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Thoracic aortic aneurysm

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https://www.readbyqxmd.com/read/29023353/staged-repair-of-a-ruptured-thoracic-aortic-aneurysm-having-an-aorto-parenchymal-fistula
#1
Akihiro Yoshitake, Kazuma Okamoto, Mio Kasai, Hideyuki Shimizu
Ruptured thoracic aortic aneurysms, having aorto-bronchial or pulmonary parenchymal fistulations, are life-threatening conditions, and current surgical treatment results are not satisfactory. Herein, we describe a 69-year-old man with a ruptured thoracic aortic aneurysm and aorto-pulmonary parenchymal fistulation that was successfully treated using a staged repair. The first stage involved an emergency thoracic endovascular aortic repair for salvage and the second stage involved radical pulmonary parenchymal repair with removal of the stent graft and aortic reconstruction for long-term survival...
October 10, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29022854/single-center-mid-term-experience-with-chimney-graft-technique-for-the-preservation-of-flow-to-the-supra-aortic-branches
#2
Robert Shahverdyan, Spyridon Mylonas, Michael Gawenda, Jan Brunkwall
Objectives To investigate the feasibility and the mid-term outcomes of the chimney-graft technique for the revascularization of supra-aortic branches in patients with thoracic aortic pathologies involving the aortic arch. Methods A retrospective analysis of a prospectively maintained database between January 2010 and July 2016 was performed. Primary endpoints were 30-day and overall mortality. Secondary endpoints were technical success, target vessel patency, stroke/transitory ischemic attack and type I/III endoleak rate...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/29022827/descending-aortic-aneurysm-in-wiskott-aldrich-syndrome-options-for-repair
#3
Greta Wood, Karen Booth, Zahid Khan, Tina Biss, Chandrika Roysam, John Dark
We report open surgical repair of a previously stented descending thoracic aneurysm in a patient with Wiskott-Aldrich syndrome and a platelet count <10 × 10(9)·L(-1). The same patient was described previously in a report of the first endovascular stent in this form of vasculitis. We describe the pre- and intraoperative management, and suggest a change in strategy in this setting.
January 1, 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/29019146/spinal-cord-injury-after-thoracic-endovascular-aortic-aneurysm-repair
#4
Hamdy Awad, Mohamed Ehab Ramadan, Hosam F El Sayed, Daniel A Tolpin, Esmerina Tili, Charles D Collard
PURPOSE: Thoracic endovascular aortic aneurysm repair (TEVAR) has become a mainstay of therapy for aneurysms and other disorders of the thoracic aorta. The purpose of this narrative review article is to summarize the current literature on the risk factors for and pathophysiology of spinal cord injury (SCI) following TEVAR, and to discuss various intraoperative monitoring and treatment strategies. SOURCE: The articles considered in this review were identified through PubMed using the following search terms: thoracic aortic aneurysm, TEVAR, paralysis+TEVAR, risk factors+TEVAR, spinal cord ischemia+TEVAR, neuromonitoring+thoracic aortic aneurysm, spinal drain, cerebrospinal fluid drainage, treatment of spinal cord ischemia...
October 10, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28984667/ascending-aortic-aneurysm-is-an-inherited-disease-a-contemporary-literature-review-based-on-hill-s-criteria-of-specificity-strength-of-association-and-biological-coherence
#5
Mirza Mujadil Ahmad, Immad Arif Kiani, Khawaja Afzal Ammar, Mirza Nubair Ahmad, Bijoy K Khandheria, Timothy E Paterick, Renuka Jain, A Jamil Tajik
There is growing evidence of a differential etiological basis for thoracic aortic aneurysms (TAA), with ascending (As) TAAs being genetically mediated and descending (Des) TAAs more strongly related to acquired pathologies. A comprehensive literature review of this hypothesis has not been carried out. We carried out a systematic literature review based on the latest guidelines on TAA endorsed by the American Heart Association. The etiologies were classified as genetic and inherited, the studies were tabulated accordingly, and Hill's epidemiological criteria of causality were applied...
