Descending thoracic aneurysm

Viony M Belvroy, Rodrigo M Romarowski, Theodorus M J van Bakel, Joost A van Herwaarden, Jean Bismuth, Ferdinando Auricchio, Frans L Moll, Santi Trimarchi
OBJECTIVE: As elastin fibres in the aorta deteriorate with age, the descending thoracic aorta (DTA) becomes longer and more tortuous. In patients with DTA aneurysms, this increased tortuosity may result in a hostile haemodynamic environment for thoracic endovascular aortic repair (TEVAR). The objective of this study was to analyse how increased tortuosity affects haemodynamic displacement forces (DFs) in different segments of the DTA in patients with DTA aneurysms (DTAAs). METHODS: Thirty patients with DTAAs were selected to form three equal groups based on the maximum tortuosity of their DTA: low < 30°, moderate 30°-60°, and high > 60°...
January 7, 2020: European Journal of Vascular and Endovascular Surgery
Ivancarmine Gambardella, Mario F L Gaudino, Mohamad Rahouma, Woodrow J Farrington, Faiza M Khan, Irbaz Hameed, Christopher Lau, Erin Iannacone, Leonard N Girardi
OBJECTIVE: To discern the impact of depressed left ventricular ejection fraction (LVEF) on the outcomes of open descending thoracic aneurysm (DTA) and thoracoabdominal aneurysms (TAAA) repair. METHODS: Restricted cubic spline analysis was used to identify a threshold of LVEF, which corresponded to an increase in operative mortality and major adverse events (MAE: operative death, myocardial infarction, stroke, spinal cord injury, need for tracheostomy or dialysis)...
November 22, 2019: Journal of Thoracic and Cardiovascular Surgery
Viony M Belvroy, Hector W L de Beaufort, Joost A van Herwaarden, Jean Bismuth, Gabriele Piffaretti, Frans L Moll, Santi Trimarchi
OBJECTIVE: Tortuosity in the descending thoracic aorta (DTA) comes with aging and increases the risk of endoleaks after TEVAR. With this report, we would like to define and classify tortuosity in the DTA of patients with thoracic aortic disease. METHODS: Retrospective case-control study of two hundred seven patients, comparing sixty-nine controls without aortic disease (CG), to sixty-nine patients with descending thoracic aortic aneurysm (AG) and sixty-nine patients with type B aortic dissection (DG)...
December 23, 2019: World Journal of Surgery
Edin Nevzati, Jeannine Rey, Daniel Coluccia, Basil Erwin Grüter, Stefan Wanderer, Michael vonGunten, Luca Remonda, Juhana Frosen, Hans Rudolf Widmer, Javier Fandino, Serge Marbacher
BACKGROUND AND PURPOSE: Despite significant technical advances, recanalization rates after endovascular therapy of ruptured intracranial aneurysms (IAs) remain a clinical challenge. A histopathological hallmark of ruptured human IA walls is mural cell loss. Mural smooth muscle cells (SMCs) are known to promote intraluminal healing in thrombosed experimental aneurysms. In this rat model we assess the natural history and healing process after coil embolization in SMC-rich and decellularized aneurysms...
December 23, 2019: Journal of Neurointerventional Surgery
Katherine M Buddemeyer, Kyle W Eudailey, Benjamin J Pearce, Adam W Beck
A 77-year-old woman presented with symptomatic thoracic aortic aneurysm within a dissected thoracoabdominal aorta distal to a previous Dacron ascending aortic replacement. She was not a candidate for open repair and had no proximal landing zone for conventional thoracic endovascular aortic repair (TEVAR) resulting from dissection extension into the brachiocephalic vessels. A concomitant parallel graft true and false lumen TEVAR was performed from the distal aortic arch to diaphragm. Follow-up imaging demonstrated successful exclusion of the false lumen aneurysm and successful protection of the true lumen with the adjacent parallel TEVAR device...
December 2019: Journal of Vascular Surgery Cases and Innovative Techniques
Alexandre Magno M N Soares, Michel Pompeu B O Sá, Antonio C Escorel Neto, Luiz Rafael P Cavalcanti, Konstantin Zhigalov, Alexander Weymann, Arjang Ruhparwar, Ricardo C Lima
We report a case of a hybrid surgical treatment of a 71-year-old fragile female with severe chronic obstructive pulmonary disease with a 5-year history of progressive back pain and diagnosis of descending thoracic aorta aneurysm (DTAA), but refused operation at first. Since the patient presented with an acute expanding painful pulsatile mass due to a ruptured DTAA contained by the subcutaneous tissue and had a high-risk surgical profile, we agreed that the simplest urgent operation should be performed. Cardiopulmonary bypass with or without deep hypothermic circulatory arrest was ruled out as an option...
