AORTA最新文献

{"title":"\"Natural\" History of Operated Type A Aortic Dissection.","authors":"Gian B Danzi, Alberto Carrozza, Silvia Frattini","doi":"10.1055/s-0043-1774415","DOIUrl":"10.1055/s-0043-1774415","url":null,"abstract":"<p><p>We describe the case of a 66-year-old gentleman with a previous replacement of the ascending aorta for an acute Type A aortic dissection who did not attend any scheduled follow-up visit. Seventeen years later, he presented to our institution with severe aortic regurgitation and with a giant aneurysmal dilation of the abdominal aorta.</p>","PeriodicalId":52392,"journal":{"name":"AORTA","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11038715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72211924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular Repair of Zone 0 Ascending Aortic Pseudoaneurysm: A Case Report.","authors":"Sarah Halbert, Christian Nagy, Jared Antevil, Shawn Sarin, Gregory Trachiotis","doi":"10.1055/s-0043-1777436","DOIUrl":"10.1055/s-0043-1777436","url":null,"abstract":"<p><p>Although open surgery is standard of care for ascending aortic pathology, endovascular approaches can be viable options. We report the case of a 77-year-old man with a 5.7-cm ascending aorta penetrating ulcer. Given his age and clinical profile, the patient underwent Zone 0 thoracic endovascular aortic repair.</p>","PeriodicalId":52392,"journal":{"name":"AORTA","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11038720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140177706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Secondary Endovascular Conversions for Failed Open Repair.","authors":"Ryan Gouveia E Melo, Paolo Spath, Jan Stana, Carlota F Prendes, Konstantinous Stavroulakis, Barbara Rantner, Maximilian Pichlmaier, Nikolaos Tsilimparis","doi":"10.1055/s-0043-1774724","DOIUrl":"10.1055/s-0043-1774724","url":null,"abstract":"<p><p>Late aortic and graft-related complications after open aortic repair are not infrequent and a significant number of them are missed, diagnosed at a very late stage, or present as urgent complications such as aortic rupture or aorto-enteric fistula. Once a late complication is diagnosed and reintervention is necessary, both open and endovascular strategies are possible. Open reintervention is complex and usually associated with very high rates of morbidity and mortality. Endovascular techniques may offer several solutions for these cases, which may be tailored to the patient and specific complication. In this review, we aim to summarize current indications, options, and strategies for endovascular salvage after failed or complicated open surgical repair.</p>","PeriodicalId":52392,"journal":{"name":"AORTA","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11038728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72211926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contributing Reviewers in 2023.","authors":"","doi":"10.1055/s-0044-1786353","DOIUrl":"https://doi.org/10.1055/s-0044-1786353","url":null,"abstract":"","PeriodicalId":52392,"journal":{"name":"AORTA","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11038712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140875019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Rare but Fatal Behçet Variant: The Hughes-Stovin Syndrome-Successful Case Report and New Evidence from Literature Review.","authors":"Andrea Ascoli Marchetti, Lorella Belvivere, Renato Argirò, Barbara Kroegler, Fabio M Oddi, Federico Pennetta, Alice de Giorgi, Stefano Fazzini, Daniele Morosetti, Paola Triggianese, Elisabetta Greco, Arianna D'Antonio, Ilaria Coccia, Manfredi Tesauro, Federica Sangiuolo, Arnaldo Ippoliti","doi":"10.1055/s-0043-1777994","DOIUrl":"10.1055/s-0043-1777994","url":null,"abstract":"<p><p>Hughes-Stovin syndrome (HSS) is a rare potentially fatal vasculitis supposedly belonging to the spectrum of Behçet disease without ocular involvement. HSS tends to play by a temporal pattern, starting with thrombosis and followed by formation of pulmonary aneurysms. Since its mortality can reach 25% of cases, early recognition and appropriate therapy represent the major clinical challenges. We describe a rare case of HSS successfully treated via multidisciplinary management by an endovascular approach and immunosuppressive therapy.