scholarly journals Primary Lymphoma Presenting in an Ascending Aortic Aneurysm: A Case Report

Aorta ◽  
2020 ◽  
Vol 08 (02) ◽  
pp. 038-040
Author(s):  
Alexander M. Schurman ◽  
David Mendoza ◽  
Chris K. Rokkas
Keyword(s):  
Management Strategies ◽  
Ascending Aorta ◽  
Aortic Aneurysms ◽  
Prior History ◽  
Primary Lymphoma ◽  
Surgical Specimen ◽  
Hematological Disorders ◽  
Thoracic Aortic Aneurysms ◽  
Asymptomatic Patients ◽  
History Of

AbstractSmall lymphocytic lymphoma (SLL) is rarely associated with thoracic aortic aneurysms. Aneurysm of the ascending aorta associated with SLL has never been reported before. We describe the case of an asymptomatic 68-year-old woman who presented with a 5.5-cm aneurysm of the ascending aorta and no prior history of hematological disorders. Following excision and repair, the surgical specimen showed infiltration of the aortic wall by lymphocytes, expressing markers consistent with SLL. While symptomatic SLL carries a poor prognosis, risk stratification tools are applied to guide management strategies in asymptomatic patients.

Cannulation of the Ascending Aorta in Left Thoracotomy for Thoracic Aortic Aneurysms

2007 ◽  
Vol 10 (1) ◽  
pp. E81-E83 ◽  
Author(s):  
Riza Turkoz ◽  
Oner Gulcan ◽  
Orhan Demirturk ◽  
Ayda Turkoz
Keyword(s):  
Ascending Aorta ◽  
Aortic Aneurysms ◽  
Left Thoracotomy ◽  
Thoracic Aortic Aneurysms

scholarly journals Comparison of 10 murine models reveals a distinct biomechanical phenotype in thoracic aortic aneurysms

2017 ◽  
Vol 14 (130) ◽  
pp. 20161036 ◽  
Author(s):  
C. Bellini ◽  
M. R. Bersi ◽  
A. W. Caulk ◽  
J. Ferruzzi ◽  
D. M. Milewicz ◽  
...  
Keyword(s):  
Extracellular Matrix ◽  
Structural Integrity ◽  
Ascending Aorta ◽  
Elastic Fibre ◽  
Cytoskeletal Proteins ◽  
Aortic Aneurysms ◽  
Genetic Mutations ◽  
Murine Models ◽  
Thoracic Aortic Aneurysms ◽  
Signalling Molecules

Thoracic aortic aneurysms are life-threatening lesions that afflict young and old individuals alike. They frequently associate with genetic mutations and are characterized by reduced elastic fibre integrity, dysfunctional smooth muscle cells, improperly remodelled collagen and pooled mucoid material. There is a pressing need to understand better the compromised structural integrity of the aorta that results from these genetic mutations and renders the wall vulnerable to dilatation, dissection or rupture. In this paper, we compare the biaxial mechanical properties of the ascending aorta from 10 murine models: wild-type controls, acute elastase-treated, and eight models with genetic mutations affecting extracellular matrix proteins, transmembrane receptors, cytoskeletal proteins, or intracellular signalling molecules. Collectively, our data for these diverse mouse models suggest that reduced mechanical functionality, as indicated by a decreased elastic energy storage capability or reduced distensibility, does not predispose to aneurysms. Rather, despite normal or lower than normal circumferential and axial wall stresses, it appears that intramural cells in the ascending aorta of mice prone to aneurysms are unable to maintain or restore the intrinsic circumferential material stiffness, which may render the wall biomechanically vulnerable to continued dilatation and possible rupture. This finding is consistent with an underlying dysfunctional mechanosensing or mechanoregulation of the extracellular matrix, which normally endows the wall with both appropriate compliance and sufficient strength.

scholarly journals Giant Aortic Aneurysm in Child with Cutis Laxa Syndrome: Unusual Presentation, New Surgical Technique

