Aortic Aneurysm, Abdominal
Abnormal outpouching in the wall of intracranial blood vessels. Most common are the saccular (berry) aneurysms located at branch points in CIRCLE OF WILLIS at the base of the brain. Vessel rupture results in SUBARACHNOID HEMORRHAGE or INTRACRANIAL HEMORRHAGES. Giant aneurysms (>2.5 cm in diameter) may compress adjacent structures, including the OCULOMOTOR NERVE. (From Adams et al., Principles of Neurology, 6th ed, p841)
Aortic Aneurysm, Thoracic
Blood Vessel Prosthesis Implantation
Blood Vessel Prosthesis
Aneurysm caused by a tear in the TUNICA INTIMA of a blood vessel leading to interstitial HEMORRHAGE, and splitting (dissecting) of the vessel wall, often involving the AORTA. Dissection between the intima and media causes luminal occlusion. Dissection at the media, or between the media and the outer adventitia causes aneurismal dilation.
A localized bulging or dilatation in the muscle wall of a heart (MYOCARDIUM), usually in the LEFT VENTRICLE. Blood-filled aneurysms are dangerous because they may burst. Fibrous aneurysms interfere with the heart function through the loss of contractility. True aneurysm is bound by the vessel wall or cardiac wall. False aneurysms are HEMATOMA caused by myocardial rupture.
Tomography, X-Ray Computed
A method of hemostasis utilizing various agents such as Gelfoam, silastic, metal, glass, or plastic pellets, autologous clot, fat, and muscle as emboli. It has been used in the treatment of spinal cord and INTRACRANIAL ARTERIOVENOUS MALFORMATIONS, renal arteriovenous fistulas, gastrointestinal bleeding, epistaxis, hypersplenism, certain highly vascular tumors, traumatic rupture of blood vessels, and control of operative hemorrhage.
Not an aneurysm but a well-defined collection of blood and CONNECTIVE TISSUE outside the wall of a blood vessel or the heart. It is the containment of a ruptured blood vessel or heart, such as sealing a rupture of the left ventricle. False aneurysm is formed by organized THROMBUS and HEMATOMA in surrounding tissue.
Surgical Procedures, Elective
Surgery which could be postponed or not done at all without danger to the patient. Elective surgery includes procedures to correct non-life-threatening medical problems as well as to alleviate conditions causing psychological stress or other potential risk to patients, e.g., cosmetic or contraceptive surgery.
Angiography, Digital Subtraction
A method of delineating blood vessels by subtracting a tissue background image from an image of tissue plus intravascular contrast material that attenuates the X-ray photons. The background image is determined from a digitized image taken a few moments before injection of the contrast material. The resulting angiogram is a high-contrast image of the vessel. This subtraction technique allows extraction of a high-intensity signal from the superimposed background information. The image is thus the result of the differential absorption of X-rays by different tissues.
Reconstruction or repair of a blood vessel, which includes the widening of a pathological narrowing of an artery or vein by the removal of atheromatous plaque material and/or the endothelial lining as well, or by dilatation (BALLOON ANGIOPLASTY) to compress an ATHEROMA. Except for ENDARTERECTOMY, usually these procedures are performed via catheterization as minimally invasive ENDOVASCULAR PROCEDURES.
Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.
An autosomal dominant disorder of CONNECTIVE TISSUE with abnormal features in the heart, the eye, and the skeleton. Cardiovascular manifestations include MITRAL VALVE PROLAPSE, dilation of the AORTA, and aortic dissection. Other features include lens displacement (ectopia lentis), disproportioned long limbs and enlarged DURA MATER (dural ectasia). Marfan syndrome is associated with mutations in the gene encoding fibrillin, a major element of extracellular microfibrils of connective tissue.
Bleeding into the intracranial or spinal SUBARACHNOID SPACE, most resulting from INTRACRANIAL ANEURYSM rupture. It can occur after traumatic injuries (SUBARACHNOID HEMORRHAGE, TRAUMATIC). Clinical features include HEADACHE; NAUSEA; VOMITING, nuchal rigidity, variable neurological deficits and reduced mental status.
Mesenteric Artery, Inferior
The artery supplying nearly all the left half of the transverse colon, the whole of the descending colon, the sigmoid colon, and the greater part of the rectum. It is smaller than the superior mesenteric artery (MESENTERIC ARTERY, SUPERIOR) and arises from the aorta above its bifurcation into the common iliac arteries.
Severe or complete loss of motor function in the lower extremities and lower portions of the trunk. This condition is most often associated with SPINAL CORD DISEASES, although BRAIN DISEASES; PERIPHERAL NERVOUS SYSTEM DISEASES; NEUROMUSCULAR DISEASES; and MUSCULAR DISEASES may also cause bilateral leg weakness.
Spinal Cord Ischemia
Reduced blood flow to the spinal cord which is supplied by the anterior spinal artery and the paired posterior spinal arteries. This condition may be associated with ARTERIOSCLEROSIS, trauma, emboli, diseases of the aorta, and other disorders. Prolonged ischemia may lead to INFARCTION of spinal cord tissue.
Mesenteric Artery, Superior
A large vessel supplying the whole length of the small intestine except the superior part of the duodenum. It also supplies the cecum and the ascending part of the colon and about half the transverse part of the colon. It arises from the anterior surface of the aorta below the celiac artery at the level of the first lumbar vertebra.
The process of generating three-dimensional images by electronic, photographic, or other methods. For example, three-dimensional images can be generated by assembling multiple tomographic images with the aid of a computer, while photographic 3-D images (HOLOGRAPHY) can be made by exposing film to the interference pattern created when two laser light sources shine on an object.
Diagnostic and therapeutic procedures that are invasive or surgical in nature, and require the expertise of a specially trained radiologist. In general, they are more invasive than diagnostic imaging but less invasive than major surgery. They often involve catheterization, fluoroscopy, or computed tomography. Some examples include percutaneous transhepatic cholangiography, percutaneous transthoracic biopsy, balloon angioplasty, and arterial embolization.
Matrix Metalloproteinase 9
Homopolymer of tetrafluoroethylene. Nonflammable, tough, inert plastic tubing or sheeting; used to line vessels, insulate, protect or lubricate apparatus; also as filter, coating for surgical implants or as prosthetic material. Synonyms: Fluoroflex; Fluoroplast; Ftoroplast; Halon; Polyfene; PTFE; Tetron.
Tomography, Spiral Computed
Computed tomography where there is continuous X-ray exposure to the patient while being transported in a spiral or helical pattern through the beam of irradiation. This provides improved three-dimensional contrast and spatial resolution compared to conventional computed tomography, where data is obtained and computed from individual sequential exposures.
An abnormal anatomical passage between the INTESTINE, and another segment of the intestine or other organs. External intestinal fistula is connected to the SKIN (enterocutaneous fistula). Internal intestinal fistula can be connected to a number of organs, such as STOMACH (gastrocolic fistula), the BILIARY TRACT (cholecystoduodenal fistula), or the URINARY BLADDER of the URINARY TRACT (colovesical fistula). Risk factors include inflammatory processes, cancer, radiation treatment, and surgical misadventures (MEDICAL ERRORS).
Carotid Artery Diseases
Anterior Cerebral Artery
Carotid Artery, Internal
Matrix Metalloproteinase 2
Databases as Topic
An abnormal direct communication between an artery and a vein without passing through the CAPILLARIES. An A-V fistula usually leads to the formation of a dilated sac-like connection, arteriovenous aneurysm. The locations and size of the shunts determine the degree of effects on the cardiovascular functions such as BLOOD PRESSURE and HEART RATE.
A distribution in which a variable is distributed like the sum of the squares of any given independent random variable, each of which has a normal distribution with mean of zero and variance of one. The chi-square test is a statistical test based on comparison of a test statistic to a chi-square distribution. The oldest of these tests are used to detect whether two or more population distributions differ from one another.
Unanticipated information discovered in the course of testing or medical care. Used in discussions of information that may have social or psychological consequences, such as when it is learned that a child's biological father is someone other than the putative father, or that a person tested for one disease or disorder has, or is at risk for, something else.
Surgical Procedures, Minimally Invasive
Predictive Value of Tests
In screening and diagnostic tests, the probability that a person with a positive test is a true positive (i.e., has the disease), is referred to as the predictive value of a positive test; whereas, the predictive value of a negative test is the probability that the person with a negative test does not have the disease. Predictive value is related to the sensitivity and specificity of the test.
Arterial Occlusive Diseases
Platinum. A heavy, soft, whitish metal, resembling tin, atomic number 78, atomic weight 195.09, symbol Pt. (From Dorland, 28th ed) It is used in manufacturing equipment for laboratory and industrial use. It occurs as a black powder (platinum black) and as a spongy substance (spongy platinum) and may have been known in Pliny's time as "alutiae".
An autosomal dominant aneurysm with multisystem abnormalities caused by increased TGF-BETA signaling due to mutations in type I or II of TGF-BETA RECEPTOR. Additional craniofacial features include CLEFT PALATE; CRANIOSYNOSTOSIS; HYPERTELORISM; or bifid uvula. Phenotypes closely resemble MARFAN SYNDROME; Marfanoid craniosynostosis syndrome (Shprintzen-Goldberg syndrome); and EHLERS-DANLOS SYNDROME.
A slowly progressive condition of unknown etiology, characterized by deposition of fibrous tissue in the retroperitoneal space compressing the ureters, great vessels, bile duct, and other structures. When associated with abdominal aortic aneurysm, it may be called chronic periaortitis or inflammatory perianeurysmal fibrosis.
The therapy of the same disease in a patient, with the same agent or procedure repeated after initial treatment, or with an additional or alternate measure or follow-up. It does not include therapy which requires more than one administration of a therapeutic agent or regimen. Retreatment is often used with reference to a different modality when the original one was inadequate, harmful, or unsuccessful.
Disease Models, Animal
Care given during the period prior to undergoing surgery when psychological and physical preparations are made according to the special needs of the individual patient. This period spans the time between admission to the hospital to the time the surgery begins. (From Dictionary of Health Services Management, 2d ed)
Severity of Illness Index
Statistical models which describe the relationship between a qualitative dependent variable (that is, one which can take only certain discrete values, such as the presence or absence of a disease) and an independent variable. A common application is in epidemiology for estimating an individual's risk (probability of a disease) as a function of a given risk factor.
A nonparametric method of compiling LIFE TABLES or survival tables. It combines calculated probabilities of survival and estimates to allow for observations occurring beyond a measurement threshold, which are assumed to occur randomly. Time intervals are defined as ending each time an event occurs and are therefore unequal. (From Last, A Dictionary of Epidemiology, 1995)
Radiographic Image Interpretation, Computer-Assisted
Finite Element Analysis
An octapeptide that is a potent but labile vasoconstrictor. It is produced from angiotensin I after the removal of two amino acids at the C-terminal by ANGIOTENSIN CONVERTING ENZYME. The amino acid in position 5 varies in different species. To block VASOCONSTRICTION and HYPERTENSION effect of angiotensin II, patients are often treated with ACE INHIBITORS or with ANGIOTENSIN II TYPE 1 RECEPTOR BLOCKERS.
Posterior Cerebral Artery
A class of statistical procedures for estimating the survival function (function of time, starting with a population 100% well at a given time and providing the percentage of the population still well at later times). The survival analysis is then used for making inferences about the effects of treatments, prognostic factors, exposures, and other covariates on the function.
Ultrasonography, Doppler, Duplex
Cardiovascular manifestations of SYPHILIS, an infection of TREPONEMA PALLIDUM. In the late stage of syphilis, sometimes 20-30 years after the initial infection, damages are often seen in the blood vessels including the AORTA and the AORTIC VALVE. Clinical signs include syphilitic aortitis, aortic insufficiency, or aortic ANEURYSM.
Age as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or the effect of a circumstance. It is used with human or animal concepts but should be differentiated from AGING, a physiological process, and TIME FACTORS which refers only to the passage of time.
Conditions in which the KIDNEYS perform below the normal level in the ability to remove wastes, concentrate URINE, and maintain ELECTROLYTE BALANCE; BLOOD PRESSURE; and CALCIUM metabolism. Renal insufficiency can be classified by the degree of kidney damage (as measured by the level of PROTEINURIA) and reduction in GLOMERULAR FILTRATION RATE.
Rare chronic inflammatory disease involving the small blood vessels. It is of unknown etiology and characterized by mucocutaneous ulceration in the mouth and genital region and uveitis with hypopyon. The neuro-ocular form may cause blindness and death. SYNOVITIS; THROMBOPHLEBITIS; gastrointestinal ulcerations; RETINAL VASCULITIS; and OPTIC ATROPHY may occur as well.
The ratio of two odds. The exposure-odds ratio for case control data is the ratio of the odds in favor of exposure among cases to the odds in favor of exposure among noncases. The disease-odds ratio for a cohort or cross section is the ratio of the odds in favor of disease among the exposed to the odds in favor of disease among the unexposed. The prevalence-odds ratio refers to an odds ratio derived cross-sectionally from studies of prevalent cases.
A class of protein components which can be found in several lipoproteins including HIGH-DENSITY LIPOPROTEINS; VERY-LOW-DENSITY LIPOPROTEINS; and CHYLOMICRONS. Synthesized in most organs, Apo E is important in the global transport of lipids and cholesterol throughout the body. Apo E is also a ligand for LDL receptors (RECEPTORS, LDL) that mediates the binding, internalization, and catabolism of lipoprotein particles in cells. There are several allelic isoforms (such as E2, E3, and E4). Deficiency or defects in Apo E are causes of HYPERLIPOPROTEINEMIA TYPE III.
Circle of Willis
A polygonal anastomosis at the base of the brain formed by the internal carotid (CAROTID ARTERY, INTERNAL), proximal parts of the anterior, middle, and posterior cerebral arteries (ANTERIOR CEREBRAL ARTERY; MIDDLE CEREBRAL ARTERY; POSTERIOR CEREBRAL ARTERY), the anterior communicating artery and the posterior communicating arteries.
Coated Materials, Biocompatible
Heart Bypass, Left
Studies which start with the identification of persons with a disease of interest and a control (comparison, referent) group without the disease. The relationship of an attribute to the disease is examined by comparing diseased and non-diseased persons with regard to the frequency or levels of the attribute in each group.
Sensitivity and Specificity
The expenses incurred by a hospital in providing care. The hospital costs attributed to a particular patient care episode include the direct costs plus an appropriate proportion of the overhead for administration, personnel, building maintenance, equipment, etc. Hospital costs are one of the factors which determine HOSPITAL CHARGES (the price the hospital sets for its services).
A class of statistical methods applicable to a large set of probability distributions used to test for correlation, location, independence, etc. In most nonparametric statistical tests, the original scores or observations are replaced by another variable containing less information. An important class of nonparametric tests employs the ordinal properties of the data. Another class of tests uses information about whether an observation is above or below some fixed value such as the median, and a third class is based on the frequency of the occurrence of runs in the data. (From McGraw-Hill Dictionary of Scientific and Technical Terms, 4th ed, p1284; Corsini, Concise Encyclopedia of Psychology, 1987, p764-5)
Microsurgical revascularization to improve intracranial circulation. It usually involves joining the extracranial circulation to the intracranial circulation but may include extracranial revascularization (e.g., subclavian-vertebral artery bypass, subclavian-external carotid artery bypass). It is performed by joining two arteries (direct anastomosis or use of graft) or by free autologous transplantation of highly vascularized tissue to the surface of the brain.
Matrix Metalloproteinase 12
Mucocutaneous Lymph Node Syndrome
An acute, febrile, mucocutaneous condition accompanied by swelling of cervical lymph nodes in infants and young children. The principal symptoms are fever, congestion of the ocular conjunctivae, reddening of the lips and oral cavity, protuberance of tongue papillae, and edema or erythema of the extremities.
The presence of co-existing or additional diseases with reference to an initial diagnosis or with reference to the index condition that is the subject of study. Comorbidity may affect the ability of affected individuals to function and also their survival; it may be used as a prognostic indicator for length of hospital stay, cost factors, and outcome or survival.
Studies in which subsets of a defined population are identified. These groups may or may not be exposed to factors hypothesized to influence the probability of the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics.
Reproducibility of Results
The statistical reproducibility of measurements (often in a clinical context), including the testing of instrumentation or techniques to obtain reproducible results. The concept includes reproducibility of physiological measurements, which may be used to develop rules to assess probability or prognosis, or response to a stimulus; reproducibility of occurrence of a condition; and reproducibility of experimental results.
Aortic Valve Insufficiency
Procedures of applying ENDOSCOPES for disease diagnosis and treatment. Endoscopy involves passing an optical instrument through a small incision in the skin i.e., percutaneous; or through a natural orifice and along natural body pathways such as the digestive tract; and/or through an incision in the wall of a tubular structure or organ, i.e. transluminal, to examine or perform surgery on the interior parts of the body.
Systemic Inflammatory Response Syndrome
A systemic inflammatory response to a variety of clinical insults, characterized by two or more of the following conditions: (1) fever >38 degrees C or HYPOTHERMIA 90 beat/minute; (3) tachypnea >24 breaths/minute; (4) LEUKOCYTOSIS >12,000 cells/cubic mm or 10% immature forms. While usually related to infection, SIRS can also be associated with noninfectious insults such as TRAUMA; BURNS; or PANCREATITIS. If infection is involved, a patient with SIRS is said to have SEPSIS.
Vertebral Artery Dissection
Splitting of the vessel wall in the VERTEBRAL ARTERY. Interstitial hemorrhage into the media of the vessel wall can lead to occlusion of the vertebral artery, aneurysm formation, or THROMBOEMBOLISM. Vertebral artery dissection is often associated with TRAUMA and injuries to the head-neck region but can occur spontaneously.
Carotid Artery, Internal, Dissection
Maleness or femaleness as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or effect of a circumstance. It is used with human or animal concepts but should be differentiated from SEX CHARACTERISTICS, anatomical or physiological manifestations of sex, and from SEX DISTRIBUTION, the number of males and females in given circumstances.
Carotid Artery, Common
The two principal arteries supplying the structures of the head and neck. They ascend in the neck, one on each side, and at the level of the upper border of the thyroid cartilage, each divides into two branches, the external (CAROTID ARTERY, EXTERNAL) and internal (CAROTID ARTERY, INTERNAL) carotid arteries.
Magnetic Resonance Imaging
Peripheral Vascular Diseases
Measurable and quantifiable biological parameters (e.g., specific enzyme concentration, specific hormone concentration, specific gene phenotype distribution in a population, presence of biological substances) which serve as indices for health- and physiology-related assessments, such as disease risk, psychiatric disorders, environmental exposure and its effects, disease diagnosis, metabolic processes, substance abuse, pregnancy, cell line development, epidemiologic studies, etc.
