scholarly journals Aortic decision-making in the Loeys–Dietz syndrome: Aortic root aneurysm and a normal-caliber ascending aorta and aortic arch

2009 ◽  
Vol 138 (2) ◽  
pp. 502-503 ◽  
Author(s):  
John G.T. Augoustides ◽  
Ted Plappert ◽  
Joseph E. Bavaria
Keyword(s):  
Decision Making ◽  
Aortic Arch ◽  
Aortic Root ◽  
Ascending Aorta ◽  
Aortic Root Aneurysm

Dilatation of the entire thoracic aorta in patients with bicuspid aortic valve: a magnetic resonance angiography study

VASA ◽  
2005 ◽  
Vol 34 (3) ◽  
pp. 181-185 ◽  
Author(s):  
Westhoff-Bleck ◽  
Meyer ◽  
Lotz ◽  
Tutarel ◽  
Weiss ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Aortic Valve ◽  
Pulmonary Artery ◽  
Aortic Arch ◽  
Thoracic Aorta ◽  
Aortic Root ◽  
Ascending Aorta ◽  
Descending Aorta ◽  
Severe Aortic Regurgitation

Background: The presence of a bicuspid aortic valve (BAV) might be associated with a progressive dilatation of the aortic root and ascending aorta. However, involvement of the aortic arch and descending aorta has not yet been elucidated. Patients and methods: Magnetic resonance angiography (MRA) was used to assess the diameter of the ascending aorta, aortic arch, and descending aorta in 28 patients with bicuspid aortic valves (mean age 30 ± 9 years). Results: Patients with BAV, but without significant aortic stenosis or regurgitation (n = 10, mean age 27 ± 8 years, n.s. versus control) were compared with controls (n = 13, mean age 33 ± 10 years). In the BAV-patients, aortic root diameter was 35.1 ± 4.9 mm versus 28.9 ± 4.8 mm in the control group (p < 0.01). The diameter of the ascending aorta was also significantly increased at the level of the pulmonary artery (35.5 ± 5.6 mm versus 27.0 ± 4.8 mm, p < 0.001). BAV-patients with moderate or severe aortic regurgitation (n = 18, mean age 32 ± 9 years, n.s. versus control) had a significant dilatation of the aortic root, ascending aorta at the level of the pulmonary artery (41.7 ± 4.8 mm versus 27.0 ± 4.8 mm in control patients, p < 0.001) and, furthermore, significantly increased diameters of the aortic arch (27.1 ± 5.6 mm versus 21.5 ± 1.8 mm, p < 0.01) and descending aorta (21.8 ± 5.6 mm versus 17.0 ± 5.6 mm, p < 0.01). Conclusions: The whole thoracic aorta is abnormally dilated in patients with BAV, particularly in patients with moderate/severe aortic regurgitation. The maximum dilatation occurs in the ascending aorta at the level of the pulmonary artery. Thus, we suggest evaluation of the entire thoracic aorta in patients with BAV.

scholarly journals The deadly “bulging balloon” within the mediastinum: a case of a giant aortic root aneurysm in a young patient with Marfan syndrome

2020 ◽  
Author(s):  
JIAYU SHEN ◽  
Changping Gan ◽  
R.D.T. Rajaguru ◽  
Dou Yuan ◽  
ZHENGHUA XIAO
Keyword(s):  
Decision Making ◽  
Aortic Valve ◽  
Ct Scan ◽  
Young Patient ◽  
Marfan Syndrome ◽  
Aortic Root ◽  
Treatment Decision ◽  
Decision Making Process ◽  
Aortic Root Aneurysm ◽  
Treatment Decision Making

Abstract Introduction: Marfan syndrome (MFS) is a common heritable connective tissue disease involving multiple organs. Even though the clinical manifestations of MFS can be various, aortic root aneurysm is estimated as one of the most serious complications. We herein describe an individualized treatment decision-making process for a 23-year-old male with MFS, suffering from a giant but stable aortic root aneurysm which is extremely rare at his age. Case: The patient, a 23-year-old male with a family history of MFS, presented to our cardiovascular department because of progressive exertional chest distress, fatigue and occasional precordial pain. Physical examinations revealed six-foot-three inches of height, high myopia, and a diastolic murmur at the aortic valve area. Laboratory examinations for systemic vasculitis and infectious diseases were negative. The transthoracic echocardiography (TTE) and enhanced thoracic computed tomography (CT) scan revealed the existence of a giant aortic root aneurysm (125.1 mm in short-axis), severe aortic valve regurgitation, cardiac dilatation (LV; 99 mm in diastolic diameter) and a poor ejection fraction (EF; 18%). Considering the risk of rupture or dissection of the dilated aortic root, we successfully performed the Bentall procedure based on the intraoperative exploration results. Postoperative thoracic CT scan revealed a normal sized reconstructed aortic root, and the patient was discharged uneventfully 7 days later. Conclusion It is extremely rare to report such a giant aortic root aneurysm in a young patient. In the treatment decision-making process, the patient’s specific situation should be taken into consideration. The composite replacement of the aortic valve and ascending aorta should be performed if the patient is not suitable for valve-sparing operation.

