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Thoracic aortic aneurysms and dissection

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https://www.readbyqxmd.com/read/28212053/transthoracic-echocardiography-pitfalls-and-limitations-as-delineated-at-cardiac-ct-and-mr-imaging
#1
Sachin B Malik, Natalie Chen, Rex A Parker, Joe Y Hsu
Transthoracic echocardiography ( TTE transthoracic echocardiography ) is a critical tool in the field of clinical cardiology. It often serves as one of the first-line imaging modalities in the evaluation of cardiac disease owing to its low cost, portability, widespread availability, lack of ionizing radiation, and ability to evaluate both anatomy and function of the heart. Consequently, a large majority of patients undergoing a cardiac computed tomography (CT) or magnetic resonance (MR) imaging examination will have a TTE transthoracic echocardiography available for review...
February 17, 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28209770/are-patients-with-loeys-dietz-syndrome-misdiagnosed-with-beals-syndrome
#2
Rebecca Woolnough, Andrew Dhawan, Kimberly Dow, Jagdeep S Walia
Beals syndrome, also known as congenital contractural arachnodactyly (Online Mendelian Inheritance in Man: 121050), is an autosomal dominant disorder caused by a mutation in FBN2 that is typically characterized by congenital contractures and arachnodactyly. It shares a number of phenotypic features with Loeys-Dietz syndrome (Online Mendelian Inheritance in Man: 609192). Loeys-Dietz syndrome, initially described in 2005, is associated with mutations for the transforming growth factor β receptor and is characterized by findings of cerebral, thoracic, and abdominal arterial aneurysms...
February 16, 2017: Pediatrics
https://www.readbyqxmd.com/read/28190713/transient-atrial-fibrillation-after-open-abdominal-aortic-revascularization-surgery-is-associated-with-increased-length-of-stay-mortality-and-readmission-rates
#3
Barbara A Blanco, Anai N Kothari, Pegge M Halandras, Robert H Blackwell, Dawn M Graunke, Paul C Kuo, Jae S Cho
BACKGROUND: It is well established that transient postoperative atrial fibrillation (TPAF) is associated with adverse postoperative outcomes after major cardiac and noncardiac operations. The purpose of this study was to elucidate the incidence, impact, and risk factors associated with the development of TPAF in patients undergoing revascularization surgery for occlusive diseases of the abdominal aorta and its branches (AAB). METHODS: By use of the Healthcare Cost and Utilization Project State Inpatient Database from Florida and California, patients who underwent open revascularization of AAB between 2006 and 2011 were identified...
February 9, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28190547/surgical-outcomes-of-chronic-descending-dissections-type-i-versus-iii-debakey
#4
Ivancarmine Gambardella, Mario Gaudino, Christopher Lau, Monica Munjal, Mohamed Elsayed, Leonard N Girardi
BACKGROUND: We evaluated the results of open operation for the treatment of descending thoracic aneurysm (DTA) and thoracoabdominal aortic aneurysm (TAAA) in patients with DeBakey type I versus type III chronic aortic dissection. METHODS: We reviewed our institutional aortic database and compared the results of open repair in patients with type I versus type III chronic aortic dissection. Between 1997 and 2015, 726 patients underwent open DTA or TAAA repair at our institution...
February 9, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28185953/a-novel-smad3-mutation-caused-multiple-aneurysms-in-a-patient-without-osteoarthritis-symptoms
#5
Audrey Courtois, Wouter Coppieters, Vincent Bours, Jean-Olivier Defraigne, Alain Colige, Natzi Sakalihasan
Heterozygous mutations in the SMAD3 gene were recently described as the cause of a form of non-syndromic familial aortic thoracic aneurysm and dissection (FTAAD) transmitted as an autosomal dominant disorder and often associated with early-onset osteoarthritis. This new clinical entity, called aneurysms-osteoarthritis syndrome (AOS) or Loeys-Dietz syndrome 3 (LDS3), is characterized by aggressive arterial damages such as aneurysms, dissections and tortuosity throughout the arterial tree. We report, here, the case of a 45 year-old man presenting multiple visceral arteries and abdominal aortic aneurysms but without dissection of the thoracic aorta and without any sign of osteoarthritis...
