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JOURNAL ARTICLE
Ian O Cook, Susan Y Green, Kimberly R Rebello, Qianzi Zhang, Veronica A Glover, Rodrigo Zea-Vera, Marc R Moon, Scott A LeMaire, Joseph S Coselli
OBJECTIVE: Aortic dissection is common in patients undergoing open surgical repair of thoracoabdominal aortic aneurysm (TAAA). Most often, dissection is chronic and is associated with progressive aortic dilatation. Because contemporary outcomes in chronic dissection are not clearly understood, we compared patient characteristics and outcomes after open TAAA repair between patients with chronic dissection and those with non-dissection aneurysm. METHODS: We retrospectively analyzed data from 3470 open TAAA repairs performed in a single practice...
March 25, 2024: Journal of Vascular Surgery
#22
JOURNAL ARTICLE
Emelie Carlestål, Anders Franco-Cereceda, Christian Olsson
Objectives. This study describes growth, local and remote aortic events, and survival in patients with proximal (root, ascending) aortic diameters just below threshold for operation. Methods. Patients with proximal aortic diameter of 4.5 to 5.4 cm at baseline, were followed with serial computed tomography studies and data collected retrospectively. Aortic growth rate was estimated using mixed effects modelling. Clinical and radiological features associated with outcomes (all-cause death, aortic death, local or remote aortic events (dissection, rupture, intramural hematoma, or intervention)) were assessed with Cox analysis...
December 2024: Scandinavian Cardiovascular Journal: SCJ
#23
JOURNAL ARTICLE
Ji Lin, Wei Liu, Cheng-Wei Yang, Kaitao Jian, Yu Xia, Hao Peng, Bin You, Li-Zhong Sun
OBJECTIVE: To evaluate the early and mid-term outcomes of open repair in patients with thoracoabdominal aortic aneurysm (TAAA) after thoracic endovascular aortic repair (TEVAR). METHODS: This was a retrospective single center study. Data were retrospectively collected and analyzed for consecutive patients undergoing open TAAA repair (TAAAR) after TEVAR from November 2016 to June 2021. Indications for TAAAR included aneurysm progression due to endoleak, persisted false lumen perfusion, proximal/distal disease progression, and aorta rupture...
March 26, 2024: BMC Cardiovascular Disorders
#24
JOURNAL ARTICLE
Josephina A N Meester, Anne Hebert, Maaike Bastiaansen, Laura Rabaut, Jarl Bastianen, Nele Boeckx, Kathryn Ashcroft, Paldeep S Atwal, Antoine Benichou, Clarisse Billon, Jan D Blankensteijn, Paul Brennan, Stephanie A Bucks, Ian M Campbell, Solène Conrad, Stephanie L Curtis, Majed Dasouki, Carolyn L Dent, James Eden, Himanshu Goel, Verity Hartill, Arjan C Houweling, Bertrand Isidor, Nicola Jackson, Pieter Koopman, Anita Korpioja, Minna Kraatari-Tiri, Liina Kuulavainen, Kelvin Lee, Karen J Low, Alan C Lu, Morgan L McManus, Stephen P Oakley, James Oliver, Nicole M Organ, Eline Overwater, Nicole Revencu, Alison H Trainer, Bhavya Trivedi, Claire L S Turner, Rebecca Whittington, Andreas Zankl, Dominica Zentner, Lut Van Laer, Aline Verstraeten, Bart L Loeys
Pathogenic loss-of-function variants in BGN, an X-linked gene encoding biglycan, are associated with Meester-Loeys syndrome (MRLS), a thoracic aortic aneurysm/dissection syndrome. Since the initial publication of five probands in 2017, we have considerably expanded our MRLS cohort to a total of 18 probands (16 males and 2 females). Segregation analyses identified 36 additional BGN variant-harboring family members (9 males and 27 females). The identified BGN variants were shown to lead to loss-of-function by cDNA and Western Blot analyses of skin fibroblasts or were strongly predicted to lead to loss-of-function based on the nature of the variant...
