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Veterinary and Comparative Oncology Jun 2017Cardiac tumours are uncommon in the canine and feline population and often an incidental finding. Common types include haemangiosarcoma (HSA), aortic body tumours... (Review)
Review
Cardiac tumours are uncommon in the canine and feline population and often an incidental finding. Common types include haemangiosarcoma (HSA), aortic body tumours (chemodectoma and paraganglioma) and lymphoma. These neoplasms can cause mild to severe, life-threatening clinical signs that are independent of the histological type and may be related to altered cardiovascular function or local haemorrhage/effusion into the pericardial space. Cardiac tumours may require symptomatic treatment aimed at controlling tumour bleeding and potential arrhythmias, and other signs caused by the mass effect. Additional treatment options include surgery, chemotherapy and radiotherapy. For all medical therapies, complete remission is unlikely and medical management, beyond adjunctive chemotherapy in HSA, requires further investigation but combination chemotherapy is recommended for lymphoma. The aim of this report is to summarize and critically appraise the current literature in a descriptive review. However, interpretation is limited by the lack of definitive diagnosis and retrospective nature of most studies.
Topics: Animals; Cat Diseases; Cats; Dog Diseases; Dogs; Heart Neoplasms
PubMed: 26420436
DOI: 10.1111/vco.12167 -
The American Journal of Cardiology Aug 2023
Topics: Humans; Aortic Bodies; Paraganglioma, Extra-Adrenal; Glomus Tumor
PubMed: 37422346
DOI: 10.1016/j.amjcard.2023.06.050 -
European Journal of Vascular and... Jan 2022
Topics: Aged, 80 and over; Aortic Aneurysm, Abdominal; Asymptomatic Diseases; Endovascular Procedures; Foreign-Body Migration; Humans; Male; Postoperative Complications; Radiography, Abdominal; Stents; Tomography, X-Ray Computed
PubMed: 34844832
DOI: 10.1016/j.ejvs.2021.10.028 -
Neuroimaging Clinics of North America May 2016Paragangliomas of the head and neck are rare vascular skull-base tumors derived from the paraganglionic system with an estimated incidence of 1:30,000 accounting for 3%... (Review)
Review
Paragangliomas of the head and neck are rare vascular skull-base tumors derived from the paraganglionic system with an estimated incidence of 1:30,000 accounting for 3% of all paragangliomas. The most common paraganglioma locations of the head and neck in descending order are the carotid body, jugular, tympanic, and vagal paragangliomas. This article discusses the clinical characterics, normal anatamy, imaging findings and protocols, pathology, staging, and differential diagnosis for paragangliomas of the head and neck.
Topics: Aortic Bodies; Carotid Arteries; Ear, Middle; Head and Neck Neoplasms; Humans; Jugular Veins; Magnetic Resonance Imaging; Paraganglioma; Tomography, X-Ray Computed
PubMed: 27154608
DOI: 10.1016/j.nic.2015.12.005 -
Journal of Atherosclerosis and... Apr 2021Reports on an association between body mass index and aortic disease, which remains controversial. This study investigated the association between body mass index and...
AIMS
Reports on an association between body mass index and aortic disease, which remains controversial. This study investigated the association between body mass index and mortality from aortic disease.
METHODS
We conducted the Japan Collaborative Cohort Study, a prospective study of 103,972 Japanese men and women aged 40-79 years. Body mass index was calculated on the basis of self-reported height and weight, and the participants were followed up from 1988-89 through 2009. Sex-specific hazard ratios (95% confidence intervals) of mortality from aortic disease according to quintiles of body mass index were analyzed using the Cox proportional hazards model.
RESULTS
During the median 18.8 years of follow-up, we documented 139 deaths due to aortic aneurysm (including 51 thoracic and 74 abdominal aortic aneurysms) and 134 deaths due to aortic dissection. We observed positive associations of body mass index with mortality from aortic aneurysm among men: the multivariable hazard ratios (95% confidence intervals) for highest versus lowest quintiles of body mass index were 4.48 (2.10-9.58), P for trend <0.0001 for aortic aneurysm; 6.52 (1.33-32.02), P=0.005 for thoracic aortic aneurysm; 3.81 (1.39-10.49), P=0.01 for abdominal aortic aneurysm; and 2.71 (1.59-4.62), P=0.001 for total aortic disease. No association was found for aortic dissection. Among ever-smokers (men ≥ 90%) but not never-smokers (women ≥ 84%), an association between body mass index and aortic disease mortality was observed regardless of sex, which may explain the sex difference (P for sex-interaction=0.046).
CONCLUSIONS
We found a positive association between body mass index and mortality from aortic aneurysm among Japanese men and smokers.
