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Thoracic aortic aneurysms and dissection

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https://www.readbyqxmd.com/read/28935963/differentially-expressed-genes-and-canonical-pathways-in-the-ascending-thoracic-aortic-aneurysm-the-tampere-vascular-study
#1
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
#2
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
#3
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
https://www.readbyqxmd.com/read/28912006/predictors-of-late-aortic-intervention-in-patients-with-medically-treated-type-b-aortic-dissection
#4
Samuel I Schwartz, Christopher Durham, W Darrin Clouse, Virendra I Patel, R Todd Lancaster, Richard P Cambria, Mark F Conrad
BACKGROUND: Patients with medically managed type B aortic dissection (TBAD) have a high incidence of aorta-related complications over time. Whereas early thoracic endovascular aortic repair (TEVAR) to seal the entry tear can promote aortic remodeling and prevent late aneurysm formation, there are sparse data as to which patients will benefit from such therapy. The goal of this study was to identify clinical and anatomic factors that are associated with the need for subsequent aortic intervention in patients who present with uncomplicated TBAD...
September 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28910688/aortic-fibromuscular-dysplasia-complicated-by-dissection-a-case-report-and-review-of-literature
#5
Takashi Tasaki, Kazuhito Hatanaka, Mari Kirishima, Shun Ohnishi, Yuko Goto, Ikumi Kitazono, Tsubasa Hiraki, Sohsuke Yamada, Michiyo Higashi, Akihide Tanimoto
Fibromuscular dysplasia (FMD) is an idiopathic, segmental, nonatherosclerotic, non-inflammatory vascular disease, which is often complicated by the occurrence of dissection. Although it is known to occur in all arteries, aortic involvement is relatively rare. To date, 33 cases of aortic FMD have been reported in available English literature, among which only three cases have been complicated by the occurrence of dissection. We describe the case of a 40-year-old woman diagnosed with aortic FMD complicated by the occurrence of a type A aortic dissection...
August 9, 2017: Cardiovascular Pathology: the Official Journal of the Society for Cardiovascular Pathology
https://www.readbyqxmd.com/read/28902661/giant-thoracoabdominal-aortic-aneurysm
#6
Luca Di Marco, Domenico Attinà, Davide Pacini
: Aneurysms of the descending thoracic and thoracoabdominal aorta are life-threatening conditions. All aneurysms which have not yet had an indication for the treatment need regular follow-up to prevent rupture or dissection. We present a case of a patient with a giant aneurysm of the thoracoabdominal aorta who was denied both surgery and endovascular treatment.
September 11, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28901506/whole-exome-sequencing-identifies-fbn1-mutations-in-two-patients-with-early%C3%A2-onset-type-b-aortic-dissection
#7
Qian Han, Wenwen Zhang, Changjian Liu, Min Zhou, Feng Ran, Long Yi, Xitai Sun, Zhao Liu
The etiology of thoracic aortic aneurysm and dissection (TAAD) is complex and heterogeneous. Emerging evidence has demonstrated that genetic causes may be a consideration in early‑onset TAAD. Owing to overlapping clinical phenotypes and the genetic heterogeneity of TAAD, it is challenging for clinicians to make a molecular diagnosis of TAAD, particularly in those who present with non‑specific syndromic features. In order to identify the causative mutation in two young patients with acute type B aortic dissection without syndromic features, whole exome sequencing (WES) was performed in the present study...
August 31, 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/28898997/angiotensin-ii-infusion-into-apoe-mice-a-model-for-aortic-dissection-rather-than-abdominal-aortic-aneurysm
#8
Bram Trachet, Lydia Aslanidou, Alessandra Piersigilli, Rodrigo A Fraga-Silva, Jessica Sordet-Dessimoz, Pablo Villanueva-Perez, Marco F M Stampanoni, Nikolaos Stergiopulos, Patrick Segers
Aims: Angiotensin II-infused ApoE-/- mice are a popular mouse model for preclinical aneurysm research. Here, we provide insight in the often-reported but seldom-explained variability in shape of dissecting aneurysms in these mice. Methods and results: N = 45 excised aortas were scanned ex vivo with phase-contrast X-ray tomographic microscopy. Micro-ruptures were detected near the ostium of celiac and mesenteric arteries in 8/11 mice that were sacrificed after 3 days of angiotensin II-infusion...
