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Aortic dissection

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https://www.readbyqxmd.com/read/29691185/common-themes-in-patients-requiring-urgent-cardiothoracic-surgery-after-percutaneous-coronary-interventions-case-series-and-review-of-the-literature
#1
REVIEW
Saad Ezad, Trent D Williams, Jeremy Condon, Andrew J Boyle, Nicholas J Collins
Urgent cardiothoracic surgical intervention for the management of complications of percutaneous coronary intervention is uncommon in the stent era. Nonetheless, given increasing procedural complexity, in part reflecting an aging population, an ongoing hazard for urgent surgery remains. We sought to review the incidence and outcome of urgent cardiothoracic surgery in patients undergoing PCI in a contemporary cohort at a tertiary referral centre. The incidence of cardiothoracic intervention for PCI related complications was low at 0...
March 21, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29691098/improved-patency-after-axillofemoral-bypass-for-aortoiliac-occlusive-disease
#2
Russell H Samson, David P Showalter, Michael R Lepore, Deepak G Nair, Douglas A Dorsay, Ricardo E Morales
OBJECTIVE: Axillofemoral bypasses (AxFBs) have been used since 1962 to treat aortoiliac disease. In the past, reported patency rates (37%-76%) for these extra-anatomic grafts have been inferior to those for anatomic aortic grafting. Reported low survival rates after AxFB (40%-50%) have confirmed that these procedures have been used primarily in patients at high risk for complications from aortofemoral bypass. However, modern medical and anesthesia management, preoperative scanning, donor artery preparation, postoperative graft surveillance, and graft technology may improve outcomes after AxFB, possibly supporting expansion of its use...
April 21, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29691051/intimal-relayering-technique-yet-another-operation-for-acute-aortic-dissection
#3
Eugenio Neri, Enrico Tucci, Giulia Guaccio, Luigi Muzzi
No abstract text is available yet for this article.
April 3, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29689197/ari-1-regulates-myonuclear-organization-together-with-parkin-and-is-associated-with-aortic-aneurysms
#4
Kai Li Tan, Nele A Haelterman, Callie S Kwartler, Ellen S Regalado, Pei-Tseng Lee, Sonal Nagarkar-Jaiswal, Dong-Chuan Guo, Lita Duraine, Michael F Wangler, Michael J Bamshad, Deborah A Nickerson, Guang Lin, Dianna M Milewicz, Hugo J Bellen
Nuclei are actively positioned and anchored to the cytoskeleton via the LINC (Linker of Nucleoskeleton and Cytoskeleton) complex. We identified mutations in the Parkin-like E3 ubiquitin ligase Ariadne-1 (Ari-1) that affect the localization and distribution of LINC complex members in Drosophila. ari-1 mutants exhibit nuclear clustering and morphology defects in larval muscles. We show that Ari-1 mono-ubiquitinates the core LINC complex member Koi. Surprisingly, we discovered functional redundancy between Parkin and Ari-1: increasing Parkin expression rescues ari-1 mutant phenotypes and vice versa...
April 23, 2018: Developmental Cell
https://www.readbyqxmd.com/read/29688450/morphological-features-of-the-thoracic-aorta-and-supra-aortic-branches-in-patients-with-acute-type-a-aortic-dissection-in-china
#5
Jin-Lin Wu, Liang Zhang, Jun-Tao Qiu, Cun-Tao Yu
OBJECTIVES: This study aimed to investigate the morphological characteristics of the dissected thoracic aorta and brachiocephalic arteries within the Chinese population. METHODS: A retrospective analysis of computed tomography scans of 387 patients with acute Type A aortic dissection was carried out. The dimensions of the thoracic aorta at multiple levels and other imaging characteristics were studied. RESULTS: The patients with a maximum diameter ≥55 mm accounted for less than one-third of the population...