2021 ◽  
Vol 24 (6) ◽  
pp. E1054-E1056
Author(s):  
Mazen Shamsaldeen Faden ◽  
Nada Ahmed Noaman ◽  
Osman Osama Osman Osama ◽  
Ahmed Abdelrahman Elassal ◽  
Arwa Mohammed Al-ghamdi ◽  
...  
Keyword(s):  
Final Diagnosis ◽  
Ascending Aorta ◽  
Accurate Diagnosis ◽  
Aortic Aneurysms ◽  
Cutis Laxa ◽  
Descending Aorta ◽  
Aorta Aneurysm ◽  
Thoracic Aortic Aneurysms ◽  
Valvular Insufficiency ◽  
New Surgical Technique

Ascending thoracic aortic aneurysms are rare in childhood and typically are seen in the setting of connective tissue defect syndromes. These aneurysms may lead to rupture, dissection, or valvular insufficiency, so root replacement is recommended. Here, we present a 17-month-old girl who presented with fever, cough, and pericardial effusion. Initially, we suspected this could be a COVID-19 case, so a nasopharyngeal swap was performed. An ascending aorta aneurysm involving the aortic arch was confirmed by echo, and urgent ascending aorta and arch replacement were done by utilizing the descending aorta as a new arch. The final diagnosis came with cutis laxa syndrome. In similar cases, good outcomes can be achieved with accurate diagnosis and appropriate surgical management.

scholarly journals The Genetics of Thoracic Aortic Aneurysms and Dissection: A Clinical Perspective

Biomolecules ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. 182 ◽  
Author(s):  
Nicolai P. Ostberg ◽  
Mohammad A. Zafar ◽  
Bulat A. Ziganshin ◽  
John A. Elefteriades
Keyword(s):  
Genetic Basis ◽  
Surgical Intervention ◽  
Clinical Manifestations ◽  
Aortic Aneurysms ◽  
Screening Tests ◽  
Cellular Mechanisms ◽  
Biomechanical Stress ◽  
Thoracic Aortic Aneurysms ◽  
Aortic Aneurysm And Dissection ◽  
History Of

Thoracic aortic aneurysm and dissection (TAAD) affects many patients globally and has high mortality rates if undetected. Once thought to be solely a degenerative disease that afflicted the aorta due to high pressure and biomechanical stress, extensive investigation of the heritability and natural history of TAAD has shown a clear genetic basis for the disease. Here, we review both the cellular mechanisms and clinical manifestations of syndromic and non-syndromic TAAD. We particularly focus on genes that have been linked to dissection at diameters <5.0 cm, the current lower bound for surgical intervention. Genetic screening tests to identify patients with TAAD associated mutations that place them at high risk for dissection are also discussed.

As-Needed Antihypertensive Therapy in Surgical Patients, Why and How: Challenging a Paradigm

2012 ◽  
Vol 78 (2) ◽  
pp. 250-253 ◽  
Author(s):  
Christopher P. Miller ◽  
Aaron M. Cook ◽  
D. Pharm ◽  
Christopher D. Case ◽  
Andrew C. Bernard
Keyword(s):  
Antihypertensive Therapy ◽  
Medical Center ◽  
Evidence Base ◽  
Prior History ◽  
Emergency General Surgery ◽  
University Of Kentucky ◽  
Asymptomatic Patients ◽  
History Of ◽  
Level I ◽  
The Cost

