Mumun Sinha, Niraj N Pandey, Nitin Parashar, Sanjeev Kumar, Sivasubramaniam Ramakrishnan
AIM: To evaluate the imaging characteristics and associations in patients with isolation of arch vessels on multidetector computed tomography angiography (CTA). MATERIALS AND METHODS: We retrospectively reviewed all multidetector CTA studies performed for the evaluation of congenital heart diseases (CHDs) at our institution from January 2014 to June 2020. Cases with isolation of arch vessels were identified. The isolated arch artery and its relationship with patent arterial duct, pulmonary artery, and aortic arch were characterized in addition to other associated intra- and extracardiac anomalies...
October 14, 2020: Journal of Cardiac Surgery
Marek K Kuzniar, Anders Wanhainen, Gustaf Tegler, Kevin Mani
INTRODUCTION: Chronic aortic dissection with aneurysm development that includes the aortic arch and/or thoraco-abdominal aorta (TAAA) is traditionally treated with open or hybrid surgery. Total endovascular treatment with fenestrated and branched stent grafts (F/B-EVAR) has recently been introduced as a less invasive alternative. The aim was to report short- and mid-term outcome from a single tertiary vascular center. METHODS: All patients with chronic aortic dissection treated with F/B-EVAR 2010-2019 at Uppsala University Hospital were identified...
October 14, 2020: Journal of Vascular Surgery
Mohammad Rezaeimoghaddam, Gokce Nur Oguz, Mehmet Sanser Ates, Tijen Alkan Bozkaya, Senol Piskin, S Samaneh Lashkarinia, Erhan Tenekecioglu, Haldun Karagoz, Kerem Pekkan
PURPOSE: This study aims to quantify the patient-specific hemodynamics of complex conduit routing configurations of coronary artery bypass grafting (CABG) operation which are specifically suitable for off-pump surgeries. Coronary perfusion efficacy and local hemodynamics of multiple left internal mammary artery (LIMA) with sequential and end-to-side anastomosis are investigated. Using a full anatomical model comprised of aortic arch and coronary artery branches the optimum perfusion configuration in multi-vessel coronary artery stenosis is desired...
October 13, 2020: Cardiovascular Engineering and Technology
Qiao Guo, Yifan Kong, Shi Zeng, Jiawei Zhou, Xiaofang Wang, Quanliang Shang, Jia Zhou, Hongxia Yuan, Ling Wang, Lili Tong, Aijiao Yi, Qichang Zhou
BACKGROUND: Fetal double aortic arch (DAA) malformation is a rare congenital heart disease with few reported cases in the literature. We aimed to investigate the characteristics of prenatal ultrasound and postnatal computed tomography angiography (CTA) of DAA and to describe the associated anomalies and clinical outcomes to improve prenatal diagnosis and assist in perinatal management. METHODS: The obstetric ultrasound imaging databases of seven tertiary referral centers were reviewed retrospectively to identify fetuses with a prenatal diagnosis of DAA between January 2013 and December 2018...
October 12, 2020: BMC Pregnancy and Childbirth
Kunal K Chawla, Xiangke Huang, Neal Hadro, Ashequl M Islam
We report a case of a 69-year-old male who was planned for a transcatheter aortic valve replacement (TAVR) with a 26 mm Sapien 3 Valve (Edwards Lifesciences, Irvine, California) for the treatment of symptomatic severe aortic stenosis. During rapid ventricular pacing and implantation of the TAVR valve, there was a loss of pacing capture and subsequent embolization of the valve into the aortic arch. Retrieval of the embolized valve was attempted unsuccessfully using several techniques. Finally, by using a 34 mm Evolut R Valve (Medtronic, Minneapolis, Minnesota), we were able to secure the embolized valve in the transverse segment of the aortic arch without compromising the branch vessels...
October 10, 2020: Catheterization and Cardiovascular Interventions
Tomoki Nagata, Takashi Yamada, Hiroyuki Johno
BACKGROUND: A right sided aortic arch (RAA) and an aortic diverticulum (AD) are a rare congenital anomaly associated with an aortic rupture and dissection. Recently, various methods for the surgical management have been described to treat RAAs and ADs. CASE REPORT: We describe a case of an RAA with a mirror image branching (RAMI) and AD in a teenager who complained of chest pain. We planned a total arch replacement with the frozen elephant trunk technique. Further, we needed to devise a way to reconnect the cerebral vessels because of his small arch anatomy and limited space in the mediastinum...
