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Thoracic aortic aneurysms and dissection

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https://www.readbyqxmd.com/read/29149323/should-the-dilated-ascending-aorta-be-repaired-at-the-time-of-bicuspid-aortic-valve-replacement
#1
Tsuyoshi Kaneko, Prem Shekar, Vladimir Ivkovic, Nicholas T Longford, Chuan-Chin Huang, Martin I Sigurdsson, Robert C Neely, Maroun Yammine, Julius I Ejilofor, Vanessa Montiero Vieira, Jasmine T Shahram, Karam M Habchi, Gregory W Malzberg, Peter S Martin, Jordan Bloom, Eric M Isselbacher, J Daniel Muehlschlegel, Thoralf M Sundt, Simon C Body
OBJECTIVES: Bicuspid aortic valve (BAV) is the most common congenital valvular abnormality and frequently presents with accelerated calcific aortic valve disease, requiring aortic valve replacement (AVR) and thoracic aortic aneurysm and dissection. Supporting evidence for Association Guidelines of aortic dimensions for aortic resection is sparse. We sought to determine whether concurrent repair of dilated or aneurysmal aortic disease during AVR in patients with BAV substantially improves morbidity and mortality outcomes...
November 14, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29129420/surgical-strategy-for-the-treatment-of-aortoesophageal-fistula
#2
Takahiro Yamazato, Tetsu Nakamura, Noriyuki Abe, Koki Yokawa, Yuki Ikeno, Yojiro Koda, Soichiro Henmi, Hidekazu Nakai, Yasuko Gotake, Takashi Matsueda, Takeshi Inoue, Hiroshi Tanaka, Yoshihiro Kakeji, Yutaka Okita
OBJECTIVE: To present a surgical strategy for aortoesophageal fistula (AEF). METHODS: From October 1999 to May 2017, 27 patients with AEF were treated at Kobe University Hospital. After 9 patients with malignancies or fish bone penetration were excluded, 18 patients who had AEF secondary to aortic lesions were investigated. The mean age was 67.2 ± 10.4 years, and the male/female ratio was 16:2. Twelve patients had a nondissection thoracic aneurysm, and 6 patients had a chronic aortic dissection...
September 20, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29124128/vascular-deformation-mapping-vdm-of-thoracic-aortic-enlargement-in-aneurysmal-disease-and-dissection
#3
Nicholas S Burris, Benjamin A Hoff, Ella A Kazerooni, Brian D Ross
Thoracic aortic aneurysm is a common and lethal disease that requires regular imaging surveillance to determine timing of surgical repair and prevent major complications such as rupture. Current cross-sectional imaging surveillance techniques, largely based on computed tomography angiography, are focused on measurement of maximal aortic diameter, although this approach is limited to fixed anatomic positions and is prone to significant measurement error. Here we present preliminary results showing the feasibility of a novel technique for assessing change in aortic dimensions, termed vascular deformation mapping (VDM)...
September 2017: Tomography: a Journal for Imaging Research
https://www.readbyqxmd.com/read/29080094/is-there-a-role-for-biomarkers-in-thoracic-aortic-aneurysm-disease
#4
Damian Balmforth, Amer Harky, Benjamin Adams, John Yap, Alex Shipolini, Neil Roberts, Rakesh Uppal, Mohamad Bashir
Thoracic aortic aneurysm (TAA) represents a major cause of mortality and morbidity in Western countries. The natural history of TAA is indolent, with patients usually being asymptomatic until a catastrophic event such as rupture or dissection ensues. As such, early diagnosis is crucial and the search is ongoing for a biomarker that can indicate the presence of TAA with sufficient accuracy to act as a screening tool. To date, no such marker has been developed for the diagnosis of non-familial or 'sporadic' TAA...
October 28, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29040313/premature-aortic-smooth-muscle-cell-differentiation-contributes-to-matrix-dysregulation-in-marfan-syndrome
#5
Matthew Dale, Matthew P Fitzgerald, Zhibo Liu, Trevor Meisinger, Andrew Karpisek, Laura N Purcell, Jeffrey S Carson, Paul Harding, Haili Lang, Panagiotis Koutakis, Rishi Batra, Constance J Mietus, George Casale, Iraklis Pipinos, B Timothy Baxter, Wanfen Xiong
Thoracic aortic aneurysm and dissection are life-threatening complications of Marfan syndrome (MFS). Studies of human and mouse aortic samples from late stage MFS demonstrate increased TGF-β activation/signaling and diffuse matrix changes. However, the role of the aortic smooth muscle cell (SMC) phenotype in early aneurysm formation in MFS has yet to be fully elucidated. As our objective, we investigated whether an altered aortic SMC phenotype plays a role in aneurysm formation in MFS. We describe previously unrecognized concordant findings in the aortas of a murine model of MFS, mgR, during a critical and dynamic phase of early development...
