Three months after current admission, there is regression in size of the descending aorta. Stable partial flow in the false lumen of the ascending aorta

ASVIDE ◽  
2018 ◽  
Vol 5 ◽  
pp. 342-342
Author(s):  
Paul Schoenhagen
Keyword(s):  
False Lumen ◽  
Ascending Aorta ◽  
Descending Aorta

scholarly journals Time-Resolved Three-Dimensional Contrast-Enhanced Magnetic Resonance Angiography in Patients with Chronic Expanding and Stable Aortic Dissections

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Michael Trojan ◽  
Fabian Rengier ◽  
Drosos Kotelis ◽  
Matthias Müller-Eschner ◽  
Sasan Partovi ◽  
...  
Keyword(s):  
Three Dimensional ◽  
False Lumen ◽  
Ascending Aorta ◽  
Stable Group ◽  
Time Resolved ◽  
Descending Aorta ◽  
Peak Intensity ◽  
Contrast Enhanced ◽  
Aortic Dissections

Objective. To prospectively evaluate our hypothesis that three-dimensional time-resolved contrast-enhanced magnetic resonance angiography (TR-MRA) is able to detect hemodynamic alterations in patients with chronic expanding aortic dissection compared to stable aortic dissections. Materials and Methods. 20 patients with chronic or residual aortic dissection in the descending aorta and patent false lumen underwent TR-MRA of the aorta at 1.5 T and repeated follow-up imaging (mean follow-up 5.4 years). 7 patients showed chronic aortic expansion and 13 patients had stable aortic diameters. Regions of interest were placed in the nondissected ascending aorta and the false lumen of the descending aorta at the level of the diaphragm (FL-diaphragm level) resulting in respective time-intensity curves. Results. For the FL-diaphragm level, time-to-peak intensity and full width at half maximum were significantly shorter in the expansion group compared to the stable group (p=0.027 and p=0.003), and upward and downward slopes of time-intensity curves were significantly steeper (p=0.015 and p=0.005). The delay of peak intensity in the FL-diaphragm level compared to the nondissected ascending aorta was significantly shorter in the expansion group compared to the stable group (p=0.01). Conclusions. 3D TR-MRA detects significant alterations of hemodynamics within the patent false lumen of chronic expanding aortic dissections compared to stable aortic dissections.

scholarly journals Modified Port-Access Technique for the Treatment of Aortic Dissection after Previous Cardiac Surgery

2017 ◽  
Vol 44 (3) ◽  
pp. 202-204
Author(s):  
Edvin Prifti ◽  
Aurel Demiraj ◽  
Roland Xhaxho
Keyword(s):  
Cardiac Surgery ◽  
Aortic Dissection ◽  
Myocardial Protection ◽  
Circulatory Arrest ◽  
False Lumen ◽  
Left Ventricular ◽  
Ascending Aorta ◽  
Descending Aorta ◽  
Severe Aortic Regurgitation ◽  
Port Access

One of the most challenging conditions to manage after previous cardiac surgery is chronic dissection of the ascending aorta. We operated on a 54-year-old man who had aortic dissection in addition to large aortic dimensions very close to the sternum, severe aortic regurgitation, and a false lumen in the descending aorta. We used a combination of perfusion and myocardial protection techniques, arising from port-access technology, that enabled antegrade flow into the aorta, endoclamping of the ascending aorta, the administration of cardioplegic solution before opening the sternum, and left ventricular venting to prevent ventricular distention. Our technique resulted in minimal blood loss, shorter circulatory-arrest and operative times, the ability to operate on a decompressed heart and descending aorta, good myocardial protection, and easier and safer access to the heart. Three years postoperatively, our patient was doing well. Other patients might benefit from this approach; however, the surgeon must ensure that an aortic segment is suitable for endoclamping.

