Aortography
Wounds, Nonpenetrating
Aorta, Thoracic
Aorta, Abdominal
Aneurysm, Dissecting
Ductus Arteriosus, Patent
Renal Artery Obstruction
Aortic Rupture
Aortic Coarctation
Fistula
Tomography, X-Ray Computed
Echocardiography, Transesophageal
Aortic Valve Insufficiency
Aortic Aneurysm, Thoracic
Aortic Aneurysm, Abdominal
Cardiac Catheterization
Aortic Valve
Prospective Studies
Sensitivity and Specificity
Community Health Centers
Health Status
Public Health
Peace Corps
Delivery of Health Care
Health Care Costs
Transcatheter arterial embolization for impending rupture of an isolated internal iliac artery aneurysm complicated with disseminated intravascular coagulation. (1/1212)
A 90-year-old male, with impending rupture of an isolated internal iliac artery aneurysm (IIAA) complicated with disseminated intravascular coagulation (DIC) was successfully treated with transcatheter arterial embolization (TAE). After TAE, enlargement of the aneurysm was arrested and coagulation-fibrinolytic abnormalities induced by DIC improved without severe complications. Although IIAA is relatively rare, the post-operative mortality of patients with ruptures is reportedly high. We assessed the usefulness of this procedure for impending rupture of IIAA, especially for patients in high risk groups. (+info)Anomalous origin of the left coronary artery from the pulmonary artery: natural history and normal pregnancies. (2/1212)
Two female patients are described with anomalous origin of the left coronary artery arising from the pulmonary artery who sustained an anterolateral myocardial infarction in infancy. Neither patient received surgical treatment although both have lived to middle age with minimal cardiovascular problems and have had uncomplicated pregnancies. Good exercise tolerance and long term survival may be possible even without surgery for patients with this anomaly. (+info)Intimal tear without hematoma: an important variant of aortic dissection that can elude current imaging techniques. (3/1212)
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)Follow-up results of transvenous occlusion of patent ductus arteriosus with the buttoned device. (4/1212)
OBJECTIVES: The purpose of this presentation is to document results of buttoned device (BD) occlusion of patent ductus arteriosus (PDA) in a large number of patients with particular emphasis on long-term follow-up in an attempt to provide evidence for feasibility, safety and effectiveness of this method of PDA closure. BACKGROUND: Immediate and short-term results of BD occlusion of PDA have been documented in a limited number of children. METHODS: During a six-year period ending August 1996, transcatheter BD closure of PDA was attempted in 284 patients, ages 0.3 to 92 years (median 7) under a protocol approved by the local institutional review boards and FDA with an investigational device exemption in U.S. cases. RESULTS: The PDAs measured 1 to 15 mm (median 4) at the narrowest diameter; 20 were larger than 8 mm and 10 larger than 10 mm. They were occluded with devices measuring from 15 to 35 mm delivered via 7F (N = 140) or 8F (N = 144) sheaths. Successful implantation of the device was accomplished in 278 (98%) of 284 patients. The Qp:Qs decreased from 1.8+/-0.6 (mean+/-SD) to 1.09+/-0.19 (p < 0.001). Effective occlusion defined as no (N = 167 [60%]) or trivial (N = 79 [28%]) residual shunt was achieved in 246 (88%) patients. All types of PDAs, irrespective of the shape (conical, tubular or short), size (small or large) or length (short or long) of the PDA and previously implanted Rashkind devices, could be occluded. Follow-up data, 1 to 60 months (median 24) after device implantation, were available in 234 (84%) patients. Seven (3%) patients required reintervention to treat residual shunt with (N = 2) or without (N = 5) hemolysis. Actuarial reintervention-free rates were 95% at 1 and 5 years. There was gradual reduction of actuarial residual shunts and were 40%, 28%, 21%, 14%, 11%, 10%, 6% and 0% respectively at 1 day, 1, 6, 12, 24, 36, 48 and 60 months after device implantation. Incorporation of folding plug over the button loop in 10 additional patients produced immediate and complete occlusion of PDA. CONCLUSIONS: This large multiinstitutional experience confirms the feasibility, safety and effectiveness of buttoned device closure of PDAs. All types of PDAs irrespective of the shape, length and diameter can be effectively occluded. Incorporation of folding plug over the button loop produces complete PDA occlusion at the time of device implantation. (+info)The snare-assisted technique for transcatheter coil occlusion of moderate to large patent ductus arteriosus: immediate and intermediate results. (5/1212)