February 6, 2017: European Journal of Medical Genetics
https://www.readbyqxmd.com/read/28180096/the-frozen-elephant-trunk-technique-european-association-for-cardio-thoracic-surgery-position-and-bologna-experience
#6
REVIEW
Luca Di Marco, Antonio Pantaleo, Alessandro Leone, Giacomo Murana, Roberto Di Bartolomeo, Davide Pacini
Complex lesions of the thoracic aorta are traditionally treated in 2 surgical steps with the elephant trunk technique. A relatively new approach is the frozen elephant trunk (FET) technique, which potentially allows combined lesions of the thoracic aorta to be treated in a 1-stage procedure combining endovascular treatment with conventional surgery using a hybrid prosthesis. These are very complex and time-consuming operations, and good results can be obtained only if appropriate strategies for myocardial, cerebral, and visceral protection are adopted...
February 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28174405/-thoracic-endovascular-aortic-repair-for-a-descending-thoracic-aneurysm-associated-with-pseudocoarctation-of-the-aorta-report-of-a-case
#7
Hiroaki Aida, Satoru Kagaya, Kazuo Abe
A 77-year-old man with a descending thoracic aneurysm associated with pseudocoarctation of the aorta underwent thoracic endovascular aortic repair (TEVAR). Computed tomography demonstrated kinking of the descending thoracic aorta. The aneurysm was located distal to a kinking and constricting aortic isthmus. TEVAR was performed because of the patient's comorbidity such as valvular heart diseases and postradiation status for the thoracic Hodgkin disease. TEVAR was successful but small aortic dissection was occurred distal to the stentgraft...
February 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28173744/glutathione-system-participation-in-thoracic-aneurysms-from-patients-with-marfan-syndrome
#8
Alejandra María Zúñiga-Muñoz, Israel Pérez-Torres, Verónica Guarner-Lans, Elías Núñez-Garrido, Rodrigo Velázquez Espejel, Claudia Huesca-Gómez, Ricardo Gamboa-Ávila, María Elena Soto
Aortic dilatation in Marfan syndrome (MFS) is progressive. It is associated with oxidative stress and endothelial dysfunction that contribute to the early acute dissection of the vessel and can result in rupture of the aorta and sudden death. We evaluated the participation of the glutathione (GSH) system, which could be involved in the mechanisms that promote the formation and progression of the aortic aneurysms in MFS patients. Patients and methods: Aortic aneurysm tissue was obtained during chest surgery from eight control subjects and 14 MFS patients...
February 8, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/28163941/novel-pathogenic-variant-in-tgfbr2-confirmed-by-molecular-modeling-is-a-rare-cause-of-loeys-dietz-syndrome
#9
Michael T Zimmermann, Raul A Urrutia, Patrick R Blackburn, Margot A Cousin, Nicole J Boczek, Eric W Klee, Colleen Macmurdo, Paldeep S Atwal
Loeys-Dietz syndrome (LDS) is a connective tissue disorder characterized by vascular findings of aneurysm and/or dissection of cerebral, thoracic, or abdominal arteries and skeletal findings. We report a case of a novel pathogenic variant in TGFBR2 and phenotype consistent with classic LDS. The proband was a 10-year-old presenting to the genetics clinic with an enlarged aortic root (Z-scores 5-6), pectus excavatum, and congenital contractures of the right 2nd and 3rd digit. Molecular testing of TGFBR2 was sent to a commercial laboratory and demonstrated a novel, likely pathogenic, variant in exon 4, c...
2017: Case Reports in Genetics
https://www.readbyqxmd.com/read/28161919/cysts-of-the-iris-pigment-epithelium-what-is-new-and-interesting-the-2016-jose-rizal-international-medal-lecture
#10
REVIEW
Jerry A Shields, Carol L Shields
PURPOSE: Cysts of the iris pigment epithelium (IPE) can involve the pupillary margin, midzone, or peripheral location or can be free-floating in the aqueous or vitreous or lodged in the anterior chamber angle. Avariant of IPE cyst, known as iris flocculi, can be a marker for systemic thoracic aneurysm. DESIGN: Review of IPE cysts and description of new observations of the lesions. METHODS: Review of IPE cysts. RESULTS: Lesions in 672 eyes were classified as of the pupillary margin (n = 49; 7%), midzone (n = 188; 28%), peripheral (n = 424; 63%), or dislodged/free-floating (n = 11; 2%)...
