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Ascending aorta aneurysm

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https://www.readbyqxmd.com/read/28329189/mid-term-results-of-zone-0-thoracic-endovascular-aneurysm-repair-after-ascending-aorta-wrapping-and-supra-aortic-debranching-in-high-risk-patients
#1
Felice Pecoraro, Mario Lachat, Michael Hofmann, Neal S Cayne, Lyubov Chaykovska, Zoran Rancic, Gilbert Puippe, Thomas Pfammatter, Nicola Mangialardi, Frank J Veith, Dominique Bettex, Francesco Maisano, Thomas A Neff
OBJECTIVES: Surgical repair of aneurysmal disease involving the ascending aorta, aortic arch and eventually the descending aorta is generally associated with significant morbidity and mortality. A less invasive approach with the ascending wrapping technique (WT), supra-aortic vessel debranching (SADB) and thoracic endovascular aneurysm repair (TEVAR) in zone 0 was developed to reduce the associated risk in these patients. METHODS: During a 10-year period, consecutive patients treated by the ascending WT, SADB and TEVAR in zone 0 were included...
March 8, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28315148/a-case-of-cardiac-tamponade-due-to-an-isolated-abscess-in-the-ascending-aorta-of-a-pregnant-woman-with-a-history-of-intravenous-substance-abuse
#2
Brandy Shattuck, John Livingstone
We describe the case of a 23-year-old white female, 10-12 weeks pregnant, with a history of intravenous drug use and a recently diagnosed pneumonia, who was found deceased in her bed after a night of sleep. Although postmortem serum toxicology tested positive for alprazolam, tetrahydrocannabinol, and morphine, the ultimate cause of death was determined to be cardiac tamponade secondary to an isolated abscess in the ascending aorta. The patient had several risk factors for aortic rupture and cardiac tamponade including intravenous drug use, pneumonia, and pregnancy...
March 17, 2017: Forensic Science, Medicine, and Pathology
https://www.readbyqxmd.com/read/28294669/-visceral-complications-of-the-aortic-dissections-indications-and-technique-of-the-thoracoabdominal-refenestration
#3
Csaba Dzsinich, Jenő Szolnoky, Gábor Vallus, Gábor Darabos, Gabriella Nyiri, Dániel Teknős
Aortic dissection is a life threatening cardiovascular catastrophy. Its incidence estimated to 5-6 cases per 100,000 patients/year. The intimal tear happens at the ascending aorta in Type A, meanwhile at the aortic isthmus in Type B, but entry point may develop anywhere alongside the entire aorta. All types may affect a short aortic segment resulting in a localized false aneurysm, others separate the intimal layer at longer extension down to the visceral segment and far beyond to the femoral arteries. Dissection of orifices of side branches may lead to cerebral, upper extremity, spinal, visceral, renal and lower extremity malperfusion...
March 2017: Magyar Sebészet
https://www.readbyqxmd.com/read/28290181/acute-type-a-aortic-dissection-beyond-the-diameter
#4
Calogera Pisano, Carmela Rita Balistreri, Oreste Fabio Triolo, Vincenzo Argano, Giovanni Ruvolo
Aortic dissection is a life-threatening condition in which early diagnosis, treatment and close follow up are critical for survival. Between 60% and 70% of patients with acute aortic dissection are affected at the ascending aorta, classified as Stanford type A (TAD). Preventive surgery of the aorta in asymptomatic patients on the basis of aortic size alone remains controversial among patient populations without known risk factors for aortic dissection. In fact, many dissection patients do not appear to have markedly dilated aortas at the time of presentation...
November 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28288887/transapical-endovascular-repair-of-thoracic-aortic-pathology
#5
Takashi Murakami, Shinsuke Nishimura, Mitsuharu Hosono, Yoshitsugu Nakamura, Etsuji Sohgawa, Yukimasa Sakai, Toshihiko Shibata
BACKGROUND: Alternative access for thoracic endovascular aortic repair (TEVAR) has been explored for patients with unsuitable femoral and iliac access, but few cases of transapical access have been described. We report our experience with transapical access for various aortic pathologies. METHODS: We reviewed six cases undergoing transapical access for endovascular repair of thoracic aortic pathology between December 2013 and August 2015. Five patients had an aortic arch aneurysm and 1 patient presented with Stanford type A subacute aortic dissection...