OBJECTIVES: The purpose of this study was to evaluate the feasibility, safety and efficacy of using a snare-assisted technique to coil occlude the moderate to large size patent ductus arteriosus (PDA). BACKGROUND: Transcatheter occlusion of small PDAs using Gianturco coils is safe and effective. However, in larger size PDAs and/or those with short PDA length, the procedure still carries risks of coil embolization, incomplete occlusion and failure to implant the coil. METHODS: From January 1994 to June 1997, the records of 104 consecutive snare-assisted coil occlusions of moderate to large PDAs (minimum diameter >2.0 mm) were reviewed. Immediate and intermediate outcomes including complete and partial occlusion, failure to implant and complications were analyzed with respect to ductal type and size. RESULTS: Patient age ranged from 0.1 to 70.1 years (median 3.3 years). Minimum PDA diameter ranged from 2.1 to 6.8 mm (mean 3.0 +/- 0.9 mm). Angiographic types were A-62, B-13, C-6, D-14 and E-9. Using the snare-assisted technique, coil placement was successful in 104/104 patients (100%), irrespective of size or angiographic type. Immediate complete closure was observed in 73/104 (70.2%) and was related to smaller PDA size, but not to angiographic type. Complete closure was documented in 102/104 (98.1%) at 2- to 16-month follow-up. Successful closure was unrelated to PDA size or type. Coil embolization to the pulmonary artery occurred in 3/104 (2.9%) patients and was not related to PDA size or type. The need for multiple coils was found in 28/104 patients (26.9%), and was related to larger PDA size, but not to angiographic type. CONCLUSIONS: The snare-assisted delivery technique allows successful occlusion of moderate to large PDAs up to 6.8 mm, irrespective of angiographic type. This technique permits improved control and accuracy of coil placement, and facilitates delivery of multiple coils. (+info)Surgical renal artery reconstruction without contrast arteriography: the role of clinical profiling and magnetic resonance angiography. (6/1212)
PURPOSE: Contrast arteriography is the accepted gold standard for diagnosis and treatment planning in patients with atherosclerotic renovascular disease (RVD). In this study, the results of a selective policy of surgical renal artery reconstruction (RAR) with magnetic resonance angiography (MRA) as the sole preoperative imaging modality are reviewed. METHODS: From May 1993 to May 1998, 25 patients underwent RAR after clinical evaluation, and aortic/renal MRA performed with a gadolinium-enhanced and 3-dimensional phase contrast technique. Clinical presentations suggested severe RVD in all patients and included poorly controlled hypertension (16 patients), hospitalization for hypertensive crises and/or acute pulmonary edema (13), and deterioration of renal function within one year of operation (15). Thirteen patients had associated aortic pathologic conditions (12 aneurysms, 1 aortoiliac occlusive disease), and eight of these patients also underwent noncontrast computed tomography scans. Significant renal dysfunction (serum creatinine level, >/=2.0 mg/dL) was present in all but 4 patients with 14 of 25 patients having extreme (creatinine level, >/=3.0 mg/dL) dysfunction. RESULTS: Hemodynamically significant RVD in the main renal artery was verified at operation in 37 of 38 reconstructed main renal arteries (24/25 patients). A single accessory renal artery was missed by MRA. RAR was comprehensive (bilateral or unilateral to a single-functioning kidney) in 21 of 25 patients and consisted of hepatorenal bypass graft (3 patients), combined aortic and RAR (13 patients), isolated transaortic endarterectomy (8 patients), and aortorenal bypass graft (1 patient). Early improvement in both hypertension control and/or renal function was noted in 21 of 25 patients without operative deaths or postoperative renal failure. Sustained favorable functional results at follow-up, ranging from 5 months to 4 years, were noted in 19 of 25 patients. CONCLUSION: MRA is an adequate preoperative imaging modality in selected patients before RAR. This strategy is best applied in circumstances where the clinical presentation suggests hemodynamically significant bilateral RVD and/or in patients at substantial risk of complications from contrast angiography. (+info)Periprosthetic leak and rupture after endovascular repair of abdominal aortic aneurysm: the significance of device design for long-term results. (7/1212)
We present a case of abdominal aortic aneurysm treated with an endovascular bifurcated aortic graft in which a periprosthetic leak caused by a tear in the polyester prosthesis appeared between 9 and 12 months after surgery. The tear appeared adjacent to a suture breakage that caused separation of two struts of the nitinol wire framework in the body of the stent graft. The leak was sealed with insertion of a new endovascular tube graft into the body of the bifurcation. Eight months later, the patient had a nonfatal rupture of the abdominal aortic aneurysm because detachment of the second limb from the bifurcation caused a new major periprosthetic leak. According to the manufacturer of this device, suture breakage with separation of metal components is commonly seen, but perforation of the polyester prosthesis caused by movement of the metal stent against the fabric has not been reported. It is likely that this occurred in our patient. Detachment of the second limb from the bifurcated stent, causing a rupture, has been described before. Increasing angulation and tortuosity of the stent graft, as a result of either remodeling of the sac or elongation of the stent, and reduced compliance to angulation after the stent-in-stent procedure might have contributed to the detachment in this case. (+info)Realistic expectations for patients with stent-graft treatment of abdominal aortic aneurysms. Results of a European multicentre registry. (8/1212)
