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At least 1,801 records · Page 100Linked to original sources
PubMed1996

Surgical treatment of ascending aortic dissecting aneurysm--clinical application of modified Cabrol's operation.

This paper reported 3 cases of ascending aortic dissecting aneurysm treated by modified Cabrol's operation. An 8 mm Gore-Tex connected with coronary arteries was employed to prevent high tension, intimal tearing and bleeding of anastomosis. Unremoved aneurysmal wall used as a sac for enclosing conduit graft could minimize the bleeding and oozing so that leaked blood can be drained to right atrium via a bypass.

Adult↗
PubMed2001

An unusual case of aortic dissection in Turner's syndrome.

Cardiovascular malformations are common in patients with Turner's syndrome. Aortic coarctation and bicuspid aortic valve are the most frequently occurring abnormalities, and are associated with cystic medial necrosis of the aortic wall. Aortic dissection is an uncommon but catastrophic complication of the 'aortopathy' of Turner's syndrome. We report the unusual case of a Turner's syndrome patient (with a bicuspid aortic valve and previous coarctation repair) who died following an intramural haemorrhage of the aortic root that was complicated by dissection and rupture, with no evidence of aortic intimal tear. The role of intramural haemorrhage in the pathogenesis of acute aortic syndromes in Turner's syndrome patients is unclear. The condition may be associated with atypical clinical presentations, it can be difficult to confirm with imaging techniques, and it carries a high risk of progression to classical aortic dissection and death. This case therefore highlights the need for a high index of suspicion when assessing Turner's syndrome patients presenting with chest pain syndromes. Furthermore, the effective management of Turner's syndrome patients with cardiovascular abnormalities requires the development of evidence-based preventive (such as echocardiographic surveillance of aortic dilatation) and interventional strategies.

Journal Article↗
PubMed2003

Repeat surgery for hemolysis 6 years after replacement of the ascending aorta for acute aortic dissection.

A 71-year-old woman underwent replacement of the ascending aorta for Type A aortic dissection. After 6 years, she suddenly developed severe hemolytic anemia, and a second operation for replacement of the ascending aorta was performed. Her hemolysis was thought to occur as follows: the proximal ascending aorta of the graft might have gradually expanded until it compressed the graft. The severe hemolysis was thought to be attributable to disturbance of blood flow by a jet of blood at the site of constriction or the reversed inner felt. Such a case as this is very unusual in that the second operation for hemolytic anemia occurred 6 years after the first surgery.

Acute Disease↗
PubMed2001

[Aortic dissection among blacks. Report of 6 Congolese cases].

INTRODUCTION: The authors report on six cases of aortic dissection (AD). The work intended to bring out AD characteristics and attempt to define a profile of African patients who manifested this disease. The diagnosis of AD was determined on the basis of: clinical and radiological criteria (six cases); echocardiographic data (five cases); aortographic and surgical informations (two cases). PATIENTS AND METHODS: There were three males and three females with an average age of 40.2 years, with a variation of +/- 10.6 years (from 17 to 49). The frequency of AD was estimated at 1.8/10,000 admissions considering all causes and 5.4/10,000 for cardiovascular disease. Strain was the only triggering factor--noted in two cases (Observations 2 and 3). All patients suffered from severe arterial hypertension (AHT) of which there was one case of renovascular AHT based on the Takayasu arteritis. All symptoms and physical findings were the same described in literature. Operations were successful on two patients. The four unoperated patients died (tamponade: two cases, undetermined cause: two cases). CONCLUSION: The authors conclude as to the similarity of the AD charts described in the literature. However they stress the almost exclusive role of AHT in African studies series as well as that, in rare cases, of Takayasu's disease. They recommend preventing AD through the sustained and effective treatment of AHT.

Adolescent↗
PubMedDate not supplied

Cocaine induces apoptosis in primary cultured rat aortic vascular smooth muscle cells: possible relationship to aortic dissection, atherosclerosis, and hypertension.