August 1, 2017: Cardiovascular Research
https://www.readbyqxmd.com/read/28887263/changes-in-geometry-and-cardiac-deformation-of-the-thoracic-aorta-after-thoracic-endovascular-aortic-repair-tevar
#9
Kelsey Hirotsu, Ga-Young Suh, Jason T Lee, Michael D Dake, Dominik Fleischmann, Christopher P Cheng
BACKGROUND: TEVAR has dramatically expanded treatment options for patients with thoracic aortic pathology. The interaction between endografts and the dynamic anatomy of the thoracic aorta is not well characterized for repetitive physiologic stressors and subsequent issues related to long-term durability. Through 3D modeling we sought to quantify cardiac-induced aortic deformation before and after TEVAR to assess the impact of endografts on dynamic aortic anatomy. METHODS: Eight patients with acute (n = 4) or chronic (n = 3) Type B dissections, or chronic arch aneurysm (n = 1), underwent TEVAR with a single (n = 5) or multiple (n = 3) Gore C-TAG(s)...
September 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28883797/genetic-bases-of-bicuspid-aortic-valve-the-contribution-of-traditional-and-high-throughput-sequencing-approaches-on-research-and-diagnosis
#10
REVIEW
Betti Giusti, Elena Sticchi, Rosina De Cario, Alberto Magi, Stefano Nistri, Guglielmina Pepe
Bicuspid aortic valve (BAV) is a common (0.5-2.0% of general population) congenital heart defect with increased prevalence of aortic dilatation and dissection. BAV has an autosomal dominant inheritance with reduced penetrance and variable expressivity. BAV has been described as an isolated trait or associated with syndromic conditions [e.g., Marfan Marfan syndrome or Loeys-Dietz syndrome (MFS, LDS)]. Identification of a syndromic condition in a BAV patient is clinically relevant to personalize aortic surgery indication...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28875285/current-status-of-cardiovascular-surgery-in-japan-2013-and-2014-a-report-based-on-the-japan-cardiovascular-surgery-database-5-thoracic-aortic-surgery
#11
REVIEW
Hideyuki Shimizu, Norimichi Hirahara, Noboru Motomura, Hiroaki Miyata, Shinichi Takamoto
BACKGROUND: Although open aortic repair (OAR) is still considered to be a standard treatment for thoracic aortic diseases, the indications for thoracic endovascular treatment (TEVAR)/hybrid aortic repair (HAR) have expanded in recent years. The purpose of this study was to review the current status of treatment of thoracic aortic diseases in Japan. METHODS: Data for 2013 and 2014 concerning surgery for diseases of the thoracic/thoracoabdominal aorta were extracted from the Japan Cardiovascular Surgery Database (JCVSD)...
September 5, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28868315/impact-of-thoracic-endovascular-repair-on-pulsatile-aortic-strain-in-acute-type-b-aortic-dissection-preliminary-results
#12
Foeke J H Nauta, Guido H W van Bogerijen, Michele Conti, Chiara Trentin, Frans L Moll, Joost A Van Herwaarden, Ferdinando Auricchio, Santi Trimarchi
BACKGROUND: The impact of thoracic endovascular aortic repair (TEVAR) on pulsatile aortic strain remains undetermined in patients with Type B aortic dissection (TBAD). Therefore, we quantified pulsatile aortic strain in TBAD patients and control subjects. METHODS: We retrospectively analyzed two TBAD patients from our database with cardiac-gated computed tomography angiography imaging available before and after TEVAR and two control subjects (67- and 76-year-old males)...
April 2017: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/28868310/genes-associated-with-thoracic-aortic-aneurysm-and-dissection-an-update-and-clinical-implications
#13
REVIEW
Adam J Brownstein, Bulat A Ziganshin, Helena Kuivaniemi, Simon C Body, Allen E Bale, John A Elefteriades
Thoracic aortic aneurysm (TAA) is a lethal disease, with a natural history of enlarging progressively until dissection or rupture occurs. Since the discovery almost 20 years ago that ascending TAAs are highly familial, our understanding of the genetics of thoracic aortic aneurysm and dissection (TAAD) has increased exponentially. At least 29 genes have been shown to be associated with the development of TAAD, the majority of which encode proteins involved in the extracellular matrix, smooth muscle cell contraction or metabolism, or the transforming growth factor-β signaling pathway...
February 2017: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/28867380/homemade-fenestrated-stent-graft-for-thoracic-endovascular-aortic-repair-of-zone-2-aortic-lesions
#14
Ludovic Canaud, Kiyofumi Morishita, Thomas Gandet, Julien Sfeir, Sebastien Bommart, Pierre Alric, Marcello Mandelli
OBJECTIVE: The aim of this retrospective analysis was to evaluate the outcomes of homemade fenestrated stent-grafts for thoracic endovascular aortic repair of zone 2 aortic lesions. METHODS: From November 2013 to January 2017, 24 patients underwent thoracic endovascular aortic repair with left subclavian artery revascularization using a homemade fenestrated stent-graft to preserve the patency of the left subclavian artery. Elective cases accounted for 54% (n = 13) of the sample...