OBJECTIVE: the outcomes for patients after endovascular treatment of abdominal aortic aneurysm (AAA) are determined primarily by the endpoints of death and endoleaks, the latter representing continued risk of rupture. The data of a multicentre registry were analysed with regard to the early outcome of stent-graft procedures for AAA and the complications associated with this treatment. In addition, the results during follow-up were analysed by determining mortality and endoleak development as separate endpoints and as a combined endpoint defined as endoleak-free survival. SETTING: 38 European institutions of Vascular Surgery collaborating in a multicentre registry project. PATIENTS AND METHODS: 899 patients with AAA underwent between May 1994 and March 1998 elective endovascular repair (818 men and 81 women; mean age 69 years). 80 (8.9%) of the patients had medical conditions that excluded them from open repair. 818 (91%) of patients had a bifurcated device, 63 (7%) had a straight tube graft, and only 18 (2%) had an aorto-uni-iliac device. Clinical examination and contrast-enhanced computed tomography was performed at fixed follow-up intervals to assess increase or decrease of the maximum transverse diameter (MTD). Endoleaks observed at follow-up were discriminated into persistent endoleak and temporary endoleak. The latter is defined as single time observed endoleaks or with two or more negative imaging studies between observed endoleaks. Life-table analyses were used to calculate the rates of freedom-from-endoleak (no endoleak at any time), freedom-from-persistent endoleak (no persistent endoleak), patient survival, and persistent-endoleak-free-survival. RESULTS: the median follow-up of this patient series was 6.2 months. The ratio between observed and expected follow-up data was 82% for the overall follow-up period. However, at 18 months of follow-up this rate was only 45%. The number of patients followed during this period was sufficient to allow statistically meaningful assessment. The MTD in patients with temporary endoleaks demonstrated a significant decrease at 6 to 12 months compared to preoperative values (mean 57 and 53 respectively, p =0.004). In patients with persistent endoleaks there was no change between the preoperative and 6-month MTD (mean 57 and 60 mm respectively). At 6 and 18 months freedom-from-endoleak was 83% and 74% and freedom-from-persistent endoleak was 93% and 90%, respectively. The 18-month cumulative patient survival was 88% and the main outcome measure, the persistent endoleak-free-survival was 79%. CONCLUSIONS: the MTD decreases in patients with temporary endoleak, but not in patients with persistent endoleak. Therefore, the use of the rate of freedom-from-persistent endoleak, reflecting absence of persisting endoleaks to estimate the prognosis with regard to the AAA, is justified. Determining persistent endoleak-free survival appears a rational approach to provide a realistic outlook for patients with stent-grafted AAA. The observed 18-month endoleak-free survival reflects a satisfactory mid-term result. (+info)The symptoms of an aortic aneurysm can vary depending on its size and location. Small aneurysms may not cause any symptoms at all, while larger ones may cause:
* Pain in the abdomen or back
* Pulsatile abdominal mass that can be felt through the skin
* Numbness or weakness in the legs
* Difficulty speaking or swallowing (if the aneurysm is pressing on the vocal cords)
* Sudden, severe pain if the aneurysm ruptures.
If you suspect that you or someone else may have an aortic aneurysm, it is important to seek medical attention right away. Aortic aneurysms can be diagnosed with imaging tests such as CT or MRI scans, and treated with surgery to repair or replace the affected section of the aorta.
In this article, we will discuss the causes and risk factors for aortic aneurysms, the symptoms and diagnosis of this condition, and the treatment options available. We will also cover the prognosis and outlook for patients with aortic aneurysms, as well as any lifestyle changes that may help reduce the risk of developing this condition.
CAUSES AND RISK FACTORS:
Aortic aneurysms are caused by weaknesses in the wall of the aorta, which can be due to genetic or acquired factors. Some of the known risk factors for developing an aortic aneurysm include:
* Age (the risk increases with age)
* Gender (men are more likely to develop an aortic aneurysm than women)
* Family history of aneurysms
* High blood pressure
* Atherosclerosis (the buildup of plaque in the arteries)
* Connective tissue disorders such as Marfan syndrome or Ehlers-Danlos syndrome
* Previous heart surgery or radiation therapy to the chest
SYMPTOMS:
In many cases, aortic aneurysms do not cause any symptoms in the early stages. However, as the aneurysm grows and puts pressure on nearby blood vessels or organs, patients may experience some of the following symptoms:
* Abdominal pain or discomfort
* Back pain
* Shortness of breath
* Dizziness or lightheadedness
* Fatigue
* Confusion or weakness
DIAGNOSIS:
Aortic aneurysms are typically diagnosed using imaging tests such as CT or MRI scans. These tests can provide detailed images of the aorta and help doctors identify any abnormalities or dilations. Other diagnostic tests may include echocardiography, ultrasound, or angiography.
