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At least 109 records · Page 6Linked to original sources
PubMed1977

Staphylococcal aortic pseudoaneurysm. Treatment employing ascending aorta-abdominal aorta bypass graft.

An adult patient developed infection of the anastomosis after resection of an isthmic coarctation, with subsequent formation of a pseudoaneurysm. He was treated successfully by an ascending aorta-abdominal aorta bypass graft. The graft was placed retrosternally and passed through the diaphragm into the retroperitoneal space. After surgery the patient developed systolic hypertension. A faint murmur was heard over the chest and abdomen, caused by the turbulent flow through the graft.

Adult↗
PubMedDate not supplied

Thoracic aorta-to-femoral artery by-pass. For the treatment of complete obstruction of the abdominal aorta at the level of the renal arteries.

Complete obstruction of the abdominal aorta at the renal artery level is often a difficult surgical problem in case of long standing thrombosis, short suprarenal aortic space, and extensive periarterial inflammatory reaction. Six patients in whom revascularization of the lower extremities was performed through a prosthetic by-pass from the thoracic aorta to the femoral arteries, were reported here. One patient underwent also a left nephrectomy for renal hypertension, chronic renal artery obstruction, shrunken kidney. Both the short and long term results have been satisfactory in all cases.

Adult↗
PubMedDate not supplied

[Ascending thoracic aorta-supraceliac abdominal aorta by-pass in a patient with coarctation and partial hypoplasia of the arch and aortic isthmus].

A twenty years old patient, with arterial hypertension at the right arm and absent pulse in both lower extremities was studied by angiography, and a coarctation of aortic arch with partial hypoplasia of aortic arch and aortic isthmus was found. Patient underwent to a surgical operation and, by anterior approach, an ascending thoracic aorta-supraceliac abdominal aorta by-pass was made. In the present case report, advantages, indications and experience with such by-pass modality are review.

Adult↗
PubMed1984

Staged resection of a life-threatening aneurysm of the descending thoracic aorta and a coexisting aneurysm of the ascending aorta.

The authors report the successful staged resection of a descending thoracic aortic aneurysm and a coexisting ascending aortic aneurysm. The main challenge was to provide optimal proximal aortic decompression to prevent rupture of the ascending aorta during the distal repair. During the period of aortic arch cross-clamping, organ protection was achieved with a Gott shunt inserted proximally in the aortic arch and distally in the left common femoral artery. The importance of this shunting procedure, which has been the basis of our surgical technique in the treatment of all lesions of the descending thoracic aorta, is emphasized.

Aged↗
PubMed1981

[Decompensated valvular disease and coarctation. One-stage repair using a median approach with an ascending aorta-abdominal aorta shunt].

The tactical decision in patients with decompensated valvular disease associated with a severe stenosis of the aortic isthmus is always difficult. One stage surgical repair using two separate approaches is a long and high risk procedure. It would seem more logical and safer to treat the lesions in two stages a few weeks apart, the severest lesion being managed first. In the two cases reported. The isthmic stenoses and valvular lesions were of the same severity and made both classical techniques impracticable. Therefore the patients underwent a single stage procedure by a median approach associating valve replacement under cardiopulmonary bypass (mitral and tricuspid in one and aortic in the other case) and an ascending aorta-abdominal aorta dacron conduit. The present postoperative survival periods are 30 and 9 months. The functional result was good (Class 1 and 0) and postoperative angiography has shown the montage to be working satisfactorily. This technique is exceptional but may be useful in borderline cases with decompensated valvular disease and severe isthmic stenosis.

Aorta↗
PubMedDate not supplied

Age dependency of stiffness of the abdominal aorta and the mechanical properties of the aorta in Kawasaki disease in children.

Measuring aortic distensibility has been shown to be useful in adults as a noninvasive method in the early detection of atherosclerosis. This study had two purposes: to assess the stiffness of the abdominal aorta by using two-dimensional echocardiography (2DE) in healthy neonates, children, and adults and to assess aortic distensibility in children with Kawasaki disease in acute and subacute phases. The study comprised 168 healthy subjects and 40 patients with Kawasaki disease. We recorded systolic (Ps) and diastolic (Pd) blood pressure and measured aortic diameter (Dd) at both minimum diastolic pressure and maximum systolic expansion (Ds) by 2DE. These measurements were used to determine (1) aortic strain (S) = (Ds - Dd)/Dd, (2) pressure strain elastic modulus (Ep) = (Ps - Pd)/S, and (3) normalized Ep (Ep*) = Ep/Pd. Significant correlations were found between S and age, Ep and age, and Ep* and age. In Kawasaki disease, Ep and Ep* showed negative correlations to day after onset. The aorta was less distensible in infants, became soft in 12- to 16-year-olds, and then stiffened with increasing age among normal subjects. In Kawasaki disease, aortic stiffness was high at the acute phase and normal at the subacute phase. These tendencies may be related to the biological characteristics of smooth muscle cells.

Acute Disease↗
PubMedDate not supplied

A case of anomalous origin of the pulmonary arteries: right pulmonary artery from the descending aorta and the left pulmonary artery from the ascending aorta.