Type A Intramural Hematoma Often Turns Out To Be a Type A Dissection

2013 ◽  
Vol 16 (6) ◽  
pp. 351 ◽  
Author(s):  
Sebastian Michel ◽  
Christian Hagl ◽  
Gerd Juchem ◽  
Ralf Sodian
Keyword(s):  
Computed Tomography ◽  
Surgical Repair ◽  
False Lumen ◽  
Intramural Hematoma ◽  
Acute Chest Pain ◽  
Type A ◽  
Ascending Aorta ◽  
Descending Aorta ◽  
Type A Dissection ◽  
Thrombosed Type

<p><b>Background:</b> The management of type A intramural hematoma (IMH) is controversial. Although most Western countries still recommend immediate surgical repair, some centers in Asia have shown good results recently with medical treatment alone. Here, we present a case of type A IMH which was discovered during the operation to be a thrombosed type A dissection.</p><p><b>Case Report:</b> An 83-year-old female patient presented with acute chest pain. After diagnostic exclusion of myocardial infarction, computed tomography was performed, which showed an IMH from the ascending to the descending aorta. No intimal flap could be detected. The ascending aorta was replaced surgically with a prosthesis. During the operation, we found a ruptured intimal plaque, which had caused dissection of the aorta with thrombosis of the false lumen. The true diagnosis�thrombosed type A dissection and not IMH�was revealed neither by computed tomography nor by transesophageal echocardiography.</p><p><b>Conclusion:</b> Type A IMH should still be treated with immediate surgical repair because in many cases it turns out to be thrombosed type A dissection.</p>

Dilatation of the entire thoracic aorta in patients with bicuspid aortic valve: a magnetic resonance angiography study

VASA ◽  
2005 ◽  
Vol 34 (3) ◽  
pp. 181-185 ◽  
Author(s):  
Westhoff-Bleck ◽  
Meyer ◽  
Lotz ◽  
Tutarel ◽  
Weiss ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Aortic Valve ◽  
Pulmonary Artery ◽  
Aortic Arch ◽  
Thoracic Aorta ◽  
Aortic Root ◽  
Ascending Aorta ◽  
Descending Aorta ◽  
Severe Aortic Regurgitation

Background: The presence of a bicuspid aortic valve (BAV) might be associated with a progressive dilatation of the aortic root and ascending aorta. However, involvement of the aortic arch and descending aorta has not yet been elucidated. Patients and methods: Magnetic resonance angiography (MRA) was used to assess the diameter of the ascending aorta, aortic arch, and descending aorta in 28 patients with bicuspid aortic valves (mean age 30 ± 9 years). Results: Patients with BAV, but without significant aortic stenosis or regurgitation (n = 10, mean age 27 ± 8 years, n.s. versus control) were compared with controls (n = 13, mean age 33 ± 10 years). In the BAV-patients, aortic root diameter was 35.1 ± 4.9 mm versus 28.9 ± 4.8 mm in the control group (p < 0.01). The diameter of the ascending aorta was also significantly increased at the level of the pulmonary artery (35.5 ± 5.6 mm versus 27.0 ± 4.8 mm, p < 0.001). BAV-patients with moderate or severe aortic regurgitation (n = 18, mean age 32 ± 9 years, n.s. versus control) had a significant dilatation of the aortic root, ascending aorta at the level of the pulmonary artery (41.7 ± 4.8 mm versus 27.0 ± 4.8 mm in control patients, p < 0.001) and, furthermore, significantly increased diameters of the aortic arch (27.1 ± 5.6 mm versus 21.5 ± 1.8 mm, p < 0.01) and descending aorta (21.8 ± 5.6 mm versus 17.0 ± 5.6 mm, p < 0.01). Conclusions: The whole thoracic aorta is abnormally dilated in patients with BAV, particularly in patients with moderate/severe aortic regurgitation. The maximum dilatation occurs in the ascending aorta at the level of the pulmonary artery. Thus, we suggest evaluation of the entire thoracic aorta in patients with BAV.

Aneurysm Hybrid Treatment by Simultaneous Replacement of Ascending Aorta and Aortic Arch and Endoluminal Stenting of the Descending Aorta

2006 ◽  
Vol 9 (1) ◽  
pp. E530-E532
Author(s):  
Friedrich-Christian Riess ◽  
Hans Krankenberg ◽  
Thilo Tübler ◽  
Matthias Danne
Keyword(s):  
Aortic Arch ◽  
Ascending Aorta ◽  
Descending Aorta ◽  
Hybrid Treatment

Cannulating a Dissecting Aorta Using Ultrasound-Epiaortic and Transesophageal Guidance

