scholarly journals A 60-year-old woman with asymptomatic total thoracic–abdominal aortic aneurysm

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Jianying Deng ◽  
Wei Liu
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Effective Treatment ◽  
Clinical Symptoms ◽  
Aortic Aneurysms ◽  
Case Presentation ◽  
Second Stage ◽  
Aortic Replacement ◽  
Abdominal Aortic ◽  
Thoracoabdominal Aortic Replacement

Abstract Introduction Total thoracic–abdominal aortic aneurysm is a rare disease in cardiovascular surgery, with high surgical risk and high mortality. Surgery is considered the most effective treatment for total aortic aneurysms. Case presentation Our group admitted a 60-year-old female patients with asymptomatic complex total thoracic–abdominal aortic aneurysm, and successfully performed two-staged surgery, namely Bentall + Sun’s operation in the first-stage and thoracoabdominal aortic replacement in the second-stage. The results of the surgery were satisfactory. Conclusions Patients with total thoracic–abdominal aortic aneurysm may not have typical clinical symptoms and require a careful and comprehensive physical examination and related auxiliary examinations by clinicians. Staged repair of total thoracic–abdominal aortic aneurysms is still a safe and effective treatment.

scholarly journals A 60-year-old female with asymptomatic total thoracic-abdominal aortic aneurysm

2021 ◽  
Author(s):  
Jian-Ying Deng ◽  
Wei Liu
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Cardiovascular Surgery ◽  
Aortic Aneurysms ◽  
Surgical Risk ◽  
Second Stage ◽  
Staged Surgery ◽  
Aortic Replacement ◽  
Abdominal Aortic ◽  
High Surgical Risk

Total thoracic-abdominal aortic aneurysm is a rare disease in cardiovascular surgery, with high surgical risk and high mortality. Surgery is considered the most effective treatment for total aortic aneurysms. Recently, our group admitted a 60-year-old female patient with asymptomatic full thoracic-abdominal aortic aneurysm, and successfully performed staged surgery, namely Bentall + Sun’s operation in the first stage and thoraco-abdominal aortic replacement in the second stage. The results of the operation were satisfactory.

scholarly journals A 52-year-old man with asymptomatic giant thoracic-abdominal aortic aneurysm

2021 ◽  
Author(s):  
Jianying Deng ◽  
Wei Liu
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Aortic Arch ◽  
Clinical Symptoms ◽  
Ascending Aorta ◽  
Local Hospital ◽  
Replacement Surgery ◽  
Aortic Replacement ◽  
Abdominal Aortic ◽  
Risk Of Rupture

A 52-year-old man was admitted to our hospital for “CT-diagnosed thoracic-abdominal aortic aneurysm”. One week ago, the patient had repeated dry coughs and went to the local hospital for treatment. A chest radiograph revealed a huge mass in the left thoracic cavity. A further chest CT examination revealed a thoracic-abdominal aortic aneurysm and was transferred to our hospital for surgical treatment.The patient is almost healthy, with no fever, no severe chest and abdomen pain, no dyspnea, no dysphagia or other clinical symptoms. Ten years ago, the patient underwent “ascending aorta and total aortic arch replacement surgery” in another cardiovascular hospital due to aortic dissection involving the ascending aorta and aortic arch (Debakey I).The patient’s thoracic-abdominal aortic aneurysm is huge and has a high risk of rupture. Recently, the patient has undergone thoracic-abdominal aortic replacement surgery and is recovering well.

Surgical outcome in patients with concomitant-infected abdominal aortic aneurysm and spondylitis

Vascular ◽  
2011 ◽  
Vol 19 (1) ◽  
pp. 34-41 ◽  
Author(s):  
Ruoyu Zhang ◽  
Omke E Teebken ◽  
Theodosios Bisdas ◽  
Axel Haverich ◽  
Maximilian Pichlmaier
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Complex Disease ◽  
Surgical Repair ◽  
Abdominal Aortic Aneurysms ◽  
Aortic Aneurysms ◽  
Greater Omentum ◽  
Aortic Replacement ◽  
Abdominal Aortic ◽  
Vertebral Stabilization

