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Aortic dissection

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https://www.readbyqxmd.com/read/27914025/case-of-an-old-man-with-aortic-dissection-type-a-and-enlarging-meningioma
#1
Giulia Lancellotti, Caterina Rontauroli, Elisabete Turrini, Marco Bertolotti, Chiara Mussi
No abstract text is available yet for this article.
December 2, 2016: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/27909279/-stanford-type-a-aortic-dissection-after-off-pump-coronary-artery-bypass-grafting-using-automated-proximal-anastomotic-device-report-of-a-case
#2
Toshiyuki Maeda, Taku Sakurada, Satoshi Muraki, Shinji Nakashima, Jun Sasaki, Eiji Araki
Operative mortality of Stanford type A aortic dissection( AAD) repair with previous cardiac surgery is high, especially with previous coronary artery bypass grafting. We report an extremely rare case of AAD related to the PAS-Port system. A 68-year-old male patient on dialysis was admitted to our hospital with a diagnosis of AAD. Half a year before he had undergone off-pump coronary artery bypass grafting using PAS-Port system for a proximal anastomosis of a vein graft. Urgent graft replacement of the ascending aorta was performed, and the proximal anastomotic site of the vein graft was attached to the prosthetic graft...
December 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/27909276/-closure-of-ascending-aortic-entry-by-debranching-endovascular-management-in-an-elderly-patient-with-acute-stanford-type-a-dissection
#3
Munehiro Saiki, Keiji Yunoki, Naoya Sakoda, Shigeru Hattori, Gaku Uchino, Takuya Kawabata, Yasufumi Fujita, Kunikazu Hisamochi, Hideo Yoshida
An 85-year-old woman was hospitalized by emergency for an acute Stanford type A aortic dissection. Computed tomography showed a primary entry on the ascending aorta and pericardial effusion. Although her hemodynamics was unstable due to cardiac shock, her family wished no open surgery considering her age and frailty. A couple of days later, her condition became stabilized with antihypertensive therapy. Since the dissection was limited within the ascending aorta, closure of the entry with the stentgraft was considered appropriate and much less invasive as compared with an open surgery...
December 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/27908812/original-off-label-endovascular-solution-to-occlude-false-lumen-rupture-in-chronic-type-b-aortic-dissection
#4
E M Marone, M Leopardi, L Bertoglio, D Mascia, R Chiesa
After Thoracic Endovascular Aortic Repair (TEVAR) for chronic type B aortic dissection (cTBD) the patency of the false lumen is quite common and its presence is associated with the risk of developing complications and is a predictor of death by aortic rupture. We report a case of a patient treated in emergency for the rupture of the false lumen in cTBD. He had previous TEVAR with persisting distal dissection and retrograde reperfusion of the false lumen. We performed an original endovascular treatment with graft relining and false lumen occlusion with a home-made "candy plug" obtained with two commercially available stent grafts...
November 28, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27907878/ultrasound-in-cardiac-trauma
#5
Theodosios Saranteas, Andreas F Mavrogenis, Christina Mandila, John Poularas, Fotios Panou
In the perioperative period, the emergency department or the intensive care unit accurate assessment of variable chest pain requires meticulous knowledge, diagnostic skills, and suitable usage of various diagnostic modalities. In addition, in polytrauma patients, cardiac injury including aortic dissection, pulmonary embolism, acute myocardial infarction, and pericardial effusion should be immediately revealed and treated. In these patients, arrhythmias, mainly tachycardia, cardiac murmurs, or hypotension must alert physicians to suspect cardiovascular trauma, which would potentially be life threatening...
