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Thoracic aortic aneurysm

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https://www.readbyqxmd.com/read/29455820/ductus-aneurysm-ruptured-into-the-esophagus-with-massive-bleeding
#1
Takeshi Soeda, Mai Sakashita, Takamitsu Hamada, Yuhei Saito, Yasuhito Kitakado, Nobuo Morioka
We report a patient with life-threatening hematemesis caused by the rupture of a ductus aneurysm into the esophagus, which was successfully treated by coil embolism for the esophageal fistula through the aorta and subsequent thoracic endovascular aortic replacement. Second-stage therapy was performed surgically after proactive antibiotic treatment and in consideration of the patient's improved general condition. This included debridement with drainage, aortic encasement with remnant aneurysmal wall, omentopexy, and jejunostomy...
March 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29452988/expert-consensus-recommendations-on-the-cardiogenetic-care-for-patients-with-thoracic-aortic-disease-and-their-first-degree-relatives
#2
Judith M A Verhagen, Marlies Kempers, Luc Cozijnsen, Berto J Bouma, Anthonie L Duijnhouwer, Jan G Post, Yvonne Hilhorst-Hofstee, Sebastiaan C A M Bekkers, Wilhelmina S Kerstjens-Frederikse, Thomas J van Brakel, Eric Lambermon, Marja W Wessels, Bart L Loeys, Jolien W Roos-Hesselink, Ingrid M B H van de Laar
BACKGROUND: Thoracic aortic aneurysm (TAA) is a potentially life-threatening disorder with a strong genetic component. The number of genes implicated in TAA has increased exponentially over the last decade. Approximately 20% of patients with TAA have a positive family history. As most TAA remain asymptomatic for a long time, screening of at risk relatives is warranted to prevent complications. Existing international guidelines lack detailed instructions regarding genetic evaluation and family screening of TAA patients...
February 7, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29444731/isolated-aortic-dilation-without-osteoarthritis-a-case-of-smad3-mutation
#3
Jose Arroyave, Juan Manuel Carretero, Domenico Gruosso
Aneurysm-osteoarthritis syndrome is a recently discovered inherited autosomal dominant connective tissue disease caused by SMAD3 mutations. Aneurysm-osteoarthritis syndrome is responsible for 2% of familial thoracic aortic aneurysms and dissections and is characterised by aneurysms, dissections, and tortuosity throughout the arterial tree in combination with osteoarthritis. Early-onset osteoarthritis is present in almost all patients. We present the case of a non-syndromic young boy with SMAD3 mutation isolated from the dilated aortic root and ascending aorta without osteoarthritis...
February 15, 2018: Cardiology in the Young
https://www.readbyqxmd.com/read/29436236/thiol-disulphide-homeostasis-in-thoracic-aortic-aneurysm-and-acute-aortic-syndrome
#4
Oğuz Akkuş, Onur Kaypaklı, Hasan Koca, Mustafa Topuz, Mehmet Kaplan, Ahmet Oytun Baykan, Muhittin Zafer Samsa, Alaa Quisi, Özcan Erel, Salim Neşelioglu, Mustafa Gür
AIM: The aim of this study was to evaluate whether ranging values of thiol and disulphide herald a dilatation or impending acute aortic syndrome at thoracic aorta. Results/methodology: Study population consisted of patients with aortic aneurysm (n = 58), with acute aortic syndrome (n = 32) and without aortic aneurysm (control group; n = 61). A spectrophotometric method was used to determine thiol and disulphide. Native and total thiol levels were moderately correlated with maximal aortic diameter...
February 13, 2018: Biomarkers in Medicine
https://www.readbyqxmd.com/read/29428836/infrarenal-to-innominate-artery-collateral-complicating-a-chronic-residual-type-b-dissection
#5
Sameer Hirji, Jehangir J Appoo, Mollie Ferris, Jason Wong, Eric Herget
Residual Type B aortic dissection following open surgical repair of a Type A thoracic aortic dissection- can sometimes be complicated by collateral blood supplies, which can impact existing flow patterns, and result in progressive aneurysmal dilatation of the thoracic false lumens. We report a unique case that describes the clinical presentation of an infrarenal to innominate artery collateral blood flow that complicated a chronic residual type B dissection, which was timely diagnosed using multi-modality imaging, and successfully managed through an innovative minimally-invasive endovascular treatment strategy (without thoracotomy) with no neurological sequela...