2017: PloS One
https://www.readbyqxmd.com/read/29022854/single-center-mid-term-experience-with-chimney-graft-technique-for-the-preservation-of-flow-to-the-supra-aortic-branches
#6
Robert Shahverdyan, Spyridon Mylonas, Michael Gawenda, Jan Brunkwall
Objectives To investigate the feasibility and the mid-term outcomes of the chimney-graft technique for the revascularization of supra-aortic branches in patients with thoracic aortic pathologies involving the aortic arch. Methods A retrospective analysis of a prospectively maintained database between January 2010 and July 2016 was performed. Primary endpoints were 30-day and overall mortality. Secondary endpoints were technical success, target vessel patency, stroke/transitory ischemic attack and type I/III endoleak rate...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28984667/ascending-aortic-aneurysm-is-an-inherited-disease-a-contemporary-literature-review-based-on-hill-s-criteria-of-specificity-strength-of-association-and-biological-coherence
#7
Mirza Mujadil Ahmad, Immad Arif Kiani, Khawaja Afzal Ammar, Mirza Nubair Ahmad, Bijoy K Khandheria, Timothy E Paterick, Renuka Jain, A Jamil Tajik
There is growing evidence of a differential etiological basis for thoracic aortic aneurysms (TAA), with ascending (As) TAAs being genetically mediated and descending (Des) TAAs more strongly related to acquired pathologies. A comprehensive literature review of this hypothesis has not been carried out. We carried out a systematic literature review based on the latest guidelines on TAA endorsed by the American Heart Association. The etiologies were classified as genetic and inherited, the studies were tabulated accordingly, and Hill's epidemiological criteria of causality were applied...
November 2017: Cardiology in Review
https://www.readbyqxmd.com/read/28977379/single-centre-experience-with-the-frozen-elephant-trunk-technique-in-251-patients-over-15%C3%A2-years
#8
Malakh Shrestha, Andreas Martens, Tim Kaufeld, Erik Beckmann, Sebastian Bertele, Heike Krueger, Julia Neuser, Felix Fleissner, Fabio Ius, Firas Abd Alhadi, Jasmin Hanke, Jan D Schmitto, Serghei Cebotari, Matthias Karck, Axel Haverich, Ajay Chavan
OBJECTIVES: Our goal was to present our 15-year experience (2001-2015) with the frozen elephant trunk (FET) technique. METHODS: A total of 251 patients (82 with aortic aneurysms, 96 with acute aortic dissection type A, 4 with acute type B dissections, 52 with chronic aortic dissection type A, 17 with chronic type B dissection and 67 redo cases) underwent FET implantation with either the custom-made Chavan-Haverich (n = 66), the Jotec E-vita (n = 31) or the Vascutek Thoraflex hybrid (n = 154) prosthesis...
November 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28973303/fbn1-mutations-largely-contribute-to-sporadic-non-syndromic-aortic-dissection
#9
Lun Tan, Zongze Li, Chengming Zhou, Yanyan Cao, Lina Zhang, Xianqing Li, Katherine Cianflone, Yan Wang, Dao Wen Wang
Mutations in FBN1 have been well identified in syndromic aortic dissection (AD) and familial thoracic aortic aneurysms and dissections. However, whether mutations of FBN1 contribute to sporadic non-syndromic AD and the characteristics of mutations remain unknown.Using next-generation-sequencing technology, FBN1 was sequenced in a total of 702 sporadic cases (including 687 of non-syndromic AD and 15 of sporadic Marfan syndrome (MFS) with aortic event, and 527 normal controls). For the sporadic non-syndromic AD cohort, we found 26 variants in 27 patients (18 with missense, 2 frameshift, 1 initiation codon mutation, 3 nonsense, and 3 splice site mutations)...
September 18, 2017: Human Molecular Genetics
https://www.readbyqxmd.com/read/28973148/a-constitutive-bcl2-down-regulation-aggravates-the-phenotype-of-pkd1-mutant-induced-polycystic-kidney-disease
#10
Laurence Duplomb, Nathalie Droin, Olivier Bouchot, Christel Robinet Thauvin, Ange-Line Bruel, Julien Thevenon, Patrick Callier, Guillaume Meurice, Noémie Pata-Merci, Romaric Loffroy, David Vandroux, Romain Da Costa, Virginie Carmignac, Eric Solary, Laurence Faivre
The main identified function of BCL2 protein is to prevent cell death by apoptosis. Mice knock-out for Bcl2 demonstrate growth retardation, severe polycystic kidney disease (PKD), gray hair and lymphopenia, and die prematurely after birth. Here, we report a 40-year-old male referred to for abdominal and thoracic aortic dissection with associated aortic root aneurysm, PKD, lymphocytopenia with a history of T cell lymphoblastic lymphoma, white hair since the age of 20, and learning difficulties. PKD, which was also detected in the father and sister, was related to an inherited PKD1 mutation...
