Surgical Correction of Ascending Type A Thoracic Aortic Dissection: Simultaneous Endoluminal Exclusion of the Arch and Distal Aorta

2005 ◽  
Vol 12 (6) ◽  
pp. 660-666 ◽  
Author(s):  
Edward B. Diethrich ◽  
Marwan Ghazoul ◽  
Grayson H. Wheatley ◽  
Jeffrey Alpern ◽  
Julio Rodriguez-Lopez ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Type A ◽  
Surgical Correction ◽  
Thoracic Aortic Dissection

scholarly journals Altered DNA methylation pattern reveals epigenetic regulation of Hox genes in thoracic aortic dissection and serves as a biomarker in disease diagnosis

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Peiru Liu ◽  
Jing Zhang ◽  
Duo Du ◽  
Dandan Zhang ◽  
Zelin Jin ◽  
...  
Keyword(s):  
Dna Methylation ◽  
Aortic Dissection ◽  
Epigenetic Regulation ◽  
Heart Development ◽  
Type A ◽  
Methylation Pattern ◽  
Healthy Controls ◽  
Global Methylation ◽  
Thoracic Aortic Dissection

Abstract Background Thoracic aortic dissection (TAD) is a severe disease with limited understandings in its pathogenesis. Altered DNA methylation has been revealed to be involved in many diseases etiology. Few studies have examined the role of DNA methylation in the development of TAD. This study explored alterations of the DNA methylation landscape in TAD and examined the potential role of cell-free DNA (cfDNA) methylation as a biomarker in TAD diagnosis. Results Ascending aortic tissues from TAD patients (Stanford type A; n = 6) and healthy controls (n = 6) were first examined via whole-genome bisulfite sequencing (WGBS). While no obvious global methylation shift was observed, numerous differentially methylated regions (DMRs) were identified, with associated genes enriched in the areas of vasculature and heart development. We further confirmed the methylation and expression changes in homeobox (Hox) clusters with 10 independent samples using bisulfite pyrosequencing and quantitative real-time PCR (qPCR). Among these, HOXA5, HOXB6 and HOXC6 were significantly down-regulated in TAD samples relative to controls. To evaluate cfDNA methylation pattern as a biomarker in TAD diagnosis, cfDNA from TAD patients (Stanford type A; n = 7) and healthy controls (n = 4) were examined by WGBS. A prediction model was built using DMRs identified previously from aortic tissues on methylation data from cfDNA. Both high sensitivity (86%) and specificity (75%) were achieved in patient classification (AUC = 0.96). Conclusions These findings showed an altered epigenetic regulation in TAD patients. This altered epigenetic regulation and subsequent altered expression of genes associated with vasculature and heart development, such as Hox family genes, may contribute to the loss of aortic integrity and TAD pathogenesis. Additionally, the cfDNA methylation in TAD was highly disease specific, which can be used as a non-invasive biomarker for disease prediction.

Risk factors predictive of unfavorable distal aortic remodeling after surgical repair of type A thoracic aortic dissection

2020 ◽  
Vol 61 (3) ◽  
Author(s):  
Robert Rhee ◽  
Aashish Gupta ◽  
Suttatip Vechvitvarakul ◽  
Mohammed Hoque ◽  
Maryanne Ruggiero ◽  
...  
Keyword(s):  
Risk Factors ◽  
Aortic Dissection ◽  
Surgical Repair ◽  
Type A ◽  
Thoracic Aortic Dissection ◽  
Aortic Remodeling

Aortic root replacement in a patient with previous coronary artery bypass

2021 ◽  
pp. 021849232199738
Author(s):  
Juan F Parra ◽  
Eric E Vinck ◽  
Jessica N González ◽  
Hernando Santos
Keyword(s):  
Coronary Artery ◽  
Aortic Dissection ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Type A ◽  
Composite Graft ◽  
Acute Type ◽  
Thoracic Aortic Dissection ◽  
Threatening Condition ◽  
Life Threatening

Acute type A thoracic aortic dissection is a life-threatening condition that requires rapid diagnosis and prompt surgical intervention. Prior cardiac surgery is recognized as a predisposing risk factor. Here, we report a rare case and successful surgical repair of a late presenting acute type A thoracic aortic dissection four years after a three-vessel coronary artery bypass grafting. Resection of the aortic valve and aneurysmal tissue was required, reconstruction was done with a composite graft, and the native coronary ostia and aorto-saphenous buttons were preserved.

scholarly journals Hybrid Strategy for Residual Arch and Thoracic Aortic Dissection following Acute Type A Aortic Dissection Repair

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Sidharth Viswanathan ◽  
Vivek Agrawal ◽  
Shashidhar Kallappa Parameshwarappa ◽  
Ajay Savlania ◽  
Santhosh Kumar ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Circulatory Arrest ◽  
Management Strategies ◽  
False Lumen ◽  
Type A ◽  
High Morbidity ◽  
Acute Type ◽  
Hybrid Strategy ◽  
Type A Aortic Dissection ◽  
Thoracic Aortic Dissection

Progressive dilatation of the false lumen in the arch and descending aorta has been encountered in one-third of survivors as a late sequelae following repair of ascending aortic dissection. Conventional treatment for the same requiring cardiopulmonary bypass and deep hypothermic circulatory arrest is associated with high morbidity and mortality especially in the elderly cohort of patients. Herein we report a case of symptomatic progressive aneurysmal dilatation of residual arch and descending thoracic aortic dissection following repair of type A aortic dissection, successfully treated by total arch debranching and ascending aortic prosthesis to bicarotid and left subclavian bypass followed by staged retrograde aortic stent-graft deployment. This case report with relevant review of the literature highlights this clinical entity and the present evidence on its appropriate management strategies. Close surveillance is mandatory following surgical repair of type A aortic dissection and hybrid endovascular procedures seem to be the most dependable modality for salvage of patients detected to have progression of residual arch dissection.

scholarly journals A case of painless acute Type-A thoracic aortic dissection

2014 ◽  
Vol 44 (1) ◽  
pp. 171-172
Author(s):  
J. Catlow ◽  
T. Cross
Keyword(s):  
Aortic Dissection ◽  
Type A ◽  
Acute Type ◽  
Thoracic Aortic Dissection

Reoperation After Surgical Correction of Acute Type A Aortic Dissection: Risk Factor Analysis

2012 ◽  
Vol 93 (2) ◽  
pp. 450-455 ◽  
Author(s):  
Giovanni Concistrè ◽  
Giovanni Casali ◽  
Eugenio Santaniello ◽  
Andrea Montalto ◽  
Brenno Fiorani ◽  
...  
Keyword(s):  
Factor Analysis ◽  
Risk Factor ◽  
Aortic Dissection ◽  
Type A ◽  
Surgical Correction ◽  
Risk Factor Analysis ◽  
Acute Type ◽  
Type A Aortic Dissection

scholarly journals Restoration of malperfusion during repair of thoracic aortic dissection

2021 ◽  
Author(s):  
Jeffrey Shuhaiber ◽  
Volodymyr Labinskyy
Keyword(s):  
Physical Activity ◽  
Aortic Dissection ◽  
Operating Room ◽  
Lower Extremities ◽  
Type A ◽  
Contralateral Limb ◽  
Thoracic Aortic Dissection ◽  
Intense Physical Activity

A 46- year old male, during intense physical activity, sustained malperfusion of the lower extremities from Type A thoracic aortic dissection. We took him to the operating room. emergently and perfusing both lower extremities using a modified straight graft with side to side anastomosis to one limb and end to side anastomoses to the inflow perfusion and contralateral limb. The patient was successfully discharged and remained to be doing well. for four years.

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