February 8, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29428538/carotid-access-for-endovascular-repair-of-aortic-pathology-a-systematic-review
#6
Thomas W Stonier, Kirtan Patel, Vamsee Bhrugubanda, Andrew Mtl Choong
BACKGROUND: Endovascular repair is now preferred to open access for the management of aortic diseases. This is typically performed via the femoral artery, however not all patients are eligible for this. This systematic review summaries the current evidence for utilising the carotid artery as an alternative access route. METHODS: A systematic review was conducted as per the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines using four electronic databases...
February 8, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29424912/the-potential-role-of-quantitative-digital-subtraction-angiography-in-evaluating-type-b-chronic-aortic-dissection-during-tevar-preliminary-results
#7
G Tinelli, F Minelli, F De Nigris, C Vincenzoni, M Filipponi, P Bruno, M Massetti, A Flex, R Iezzi
OBJECTIVE: To evaluate the role of quantitative digital subtraction angiography (Q-DSA) with parametric color coding (PCC) in assessing patients with type B chronic thoracic aortic dissection (TBCAD) during thoracic endovascular aortic repair (TEVAR) procedures. PATIENTS AND METHODS: A total of 11 patients electively treated in our Department for a TBCAD were retrospectively enrolled. All cases were treated with TEVAR for false lumen aneurysm of the thoracic descending aorta...
January 2018: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29421425/a-custom-made-treovance%C3%A2-abdominal-aortic-aneurysm-endograft-to-correct-late-failure-of-trombone-technique-with-a-tube-endograft
#8
George S Georgiadis, Christos Argyriou, Christina D Valsamidou, Alexandrina S Nikova, Miltos K Lazarides
PURPOSE: Unfavorable anatomy is one of the major limitations of endovascular aortic aneurysm repair (EVAR) with specifically, adverse proximal neck morphology excluding many patients from receiving the standard endograft devices. Thoracic tube endografts have been used to overcome the issue of wide infrarenal necks, either as a sole device (single tubes or double tubes using the trombone technique) or as the proximal part of a bifurcated device fixed to the aortic bifurcation or infrarenally oriented...
February 5, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29415372/one-stage-replacement-of-the-aorta-from-arch-to-thoracoabdominal-region
#9
Takashi Matsueda, Yuki Ikeno, Koki Yokawa, Yojiro Koda, Soichiro Henmi, Takeshi Inoue, Hiroshi Tanaka, Yutaka Okita
OBJECTIVES: We present our experience with one-stage replacement of thoracic aneurysm from the ascending aorta to the thoracoabdominal aorta. PATIENTS AND METHODS: Fourteen patients (10 male and 4 female; mean age 53.6 ± 12.4 years) with extended thoracic aortic aneurysms underwent graft replacement. The pathology of the diseased aorta was chronic aortic dissection in 13 patients and intraoperative retrograde aortic dissection in 1 patient. Five patients had Marfan syndrome...
February 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29415193/ten-year-experience-of-the-thoraco-abdominal-aortic-aneurysm-treatment-using-a-hybrid-thoracic-endovascular-aortic-repair
#10
Takashi Shuto, Tomoyuki Wada, Shinji Miyamoto, Noritaka Kamei, Norio Hongo, Hiromu Mori
OBJECTIVES: The treatment of thoraco-abdominal aortic aneurysm continues to have a high mortality and paraplegia rate. In superaging societies, the methods of performing less invasive operations remain a major issue. We reviewed our 10-year experience in the treatment of thoraco-abdominal aortic aneurysm using a hybrid procedure of combined visceral reconstruction and thoracic endovascular aortic repair. METHODS: Sixty patients underwent a hybrid repair for the treatment of the thoraco-abdominal aortic aneurysm between 2007 and 2016...
February 2, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29400263/geometric-deformations-of-the-thoracic-aorta-and-supra-aortic-arch-branch-vessels-following-thoracic-endovascular-aortic-repair
#11
Brant W Ullery, Ga-Young Suh, Kelsey Hirotsu, David Zhu, Jason T Lee, Michael D Dake, Dominik Fleischmann, Christopher P Cheng
OBJECTIVE: To utilize 3-D modeling techniques to better characterize geometric deformations of the supra-aortic arch branch vessels and descending thoracic aorta after thoracic endovascular aortic repair. METHODS: Eighteen patients underwent endovascular repair of either type B aortic dissection (n = 10) or thoracic aortic aneurysm (n = 8). Computed tomography angiography was obtained pre- and postprocedure, and 3-D geometric models of the aorta and supra-aortic branch vessels were constructed...
