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At least 109 records · Page 6Linked to original sources
PubMed1993

[Aortic valve replacement and coronary artery bypass grafting in a patient with a porcelain aorta due to aortitis syndrome].

Clamping a calcified aorta during cardiac operation increases the risk of cerebral embolism by aortic debris. We operated upon a 61-year-old female with severe angina pectoris due to aortic regurgitation and bilateral coronary calcific ostial stenosis associated with porcelain aorta secondary to aortitis syndrome. At operation, cardiopulmonary bypass was begun with profound hypothermia. Using an occlusion balloon catheter inflated in the ascending aorta, the calcified aorta was incised with scissors. However accidentally the balloon was ruptured by intimal calcification of the ascending aorta, and cardiopulmonary bypass was discontinued for 11 minutes under 20 degrees C hypothermia. Extensive removal of the intimal calcification of the ascending aorta was performed with care and then, the aorta was clamped. Aortic valve replacement and triple coronary bypass operation (SVG to LAD, SVG to LCX, GEA to RCA) were performed. The proximal anastomoses of the SVGs were made on the decalcified aortic wall. The postoperative course was uneventful and aortography revealed neither dissection nor dilatation of the ascending aorta following extensive decalcification procedure of the ascending aorta, and the 3 grafts were all patent. From the experience, we learned that extensive removal of calcification of the aorta can be successfully performed in porcelain aorta due to aortitis syndrome. For CABG in aortitis syndrome, the use of ITA is rarely possible, but the GEA may be a versatile graft.

Aorta↗
PubMed1993

[A case report--successful surgical treatment of prosthetic aortic valve detachment with enlargement of sinuses of Valsalva caused by the recurrence of aortitis].

A successful operation on a 49-year-old female with aortitis syndrome associated with prosthetic aortic valve detachment was reported. Aortic valve replacement using SJM 25A had been performed for aortic regurgitation caused by aortitis. Though her C-reactive protein (CRP) was kept between (+/-) and (2+) with prednisolone administered, general fatigue suddenly appeared 4 years after the first operation. The blood sedimentation rate was 65 mm/30 min and CRP was (4+), and the echocardiography showed abnormal movement of the prosthetic valve with perivalvular leakage on admission. Aortography showed the valve detachment and abnormal movement due to enlargement of sinuses of Valsalva, one of which was transformed as a diverticulum and projected into Left ventricular cavity with moderate leakage. After the inflammation was well controlled, she was operated upon. Dilatation of sinuses, perforation of intima around the prosthetic valve were recognized as left ventricular-aortic discontinuity, but ascending aorta was not enlarged. So the prosthetic valve was suspended below coronary ostia with transmural mattress sutures from right atrium. Postoperative course was uneventful. The postoperative aortography revealed only trivial perivalvular leakage without abnormal movement of the valve. This was a rare case of the valve detachment in the aortitis patient.

Aortic Arch Syndromes↗
PubMed1995

[Surgical results of aortitis syndrome (Takayasu disease) combined with annuloaortic ectasia].

From March 1973 to December 1994, 8 patients (2 males and 6 females) aged 34.4 +/- 7.8 years, underwent composite graft replacement (CGR) for aortitis syndrome combined with annuloaortic ectasia (AAE) in our institute. Five patients showed active aortitis syndrome and steroid therapy was administrated to 2 of them. The mean value of the C-reactive protein (CRP) was 1.6 +/- 1.8 before the operation. The maximum diameter of the ascending aorta was 67.1 +/- 10.3 mm (range 53 to 85 mm). Stenosis and/or ectasia of the neck vessels were recognized in 5 cases, as well as the coronary artery in 2 cases. Isolated CGR was performed in 6 cases, and combined with single CABG to LAD in 1 case and with total arch replacement in 1 case. The enlarged ascending aorta was replaced with main graft using the exclusion method and interposed grafts for coronary arteries were sutured with pledgetted mattress sutures all around the coronary ostia. In patients with stenosis of neck vessels, oxygen saturation of the jugular vein was monitored during extracorporeal circulation for surveillance of cerebral ischemia. There was 1 early death due to pulmonary failure. Seven cases survived without any complications during 4-132 months (mean 83.4 months) of the follow-up period. After the operation, 3 cases required steroid therapy during 4-50 months. We concluded that preoperative control of active inflammation, selection of operative procedures, timing for the operation, and the long-term precise management of the intractable disease were essential for successful treatment of aortitis syndrome with AAE.

