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Ascending aorta aneurysm

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https://www.readbyqxmd.com/read/28631316/recannulation-of-the-axillary-artery-in-aortic-and-complex-cardiac-surgery
#1
Philippa Jane Temple Bowers, Manu Narain Mathur
OBJECTIVES: Axillary artery cannulation has been used as an alternative site for cardiopulmonary bypass during surgery for aortic dissections and aneurysmal disease of the ascending aorta and arch. This study reports our experience with reusing the axillary artery for cardiopulmonary bypass during complex aortic and cardiac surgical procedures. METHODS: This was a retrospective review of a single surgeon's experience of recannulating the axillary artery for redo operations in complex aortic surgery...
June 19, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28616351/hybrid-aortic-repair-with-antegrade-supra-aortic-and-renovisceral-debranching-from-ascending-aorta
#2
José Antonio Del Castro-Madrazo, Margarita Rivas-Domínguez, Carlota Fernández-Prendes, Amer Zanabili Al-Sibbai, José Manuel Llaneza-Coto, Manuel Alonso-Pérez
Aortic dissection is a life threatening condition. Hybrid repair has been described for the treatment of complex aortic pathology such as thoracoabdominal aortic aneurysms (TAAA) and type A and B dissections, although open and total endovascular repair are also possible. Open surgery is still associated with substantial perioperative morbi-mortality rates, thus less invasive techniques such as endovascular repair and hybrid procedures can achieve good results in centers with experience. We present the case of a patient with a chronic type B dissection and TAAA degeneration that was treated in a single stage hybrid procedure with antegrade supra-aortic and renovisceral debranching from the ascending aorta and TEVAR...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28616345/wrapping-of-the-ascending-aorta-revisited-is-there-any-role-left-for-conservative-treatment-of-ascending-aortic-aneurysm
#3
REVIEW
José María González-Santos, María Elena Arnáiz-García
Dilatation of the ascending aorta (AA) is a common finding in patients with aortic valve disease. The clinical practice guidelines recommend replacing the AA whenever the diameter exceeds 45 mm. However, no consensus has been reached regarding the approach when the aorta is only moderately dilated. Although the risk in aorta replacement is generally low, it may be higher when associated with other complex surgical procedures or it is carried out in elderly patients or patients with significant comorbidity. This would justify the use of alternative surgical techniques, which reduce surgical risk and guarantee a durable correction of the aortic pathology...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28606209/massive-aortic-root-aneurysm-in-an-infant-with-the-loeys-dietz-syndrome
#4
Tatiana Molina-Sánchez, Juan Calderón-Colmenero, Juan Pablo Sandoval
A 10-month-old girl with type I Loeys-Dietz syndrome developed a conspicuous aortic root aneurysm that was well demonstrated on chest X-ray/CT reconstruction. She underwent successful valve-spare repair of the ascending aorta.
June 13, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28599977/fate-of-remnant-sinuses-of-valsalva-in-patients-with-bicuspid-and-trileaflet-valves-undergoing-aortic-valve-ascending-aorta-and-aortic-arch-replacement
#5
Rita Karianna Milewski, Andreas Habertheuer, Joseph E Bavaria, Mary Siki, Wilson Y Szeto, Eric Krause, Varun Korutla, Nimesh D Desai, Prashanth Vallabhajosyula
OBJECTIVE: In patients presenting with aortic valvulopathy with concomitant ascending aortic aneurysm, surgical management of the sinus of Valsalva segment remains undefined, especially for moderately dilated aortic roots. In patients with this pathology undergoing aortic valve replacement with supracoronary ascending aorta replacement, we assessed the fate of the remnant preserved sinus of Valsalva segment stratified by aortic valve morphology and pathology. METHODS: From 2002 to 2015, 428 patients underwent elective aortic valve replacement with supracoronary ascending aorta replacement...
