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Acute dissection

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https://www.readbyqxmd.com/read/29666717/aortic-dissection-presenting-as-septic-shock-a-case-report-and-literature-review
#1
Jing Feng, Rui Liu, Sai Ma, Changkui Cao, Wei Zhang, Yang Zhao, Shinan Nie
Acute aortic dissection is a life-threatening clinical emergency, which mostly occurs in aged patients and presents with sharp chest pain. In this paper, we reported a case of acute aortic dissection, which induced septic shock in a young woman, without typical chest pain. The septic shock was possibly due to the bacterial translocation caused by aortic dissection-induced intestinal ischemia and intestinal epithelial barrier dysfunction. Our case appeared as the first case report of aortic dissection presenting as septic shock...
2018: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/29666091/dissection-flap-masquerading-as-double-aortic-valve-an-acquired-complication
#2
Bhagya Narayan Pandit, Richa Agrawal, Tarun Kumar, Munish Guleria
Aortic dissection usually presents as an acute emergency and less commonly presents as chronic dissection. Two-dimensional and transoesophageal echocardiographic features of aortic dissection generally show dissection flap, dilated aorta and aortic regurgitation. We report a very unusual and extremely rare case of a 40-year-old female patient with chronic aortic dissection presenting as functional double aortic valve.
April 17, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29663944/repair-of-a-large-ventral-hernia-in-a-rhesus-macaque-macaca-mulatta-by-using-an-abdominal-component-separation-technique
#3
Steve J Kempton, Jacqueline S Israel, Saverio Capuano Iii, Samuel O Poore
Here we present a 32-y-old rhesus macaque (Macaca mulatta) with a large recurrent ventral incisional hernia. The initial surgery included midline celiotomy for treatment of endometriosis, in which the animal developed a hernia that was repaired with interposition of mesh. Hernia recurrence at 1 y resulted in a defect measuring 7 × 13 cm, with loss of abdominal domain. Skin breakdown was noted with areas of exposed mesh through the skin with associated acute on chronic infection. Clinically, the animal was lethargic, not eating, and failing to thrive...
April 2, 2018: Comparative Medicine
https://www.readbyqxmd.com/read/29663140/poorly-differentiated-ductal-adenocarcinoma-of-the-pancreas-with-rapid-progression-in-a-young-man
#4
Koji Tezuka, Tomoharu Ishiyama, Akiko Takeshita, Hidekazu Matsumoto, Akira Jingu, Jiro Kikuchi, Hideyuki Yamaya, Rintaro Ohe, Tetsuya Ishizawa
Pancreatic cancer in young adults is very rare. We report a case of young-onset poorly differentiated pancreatic ductal adenocarcinoma with rapid progression and poor prognosis in a 31-year-old Japanese man with no obvious family history of malignancy. Preoperative examinations revealed a mass lesion in the body of the pancreas, accompanied by a slightly dilated main pancreatic duct distal to the mass lesion. Pancreatic cancer with acute pancreatitis was suspected because of an elevation of serum pancreatic enzyme and tumor marker, along with imaging findings...
April 16, 2018: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/29662703/aortic-dissection-presenting-as-acute-pancreatitis-suspecting-the-unexpected
#5
Adam Hafeez, Dillon Karmo, Adrian Mercado-Alamo, Alexandra Halalau
Aortic dissection is a life-threatening condition in which the inner layer of the aorta tears. Blood surges through the tear, causing the inner and middle layers of the aorta to separate (dissect). It is considered a medical emergency. We report a case of a healthy 56-year-old male who presented to the emergency room with sudden onset of epigastric pain radiating to his back. His blood pressure was 167/91 mmHg, equal in both arms. His lipase was elevated at 1258 U/L, and he was clinically diagnosed with acute pancreatitis (AP)...
2018: Case Reports in Cardiology
https://www.readbyqxmd.com/read/29659089/recurrent-aortic-root-pseudoaneurysm-after-transcatheter-occlusion-a-word-of-caution
#6
Makoto Hibino, Yoshiaki Katada, Kentaro Shibayama, Kotaro Obunai, Hiroyuki Watanabe, Yuji Kawano, Shun Watanabe, Minoru Tabata
A 48-year-old male developed a recurrent aortic-root pseudoaneurysm after surgical repair for acute dissection. Although the initial closure of the pseudoaneurysm was successfully managed by transcatheter endovascular occlusion and coiling utilizing a hybrid transapical and transfemoral approach, the pseudoaneurysm was recanalized after 3 months and a third-time surgical repair was required. The potential risk for recurrence of pseudoaneurysms should be considered when applying endovascular occlusion devices to treat aortic root anatomy...