January 2017: Asia-Pacific Journal of Ophthalmology
https://www.readbyqxmd.com/read/28158996/igg4-positive-cell-infiltration-in-various-cardiovascular-disorders-results-from-histopathological-analysis-of-surgical-samples
#11
Ryoto Hourai, Satomi Kasashima, Koichi Sohmiya, Yohei Yamauchi, Hideki Ozawa, Yoshinobu Hirose, Yasuhiro Ogino, Takahiro Katsumata, Masahiro Daimon, Shu-Ichi Fujita, Masaaki Hoshiga, Nobukazu Ishizaka
BACKGROUND: The diagnosis of Immunoglobulin G4 (IgG4)-related disease (IgG4-RD), in general, depends on serum IgG4 concentrations and histopathological findings; therefore, diagnosis of IgG4-RD in cardiovascular organs/tissues is often difficult owing to the risk of tissue sampling. METHODS: Prevalence of IgG4-positive lymphoplasmacytic infiltration in 103 consecutive cardiovascular surgical samples from 98 patients with various cardiovascular diseases was analyzed immunohistochemically...
February 3, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28153878/nlrp3-nucleotide-oligomerization-domain-like-receptor-family-pyrin-domain-containing-3-caspase-1-inflammasome-degrades-contractile-proteins-implications-for-aortic-biomechanical-dysfunction-and-aneurysm-and-dissection-formation
#12
Darrell Wu, Pingping Ren, Yanqiu Zheng, Lin Zhang, Gaiping Xu, Wanmu Xie, Eric E Lloyd, Sui Zhang, Qianzi Zhang, John A Curci, Joseph S Coselli, Dianna M Milewicz, Ying H Shen, Scott A LeMaire
OBJECTIVE: Increasing evidence suggests that contractile dysfunction in smooth muscle cells (SMCs) plays a critical role in aortic biomechanical dysfunction and aortic aneurysm and dissection (AAD) development. However, the mechanisms underlying SMC contractile dysfunction in sporadic AAD are poorly understood. In this study, we examined the role of the NLRP3 (nucleotide oligomerization domain-like receptor family, pyrin domain containing 3)-caspase-1 inflammasome, a key inflammatory cascade, in SMC contractile dysfunction in AAD...
February 2, 2017: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/28134482/modelling-of-aortic-aneurysm-and-aortic-dissection-through-3d-printing
#13
Daniel Ho, Andrew Squelch, Zhonghua Sun
INTRODUCTION: The aim of this study was to assess if the complex anatomy of aortic aneurysm and aortic dissection can be accurately reproduced from a contrast-enhanced computed tomography (CT) scan into a three-dimensional (3D) printed model. METHODS: Contrast-enhanced cardiac CT scans from two patients were post-processed and produced as 3D printed thoracic aorta models of aortic aneurysm and aortic dissection. The transverse diameter was measured at five anatomical landmarks for both models, compared across three stages: the original contrast-enhanced CT images, the stereolithography (STL) format computerised model prepared for 3D printing and the contrast-enhanced CT of the 3D printed model...
January 30, 2017: Journal of Medical Radiation Sciences
https://www.readbyqxmd.com/read/28115748/acute-aorta-overview-of-acute-ct-findings-and-endovascular-treatment-options
#14
Marie Cerna, Martin Kocher, Rohit Philip Thomas
Acute aortic pathologies include acute aortic syndrome (aortic dissection, intramural hematoma, penetrating aortic ulcer), impending rupture, aortic aneurysm rupture and aortic trauma. Acute aortic syndrome, aortic aneurysm rupture and aortic trauma are life-threatening conditions requiring prompt diagnosis and treatment. The basic imaging modality for "acute aorta" is CT angiography with typical findings for these aortic pathologies. Based on the CT, it is possible to classify aortic diseases and anatomical classifications are essential for the planning of treatment...
January 2, 2017: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
https://www.readbyqxmd.com/read/28112018/reversed-frozen-elephant-trunk-technique-to-treat-a-type-ii-thoracoabdominal-aortic-aneurysm
#15
E Sebastian Debus, Tilo Kölbel, Sabine Wipper, Holger Diener, Beate Reiter, Christian Detter, Nikolaos Tsilimparis
PURPOSE: To describe a hybrid technique of reversed frozen elephant trunk to treat thoracoabdominal aortic aneurysms (TAAA) through an abdominal only approach. TECHNIQUE: The technique is demonstrated in a 29-year-old Marfan patient with a chronic type B aortic dissection previously treated with a thoracic stent-graft who presented with a thoracoabdominal false lumen aneurysm. Through an open distal retroperitoneal approach to the abdominal aorta, a frozen elephant trunk graft was implanted over a super-stiff wire upside down with the stent-graft component in the thoracic aorta...