April 28, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28596039/assessment-of-aortic-wall-thrombus-predicts-outcomes-of-endovascular-repair-of-complex-aortic-aneurysms-using-fenestrated-and-branched-endografts
#6
Mauricio Ribeiro, Gustavo S Oderich, Thanila Macedo, Terri J Vrtiska, Jan Hofer, Julia Chini, Bernardo Mendes, Stephen Cha
OBJECTIVE: The goal of this study was to investigate the correlation between atherothrombotic aortic wall thrombus (AWT) and clinical outcomes in patients treated by fenestrated-branched endovascular aortic repair (F-BEVAR) and present a new classification system for assessment of AWT burden. METHODS: The clinical data of 301 patients treated for pararenal and thoracoabdominal aortic aneurysms (TAAAs) by F-BEVAR was reviewed. The study excluded 89 patients with extent I to III TAAA because of extensive laminated thrombus within the aneurysm sac...
June 5, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28587739/aortic-valve-pathology-as-a-predictive-factor-for-acute-aortic-dissection
#7
Denis Berdajs, Selim Mosbahi, Enrico Ferrari, Dominique Charbonnier, Ludwig K von Segesser
BACKGROUND: In this study, the effect of aortic valve (AV) pathology on local hemodynamic conditions was evaluated as a potential trigger for the onset of acute type A and B aortic dissection. METHODS: A time- and pressure-related four-dimensional (4-D) computed fluid dynamic model of the aorta was established. In an experimental setup, AV stenosis and AV insufficiency were created. 4-D pressure-related geometry of the aortic root (AR) with valve insufficiency and valve stenosis were determined by high-fidelity (200 Hz) microsonometric crystals...
June 3, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28582524/acute-non-a-non-b-aortic-dissection-incidence-treatment-and-outcome
#8
Bartosz Rylski, Marta Pérez, Friedhelm Beyersdorf, Diana Reser, Fabian A Kari, Matthias Siepe, Martin Czerny
OBJECTIVES: Our aim was to report outcome of patients with acute non-A non-B aortic dissection involving the aortic arch but not the ascending aorta. METHODS: Dissection extension and entry location were analysed in patients with acute aortic dissection admitted between 2001 and 2016 at a tertiary centre. Non-A non-B dissection was classified as descending-entry type with entry distal to the left subclavian artery and dissection extending into the aortic arch, and arch-entry type with entry between the innominate and left subclavian arteries...
June 3, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28574035/-vascular-pathology-in-the-aspect-of-sudden-death-in-young-adults-and-connective-tissue-dysplasia-anatomical-physiological-and-morphological-parallels
#9
Iu I Pigolkin, M A Shilova, I V Globa
Vascular pathology in young adults has during the last 10 years been diagnosed more often during forensic medical examination of sudden death. Major morphological alterations are revealed in cerebral vessels, coronary vessels, and at the level of the ascending portion of the aorta. Generally, in the young age there is no stenosing atherosclerosis inducing vascular lesions and the development of complications. It was determined that connective tissue dysplasia is pathology wherein weakness of the vascular wall is genetically preconditioned, thus promoting formation of vascular aneurysms and rupture of the latter under conditions of provoking factors such as going in for sports, physical loads, and psychoemotional stress...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28553761/innominate-artery-aneurysm-how-to-solve-it
#10
Xiao-Long Wang, Xin-Liang Guan, Wen-Jian Jiang, Ou Liu, Hong-Jia Zhang
We herein describe our *These authors contributed equally to this work. experience with a congenital innominate artery aneurysm (IAA) that was managed with a simple surgical procedure. A 44-year-old woman was admitted for chest distress. Computed tomography angiography showed a 3.6-cm IAA arising from the aortic arch and compressing the trachea. A median sternotomy was performed with the patient under general anesthesia, and the IAA was found to involve the origin of the innominate artery and the bifurcation of the right subclavian artery and common carotid artery; however, the aorta was intact...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28550176/mechanical-behavior-and-matrisome-gene-expression-in-aneurysm-prone-thoracic-aorta-of-newborn-lysyl-oxidase-knockout-mice
#11
Marius Catalin Staiculescu, Jungsil Kim, Robert P Mecham, Jessica Wagenseil
Mutations in lysyl oxidase (LOX) are associated with thoracic aortic aneurysm and dissection (TAAD). Mice that do not express Lox (Lox(-/-)) die soon after birth and have 60% and 40% reductions in elastin- and collagen-specific crosslinks, respectively. LOX inactivation could also change the expression of secreted factors, structural matrix, and matrix-associated proteins that constitute the aortic matrisome. We hypothesize that the absence of Lox will change the mechanical behavior of the aortic wall due to reduced elastin and collagen crosslinking and alter the expression levels of matrisome and smooth muscle cell (SMC) genes in a vascular location-specific manner...
