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3.
Arch. cardiol. Méx ; 90(4): 520-528, Oct.-Dec. 2020. graf
Article in Spanish | LILACS | ID: biblio-1152828

ABSTRACT

Resumen La válvula aórtica bicúspide es la cardiopatía congénita más frecuente en la población general. Lejos de ser solo una malformación valvular inocua, supone una enfermedad compleja y heterogénea. A menudo es identificada como un hallazgo incidental en personas sanas, cursando de manera asintomática. Sin embargo, en un alto porcentaje de pacientes conduce a lo largo de su vida a complicaciones valvulares (estenosis, insuficiencia, endocarditis) o aórticas (dilatación o disección). Con frecuencia estas manifestaciones suceden a una edad temprana y causan una elevada morbimortalidad. A pesar de que en los últimos años se ha producido una intensa investigación en este campo, la fisiopatogenia de la enfermedad no es del todo conocida y muchas preguntas siguen abiertas. En este artículo se revisan de forma actualizada los aspectos clínicos y fisiopatológicos más novedosos y relevantes sobre esta cardiopatía congénita.


Abstract The most common congenital heart disease in the general population is the bicuspid aortic valve. Far from being just a harmless valve malformation, it is a complex and heterogeneous disease. It is often identified as an incidental finding in healthy people. However, in a high percentage of patients it leads throughout their life towards valvular (stenosis, insufficiency, endocarditis) or aortic (dilatation or dissection) complications. Frequently, manifestations occur at an early age, being responsible for high morbidity and mortality. Even though in recent years intense research has been carried out in this field, the pathophysiogenesis of the disease is not fully known and many questions remain open. In this article, we review the most innovative and relevant clinical and pathophysiological aspects of this congenital heart disease.


Subject(s)
Humans , Bicuspid Aortic Valve Disease/physiopathology , Aortic Diseases/etiology , Aortic Diseases/physiopathology , Aortic Diseases/epidemiology , Bicuspid Aortic Valve Disease/complications , Bicuspid Aortic Valve Disease/diagnosis , Heart Valve Diseases/etiology , Heart Valve Diseases/physiopathology , Heart Valve Diseases/epidemiology
4.
Rev. bras. cir. cardiovasc ; 35(6): 977-985, Nov.-Dec. 2020. tab, graf
Article in English | SES-SP, LILACS, SES-SP | ID: biblio-1144002

ABSTRACT

Abstract Objective: To review the currently available literature to define the role of thoracic endovascular aortic repair (TEVAR) in patients with connective tissue disorders (CTD). Methods: A comprehensive electronic database search was performed in PubMed, SCOPUS, Embase, Google scholar, and OVID to identify all the articles that reported on outcomes of utilizing TEVAR in patients with CTD during elective and emergency settings. The search was not limited to time or language of the published study. Results: All the relevant studies have been summarized in its correspondence section. The outcomes were analyzed in narrative format. The role of TEVAR has been elaborated as per each study. Currently, there is limited large cohort size studies outlining the use of TEVAR in patients with CTD. The use of endovascular repair in patients with CTD is limited due to progressive aortic dilatations and high possibility of further reinterventions at later stage of life. Conclusion: Open repair remains the gold standard method of intervention in young patients with progressive CTD, especially in the setting of acute type A aortic dissection. However, TEVAR can be sought as a reliable alternative in emergency setting of diseases involving the descending thoracic aorta; yet the long-term data needs to be published to support such practice.


Subject(s)
Humans , Aortic Diseases/surgery , Blood Vessel Prosthesis Implantation , Endovascular Procedures , Aorta, Thoracic/surgery , Postoperative Complications/surgery , Retrospective Studies , Risk Factors , Treatment Outcome , Aortic Aneurysm, Thoracic/surgery , Connective Tissue
5.
Rev. cir. (Impr.) ; 72(1): 59-63, feb. 2020. ilus
Article in Spanish | LILACS | ID: biblio-1092891

ABSTRACT

Resumen Introducción Las fístulas aorto-entéricas (FAE) son una causa infrecuente de hemorragia digestiva. El pronóstico, generalmente ominoso, depende de una alta sospecha clínica y diagnóstico oportuno. Caso clínico Reportamos el caso de una mujer de 66 años intervenida por un aneurisma sacular aórtico abdominal (AAA) yuxtarrenal, con rotura contenida, fistulizado al duodeno. Presentó una hemorragia digestiva en el preoperatorio; sin embargo, el diagnóstico de la fístula se hizo en el intraoperatorio. La paciente fue sometida a reparación quirúrgica urgente con instalación de una prótesis aórtica bifemoral y resección duodenal. En el postoperatorio inmediato presentó una trombosis parcial de las ramas de la prótesis aórtica e isquemia de extremidades, siendo reintervenida exitosamente. Discusión La FAE es una causa potencialmente fatal de hemorragia digestiva. El diagnóstico continúa siendo un desafío debido a su presentación inespecífica y siempre debiese ser considerado frente a una hemorragia digestiva sin causa aparente. Existen varias opciones para el enfrentamiento quirúrgico que deben ser analizadas caso a caso, sin retrasar la reparación de la fístula. Es preferible la resección duodenal ante la simple duodenorrafia.