April 2018: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/29657948/early-results-of-the-petticoat-technique-for-the-management-of-acute-type-a-aortic-dissection
#7
Vamshi Krishna Kotha, Zlatko I Pozeg, Eric J Herget, Michael C Moon, Jehangir J Appoo
Conventional surgical techniques for acute Type A aortic dissection (ATAAD) generally fail to address residual dissection in the descending aorta. The persistence of a false lumen is associated with visceral malperfusion in the acute setting and adverse aortic remodeling in the chronic setting. Hybrid aortic arch repair techniques may improve perioperative and long-term mortality by expanding the true lumen and obliterating the false lumen. However, there is a limit to the extent of aortic coverage due to the concomitant risk of spinal cord ischemia...
August 2017: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/29657947/modifiable-risk-factors-for-early-mortality-in-low-risk-penn-class-aa-acute-type-a-aortic-dissection-patients-a-descriptive-study
#8
Christian Olsson
Background: Acute Type A aortic dissection (ATAAD) without end-organ or generalized ischemia is Penn class Aa and considered low-risk. Nevertheless, surgical mortality can be considerable in this subgroup and may be related to modifiable factors. The objective of this study was to analyze 30-day mortality among ATAAD Penn class Aa patients with special reference to modifiable perioperative factors. Methods: Among all patients operated for ATAAD from 1990 to 2010, all Penn class Aa patients dying within 30 days were included in a retrospective descriptive study...
August 2017: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/29657734/treatment-of-a-patient-with-acute-aortic-dissection-using-extracorporeal-cardiopulmonary-resuscitation-after-an-out-of-hospital-cardiac-arrest-a-case-report
#9
Takahiro Yukawa, Kazuhiro Sugiyama, Kazuki Miyazaki, Takahiro Tanabe, Susumu Ishikawa, Yuichi Hamabe
Case: Circulatory support using veno-arterial extracorporeal membrane oxygenation for aortic disease is conventionally contraindicated. In this case, a 66-year-old man experienced cardiopulmonary arrest caused by acute aortic dissection. When exercising in the gym, he experienced chest discomfort, so the staff immediately called an ambulance. While in the ambulance, he experienced cardiopulmonary arrest. His initial electrocardiogram showed ventricular fibrillation. At the emergency department, we immediately performed extracorporeal cardiopulmonary resuscitation...
April 2018: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29650398/the-role-of-optical-coherence-tomography-in-the-setting-of-acute-myocardial-infarction
#10
REVIEW
Yongcheol Kim, Thomas W Johnson, Takashi Akasaka, Myung Ho Jeong
In recent years, intravascular imaging-guided percutaneous coronary intervention (PCI) has been increasing in patients with acute myocardial infarction (AMI). However, the role of optical coherence tomography (OCT) has not been established in the setting of AMI despite OCT providing superior resolution (10μm axial resolution) and facilitating assessment of baseline lesion characteristics and post-intervention evaluation of the acute result of stent implantation, including visualization of procedural dissections, malapposition, tissue prolapse, and thrombus...
April 9, 2018: Journal of Cardiology
https://www.readbyqxmd.com/read/29649955/repair-of-tevar-associated-type-a-dissection-in-the-elderly-is-possible-with-reasonable-morbidity-and-mortality
#11
Angela Kornberger, Risteski Petar, Hazem El Beyrouti, Mahmud Khalil, Iris Burck, Nancy Halloum, Andres Beiras-Fernandez, Christian-Friedrich Vahl
BACKGROUND: Type A aortic dissection (AAD) is a devastating complication of thoracic endovascular repair (TEVAR). In elderly patients, surgery for AAD carries considerable morbidity and mortality. Repair of AAD after previous TEVAR is an even greater challenge as it usually requires the arch to be addressed and a preexisting stent graft to be included into the aortic repair. METHODS: A case series of 5 elderly patients who presented with acute AAD after previous TEVAR was reviewed...