TREATMENT:
The treatment for an aortic aneurysm will depend on the size and location of the aneurysm, as well as the patient's overall health. Some options may include:
* Monitoring: Small aneurysms that are not causing any symptoms may not require immediate treatment. Instead, doctors may recommend regular check-ups to monitor the aneurysm's size and progression.
* Surgery: If the aneurysm is large or growing rapidly, surgery may be necessary to repair or replace the affected section of the aorta. This may involve replacing the aneurysm with a synthetic tube or sewing a patch over the aneurysm to reinforce the aortic wall.
* Endovascular repair: In some cases, doctors may use a minimally invasive procedure called endovascular repair to treat the aneurysm. This involves inserting a small tube (called a stent) into the affected area through a small incision in the groin. The stent is then expanded to reinforce the aortic wall and prevent further growth of the aneurysm.
PROGNOSIS:
The prognosis for aortic aneurysms is generally good if they are detected and treated early. However, if left untreated, aortic aneurysms can lead to serious complications, such as:
* Aneurysm rupture: This is the most severe complication of aortic aneurysms and can be life-threatening. If the aneurysm ruptures, it can cause massive internal bleeding and potentially lead to death.
* Blood clots: Aortic aneurysms can increase the risk of blood clots forming in the affected area. These clots can break loose and travel to other parts of the body, causing further complications.
* Heart problems: Large aortic aneurysms can put pressure on the heart and surrounding vessels, leading to heart problems such as heart failure or coronary artery disease.
PREVENTION:
There is no guaranteed way to prevent aortic aneurysms, but there are several factors that may reduce the risk of developing one. These include:
* Family history: If you have a family history of aortic aneurysms, your doctor may recommend more frequent monitoring and check-ups to detect any potential problems early.
* High blood pressure: High blood pressure is a major risk factor for aortic aneurysms, so managing your blood pressure through lifestyle changes and medication can help reduce the risk.
* Smoking: Smoking is also a major risk factor for aortic aneurysms, so quitting smoking can help reduce the risk.
* Healthy diet: Eating a healthy diet that is low in salt and fat can help reduce the risk of developing high blood pressure and other conditions that may increase the risk of aortic aneurysms.
DIAGNOSIS:
Aortic aneurysms are typically diagnosed through a combination of physical examination, medical history, and imaging tests. These may include:
* Physical examination: Your doctor may check for any signs of an aneurysm by feeling your pulse and listening to your heart with a stethoscope. They may also check for any swelling or tenderness in your abdomen.
* Medical history: Your doctor will ask about your medical history, including any previous heart conditions or surgeries.
* Imaging tests: Imaging tests such as ultrasound, CT scan, or MRI can be used to confirm the diagnosis and measure the size of the aneurysm.
TREATMENT:
The treatment for aortic aneurysms depends on the size of the aneurysm and how quickly it is growing. For small aneurysms that are not growing, doctors may recommend regular monitoring with imaging tests to check the size of the aneurysm. For larger aneurysms that are growing rapidly, surgery may be necessary to repair or replace the aorta.
SURGICAL REPAIR:
There are several surgical options for repairing an aortic aneurysm, including:
* Open surgery: This is the traditional method of repairing an aortic aneurysm, where the surgeon makes an incision in the abdomen to access the aorta and repair the aneurysm.
* Endovascular repair: This is a minimally invasive procedure where the surgeon uses a catheter to insert a stent or graft into the aorta to repair the aneurysm.
POST-OPERATIVE CARE:
After surgery, you will be monitored in the intensive care unit for several days to ensure that there are no complications. You may have a drainage tube inserted into your chest to remove any fluid that accumulates during and after surgery. You will also have various monitors to check your heart rate, blood pressure, and oxygen levels.
RECOVERY:
The recovery time for aortic aneurysm repair can vary depending on the size of the aneurysm and the type of surgery performed. In general, patients who undergo endovascular repair have a faster recovery time than those who undergo open surgery. You may need to take medications to prevent blood clots and manage pain after surgery. You will also need to follow up with your doctor regularly to check on the healing of the aneurysm and the functioning of the heart.
LONG-TERM OUTLOOK:
The long-term outlook for patients who undergo aortic aneurysm repair is generally good, especially if the surgery is successful and there are no complications. However, patients with large aneurysms or those who have had complications during surgery may be at higher risk for long-term health problems. Some potential long-term complications include:
* Infection of the incision site or graft
* Inflammation of the aorta (aortitis)
* Blood clots forming in the graft or legs
* Narrowing or blockage of the aorta
* Heart problems, such as heart failure or arrhythmias.