March 26, 2024: NPJ Genomic Medicine
#25
JOURNAL ARTICLE
Marc R Moon, Puja Kachroo
No abstract text is available yet for this article.
March 21, 2024: Texas Heart Institute Journal
#26
JOURNAL ARTICLE
Robert T Kay, Pishoy Gouda, Robert C Welsh
INTRODUCTION: Loeys-Dietz syndrome (LDS) is a heritable disease that is the result of dysregulation of the transforming growth factor beta (TGFβ) pathway. The pathogenic variants associated with the condition are linked to aortic aneurysms and dissections along with other cardiovascular and non-cardiovascular abnormalities. LDS type III is associated with pathogenic variants in the SMAD3 gene responsible for signally in the TGFβ pathway. Most of the current knowledge of LDS stems from studies of LDS I and II patient with limited data on large cohorts of LDS III patients...
March 18, 2024: International Journal of Cardiology
#27
REVIEW
Hiroshi Banno, Changi Lee, Shuta Ikeda, Yohei Kawai, Masayuki Sugimoto, Kiyoaki Niimi
We previously reported that spinal cord injury following thoracic endovascular aortic repair for a thoracic aortic aneurysm is a micro embolism caused by a vulnerable mural thrombus. Conversely, patients who underwent thoracic endovascular aortic repair for aortic dissection develop spinal cord injury less frequently due to fewer mural thrombi. Paying attention to preserving blood flow toward the spinal cord, namely collateral circulation and steal phenomenon, prevents spinal cord injury following thoracic endovascular aortic repair for aortic dissection...
February 2024: Nagoya Journal of Medical Science
#28
JOURNAL ARTICLE
Cristina Calderan, Ugo Sorrentino, Luca Persano, Eva Trevisson, Geppo Sartori, Leonardo Salviati, Maria Andrea Desbats
The ACTA2 gene codes for alpha-smooth muscle actin, a critical component of the contractile apparatus of the vascular smooth muscle cells. Autosomal dominant variants in the ACTA2 gene have been associated to familial non-syndromic thoracic aortic aneurysm/dissection (TAAD). They are thought to act through a dominant-negative mechanism. These variants display incomplete penetrance and variable expressivity, complicating the validation of ACTA2 variants pathogenicity by family segregation studies. In this study, we developed a yeast based assay to test putative TAAD-associated ACTA2 variants...
March 15, 2024: European Journal of Human Genetics: EJHG
#29
REVIEW
Alexander C Mills, Harleen K Sandhu, Yuki Ikeno, Akiko Tanaka
Heritable thoracic aortic disease puts patients at risk for aortic aneurysms, rupture, and dissections. The diagnosis and management of this heterogenous patient population continues to evolve. Last year, the American Heart Association/American College of Cardiology Joint Committee published diagnosis and management guidelines for aortic disease, which included those with genetic aortopathies. Additionally, evolving research studying the implications of underlying genetic aberrations with new genetic testing continues to become available...
March 14, 2024: General Thoracic and Cardiovascular Surgery
#30
JOURNAL ARTICLE
Shishan Xue, Shuai Leng, Fengquan Zhang, Zhiqiao Dang, Guohai Su, Wenqian Yu
Thoracic aortic aneurysms (TAAs) are a major cause of death owing to weaker blood vessel walls and higher rupture rates in affected individuals. Vascular smooth muscle cells (VSMCs) are the predominant cell type within the aortic wall and their dysregulation may contribute to TAA progression. Enhancer of zeste homolog 2 (EZH2), a histone methyltransferase, is involved in several pathological processes; however, the biological functions and mechanisms underlying VSMC phenotype transition and vascular intimal hyperplasia remain unclear...
