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Thoracic aortic aneurysm

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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/29682469/conservative-management-versus-endovascular-or-open-surgery-in-the-spectrum-of-type-b-aortic-dissection
#2
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/29682117/characterization-of-smad2-activation-in-human-thoracic-aortic-aneurysm
#3
Hayato Fukuda, Hiroki Aoki, Shohei Yoshida, Satoru Tobinaga, Hiroyuki Otsuka, Takahiro Shojima, Kazuyoshi Takagi, Yoshihiro Fukumoto, Hidetoshi Akashi, Seiya Kato, Hiroyuki Tanaka
Objective : Thoracic aortic aneurysm (TAA) reflects the local expansion of the thoracic aorta; the underlying causal molecular mechanism of TAA is not well understood. Recent studies have shown the importance of transforming growth factor beta (TGFβ) signaling in Marfan and Loeys-Dietz syndromes; however, its role in non-familial, non-syndromic TAA remains unclear. Materials and Methods : We performed histochemical and immunohistochemical analyses for activated (phosphorylated) SMAD2 (P-SMAD2) as an indicator of TGFβ signaling activities in the ascending TAA tissue as well as in the ascending aortic tissue with a normal diameter obtained from 7 patients without any clinical findings suggesting familial or syndromic TAA...
March 25, 2018: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29678647/post-mortem-retrieval-of-arterial-allografts-preliminary-results
#4
Dorian Verscheure, Julien Gaudric, Jérémie Jayet, Philippe Tresson, Mohamed Jarraya, Pierre Julia, Marc Coggia, Laurent Chiche, Fabien Koskas
OBJECTIVES: Cryopreserved arterial allografts are vascular substitutes used for arterial reconstructions in a septic field. Their use remains however limited by the shortage of donors. One of the possibilities to address this lack of grafts is to multiply the sources of retrieval. The objective of this preliminary study was the evaluation of the early clinical results and the microbiological safety of arterial grafts retrieved after death. MATERIAL AND METHODS: In addition to the standard conditions of arterial sampling the criteria of inclusion for postmortem retrieval comprised the refrigeration of the body of the donor within four hours following the death, a 24-hour time limit from the death, and the availability of an adapted place for retrieval (surgical unit or death chamber respecting the required aseptic conditions)...
April 17, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29666015/patient-selection-could-be-the-holy-grail-of-thoracic-endovascular-aortic-repair-for-chronic-dissecting-aneurysm
#5
EDITORIAL
Ourania Preventza, Peter Chen
No abstract text is available yet for this article.
March 28, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29664433/case-image-treatment-of-aortic-coarctation-saccular-thoracic-aortic-aneurysm-and-corresponding-feeding-collateral-vessel-with-a-fully-percutaneous-endovascular-approach
#6
Ertan Vuruşkan, Gökhan Altunbaş, Fatma Yılmaz Coşkun, Osman Başpınar, Murat Sucu
No abstract text is available yet for this article.
April 2018: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/29661408/cerebrospinal-fluid-drain-related-complications-in-patients-undergoing-open-and-endovascular-repairs-of-thoracic-and-thoraco-abdominal-aortic-pathologies-a-systematic-review-and-meta-analysis
#7
REVIEW
L Q Rong, M K Kamel, M Rahouma, R S White, A D Lichtman, K O Pryor, L N Girardi, M Gaudino
BACKGROUND: Cerebrospinal-fluid (CSF) drainage is recommended by current guidelines for spinal protection during open and endovascular repairs of thoracic and thoraco-abdominal aortic aneurysms. In the published literature, great variability exists in the rate of CSF-related complications and morbidity. Herein, we perform a systematic review and meta-analysis on the incidence of CSF drainage-related complications, and compare the complication rates between open and endovascular repairs...
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29658870/descending-thoracic-aortic-aneurysm-rupture-treated-with-thoracic-endovascular-aortic-repair-in-a-patient-with-peripheral-artery-disease
#8
Ovidiu Stiru, Roxana Carmen Geana, Platon Pavel, Marian Croitoru, Cristian Boros, Ion Iovu, Vlad Anton Iliescu
Descending thoracic aortic aneurysm rupture is a life-threatening disease associated with high rates of morbidity and mortality. Treatment in these cases is a surgical emergency. Less invasive therapies for the treatment of this pathology have been developed over time. For descending thoracic aneurysm rupture, endovascular stent grafting is less invasive, life-saving, and a unique alternative to open repair. However, this approach is subject to anatomical and logistic limitations. The purpose of the present study is to report a case of an emergency endovascular repair for a ruptured thoracic aortic aneurysm in a patient with peripheral arterial disease, and to discuss some important issues related to this approach...