</p>","PeriodicalId":52392,"journal":{"name":"AORTA","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11038734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140295300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Near-Infrared Spectroscopy for Spinal Cord Monitoring-A Roadmap to Translational Research in Aortic Medicine.","authors":"Konstantin von Aspern, Josephina Haunschild, Jens Garbade, Christian D Etz","doi":"10.1055/s-0043-1772774","DOIUrl":"10.1055/s-0043-1772774","url":null,"abstract":"<p><p>Extensive aortic aneurysms represent a unique challenge necessitating interdisciplinary efforts for safe and effective treatment. Despite various adjunctive neuroprotective strategies, ischemic spinal cord injury remains a devastating complication. This article describes the implementation of collateral network near-infrared spectroscopy as the first noninvasive spinal cord monitoring modality in the setting of extensive open and endovascular aortic repair, from early conceptualization to clinical utilization. Potential capabilities and remaining uncertainties based on current evidence are outlined and discussed.</p>","PeriodicalId":52392,"journal":{"name":"AORTA","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11038735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72211925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Genes Associated with Thoracic and Abdominal Aortic Aneurysms.","authors":"Argyrios Gyftopoulos, Bulat A Ziganshin, John A Elefteriades, Cassius I Ochoa Chaar","doi":"10.1055/s-0043-57266","DOIUrl":"10.1055/s-0043-57266","url":null,"abstract":"<p><p>Aneurysms impacting the ascending thoracic aorta and the abdominal aorta affect patient populations with distinct clinical characteristics. Through a literature review, this paper compares the genetic associations of ascending thoracic aortic aneurysm (ATAA) with abdominal aortic aneurysms (AAA). Genes related to atherosclerosis, lipid metabolism, and tumor development are associated specifically with sporadic AAA, while genes controlling extracellular matrix (ECM) structure, ECM remodeling, and tumor growth factor β function are associated with both AAA and ATAA. Contractile element genes uniquely predispose to ATAA. Aside from known syndromic connective tissue disease and poly-aneurysmal syndromes (Marfan disease, Loeys-Dietz syndrome, and Ehlers-Danlos syndrome), there is only limited genetic overlap between AAA and ATAA. The rapid advances in genotyping and bioinformatics will elucidate further the various pathways associated with the development of aneurysms affecting various parts of the aorta.</p>","PeriodicalId":52392,"journal":{"name":"AORTA","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/44/1a/10-1055-s-0043-57266.PMC10449569.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10071936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frozen Elephant Trunk for Acute Type A Dissection: Is Risk from Procedure or Patient Characteristics?","authors":"R Wilson King,&nbsp;Adam M Carroll,&nbsp;Kelly C Higa,&nbsp;Joseph C Cleveland,&nbsp;Jessica Y Rove,&nbsp;Muhammad Aftab,&nbsp;Thomas Brett Reece","doi":"10.1055/s-0043-1768970","DOIUrl":"https://doi.org/10.1055/s-0043-1768970","url":null,"abstract":"<p><strong>Background: </strong> The initial goal of acute Type A aortic dissection (ATAAD) repair remains to get the patient off the table safely. More extensive repair is being pushed at the index operation with the frozen elephant trunk (FET) operation, but outcomes are suggested to be worse. However, we hypothesize that the risk associated with the FET in ATAAD is from the patient presenting factors rather than the operation itself.</p><p><strong>Methods: </strong> A retrospective review of a single institution prospective database from 2015 to 2021 was performed. Two cohorts were created based on the indication for FET: evidence of radiographic malperfusion (<i>n</i> = 44) or clinical malperfusion (<i>n</i> = 31). Data were analyzed for preoperative characteristics, intraoperative characteristics, and postoperative outcomes. Statistical univariate analysis was performed with chi-square analysis and <i>t</i>-tests with significance determined at an alpha level of 0.05.