November 1, 2016: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28102102/impact-of-thoracic-endovascular-aortic-repair-on-pulsatile-circumferential-and-longitudinal-strain-in-patients-with-aneurysm
#16
Foeke J H Nauta, Guido H W van Bogerijen, Chiara Trentin, Michele Conti, Ferdinando Auricchio, Frans L Moll, Joost A van Herwaarden, Santi Trimarchi
PURPOSE: To quantify both pulsatile longitudinal and circumferential aortic strains before and after thoracic endovascular aortic repair (TEVAR), potentially clarifying TEVAR-related complications. METHODS: This retrospective study assessed the impact of TEVAR on pulsatile aortic strains through custom developed software and cardiac-gated computed tomography imaging of 8 thoracic aneurysm patients (mean age 71.0±8.2 years; 6 men) performed before TEVAR and during follow-up (median 0...
January 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28099082/therapeutics-targeting-drivers-of-thoracic-aortic-aneurysms-and-acute-aortic-dissections-insights-from-predisposing-genes-and-mouse-models
#17
Dianna M Milewicz, Siddharth K Prakash, Francesco Ramirez
Thoracic aortic diseases, including aneurysms and dissections of the thoracic aorta, are a major cause of morbidity and mortality. Risk factors for thoracic aortic disease include increased hemodynamic forces on the ascending aorta, typically due to poorly controlled hypertension, and heritable genetic variants. The altered genes predisposing to thoracic aortic disease either disrupt smooth muscle cell (SMC) contraction or adherence to an impaired extracellular matrix, or decrease canonical transforming growth factor beta (TGF-β) signaling...
January 14, 2017: Annual Review of Medicine
https://www.readbyqxmd.com/read/28097184/kif6-719arg-genetic-variant-and-risk-for-thoracic-aortic-dissection
#18
Olga A Iakoubova, Carmen H Tong, Joseph Catanese, Charles M Rowland, May M Luke, Maryann Tranquilli, John A Elefteriades
BACKGROUND: Carriers of the 719Arg variant in KIF6, compared with noncarriers, have been reported to be at greater risk for coronary heart disease (CHD) in six prospective studies. Because CHD, thoracic aortic dissection, and nondissection thoracic aortic aneurysm share some risk factors and aspects of pathophysiology, we investigated whether carriers of the 719Arg variant also have greater odds of thoracic aortic dissection or nondissected thoracic aortic aneurysm than noncarriers. METHODS: We genotyped 140 thoracic aortic dissection cases, 497 nondissection thoracic aortic aneurysm cases, and 275 disease-free controls collected in the United States, Hungary, and Greece and investigated the association between KIF6 719Arg carrier status and thoracic aortic dissection, and between KIF6 719Arg carrier status and nondissection thoracic aortic aneurysm, using logistic regression models adjusted for age, sex, hypertension, smoking, and country...
June 2016: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/28095402/a-general-shear-dependent-model-for-thrombus-formation
#19
Alireza Yazdani, He Li, Jay D Humphrey, George Em Karniadakis
Modeling the transport, activation, and adhesion of platelets is crucial in predicting thrombus formation and growth following a thrombotic event in normal or pathological conditions. We propose a shear-dependent platelet adhesive model based on the Morse potential that is calibrated by existing in vivo and in vitro experimental data and can be used over a wide range of flow shear rates ([Formula: see text]). We introduce an Eulerian-Lagrangian model where hemodynamics is solved on a fixed Eulerian grid, while platelets are tracked using a Lagrangian framework...
January 2017: PLoS Computational Biology
https://www.readbyqxmd.com/read/28094152/use-of-3d-printer-technology-to-facilitate-surgical-correction-of-a-complex-vascular-anomaly-with-esophageal-entrapment-in-a-dog
#20
A Dundie, G Hayes, P Scrivani, L Campoy, D Fletcher, K Ash, E Oxford, N S Moïse
A 10 week old female intact Staffordshire terrier was presented with a total of five congenital cardio-thoracic vascular anomalies consisting of a patent ductus arteriosus (PDA) with an aneurysmic dilation, pulmonic stenosis, persistent right aortic arch, aberrant left subclavian artery and persistent left cranial vena cava. These abnormalities were identified with a combination of echocardiogram and computed tomography angiography (CTA). The abnormalities were associated with esophageal entrapment, regurgitation, and volume overload of the left heart with left atrial and ventricular enlargement...
January 13, 2017: Journal of Veterinary Cardiology: the Official Journal of the European Society of Veterinary Cardiology
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