narrowing of the aortic valve and can be caused by calcific disease, congenital causes, or rheumatic valvular disease...
March 7, 2018: Journal of Emergency Medicine
Michael Ibrahim, Audrey E Spelde, Timothy I Carter, Prakash A Patel, Nimesh Desai
The normal aortic valve is a sophisticated and dynamic structure whose equal replacement has not yet been actualized by modern technology. The use of the pulmonary autograft as a substitute for a diseased aortic valve (the Ross procedure) has been in practice for several decades in many types of patient. In the adult, it has not been adopted widely due to concerns about its technical challenge, complex perioperative care, the development of pulmonic valve disease, and concerns about long-term dilatation of the neo-aortic root, among others...
December 29, 2017: Journal of Cardiothoracic and Vascular Anesthesia
Xiaofan Huang, Zhang Yue, Jia Wu, Jiuling Chen, Sihua Wang, Jie Wu, Linyun Ren, Anchen Zhang, Peng Deng, Ke Wang, Chuangyan Wu, Xiangchao Ding, Ping Ye, Jiahong Xia
OBJECTIVE: Thoracic aortic aneurysm and dissection (TAAD) are severe vascular conditions. Dysfunctional transforming growth factor-β (TGF-β) signaling in vascular smooth muscle cells and elevated angiotensin II (AngII) levels are implicated in the development of TAAD. In this study, we investigated whether these 2 factors lead to TAAD in a mouse model and explored the possibility of using microRNA-21 ( miR-21 ) for the treatment of TAAD. APPROACH AND RESULTS: TAAD was developed in Smad3 heterozygous (S3+/- ) mice infused with AngII...
March 8, 2018: Arteriosclerosis, Thrombosis, and Vascular Biology
Nicolaj C Hansson, Jonathon Leipsic, Francesca Pugliese, Henning R Andersen, Alexia Rossi, Matheus Simonato, Kaare T Jensen, Evald H Christiansen, Christian J Terkelsen, Philipp Blanke, Mariann Tang, Lars R Krusell, Kaj-Erik Klaaborg, Kim Terp, Simon Kennon, Danny Dvir, Hans Erik Bøtker, John Webb, Bjarne L Nørgaard
OBJECTIVES: We sought to determine the impact of aortic root calcium on the risk of significant paravalvular regurgitation (sPAR) in transcatheter aortic valve replacement (TAVR). METHODS: In 302 consecutive patients from 3 centers, aortic root calcium was quantified volumetrically on pre-TAVR multidetector computed tomography (MDCT) in three regions: 1) the aortic valve region, 2) the overall left ventricular outflow tract (LVOT) and 3) the upper LVOT. Transcathether heart valve (THV) oversizing was calculated as (THV nominal area/MDCT annular area-1) × 100...
February 15, 2018: Journal of Cardiovascular Computed Tomography
Ilaria Biasato, Renato Zanatta, Lorella Maniscalco, Rocchina Evangelista, Bryan Iotti, Selina Iussich
The unexpected demise of a 12-year-old male neutered English bulldog solicited a gross examination, which revealed a blood-filled space occurring in the proximal left subclavian artery (LSA). It originated about 1 cm from the branching point of the vessel and progressively dilated for 3 cm distal to this origin. Histopathological investigation showed that the tunica media of the LSA was more than 50% split, with the blood-filled space dissecting through the arterial wall. In the tunica media of the LSA, severe multifocal fragmentation and/or loss of the elastic fibers was observed...
March 5, 2018: Journal of Veterinary Cardiology: the Official Journal of the European Society of Veterinary Cardiology
Antonio F Corno, Saravanan Durairaj, Robert H Anderson
Aorto-ventricular tunnel is an extremely rare congenital heart defect, consisting of failure of attachment of an aortic leaflet along the semilunar hinge. In all published reports the leaflet involved was either the right coronary leaflet, most frequently, or the left coronary leaflet, in most of the cases opening toward the left ventricle, with only one-eighth of the reported cases communicating with the right ventricle. Treatment of the aorto-ventricular tunnel has been anecdotally reported by interventional closure with a device and more frequently with surgical approach, either as an isolated malformation or as associated lesions...
2018: Frontiers in Pediatrics
Masahide Komagamine, Nobuyuki Furukawa, Jan Gummert, Jochen Börgermann
Transapical transcatheter aortic valve implantation is a well-established alternative in patients at a high risk for conventional aortic valve replacement. We performed transapical transcatheter aortic valve implantation on an 83-year-old woman with symptomatic severe aortic stenosis. Intraoperative transoesophageal echocardiography (TOE) after transcatheter aortic valve implantation showed mild mitral regurgitation without intracardiac structural injury. In the intensive care unit, the patient gradually had haemodynamic instability; TOE revealed severe mitral regurgitation with A2 and A3 prolapse due to rupture of the posterior papillary muscle...