April 24, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29688286/endovascular-repair-of-thrombosed-type-acute-type-a-aortic-dissection-with-critical-renal-artery-malperfusion
#6
Atsushi Omura, Hitoshi Matsuda, Jiro Matsuo, Junjiro Kobayashi
An 81-year-old woman was referred to our centre for emergency surgery with a suspected diagnosis of acute aortic dissection. Laboratory tests showed marked elevation of serum creatinine and blood urea nitrogen. Enhanced computed tomography (CT) demonstrated Type A aortic dissection with a thrombosed false lumen in the ascending aorta. The primary entry tear was located 2 cm distal to the left subclavian artery. Malperfusion of bilateral renal arteries was also evident due to compression by the false lumen...
April 24, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29688208/technical-aspects-of-using-the-thoraflex-tm-hybrid-prosthesis-in-acute-type-a-aortic-dissection
#7
A Rukosuev, C Martens
The most tried out, 'classical' technique of the operation in acute type A aortic dissection is supracoronary prosthetic repair of the ascending aorta and proximal portion of the aortic arch, as the simplest and fastest intervention. However, this technique is associated with late complications related primarily to formation of a persistent false lumen leading to formation of an aneurysm of the descending aorta. Total prosthetic repair of the aortic arch, including the 'frozen elephant trunk' technique, contributes to thrombosis of the false lumen and remodelling of the thoracic aorta...
2018: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/29687971/indication-and-treatment-strategies-in-aortic-dissection-the-fog-is-rising
#8
Konstantinos Spanos, Tilo Kölbel
No abstract text is available yet for this article.
April 24, 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29687861/mst1-down-regulation-in-decreasing-apoptosis-of-aortic-dissection-smooth-muscle-cell-apoptosis
#9
Y Shi, B Liu, C-S Wang, C-S Yang
OBJECTIVE: Elevated apoptosis of vascular smooth muscle cell (VSMC) is correlated with the occurrence of aortic dissection (AD). Mammalian ste20-like protein kinase 1 (MST1) is one important component of Hippo-YAP signal pathway for activation and cell apoptosis facilitation. Whether MST1 plays a role in AD pathogenesis is unclear yet. This study established an AD rat model to investigate the role of MST1 in regulating VSMC apoptosis and AD pathogenesis. MATERIALS AND METHODS: Cell apoptosis was compared between AD vascular tissues and normal rats, in addition to Caspase-3 activity, and expression of MST1, p-LATS1, p-YAP1, YAP1...
April 2018: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29685932/insights-from-the-international-registry-of-acute-aortic-dissection-a-20-year-experience-of-collaborative-clinical-research
#10
REVIEW
Arturo Evangelista, Eric M Isselbacher, Eduardo Bossone, Thomas G Gleason, Marco Di Eusanio, Udo Sechtem, Marek P Ehrlich, Santi Trimarchi, Alan C Braverman, Truls Myrmel, Kevin M Harris, Stuart Hutchinson, Patrick O'Gara, Toru Suzuki, Christoph A Nienaber, Kim A Eagle
Acute aortic dissection (AAD) is a life-threatening condition associated with high morbidity and mortality rates, and it remains a challenge to diagnose and treat. The International Registry of Acute Aortic Dissection was established in 1996 with the mission to raise awareness of this condition and provide insights to guide diagnosis and treatment. Since then, >7300 cases have been included from >51 sites in 12 countries. Although presenting symptoms and physical findings have not changed significantly over this period, the use of computed tomography in the diagnosis has increased, and more patients are managed with interventional procedures: surgery in type A AAD and endovascular therapy in type B AAD; with these changes in care, there has been a significant decrease in overall in-hospital mortality in type A AAD but not in type B AAD...
April 24, 2018: Circulation
https://www.readbyqxmd.com/read/29685679/extra-thoracic-supra-aortic-bypass-surgery-is-safe-in-thoracic-endovascular-aortic-repair-and-arterial-occlusive-disease-treatment
#11
Alexander Gombert, Lea van Issum, Mohammad E Barbati, Jochen Grommes, Andras Keszei, Drosos Kotelis, Houman Jalaie, Andreas Greiner, Michael J Jacobs, Johannes Kalder
OBJECTIVE: The safety and feasibility of supra-aortic debranching as part of endovascular aortic surgery or as a treatment option for arterial occlusive disease (AOD) remains controversial. The aim of this study was to assess the clinical outcome of this surgery. METHODS: This single centre, retrospective study included 107 patients (mean age 69.2 years, 38.4% women) who underwent supra-aortic bypass surgery (carotid-subclavian bypass, carotid-carotid bypass, and carotid-carotid-subclavian bypass) because of thoracic or thoraco-abdominal endovascular aortic repair (57%; 61/107) or as AOD treatment (42...