December 19, 2019: Journal of Cardiac Surgery
V V Shlomin, I V Korovin, I G Drozhzhin, P B Bondarenko, P D Puzdriak, E Iu Belousov, N V Kuz'min
Described herein is a clinical case report regarding treatment of a 70-year-old male patient presenting with a late complication following endoprosthetic repair for a Stanford type B dissecting thoracic aortic aneurysm. The man was admitted to our hospital for persistent type IIb endoleak and an increased diameter of the aorta in its thoracic and thoracoabdominal portions. Two years previously, he had endured endoprosthetic repair of the thoracic aorta. The findings of computed tomography revealed negative dynamics manifesting as an increase in the diameter of the false channel of the arch and descending thoracic aorta with persistent type IIb endoleak...
2019: Angiology and Vascular Surgery
Luis Ribeiro, Saissan Rajendran, Katherine Stenson, Ian Loftus
A 79-year-old man presented with an enlarging thoracic aneurysm on the background of superficial bladder cancer treated with intravesical bacillus Calmette-Guérin (BCG) injections. Following the injections, he developed deranged liver function tests and hepatomegaly. Liver biopsy revealed granulomatous hepatitis compatible with disseminated mycobacterial infection (BCG-osis) and was treated with anti-tuberculosis agents for 12 months. A surveillance CT scan performed as a follow-up for his bladder cancer in 2018 revealed a saccular thoracic aneurysm at the ligamentum arteriosum, which was metabolically active on positron emission tomography (PET) scan...
December 15, 2019: BMJ Case Reports
C López Espada, J P Linares Palomino, J M Domínguez González, E Iborra Ortega, P Lozano Vilardell, T Solanich Valldaura, G Volo Pérez, E Blanco Cañibano, A Álvarez Salgado, J C Fernández Fernández, M Hernando Rydings, M Miralles Hernández
OBJECTIVE: Endovascular techniques have become an essential tool for the treatment of descending thoracic aortic disease (thoracic endovascular aneurysm repair [TEVAR]). The aim is to analyze the indications and outcomes of emergency TEVAR at national level in relation to elective surgery. STUDY DESIGN AND SCOPE: A retrospective multicenter registry of patients with descending thoracic aortic disease treated on an emergency basis using endovascular techniques between 2012-2016, in 11 clinical units...
December 10, 2019: Medicina Intensiva
Danielle Dombrowski, Graham W Long, Jonathan Chan, O William Brown
OBJECTIVE: This study quantifies the prevalence of thoracic aortic aneurysm (TAA) in patients with known abdominal aortic aneurysm (AAA). METHODS: A retrospective review of patients with a diagnosis of AAA from January 2007 to December 2017 within Beaumont Health was undertaken. Radiology reports of abdominal ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) were reviewed to identify patients with AAA. Of these, patients with CT chest performed within 180 days prior to or following abdominal imaging were reviewed for diagnosis of thoracic aortic aneurysm (TAA)...
November 26, 2019: Annals of Vascular Surgery
Patrick Moeller, Suveeksha Naidu, Joseph Bavaria, Prashanth Vallabhajosyula, Grace Wang, Benjamin Jackson, Wilson Szeto, Nimesh Desai
BACKGROUND: TEVAR remains an important minimally invasive tool for the treatment of descending thoracic aneurysm. The long term effects of these repairs in both reduction of the aneurysmal sac size as well as stability of the stented portion require study. We report the results of 12 years of radiographic follow-up. METHODS: All patients with TEVAR for descending thoracic aneurysms from January 2005 to December 2017(n=371) were evaluated for immediate postoperative and follow-up CT scans suitable for 3D reconstruction of the aorta(excluding those with an interim reoperation)...
November 23, 2019: Annals of Thoracic Surgery
Kyokun Uehara, Hitoshi Matsuda, Jiro Matsuo, Yosuke Inoue, Takayuki Shijo, Atsushi Omura, Yoshimasa Seike, Hiroaki Sasaki, Junjiro Kobayashi
OBJECTIVES: Although the advent of thoracic endovascular aortic repair (TEVAR) has provided an alternative treatment option for descending thoracic aortic aneurysm (DTAA), open repair still plays a crucial role in DTAA repair. The purpose of this study was to re-evaluate the operative and long-term outcomes of open repair with partial cardiopulmonary bypass, compared to the results of TEVAR with a proximal landing zone of 3 or 4. METHODS: Between 2007 and 2017, open repair was performed for 44 patients and TEVAR for 282 patients...
November 20, 2019: General Thoracic and Cardiovascular Surgery
Rodrigo Barbosa de Souza, Luis Ernesto Farinha-Arcieri, Marcia Helena Braga Catroxo, Ana Maria Cristina Rebelo Pinto da Fonseca Martins, Roberto Carlos Tedesco, Luis Garcia Alonso, Ivan Hong Jun Koh, Lygia V Pereira
AIMS: Cardiovascular manifestations are a major cause of mortality in Marfan syndrome (MFS). Animal models that mimic the syndrome and its clinical variability are instrumental for understanding the genesis and risk factors for cardiovascular disease in MFS. This study used morphological and ultrastructural analysis to the understanding of the development of cardiovascular phenotypes of the the mgΔloxPneo model for MFS. METHODS AND RESULTS: We studied 6-month-old female mice of the 129/Sv background, 6 wild type (WT) and 24 heterozygous animals from the mgΔloxPneo model...