January 1, 2018: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29644398/stent-placement-in-patients-with-acute-subarachnoid-haemorrhage-when-is-it-justified
#12
Andrew G Murchison, Victoria Young, Tanja Ddjurdjevic, Martino Cellerini, Rufus Corkill, Wilhelm Küker
PURPOSE: Endovascular stents are widely used for the elective treatment of cerebral aneurysms. Acute stenting is performed in the management of dissections, pseudo-aneurysms, broad-based aneurysms or as a 'bail out' measure after coil migration. The purpose of this study is to review the safety of using stents in acute subarachnoid haemorrhage. METHODS: The stent registry of our institution was reviewed for procedures in patients with acute subarachnoid haemorrhage...
April 11, 2018: Neuroradiology
https://www.readbyqxmd.com/read/29629999/cholesterol-transfer-at-endosomal-organelle-membrane-contact-sites
#13
Neale D Ridgway, Kexin Zhao
PURPOSE OF REVIEW: Cholesterol is delivered to the limiting membrane of late endosomes by Niemann-Pick Type C1 and C2 proteins. This review summarizes recent evidence that cholesterol transfer from endosomes to the endoplasmic reticulum and other organelles is mediated by lipid-binding proteins that localize to membrane contact sites (MCS). RECENT FINDINGS: LDL-cholesterol in the late endosomal/lysosomes is exported to the plasma membrane, where most cholesterol resides, and the endoplasmic reticulum, which harbors the regulatory complexes and enzymes that control the synthesis and esterification of cholesterol...
April 7, 2018: Current Opinion in Lipidology
https://www.readbyqxmd.com/read/29629837/impact-of-hypertension-on-early-outcomes-and-long-term-survival-of-patients-undergoing-aortic-repair-with-stanford-a-dissection
#14
Julia Merkle, Anton Sabashnikov, Antje-Christin Deppe, Mohamed Zeriouh, Kaveh Eghbalzadeh, Carolyn Weber, Parwis Rahmanian, Elmar Kuhn, Navid Madershahian, Axel Kroener, Yeong-Hoon Choi, Ferdinand Kuhn-Régnier, Oliver Liakopoulos, Thorsten Wahlers
INTRODUCTION: Stanford A acute aortic dissection (AAD) is a life-threatening emergency, typically occurring in hypertensive patients, requiring immediate surgical repair. The aim of this study was to evaluate early outcomes and long-term survival of hypertensive patients in comparison to normotensive patients suffering from Stanford A AAD. METHODS: In our center, 240 patients with Stanford A AAD underwent aortic surgical repair from January 2006 to April 2015. After statistical and logistic regression analysis, Kaplan-Meier survival estimation was performed, with up to 9-year follow-up...
April 1, 2018: Perfusion
https://www.readbyqxmd.com/read/29629554/single-stage-thoracic-aortic-replacement-and-aortic-valve-replacement-via-clamshell-thoracotomy
#15
Thomas Schachner
Aortic surgery is sometimes complicated by aortic arch anomalies. This tutorial illustrates the technique of single-stage thoracic aorta replacement and aortic valve replacement via a clamshell thoracotomy in acute aortic arch dissection with proximal aneurysms of the left subclavian artery and an aberrant right subclavian artery. The advantage of this technique is that only brief partial hypothermic circulatory arrest is required and the procedure can be performed with one quadrifurcated tube graft.
February 20, 2018: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://www.readbyqxmd.com/read/29628463/-vascular-smooth-muscle-cell-response-to-cyclic-mechanical-stretch-and-aortic-dissection
#16
Masanori Yoshizumi, Jing Zhao, Yoji Kyotani
Acute aortic dissection is the most common life-threatening vascular disease, with sudden onset of severe pain and a high fatality rate. The pulsatile nature of blood flow exposes vascular smooth muscle cells (VSMCs) in the vessel wall to cyclic mechanical stretch (CMS), which evokes VSMC death, phenotypic switching, and migration, leading to aortic dissection. We have revealed that CMS of rat aortic smooth muscle cells (RASMCs) caused JNK- and p38-dependent cell death and that a calcium channel blocker, azelnidipine and an angiotensin II receptor antagonist, olmesartan decreased the phosphorylation of JNK and p38 and, subsequently, decreased cell death by CMS...