March 20, 2018: Heart Surgery Forum
https://www.readbyqxmd.com/read/29657953/factors-affecting-follow-up-compliance-in-patients-after-endovascular-aneurysm-repair
#9
Patrick T Jasinski, Nicos Labropoulos, Olympia G Christoforatos, Apostolos K Tassiopoulos
Objective: The purpose of this study was to evaluate potential factors affecting patient non-compliance after endovascular aneurysm repair. Method: We performed a retrospective review of patients undergoing elective or emergency endovascular repair for thoracic, abdominal aorta, or iliac artery aneurysm at a single institution from November 2007 to March 2014. Compliance to follow-up at 1, 6, and 12 months was assessed. Factors evaluated included patient demographics, size of aneurysm, distance between the patient's residence and outpatient clinic, urgency of surgery, and time of year in which the follow-up visits were scheduled...
October 2017: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/29656820/wall-stress-on-ascending-thoracic-aortic-aneurysms-with-bicuspid-compared-with-tricuspid-aortic-valve
#10
Yue Xuan, Zhongjie Wang, Raymond Liu, Henrik Haraldsson, Michael D Hope, David A Saloner, Julius M Guccione, Liang Ge, Elaine Tseng
OBJECTIVE: Guidelines for repair of bicuspid aortic valve-associated ascending thoracic aortic aneurysms have been changing, most recently to the same criteria as tricuspid aortic valve-ascending thoracic aortic aneurysms. Rupture/dissection occurs when wall stress exceeds wall strength. Recent studies suggest similar strength of bicuspid aortic valve versus tricuspid aortic valve-ascending thoracic aortic aneurysms; thus, comparative wall stress may better predict dissection in bicuspid aortic valve versus tricuspid aortic valve-ascending thoracic aortic aneurysms...
March 8, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29656146/genetics-of-the-extracellular-matrix-in-aortic-aneurysmal-diseases
#11
REVIEW
Chien-Jung Lin, Chieh-Yu Lin, Nathan O Stitziel
Aortic aneurysms are morbid conditions that can lead to rupture or dissection and are categorized as thoracic (TAA) or abdominal aortic aneurysms (AAA) depending on their location. While AAA shares overlapping risk factors with atherosclerotic cardiovascular disease, TAA exhibits strong heritability. Human genetic studies in the past two decades have successfully identified numerous genes involved in both familial and sporadic forms of aortic aneurysm. In this review we will discuss the genetic basis of aortic aneurysm, focusing on the extracellular matrix and how insights from these studies have informed our understanding of human biology and disease pathogenesis...
April 12, 2018: Matrix Biology: Journal of the International Society for Matrix Biology
https://www.readbyqxmd.com/read/29656120/systemic-inflammatory-response-syndromes-in-the-era-of-interventional-cardiology
#12
REVIEW
Riccardo Gorla, Raimund Erbel, Kim A Eagle, Eduardo Bossone
Systemic inflammatory response syndrome (SIRS), initially reported after cardiovascular surgery, has been described after various interventional cardiology procedures, including endovascular/thoracic aortic repair (EVAR/TEVAR), implantation of heart rhythm devices, percutaneous coronary intervention (PCI), electrophysiology procedures (EP), and transcatheter aortic valve implantation (TAVI). In these settings, a comprehensive understanding of the triggers, pathogenesis as well as a common diagnostic/therapeutic algorithm is lacking and will be discussed in this review...
April 12, 2018: Vascular Pharmacology
https://www.readbyqxmd.com/read/29644813/endovascular-repair-of-aortic-arch-disease-with-double-inner-branched-thoracic-stent-graft-the-bolton-perspective
#13
Ciro Ferrer, Carlo Coscarella, Piergiorgio Cao
BACKGROUND: In the light of current evidence, endovascular repair of aortic arch pathologies with custom-made devices should be considered a valid alternative to decrease operative mortality and morbidity associated with open or hybrid repair. Today, two double inner branch devices are available on market. We report our single-center experience with Bolton double branch stent graft in the treatment of aortic arch disease. METHODS: Between 2013 and 2016, 15 high-risk patients with arch pathology were treated in our center with a custom-made branched device...
April 11, 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29642797/recurrent-aortic-dissection-in-a-patient-with-an-actin-mutation-treated-with-a-laser-fenestrated-aortic-arch-stent-graft
#14
J Michael Cullen, Gorav Ailawadi, John F Angle, Matthew Thomas, Gilbert R Upchurch
A 58-year-old African American female, who had previously undergone a valve-sparing aortic root replacement for a type A dissection, represented 2 months later with a new focal dissection and aneurysm with intramural hematoma just distal to the origin of the left subclavian artery. Since no landing zone distal to the subclavian artery existed, the patient underwent thoracic endovascular aortic repair with laser fenestration-aided stent-graft placement in the left subclavian artery. The patient recovered without complication, and 52 months later, she is doing well with normal renal function and ambulatory status...
January 1, 2018: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29629554/single-stage-thoracic-aortic-replacement-and-aortic-valve-replacement-via-clamshell-thoracotomy
#15
Thomas Schachner
Aortic surgery is sometimes complicated by aortic arch anomalies. This tutorial illustrates the technique of single-stage thoracic aorta replacement and aortic valve replacement via a clamshell thoracotomy in acute aortic arch dissection with proximal aneurysms of the left subclavian artery and an aberrant right subclavian artery. The advantage of this technique is that only brief partial hypothermic circulatory arrest is required and the procedure can be performed with one quadrifurcated tube graft.