The coexistence of infected abdominal aortic aneurysms and spondylitis is rare but challenging. The etiology of the infection is frequently unknown. The aim of this study was to review the outcome of surgical repair of this complex disease. From 2004 to 2006, six patients were identified who underwent surgical repair of concomitant infected abdominal aortic aneurysm and spondylitis. Diagnosis, treatment and intermediate-term results are presented. The clinical manifestation included the signs of ongoing systemic infection, neurological deficit and abdominal or back pain. Computed tomography revealed abdominal aortic aneurysms associated with polysegmental spondylitis. Patients underwent radical debridement and aortic replacement with cryopreserved aortic allografts or silver-coated prostheses followed by antibiotic treatment. Only one patient received a simultaneous anterior vertebral stabilization. Greater omentum was placed in the abscess cavity. Intensive care unit and hospital stay averaged 3.0 and 28.0 days, respectively. Organisms were identified in all but one patient. Over a follow-up period of 4.4 years, four patients are alive and showing freedom from infection, and two patients had died unrelated at seven and eight months. In conclusion, surgical repair of infected aortic aneurysms with resection of infected tissues and implantation of a homograft or a silver-coated prosthesis achieved favorable results in this sick patient group. Simultaneous vertebral stabilization is rarely necessary.

Current evidence and prospects for medical treatment of abdominal aortic aneurysms

VASA ◽  
2005 ◽  
Vol 34 (4) ◽  
pp. 217-223 ◽  
Author(s):  
Diehm ◽  
Schmidli ◽  
Dai-Do ◽  
Baumgartner
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Medical Treatment ◽  
Endovascular Treatment ◽  
Abdominal Aortic Aneurysms ◽  
Aortic Aneurysms ◽  
Current Evidence ◽  
Significant Morbidity ◽  
Abdominal Aortic ◽  
Risk Of Rupture

Abdominal aortic aneurysm (AAA) is a potentially fatal condition with risk of rupture increasing as maximum AAA diameter increases. It is agreed upon that open surgical or endovascular treatment is indicated if maximum AAA diameter exceeds 5 to 5.5cm. Continuing aneurysmal degeneration of aortoiliac arteries accounts for significant morbidity, especially in patients undergoing endovascular AAA repair. Purpose of this review is to give an overview of the current evidence of medical treatment of AAA and describe prospects of potential pharmacological approaches towards prevention of aneurysmal degeneration of small AAAs and to highlight possible adjunctive medical treatment approaches after open surgical or endovascular AAA therapy.

Gender differences in abdominal aortic aneurysm therapy – a systematic review

VASA ◽  
2018 ◽  
Vol 47 (4) ◽  
pp. 267-272 ◽  
Author(s):  
Konstanze Stoberock ◽  
Tilo Kölbel ◽  
Gülsen Atlihan ◽  
Eike Sebastian Debus ◽  
Nikolaos Tsilimparis ◽  
...  
Keyword(s):  
Gender Differences ◽  
Abdominal Aortic Aneurysm ◽  
Survival Rate ◽  
Aortic Aneurysm ◽  
Endovascular Treatment ◽  
Aortic Aneurysms ◽  
Lower Survival Rate ◽  
Lower Survival ◽  
Abdominal Aortic ◽  
Risk Of Rupture

Abstract. This article analyses if and to what extent gender differences exist in abdominal aortic aneurysm (AAA) therapy. For this purpose Medline (PubMed) was searched from January 1999 to January 2018. Keywords were: “abdominal aortic aneurysm”, “gender”, “prevalence”, “EVAR”, and “open surgery of abdominal aortic aneurysm”. Regardless of open or endovascular treatment of abdominal aortic aneurysms, women have a higher rate of complications and longer hospitalizations compared to men. The majority of studies showed that women have a lower survival rate for surgical and endovascular treatment of abdominal aneurysms after both elective and emergency interventions. Women receive less surgical/interventional and protective medical treatment. Women seem to have a higher risk of rupture, a lower survival rate in AAA, and a higher rate of complications, regardless of endovascular or open treatment. The gender differences may be due to a higher age of women at diagnosis and therapy associated with higher comorbidity, but also because of genetic, hormonal, anatomical, biological, and socio-cultural differences. Strategies for treatment in female patients must be further defined to optimize outcome.

scholarly journals A Case Report on the Successful Treatment ofStreptococcus pneumoniae-Induced Infectious Abdominal Aortic Aneurysm Initially Presenting with Meningitis