Equipment Failure Analysis
Myocytes, Smooth Muscle
Intimal tear without hematoma: an important variant of aortic dissection that can elude current imaging techniques. (1/1306)BACKGROUND: The modern imaging techniques of transesophageal echocardiography, CT, and MRI are reported to have up to 100% sensitivity in detecting the classic class of aortic dissection; however, anecdotal reports of patient deaths from a missed diagnosis of subtle classes of variants are increasingly being noted. METHODS AND RESULTS: In a series of 181 consecutive patients who had ascending or aortic arch repairs, 9 patients (5%) had subtle aortic dissection not diagnosed preoperatively. All preoperative studies in patients with missed aortic dissection were reviewed in detail. All 9 patients (2 with Marfan syndrome, 1 with Takayasu's disease) with undiagnosed aortic dissection had undergone >/=3 imaging techniques, with the finding of ascending aortic dilatation (4.7 to 9 cm) in all 9 and significant aortic valve regurgitation in 7. In 6 patients, an eccentric ascending aortic bulge was present but not diagnostic of aortic dissection on aortography. At operation, aortic dissection tears were limited in extent and involved the intima without extensive undermining of the intima or an intimal "flap." Eight had composite valve grafts inserted, and all survived. Of the larger series of 181 patients, 98% (179 of 181) were 30-day survivors. CONCLUSIONS: In patients with suspected aortic dissection not proven by modern noninvasive imaging techniques, further study should be performed, including multiple views of the ascending aorta by aortography. If patients have an ascending aneurysm, particularly if eccentric on aortography and associated with aortic valve regurgitation, an urgent surgical repair should be considered, with excellent results expected. (+info)
Pathogenetic sequence for aneurysm revealed in mice underexpressing fibrillin-1. (2/1306)Dissecting aortic aneurysm is the hallmark of Marfan syndrome (MFS) and the result of mutations in fibrillin-1, the major constituent of elastin-associated extracellular microfibrils. It is yet to be established whether dysfunction of fibrillin-1 perturbs the ability of the elastic vessel wall to sustain hemodynamic stress by disrupting microfibrillar assembly, by impairing the homeostasis of established elastic fibers, or by a combination of both mechanisms. The pathogenic sequence responsible for the mechanical collapse of the elastic lamellae in the aortic wall is also unknown. Targeted mutation of the mouse fibrillin-1 gene has recently suggested that deficiency of fibrillin-1 reduces tissue homeostasis rather than elastic fiber formation. Here we describe another gene-targeting mutation, mgR, which shows that underexpression of fibrillin-1 similarly leads to MFS-like manifestations. Histopathological analysis of mgR/mgR specimens implicates medial calcification, the inflammatory-fibroproliferative response, and inflammation-mediated elastolysis in the natural history of dissecting aneurysm. More generally, the phenotypic severity associated with various combinations of normal and mutant fibrillin-1 alleles suggests a threshold phenomenon for the functional collapse of the vessel wall that is based on the level and the integrity of microfibrils. (+info)
Observations on the treatment of dissection of the aorta. (3/1306)The results are presented of treatment in twenty-three patients with dissection of the thoracic aorta, in four of whom it was acute (less than 14 days' duration), and in nineteen chronic (more than 14 days' duration). Sixteen patients had Type I and II dissection (involving the ascending aorta) and five Type III (descending aorta at or distal to the origin of the left subclavian artery); in two, dissection complicated coarctation of the aorta in the usual site. Thirteen patients had aortic regurgitation. Three of the patients with acute dissection were treated medically; two, both with Type I dissection, died, and the third, with Type III, survived. The remaining acute patient was treated surgically and also died. Of the patients with chronic dissection, eight were treated medically and eleven surgically. None of the medical group died in hospital; three died between 3 months and 1 year, and five have survived from periods of 12-72 months. Eleven patients with chronic dissection were treated surgically; four died in hospital at or shortly after operation; and the remaining seven lived for periods of 12-84 months. The presentation, indications for surgical treatment and results are discussed. It is concluded that surgical treatment of chronic dissection may carry a higher initial mortality than medical, but that there may be slightly better overall long term results in the former. As this series was not selected randomly, because patients with complications were selected for surgery, and there are only a few patients in each group, the results do not permit firm conclusion regarding the relative merits of medical and surgical treatment. It is suggested that all patients should initially be treated medically but that surgical treatment should be considered if the dissection continues, if aortic regurgitation is severe, if an aneurysm develops or enlarges, if cardiac tamponade develops or there is evidence of progressive involvement of the branches of the aorta. Attention is drawn to the important syndrome of chronic dissecting aneurysm of the ascending aorta with severe aortic regurgitation which requires definitive surgical treatment and aortic valve replacement. The importance of adequate visualization of the origin and extent of the dissection as a preliminary to surgical treatment is stressed. (+info)
Replacement of the aortic root in patients with Marfan's syndrome. (4/1306)BACKGROUND: Replacement of the aortic root with a prosthetic graft and valve in patients with Marfan's syndrome may prevent premature death from rupture of an aneurysm or aortic dissection. We reviewed the results of this surgical procedure at 10 experienced surgical centers. METHODS: A total of 675 patients with Marfan's syndrome underwent replacement of the aortic root. Survival and morbidity-free survival curves were calculated, and risk factors were determined from a multivariable regression analysis. RESULTS: The 30-day mortality rate was 1.5 percent among the 455 patients who underwent elective repair, 2.6 percent among the 117 patients who underwent urgent repair (within 7 days after a surgical consultation), and 11.7 percent among the 103 patients who underwent emergency repair (within 24 hours after a surgical consultation). Of the 675 patients, 202 (30 percent) had aortic dissection involving the ascending aorta. Forty-six percent of the 158 adult patients with aortic dissection and a documented aortic diameter had an aneurysm with a diameter of 6.5 cm or less. There were 114 late deaths (more than 30 days after surgery); dissection or rupture of the residual aorta (22 patients) and arrhythmia (21 patients) were the principal causes of late death. The risk of death was greatest within the first 60 days after surgery, then rapidly decreased to a constant level by the end of the first year. CONCLUSIONS: Elective aortic-root replacement has a low operative mortality. In contrast, emergency repair, usually for acute aortic dissection, is associated with a much higher early mortality. Because nearly half the adult patients with aortic dissection had an aortic-root diameter of 6.5 cm or less at the time of operation, it may be prudent to undertake prophylactic repair of aortic aneurysms in patients with Marfan's syndrome when the diameter of the aorta is well below that size. (+info)
Endovascular stent-graft placement for the treatment of acute aortic dissection. (5/1306)BACKGROUND: The standard treatment for acute aortic dissection is either surgical or medical therapy, depending on the morphologic features of the lesion and any associated complications. Irrespective of the form of treatment, the associated mortality and morbidity are considerable. METHODS: We studied the placement of endovascular stent-grafts across the primary entry tear for the management of acute aortic dissection originating in the descending thoracic aorta. We evaluated the feasibility, safety, and effectiveness of transluminal stent-graft placement over the entry tear in 4 patients with acute type A aortic dissections (which involve the ascending aorta) and 15 patients with acute type B aortic dissections (which are confined to the descending aorta). Dissections involved aortic branches in 14 of the 19 patients (74 percent), and symptomatic compromise of multiple branch vessels was observed in 7 patients (37 percent). The stent-grafts were made of self-expanding stainless-steel covered with woven polyester or polytetrafluoroethylene material. RESULTS: Placement of endovascular stent-grafts across the primary entry tears was technically successful in all 19 patients. Complete thrombosis of the thoracic aortic false lumen was achieved in 15 patients (79 percent), and partial thrombosis was achieved in 4 (21 percent). Revascularization of ischemic branch vessels, with subsequent relief of corresponding symptoms, occurred in 76 percent of the obstructed branches. Three of the 19 patients died within 30 days, for an early mortality rate of 16 percent (95 percent confidence interval, 0 to 32 percent). There were no deaths and no instances of aneurysm or aortic rupture during the subsequent average follow-up period of 13 months. CONCLUSIONS: These initial results suggest that stent-graft coverage of the primary entry tear may be a promising new treatment for selected patients with acute aortic dissection. This technique requires further evaluation, however, to assess its therapeutic potential fully. (+info)
The highs and lows of endovascular aneurysm repair: the first two years of the Eurostar Registry. (6/1306)The Eurostar Registry was established in 1996 to collate information, from centres across Europe, on the outcome from endovascular grafting of aortic aneurysms. At the end of the first year of the project, data on 430 patients had been entered onto the database. In 420 patients (97.7%), the endografts were deployed without major complications. The 30-day mortality rate was low at 3.4% and deaths were confined mostly to 'high risk' patients with major co-morbidity. Endoleaks, which were present on discharge from hospital in 15.7% of patients, were associated with a significantly increased incidence of continued expansion of the aneurysm sac postoperatively (P < 0.01). Thus the early results confirmed the feasibility and low complication rate of endovascular repair of aneurysms, but a higher than expected incidence of endoleaks. At 2 years, 895 patients had been registered. The rate of early endoleaks remained significantly unchanged but another 18% of patients had developed new endoleaks during the first year of follow-up. Six delayed ruptures had been reported, 3 fatal. There were indications that 'self sealed' endoleaks continued to pressurise the aneurysm sac. Severe distortion of the grafts with kinking and other structural changes associated with postoperative longitudinal shrinking of the aneurysm sac was observed in 69% of patients at 1 year. Clinical complications associated with these changes included late endoleak and graft limb occlusion. Early unrealistic optimism about endovascular aneurysm repair has been replaced with a more realistic understanding of its benefits and limitations as a result of the Eurostar project and other registries. Randomised studies are now required to establish the most appropriate role for this approach, alongside established therapies. (+info)
Increased chymase-dependent angiotensin II formation in human atherosclerotic aorta. (7/1306)Locally formed angiotensin II (Ang II) and mast cells may participate in the development of atherosclerosis. Chymase, which originates from mast cells, is the major Ang II-forming enzyme in the human heart and aorta in vitro. The aim of the present study was to investigate aortic Ang II-forming activity (AIIFA) and the histochemical localization of each Ang II-forming enzyme in the atheromatous human aorta. Specimens of normal (n=9), atherosclerotic (n=8), and aneurysmal (n=6) human aortas were obtained at autopsy or cardiovascular surgery from 23 subjects (16 men, 7 women). The total, angiotensin-converting enzyme (ACE)-dependent, and chymase-dependent AIIFAs in aortic specimens were determined. The histologic and cellular localization of chymase and ACE were determined by immunocytochemistry. Total AIIFA was significantly higher in atherosclerotic and aneurysmal lesions than in normal aortas. Most of AIIFA in the human aorta in vitro was chymase-dependent in both normal (82%) and atherosclerotic aortas (90%). Immunocytochemical staining of the corresponding aortic sections with antichymase, antitryptase or anti-ACE antibodies showed that chymase-positive mast cells were located in the tunica adventitia of normal and atheromatous aortas, whereas ACE-positive cells were localized in endothelial cells of normal aorta and in macrophages of atheromatous neointima. The density of chymase- and tryptase-positive mast cells in the atherosclerotic lesions was slightly but not significantly higher than that in the normal aortas, and the number of activated mast cells in the aneurysmal lesions (18%) was significantly higher than in atherosclerotic (5%) and normal (1%) aortas. Our results suggest that local Ang II formation is increased in atherosclerotic lesions and that chymase is primarily responsible for this increase. The histologic localization and potential roles of chymase in the development of atherosclerotic lesions appear to be different from those of ACE. (+info)
Effect of nitrous oxide on myogenic motor potentials evoked by a six pulse train of transcranial electrical stimuli: a possible monitor for aortic surgery. (8/1306)Intraoperative recording of myogenic motor potentials evoked by transcranial electrical stimulation (tcMEP) is a method of monitoring the integrity of the vulnerable motor pathways during thoracoabdominal aortic aneurysm (TAAA) surgery. Deflation of the left lung during TAAA surgery may result in impairment of arterial oxygenation. Ventilation with nitrous oxide may cause further desaturation. We studied the effects of 20%, 40% and 60% nitrous oxide in oxygen on within-patient variability and magnitude of tcMEP in response to six pulse transcranial electrical stimulation during fentanyl-low-dose propofol anaesthesia with partial neuromuscular block. Ten patients (two females; aged 63-74 yr) were studied. After achieving a stable anaesthetic state and before surgery, 10 tcMEP were recorded from the right tibialis anterior muscle during addition of 20%, 40% and 60% nitrous oxide in oxygen in random order. When ventilation with 40% or 60% nitrous oxide in oxygen was performed, there was 50-70% depression of tcMEP amplitude (P < 0.05) and 40-60% reduction in tcMEP area under the curve (P < 0.05) compared with 20% nitrous oxide in oxygen. There was no significant difference in the coefficients of variation for tcMEP between the three nitrous oxide anaesthetic regimens. Our results suggest that increasing doses of nitrous oxide reduce the MEP waveform to six pulse transcranial electrical stimulation, but even with 60% nitrous oxide in oxygen, the tcMEP were recordable and as reproducible as with 20% and 40% nitrous oxide regimens. The method is sufficiently robust for use in aortic surgery. (+info)
Aortic Root Reconstruction | IntechOpen
Aortic root reconstruction represents one of the most complex areas of cardiac surgery as well as one of the most dynamic-major developments in understanding of the aortic root anatomy and physiology, improvements in imaging and surgical technique allowed for development and acceptance into clinical practice of several novel procedures over last couple of decades. From first aortic root replacement reported by Bentall and De Bono in 1968 to aortic root reimplantation (David procedure) and remodeling (Yacoub operation) with multiple contemporary modifications, aortic root reconstruction now is widely used in treatment of chronic aortic aneurysmal disease and acute aortic dissections alike. Basic principles of aortic root structure and function and critical operative strategies for aortic root surgery are reviewed in this chapter.
A quarter of a century of experience with aortic valve-sparing operations<...
TY - JOUR. T1 - A quarter of a century of experience with aortic valve-sparing operations. AU - David, Tirone E.. AU - Feindel, Christopher M.. AU - David, Carolyn M.. AU - Manlhiot, Cedric. PY - 2014/1/1. Y1 - 2014/1/1. N2 - Objective To examine the late outcomes of aortic valve-sparing operations to treat patients with aortic root aneurysm with and without aortic insufficiency (AI) in a cohort of patients followed up prospectively since 1988. Methods A total of 371 consecutive patients had undergone aortic valve-sparing surgery (mean age, 47 ± 15 years; 78% men) from 1988 through 2010. In addition to the aortic root aneurysm, 47% had moderate or severe AI, 35.5% had Marfan syndrome, 12.1% had type A aortic dissection, 9.2% had bicuspid aortic valve, 8.4% had mitral insufficiency, 16.1% had aortic arch aneurysm, and 10.2% had coronary artery disease. Reimplantation of the aortic valve was used in 296 patients and remodeling of the aortic root in 75. Cusp repair by plication of the free margin ...
Minimally Invasive Modified Bentall Operation in a Young Chinese Male with Severe Aortic Regurgitation Secondary to Infective Endocarditis in the Backgrou
Variation in the histopathological features of patients with ascending aortic aneurysms: a study of 111 surgically excised...
Background: Ascending aortic aneurysms (AA) are a common, though poorly understood medical condition.. Aims: To document the histological changes in a large series of human ascending AA, and to correlate these changes with clinical variables.. Methods: 111 ascending AA were excised at surgery over a 3 year period. Each aneurysm was received as a continuous ring of tissue. Sections were taken from the anterior, posterior, greater and lesser curvature of the aorta and graded in a semi-quantitative fashion for the degree of elastin fragmentation, elastin loss, smooth muscle cell (SMC) loss, intimal changes and inflammation.. Results: Mean patient age at surgery was 58.7 (15.6) years; there were 70 men and 41 women. 12 patients had Marfan syndrome, 34 (30.6%) had a bicuspid aortic valve (BAV), while 71 (64.0%) had a tricuspid aortic valve (TAV). Inflammatory cells were present in 28 cases (25.2%) and were confined to the adventitia. No particular region of the aortic circumference was more severely ...
Surgical Management of Descending Thoracic Aortic Disease: Open and Endovascular Approaches | Circulation
Understanding the pathogenesis of aortic dissection requires consideration of the inciting event that causes the intimal-medial tear and the propagation of blood within the aortic media. Although various risk factors that predispose the aorta to dissection have been described well, the precise insult that leads to laceration of the intima and media remains unclear.. Historically, the primary causative event that leads to aortic dissection has been extremely controversial. Cystic medial necrosis associated with Marfan disease and other connective tissue disorders was once believed to contribute to aortic medial degeneration, leading to aortic dissection. Larson and Edwards,42 however, demonstrated that only a few of their 161 patients with known aortic dissection exhibited medial degeneration. They found that 158 of these patients had intimal aortic tears at autopsy, which supports the theory initially proposed by Murray and Edwards43 that the intimal tear is the primary event, allowing the blood ...
Natural History of Ascending Aortic Aneurysms in the Setting of an Unreplaced Bicuspid Aortic Valve - Fingerprint -...
Dive into the research topics of Natural History of Ascending Aortic Aneurysms in the Setting of an Unreplaced Bicuspid Aortic Valve. Together they form a unique fingerprint. ...
New Diagnosis - ascending aorta aneurysm | Mayo Clinic Connect
I just returned from my first visit with the cardio/thoracic surgeon. He gave me good news that my ascending aortic aneurysm is 3.9 and technically not at the 4.0 stage for a true aneurysm. But I will get the echo cardio gram and another CAT scan in a year to see if it is stable. He assured me that there really is only a 3% chance of it rupturing at this level. And of course as the centimeters increase so does the chances. But they still do not do surgery until 6 cm because there is a greater risk of rupture than the surgery. So I am content to just get my yearly screenings and he said there is a great chance that I will never be operated on but you have to be vigilant with your check ups. And not lift over 30 pounds, but continue to do aerobic exercise !. ...
ASSA13-08-14 Aortic Valve-Sparing Surgery For Aortic Root Aneurysms: A Six-Year Experience | Heart
Results Total hospital (30-day) mortality was 4% (n = 2). 2(4%) patients required reoperation due to post-operative bleeding. Echocardiography showed none or trivial AI in 38%, mild AI in 54% and moderate AI in 8%. We revealed positive correlation between residual AI and size of aortic annulus, previous AI grade, and size of aortic prosthesis (optimal result in linear aortic graft size 3-5 mm exceeding aortic annulus size). Follow-up was 60% completed. Late mortality was 2% (1 patient). Echocardiography revealed none or trivial AI in 53%, mild AI in 20%, moderate AI in 17% and severe AI in 10% (3 patients). One patient required reoperation 3 years after TD-I operation, the AV replacement with mechanical prosthesis was performed. Another two patients with severe AI are under close surveillance due to normal LV size and NYHA class 1-2. We revealed positive correlation between late AI and residual AI grade, and aortic leaflets coaptation point (optimal result in cases with location of coaptation ...
