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Ascending aorta aneurysm

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https://www.readbyqxmd.com/read/29165599/direct-axillary-cannulation-with-open-seldinger-guided-technique-is-it-safe
#1
Davide Carino, Makoto Mori, Philip Y K Pang, Mrinal Singh, Sherif Elkinany, Maryann Tranquilli, Bulat A Ziganshin, John A Elefteriades
OBJECTIVES: Axillary artery cannulation is commonly used in thoracic aortic surgery, often utilizing a sidearm graft. Although our institutional preference is femoral cannulation, we use axillary cannulation in select cases with a 'dirty' aorta on computed tomography scan or intraoperative transoesophageal echocardiography. Since 2011, we have routinely used an open Seldinger-guided approach for axillary cannulation. Here, we report our experience with open Seldinger-guided technique, evaluating its safety and efficacy...
November 20, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29164158/development-of-multiple-aortic-mycotic-aneurysms-after-cardiac-catheterization
#2
Desiree A Steimer, John J Squiers, J Michael DiMaio, Katherine B Harrington
A 71-year-old male with a past medical history of coronary artery bypass surgery developed multiple, infected pseudoaneurysms of the ascending aorta and aortic root 1 year after cardiac catheterization. He underwent aortic root replacement with a 24-mm homograft. Tissue culture from operative specimens revealed invasive Aspergillus fumigatus infection. He was treated with voriconazole for 3 months. After 1 year, he had no recurrence of symptoms, pseudoaneurysm, or fungal infection.
October 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/29158612/detection-of-pathological-changes-in-the-aorta-during-thoracic-aortic-aneurysm-progression-on-molecular-level
#3
Miroslava Rabajdová, Peter Urban, Ivana Špaková, Artemiou Panagiotis, Michaela Ferenčáková, Dušan Rybár, Nikita Bobrov, František Sabol, Mária Mareková
The progression of thoracic aortic aneurysm depends on regulation of aortic wall homeostasis and on changes in the structural components of the extracellular matrix, which are affected by multiple molecular signalling pathways. We decided to correlate the diameter of ascending thoracic aneurysm with gene expression of inflammation markers (IL-6, CRP), cytokine receptors (IL-6R, TNFR1, and TNFR2), and extracellular matrix components (Emilin-1, MMP9, and TIMP) for detection of the degree of pathological process of TAA formation...
2017: Disease Markers
https://www.readbyqxmd.com/read/29155940/stented-balloon-fenestration-before-entry-repair-using-the-frozen-elephant-trunk-technique-for-chronic-aortic-dissection
#4
Naomichi Uchida, Yoshitaka Yamane, Tomokuni Furukawa
Endovascular fenestration on the abdominal aorta is effective for preventing visceral malperfusion in aortic dissection. We report a case of stented balloon fenestration before residual entry repair using the frozen elephant trunk technique for chronic aneurysmal dissection after ascending aortic replacement for DeBakey I aortic dissection. We recognized poor communication between the true lumen and false lumen in the abdominal aorta, and visceral perfusion depended almost entirely on the proximal large entry...
October 9, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29149696/clearance-of-plasmin-pn-1-complexes-by-vascular-smooth-muscle-cells-in-human-aneurysm-of-the-ascending-aorta
#5
Kamel Boukais, Luciano F Borges, Laurence Venisse, Ziad Touat, Déborah François, Véronique Arocas, Guillaume Jondeau, Paul Declerck, Marie-Christine Bouton, Jean-Baptiste Michel
Plasminogen is a circulating zymogen which enters the arterial wall by radial, transmural hydraulic conductance, where it is converted to plasmin by tissue plasminogen activator t-PA on an activation platform involving S100A4 on the vascular smooth muscle cell (vSMC) membrane. Plasmin is involved in the progression of human thoracic aneurysm of the ascending aorta (TAA). vSMCs protect the TAA wall from plasmin-induced proteolytic injury by expressing high levels of antiproteases. Protease nexin-1 (PN-1) is a tissue antiprotease belonging to the serpin superfamily, expressed in the vascular wall, and is able to form a covalent complex with plasmin...
