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Aortic arch aneurysm

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https://www.readbyqxmd.com/read/29350460/three-generation-family-with-novel-contiguous-gene-deletion-on-chromosome-2p22-associated-with-thoracic-aortic-aneurysm-syndrome
#1
Bianca Quiñones-Pérez, Grace E VanNoy, Meghan C Towne, Yiping Shen, Michael N Singh, Pankaj B Agrawal, Sharon E Smith
Latent transforming growth factor binding proteins (LTBP) are a family of extracellular matrix glycoproteins that play an important role in the regulation of transforming growth factor beta (TGF-ß) activation. Dysregulation of the TGF-ß pathway has been implicated in the pathogenesis of inherited disorders predisposing to thoracic aortic aneurysms syndromes (TAAS) including Marfan syndrome (MFS; FBN1) and Loeys-Dietz syndrome (LDS; TGFBR1, TGFBR2, TGFB2, TGFB3, SMAD2, SMAD3). While these syndromes have distinct clinical criteria, they share clinical features including aortic root dilation and musculoskeletal findings...
January 19, 2018: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/29349432/aortic-arch-banding-procedure-for-proximal-type-i-endoleak-after-thoracic-endovascular-aneurysm-repair-with-the-chimney-technique
#2
Genta Chikazawa, Arudo Hiraoka, Koichi Inoue, Kentaro Tamura, Taichi Sakaguchi, Hidenori Yoshitaka
An aortic arch banding procedure was performed on an 82-year-old man for treatment of proximal type I endoleaks 2 days after he had undergone emergency thoracic endovascular aortic repair with the chimney technique for a ruptured aortic arch aneurysm. Contrast-enhanced computed tomography after the second procedure demonstrated significant shrinkage of the aneurysmal sac as well as a complete disappearance of the endoleaks. The basic concept of this technique is to treat the type IA endoleak, including possible gutter endoleaks, by creating a new proximal seal zone distal to the chimney graft using a banding technique...
December 2017: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29349422/hybrid-management-of-a-ruptured-right-subclavian-artery-aneurysm-dissection
#3
David Drullinsky, Heather Gill, Jason P Bayne, Jean-Francois Morin, Daniel Obrand
Aberrant right subclavian artery is the most common congenital malformation of the aortic arch (0.4%-2.0%). Aneurysms of aberrant subclavian arteries are extremely rare. This results in little experience with their treatment. We describe a case of a patient who presented to the emergency department with a dissection of an aberrant right subclavian artery that later progressed to rupture. Besides hemodynamic instability, this caused an acute superior vena cava syndrome, making airway control difficult. In the operating room, we obtained proximal control through thoracic endovascular aortic repair; median sternotomy was performed for distal control and evacuation of massive hemomediastinum...
December 2017: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29349376/directional-tip-control-technique-for-optimal-stent-graft-alignment-in-angulated-proximal-aortic-landing-zones
#4
Toshio Takayama, Patrick J Phelan, Jon S Matsumura
Angulated anatomy in the aorta, such as tortuous infrarenal aortic necks or steep aortic arches, is a significant challenge for endovascular aortic repair because it often causes inadequate sealing and fixation, which may lead to treatment failure. We have developed a technique using off-the-shelf equipment to precisely control the deployment of stent grafts in challenging landing zones. The key of this technique is to create a through-and-through wire between two access sites and to use a guiding device over the wire...
June 2017: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29340633/kinking-of-an-open-stent-graft-after-total-arch-replacement-with-the-frozen-elephant-technique-for-acute-type-a-aortic-dissection
#5
Akimasa Morisaki, Tadashi Isomura, Yasuhisa Fukada, Minoru Yoshida
Recently, in Japan, the J Graft Open Stent Graft (JOSG) was commercialized for surgical repair of an aortic aneurysm and aortic dissection and the frozen elephant trunk technique was applied. Kinking of the JOSG is a rare adverse event that requires additional intervention. We experienced 2 patients who developed kinking of a JOSG after translocated total arch replacement with the frozen elephant trunk technique for acute Type A aortic dissection. Both patients had intermittent claudication with a decreased ankle-brachial pressure index after the operation...