It is important to follow up with your doctor regularly to monitor your condition and address any potential complications early on.
LIFESTYLE CHANGES:
After undergoing aortic aneurysm repair, you may need to make some lifestyle changes to help manage the condition and reduce the risk of complications. These may include:
* Avoiding heavy lifting or bending
* Taking regular exercise to improve cardiovascular health
* Eating a healthy diet that is low in salt and fat
* Quitting smoking, if you are a smoker
* Managing high blood pressure and other underlying medical conditions.
It is important to discuss any specific lifestyle changes with your doctor before making any significant changes to your daily routine. They can provide personalized guidance based on your individual needs and condition.
EMOTIONAL SUPPORT:
Undergoing aortic aneurysm repair can be a stressful and emotional experience, both for the patient and their loved ones. It is important to seek emotional support during this time to help cope with the challenges of the procedure and recovery. This may include:
* Talking to family and friends about your feelings and concerns
* Joining a support group for patients with aortic aneurysms or other cardiovascular conditions
* Seeking counseling or therapy to manage stress and anxiety
* Connecting with online resources and forums to learn more about the condition and share experiences with others.
Remember, it is important to prioritize your mental health and well-being during this time, as well as your physical health. Seeking emotional support can be an important part of the recovery process and can help you feel more supported and empowered throughout the journey.
Contusions are bruises that occur when blood collects in the tissue due to trauma. They can be painful and may discolor the skin, but they do not involve a break in the skin. Hematomas are similar to contusions, but they are caused by bleeding under the skin.
Non-penetrating wounds are typically less severe than penetrating wounds, which involve a break in the skin and can be more difficult to treat. However, non-penetrating wounds can still cause significant pain and discomfort, and may require medical attention to ensure proper healing and minimize the risk of complications.
Examples of Non-Penetrating Wounds
* Contusions: A contusion is a bruise that occurs when blood collects in the tissue due to trauma. This can happen when someone is hit with an object or falls and strikes a hard surface.
* Hematomas: A hematoma is a collection of blood under the skin that can cause swelling and discoloration. It is often caused by blunt trauma, such as a blow to the head or body.
* Ecchymoses: An ecchymosis is a bruise that occurs when blood leaks into the tissue from damaged blood vessels. This can happen due to blunt trauma or other causes, such as injury or surgery.
Types of Non-Penetrating Wounds
* Closed wounds: These are injuries that do not involve a break in the skin. They can be caused by blunt trauma or other forms of injury, and may result in bruising, swelling, or discoloration of the skin.
* Open wounds: These are injuries that do involve a break in the skin. They can be caused by penetrating objects, such as knives or gunshots, or by blunt trauma.
Treatment for Contusions and Hematomas
* Rest: It is important to get plenty of rest after suffering a contusion or hematoma. This will help your body recover from the injury and reduce inflammation.
* Ice: Applying ice to the affected area can help reduce swelling and pain. Wrap an ice pack in a towel or cloth to protect your skin.
* Compression: Using compression bandages or wraps can help reduce swelling and promote healing.
* Elevation: Elevating the affected limb above the level of your heart can help reduce swelling and improve circulation.
* Medication: Over-the-counter pain medications, such as acetaminophen or ibuprofen, can help manage pain and inflammation.
Prevention
* Wear protective gear: When engaging in activities that may cause injury, wear appropriate protective gear, such as helmets, pads, and gloves.
* Use proper technique: Proper technique when engaging in physical activity can help reduce the risk of injury.
* Stay fit: Being in good physical condition can help improve your ability to withstand injuries.
* Stretch and warm up: Before engaging in physical activity, stretch and warm up to increase blood flow and reduce muscle stiffness.
* Avoid excessive alcohol consumption: Excessive alcohol consumption can increase the risk of injury.
It is important to seek medical attention if you experience any of the following symptoms:
* Increasing pain or swelling
* Difficulty moving the affected limb
* Fever or chills
* Redness or discharge around the wound
* Deformity of the affected limb.
Dissecting aneurysms are often caused by trauma, such as a car accident or fall, but they can also be caused by other factors such as atherosclerosis (hardening of the arteries) or inherited conditions. They can occur in any blood vessel, but are most common in the aorta, which is the main artery that carries oxygenated blood from the heart to the rest of the body.
Symptoms of dissecting aneurysms can include sudden and severe pain, numbness or weakness, and difficulty speaking or understanding speech. If left untreated, a dissecting aneurysm can lead to serious complications such as stroke, heart attack, or death.
Treatment for dissecting aneurysms typically involves surgery to repair the damaged blood vessel. In some cases, endovascular procedures such as stenting or coiling may be used to treat the aneurysm. The goal of treatment is to prevent further bleeding and damage to the blood vessel, and to restore normal blood flow to the affected area.