Topics: Aged; Aortic Dissection; Aortic Aneurysm, Abdominal; Aortic Aneurysm, Thoracic; Body Mass Index; Female; Follow-Up Studies; Humans; Japan; Male; Mass Screening; Middle Aged; Obesity; Preventive Health Services; Risk Factors; Risk Reduction Behavior; Sex Factors; Smoking; Ultrasonography
PubMed: 32727971
DOI: 10.5551/jat.57232 -
Vascular Specialist International Mar 2021While rare, abdominal aortic infections remain one of the most technically and emotionally challenging cases that a vascular surgeon may face. Secondary infections of... (Review)
Review
While rare, abdominal aortic infections remain one of the most technically and emotionally challenging cases that a vascular surgeon may face. Secondary infections of either endovascular, or open aortic reconstructions range from 0.2% to 8%. Primary aortic infections are much more rare. Diagnosis can be elusive, depending upon the virulence of the causative microbes, and extent of the infection. Patients are often brittle, with immunocompromise and malnutrition prevalent in this patient population. The gold standard diagnostic test remains a computed tomographic angiogram. The mainstay of management requires vascular control, and wide debridement of all infected materials and revascularization. Multiple methods exist to reconstruct the vascular supply. The neo-aortoiliac system (NAIS) is attractive as it utilizes the patient's own femoral veins to reconstruct the vascular supply after the infection has been extirpated. The procedure is demanding upon the patient and surgeons alike. Also, the rarity of aortic infections limit experiences the literature to centers of excellence. However, the NAIS resists infection well, leaving the patient without any remaining foreign bodies. No further costs for conduit are incurred. Moreover, multiple experiences show excellent durability. While comparative effectiveness literature remains sparse, we believe the NAIS to be the optimal method of revascularization for select patients. In this article, we will review the use of NAIS for primary and secondary aortic infections. In particular, we will emphasize procedural details to help enable the reader to apply this procedure most effectively to their own patients.
PubMed: 33795548
DOI: 10.5758/vsi.210002 -
Journal of the American College of... Feb 2022High plasma lipoprotein(a) and high body mass index are both causal risk factors for calcific aortic valve disease.
BACKGROUND
High plasma lipoprotein(a) and high body mass index are both causal risk factors for calcific aortic valve disease.
OBJECTIVES
This study sought to test the hypothesis that risk of calcific aortic valve disease is the highest when both plasma lipoprotein(a) and body mass index are extremely high.
METHODS
From the Copenhagen General Population Study, we used information on 69,988 randomly selected individuals recruited from 2003 to 2015 (median follow-up 7.4 years) to evaluate the association between high lipoprotein(a) and high body mass index with risk of calcific aortic valve disease.
RESULTS
Compared with individuals in the 1st to 49th percentiles for both lipoprotein(a) and body mass index, the multivariable adjusted HRs for calcific aortic valve disease were 1.6 (95% CI: 1.3-1.9) for the 50th to 89th percentiles of both (16% of all individuals) and 3.5 (95% CI: 2.5-5.1) for the 90th to 100th percentiles of both (1.1%) (P for interaction = 0.92). The 10-year absolute risk of calcific aortic valve disease increased with higher lipoprotein(a), body mass index, and age, and was higher in men than in women. For women and men 70-79 years of age with body mass index ≥30.0 kg/m, 10-year absolute risks were 5% and 8% for lipoprotein(a) ≤42 mg/dL (88 nmol/L), 7% and 11% for 42-79 mg/dL (89-169 nmol/L), and 9% and 14% for lipoprotein(a) ≥80 mg/dL (170 nmol/L), respectively.
CONCLUSIONS
Extremely high lipoprotein(a) levels and extremely high body mass index together conferred a 3.5-fold risk of calcific aortic valve disease. Ten-year absolute risk of calcific aortic valve disease by categories of lipoprotein(a) levels, body mass index, age, and sex ranged from 0.4% to 14%.
Topics: Adult; Aged; Aged, 80 and over; Aortic Valve; Aortic Valve Stenosis; Biomarkers; Body Mass Index; Calcinosis; Denmark; Female; Follow-Up Studies; Forecasting; Humans; Incidence; Lipoprotein(a); Male; Middle Aged; Retrospective Studies; Risk Factors; Young Adult
PubMed: 35144746
DOI: 10.1016/j.jacc.2021.11.043 -
Journal of Cardiothoracic Surgery Nov 2023In open thoracoabdominal aortic aneurysm (TAAA) repair, we have been performing vascular reconstruction under moderate to deep hypothermia and assisted circulation using...
BACKGROUND
In open thoracoabdominal aortic aneurysm (TAAA) repair, we have been performing vascular reconstruction under moderate to deep hypothermia and assisted circulation using simultaneous upper and lower body perfusion. This method is effective for protecting the spinal cord and the brain, heart, and abdominal organs and for avoiding lung damage.
METHODS
TAAA repair was performed under hypothermia at 20-28 °C in 18 cases (Crawford type I in 0 cases, type II in 5, type III in 3, type IV in 4, and Safi V in 6) between October 2014 and January 2023. Cardiopulmonary bypass was conducted by combined upper and lower body perfusion, with perfusion both via the femoral artery and either transapically or via the descending aorta or the left brachial artery.