October 8, 2020: Journal of Cardiac Surgery
Vasiliki E Georgakopoulou, Dimitrios Mermigkis, Ourania Kairi, Anna Garmpi, Xanthi Tsiafaki
Giant cell arteritis (GCA) is a chronic granulomatous vasculitis of unknown aetiology occurring in the older patients and affecting mostly the cranial branches of the arteries originating from the aortic arch. GCA is associated with polymyalgia rheumatica (PMR). Clinical features of the disorder include headache, scalp tenderness, jaw claudication, temporal artery abnormalities on physical examination, vision changes, and symptoms associated to PMR. Systemic manifestations include fever, anorexia and weight loss while less rare manifestations are related to the nervous system, the respiratory system, the pericardium and extra-cranial large vessels...
August 31, 2020: Curēus
Stefan P M Smorenburg, Matthew Montesano, Tijs J Hoogteijling, Maarten Truijers, Petr Symersky, Evert K Jansen, Harmen R Zandbergen, Willem Wisselink, Theodorus G van Schaik, Kak Khee Yeung
Background Endovascular repair has become a viable alternative for aortic pathological features, including those located within the aortic arch. We investigated the anatomic suitability for branched thoracic endovascular repair in patients previously treated with conventional open surgery for aortic arch pathological features. Methods and Results Patients who underwent open surgery for aortic arch pathological features at our institution between 2000 and 2018 were included. Anatomic suitability was determined by strict compliance with the anatomic criteria within manufacturers' instructions for use for each of the following branched thoracic stent grafts: Relay Plus Double-Branched (Terumo-Aortic), TAG Thoracic Branch Endoprosthesis (W...
October 3, 2020: Journal of the American Heart Association
Sameh M Said, Gamal Marey, Stacie Knutson, Nathan Rodgers, Martina Richtsfeld, Brain Joy, Massimo Griselli
Vascular rings (VRs) are rare aortic arch anomalies that may present with a wide variety of symptoms related to esophageal and/or airway compression. We reviewed our surgical experience in both symptomatic and asymptomatic children. All children (n = 58) who underwent surgical repair of VRs or slings (mean age 27.4±45.60 months; 36 males [62%]) between March 2000 and April 2020 were included. The most common anatomic variant was a right aortic arch (RAA) with aberrant left subclavian artery (ALSCA)(n = 29; 50%)...
September 22, 2020: Seminars in Thoracic and Cardiovascular Surgery
Eleni Panagouli, Ioannis Antonopoulos, Gregory Tsoucalas, Alexandros Samolis, Dionysios Venieratos, Theodore Troupis
Introduction The brachiocephalic artery (BCA) is the largest branch that arises from the aortic arch, which varies in length. The present study focuses on BCA length and its probable correlation with height and torso length. Methods The BCA length (from the artery's origin to the arcus aortae), the length of the torso, and height were measured in 76 embalmed adult human cadavers of Caucasian (Hellenic) origin. Results A total of 74 arteries were measured (36 females and 38 males). The mean length was found to be 3...
August 20, 2020: Curēus
Weiwei Qin, Huiyu Yang, Gaizhen Liu, Rui Bai, Yunfei Bian, Zhiming Yang, Chuanshi Xiao
ATF3 (activating transcription factor 3) is a member of the mammalian activation transcription factor/cAMP-responsive element-binding (CREB) family. It plays a role in inflammation and innate immunity, and suggests that ATF3 is associated with atherosclerosis. In our study, we analyzed datasets of atherosclerosis from the NCBI-GEO (Gene Expression Omnibus) database and found that expression levels of ATF3 were lower in macrophages from ruptured atherosclerotic plaques than from stable atherosclerotic plaques...
September 21, 2020: Human Cell
Marina Borri Wolosker, Dafne Braga Diamante Leiderman, Fernanda Alvarenga Estevan, Nelson Wolosker, Antonio Eduardo Zerati, Edson Amaro
INTRODUCTION: To date, no study has been performed analyzing changes in the vascular system comparing paired examinations of patients alive and after death with the use of cardiopulmonary bypass and CT angiography. MATERIALS AND METHODS: The aim of this study was to analyze in a large series (38 patients) the aorta and its branches by CT (without contrast) and CT angiography of patients still alive and after death comparing their diameters and length variations...
September 16, 2020: Annals of Vascular Surgery
Ertugrul Cagri Bolek, Ummusen Kaya Akca, Alper Sari, Erdal Sag, Selcan Demir, Levent Kilic, Yusuf Ziya Sener, Hayrettin Hakan Aykan, Ergun Baris Kaya, Yelda Bilginer, Ali Akdogan, Sedat Kiraz, Omer Karadag, Seza Ozen
OBJECTIVES: Takayasu's arteritis (TAK) is a chronic vasculitis, affecting predominantly the aorta and/or its major branches. The aim of this study was to compare the differences between childhood and adult onset TAK. METHODS: We retrospectively evaluated 179 TAK patients followed between August 2005 and July 2019. Demographic characteristics, laboratory features, disease activity, echocardiographic data at diagnosis and treatment regimens in the disease course were compared between the paediatric and adult onset patients...