April 20, 2018: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29685514/the-effect-of-false-lumen-procedures-during-thoracic-endovascular-aortic-repair-in-patients-with-chronic-debakey-type-iiib-dissections
#12
Tae-Hoon Kim, Suk-Won Song, Kwang-Hun Lee, Min-Young Baek, Kyung-Jong Yoo, Bum-Koo Cho
OBJECTIVE: Although thoracic endovascular aortic repair (TEVAR) is commonly used for chronic DeBakey type IIIB (CDIIIB) dissections, aortic remodeling outcomes after the procedure have been unsatisfactory. Persistent retrograde flow to the false lumen (FL) through re-entry tears commonly causes treatment failure. The aim of this study was to clarify the safety and effect of the FL procedure (FLP) for aortic remodeling in patients with CDIIIB dissections. METHODS: From 2012 to 2016, there were 73 patients who underwent TEVAR for CDIIIB dissections...
April 20, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29685513/expression-of-platelet-derived-growth-factor-b-is-upregulated-in-patients-with-thoracic-aortic-dissection
#13
Weixin Meng, Shangdian Liu, Dandan Li, Zonghong Liu, Hui Yang, Bo Sun, Hongyu Liu
OBJECTIVE: Thoracic aortic dissection (TAD) is a serious condition requiring urgent treatment to avoid catastrophic consequences. The inflammatory response is involved in the occurrence and development of TAD, possibly potentiated by platelet-derived growth factors (PDGFs). This study aimed to determine whether expression of PDGF-B (a subunit of PDGF-BB) was increased in TAD patients and to explore the factors responsible for its upregulation and subsequent effects on TAD. METHODS: Full-thickness ascending aorta wall specimens from TAD patients (n = 15) and control patients (n = 10) were examined for expression of PDGF-B and its receptor (PDGFRB) and in terms of morphology, inflammation, and fibrosis...
April 20, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29685509/rankl-mediated-osteoclastogenic-differentiation-of-macrophages-in-the-abdominal-aorta-of-angiotensin-ii-infused-apolipoprotein-e-knockout-mice
#14
Teruyoshi Tanaka, Matthew Kelly, Yuichiro Takei, Dai Yamanouchi
OBJECTIVE: Osteoclastogenic activation of macrophages (OCG) occurs in human abdominal aortic aneurysms (AAAs) and in calcium chloride-induced degenerative AAAs in mice, which have increased matrix metalloproteinase activity. As the activity of OCG in dissecting aneurysms is not clear, we tested the hypothesis that OCG contributes to angiotensin II (Ang II)-induced dissecting aneurysm (Ang II-induced AAA) in apolipoprotein E knockout mice. METHODS: AAAs were produced in apolipoprotein E knockout mice via the administration of Ang II...
April 20, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29684119/aortic-stiffness-in-adolescent-turner-and-marfan-syndrome-patients
#15
Michal Schäfer, Lorna P Browne, Uyen Truong, James J Jaggers, Max B Mitchell, Ladonna Malone, Gareth Morgan, Kathryn Chatfield, Daniel McLennan, Harma Turbendian, Danial Vargas, Brian Fonseca, Michael DiMaria, Anar Shah, Margaret P Ivy, Alex J Barker, Kendall S Hunter, Neil Wilson, D Dunbar Ivy, David N Campbell
OBJECTIVES: Turner syndrome (TS) and Marfan syndrome (MFS) are partially characterized by aortopathies with a risk of developing severe aortic dilation, stiffness and consequent dissection and aneurysm formation. The incidence of a bicuspid aortic valve (BAV) is also increased in TS. We investigated aortic stiffness in teenage TS and MFS patients and evaluated to what degree stiffness in TS patients is augmented by the presence of a BAV. METHODS: Fifty-seven patients with TS (n = 37) and MFS (n = 20), as well as 22 controls with similar age and size distribution underwent evaluation of thoracic aortic stiffness using phase-contrast magnetic resonance imaging...
