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Acute aortic dissection

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https://www.readbyqxmd.com/read/28716062/the-effects-of-acute-and-elective-cardiac-surgery-on-the-anxiety-traits-of-patients-with-marfan-syndrome
#1
Kálmán Benke, Bence Ágg, Miklós Pólos, Alex Ali Sayour, Tamás Radovits, Elektra Bartha, Péter Nagy, Balázs Rákóczi, Ákos Koller, Viola Szokolai, Julianna Hedberg, Béla Merkely, Zsolt B Nagy, Zoltán Szabolcs
BACKGROUND: Marfan syndrome is a genetic disease, presenting with dysfunction of connective tissues leading to lesions in the cardiovascular and skeletal muscle system. Within these symptoms, the most typical is weakness of the connective tissue in the aorta, manifesting as aortic dilatation (aneurysm). This could, in turn, become annuloaortic ectasia, or life-threatening dissection. As a result, life-saving and preventative cardiac surgical interventions are frequent among Marfan syndrome patients...
July 17, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28711328/overexpression-of-microrna-30a-contributes-to-the-development-of-aortic-dissection-by-targeting-lysyl-oxidase
#2
Yang Yu, Enyi Shi, Tianxiang Gu, Rui Tang, Shilun Gao, Yongchao Wang, Hongbo Liu
OBJECTIVE: To explore the role of microRNA (miR)-30a in the development of aortic dissection. METHODS: Human aortic specimens of aortic dissections and aneurysms were harvested. Aortic specimens from donors for heart transplantation served as controls. Rat aortic vascular smooth muscle cells (VSMCs) were transfected with agomiR-30a or antagomiR-30a, and control cells were incubated with empty vectors. Rats were pretreated with agomiR-30a or antagomiR-30a (5 × 10(7) transfection units every 3 days for 4 weeks), and empty vectors were infused to controls...
June 16, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28700467/early-and-midterm-outcomes-of-thoracic-endovascular-aortic-repair-tevar-for-acute-and-chronic-complicated-type-b-aortic-dissection
#3
Min-Hong Zhang, Xin Du, Wei Guo, Xiao-Ping Liu, Xin Jia, Yang-Yang Ge
Thoracic endovascular aortic repair (TEVAR) in the current era has been chosen as a dominant and minimally invasive treatment for complicated aorta dissection. This study aimed to assess safety and feasibility of TEVAR in acute and chronic type B aortic dissection.Between January 2011 and December 2013, 85 patients with complicated type B aortic dissection undergoing TEVAR were divided into acute aortic dissection (AAD) (n = 60) group and chronic aortic dissection (CAD) group (n = 25). Computed tomography was used to evaluate postoperative changes in maximal aortic diameter and true and false lumen diameters at 3 levels during a mean follow-up period of 26...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28697941/early-outcomes-of-the-conformable-stent-graft-for-acute-complicated-and-uncomplicated-type-b-aortic-dissection
#4
Ting Zhu, Yi Si, Yuan Fang, Bin Chen, Jue Yang, Junhao Jiang, Jianing Yue, Weiguo Fu
OBJECTIVE: The objective of this study was to evaluate the safety, efficacy, and outcomes of the conformable thoracic endograft (Conformable TAG Thoracic Endoprosthesis [CTAG]; W. L. Gore & Associates, Flagstaff, Ariz) for acute complicated and uncomplicated type B aortic dissection (TBAD). METHODS: Between February and October 2016, 52 consecutive patients with acute complicated or uncomplicated TBAD were treated with a CTAG device. We assessed safety, complications, and device conformability using intraoperative angiography and computed tomography angiography...
July 8, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28694136/iatrogenic-aortic-dissection-in-a-preterm-neonate-presenting-as-acute-renal-failure
#5
Alejandro Avila-Alvarez, Victor Bautista-Hernandez, Fernando Rueda-Nuñez
No abstract text is available yet for this article.
