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abdominal aortic dissection

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https://www.readbyqxmd.com/read/28209770/are-patients-with-loeys-dietz-syndrome-misdiagnosed-with-beals-syndrome
#1
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
#2
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/28186882/multi-modality-imaging-enables-detailed-hemodynamic-simulations-in-dissecting-aneurysms-in-mice
#3
Evan Phillips, Paolo Di Achille, Matthew Bersi, Jay Humphrey, Craig Goergen
A multi-modality imaging based modeling approach was used to study complex unsteady hemodynamics and lesion growth in a dissecting abdominal aortic aneurysm model. We combined in vivo ultrasound (geometry and flow) and in vitro optical coherence tomography (geometry) to obtain the high resolution needed to construct detailed hemodynamic simulations over large portions of the murine vasculature, which include fine geometric complexities. We illustrate this approach for a spectrum of dissecting abdominal aortic aneurysms induced in male apolipoprotein E-null mice by high-dose angiotensin II infusion...
February 6, 2017: IEEE Transactions on Medical Imaging
https://www.readbyqxmd.com/read/28185953/a-novel-smad3-mutation-caused-multiple-aneurysms-in-a-patient-without-osteoarthritis-symptoms
#4
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/28183174/the-petticoat-concept-for-endovascular-treatment-of-type-b-aortic-dissection
#5
Luca Bertoglio, Enrico Rinaldi, Germano Melissano, Roberto Chiesa
INTRODUCTION: A systematic literature search on outcomes of the PETTICOAT technique was aimed at verifying the feasibility and safety of the procedure, comparing clinical outcomes with standard stent-grafting of the proximal entry tear as well as describing the possible benefits in terms of aortic remodeling. EVIDENCE ACQUISITION: Potentially eligible papers were sought through a computerized search of MEDLINE and SCOPUS databases between January 2006 and June 2016...
February 9, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28165556/complicated-thoraco-abdominal-aortic-dissection-presenting-with-lower-limb-ischemia-in-a-patient-with-bovine-arch-and-arteria-lusoria
#6
G-R Joliat, C Dubuis, S Déglise
We report the case of a 58-year-old man who presented with thoraco-abdominal pain and right lower limb ischemia due to type B aortic dissection. Moreover, the patient was discovered to have several concomitant aortic arch anomalies (bovine arch, arteria lusoria, and left vertebral artery arising from the aortic arch). Taking into account this complex anatomy, emergent femoral exploration with fenestration and thrombectomy was performed. The blood flow to the right lower limb was restored. A few days later the aortic dissection spread proximally, and the aortic arch dilatation enlarged...
January 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28163941/novel-pathogenic-variant-in-tgfbr2-confirmed-by-molecular-modeling-is-a-rare-cause-of-loeys-dietz-syndrome
#7
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/28163208/anatomical-variations-of-the-renal-arteries-cadaveric-and-radiologic-study-review-of-the-literature-and-proposal-of-a-new-classification-of-clinical-interest
#8
Clara Cases, Laura García-Zoghby, Paula Manzorro, Francisco J Valderrama-Canales, Miguel Muñoz, María Vidal, Clara Simón, Jose R Sanudo, Stephen McHanwell, Juan Arrazola
PURPOSE: To analyse the variations of the renal arteries in two samples, cadaveric and computerized tomographic (CT) images, as well as to propose a simple classification of such variations based on the obtained results and an extensive review of the literature on the topic. MATERIAL AND METHODS: Sixty human dissected kidneys and their vessels, and 583 abdominal CT were studied. RESULTS: A total of 86 arteries were described in the cadaveric sample, whereas 1223 were analysed in the radiological one...
February 3, 2017: Annals of Anatomy, Anatomischer Anzeiger: Official Organ of the Anatomische Gesellschaft
https://www.readbyqxmd.com/read/28158996/igg4-positive-cell-infiltration-in-various-cardiovascular-disorders-results-from-histopathological-analysis-of-surgical-samples
#9
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
#10
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/28133328/-a-case-of-ovarian-cancer-with-lymph-node-metastasis-in-the-lesser-curvature-of-the-stomach-resected-using-laparoscopic-surgery
#11
Katsunao Tanaka, Moon Jeongho, Nobutaka Hatanaka, Masashi Inoue, Tatsuya Miyamoto, Megumi Yamaguchi, Shingo Seo, Toshihiro Misumi, Wataru Shimizu, Toshimitsu Irei, Takahisa Suzuki, Takashi Onoe, Takeshi Sudo, Yosuke Shimizu, Takao Hinoi, Hirotaka Tashiro
A 67-year-old woman, who was diagnosed with ovarian cancer with multiple metastases, underwent abdominal total hysterectomy, bilateral salpingo-oophorectomy, para-aortic lymph node dissection(b2), omental subtotal hysterectomy, and lower anterior rectal resection after receiving a combination of PTX plus CBDCA chemotherapy. Macroscopically, complete resection was achieved and histopathological examination of the resectedspecimen showedpoorly differentiatedserous adenocarcinoma. After surgery, additional chemotherapy was administered...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28133172/-a-case-of-stage-iv-gastric-cancer-successfully-treated-using-salvage-surgery-after-s-1-cddp-therapy
#12
Yuko Shimada, Tsutomu Hayashi, Keisuke Minamizawa, Taisuke Shibuya, Daiji Nemoto, Hideto Yokoi, Tomoko Wada, Takuo Watanabe, Ryo Takagawa, Hitoshi Murakami, Seiji Hasegawa, Tadao Fukushima, Hideyuki Ike, Yasushi Rino, Munetaka Masuda
