Acute Aortic Dissection as a Rare Complication of Descending Thoracic Aortic Aneurysm

2021 ◽  
Author(s):  
Marine Bordet ◽  
Philippe Tresson
Keyword(s):  
Aortic Aneurysm ◽  
Aortic Dissection ◽  
Thoracic Aortic Aneurysm ◽  
Acute Aortic Dissection ◽  
Rare Complication ◽  
Descending Thoracic Aortic Aneurysm

scholarly journals Inhibition of HIPK2 Alleviates Thoracic Aortic Disease in Mice With Progressively Severe Marfan Syndrome

2021 ◽  
Author(s):  
Cristina I. Caescu ◽  
Jens Hansen ◽  
Brittany Crockett ◽  
Wenzhen Xiao ◽  
Pauline Arnaud ◽  
...  
Keyword(s):  
Protein Kinase ◽  
Aortic Aneurysm ◽  
Aortic Dissection ◽  
Marfan Syndrome ◽  
Thoracic Aortic Aneurysm ◽  
Acute Aortic Dissection ◽  
Transforming Growth Factor ◽  
Transforming Growth Factor Β ◽  
Aortic Disease ◽  
Computational Analyses

Objective: Despite considerable research, the goal of finding nonsurgical remedies against thoracic aortic aneurysm and acute aortic dissection remains elusive. We sought to identify a novel aortic protein kinase that can be pharmacologically targeted to mitigate aneurysmal disease in a well-established mouse model of early-onset progressively severe Marfan syndrome (MFS). Approach and Results: Computational analyses of transcriptomic data derived from the ascending aorta of MFS mice predicted a probable association between thoracic aortic aneurysm and acute aortic dissection development and the multifunctional, stress-activated HIPK2 (homeodomain-interacting protein kinase 2). Consistent with this prediction, Hipk2 gene inactivation significantly extended the survival of MFS mice by slowing aneurysm growth and delaying transmural rupture. HIPK2 also ranked among the top predicted protein kinases in computational analyses of genes differentially expressed in the dilated aorta of 3 MFS patients, which strengthened the clinical relevance of the experimental finding. Additional in silico analyses of the human and mouse data sets identified the TGF (transforming growth factor)-β/Smad3 signaling pathway as a potential target of HIPK2 in the MFS aorta. Chronic treatment of MFS mice with an allosteric inhibitor of HIPK2-mediated stimulation of Smad3 signaling validated this prediction by mitigating thoracic aortic aneurysm and acute aortic dissection pathology and partially improving aortic material stiffness. Conclusions: HIPK2 is a previously unrecognized determinant of aneurysmal disease and an attractive new target for antithoracic aortic aneurysm and acute aortic dissection multidrug therapy.

scholarly journals The role of genetic testing in the prevention of acute aortic dissection

2018 ◽  
Vol 25 (1_suppl) ◽  
pp. 15-23 ◽  
Author(s):  
Davide Carino ◽  
Andrea Agostinelli ◽  
Alberto Molardi ◽  
Filippo Benassi ◽  
Tiziano Gherli ◽  
...  
Keyword(s):  
Genetic Testing ◽  
Aortic Aneurysm ◽  
Aortic Dissection ◽  
Thoracic Aortic Aneurysm ◽  
Acute Aortic Dissection ◽  
Aortic Disease ◽  
Technological Advance ◽  
Genetic Mutations ◽  
Thoracic Aortic Disease

Although much has been learned about disease of the thoracic aorta, most diagnosis of thoracic aortic aneurysm (TAA) is still incidental. The importance of the genetic aspects in thoracic aortic disease is overwhelming, and today different mutations which cause TAA or alter its natural history have been discovered. Technological advance has made available testing which detects genetic mutations linked to TAA. This article analyses the genetic aspects of TAA and describes the possible role of genetic tests in the clinical setting in preventing devastating complications of TAA.

scholarly journals A meta-analysis of weekend admission and surgery for aortic rupture and dissection

2017 ◽  
Vol 22 (5) ◽  
pp. 398-405 ◽  
Author(s):  
Hisato Takagi ◽  
Tomo Ando ◽  
Takuya Umemoto
Keyword(s):  
Aortic Aneurysm ◽  
Aortic Dissection ◽  
Confidence Interval ◽  
Thoracic Aortic Aneurysm ◽  
Acute Aortic Dissection ◽  
Aortic Rupture ◽  
Meta Analysis ◽  
Pooled Analysis ◽  
Funnel Plot ◽  
Trim And Fill

We performed a meta-analysis to determine whether weekend admission and surgery for ruptured abdominal/thoracic aortic aneurysm (RAAA/RTAA) and acute aortic dissection (AAD) is associated with increased mortality. MEDLINE and EMBASE were searched from January 1946 to December 2016 using PubMed and OVID. Eligible studies were prospective or retrospective, comparative or cohort studies enrolling patients admitting or undergoing surgery for RAAA/RTAA/AAD and reporting mortality after weekend (including holiday) versus weekday admission/surgery. Our search identified 11 studies including a total of 166,195 patients. A pooled analysis of 13 adjusted odds ratios (ORs), one adjusted hazard ratio, and one unadjusted OR from all 11 studies demonstrated a statistically significant 32% increase in mortality with weekend admission/surgery (OR, 1.32; 95% confidence interval (CI), 1.20 to 1.45; p < 0.00001). Despite possible publication bias disadvantageous to weekend admission/surgery based on funnel plot asymmetry, adjustment for the asymmetry using the trim-and-fill method did not alter the significant association of weekend admission/surgery with increased mortality (OR, 1.21; 95% CI, 1.09 to 1.34; p = 0.0006). In conclusion, weekend admission/surgery for ruptured abdominal/thoracic aortic aneurysm and acute aortic dissection (AAD) may be associated with increased mortality.

Repetitive aortic dissection in a patient with giant cell arteritis

2020 ◽  
pp. 021849232096086
Author(s):  
Yusuke Motoji ◽  
Jiro Kurita ◽  
Yasuhiro Kawase ◽  
Yosuke Ishii ◽  
Tetsuro Morota ◽  
...  
Keyword(s):  
Aortic Aneurysm ◽  
Aortic Dissection ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Thoracic Aortic Aneurysm ◽  
Acute Aortic Dissection ◽  
Type A ◽  
Ascending Aorta ◽  
Healthy Individuals ◽  
Short Period

Giant cell arteritis is reportedly associated with thoracic aortic aneurysm and acute aortic dissection. We encountered a patient with giant cell arteritis who suffered acute aortic dissection three times within a short period. A pathological specimen of the ascending aorta taken at surgery for type A acute aortic dissection revealed the typical features of giant cell arteritis. Giant cell arteritis patients might be at greater risk of acute aortic dissection than healthy individuals.

Case report: A descending thoracic aortic aneurysm presenting as airway challenge

2021 ◽  
Vol 71 ◽  
pp. 110230
Author(s):  
Thushara Madathil ◽  
Sudheer Babu Vanga ◽  
Reshmi Liza Jose ◽  
Gopan Gopalakrishna Pillai
Keyword(s):  
Case Report ◽  
Aortic Aneurysm ◽  
Thoracic Aortic Aneurysm ◽  
Descending Thoracic Aortic Aneurysm
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