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At least 145 records · Page 8Linked to original sources

Mice with a deletion in the first intron of the Col1a1 gene develop dissection and rupture of aorta in the absence of aneurysms: high-resolution magnetic resonance imaging, at 4.7 T, of the aorta and cerebral arteries.

Deletion of the majority of the first intron of the Col1a1 gene in mice leads to decreased type I collagen synthesis and content in the aortic wall. In 54% of cases, mice homozygous for the Col1a1 mutation die of thoracic hemorrhage by the age of 18 months. It is unknown whether the fatal bleeding results from an acute dissection of the aortic wall or a gradually developing dilatation of the medial layer prior to rupture. We optimized high-resolution MRI methods using a 4.7 T MR scanner to obtain in vivo images of the entire mouse aorta. The MR images were acquired in three imaging planes using gradient echo, spin echo, and spin echo with inversion recovery pulse sequences with a maximum in-plane resolution of 68 x 68 microm and acquisition times less than 10 min. In five Col1a1 mutated mice aged 16 months, the MR images showed no signs of aneurysmal dilatation, wall defects, or former dissection, suggesting that the mechanism for aortic rupture is an acute dissection of the aortic medial layer. Cerebral arteries were imaged using a three-dimensional time of fight pulse sequence. The resolution of 73 x 73 x 94 microm showed normal cerebral arteries. Histology showed a 22% thinner cerebral artery wall in Col1a1 mutated mice.

Animals↗

Right aortic arch with left descending aorta (circumflex aorta). Roentgenographic diagnosis.

Right aortic arch with retroesophageal segment is a rare anomaly with distinctive roentgenographic features. We present 2 patients, who on the barium oesophogram had an additional finding which has not previously been described. The typical features include an indentation on the right upper barium filled oesophagus (in the antero-posterior view), an oblique indentation descending from right to left (caused by the retroesophageal segment) and the left descending aorta. The oblique identation has not previously been described. The embryology and incidence of the lesion are briefly discussed.

Aorta, Thoracic↗

Pitfalls in the plain film evaluation of the thoracic aorta: the mimicry of aneurysms and adjacent masses and the value of aortography. Part II. Descending thoracic aorta.

Distinguishing posterior mediastinal and pulmonary masses from aneurysms and tortuosity of the descending thoracic aorta may be difficult, as five such cases illustrate. Both the neoplasms and the aortic aneurysms or tortuosity can compress the same vital mediastinal structures; thus, they may give rise to the same symptoms. Because the plain film findings may also be similar, aortography is essential to their diagnosis.

Aged↗

Homologous desensitization of the effects of endothelin on rabbit aorta rings and on cultured rat aorta smooth muscle cells.

The effects of endothelin-1 on normal and everted rabbit aorta rings and on cultured rat aortic smooth muscle cells were studied. Endothelin-1 (40 nM) contracted both normal and everted rings, and was still able to induce a prolonged contraction in Ca2(+)-free medium. Treatment of cultured cells with 100 nM endothelin-1 caused a sharp transient increase in 45Ca2+ efflux. The contractile and 45Ca2+ responses showed severe and specific desensitization towards endothelin-1; the responses to angiotensin II and adrenaline were not affected. The contractile responses to endothelin-1 were not affected by previous treatment with angiotensin II or with the angiotensin receptor antagonist, [Sar1,Ala8]angiotensin II. It is concluded that endothelin-1 acts on its own specific receptors to elicit Ca2+ mobilization from both intracellular and extracellular sources.

Angiotensin II↗

Migration of an amplatzer septal occluder device for closure of atrial septal defect into the ascending aorta with formation of an aorta-to-right atrial fistula.

The percutaneous closure of atrial septal defects is increasingly used. Serious complications of the procedure, such as cardiac perforation and tamponade, are rare and usually occur <72 hours after device placement. The investigators report the late development of the erosion of an Amplatzer septal occluder into the ascending aorta with associated aortic-to-right atrial fistula formation.

Adult↗

Endarterectomy of the ascending aorta: an alternative method in patients with extensively calcified (porcelain) aorta requiring aortic valve replacement.

A variety of surgical techniques have been described to manage the extensively calcified (porcelain) aortic root in patients requiring aortic valve replacement. We report two cases in which endarterectomy of the proximal ascending aorta was successfully performed. Endarterectomy of the left main coronary artery ostium was also performed in the one patient, and aortic root enlargement with patch aortoplasty in another. The technical aspects of the procedure and alternative approaches are discussed.

Aged↗

Dissection of an aneurysmal ascending aorta in association with coarctation of the aorta.