Preventive measures for dissecting aneurysms are not always possible, but maintaining a healthy lifestyle, avoiding trauma, and managing underlying conditions such as hypertension or atherosclerosis can help reduce the risk of developing an aneurysm. Early detection and treatment are key to preventing serious complications and improving outcomes for patients with dissecting aneurysms.
Patent ductus arteriosus (PDA) is a condition in which the DA fails to close after birth. This can result in excessive blood flow to the lungs and put extra strain on the heart. PDA is relatively common, occurring in about 1 in every 2000 live births.
Symptoms of PDA may include:
* Fast breathing (tachypnea)
* Shortness of breath (dyspnea)
* Fatigue
* Sweating during feedings
* Frequent respiratory infections
If left untreated, PDA can lead to long-term complications such as:
* Increased risk of respiratory infections
* Heart failure
* Developmental delays
* Cognitive impairments
Treatment for PDA may include:
* Medications to reduce blood pressure in the lungs and improve oxygenation
* Surgery to close the ductus arteriosus, either through a catheter or open-heart surgery
In some cases, PDA may be treated with medication alone. However, if the condition is not treated promptly, surgical intervention may be necessary to prevent long-term complications.
Renal artery obstruction can be caused by a variety of factors, including:
1. Atherosclerosis (hardening of the arteries): This is the most common cause of renal artery obstruction and occurs when plaque builds up in the arteries, leading to narrowing or blockages.
2. Stenosis (narrowing of the arteries): This can be caused by inflammation or scarring of the arteries, which can lead to a decrease in blood flow to the kidneys.
3. Fibromuscular dysplasia: This is a rare condition that causes abnormal growth of muscle tissue in the renal arteries, leading to narrowing or blockages.
4. Embolism (blood clot): A blood clot can break loose and travel to the kidneys, causing a blockage in the renal artery.
5. Renal vein thrombosis: This is a blockage of the veins that drain blood from the kidneys, which can lead to decreased blood flow and oxygenation of the kidneys.
Symptoms of renal artery obstruction may include:
1. High blood pressure
2. Decreased kidney function
3. Swelling in the legs or feet
4. Pain in the flank or back
5. Fatigue
6. Nausea and vomiting
7. Weight loss
Diagnosis of renal artery obstruction is typically made through a combination of physical examination, medical history, and diagnostic tests such as:
1. Ultrasound: This can help identify any blockages or narrowing in the renal arteries.
2. Computed tomography (CT) scan: This can provide detailed images of the renal arteries and any blockages or narrowing.
3. Magnetic resonance angiogram (MRA): This is a non-invasive test that uses magnetic fields and radio waves to create detailed images of the renal arteries.
4. Angiography: This is a minimally invasive test that involves inserting a catheter into the renal artery to visualize any blockages or narrowing.
Treatment for renal artery obstruction depends on the underlying cause and severity of the condition. Some possible treatment options include:
1. Medications: Drugs such as blood thinners, blood pressure medication, and anticoagulants may be prescribed to manage symptoms and slow the progression of the disease.
2. Endovascular therapy: This is a minimally invasive procedure in which a catheter is inserted into the renal artery to open up any blockages or narrowing.
3. Surgery: In some cases, surgery may be necessary to remove any blockages or repair any damage to the renal arteries.
4. Dialysis: This is a procedure in which waste products are removed from the blood when the kidneys are no longer able to do so.
5. Kidney transplantation: In severe cases of renal artery obstruction, a kidney transplant may be necessary.
It is important to note that early detection and treatment of renal artery obstruction can help prevent complications and improve outcomes for patients.
Symptoms of an aortic rupture may include sudden and severe chest pain, difficulty breathing, and coughing up blood. Diagnosis is typically made through imaging tests such as CT scans or echocardiograms. Treatment options range from medication to stabilize blood pressure to surgical repair of the aorta.
If left untreated, an aortic rupture can lead to catastrophic consequences, including bleeding to death, cardiac arrest, and stroke. Therefore, prompt medical attention is essential if symptoms of an aortic rupture are present.
Aortic coarctation can be caused by a variety of genetic mutations or can be acquired through other conditions such as infections or autoimmune disorders. It is often diagnosed in infancy or early childhood, and symptoms can include:
* High blood pressure in the arms and low blood pressure in the legs
* Pulse narrowing or absence of a pulse in one or both arms
* Bluish skin color (cyanosis)
* Shortness of breath or fatigue during exercise
If left untreated, aortic coarctation can lead to complications such as heart failure, aneurysms, or cardiac arrhythmias. Treatment options for aortic coarctation include:
* Balloon dilation: A procedure in which a balloon is inserted through a catheter into the narrowed section of the aorta and inflated to widen the passage.
* Surgical repair: An open-heart surgery that involves cutting out the narrowed section of the aorta and sewing it back together with a patch or graft.