February 20, 2018: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://www.readbyqxmd.com/read/29627015/spinal-cord-infarction-clinical-and-imaging-insights-from-the-periprocedural-setting
#16
Nicholas L Zalewski, Alejandro A Rabinstein, Karl N Krecke, Robert D Brown, Eelco F M Wijdicks, Brian G Weinshenker, Derrick A Doolittle, Eoin P Flanagan
OBJECTIVE: Describe the range of procedures associated with spinal cord infarction (SCI) as a complication of a medical/surgical procedure and define clinical and imaging characteristics that could be applied to help diagnose spontaneous SCI, where the diagnosis is often less secure. METHODS: We used an institution-based search tool to identify patients evaluated at Mayo Clinic, Rochester, MN from 1997 to 2016 with a periprocedural SCI. We performed a descriptive analysis of clinical features, MRI and other laboratory findings, and outcome...
May 15, 2018: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/29625025/ltbp3-pathogenic-variants-predispose-individuals-to-thoracic-aortic-aneurysms-and-dissections
#17
Dong-Chuan Guo, Ellen S Regalado, Amelie Pinard, Jiyuan Chen, Kwanghyuk Lee, Christina Rigelsky, Lior Zilberberg, Ellen M Hostetler, Micheala Aldred, Stephanie E Wallace, Siddharth K Prakash, Suzanne M Leal, Michael J Bamshad, Deborah A Nickerson, Marvin Natowicz, Daniel B Rifkin, Dianna M Milewicz
The major diseases affecting the thoracic aorta are aneurysms and acute dissections, and pathogenic variants in 11 genes are confirmed to lead to heritable thoracic aortic disease. However, many families in which multiple members have thoracic aortic disease do not have alterations in the known aortopathy genes. Genes highly expressed in the aorta were assessed for rare variants in exome sequencing data from such families, and compound rare heterozygous variants (p.Pro45Argfs∗ 25 and p.Glu750∗ ) in LTBP3 were identified in affected members of one family...
April 5, 2018: American Journal of Human Genetics
https://www.readbyqxmd.com/read/29622560/role-of-adamts-a-disintegrin-and-metalloproteinase-with-thrombospondin-motifs-5-in-aortic-dilatation-and-extracellular-matrix-remodeling
#18
Marika Fava, Javier Barallobre-Barreiro, Ursula Mayr, Ruifang Lu, Athanasios Didangelos, Ferheen Baig, Marc Lynch, Norman Catibog, Abhishek Joshi, Temo Barwari, Xiaoke Yin, Marjan Jahangiri, Manuel Mayr
OBJECTIVE: Thoracic aortic aneurysm (TAA), a degenerative disease of the aortic wall, is accompanied by changes in the structure and composition of the aortic ECM (extracellular matrix). The ADAMTS (a disintegrin and metalloproteinase with thrombospondin motifs) family of proteases has recently been implicated in TAA formation. This study aimed to investigate the contribution of ADAMTS-5 to TAA development. APPROACH AND RESULTS: A model of aortic dilatation by AngII (angiotensin II) infusion was adopted in mice lacking the catalytic domain of ADAMTS-5 (Adamts5Δcat )...
April 5, 2018: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/29620622/cc1-emergent-endovascular-repair-of-a-ruptured-descending-thoracic-aortic-aneurysm-in-an-arresting-patient
#19
Warren Naselsky, Charles F Evans, Brody Wehman, Bradley S Taylor
OBJECTIVE: Our goal was to present a case of emergent endovascular repair of a ruptured descending aortic aneurysm in an actively arresting patient. PATIENT: The patient was a 75-year-old woman with a known history of a 6.5-cm descending thoracic aortic aneurysm with acute onset of back pain and syncope. A computed tomographic angiogram revealed disruption of the descending thoracic aorta and a mediastinal hematoma. The patient was taken emergently to the operating room...
April 4, 2018: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29615357/use-of-extracorporeal-bypass-is-associated-with-improved-outcomes-in-open-thoracic-and-thoracoabdominal-aortic-aneurysm-repair
#20
Jahan Mohebali, Stephanie Carvalho, R Todd Lancaster, Emel A Ergul, Mark F Conrad, W Darrin Clouse, Richard P Cambria, Virendra I Patel
OBJECTIVE: There is no consensus on the use or benefit of extracorporeal circulation (EC) during aneurysm repair of the descending thoracic aorta (DTA) or thoracoabdominal aorta (TAA). We evaluated the role of EC during DTA or TAA aneurysm repair using U.S. Medicare data. METHODS: Medicare (2004-2007) patients undergoing open repair of nonruptured DTA or TAA aneurysm were identified by International Classification of Diseases, Ninth Revision code. Specific exclusions included ascending aortic or arch repairs, concomitant cardiac procedures, and procedures employing deep hypothermic circulatory arrest...
March 31, 2018: Journal of Vascular Surgery
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