November 2017: Cardiology in Review
https://www.readbyqxmd.com/read/28977379/single-centre-experience-with-the-frozen-elephant-trunk-technique-in-251-patients-over-15%C3%A2-years
#6
Malakh Shrestha, Andreas Martens, Tim Kaufeld, Erik Beckmann, Sebastian Bertele, Heike Krueger, Julia Neuser, Felix Fleissner, Fabio Ius, Firas Abd Alhadi, Jasmin Hanke, Jan D Schmitto, Serghei Cebotari, Matthias Karck, Axel Haverich, Ajay Chavan
OBJECTIVES: Our goal was to present our 15-year experience (2001-2015) with the frozen elephant trunk (FET) technique. METHODS: A total of 251 patients (82 with aortic aneurysms, 96 with acute aortic dissection type A, 4 with acute type B dissections, 52 with chronic aortic dissection type A, 17 with chronic type B dissection and 67 redo cases) underwent FET implantation with either the custom-made Chavan-Haverich ( n  = 66), the Jotec E-vita ( n  = 31) or the Vascutek Thoraflex hybrid ( n  = 154) prosthesis...
August 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28976392/-approach-to-aortic-aneurysms-in-the-elderly
#7
Şeyda Günay, N Sümeyye Güllülü
There is an increase in the number of older persons worldwide. Because of this in the future we will much more manage the diseases which are more commonly seen in elderly in daily practice. One of the mortal diseases commonly seen in elderly patients is aortic aneurysm. Aort aneurysms are vary rare in patients under 50 age. When a patient over 65 age is examined, aortic aneurysm should take place in differential diagnosis list. aneurysm may be seen at both thoracic and abdominal aorta, but abdominal aorta is a more common site...
September 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28974934/corrigendum-candidate-gene-resequencing-in-a-large-bicuspid-aortic-valve-associated-thoracic-aortic-aneurysm-cohort-smad6-as-an-important-contributor
#8
Elisabeth Gillis, Ajay A Kumar, Ilse Luyckx, Christoph Preuss, Elyssa Cannaerts, Gerarda van de Beek, Björn Wieschendorf, Maaike Alaerts, Nikhita Bolar, Geert Vandeweyer, Josephina Meester, Florian Wünnemann, Russell A Gould, Rustam Zhurayev, Dmytro Zerbino, Salah A Mohamed, Seema Mital, Luc Mertens, Hanna M Björck, Anders Franco-Cereceda, Andrew S McCallion, Lut Van Laer, Judith M A Verhagen, Ingrid M B H van de Laar, Marja W Wessels, Emmanuel Messas, Guillaume Goudot, Michaela Nemcikova, Alice Krebsova, Marlies Kempers, Simone Salemink, Toon Duijnhouwer, Xavier Jeunemaitre, Juliette Albuisson, Per Eriksson, Gregor Andelfinger, Harry C Dietz, Aline Verstraeten, Bart L Loeys
[This corrects the article on p. 400 in vol. 8, PMID: 28659821.].
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28973303/fbn1-mutations-largely-contribute-to-sporadic-non-syndromic-aortic-dissection
#9
Lun Tan, Zongze Li, Chengming Zhou, Yanyan Cao, Lina Zhang, Xianqing Li, Katherine Cianflone, Yan Wang, Dao Wen Wang
Mutations in FBN1 have been well identified in syndromic aortic dissection (AD) and familial thoracic aortic aneurysms and dissections. However, whether mutations of FBN1 contribute to sporadic non-syndromic AD and the characteristics of mutations remain unknown.Using next-generation-sequencing technology, FBN1 was sequenced in a total of 702 sporadic cases (including 687 of non-syndromic AD and 15 of sporadic Marfan syndrome (MFS) with aortic event, and 527 normal controls). For the sporadic non-syndromic AD cohort, we found 26 variants in 27 patients (18 with missense, 2 frameshift, 1 initiation codon mutation, 3 nonsense, and 3 splice site mutations)...
September 18, 2017: Human Molecular Genetics
https://www.readbyqxmd.com/read/28973148/a-constitutive-bcl2-down-regulation-aggravates-the-phenotype-of-pkd1-mutant-induced-polycystic-kidney-disease
#10
Laurence Duplomb, Nathalie Droin, Olivier Bouchot, Christel Robinet Thauvin, Ange-Line Bruel, Julien Thevenon, Patrick Callier, Guillaume Meurice, Noémie Pata-Merci, Romaric Loffroy, David Vandroux, Romain Da Costa, Virginie Carmignac, Eric Solary, Laurence Faivre
The main identified function of BCL2 protein is to prevent cell death by apoptosis. Mice knock-out for Bcl2 demonstrate growth retardation, severe polycystic kidney disease (PKD), gray hair and lymphopenia, and die prematurely after birth. Here, we report a 40-year-old male referred to for abdominal and thoracic aortic dissection with associated aortic root aneurysm, PKD, lymphocytopenia with a history of T cell lymphoblastic lymphoma, white hair since the age of 20, and learning difficulties. PKD, which was also detected in the father and sister, was related to an inherited PKD1 mutation...
