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Thoracic aortic aneurysm

Elizabeth Robertson, Brett Hambly, Richmond Jeremy
No abstract text is available yet for this article.
February 2016: Pathology
Moussa Abi Ghanem, Mario Gomez-Sanchez, Xavier Chaufour, Bertrand Marcheix
Thoracic endovascular aortic repair (TEVAR) is recognized as an attractive option to treat complicated Type B aortic dissection. Nevertheless, TEVAR is not always technically possible. We report the case of a 53-year-old male with complicated Type B aortic dissection, in the setting of a complex anomalous aortic arch anatomy with an aneurysmal aberrant right subclavian artery. He was successfully treated by the frozen elephant trunk technique using the Thoraflex hybrid graft.
February 2016: Aorta (Stamford, Conn.)
Kailash Prasad, Abdullah Sarkar, Mohammad A Zafar, Ahmed Shoker, Hamdi Ei Moselhi, Maryann Tranquilli, Bulat A Ziganshin, John A Elefteriades
BACKGROUND: Matrix metalloproteinases (MMPs) have been implicated in the pathogenesis of thoracic aortic aneurysms (TAAs). Cytokines [Interleukin (IL)-Iβ, IL-2, IL-6, and TNF-α)] increase the expression of MMP-2 and -3. Advanced glycation end products (AGEs) interact with cell receptors to increase the release of cytokines. Circulating soluble receptors for AGEs (sRAGE) and endogenous secretory RAGE (esRAGE) compete with membrane bound RAGE for binding with AGEs and reduce the production of cytokines...
February 2016: Aorta (Stamford, Conn.)
Ryan C Shelstad, Justin G Reeves, Katsuhiro Yamanaka, T Brett Reece
We review the operative techniques of aortic arch replacement. Aortic arch replacement presents several formidable challenges, as it requires arresting the circulation to the body and replacement of the brachiocephalic vessels with special consideration for protecting the central nervous system. Perfusion strategies, selective antegrade cerebral perfusion, and operative graft selection are key elements in aortic arch replacement surgery. Standard approaches include the island technique, the branched graft technique, and the "Spielvogel" trifurcated graft technique-each having its own advantages...
October 7, 2016: Seminars in Cardiothoracic and Vascular Anesthesia
J Sobocinski, B O Patterson, A Vidal-Diez
No abstract text is available yet for this article.
August 2016: Journal of Vascular Surgery
Yuji Kanaoka, Takao Ohki, Koji Maeda, Takeshi Baba
PURPOSE: To evaluate risk factors for early (<30 days) type I endoleak following thoracic endovascular aortic repair (TEVAR). METHODS: A retrospective study was conducted of 439 consecutive patients (mean age 74.0±10.0 years; 333 men) who underwent TEVAR at a single center between June 2006 and June 2013. Pathologies included 237 aortic arch aneurysms and 202 descending thoracic aortic aneurysms (dTAA). Maximum TAA diameter was 63.6±13.7 mm. Among the distal aortic arch aneurysms, 124 required coverage of the left subclavian artery (LSA), while the remaining 113 arch aneurysms had debranching (n=40), the chimney technique (n=52), and a branched stent-graft (n=13)...
October 19, 2016: Journal of Endovascular Therapy
Karina Di Gregoli, Nur Najmi Mohamad Anuar, Rosaria Bianco, Stephen J White, Andrew C Newby, Sarah J George, Jason L Johnson
RATIONALE: Atherosclerosis and aneurysms are leading causes of mortality worldwide. MicroRNAs (miRs) are key determinants of gene and protein expression, and atypical miR expression has been associated with a number of cardiovascular diseases; although their contributory role to atherosclerotic plaque and abdominal aortic aneurysm (AAA) stability are poorly understood. OBJECTIVE: To investigate whether miR-181b regulates TIMP-3 expression and affects atherosclerosis and aneurysms Methods and Results: Here, we demonstrate that miR-181b was over-expressed in symptomatic human atherosclerotic plaques and abdominal aortic aneurysms, and correlated with decreased expression of predicted miR-181b targets, TIMP-3 and elastin...