The outcome after aortic valve-sparing (David) operation in 179 patients: A single-centre experience<...
TY - JOUR. T1 - The outcome after aortic valve-sparing (David) operation in 179 patients. T2 - A single-centre experience. AU - Leontyev, Sergey. AU - Trommer, Constanze. AU - Subramanian, Sreekumar -. AU - Lehmann, Sven. AU - Dmitrieva, Yaroslava. AU - Misfeld, Martin. AU - Mohr, Friedrich W.. AU - Borger, Michael A.. PY - 2012/8. Y1 - 2012/8. N2 - Objectives: The David aortic valve-sparing reimplantation (AVr-D) operation is increasingly being used in patients with aortic root aneurysmal disease and pliable aortic cusps. The objective of this study was to assess our early and medium-term outcomes with the AVr-D operation. Methods: Between 2003 and 2011, a total of 179 patients underwent AVr-D procedures. The mean patient age was 49.7 ± 15.1 years, and 23.5% (n = 42) were females. Marfan syndrome was present in 17.3% of patients (n = 31), and acute Type A aortic dissection in 15.6% (n = 28). Clinical follow-up was 100% complete and was 1.8 ± 1.6 years (0 days to 7.5 years) long. ...
New Diagnosis - ascending aorta aneurysm | Mayo Clinic Connect
I joined this group today. I am a 73 YO female and have a lot of heart issues that worry me: CAD, Valvular Disease (aortic and mitral), ascending aortic aneurysm (3.9 CM as measured on an echo). The CAD was diagnosed 11 years ago through a calcium scan and then I began treatment with a cardio and had all the usual tests. I guess I am most concerned about having a heart attack and not know what is happening as the female experience is so different from that of males. I am also worried that I will be in a situation where immediate treatment is not available, such as on a plane or while riding a bike on a trail. I am appreciating reading the experiences of others with similar diagnosiss.. ...
treatment of ascending aorta aneurysm using new modification of modified bentall procedure
عنوان کنگره : هشتمین کنگره بین المللی قلب و عروق رضوی, ایران,مشهد,1395/05/06-1395/05/08 ...
Aortic dissection & aortic aneurysm information support group - Aortic dissection, aortic aneurysm - The aorta - Life after an...
Social media support group dedicated to questions & information for aortic dissection survivors & aortic aneurysm sufferers family & friends
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Social media support group dedicated to questions & information for aortic dissection survivors & aortic aneurysm sufferers family & friends
Verdacht auf akutes Aortensyndrom? | SpringerLink
Rogers AM, Hermann LK, Booher AM, Nienaber CA, Williams DM, Kazerooni EA, Froehlich JB, OGara PT, Montgomery DG, Cooper JV, Harris KM, Hutchison S, Evangelista A, Isselbacher EM, Eagle KA, IRAD Investigators (2011) Sensitivity of the aortic dissection detection risk score, a novel guideline-based tool for identification of acute aortic dissection at initial presentation: results from the international registry of acute aortic dissection. Circulation 123(20):2213-2218. https://doi.org/10.1161/CIRCULATIONAHA.110.988568 CrossRefPubMedGoogle Scholar ...
Most recent papers with the keyword Acute dissection | Read by QxMD
Medial degeneration associated with thoracic aortic aneurysm and acute aortic dissection was originally described by Erdheim as a noninflammatory lesion related to the loss of smooth muscle cells and elastic fibre fragmentation in the media. Recent evidences propose the strong role of a chronic immune/inflammatory process in aneurysm evocation and progression. The coexistence of inflammatory cells with markers of apoptotic vascular cell death in the media of ascending aorta with aneurysms and type A dissections raises the possibility that activated T cells and macrophages may contribute to the elimination of smooth muscle cells and degradation of the matrix ...
Evaluation of the intraoperative specimens of the thoracic and abdominal aorta | Journal of Cardiothoracic Surgery | Full Text
Medial degeneration was the most frequent diagnosis in this series of aortic specimens. Medial degeneration was equally common in patients above and below 65 years of age. However, in cases with acute type A aortic dissections, high grade atherosclerosis was the leading histopathological diagnosis in patients older than 65 years. Acute type A aortic dissections seem to have different underlying pathologies in different age groups.. This series represents a one-year volume of an aortic referral center. The intention of this analysis was to correlate histopathological to morphological findings from imaging as well as to raise our intraoperative macroscopic and subjective impressions to a microscopic and objective level.. According to the risk factors a height prevalence of hypertension was observed in all of the patient groups. Especially the TAD group ≥ 65 years of age showed a relatively high rate of hypertension with no clinical diagnosis of connective tissue disease in this group. Generally, ...
Ascending aortic aneurysm | Radiology Case | Radiopaedia.org
This is a 45 year old male patient previously healthy presented with severe abdominal pain, admitted through the ER as a case of AF and signs of acute coronary syndrome. The widened mediation seen in the initial chest x-ray in addition to the si...
Ascending Aortic Aneurysms - Your forearms and hands should be strengthened if you to handle the ball better.
Your forearms and hands should be strengthened if you to handle the ball better. Tips For Improving Your NBA Live Mobile Skills Today NBA Live Mobile season tends to be an exciting time of year...
I WAS DIAGNOSED WITH AN ASCENDING AORTA ANEURYSM OF 4.5 cm about A YEAR AGO, I LOST 28 POUNDS AND DROPPED MY BLOOD PRESSURE TO 109/69 ON A DAILY BASIS...
CiNii Articles - Iwahashi Kazuhiko
130)僧帽弁置換手術後無症状にてDeBakey I型大動脈解離を呈した一例(日本循環器学会 第92回近畿地方会) （2002 ...
Outcome of medical and surgical treatment in patients with acute type B aortic dissection<...
TY - JOUR. T1 - Outcome of medical and surgical treatment in patients with acute type B aortic dissection. AU - Hsu, Ron Bin. AU - Ho, Yi Lwun. AU - Chen, Robert J.. AU - Wang, Shoei Shen. AU - Lin, Fang Yue. AU - Chu, Shu Hsun. PY - 2005/1/1. Y1 - 2005/1/1. N2 - Background. Optimal treatment of acute type B aortic dissection remain unclear. The aim of this study was to assess the clinical outcome of acute type B aortic dissection. Methods. In the last 8 years, 107 patients were admitted for acute type B aortic dissection. We medically treated patients at the time of onset with antihypertensives. Surgery was considered if there is intractable pain, uncontrolled hypertension, severe aortic branch malperfusion, or aneurysm expansion. Results. Twenty-nine patients had pleural effusion (27%), 9 patients had leg ischemia (8%), 5 patients had impending rupture, and 2 patients had aneurysm enlargement exceeding 60 mm on repeated imaging studies. A total of 16 patients (15%) underwent surgical ...
Toward the Best Treatment for Uncomplicated Patients With Type B Acute Aortic Dissection | Circulation
The optimal treatment for patients with type B aortic dissection remains a matter of debate. Each cardiologist or surgeon determines the surgical indications for type B aortic dissection according to his or her experience and the surgical results of the institution.. Recently, however, it was advocated that patients who had type B acute aortic dissection without complications, such as rupture or organ ischemia, be treated with hypotensive drugs during the acute phase, because the mortality rate with this treatment is reported to be equal to or slightly better than that for surgical treatment during the acute phase.4 5 12 13 14 15 16 17 Surgical treatment should be selected if the aortic diameter becomes enlarged during the chronic phase; careful observation of aortic enlargement in all patients treated during the chronic phase is very important but very difficult. Unfortunately, some patients who have successfully gone through the acute phase with medical hypotensive therapy suddenly die during ...
Acute aortic intramural hematoma: An analysis from the international registry of acute aortic dissection<...
TY - JOUR. T1 - Acute aortic intramural hematoma. T2 - An analysis from the international registry of acute aortic dissection. AU - Harris, Kevin M.. AU - Braverman, Alan C.. AU - Eagle, Kim A.. AU - Woznicki, Elise M.. AU - Pyeritz, Reed E.. AU - Myrmel, Truls. AU - Peterson, Mark D.. AU - Voehringer, Matthias. AU - Fattori, Rossella. AU - Januzzi, James L.. AU - Gilon, Dan. AU - Montgomery, Daniel G.. AU - Nienaber, Christoph A.. AU - Trimarchi, Santi. AU - Isselbacher, Eric M.. AU - Evangelista, Arturo. PY - 2012/9/11. Y1 - 2012/9/11. N2 - Background-Acute aortic intramural hematoma (IMH) is an important subgroup of aortic dissection, and controversy surrounds appropriate management. Methods and Results-Patients with acute aortic syndromes in the International Registry of Acute Aortic Dissection (1996-2011) were evaluated to examine differences between patients (based on the initial imaging test) with IMH or classic dissection (AD). Of 2830 patients, 178 had IMH (64 type A [42%], 90 type B ...
The Risk for Type B Aortic Dissection in Marfan Syndrome | JACC: Journal of the American College of Cardiology
In this study, we provide a contemporary overview of clinical outcomes in patients with known MFS without prior aortic dissection. This represents one of the largest MFS studies to date using 3-dimensional imaging techniques. We found a type B aortic dissection rate of 9% during a median follow-up period of 6 years. Type B aortic dissections generally occurred in mildly dilated proximal descending aortas, especially in patients with prior prophylactic aortic surgery. From our data, we were able to develop a risk score to predict type B aortic dissection in patients with MFS, on the basis of history of prophylactic aortic root surgery and proximal descending aortic diameter.. The occurrence of type A aortic dissection has become a rare event in patients with known MFS in the era of aggressive prophylactic surgery. Although AoRR has improved life expectancy considerably, distal aortic disease may develop later in patients with MFS (14,15). Replacement of the aortic root or ascending aorta with a ...
The Risk for Type B Aortic Dissection in Marfan Syndrome | JACC: Journal of the American College of Cardiology
In this study, we provide a contemporary overview of clinical outcomes in patients with known MFS without prior aortic dissection. This represents one of the largest MFS studies to date using 3-dimensional imaging techniques. We found a type B aortic dissection rate of 9% during a median follow-up period of 6 years. Type B aortic dissections generally occurred in mildly dilated proximal descending aortas, especially in patients with prior prophylactic aortic surgery. From our data, we were able to develop a risk score to predict type B aortic dissection in patients with MFS, on the basis of history of prophylactic aortic root surgery and proximal descending aortic diameter.. The occurrence of type A aortic dissection has become a rare event in patients with known MFS in the era of aggressive prophylactic surgery. Although AoRR has improved life expectancy considerably, distal aortic disease may develop later in patients with MFS (14,15). Replacement of the aortic root or ascending aorta with a ...
Aortic root replacement in 271 Marfan patients: A 24-year experience<...
TY - JOUR. T1 - Aortic root replacement in 271 Marfan patients. T2 - A 24-year experience. AU - Gott, Vincent L.. AU - Cameron, Duke E.. AU - Alejo, Diane E.. AU - Greene, Peter S.. AU - Shake, Jay G.. AU - Caparrelli, David J.. AU - Dietz, Harry C.. N1 - Funding Information: This study was supported in part by the Dana and Albert Cubby Broccoli Center for Aortic Diseases at the Johns Hopkins Medical Institutions, by National Institutes of Health Grant RO1-AR41135, by the Howard Hughes Medical Institute, and by the Smilow Family Foundation. Copyright: Copyright 2008 Elsevier B.V., All rights reserved.. PY - 2002. Y1 - 2002. N2 - Background. The introduction of composite graft repair of aortic root aneurysm by Hugh Bentall in 1968 promised Marfan patients the choice for a normal life expectancy. We performed our first Bentall composite graft procedure in 1976 and herein report our 24-year experience with 271 Marfan patients. Methods. Between September 1976 and August 2000, 232 Marfan patients ...
LOX Mutations Predispose to Thoracic Aortic Aneurysms and DissectionsNovelty and Significance | Circulation Research
The data presented here support the conclusion that heterozygous loss-of-function mutations in LOX, specifically variants that disrupt the catalytic activity or lead to haploinsufficiency, predispose to thoracic aortic aneurysms and acute aortic dissections. Overlapping syndromic features of Marfan syndrome, such as pectus deformities and striae, were reported in family members with LOX variants, but these features were not sufficient to meet diagnostic criteria for Marfan syndrome.13 Thoracic aortic aneurysms in these individuals are either aortic root aneurysms or fusiform aneurysms, involving both the aortic root and ascending aorta. Although mutation carriers died of ascending aortic dissections, there were no reports of aortic dissections with minimal enlargement of the ascending aorta. None of the affected individuals presented with descending thoracic aortic aneurysms or dissections. Interestingly, a bicuspid aortic valve was identified in 3 of 18 individuals with LOX mutations. It is ...
Stent Grafting of Dissected Descending Aorta in Patients With Marfans Syndrome | JACC: Cardiovascular Interventions
In patients with Marfans syndrome, AD with rupture has long been the main cause of death, even in younger patients. Modern surgical techniques of ascending aortic repair have been essential for improving patient prognoses. Bentall procedures or aortic root reconstruction are currently electively performed with acceptable morbidity and mortality rates.. Unlike in aortic root surgery, which is well codified and may be routinely performed on patients with Marfans syndrome, management of the dissected DTA is still challenging. This is especially true in cases involving aneurysmal dilatation (1,4,14). In contrast with the excellent surgical results of elective root replacement, both early and long-term results of repeat surgery for the descending aorta remain poor (15). De Olivera et al. (16) reported on 6 surgical repairs of the DTA after previous valve-sparing operations. In this series, 3 patients died after surgical repair of the descending aorta, 1 sustained post-operative paraplegia, and 2 ...
Aortic dissection in pregnancy in England: an incidence study using linked national databases | BMJ Open
Aortic dissection, though rare, is an often fatal event.1 A recent population-based study from Oxford showed that women have higher mortality from aortic dissection and are more likely to die before hospital assessment,2 which was also shown by the worlds largest registry of aortic dissection.3 Importantly, most individuals with aortic dissection had inadequately controlled hypertension, suggesting that modifiable risk factors may play a role in prevention.2 Moreover, women have worse outcomes following surgery for aortic dissection,3 and the surgical risk is even higher during pregnancy.4 ,5 The majority of aortic dissections in women of childbearing age occur during pregnancy and have adverse consequences for the mother and the fetus.6 Data from the Swedish National Birth Registry in women ,40 years of age have shown that pregnancy is associated with a 25-fold increased risk of aortic dissection.6 The scientific literature regarding aortic dissection and pregnancy is largely made up of case ...
Plasma levels of metalloproteinases-9 and -2 in the acute and subacute phases of type A and type B aortic dissection<...
TY - JOUR. T1 - Plasma levels of metalloproteinases-9 and -2 in the acute and subacute phases of type A and type B aortic dissection. AU - Sangiorgi, Giuseppe. AU - Trimarchi, Santi. AU - Mauriello, Alessandro. AU - Righini, Paolo. AU - Bossone, Eduardo. AU - Suzuki, Toru. AU - Rampoldi, Vincenzo. AU - Eagle, Kim A.. PY - 2006/5. Y1 - 2006/5. N2 - OBJECTIVES: Aortic dissection is characterized by an acute phase of medial dissection and a subacute-chronic phase of vessel wall repair. Matrix metalloproteinases (MMPs), through degradation of extracellular matrix, may play an important role in these processes. Elevation of MMPs might represent an opportunity to diagnostically characterize acute or chronic aortic processes. We examined the potential diagnostic role of MMP-9 and MMP-2 in different phases of aortic dissection. METHODS: Plasma levels of MMPs were evaluated by enzyme-linked immunosorbent assay technique in 13 patients affected by acute aortic dissection (nine type A, four type B). Ten ...
Treatment of Aortic Root Aneurysm and Mitral Valve Pathology through a Single Aortotomy
AbstractBackground:Aortic root aneurysms combined with lesions of the mitral valve requires synchronous operations. The conventional approach is to treat the two lesions through separate aortic and atrial incisions.Methods:From May 2009 to August 2012, 28 transaortic mitral valve operations were per
Blood groups and acute aortic dissection type III
Introduction : Acute aortic type III dissection is one of the most catastrophic events, with in-hospital mortality ranging between 10% and 12%. The majority of patients are treated medically, but complicated dissections, which represent 15% to 20% of cases, require surgical or thoracic...
Acute Aortic Dissection in Singapore - View Cost, Book Appointment Online | Practo
Doctors for acute aortic dissection in Singapore, find doctors near you. Book Doctors Appointment Online, View Cost for acute aortic dissection in Singapore | Practo
Replacement of infected aortic prosthetic graft with aortic homograft after heart transplantation: 13-year follow-up<...
TY - JOUR. T1 - Replacement of infected aortic prosthetic graft with aortic homograft after heart transplantation. T2 - 13-year follow-up. AU - Macedo, Francisco Igor B. AU - Salerno, Tomas. AU - Pham, Si M.. PY - 2013/5/1. Y1 - 2013/5/1. N2 - Acute ascending aortic dissection (AAAD) is a rare complication after orthotopic heart transplantation. We report a patient with AAAD after heart transplantation in whom repair was complicated by infection of the ascending aortic prosthetic graft. This was successfully managed by re-do replacement with two cryopreserved aortic homografts. Despite extensive calcification in the wall, the homografts show no aneurysm or dilation after 10 years.. AB - Acute ascending aortic dissection (AAAD) is a rare complication after orthotopic heart transplantation. We report a patient with AAAD after heart transplantation in whom repair was complicated by infection of the ascending aortic prosthetic graft. This was successfully managed by re-do replacement with two ...
How does the ascending aorta geometry change when it dissects? - Zurich Open Repository and Archive
OBJECTIVES The purpose of this study is to delineate changes in aortic geometry and diameter due to dissection. BACKGROUND Aortic diameter is the major criterion for elective ascending aortic replacement for dilated ascending aortas to prevent aortic dissection. However, recommendations are made on the basis of clinical experience and observation of diameters of previously dissected aortas. METHODS Six tertiary centers on 2 continents reviewed their acute aortic dissection type A databases, which contained 1,821 patients. Included were all non-Marfan patients with nonbicuspid aortic valves who had undergone computed tomography angiography ,2 years before and within 12 h after aortic dissection onset. Aortic geometry before and after dissection onset were compared. RESULTS Altogether, 63 patients were included (27 spontaneous and 36 retrograde dissections, median age 68 [57; 77] years; 54% were men). In all but 1 patient, maximum ascending aortic diameter was ,55 mm before aortic dissection ...
