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Acute aortic dissection

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https://www.readbyqxmd.com/read/28453793/impact-of-gender-on-long-term-outcomes-after-surgical-repair-for-acute-stanford-a-aortic-dissection-a-propensity-score-matched-analysis%C3%A2
#1
Anton Sabashnikov, Stephanie Heinen, Antje Christin Deppe, Mohamed Zeriouh, Alexander Weymann, Ingo Slottosch, Kaveh Eghbalzadeh, Aron-Frederik Popov, Oliver Liakopoulos, Parwis B Rahmanian, Navid Madershahian, Axel Kroener, Yeong-Hoon Choi, Ferdinand Kuhn-Régnier, André R Simon, Thorsten Wahlers, Jens Wippermann
OBJECTIVES: Previous research suggests that female gender is associated with increased mortality rates after surgery for Stanford A acute aortic dissection (AAD). However, women with AAD usually present with different clinical symptoms that may bias outcomes. Moreover, there is a lack of long-term results regarding overall mortality and freedom from major cerebrovascular events. We analysed the impact of gender on long-term outcomes after surgery for Stanford A AAD by comparing genders with similar risk profiles using propensity score matching...
May 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28449426/-a-case-of-intramural-hematoma-of-the-esophagus-mimicking-acute-coronary-syndrome
#2
Dae Gon Ryu, Cheol Woong Choi, Dae Hwan Kang, Hyung Wook Kim, Dong Il Jeong, Wan Chul Kim, Jae Gyu Shin, Tae Won Lim
Intramural hematoma of the esophagus is a rare condition that can be spontaneous or secondary to trauma, toxic ingestion, or intervention. If it is the spontaneous type, it usually presents initially with epigastric pain, hematemesis or dysphagia. We present a case of intramural hematoma of the esophagus mimicking acute coronary syndrome. A 63-year-old man presented with severe acute chest pain. He has four coronary stents that were inserted five years ago, from a different hospital, and is on dual antiplatelet agents...
April 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/28446857/hemolytic-anemia-caused-by-kinking-of-dacron-grafts-implanted-in-repair-of-after-aortic-dissection
#3
Feridoun Sabzi, Fahimeh Ghasemi, Atefeh Asadmobini
BACKGROUND: Hemolytic anemia caused by a kinked Dacron graft is a rare complication after repair of acute aortic dissection. We present a case of hemolytic anemia due to kinking of previously implanted Dacron graft for ascending aorta dissection treated by surgery and replaced with new Dacron. CASE DETAILS: We report a case of postoperative hemolytic anemia with kinking of the graft at the outer graft layer and intra luminal bulging of the inner graft. Postoperative computed tomography showed Dacron graft kinking at the mid part of the graft...
September 2016: Ethiopian Journal of Health Sciences
https://www.readbyqxmd.com/read/28445305/a-case-report-of-painless-type-a-aortic-dissection-with-intermittent-convulsive-syncope-as-initial-presentation
#4
Chun-Hsien Chen, Kuan-Ting Liu
RATIONALE: The initial presenting symptoms and signs of acute aortic dissection are so diverse that it makes early and accurate diagnosis arduous. Painless and convulsive syncope due to cardiac arrhythmia were not typical presentations of acute aortic dissection. PATIENT CONCERNS: A 61-year-old male presenting with transient consciousness loss and suspected seizure attack was sent to emergency room (ER) by ambulance. Consciousness loss accompanying with upward gaze and limb convulsion was noted in ER, and electrocardiogram monitor recorded a transient cardiac asystole then spontaneous recovery of sinus rhythm...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28440669/can-multiphase-dynamic-ct-angiography-provide-a-better-assessment-of-aortic-dissection-compared-with-the-standard-triphasic-protocol
#5
Chun-Yan Lu, Yi-Ke Diao, Ying-Qiang Guo, Xiao-Hui Zhang, Hong-Li Bai, Zhen-Lin Li
Background Acute aortic dissection (AD) is a life-threatening medical emergency. It has been debated whether the multiphase dynamic computed tomography angiography (CTA) protocol is superior to the standard triphasic protocol for revealing the characteristics of AD. Purpose To examine two multiphase dynamic protocols, Dynamic four-dimensional (4D) CTA using the shuttle mode and Flash 4D CTA using the high-pitch mode for the assessment of AD and to compare them with the standard triphasic protocol. Material and Methods A total of 54 consecutive patients were randomly and equally assigned to three groups and scanned with a second-generation DSCT scanner...
