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The Journal of Thoracic and... Apr 2022
Topics: Aorta; Aortic Aneurysm; Humans
PubMed: 32763036
DOI: 10.1016/j.jtcvs.2020.05.113 -
Circulation Journal : Official Journal... Nov 2021
Topics: Adipose Tissue; Aortic Aneurysm; Aortic Aneurysm, Abdominal; Humans
PubMed: 34148930
DOI: 10.1253/circj.CJ-21-0388 -
Deutsches Arzteblatt International Jul 2012
Topics: Angiography; Aortic Aneurysm; Endovascular Procedures; Humans
PubMed: 23056155
DOI: 10.3238/arztebl.2012.0504b -
Nature May 2011Aortic aneurysm is common, accounting for 1-2% of all deaths in industrialized countries. Early theories of the causes of human aneurysm mostly focused on inherited or... (Review)
Review
Aortic aneurysm is common, accounting for 1-2% of all deaths in industrialized countries. Early theories of the causes of human aneurysm mostly focused on inherited or acquired defects in components of the extracellular matrix in the aorta. Although several mutations in the genes encoding extracellular matrix proteins have been recognized, more recent discoveries have shown important perturbations in cytokine signalling cascades and intracellular components of the smooth muscle contractile apparatus. The modelling of single-gene heritable aneurysm disorders in mice has shown unexpected involvement of the transforming growth factor-β cytokine pathway in aortic aneurysm, highlighting the potential for new therapeutic strategies.
Topics: Angiotensin II; Animals; Aortic Aneurysm; Disease Models, Animal; Elastin; Humans; Muscle, Smooth, Vascular; Transforming Growth Factor beta
PubMed: 21593863
DOI: 10.1038/nature10145 -
Methodist DeBakey Cardiovascular Journal 2022A 74-year-old female with previous permanent pacemaker insertion for complete heart block and no history of connective tissue disease presented to our regional...
A 74-year-old female with previous permanent pacemaker insertion for complete heart block and no history of connective tissue disease presented to our regional cardiothoracic center with progressive exertional shortness of breath. Nine years later, when the patient was 83 years old, a computed tomography scan of the thoracic aorta revealed an isolated aneurysm of the aortic root measuring 7.6 × 5.1 cm at the sinus of Valsalva.
Topics: Aged; Aged, 80 and over; Aortic Aneurysm; Aortic Aneurysm, Thoracic; Aortic Valve; Aortic Valve Insufficiency; Female; Heart Valve Prosthesis; Humans; Sinus of Valsalva
PubMed: 35935098
DOI: 10.14797/mdcvj.1118 -
The Journal of Thoracic and... Feb 2022
Topics: Aortic Aneurysm; Atherosclerosis; Freedom; Humans
PubMed: 34688486
DOI: 10.1016/j.jtcvs.2021.09.042 -
The Kaohsiung Journal of Medical... Jun 2012The aorta, which has a complex intrinsic biology and sophisticated mechanical properties for conducting the blood ejected from the left ventricle to the rest of the... (Review)
Review
The aorta, which has a complex intrinsic biology and sophisticated mechanical properties for conducting the blood ejected from the left ventricle to the rest of the systemic arterial bed, is the largest and strongest artery in the body. It carries roughly 200 million liters of blood in an average lifetime. Any process that undermines the architecture threatens the structure, stability, and functionality of the aorta. In this regard, acute aortic dissection (AAD) requires special attention because it is the most catastrophic acute illness of the aorta; it has high morbidity and mortality because of potentially fatal complications. AAD has, therefore, become an important topic of recent research, and knowledge about this disease has improved during the past few years. Up-to-date knowledge about the natural history, epidemiology, presentation, physiopathology, evolution, management, follow-up, and long-term outcomes of AAD are summarized in this review.
Topics: Aortic Dissection; Aortic Aneurysm; Female; Humans; Male
PubMed: 22632884
DOI: 10.1016/j.kjms.2011.11.010 -
Annals of Thoracic and Cardiovascular... Jan 2024A syphilitic aortitis is a late cardiovascular lesion of tertiary syphilis that has become exceptionally rare in the antibiotic era but not eradicated completely....
A syphilitic aortitis is a late cardiovascular lesion of tertiary syphilis that has become exceptionally rare in the antibiotic era but not eradicated completely. Syphilitic aortitis of ascending aorta complicates in ascending aortic aneurysm formation and aortic valve regurgitation, both requiring surgical treatment. After surgery, lifelong surveillance of the remainder of the aorta is recommended because of a priori supposed high incidence of delayed involvement of noninvolved aortic segments. A 3-year follow-up result of surgery of syphilitic ascending aortic aneurysm with aortic valve regurgitation in condition of active ongoing syphilitic aortitis and valvulitis is described with addressing the dimensions of remaining aortic segments. This case demonstrates that the dilatation of the remainder of the aorta does not occur during 3 years, at least when anti-syphilitic course of antibiotic is used just after operation without additional treatment during the follow-up period. A few reports on surgical treatment of syphilitic aneurysms of the ascending aorta are discussed.
