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Ascending aorta aneurysm

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https://www.readbyqxmd.com/read/28542808/ascending-aortic-rupture-through-a-penetrating-atherosclerotic-ulcer-a-rare-cause-of-sudden-unexpected-death
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
https://www.readbyqxmd.com/read/28483261/computational-fluid-dynamics-simulation-of-the-right-subclavian-artery-cannulation
#10
Satoshi Numata, Keiichi Itatani, Hidetake Kawajiri, Sachiko Yamazaki, Keiichi Kanda, Hitoshi Yaku
OBJECTIVE: The purpose of this study was to evaluate the efficacy of right subclavian artery cannulation using computational fluid dynamics. METHODS: Patient-specific models of the aortic arch were made with 4 patterns (1: normal aorta, 2: ascending aorta aneurysm, 3: distal arch aneurysm, 4: bovine arch) based on the computed tomography images. Right subclavian artery and ascending aorta cannulation models were created to simulate the physiologic pulsatile flow...
April 12, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28473723/high-resolution-morphological-approach-to-analyse-elastic-laminae-injuries-of-the-ascending-aorta-in-a-murine-model-of-marfan-syndrome
#11
Júlia López-Guimet, Jordi Andilla, Pablo Loza-Alvarez, Gustavo Egea
In Marfan syndrome, the tunica media is disrupted, which leads to the formation of ascending aortic aneurysms. Marfan aortic samples are histologically characterized by the fragmentation of elastic laminae. However, conventional histological techniques using transverse sections provide limited information about the precise location, progression and 3D extension of the microstructural changes that occur in each lamina. We implemented a method using multiphoton excitation fluorescence microscopy and computational image processing, which provides high-resolution en-face images of segmented individual laminae from unstained whole aortic samples...
May 4, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28461455/loss-of-smooth-muscle-%C3%AE-actin-leads-to-nf-%C3%AE%C2%BAb-dependent-increased-sensitivity-to-angiontensin-ii-in-smooth-muscle-cells-and-aortic-enlargement
#12
Jiyuan Chen, Andrew M Peters, Christina L Papke, Carlos Villamizar, Lea-Jeanne Ringuette, Jiu-Mei Cao, Shanzhi Wang, Shuangtao Ma, Limin Gong, Katerina Byanova, Jian Xiong, Michael X Zhu, Rosalinda Madonna, Patrick Kee, Yong-Jian Geng, Allan Brasier, Elaine C Davis, Siddharth K Prakash, Callie S Kwartler, Dianna M Milewicz
Rationale: Mutations in ACTA2, encoding the smooth muscle isoform of α-actin (SM α-actin), cause thoracic aortic aneurysms, acute aortic dissections, and occlusive vascular diseases. Objective: We sought to identify the mechanism by which loss of SM α-actin causes aortic disease. Methods and Results:Acta2(-/-) mice have an increased number of elastic lamellae in the ascending aorta and progressive aortic root dilation as assessed by echocardiography that can be attenuated by treatment with losartan, an angiotensin II (AngII) type 1 receptor blocker...
May 1, 2017: Circulation Research
https://www.readbyqxmd.com/read/28455451/long-term-mir-29b-suppression-reduces-aneurysm-formation-in-a-marfan-mouse-model
#13
Homare Okamura, Fabian Emrich, Jeffrey Trojan, Peter Chiu, Alex R Dalal, Mamoru Arakawa, Tetsuya Sato, Kiril Penov, Tiffany Koyano, Albert Pedroza, Andrew J Connolly, Marlene Rabinovitch, Cristina Alvira, Michael P Fischbein
Aortic root aneurysm formation and subsequent dissection and/or rupture remain the leading cause of death in patients with Marfan syndrome. Our laboratory has reported that miR-29b participates in aortic root/ascending aorta extracellular matrix remodeling during early aneurysm formation in Fbn1(C1039G/+) Marfan mice. Herein, we sought to determine whether miR-29b suppression can reduce aneurysm formation long-term. Fbn1(C1039G/+) Marfan mice were treated with retro-orbital LNA-anti-miR-29b inhibitor or scrambled-control-miR before aneurysms develop either (1) a single dose prenatally (pregnant Fbn1(C1039G/+) mice at 14...
April 2017: Physiological Reports
https://www.readbyqxmd.com/read/28444195/dna-methylome-analysis-reveals-distinct-epigenetic-patterns-of-ascending-aortic-dissection-and-bicuspid-aortic-valve
#14
Sun Pan, Hao Lai, Yiru Shen, Charles Breeze, Stephan Beck, Tao Hong, Chunsheng Wang, Andrew E Teschendorff
Aims: Epigenetics may mediate the effects of environmental risk factors on disease, including heart disease. Thus, measuring the DNA methylome offers the opportunity to identify novel disease biomarkers and novel insights into disease mechanisms. The DNA methylation landscape of ascending aortic dissection (AD) and bicuspid aortic valve (BAV) with aortic aneurysmal dilatation remain uncharacterized. The present study aimed to explore the genome-wide DNA methylation landscape underpinning these two diseases...