January 1, 2017: Acta Radiologica
https://www.readbyqxmd.com/read/28438361/influence-of-distal-entry-tears-in-acute-type-b-aortic-dissection-after-thoracic-endovascular-aortic-repair
#6
Chenmou Zhu, Bin Huang, Jichun Zhao, Yukui Ma, Ding Yuan, Yi Yang, Fei Xiong, Tiehao Wang
OBJECTIVE: This study evaluated the clinical influence of distal entry tears in acute type B aortic dissection (ATBAD) after thoracic endovascular aortic repair (TEVAR). METHODS: From August 2009 to December 2014, the clinical outcomes of 130 patients who underwent TEVAR for ATBAD were retrospectively analyzed. According to whether distal entry tears existed after TEVAR, patients were divided into group A (n = 25, absence of distal entry tears) and group B (n = 105, presence of distal entry tears)...
April 21, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28432073/in-situ-laser-fenestration-is-a-feasible-method-for-revascularization-of-aortic-arch-during-thoracic-endovascular-aortic-repair
#7
Jinbao Qin, Zhen Zhao, Ruihua Wang, Kaichuang Ye, Weimin Li, Xiaobing Liu, Guang Liu, Chaoyi Cui, Huihua Shi, Zhiyou Peng, Fukang Yuan, Xinrui Yang, Min Lu, Xintian Huang, Mier Jiang, Xin Wang, Minyi Yin, Xinwu Lu
BACKGROUND: Reconstruction of the aortic major branches during thoracic endovascular aortic repair is complicated because of the complex anatomic configuration and variation of the aortic arch. In situ laser fenestration has shown great potential for the revascularization of aortic branches. This study aims to evaluate the feasibility, effectiveness, and safety of in situ laser fenestration on the three branches of the aortic arch during thoracic endovascular aortic repair. METHODS AND RESULTS: Before clinical application, the polytetrafluoroethylene and Dacron grafts were fenestrated by an 810-nm laser system ex vivo, which did not damage the bare metal portion of the endografts and created a clean fenestration while maintaining the integrity of the endografts...
April 21, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28430850/trends-in-hospitalization-for-hypertensive-emergency-and-relationship-of-end-organ-damage-with-in-hospital-mortality
#8
Mahek Shah, Shantanu Patil, Brijesh Patel, Shilpkumar Arora, Nilay Patel, Lohit Garg, Sahil Agrawal, Larry Jacobs, Susan P Steigerwalt, Matthew W Martinez
BACKGROUND: There are no comprehensive guidelines on management of hypertensive emergency (HTNE) and complications. Despite advances in antihypertensive medications HTNE is accompanied with significant morbidity and mortality. METHODS: We queried the 2002-2012 nationwide inpatient sample database to identify patients with HTNE. Trends in incidence of HTNE and in-hospital mortality were analyzed. Logistic regression analysis was used to assess the relationship between end-organ complications and in-hospital mortality...
April 20, 2017: American Journal of Hypertension
https://www.readbyqxmd.com/read/28428527/-treatment-strategy-for-complicated-acute-type-b-aortic-dissection-in-the-thoracic-endovascular-aortic-repair-era
#9
Norihisa Karube, Keiji Uchida, Shinichi Suzuki, Munetaka Masuda
Our treatment strategy for acute type B aortic dissection (ABAD) included complicated type is as follows. Indications of thoracic endovascular aortic repair (TEVAR) for ABAD are rupture and organ ischemia, and TEVAR has been the 1st line central repair therapy since January 2009 in our institution. At the time of TEVAR for ruptured communicating type ABAD, we usually seal the proximal entry tear and cover the existing range of hematoma at descending aorta. Procedures for ABAD with malperfusion should be changed according to the patient's condition such as branch vessel obstructions either dynamic type or static type...
