Search results for "thoracic"
showing 10 items of 511 documents
Aortic intramural hemorrhage visualized by transesophageal echocardiography: Findings and prognostic implication
1994
Abstract Objectives. This study describes the transesophageal echocardiographic and follow-up findings in patients with aortic intramural hemorrhage. Background. Localized aortic intramural hemorrhage resulting in layered thickening of the aortic wall seems to represent a variant of acute aortic dissection without communication or a typical moving intimal flap. In autopsy studies this variant, attributed to a rupture of the van vasorum, has been described in 5% to 10% of patients with dissection. Methods. In a prospective transesophageal echocardiographic study in patients with aortic dissection performed between 1986 and 1991, the diagnosis of intramural hemorrhage was established in 15 of…
Periscope endograft technique to revascularize the left subclavian artery during thoracic endovascular aortic repair.
2013
To present early and midterm results of the periscope endograft (PG) technique to maintain left subclavian artery (LSA) blood flow in thoracic endovascular aortic repairs (TEVAR) involving zone 3.From April 2010 to January 2013, 14 consecutive high-risk patients (11 men; mean age 70±8 years, range 56-87) underwent TEVAR with the PG technique for 10 thoracic aortic aneurysms (TAA), 2 traumatic aortic ruptures, and 2 aortic dissections without a suitable landing zone (2 cm distal to the LSA). Five procedures were performed emergently for rupture (3 TAAs and the 2 trauma cases). Two patients had a periscope deployed in an aberrant right subclavian artery. The periscope endografts were sized 1 …
Immunoglobulin G4-Related Aortitis and Severe Aortic Valve Stenosis Treated With Transcatheter Aortic Valve Replacement and Immunosuppression.
2021
Abstract IgG4-related disease is an immune-mediated fibro-inflammatory disorder with multisystemic involvement. Aortitis and peri-aortitis are the most common cardiovascular manifestations of the disease. We present the case of a 65-year-old man with symptomatic severe aortic stenosis and concomitant IgG4 aortitis. The diagnosis was confirmed by IgG4 serum levels, positive positron emission computed tomography (PET-CT) scans, and pathology from mediastinal dissection. Surgical aortic valve replacement (SAVR) was unfeasible owing to extensive mediastinal fibrosis, and transcatheter aortic valve replacement (TAVR) was successfully performed. As ascending aorta access for SAVR in IgG4 aortitis…
The Gore Hybrid Vascular Graft in renovisceral debranching for complex aortic aneurysm repair.
2016
Objective This study reports our initial experience with the Gore Hybrid Vascular Graft (GHVG; W. L. Gore & Associates, Flagstaff, Ariz) for staged hybrid open renovisceral debranching and endovascular aneurysm repair in patients affected by thoracoabdominal aortic aneurysms and pararenal abdominal aortic aneurysms (PAAAs). Methods Between December 2012 and December 2013, we analyzed outcomes of 13 patients who underwent open surgical debranching of renovisceral vessels for thoracoabdominal aortic aneurysm and PAAAs. All patients were considered at high risk for conventional surgery. Inclusion criterion was treatment by open surgical debranching of at least one visceral artery (renal artery…
Patency of renal and visceral vessels after open thoracoabdominal aortic replacement.
2015
Objective In thoracoabdominal aortic aneurysms (TAAAs), a paradigm shift is observed from open surgery toward total endovascular aortic repair using fenestrated and branched endografts. Whereas outcome after open replacement in terms of mortality and paraplegia has been evaluated extensively, no studies exist addressing long-term patency of visceral and renal vessels. To enable comparison of target vessel patency between open and endovascular treatment, we analyzed our series of open TAAA replacements. Methods Our vascular surgery database was screened for patients who received open TAAA replacement between 1998 and 2012, and patient records were analyzed retrospectively. All available imag…
Mechanism of the cardiovascular activity of laudanosine: comparison with papaverine and other benzylisoquinolines.
1994
1. The activity of (+/-)-laudanosine, a benzyltetrahydroisoquinoline alkaloid, was investigated in pithed rats and rat isolated aorta. Its effects on [3H]-(+)-cis-diltiazem and [3H]-nitrendipine binding to rat cerebral cortical membranes, and on the different molecular forms of cyclic nucleotide phosphodiesterases (PDE) isolated from bovine aorta were investigated. 2. The dose-response curve to methoxamine (3-300 micrograms kg-1, i.v.) in normotensive pithed rats was shifted to the right by (+/-)-laudanosine, 3 and 6 mg kg-1. 3. (+/-)-Laudanosine inhibited in a concentration-dependent manner the contractile responses evoked by noradrenaline (NA 1 microM), depolarizing solution (KCl 80 mM) o…
Actions of alpha-adrenoceptor blocking agents on two types of intracellular calcium stores mobilized by noradrenaline in rat aorta.
1993
In isolated rat aortic strips noradrenaline induces a biphasic contractile response in Ca-free medium, associated with two different intracellular calcium pools, one of which is common to caffeine. We analyzed the mechanisms involved in the depletion and repletion of both intracellular Ca pools sensitive to noradrenaline in different experimental procedures in presence of prazosin, phentolamine and yohimbine. At 37 degrees C the alpha-adrenergic blocking agents inhibited contractile responses to noradrenaline in Ca-free medium, with prazosin being highly selective. alpha 2-adrenoceptors probably do not participate in the release of Ca from internal stores, as no contractile response was obs…
Endograft repair of spontaneous infrarenal abdominal aortic dissection
2005
A 71-year-old man with a history of hypertension and a recent myocardial infarction experienced a sudden periumbilical and back pain. Abdominal tenderness was found at physical examination, with no changes in electrocardiogram and serial enzyme determinations. Computed tomographic angiography (CTA) showed a normal thoracic aorta, an infrarenal aortic dissection extending into the left common iliac artery and a contralateral iliac occlusive disease (A, Cover). Although antihypertensive therapy was administered, the patient had persistent pain; subsequently, he underwent endovascular repair with a bifurcated stent graft (Talent, Medtronic Ave, Santa Rosa, Calif) introduced via the left femora…
Haemodynamic predictors of a penetrating atherosclerotic ulcer rupture using fluid-structure interaction analysis
2013
We present preliminary data on the flow-induced haemodynamic and structural loads exerted on a penetrating atherosclerotic aortic ulcer (PAU). Specifically, one-way fluid-structure interaction analysis was performed on the aortic model reconstructed from a 66-year-old male patient with a PAU that evolved into an intramural haematoma and rupture of the thoracic aorta. The results show that elevated blood pressure (117 mmHg) and low flow velocity at the aortic wall (0.15 m/s(2)) occurred in the region of the PAU. We also found a low value of time-averaged wall shear stress (1.24 N/m(2)) and a high value of the temporal oscillation in the wall shear stress (oscillatory shear index = 0.13) in t…
Cardiac Injury in COVID-19–Echoing Prognostication∗
2020
Background Myocardial injury is frequent among patients hospitalized with coronavirus disease-2019 (COVID-19) and is associated with a poor prognosis. However, the mechanisms of myocardial injury remain unclear and prior studies have not reported cardiovascular imaging data. Objectives This study sought to characterize the echocardiographic abnormalities associated with myocardial injury and their prognostic impact in patients with COVID-19. Methods We conducted an international, multicenter cohort study including 7 hospitals in New York City and Milan of hospitalized patients with laboratory-confirmed COVID-19 who had undergone transthoracic echocardiographic (TTE) and electrocardiographic…