September 16, 2020: Clinical and Experimental Rheumatology
Liang Wang, Lei Bai, Yujing Zhang, Jianglong Liu, Xiaodong Li
OBJECTIVES: Aortic dissection involving the ascending aorta and aortic arch is a serious condition. Treatment using traditional surgical methods has certain disadvantages. This study investigated the effectiveness of thoracic endovascular repair of aortic dissection using an external prefenestrated stent. METHODS: We present a series of aortic dissection cases involving the ascending aorta and aortic arch treated with an external prefenestrated stent. RESULTS: Postoperative follow-up of the patients showed that all stents were released at the proper position and that branch vessels were not occluded, and there were no instances of type I endoleak...
September 14, 2020: Vascular
Noriko Matsumoto, Mizuho Takahashi, Takehiro Katano, Akihito Kutsuna, Takuya Kanamaru, Yuki Sakamoto, Kentaro Suzuki, Junya Aoki, Yasuhiro Nishiyama, Shinobu Kunugi, Akira Shimizu, Kazumi Kimura
Aortogenic embolic stroke (AES) is an important stroke mechanism. However, as many stroke patients have aortic atheromatous lesions, it is unclear whether these lesions are the cause of these strokes. Cholesterol crystals are the solid, crystalline form of cholesterol that is found in atherosclerosis, but not in cardiac diseases such as atrial fibrillation, valvular diseases, and cardiomyopathy. Therefore, if a cholesterol crystal is found in a thrombus removed by mechanical thrombectomy (MT), this makes it possible to diagnose a patient as having an atheromatous lesion...
October 2020: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Farhad Rikhtegar Nezami, Farhan Khodaee, Elazer R Edelman, Steven P Keller
Extracorporeal membrane oxygenation (ECMO) is increasingly deployed to provide percutaneous mechanical circulatory support despite incomplete understanding of its complex interactions with the failing heart and its effects on hemodynamics and perfusion. Using an idealized geometry of the aorta and its major branches and a peripherally inserted return cannula terminating in the iliac artery, computational fluid dynamic simulations were performed to (1) quantify perfusion as function of relative ECMO flow and (2) describe the watershed region produced by the collision of antegrade flow from the heart and retrograde ECMO flow...
July 27, 2020: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Shabana Shahanavaz, Osamah Aldoss, Kaitlin Carr, Brent Gordon, Michael D Seckeler, Gurumurthy Hiremath, Cameron Seaman, Jenny Zablah, Gareth Morgan
OBJECTIVES AND BACKGROUND: Coarctation of the aorta represents 5-8% of all congenital heart disease. Although balloon expandable stents provide an established treatment option for native or recurrent coarctation, outcomes from transverse arch (TAO) stenting, including resolution of hypertension have not been well studied. This study aims to evaluate immediate and midterm results of TAO stenting in a multi-center retrospective cohort. METHODS: TAO stenting was defined as stent placement traversing any head and neck vessel, with the primary intention of treating narrowing in the transverse aorta...
September 9, 2020: Catheterization and Cardiovascular Interventions
Bettina Pretterklieber, Michael L Pretterklieber
Background and objectives: Anatomical dissection is an indispensable means of acquiring knowledge about the variability of the human body. We detected the co-existence of several arterial variations within one female anatomic specimen during routine anatomical dissection. The aim of this study was to evaluate if this status is a regular pattern in any of other vertebrates. Materials and Methods : Besides of a meticulous anatomic dissection, we performed a literature review concerning the frequency, the phylogenesis, and ontogenesis of all of these variations...
September 4, 2020: Medicina
John P McGahan, Gina James, Herman Hedriana, Sherzana Sunderji
Right aortic arch anomalies are a spectrum of malformations that include right aortic arch with mirror image branching, right aortic arch with an aberrant left subclavian artery, and double aortic arch. Although these are rare anomalies, they are of importance as they form vascular rings, which can cause symptoms in the newborn period. These anomalies are not detected with routine cardiac views, and it is only with the 3-vessel, and the 3-vessel tracheal view that they can be identified and characterized. We describe specific sonographic findings of these anomalies on the 3-vessel and the 3-vessel tracheal view...
September 2020: Ultrasound Quarterly
Sarv Priya, Prashant Nagpal
A double aortic arch (DAA) with atresia is an uncommon cause of a symptomatic vascular ring resulting in trachea-esophageal compression. An atretic double aortic arch can resemble the right aortic arch with a mirror image branching pattern or the right arch with an aberrant left subclavian artery depending upon the level of atresia. The double aortic arch with atresia is difficult to detect on pre-surgical computed tomography angiography or magnetic resonance angiography due to a lack of contrast in the obliterated arch segment...
July 30, 2020: Curēus
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