scholarly journals Association of gene polymorphisms in MYH11 and TGF-β signaling with the susceptibility and clinical outcomes of DeBakey type III aortic dissection

2021 ◽  
Author(s):  
Yafei Chang ◽  
Qinghua Yuan ◽  
Peipei Jiang ◽  
Ling Sun ◽  
Yitong Ma ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Clinical Outcomes ◽  
Gene Polymorphisms ◽  
Type Iii

scholarly journals Association of gene polymorphisms in MYH11 and TGF-β signaling with the susceptibility and clinical outcomes of Debakey type Ⅲ aortic dissection

2021 ◽  
Author(s):  
Yafei Chang ◽  
Qinghua Yuan ◽  
Peipei Jiang ◽  
Ling Sun ◽  
Yitong Ma ◽  
...  
Keyword(s):  
Chest Pain ◽  
Aortic Dissection ◽  
Clinical Outcomes ◽  
Gene Polymorphisms ◽  
Transforming Growth Factor ◽  
Transforming Growth Factor Β ◽  
Prognostic Indicators ◽  
Type Iii ◽  
Gene Environment ◽  
And Function

Abstract Background: Myosin heavy chain 11 (MYH11) and transforming growth factor-β (TGF-β) signaling-related genes as the regulation of the structure and function of vascular smooth muscle cells (VSMCs) play a key role in the pathogenesis of aortic dissection (AD). This study aims to investigate the association of MYH11 and TGF-β signaling-related gene polymorphisms with the susceptibility of DeBakey type III AD and its clinical outcomes. Methods: A total of 159 patients with DeBakey Ⅲ AD and 305 healthy subjects were enrolled in this study. 4 SNPs (MYH11 rs115364997, rs117593370, TGFB1 rs1800469 and TGFBR1 rs1626340) were selected and analyzed. GMDR was used to evaluate gene-gene and gene-environment interactions. Patients were followed up for a median of 55.7 months. Results: MYH11 rs115364997 G carriers (OR = 1.629; 95%CI: 1.077-2.462, P = 0.020) or TGFBR1 rs1626340 A carriers (OR = 1.500; 95CI: 1.032-2.181, P = 0.033) had a higher risk of DeBakey type Ⅲ AD. MYH11, TGFB1, TGFBR1, and environment interactions are contribute to DeBakey type Ⅲ AD risk (CVC=10/10, P = 0.001). Dominant models of MYH11 rs115364997 AG+GG genotype (HR = 2.443; 95%CI:1.096-5.445, P = 0.029), TGFB1 rs1800469 AG+GG (HR = 2.303; 95%CI:1.069-4.96, P = 0.033) were associated with a higher risk of mortality in DeBakey type III AD. TGFB1 rs1800469 dominant model AG+GG genotype was associated with a higher risk of recurrence of chest pain in DeBakey type III AD (HR = 1.566; 95%CI: 1.018-2.378, P = 0.041). Conclusions: This study indicated that variations of MYH11 rs115364997 and TGFBR1 rs1626340 are associated with genetic predisposition of DeBakey type III AD. G carriers of MYH11 rs115364997 or TGFB1 rs1800469 may be the poor prognostic indicators of mortality and recurrent chest pain in DeBakey type III AD. The interactions of gene-gene and gene-environment are associated with the risk of DeBakey type III AD.

Endovascular aortic repair in DeBakey type III aortic dissection: 13-year results of single center experience

2020 ◽  
Vol 8 (2) ◽  
pp. 7-16
Author(s):  
A.V. Kudrinskiy ◽  
◽  
S.A. Abugov ◽  
M.V. Puretskiy ◽  
R.S. Polyakov ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Endovascular Aortic Repair ◽  
Single Center ◽  
Type Iii ◽  
Single Center Experience ◽  
Aortic Repair

Influence of Sex on Outcomes After Thoracic Endovascular Repair for Type B Aortic Dissection

Angiology ◽  
2021 ◽  
pp. 000331972098795
Author(s):  
Songyuan Luo ◽  
Yi Zhu ◽  
Enmin Xie ◽  
Huanyu Ding ◽  
Fan Yang ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Clinical Outcomes ◽  
Cox Regression ◽  
Type B ◽  
Type B Aortic Dissection ◽  
Landing Zone ◽  
End Point ◽  
Male Patients ◽  
Long Term Mortality

