Abstract 490: Quantitative and Dynamic Measurements of Aortic Wall of Acute Type-A Aortic Dissection With X-Ray Phase-Contrast Tomography

2017 ◽  
Vol 37 (suppl_1) ◽  
Author(s):  
Koki Yokawa ◽  
Takuro Tsukube ◽  
Naoto Yagi ◽  
Masato Hoshino ◽  
Yutaka Nakashima ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Phase Contrast ◽  
Aortic Wall ◽  
Tensile Force ◽  
Type A ◽  
Acute Type ◽  
Type A Aortic Dissection ◽  
X Ray ◽  
Phase Contrast Tomography ◽  
Formalin Fixed

Objectives: We previously reported excellent findings of X-ray phase-contrast tomography (PCX) for visualization of the formalin-fixed human aortic wall samples, and PCX enabled to demonstrate changes of tunica media in acute type A aortic dissection (AADA) . This study evaluates quantitative and dynamic measurements of fresh aortic wall samples of AADA with this modality. Methods: Fresh human aortic samples of the ascending aorta (n=7) were obtained during emergent aortic repair for AADA. Formalin-fixed human aortic walls of AADA (n=15) and normal aorta (n=15) were also investigated. PCX is approximately 1000 times more sensitive than absorption-contrast X-ray imaging and effective resolution of PCX is 11.7 μm. Quantitative and dynamic measurement has been developed to visualize changes in imaging of fresh aortic wall under various tensile force to simulate physiological condition, in which aortic wall is stretched according to blood pressure. Results: In normal aorta, quantitative measurement of density of the media was 1.095±0.003(g/cm3), and no different between intimal side (1.083±0.002) and adventitial side (1.085±0.003). On contrast, in formalin-fixed aorta of AADA, the medial density was 1.063±0.027, significantly lower than normal aorta (Figure-1), and different between intimal side and adventitial side (1.061±0.008 vs 1.081±0.011, respectively; p<0.005). In fresh sample of AADA, distribution of the medial density was equal to that of formalin-fixed aorta and differences of the medial density were clearly observed with elevation of tensile force of the aortic wall (Figure-1). These differences in density within tunica media were well correlated with distribution of elastic fibers and existence of cystic medial necrosis in pathological analysis. Conclusions: X-ray phase-contrast tomography was a strong modality to understand aortic structures and pathogenesis of acute type A aortic dissection.

scholarly journals A case report of aortic root repair using a pericardial autograft for type A aortic dissection

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Yi Chang ◽  
Hongwei Guo ◽  
Xiangyang Qian ◽  
Fang Fang
Keyword(s):  
Aortic Dissection ◽  
Aortic Root ◽  
Aortic Wall ◽  
Type A ◽  
Acute Type ◽  
Type A Aortic Dissection ◽  
Intimal Flap ◽  
Root Repair ◽  
Coronary Ostia

Abstract Background Acute type A aortic dissection with a dissection flap extending into the sinus segment often involves the commissures and the coronary ostia. In most cases, the intimal flap must be retained in order to restore aortic valve competence and reconstruct the coronary ostia. Residual dissection flap has the potential risks of proximal bleeding and adverse effects on long-term durability. We established a novel technique to reconstruct the aortic root using a pericardial autograft and significantly reduce remnant dissection tissues. Case presentation A 50-year-old female was admitted to our center with acute anterior chest pain and backache lasting about 10 h. Computed tomographic (CT) scans showed type A aortic dissection, with both coronary ostia being involved. Doppler echocardiography showed moderate aortic insufficiency. The dissection intimal flap was removed to the normal aorta wall near the annulus at the noncoronary sinus, leaving a 5 mm rim of intimal flap near the commissures and coronary ostia. Using a pericardial patch as a new aortic wall to reconstruct the root while preserving the aortic adventitia to fix and strengthen the new pericardial aortic wall. Ascending aorta and total arch replacement combined with frozen elephant trunk procedure was performed at the same time. The patient got an uneventful postoperative course. Conclusion Aortic root repair with a pericardial autograft is a safe and effective technique to treat acute type A dissection involving the sinus. Using this technique, residual dissection tissues could be significantly reduced, which subsequently decreases the risk of proximal bleeding and hence increases long-term durability.