January 10, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29338298/coronary-and-arch-hybrid-surgery-in-a-patient-with-infrarenal-aortic-occlusion
#6
Teng Kiat Koh, Jocelyn Zi Lin Ting, Bernard Wee, Rustem Khamitov, Kristine Teoh, Julian Wong, Vitaly A Sorokin
A 65-year-old gentleman with claudication underwent contrast-enhanced computed tomography. The scan showed occlusion of the infrarenal abdominal aorta and a 6.0 × 3.7 cm saccular zone-3 arch aneurysm. The left ventricular ejection fraction was 35% and a coronary angiogram revealed triple-vessel disease. In view of the patient's high risk with EuroSCORE II 20.34%, coronary artery surgery was combined with hybrid type I arch aneurysm repair. An endovascular stent was delivered in an antegrade manner. Open heart surgery and a hybrid type I arch intervention can be performed simultaneously through a midline sternotomy approach...
January 1, 2018: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/29334980/reoperation-for-a-giant-arch-anastomotic-pseudoaneurysm-eleven-years-after-total-arch-replacement-with-island-reconstruction
#7
Ryohei Matsuura, Yasushi Tsutsumi, Osamu Monta, Hisazumi Uenaka, Kenji Tanaka, Takaaki Samura, Hirokazu Ohashi
BACKGROUND: The long-term effects of some surgical treatment procedures of arch replacement for aortic dissection or aortic aneurysm are unknown. CASE PRESENTATION: The present study reports the case of a 68-year-old man admitted to our hospital for aortic arch anastomotic pseudoaneurysm with concomitant aortic root enlargement and coronary artery stenosis. Eleven years ago, at the age of 56 years, he underwent total arch replacement with island reconstruction for chronic aortic dissection...
January 15, 2018: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29326371/mycoplasma-pneumoniae-infection-presenting-as-stroke-and-meningoencephalitis-with-aortic-and-subclavian-aneurysms-without-pulmonary-involvement
#8
Pournamy Sarathchandran, Abubaker Al Madani, Ayman M Alboudi, Jihad Inshasi
A 39-year-old Philipino man presented with acute onset fever and headache. Neurological examination was normal except for neck stiffness. There was no history of chest pain, cough or breathlessness. Cerebrospinal fluid (CSF) showed a mild increase in protein with normal sugar and lymphocytic pleocytosis. CSF PCR for herpes simplex and varicella zoster virus was negative. He developed acute right haemiplegia a week after hospitalisation. MRI showed acute infarct in the left centrum semiovale. His angiogram showed aneurysm in the left subclavian artery and aortic arch...
January 11, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29325938/aortic-coarctation-complicated-with-intracranial-aneurysm-a-case-report-and-literature-review
#9
Hui Zhang, Lei Feng
BACKGROUND: Cases of aortic coarctation complicated with rupture and hemorrhage of intracranial aneurysms are not common in clinical practice. This paper reports a case of middle-aged female patient presented with acute severe headache. CASE DESCRIPTION: Head CT demonstrated her extensive subarachnoid hemorrhage. DSA demonstrated coarctation and occlusion of proximal thoracic aorta and occlusion of terminal aortic arch. Aortic-intracranial CTA confirmed that the patient had aortic coarctation complicated with anterior communicating artery aneurysm...
January 8, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29320978/two-vessel-branched-stent-graft-for-severely-angulated-aortic-arch-aneurysm-in-a-jehovah-s-witness
#10
Chung S Lim, A Dhutia, Celia Riga, A Dharmadasa, Richard G J Gibbs, Mohamad S Hamady
Aneurysmal disease involving the origins of supra aortic vessels often requires complex open and/or endovascular repair that is not only associated with significant risk of mortality and morbidity but also often with perioperative blood loss requiring transfusion. We report a successful repair of a large thoracic aortic aneurysm (TAA) involving the aortic arch with a custom-made Bolton Relay 2-vessel branched thoracic aortic endograft in a 42-year-old Jehovah's Witness who would otherwise be very unlikely to survive an open repair...