2019: PloS One
Anjith Prakash Rajakumar, Mithun Sundararaaja Ravikumar, Karthik Raman, Arun Singh, Ejaz Ahmed Sheriff, Rajan Sethuratnam
We report a case of a type B aortic dissection with an aneurysm treated by the replacement of the proximal descending thoracic aorta via the reversed elephant trunk technique. A 48-year-old asymptomatic man was diagnosed with a type B aortic dissection, moderate aortic regurgitation, and a good biventricular function in March 2012. Four years later (April 2016), a contrast-enhanced computed tomography examination revealed an aneurysmal dilatation in the patient's descending thoracic aorta with a thrombosis in the proximal part of the false lumen, which warranted surgical repair...
April 2019: Journal of Tehran Heart Center
Donald G Harris, Sydney L Olson, Annalise M Panthofer, Jon S Matsumura, Paul D DiMusto
OBJECTIVE: Thoracic endovascular aortic repair (TEVAR) has expanded access to descending thoracic aortic aneurysm (DTAA) repair particularly for elderly and frail patients. This high-risk population has limited long-term overall survival, such that appropriate patient selection is required to optimize patient benefit and resource utilization. Our objective was to develop and validate a frailty based, procedure specific risk score for patients undergoing elective TEVAR for DTAA. METHODS: Patients undergoing non-emergent TEVAR for DTAA during 2005 - 2016 were identified in the National Surgical Quality Improvement Program database...
November 6, 2019: Annals of Vascular Surgery
Hajime Kinoshita, Mariko Hori, Atsushi Tamura, Kei Kazuno, Hiroshige Sato, Seiichiro Murata
Spontaneous rupture of the thoracic aorta is a rare disease with a poor prognosis without obvious trauma, aortic aneurysm and aortic dissection. We report 2 cases of successful endovascular aortic repair for spontaneous rupture of the thoracic aorta. Case 1:A 79-year-old man was referred to our hospital complaining of general fatigue. He returned home without any obvious abnormalities in blood tests and computed tomography (CT). The patient was aware of dizziness and fluttering in the early morning the next day, and was transported to the hospital by shock vital...
November 2019: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Takahiro Tokuda, Mototsugu Tamaki, Hideki Kitamura, Yutaka Koyama, Koshi Sawada, Yasuhiko Kawaguchi, Kazuya Konakano, Yasuhide Okawa
An 88-year-old man was admitted with general fatigue. Computed tomography (CT) showed a descending aortic aneurysm. The laboratory data indicated severe infection. Despite negative blood cultures, broad-spectrum intravenous antibiotic therapy was started. Though antibiotic therapy was continued for about 2 weeks, the aneurysm extended 20 mm. Thoracic endovascular aortic repair was performed, and antibiotic therapy was continued for 4 weeks after the procedure, followed by oral antibiotics for 1 year. CT showed regression of the aneurysm 15 months after reconstruction...
November 2019: Journal of Surgical Case Reports
Akiko Tanaka, Harleen K Sandhu, Rana O Afifi, Charles C Miller, Amberly Ray, Madiha Hassan, Hazim J Safi, Anthony L Estrera
OBJECTIVE: To review short-term outcomes and long-term survival and durability after open surgical repairs for chronic distal aortic dissections in patients whose anatomy was amenable to thoracic endovascular aortic repair (TEVAR). METHODS: Between February 1991 and August 2017, we repaired chronic distal dissections in 697 patients. Of those patients, we enrolled 427 with anatomy amenable to TEVAR, which included 314 descending thoracic aortic aneurysms (DTAAs) and 105 extent I thoracoabdominal aortic aneurysms (TAAAs)...
October 1, 2019: Journal of Thoracic and Cardiovascular Surgery
Y F Tang, L Han, X L Fan, B Y Zhang, J J Zhang, Q Xue, Z Y Xu
Objective: To examine the results of surgical treatment for endograft infection after thoracic endovascular aortic repair (TEAVR). Methods: Clinical data of 7 patients underwent surgical treatment for endograft infection after TEAVR at Department of Cardiothoracic Surgery, Changhai Hospital, the Navy Medical University between January 2016 and December 2018 were analyzed retrospectively. There were 6 males and 1 female, aging (51.5±16.7) years (range: 25 to 68 years). The origin of the aortic disease was descending aortic aneurysm in 5 cases, and Stanford B aortic dissection in 2 cases...
November 1, 2019: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Dan Rong, Yangyang Ge, Jie Liu, Xiaoping Liu, Wei Guo
BACKGROUND: Aortic dissection is a separation of the aortic wall, caused by blood flowing through a tear in the inner layer of the aorta. Aortic dissection is an infrequent but life-threatening condition. The incidence of aortic dissection is 3 to 6 per 10,000 per year in the Western population, and can be up to 43 per 10,000 per year in the Eastern population. Over 20% of people with an aortic dissection do not reach a hospital alive. After admission, the mortality rates for people with an aortic dissection are between 10% and 20% for those who received endovascular treatment, and between 20% and 30% for those who had open surgery...
October 30, 2019: Cochrane Database of Systematic Reviews
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"