November 5, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27906676/role-of-systematic-lymphadenectomy-as-part-of-primary-debulking-surgery-for-optimally-cytoreduced-advanced-ovarian-cancer-reappraisal-in-the-era-of-radical-surgery
#6
Kyung Jin Eoh, Jung-Yun Lee, Jung Won Yoon, Eun Ji Nam, Sunghoon Kim, Sang-Wun Kim, Young Tae Kim
The prognostic significance of pelvic and para-aortic lymphadenectomy during primary debulking surgery for advanced-stage ovarian cancer remains unclear. This study aimed to evaluate the survival impact of lymph node dissection (LND) in patients treated with optimal cytoreduction for advanced ovarian cancer. Data from 158 consecutive patients with stage IIIC-IV disease who underwent optimal cytoreduction (<1 cm) were obtained via retrospective chart review. Patients were classified into two groups: (1) lymph node sampling (LNS), node count <20; and (2) LND, node count ≥20...
November 29, 2016: Oncotarget
https://www.readbyqxmd.com/read/27903487/disturbed-p53-mdm2-feedback-loop-contributes-to-thoracic-aortic-dissection-formation-and-may-be-a-result-of-trim-25-overexpression
#7
Bin Gong, Zhiwei Wang, Min Zhang, Zhipeng Hu, Zongli Ren, Zheng Tang, Wanli Jiang, Lianghao Cheng, Jun Huang, Wei Ren, Qingtao Wang
BACKGROUND: The development of thoracic aortic dissection (TAD) is attributed to a broad range of degenerative, genetic, structural, oxidative, apoptotic, and acquired disease states. In this study, we examined the role of the disturbed p53-MDM2 feed-back loop in the formation of TAD, and one of a potential feed-back loop regulator, TRIM-25. METHODS: Surgical specimens of the aorta from TAD patients (n=10) and controls (n=10) were tested for α-smooth muscle actin (α-SMA),p53,murine double minute2(MDM2) and tripartite motif protein-25(TRIM-25) by western blot, immunohistochemical staining and quantitative real-time reverse transcription polymerase chain reaction (qRT-PCR) , respectively...
November 26, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27903477/simultaneous-endovascular-repair-for-thoracic-and-abdominal-aortic-pathologies-early-and-mid-term-results
#8
Yuanyuan Guo, Hongbo Cai, Bin Yang, Hui Jin
OBJECTIVES: To analyse information from a single clinical centre, evaluating early and mid-term results of simultaneous thoracic endovascular aortic repair (TEVAR) and endovascular aneurysm repair (EVAR) for co-existing thoracic and abdominal aortic pathologies. METHODS: From January 2005 to December 2014, 13 patients (8 men, 5 women; mean age, 75.3 years, range, 69-82 years) with concomitant thoracic and abdominal aortic disease (aneurysms, type B dissection, penetrating aortic ulcers) were treated with simultaneous TEVAR and EVAR...
November 26, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27903476/rapid-aneurysmal-sac-expansion-following-endovascular-repair-of-a-dissecting-thoracoabdominal-aneurysm
#9
Pau Bargay-Juan, Teresa Martin-Gonzalez, Rachel Clough, Rafaëlle Spear, Jonathan Sobocinski, Stephan Haulon
Endovascular repair of dissecting thoracoabdominal aneurysms (TAAA) is challenging and often requires multiple procedures. A 61-year-old man with a dissecting type-II TAAA treated first by placement of a thoracic endograft, and subsequently implantation of a fenestrated endograft. Six months postoperatively, a 10mm increase of the aorta was observed. A re-entry tear in left external iliac artery(EIA) was perfusing the false lumen in a retrograde fashion connecting with the endoleak caused by the inferior mesenteric artery and lumbar arteries...
November 26, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27903475/technical-aspects-of-open-repair-for-degenerative-aneurysmal-evolution-despite-early-thoracic-endovascular-repair-of-type-b-aortic-dissection
#10
Sonia Aguir, Salma El Batti, Paul Achouh, Pierre Julia, Alain Bel, Jean-Noël Fabiani, Jean-Marc Alsac
: Closure of the proximal tear by Thoracic Endovascular Aortic Repair (TEVAR) at the acute phase appears to be an safe effective treatment to prevent aneurysmal degeneration type B dissection. However, it appears to be inefficient in up to a third of the patient. We report the technical aspects of our experience with patients undergoing secondary open repair after TEVAR for dissecting thoraco-abdominal aneurysm despite early closure proximal tear by TEVAR. METHODS: During a period of 5 years, 96 patients presenting acute Type B Aortic Dissections (TBAD) were treated by TEVAR and followed-up in our institution...