March 10, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28228701/chiropractic-management-of-a-patient-with-thoracic-pain-and-a-stable-thoracic-aortic-aneurysm-a-case-report
#6
Shawn M Neff, Casey S Okamoto
OBJECTIVE: The purpose of this case report was to describe chiropractic management of thoracic pain in a patient with a stable thoracic aortic aneurysm. CLINICAL FEATURES: An 89-year-old man presented with axial mid- and upper back pain localized predominantly at the T8 and T1 spinal segmental levels. A review of available imaging revealed a stable aneurysmal dilatation of the ascending aorta, which measured 4.3 cm. INTERVENTION AND OUTCOME: Because the thoracic pain was musculoskeletal in nature and the thoracic aortic aneurysm was stable, mechanical manipulation was provided using the Impulse adjusting instrument...
March 2017: Journal of Chiropractic Medicine
https://www.readbyqxmd.com/read/28194732/late-post-avr-progression-of-bicuspid-aortopathy-link-to-hemodynamics
#7
Shiho Naito, Tatiana Gross, Kushtrim Disha, Yskert von Kodolitsch, Hermann Reichenspurner, Evaldas Girdauskas
BACKGROUND AND AIM OF THE STUDY: The ascending aortic dilatation may progress after aortic valve replacement (AVR) in bicuspid aortic valve (BAV) patients. Our aim was to evaluate rheological flow patterns and histological characteristics of the aneurysmal aorta in BAV patients at the time of reoperative aortic surgery. MATERIALS AND METHODS: 13 patients (mean age: 42 ± 9 years, 10 (77%) male) with significant progression of proximal aortopathy after isolated AVR surgery for BAV disease (i...
February 13, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28190607/patient-specific-assessment-of-hemodynamics-by-computational-fluid-dynamics-in-patients-with-bicuspid-aortopathy
#8
Naoyuki Kimura, Masanori Nakamura, Kenji Komiya, Satoshi Nishi, Atsushi Yamaguchi, Osamu Tanaka, Yoshio Misawa, Hideo Adachi, Koji Kawahito
OBJECTIVE: Hemodynamics related to eccentric blood flow may factor into the development of bicuspid aortic valve aortopathy. We investigated wall shear stress distribution by means of magnetic resonance imaging-based computational fluid dynamics in patients with a bicuspid aortic valve. METHODS: Included were 12 patients with a bicuspid aortic valve (aortic stenosis, n = 11; root enlargement, n = 1). Three patients with a normal tricuspid aortic valve (arch aneurysm, n = 1; descending aortic aneurysm, n = 2) were included for comparison...
January 11, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28185644/bicuspid-aortic-valve-morphotype-correlates-with-regional-antioxidant-gene%C3%A2-expression-profiles-in-the-proximal%C3%A2-ascending-aorta
#9
Julie A Phillippi, Jennifer C Hill, Marie Billaud, Benjamin R Green, Mary P Kotlarczyk, Thomas G Gleason
BACKGROUND: Bicuspid aortic valve (BAV) is associated with asymmetric dilatation of the proximal ascending aorta. We previously demonstrated increased susceptibility of smooth muscle cells to oxidative stress in the BAV-aneurysmal aorta and hypothesized that antioxidant expression is regionally defined and influenced by the BAV morphotype. METHODS: BAV valve morphology was defined according to number of raphes: type 0 (0 raphes), type 1 (1 raphe), or type 2 (2 raphes) and by the raphe location among the left (L), right (R) or non (N) coronary cusps...
February 6, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28185277/three-dimensional-parametric-modeling-of-bicuspid-aortopathy-and-comparison-with-computational-flow-predictions
#10
Salvatore Pasta, Giovanni Gentile, Giuseppe M Raffa, Francesco Scardulla, Diego Bellavia, Angelo Luca, Michele Pilato, Cesare Scardulla
Bicuspid aortic valve (BAV)-associated ascending aneurysmal aortopathy (namely "bicuspid aortopathy") is a heterogeneous disease making surgeon predictions particularly challenging. Computational flow analysis can be used to evaluate the BAV-related hemodynamic disturbances, which likely lead to aneurysm enlargement and progression. However, the anatomic reconstruction process is time consuming so that predicting hemodynamic and structural evolution by computational modeling is unfeasible in routine clinical practice...