A 75-year-old man admitted for left lateral abdominal pain was found to have advanced poorly differentiated gastric adenocarcinoma with abdominal para-aortic and Virchow's lymph node metastases, which was diagnosed to be clinical Stage IV (T3N3H0M1[LYM]). As curative surgery was not deemed possible, we started chemotherapy administration using S-1 (120mg/day)administered orally for 3 weeks and cisplatin(CDDP 100mg/body)administered intravenously on day 8. After 6 courses of chemotherapy, a CT scan showed that all lymph nodes metastases had disappeared, resulting in downstaging to clinical Stage II (T3[SE]N0H0P0M0)...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28125720/false-lumen-flow-patterns-and-their-relation-with-morphological-and-biomechanical-characteristics-of-chronic-aortic-dissections-computational-model-compared-with-magnetic-resonance-imaging-measurements
#13
Paula A Rudenick, Patrick Segers, Victor Pineda, Hug Cuellar, David García-Dorado, Arturo Evangelista, Bart H Bijnens
Aortic wall stiffness, tear size and location and the presence of abdominal side branches arising from the false lumen (FL) are key properties potentially involved in FL enlargement in chronic aortic dissections (ADs). We hypothesize that temporal variations on FL flow patterns, as measured in a cross-section by phase-contrast magnetic resonance imaging (PC-MRI), could be used to infer integrated information on these features. In 33 patients with chronic descending AD, instantaneous flow profiles were quantified in the FL at diaphragm level by PC-MRI...
2017: PloS One
https://www.readbyqxmd.com/read/28116473/factors-affecting-optimal-aortic-remodeling-after-thoracic-endovascular-aortic-repair-of-type-b-iiib-aortic-dissection
#14
I-Ming Chen, Po-Lin Chen, Chun-Yang Huang, Shih-Hsien Weng, Wei-Yuan Chen, Chun-Che Shih
PURPOSE: The purpose of this study was to determine factors associated with entire aortic remodeling after thoracic endovascular aortic repair (TEVAR) in patients with type B dissection. MATERIALS AND METHODS: The patients with type B (IIIb) dissections who underwent TEVAR from 2006 to 2013 with minimum of 2 years of follow-up computed tomography data were retrospectively reviewed. Based on the status of false lumen remodeling of entire aorta, patients were divided into three groups: complete regression, total thrombosis, and inadequate regression with patent abdominal false lumen...
January 23, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28115748/acute-aorta-overview-of-acute-ct-findings-and-endovascular-treatment-options
#15
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
#16
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/28109395/hybrid-repair-of-ruptured-arch-aneurysm-without-sternotomy-through-an-unusual-extraanatomic-bypass
#17
Chung-Lin Tsai, Chih-Chun Yang, Takuya Fujikawa, Shih-Rong Hsieh
A 42-year-old man experienced a complex aortic arch aneurysm rupture. He had previously undergone an operation for type A dissection and had extremely poor cardiac performance as well as deep sternal infection after the first procedure. The conventional open repair was considered to be a high risk for this patient. We therefore performed an alternative hybrid aortic procedure. The supraarch vessels were perfused through an extraanatomic bypass from an unusual and remote route, namely, the abdominal aorta. Then, stent grafts were implanted in the previously replaced aortic prostheses to exclude the aortic aneurysm...
February 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28095402/a-general-shear-dependent-model-for-thrombus-formation
#18
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/28076621/experimental-model-for-sutureless-proximal-anastomosis-by-the-viabahn-open-revascularization-technique-vortec
#19
Lucas Marcelo Dias Freire, Giuliana Biasi Gobbi, Inácio Maria Dal Fabbro, Fábio Hüsemann Menezes
Introduction: In the treatment of complex aneurysms, debranching is an extra-anatomical revascularization of visceral arteries followed by endograft coverage of the thoracoabdominal aorta. It eliminates the need for a thoracotomy and aortic clamping, but requires the performance of several technically demanding visceral anastomosis. In 2008, Lachat described visceral revascularization with the use of a sutureless distal anastomosis, performed by the telescoping of an endograft in the visceral branch, named VORTEC (Viabahn Open Revascularization TEChnique)...
November 2016: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28062548/modified-frozen-elephant-trunk-for-acute-type-a-aortic-dissection-a-comparative-study-with-standard-repair-technique
#20
Peter Matt, Prerana Banerjee, Martin Grapow, Florian Rueter, Ulrich Schurr, Martin Siegemund, Jens Fassl, Oliver Reuthebuch, Friedrich Eckstein
OBJECTIVES: We hypothesized that antegrade open stent graft implantation in the descending aorta during acute type A aortic dissection surgery is safe and improves patient outcome compared with the standard repair technique. METHODS: Hundred and forty-one consecutive patients underwent surgery for acute type A aortic dissection at our institution from 2010 to 2016. Of those, 104 patients underwent ascending aorta and hemiarch repair under hypothermic circulatory arrest with antegrade cerebral perfusion (standard group)...
January 5, 2017: European Journal of Cardio-thoracic Surgery
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