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

Aortic Aneurysm ◽

Aortic Arch ◽

Clinical Symptoms ◽

Ascending Aorta ◽

Local Hospital ◽

Replacement Surgery ◽

Aortic Replacement ◽

Abdominal Aortic ◽

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.

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

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-021-01600-0 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Jianying Deng ◽

Wei Liu

Keyword(s):

Thoracoabdominal Aortic Replacement

Aortic Aneurysm ◽

Effective Treatment ◽

Clinical Symptoms ◽

Aortic Aneurysms ◽

Case Presentation ◽

Second Stage ◽

Aortic Replacement ◽

Abdominal Aortic ◽

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.

Current evidence and prospects for medical treatment of abdominal aortic aneurysms

VASA ◽

10.1024/0301-1526.34.4.217 ◽

2005 ◽

Vol 34 (4) ◽

pp. 217-223 ◽

Cited By ~ 11

Author(s):

Diehm ◽

Schmidli ◽

Dai-Do ◽

Baumgartner

Keyword(s):

Aortic Aneurysm ◽

Medical Treatment ◽

Endovascular Treatment ◽

Abdominal Aortic Aneurysms ◽

Aortic Aneurysms ◽

Current Evidence ◽

Significant Morbidity ◽

Abdominal Aortic ◽

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 ◽

10.1024/0301-1526/a000703 ◽

2018 ◽

Vol 47 (4) ◽

pp. 267-272 ◽

Cited By ~ 9

Author(s):

Konstanze Stoberock ◽

Tilo Kölbel ◽

Gülsen Atlihan ◽

Eike Sebastian Debus ◽

Nikolaos Tsilimparis ◽

...

Keyword(s):

Gender Differences ◽

Survival Rate ◽

Aortic Aneurysm ◽

Endovascular Treatment ◽

Aortic Aneurysms ◽

Lower Survival Rate ◽

Lower Survival ◽

Abdominal Aortic ◽

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.

Correction to: Isolated ascending aorta dilatation is associated with increased risk of abdominal aortic aneurysm

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-021-01553-4 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Enrique Gallego-Colon ◽

Chaim Yosefy ◽

Evgenia Cherniavsky ◽

Azriel Osherov ◽

Vladimir Khalameizer ◽

...

Keyword(s):

Aortic Aneurysm ◽

Ascending Aorta ◽

Abdominal Aortic ◽

Increased Risk ◽

Aorta Dilatation

Comparison of open versus endovascular surgical treatment of abdominal aortic aneurysm

Current Directions in Biomedical Engineering ◽

10.1515/cdbme-2020-3123 ◽

2020 ◽

Vol 6 (3) ◽

pp. 477-480

Author(s):

Sabine Kischkel ◽

Carsten M. Bünger

Keyword(s):

Aortic Aneurysm ◽

Treatment Options ◽

Prosthetic Graft ◽

Healthcare Research ◽

Vascular Medicine ◽

Related Complication ◽

Abdominal Aortic ◽

Open Aortic Repair ◽

AbstractAbdominal aortic aneurysm (AAA) is a common condition of increasing prevalence, particularly among older men. An AAA is defined as a permanent dilation of the abdominal aorta, with a diameter greater than 30 mm or a diameter greater than 50% of the aortic diameter at the level of the diaphragm. As the size of the aneurysm increases, so does the risk of rupture. Therefore, prophylactic repair with insertion of a prosthetic graft is offered. Since 1951 traditional open aneurysm repair (OAR) was reported and minimally invasive endovascular repair (EVAR) was first reported in 1986. Data from four randomized controlled trials (EVAR-1, DREAM, OVER, ACE) for abdominal aortic aneurysm, which enrolled almost 3000 patients, in a period from 1999 to 2008, were summarized. In addition, registry databases on the treatment of AAA of average 4000 patients per year, based from 2015 to 2018 of the German Institute for Vascular Medicine Healthcare Research of the German Society for Vascular Surgery and Vascular Medicine, were compared. The EVAR procedure for AAA showed a lower risk of perioperative mortality but was associated with a higher cardiovascular and aneurysm-related complication rate. In particular, patients aged 80 years or older benefited from EVAR since the 30-day mortality of patients receiving OAR was higher. In mid-term and long-term follow-up there were no differences in survival after endovascular and open aortic repair. Overall, it depends on the respective underlying disease and anatomy which of the two approaches is to be preferred. In conclusion, both treatment options can be considered as equal and can be offered to patients.

Isolated ascending aorta dilatation is associated with increased risk of abdominal aortic aneurysm

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-021-01488-w ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Enrique Gallego-Colon ◽

Chaim Yosefy ◽

Evgenia Cherniavsky ◽

Azriel Osherov ◽

Vladimir Khalameizer ◽

...