October 24, 2017: Cardiovascular Pathology: the Official Journal of the Society for Cardiovascular Pathology
https://www.readbyqxmd.com/read/29149323/should-the-dilated-ascending-aorta-be-repaired-at-the-time-of-bicuspid-aortic-valve-replacement
#6
Tsuyoshi Kaneko, Prem Shekar, Vladimir Ivkovic, Nicholas T Longford, Chuan-Chin Huang, Martin I Sigurdsson, Robert C Neely, Maroun Yammine, Julius I Ejilofor, Vanessa Montiero Vieira, Jasmine T Shahram, Karam M Habchi, Gregory W Malzberg, Peter S Martin, Jordan Bloom, Eric M Isselbacher, J Daniel Muehlschlegel, Thoralf M Sundt, Simon C Body
OBJECTIVES: Bicuspid aortic valve (BAV) is the most common congenital valvular abnormality and frequently presents with accelerated calcific aortic valve disease, requiring aortic valve replacement (AVR) and thoracic aortic aneurysm and dissection. Supporting evidence for Association Guidelines of aortic dimensions for aortic resection is sparse. We sought to determine whether concurrent repair of dilated or aneurysmal aortic disease during AVR in patients with BAV substantially improves morbidity and mortality outcomes...
November 14, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29147966/polyamine-concentration-is-increased-in-thoracic-ascending-aorta-of-patients-with-bicuspid-aortic-valve
#7
Amalia Forte, Mario Grossi, Ciro Bancone, Marilena Cipollaro, Marisa De Feo, Per Hellstrand, Lo Persson, Bengt-Olof Nilsson, Alessandro Della Corte
Polyamines are cationic molecules synthesized via a highly regulated pathway, obtained from the diet or produced by the gut microbiota. They are involved in general molecular and cellular phenomena that play a role also in vascular disease. Bicuspid aortic valve (BAV) is a congenital malformation associated to a greater risk of thoracic ascending aorta (TAA) aneurysm, whose pathogenesis is not yet well understood. We focused on differential analysis of key members of polyamine pathway and on polyamine concentration in non-dilated TAA samples from patients with either stenotic tricuspid aortic valve (TAV) or BAV (diameter ≤ 45 mm), vs...
November 17, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/29129420/surgical-strategy-for-the-treatment-of-aortoesophageal-fistula
#8
Takahiro Yamazato, Tetsu Nakamura, Noriyuki Abe, Koki Yokawa, Yuki Ikeno, Yojiro Koda, Soichiro Henmi, Hidekazu Nakai, Yasuko Gotake, Takashi Matsueda, Takeshi Inoue, Hiroshi Tanaka, Yoshihiro Kakeji, Yutaka Okita
OBJECTIVE: To present a surgical strategy for aortoesophageal fistula (AEF). METHODS: From October 1999 to May 2017, 27 patients with AEF were treated at Kobe University Hospital. After 9 patients with malignancies or fish bone penetration were excluded, 18 patients who had AEF secondary to aortic lesions were investigated. The mean age was 67.2 ± 10.4 years, and the male/female ratio was 16:2. Twelve patients had a nondissection thoracic aneurysm, and 6 patients had a chronic aortic dissection...
September 20, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29120015/ascending-aortic-remodelling-in-fabry-disease-after-long-term-enzyme-replacement-therapy
#9
Pierre Monney, Salah Dine Qanadli, Steven Hajdu, Christel Tran, Juerg Schwitter, Olivier Dormond, Frédéric Barbey
BACKGROUND: Previous cross-sectional studies reported a high prevalence of ascending aorta dilations/aneurysms in male adults with Fabry disease, independently of cardiovascular risk factors. AIMS OF THE STUDY: To characterise the remodelling of the ascending aorta in classic Fabry disease under long-term enzyme replacement therapy. METHODS: Diameter of the ascending aorta was measured with magnetic resonance imaging at the sino-tubular junction (STJ), and proximal (pAsAo), and distal ascending aorta (dAsAo) at baseline, and after 5 and 10 years of enzyme replacement therapy in 15 adult Fabry patients (10 males; 5 females)...
November 9, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29119033/the-utility-of-mri-in-the-diagnosis-of-takayasu-arteritis
#10
Marian Gaballah, Rachelle Goldfisher, John B Amodio
Takayasu Arteritis (TA) is an inflammatory disorder involving the thoracoabdominal aorta and its branches and the pulmonary arteries, with eventual vascular stenosis, occlusion, or aneurysm formation. Conventional angiography has been the reference imaging standard for diagnosis of TA. The purpose of this case report is to demonstrate the utility of MR imaging and MR angiography in the diagnosis of Takayasu Arteritis in a pediatric patient. The patient is a 15-year-old female patient presenting with anemia, hypertension, and acute kidney injury...