Cocaine abuse is known to induce many adverse cardiovascular effects, including hypertension, atherosclerosis, and aortic dissection. A major physiological event leading to these pathophysiological actions of cocaine could be apoptosis. This study was designed to investigate if primary cultured rat aortic vascular smooth muscle cells (VSMCs) can undergo apoptosis when treated with cocaine. After treatment with cocaine (10(-6) to 10(-4) M), morphological analysis of aortic VSMCs using confocal fluoresence microscopy showed that the percentage of apoptotic aortic VSMCs increased after cocaine (10(-6) to 10(-4) M) treatment for 12, 24, and 48 h. These results demonstrate that aortic VSMCs can undergo rapid apoptosis in response to cocaine in a concentration-dependent manner. Cocaine-induced apoptosis may thus play a major role in cocaine abuse-induced aortic dissection, atherosclerosis, and hypertension.

Animals↗
PubMed1987

Factors in the propagation of aortic dissections in canine thoracic aortas.

Factors were examined which altered the propagation of aortic dissections in canine aortas. Thoracic aortas were removed from sacrificed dogs from the distal end of the arch to the diaphragm. An intimal tear was created at the proximal end of the aorta. The dissection was propagated using a pulsatile pressure system with no flow. The aorta was perfused with a dilute black paint solution, which allowed both video monitoring of the extension of the dissection and measurement of the dissection rate. The dependence of the dissection rate on the variables peak pressure, (dP/dt)max and intimal tear depth was examined. The dissection rate was found to be dependent on (dP/dt)max (p less than 0.005) and the intimal tear depth, expressed as a percentage of wall thickness (p less than 0.01), but not on the peak pressure or intimal tear length. The equation relating the significant variables was log (dissection rate) = (-0.034) X % tear depth +(1.89 +/- 0.56) X (dP/dt)max -(4.3 +/- 1.8); r = 78. Thus a higher (dP/dt)max was associated with a more rapid dissection rate and a deeper intimal tear was associated with a slower dissection rate.

Aortic Dissection↗
PubMed1997

Aortic dissection and use of the nicotine patch: a case involving a temporal relationship.

A 33-year-old woman presented with chest and abdominal pain shortly after first and second applications of the nicotine patch. Type A aortic dissection was diagnosed and repaired. Pathological examination revealed cystic medial necrosis, subacute and acute dissection, with no evidence of chronic aortic insufficiency. The close temporal relationship between applications of the nicotine patch and onset of symptoms compatible with dissection followed by extension raises the possibility that the nicotine patch was implicated in, or precipitated, this woman's aortic dissection.

Adult↗
PubMed1995

Acute aortic dissection in a patient with osteogenesis imperfecta.

A case of osteogenesis imperfecta complicated with acute type A aortic dissection is presented. Emergency graft replacement of the ascending aorta was performed successfully despite the anticipated difficulties with tissue friability. Therefore, such an operation is suggested to be worthy of consideration and feasible in patients with osteogenesis imperfecta.

Acute Disease↗
PubMed2005

[Acute type A aortic dissection associated with intestinal necrosis].

We report a case with acute type A aortic dissection associated with occlusion of the celiac artery (CA) and the superior mesenteric artery (SMA) who underwent replacement of the aortic valve and the ascending aorta concomitant with CA and SMA bypass grafting and partial resection of the ileum and the cecum. A 79-year-old man who has a history of Y-graft replacement of abdominal aortic aneurysm developed re-dissection of thrombosed type A acute dissection 2 weeks after the onset. We performed CA and SMA bypass grafting followed by replacement of the aortic valve and the ascending aorta. In spite of successful revascularization of the CA and SMA, residual necrosis in the ileum and the cecum necessitated resection of them. He was discharged 11 months postoperatively without neurological sequelae.

Aged↗
PubMed1981

[Dissecting aortic aneurysm in the 8th month of a twin pregnancy. A review of the literature (author's transl)].

48 % of women under the age of 40 who have an acute dissecting aortic aneurysm are pregnant. Dissection of the ascending aorta (types I and II of De Bakey) are most frequent types to be found, as indeed they are outside pregnancy. There are no histological lesions that are specific for pregnancy. The clinical and angiographic signs are not specially modified in pregnancy. Surgical treatment is made more difficult by the pregnant state. It seems to have been used very little in pregnancy, as there have been only two cases published since 1961. The prognosis for the mother is frightful, with 94 % of cases dying, most of them within the first 48 hours. The fetal prognosis is not much better, with 10 children alive (including our 2 children) out of 78 case histories published to date.

Adult↗
PubMed1994

[Surgical treatment of thrombosed aortic dissection].