scholarly journals Ascending aorta and aortic root replacement in an infant: a case report

2021 ◽  
Vol 25 (3) ◽  
pp. 83
Author(s):  
V. A. Mironenko ◽  
V. S. Rasumovsky ◽  
A. A. Svobodov ◽  
S. V. Rychin
Keyword(s):  
Carotid Artery ◽  
Aortic Arch ◽  
Subclavian Artery ◽  
Aortic Root ◽  
Common Carotid Artery ◽  
Left Subclavian Artery ◽  
Vascular Prosthesis ◽  
Ascending Aorta ◽  
Left Common Carotid Artery ◽  
Brachiocephalic Trunk

<p>We herein report the first clinical case of prosthetic replacement of the ascending aorta and aortic arch to repair a giant aneurysm in a 7-month-old child. The ascending aorta and arch replacement to the level of left subclavian artery was performed using a no. 16 Polymaille prosthesis, the brachiocephalic trunk was reimplanted into the vascular prosthesis and the kinked section of the left common carotid artery was removed, followed by reimplanting the left common carotid artery into the left subclavian artery. First, proximal anastomosis with the vascular prosthesis was created using a no. 16 Polymaille prosthesis and the vascular suture was strengthened with a Teflon strip. During circulatory arrest, the aortic arch was crossed between the orifice of the left common carotid artery and left subclavian artery, with the cut extended to the isthmus region along the small curvature of the arch. The brachiocephalic trunk was aligned and brought down, with subsequent implantation into the ascending aorta prosthesis 2 cm below the initial fixation point. In the final stage, the kinked section of the left common carotid artery was resected and the aligned left carotid artery was directly reimplanted into the left subclavian artery using end-to-side anastomosis. The patient developed tracheobronchitis and moderate heart failure during the postoperative period. The duration of mechanical ventilation was 16 hours. Infusion and antibacterial therapy were discontinued on postoperative day 8. On postoperative day 13, the patient was discharged and referred to the outpatient centre for further treatment and rehabilitation. A sufficiently large-sized prosthesis allows for further development in paediatric patients. This is facilitated by the preservation of the native aortic root with restored valve function and the formation of a bevelled distal anastomosis with a small unchanged aortic section in the isthmus region, which maintains growth potential. This first reported case of an infant demonstrates the possibility of combination interventions on the aortic arch and brachiocephalic artery during the first year of life.</p><p>Received 30 January 2021. Revised 24 March 2021. Accepted 29 March 2021.</p><p><strong>Funding:</strong> The study did not have sponsorship.</p><p><strong>Conflict of interest:</strong> The authors declare no conflicts of interests.</p><p><strong>Contribution of the authors: </strong>The authors contributed equally to this article.</p>

scholarly journals Successful case of Benthal de Bono surgery in Cabrol modification with one-step aortic arch prosthesis and repeat coronary artery bypass surgery in a patient with de Bakey type 1 acute aortic dissection

2021 ◽  
Vol 38 (3) ◽  
pp. 153-158
Author(s):  
B. K. Kadyraliev ◽  
V. B. Arutyunyan ◽  
S. V. Kucherenko ◽  
V. N. Pavlova ◽  
E. S. Spekhova ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Aortic Valve ◽  
Aortic Arch ◽  
Aortic Root ◽  
Artery Bypass ◽  
Aortic Disease ◽  
Ascending Aorta ◽  
Aortic Aneurysms ◽  
Golden Standard ◽  
Valve Reconstruction

The ascending aortic aneurysm occurs in 45 % of cases from the total number of aortic aneurysms of various localization. The incidence rate of combination of the aortic disease with aneurysm per 100 000 of the population is 5.9. The problem of prosthetics of the aortic root and aortic valve due to aneurysm and the changed AV is rather actual. The main principle of aneurysm surgery is the prevention of the risk of dissection and rupture with reconstruction of normal dimensions of the ascending aorta. Currently, there are different techniques for the treatment of root aneurysms and ascending aorta. The standard techniques are aortic root replacement, aortic valve reconstruction with replacement of aortic root or ascending aorta and partial or full replacement of aortic arch depending on the situation. The Bentall De Bono operation at present remains a golden standard of surgical treatment of the aneurysms of the root and ascending aorta with changed aortic valve. This surgery can have the following complications: thrombotic, thromboembolic followed by conduit dysfunction, formation of false anastomosis aneurysms, hemorrhage, compression of coronary artery orifices due to tension in the zone of coronary anastomoses.