May 1, 2017: Cardiovascular Research
https://www.readbyqxmd.com/read/28428524/-hybrid-thoracic-endovascular-aortic-repair-with-total-debranching-of-supra-aortic-trunks
#15
Yoshimasa Seike, Hiroshi Tanaka, Hitoshi Matsuda
The method of hybrid arch thoracic endovascular aortic repair (TEVAR) to treat aneurysm with zone 0 landing has changed according to its invasiveness and complications. The real chimney technique allows supra-aortic bypass from ascending aorta without side clamp is the current choice of treatment. The comprehensive strategy to prevent stroke during hybrid arch TEVAR consisting of magnetization-prepared rapid acquisition with gradient-echo for evaluation of the atheromatous change and balloon protection of the left subclavian artery has contributed for the marked reduction of stroke...
April 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28428523/-efficacy-of-total-debranching-thoracic-endovascular-aortic-repair-for-the-re-operation-of-aortic-arch-aneurysm
#16
Kyohei Ueno, Megumu Kanno, Hirofumi Midorikawa, Gaku Takinami, Rie Kageyama
Thoracic endovascular aortic repair (TEVAR) combined with all-neck-branch reconstruction (total debranching TEVAR)[td TEVAR] is applied to aortic arch aneurysms as a minimally invasive procedure to improve treatment results. We report the initial and long-term results of td TEVAR for the reoperation of aortic arch aneurysm. By September 2016, td TEVAR for reoperation had been applied in 5 cases. The reasons for the reoperation were dilation of the arch aneurysm after ascending aorta replacement in 4 cases and localized dissection of the proximal landing zone after zone 2 TEVAR in 1 case...
April 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28386986/thrombus-formation-in-the-interrupted-segment-of-the-aorta
#17
Yusuf Karavelioğlu, Macit Kalçık, Mucahit Yetim, Tolga Doğan, Zehra Gölbaşı
Interrupted aorta is a very rare heart defect in which there is a gap between the ascending and the descending thoracic aorta. It is usually associated with other cardiac anomalies, including ventricular septal defect, ductus arteriosus, and truncus arteriosus. Severe cases present with serious complications such as hypertension, heart failure, or intracranial hemorrhage. Neurological complications are very rare form of presentation and commonly associated with intracranial aneurysms. We have reported a case of interrupted aorta who presented with transient ischemic attack due to thrombus formation in the interrupted segment of the aorta...
April 7, 2017: Echocardiography
https://www.readbyqxmd.com/read/28386685/a-machine-learning-approach-to-investigate-the-relationship-between-shape-features-and-numerically-predicted-risk-of-ascending-aortic-aneurysm
#18
Liang Liang, Minliang Liu, Caitlin Martin, John A Elefteriades, Wei Sun
Geometric features of the aorta are linked to patient risk of rupture in the clinical decision to electively repair an ascending aortic aneurysm (AsAA). Previous approaches have focused on relationship between intuitive geometric features (e.g., diameter and curvature) and wall stress. This work investigates the feasibility of a machine learning approach to establish the linkages between shape features and FEA-predicted AsAA rupture risk, and it may serve as a faster surrogate for FEA associated with long simulation time and numerical convergence issues...
April 6, 2017: Biomechanics and Modeling in Mechanobiology
https://www.readbyqxmd.com/read/28369587/acute-aortitis-of-the-ascending-aorta
#19
Sahar A Saddoughi, Martin D Abel, Joseph J Maleszewski, Hartzell V Schaff
We report a rare presentation of focal non-aneurysmal aortitis with mural thrombus of the ascending aorta. This was successfully treated with surgical resection and intravenous antibiotics. Pathology of the surgical specimen suggests that this was likely infectious aortitis, but the source of infection has not been identified.
March 20, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28369453/fate-of-the-dissected-aortic-arch-after-ascending-replacement-in-type-a-aortic-dissection%C3%A2
#20
Bartosz Rylski, Natalie Hahn, Friedhelm Beyersdorf, Stoyan Kondov, Martin Wolkewitz, Philipp Blanke, Tomasz Plonek, Martin Czerny, Matthias Siepe
OBJECTIVES: To evaluate the fate of a dissected aortic arch after limited surgical repair of type A aortic dissection. METHODS: Of the 271 patients operated for acute type A dissection between 2001 and 2015, 86 (age 57 ± 13 years, 74% men) with predischarge computed tomographic (CT) scans had a residual dissection in the arch. Aortic diameters, lengths, ellipticity and communications between lumina were assessed using predischarge and follow-up CT scans. The median CT scan follow-up was 31 months (first quartile 15, third quartile 52)...
June 1, 2017: European Journal of Cardio-thoracic Surgery
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