January 1, 2018: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29398314/infrarenal-aortic-repair-with-or-without-false-lumen-intentional-placement-of-endografts-for-hybrid-management-of-complex-aortic-dissection
#12
William J Quinones-Baldrich, Taimur Saleem, Adam Oskowitz
OBJECTIVE: Aortic dissection (AD) often involves the infrarenal aorta. We review our experience with open infrarenal aortic repair with or without false lumen intentional placement (FLIP) of endografts in the proximal dissected aorta as part of a hybrid strategy to treat complex AD. METHODS: A prospectively maintained database of patients undergoing intervention for AD was reviewed. Data regarding diagnosis, imaging features, nature of the infrarenal repair (one- vs two-stage procedure), endoleaks, need for additional interventions, morbidity, and mortality were collected...
February 2, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29395709/aortic-arch-reconstructive-surgery-with-conventional-techniques-vs-frozen-elephant-trunk-a-systematic-review-and-meta-analysis
#13
REVIEW
Hasib Hanif, Luc Dubois, Maral Ouzounian, Mark D Peterson, Ismail El-Hamamsy, Francois Dagenais, Ansar Hassan, Michael W A Chu
BACKGROUND: Frozen elephant trunk (FET) surgery offers a new alternative in the management of complex thoracic aortic aneurysms and dissections. We performed a systematic review and meta-analysis of comparator observational studies evaluating the efficacy of FET compared with conventional aortic arch surgery, primarily focusing on mortality and stroke as well as the secondary outcomes of spinal cord ischemia, major bleeding, and operative time. METHODS: We searched MEDLINE, EMBASE, PubMed, and the Cochrane Library for trials and studies comparing the FET technique with conventional surgery in patients with aortic aneurysms or dissections, or both...
December 26, 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29395211/height-alone-rather-than-body-surface-area-suffices-for-risk-estimation-in-ascending-aortic-aneurysm
#14
Mohammad A Zafar, Yupeng Li, John A Rizzo, Paris Charilaou, Ayman Saeyeldin, Camilo A Velasquez, Ahmed M Mansour, Syed Usman Bin Mahmood, Wei-Guo Ma, Adam J Brownstein, Maryann Tranquilli, Julia Dumfarth, Panagiotis Theodoropoulos, Kabir Thombre, Maryam Tanweer, Young Erben, Sven Peterss, Bulat A Ziganshin, John A Elefteriades
BACKGROUND: In international guidelines, risk estimation for thoracic ascending aortic aneurysm (TAAA) is based on aortic diameter. We previously introduced the aortic size index (ASI), defined as aortic size/body surface area (BSA), as a predictor of aortic dissection, rupture, and death. However, weight might not contribute substantially to aortic size and growth. We seek to evaluate the height-based aortic height index (AHI) versus ASI for risk estimation and revisit our natural history calculations...
December 6, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29395204/intercostal-artery-management-in-thoracoabdominal-aortic-surgery-to-reattach-or-not-to-reattach
#15
Rana O Afifi, Harleen K Sandhu, Syed T Zaidi, Ernest Trinh, Akiko Tanaka, Charles C Miller, Hazim J Safi, Anthony L Estrera
BACKGROUND: The need for intercostal artery (ICA) reattachment in surgery for descending thoracic aortic aneurysm (DTAA) or thoracoabdominal aortic aneurysm (TAAA) remains controversial. We reviewed our experience over a 14-year period to assess the effects of ICA management on neurologic outcome after DTAA/TAAA repair. METHODS: Intraoperative data were reviewed to ascertain the status of T3-12 ICAs and L1-4 ICAs. Arteries were classified as reattached, ligated, occluded, or not exposed...