2015 ◽  
Vol 2015 ◽  
pp. 1-6
Author(s):  
Yohei Kawatani ◽  
Yoshitsugu Nakamura ◽  
Yujiro Hayashi ◽  
Tetsuyoshi Taneichi ◽  
Yujiro Ito ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Abdominal Aortic Aneurysm ◽  
Back Pain ◽  
Streptococcus Pneumoniae ◽  
Aortic Aneurysm ◽  
Successful Treatment ◽  
Abdominal Aortic Aneurysms ◽  
Aortic Aneurysms ◽  
Limb Weakness ◽  
Abdominal Aortic

Infectious abdominal aortic aneurysms often present with abdominal and lower back pain, but prolonged fever may be the only symptom. Infectious abdominal aortic aneurysms initially presenting with meningitis are extremely rare; there are no reports of their successful treatment. Cases withStreptococcus pneumoniaeas the causative bacteria are even rarer with a higher mortality rate than those caused by other bacteria. We present the case of a 65-year-old man with lower limb weakness and back pain. Examination revealed fever and neck stiffness. Cerebrospinal fluid showed leukocytosis and low glucose levels. The patient was diagnosed with meningitis and bacteremia caused byStreptococcus pneumoniaeand treated with antibiotics. Fever, inflammatory response, and neurologic findings showed improvement. However, abdominal computed tomography revealed an aneurysm not present on admission. Antibiotics were continued, and a rifampicin soaked artificial vascular graft was implanted. Tissue cultures showed no bacteria, and histological findings indicated inflammation with high leukocyte levels. There were no postoperative complications or neurologic abnormalities. Physical examination, blood tests, and computed tomography confirmed there was no relapse over the following 13 months. This is the first reported case of survival of a patient with an infectious abdominal aortic aneurysm initially presenting with meningitis caused byStreptococcus pneumoniae.

scholarly journals Endovascular repair of aortic aneurysm: Preliminary results

2009 ◽  
Vol 137 (1-2) ◽  
pp. 10-17 ◽  
Author(s):  
Lazar Davidovic ◽  
Momcilo Colic ◽  
Igor Koncar ◽  
Dejan Markovic ◽  
Dusan Kostic ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Stent Graft ◽  
Endovascular Aneurysm Repair ◽  
Aortic Aneurysms ◽  
Endovascular Stent ◽  
Stent Grafts ◽  
Graft Thrombosis ◽  
Abdominal Aortic

Introduction. Endovascular aneurysm repair (EVAR) has been introduced into clinical practice at the beginning of the 90's of the last century. Because of economic, political and social problems during the last 25 years, the introduction of this procedure in Serbia was not possible. Objective. The aim of this study was to present preliminary experiences and results of the Clinic for Vascular Surgery of the Serbian Clinical Centre in Belgrade in endovascular treatment of thoracic and abdominal aortic aneurysms. Methods. The procedure was performed in 33 patients (3 female and 30 male), aged from 42 to 83 years. Ten patients had a descending thoracic aorta aneurysm (three atherosclerotic, four traumatic - three chronic and one acute as a part of polytrauma, one dissected, two penetrated atherosclerotic ulcers), while 23 patients had the abdominal aortic aneurysm, one ruptured and two isolated iliac artery aneurysms. The indications for EVAR were isthmic aneurismal localisation, aged over 80 years and associated comorbidity (cardiac, pulmonary and cerebrovasular diseases, previous thoracotomy or multiple laparotomies associated with abdominal infection, idiopatic thrombocitopaenia). All of these patients had three or more risk factors. The diagnosis was established using duplex ultrasonography, angiography and MSCT. In the case of thoracic aneurysm, a Medtronic-Valiant? endovascular stent graft was implanted, while for the abdominal aortic aneurysm Medtronic-Talent? endovascular stent grafts with delivery systems were used. In three patients, following EVAR a surgical repair of the femoral artery aneurysm was performed, and in another three patients femoro-femoral cross over bypass followed implantation of aortouniiliac stent graft. Results. During procedure and follow-up period (mean 1.6 years), there were: one death, one conversion, one endoleak type 1, six patients with endoleak type 2 that disappeared during the follow-up period, one early graft thrombosis. No other complications, including aneurysm expansion, collapse, deformity and migration of the endovascular stent grafts, were registered. Conclusion. According to all medical and economic aspects, we recommend EVAR to treat acute traumatic thoracic aortic aneurysm, as well as in elderly and high-risk patients with abdominal or thoracic aneurysms, when open surgery is related to a significantly higher mortality and morbidity.

