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Ascending aorta aneurysm

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https://www.readbyqxmd.com/read/27890843/total-endovascular-aortic-repair-in-a-patient-with-marfan-syndrome
#1
Mau Amako, Rafaëlle Spear, Rachel E Clough, Adrien Hertault, Richard Azzaoui, Teresa Martin Gonzalez, Jonathan Sobocinski, Stéphan Haulon
OBJECTIVE: To describe a total endovascular aortic repair with branched and fenestrated endografts in a young patient with Marfan syndrome and a chronic aortic dissection. Open surgery is the gold standard to treat aortic dissections in patients with aortic disease and Marfan syndrome. METHODS: In 2000, a 38-year-old man with Marfan syndrome underwent open ascending aorta repair for an acute type A aortic dissection. One year later, a redo sternotomy was performed for aortic valve replacement...
November 24, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27888778/loss-of-mechanical-directional-dependency-of-the-ascending-aorta-with-severe-medial-degeneration
#2
Jennifer Chung, Kevin Lachapelle, Raymond Cartier, Rosaire Mongrain, Richard L Leask
Biomechanical characterization of the aortic wall may help risk stratify patients with aneurysms. We investigated the degree of anisotropy, the directional dependency of mechanical properties, in control and aneurysmal ascending aortic tissue. We hypothesized that medial degeneration and aortic wall remodeling as found in aneurysmal tissue alter energy loss in both the circumferential and longitudinal directions, thereby reducing anisotropy. Aneurysmal and control ascending aortic tissue excised during surgery was subjected to biaxial tensile testing...
November 15, 2016: Cardiovascular Pathology: the Official Journal of the Society for Cardiovascular Pathology
https://www.readbyqxmd.com/read/27879251/altered-smooth-muscle-cell-force-generation-as-a-driver-of-thoracic-aortic-aneurysms-and-dissections
#3
REVIEW
Dianna M Milewicz, Kathleen M Trybus, Dongchuan Guo, H Lee Sweeney, Ellen Regalado, Kristine Kamm, James T Stull
The importance of maintaining contractile function in aortic smooth muscle cells (SMCs) is evident by the fact that heterozygous mutations in the major structural proteins or kinases controlling contraction lead to the formation of aneurysms of the ascending thoracic aorta that predispose to life-threatening aortic dissections. Force generation by SMC requires ATP-dependent cyclic interactions between filaments composed of SMC-specific isoforms of α-actin (encoded by ACTA2) and myosin heavy chain (MYH11). ACTA2 and MYH11 mutations shown to disrupt this cyclic interaction predispose to thoracic aortic disease...
November 22, 2016: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/27861233/aortic-volumetry-at-contrast-enhanced-magnetic-resonance-angiography-feasibility-as-a-sensitive-method-for-monitoring-bicuspid-aortic-valve-aortopathy
#4
Brian Trinh, Iram Dubin, Ozair Rahman, Marcos P Ferreira Botelho, Nicholas Naro, James C Carr, Jeremy D Collins, Alex J Barker
OBJECTIVES: Bicuspid aortic valve patients can develop thoracic aortic aneurysms and therefore require serial imaging to monitor aortic growth. This study investigates the reliability of contrast-enhanced magnetic resonance angiography (CEMRA) volumetry compared with 2-dimensional diameter measurements to identify thoracic aortic aneurysm growth. MATERIALS AND METHODS: A retrospective, institutional review board-approved, and Health Insurance Portability and Accountability Act-compliant study was conducted on 20 bicuspid aortic valve patients (45 ± 8...
November 17, 2016: Investigative Radiology
https://www.readbyqxmd.com/read/27847075/combined-nuss-procedure-and-cardiac-procedure-through-a-left-anterolateral-thoracotomy
#5
François Roubertie, Sowmya Ramanan, Frederic Lavrand, Jean-Benoit Thambo
Aortic root aneurysms associated with severe pectus excavatum caused by Marfan's syndrome can be challenging to correct in children. Recent reports suggest single-stage correction of both cardiac and chest wall deformities through a median sternotomy. We report a 9-year-old girl with Marfan's syndrome, an ascending aorta aneurysm, mitral regurgitation, and pectus excavatum, who underwent David's procedure with mitral valve repair and the Nuss procedure to correct the thoracic deformity. This single-stage combined procedure was performed through a left anterolateral thoracotomy...