February 2018: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29310335/two-stage-hybrid-treatment-strategy-for-an-adult-patient-with-aortic-arch-coarctation-poststenotic-aneurysm-and-hypoplastic-left-subclavian-artery-a-case-report
#11
Xiao-Bo Pu, Shi-Jian Chen, Mao Chen, Yuan Feng
RATIONALE: Coarctation of aorta in adulthood is usually complicated by other cardiovascular anomalies, posing great technical challenge for intervention. PATIENT CONCERNS: Here, we report an extremely rare case of aortic arch coarctation combined with a poststenotic biloculated calcified aneurysm and hypoplastic left subclavian artery. INTERVENTIONS: First, an extra-anatomic bypass was established, along with narrowing of aorta just proximal and distal to the aneurysm...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29299821/brain-protection-in-aortic-arch-aneurysm-antegrade-or-retrograde
#12
Amer Harky, Matthew Fok, Mohamad Bashir, Anthony L Estrera
During open aortic arch repair, there is an interruption of cerebral perfusion and to prevent neurological sequelae, the hypothermic circulatory arrest has been established to provide sufficient brain protection coupled with adjuncts including retrograde and antegrade cerebral perfusion. To date, brain protection during open aortic arch repair is a contested topic as to which provides superior brain protection with little evidence existing to suggest supremacy of one modality over the other. This article reviews current literature reflecting on key and emerging studies in brain protection and their associated outcomes in patients undergoing open aortic arch surgery...
January 3, 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29276439/endovascular-treatment-of-distal-aortic-arch-aneurysm-associated-with-coarctation-of-aorta-in-a-jehovah-s-witness
#13
Luigi Di Tommaso, Vito A Mannacio, Ettorino Di Tommaso, Giovanni B Pinna, Immacolata Fontana, Gabriele Iannelli
Late aneurysm formation in the proximal aorta or distal aortic arch is a recognized sequela of untreated stenosis of the aortic isthmus and is associated with substantial risk of aortic rupture. We describe the case of a 44-year-old man with untreated coarctation of the aorta who presented with a prestenotic dissecting thoracic aortic aneurysm. He declined surgery because he was a Jehovah's Witness. Instead, we performed emergency endovascular aortic repair in which 2 stent-grafts were placed in the descending aorta...
December 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/29276106/natural-history-of-the-proximal-aorta-in-patients-with-descending-thoracic-aortic-disease
#14
Paul C Tang, Paul D DiMusto, Nilto C De Oliveira, Brooks L Rademacher, Jennifer L Philip, Shahab A Akhter, Charles W Acher
OBJECTIVE: This study investigated the growth and behavior of the ascending aorta in patients with descending thoracic aortic disease. METHODS: We examined 200 patients with descending thoracic aortic disease including acute type B dissection (n = 95), chronic type B dissection (n = 38), intramural hematoma (n = 23), and thoracoabdominal aortic aneurysms (n = 44). Images from computed tomography and magnetic resonance imaging were evaluated after three-dimensional reconstruction to examine the growth rate in those with >1 year of imaging follow-up (n = 108)...
December 21, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29274694/acute-type-a-aortic-dissection-causing-collapse-of-previous-stent-graft
#15
Ha-Eun Kim, Hyun-Chel Joo
A 69-year old man presented to the emergency department with back pain and paraplegia. Computed tomography showed acute type A aortic dissection with primary tear right below the origin of the left subclavian artery. He had undergone endovascular aneurysm repair (EVAR) 13 months earlier, and the previously inserted EVAR graft totally collapsed. Total arch replacement covering primary entry tear was performed. Femoral pulse was undetected prior to surgery, but was monitored post-surgically after cardiopulmonary bypass weaning...