July 1, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28693381/a-meta-analysis-of-weekend-admission-and-surgery-for-aortic-rupture-and-dissection
#6
Hisato Takagi, Tomo Ando, Takuya Umemoto
We performed a meta-analysis to determine whether weekend admission and surgery for ruptured abdominal/thoracic aortic aneurysm (RAAA/RTAA) and acute aortic dissection (AAD) is associated with increased mortality. MEDLINE and EMBASE were searched from January 1946 to December 2016 using PubMed and OVID. Eligible studies were prospective or retrospective, comparative or cohort studies enrolling patients admitting or undergoing surgery for RAAA/RTAA/AAD and reporting mortality after weekend (including holiday) versus weekday admission/surgery...
July 1, 2017: Vascular Medicine
https://www.readbyqxmd.com/read/28693049/hybrid-repair-techniques-for-complex-aneurysms-and-dissections-involving-the-aortic-arch-and-thoracic-aorta
#7
Rami Tadros, Scott R Safir, Peter L Faries, Daniel K Han, Rajiv K Chander, James F McKinsey, Michael L Marin, Allan S Stewart, Sharif Ellozy
Aortic aneurysms involving the ascending aorta, aortic arch, and descending thoracic aorta have been a challenging entity to surgically treat for over 60 years. Despite the mortality of the disease, early open surgical procedures also had significant morbidity and mortality. The inherent risk in treating multiple anatomic segments simultaneously led to the innovation of the staged elephant trunk (ET) approach by Borst in 1983. To avoid the thoracotomy and associated complications related to the second stage of the procedure, an endovascular completion paradigm was begun by Volodos in 1991...
July 11, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28691228/intra-and-post-partum-acute-aortic-dissection-stanford-type-b-report-of-two-cases
#8
Mitsuhiro Tsuritani, Chizuko A Kamiya, Masami Sawada, Chinami Horiuchi, Naoko Iwanaga, Jun Yoshimatsu
Pregnancy with Marfan syndrome (MFS) presents challenges to the clinician because of the increased incidence of maternal cardiovascular complications, including acute aortic dissection (ADD) and the involvement of the fetus owing to the urgency of the need for surgery and the low likelihood of survival with premature delivery. Patient 1 was a 36-year-old pregnant Japanese woman with MFS who was referred at 16 gestational weeks with aortic root diameter 35.1 mm. Stanford type B AAD occurred on delivery without evident blood pressure changes...
July 10, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28689951/spot-stenting-of-supra-aortic-branch-vessels-for-residual-type-a-dissection
#9
Ciro Ferrer, Raffaele Grande, Luigi Venturini, Valerio Scarano Catanzaro, Gabriele Maritati, Luca di Marzo
of this report is to describe the exclusion of the false lumen in a residual type A aortic dissection (TAAD) by the deployment of two covered stents: one in the right common carotid artery (RCCA) and one in the left subclavian artery (LSA). A 77-year-old female, already treated with ascending aorta replacement for acute TAAD, was referred to our center for a 97-mm post-dissection arch aneurysm. A computed tomography angiography (CTA) showed false lumen patency by reperfusion from secondary tears located at level of RCCA and LSA...
July 6, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28689484/transcatheter-aortic-valve-implantation-as-a-bailout-procedure-for-acute-aortic-valve-regurgitation-during-endovascular-arch-repair
#10
Adrien Hertault, Rachel E Clough, Thomas Modine, Jean-Luc Auffray, Mohamad Koussa, Stéphan Haulon
PURPOSE: To report emergent transcatheter aortic valve implantation (TAVI) to treat acute severe aortic regurgitation caused by valve cusp dysfunction following proximal migration of an endograft implanted in the ascending aorta during endovascular arch repair. CASE REPORT: A 65-year-old man had been previously treated with thoracic and fenestrated endografts in a 2-stage procedure for a chronic type B dissection. At 2-year follow-up, aneurysmal evolution of the distal arch led to development of a proximal type Ia endoleak...