Could You Please Tell Me Something About Abdominal Aortic Aneurysm Warning Signs? - Healthtopquestions - HTQ
Abdominal aortic aneurysm is an aneurysmal dilatation of the abdominal aorta, usually defined as an aneurysm whose diameter increases by more than 50%. Abdominal aortic aneurysms are predominant in elderly males, with a male-to-female ratio of 10:3. Smoking significantly increases the risk of aneurysm rupture. Most abdominal aortic aneurysms are lesions below the renal artery level. Common causes include atherosclerosis, and other rare causes include cystic degeneration of the middle layer of the artery, syphilis, congenital dysplasia, trauma, infection, connective tissue disease, etc. Common risk factors for abdominal aortic aneurysm include smoking, hypertension, old age, male, etc. Most patients are asymptomatic and are often found by chance by physical examination for other reasons. A typical abdominal aortic aneurysm is an expansive mass pulsating laterally and anteroposterior. Half of the patients are accompanied by vascular murmurs. A few patients have symptoms of compression. Abdominal ...
Aortic Dissection - International Emergency Medicine Education Project
As initial stabilization and initial resuscitation take place, a focused clinical examination should simultaneously be performed. The physician should assess for signs of shock (e.g., cold extremities, delayed capillary refill, weak, thready pulse.) and aim to determine the etiology of hypotension if present. The physician should always consider bedside ultrasonography (RUSH protocol) to facilitate diagnosis as soon as possible. Assess for pulse deficits. Pulse deficits are diminished or absent pulses caused by compression of the true lumen by the false lumen. Blood pressure difference between the left and right arm suggests aortic dissection. BP difference ,20 mmHg between the two limbs is significant. Data analysis from the International Registry of Acute Aortic Dissection (IRAD) revealed that fewer than 20% of patients with proven acute aortic dissection had reported pulse deficits. The cardiopulmonary examination should focus on signs of cardiac ischemia, aortic insufficiency, cardiac ...
T. Bisdas | Treatment of a type II post dissection TAAA with one renal artery originating from false lumen - Livemedia -...
7/11|br />18:50-21:10 Aortic Dissections/ Transection/ Trauma|br />Πρόεδροι: E. Brountzos,M. Khoury,F. Sigala,A. Trikas|br />18:50-19:00 Single stage hybrid repair for De Bakey type I aortic dissection|br /> . Tzilalis|br />19:00-19:10 Innominate artery dissection mimicking saccular aortic rupture|br />C. Kotoulas|br />19:10-19:20 Treatment of a type II post dissection TAAA with one renal artery originating from false lumen|br />T. Bisdas|br />19:20-19:30 Right axillary and left femoral artery perfusion for repair of posttraumatic aortic arch disruption|br />T. Karaiskos|br />19:30-19:40 Endovascular treatment of subacute type B thoracic dissection in a young patient|br />T. Kratimenos |br />19:40-19:50 Urgent endovascular repair of suprarenal aortic perforation during TAVI|br />S. Kalliafas|br />19:50-20:00 Valve sparing procedure (DAVID) in acute Type I Dissection|br />D. Iliopoulos|br />20:00-20:10 Left Carotid Cannulation for acute aortic dissection|br />V. Patris|br />20:10-20:20 Treatment
A Case of Acute Type A Aortic Dissection Complicated with Cerebral Malperfusion
A 59-year-old man with a history of hypertension who suddenly developed back pain and apoplexy was transferred to our hospital 20 min after the clinical onset. Physical examination showed right conjugate deviation of the eyes and left paralysis, suggesting disorder of the right cerebral hemisphere. Enhance computed tomography showed an aortic dissection from the ascending aorta to bilateral iliac arteries, and the right common cranial artery was compressed by a false lumen. Acute type A aortic dissection complicated with cerebral malperfusion was diagnosed, and an emergency operation was performed 2.5h after the onset. Cardiopulmonary bypass was established with right femoral artery inflow and bicaval venous drainage. We found the dissection entry at the ascending aorta using the distal open technique, and performed hemiarch graft replacement with selective cerebral perfusion. The postoperative course was uneventful without deterioration of neurological function. Postoperative computed ...
Ascending Aortic Dissection with Atypical Presentation of Headache
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Spotlight Dissecting the Presentation. This presentation is based on the April 2015 AHRQ WebM&M Spotlight Case -See the full...
Objectives At the conclusion of this educational activity, participants should be able to: Define aortic dissection Describe epidemiology of acute aortic dissection State common and uncommon presentations of acute aortic dissection Appreciate that a normal chest radiograph should not be used to rule out acute aortic dissection List three factors leading to a missed diagnosis of aortic dissection List key pitfalls in the management of acute aortic dissection 3
Two stage hybrid approach for complex aortic coarctation repair | Journal of Cardiothoracic Surgery | Full Text
Management of an adult patient with aortic coarctation and an associated cardiac pathology poses a great surgical challenge since there are no standard guidelines for the therapy of such complex pathology. Debate exists not only on which lesion should be corrected first, but also upon the type and timing of the procedure. Surgery can be one- or two-staged. Both of these strategies are accomplice with elevate morbidity and mortality. In the face of such an extended surgical approach, balloon dilatation seems preferable for treatment of severe aortic coarctation. We present an adult male patient with aortic coarctation combined with ascending aorta aneurysm and concomitant aortic valve regurgitation. The aortic coarctation was corrected first, using percutaneous balloon dilatation; and in a second stage the aortic regurgitation and ascending aorta aneurysm was treated by Bentall procedure. The patients postoperative period was uneventful. Three years after the operation he continues to do well.
Acute aortic dissection: be aware of misdiagnosis | BMC Research Notes | Full Text
Acute aortic dissection (AAD) is a life-threatening condition requiring immediate assessment and therapy. A patient suffering from AAD often presents with an insignificant or irrelevant medical history, giving rise to possible misdiagnosis. The aim of this retrospective study is to address the problem of misdiagnosing AD and the different imaging studies used. From January 2000 to December 2004, 49 patients (41 men and 8 women, aged from 18-75 years old) presented to the Emergency Department of our hospital for different reasons and finally diagnosed with AAD. Fifteen of those patients suffered from arterial hypertension, one from giant cell arteritis and another patient from Marfans syndrome. The diagnosis of AAD was made by chest X-ray, contrast enhanced computed tomography (CT), transthoracic echocardiography (TTE) and coronary angiography. Initial misdiagnosis occurred in fifteen patients (31%) later found to be suffering from AAD. The misdiagnosis was myocardial infarction in 12 patients and
Acute type A aortic dissection repair with mild-to-moderate hypothermic circulatory arrest and selective cerebral perfusion -...
METHODS: Between 2000 and 2011, 109 consecutive patients underwent surgical repair for acute type A aortic dissection with circulatory arrest and ASCP and MH in our institution. Mean patient age was 67±11 years old. Total arch replacement was performed in 85 patients (78%). Thirty (27%) patients had shock status preoperatively. The patients were divided into two different subsets, which is group A (circulatory arrest at less than 27.9 °C, N.=70), and group B (at more than 28 °C, N.=39 ...
Acute aortic dissection: a missed diagnosis | BMJ Case Reports
A 60-year-old man with a history of indigestion and untreated hypertension presented with sudden-onset central chest pain which radiated to his back. Acute coronary syndrome was initially suspected but excluded in the emergency department before the patient was discharged. The pain subsequently abated to mild intermittent episodes and was misdiagnosed as indigestion. A week later the patient developed new shortness of breath and flu-like symptoms with a positive d-dimer test. CT angiography revealed a Stanford type B aortic dissection which was causing hypoperfusion of the right kidney, resulting in an acute kidney injury. Due to uncontrolled hypertension despite rigorous antihypertensive medication and his failing renal function, the patient underwent endovascular repair and made a good recovery postoperatively. ...
Valve-sparing aortic root replacement - wikidoc
Marfan Syndrome: A Primer For Clinicians And Scientists. Peter Nicholas Robinson, Maurice Godfrey eds. Chapter 5: Duke E. Cameron and Vincent L. Gott. Surgical Management of the Marfan Patient at The Johns Hopkins Hospital. ...
Number 09-11: Gerbode Ventricular Septal Defect after Ross Procedure - Society for Cardiovascular Magnetic Resonance
Perspective: Left ventricle-right atrium (LV-RA) communication is mostly congenital and extremely rare (,1% of all congenital heart disease) finding. This was first classified by Gerbode et al. in 1958(1,2). Acquired LV-RA communications can be secondary to endocarditis, trauma, myocardial infarction (1) or valve replacement (1,3). This defect was likely a postoperative complication of the Ross procedure. Cardiac MR imaging was able to show the type and location of the defect, and to help quantify the degree of shunt across the defect (4). References:. 1. Cheema OM, Patel AA, Chang SM, Dipan JS. Gerbode Ventricular Septal Defect Diagnosed at Cardiac MR Imaging: Case Report. Radiology. 2009; 252:50-52.. 2. Ramasubbu K., Coselli J, Zoghbi WA. Unusual complication of aortic root reconstruction with sparing of the aortic valve: left ventricular outflow tract to right atrial fistula. J Am Soc Echocardiogr 2006; 19(4): 469.e5-469.e9.. 3. Wasserman SM, Fann JI, Atwood JE, Burdon TA, Fadel BM. Acquired ...
Thomas Gleason, MD discusses Type B Aortic Dissection at the 2017 Society for Thoracic Surgery Annual Meeting :News
Friday, March 23, 2018 Herberman Conference Center at UPMC Cancer Pavilion, UPMC Shadyside Pittsburgh, Pa. 1 to 8 p.m.* *Times are Tentative Program Goal To provide oncology health care professionals with the knowledge and skills needed to promote evidence-based care to oncology patients and their families throughout the survivorship continuum. Who Should ...
Ascending aortic aneurysm - stl file processed - Thorax and Ribs - embodi3D.com
Ascending aortic aneurysm - stl file processedHave embodi3D 3D print this model for you. This file was created with democratiz3D. Automatically create 3D printable models from CT scans. thorax, chest, .stl, 3d, model, printable, bone, sternum, manubrium, ribs, clavicle, scapula, coracoid, process...
Aortic Root Surgery: Medical Procedure, Preparation & Definitions | FindATopDoc
Learn more about Aortic Root Surgery medical procedure, risk, preparation, definitions, what to expect after and results at FindaTopDoc.
Aortic dissection - Wikipedia
Aortic dissection (AD) occurs when an injury to the innermost layer of the aorta allows blood to flow between the layers of the aortic wall, forcing the layers apart. In most cases this is associated with a sudden onset of severe chest or back pain, often described as tearing in character. Also, vomiting, sweating, and lightheadedness may occur. Other symptoms may result from decreased blood supply to other organs such as stroke or mesenteric ischemia. Aortic dissection can quickly lead to death from not enough blood flow to the heart or rupture of the aorta. Aortic dissection is more common in those with a history of high blood pressure, a number of connective tissue diseases that affect blood vessel wall strength such as Marfan syndrome, a bicuspid aortic valve, and previous heart surgery. Major trauma, smoking, cocaine use, pregnancy, a thoracic aortic aneurysm, inflammation of arteries, and abnormal lipid levels are also associated with an increased risk. The diagnosis is suspected based ...
Automated Assessment of Acute Aortic Dissection on Thoracic CT Using D by Varun Singh, Richard Gorniak, MD et al.
Purpose To assess the efficacy of deep convolutional neural networks (DCNNs ) in differentiating acute aortic dissections from non-dissected aortas on thoracic CT.
Blood test on horizon to detect aortic aneurysm, dissection - Healthcanal.com : Healthcanal.com
The aorta is the large artery that carries blood away from the heart. Aortic aneurysms and dissections, which often have symptoms similar to a heart attack, cause more than 10,000 deaths annually in the U.S., according to the Centers for Disease Control. Certain types of dissections (Type A), if left untreated, kill 33% of patients within the first 24 hours, and 50% of patients within 48 hours, according to research by the International Registry of Acute Aortic Dissections (IRAD). The research from Shriners Hospital for Children and Oregon Health & Science University, Portland, and Baylor College of Medicine and the Texas Heart Institute in Houston, which was published online today by Circulation Research, found that high blood levels of fibrillin-1, a protein essential to the make-up of the bodys connective tissue and blood vessels, are about twice as common in people with thoracic aortic aneurysm than in people with other types of aortic aneurysms. The high fibrillin-1 levels most likely are ...
132311 | Stanford Health Care
BACKGROUND: Over the past two decades elective valve-sparing aortic root replacement (V-SARR) has become more common in the treatment of patients with aortic root and ascending aortic aneurysms. Currently there are little data available to predict complications in the post-operative population. The study goal was to determine if altered flow patterns in the thoracic aorta, as measured by MRI, are associated with complications after V-SARR. METHODS: Time-resolved three-dimensional phase-contrast MRI (4D flow) was used to image 12 patients with Marfan syndrome after V-SARR. The patients were followed up for an average of 5.8years after imaging and 8.2years after surgery. Additionally 5 volunteers were imaged for comparison. Flow profiles were visualized during peak systole using streamlines. Wall shear stress estimates and normalized flow displacement were evaluated at multiple planes in the thoracic aorta. RESULTS: During the follow-up period, a single patient developed a Stanford Type B aortic ...
ASSA13-15-26 Echocardiography Guided Endovascular Graft Exclusion For the Treatment of Stanford B Aortic Dissection | Heart
Methods In 11 patients with Stanford B aortic dissection, TEE and TTE were used to determine the parameters for pre-surgery diagnosis and selection of a coated stent. During surgery, TEE and TTE provided real-time and dynamic monitoring and guiding for precise implantation of the coated stent to effectively seal the tear of the aortic dissection. After surgery, clinical efficacy and potential side effects of the implantation of the coated stent were evaluated.. ...
Best management of short abdominal aortic aneurysm necks to be highlighted in the CX Abdominal Aortic sessions - CX Symposium
Management of ruptured abdominal aortic aneurysms. The latest evidence on the best way to manage a ruptured aneurysm will be presented including the one-year results of the IMPROVE trial and the IPD 3 trial. In the same session, the controversy as to whether many patients with ruptured abdominal aortic aneurysms are denied intervention will be discussed. Greenhalgh comments: Perhaps doctors are becoming more concerned about operating for fear of having poor mortality figures. We need to find evidence whether indeed patients are denied intervention.. Janet Powell (Imperial College, London, UK), member of the CX Programme Organising Board, considers that a few patients are offered repair of ruptured aortic aneurysm because perhaps not all centres have an endovascular team and facilities available at all times; additionally, there are financial stringencies on healthcare systems and many of these patients may need intervention out of hours. Holden adds that many questions on this subject remain ...
Bentall procedure recovery
A Bentall procedure is a type of surgical operation usually done in open heart surgeries that concerns the aorta, the largest artery of the heart.This can involve replacing some defective parts of the aorta, such as the valve or the upper part called the ascending aorta, with a graft.Some patients with Marfan syndrome may especially have to undergo a Bentall procedure, as the condition causes .... https://www.wisegeek.com/what-is-a-bentall-procedure.htm DA: 16 PA: 32 MOZ Rank: 48 ...
Treatment of nonocclusive mesenteric ischemia with type B aortic dissection using intra-arterial catheterization after trauma...
We present a successful case of catheter-directed infusion into the SMA for a patient with NOMI complicated with traumatic type B AD involving the SMA. Vasodilator infusion via arterial catheter has been reported as an effective treatment for NOMI and many reports suggested efficacy of this strategies [4-7]. In 1977, Boley et al. decreased mortality rate from about 70-80% to 40% performing catheter intra-arterial infusion of papaverine . Other recent study revealed vasodilator administration from SMA achieved successful treatment in 64% patients of NOMI after open heart surgery with nonsurgical treatment . The strategy and management of NOMI with type B AD involving the SMA have not yet been established, and research is limited . Thus, there are two overwhelming difficulties: risk from the catheterization of the dissected aorta and the accurate and prompt evaluation of NOMI.. First, the catheterization of and arterial infusion for the dissected aorta are essential, and more safety ...
Blood Test on the Horizon to Detect Aortic Aneurysm and Aortic Dissection - Marfan Syndrome UK from the Marfan Forum
A team of investigators has developed an innovative blood test that may provide a faster, simpler way for emergency room doctors and others to diagnose and monitor potentially deadly aortic aneurysms and aortic dissections (a tear in the wall of the aorta) for which early diagnosis is critical for survival. The aorta is the large…
May | 2017 | SinaiEM
The 52 in 52 Review: The International Registry of Acute Aortic Dissection (IRAD) New Insights Into an Old Disease. Article Citation: Hagan PG et al. The International Registry of Acute Aortic Dissection (IRAD)New Insights Into an Old Disease. JAMA. 2000;283(7):897-903. doi:10.1001/jama.283.7.897 What We Already Know About the Topic: Aortic dissection has challenged physicians since itRead more. ...
COMPUTATIONAL FLUID DYNAMICS OF TYPE B AORTIC DISSECTION | IRIS Università degli Studi di Palermo
Type B aortic dissection (AoD) is a disease connected to high blood load on the aortic wall and to a reduced aortic wall resistance. Nowadays, prognosis on type B AoD results to be particularly difficult with an high incidence of patients treated with medical therapy which manifest complication connected with dissection and which should have been treated with surgical repair immediately. This work aims to study those haemodynamical and morphological proprieties of dissected aorta, which can influence the progression or stability of type B AoD. Computational fluid-dynamic analyses were performed on twenty-five patients with type B AoD, whose nine presented an aneurysm evolution and sixteen presented no further complication connected with dissection. Blood flow features showed that the true lumen flow was laminar and uniform while false lumen flow was less homogeneous with a consequent recirculating path. We found that entry point zone proximal to the aortic arch showed both high blood velocity ...
Technical eligibility for endovascular treatment of the aortic arch after open type A aortic dissection repair
Objective: To report on the technical eligibility of patients previously treated for Stanford type A aorta dissection (AAD) for endovascular aortic arch repair based on contemporary anatomical criteria for an arch inner-branched stentgraft (AIBS). Methods: All patients treated for AAD from 2004-2015 at a single aortic centre were identified. Extent of repair and use of circulatory arrest were reported. Survival and reoperation were assessed using Kaplan Meier and competing risk models. Anatomic assessment was performed using 3-dimensional CT-imaging software. Primary outcome was survival ≥ 1 year and fulfilment of the AIBS anatomical criteria. Results: A total of 198 patients were included (158 Debakey I, 32 Debakey II, and 8 Intramural hematoma). Mortality was 30-days: 16.2%, 1-year: 19.2%, 10-years: 45.0%. There were 129 patients with imaging beyond 1 year (mean, 47.8 months), while 89 (69.0%) were AIBS eligible. During follow-up, 19 (14.7%) patients met the threshold criteria for aortic ...