December 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27836291/the-megaaortic-syndrome-progression-of-ascending-aortic-aneurysm-or-a-disease-of-distinct-origin
#6
Ulrike Baranyi, Christian Stern, Birgitta Winter, Adrian Türkcan, Bernhard Scharinger, Marie-Elisabeth Stelzmüller, Thomas Aschacher, Martin Andreas, Marek Ehrlich, Günther Laufer, David Bernhard, Barbara Messner
BACKGROUND: Thoracic aortic aneurysm (TAA) is an often asymptomatic disease with fatal outcome, such as dissection or rupture. The megaaortic syndrome (MAS) is an extensive dilatation of the whole aorta with low incidence but high lethal outcome with unknown pathophysiology so far. METHODS AND RESULTS: We compared aortic tissue of patients with sporadic TAAs and MAS of the ascending aorta with non-aneurysmal control tissues. Specimens of MAS patients showed a significantly reduced thickness of the media but an increased thickness of the intima compared to control tissue and TAAs with moderate dilatation...
October 29, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27833782/telescoping-technique-to-engage-left-main-coronary-artery-in-a-case-of-giant-aortic-aneurysm-in-a-geriatric-patient
#7
Priyank Shah, Rahul Vasudev, Mahesh Bikkina, Hartaj Virk
We present a case of a geriatric male with giant ascending aortic aneurysm (AAA) who underwent successful coronary angiography using telescoping technique for evaluation his coronary arteries before surgery for AAA. Since the ascending aorta and root were extremely dilated, we knew it would not have been possible to engage the coronaries using regular catheters and standard technique. Hence, telescopic technique was used. Amplatz left 3 (AL3) 7F (French) guide catheter (90 cm) was initially used, and nonselective injection of contrast was done to see the coronary ostium...
2016: Journal of Clinical Imaging Science
https://www.readbyqxmd.com/read/27819806/pseudoaneurysm-as-a-late-complication-of-hybrid-aortic-arch-repair
#8
Cristian Rosu, Nicolas Beaulieu, Raymond Cartier, Philippe Demers
Hybrid aortic arch repair is increasingly used for the management of aortic arch aneurysm. Pseudoaneurysm is a newly described late complication of this procedure. A 57-year-old man underwent emergent supra-aortic debranching and aortic arch stent grafting after rupture of an arch aneurysm. Three years later, the patient presented with a pseudoaneurysm at the junction between the stent graft's proximal landing zone and the origin of the debranching graft. At reoperative repair, the proximal stent graft had eroded through the aortic wall at the junction of the endograft proximal landing zone and the proximal anastomosis of the debranching graft...
September 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/27804164/repair-of-ascending-aortic-aneurysms-following-cardiac-transplantation
#9
Shinichi Fukuhara, Elizabeth H Stephens, Jason P Glotzbach, Michael A Borger
Ascending aortic aneurysms arising from the native aorta following cardiac transplantation are rare. We report two patients who developed aneurysms of the native ascending aorta requiring surgical repair post-transplantation. Both patients underwent ascending and hemi-arch replacement and recovered uneventfully. Heart transplant patients with pre-existing aortic dilation/ectasia may display more rapid aneurysmal growth compared to non-transplant patients. Therefore close observation is warranted in these patients...
November 1, 2016: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/27779199/mesenchymal-state-of-intimal-cells-may-explain-higher-propensity-to-ascending-aortic-aneurysm-in-bicuspid-aortic-valves
#10
Shohreh Maleki, Sanela Kjellqvist, Valentina Paloschi, Joelle Magné, Rui Miguel Mamede Branca, Lei Du, Kjell Hultenby, Johan Petrini, Jonas Fuxe, Janne Lehtiö, Anders Franco-Cereceda, Per Eriksson, Hanna M Björck
Individuals with a bicuspid aortic valve (BAV) are at significantly higher risk of developing aortic complications than individuals with tricuspid aortic valves (TAV) and defective signaling during the embryonic development and/or life time exposure to abnormal hemodynamic have been proposed as underlying factors. However, an explanation for the molecular mechanisms of aortopathy in BAV has not yet been provided. We combined proteomics, RNA analyses, immunohistochemistry, and electron microscopy to identify molecular differences in samples of non-dilated ascending aortas from BAV (N = 62) and TAV (N = 54) patients...