A 3-month-old girl classified as having persistent truncus arteriosus underwent surgical correction of the anomalous origin of the pulmonary arteries; the right pulmonary artery from the descending aorta and the left pulmonary artery from the ascending aorta. The patient died on the fourth postoperative day. The definite diagnosis and choice of surgical strategies should be further examined.

Abnormalities, Multiple↗
PubMed1992

Increased stiffness and persistent narrowing of the aorta after successful repair of coarctation of the aorta: relationship to left ventricular mass and blood pressure at rest and with exercise.

Fifteen children and adolescents who had repair of coarctation of the aorta before age 15, who were not hypertensive at rest, and who had resting arm-leg blood pressure gradients of less than 20 mm Hg underwent noninvasive evaluation of left ventricular structure and function, aortic stiffness, and residual coarctation as well as bicycle exercise testing. These results were compared with those in 15 age- and sex-matched control subjects. The mean resting age-related systolic blood pressure percentiles (63% versus 46%), transverse aortic stiffness measured by the elastic modulus (Ep) (42.1 versus 23.2 kPa), stiffness index beta (beta) (3.66 versus 2.17), echocardiographic left ventricular fractional shortening (0.42 versus 0.36), left ventricular mass index (99.3 versus 81.0 gm/m2), maximum exercise right arm systolic blood pressure (173 versus 156 mm Hg), and exercise arm-leg blood pressure gradient (35 versus 6 mm Hg) were significantly increased in the coarctectomy patients compared with controls. Univariate correlations in the coarctectomy group showed significant relationships of residual aortic narrowing with left ventricular mass index (r = 0.68, p less than 0.01) and resting systolic blood pressure percentile for age (r = 0.55, p less than 0.05). Residual aortic narrowing did not significantly correlate with aortic stiffness, resting blood pressure gradient, or exercise blood pressure gradient. Neither left ventricular mass index nor resting systolic blood pressure percentile significantly correlated with age of repair or years after repair. These results demonstrate persistent abnormalities in aortic stiffness and left ventricular mass and function after successful repair of coarctation of the aorta in childhood and adolescence.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

Anomalous origin of either the right or left main coronary artery from the aorta without coursing of the anomalistically arising artery between aorta and pulmonary trunk.

Clinical and necropsy findings are described in 12 adults (10 men) in whom either the left main coronary artery or the right coronary artery arose abnormally from the aorta and the anomalistically arising artery coursed thereafter either normally or abnormally, but if abnormally not between the pulmonary trunk and ascending aorta. None of the 12 patients had symptoms of myocardial ischemia that unequivocally could be attributed to the anomalously arising coronary artery. One patient, a 19-year-old man, however, died suddenly and no abnormality other than the anomalistically arising right coronary artery from the posterior aortic valve sinus was found.

Adult↗
PubMed1988

Anomalous origin of either the right or left main coronary artery from the aorta with subsequent coursing between aorta and pulmonary trunk: analysis of 32 necropsy cases.

Anomalous origin of either the left main coronary artery (LMCA) or right coronary artery (RCA) from the aorta with subsequent coursing between the aorta and pulmonary trunk is a rare and sometimes fatal coronary artery anomaly. Thirty-two cases of these anomalies were reviewed, with particular attention to the exact location and shape of the anomalistically positioned ostium and coronary dominance. The LMCA (7 cases) arose either from behind the right coronary sinus (6 cases) or as a single ostium with the RCA straddling the right-left commissure and right coronary sinus (1 case). In 5 of the 7 cases, the anomaly was fatal. In 6 cases of anomalous origin of the LMCA, the RCA was dominant and in 4 the anomaly was fatal. In only 1 case of anomalous origin of the LMCA was the left circumflex coronary artery dominant, and in this case the anomaly also was fatal. The RCA (25 cases) arose either from behind the left coronary sinus (8 cases), above the left coronary sinus (5 cases), from above the right-left commissure (10 cases) or as a single ostium with the LMCA above the right-left commissure and left coronary sinus (2 cases). In 8 of these 25 cases the anomaly was fatal. In 7 cases of anomalous origin of the RCA, the left circumflex coronary artery was dominant and in no case was the anomaly clinically significant. In 1 case, both the RCA and left circumflex coronary artery were hypoplastic and the anomaly was fatal. Coronary dominance, not ostial shape, was useful in separating the clinically significant from the clinically insignificant anomalies.

Adolescent↗
PubMed1985

Tandem coarctation of the thoracic aorta with hypoplasia of the abdominal aorta.

After resection of the coarctation in a 3-year-old child with end-to-end anastomosis, a second membrane was found 1.5 cm lower. After a successful reoperation with an aortoplasty using Gore-Tex weak femoral pulses persisted. At catheterization, an area of irregular narrowing of the abdominal aorta just distal to the superior mesenteric artery was found with hypoplasia of the iliac and femoral arteries. In addition, this child had a two-sided cheilo-gnatho-palatoschisis, vesicoureteral reflux and absence of gall bladder and hepato-duodenal ligament. It is worthwhile considering that a second or third aortic abnormality can be hidden by a coarctation of the aorta.