Adult↗
PubMed1996

[A case of Vogt-Koyanagi-Harada disease associated with aortitis syndrome].

This in a case report of Vogt-Koyanagi-Harada disease associated with aortitis syndrome in a 44-year-old female. She was diagnosed as having aortitis syndrome twenty years ago, and has been treated with systemic corticosteroids. At the first ophthalmic examination, her visual acuity was 0.2 (n. c.) in the right eye and 0.4(0.5) in the left eye. Inflammatory cells in the anterior chamber of the left eye and bilateral serous retinal detachment were observed. Fluorescein angiography revealed subretinal pooling of fluorescein. In the systemic examination, pleocytosis of the cerebrospinal fluid and human leukocyte antigen (HLA) types DR2 and DR4 were also found. We diagnosed the condition as Harada's disease from these findings, and then applied systemic administration of corticosteroids. After the treatment, the bilateral serous retinal detachment immediately disappeared, and the visual acuity improved to (1.0). Vogt-Koyanagi-Harada disease associated with aortitis syndrome is very rare, because it has never been reported previously. It is possible that there is some unknown common mechanism in these two diseases, but it is more probable that this case was simply coincidental.

Adult↗
PubMed1996

[A case of aortitis syndrome, in which carotid ultrasonography was a useful approach for the diagnosis].

We report a case of aortitis syndrome, in which carotid ultrasonography was a useful approach for the diagnosis. A 21-year-old woman was admitted to our hospital for persistent fever. No specific physical findings or laboratory abnormalities were observed except high fever and marked increase of erythrocyte sedimentation rate and c reactive protein. Since clinical trial of antibiotics and antituberculosis agents resulted in no effectiveness, prednisolone was started, but the effect was limited. After that, she complained of the neck pain, and vascular murmur became apparently audible at the pain site. Ultrasonography of the carotid artery revealed the smooth lumen and homogeneous, non-hyperechoic intimal thickening. Then aortography confirmed the diagnosis of aortitis syndrome. Cyclophosphamide combined with steroid therapy diminished the disease activity. In this case, carotid ultrasonography gave us the important information to enforce the aortography. If ultrasonography of the carotid artery has been popularized for aortitis syndrome, and its findings have been standardized, non-invasive diagnosis of this disease will be taken a step forward.

Adult↗
PubMed1997

[Ruptured descending thoracic aortic aneurysm due to aortitis syndrome--a case report].

Ruptured fusiform descending thoracic aortic aneurysms due to aortitis syndrome are rare. A 29-year-old woman was readmitted to our hospital with a chief complaint of back pain and shock, and diagnosed as having rupture of a descending thoracic aortic aneurysm. She had a past history of aortitis syndrome beginning eight years ago. On chest CT examination earlier a year, the descending thoracic aortic aneurysm was 4.5 cm in diameter, and calcification we observed in the aortic wall. An inflammatory reaction had been controlled by steroid therapy and her blood pressure had been controlled by vasodilator drugs. Emergent graft replacement of a descending aortic aneurysm was successfully performed under a femoro-femoral bypass using a centrifugal pump and membrane oxygenerator, and Cell Sver. Although in the literature surgical treatment is indicated only if there is a symptomatic or enlarging aneurysm especially of saccular type and no operation is justified for an aortic aneurysm showing marked calcification, we concluded that aggressive surgical treatment was necessary for this fusiform aneurysm due to aortitis syndrome.