Hypertension is common in hospitalized patients and there are many causes. Some patients have no prior history of hypertension, few symptoms, and no apparent morbidity related to acute rises in blood pressure. Though there is no established guideline for therapy in these cases, patients often receive therapy directed at the abnormal vital sign. It is hypothesized that this practice is common and the associated costs are significant. Using the inpatient pharmacy database at the University of Kentucky Chandler Medical Center, a verified Level I trauma center and quaternary referral center, patients on the emergency general surgery or orthopedic surgery services receiving intravenous hydralazine, metoprolol, or labetalol were identified. Subjects were analyzed for indications, parameters, associated history of hypertension, and direct costs. Over the 4-month study period, 114 subjects received 522 drug doses. More than half (55%) of subjects had a prior history of hypertension but only 75 per cent were started on their home medication. Of those without hypertension before admission, 18 per cent required therapy at discharge. Labetalol was the most frequently used agent and total pharmacy costs for this cohort of patients was over $1200. Pro re nata (PRN), short-acting antihypertensive therapy has little evidence base in asymptomatic patients, but its prevalence is high on surgical services. The cost is significant, especially when extrapolated to the larger hospital population at this single institution. Further research is warranted to determine the prevalence of this practice in other centers or national regions, as well as its cost and benefit.

Endovascular versus open treatment of degenerative aneurysms of the descending thoracic aorta: a single center experience

Vascular ◽  
2011 ◽  
Vol 19 (1) ◽  
pp. 8-14 ◽  
Author(s):  
Joachim Andrassy ◽  
Rolf Weidenhagen ◽  
Georgios Meimarakis ◽  
M Rentsch ◽  
K-W Jauch ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Thoracic Aorta ◽  
Open Surgery ◽  
Aortic Aneurysms ◽  
Descending Thoracic Aorta ◽  
Entire Cohort ◽  
Thoracic Aortic Aneurysms ◽  
Asymptomatic Patients ◽  
Open Treatment ◽  
One Year

Multiple reports could show a reduced risk for thoracic endovascular aortic repair (TEVAR) compared with open treatment. The aim of this study was to evaluate our twelve-year TEVAR experience for thoracic aortic aneurysms and compare these results with open repair. All patients who had received either open or endovascular surgery for a degenerative aortic aneurysm of the descending thoracic aorta in our center were evaluated retrospectively. N = 53 TEVAR patients (1997–2008) were included and their course was compared with an open-surgery group of n = 24 patients (1992–2002). The percentage of symptomatic patients was 43% (TEVAR) and 42% (open surgery). Endovascular treatment resulted in a significantly reduced 30-day (5.7% versus 25% P = 0.02) and one-year mortality (19% versus 42% P = 0.05) in the entire cohort. Symptomatic patients benefited the most from TEVAR (30-day mortality: 9% versus 40%, P = 0.06; one-year mortality: 27% versus 70%, P = 0.049) whereas the survival of our asymptomatic patients was not significantly different (30-day mortality: 3% versus 14%, P = 0.22; one-year mortality: 13% versus 21%, P = 0.65). Lastly, Kaplan–Meier analysis showed a significantly improved survival after TEVAR ( P = 0.05) and in particular for the symptomatic patients ( P = 0.003). In conclusion, endovascular treatment for patients with degenerative thoracic aortic aneurysms has significant advantages over open surgery.

Ascending Thoracic Aorta Exhibits Anisotropic Failure Behavior in Shear Lap Testing

2013 ◽  
Author(s):  
Colleen Witzenburg ◽  
Sachin Shah ◽  
Hallie P. Wagner ◽  
Janna Goodrich ◽  
Victor H. Barocas
Keyword(s):  
Arterial Pressure ◽  
Mechanical Behavior ◽  
Thoracic Aorta ◽  
Ascending Aorta ◽  
Aortic Aneurysms ◽  
Failure Behavior ◽  
Thoracic Aortic Aneurysms ◽  
Wall Strength ◽  
Imminent Death ◽  
Aneurysm Dissection

Aneurysm dissection and rupture, resulting in imminent death, is the primary risk associated with thoracic aortic aneurysms (TAA). Nearly 60% of TAA involves the ascending aorta [1]. Dissection and rupture occur when the remodeled tissue is no longer able to withstand the stresses generated by the arterial pressure. As the ascending TAA grows, however, changes in its mechanical behavior, particularly wall strength, are unknown.

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