We have performed the graft replacement of descending thoracic aorta for 6 patients with aortic dissection having non-opacified false channel on their initial CT and aortography from April 1990 to January 1993. We report the findings obtained from preoperative CT and aortographic findings and from operation with these patients. We also report the microscopic study of aortic wall resected at operation. In all the six patients were found by CT and angiography performed at the admission non-opacified false channel. In one patient, a re-dissection occurred at the mid-descending aorta four weeks later and extended into the abdominal aorta. Intimal tears were found during operation both at distal to the left subclavian artery and at mid-descending aorta in this patient, and microscopically the outer media of aortic wall had been ruptured and the advential scarring were more conspicuous than usual. In the other 5 patients, the local opacification was gradually increased in size during the follow up period. The site of local opacification was at the distal to the left subclavian artery in 3 and at the mid-descending aorta in 2. The operation for these patients revealed the existence of intimal tear at the involved aorta but the false channel had been closed. Microscopically, the involved aorta formed pseudoaneurysm and false channel had been closed with the organized thrombus. From these findings we conclude that surgical treatment should be considered for the aortic dissection when re-dissection occurred or local opacification was increased in size during follow up period, even if initial CT and aortography showed non-opacified false channel.

Aged↗
PubMed2006

Life-threatening aortic dissection with cardiac tamponade in a healthy 15-year-old male.

We present a case of aortic dissection with shock due to cardiac tamponade in a previously healthy 15-year-old male. The diagnosis was suspected and confirmed by transthoracic echocardiography before transfer to the cardiothoracic unit for successful surgical intervention. Because it is a rare life-threatening condition with a high mortality rate in the pediatric population, a very high index of suspicion is required to reach the clinical diagnosis in a timely manner and institute appropriate surgical management.

Adolescent↗
PubMed1997

Aortic dissection occurring during coronary angioplasty: angiographic and transesophageal echocardiographic findings.

A localized acute aortic dissection was produced in 2 patients, complicating coronary angioplasty. In both cases a coronary dissection provided the entry door, with subsequent retrograde progression of the dissection into the aortic root. After sealing the entry door, both patients could be managed conservatively using transesophageal echocardiography to accurately define the location of the intimal flap and to rule out dissection progression.

Aged↗
PubMed2002

Clinical significance of pleural effusion in acute aortic dissection.

STUDY OBJECTIVE: To clarify the clinical significance of pleural effusion in the clinical course of acute aortic dissection (AAD). DESIGN: Retrospective clinical series. SETTING: A university hospital. PATIENTS: Fifty-five patients strongly suspected of having AAD because of severe chest or back pain. Patients with obvious ischemic heart disease, lung disease, and pleural disease were excluded. INTERVENTIONS: An additional diagnosis of pleural effusion was made when evident by CT. MEASUREMENTS AND RESULTS: Pleural effusion was detected in 42 of 48 patients (88%) with AAD (mean plus minus SD age, 65 plus minus 12 years; 35 men and 13 women), but in only 1 of 7 patients (14%) who proved not to have AAD (mean age, 74 +/- 10 years; 6 men and 1 woman). Effusion appeared at a mean of 4.5 days after onset of dissection. Thoracentesis performed in six patients showed a bloody effusion in three patients and an exudative effusion in three patients. In the six AAD patients without pleural effusion, four patients underwent surgery within 3 days after onset of dissection. In patients with AAD, effusion was demonstrated on the first CT after hospital admission in 18 patients, and was bilateral in 32 patients. WBC count in blood, serum C-reactive protein concentration, and body temperature were higher in patients with effusion (13,400 +/- 3,600/microL, 18.4 +/- 11.5 mg/dL, and 38.2 +/- 0.7 degrees C) than in those without effusion (10,300 +/- 2,900/microL, 4.5 +/- 4.2 mg/dL, and 37.0 +/- 1.0 degrees C, respectively). CONCLUSIONS: Pleural effusion occurs frequently in patients with AAD, often in association with inflammatory reactions.

Acute Disease↗
PubMed1997

Modified "elephant trunk" procedure obliterating the false lumen in aortic dissection.

We describe a new application of the "elephant trunk" procedure for repairing aortic dissection. The false lumen of the distal aorta is obliterated between an external sheath of Teflon felt and an internal Dacron graft used as the "elephant trunk". This simple technique makes possible secure anastomosis with the distal friable tissue, and prevents suture hole leaks.

Adult↗

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