2018: Nihon Yakurigaku Zasshi. Folia Pharmacologica Japonica
https://www.readbyqxmd.com/read/29627025/cerebrovascular-imaging-of-cerebral-ischemia-in-acute-type-a-aortic-dissection
#17
Soichiro Matsubara, Masatoshi Koga, Tomoyuki Ohara, Yasuyuki Iguchi, Kenji Minatoya, Yoshio Tahara, Tetsuya Fukuda, Yuichi Miyazaki, Katsufumi Kajimoto, Yuki Sakamoto, Naoki Makita, Naoki Tokuda, Kazuyuki Nagatsuka, Yukio Ando, Kazunori Toyoda
BACKGROUND AND PURPOSE: Stanford type A aortic dissection (AAD) sometimes causes acute ischemic stroke (AIS) or transient ischemic attack (TIA). There is little understanding of cerebrovascular imaging of AIS or TIA in patients with AAD. METHODS: Consecutive AIS/TIA patients with AAD who were admitted within 4.5 h of onset were reviewed. We compared findings of MRI/MRA between these and consecutive AIS/TIA patients without AAD within 4.5 h of onset. RESULTS: Seventeen AAD and 249 non-AAD patients were identified...
May 15, 2018: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/29626287/suppressive-effect-of-pitavastatin-on-aortic-arch-dilatation-in-acute-stanford-type-b-aortic-dissection-analysis-of-stanp-trial
#18
Naoki Masaki, Kiichiro Kumagai, Konosuke Sasaki, Satoshi Matsuo, Naotaka Motoyoshi, Osamu Adachi, Masatoshi Akiyama, Shunsuke Kawamoto, Koichi Tabayashi, Yoshikatsu Saiki
OBJECTIVES: Medical therapy for patients with uncomplicated acute type B aortic dissection (ABAD) is essentially accepted for its excellent early outcome; however, long-term outcomes have not been satisfactory due to aorta-related complications. This trial was performed to investigate the efficacy of a statin as an additive that may enhance the effectiveness of conventional medical treatment in patients with ABAD. METHODS: This was a multi-center, prospective, and randomized comparative investigation of patients with uncomplicated ABAD...
April 6, 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29626067/endothelial-c-type-natriuretic-peptide-acts-on-pericytes-to-regulate-microcirculatory-flow-and-blood-pressure
#19
Katarina Špiranec, Wen Chen, Franziska Werner, Viacheslav O Nikolaev, Takashi Naruke, Franziska Koch, Andrea Werner, Petra Eder-Negrin, Rodrigo Diéguez-Hurtado, Ralf H Adams, Hideo A Baba, Hannes Schmidt, Kai Schuh, Boris V Skryabin, Kiavash Movahedi, Frank Schweda, Michaela Kuhn
Background -Peripheral vascular resistance has a major impact on arterial blood pressure levels. Endothelial C-type natriuretic peptide (CNP) participates in the local regulation of vascular tone but the target cells remain controversial. The cGMP-producing guanylyl cyclase-B (GC-B) receptor for CNP is expressed in vascular smooth muscle cells (VSMC). However, whereas endothelial cell-specific CNP knockout mice are hypertensive, mice with deletion of GC-B in VSMC have unaltered blood pressure. Methods -We analyzed whether the vasodilating response to CNP changes along the vascular tree, i...
April 6, 2018: Circulation
https://www.readbyqxmd.com/read/29625025/ltbp3-pathogenic-variants-predispose-individuals-to-thoracic-aortic-aneurysms-and-dissections
#20
Dong-Chuan Guo, Ellen S Regalado, Amelie Pinard, Jiyuan Chen, Kwanghyuk Lee, Christina Rigelsky, Lior Zilberberg, Ellen M Hostetler, Micheala Aldred, Stephanie E Wallace, Siddharth K Prakash, Suzanne M Leal, Michael J Bamshad, Deborah A Nickerson, Marvin Natowicz, Daniel B Rifkin, Dianna M Milewicz
The major diseases affecting the thoracic aorta are aneurysms and acute dissections, and pathogenic variants in 11 genes are confirmed to lead to heritable thoracic aortic disease. However, many families in which multiple members have thoracic aortic disease do not have alterations in the known aortopathy genes. Genes highly expressed in the aorta were assessed for rare variants in exome sequencing data from such families, and compound rare heterozygous variants (p.Pro45Argfs∗ 25 and p.Glu750∗ ) in LTBP3 were identified in affected members of one family...
April 5, 2018: American Journal of Human Genetics
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