Adult↗
PubMed1989

[Present status of aortitis syndrome surgery in Japan].

It is well known in patients with aortitis syndrome that the clinical features and prognosis vary with location, spread, and degree of the lesion in the affected artery. Therefore, both an indication for surgery and suitable surgical procedures are very manifold in each case. The indication of surgical management for aortitis syndrome is mainly to prevent the cerebral ischemia, cardiac failure and for aneurysm. We reviewed the current status of surgical treatment for aortitis syndrome on the cases reported in Japan and some cases surgically treated in our institute.

Aortic Arch Syndromes↗
PubMedDate not supplied

Aortitis syndrome due to Takayasu's disease. A guideline for the surgical indication.

Seven cases of aortitis syndrome were surgically treated with good results: Abdominal aortic aneurysm 1, atypical coarctation of aorta 2, aortic valve insufficiency 2, renovascular hypertension 2. Several attentions were paid as following: 1. Operation should be avoided during acute phase of aortitis. 2. Synthetic graft material should be avoided if possible. Autogenous vein is advisable for reconstruction of small-sized artery. 3. Surgical intervention should be performed before the loss of organ function. 4. Hematological consideration is worthwhile to prevent hypercoagulopathy due to aortitis.

Adult↗
PubMed1998

[Urgent cesarean section under combined spinal and epidural anesthesia in a patient with aortitis syndrome].

We report the anesthetic management of a patient with aortitis syndrome using combined spinal and epidural anesthesia. A 28-year-old gravida with aortitis syndrome accompanied by faints was scheduled for an urgent cesarean section. Combined spinal and epidural anesthesia was thought to be better for this case in order to monitor the cerebral circulation by her consciousness level and to reduce the hemodynamic change during surgery as compared to spinal or epidural anesthesia alone. After inserting an epidural catheter at the Th 12/L 1 interspace, spinal anesthesia was performed with 1.5 ml of 0.3% dibucaine at the L 4/L 5 interspace. The level of analgesia was under L 1 with the pinprick method 10 min after the spinal anesthesia. Next, 5 ml of 1.5% mepivacaine was injected through the epidural catheter. The level of analgesia reached to Th 6 without major hemodynamic changes. A healthy 2740 g infant was delivered and she had an uneventful recovery. We conclude that combined spinal and epidural anesthesia is useful in a patient with aortitis syndrome undergoing an urgent cesarean section in order to monitor the cerebral circulation by the consciousness level and to reduce the hemodynamic change.

Adult↗
PubMed1981

Nonaneurysmal suppurative aortitis.

Two patients had nonaneurysmal suppurative aortitis. In one, the aortic ruptured and the patient died. The second patient had Salmonella sepsis and occlusion of the infrarenal aorta. He was treated with aortic resection and extra-anatomic bypass, but died 20 months later of an unrelated illness. Patients with Salmonella sepsis who are over 50 years of age or who are suspected of having aortic atherosclerosis should be evaluated carefully for aortitis since rupture or aneurysm formation is associated with a dismal prognosis.

Aged↗
PubMed1997

Transesophageal echocardiographic evaluation of aortitis.

Aortitis is an uncommon infection which may occur in patients with preexisting atherosclerotic disease of the aorta. The clinical features in two patients presenting with fever and nonspecific symptoms are reviewed. In these patients, transesophageal echocardiographic features of wall thickening and false aneurysm formation were suggestive of the diagnosis of aortitis. Both patients were taken for surgical excision of the descending aorta and subsequently improved.

Aneurysm, Infected↗
PubMedDate not supplied

Influence of angiographic morphology on the acute and longer-term outcome of percutaneous transluminal angioplasty in patients with aortic stenosis due to nonspecific aortitis.