scholarly journals Aortic root aneurysm with right atrial clot: a rare combination

2021 ◽  
Author(s):  
Debmalya Saha ◽  
Kaushik Mukherjee ◽  
Amrita Guha
Keyword(s):  
Aortic Root ◽  
Liver Function Tests ◽  
Ascending Aorta ◽  
Right Atrial ◽  
Poor General Condition ◽  
Aortic Root Aneurysm ◽  
Bentall Procedure ◽  
Clot Removal ◽  
Preoperative Optimization ◽  
The Right

Though the incidence of aneurysms involving the aortic root and/or ascending aorta is common, the combination of aortic root aneurysm and the right atrial clot is extremely rare. No such case is reported in literature till date. This case report presents a 52-year gentleman who came to our emergency department with complaints of breathlessness, abdominal distention, pedal swelling, and decreased urine output with extremely poor general condition. After hemodynamic stabilization and preoperative optimization and workup, he was managed with Bentall procedure with right atrial clot removal. The immediate postoperative course was normal except for deranged liver function tests. The patient was discharged on postoperative day ten.

scholarly journals Should aortic arch replacement be performed during initial surgery for aortic root aneurysm in patients with Marfan syndrome?†

2013 ◽  
Vol 44 (2) ◽  
pp. 346-351 ◽  
Author(s):  
Florian S. Schoenhoff ◽  
Alexander Kadner ◽  
Martin Czerny ◽  
Silvan Jungi ◽  
Katharina Meszaros ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Marfan Syndrome ◽  
Aortic Root ◽  
Aortic Arch Replacement ◽  
Aortic Root Aneurysm ◽  
Initial Surgery

Valve-sparing aortic root and aortic arch replacement in a 5-year-old boy with Loeys–Dietz syndrome

2019 ◽  
Vol 56 (2) ◽  
pp. 409-411
Author(s):  
Houda Ajmi ◽  
Nadia Arifa ◽  
Essia Boughzela ◽  
Lotfi Ben Mime
Keyword(s):  
Aortic Arch ◽  
Subclavian Artery ◽  
Aortic Root ◽  
Left Subclavian Artery ◽  
Ascending Aorta ◽  
Aortic Arch Replacement ◽  
Aortic Isthmus ◽  
Valve Sparing ◽  
Slight Narrowing

Abstract In this study, we describe the case of a 5-year-old boy who presumably presented with Loeys–Dietz syndrome. A huge aneurysm of the ascending aorta and the aortic arch extended beyond the left subclavian artery and was accompanied by a slight narrowing of the aortic isthmus.

scholarly journals Management of a giant aortic root aneurysm in a young patient with Marfan syndrome: a case report

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Jiayu Shen ◽  
Changping Gan ◽  
R. D. T. Rajaguru ◽  
Dou Yuan ◽  
Zhenghua Xiao
Keyword(s):  
Decision Making ◽  
Aortic Valve ◽  
Ct Scan ◽  
Young Patient ◽  
Aortic Root ◽  
Treatment Decision ◽  
Decision Making Process ◽  
Aortic Root Aneurysm ◽  
Treatment Decision Making ◽  
Bentall Procedure

Abstract Introduction Marfan syndrome (MFS) is a common heritable connective tissue disease involving multiple organs. Even though the clinical manifestations of MFS can be various, aortic root aneurysm is estimated as one of the most serious complications. We herein describe an individualized treatment decision-making process for a 23-year-old male with MFS, suffering from a giant but stable aortic root aneurysm which is extremely rare at his age. Case The patient, a 23-year-old male with a family history of MFS, presented to our cardiovascular department because of progressive exertional chest distress, fatigue and occasional precordial pain. Physical examinations revealed 190.5 cm of height, high myopia, and a diastolic murmur at the aortic valve area. Laboratory examinations for systemic vasculitis and infectious diseases were negative. Transthoracic echocardiography and enhanced thoracic computed tomography (CT) scan revealed the existence of a giant aortic root aneurysm (125.1 mm in short-axis), severe aortic valve regurgitation, cardiac dilatation (LV; 99 mm in diastolic diameter) and a poor ejection fraction (EF; 18%). Considering the risk of rupture or dissection of the dilated aortic root, we performed Bentall procedure based on the results of multidisciplinary team discussion and intraoperative exploration. Postoperative thoracic CT scan revealed a normal sized reconstructed aortic root, and the patient was discharged uneventfully 7 days later. Conclusion It is extremely rare to report such a giant aortic root aneurysm in a young patient. In the treatment decision-making process, the patient’s specific situation should be taken into consideration. A mechanical Bentall procedure seems to be an acceptable option for some selected cases.

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