February 10, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28148315/assessment-of-the-structure-and-function-of-the-aorta-by-echocardiography
#11
REVIEW
Anitha Parthiban, Girish Shirali
Echocardiography is the primary modality for imaging the aorta for the diagnosis and serial evaluation of pathological conditions. In this article, we review the methodology for optimal echocardiographic imaging of the various segments of the aorta and discuss abnormalities of the aorta including stenosis, dilation including aortopathy and sinus of Valsalva aneurysms, and fistulous communications involving the ascending aorta including aortoventricular tunnel and ruptured sinus of Valsalva aneurysm. We review novel echocardiographic measurements of aortic functional properties of the aorta such as elasticity and stiffness, and review the literature on the potential additive value of such measurements for structural assessment alone...
December 2016: Cardiology in the Young
https://www.readbyqxmd.com/read/28109377/antineutrophil-cytoplasmic-antibody-associated-multiple-giant-saccular-aortic-aneurysms
#12
Ryoji Kinoshita, Tomohiro Mizuno, Tsuyoshi Hachimaru, Keiji Oi, Masafumi Yashima, Eiki Nagaoka, Tatsuki Fujiwara, Hidehito Kuroki, Dai Tasaki, Hirokuni Arai
We describe a very rare case of a 67-year-old man with multiple saccular aortic aneurysms throughout the entire aorta due to antineutrophil cytoplasmic antibody-associated vasculitis (AAV). The patient underwent staged aortic surgical procedures, including stent-graft insertion for a left iliac artery aneurysm, thoracic endovascular aortic repair for a descending aortic aneurysm, and total replacement of the ascending aorta and aortic arch with the use of high-dose steroids to control inflammation. The histologic findings demonstrated that the damage to the vasa vasorum of the adventitia resulting from AAV caused ischemia of the media, resulting in the formation of saccular aneurysmal changes...
February 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28102102/impact-of-thoracic-endovascular-aortic-repair-on-pulsatile-circumferential-and-longitudinal-strain-in-patients-with-aneurysm
#13
Foeke J H Nauta, Guido H W van Bogerijen, Chiara Trentin, Michele Conti, Ferdinando Auricchio, Frans L Moll, Joost A van Herwaarden, Santi Trimarchi
PURPOSE: To quantify both pulsatile longitudinal and circumferential aortic strains before and after thoracic endovascular aortic repair (TEVAR), potentially clarifying TEVAR-related complications. METHODS: This retrospective study assessed the impact of TEVAR on pulsatile aortic strains through custom developed software and cardiac-gated computed tomography imaging of 8 thoracic aneurysm patients (mean age 71.0±8.2 years; 6 men) performed before TEVAR and during follow-up (median 0...
January 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28099082/therapeutics-targeting-drivers-of-thoracic-aortic-aneurysms-and-acute-aortic-dissections-insights-from-predisposing-genes-and-mouse-models
#14
Dianna M Milewicz, Siddharth K Prakash, Francesco Ramirez
Thoracic aortic diseases, including aneurysms and dissections of the thoracic aorta, are a major cause of morbidity and mortality. Risk factors for thoracic aortic disease include increased hemodynamic forces on the ascending aorta, typically due to poorly controlled hypertension, and heritable genetic variants. The altered genes predisposing to thoracic aortic disease either disrupt smooth muscle cell (SMC) contraction or adherence to an impaired extracellular matrix, or decrease canonical transforming growth factor beta (TGF-β) signaling...
January 14, 2017: Annual Review of Medicine
https://www.readbyqxmd.com/read/28094007/obtaining-the-biomechanical-behavior-of-ascending-aortic-aneurysm-via-the-use-of-novel-speckle-tracking-echocardiography
#15
Mohammed Alreshidan, Nastaran Shahmansouri, Jennifer Chung, Vynka Lash, Alexander Emmott, Richard L Leask, Kevin Lachapelle
INTRODUCTION: Ex vivo measurement of ascending aortic biomechanical properties may help understand the risk for rupture or dissection of dilated ascending aortas. A validated in vivo method that can predict aortic biomechanics does not exist. Speckle tracking transesophageal echocardiography (TEE) has been used to measure ventricular stiffness; we sought to determine whether speckle TEE could be adapted to estimate aortic stiffness in vivo and compare these findings with those obtained by ex vivo tissue measurements...