2017: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/29118111/differential-cell-matrix-mechanoadaptations-and-inflammation-drive-regional-propensities-to-aortic-fibrosis-aneurysm-or-dissection-in-hypertension
#11
M R Bersi, R Khosravi, A J Wujciak, D G Harrison, J D Humphrey
The embryonic lineage of intramural cells, microstructural organization of the extracellular matrix, local luminal and wall geometry, and haemodynamic loads vary along the length of the aorta. Yet, it remains unclear why certain diseases manifest differentially along the aorta. Toward this end, myriad animal models provide insight into diverse disease conditions-including fibrosis, aneurysm and dissection-but inherent differences across models impede general interpretations. We examined region-specific cellular, matrix, and biomechanical changes in a single experimental model of hypertension and atherosclerosis, which commonly coexist...
November 2017: Journal of the Royal Society, Interface
https://www.readbyqxmd.com/read/29101897/estimation-of-in-vivo-mechanical-properties-of-the-aortic-wall-a-multi-resolution-direct-search-approach
#12
Minliang Liu, Liang Liang, Wei Sun
The patient-specific biomechanical analysis of the aorta requires in vivo mechanical properties of individual patients. Existing approaches for estimating in vivo material properties often demand high computational cost and mesh correspondence of the aortic wall between different cardiac phases. In this paper, we propose a novel multi-resolution direct search (MRDS) approach for estimation of the nonlinear, anisotropic constitutive parameters of the aortic wall. Based on the finite element (FE) updating scheme, the MRDS approach consists of the following three steps: (1) representing constitutive parameters with multiple resolutions using principal component analysis (PCA), (2) building links between the discretized PCA spaces at different resolutions, and (3) searching the PCA spaces in a 'coarse to fine' fashion following the links...
January 2018: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/29096006/treatment-of-prosthetic-valve-endocarditis-by-aortic-valve-neocuspidization-using-bovine-pericardium
#13
Yasunori Iida, Kazuma Shimura, Sho Akiyama, Shigeharu Sawa
A 78-year-old man who had undergone aortic valve and ascending aorta replacements presented with fever and was referred to our hospital. Blood culture revealed Gram-positive cocci, thus antibiotic therapy was started. Brain magnetic resonance imaging showed fresh cerebral infarction without cerebral haemorrhage or mycotic aneurysm. Transoesophageal echocardiogram revealed a vegetation that was attached to the right coronary cusp. The patient underwent successful aortic valve neocuspidization using glutaraldehyde-treated bovine pericardium...
October 31, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29059361/surgical-treatment-of-an-extracranial-carotid-artery-aneurysm-in-a-child-by-an-arterial-autograft
#14
Marine Gaudry, Abdallah Al Farai, Virginie Fouilloux, Philippe Piquet
We report a symptomatic aneurysm of the left common carotid artery (LCCA) in a 6-year-old boy. The patient had been diagnosed and treated 3 years earlier for an isolation of the LCCA with a right-sided aortic arch. At the age of 3 years, the LCCA was reimplanted in the ascending aorta. Three years later, the patient developed a voluminous aneurysm of the LCCA complicated by stroke. An arterial graft was used for the carotid reconstruction with good long-term patency and no aneurysm evolution.
November 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29042101/machine-learning-phenotypic-classification-of-bicuspid-aortopathy
#15
Charles M Wojnarski, Eric E Roselli, Jay J Idrees, Yuanjia Zhu, Theresa A Carnes, Ashley M Lowry, Patrick H Collier, Brian Griffin, John Ehrlinger, Eugene H Blackstone, Lars G Svensson, Bruce W Lytle
BACKGROUND: Bicuspid aortic valves (BAV) are associated with incompletely characterized aortopathy. Our objectives were to identify distinct patterns of aortopathy using machine-learning methods and characterize their association with valve morphology and patient characteristics. METHODS: We analyzed preoperative 3-dimensional computed tomography reconstructions for 656 patients with BAV undergoing ascending aorta surgery between January 2002 and January 2014. Unsupervised partitioning around medoids was used to cluster aortic dimensions...