It is important for individuals with aortic coarctation to receive regular monitoring and treatment from a cardiologist or cardiac surgeon to prevent complications and manage symptoms. With appropriate treatment, most individuals with aortic coarctation can lead active and healthy lives.
There are several types of fistulas, including:
1. Anal fistula: a connection between the anus and the skin around it, usually caused by an abscess or infection.
2. Rectovaginal fistula: a connection between the rectum and the vagina, often seen in women who have had radiation therapy for cancer.
3. Vesicovaginal fistula: a connection between the bladder and the vagina, often caused by obstetric injuries or surgery.
4. Enterocutaneous fistula: a connection between the intestine and the skin, often seen in patients with inflammatory bowel disease or cancer.
5. Fistula-in-ano: a connection between the rectum and the skin around the anus, often caused by chronic constipation or previous surgery.
Symptoms of fistulas can include pain, bleeding, discharge, and difficulty controlling bowel movements. Treatment depends on the type and location of the fistula, but may include antibiotics, surgery, or other interventional procedures.
1. Aneurysms: A bulge or ballooning in the wall of the aorta that can lead to rupture and life-threatening bleeding.
2. Atherosclerosis: The buildup of plaque in the inner lining of the aorta, which can narrow the artery and restrict blood flow.
3. Dissections: A tear in the inner layer of the aortic wall that can cause bleeding and lead to an aneurysm.
4. Thoracic aortic disease: Conditions that affect the thoracic portion of the aorta, such as atherosclerosis or dissections.
5. Abdominal aortic aneurysms: Enlargement of the abdominal aorta that can lead to rupture and life-threatening bleeding.
6. Aortic stenosis: Narrowing of the aortic valve, which can impede blood flow from the heart into the aorta.
7. Aortic regurgitation: Backflow of blood from the aorta into the heart due to a faulty aortic valve.
8. Marfan syndrome: A genetic disorder that affects the body's connective tissue, including the aorta.
9. Ehlers-Danlos syndrome: A group of genetic disorders that affect the body's connective tissue, including the aorta.
10. Turner syndrome: A genetic disorder that affects females and can cause aortic diseases.
Aortic diseases can be diagnosed through imaging tests such as ultrasound, CT scan, or MRI. Treatment options vary depending on the specific condition and may include medication, surgery, or endovascular procedures.
There are several causes of aortic valve insufficiency, including:
1. Congenital heart defects
2. Rheumatic fever
3. Endocarditis (infection of the inner lining of the heart)
4. Aging and wear and tear on the valve
5. Trauma to the chest
6. Connective tissue disorders such as Marfan syndrome or Ehlers-Danlos syndrome.
Symptoms of aortic valve insufficiency can include fatigue, shortness of breath, swelling in the legs and feet, and chest pain. Diagnosis is typically made through a combination of physical examination, echocardiogram (ultrasound of the heart), electrocardiogram (ECG or EKG), and chest X-ray.
Treatment options for aortic valve insufficiency depend on the severity of the condition and may include:
1. Medications to manage symptoms such as heart failure, high blood pressure, and arrhythmias (abnormal heart rhythms)
2. Lifestyle modifications such as a healthy diet and regular exercise
3. Repair or replacement of the aortic valve through surgery. This may involve replacing the valve with an artificial one, or repairing the existing valve through a procedure called valvuloplasty.
4. In some cases, catheter-based procedures such as balloon valvuloplasty or valve replacement may be used.
It is important to note that aortic valve insufficiency can lead to complications such as heart failure, arrhythmias, and endocarditis, which can be life-threatening if left untreated. Therefore, it is important to seek medical attention if symptoms persist or worsen over time.
Symptoms:
* Chest pain or discomfort
* Shortness of breath
* Coughing up blood
* Pain in the back or shoulders
* Dizziness or fainting
Diagnosis is typically made with imaging tests such as chest X-rays, CT scans, or MRI. Treatment may involve monitoring the aneurysm with regular imaging tests to check for growth, or surgery to repair or replace the affected section of the aorta.
This term is used in the medical field to identify a specific type of aneurysm and differentiate it from other types of aneurysms that occur in different locations.
An abdominal aortic aneurysm can cause symptoms such as abdominal pain, back pain, and difficulty breathing if it ruptures. It can also be diagnosed through imaging tests such as ultrasound, CT scan, or MRI. Treatment options for an abdominal aortic aneurysm include watchful waiting (monitoring the aneurysm for signs of growth or rupture), endovascular repair (using a catheter to repair the aneurysm from within the blood vessel), or surgical repair (open surgery to repair the aneurysm).
Word Origin and History
The word 'aneurysm' comes from the Greek words 'aneurysma', meaning 'dilation' and 'sma', meaning 'a vessel'. The term 'abdominal aortic aneurysm' was first used in the medical literature in the late 19th century to describe this specific type of aneurysm.