Aortic Aneurysm and Aortic Dissection - Scripps Health
Offering highly specialized care for aortic disease in San Diego, Scripps uses the latest in treating aortic aneurysm and aortic dissection.
Case Report of a Hybrid Endovascular Approach to an Abdominal Aortic Dissection With Retrograde Thoracic Extension and...
Spontaneous abdominal aortic dissection (AAD) with retrograde thoracic extension is an extremely rare occurrence with a high mortality. Abdominal aortic dissection can be associated with an abdominal aortic aneurysm (AAA) and the presence of an AAD w
... aortic arch, or descending aneurysms. Abdominal aortic aneurysms, "AAA" or "Triple A", the most common form of aortic aneurysm ... Aortic aneurysms are classified by their location on the aorta. An aortic root aneurysm, or aneurysm of the ... Aortic aneurysms resulted in about 152,000 deaths in 2013 up from 100,000 in 1990. Aortic valve repair Aortic dissection ... Thoracoabdominal aortic aneurysms involve both the thoracic and abdominal aorta. is painful. Thoracoabdominal aortic aneurysms ...
Inflammatory aortic aneurysm
... (IAA), also known as Inflammatory abdominal aortic aneurysm (IAAA), is a type of abdominal aortic ... "Aortic Aneurysm: Causes, Symptoms, Treatments, and More." WebMD. WebMD, n.d. Web. 22 July 2015. "Abdominal Aortic Aneurysm: ... The rupture of an aortic aneurysm is a catastrophic, life-threatening event. Aortic aneurysms are often encountered during an X ... "Infected aortic aneurysm and inflammatory aortic aneurysm-In search of an optimal differential diagnosis". Journal of ...
Thoracic aortic aneurysm
A thoracic aortic aneurysm is an aortic aneurysm that presents primarily in the thorax. A thoracic aortic aneurysm is the " ... However, a syphilitic aneurysm is more likely to be a thoracic aortic aneurysm than an abdominal aortic aneurysm. This ... Thoracic Aortic Aneurysm at eMedicine Aneurysms: Aneurysms and Aortic Dissection at Merck Manual of Diagnosis and Therapy Home ... Atherosclerosis is the principal cause of descending aortic aneurysms, while aneurysms of the aortic arch may be due to ...
Abdominal aortic aneurysm
"NHS Abdominal Aortic Aneurysm Screening Programme" (PDF). "Aortascreening av nära släkting (Aortic screening of close relative ... ISBN 978-0-07-146633-2. Abdominal Aortic Aneurysm at eMedicine Brown LC, Powell JT (September 1999). "Risk Factors for Aneurysm ... Evar Trial Participants (2005). "Endovascular aneurysm repair versus open repair in patients with abdominal aortic aneurysm ( ... "Abdominal aortic aneurysm". Am Fam Physician. 73 (7): 1198-204. PMID 16623206. Wittels K (November 2011). "Aortic emergencies ...
Familial thoracic aortic aneurysm
GeneReview/NCBI/NIH/UW entry on Thoracic Aortic Aneurysms and Aortic Dissections v t e (Articles with short description, Short ... Familial thoracic aortic aneurysm is an autosomal dominant disorder of large arteries. There is an association between familial ... In the aorta, this can result in the formation of a fusiform aneurysm. There is also increased risk of aortic dissection.[ ... thoracic aortic aneurysm and Marfan syndrome as well as other hereditary connective tissue disorders. A degenerative breakdown ...
Familial thoracic aortic aneurysm and aortic dissection
"Familial thoracic aortic aneurysm and dissection: MedlinePlus Genetics". "Familial thoracic aortic aneurysm and aortic ... Familial thoracic aortic aneurysm and aortic dissection is a very rare vascular genetic disorder, it's characterized by ... "Thoracic Aortic Aneurysm & Aortic Dissection". Guo, Dong-Chuan; Regalado, Ellen S.; Minn, Charles; Tran-Fadulu, Van; Coney, ... "Orphanet: Familial thoracic aortic aneurysm and aortic dissection". Omar, Sabry; Moore, Tyler; Payne, Drew; Momeni, Parastoo; ...
Isolated aortic root aneurysms". In Kırali, Kaan (ed.). Aortic Aneurysm. BoD - Books on Demand. p. 29. ISBN 978-953-51-2933-2. ... Replacing a diseased aortic valve with an aortic valve from a cadaver was first performed by Donald Ross in England in June ... In 1967 Ross took the normal pulmonary valve of a person with severe aortic valve disease, and placed it in the aortic position ... such as in children and young adults with a bicuspid aortic valve. It involves removing the diseased aortic valve, situated at ...
Poredos, Pavel (2008). "Inflammatory aortic aneurysm". e-Journal of the European Society for Cardiology Practice. 7 (10). ... "Inflammatory Abdominal Aortic Aneurysm with Retroperitoneal Fibrosis". Circulation. 130 (15): 1300-1302. doi:10.1161/ ... ANCA-associated vasculitis autoimmune pancreatitis sarcoidosis primary biliary cirrhosis inflammatory abdominal aortic aneurysm ...
... he used his nylon shirt to successfully repair an aortic aneurysm in a human. After debriding and resecting the aneurysm, the ... In 1955, he presented his experiences of over 30 abdominal aortic aneurysms to the Royal College of Surgeons. In 1955, Rob ... In addition, he introduced using frozen cadaver arterial grafts in the treatment of aortic aneurysms. ... Frederick, John R.; Woo, Y. Joseph (September 2012). "Thoracoabdominal aortic aneurysm". Annals of Cardiothoracic Surgery. 1 (3 ...
... "abdominal aortic aneurysm"; "anti-aircraft artillery"; "Asistencia, Asesoría y Administración" (Three-As) "Amateur Athletic ...
Deaths in November 2021
Brian Clark, 89, British playwright (Whose Life Is It Anyway?) and screenwriter, aortic aneurysm. Bobby Collins, 88, American ...
a ruptured aortic aneurysm. a ruptured renal aneurysm. acute pancreatitis. malignancy. Retroperitoneal bleeds ... A Clinical Sign of a Forthcoming Life-Threatening Rupture of an Intraparenchymal Aneurysm of Renal Artery (Wunderlich's ...
Abdominal aortic aneurysm". The Advanced Practice Nurse Cardiovascular Clinician. New York: Springer. p. 299. ISBN 978-0-8261- ... In 2006, the year before he co-authored his Cochrane review on screening for abdominal aortic aneurysms (AAA), he was appointed ... Tillman, Ken; Lee, O. Danny; Whitty, Kristin (March 2013). "Abdominal aortic aneurysm: an often asymptomatic and fatal men's ... Cosford, Paul A.; Leng, Gillian C.; Thomas, Justyn (18 April 2007). "Screening for abdominal aortic aneurysm". The Cochrane ...
"Abdominal Aortic Aneurysms". The Lecturio Medical Concept Library. 16 October 2020. Retrieved 30 June 2021. "Aortic Aneurysm, ... Turner syndrome also increases the risk of aortic dissection, by aortic root dilatation. Chest trauma leading to aortic ... Individuals who have undergone aortic valve replacement for aortic insufficiency are at particularly high risk because aortic ... a bicuspid aortic valve; and previous heart surgery. Major trauma, smoking, cocaine use, pregnancy, a thoracic aortic aneurysm ...
Cosford, Paul A.; Leng, Gillian C.; Thomas, Justyn (18 April 2007). "Screening for abdominal aortic aneurysm". The Cochrane ...
Vilacosta, Isidre; Godoy, Victoria Cañadas (2008). "Bifid Uvula and Aortic Aneurysm". New England Journal of Medicine. 359 (2 ... which is associated with an increased risk of aortic aneurysm. During swallowing, the soft palate and the uvula move together ...
The most common cause is an abdominal aortic aneurysm that has ruptured spontaneously. Aortic rupture is distinct from aortic ... Traumatic aortic rupture Aortic rupture secondary to an aortic aneurysm Tearing pain, located in the abdomen, flank, groin, or ... Death The most common cause of aortic rupture is a ruptured aortic aneurysm. Other causes include trauma and iatrogenic ( ... just as non-ruptured aortic aneurysms are repaired. An aortic occlusion balloon can be placed to stabilize the patient and ...
List of OMIM disorder codes
SLC6A4 Aortic aneurysm, familial thoracic 4; 132900; MYH11 Aortic aneurysm, familial thoracic 6; 611788; ACTA2 Aortic valve ... aneurysms, and muscle cramps; 611773; COL4A1 Aniridia; 106210; PAX6 Anonychia congenita; 206800; RSPO4 Anterior segment ... MAPT Supravalvar aortic stenosis; 185500; ELN Surfactant metabolism dysfunction, pulmonary, 1; 265120; SFTPB Surfactant ...
De Musset's sign
Aortic aneurysm Tremor Gallo, Vittorio (2011). Unusual Signs and Symptoms in Internal Medicine (1st ed.). Torino: SEEd Srl. p. ... result of aortic regurgitation whereby blood from the aorta regurgitates into the left ventricle due to a defect in the aortic ... that the systolic pulse is being felt by the patient because of the increased pulse pressure resulting from the aortic ...
Ascending aortic aneurysm causing pulmonary stenosis. Odeku, E. L.; Antia, A. U.; Udekwu, F. A. O. (1970). "Persistent ascites ... Anyanwu, CH; Ihenacho, HN; Okoroma, EO; Nwafo, DC; Udekwu, FA (September 1979). "Ascending aortic aneurysm causing pulmonary ... Traumatic aneurysms and arteriovenous fistulas in Nigeria. Clinical aspects of pulmonary and pleural carcinoma in Nigeria. ... Udekwu, FA; Cabre, CA; Sen, SK (November 1965). "Aneurysm of the left pulmonary artery with hemoptysis and bronchial ...
"Galvano-puncture of Aortic Aneurysm." - Lancet, 1873. "Three Cases of Trephining for Haemorrhage from the Middle Meningeal ...
Geneton Moraes Neto
He died of an aortic aneurysm. Mergulhão, Alfredo (22 August 2016). "Jornalista Geneton Moraes Neto morre aos 60 anos vítima de ...
Richard Wolfson (musician)
He died of an aortic aneurysm. Saunders with Cutler, Jah Wobble, Bob Drake, Dave Kerman, Glyn Perrin, Greg Skerman, and others ... Deaths from aortic aneurysm, English pop musicians, Jewish English musicians, People from Solihull, English male journalists). ...
Orr, Conor (September 8, 2017). "Jon Dorenbos diagnosed with aortic aneurysm". NFL.om. "TRANSACTIONS". neworleanssaints.com. ... it was revealed that Dorenbos was diagnosed with an aortic aneurysm, which required immediate heart surgery. He was placed on ...
After getting traded to the New Orleans Saints in the 2017 preseason, it was discovered Dorenbos had an aortic aneurysm that ... During a physical, Dorenbos was diagnosed with an aortic aneurysm, and required open-heart surgery. He has since recovered and ... On September 7, it was revealed that Dorenbos was diagnosed with aortic aneurysm, which required immediate heart surgery. He ... Orr, Conor (September 8, 2017). "Jon Dorenbos diagnosed with aortic aneurysm". NFL.om. Gartland, Dan (February 5, 2018). " ...
High-attenuation crescent sign
Iranpour, Pooya; Haseli, Sara (31 May 2018). "Crescent sign in abdominal aortic aneurysm". Case Reports. 2018: bcr. doi:10.1136 ... Iranpour, Pooya; Haseli, Sara (4 June 2018). "Crescent sign in abdominal aortic aneurysm". BMJ Case Reports. 2018: ... "High-attenuation crescent sign on computed tomography in acute abdominal aortic aneurysm". The American Journal of Emergency ... The blood that dissects through mural thrombosis or wall of the aneurysm causes weakening of the wall. This is of relatively ...
Charles Thurstan Holland
Holland, C. T. (1903). Description of Plates: Plate CLIII.(a): Aortic Aneurism. Archives of the Roentgen Ray. 7(4), 70-70. ...
Fortner G, Johansen K (January 1984). "Abdominal aortic aneurysms". West. J. Med. 140 (1): 50-9. PMC 1011036. PMID 6702193. ... He is most notable for his method of treatment of aneurysms. He described the types of aneurysms, and created a taxonomy ... His operation for aneurysm remained the standard procedure until the 19th century. Antyllus is also said to have developed a ...
Bicuspid aortic valve
... disease andascending aortic aneurysms: gaps in knowledge. Hindawi 2012; 2012:145202 - 145218. Bissell MM ... The patient-specific risk of developing complications such as aortic aneurysms is dependent on the particular aortic leaflet ... A bicuspid aortic valve may cause the heart's aortic valve to narrow (aortic stenosis). This narrowing prevents the valve from ... Bicuspid aortic valve (aka BAV) is a form of heart disease in which two of the leaflets of the aortic valve fuse during ...
Slater EE, DeSanctis RW (May 1976). "The clinical recognition of dissecting aortic aneurysm". The American Journal of Medicine ... while chest pain described as tearing may indicate aortic dissection. Functional magnetic resonance imaging brain scanning has ...
List of ICD-9 codes 390-459: diseases of the circulatory system
... ruptured 441.4 Abdominal aortic Aneurysm, w/o rupture 441.9 Abdominal Aortic Aneurysm, unspecified 442 Other aneurysm 443 Other ... ulceration 441 Aortic aneurysm and dissection 441.0 Aortic Dissection 441.3 Abdominal Aortic Aneurysm, ... 395 Diseases of aortic valve 395.0 Rheumatic aortic stenosis 395.1 Rheumatic aortic insufficiency 395.2 Rheumatic aortic ... forms of chronic ischemic heart disease 414.0 Coronary atherosclerosis 414.1 Aneurysm and dissection of heart 414.10 Aneurysm ...
List of cardiology mnemonics
PAID: Pulmonic & Aortic Insufficiency=Diastolic.p. 32 CARDIAC RIND:p. 34 Collagen vascular disease Aortic aneurysm Radiation ... CREAM: Congenital Rheumatic damage Endocarditis Aortic dissection/ Aortic root dilatation Marfan's SAD:p. 29 Syncope Angina ... 1 Aortic arch gives rise to: Brachiocephalic trunk Left Common Carotid Left Subclavian Toilet Paper My Ass, or They Pay Me ... RAMP:p. 31 Recent MI Aortic stenosis MI in the last 7 days Pulmonary hypertension FROM JANE: Fever Roth's spots Osler's nodes ...
... for abdominal aortic aneurysm repair, coronary artery bypass, aortic valve repair and mitral valve repair. Risk-adjusted ... for coronary artery bypass and aortic valve repair. A similar study published in Archives of Surgery in 2011 evaluated ...
... during surgical procedures that involve abrupt disruption of blood flow through the aorta for example during aortic aneurysm ...
He had been suffering lung problems, but died of an aortic aneurysm, and was buried privately at St David's cemetery in Davey ...
Emin (esoteric movement)
Armin who died in August 2002 from an aortic aneurysm. Violet Armin (Ruth) died in 2008 in her sleep. The Emin was Truly ...
... or Death Blow may refer to: death blow Coup de grace Dissecting aortic aneurysm Deathblow (comics) is a fictional ...
Deaths in June 2011
Bruce Crozier, 72, Canadian politician, Ontario MPP for Essex South (1993-1999) and Essex (since 1999), aortic aneurysm. Andrew ... Shelby Grant, 74, American actress (Our Man Flint, Fantastic Voyage, Medical Center), brain aneurysm. Martin H. Greenberg, 70, ... Albert Wiggins, 76, American Olympic swimmer, aortic dissection. Ray Bryant, 79, American jazz pianist, after long illness. ... brain aneurysm. Ian Mitchell, 86, English cricketer, natural causes. Andreas P. Nielsen, 58, Danish author and ...
It is believed that he suffered an aortic aneurysm. Wesker wrote a book chronicling the out-of-town tribulations that beset the ... Deaths from aortic aneurysm, Hollywood blacklist, Jewish American male actors, Art Students League of New York alumni, ...
List of circulatory system conditions
Vascular surgery Aortic aneurysm Saladin, Kenneth S.; Miller, Leslie (2004). "18". Anatomy & Physiology: The Unity of form and ... Angina Acute coronary syndrome Anomic aphasia Aortic dissection Aortic regurgitation Aortic stenosis Apoplexy Apraxia ... Congenital heart defects Aortic coarctation (Aortic coarctation) Acyanotic heart defect Atrial septal defect Cor triatriatum ... Tricuspid atresia Interrupted aortic arch Coarctation of aorta Pulmonary atresia (PA) Pulmonary stenosis (critical) Atrial ...
Activated protein C-protein C inhibitor
... and platelet activation in patients undergoing open and endovascular repair of abdominal aortic aneurysm". J Vasc Surg. 54 (3 ...
These comorbidity conditions include aortic aneurysm, aortic stenosis, extensive three-vessel coronary artery disease, diabetes ... For example, in aortic valve area calculation the Gorlin equation can be used to calculate the area if the cardiac output, ... endovascular aneurysm repair) Persistent chest pain despite medical therapy thought to be cardiac in origin New-onset ...
James L. Holloway Jr.
He died on January 11, 1984, of an aortic aneurysm at Fairfax Hospital in Falls Church, Virginia. Holloway was a husky, round- ... Deaths from aortic aneurysm, Burials at the United States Naval Academy Cemetery, Recipients of the Legion of Merit, ...
The cause was not immediately known, but he had suffered from kidney failure following surgery for an abdominal aortic aneurysm ...
Elderly: diverticulitis, intestinal obstruction, colonic carcinoma, mesenteric ischemia, leaking aortic aneurysm. The term " ...
Jeremy Dale (racing driver)
Dale was forced to take time off through 2011 and 2012 due to the discovery of an aortic aneurysm, leading to open heart ...
... aortic aneurysms are preventable, treatable and not so rare. Helliker is a graduate of the Department of English at the ... "their groundbreaking examination of aneurysms, an often overlooked medical condition that kills thousands of Americans each ...
... and academic administrator noted for his contributions to aortic aneurysm biomechanics and pathobiology, and tissue engineered ...
Darrett B. Rutman
He died of an aortic aneurysm on April 11, 1997. Several of his books were co-authored by his wife, Anita H. Rutman. ... Deaths from aortic aneurysm, University of Florida faculty, 20th-century American historians, American male non-fiction writers ...
Huston died of an aortic aneurysm in his hotel suite in Beverly Hills, two days after his 67th birthday. He was cremated. In ... Deaths from aortic aneurysm, People from Old Toronto, Huston family, People from Orangeville, Ontario, Vaudeville performers). ...