April 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28428525/-total-arch-replacement-using-manufactured-frozen-elephant-trunk-after-acute-type-a-dissection-repair
#10
Makoto Hibino, Masato Mutsuga, Hideki Oshima, Yuji Narita, Tomonobu Abe, Kazuro Fujimoto, Yoshiyuki Tokuda, Akihiko Usui
The purpose of this study is to assess the result of total arch replacement(TAR) using manufactured frozen elephant trunk(FET) for chronic aortic dissection after initial repair including the effect of aortic remodeling by the FET. Between 2003 and 2015, we performed 11 TAR using manufactured FET. Initial repairs before were 9 ascending aortic replacements and 2 Bentall operations. The entry of residual dissection was located at arch in 7 and at distal anastomosis site in 4. There was no hospital death. The operative complication included 2 surgical site infection, 1 interstitial pneumonia and 1 paraplegia with almost full recovery...
April 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28420841/tranexamic-acid-controlled-chronic-disseminated-intravascular-coagulation-associated-with-aortic-dissection-and-patent-false-lumen-for-three-years
#11
Yodo Gatate, Nobuyuki Masaki, Atsushi Sato, Risako Yasuda, Takayuki Namba, Hirotaka Yada, Akio Kawamura, Takeshi Adachi
The management of chronic disseminated intravascular coagulation (DIC) caused by aortic dissection has not yet been established. Even in cases where surgical correction is performed, therapeutic control of systemic hemorrhaging is still required. We herein report the successful treatment of a case of aortic dissection with a patent false lumen using tranexamic acid for acute exacerbation of chronic DIC. Oral administration of 1,500 mg tranexamic acid per day stabilized the coagulative and fibrinolytic parameters and relieved bleeding tendencies with no side effects...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28420536/malperfusion-rather-than-merely-timing-of-operative-repair-determines-early-and-late-outcome-in-type-a-aortic-dissection
#12
Pradeep Narayan, Chris A Rogers, Umberto Benedetto, Massimo Caputo, Gianni D Angelini, Alan J Bryan
BACKGROUND: Although generally better outcomes are reported in patients undergoing early repair of type A aortic dissection, patients who survive the first 48 hours self-select themselves toward better outcomes as well. Malperfusion is another important determinant of outcome in these patients. The aim of this study was to examine the hypothesis that malperfusion, not the timing of operation, is the dominant determinant of outcome in repair of type A aortic dissection. METHODS: A total of 205 patients underwent operative repair of acute type A aortic dissection in our hospital over a 17-year period...
March 21, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28420472/-analysis-of-the-onset-time-of-acute-aortic-dissection-and-the-influence-of-climate-on-acute-aortic-dissection-occurrence-in-urumqi-city-a-retrospective-study-of-a-single-center
#13
Jing Shi, Zixiang Yu, Yitong Ma, Liu Yang, Jun Peng, Xiang Ma, Yining Yang, Feng Liu
OBJECTIVE: To observe the time characteristics of acute aortic dissection (AAD) in Urumqi and its peripheral areas in Xinjiang Uygur autonomous region, and to explore the effect of meteorological conditions on the onset of AAD. METHODS: Retrospective analysis of the related data of the adult AAD patients diagnosed by imaging examination, and admitted to the First Affiliated Hospital of Xinjiang Medical University from March 2010 to July 2016 was performed. The onset time, the contemporaneous meteorological data, including daily minimum, average, and the highest temperature, daily average air pressure, daily average relative humidity, daily precipitation, daily average wind speed, daily maximum wind speed, and sunshine duration per day were collected...
April 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28418891/risk-of-aortic-aneurysm-and-dissection-in-patients-with-autosomal-dominant-polycystic-kidney-disease-a-nationwide-population-based-cohort-study
#14
Pei-Hsun Sung, Yao-Hsu Yang, Hsin-Ju Chiang, John Y Chiang, Chi-Jen Chen, Chien-Ting Liu, Cheuk-Man Yu, Hon-Kan Yip
Although cardiovascular complications are the most common cause of death in patients with autosomal-dominant polycystic kidney disease (ADPKD), the incidence and risk of aortic aneurysm and dissection (AAD) in ADPKD remains unclear due to limited data and insufficient cases. We utilized the data from Taiwan National Health Insurance Research Database (NHIRD) to do a population-based cohort study (1997-2008). After excluding those patients with age <18 years old and initially concomitant diagnoses of end-stage renal disease and AAD, a total of 2076 ADPKD patients were selected from 1,000,000 of general population...