Prevalence and Incidence
Abdominal aortic aneurysms are relatively common, especially among older adults. According to the Society for Vascular Surgery, approximately 2% of people over the age of 65 have an abdominal aortic aneurysm. The prevalence of abdominal aortic aneurysms increases with age, and men are more likely to be affected than women.
Risk Factors
Several risk factors can increase the likelihood of developing an abdominal aortic aneurysm, including:
* High blood pressure
* Atherosclerosis (hardening of the arteries)
* Smoking
* Family history of aneurysms
* Previous heart attack or stroke
* Marfan syndrome or other connective tissue disorders.
Symptoms and Diagnosis
Abdominal aortic aneurysms can be asymptomatic, meaning they do not cause any noticeable symptoms. However, some people may experience symptoms such as:
* Abdominal pain or discomfort
* Back pain
* Weakness or fatigue
* Palpitations
* Shortness of breath
If an abdominal aortic aneurysm is suspected, several diagnostic tests may be ordered, including:
* Ultrasound
* Computed tomography (CT) scan
* Magnetic resonance imaging (MRI)
* Angiography
Treatment and Management
The treatment of choice for an abdominal aortic aneurysm depends on several factors, including the size and location of the aneurysm, as well as the patient's overall health. Treatment options may include:
* Watchful waiting (for small aneurysms that are not causing any symptoms)
* Endovascular repair (using a stent or other device to repair the aneurysm from within the blood vessel)
* Open surgical repair (where the surgeon makes an incision in the abdomen to repair the aneurysm)
In some cases, emergency surgery may be necessary if the aneurysm ruptures or shows signs of impending rupture.
Complications and Risks
Abdominal aortic aneurysms can lead to several complications and risks, including:
* Rupture (which can be life-threatening)
* Infection
* Blood clots or blockages in the blood vessels
* Kidney damage
* Heart problems
Prevention
There is no guaranteed way to prevent an abdominal aortic aneurysm, but several factors may reduce the risk of developing one. These include:
* Maintaining a healthy lifestyle (including a balanced diet and regular exercise)
* Not smoking
* Managing high blood pressure and other medical conditions
* Getting regular check-ups with your healthcare provider
Prognosis and Life Expectancy
The prognosis for abdominal aortic aneurysms depends on several factors, including the size of the aneurysm, its location, and whether it has ruptured. In general, the larger the aneurysm, the poorer the prognosis. If treated before rupture, many people with abdominal aortic aneurysms can expect a good outcome and a normal life expectancy. However, if the aneurysm ruptures, the survival rate is much lower.
In conclusion, abdominal aortic aneurysms are a serious medical condition that can be life-threatening if left untreated. It is important to be aware of the risk factors and symptoms of an aneurysm, and to seek medical attention immediately if any are present. With proper treatment, many people with abdominal aortic aneurysms can expect a good outcome and a normal life expectancy.
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Abdominal1
- Biplane aortography is the standard test for the diagnosis of abdominal angina. (wikidoc.org)
Aorta3
- Parma Community General Hospital is committed to providing outstanding patient care in the Parma, OH area, but before you commit to Parma Community General Hospital for a Aorta X-Ray (Aortography) make sure you compare and shop other medical facilities. (newchoicehealth.com)
- View a Aorta X-Ray (Aortography) cost comparison for Parma and Request a Free Quote before you make a decision. (newchoicehealth.com)
- During aortography, performed in a hospital, you'll be mildly sedated while your doctor threads a catheter from your groin or arm into the aorta. (sutterhealth.org)
Cardiac1
- Immediately after the procedure, no significant change was observed in heart rate, systemic blood pressure, cardiac output or aortic insufficiency (as measured by visual or quantitative aortography). (duke.edu)
Aortic1
- however, aortography is still the preferred modality for the preoperative evaluation of thoracic aortic aneurysms and for precise definition of the anatomy of the aneurysm and great vessels. (medscape.com)
Body1
- Yanaga Y, Awai K, Nakaura T, Utsunomiya D, Oda S, Hirai T, Yamashita Y. Contrast material injection protocol with the dose adjusted to the body surface area for MDCT aortography. (hiroshima-u.ac.jp)
Aorta1
- Injection aortography was used as a gold standard and to assess the presence of ascending aorta dilatation in those patients. (bvsalud.org)
Echocardiography1
- The smooth muscle myosin heavy-chain assay has greater sensitivity and specificity than transthoracic echocardiography (TTE), CT, and aortography, but it has less sensitivity and specificity than transesophageal echocardiography (TEE), MRI, and helical CT. (medscape.com)
Criterion standard1
- Aortography is still considered by some as the diagnostic criterion standard test for aortic dissection. (medscape.com)