September 11, 2017: Human Molecular Genetics
https://www.readbyqxmd.com/read/28955701/sequential-hybrid-repair-of-aorta-and-bilateral-common-iliac-arteries-secondary-to-chronic-aortic-dissection-with-extensive-aneurysmal-degeneration-in-a-marfan-patient
#11
Carlos A Hinojosa, Javier E Anaya-Ayala, Hugo Laparra-Escareno, Rene Lizola, Adriana Torres-Machorro
Marfan syndrome is a connective tissue disorder associated with aortic dissection, aneurysmal degeneration and rupture. These cardiovascular complications represent the main cause of mortality, therefore repair is indicated. We present a 35-year-old woman who experienced acute onset of chest pain. Her imaging revealed a chronic DeBakey type I dissection with aortic root dilation and descending thoracic aneurysmal degeneration. She underwent a Bentall procedure and endovascular exclusion of the descending thoracic aortic aneurysm...
September 2017: Vascular Specialist International
https://www.readbyqxmd.com/read/28955046/critical-role-of-adamts-4-in-the-development-of-sporadic-aortic-aneurysm-and-dissection-in-mice
#12
Pingping Ren, Michael Hughes, Swapna Krishnamoorthy, Sili Zou, Lin Zhang, Darrell Wu, Chen Zhang, John A Curci, Joseph S Coselli, Dianna M Milewicz, Scott A LeMaire, Ying H Shen
Sporadic aortic aneurysm and dissections (AADs) are common vascular diseases that carry a high mortality rate. ADAMTS-4 (a disintegrin-like and metalloproteinase with thrombospondin motifs-4) is a secreted proteinase involved in inflammation and matrix degradation. We previously showed ADAMTS-4 levels were increased in human sporadic descending thoracic AAD (TAAD) samples. Here, we provide evidence that ADAMTS-4 contributes to aortic destruction and sporadic AAD development. In a mouse model of sporadic AAD induced by a high-fat diet and angiotensin II infusion, ADAMTS-4 deficiency (Adamts-4-/-) significantly reduced challenge-induced aortic diameter enlargement, aneurysm formation, dissection and aortic rupture...
September 27, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28947226/outcomes-of-thoracic-endovascular-aortic-repair-in-adult-coarctation-patients
#13
Salim Lala, Salvatore T Scali, Robert J Feezor, Satish Chandrekashar, Kristina A Giles, Javairiah Fatima, Scott A Berceli, Martin R Back, Thomas S Huber, Thomas M Beaver, Adam W Beck
BACKGROUND: Aortic coarctation (AC) is most commonly identified in pediatric patients; however, adults can present with late sequelae of untreated coarctation or complications of prior open repair. To date, there are limited data about the role of thoracic endovascular aortic repair (TEVAR) in this group of patients. The purpose of this analysis was to describe our experience with management of adult coarctation patients using TEVAR. METHODS: All TEVAR patients treated for primary coarctation or late sequelae of previous open repair (eg, pseudoaneurysm, recurrent coarctation or anastomotic stenosis related to index open coarctation repair) were reviewed...
September 22, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28943007/thoracic-endovascular-aortic-repair-migration-and-aortic-elongation-differentiated-using-dual-reference-point-analysis
#14
Hillary B Alberta, Toshio Takayama, Annalise Panthofer, Richard P Cambria, Mark A Farber, William D Jordan, Jon S Matsumura
OBJECTIVE: We evaluated images of patients undergoing a thoracic endovascular aortic repair procedure using two reference points as a means for differentiating stent graft migration from aortic elongation. Conventional standards define migration of a stent graft as an absolute change in the distance from the distal graft ring to a distal landmark ≥10 mm compared with a baseline measurement. Aortic elongation occurs over time in both healthy individuals and patients with aortic disease...
September 21, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28939705/retrograde-type-a-aortic-dissection-after-thoracic-endovascular-aortic-repair-a-systematic-review-and-meta-analysis
#15
REVIEW
Yanqing Chen, Simeng Zhang, Lei Liu, Qingsheng Lu, Tianyi Zhang, Zaiping Jing
BACKGROUND: Retrograde type A aortic dissection (RTAD) is a potentially lethal complication after thoracic endovascular aortic repair (TEVAR). However, data are limited regarding the development of RTAD post-TEVAR. This systematic review aims to define the incidence, mortality, and potential risk factors of RTAD post-TEVAR. METHODS AND RESULTS: Multiple electronic searches were performed. Fifty publications with a total of 8969 patients were analyzed. Pooled estimates for incidence and mortality of RTAD were 2...