We aimed to investigate whether sex differences influence the clinical outcomes of patients who undergo thoracic endovascular aortic repair (TEVAR) for type B aortic dissection (TBAD). We retrospectively analyzed a prospectively maintained single-center cohort of patients with TBAD who underwent TEVAR between January 2010 and June 2017. We evaluated the in-hospital and long-term mortality and composite end point. Of the 913 patients, 793 (86.8%) were male and 120 (13.1%) were female. Compared to male patients, the female patients were older, more likely to have diabetes mellitus, but less likely to smoke or have hypertension. The proximal landing zone in 0 and 1 was higher in male patients ( P = .023), who were more likely to require an aortic arch bypass. Endoleak, delirium, and ICU stay after stent-graft implantation were also more frequent in men. Sex factor was not associated with in-hospital or long-term mortality or the composite end point in the multivariable regression analyses and Cox regression model. The mean estimated survival time was similar between males and females (2462.9 ± 141.2 vs 2804.1 ± 117.4 days, P = .167) in the propensity score–matched cohort. Despite distinct characteristics between sex, there was no sex-related difference in long-term clinical outcomes after TEVAR for TBAD.

Clinical outcomes of valve-sparing root replacement in acute type A aortic dissection

2015 ◽  
Vol 49 (6) ◽  
pp. 331-336 ◽  
Author(s):  
Heemoon Lee ◽  
Yang Hyun Cho ◽  
Kiick Sung ◽  
Wook Sung Kim ◽  
Kay-Hyun Park ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Clinical Outcomes ◽  
Type A ◽  
Acute Type ◽  
Type A Aortic Dissection ◽  
Valve Sparing

Relief of mesenteric ischemia in type III aortic dissection with percutaneous fenestration of the aortic septum.

Radiology ◽  
1990 ◽  
Vol 174 (2) ◽  
pp. 450-452 ◽  
Author(s):  
D M Williams ◽  
T E Brothers ◽  
L M Messina
Keyword(s):  
Aortic Dissection ◽  
Mesenteric Ischemia ◽  
Type Iii

scholarly journals Clinical Outcomes of VasoRing Connector in Patients With Acute Type A Aortic Dissection

2018 ◽  
Vol 106 (3) ◽  
pp. 764-770 ◽  
Author(s):  
I-Ming Chen ◽  
Po-Lin Chen ◽  
Shih-Hsien Weng ◽  
Chiao-Po Hsu ◽  
Chun-Che Shih ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Clinical Outcomes ◽  
Type A ◽  
Acute Type ◽  
Type A Aortic Dissection

Diverse MRI findings and clinical outcomes of acute Marchiafava-Bignami disease

2020 ◽  
pp. 028418512094304
Author(s):  
Wei Li ◽  
Chao Ran ◽  
Jun Ma
Keyword(s):  
Clinical Outcomes ◽  
Clinical Manifestations ◽  
Acute Onset ◽  
Restricted Diffusion ◽  
Type I ◽  
Type Ii ◽  
Mri Findings ◽  
Type Iii ◽  
Mri Features ◽  
Magnetic Resonance Imaging Mri

Background The acute onset of Marchiafava-Bignami disease (MBD) is difficult to capture, and its clinical manifestations are overlapped. Magnetic resonance imaging (MRI) is very useful in the diagnosis of acute MBD. Purpose To investigate the MRI features and clinical outcomes of acute MBD. Materials and Methods Sagittal T2-weighted (T2W) or T1-weighted (T1W) imaging, axial T1W and T2W imaging, and axial FLAIR and diffusion-weighted imaging (DWI) sequences were performed in 17 patients with acute MBD on 1.5-T MR. According to the different ranges of callosal restricted diffusion, MBD was divided into Type I (n = 7, the completely involved), Type II (n = 5, the mostly involved), and Type III (n = 5, the partly involved). The MRI findings and outcomes of each type were retrospectively analyzed. Results With the reduced range of the callosal restricted diffusion, the callosal atrophy or cavitation was more common: no case of Type I; 1 (20%) case of Type II; and 3 (60%) cases of Type III. With the increased range of callosal restricted diffusion, the extracallosal involvement was more common: 6 (86%) cases of Type I; 3 (60%) cases of Type II; and 1 (20%) case of Type III. During the follow-up, five cases had neuropsychiatric sequelae: 1 (14%) case of type I; 1 (20%) case of Type II; 3 (60%) cases of Type III. Conclusion The MRI findings and clinical outcomes of acute MBD are regular. The extensive restricted diffusion of acute MBD may present the curable condition. Callosal heterogeneity may affect the outcome of acute MBD.