October 25, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27777529/repair-of-multiple-subclavian-and-axillary-artery-aneurysms-in-a-58-year-old-man-with-marfan-syndrome
#11
Ahmet Dolapoglu, Kim I de la Cruz, Ourania Preventza, Joseph S Coselli
Dilation of the ascending aorta and aortic dissections are often seen in Marfan syndrome; however, true aneurysms of the subclavian and axillary arteries rarely seem to develop in patients who have this disease. We present the case of a 58-year-old man with Marfan syndrome who had undergone a Bentall procedure and thoracoabdominal aortic repair for an aortic dissection and who later developed multiple aneurysmal dilations of his right subclavian and axillary arteries. The aneurysms were successfully repaired by means of a surgical bypass technique in which a Dacron graft was placed between the carotid and brachial arteries...
October 2016: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/27777368/mycotic-aneurysm-of-the-ascending-aorta-in-a-child-with-bicuspid-aortic-valve
#12
Shotaro Higa, Tai Fuchigami, Nobuhiro Nagata
No abstract text is available yet for this article.
October 24, 2016: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/27760812/analysis-of-risk-factors-for-early-type-i-endoleaks-after-thoracic-endovascular-aneurysm-repair
#13
Yuji Kanaoka, Takao Ohki, Koji Maeda, Takeshi Baba
PURPOSE: To evaluate risk factors for early (<30 days) type I endoleak following thoracic endovascular aortic repair (TEVAR). METHODS: A retrospective study was conducted of 439 consecutive patients (mean age 74.0±10.0 years; 333 men) who underwent TEVAR at a single center between June 2006 and June 2013. Pathologies included 237 aortic arch aneurysms and 202 descending thoracic aortic aneurysms (dTAA). Maximum TAA diameter was 63.6±13.7 mm. Among the distal aortic arch aneurysms, 124 required coverage of the left subclavian artery (LSA), while the remaining 113 arch aneurysms had debranching (n=40), the chimney technique (n=52), and a branched stent-graft (n=13)...
October 19, 2016: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/27756793/microrna-181b-controls-atherosclerosis-and-aneurysms-through-regulation-of-timp-3-and-elastin
#14
Karina Di Gregoli, Nur Najmi Mohamad Anuar, Rosaria Bianco, Stephen J White, Andrew C Newby, Sarah J George, Jason L Johnson
RATIONALE: Atherosclerosis and aneurysms are leading causes of mortality worldwide. MicroRNAs (miRs) are key determinants of gene and protein expression, and atypical miR expression has been associated with a number of cardiovascular diseases; although their contributory role to atherosclerotic plaque and abdominal aortic aneurysm (AAA) stability are poorly understood. OBJECTIVE: To investigate whether miR-181b regulates TIMP-3 expression and affects atherosclerosis and aneurysms Methods and Results: Here, we demonstrate that miR-181b was over-expressed in symptomatic human atherosclerotic plaques and abdominal aortic aneurysms, and correlated with decreased expression of predicted miR-181b targets, TIMP-3 and elastin...