September 22, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28939200/open-distal-fenestration-of-chronic-dissection-facilitates-endovascular-elephant-trunk-completion-late-outcomes
#16
Muhammad Aftab, Jay J Idrees, Frank Cikach, Jose L Navia, Donald Hammer, Eric E Roselli
BACKGROUND: Retrograde false lumen perfusion is a common mode of failure after stent grafting chronic aortic dissection. Open fenestration during the first-stage elephant trunk (ET) creates a landing zone for second-stage endovascular ET completion in patients with a false lumen aneurysm. Our objectives were to assess long-term safety and durability of this technique. METHODS: From 2007 to 2014, 56 patients with thoracoabdominal dissection and aneurysm underwent stage 1 ET and open fenestration...
September 19, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28939111/open-descending-thoracic-or-thoracoabdominal-aortic-approaches-for-complications-of-endovascular-aortic-procedures-19-year-experience
#17
Konstantinos Spiliotopoulos, Ourania Preventza, Susan Y Green, Matt D Price, Hiruni S Amarasekara, Brittany M Davis, Kim I de la Cruz, Scott A LeMaire, Joseph S Coselli
OBJECTIVES: Endovascular aortic repair is increasingly being used to treat aneurysms, dissections, and traumatic injuries, despite its unknown long-term durability. We describe our 19-year experience with open descending thoracic and thoracoabdominal aortic repair after endovascular aortic repair. METHODS: Between 1996 and 2015, 67 patients were treated with open distal arch, descending thoracic, or thoracoabdominal aortic repair, or extra-anatomic bypass repair with aortic extirpation for complications after endovascular repair of the thoracic (n = 45, 67%) or abdominal (n = 22, 33%) aorta...
August 26, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28935963/differentially-expressed-genes-and-canonical-pathways-in-the-ascending-thoracic-aortic-aneurysm-the-tampere-vascular-study
#18
Miska Sulkava, Emma Raitoharju, Ari Mennander, Mari Levula, Ilkka Seppälä, Leo-Pekka Lyytikäinen, Otso Järvinen, Thomas Illig, Norman Klopp, Nina Mononen, Reijo Laaksonen, Mika Kähönen, Niku Oksala, Terho Lehtimäki
Ascending thoracic aortic aneurysm (ATAA) is a multifactorial disease with a strong inflammatory component. Surgery is often required to prevent aortic rupture and dissection. We performed gene expression analysis (Illumina HumanHT-12 version 3 Expression BeadChip) for 32 samples from ATAA (26 without/6 with dissection), and 28 left internal thoracic arteries (controls) collected in Tampere Vascular study. We compared expression profiles and conducted pathway analysis using Ingenuity Pathway Analysis (IPA) to reveal differences between ATAA and a healthy artery wall...
September 21, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28932555/does-bioglue-contribute-to-anastomotic-pseudoaneurysm-after-thoracic-aortic-surgery
#19
Wei-Guo Ma, Bulat A Ziganshin, Chang-Fa Guo, Mohammad A Zafar, Richard S Sieller, Maryann Tranquilli, John A Elefteriades
BACKGROUND: Although bovine serum albumin-glutaraldehyde glue (BioGlue®) has been successfully used as a hemostatic adjunct in aortic surgical procedures, there are reports that it may lead to anastomotic pseudoaneurysm formation. We seek to examine if the use of BioGlue is associated with a high incidence of anastomotic pseudoaneurysm formation following surgical repair of thoracic aortic disease. METHODS: We reviewed the medical records and follow-up computed tomography (CT) scans of patients from 2001 to 2015 in whom BioGlue was used during surgical repair of thoracic aortic disease to detect postoperative anastomotic pseudoaneurysm formation...
August 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28932545/effects-of-preemptive-cerebrospinal-fluid-drainage-on-spinal-cord-protection-during-thoracic-endovascular-aortic-repair
#20
Seungjun Song, Suk-Won Song, Tae Hoon Kim, Kwang-Hun Lee, Kyung-Jong Yoo
BACKGROUND: Spinal cord injury (SCI) is reported to occur in 3-12% of thoracic endovascular aortic repair (TEVAR) cases, but is a potentially preventable complication of TEVAR for thoracoabdominal pathologies. Although many strategies have been devised to reduce the incidence of SCI, the effectiveness of prophylactic cerebrospinal fluid drainage (CSFD) and left subclavian artery (LSA) revascularization remains controversial. METHODS: From 2012 to 2014, 162 patients underwent TEVAR at a single institution...
August 2017: Journal of Thoracic Disease
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