Images show small residual flap in the non-coronary cusp of the native root, surgical graft ascending aorta, and residual dissection of the descending aorta

ASVIDE ◽  
2018 ◽  
Vol 5 ◽  
pp. 487-487
Author(s):  
Paul Schoenhagen
Keyword(s):  
Ascending Aorta ◽  
Descending Aorta ◽  
Coronary Cusp ◽  
Native Root

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

An Unusual Femoral Sheath Severing with Successful Recapture: A Case Report

Reports ◽  
2021 ◽  
Vol 4 (4) ◽  
pp. 34
Author(s):  
Frane Runjić ◽  
Andrija Matetic ◽  
Matjaž Bunc ◽  
Nikola Crnčević ◽  
Ivica Kristić
Keyword(s):  
Case Report ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Balloon Catheter ◽  
Proximal Part ◽  
Ascending Aorta ◽  
Introducer Sheath ◽  
Transcatheter Aortic Valve ◽  
Coronary Cusp

This study presents a case of a successful severed femoral sheath recapture during transfemoral transcatheter aortic valve replacement (TAVR). During skin tunneling with a scalpel, the discontinuity of the femoral sheath occurred. Grasping of the distal sheath with the surgical hemostat was attempted unsuccessfully. A proximal part of the severed sheath was removed and Medtronic Sentrant introducer sheath (14 French) was then placed over the existing Confida wire which permanently remained in position, followed by the introduction of the Amplatz Left 2 (AL2) catheter which pushed the severed sheath in the ascending aorta over the Confida wire. The crucial maneuver was the entanglement of the severed sheath in the aortic non-coronary cusp which allowed for its entrapment by the AL2 catheter. This allowed for the coronary guidewire BMW Universal (0.014”) placement and a slow balloon retrieval (SeQuent NEO 2.5 x 25 mm) of the severed sheath into the introducer sheath. The guidewire/balloon catheter was then exchanged for the support wire (0.035”) followed by the removal of the introducer sheath, AL2 catheter and the severed sheath. In conclusion, sheath severing is a complex accidental event during TAVR, which can be solved by intra-aortic recapture and retraction.

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.

Impact of fetal haemodynamics on surgical and neurodevelopmental outcomes in patients with Ebstein anomaly and tricuspid valve dysplasia

2022 ◽  
pp. 1-12
Author(s):  
Min Bao ◽  
Edgar Jaeggi ◽  
Liqun Sun ◽  
Fu-Tsuen Lee ◽  
Renee Sananes ◽  
...  
Keyword(s):  
Tricuspid Valve ◽  
Motor Skills ◽  
Umbilical Vein ◽  
Brain Mri ◽  
Ascending Aorta ◽  
Neurodevelopmental Outcomes ◽  
Ebstein Anomaly ◽  
Descending Aorta ◽  
Neurodevelopmental Delay

Abstract Objectives: To evaluate the impact of fetal haemodynamics on surgical and neurodevelopmental outcomes in severe Ebstein anomaly and tricuspid valve dysplasia. Methods: Thirty-four fetuses with Ebstein anomaly/tricuspid valve dysplasia were referred from 2013 to 2019 for fetal echocardiography and clinical management. Nineteen fetuses with Ebstein anomaly/tricuspid valve dysplasia and 30 controls underwent cardiovascular magnetic resonance to quantify the fetal blood flow and to calculate cerebral oxygen delivery (cDO2) and consumption (cVO2). The 3D steady-state free precession acquisition was used to measure fetal brain volume. Surgical outcome, brain MRI, and neurodevelopmental follow-up were reviewed. Results: Twenty-six fetuses were live born (76%) and survival (65%) at a mean follow-up of 4 years. Nine fetuses had a brain MRI before discharge, and all had clinically silent injuries and volume loss. At 18 months, five single-ventricle patients had a neurodevelopmental delay in cognition and language (mean percentile: 11th), with gross-motor skills more affected than fine-motor skills (mean percentiles: 4th and 34th). Fetuses with Ebstein anomaly/tricuspid valve dysplasia had smaller brains, lower combined ventricular output, ascending aorta, superior caval vien and umbilical vein flows, lower oxygen saturation in ascending aorta and superior caval vien, lower cDO2 and cVO2 (p < 0.05). Superior caval vien/combined ventricular output and descending aorta/combined ventricular output ratios were lower in fetuses with circular shunt (p < 0.05). Fetuses requiring the Starnes procedure tended to have smaller brains, lower combined ventricular output, superior caval vien, descending aorta, and umbilical vein flows. Conclusions: All patients with Ebstein anomaly/tricuspid valve dysplasia are at high risk of neurodevelopmental delay and warrant follow-up. Fetal cardiovascular magnetic resonance revealed impaired brain growth with diminished cerebral blood flow and cDO2, the extenting dependent on the severity of the haemodynamic compromise.

Abstract P230: The Influence of Calcification of Ascending Aorta on Dicrotic Notch of Thoracic Aorta

Hypertension ◽  
2016 ◽  
Vol 68 (suppl_1) ◽  
Author(s):  
Aahad Khan ◽  
Scott Ray ◽  
Syed Haris Pir ◽  
Mustafa Noor Muhammad ◽  
Mirza Mujadil Ahmad ◽  
...  
Keyword(s):  
Thoracic Aorta ◽  
Aortic Pressure ◽  
Ascending Aorta ◽  
Arterial Calcification ◽  
Sample Population ◽  
Descending Aorta ◽  
Dicrotic Notch ◽  
One Year ◽  
Arch Of The Aorta ◽  
Contrast Ct

Background: Dicrotic Notch (DN) is known to dampen with age, with increasing arterial stiffness probably due to arterial calcification. Since arterial calcification has recently been shown to predominantly involve descending thoracic aorta, we hypothesized that calcification in different segments of thoracic aorta will have a different impact on DN. Methods: A sample of 44 patients with invasive thoracic aortic pressure tracings during cardiac catheterization was selected for this study. Non-contrast CT scans were evaluated for presence of calcification in aortic segments (ascending aorta (AA), aortic arch (arch) and descending aorta (DA)) and then quantified. DN was categorized based on aortic pressure tracings into 4 grades. Grade 1 represented normal DN; grades 2, 3 and 4 represented progressively diminishing DN, where grade 4 represented absent DN. Compliance was calculated as a change in stroke volume over aortic pulse pressure with both measurements obtained from echocardiography reports done within one year of catheterization. Results: The mean age of the sample population was 64.6 ± 10.5 years. Out of the 44 patients, 14 (32%) had a calcified AA, 25 (56%) had a calcified DA and n=28 (63%) had a calcified arch. Furthermore, 14 (32%) patients had only one segment calcified, whereas 10 (23%) had two and 11 (25%) had all three segments calcified. Abnormal DN was present in 16 (36%) patients. The odds of having an abnormal DN in the presence of calcified AA were more than 3 times (OR: 3.67; p=0.05). Compliance was higher in those with a normal DN versus those with an abnormal DN (1.64 ml/mmHg vs. 1.21 ml/mmHg) (p = 0.09). There was no significant association between calcification in the DA or arch of aorta. Conclusion: There was no association between dicrotic notch and presence of calcification in the arch of the aorta and descending aorta.

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