July 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28683909/type-b-aortic-dissections-current-guidelines-for-treatment
#11
REVIEW
Daniel B Alfson, Sung W Ham
Stanford type B aortic dissections (TBADs) involve the descending aorta and can present with complications, including malperfusion syndrome or aortic rupture, which are associated with significant morbidity and mortality if left untreated. Clinical diagnosis is straightforward, typically confirmed using CT angiography. Treatment begins with immediate anti-impulse medical therapy. Acute TBAD with complications should be repaired with emergent thoracic endovascular aortic repair (TEVAR). Uncomplicated TBAD with high-risk features should undergo TEVAR in the subacute phase...
August 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/28683905/acute-type-a-aortic-dissection
#12
REVIEW
Ramsey S Elsayed, Robbin G Cohen, Fernando Fleischman, Michael E Bowdish
Type A aortic dissection is a surgical emergency occurring when an intimal tear in the aorta creates a false lumen in the ascending aorta. Prompt diagnosis and surgical treatment are imperative to optimize outcomes. Surgical repair requires replacement of the ascending aorta with or without aortic root or aortic arch replacement. Surgical outcomes for this highly lethal diagnosis have improved, with contemporary survival to discharge at Centers of Excellence of 85% to 90%. Survival is related to prompt treatment, preexisting medical comorbidities, presence or absence of end organ malperfusion, extent of aortic repair required, and the development of postoperative complications...
August 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/28683904/surgery-for-diseases-of-the-aortic-root
#13
REVIEW
Robbin G Cohen, Ramsey S Elsayed, Michael E Bowdish
The aortic root is the junction between the heart and aorta, containing the aortic valve and the coronary artery ostia. Various pathologic conditions arise in this region requiring complex surgical correction. These include aneurysmal dilatation with and without aortic regurgitation, acute aortic dissection extending below the sinotubular junction, and infective endocarditis with valve and periannular destruction. Multiple strategies for correction of these complex surgical issues exist, with excellent early results and long-term survival...
August 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/28679305/iatrogenic-aortic-dissection-during-percutaneous-coronary-intervention-a-case-report-and-review-of-the-literature
#14
Jia-Chen Li, Xin-Liang Guan, Ming Gong, Hong-Jia Zhang
A 64-year-old female complaining of unrelieved chest pain for 2 days was admitted to the Emergency Room of the Beijing Anzhen Hospital, Beijing, China. After definitive diagnosis, a percutaneous coronary intervention was implemented, but immediately after embedding the stent in the distal area of the right coronary artery, an acute coronary and aortic dissection was found. Cardiologists immediately gave the patient conservative management. At the same time, another smaller stent was immediately embedded in the proximal area of the right coronary artery and plunged into the ascending aorta by 2 mm, with the intention of covering the tear of the dissection...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28674354/left-mandibular-pain-a-rare-initial-symptom-of-acute-aortic-dissection-without-coronary-obstruction
#15
Masaki Tago, Naoko E Furukawa, Rika Yamaguchi, Yoshinori Tokushima, Hidetoshi Aihara, Shu-Ichi Yamashita
An 88-year-old woman experienced sharp pain in the left mandible for a few minutes 3 days prior to hospital presentation. On the day of hospital presentation, the patient experienced similar pain and cold sweating for more than an hour early in the morning. On arrival, there was only mild discomfort ranging from the left mandible to the neck, without definite pain. Computed tomography revealed Stanford type A acute aortic dissection. Blood vessel prosthesis implantation was performed. Intraoperatively, the coronary arteries were confirmed to be intact...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28671869/prognostic-value-of-neutrophil-to-lymphocyte-ratio-and-risk-factors-for-mortality-in-patients-with-stanford-type-a-aortic-dissection
#16
Kursad Oz, Taner Iyigun, Zeynep Karaman, Ömer Çelik, Ertan Akbay, Okan Akınc, Okan Akınc, Korhan Erkanli
BACKGROUND: Neutrophil to lymphocyte ratio (NLR) is a prognostic predictor in a wide range of cardiovascular disease. Acute aortic dissection (AD) is an uncommon but fatal cardiovascular disease. In this study, we investigated both prognostic factors in patients with AD and whether NLR can be a predictor for mortality. Methods: We analyzed retrospectively the data of 57 patients with AD who had undergone emergent surgery in our hospital and included 128 consecutive patients with chest pain admitted to the emergency room as a control group...