Excision of the aortic wall in the surgical treatment of acute type-A aortic dissection

1990 ◽  
Vol 50 (2) ◽  
pp. 274-276 ◽  
Author(s):  
Carlo G. Massimo ◽  
Luigi F. Presenti ◽  
Piero P. Favi ◽  
Maurizio Ponzalli ◽  
Pierluigi Marranci ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Aortic Dissection ◽  
Aortic Wall ◽  
Type A ◽  
Acute Type ◽  
Type A Aortic Dissection

scholarly journals Surgical Management of Acute Type A Aortic Dissection: An Overview

2021 ◽  
pp. 263246362097804
Author(s):  
Sreedhar Reddy Nagaradona ◽  
Krishna Machiraju ◽  
Srinivasulu Reddy Kurapati ◽  
Srinivas Boggula ◽  
Sridhar Anumala Setty ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Aortic Wall ◽  
False Lumen ◽  
Type A ◽  
Ascending Aorta ◽  
Acute Type ◽  
Aortic Arch Replacement ◽  
Type A Aortic Dissection ◽  
The Past ◽  
Catastrophic Disease

Acute type A aortic dissection is a catastrophic disease that develops from a tear within the intima of the aortic wall, thereby creating a false lumen in the ascending aorta. Early suspicion, diagnosis, and prompt surgery play a key role in the survival of patients. It is a surgical emergency and requires replacement of the ascending aorta/aortic root with or without aortic arch replacement. Over the past decade the surgical outcomes have improved in specialized tertiary centers.

scholarly journals Giant bronchogenic cyst within the aortic wall mimicking symptoms of acute type A aortic dissection

2011 ◽  
Vol 141 (1) ◽  
pp. e7-e8
Author(s):  
Ömer Senbaklavaci ◽  
Lars Oliver Conzelmann ◽  
Christoph Brochhausen ◽  
Christian F. Vahl
Keyword(s):  
Aortic Dissection ◽  
Aortic Wall ◽  
Bronchogenic Cyst ◽  
Type A ◽  
Acute Type ◽  
Type A Aortic Dissection

scholarly journals A Modified Adventitial Inversion With Graft Insertion Technique in Acute Type A Aortic Dissection

2021 ◽  
Author(s):  
Wei-Tao Liang ◽  
Hong-Hua Yue ◽  
Zhong Wu
Keyword(s):  
Aortic Dissection ◽  
Aortic Root ◽  
Aortic Wall ◽  
False Lumen ◽  
Type A ◽  
Ascending Aorta ◽  
Acute Type ◽  
Insertion Technique ◽  
Type A Aortic Dissection ◽  
Anastomotic Technique

Abstract Acute type A aortic dissection may originate from a primary intimal tear located in the ascending aorta and often extends retrogradely into the aortic root. How to prevent bleeding in the aortic root and eliminate false lumen is very important in aortic dissection. We have developed a modified anastomotic technique that involves inverting adventitial and graft into aorta and reinforcing with a felt strip on the external border of the aortic wall. 45 consecutive patients had undergone this surgical procedure for aortic root reconstruction in aortic dissection, there had been no reoperations either for bleeding or remnant dissection so far.

Acute type A aortic dissection: Antegrade vs. retrograde perfusion strategy – a series of 401 consecutive cases

2013 ◽  
Vol 61 (S 01) ◽  
Author(s):  
CD Etz ◽  
JG da Rocha e Silva ◽  
K von Aspern ◽  
S Leontyev ◽  
F Girrbach ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Type A ◽  
Acute Type ◽  
Type A Aortic Dissection ◽  
Retrograde Perfusion
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