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Open Surgical Repair of Abdominal Aortic Aneurysms Maintains a Pivotal Role in the Endovascular Era.Seminars in Interventional Radiology Oct 2020Since the advent of endovascular aortic repair (EVAR) nearly three decades ago, there has been a paradigm shift in the treatment of the abdominal aortic aneurysm (AAA)... (Review)
Review
Since the advent of endovascular aortic repair (EVAR) nearly three decades ago, there has been a paradigm shift in the treatment of the abdominal aortic aneurysm (AAA) to favor EVAR due to its reduced operative mortality, less invasive nature, and faster recovery times. However, more recently there has been an accumulation of data from large meta-analyses and randomized clinical trials revealing that EVAR has no survival benefit after approximately 2 years and is associated with substantially higher rates of reintervention and aneurysm rupture in the long term. These findings call into question the durability of EVAR compared with open aortic repair and emphasize the need for surgeons to remain competent with open aortic surgery in the modern era. This article will provide comprehensive review of a large body of literature comparing endovascular repair to open aortic surgery for the management of AAAs, and it will offer an overview of the open surgical repair technique for AAAs.
PubMed: 33041480
DOI: 10.1055/s-0040-1715881 -
Diabetes, Metabolic Syndrome and... 2023To investigate the effect of high-fat diet on protein expression in mouse heart and aorta using proteomic techniques.
PURPOSE
To investigate the effect of high-fat diet on protein expression in mouse heart and aorta using proteomic techniques.
METHODS
A high-fat diet was used to construct an obese mouse model, and body weight was checked regularly. After the experiment, serum lipid and oxidative stress levels were measured. Proteomic detection of cardiac and aortic protein expression. Cardiac and aortic common differentially expressed proteins (Co-DEPs) were screened based on proteomic results. Subsequently, functional enrichment analysis and screening of key proteins were performed.
RESULTS
A high-fat diet significantly increased body weight in mice. Obese mice had considerably higher levels of TC, TG, LDL-C, ROS, and MDA. In the heart and aorta, 17 Co-DEPs were discovered. The results of functional analysis of these proteins indicated that they were mainly related to lipid metabolism. Ech1, Decr1, Hsd17b4, Hsdl2 and Acadvl were screened as key proteins. In mice, a high-fat diet causes lipid metabolism to become disrupted, resulting in higher levels of oxidative stress and lipid peroxidation products.
CONCLUSION
Ech1, Decr1, Hsd17b4, Hsdl2 and Acadvl as cardiac and aortic Co-DEPs are closely related to lipid metabolism and may serve as potential diagnostic and therapeutic targets for obesity-induced cardiovascular disease.
PubMed: 37012931
DOI: 10.2147/DMSO.S405327 -
Journal of Cardiovascular Translational... Apr 2023Irisin, a myokine mainly secreted by skeletal and cardiac muscles, is actively involved in cardiovascular diseases. However, whether irisin is associated with aortic...
Irisin, a myokine mainly secreted by skeletal and cardiac muscles, is actively involved in cardiovascular diseases. However, whether irisin is associated with aortic stenosis remains unknown. Two hundred ninety-three severe AS patients who underwent transcatheter aortic valve implantation were enrolled and followed-up for 35 months on average. Enzyme-linked immunosorbent assay (ELISA) was applied to measure circulating irisin levels. Patients were divided into two groups based on the median plasma irisin level. We found that high plasma irisin levels were independently associated with pure aortic stenosis (PAS) after adjusting for age, body mass index, history of peripheral vascular disease, and creatinine (OR = 3.015, 95% CI 1.775-5.119, P < 0.001). ROC curve analysis showed a significant predictive value of irisin for PAS (AUC = 0.647, 95% CI 0.583-0.711, P < 0.001). The severity of aortic valve calcification was negatively associated with plasma irisin levels (P < 0.05). In conclusion, irisin is an independent predictor for PAS and is negatively associated with the severity of aortic valve calcification.
Topics: Humans; Aortic Valve; Fibronectins; Treatment Outcome; Aortic Valve Stenosis; Biomarkers; Severity of Illness Index
PubMed: 36223050
DOI: 10.1007/s12265-022-10327-9 -
World Journal of Cardiology Apr 2024Pacemaker post-transcatheter aortic valve replacement is related to multifactorial risk. Nwaedozie brought to the body of evidence electrocardiogram and clinical...
Pacemaker post-transcatheter aortic valve replacement is related to multifactorial risk. Nwaedozie brought to the body of evidence electrocardiogram and clinical findings. However, procedural characteristics have at least as much impact on the final need for a permanent pacemaker and potentially on the pacing rate. In this regard, long-term follow-up and understanding of the impact of long-term stimulation is of utmost importance.
PubMed: 38690219
DOI: 10.4330/wjc.v16.i4.168 -
Medicine International 2023Abdominal aortic aneurysm (AAA) is a medical condition characterized by abnormal enlargement or the ballooning of the aorta, the largest blood vessel in the human body,...
Abdominal aortic aneurysm (AAA) is a medical condition characterized by abnormal enlargement or the ballooning of the aorta, the largest blood vessel in the human body, in the abdomen. AAA usually develops slowly and asymptomatically and becomes a potentially life-threatening condition if left untreated. Although the exact cause of AAA is not always clear, risk factors such as age, sex, smoking, hypertension, and family history may increase the likelihood of developing AAA. It is essential to manage and prevent AAA rupture, which can lead to severe internal bleeding and pose a serious risk to a person's health if not diagnosed in a timely manner and appropriate medical attention. Awareness, early diagnosis and appropriate medical care are critical factors when addressing this condition, providing a glimpse into the complex and critical nature of AAA. The present study describes the case of a patient who applied to the family medicine unit with hypertension and dysuria, and was diagnosed with AAA incidentally.