June 30, 2017: Heart Surgery Forum
https://www.readbyqxmd.com/read/28671865/quality-of-life-after-surgery-for-stanford-type-a-aortic-dissection-influences-of-different-operative-strategies
#17
Tamer Ghazy, Mohamed Eraqi, Adrian Mahlmann, Helena Hegelmann, Klaus Matschke, Utz Kappert, Norbert Weiss
BACKGROUND: Outcome of surgery for acute Stanford type A aortic dissection extends beyond mortality and morbidity. More than one operative strategy is available but little is known regarding their influence on quality of life. This study analyzes the influence of defensive and aggressive operative strategies on the patients' midterm quality of life (QoL). METHODS: From July 2007 to July 2010, 95 patients underwent surgery for acute Stanford type A aortic dissection in our institution...
June 22, 2017: Heart Surgery Forum
https://www.readbyqxmd.com/read/28670981/keep-an-eye-out-a-rare-case-of-acute-onset-charles-bonnet-syndrome-after-stanford-type-a-aortic-dissection-repair-surgery
#18
Fabian Cook, Scott Dougherty, Robert Moreton, Maziar Khorsandi
Charles Bonnet Syndrome describes the triad of complex visual hallucinations secondary to ophthalmic pathology in psychologically normal people. We present a rare case of acute-onset Charles Bonnet Syndrome following cardiac surgery that resulted in profound loss of visual acuity in both eyes with characteristic visual hallucinations that were initially mistaken for delirium. Computed tomography of the brain revealed bilateral occipital infarcts, providing the substrate for Charles Bonnet Syndrome. A high index of suspicion should be maintained in cognitively intact patients with visual loss who are also experiencing visual hallucinations to ensure prompt diagnosis and management of this often overlooked condition...
May 2017: Scottish Medical Journal
https://www.readbyqxmd.com/read/28669696/clevidipine-versus-sodium-nitroprusside-in-acute-aortic-dissection-a-retrospective-chart-review
#19
Alexandru Ulici, Jon Jancik, Timothy S Lam, Shannon Reidt, Domenico Calcaterra, Jon B Cole
AIM: Intravenous vasodilators are often added to beta-blocking agents to reach blood pressure (BP) goals in aortic dissection. Control of BP using clevidipine has been described in hypertensive emergencies and cardiac surgery but not in aortic dissection. The aim of this study was to compare clevidipine versus sodium nitroprusside (SNP) as adjunct agents to esmolol for BP management in aortic dissection. METHODS: A single-center retrospective chart review evaluated patients diagnosed with aortic dissection...
June 16, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28669506/risk-factors-for-late-aortic-valve-dysfunction-after-the-david-v-valve-sparing-root-replacement
#20
Jiro Esaki, Bradley G Leshnower, Jose N Binongo, Yi Lasanajak, LaRonica McPherson, Robert A Guyton, Edward P Chen
BACKGROUND: Valve-sparing root replacement (VSRR) is an established therapy for aortic root pathology. However, late aortic valve dysfunction requiring reoperation remains a primary concern of this procedure. This study examines risk factors for late aortic insufficiency (AI) and aortic stenosis (AS) after David V VSRR. METHODS: A retrospective review from 2005 to 2015 at a US academic center identified 282 patients who underwent VSRR. Cox proportional hazards regression analysis was used to identify risk factors for late AI and AS after VSRR...
June 29, 2017: Annals of Thoracic Surgery
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