Abdominal aortic aneurysm Appendicitis Blunt force trauma to the abdomen Bowel obstruction Diverticulitis Dyspepsia Ectopic ... Peritonitis Ectopic pregnancy Ovarian cysts Fluid/blood secondary to trauma Appendicitis Aneurysm KUB x-ray imaging (kidney, ... Organ contusion Organ laceration Aneurysm Diverticulitis Appendicitis Pelvic, abdominal and/or transvaginal ultrasound ...
... s are involved in many types of surgical procedures, including: Abdominal aortic aneurysm ... transplants Hip replacement Knee replacement Hysterectomy Myomectomy Endovascular aneurysm repair Thoracic aortic aneurysm ENT ...
Thomas J. Fogarty
One of his most successful products is the Stent-Graft, which dealt with the difficult problem of abdominal aortic aneurysms (a ...
He died in London in 1992, aged 69, from a ruptured aortic aneurysm. He is buried in Putney Vale Cemetery. In years 1950-1957 ... Deaths from aortic aneurysm, Naturalised citizens of the United Kingdom, Nazi concentration camp survivors, People from Zgierz ...
... abdominal aortic aneurysm ultrasound, hardening of the arteries test, and peripheral arterial disease test. HealthFair charges ...
... died on January 23, 1978, in Los Angeles, California, at the age of 74 from an aortic aneurysm. His remains were ... Deaths from aortic aneurysm, Burials at Forest Lawn Memorial Park (Glendale), 20th-century American male actors). ...
Computed tomography angiography
Another positive of CTA in abdominal aortic aneurysm assessment is that it allows for better estimation of blood vessel ... CTA can be used in the chest and abdomen to identify aneurysms in the aorta or other major blood vessels. These areas of ... CTA is the test of choice when assessing aneurysm before and after endovascular stenting due to the ability to detect calcium ... It can also be used to identify small aneurysms or arteriovenous malformation inside the brain that can be life-threatening. ...
Charles C. G. Chaplin
Chaplin died in 1991 of an aortic aneurysm. He is survived by two children, Gordon Waterman Chaplin of New York City and Susan ...
... for the treatment of abdominal aortic aneurysm, which compared the older open aortic repair technique to the newer endovascular ... "Outcomes following endovascular vs open repair of abdominal aortic aneurysm: a randomized trial". JAMA. 302 (14): 1535-42. doi: ... aneurysm repair device. An example of the latter are clinical trials on mechanical devices used in the management of adult ...
Aortic Aneurysm | cdc.gov
Learn about aortic aneurysms, a balloon-like bulge in the aorta that can dissect or rupture. ... Abdominal Aortic Aneurysms An abdominal aortic aneurysm happens below the chest. Abdominal aortic aneurysms happen more often ... Facts About Aortic Aneurysm in the United States. *Aortic aneurysms or aortic dissections were the cause of 9,904 deaths in ... Thoracic Aortic Aneurysms A thoracic aortic aneurysm happens in the chest. Men and women are equally likely to get thoracic ...
Aortic Aneurysm | MedlinePlus
An aneurysm is a bulge or ballooning in the wall of an artery. Arteries carry oxygen-rich blood from the heart to the rest of ... Abdominal aortic aneurysm (Medical Encyclopedia) Also in Spanish * Abdominal aortic aneurysm repair - open (Medical ... ClinicalTrials.gov: Aortic Aneurysm (National Institutes of Health) * ClinicalTrials.gov: Aortic Aneurysm, Abdominal (National ... Abdominal aortic aneurysm repair - open - discharge (Medical Encyclopedia) Also in Spanish * Aortic aneurysm repair - ...
Abdominal Aortic Aneurysm Clinical Presentation: History, Physical Examination, Complications
Aneurysms are defined as a focal dilatation in an artery, with at least a 50% increase over the vessels normal diameter. ... Abdominal aortic aneurysms (AAAs) are relatively common and are potentially life-threatening. ... The management of ruptured abdominal aortic aneurysms: screening for abdominal aortic aneurysm and incidence of rupture. J ... encoded search term (Abdominal Aortic Aneurysm) and Abdominal Aortic Aneurysm What to Read Next on Medscape ...
Thoracic Aortic Aneurysm Guidelines: ACC/AHA Guidelines for Aortic Disease
By definition, an aneurysm is a localized or diffuse dilation of an artery with a diameter at least 50% greater than the normal ... encoded search term (Thoracic Aortic Aneurysm) and Thoracic Aortic Aneurysm What to Read Next on Medscape ... Transverse aortic arch aneurysm: improved results of treatment employing new modifications of aortic reconstruction and ... Novel measurement of relative aortic size predicts rupture of thoracic aortic aneurysms. Ann Thorac Surg. 2006 Jan. 81 (1):169- ...
Aortic aneurysm - Doctors and departments - Mayo Clinic
Thoracic aortic aneurysm, Marfan syndrome, Aneurysm, Renal artery stenosis, Popliteal aneurysm, Aortic dissection, ... Thoracic aortic aneurysm surgery, Varicose vein ablation, Angioplasty, Thoracoabdominal aortic aneurysm repair, Carotid ... Transcatheter aortic valve replacement, Extracorporeal membrane oxygenation, Aortic aneurysm, Aortic valve disease, Mitral ... Aortic aneurysm repair, Aortic valve repair and replacement, Left ventricular assist device implantation, Heart transplant, ...
Endovascular Stent Graft: Aortic Aneurysm Repair
... why and how endovascular grafting is performed for aneurysms plus risks, side effects and recovery from the procedure from the ... Learn more about endovascular grafting and repair for aneurysms (aka EVAR, TEVAR or TA-EVAR), ... How are aortic aneurysms treated?. The best method to repair an aneurysm depends upon several factors, including the location ... The goals of aortic aneurysm treatment are to reduce the risk of complications from aneurysms. The major risk for untreated ...
Psoriasis severity predicts risk of abdominal aortic aneurysms
Psoriasis and abdominal aortic aneurysms. In the general population, abdominal aortic aneurysms occur at a rate of 3.72 cases ... In general, abdominal aortic aneurysms have no symptoms as they slowly swell over a number of years. Some of the major causes ... When an abdominal aortic aneurysm ruptures, often with little warning, it becomes a medical emergency and can be fatal. Because ... The patients were followed until they suffered an abdominal aortic aneurysm, moved out of the country, died or the study ended ...
Ultrasound in Abdominal Aortic Aneurysm
... , Ultrasonography of Abdominal Aortic Aneurysm, Ultrasound of AAA, Abdominal Aorta ... Ultrasound in Abdominal Aortic Aneurysm. Aka: Ultrasound in Abdominal Aortic Aneurysm, Ultrasonography of Abdominal Aortic ... Screening for Abdominal Aortic Aneurysm. *See Abdominal Aortic Aneurysm for screening indications ... Aorta diameter ,3 cm is consistent with Abdominal Aortic Aneurysm. *Aorta diameter ,5.5 cm meets criteria for elective repair ...
Tricuspid aortic valve aneurysm | Heart
Abdominal Aortic Aneurysm Screening | NUH
Endovascular Repair of Abdominal Aortic Aneurysm (EVAR) | CTSNet
Comparison of endovascular aneurysm repair with open repair in patients with abdominal aortic aneurysms (EVAR trial 1). Lancet ... Indications for endovascular repair of the abdominal aortic aneurysm are:. *Patients with asymptomatic abdominal aortic ... Guidelines for the treatment of abdominal aortic aneurysm: report of a subcommittee of the Joint Council of the American ... A randomized trial comparing conventional and endovascular repair of abdominal aortic aneurysms. N Eng J Med 2004;351:1607-1618 ...
Bentall surgery corrects ascending aortic aneurysm
patient care medical feed bentall surgery corrects ascending aortic aneurysm ... Ascending aortic aneurysms are a subtype of thoracic aortic aneurysms that develop above the diaphragm. Since it weakens the ... Further, 2D echo showed severe aortic regurgitation and ascending aortic aneurysm. Coronary angiography along with LV shoot ... Chest X-ray and Two-Dimensional Echocardiography showed severe aortic regurgitation and ascending aortic aneurysm. ...
Helicobacter cinaedi Infection of Abdominal Aortic Aneurysm, Japan - Volume 20, Number 11-November 2014 - Emerging Infectious...
To the Editor: Infected abdominal aortic aneurysm (IAAA) is uncommon, but life-threatening; the mortality rate ranges from 25% ... Helicobacter cinaedi Infection of Abdominal Aortic Aneurysm, Japan. Emerging Infectious Diseases. 2014;20(11):1942-1945. doi: ... Clinical characteristics of 3 patients with Helicobacter cinaedi-infected abdominal aortic aneurysms and molecular ... Helicobacter cinaedi Infection of Abdominal Aortic Aneurysm, Japan. Volume 20, Number 11-November 2014 ...
Aortic Aneurysms - Aortic Care | UCLA Health
UCLA Aortic Center: World Leaders in Aortic Aneurysm Treatment. An aortic aneurysm is a very serious condition. Our surgeons ... What is an Aortic Aneurysm?. The aorta is the largest blood vessel in your body. Aortic aneurysms occur when a weak part of the ... Types of Aortic Aneurysms. The type of aortic aneurysm you have depends on where it is located. They can occur anywhere along ... Expert Diagnosis for Aortic Aneurysm at UCLA. If you have a large aortic aneurysm (bigger than 2 inches), your doctor may be ...
Thoracic Aortic Aneurysm | TriHealth
A thoracic aortic aneurysm is an expansion or bulge in the artery wall resulting from a weakening of the artery wall, with the ... Institutes & Services , TriHealth Heart Institute , Conditions , Thoracic Aortic Aneurysm Start of Thoracic Aortic Aneurysm ... How is Thoracic Aortic Aneurysm Treated at TriHealth?. A thoracic aortic aneurysm should be monitored carefully, and will often ... What is a Thoracic Aortic Aneurysm? A thoracic aortic aneurysm (TAA) is an expansion or bulge in the artery wall resulting from ...
Archived: Evidence Summary: Abdominal Aortic Aneurysm: Screening | United States Preventive Services Taskforce
NHS Abdominal Aortic Aneurysm Screening Programme. NHS Abdominal Aortic Aneurysm Screening Programme 2011-12 Summary. ... Archived: Evidence Summary: Abdominal Aortic Aneurysm: Screening * Archived: Evidence Summary: Abdominal Aortic Aneurysm: ... Late diagnosis of abdominal aortic aneurysms substantiates underutilization of abdominal aortic aneurysm screening for Medicare ... AAA = abdominal aortic aneurysm; MASS = Multicentre Aneurysm Screening Study; PCP = primary care physician.. * Men only.. † ...
Citizen's Campus: The abdominal aortic aneurysm - A ticking time bomb | Technische Universität Ilmenau
Aortic Aneurysm | Ohio State Medical Center
Learn more about aortic aneurysm treatment from Ohio States Wexner Medical Center. ... An aortic aneurysm could cause the aorta to rupture, causing internal bleeding. ... Aortic aneurysms most often occur in the abdomen as an abdominal aortic aneurysm, but can also occur in the upper chest as a ... Aortic Aneurysm Causes. While the exact cause is unclear, an aortic aneurysm may be caused by multiple factors that damage the ...
Catheter intervention for aortic aneurysm - Handmade prosthesis for emergencies
... The aorta is the main artery of the human body ... An aneurysm is said to be present when the diameter of the abdominal aorta exceeds three centimeters at a given point. ... Specialties: Catheter-based and open aortic surgery , Open surgical treatment of the carotid artery, Bypass-surgery ... The main causes of aortic dilatation besides increasing age include smoking and high blood pressure. Regular preventive ...
Tribological analysis of type I endoleaks in a stented abdominal aortic aneurysm - Archive ouverte HAL
Innovative Aortic Repair Spares Patients From Grueling Aneurysm Surgery | Resource | Baptist Health South Florida
Dienst now had a thoracoabdominal aortic aneurysm, a bulging in the aorta that extends from the chest to the abdomen. Because ... After he developed a thoracoabdominal aortic aneurysm, a very complex and dangerous condition also known as a TAAA, he ... These are among the most difficult aortic aneurysms to treat due to the complexity of their location. ... What differentiates a TAAA from other aneurysms is that it extends upward into the chest as well as downward into the abdomen. ...
Cystatin C deficiency in human atherosclerosis and aortic aneurysms
... dc.contributor.author. Shi, Guo-Ping. ... "Cystatin C Deficiency in Human Atherosclerosis and Aortic Aneurysms." J. Clin. Invest. 104 (9) (November 1): 1191-1197. doi: ... The pathogenesis of atherosclerosis and abdominal aortic aneurysm involves breakdown of the elastic laminae. Elastolytic ... Furthermore, increased abdominal aortic diameter among 122 patients screened by ultrasonography correlated inversely with serum ...
Abdominal aortic aneurysm repair - open | Lima Memorial Health System
Abdominal aortic aneurysm repair - open. Site Map Abdominal aortic aneurysm repair - open. AAA - open; Repair - aortic aneurysm ... Abdominal aortic aneurysm. Atherosclerosis. Thoracic aortic aneurysm. Abdominal CT scan. Abdominal MRI scan. Aortic angiography ... Open abdominal aortic aneurysm (AAA) repair is surgery to fix a widened part in your aorta. This is called an aneurysm. The ... Abdominal aortic aneurysm repair - open - discharge Getting out of bed after surgery. References. Ramdon AR, Roddy SP, Darling ...
Association of crossed renal ectopia and aortic aneurism. Case report
The association with aortic aneurysm is even more exceptional.. METHODS. We present our case and perform a bibliographic review ... Association of crossed renal ectopia and aortic aneurism. Case report.. Oct 1, 2010 , Magazine: Archivos Españoles de Urología ... The association of crossed renal ectopia and aortic aneurysm is a rare event. The surgical intervention of the aorta does not ... To date and in our knowledge, seven cases of crossed renal ectopia associated with aortic aneurysm were described on the ...
Genetic basis of abdominal aortic aneurysm disease | Precision Health | Geisinger
'Abdominal Aortic Aneurysms Global Clinical Trials Review, H1, 2016' Published |...
"Abdominal Aortic Aneurysms Global Clinical Trials Review, H1, 2016" Published. "Abdominal Aortic Aneurysms Global Clinical ... Abdominal Aortic Aneurysms Global Clinical Trials Review, H1, 2016 provides an overview of Abdominal Aortic Aneurysms clinical ... Cerebral Aneurysms Global Clinical Trials Review, H1, 2016 - Aortic Aneurysm Global Clinical Trials Review, H1, 2015 - Cerebral ... This report provides top line data relating to the clinical trials on Abdominal Aortic Aneurysms. Report includes an overview ...
Abdominal aortic aneurysm - Symptoms, diagnosis and treatment | BMJ Best Practice US
Patients are usually asymptomatic and their abdominal aortic aneurysm is detected incidentally. In the minority of patients who ... Abdominal aortic aneurysm (AAA) is a permanent pathologic dilation of the aorta with a diameter ,1.5 times the expected ... Screening for abdominal aortic aneurysm: US Preventive Services Task Force recommendation statement. JAMA. 2019 Dec 10;322(22): ... Patients are usually asymptomatic and their abdominal aortic aneurysm is detected incidentally. In the minority of patients who ...
Aortic Branch Aneurysms - Heart and Blood Vessel Disorders - Merck Manuals Consumer Version
Aortic Branch Aneurysms - Learn about the causes, symptoms, diagnosis & treatment from the Merck Manuals - Medical Consumer ... Such aneurysms are much less common than abdominal aortic aneurysms Abdominal Aortic Aneurysms Abdominal aortic aneurysms are ... or thoracic aortic aneurysms Thoracic Aortic Aneurysms Thoracic aortic aneurysms are bulges (dilations) in the wall of the ... See also Overview of Aortic Aneurysms and Aortic Dissection. Overview of Aortic Aneurysms and Aortic Dissection The aorta, ...
Assessment of the GORE® EXCLUDER® Conformable AAA Endoprosthesis in the Treatment of Abdominal Aortic Aneurysms - Full Text...
Aneurysm. Aortic Aneurysm. Aortic Aneurysm, Abdominal. Vascular Diseases. Cardiovascular Diseases. Aortic Diseases. ... MedlinePlus related topics: Aneurysms Aortic Aneurysm Genetic and Rare Diseases Information Center resources: Abdominal Aortic ... Subjects with abdominal aortic aneurysms having infrarenal aortic neck angulation ≤ 60˚ and infrarenal aortic neck length ≥10 ... Subjects with abdominal aortic aneurysms having infrarenal aortic neck angulation , 60˚ and ≤ 90˚ and infrarenal aortic neck ...