RESULTS
The ischemic time for the artery of Adamkiewicz and the main segmental arteries was 40-124 min (75 ± 33 min). No spinal cord ischemic injury or brain or heart complications occurred. One patient with postoperative right renal artery occlusion and one with an infected aneurysm required tracheostomy, but the intubation time for the other 16 was 32 ± 33 h. The duration of postoperative intensive care unit stay was 6.5 ± 6.2 days, the length of hospital stay was 29 ± 15 days, and no in-hospital deaths occurred.
CONCLUSIONS
Simultaneous upper and lower body perfusion under moderate to deep hypothermia during thoracoabdominal aortic surgery may avoid not only spinal cord injury, but also cardiac and brain complications.
Topics: Humans; Aortic Aneurysm, Thoracic; Hypothermia; Treatment Outcome; Retrospective Studies; Spinal Cord Injuries; Perfusion; Aortic Aneurysm, Abdominal
PubMed: 37964285
DOI: 10.1186/s13019-023-02439-3 -
Journal of Atherosclerosis and... Jul 2023Aortic diseases (ADs), including aortic dissection, aortic aneurysm, and aortic rupture, are fatal, with extremely high mortality rates. A body shape index (ABSI), an...
AIMS
Aortic diseases (ADs), including aortic dissection, aortic aneurysm, and aortic rupture, are fatal, with extremely high mortality rates. A body shape index (ABSI), an anthropometric measure calculated as waist circumference adjusted by height and weight, improves the predictive capacity for mortality. However, whether ABSI is a risk factor for AD-related mortality in the general population remains unclear.
METHODS
We used a nationwide database of 630,842 individuals (aged 40-75 years) who participated in the annual "Specific Health Check and Guidance in Japan" between 2008 and 2010.
RESULTS
During the follow-up period of 3.8 years, 159 AD-related deaths occurred, including 105 aortic dissections and 54 aortic aneurysm ruptures. The subjects were divided into three groups based on ABSI tertiles. Kaplan-Meier analysis demonstrated that the 3 tertile (with the highest ABSI) had the greatest risk among the three groups. Multivariate Cox proportional hazard regression analysis demonstrated that ABSI was significantly associated with AD-related death after adjusting for confounding risk factors. Neither waist circumference nor body mass index consistently predicted AD-related death in the multivariate model. The prediction capacity was significantly improved by the addition of ABSI to the confounding risk factors.
CONCLUSIONS
We demonstrated for the first time that ABSI, a surrogate marker for abdominal visceral fat tissue, was associated with AD-related deaths in the general population, suggesting the importance of central adiposity in the development of AD.
Topics: Humans; Anthropometry; Aortic Diseases; Body Mass Index; East Asian People; Obesity; Risk Factors; Waist Circumference; Adult; Middle Aged; Aged; Adiposity; Obesity, Abdominal
PubMed: 36070887
DOI: 10.5551/jat.63753 -
The American Journal of Cardiology Jul 2023Chemodectomas are tumors derived from parasympathetic nonchromaffin cells and are often found in the aortic and carotid bodies. They are generally benign but can cause...
Chemodectomas are tumors derived from parasympathetic nonchromaffin cells and are often found in the aortic and carotid bodies. They are generally benign but can cause mass-effect symptoms and have local or distant spread. Surgical excision has been the main curative treatment strategy. The National Cancer Database was reviewed to study all patients with carotid or aortic body tumors from 2004 to 2015. Demographic data, tumor characteristics, treatment strategies, and patient outcomes were examined, split by tumor location. Kaplan-Meier survival estimates were generated for both locations. In total, 248 patients were examined, with 151 having a tumor in the carotid body and 97 having a tumor in the aortic body. Many variables were similar between both tumor locations. However, aortic body tumors were larger than those in the carotid body (477.80 ± 477.58 mm vs 320.64 ± 436.53 mm, p = 0.008). More regional lymph nodes were positive in aortic body tumors (65.52 ± 45.73 vs 35.46 ± 46.44, p <0.001). There were more distant metastases at the time of diagnosis in carotid body tumors (p = 0.003). Chemotherapy was used more for aortic body tumors (p = 0.001); surgery was used more for carotid body tumors (p <0.001). There are slight differences in tumor characteristics and response to treatment. Surgical resection is the cornerstone of management, and radiation can often be considered. In conclusion, chemodectomas are generally benign but can present with metastasis and compressive symptoms that make understanding their physiology and treatment important.
Topics: Humans; Carotid Body Tumor; Aortic Bodies; Paraganglioma, Extra-Adrenal; Kaplan-Meier Estimate; Retrospective Studies
PubMed: 37262989
DOI: 10.1016/j.amjcard.2023.05.003