March 5, 2018: European Journal of Cardio-thoracic Surgery
Patrizia Presbitero, Loredana Iannetta, Paolo Pagnotta, Bernhard Reimers, Marco L Rossi, Dennis Zavalloni Parenti, Giovanni Bianchi, Francesco Bedogni
BACKGROUND: It is well known that bicuspid valve stenosis can be treated with transcatheter aortic valve implantation (TAVI) even if specific issues can cause problems: dilatation of ascending aorta, possible aorthopathy, eccentricity of the valve and calcium distribution in leaflets and in commissures. We classified Bicuspid aortic valve (BAV) in type 0 (2 cusps and no raphe), and type 1 (2 cusps and one or more raphes). The aim of the present study was to report the results of two types of valve (CoreValve from 2009 to 2016 and Lotus valve from 2014 to 2017) in a consecutive series of BAV patients treated in 2 Italian centers...
April 2018: Minerva Cardioangiologica
Hozan Mufty, Athanasios Katsargyris, Sabrina Houthoofd, Inge Fourneau, Eric Verhoeven, Geert Maleux
INTRODUCTION: Fenestrated/branched thoracic endovascular aneurysm repair (F/Br-TEVAR) is a new minimal invasive treatment option for patients with post-dissection thoracoabdominal aortic aneurysms. This specific pathology is challenging to F/Br-TEVAR, especially when target vessels originate from the false lumen. Crossing from the true lumen into the false lumen to catheterize such target vessels may prove cumbersome in the usually thickened dissection flap. TECHNIQUE: We describe a bailout technique when standard catheterization techniques fail, by using a transjugular intrahepatic portosystemic shunt (TIPS)-needle to perforate the dissection flap...
March 6, 2018: Cardiovascular and Interventional Radiology
Bradley J Toghill, Athanasios Saratzis, Peter J Freeman, Nicolas Sylvius, Matthew J Bown
Background: Abdominal aortic aneurysm (AAA) is a deadly cardiovascular disease characterised by the gradual, irreversible dilation of the abdominal aorta. AAA is a complex genetic disease but little is known about the role of epigenetics. Our objective was to determine if global DNA methylation and CpG-specific methylation at known AAA risk loci is associated with AAA, and the functional effects of methylation changes. Results: We assessed global methylation in peripheral blood mononuclear cell DNA from 92 individuals with AAA and 93 controls using enzyme-linked immunosorbent assays, identifying hyper-methylation in those with large AAA and a positive linear association with AAA diameter ( P  < 0...
2018: Clinical Epigenetics
Nilukshana Yogendranathan, H M M T B Herath, W D Jayamali, Anne Thushara Matthias, Aruna Pallewatte, Aruna Kulatunga
BACKGROUND: Spinal cord infarction is an uncommon condition. Anterior cord syndrome present with paraparesis or quadriparesis with sparing of vibration and proprioceptive senses. The common causes of anterior cord syndrome are aortic dissection and aortic surgical interventions. Spontaneous unruptured nondissected aortic aneurysms with intramural thrombus can rarely cause anterior cord infarctions. CASE PRESENTATION: We report a case of anterior spinal cord syndrome due to aneurysm of the thoracic aorta with a mural thrombus...
March 5, 2018: BMC Cardiovascular Disorders
Nazan Puluca, Melchior Burri, Julie Cleuziou, Markus Krane, Rüdiger Lange
OBJECTIVES: Most patients (75%) with Marfan syndrome present with aortic root dilatation that may require surgical intervention. However, associated cardiovascular disorders are not limited to the aortic root. These patients frequently require consecutive operations on the remaining thoracic aorta or the heart valves. Our intent was to characterize the spectrum of such procedures. METHODS: Data from all patients with Marfan syndrome undergoing aortic root surgery at our centre between 1988 and 2016 were analysed retrospectively...
February 28, 2018: European Journal of Cardio-thoracic Surgery
Anthony L Putrino, Damian Roper, Christopher O Raffel, Darren L Walters
No abstract text is available yet for this article.
February 22, 2018: JACC. Cardiovascular Interventions
Yeliz Akturk, Serra Ozbal Gunes
NORMAL ABDOMINAL AORTA DIAMETERS IN INFANTS, CHILDREN AND ADOLESCENTS: BACKGROUND: The normal limits of arterial diameters must be known to diagnose pathologies such as dilatation, stenosis and hypoplasia. There are studies which measure the thoracic aorta diameter in childhood, but the number of studies in which the normal aortic diameters are determined is very small. In this study, it was aimed to determine normal standard diameters of aorta and iliac arteries in pediatrics cases, both genders and at different levels...
March 2, 2018: Pediatrics International: Official Journal of the Japan Pediatric Society
Gilbert H L Tang, Syed Zaid, Samuel R Schnittman, Hasan Ahmad, Ryan Kaple, Cenap Undemir, Tanya Dutta, Angelica Poniros, Joanne Bennett, Cheng Feng, Martin Cohen, Steven L Lansman
AIMS: Paravalvular leak(PVL) remains an important issue in TAVI. The Edwards Sapien3(S3) valve has reduced PVL but up to one-third of patients remain with mild leak. Our study aims to identify predictors of mild PVL after TAVI with S3 valve. METHODS AND RESULTS: From 10/2015 to 5/2017, 122 consecutive patients underwent S3 TAVI for symptomatic severe aortic stenosis. 33 patients with mild PVL on transthoracic echocardiography at 30-day follow-up were compared to 89 with none/trace PVL...
February 27, 2018: EuroIntervention
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