December 20, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28055841/a-regression-method-based-on-non-invasive-clinical-data-to-predict-the-mechanical-behavior-of-ascending-aorta-aneurysmal-tissuea-regression-method-based-on-non-invasive-clinical-data-to-predict-the-mechanical-behavior-of-ascending-aorta-aneurysmal-tissue
#16
Ferdinando Auricchio, Anna Ferrara, Ettore Lanzarone, Simone Morganti, Pasquale Totaro
GOAL: Ascending aorta aneurysms represent a severe life-threatening condition associated with asymptomatic risk of rupture. Prediction of aneurysm evolution and rupture is one of the hottest investigation topics in cardiovascular science, and the decision on when and whether to surgically operate is still an open question. We propose an approach for estimating the patient-specific ultimate mechanical properties and stress-stretch characteristics based on non-invasive data. METHODS: As for the characteristics, we consider a non-linear constitutive model of the aortic wall and assume patient-specific model coefficients...
December 29, 2016: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/28040678/aortic-root-aneurysm-extending-into-the-arch-as-a-rare-complication-of-kawasaki-disease-surgical-management
#17
Zoltan Szalay, Vassil Papantchev, Thomas Walther
An aortic aneurysm complicating Kawasaki disease (KD) is extremely rare. We herein report a case of 48-year-old KD patient with severe aortic regurgitation, aneurysm of the aortic root, ascending aorta and aortic arch, and giant heavily calcified coronary aneurysms. The patient underwent successful surgical management. This case raises some unusual technical issues, which are discussed. A review of the literature is also offered.
December 30, 2016: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28029670/evaluation-of-distensibility-and-stiffness-of-ascending-aortic-aneurysm-using-magnetic-resonance-imaging
#18
K K Tiwari, S Bevilacqua, G Aquaro, P Festa, L Ait-Ali, M Solinas
INTRODUCTION: Magnetic resonance imaging emerging as a new tool for the diagnosis and evaluation of ascending aortic aneurysm. The aim of our study is to evaluate in vivo distensibility and pulse wave velocity of the aortic wall using functional magnetic resonance imaging technique. METHODS: We enrolled 25 patients undergoing surgery for ascending aortic aneurysm and or aortic valve replacement for a period of 8 months. Preoperatively, all the patients underwent functional MRI study of the aorta...
October 2016: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/28027889/extensibility-and-distensibility-of-the-thoracic-aorta-in-patients-with-aneurysm
#19
H W L de Beaufort, F J H Nauta, M Conti, E Cellitti, C Trentin, E Faggiano, G H W van Bogerijen, C A Figueroa, F L Moll, J A van Herwaarden, F Auricchio, S Trimarchi
OBJECTIVES: Reference values of aortic deformation during the cardiac cycle can be valuable for the pre-operative planning of thoracic endovascular aortic repair (TEVAR) and for facilitating computational fluid dynamics. This study aimed to quantify normal aortic extensibility (longitudinal extension) and distensibility (radial expansion), as well as pulsatile strain, in a group of 10 (>60 years) individuals with abdominal or thoracic aortic aneurysms. METHODS: ECG gated CT images of the thoracic aorta were reconstructed into virtual 3D models of aortic geometry...
February 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28018834/detailed-measurement-of-wall-strain-with-3d-speckle-tracking-in-the-aortic-root-a-case-of-bionic-support-for-clinical-decision-making
#20
Sebastian Vogt, Konstantinos Karatolios, Andreas Wittek, Christopher Blasé, Anette Ramaswamy, Nikolas Mirow, Rainer Moosdorf
Three-dimensional (3D) wall motion tracking (WMT) based on ultrasound imaging enables estimation of aortic wall motion and deformation. It provides insights into changes in vascular compliance and vessel wall properties essential for understanding the pathogenesis and progression of aortic diseases. In this report, we employed the novel 3D WMT analysis on the ascending aorta aneurysm (AA) to estimate local aortic wall motion and strain in case of a patient scheduled for replacement of the aortic root. Although progression of the diameter indicates surgical therapy, at present we addressed the question for optimal surgical time point...
December 2016: Thoracic and Cardiovascular Surgeon Reports
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