PubMed: 37745153
DOI: 10.3892/mi.2023.103 -
JACC. Cardiovascular Interventions Aug 2022Given the expanding indications of transcatheter aortic valve replacement (TAVR) in younger patients with longer life expectancies, the ability to perform postprocedural... (Review)
Review
Given the expanding indications of transcatheter aortic valve replacement (TAVR) in younger patients with longer life expectancies, the ability to perform postprocedural coronary access represents a priority in their lifetime management. A growing body of evidence suggests that commissural (and perhaps coronary) alignment in TAVR impacts coronary access and valve hemodynamics as well as coronary flow and access after redo-TAVR. Recent studies have provided modified delivery system insertion and rotation techniques to obtain commissural alignment with available transcatheter heart valve devices. Moreover, patient-specific preprocedural planning and postprocedural imaging tools have been developed to facilitate and evaluate commissural alignment. Future efforts should aim to refine transcatheter heart valve and delivery system designs to make neocommissural alignment easier and more reproducible. The aim of this review is to present an in-depth insight of commissural alignment in TAVR, including its rationale, standardized definitions, technical steps, outcomes, and future directions.
Topics: Aortic Valve; Aortic Valve Stenosis; Heart Valve Prosthesis; Humans; Prosthesis Design; Risk Factors; Transcatheter Aortic Valve Replacement; Treatment Outcome
PubMed: 35926918
DOI: 10.1016/j.jcin.2022.06.001 -
Frontiers in Bioengineering and... 2020The aorta is the largest artery in the body, so any diseases or conditions which could cause damage to the aorta would put patients at considerable and life-threatening... (Review)
Review
The aorta is the largest artery in the body, so any diseases or conditions which could cause damage to the aorta would put patients at considerable and life-threatening risk. In the management of aortic diseases, the major treatments include drug therapy, endovascular treatment, and surgical treatment, which are of great danger or with a poor prognosis. The delivery of nano-biomaterials provides a potential development trend and an emerging field where we could monitor patients' conditions and responses to the nanotherapeutics. One of the putative applications of nanotechnology is ultrasensitive monitoring of cardiovascular markers by detecting and identifying aneurysms. Moreover, the use of nanosystems for targeted drug delivery can minimize the systemic side effects and enhance drug positioning and efficacy compared to conventional drug therapies. This review shows some examples of utilizing nano-biomaterials in organ and cell culture experiments and explains some developing technologies in delivering and monitoring regenerative therapeutics.
PubMed: 33224934
DOI: 10.3389/fbioe.2020.583879 -
Mathematical Biosciences and... Jul 2022Abdominal aortic aneurysms are serious and difficult to detect, conditions can be deadly if they rupture. In this study, the heat transfer and flow physics of Abdominal...
Abdominal aortic aneurysms are serious and difficult to detect, conditions can be deadly if they rupture. In this study, the heat transfer and flow physics of Abdominal Aortic Aneurysm (AAA) were discussed and associated with cardiac cycle to illustrate the cardiac thermal pulse (CTP) of AAA. A CTP and infrared thermography (IRT) evaluation-based on AAA and abdomen skin surface detection method was proposed, respectively. Infrared thermography (IRT) is a promising imaging technique that may detect AAA quicker and cheaper than other imaging techniques (as biomarker). From CFD rigid-wall and FSI Analysis, the transient bioheat transfer effect resulted in a distinct thermal signature (circular thermal elevation) on the temperature profile of midriff skin surface, at both regular body temperature and supine position, under normal clinical temperature. However, it is important to note that thermography is not a perfect technology, and it does have some limitations, such as lack of clinical trials. There is still work to be done to improve this imaging technique and make it a more viable and accurate method for detecting abdominal aortic aneurysms. However, thermography is currently one of the most convenient technologies in this field, and it has the potential to detect abdominal aortic aneurysms earlier than other techniques. CTP, on the other hand, was used to examine the thermal physics of AAA. In CFD rigid-wall Analysis, AAA had a CTP that only responded to systolic phase at regular body temperature. In contrast, a healthy abdominal aorta displayed a CTP that responded to the full cardiac cycle, including diastolic phase at all simulated cases. Besides, the findings from FSI Analysis suggest the influence of numerical simulation techniques on the prediction of thermal physics behaviours of AAA and abdominal skin surface. Lastly, this study correlated the relationship between natural convective heat transfer coefficient with AAA and provided reference for potential clinical diagnostic using IRT in clinical implications.
Topics: Humans; Aortic Aneurysm, Abdominal
PubMed: 36031992
DOI: 10.3934/mbe.2022479 -
JTCVS Techniques Jun 2023The Commando procedure involves division of the intervalvular fibrous body, mitral valve replacement, and aortic valve replacement. It is considered a technically...
OBJECTIVE
The Commando procedure involves division of the intervalvular fibrous body, mitral valve replacement, and aortic valve replacement. It is considered a technically challenging procedure and traditionally has had high mortality.
METHODS
Five pediatric patients with combined left ventricular inflow and outflow obstruction were included in this study.
RESULTS
There were no early or late deaths during follow-up, and no pacemakers were implanted. None of the patients required reoperation during follow-up, and none developed a clinically significant gradient across the mitral valve or aortic valve.
CONCLUSIONS
The risks of this operation for patients with congenital heart disease undergoing multiple redo operations should be weighed against the benefits of normal-size mitral and aortic annular diameters and dramatically improved hemodynamics.
PubMed: 37324341
DOI: 10.1016/j.xjtc.2023.03.008