A previously fit 21-year-old man presented with severel central chest pain. Clinical, electrocardiographic, and echocardiographic examination confirmed a dissection of an aneurysmal ascending aorta in the presence of previously undiagnosed severe aortic coarctation. Initial aortic dissection had occurred five days before admission. The medical and staged surgical management of the case are presented. Surgical survival with such a combination of lesions does not appear to have been previously recorded.

Adult↗

CFU-S(11) activity does not localize solely with the aorta in the aorta-gonad-mesonephros region.

The aorta-gonad-mesonephros (AGM) region is a potent hematopoietic site in the midgestation mouse conceptus and first contains colony-forming units-spleen day 11 (CFU-S(11)) at embryonic day 10 (E10). Because CFU-S(11) activity is present in the AGM region before the onset of hematopoietic stem cell (HSC) activity, CFU-S(11) activity in the complex developing vascular and urogenital regions of the AGM was localized. From E10 onward, CFU-S(11) activity is associated with the aortic vasculature, and is found also in the urogenital ridges (UGRs). Together with data obtained from organ explant cultures, in which up to a 16-fold increase in CFU-S(11) activity was observed, it was determined that CFU-S(11) can be increased autonomously both in vascular sites and in UGRs. Furthermore, CFU-S(11) activity is present in vitelline and umbilical vessels. This, together with the presence of CFU-S(11) in the UGRs 2 days before HSC activity, suggests both temporally and spatially distinct emergent sources of CFU-S(11). (Blood. 2000;96:2902-2904)

Animals↗

[A fistula between the aorta and esophagus--an uncommon sequela of dissection of the thoracic aorta].

In a patient with repeated dissection of the ascendent aorta where the first episode was resolved surgically by an intraluminal prosthesis the authors describe the rare consequence of the development of a new dissection manifested by an aorto-oesophageal fistula. In the described case an inoperable episode was involved which fully confirmed the clinical validity of the pathognomic Chiari triad.

Aortic Dissection↗

Are polyamines involved in the contractile effects of angiotensin II in the rat aorta? (Polyamines and angiotensin II in rat aorta).

Angiotensin II (AII) is a central factor involved in the pathophysiology of arterial hypertension and atherosclerosis. On the other hand, polyamines represent a family of organic cations with low molecular weight, playing intracellular regulatory roles essential for the cellular growth and differentiation. The cellular contents, the synthesis and the transport of polyamines are increased following the actions of AII, as well as of other cellular growth factors. Our results show that the administration of polyamines as pre-treatment modulates the contractile effects of extracellular AII (80 nM). This modulation is concentration-dependent and dual: the lower concentrations amplify and the higher concentrations reduce the effects of AII in the isolated rat aorta rings without endothelium. Moreover, DL-alpha-Difluoromethylomithine (DFMO), a specific inhibitor of ornithine decarboxylase, does not significantly modify the contractile effects of AII. Thus, these data suggest that polyamines generated through this metabolic pathway are not involved in the contractile effects of AII in rat aortic vascular smooth muscle.

Angiotensin II↗

Renal revascularization in patients with severe atherosclerosis of the abdominal aorta or a previous operation on the abdominal aorta.

Renal revascularization has been performed in six patients in whom severe atherosclerosis or previous operative procedures on the abdominal aorta precluded the performance of a standard aortorenal bypass graft. Splenorenal anastomoses were performed in three patients, superior mesenterorenal anastomosis in one patient, long saphenous vein iliorenal anastomosis in one patient, and renal autotransplantation in one patient. Successful renal revascularization with preservation of renal function was accomplished in all patients. The natural history of severe atherosclerotic renovascular disease has demonstrated the relatively frequent occurrence of arterial thrombosis and renal failure in patients with solitary kidneys. Occasionally, the presence of severe aortic disease precludes the use of standard aortorenal bypass grafting. Fortunately, as reported herein, alternate methods of revascularization are available whereby renovascular hypertension can be corrected and renal function preserved, with minimal operative risk.

Adult↗

Ascending aorta to bifemoral bypass--a ventral aorta.

In the decade since April 1975 we accumulated a series of 18 patients with arterial conduits from the ascending aorta to the femoral arteries, 10 men aged 53 to 75 years (mean, 60 years) and eight women aged 33 to 56 years (mean, 50 years). In the first two patients, the conduit was placed subcutaneously; in the remaining 16 patients, it was placed behind the rectus muscle and in front of the posterior rectus fascia, thus following the ventral anastomotic axis of the internal mammary and inferior epigastric arteries. The conduit is not visible, palpable, or compressible in this position. This approach was usually chosen because of multiple failures of standard intra-abdominal and axillofemoral vascular reconstructions. Five patients had concurrent intramediastinal procedures, mostly coronary bypass or innominate artery repair. The early operations were performed with Dacron grafts with a bifurcation constructed just below the umbilicus. In the last nine patients, we have used an 8 or 10 mm polytetrafluoroethylene (PTFE) prosthesis and connected it to a 6 or 8 mm PTFE crossfemoral bypass. No operative deaths occurred. The 5-year patency rate by life-table analysis is 70%. This operation is an alternative to axillofemoral bypass in patients with an inoperable abdominal aortic aneurysm.