April 2024: Experimental and Therapeutic Medicine
#31
Takeo Yuno, Yusuke Nakade, Kenji Iino, Takumi Taniguchi, Hiroyasu Oe
Intraoperative motor-evoked potentials (MEPs) are measured for assessing motor function during surgery. MEP monitoring is often performed in thoracoabdominal aortic aneurysm (TAAA) surgery, but false positives are common and amplification methods are needed to obtain waveforms under severe conditions to assess proper spinal cord function. One method of amplitude amplification in transcranial-stimulated MEP monitoring is multitrain stimulation. There are few reports on multitrain-stimulated MEP monitoring for this surgery...
February 2024: Curēus
#32
JOURNAL ARTICLE
Zhiqiao Dang, Haijie Li, Shishan Xue, Baowei Shao, Yansong Ning, Guohai Su, Fengquan Zhang, Wenqian Yu, Shuai Leng
Aortic aneurysm/dissection (AAD) is a serious cardiovascular condition characterized by rapid onset and high mortality rates. Currently, no effective drug treatment options are known for AAD. AAD pathogenesis is associated with the phenotypic transformation and abnormal proliferation of vascular smooth muscle cells (VSMCs). However, endogenous factors that contribute to AAD progression remain unclear. We aimed to investigate the role of histone deacetylase 9 (HDAC9) in AAD pathogenesis. HDAC9 expression was considerably increased in human thoracic aortic dissection specimens...
March 8, 2024: Biomedicine & Pharmacotherapy
#33
JOURNAL ARTICLE
Shuichi Okada, Masahiko Ezure, Yutaka Hasegawa, Yasuyuki Yamada, Joji Hoshino, Hiroyuki Morishita, Masahiro Seki, Kazuki Tamura, Takashi Soda
A 75-year-old woman was diagnosed with type B acute aortic dissection 14 years ago and 3-channeled aortic dissection 7 years ago. She received total arch replacement 6 years ago and descending aortic replacement with double barrel anastomosis technique for distal anastomosis 5 years ago. Computed tomography( CT) revealed giant thyroid tumor and thoracoabdominal aortic aneurysm( 58 mm in diameter). She suffered from back pain during her follow-up period. CT revealed ruptured thoracoabdominal aortic aneurysm...
February 2024: Kyobu Geka. the Japanese Journal of Thoracic Surgery
#34
JOURNAL ARTICLE
Petroula Nana, Giuseppe Panuccio, Fiona Rohlffs, Jose I Torrealba, Nikolaos Tsilimparis, Tilo Kölbel
BACKGROUND: Fenestrated and branched endovascular aortic repair (F/BEVAR) of thoracoabdominal aortic aneurysms (TAAAs) has shown high technical success and low early mortality rates. Aneurysm extent has been reported as a factor affecting outcomes. This study aimed to assess the early and midterm follow-up outcomes of patients managed by F/BEVAR for types I through III TAAAs. METHODS: A single-center retrospective analysis was conducted, including data from consecutive, elective and urgent (symptomatic and ruptured cases), patients treated for types I through III TAAAs, between October 1, 2011, and October 1, 2022, using F/BEVAR...
March 2024: Journal of Vascular Surgery
#35
REVIEW
Aminder A Singh, Deeti K Shetty, Aishwarya G Jacob, Semih Bayraktar, Sanjay Sinha
Thoracic aortic disease (TAD) is often silent until a life-threatening complication occurs. However, genetic information can inform both identification and treatment at an early stage. Indeed, a diagnosis is important for personalised surveillance and intervention plans, as well as cascade screening of family members. Currently, only 20% of heritable TAD patients have a causative mutation identified and, consequently, further advances in genetic coverage are required to define the remaining molecular landscape...
