Search results for "Ascending"

The Endothelial Transcription Factor ERG Mediates a Differential Role in the Aneurysmatic Ascending Aorta with Bicuspid or Tricuspid Aorta Valve: A P…

2022

The pathobiology of ascending aorta aneurysms (AAA) onset and progression is not well understood and only partially characterized. AAA are also complicated in case of bicuspid aorta valve (BAV) anatomy. There is emerging evidence about the crucial role of endothelium-related pathways, which show in AAA an altered expression and function. Here, we examined the involvement of ERG-related pathways in the differential progression of disease in aortic tissues from patients having a BAV or tricuspid aorta valve (TAV) with or without AAA. Our findings identified ERG as a novel endothelial-specific regulator of TGF-β-SMAD, Notch, and NO pathways, by modulating a differential fibrotic or calcified A…

Orthotopic MAINZ pouch bladder substitution – long-term follow-up

2021

Introduction After radical cystectomy, orthotopic neobladder is one surgical strategy for urinary diversion. To assess the usefulness of an operation, long-term data are essential. We examined long-term complications and continence rates of orthotopic ileocecal (MAINZ pouch) bladder substitution. Material and methods Between 1986 and 2011, 193 patients underwent orthotopic MAINZ pouch bladder substitution. Until July 2000, ureter implantation was performed into the ascending colon through a submucosal tunnel technique (Goodwin-Hohenfellner). After July 2000, ureters were implanted into the terminal Ileum using the ileocecal valve to prevent reflux: the left spatulated ureter by an end-to-en…

Local ex-vivo evaluation of the biomechanical properties of the ascending aortic aneurysms

2019

Introduction Currently, surgical recommendations for aneurysm of the ascending aorta (AsAA) are based on the maximum diameter of the ascending aorta, but this factor is not reliable. Understanding the biomechanical properties of the aorta could lead to improve the prediction of the development of an AsAA. The aim of this study is to obtain the local patient specific elastic modulus distribution of the AsAA from a biaxial tensile test. Methods Pathologic ascending aortic tissue samples (n = 10) were obtained from patients undergoing elective surgical repair of AsAA ( Table 1 ). All the aortic wall samples were partitioned related to medial, posterior, lateral, and anterior quadrants. Each As…

Aussagefähigkeit der Abdomenübersichtsaufnahme in der Differenzierung der Rotavirus-negativen und Rotavirus-positiven nekrotisierenden Enterokolitis

1991

Clinical data and radiographic findings of 32 newborn suffering from necrotising enterocolitis were analysed [12 patients with rotavirus-positive necrotising enterocolitis (RV + NEC), 20 patients with rotavirus-negative necrotising enterocolitis (RV-NEC)]. The presence and degree of pneumatosis intestinalis, portal venous gas and pneumoperitoneum on abdominal radiographs were graded after Kosloske et al. according to "mild, moderate, and severe". Pneumatosis intestinalis occurred twice as often in the ascending colon in RV-NEC compared to RV + NEC, whereas the transverse colon was involved nearly as frequently as the descending colon in both groups. Portal venous gas was present in 10% of t…

Computational fluid dynamics of the ascending aorta before the onset of type A aortic dissection.

2016

We performed a pre-dissection computational fluid analysis of an ascending aortic aneurysm associated with unicuspid aortic valve. The analysis showed an abnormal helical flow pattern inside the aneurysm and an increased wall stress on the right postero-lateral wall of the ascending aorta. These values were largely higher than the theoretical cut-off for aortic wall dissection, their topographic distribution followed the intimal tear site as subsequently diagnosed by computed tomography scan and confirmed during the operation for dissection repair.

How to do it: direct true lumen cannulation technique of the ascending aorta in acute aortic dissection type A†

2012

In acute aortic dissection type A (AADA), direct true lumen cannulation (DTLC) of the ascending aorta is a fast and safe cannulation site providing antegrade perfusion of the supraaortic and visceral vessels. An Overholt clamp is passed around the ascending aorta to place a Mersilene tape for later securing of the arterial cannula. After draining venous blood into the cardiopulmonary bypass system (CPB), the ascending aorta is transected and the aortic lumen inspected. The true lumen is identified and an arterial cannula inserted directly. Finally, the cannula is secured with the previously placed tape and CPB is initiated. DTLC can be used as arterial cannulation standard technique in oper…

True-lumen collapse of the ascending aorta in acute type A aortic dissection

2010

Identification of abscess formation in native-valve infective endocarditis using transesophageal echocardiography: implications for surgical treatmen…

1991

The object of the study was to follow patients with endocarditis-associated abscesses in order to evaluate the clinical outcome with and without surgical intervention. Transesophageal echocardiography successfully displayed the location and extent of abscess cavities in 14 patients (group A) with aortic valve endocarditis. The infective process was limited to the perivalvular tissue in two, extended into the ascending aorta in six, and included the interventricular septum, the right ventricular outflow tract, interatrial septum, and/or mitral valve annulus in six patients. The complication rate was significantly higher in group A than in group B, which consisted of 27 patients with proven s…

A particular phenotype of ascending aorta aneurysms as precursor of type A aortic dissection.

2012

Objectives: We aimed to identify a phenotype of ascending thoracic aortic aneurysm (TAA), which, more than others, evolves into type A dissection (TAD). Methods: Aortic specimens were obtained from patients undergoing surgical repair of TAA and TAD (108 and 26, respectively). Histopathological and immunohistochemical analyses were performed by using adequate tissue specimens, appropriate techniques and criteria. Results: We identified the three following TAA phenotypes: phenotype I (cystic medial degeneration balanced by a substitutive fibrosis, in absence of medial apoptosis and with a faint collagenase concentration), phenotype II (cystic medial degeneration of higher grade, respectively,…

Survival and reinterventions after isolated proximal aortic repair in acute type A aortic dissection.

2018

OBJECTIVES Conventional treatment for acute type A dissection is the replacement of the ascending aorta. This study demonstrates the results of a conventional approach with isolated proximal repair combined with concomitant endovascular procedures. METHODS Replacement of the ascending aorta with or without an open distal anastomosis was defined as isolated proximal repair and was performed in 562/588 patients between January 2004 and June 2017. A total of 68% were DeBakey type I and 32% were DeBakey type II aortic dissections. Concomitant procedures were thoracic endovascular aortic repair (3.6%); visceral, renal and iliac stents (2%); and peripheral bypasses (1.1%). Mean follow-up was 4.6 …