September 11, 2017: Human Molecular Genetics
https://www.readbyqxmd.com/read/28973104/use-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta-for-proximal-aortic-control-in-patients-with-severe-hemorrhage-and-arrest
#11
Megan Brenner, William Teeter, Melanie Hoehn, Jason Pasley, Peter Hu, Shiming Yang, Anna Romagnoli, Jose Diaz, Deborah Stein, Thomas Scalea
Importance: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a percutaneous transfemoral balloon technique used in select centers for resuscitation and temporary hemostasis, often instead of emergency department thoracotomy. The ability to perform aortic occlusion (AO) with an intravascular device allows focused occlusion at the most distal level to perfuse proximal regions while slowing hemorrhage to injured areas. Objective: To describe what is to date the largest single-institution experience with REBOA in the United States...
September 27, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28966285/preliminary-evaluation-of-aortic-aneurysm-screening-using-oscillometric-device-equipped-with-novel-algorithm-analyzing-pulse-wave-transfer
#12
Shigeo Ichihashi, Tomoko Hashimoto, Shinichi Iwakoshi, Kenji Obayashi, Keigo Saeki, Kimihiko Kichikawa
BACKGROUND: Detection of aortic aneurysm (AA) prior to rupture is crucial to decreasing its mortality. Towards this purpose, a novel detection algorithm was developed from pulse volume recording (PVR), analyzing the propagation loss of pulse waves caused by expansion of the aortic wall. The diagnostic ability of the algorithm was evaluated in this prospective study.Methods and Results:PVR were measured for 30 s using the oscillometric device designed for automatic measurement of the ankle-brachial index (ABI)...
September 29, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28956729/the-use-of-thoracic-stent-grafts-for-endovascular-repair-of-abdominal-aortic-aneurysms
#13
V P Bastiaenen, Mgj Snoeijs, Jgam Blomjous, J Bosma, V J Leijdekkers, R C van Nieuwenhuizen, A C Vahl
Objectives Stent grafts for endovascular repair of infrarenal aneurysms are commercially available for aortic necks up to 32 mm in diameter. The aim of this study was to evaluate the feasibility of endovascular repair with large thoracic stent grafts in the infrarenal position to obtain adequate proximal seal in wider necks. Methods All patients who underwent endovascular aneurysm repair using thoracic stent grafts with diameters greater than 36 mm between 2012 and 2016 were included. Follow-up consisted of CT angiography after six weeks and annual duplex thereafter...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28955701/sequential-hybrid-repair-of-aorta-and-bilateral-common-iliac-arteries-secondary-to-chronic-aortic-dissection-with-extensive-aneurysmal-degeneration-in-a-marfan-patient
#14
Carlos A Hinojosa, Javier E Anaya-Ayala, Hugo Laparra-Escareno, Rene Lizola, Adriana Torres-Machorro
Marfan syndrome is a connective tissue disorder associated with aortic dissection, aneurysmal degeneration and rupture. These cardiovascular complications represent the main cause of mortality, therefore repair is indicated. We present a 35-year-old woman who experienced acute onset of chest pain. Her imaging revealed a chronic DeBakey type I dissection with aortic root dilation and descending thoracic aneurysmal degeneration. She underwent a Bentall procedure and endovascular exclusion of the descending thoracic aortic aneurysm...
September 2017: Vascular Specialist International
https://www.readbyqxmd.com/read/28955046/critical-role-of-adamts-4-in-the-development-of-sporadic-aortic-aneurysm-and-dissection-in-mice
#15
Pingping Ren, Michael Hughes, Swapna Krishnamoorthy, Sili Zou, Lin Zhang, Darrell Wu, Chen Zhang, John A Curci, Joseph S Coselli, Dianna M Milewicz, Scott A LeMaire, Ying H Shen
Sporadic aortic aneurysm and dissections (AADs) are common vascular diseases that carry a high mortality rate. ADAMTS-4 (a disintegrin-like and metalloproteinase with thrombospondin motifs-4) is a secreted proteinase involved in inflammation and matrix degradation. We previously showed ADAMTS-4 levels were increased in human sporadic descending thoracic AAD (TAAD) samples. Here, we provide evidence that ADAMTS-4 contributes to aortic destruction and sporadic AAD development. In a mouse model of sporadic AAD induced by a high-fat diet and angiotensin II infusion, ADAMTS-4 deficiency (Adamts-4-/-) significantly reduced challenge-induced aortic diameter enlargement, aneurysm formation, dissection and aortic rupture...