October 18, 2016: Circulation Research
https://www.readbyqxmd.com/read/27753846/ed-02-3-clinical-implications-of-central-hemodynamics-on-aortic-and-end-organ-diseases
#15
Junichiro Hashimoto
The central aorta constitutes the main trunk of the systemic arterial tree. It dilates passively with cardiac ejection during systole and then constricts with its recoil function during diastole, thereby regulating blood pressure and blood flow. The central pulsatile hemodynamics affects local hemodynamics within as well as downstream of the aorta (e.g., end organs).The aorta progressively stiffens and dilates with advancing age, and such age-dependent change is accelerated by hypertension. According to the law of Laplace, wall stress depends on the diameter and pressure of the blood vessel...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27753844/ed-02-1-acute-aortic-syndrome
#16
Jae-Kwan Song
The successful clinical introduction of various non-invasive imaging modalities has contributed to the establishment of 'acute aortic syndrome', a relatively new clinical syndrome incorporating several disease entities with similar clinical features (at the time of clinical presentation). Aortic dissection (AD) with intimal flap and two aortic channels (true and false lumens) is the most important disease entity in acute aortic syndrome. Clinical characteristics of AD have been established, with standardized treatment strategies depending on the affected site of the aorta...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27751737/perigraft-fluid-collection-mimicking-graft-infection-in-patients-with-a-para-anastomotic-aneurysm
#17
Yosuke Takahashi, Yasuyuki Sasaki, Yasuyuki Bito, Manabu Motoki, Takashi Murakami, Toshihiko Shibata
We herein report two cases of perigraft effusion mimicking graft infection after debranching thoracic endovascular repair for an anastomotic pseudoaneurysm of the distal ascending aorta. Both patients presented with a bulging tumor on the sternum. Enhanced computed tomography showed no endoleak, but extension of periprosthetic graft fluid to a subcutaneous sternal wound was present. We suspected a deep sternal wound infection; however, cultures of débrided tissues were negative. After drainage of the subcutaneous fluid or negative pressure wound therapy, both patients were doing well without recurrence of effusion...
October 14, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27749539/a-huge-saccular-aortic-aneurysm-compressing-right-coronary-artery-7-years-after-aortic-valve-replacement-due-to-bicuspid-aortic-valve-insufficiency-a-rare-case-report
#18
Sang Min Park, Haemin Jeong, Kyung-Soon Hong, Christopher Kim
BACKGROUND: In a patient underwent aortic valve replacement (AVR) due to bicuspid aortic valve (BAV) insufficiency without marked dilation of ascending aorta, the development of delayed-typed aneurysmal complication of ascending aorta has been often reported because the dilated aorta tends to grow insidiously with age. CASE SUMMARY: A 58-year-old man who underwent AVR with mechanical valve due to severe aortic regurgitation secondary to BAV 7 years previously presented with exertional chest discomfort for 1 year...
October 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27739498/smooth-muscle-cell-specific-tgfbr1-deficiency-promotes-aortic-aneurysm-formation-by-stimulating-multiple-signaling-events
#19
Pu Yang, Bradley M Schmit, Chunhua Fu, Kenneth DeSart, S Paul Oh, Scott A Berceli, Zhihua Jiang
Transforming growth factor (TGF)-β signaling disorder has emerged as a common molecular signature for aortic aneurysm development. The timing of postnatal maturation plays a key role in dictating the biological outcome of TGF-β signaling disorders in the aortic wall. In this study, we investigated the impact of deficiency of TGFβ receptors on the structural homeostasis of mature aortas. We used an inducible Cre-loxP system driven by a Myh11 promoter to delete Tgfbr1, Tgfbr2, or both in smooth muscle cells (SMCs) of adult mice...
October 14, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27733430/coronary-artery-ectasia-are-frequently-observed-in-patients-with-bicuspid-aortic-valves-with-and-without-dilatation-of-the-ascending-aorta
#20
Christine Meindl, Birgit Achatz, Deborah Huber, Andrea Baessler, Ute Hubauer, Christa Meisinger, Christian Hengstenberg, Jeanette Erdmann, Stefan Buchner, Lars Maier, Heribert Schunkert, Kurt Debl, Marcus Fischer
BACKGROUND: The presence of coronary artery ectasia (CAE) is influenced by genetic factors and related to the presence of aneurysms in other vascular beds. Bicuspid aortic valve (BAV) disease is frequently accompanied by ascending aortic aneurysm. Because the aortic valve and the proximal parts of the coronary arteries share a common embryonic origin, we hypothesized that CAE is associated with BAV disease. METHODS AND RESULTS: One hundred seventy-seven patients with suspected aortic valve disease (n=94 BAV, n=83 tricuspid aortic valve) underwent both cardiac magnetic resonance imaging and coronary angiography...
October 2016: Circulation. Cardiovascular Interventions
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