October 18, 2016: Circulation Research
Charbel Saade, Fadi El-Merhi, Bassam El-Achkar, Racha Kerek, Thomas J Vogl, Gilbert Georges Maroun, Lamia Jamjoom, Hussain Al-Mohiy, Lena Naffa
CLINICAL RELEVANCE STATEMENT: Caudocranial scan direction and contrast injection timing based on measured patient vessel dynamics can significantly improve arterial and aneurysmal opacification and reduce both contrast and radiation dose in the assessment of thoracic aortic aneurysms (TAA) using helical thoracic computed tomography angiography (CTA). OBJECTIVES: To investigate opacification of the thoracic aorta and TAA using a caudocranial scan direction and a patient-specific contrast protocol...
October 17, 2016: Journal of Computer Assisted Tomography
Junichiro Hashimoto
The central aorta constitutes the main trunk of the systemic arterial tree. It dilates passively with cardiac ejection during systole and then constricts with its recoil function during diastole, thereby regulating blood pressure and blood flow. The central pulsatile hemodynamics affects local hemodynamics within as well as downstream of the aorta (e.g., end organs).The aorta progressively stiffens and dilates with advancing age, and such age-dependent change is accelerated by hypertension. According to the law of Laplace, wall stress depends on the diameter and pressure of the blood vessel...
September 2016: Journal of Hypertension
Ahmet Karabulut, Selim Aydın
Ruptured abdominal aortic aneurysm (rAAA) is an emergent condition that carries higher mortality rate. Although there had been development of interventional and surgical technique besides improved critical care, mortality rates were still varied between 35 and 53% in the reported series. Preoperative shock was reported as a major factor predicting mortality rate. Feasibility of simultaneous endovascular repair of rAAA and silent thoracic aortic aneurysm (TAA) is not known. Herein, we aimed to demonstrate the advantage of simultaneous endovascular repair of rAAA and silent TAA in the settling of hemodynamic and neurologic instability...
September 2016: Indian Heart Journal
Deepak Ameta, Rajiv Bharat Kharwar, Pallavi Aga, Rishi Sethi, Sharad Chandra, Sudhanshu Kumar Dwivedi, Varun Shankar Narain, Ram Kirti Saran
Bicuspid aortic valve (BAV) is a common congenital cardiac anomaly, and rarely, it is associated with sinus of Valsalva aneurysms (SOVAs). And very infrequently, these SOVAs rupture into left side of heart. We hereby report a case of 12-year-old male with BAV with severe aortic stenosis with a large SOVA that ruptured into the left side of the heart. The anatomy was delineated with multimodality imaging; initially with two-dimensional trans-thoracic echocardiography (TTE), and later on with three-dimensional TTE and with multi detector computed tomography...
September 2016: Indian Heart Journal
B O Patterson, J Sobocinski, A Karthikesalingam, R J Hinchliffe, I Loftus, M M Thompson, P J Holt
BACKGROUND: Surveillance is mandatory for all patients with a thoracic aortic aneurysm (TAA). The frequency of surveillance imaging, however, is not evidence-based, as few data exist regarding TAA growth rates. This study aimed to determine the rate of TAA expansion and to inform surveillance intervals based on TAA diameter. METHODS: Patients with a TAA for whom morphological data were available from serial CT scans were studied. Annualized growth rates based on diameter at presentation and time taken to reach a theoretical intervention threshold of 55 mm were calculated...
October 17, 2016: British Journal of Surgery
Giacomo Murana, Antonio Pantaleo, Alessandro Parolari, Roberto Di Bartolomeo, Davide Pacini
No abstract text is available yet for this article.
September 2016: Journal of Thoracic Disease
Mitsuaki Sakai, Yuichiro Ozawa, Tomomi Nakajima, Akihiko Ikeda, Taisuke Konishi, Kanji Matsuzaki
Massive hemoptysis from an aortobronchial fistula due to thoracic aortic dissection is an extremely rare symptom, but is a potentially life-threatening condition. We report a case of acute massive hemoptysis due to aortobronchial fistula that was successfully controlled by a simple and rapid thick wedge resection of the lung with hematoma by using the black cartilage stapler. A 65-year-old man was admitted to our hospital with acute massive hemoptysis. After tracheal intubation, chest computed tomography revealed hematoma in the left lung and ruptured aortic dissection from the distal arch to the descending aorta...