August 5, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28855619/identification-of-novel-clinically-relevant-variants-in-70-southern-chinese-patients-with-thoracic-aortic-aneurysm-and-dissection-by-next-generation-sequencing
#15
Miaoxian Fang, Changjiang Yu, Siyao Chen, Weiping Xiong, Xin Li, Rong Zeng, Jian Zhuang, Ruixin Fan
Thoracic Aortic Aneurysm and Dissection (TAAD) is a life-threatening pathology and remains challenging worldwide. Up to 40% of TAAD are hereditary with complex heterogeneous genetic backgrounds. Recently, next-generation sequencing (NGS) has been successfully applied to identify genetic variants in an efficient and cost-effective manner. In our study, NGS coupled with DNA target-capture array was used to screen 11 known causative genes of TAAD in 70 patients from Southern China. All the identified variants were confirmed by Sanger sequencing...
August 30, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28845874/-the-frozen-elephant-trunk-technique-for-the-treatment-of-complex-lesions-of-the-thoracic-aorta
#16
Luca Di Marco, Davide Pacini, Alessandro Leone, Antonio Pantaleo, Giacomo Murana, Roberto Di Bartolomeo
The treatment of patients with extensive disease of the thoracic aorta represents a formidable challenge for the cardiovascular surgeon. The beginning of thoracic aortic endovascular aortic arch repair has promoted the development of different hybrid approaches as the frozen elephant trunk (FET) strategy, which includes classic arch replacement and antegrade stenting of the descending thoracic aorta. It represents an interesting approach for patients with extensive disease of the thoracic aorta, and its application has significantly increased over recent years...
September 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28844469/a-systematic-review-of-primary-endovascular-repair-of-the-ascending-aorta
#17
REVIEW
Corbin E Muetterties, Rohan Menon, Grayson H Wheatley
OBJECTIVE: Endovascular repair of the ascending aorta is currently limited to patients at high surgical risk with aortic diseases originating above the sinotubular junction. A number of different endovascular technologies and approaches have been used, although no consensus exists regarding a standardized technique. To better understand real-world endovascular approaches to the ascending aorta, we performed a comprehensive review of the types of endovascular aortic stents and associated vascular access used in repair of the ascending aorta...
August 22, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28833419/multislice-spiral-ct-angiography-for-evaluation-of-acute-aortic-syndrome
#18
De-Li Zhao, Xin-Ding Liu, Cheng-Lei Zhao, Hai-Ting Zhou, Guo-Kun Wang, Hong-Wei Liang, Jin-Ling Zhang
OBJECTIVE: To discuss the diagnostic value of multislice CT angiography (MSCTA) in acute aortic syndrome (AAS). MATERIALS AND METHODS: The clinical and imaging data of 36 cases diagnosed as AAS by MSCTA were collected. The manifestations of the MSCTA images were reviewed retrospectively, and the average x-ray dose was calculated. RESULTS: Among 36 AAS cases, 16 cases had aortic dissection (AD), 8 cases had penetrating atherosclerotic ulcer (PAU), 7 cases had intramural hematoma (IMH), and 5 cases had unstable thoracic aneurysm (UTA)...
August 22, 2017: Echocardiography
https://www.readbyqxmd.com/read/28818667/endoconduits-with-pave-and-crack-technique-avoid-open-ilio-femoral-conduits-with-sustainable-mid-term-results
#19
G Asciutto, M Aronici, T Resch, B Sonesson, T Kristmundsson, N V Dias
OBJECTIVE/BACKGROUND: The objective was to evaluate the feasibility and mid-term outcomes of endoconduits (EC) with the "pave and crack" technique during endovascular aneurysm repair (EVAR) of varying complexity. METHODS: This was a retrospective study. All patients undergoing EC between July 2009 and October 2015 were included. The primary endpoint was technical success of the EC defined as the ability to successfully deliver the aortic stent graft through the EC without rupture, dissection, or thrombosis of the iliac or femoral arteries, and with the absence of haemodynamically significant blood loss related to the EC...
August 14, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28814170/a-novel-reverse-branch-technique-for-reconstruction-of-a-renal-artery-perfused-by-the-false-lumen-after-thoracic-endovascular-aortic-repair
#20
Jie Jin, Jun Bai, Yongfa Wu, Kangkang Zhi, Xiaomin Wang, Xingzhu Wen, Jianjin Wu, Lefeng Qu
PURPOSE: To describe an innovative endovascular technique that successfully reconstructs a renal artery completely perfused by the false lumen after thoracic endovascular aortic repair (TEVAR). CASE REPORT: A 65-year-old patient diagnosed with acute Stanford type B aortic dissection underwent successful TEVAR 4 years ago. Regular follow-up found that the thoracic aorta was well repaired, but the false lumen in the abdominal aorta had enlarged year by year. The left renal artery was supplied entirely by the false lumen, which caused kidney hypoperfusion...
August 1, 2017: Journal of Endovascular Therapy
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