May 26, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/28542808/ascending-aortic-rupture-through-a-penetrating-atherosclerotic-ulcer-a-rare-cause-of-sudden-unexpected-death
#12
Supawon Srettabunjong
Spontaneous rupture of the aorta through an atherosclerotic lesion without preexisting aortic aneurysm, dissection, or history of trauma is very rare. Without prompt aortic repair, all cases result in sudden death with a definitive diagnosis made only intraoperatively or during autopsy. The phenomenon has been uniformly found in individuals with hypertension. The author reports a sudden unexpected death caused by spontaneous rupture of the ascending aorta in a 57-year-old man with a history of hypertension...
May 23, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28536892/patient-specific-stress-analyses-in-the-ascending-thoracic-aorta-using-a-finite-element-implementation-of-the-constrained-mixture-theory
#13
S Jamaleddin Mousavi, Stéphane Avril
It is now a rather common approach to perform patient-specific stress analyses of arterial walls using finite-element models reconstructed from gated medical images. However, this requires to compute for every Gauss point the deformation gradient between the current configuration and a stress-free reference configuration. It is technically difficult to define such a reference configuration, and there is actually no guarantee that a stress-free configuration is physically attainable due to the presence of internal stresses in unloaded soft tissues...
May 23, 2017: Biomechanics and Modeling in Mechanobiology
https://www.readbyqxmd.com/read/28533581/bicuspid-aortic-valve-an-unusual-cause-of-aneurysm-of-left-coronary-sinus-of-valsalva
#14
Euden Bhutia, Dinesh Kumar, Binoy Shankar, Shakti Pad Das, Sunil Kishore
Bicuspid aortic valve is traditionally considered an innocuous congenital anomaly. Due to a better and widespread availability of non-invasive imaging techniques, it has come to the fore that 30% of these cases develop complications, viz., valve abnormality (aortic regurgitation and stenosis), and aneurysm of aortic root and ascending aorta. Sinus of Valsalva aneurysm is an uncommon complication of bicuspid aortic valve and more so those arising from the left coronary sinus are the rarest. These complications generally occur in the third or fourth decade of life...
May 2017: Iranian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28526040/catching-a-floating-thrombus-a-case-report-on-the-treatment-of-a-large-thrombus-in-the-ascending-aorta
#15
Gijs Eduard de Maat, Giorgio Vigano, Massimo Alessandro Mariani, Ehsan Natour
BACKGROUND: The ascending aorta is an uncommon site for non-infective thrombus. In non-aneurysmal and non-atherosclerotic vessels this condition becomes extremely rare, while it represents a source of potential cerebral and peripheral embolic events. Currently, there is no consensus in the guidelines on how to treat a free floating thrombus in ascending aorta, therefore we present our decision making process and therapeutic strategy. CASE PRESENTATION: A healthy 48-year-old man was hospital admitted with acute abdominal pain...
May 19, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28515742/the-use-of-intraoperative-epiaortic-ultrasonography-in-monitoring-patients-over-75-years-old-treated-with-aortic-valve-replacement
#16
Tomasz Niklewski, Michał Zembala, Dariusz Puszczewicz, Paweł Nadziakiewicz, Wojciech Karolak, Marian Zembala
INTRODUCTION: Epiaortic ultrasound scanning (EAS) extended the use of ultrasound to the intraoperative diagnosis of aortic pathology. Surgical palpation of the ascending aorta underestimates the presence and severity of atherosclerotic plaques. Epiaortic ultrasound scanning has been used as an adjunct to transesophageal echocardiography (TEE) or as a primary direct diagnostic tool for imaging the ascending aorta as well as the aortic arch, which gained prominence as part of a multipronged intraoperative strategy to reduce atherosclerotic emboli...