PURPOSE: We studied the relationship of initial angiographic morphology in patients with aortic stenosis due to nonspecific aortitis and its relationship to immediate and later outcome following percutaneous transluminal angioplasty (PTA). METHODS: Correlation was performed in 10 successive patients by retrospective analysis. All had clinically inactive nonspecific aortitis and hemodynamically significant aortic stenosis resulting in hypertension or lower limb claudication. Five patients had discrete concentric stenosis; the other five had eccentric stenosis with diseased aortic segments adjacent to the stenosis. RESULTS: The five patients with concentric stenosis (Group I) had primarily successful and uncomplicated PTA with sustained improvement. The five patients (Group II) with eccentric stenosis had initial success in three patients and two initial treatment failures with one patient showing late improvement. Four of these patients developed large intimal flaps. One of these had an aneurysm during follow-up. Follow-up angiograms in five patients showed remodelling with further angiographic and clinical improvement. CONCLUSION: Eccentricity of the stenosis and diffuse aortic disease correlate unfavorably with immediate outcome of PTA but late improvement may still be seen.

Adolescent↗
PubMed1987

Hereditary angioedema and aortitis.

A 28-year-old male with hereditary angioedema died of an extensive stroke. Autopsy revealed cicatricial aortitis with narrowing of the coronary ostia, myocardial infarctions, and a left ventricular mural thrombus. There was neither acute inflammation of the aorta nor systemic vasculitis. A possible association of the aortitis with the hereditary angioedema is discussed.

Adult↗
PubMedDate not supplied

Evolution of the infected abdominal aortic aneurysm: CT observation of early aortitis.

Infected aortic aneurysm is an uncommon, life-threatening disease. Early surgical treatment is crucial to survival. An early diagnosis could be made on CT in suspected cases, although CT features of infectious aortitis overlap with retroperitoneal fibrosis, hemorrhage, and lymphadenopathy. We report the case of an infected abdominal aortic aneurysm and describe the additional potentially useful CT finding of early infectious aortitis, which helps localize the abnormality to the aortic wall.

Aneurysm, Infected↗
PubMed1997

Infectious aortitis due to penicillin-resistant Streptococcus pneumoniae.

Infectious aortitis is uncommon and typically affects elderly immunocompromised men, with a Salmonella or Staphylococcal infection of an atheromatous or aneurysmal aorta. We present a fit young man who developed infectious aortitis with peripheral embolization due to a penicillin-resistant Streptococcus pneumoniae bacteremia.

Adult↗
PubMed1991

Cogan's syndrome with aortitis, aortic regurgitation, and aortic arch vessel stenoses.

Cogan's syndrome of interstitial keratitis and vestibuloauditory dysfunction is rare. Systemic vasculitic manifestations occur, and 10% of patients with this syndrome have aortic valvular disease. A patient with Cogan's syndrome is presented who had aortitis of the ascending thoracic aorta, severe aortic valve regurgitation, orificial stenosis of the right coronary artery, and orificial stenoses of all three aortic arch vessels. Histopathology confirmed aortitis. Aortic valve replacement combined with coronary and aortic arch vessel reconstruction was required for correction.

Adult↗
PubMed1995

Cell viability of aortic allografts after long-term cryopreservation and clinical application to aortic root replacement in a patient with aortitis.

A key point in the establishment of a tissue cryopreservation system is to maintain cell viability for an extended period. The viability of the tissue cells in the authors' cryopreservation system was examined, and the first clinical application reported. The tissue culture method demonstrated 95% of rat aortas (21 of 22 specimens) and 88% of human cardiac valves (seven of eight) to be viable after 6.4 months and 5.8 months of cryopreservation, respectively. The first clinical case, a 54-year-old man with aortic valve replacement and complications of aortitis, underwent successful aortic root replacement. Whereas the use of allografts in aortitis cases is controversial, such an approach was assumed reasonable because the mechanical stress between the native aortic annulus and the inserted valve could be reduced by aortic root replacement with the allograft.

Adult↗