September 14, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29038409/-total-arch-replacement-for-distal-arch-aneurysm-with-isolated-left-vertebral-artery-report-of-a-case
#16
Motonori Uchino, Masaru Yoshikai, Hisashi Sato, Jun Osaki
We herein present a case of distal aortic arch aneurysm with an isolated left vertebral artery(LVA). In surgery, after establishing cardiopulmonary bypass, the LVA was anastomosed to the left common carotid artery (LCCA) while under moderate hypothermia. Selective cerebral perfusion (SCP) was then initiated by inserting catheters into the brachiocephalic artery( BCA), the LCCA and the left subclavian artery (LSA). The aorta was transected between the BCA and the LCCA, and an open stent graft was deployed into the descending aorta during circulatory arrest...
October 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28983176/bentall-operation-in-a-patient-with-an-anomalous-left-circumflex-artery-case-report-and-review
#17
Ivo Gasparovic, Panagiotis Artemiou, Mikulas Kiss, Michal Hulman
Anomalous origin of a left circumflex artery from the right coronary sinus represents a technical challenge in patients who require aortic valve/root procedures. This case report describes a patient who presented with bicuspid aortic valve, anomalous origin of the circumflex artery, severe aortic regurgitation, and aneurysm of the ascending aorta as well as aortic root that was safely managed following the Bentall procedure with the combined button technique.
October 2017: Journal of the Saudi Heart Association
https://www.readbyqxmd.com/read/28958041/endovascular-treatment-of-non-dissected-ascending-aorta-disease-a-systematic-review
#18
Changtian Wang, Evelyn Regar, Mario Lachat, Ludwig K von Segesser, Francesco Maisano, Enrico Ferrari
Severe ascending aorta disease includes aneurysms, pseudoaneurysms (ascending aorta pseudoaneurysms), penetrating aortic ulcers and Type A aortic dissections. Surgical replacement of the aortic root, ascending aorta or aortic arch is the common treatment for severe ascending aortic disease involving the root, the ascending aorta and/or the arch. Despite good surgical results, there is still a risk for morbidity and mortality following surgery for ascending aorta replacement when elderly patients or patients at high risk for surgery are concerned...
September 18, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28955046/critical-role-of-adamts-4-in-the-development-of-sporadic-aortic-aneurysm-and-dissection-in-mice
#19
Pingping Ren, Michael Hughes, Swapna Krishnamoorthy, Sili Zou, Lin Zhang, Darrell Wu, Chen Zhang, John A Curci, Joseph S Coselli, Dianna M Milewicz, Scott A LeMaire, Ying H Shen
Sporadic aortic aneurysm and dissections (AADs) are common vascular diseases that carry a high mortality rate. ADAMTS-4 (a disintegrin-like and metalloproteinase with thrombospondin motifs-4) is a secreted proteinase involved in inflammation and matrix degradation. We previously showed ADAMTS-4 levels were increased in human sporadic descending thoracic AAD (TAAD) samples. Here, we provide evidence that ADAMTS-4 contributes to aortic destruction and sporadic AAD development. In a mouse model of sporadic AAD induced by a high-fat diet and angiotensin II infusion, ADAMTS-4 deficiency (Adamts-4-/-) significantly reduced challenge-induced aortic diameter enlargement, aneurysm formation, dissection and aortic rupture...
September 27, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28950334/ascending-aorta-dilatation-rates-in-patients-with-tricuspid-and-bicuspid-aortic-stenosis-the-cofrasa-generac-study
#20
Caroline Kerneis, Nicoletta Pasi, Dimitri Arangalage, Virginia Nguyen, Tiffany Mathieu, Constance Verdonk, Isabelle Codogno, Phalla Ou, Xavier Duval, Sarah Tubiana, Claire Cimadevilla, Alec Vahanian, And David Messika-Zeitoun
Background: Ascending aorta (AA) dilatation is common in aortic valve stenosis (AS) but data regarding AA progression, its determinants and impact of valve anatomy [bicuspid (BAV), or tricuspid (TAV)] are scarce. Methods and Results: Asymptomatic AS patients enrolled in a prospective cohort (COFRASA/GENERAC) with at least 2 years of follow-up were considered in the present analysis. A transthoracic echocardiography (TTE) and a computed tomography (CT) scan were performed at inclusion and yearly thereafter...
July 25, 2017: European Heart Journal Cardiovascular Imaging
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