March 17, 2017: Oncotarget
https://www.readbyqxmd.com/read/28416358/non-gated-high-pitch-computed-tomography-aortic-angiography-myocardial-perfusion-defects-in-patients-with-suspected-aortic-dissection
#15
Li-Ting Huang, Shih-Hung Chan, Chia-Chang Chuang, Yi-Shan Tsai
OBJECTIVES: To investigate the diagnostic value of first-pass myocardial perfusion defects visualised in non-gated high-pitch computed tomography angiography (CTA) in patients admitted to the emergency department (ED) for suspected aortic dissection. METHODS: We recruited 174 ED patients who underwent high-pitch CTA of the aorta because of suspected aortic dissection. We divided these patients into two groups (diseased and control groups) based on whether their clinical data fulfilled the third universal definition of acute myocardial infarction (AMI), specifically an increase in cardiac troponin (cTn) with at least one of the following: (a) symptoms of ischemia; (b) new ST-segment-T wave (ST-T) changes or new left bundle branch block (LBBB); (c) development of pathological Q wave; (d) new loss of viable myocardium or new regional wall motion abnormality; or (e) identification of an intracoronary thrombus by angiography or autopsy...
April 12, 2017: Journal of Cardiovascular Computed Tomography
https://www.readbyqxmd.com/read/28416334/a-systematic-approach-to-improve-the-outcomes-of-type-a-aortic-dissection
#16
Hidefumi Nishida, Minoru Tabata, Toshihiro Fukui, Yasunori Sato, Hajime Kin, Shuichiro Takanashi
OBJECTIVES: The aims of this study are to evaluate the outcomes and trends of contemporary emergency surgery for acute type A aortic dissection on the basis of a systematic approach and to assess the impact of temporary aortic crossclamping during systemic cooling on early and late outcomes. METHODS: We retrospectively reviewed 702 consecutive patients who underwent emergency surgery for acute type A aortic dissection between March 2004 and May 2015. Our clinical protocol includes rapid transfer to the operating room, quick establishment of cardiopulmonary bypass, temporary aortic crossclamping during cooling, primary entry resection, and open distal anastomosis...
March 23, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28415956/the-relationship-between-neutrophil-lymphocyte-ratio-and-acute-aortic-dissection
#17
Sevket Balta, Recai Alemdar, Ali Osman Yildirim, Sıddık Erdogan, Cengiz Ozturk, Turgay Celik
No abstract text is available yet for this article.
May 2017: Perfusion
https://www.readbyqxmd.com/read/28414679/misses-opportunity-tof-diagnoses-in-4th-decade-of-life
#18
O Baniahmad, T Jarreau, A Johnson
CASE: A 40 year old woman with a history of HIV, congestive heart failure secondary to an unknown congenital heart defect, and hypertension presented to our emergency department with worsening edema. On room air, oxygen saturation was 55 percent . On 5L of oxygen via nasal cannula, oxygen saturation was 88 percent . Physical examination was notable for central cyanosis, facial and lid edema, a II/VI holosystolic murmur across right chest radiating to entire right back hemithorax, decreased breath sounds at bases with pulmonary crackles, clubbing of fingers and edema of bilateral lower extremities...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28413582/a-case-of-iatrogenic-aortic-intramural-hematoma
#19
Kamil Muhyieddeen, Arang Samim, Michah Roberts, Sundararajan Srikanth
Iatrogenic aortic dissection during percutaneous coronary intervention is a rare but serious complication. Both conservative and surgical approaches have been proposed as management strategies. We describe a case of an 87-year-old female who presented with an acute coronary syndrome complicated by the development of an ascending aortic dissection during percutaneous intervention, and we provide a brief review of the literature.
January 2017: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/28412719/combined-measurement-of-factor-xiii-and-d-dimer-is-helpful-for-differential-diagnosis-in-patients-with-suspected-pulmonary-embolism
#20
Ning Tang, Ziyong Sun, Dengju Li, Jun Yang, Shiyu Yin, Qing Guan
BACKGROUND: D-dimer has been used to rule out pulmonary embolism (PE). Based on previous reports of decreased concentrations of coagulation factor XIII (FXIII) in venous thromboembolism, and no change in FXIII concentration in patients with acute cardiovascular disease, we evaluated the benefit of simultaneously measuring D-dimer and FXIII concentrations for diagnosing PE. METHODS: In this prospective single-center study, we enrolled 209 patients initially suspected of having PE, and measured their D-dimer and FXIII concentrations...
April 17, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
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