2011 ◽  
Vol 14 (6) ◽  
pp. 373 ◽  
Author(s):  
Saina Attaran ◽  
Maria Safar ◽  
Hesham Zayed Saleh ◽  
Mark Field ◽  
Manoj Kuduvalli ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Aortic Dissection ◽  
Acute Aortic Dissection ◽  
False Lumen ◽  
Type A ◽  
Ascending Aorta ◽  
Type A Aortic Dissection ◽  
Complete Rupture

<p>Management of acute Stanford type A aortic dissection remains a major surgical challenge. Directly cannulating the ascending aorta provides a rapid establishment of cardiopulmonary bypass but consists of risks such as complete rupture of the aorta, false lumen cannulation, subsequent malperfusion and propagation of the dissection.</p><p>We describe a technique of cannulating the ascending aorta in patients with acute aortic dissection that can be performed rapidly in hemodynamically unstable patients under ultrasound-epiaortic and transesophageal (TEE) guidance.</p>

scholarly journals Structural Features in Tunica Media of the Aorta in Lamb

2017 ◽  
Vol 74 (1) ◽  
pp. 111
Author(s):  
Dalma CSIBI ◽  
Adrian Florin GAL ◽  
Cristian RATIU ◽  
Viorel MICLAUS
Keyword(s):  
Aortic Arch ◽  
Outer Part ◽  
Structural Features ◽  
Ascending Aorta ◽  
Tissue Samples ◽  
Descending Aorta ◽  
Tunica Media ◽  
Classic Pattern ◽  
The Media ◽  
Thoracic And Abdominal

In blood vessels situated just after the heart, an irregular blood flow occurs due to some specific structural elements of the tunica media. The current paper describes the histological aspects of some post-cardiac arterial sections in lamb. The tissue samples were collected from five 30 days old male lambs (Țurcană breed). Histological specimens from different regions of the aorta were harvested (i.e., the ascending aorta, aortic arch, thoracic and abdominal regions of the descending aorta). From the specified regions, small pieces (cca. 0.5 cm) were fixed in neutral 10% buffered formalin. The tissues were subsequently embedded in paraffin wax, sectioned at 5 μm, and stained with Goldner’s trichrome and Verhoeff methods. Tissue analysis was performed using an Olympus system for image acquisition and analysis. Histological appearance of the assessed segments of the aorta in lamb is unusual. Major changes occur in tunica media of the aorta. In the ascending aorta, aortic arch and thoracic regions of the aorta, the histological outline is somewhat the same. The internal region of the media possesses the typical lamellar arrangement. Concerning the outer part of tunica media, the smooth muscle has a tendency to form bundles of various sizes. The muscle islands are not present in the media of abdominal region of the aorta, which exhibits the classic pattern of elastic arteries.

scholarly journals Giant Aortic Aneurysm in Child with Cutis Laxa Syndrome: Unusual Presentation, New Surgical Technique

2021 ◽  
Vol 24 (6) ◽  
pp. E1054-E1056
Author(s):  
Mazen Shamsaldeen Faden ◽  
Nada Ahmed Noaman ◽  
Osman Osama Osman Osama ◽  
Ahmed Abdelrahman Elassal ◽  
Arwa Mohammed Al-ghamdi ◽  
...  
Keyword(s):  
Final Diagnosis ◽  
Ascending Aorta ◽  
Accurate Diagnosis ◽  
Aortic Aneurysms ◽  
Cutis Laxa ◽  
Descending Aorta ◽  
Aorta Aneurysm ◽  
Thoracic Aortic Aneurysms ◽  
Valvular Insufficiency ◽  
New Surgical Technique

Ascending thoracic aortic aneurysms are rare in childhood and typically are seen in the setting of connective tissue defect syndromes. These aneurysms may lead to rupture, dissection, or valvular insufficiency, so root replacement is recommended. Here, we present a 17-month-old girl who presented with fever, cough, and pericardial effusion. Initially, we suspected this could be a COVID-19 case, so a nasopharyngeal swap was performed. An ascending aorta aneurysm involving the aortic arch was confirmed by echo, and urgent ascending aorta and arch replacement were done by utilizing the descending aorta as a new arch. The final diagnosis came with cutis laxa syndrome. In similar cases, good outcomes can be achieved with accurate diagnosis and appropriate surgical management.

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