September 27, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28947226/outcomes-of-thoracic-endovascular-aortic-repair-in-adult-coarctation-patients
#16
Salim Lala, Salvatore T Scali, Robert J Feezor, Satish Chandrekashar, Kristina A Giles, Javairiah Fatima, Scott A Berceli, Martin R Back, Thomas S Huber, Thomas M Beaver, Adam W Beck
BACKGROUND: Aortic coarctation (AC) is most commonly identified in pediatric patients; however, adults can present with late sequelae of untreated coarctation or complications of prior open repair. To date, there are limited data about the role of thoracic endovascular aortic repair (TEVAR) in this group of patients. The purpose of this analysis was to describe our experience with management of adult coarctation patients using TEVAR. METHODS: All TEVAR patients treated for primary coarctation or late sequelae of previous open repair (eg, pseudoaneurysm, recurrent coarctation or anastomotic stenosis related to index open coarctation repair) were reviewed...
September 22, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28943527/crossing-bridges-between-extra-and-intra-cellular-events-in-thoracic-aortic-aneurysms
#17
Yoshito Yamashiro, Hiromi Yanagisawa
Thoracic aortic aneurysms (TAAs) are common, life-threatening diseases and are a major cause of mortality and morbidity. Over the past decade, genetic approaches have revealed that 1) activation of the transforming growth factor beta (TGF-β) signaling, 2) alterations in the contractile apparatus of vascular smooth muscle cells (SMCs), and 3) defects in the extracellular matrix (ECM) were responsible for development of TAAs. Most recently, a fourth mechanism has been proposed in that dysfunction of mechanosensing in the aortic wall in response to hemodynamic stress may be a key driver of TAAs...
September 22, 2017: Journal of Atherosclerosis and Thrombosis
https://www.readbyqxmd.com/read/28943007/thoracic-endovascular-aortic-repair-migration-and-aortic-elongation-differentiated-using-dual-reference-point-analysis
#18
Hillary B Alberta, Toshio Takayama, Annalise Panthofer, Richard P Cambria, Mark A Farber, William D Jordan, Jon S Matsumura
OBJECTIVE: We evaluated images of patients undergoing a thoracic endovascular aortic repair procedure using two reference points as a means for differentiating stent graft migration from aortic elongation. Conventional standards define migration of a stent graft as an absolute change in the distance from the distal graft ring to a distal landmark ≥10 mm compared with a baseline measurement. Aortic elongation occurs over time in both healthy individuals and patients with aortic disease...
September 21, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28939705/retrograde-type-a-aortic-dissection-after-thoracic-endovascular-aortic-repair-a-systematic-review-and-meta-analysis
#19
REVIEW
Yanqing Chen, Simeng Zhang, Lei Liu, Qingsheng Lu, Tianyi Zhang, Zaiping Jing
BACKGROUND: Retrograde type A aortic dissection (RTAD) is a potentially lethal complication after thoracic endovascular aortic repair (TEVAR). However, data are limited regarding the development of RTAD post-TEVAR. This systematic review aims to define the incidence, mortality, and potential risk factors of RTAD post-TEVAR. METHODS AND RESULTS: Multiple electronic searches were performed. Fifty publications with a total of 8969 patients were analyzed. Pooled estimates for incidence and mortality of RTAD were 2...
September 22, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28939200/open-distal-fenestration-of-chronic-dissection-facilitates-endovascular-elephant-trunk-completion-late-outcomes
#20
Muhammad Aftab, Jay J Idrees, Frank Cikach, Jose L Navia, Donald Hammer, Eric E Roselli
BACKGROUND: Retrograde false lumen perfusion is a common mode of failure after stent grafting chronic aortic dissection. Open fenestration during the first-stage elephant trunk (ET) creates a landing zone for second-stage endovascular ET completion in patients with a false lumen aneurysm. Our objectives were to assess long-term safety and durability of this technique. METHODS: From 2007 to 2014, 56 patients with thoracoabdominal dissection and aneurysm underwent stage 1 ET and open fenestration...
September 19, 2017: Annals of Thoracic Surgery
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