November 26, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27900728/distant-lymph-node-metastases-caused-by-esophageal-cancer-invasion-to-the-lamina-propria-a-case-report
#11
Satoshi Tsutsumi, Hiroshi Saeki, Yuichiro Nakashima, Yu Nakaji, Kensuke Kudou, Ryosuke Tsutsumi, Sho Nishimura, Shingo Akiyama, Hirotada Tajiri, Takafumi Yukaya, Kimihiro Tanaka, Ryota Nakanishi, Masahiko Sugiyama, Kippei Ohgaki, Hideto Sonoda, Minako Hirahashi, Eiji Oki, Masaru Morita, Yoshinao Oda, Yoshihiko Maehara
BACKGROUND: Pathological examination after endoscopic submucosal dissection revealed that a 62-year-old male had esophageal squamous cell carcinoma with lamina propria mucosal invasion and lymphatic permeation. CASE PRESENTATION: The patient underwent subtotal esophagectomy and reconstruction as an additional therapy. At 3 years and 4 months after esophagectomy, enlargement of abdominal para-aortic lymph nodes metastases was detected by computed tomography scanning...
December 2016: Surgical Case Reports
https://www.readbyqxmd.com/read/27900191/deaths-in-triathletes-immersion-pulmonary-oedema-as-a-possible-cause
#12
Richard E Moon, Stefanie D Martina, Dionne F Peacher, William E Kraus
BACKGROUND/AIM: To address the question as to whether immersion pulmonary oedema (IPO) may be a common cause of death in triathlons, markers of swimming-induced pulmonary oedema (SIPO) susceptibility were sought in triathletes' postmortem examinations. METHODS: Deaths while training for or during triathlon events in the USA and Canada from October 2008 to November 2015 were identified, and postmortem reports requested. We assessed obvious causes of death; the prevalence of left ventricular hypertrophy (LVH); comparison with healthy triathletes...
2016: BMJ Open Sport & Exercise Medicine
https://www.readbyqxmd.com/read/27895881/morphologic-evaluation-of-ductus-diverticulum-using-multi-detector-computed-tomography-comparison-with-traumatic-pseudoaneurysm-of-the-aortic-isthmus
#13
Jun Hyung Ann, Eun Young Kim, Yu Mi Jeong, Jeong Ho Kim, Hyung Sik Kim, Hye-Young Choi
OBJECTIVES: To evaluate morphologic variations at the aortic isthmus with particular attention to ductus diverticulum, a mimicker of traumatic pseudoaneurysm, and to describe differences using Computed Tomography (CT) images. PATIENTS AND METHODS: From December 2013 to December 2014, patients who underwent a chest CT examination after blunt trauma at our emergency department were included. Aortic isthmus morphologies were evaluated using multiplanar reconstruction (MPR) and maximum intensity projection (MIP) images as follows...
October 2016: Iranian Journal of Radiology: a Quarterly Journal Published By the Iranian Radiological Society
https://www.readbyqxmd.com/read/27894786/mr-angiography-can-guide-ed-management-of-suspected-acute-aortic-dissection
#14
Gary X Wang, Sandeep S Hedgire, Thang Q Le, Jonathan D Sonis, Brian J Yun, Michael H Lev, Ali S Raja, Anand M Prabhakar
BACKGROUND: Aortic dissection is typically evaluated with computed tomography angiography (CTA). However, the feasibility of using magnetic resonance angiography (MRA) in the ED is unclear. This study examined the indications and outcomes of MRA in suspected aortic dissection evaluation in the ED. METHODS: An IRB approved review identified patients who underwent MRA in the ED for acute thoracic aortic dissection from January 2010 to June 2016. Demographics, clinical assessment, CTA contraindications, outcomes, and ED disposition were analyzed...