DissectionAortaRuptureThoracic aortic aneurysmsScreeningArteryEVARAtherosclerosisSymptomsOpen Abdominal Aortic AneurysmSuffered an abdominal aortic aAbdomenVascularAsymptomaticSize of the aneurysmSmall abdominal aortic aneurysmsArteriesStent graftTypes of aortic aneurysmSurgeryGraftDiameterRupturesDiagnosis and managementValveRepairChestArterialMortalityDilatationHistory of aorticThoracoabdominal aorticInfrarenalDiseaseEndovascular aorticDiseasesPatientsMarfanPrevalenceAAAsPathogenesisRiskDissectionsDissectCoronary
- In 2019, about 59% of deaths due to aortic aneurysm or aortic dissection happen among men. (cdc.gov)
- Screen first-degree relatives of individuals diagnosed with aneurysms of the aortic root or ascending thoracic aorta, or those with aortic dissection to identify individuals most at risk for aortic disease. (medscape.com)
- Consider transferring clinically stable patients with acute type A aortic dissection to a high-volume aortic center to improve survival. (medscape.com)
- Operative repair of type A aortic dissection should entail at least an open distal anastomosis rather than just a simple supracoronary interposition graft. (medscape.com)
- An increasing role exists for thoracic endovascular aortic repair in the management of uncomplicated type B aortic dissection. (medscape.com)
- In fact, during his second aortic dissection, which occurred while he was at a medical conference in San Francisco, he suffered a cardiac arrest and nearly died but was brought back through quick medical intervention. (baptisthealth.net)
- Overview of Aortic Aneurysms and Aortic Dissection The aorta, which is about 1 inch (2.5 centimeters) in diameter, is the largest artery of the body. (merckmanuals.com)
- Aortic aneurysm and dissection are important causes of death in older people. (biomedcentral.com)
- The objective of the present study was to use multiple-cause-of-death methodology in the analysis of mortality trends related to aortic aneurysm and dissection in the state of Sao Paulo, between 1985 and 2009. (biomedcentral.com)
- We analyzed mortality data from the Sao Paulo State Data Analysis System, selecting all death certificates on which aortic aneurysm and dissection were listed as a cause-of-death. (biomedcentral.com)
- Over a 25-year period, there were 42,615 deaths related to aortic aneurysm and dissection, of which 36,088 (84.7%) were identified as underlying cause and 6,527 (15.3%) as an associated cause-of-death. (biomedcentral.com)
- Dissection and ruptured aneurysms were considered as an underlying cause of death in 93% of the deaths. (biomedcentral.com)
- A significant seasonal variation, with highest frequency in winter, occurred in deaths identified as underlying cause for aortic dissection, ruptured and non-ruptured aneurysms. (biomedcentral.com)
- This study introduces the methodology of multiple-causes-of-death to enhance epidemiologic knowledge of aortic aneurysm and dissection in São Paulo, Brazil. (biomedcentral.com)
- An aortic dissection is a serious progressive condition that occurs when a tear in the inner layer (intima) of the aorta causes blood to flow between the layers of the wall of the aorta and force them apart. (biomedcentral.com)
- If the blood-filled channel ruptures through the outside aortic wall, aortic dissection is usually fatal. (biomedcentral.com)
- Prevalence, fatality and mortality rates of aortic aneurysm and dissection varies geographically. (biomedcentral.com)
- When this aortic Aneurysm occurs at the thoracic portion of the aorta it is known as the Thoracic Aortic Aneurysm (TAA) or Thoracic Aortic dissection. (epainassist.com)
- Well-timed analysis of thoracic aneurysm is essential considering that early medical or medical intervention can avoid the substantial morbidity and mortality connected with rupture and dissection. (hwupdate.org)
- Management of Aortic Aneurysm & Dissection Surgery Conclave 2022 was organized by Apollo Hospitals in Chennai. (apollohospitals.com)
- Assistant chief dies after suffering aortic dissection during a fire alarm response - Connecticut. (cdc.gov)
- Testing revealed a possible aortic aneurysm dissection and he was flown to a regional hospital for surgery. (cdc.gov)
- The death certificate, completed by the attending physician, listed "multi-organ system dysfunction" due to "cardiac arrest" as the immediate cause of death with "aortic dissection" as a significant condition. (cdc.gov)
- An aortic aneurysm is a balloon-like bulge in the aorta, the large artery that carries blood from the heart through the chest and torso. (cdc.gov)
- Peripheral aneurysms-those found in arteries other than the aorta-can happen in the neck, in the groin, or behind the knees. (cdc.gov)
- Most aneurysms are in the aorta, the main artery that runs from the heart through the chest and abdomen. (medlineplus.gov)
- Abdominal examination includes palpation of the aorta and estimation of the size of the aneurysm. (medscape.com)
- Surgery is recommended for patients with aneurysms of aortic root and ascending thoracic aorta with a confirmed growth rate of ≥0.3 cm per year across 2 consecutive years or ≥0.5 cm in 1 year. (medscape.com)
- An abdominal aortic aneurysm occurs when the aorta becomes enlarged and balloons out. (medicalnewstoday.com)
- It involved replacement of ascending aorta, aortic root and aortic valve with imported SJM composite prosthetic graft. (apollohospitals.com)
- Aortic aneurysms occur when a weak part of the aorta expands like a balloon, forming a blood-filled sac. (uclahealth.org)
- Changes in the activity of certain elements within the aorta are thought to weaken the wall and lead to the formation of an aneurysm. (uclahealth.org)
- An abdominal aortic aneurysm (AAA) is a weakening in the wall of the infrarenal aorta that results in an anteroposterior diameter of 3 cm or greater 1 . (uspreventiveservicestaskforce.org)
- The aorta is the body's largest blood vessel and if a section of this large artery forms an aneurysm (has damage) and ruptures, you will have life-threatening internal bleeding. (osu.edu)
- Infection, injury to the aorta and genetic disorders, including Marfan syndrome , are also factors that increase the risk of developing an aortic aneurysm. (osu.edu)
- An aneurysm is said to be present when the diameter of the abdominal aorta exceeds three centimeters at a given point. (usz.ch)
- During follow-up care in Florida, Dr. Lee detected that Dr. Dienst now had a thoracoabdominal aortic aneurysm, a bulging in the aorta that extends from the chest to the abdomen. (baptisthealth.net)
- Open abdominal aortic aneurysm (AAA) repair is surgery to fix a widened part in your aorta. (limamemorial.org)
- Aortic branch aneurysms are bulges (dilations) in the wall of the major arteries that come directly off of the aorta. (merckmanuals.com)
- Aneurysms may occur in any major branch of the aorta. (merckmanuals.com)
- Abdominal Aortic Aneurysms Abdominal aortic aneurysms are bulges (dilations) in the wall of the aorta in the part that passes through the abdomen (abdominal aorta). (merckmanuals.com)
- Thoracic Aortic Aneurysms Thoracic aortic aneurysms are bulges (dilations) in the wall of the aorta in the part that passes through the chest (thorax). (merckmanuals.com)
- The purpose of the study is to assess the safety and effectiveness of the GORE® EXCLUDER® Conformable AAA Endoprosthesis to treat an infrarenal aneurysm located in the abdominal aorta. (clinicaltrials.gov)
- Endovascular Aneurysm repair (EVAR) is a minimally invasive procedure designed to exclude an aneurysmal segment of the aorta from blood circulation. (clinicaltrials.gov)
- An aortic aneurysm refers to any abnormal bulging or swelling in a segment of the aorta, usually representing a primary weakness in the wall of the aorta at that location. (biomedcentral.com)
- The surgeon she consults agrees and orders a computed tomography angiography (CTA) to confirm the size of the aorta, visualize retroperitoneal bleeding, and evaluate the location of the aneurysm and the renal arteries. (myamericannurse.com)
- Patients at poor risk for surgery may be candidates for endovascular aneurysm repair (EVAR), in which a stent is inserted into the portion of the dilated aorta to facilitate blood flow. (myamericannurse.com)
- Aneurysms that occur in the section of the aorta that runs through the abdomen (abdominal aorta) are called abdominal aortic aneurysms (ABDOMINAL AORTIC ANEURYSM). (delveinsight.com)
- The pressure of blood pumping through the aorta may then cause this weak area to bulge outward, like a balloon (called an aneurysm). (delveinsight.com)
- An ABDOMINAL AORTIC ANEURYSM occurs when this type of vessel weakening happens in the portion of the aorta that runs through the abdomen. (delveinsight.com)
- As an aneurysm grows in size, the aorta wall becomes weaker and weaker, which means surgical intervention may be needed. (delveinsight.com)
- Aortic Aneurysm is a medical condition in which the Aorta (the major blood vessel which starts from the heart and ends up supplying blood to various parts of the body) enlarges in size and becomes about 1.5 times more than the normal. (epainassist.com)
- The thoracic aortic aneurysm involves the enlargement and weakening of the upper part of the aorta. (epainassist.com)
- The term aneurysm is generally used when the axial diameter of the thoracic aorta becomes greater than 5 cm but when it measures about 4-5 cm the name 'dilatation' is used. (epainassist.com)
- If an aneurysm bursts, one or more layers of the walls of the aorta splits which causes a sudden and sharp pain at the upper portion of the back. (epainassist.com)
- True Aneurysm is characterized by the involvement of all the three layers of Aorta i.e. (epainassist.com)
- Ultrasound is not of much use in the diagnosis of TAA or thoracic aortic aneurysm however the descending aorta can be visualize upto large extent with the help of Transoesophageal echocardiography but because it involves invasion it is not much used. (epainassist.com)
- Post Covid I now have been diagnosed with aorta aneurism. (mayoclinic.org)
- An abdominal aortic aneurysm (AAA) is a swelling of the aorta, the main artery in the body. (healthscotland.scot)
- With all this finding on the history of surgically changed bicuspid aortic valve he was known for immediate CT aortogram which demonstrated proof a fusiform aneurysm from the ascending aorta increasing through the aortic main to the spot Bay 60-7550 of the foundation of the remaining common carotid artery. (hwupdate.org)
- It Bay 60-7550 got maximum measurements of 6.9?cm6.5?cm (anteroposteriorlateral) within the mid ascending aorta and 67?cm (anteroposteriorlateral) in the aortic main. (hwupdate.org)
- Aneurysms of the abdominal aorta (AAA) are relatively common - affecting as many as 8% of men and 1% of women over the age of 65. (mssm.edu)
- To evaluate the incidence and clinical relevance of extravascular incidental findings (EVIF), particularly malignancies, in planning and follow-up CT angiograms (CTA) of the abdominal aorta in patients who underwent endovascular aneurysm repair (EVAR) of abdominal aortic aneurysm. (springeropen.com)
- Aortic aneurysms occur when the aorta , the body's largest artery , grows in size, and can occur in the thoracic or abdominal aorta . (bvsalud.org)
- The approaches to repair aortic aneurysms include directly exposing the aorta and replacing the diseased segment via open repair, or endovascular repair. (bvsalud.org)
- Endovascular repair uses fluoroscopic-guidance to access the aorta and deliver a device to exclude the aneurysmal aortic segment without requiring a large surgical incision . (bvsalud.org)
- An Abdominal Aortic Aneurysm - or AAA - is when a swelling or bulge in the aorta, the main blood vessel running from your heart to your tummy, ruptures. (bruntonparkhc.nhs.uk)
- Dilatación anómala de la pared de la AORTA en forma sacular o globulosa. (bvsalud.org)
- The present study shows that there was increase prevalence of aortic root dilatation 13 patients (26%) and ascending aorta dilatation 9patients(18%) in patients with CAE. (bvsalud.org)
- Increase prevalence of aortic root dilatation and ascending aorta dilatation in patients with coronary artery ectasia. (bvsalud.org)
- These aneurysms are less likely to rupture or dissect than aortic aneurysms, but they can form blood clots. (cdc.gov)
- The clinician need not be afraid of properly palpating the abdomen, because there is no evidence to indicate that aortic rupture can be precipitated by this maneuver. (medscape.com)
- Rapid aortic growth is a risk factor for rupture, and the definition for rapid aneurysm growth rate has been updated. (medscape.com)
- The major risk for untreated aneurysms is rupture, and as an aneurysm gets bigger, the risk gets greater. (clevelandclinic.org)
- Complications that are rare but serious include paralysis, delayed rupture of the aneurysm or infection. (clevelandclinic.org)
- If there is a concern about aortic rupture, a 12F sheath may be used in order to accommodate large diameter occlusion balloon. (ctsnet.org)
- Ascending aortic aneurysm is a serious disease, and rupture of the bulge can be life-threatening. (apollohospitals.com)
- Aneurysms often cause no symptoms, but they can be life-threatening if they get too large and rupture, or burst. (uclahealth.org)
- But medium and large aneurysms often require immediate treatment to repair them fast before they rupture. (uclahealth.org)
- The main concern with a thoracic aortic aneurysm is preventing a potential rupture. (trihealth.com)
- A thoracic aortic aneurysm should be monitored carefully, and will often require surgery to prevent rupture. (trihealth.com)
- Abdominal aortic aneurysms are often undiagnosed because a large proportion are asymptomatic until the development of rupture, which is generally acute and often fatal (59% to 83% of patients die before hospitalization) 2 . (uspreventiveservicestaskforce.org)
- Although it is possible to repair a ruptured aneurysm surgically, it is important to identify and treat aneurysms before a rupture occurs. (osu.edu)
- Although such catheter-guided interventions now form part of standard surgical protocols, they could not be deployed until recently in patients with aortic rupture involving vascular branches to various organs, since several such vessels arise from this large artery. (usz.ch)
- Because aneurysms weaken the artery, they can rupture, leading to internal bleeding and death. (baptisthealth.net)
- There is a risk that this aneurysm may suddenly break open (rupture) if you do not have surgery to repair it. (limamemorial.org)
- Because of the size of the aneurysm, Julie realizes that Mr. Jones needs surgery to avoid possible rupture and subsequent acute bleeding. (myamericannurse.com)
- The larger an aneurysm grows, the greater the chance it will burst or rupture. (delveinsight.com)
- ABDOMINAL AORTIC ANEURYSM may be detected incidentally or at the time of rupture. (delveinsight.com)
- The goal of any treatment strategy is to prevent the rupture of an aneurysm by controlling its growth. (delveinsight.com)
- These medications will lessen the chance of rupture of aneurysm. (delveinsight.com)
- Methods: Our primary outcome measure was 12-month treatment success, defined as successful endograft delivery and deployment and the absence of type I or III endoleak, stent migration or limb occlusion, late conversion, and abdominal aortic aneurysm diameter increase or rupture. (eur.nl)
- The danger of rupture is directly proportional to the extent of the aneurysm. (epainassist.com)
- Determination of the genetic mechanism behind aneurysm formation, progression, and rupture crosses disciplines requiring input from multiple fields of study, larger patient cohorts, and the evolving modalities of genetic testing. (mssm.edu)
- 2006 ). Indications for re-intervention often include stent migration and endoleak with the associated risk of subsequent aneurysm rupture. (springeropen.com)
- So if there's an aneurysm or a ballooning or a stretching, it can rupture and people can bleed and it's a life-threatening emergency. (nursebarb.com)
- This publication was the first of its kind in South Africa (SA), and aneurysm rupture during the next year? (who.int)
Thoracic aortic aneurysms10
- Men and women are equally likely to get thoracic aortic aneurysms, which become more common with increasing age. (cdc.gov)
- Thoracic aortic aneurysms are usually caused by high blood pressure or sudden injury. (cdc.gov)
- Sometimes people with inherited connective tissue disorders, such as Marfan syndrome and Ehlers-Danlos syndrome, get thoracic aortic aneurysms. (cdc.gov)
- Abdominal aortic aneurysms happen more often than thoracic aortic aneurysms. (cdc.gov)
- Improved prognosis of thoracic aortic aneurysms: a population-based study. (cdc.gov)
- At centers with multidisciplinary aortic teams and experienced surgeons, the threshold for surgical intervention for sporadic aortic root and ascending aortic aneurysms is now 5.0 cm (from 5.5 cm) in select individuals, and it is even lower in specific settings among patients with heritable thoracic aortic aneurysms. (medscape.com)
- Society for Vascular Surgery clinical practice guidelines of thoracic endovascular aortic repair for descending thoracic aortic aneurysms. (medscape.com)
- Ascending aortic aneurysms are a subtype of thoracic aortic aneurysms that develop above the diaphragm. (apollohospitals.com)
- Thoracic aortic aneurysms may not cause symptoms, or they may cause. (merckmanuals.com)
- Cough continues to be reported to become supplementary to thoracic aortic aneurysms within the books.3 It really is presumed to become Rabbit Polyclonal to CDK5RAP2 supplementary to bronchial compression from regional mass effect.4 an individual is presented by us having a bicuspid aortic valve, susceptible to aortic main enlargement thus, presenting with chronic coughing without apparent cause. (hwupdate.org)
- The U.S. Preventive Services Task Force recommends that men 65 to 75 years old who have ever smoked should get an ultrasound screening for abdominal aortic aneurysms, even if they have no symptoms. (cdc.gov)
- Screening for abdominal aortic aneurism. (cdc.gov)
- It is important for them to get screening, because aneurysms can develop and become large before causing any symptoms. (medlineplus.gov)
- As evidence mounts for the link between cardiovascular health and psoriasis, Dr. Khalid asks whether routine screening for abdominal aortic aneurysms should be employed in psoriasis sufferers at the most severe end of the scale. (medicalnewstoday.com)
- The NHS Abdominal Aortic Aneurysm (AAA) Screening Programme's main aim is to reduce the number of deaths from ruptured AAAs through early detection, appropriate follow-on tests and treatment, by providing a systematic population-based screening programme for those eligible. (nuh.nhs.uk)
- Long-term follow-up of population-based randomized, controlled trials (RCTs) have demonstrated that screening for abdominal aortic aneurysms (AAAs) measuring 3 cm or greater decreases AAA-related mortality rates in men aged 65 years or older. (uspreventiveservicestaskforce.org)
- Medical professionals recommend that men older than 60 who have ever smoked should have a one-time screening for an abdominal aortic aneurysm with a simple ultrasound test. (osu.edu)
- There isn't enough evidence to determine whether women ages 65 to 75 who have ever smoked cigarettes or have a family history of abdominal aortic aneurysm would benefit from abdominal aortic aneurysm screening. (osu.edu)
- If you are showing signs of common risk factors associated with aortic aneurysm, ask your doctor if you need to have an ultrasound screening. (osu.edu)
- Screening for abdominal aortic aneurysm: US Preventive Services Task Force recommendation statement. (bmj.com)
- An aneurysm will be monitored if detected through screening. (healthscotland.scot)
- Public Health Scotland annually publishes the Scottish Abdominal Aortic Aneurysm (AAA) screening programme statistics which has more information on the Key Performance Indicators (KPIs) and screening trends over time. (healthscotland.scot)
- The five main screenings are carotid artery, abdominal aortic, aneurysm screening, peripheral arterial disease. (nursebarb.com)
- An aneurysm is a bulge or "ballooning" in the wall of an artery. (medlineplus.gov)
- By tightly sealing the area with your artery above and below the aortic aneurysm, the graft allows blood to pass through it without pushing on the aneurysm. (clevelandclinic.org)
- A thoracic aortic aneurysm (TAA) is an expansion or bulge in the artery wall resulting from a weakening of the artery wall. (trihealth.com)
- Other potential risk factors include a history of other vascular aneurysms 9 , coronary artery disease 10 , cerebrovascular disease 9 , atherosclerosis 10 , hypercholesterolemia 10 , and hypertension 1 , 10 . (uspreventiveservicestaskforce.org)