April 19, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29683463/a-closed-chest-model-to-induce-transverse-aortic-constriction-in-mice
#16
Lars Eichhorn, Christina Katharina Weisheit, Christopher Gestrich, Konrad Peukert, Georg Daniel Duerr, Muhammad Ajmal Ayub, Felix Erdfelder, Florian Stöckigt
Research on cardiac hypertrophy and heart failure is frequently based on pressure overload mouse models induced by TAC. The standard procedure is to perform a partial thoracotomy to visualize the transverse aortic arch. However, the surgical trauma caused by the thoracotomy in open-chest models changes the respiratory physiology as the ribs are dissected and left unattached after chest closure. To prevent this, we established a minimally invasive, closed chest approach via lateral thoracotomy. Herein we approach the aortic arch via the 2nd intercostal space without entering the chest cavities, leaving the mouse with a less traumatic injury to recover from...
April 5, 2018: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29683349/video-rethinking-mural-thickening-vasculitis-or-aortic-dissection
#17
Caitlin A Harrington, Alexander A Brescia, Brandon H Tieu, Cristina Fuss
OBJECTIVE: The objective of this video article is to provide education about the similarities and differences between vasculitis and rare, acute aortic pathologic findings so that an appropriate diagnosis can be made in a timely manner, especially for patients with life-threatening aortic pathologic findings. CONCLUSION: Although they are rare, acute aortic pathologic findings, such as aortic dissection and intramural hematoma, can have radiographic characteristics similar to those of vasculitis, which can make it challenging to discern between these vastly different diagnoses without the use of properly timed imaging studies...
May 2018: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/29682475/malperfusion-syndromes-in-type-a-aortic-dissection-what-we-have-learned-from-irad
#18
REVIEW
Paolo Berretta, Santi Trimarchi, Himanshu J Patel, Thomas G Gleason, Kim A Eagle, Marco Di Eusanio
Patients presenting with type A acute aortic dissection (TAAD) complicated by malperfusion syndromes represent one of the highest surgical risk cohorts for cardiovascular surgeons. In the setting of aortic dissection, end-organ ischemia may involve any of the major arterial side branches resulting in myocardial, cerebral, spinal cord, visceral and/or limb ischemia. In TAAD patients with malperfusion, notwithstanding continuous improvement in diagnostic and management strategies, surgical and clinical outcomes remain poor and the optimal therapy is controversial...
2018: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29682469/conservative-management-versus-endovascular-or-open-surgery-in-the-spectrum-of-type-b-aortic-dissection
#19
Xun Yuan, Andreas Mitsis, Mohammed Ghonem, Ilias Iakovakis, Christoph A Nienaber
Background: Type B aortic dissection is a life-threatening acute aortic condition often with acute ischemic signs or symptoms. With initial management focusing on alleviating malperfusion and pain, and avoiding propagation of dissection or rupture both systolic blood and pulse pressure should be reduced initially by an aggressive medical approach. In the setting of persistent signs of complications endovascular strategies have replaced open surgery and led to a fourfold increase in early survival and better long-term outcomes...
2018: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29682123/a-case-of-traumatic-retrograde-type-a-aortic-dissection-accompanied-by-multiorgan-injuries
#20
Katsuaki Tsukioka, Tetsuya Kono, Kohei Takahashi, Hiromu Kehara, Shuichi Urashita, Kazunori Komatsu
A 75-year-old woman was involved in a traffic accident and suffered retrograde type A aortic dissection, multiple rib fractures, and grade II hepatic injury accompanied by intraperitoneal bleeding. We performed total arch replacement using an open stent graft with cardiopulmonary bypass and circulatory arrest. This procedure requires anticoagulation and hypothermia, which are principally contraindicated in severe trauma patients. However, this situation was resolved by managing the patient non-operatively for 7 days, confirming the stabilization of other injured organs, and then performing the surgery...
March 25, 2018: Annals of Vascular Diseases
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