Adult↗

Two-stage operation for multiple aneurysms of the thoracic aorta, abdominal aorta, and left common iliac artery in an octogenarian.

Multiple aortic aneurysms are well described in the surgical literature. However, there are many problems related to surgical treatment of elderly patients with such aneurysms. This report presents the case, an octogenarian with multiple aortic aneurysms that were successfully treated by graft replacement. An 82-year-old man with a descending aortic aneurysm was referred to our institution for surgery. In addition to the previously diagnosed aneurysm, computed tomography and aortography showed an abdominal aortic aneurysm and a left common iliac aneurysm. Since the patient was an elderly man with chronic obstructive pulmonary disease, a two-stage operation was performed. The abdominal aortic aneurysm and left common iliac aneurysm were resected first due to the risk of thromboembolism from the abdominal aortic aneurysm during surgery involving replacement of the descending aorta under femoro-femoral (F-F) bypass. Fifty-two days after the first operation, a second operation was performed to repair the descending aortic aneurysm. The postoperative course was uneventful. Angiography after the operation showed satisfactory replacement of the multiple aortic aneurysms. The patient was discharged 25 days after the second operation.

Aged↗

[Simultaneous replacement of the aortic valve and the ascending aorta: its operative procedure, early and late postoperative results: especially for annuloaortic ectasia and dissecting aneurysm of the aorta].

During the past 18 years, from March 1972 to February 1991, 105 patients had replacement of the ascending aorta and aortic valve. Operative techniques used in these patients, early and late postoperative results of these patients were reported. One hundred patients had composite graft replacement, and 76 patients of them were treated by Bentall's technique or its modification. Anastomotic leakages after Bentall's operation were found mostly at the bilateral coronary ostia, and incidence rate of the leakages experienced in the first 22 patients who had one lane coronary-graft anastomosis, reduced statistically significantly in patients who had two lane coronary-graft anastomosis, and also survival rate of these latter patients improved significantly than the former patients. A small caliber graft which was interposed between the coronary ostia and side holes of the composite graft was used for coronary reimplantation (Piehler's technique) in cases in which coronary ostia were not displaced cephalad, or in which dissection involved around the coronary ostial tissue even in annuloaortic ectasia. Also CABG was employed in a small number of patients. In the early postoperative results, overall operative mortality was 9.5%. In the long-term results for patients received composite graft replacement until 1989, the actuarial survival rate at 5, 10 and 14 years after surgery was 77, 66 and 60%, respectively. The actuarial survival rate for patients received composite graft replacement with two lane coronary anastomosis at 5 and 10 years after surgery was 82 and 76.2%, respectively, and this results were almost similar to the survival rate after AVR.

Aortic Dissection↗

[Case report of miliary TB, with mediastinal TB involving the aorta, trachea and esophagus with death due to hemorrhage from perforation of aorta into the esophagus during treatment].

A 32-year-old male was diagnosed as having miliary tuberculosis in May 1990. In spite of antituberculosis chemotherapy, he developed tuberculous meningitis and intracranial tuberculoma in September 1990. Miliary shadows on chest X-ray disappeared in December 1990. However, he developed left atelectasis, and bronchofiberscopy revealed soft tumor in the left main bronchus in January 1991. He suddenly vomited large amounts of blood and expired in February 1991. At autopsy, tuberculous lymphadenitis and cavitation were noted in the mediastinum, through which the left main bronchus, esophagus and descending aorta communicated. The patient died of massive bleeding which resulted from the rupture of tuberculous aortitis into the esophagus. This is a very rare case of tuberculous aortic aneurysm rupturing into both the bronchus and esophagus.

Adult↗

[Imaging of aneurysms and dissections of the aorta. Part 1--Aneurysms of the abdominal aorta].

The authors review the main imaging findings of aneurysms and dissections of the aorta. Based on the experience and imaging techniques available in their institution (Conventional Radiology, Sonography and Computed Tomography), they try to make a decision tree of radiologic procedures in ambulatory and emergency patients. Nowadays, in the majority of situations, these techniques allow the Radiologist to make the correct diagnosis, detect the complications and evaluate the patients in the pre and post-surgical phases. Other imaging techniques not available in their institution, such as Magnetic Resonance Imaging and Aortography, will be mentioned in view of their usefulness in some specific situations.

Aortic Dissection↗