</p><p><strong>Results: </strong> Preoperative characteristics were similar in each group, independent of malperfusion markers. The intraoperative characteristics were similar, except the clinical malperfusion group had more packed red blood cells and cryoprecipitate given. The clinical malperfusion group had longer intensive care unit length of stay (<i>p</i> < 0.001), more postoperative strokes (<i>p</i> < 0.001), more reoperations (<i>p</i> <0.0001), and higher mortality rate (<i>p</i> = 0.0003).</p><p><strong>Conclusion: </strong> These data suggest that clinical malperfusion increases the risk of major complications and death. However, full arch replacement with FET in the absence of clinical malperfusion does not appear to add risk to the operation for ATAAD. Patients with increased risk of distal degeneration should be considered for more aggressive replacement to avoid subsequent arch replacement.</p>","PeriodicalId":52392,"journal":{"name":"AORTA","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/70/07/10-1055-s-0043-1768970.PMC10449567.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10065376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reoperation or Aortic Regurgitation Progression after Reimplantation of the Aortic Valve (David's Procedure) Using the Valsalva Graft.","authors":"Kristina Ma,&nbsp;Emelie Carlestål,&nbsp;Anders Franco-Cereceda,&nbsp;Christian Olsson","doi":"10.1055/s-0043-1768968","DOIUrl":"https://doi.org/10.1055/s-0043-1768968","url":null,"abstract":"<p><strong>Background: </strong> This study aimed to assess predictors of a composite endpoint (reoperation for aortic valve [AV] failure or aortic regurgitation [AR] grade ≥ 2) after reimplantation of the aortic valve (RAV) using the Valsalva graft.</p><p><strong>Methods: </strong> From 2012 to 2021, 112 patients underwent RAV in a single center. Clinical and echocardiographic data were collected retrospectively. Cox regression analysis was used to identify predictors of the composite endpoint. Kaplan-Meier methods were used for time-to-event analysis.</p><p><strong>Results: </strong> Median (interquartile range) age was 52 years (44, 62). Nineteen patients (17%) were operated for acute Type A aortic dissection, and the remainder for aortic root aneurysm, 60 mm or larger in 12/112 (11%). Thirty-day mortality was 1/112 (1%). During follow-up, four patients (3.6%) were reoperated for AV failure, and another nine patients (8.1%) developed AR grade ≥ 2. Overall estimated freedom from reoperation or AR grade ≥ 2 was 87% (95% confidence interval: 76-93%) at 5 years. Significantly lower estimated 5-year freedom from the composite endpoint was found in cases with simultaneous aortic valve repair (AVr; 77 vs. 90%, <i>p</i> = 0.007) and nearly significant for large (≥ 6 cm) aortic root diameter (82 vs. 87%, <i>p</i> = 0.055). In Cox's analysis, aortic root diameter and simultaneous AVr were independent predictors for the composite endpoint.</p><p><strong>Conclusion: </strong> Outcomes (survival, reoperation, freedom from AR grade ≥ 2) with RAV were good up to 11-year follow-up. Larger aortic root diameter and simultaneous AVr were identified as predictors for reoperation or AR grade ≥ 2. Long-term follow-up remains necessary to confirm adequate AV function.</p>","PeriodicalId":52392,"journal":{"name":"AORTA","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/bb/18/10-1055-s-0043-1768968.PMC10449566.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10065379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Redo Aortic Surgery in a Patient with a Large Arachnoid Cyst and Myelodysplasia.","authors":"Syed F Hashmi,&nbsp;Ragheb Traify,&nbsp;Ioannis Dimarakis","doi":"10.1055/s-0043-1770959","DOIUrl":"https://doi.org/10.1055/s-0043-1770959","url":null,"abstract":"<p><p>A 70-year-old man was referred for redo root and ascending aortic surgery. Preoperative investigations depicted a large arachnoid cyst occupying the left frontotemporal region and myelodysplasia with persistent thrombocytopenia. We describe successful operative management of this patient in the context of such rare intracranial pathology.</p>","PeriodicalId":52392,"journal":{"name":"AORTA","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c0/ba/10-1055-s-0043-1770959.PMC10449563.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10127246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}