scholarly journals Different aortic arch surgery methods for type A aortic dissection: clinical outcomes and follow-up results

2020 ◽  
Vol 31 (2) ◽  
pp. 254-262
Author(s):  
Yunxing Xue ◽  
Jun Pan ◽  
Hailong Cao ◽  
Fudong Fan ◽  
Xuan Luo ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Aortic Arch ◽  
Clinical Outcomes ◽  
Type A ◽  
Frozen Elephant Trunk ◽  
Elephant Trunk ◽  
Type A Aortic Dissection ◽  
Aortic Arch Surgery

Abstract OBJECTIVES The aim of this study was to investigate the clinical outcomes and follow-up results among 5 main aortic arch surgery methods for type A aortic dissection in a single centre. METHODS From 2002 to 2018, 958 type A aortic dissection patients who received surgical repair were divided into 5 groups according to the arch surgery method: hemiarch replacement (n = 206), island arch replacement (n = 54), total arch replacement with frozen elephant trunk (n = 425), triple-branched stent (n = 39) and fenestrated stent (n = 234). The indications for the different arch methods were related to the patient’s preoperative status, the location and extent of the dissection and the surgical ability of the surgeons. A comparative study was performed to identify the differences in the perioperative data, and the Kaplan–Meier analysis was used to assess the long-term survival and reintervention rates. Thirty matched surviving patients that were included in each group completed Computed tomography angiography to determine long-term reshaping effect. RESULTS The 30-day mortality rate was 15.8%, and there was no difference among the 5 groups (P = 0.848). The follow-up survival rates were similar among the 5 groups (P = 0.130), and the same was true for patients without reintervention (P = 0.471). In the propensity matching study, patients with stents (frozen elephant trunk, triple-branched stent, fenestrated stent) had a slower aortic dilation rate and a higher ratio of thrombosis in the false lumen at the descending aortic and abdominal aortic levels than patients without stents. CONCLUSIONS No standard method is available for arch surgery, and indications and long-term effects should be identified with clinical data. In our experiences, simpler surgical procedures could reduce mortality in critically ill patients and stents in the distal aorta could improve long-term reshape effects.

scholarly journals Clinical outcomes and quality of life in patients with acute and subacute type B aortic dissection after thoracic endovascular aortic repair

2020 ◽  
Vol 48 (8) ◽  
pp. 030006052094550
Author(s):  
Yonghua Bi ◽  
Mengfei Yi ◽  
Xinwei Han ◽  
Jianzhuang Ren
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Aortic Dissection ◽  
Clinical Outcomes ◽  
Thoracic Endovascular Aortic Repair ◽  
Endovascular Aortic Repair ◽  
Type B ◽  
Type B Aortic Dissection ◽  
Aortic Repair

Objective Thoracic endovascular aortic repair (TEVAR) is considered the mini-invasive treatment of choice for patients with Stanford type B aortic dissection (TBAD). This study aimed to investigate the clinical outcomes and quality of life (QoL) in patients with acute and subacute TBAD after TEVAR. Methods From January 2014 until July 2016, 22 acute patients (Group A) and 18 subacute patients received TEVAR (Group B), and 13 patients were managed non-operatively (Group C). The Medical Outcomes Study Short Form-36 was used to assess QoL preoperatively and after TEVAR. Operative techniques and complications were retrospectively analyzed. Results The role emotion, vitality, and mental health domains scored well preoperatively. Except for role emotion, vitality, and mental health, the remaining domains significantly improved after TEVAR. There was no significant difference in QoL metrics between Groups A and B. In Group C, bodily pain and social functioning domains were improved, and role emotion was decreased, with no improvement in the remaining domains. The 3-year survival rates were 95.5%, 100%, and 85.7% for Groups A, B, and C, respectively. Conclusions TEVAR may be safe and effective in patients with acute and subacute TBAD with similar and favorable clinical and QoL metrics.

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