Aorta, Abdominal↗
PubMed1983

Comparison of longitudinal elastic properties of proximal and distal strips of aorta-branch junctions from the abdominal aorta of sheep.

Narrow longitudinal continuous strips were cut from the abdominal aorta and its major branches so that each strip contained the same width of aorta, bifurcation, and branch although the lengths of the three segments were different. A grid was marked on each region, and photographs made at a variety of strains as the whole strip was stretched at a strain rate of 2 cm/min with an Instron tensile testing machine. Measurements from the grids gave the strains for each region, and stress-strain curves were calculated. The proximal bifurcation zone was much more extensible than any of the other regions, owing mainly to changes in the "slack" of the collagen fibers (p less than 0.01). This would imply that the shape and cross-sectional area of the bifurcation region are apt to change between diastole and systole, and implies that model studies which assume the shape of the bifurcation region is constant may not be accurate.

Animals↗
PubMed2003

Ascending aorta-abdominal aorta bypass for Takayasu's arteritis.

Three patients with type III Takayasu's arteritis were referred to us because of the upper extremity hypertension and vascular claudication of the lower extremities. They underwent extra-anatomic ascending aorta-abdominal aorta bypass with vascular graft under a median sternotomy and a splitted midline laparotomy incision without cardiopulmonary bypass. The postoperative course was uneventful. Upper extremity hypertension and vascular claudication were completely resolved.

Aorta↗
PubMed2001

Hemophilia A, von Willebrand disease, and atherosclerosis of abdominal aorta and leg arteries: factor VIII and von Willebrand factor defects appear to protect abdominal aorta and leg arteries from atherosclerosis.

We hypothesized that patients with hemophilia or von Willebrand disease might be protected from atherosclerosis because of their coagulation defect. We studied 40 subjects affected by these two coagulation diseases using echocolor Doppler of the abdominal aorta and leg arteries, and compared the results with those obtained in 40 control patients who were homogenous with study patients in terms of sex, age, and risk factors for atherosclerosis. The probands presented a lower number of plaques than the 40 control subjects in the aorta and in the leg arteries. The most serious hemophilic patients had fewer plaques than controls or than patients with mild hemophilia. Both hemophilia and von Willebrand disease seem to protect against atherosclerosis.

Aorta, Abdominal↗
PubMed2001

Successful removal of a left main coronary artery thrombus induced by vasospasm to the aorta [correction of vasospasm of the aorta] after the injection of contrast medium.

A 51-year-old woman with acute myocardial infarction underwent emergency coronary angiography. The patient had an episode of idiopathic thrombocytopenic purpura, and underwent splenectomy at the age of 36. On admission, platelet count in the peripheral blood was 43.2x10(4)/microl. During the initial emergency left coronary angiography, a thrombus was detected in the left main trunk. The thrombus was drawn back to the orifice of the left coronary artery, and finally disappeared into the aorta by injecting contrast media. After the thrombus disappeared, no stenotic lesion was detected in the left coronary artery. One month later, when acetylcholine-provocation coronary angiography was performed, marked vasospasm was detected in the left coronary arteries. Coronary thrombosis in the patient might have been induced by a coronary spasm, and the presence of thrombocytosis might also have affected the development of a coronary thrombus. However, it was spontaneously drawn back to the aorta by back flow of contrast media, which was injected via the entrance of the left coronary artery. A case of acute myocardial infarction whose thrombus occluded the left main coronary artery and was removed at first injection of contrast media is presented.

Aorta↗
PubMed2000

Transesophageal echocardiography in the diagnosis of diseases of the thoracic aorta: part II-atherosclerotic and traumatic diseases of the aorta.

Transesophageal echocardiography (TEE) has provided an accurate new window for the evaluation of diseases of the thoracic aorta. Experience with TEE has led to an increased recognition of atherosclerosis of the thoracic aorta as a source of cerebral and systemic embolism. Certain features of aortic plaque morphology detected by TEE may prove to have prognostic and therapeutic significance. The intraoperative assessment of thoracic aortic atherosclerosis by TEE may guide modifications in surgical techniques and aortic manipulations that reduce the incidence of perioperative neurologic complications. TEE has also become a valuable tool for the diagnostic evaluation of patients with blunt chest trauma. The precise role of TEE in the management of these disorders is currently under investigation.

Aorta, Thoracic↗
PubMed2000

Management of inflammatory aneurysm of the infrarenal aorta using retroperitoneal exposure, open aneurysmorrhaphy and descending aorta-to-femoral artery bypass.

The authors present a technique consisting of retroperitoneal exposure, but not dissection of the inflammatory aneurysm, anastomosis of a bypass graft through a short thoracotomy to the lowermost thoracic aorta, carrying it down retroperitoneally to both femoral arteries and under brief occlusion of the descending thoracic aorta, opening of the aneurysm and intra-aneurysmal occlusion of the inflow and outflow to the aneurysm. An illustrative case is presented.

Anastomosis, Surgical↗