- Dr. Dienst knew his health was still delicate even though he had survived the aortic dissections, a life-threatening condition in which a tear occurs in the inner layer of the body's main artery. (baptisthealth.net)
- An aortic aneurysm is when part of this artery becomes too large or balloons outward. (limamemorial.org)
- Infection in tissues near an artery can cause an infected aneurysm (mycotic aneurysm). (merckmanuals.com)
- Splenic artery aneurysms occur in more women than men. (merckmanuals.com)
- Hepatic artery aneurysms occur in more men than women. (merckmanuals.com)
- The majority of ABDOMINAL AORTIC ANEURYSMs result from atherosclerosis, a chronic degenerative disease of the artery wall, in which fat, cholesterol, and other substances build up in the walls of arteries and form soft or hard deposits called plaques. (delveinsight.com)
- Aneurysms are defined as a focal dilatation in an artery, with at least a 50% increase over the vessel's normal diameter. (medscape.com)
- CVD outcomes included death and hospitalisations for ischaemic heart disease, heart failure, cerebrovascular disease, peripheral artery disease or aortic aneurysm. (bmj.com)
- Objective: The aim of this study was to compare 2D-TTEand 3D-TTE measurements of the aortic root diameter in patients with coronary artery ectasia to assess the presence of aortic root dilatation. (bvsalud.org)
- Instead of an open aneurysm repair in which your chest/abdomen are surgically opened, your surgeon may consider a procedure called an endovascular aneurysm repair (EVAR). (clevelandclinic.org)
- In addition to EVAR, you may also hear your doctor refer to the procedure as a thoracic endovascular aneurysm repair (TEVAR) or fenestrated endovascular aneurysm Repair (FEVAR), depending on the type of repair that is being discussed. (clevelandclinic.org)
- BACKGROUND: This study aimed to assess the outcomes of standard and fenestrated grafts to treat proximal failure of previous endovascular aneurysm repair (EVAR) in a tertiary referral center. (minervamedica.it)
- Endovascular aneurysm repair (EVAR) has become the predominant treatment option for patients with abdominal aortic aneurysm (AAA) accounting for 78% of all elective repair in the United States in 2010 (Dua et al. (springeropen.com)
- Abdominal aortic aneurysms are usually caused by atherosclerosis (hardened arteries), but infection or injury can also cause them. (cdc.gov)
- The pathogenesis of atherosclerosis and abdominal aortic aneurysm involves breakdown of the elastic laminae. (harvard.edu)
- Abdominal aortic aneurysm is more common in those who suffer from atherosclerosis or the progressive narrowing and hardening of the arteries over time. (wordinfo.info)
- Abdominal aortic aneurysms often don't have any symptoms. (cdc.gov)
- In general, abdominal aortic aneurysms have no symptoms as they slowly swell over a number of years. (medicalnewstoday.com)
- Most aortic aneurysms cause no symptoms. (uclahealth.org)
- Symptoms of a growing aortic aneurysm can include pain in the abdominal area, groin or lower back. (osu.edu)
- Many aortic aneurysms are asymptomatic, meaning that the patient often does not experience noticeable symptoms prior to the detection that an aortic aneurysm is present. (osu.edu)
- Treatment of an aortic aneurysm depends on its size and the symptoms an individual may be experiencing. (osu.edu)
- Regular preventive examinations are recommended for patients at risk since the aneurysm itself causes no symptoms, "Critical dilatation of the vessel detected on ultrasound should be reviewed in consultation with specialists to decide whether preventive intervention is appropriate," says Professor Alexander Zimmermann, head of the Department of Vascular Surgery at the University Hospital Zurich. (usz.ch)
- Julie also knows that although the most common symptoms of AAA include flank, back, and abdominal pain, Mr. Jones' GI symptoms also can be caused by compression from an aneurysm. (myamericannurse.com)
- ABDOMINAL AORTIC ANEURYSM typically develop slowly over a period of many years and hardly ever cause any noticeable symptoms. (delveinsight.com)
- People who have this type of aneurysm do not notice it usually, and this is because it typically does not cause any symptoms. (delveinsight.com)
- Aortic aneurysm: how do you know if symptoms are related or serious? (mayoclinic.org)
- Provided widening from the mediastinum on his upper Bay 60-7550 body radiograph together with his fresh symptoms there have been concerns there could be regional compression from a thoracic ascending aortic aneurysm. (hwupdate.org)
Open Abdominal Aortic Aneurysm1
- Spencer, B & Aziz, F 2019, ' Excessive tortuosity of the iliac arteries is an indication for open abdominal aortic aneurysm repair ', Journal of Vascular Surgery , vol. 70, no. 1, pp. 272-273. (elsevier.com)
Suffered an abdominal aortic a1
- The patients were followed until they suffered an abdominal aortic aneurysm, moved out of the country, died or the study ended. (medicalnewstoday.com)
- Aortic aneurysms most often occur in the abdomen as an abdominal aortic aneurysm , but can also occur in the upper chest as a thoracic aortic aneurysm . (osu.edu)
- What differentiates a TAAA from other aneurysms is that it extends upward into the chest as well as downward into the abdomen. (baptisthealth.net)
- As noted (see Etiology ), patients at greatest risk for abdominal aortic aneurysms (AAAs) are those who are older than 65 years and have peripheral atherosclerotic vascular disease. (medscape.com)
- Less frequent causes include Marfan and Ehlers-Danlos syndromes, collagen vascular diseases, and mycotic aneurysm. (medscape.com)
- Mayo Clinic doctors trained in vascular diseases, vascular surgery, cardiovascular surgery, cardiovascular diseases and other areas research new and improved diagnosis and treatment options for aortic aneurysms. (mayoclinic.org)
- New research, published in the journal Arteriosclerosis, Thrombosis and Vascular Biology , describes a link between psoriasis and abdominal aortic aneurysms. (medicalnewstoday.com)
- We show here that, whereas cystatin C is normally expressed in vascular wall smooth muscle cells (SMCs), this cysteine protease inhibitor is severely reduced in both atherosclerotic and aneurysmal aortic lesions. (harvard.edu)
- During the aortic intervention vascular conservation must be performed and it is necessary to minimize the time of renal ischemia. (cun.es)
- Patients are usually asymptomatic and their abdominal aortic aneurysm is detected incidentally. (bmj.com)
- It aims to improve care by helping people who are at risk to get tested, specifying how often to monitor asymptomatic aneurysms, and identifying when aneurysm repair is needed and which procedure will work best. (bvsalud.org)
Size of the aneurysm1
- however, the sensitivity of palpation depends on the experience of the examiner, the size of the aneurysm, and the size of the patient. (medscape.com)
Small abdominal aortic aneurysms2
- Atheroemboli from small abdominal aortic aneurysms produce livedo reticularis of feet (ie, blue toe syndrome). (medscape.com)
- Greenhalgh, Roger M. / Repair of small abdominal aortic aneurysms  . (umn.edu)
- https://jamanetwork.com/journals/jama/fullarticle/2757234 http://www.ncbi.nlm.nih.gov/pubmed/31821437?tool=bestpractice.com More than 90% of aneurysms originate below the renal arteries. (bmj.com)
- can cause inflammation in different arteries, leading to weakening of the arterial wall, and formation of aneurysms (inflammatory aneurysm). (merckmanuals.com)
- Aneurysms in the arteries that deliver blood to the digestive tract (splanchnic arteries) are uncommon. (merckmanuals.com)
- Catheters are inserted in the incisions to guide and deliver a stent-graft through the blood vessels to the aneurysm. (clevelandclinic.org)
- Stent graft limb occlusion estimated overall survival, and freedom from aneurysm-related mortality and endovascular interventions were comparable in both patient groups through the 5-year follow-up. (eur.nl)
- Despite the challenges presented from the broad range of aortic and abdominal aortic aneurysm morphologies, the Endurant stent graft showed promising 5-year outcomes. (eur.nl)
- If a patient requires an extension procedure due to the extent of aortic disease, a RelayPro NBS Stent-graft should be placed inside the distal end of the previously placed Thoraflex Hybrid device via a retrograde approach. (who.int)
Types of aortic aneurysm1
- What are the types of aortic aneurysm? (cdc.gov)
- The two main treatments for aortic aneurysms are medicines and surgery . (cdc.gov)
- For individuals who require aortic intervention, note that outcomes are optimized when surgery is performed by an experienced surgeon working in a multidisciplinary aortic team. (medscape.com)
- It is reasonable for patients undergoing aortic root replacement surgery to receive valve-sparing aortic root replacement if the valve is suitable for repair and when performed by experienced surgeons in a multidisciplinary aortic team. (medscape.com)
- We offer comprehensive options for treating aneurysms, from traditional, open surgery to the latest advancements in minimally invasive, endovascular repair . (uclahealth.org)
- Surgery for aortic aneurysm replacement may take 2 to 4 hours. (limamemorial.org)
- Open surgery to repair an AAA is sometimes done as an emergency procedure when there is bleeding inside your body from the aneurysm. (limamemorial.org)
- However, surgery to repair the aneurysm may also be risky, depending on your overall health. (limamemorial.org)
- This custom medical exhibit reveals the repair surgery of an Abdominal Aortic Aneurysm by placement of a Gore-tex graft. (doereport.com)
- When indicated, unruptured aneurysms can be addressed with elective surgery, whereas ruptured AAAs necessitate emergency repair. (medscape.com)
- Using X-ray guidance, the surgeon places the graft in the area of the aneurysm. (clevelandclinic.org)
- Complications that can happen after endovascular aneurysm repair include leaking of blood around the graft, the graft moving away from its initial placement and the stent breaking. (clevelandclinic.org)
- The graft is inserted into the aneurysm and seals the aneurysm from within. (osu.edu)
- In patients who are significantly smaller or taller than average, surgical thresholds may incorporate indexing of the aortic root or ascending aortic diameter to either patient body surface area or height, or aortic cross-sectional area to patient height. (medscape.com)
- Depending on device availability, the patient's landing zone diameter has to be within the manufacturer's instruction for use (IFU), for example the Medtronic AneuRx AAAdvantage device is indicated for an infrarenal aortic neck diameter of 16-25 mm (10-20% smaller than labeled device) and iliac diameter of 10-18 mm. (ctsnet.org)
- Furthermore, increased abdominal aortic diameter among 122 patients screened by ultrasonography correlated inversely with serum cystatin C levels. (harvard.edu)
- Dissections and ruptures are the cause of most deaths from aortic aneurysms. (cdc.gov)
- When an abdominal aortic aneurysm ruptures, often with little warning, it becomes a medical emergency and can be fatal. (medicalnewstoday.com)
- If a large ABDOMINAL AORTIC ANEURYSM is detected before it ruptures, most people will be advised to have treatment to prevent it from rupturing. (delveinsight.com)
- Conditions that fit these criteria are part of the NHS programme include bowel, breast, and cervical cancer and abdominal aortic aneurysm (a condition when a major blood vessel swells and ruptures). (bruntonparkhc.nhs.uk)
Diagnosis and management3
- In November 2022, guidelines on the diagnosis and management of aortic disease were published by the American College of Cardiology (ACC) and the American Heart Association (AHA). (medscape.com)
- 2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines. (medscape.com)
- The NICE Guidelines: Abdominal aortic aneurysm: diagnosis and management (external website) covers diagnosing and managing abdominal aortic aneurysms, giving evidence-based recommendations. (healthscotland.scot)
- He previously a background of the bicuspid aortic valve that he had got a metallic aortic valve alternative in 2002 for combined aortic valve disease. (hwupdate.org)
- The bicuspid native aortic valve was resected the same day, and several bacterial patches were observed. (cdc.gov)
- For patients with suitable anatomy, a potential option might be endovascular repair of thoracoabdominal aortic aneurysms with endografts. (medscape.com)
- Shared decision-making between the patient and multidisciplinary aortic team is highly encouraged in the following patients: (1) patients on the borderline of thresholds for repair or those who are eligible for different types of surgical repair and (2) individuals with aortic disease who are pregnant or may become pregnant, for consideration of their risks of pregnancy. (medscape.com)
- The best method to repair an aneurysm depends upon several factors, including the location and shape of the aneurysm as well as the physical condition of the patient. (clevelandclinic.org)
- Symptomatic aneurysms mandate endovascular (or open) repair regardless of size. (ctsnet.org)
- In fact, our team developed the most advanced treatment available today: endovascular aneurysms repair. (uclahealth.org)
- Thoracic endovascular aneurysm repair (TEVAR) is a minimally invasive procedure that helps protect an aneurysm from the pressure of blood flow. (trihealth.com)
- Open surgical repair of the aneurysm may be recommended if the anatomy of the aneurysm prevents endovascular repair. (osu.edu)
- Sometimes endovascular repair is done as a treatment of choice for thoracic aortic aneurysm to reduce mortality. (epainassist.com)
- I had aortic aneurysm and subclavian aneurysm repair. (mayoclinic.org)
- Marques de Marino P, Malgor RD, Verhoeven EL, Katsargyris A. Rescue of proximal failure of endovascular abdominal aortic aneurysm repair with standard and fenestrated grafts. (minervamedica.it)
- We report the first successful aortic repair in a neonate with LDS presenting in extremis with an early onset, massive aortic aneurysm. (elsevier.com)
- European Collaborations on Thoraco-Abdominal Aortic Aneurysm Repair: "We Want More! (maastrichtuniversity.nl)
- General versus loco-regional anesthesia for endovascular aortic aneurysm repair. (bvsalud.org)
- It remains unclear which anesthetic technique is associated with better outcomes following the endovascular repair of aortic aneurysms . (bvsalud.org)
- To evaluate the benefits and harms of general anesthesia compared to loco- regional anesthesia for endovascular aortic aneurysm repair. (bvsalud.org)
- We did not identify any randomized controlled trials that compared general versus loco- regional anesthesia for endovascular aortic aneurysm repair. (bvsalud.org)
- There is currently insufficient high-quality evidence to determine the benefits or harms of either anesthetic approach during endovascular aortic aneurysm repair. (bvsalud.org)
- He also specializes in percutaneous aortic aneurysm repair, among other advanced endovascular procedures. (memphishealthandfitness.com)
- A thoracic aortic aneurysm happens in the chest. (cdc.gov)
- An abdominal aortic aneurysm, which is more common, happens below the chest. (cdc.gov)
- Patient underwent medical evaluation in his native country, where an ECG, Chest X-ray and Two-Dimensional Echocardiography showed severe aortic regurgitation and ascending aortic aneurysm. (apollohospitals.com)
- Suggested standards for reporting on arterial aneurysms. (bmj.com)
- At increased risk of developing an abdominal aortic aneurysm are men over 60 years of age, smokers, men with arterial disease (coronary or peripheral) and men whose father or brother has/had got an aneurysm. (angionet.gr)
- Secondary outcome measures included 30-day all-cause mortality, major adverse events, secondary procedures, technical observations, aneurysm-related mortality, and all-cause mortality within 12 months. (eur.nl)
- Conclusions: Differences were not observed in all-cause mortality, aneurysm-related mortality, and secondary procedures between within and outside IFU patients through a 5-year follow-up in the ENGAGE registry. (eur.nl)
- It is unknown what effect deprivation has upon mortality from abdominal aortic aneurysm. (healthscotland.scot)
- The main causes of aortic dilatation besides increasing age include smoking and high blood pressure. (usz.ch)
History of aortic2
- Your family may also have a history of aortic aneurysms that can increase your risk. (cdc.gov)
- Learn more about the history of aortic treatment at UCLA . (uclahealth.org)
- After he developed a thoracoabdominal aortic aneurysm, a very complex and dangerous condition also known as a TAAA, he underwent an investigational procedure with Dr. Lee that is offered in only 10 medical centers in the United States. (baptisthealth.net)
- Subjects with abdominal aortic aneurysms having infrarenal aortic neck angulation ≤ 60˚ and infrarenal aortic neck length ≥10 mm treated with the GORE® EXCLUDER® Conformable AAA Endoprosthesis. (clinicaltrials.gov)
- [ 2 ] These guidelines replace the 2010 ACC Foundation (ACCF)/AHA guidelines for diagnosing and managing thoracic aortic disease. (medscape.com)
- Our specialists are experts in treating aortic disease. (uclahealth.org)
- These include pancreatic disease, aortic aneurysms, and kidney stones. (perfectbalanceclinic.com)
- The decrease in death rates due to heart disease, cancer, stroke, pneumonia, and aortic aneurysm contributed 1.928 years to the change in life expectancy at birth ( Figure 2 ). (cdc.gov)
- SELECTION CRITERIA We searched for all randomized controlled trials that assessed the effects of general anesthesia compared to loco- regional anesthesia for endovascular aortic aneurysm repairs. (bvsalud.org)
- Diseases and unhealthy behaviors that damage your heart and blood vessels also increase your risk for aortic aneurysm. (cdc.gov)
- Increased awareness of heightened risk of other cardiovascular diseases, including abdominal aortic aneurysms, in patients with psoriasis is also required. (medicalnewstoday.com)
- One of these diseases is abdominal aortic aneurysm. (tu-ilmenau.de)
- Because their abdominal aneurysms enlarged rapidly, all 3 patients underwent resection of the aneurysm and extensive local debridement and irrigation. (cdc.gov)
- Nine patients died during follow-up, one (2%) of them aneurysm-related. (minervamedica.it)
- Some inherited connective tissue disorders, such as Marfan syndrome and Ehlers-Danlos syndrome, can also increase your risk for aortic aneurysm. (cdc.gov)
- In Brazil there are only prevalence studies related to abdominal aortic aneurysms. (biomedcentral.com)
- Prevalence of aortic aneurysms in the Twin Cities metropolitan area, 1979-84. (cdc.gov)
- Pain upon palpation over the aneurysm is a sign of symptomatic AAA, but approximately 60% of AAAs are misdiagnosed. (myamericannurse.com)
- Abdominal aortic aneurysms (AAAs) are relatively common and are potentially life-threatening. (medscape.com)
- Degeneration of structural components of the aortic wall is believed to be central in the pathogenesis of AAAs. (mssm.edu)
- Understanding the effects of tobacco smoke on the pathogenesis of aortic aneurysm. (cdc.gov)
- What are the risk factors for aortic aneurysm? (cdc.gov)
- Medicines can lower blood pressure and reduce risk for an aortic aneurysm. (cdc.gov)
- Some people are at high risk for aneurysms. (medlineplus.gov)
- The goals of aortic aneurysm treatment are to reduce the risk of complications from aneurysms. (clevelandclinic.org)
- Compared to the general population, the adjusted incidence rate ratios were significantly increased for severe psoriasis […] That's a 67% greater risk of abdominal aortic aneurysms likelihood for severe psoriasis sufferers. (medicalnewstoday.com)
- Smoking is the most important modifiable risk factor for AAA development 12-14 and aneurysm growth 15 . (uspreventiveservicestaskforce.org)
- Know the risk factors for aortic aneurysms, educate yourself about this silent killer, and protect your health - starting today. (osu.edu)
- If you are a male and a smoker, there is an increased risk of aortic aneurysm. (osu.edu)
- Men are at higher risk if they are smokers, have high cholesterol, have high blood pressure and have a family history of aneurysms. (healthscotland.scot)
- Who is at risk of developing an aortic aneurysm? (angionet.gr)
- Aortic aneurysms or aortic dissections were the cause of 9,904 deaths in 2019. (cdc.gov)
- After surviving two life-threatening aortic dissections, Ted Dienst, M.D., knew he needed careful monitoring. (baptisthealth.net)
- Abdominal aortic aneurysms and aortic dissections prevailed among men and aortic dissections and aortic aneurysms of unspecified site among women. (biomedcentral.com)
- IMSEAR at SEARO: Should an aortic aneurysm dissect? (who.int)
- Coronary angiography along with LV shoot revealed normal coronaries and severe aortic regurgitation. (apollohospitals.com)