September 2016: Journal of Thoracic Disease
Pu Yang, Bradley M Schmit, Chunhua Fu, Kenneth DeSart, S Paul Oh, Scott A Berceli, Zhihua Jiang
Transforming growth factor (TGF)-β signaling disorder has emerged as a common molecular signature for aortic aneurysm development. The timing of postnatal maturation plays a key role in dictating the biological outcome of TGF-β signaling disorders in the aortic wall. In this study, we investigated the impact of deficiency of TGFβ receptors on the structural homeostasis of mature aortas. We used an inducible Cre-loxP system driven by a Myh11 promoter to delete Tgfbr1, Tgfbr2, or both in smooth muscle cells (SMCs) of adult mice...
October 14, 2016: Scientific Reports
Tatsushi Onzuka, Yasuhisa Oishi, Hikaru Uchiyama, Yoshie Ochiai, Atsuhiro Nakashima, Kenji Shinozaki
Aberrant right subclavian artery embolization is problematic in debranching thoracic endovascular aortic repair, because concomitant bypass grafting to the right upper arm may hinder complete embolization. We report a case of a thoracic aortic aneurysm with aberrant right subclavian artery successfully treated with debranching thoracic endovascular aortic repair and bypass grafting. Although endoleakage was found from aberrant right subclavian artery after single use of Amplatzer vascular plug, additional deployment of Amplatzer vascular plug II completely eliminated residual endoleakage...
2016: Annals of Vascular Diseases
Nikolaos A Papakonstantinou, Nikolaos G Baikoussis, Panagiotis Dedeilias, Michalis Argiriou, Christos Charitos
A hybrid strategy, firstly performed in the 1990s, is a combination of tools available only in the catheterization laboratory with those available only in the operating room in order to minimize surgical morbidity and face with any cardiovascular lesion. The continuous evolution of stent technology along with the adoption of minimally invasive surgical approaches, make hybrid approaches an attractive alternative to standard surgical or transcatheter techniques for any given set of cardiovascular lesions. Examples include hybrid coronary revascularization, when an open surgical anastomosis of the left internal mammary artery to the left anterior descending coronary artery is performed along with stent implantation in non-left anterior descending coronary vessels, open heart valve surgery combined with percutaneous coronary interventions to coronary lesions, hybrid aortic arch debranching combined with endovascular grafting for thoracic aortic aneurysms, hybrid endocardial and epicardial atrial fibrillation procedures, and carotid artery stenting along with coronary artery bypass grafting...
October 8, 2016: Journal of Cardiology
Rustam Zhurayev, Dorien Proost, Dmytro Zerbino, Viktor Fedorenko, Josephina A N Meester, Lut VAN Laer, Bart L Loeys
Marfan syndrome is an autosomal dominant connective tissue disorder, predominantly affecting the ocular, skeletal and cardiovascular systems. Here, we present the results of the first genetic testing in 40 Ukrainian Marfan (-like) patients and 10 relatives. We applied a targeted next generation sequencing panel comprising FBN1 and 13 thoracic aortic aneurysm genes. We identified 27 causal mutations in FBN1, obtaining a mutation yield of 67·5%. A significant difference in age at aortic surgery between mutation positive and negative patients was observed...
October 11, 2016: Genetics Research
Marina Dias-Neto, Pedro Videira Reis, Dalila Rolim, José Fernando Ramos, José Fernando Teixeira, Sérgio Sampaio
Spinal cord ischemia remains the Achilles' heel of thoracic and thoracoabdominal diseases management. Great improvements in morbidity and mortality have been obtained with the endovascular approach TEVAR (Thoracic Endovascular Aortic Repair) but this devastating complication continues to severely affect the quality of life, even if the primary success of the procedure - dissection/aneurysm exclusion - has been achieved.Several strategies to deal with this complication have been published in the literature over the time...
September 30, 2016: Vascular
Christoph A Nienaber, Natzi Sakalihasan, Rachel E Clough, Mohamed Aboukoura, Enrico Mancuso, James S M Yeh, Jean-Olivier Defraigne, Nick Cheshire, Ulrich Peter Rosendahl, Cesare Quarto, John Pepper
OBJECTIVE: Thoracic endovascular aortic repair (TEVAR) has demonstrated encouraging results and is gaining increasing acceptance as a treatment option for aortic aneurysms and dissections. Yet, its role in managing proximal aortic pathologies is unknown-this is important because in proximal (Stanford type A) aortic dissections, 10% to 30% are not accepted for surgery and 30% to 50% are technically amenable for TEVAR. We describe our case series of type A aortic dissections treated by using TEVAR...
August 29, 2016: Journal of Thoracic and Cardiovascular Surgery
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