Keyword(s):

Aortic Aneurysm ◽

Multiple Logistic Regression Analysis ◽

Ascending Aorta ◽

Predictive Tool ◽

Computed Tomographic ◽

Hemodynamic Compromise ◽

Abdominal Aortic ◽

Imaging Results ◽

Increased Risk

Abstract Background Abdominal aortic aneurysm (AAA) is an asymptomatic condition characterized by progressive dilatation of the aorta. The purpose of this study is to identify important 2D-TTE aortic indices associated with AAA as predictive tools for undiagnosed AAA. Methods In this retrospective study, we evaluated the size of the ascending aorta in patients without known valvular diseases or hemodynamic compromise as predictive tool for undiagnosed AAA. We studied the tubular ascending aorta of 170 patients by 2-dimensional transthoracic echocardiography (2D-TTE). Patients were further divided into two groups, 70 patients with AAA and 100 patients without AAA with normal imaging results. Results Dilatation of tubular ascending aorta was measured in patients with AAA compared to the group with absent AAA (37.5 ± 4.8 mm vs. 31.2 ± 3.6 mm, p < 0.001, respectively) and confirmed by computed tomographic (CT) (35.6 ± 5.1 mm vs. 30.8 ± 3.7 mm, p < 0.001, respectively). An increase in tubular ascending aorta size was associated with the presence of AAA by both 2D-TTE and CT (r = 0.40, p < 0.001 and r = 0.37, p < 0.001, respectively). The tubular ascending aorta (D diameter) size of ≥33 mm or ≥ 19 mm/m2 presented with 2–4 times more risk of AAA presence (OR 4.68, CI 2.18–10.25, p = 0.001 or OR 2.63, CI 1.21–5.62, p = 0.02, respectively). In addition, multiple logistic regression analysis identified tubular ascending aorta (OR 1.46, p < 0.001), age (OR 1.09, p = 0.013), gender (OR 0.12, p = 0.002), and LVESD (OR 1.24, p = 0.009) as independent risk factors of AAA presence. Conclusions An increased tubular ascending aortic diameter, measured by 2D-TTE, is associated with the presence of AAA. Routine 2D-TTE screening for silent AAA by means of ascending aorta analysis, may appear useful especially in older patients with a dilated tubular ascending aorta (≥33 mm).

Challenges of applying circulating biomarkers for abdominal aortic aneurysm progression

Experimental Biology and Medicine ◽

10.1177/1535370221992530 ◽

2021 ◽

pp. 153537022199253

Author(s):

Yuan Li ◽

Dan Yang ◽

Yuehong Zheng

Keyword(s):

Aortic Aneurysm ◽

Prognostic Models ◽

Rapid Progression ◽

Circulating Biomarkers ◽

Invasive Treatment ◽

Abdominal Symptoms ◽

Abdominal Aortic ◽

Risk Of Rupture ◽

Threatening Condition

As a prevalent potentially life-threatening condition, abdominal aortic aneurysm (AAA) presents increasing risk of rupture as its diameter grows. However, rapid progression and rupture may occasionally occur in smaller AAAs. Earlier surgery for patients with high risk of disease progression may improve the outcome. Therefore, more precise indicators for invasive treatment in addition to diameter and abdominal symptoms are demanded. This systematic review aimed to identify potential circulating biomarkers that may predict growth rate of AAA. Cochrane and PubMed library were searched (until August 2020) for researches which reported circulating biomarkers associated with AAA expansion, and 25 papers were included. Twenty-eight identified biomarkers were further classified into five categories (inflammation and oxidative stress, matrix degradation, hematology and lipid metabolism, thrombosis and fibrinolysis, and others), and discussed further with their correlation and regression analysis results. Larger prospective trials are required to establish and evaluate prognostic models with highest values with these markers.

ASCENDING AORTIC ANEURYSM – A CASE REPORT

Journal Of Healthcare In Developing Countries ◽

10.26480/jhcdc.03.2021.54.55 ◽

2020 ◽

Vol 1 (3) ◽

pp. 54-55

Author(s):

Prathap Kumar. J.

Keyword(s):

Case Report ◽

Aortic Aneurysm ◽

Ascending Aorta ◽

Leg Pain ◽

Ultrasound Screening ◽

Ascending Aortic Aneurysm ◽

Risk Of Mortality ◽

Abdominal Aortic ◽

Life Threatening

An aortic aneurysm is an abnormal dilation of the aorta to greater than 1.5 times its normal size. They usually cause no symptoms except when ruptured. Occasionally, there may be symptoms like abdominal, back, or leg pain. They are most commonly located in the abdominal aorta, but can also be located in the thoracic aorta, rarely in arch of aorta. Abdominal aortic aneurysm is more common in men, a disease that is often asymptomatic and has up to a 90% risk of mortality if the aneurysm ruptures. It can be easily diagnosed by an ultrasound screening, and if the aneurysm is > 5.5 cm, it can be surgically repaired to prevent a life-threatening rupture. Aneurysm of the ascending aorta is rare but can be easily diagnosed by echocardiogram.