March 2017: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28508064/fibulin-4-is-essential-for-maintaining-arterial-wall-integrity-in-conduit-but-not-muscular-arteries
#17
Carmen M Halabi, Thomas J Broekelmann, Michelle Lin, Vivian S Lee, Mon-Li Chu, Robert P Mecham
Homozygous or compound heterozygous mutations in fibulin-4 (FBLN4) lead to autosomal recessive cutis laxa type 1B (ARCL1B), a multisystem disorder characterized by significant cardiovascular abnormalities, including abnormal elastin assembly, arterial tortuosity, and aortic aneurysms. We sought to determine the consequences of a human disease-causing mutation in FBLN4 (E57K) on the cardiovascular system and vascular elastic fibers in a mouse model of ARCL1B. Fbln4(E57K/E57K) mice were hypertensive and developed arterial elongation, tortuosity, and ascending aortic aneurysms...
May 2017: Science Advances
https://www.readbyqxmd.com/read/28496512/takayasu-s-arteritis-presenting-with-headache-and-peripheral-facial-palsy-a-case-report
#18
Maryam Sotoudeh Anvari, Farzad Masoudkabir, Kyomars Abbasi, Mohammad Ali Boroumand, Manijeh Zarghampour, Hamidreza Goodarzynejad
Takayasu's arteritis (TA) is a rare case of granulomatous arteritis which mainly involves the aorta and its large branches. Although arterial hypertension is the most common feature of the disease in both adults and children, patients with TA may present with numerous clinical manifestations. Our patient was a 45-year-old woman, known to have hypertension from 3 years earlier following assessments made for severe headache. One year after the diagnosis of hypertension, she developed a left-sided lower motor neuron facial palsy, which was treated with oral corticosteroids (Prednisolone)...
October 3, 2016: Journal of Tehran Heart Center
https://www.readbyqxmd.com/read/28496083/-retrograde-type-a-aortic-dissection-after-thoracic-endovascular-aortic-repair-report-of-a-case
#19
Sei Morizumi, Takafumi Inoue, Satoshi Nishi, Akihiro Yoshimoto, Masashi Fujisaki, Yoshihiro Suematsu
A 72-year-old man presented with aneurysms of the distal aortic arch and the distal descending aorta due to chronic type B aortic dissection. We first performed thoracic endovascular aortic repair (TEVAR) in the distal descending aorta, and the aneurysm was successfully excluded using a Gore Tag stentgraft. Seven days after TEVAR, computed tomography revealed retrograde type A aortic dissection occurring from the ascending aorta to the distal aortic arch. In emergency surgery, ascending aorta and total arch replacement were performed under selective cerebral perfusion with moderate hypothermia, and after coming off cardiopulmonary bypass, the distal aortic arch aneurysm was excluded using a Gore Tag stentgraft...
May 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28490606/comparison-of-10-murine-models-reveals-a-distinct-biomechanical-phenotype-in-thoracic-aortic-aneurysms
#20
C Bellini, M R Bersi, A W Caulk, J Ferruzzi, D M Milewicz, F Ramirez, D B Rifkin, G Tellides, H Yanagisawa, J D Humphrey
Thoracic aortic aneurysms are life-threatening lesions that afflict young and old individuals alike. They frequently associate with genetic mutations and are characterized by reduced elastic fibre integrity, dysfunctional smooth muscle cells, improperly remodelled collagen and pooled mucoid material. There is a pressing need to understand better the compromised structural integrity of the aorta that results from these genetic mutations and renders the wall vulnerable to dilatation, dissection or rupture. In this paper, we compare the biaxial mechanical properties of the ascending aorta from 10 murine models: wild-type controls, acute elastase-treated, and eight models with genetic mutations affecting extracellular matrix proteins, transmembrane receptors, cytoskeletal proteins, or intracellular signalling molecules...
May 2017: Journal of the Royal Society, Interface
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