Abstract 486: The Effects of Weekend Admission on the Outcomes and Management of Ruptured Aortic Aneurysms

2014 ◽  
Vol 34 (suppl_1) ◽  
Author(s):  
Elliott M Groves ◽  
Mahdi Khoshchehreh ◽  
Christine Le ◽  
Shaista Malik
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Surgical Intervention ◽  
Surgical Care ◽  
Aortic Aneurysms ◽  
High Rate ◽  
Ruptured Aortic Aneurysm ◽  
Primary Endpoints ◽  
Abdominal Aortic ◽  
Thoracic And Abdominal

The Effects of Weekend Admission on the Outcomes and Management of Ruptured Aortic Aneurysms Objective: Ruptured aortic aneurysm is a condition with a high rate of mortality that requires prompt surgical intervention. It has been noted that in some conditions requiting such prompt intervention, in-hospital mortality is increased in patients admitted on the weekends as compared to patients admitted on weekdays. We sought to determine if this was indeed the case for both ruptured thoracic and abdominal aortic aneurysm and elucidate the possible reasons. Methods: Using the Nationwide Inpatient Sample (NIS), a publicly available database of inpatient care, we analyzed the incidence of mortality among patients admitted on the weekends compared to weekdays for ruptured aortic aneurysm. Ultimately the care of over 7,000 patients was analyzed for the primary endpoints. We adjusted for demographics, comorbid conditions, hospital characteristics, rates of surgical intervention, timing of surgical intervention and use of additional therapeutic measures. Results: Patients admitted on the weekend for both ruptured thoracic and abdominal aortic aneurysm had a statistically significant increase in mortality as compared to those admitted on the weekdays (OR 2.55 for Thoracic and 1.32 for Abdominal). By our analysis this is likely due to a delay in surgical care on the weekends. Conclusions: Weekend admission for ruptured aortic aneurysm is associated with an increased mortality when compared to those admitted on the weekend and this is likely due to several factors with the most predominant being a delay in surgical intervention.

Abstract 667: The Role of Aortic Wall-Nuclear Factor- kappa B (NF-kB) Signaling in Formation of Dissecting Aortic Aneurysms

2015 ◽  
Vol 35 (suppl_1) ◽  
Author(s):  
Talha Ijaz ◽  
Hong Sun ◽  
Adrian Recinos ◽  
Ronald G Tilton ◽  
Allan R Brasier
Keyword(s):  
Flow Cytometry ◽  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Aortic Wall ◽  
Aortic Rupture ◽  
Aortic Aneurysms ◽  
Tunel Staining ◽  
Abdominal Aortic ◽  
Significant Difference

Introduction: Abdominal aortic aneurysm is a devastating disease since it can lead to aortic rupture and instantaneous death. We previously demonstrated that IL-6 secreted from the aortic wall is necessary for the development of abdominal aortic aneurysm and dissection (AAD). Since IL-6 is a NF-kB/RelA dependant gene, we investigated the role of aortic wall- NF-kB/RelA signaling in the development of AAD. Methods and Results: To test the role of aortic wall-RelA, we utilized Cre-Lox technology to delete RelA from aortic cells. Tamoxifen-inducible, Col1a2-promoter driven Cre mice (Col1a2-Cre) were crossed with mT/mG Cre-reporter mice to determine which aortic cells undergo genetic recombination after Cre activation. Flow cytometry analysis of the aortic wall indicated that 88% of the genetically recombined cells were SMCs and 8% were fibroblasts. Next, RelA floxed (RelA f/f) mice, generated in our lab, were crossed with Col1a2-Cre mice. RelA f/f Cre+ and RelA f/f Cre- were stimulated with tamoxifen for 10 days to generate aortic-RelA deficient (Ao-RelA-/-) or wild-type (Ao-RelA+/+) transgenics. Flow cytometry, qRT-PCR, and immunohistochemistry analysis suggested a depletion of aortic-RelA greater than 60%. To test the role of Ao-RelA in AAD, Ao-RelA -/- (n= 20) and Ao-RelA +/+ (n=14) mice were infused with angiotensin II for 7 days. Surprisingly, 20% of Ao-RelA-/- mice died from development of AAD and aortic rupture while no deaths were observed in Ao-RelA+/+ group. In addition, 40% of Ao-RelA-/- mice developed AAD compared to 14% of Ao-RelA+/+ mice. There was no significant difference in TUNEL staining or ERTR7+ fibroblast population between the two groups. Conclusion: Our studies suggest that aortic wall-RelA may be necessary for protection from AAD.

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