2024: Frontiers in Cardiovascular Medicine
#36
JOURNAL ARTICLE
Siavash Zamirpour, Yue Xuan, Zhongjie Wang, Axel Gomez, Joseph R Leach, Dimitrios Mitsouras, David A Saloner, Julius M Guccione, Liang Ge, Elaine E Tseng
OBJECTIVES: Current diameter-based guidelines for ascending thoracic aortic aneurysms (aTAA) do not consistently predict risk of dissection/rupture. ATAA wall stresses may enhance risk stratification independent of diameter. The relation of wall stresses and diameter indexed to height and body surface area (BSA) is unknown. Our objective was to compare aTAA wall stresses with indexed diameters in relation to all-cause mortality at 3.75 years follow-up. METHODS: Finite element analyses were performed in a veteran population with aortas ≥ 4...
April 2024: IJC Heart & Vasculature
#37
JOURNAL ARTICLE
Matti Jubouri, Fatima Kayali, Tiffany Agbobu, Owais Tahhan, Thurkga Moothathamby, Eyad R Abdulwahab, Bashi Velayudhan, Idhrees Mohammed, Mohamad Bashir
INTRODUCTION: With the incidence of thoracic aortic disease on the rise, total arch replacement (TAR) with frozen elephant trunk (FET) remains the gold-standard management strategy due to optimal results. Several FET devices exist commercially on the global market. However, the mainstay and most commonly used and reported device is the Thoraflex Hybrid Prosthesis (THP), with several recent reports suggesting its superiority. AREAS COVERED: This review aims to collate and summarize the evidence in the literature on the clinical outcomes of TAR with FET using THP, with a focus on mortality, neurological complications, endoleak, distal stent-induced new entry (dSINE), aortic remodeling, coagulopathy and graft kinking...
March 2, 2024: Expert Review of Medical Devices
#38
JOURNAL ARTICLE
Maria Nucera, Maximilian Kreibich, Murat Yildiz, Tim Berger, Rosa Klara Kolb, Stoyan Kondov, Sophie Kunzmann, Bartosz Rylski, Vladimir Makaloski, Matthias Siepe, Martin Czerny, Florian S Schoenhoff
OBJECTIVES: The aim of this study was to report on mid-term outcomes after endovascular aortic repair in patients with Marfan (MFS) or Loeys-Dietz (LDS) syndrome. METHODS: We analyzed data from two European centers of patients with MFS and LDS undergoing endovascular aortic repair. Patients were analyzed based on (1) timing of the procedure (planned vs emergency procedure) and (2) the nature of the landing zone (safe vs non-safe). The primary end-point was freedom from reintervention...
March 2, 2024: European Journal of Cardio-thoracic Surgery
#39
JOURNAL ARTICLE
Christian Doppler, Marlene Rezk, Barbara Arbeithuber, David Bernhard
BACKGROUND: Thoracic aortic dissections (TAD) are life-threatening events mostly requiring immediate surgical treatment. Although dissections mainly occur independently of thoracic aortic aneurysms (TAA), both share a high comorbidity. There are several indications for an involvement of the immune system in the development of TAD, just as in TAA. Nevertheless, specific disease-relevant genes, biomolecular processes, and immune-specific phenotypes remain unknown. METHODS: RNA from isolated aortic smooth muscle cells from TAD (n = 4), TAA (n = 3), and control patients were analyzed using microarray-based technologies...
February 6, 2024: Frontiers in Bioscience (Landmark Edition)
#40
JOURNAL ARTICLE
Irbaz Hameed, Adham Ahmed, Stevan Pupovac, Naiem Nassiri, Roland Assi, Prashanth Vallabhajosyula
OBJECTIVE: For high-risk patients with aortic arch pathology, hybrid aortic arch repair with simultaneous or staged thoracic endovascular repair of the descending aorta may be a viable alternative to open repair. However, data on postintervention aortic remodeling remain limited. We report the short-term outcomes of remodeling of the thoracoabdominal aorta after hybrid arch repair + thoracic endovascular repair. METHODS: All patients undergoing hybrid arch repair with planned zones 0 to 5 thoracic endovascular repair from January 2020 to March 2022 were retrospectively reviewed...
February 2024: JTCVS open
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