Topics: Humans; Syphilis, Cardiovascular; Aortic Valve Insufficiency; Aneurysm, Ascending Aorta; Treatment Outcome; Aortic Aneurysm; Anti-Bacterial Agents; Aortic Valve
PubMed: 36967122
DOI: 10.5761/atcs.cr.22-00236 -
Interactive Cardiovascular and Thoracic... Jun 2022Ascending thoracic aortic aneurysms (aTAAs) carry a risk of acute type A dissection. Elective repair guidelines are based on diameter, but complications often occur...
OBJECTIVES
Ascending thoracic aortic aneurysms (aTAAs) carry a risk of acute type A dissection. Elective repair guidelines are based on diameter, but complications often occur below diameter threshold. Biomechanically, dissection can occur when wall stress exceeds wall strength. Aneurysm wall stresses may better capture dissection risk. Our aim was to investigate patient-specific aTAA wall stresses associated with a tricuspid aortic valve (TAV) by anatomic region.
METHODS
Patients with aneurysm diameter ≥4.0 cm underwent computed tomography angiography. Aneurysm geometries were reconstructed and loaded to systemic pressure while taking prestress into account. Finite element analyses were conducted to obtain wall stress distributions. The 99th percentile longitudinal and circumferential stresses were determined at systole. Wall stresses between regions were compared using one-way analysis of variance with post hoc Tukey HSD for pairwise comparisons.
RESULTS
Peak longitudinal wall stresses on aneurysms (n = 204) were 326 [standard deviation (SD): 61.7], 246 (SD: 63.4) and 195 (SD: 38.7) kPa in sinuses of Valsalva, sinotubular junction (STJ) and ascending aorta (AscAo), respectively, with significant differences between AscAo and both sinuses (P < 0.001) and STJ (P < 0.001). Peak circumferential wall stresses were 416 (SD: 85.1), 501 (SD: 119) and 340 (SD: 57.6) kPa for sinuses, STJ and AscAo, respectively, with significant differences between AscAo and both sinuses (P < 0.001) and STJ (P < 0.001).
CONCLUSIONS
Circumferential and longitudinal wall stresses were greater in the aortic root than AscAo on aneurysm patients with a TAV. Aneurysm wall stress magnitudes and distribution relative to respective regional wall strength could improve understanding of aortic regions at greater risk of dissection in a particular patient.
Topics: Aorta; Aortic Aneurysm; Aortic Aneurysm, Thoracic; Aortic Valve; Humans; Stress, Mechanical; Tricuspid Valve
PubMed: 34718581
DOI: 10.1093/icvts/ivab269 -
Deutsches Arzteblatt International Mar 2012Aneurysms of the ascending aorta present a special challenge to primary care physicians, internists, and cardiac surgeons because they remain asymptomatic until they... (Review)
Review
BACKGROUND
Aneurysms of the ascending aorta present a special challenge to primary care physicians, internists, and cardiac surgeons because they remain asymptomatic until they present with either dissection or rupture.
METHOD
This review article is based on a selective search of the literature.
RESULTS
In the elderly, aneurysms of the ascending aorta are mainly caused by atherosclerosis. In younger patients, the most common cause is Marfan syndrome; less commonly, younger patients may have Loeys-Dietz syndrome, non-syndromic familial aortic aneurysms, or aortic valve malformations. Genetic variants predisposing to the development of sporadic aortic aneurysms have recently been identified. The risk of rupture and dissection depends on the aortic diameter: when the diameter exceeds 55 mm, surgery improves the outcome, as the risk of surgical complications is lower than the mortality due to rupture or dissection. A more accurate prognosis can be obtained by normalizing the aortic diameter to the body surface area. For patients with Marfan syndrome or a bicuspid aortic valve, the indications for surgery should be determined on an individual basis, depending on additional risk factors. Randomized treatment trials are lacking. The medical management of aneurysms of the ascending aorta consists of monitoring the size of the aneurysm, controlling blood pressure, and treating any cardiovascular risk factors. Patients with Marfan syndrome benefit from preventive treatment with beta-blockers. Advances in the pathophysiological understanding of aortic aneurysms have led to the testing of new types of treatment, e.g., with AT1 antagonists.
CONCLUSION
With the aid of a risk-based treatment strategy, surgery can be properly timed to prevent dissection, which is usually lethal when it occurs. More research is needed on the pathogenesis of this condition so that better preventive treatments can be developed.
Topics: Angiography; Aortic Aneurysm; Endovascular Procedures; Humans
PubMed: 22532815
DOI: 10.3238/arztebl.2012.0227