January 6, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29388028/total-arch-replacement-versus-debranching-thoracic-endovascular-aortic-repair-for-aortic-arch-aneurysm-what-indicates-a-high-risk-patient-for-arch-repair-in-octogenarians
#16
Yoshimasa Seike, Hitoshi Matsuda, Tetsuya Fukuda, Yosuke Inoue, Atsushi Omura, Kyokun Uehara, Hiroaki Sasaki, Junjiro Kobayashi
OBJECTIVES: This study aimed to reveal the differences in intermediate outcomes between TAR and d-TEVAR in octogenarians and to identify risk factors for adverse events after aortic arch repair in octogenarians. METHODS: We reviewed medical records of 125 patients aged > 80 years who underwent surgical intervention for aortic aneurysm between 2008 and 2016. Of these, 60 underwent conventional TAR (43 men; age, 82 ± 2.2 years) and 65 underwent d-TEVAR (49 men; age, 84 ± 3...
January 31, 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29380632/model-reduction-methodology-for-computational-simulations-of-endovascular-repair
#17
V A Acosta Santamaría, G Daniel, D Perrin, J N Albertini, E Rosset, S Avril
Endovascular aneurysm repair (EVAR) is a current alternative treatment for thoracic and abdominal aortic aneurysms, but is still sometimes compromised by possible complications such as device migration or endoleaks. In order to assist clinicians in preventing these complications, finite element analysis (FEA) is a promising tool. However, the strong material and geometrical nonlinearities added to the complex multiple contacts result in costly finite-element models. To reduce this computational cost, we establish here an alternative and systematic methodology to simplify the computational simulations of stent-grafts (SG) based on FEA...
January 30, 2018: Computer Methods in Biomechanics and Biomedical Engineering
https://www.readbyqxmd.com/read/29371244/cell-type-specific-contributions-of-the-angiotensin-ii-type-1a-receptor-to-aorta-homeostasis-and-aneurysmal-disease
#18
Josephine Galatioto, Cristina I Caescu, Jens Hansen, Jason Cook, Irving Miramontes, Ravi Iyengar, Francesco Ramirez
OBJECTIVE: Two were the aims of this study: first, to translate whole-genome expression profiles into computational predictions of functional associations between signaling pathways that regulate aorta homeostasis and the activity of angiotensin II type 1a receptor (At1ar) in either vascular endothelial or smooth muscle cells and second, to characterize the impact of endothelial cell- or smooth muscle cell-specific At1ar disruption on the development of thoracic aortic aneurysm in fibrillin-1 hypomorphic mice, a validated animal model of early onset progressively severe Marfan syndrome...
January 25, 2018: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/29370354/systematic-evaluation-of-collateral-pathways-to-the-artery-of-adamkiewicz-using-computed-tomography
#19
Kunihiro Yoshioka, Ryoichi Tanaka, Hidenobu Takagi, Yuta Ueyama, Tsuyoshi Sugawara, Takuya Chiba, Kazumasa Arakita, Joanne D Schuijf
OBJECTIVES: Preoperative identification of the artery of Adamkiewicz can help prevent postoperative spinal cord injury in patients undergoing thoracic and thoraco-abdominal aortic aneurysm repair. Although several studies have shown the feasibility of evaluating the artery of Adamkiewicz using multidetector row computed tomography (MDCT), no detailed investigations regarding the collateral circulation to the artery of Adamkiewicz have been performed. The purpose of this study was to investigate the collateral circulation to the artery of Adamkiewicz using MDCT in patients with thoracic and thoraco-abdominal aortic aneurysms...
January 22, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29365098/safety-of-perioperative-cerebral-oxygen-saturation-during-debranching-in-patients-with-incomplete-circle-of-willis
#20
Yosuke Takahashi, Takashi Murakami, Yasuyuki Sasaki, Yasuyuki Bito, Hiromichi Fujii, Shinsuke Nishimura, Toshihiko Shibata
OBJECTIVES: The consequences of common carotid artery (CCA) cross-clamping during debranching before thoracic endovascular aortic repair are unclear. We examined the safety of a simple CCA cross-clamping procedure under regional cerebral oxygen saturation monitoring (rSO2) in patients with a complete or incomplete circle of Willis (CoW) anatomy. METHODS: Twenty-eight patients with thoracic aneurysm underwent elective debranching thoracic endovascular aortic repair with bilateral frontal rSO2 monitoring at our institution between January 2012 and October 2015...
January 19, 2018: Interactive Cardiovascular and Thoracic Surgery
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