December 21, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29249769/open-conversion-for-type-a-ascending-aortic-dissection-after-thoracic-endovascular-aortic-repair-by-the-chimney-graft-technique
#16
Hirofumi Kasahara, Yoshito Inoue, Takashi Hachiya
An 83-year-old man with aortic arch aneurysm underwent zone 0 thoracic endovascular aortic repair (TEVAR) by the chimney graft technique with two supra-aortic arch debranching grafts and developed subacute type A ascending aortic dissection. We performed emergency open conversion with circulatory arrest under deep hypothermia. The tip of the chimney graft (around the sino-tubular junction in the ascending aorta) was stiff, making it difficult to inspect the lumen and perform anastomosis. Deep hypothermic circulatory arrest and cutting the endograft stents to mobilize the graft were necessary for secure anastomosis...
December 18, 2017: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29242743/open-repair-management-of-a-patient-with-aortic-arch-saccular-aneurysm-penetrating-atherosclerotic-ulcer-one-vessel-coronary-artery-disease-and-an-isolated-dissection-of-the-abdominal-aorta
#17
Harvey Romolo, Dicky A Wartono, Sugisman Suyuti, Bagus Herlambang, Michael Caesario, Ismoyo Sunu
Isolated saccular compared to fusiform aneurysm is considered to be a rare entity with challenges of its own. A 62-year-old female was diagnosed with a case of saccular aneurysm and penetrating atherosclerotic ulcer of the aortic arch. Additionally, she also had one vessel coronary artery disease and type B abdominal aortic dissection. She was then managed with open aortic arch repair and coronary artery bypass grafting. If required, elective endovascular repair will be done for the abdominal aorta on a later date...
2017: SAGE Open Medical Case Reports
https://www.readbyqxmd.com/read/29240061/-hybrid-treatment-of-patients-with-aneurysms-and-dissections-of-the-aortic-arch-and-descending-portion-of-the-thoracic-aorta
#18
V V Shlomin, M L Gordeev, D A Zverev, E A Shloĭdo, V E Uspenskiĭ, E D Zvereva, P B Bondarenko, P D Puzdriak
The authors share herein their experience with hybrid surgical treatment of 21 patients presenting with lesions of the aortic arch and descending thoracic aorta. Aortic pathology included dissection of the thoracoabdominal aorta (n=15), a sacciform aneurysm of the aortic arch (n=5), and a spindle-shaped aneurysm of the distal portions of the aortic arch (n=1). The first stage consisted of the following operations: transposition of the left subclavian artery into the left common carotid artery (n=9; 42.8%), partial debranching (n=11; 52...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/29239196/clinical-experience-of-positron-emission-tomography-in-infective-aortic-disease
#19
Julian S Tsang, Yiu Che Chan, Yuk Law, Stephen W Cheng
Background Fluorine-18-fluorodeoxyglucose positron-emission tomography with computed tomography has revolutionized medical diagnosis by adding functional activity to anatomic imaging. We report our experience with this technique in patients with mycotic aortic pathology and aortic vascular graft infection. Methods We conducted a retrospective review of a prospective database of patients who underwent 18F-fluorodeoxyglucose positron-emission tomography with computed tomography for suspected infective aortic disease...
January 1, 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/29236196/thoracoabdominal-aortic-mural-and-floating-thrombus-extending-into-superior-mesenteric-artery
#20
Sedat Giray Kandemirli, Ozan Onur Balkanay, Muhammad Osama Awiwi, Eser Durmaz, Deniz Goksedef, Nil Comunoglu
Thrombus in the thoracic aorta not related to aneurysm or atherosclerosis is a rare clinical entity with a limited number of cases reported. Floating thrombus is defined as non-adherent part of the thrombus floating within the aortic lumen. Herein, we present a 48-year-old woman who presented with progressive midline dull, aching abdominal pain of 2-day duration. Thoracoabdominal computed tomography revealed a free floating thrombus extending from the aortic arch into the superior mesenteric artery. Transesophageal echocardiography confirmed the findings of a thrombus extending through the aortic arch...
December 13, 2017: Journal of Medical Ultrasonics
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