November 17, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27894713/abdominal-aortic-aneurysm-in-marfan-syndrome
#15
Tracy Hagerty, Patrick Geraghty, Alan C Braverman
OBJECTIVE: Marfan syndrome (MFS) leads to aortic root aneurysm, while descending thoracic aortic aneurysm (TAA) occurs less commonly. Abdominal aortic aneurysm (AAA) is rarely reported in MFS. Risk factors for AAA are poorly understood and there are no guidelines for AAA screening in MFS. We sought to characterize AAA among Marfan patients in our center. METHODS: The records of 12 adults with MFS and AAA disease were reviewed. Clinical features, imaging, operative reports, and outcomes were analyzed...
November 25, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27893734/an-ipsc-derived-vascular-model-of-marfan-syndrome-identifies-key-mediators-of-smooth-muscle-cell-death
#16
Alessandra Granata, Felipe Serrano, William George Bernard, Madeline McNamara, Lucinda Low, Priya Sastry, Sanjay Sinha
Marfan syndrome (MFS) is a heritable connective tissue disorder caused by mutations in FBN1, which encodes the extracellular matrix protein fibrillin-1. To investigate the pathogenesis of aortic aneurysms in MFS, we generated a vascular model derived from human induced pluripotent stem cells (MFS-hiPSCs). Our MFS-hiPSC-derived smooth muscle cells (SMCs) recapitulated the pathology seen in Marfan aortas, including defects in fibrillin-1 accumulation, extracellular matrix degradation, transforming growth factor-β (TGF-β) signaling, contraction and apoptosis; abnormalities were corrected by CRISPR-based editing of the FBN1 mutation...
November 28, 2016: Nature Genetics
https://www.readbyqxmd.com/read/27893044/failure-of-the-porcine-ascending-aorta-multidirectional-experiments-and-a-unifying-microstructural-model
#17
Colleen M Witzenburg, Rohit Y Dhume, Sachin B Shah, Christopher E Korenczuk, Hallie P Wagner, Patrick W Alford, Victor H Barocas
The ascending thoracic aorta is poorly understood mechanically, especially its risk of dissection. To make better predictions of dissection risk, more information about the multi-dimensional failure behavior of the tissue is needed, and this information must be incorporated into an appropriate theoretical / computational model. Towards the creation of such a model, uniaxial, equibiaxial, peel, and shear lap tests were performed on healthy porcine ascending aorta samples. Uniaxial and equibiaxial tests showed anisotropy with greater stiffness and strength in the circumferential direction...
November 18, 2016: Journal of Biomechanical Engineering
https://www.readbyqxmd.com/read/27890890/perivascular-hematoma-along-pulmonary-artery-complicating-aortic-dissection
#18
Hiroaki Wakakuri, Hideya Hyodo, Toshihiko Ohara, Masahiro Yasutake
No abstract text is available yet for this article.
2016: Journal of Nippon Medical School, Nippon Ika Daigaku Zasshi
https://www.readbyqxmd.com/read/27890847/fenestrated-and-branched-stent-grafting-in-complex-aneurysmatic-aortic-disease-a-single-center-early-experience
#19
Georgios D Vourliotakis, Vasileios D Tzilalis, Panagiotis G Theodoridis, Charalampos S Stoumpos, Dimitrios G Kamvysis, Giannis G Kantounakis
PURPOSE: To present our early experience and highlight the technical difficulties associated with the use of fenestrated and branched stent-grafts to treat patients with juxta-, para-renal abdominal aortic aneurysms (AAA) and thoracoabdominal aortic aneurysms (TAAA). METHODS: A prospectively held database maintained at our department, was queried for patients who have undergone branched and fenestrated stent-grafting for AAA or TAAA treatment. Indication for repair, co-morbidity precluding open repair, technical challenges associated with the repair, as well as operative mortality, morbidity and re-intervention rate were evaluated...
November 24, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27890843/total-endovascular-aortic-repair-in-a-patient-with-marfan-syndrome
#20
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
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