Introduction Aorto-enteric fistulae (AEF) are a rare cause of gastrointestinal bleeding. The prognosis tends to be ominous, depending greatly in a high level of clinical suspicion and prompt diagnosis. Clinical case We report a case of a 66-year-old female with a saccular juxta-renal abdominal aortic aneurysm (AAA), with a contained rupture. The patient was urgently submitted to surgical repair using an bifemoral aortic prosthesis. A duodenal partial resection was performed. During the immediate postoperative time she presented partial thrombosis of prosthesis and ischemia of lower extremities so she was reoperated successfully. Discussion AEF is a potentially fatal cause of gastrointestinal bleeding. Diagnosis is still troublesome due to its vague presentation and it should always be considered when facing gastrointestinal haemorrhage with no apparent cause. There are several surgical approaches that should be pondered case to case without delaying the repair of the defect.


Subject(s)
Humans , Female , Aged , Aortic Diseases/complications , Intestinal Fistula/surgery , Intestinal Fistula/complications , Duodenal Diseases/complications , Gastrointestinal Hemorrhage/surgery , Intestinal Fistula/diagnosis , Treatment Outcome , Aortic Aneurysm, Abdominal/surgery , Aortic Aneurysm, Abdominal/complications , Blood Vessel Prosthesis Implantation/methods , Perioperative Period , Gastrointestinal Hemorrhage/diagnosis
6.
Int. j. morphol ; 38(1): 215-221, Feb. 2020. graf
Article in English | LILACS | ID: biblio-1056424

ABSTRACT

The potential inhibitory effect of the insulin mimicking agent, vanadium on type 2 diabetes mellitus (T2DM)induced alterations to the aorta ultrastructure associated with the suppression of dyslipedima and biomarkers of inflammation has not been investigated before. Therefore, we tested whether vanadium can protect against aortic injury induced secondary to T2DM possibly via the inhibition of blood lipid and inflammatory biomarkers. T2DM was induced in rats by a high-fat diet and streptozotocin (50 mg/ kg), and the treatment group started vanadium treatment five days post diabetic induction and continued until being sacrificed at week 10. Using light and electron microscopy examinations, we observed in the model group substantial damage to the aorta tissue such as damaged endothelium, degenerative cellular changes with vacuolated cytoplasm and thickened internal elastic lamina that were substantially ameliorated by vanadium. Administration of vanadium to diabetic rats also significantly (p<0.05) reduced blood levels of glucose, hyperlipidemia and biomarkers of inflammation (TNF-a, IL-6). We conclude that vanadium protects against T2DM-induced aortic ultrastructural damage in rats, which is associated with the inhibition of blood sugar and lipid and inflammatory biomarkers.


El potencial efecto inhibidor del agente imitador de la insulina, el vanadio en las alteraciones inducidas por la diabetes mellitus tipo 2 (DM2) en la ultraestructura de la aorta, asociada con la supresión de dislipidemia y los biomarcadores de inflamación no se ha investigado anteriormente. El objetivo fue estudiar las propiedades del vanadio para proteger contra la lesión aórtica inducida a la DM2, a través de la inhibición de los lípidos sanguíneos y los biomarcadores inflamatorios. La DM2 fue inducida en ratas con una dieta alta en grasas y estreptozotocina (50 mg / kg), y el grupo de tratamiento fue sometido a un régimen continuo con vanadio, cinco días después de la inducción diabética hasta ser sacrificadas en la semana 10. Se utilizaron exámenes de luz y microscopía electrónica en el grupo modelo y se observó un daño sustancial al tejido de la aorta, como también en el endotelio; los cambios celulares degenerativos con citoplasma vacuolado y lámina elástica interna engrosada mejoró sustancialmente con vanadio. La administración de vanadio a ratas diabéticas también redujo significativamente (p <0,05) los niveles sanguíneos de la glucosa, hiperlipidemia y los biomarcadores de inflamación (TNFa, IL-6). En conclusión, el vanadio protege contra el daño ultraestructural aórtico inducido por T2DM en ratas, que es asociado con la inhibición del azúcar en la sangre y los biomarcadores de lípidos y de inflamatorios.


Subject(s)
Animals , Male , Rats , Aorta/drug effects , Vanadium/administration & dosage , Diabetes Mellitus, Type 2/complications , Aorta/injuries , Aorta/ultrastructure , Aortic Diseases/etiology , Vanadium/pharmacology , Rats, Sprague-Dawley , Microscopy, Electron, Transmission , Disease Models, Animal , Dyslipidemias/drug therapy , Inflammation/drug therapy
7.
Arq. bras. cardiol ; 114(1): 109-117, Jan. 2020. tab, graf
Article in English | LILACS | ID: biblio-1055081

ABSTRACT

Abstract Background: Non-dipper blood pressure (NDBP) is one of the important causes of hypertension-related target organ damage and future cardiovascular events. Currently, there is no practical tool to predict NDBP pattern. Objectives: The aim of this study was to investigate the relationship between aortic arch calcification (AAC) on chest radiography and NDBP pattern. Methods: All patients referred for ambulatory BP monitoring test were approached for the study participation. NDBP was defined as the reduction of ≤10% in nighttime systolic BP as compared to the daytime values. AAC was evaluated with chest radiography and inter-observer agreement was analyzed by using kappa statistics. Univariate and multivariate logistic regression analysis was conducted to assess the association of AAC and NDBP pattern. A 2-tailed p-value < 0.05 was considered statistically significant. Results: A total of 406 patients (median age: 51.3) were included. Of these, 261(64%) had NDBP pattern. Overall, the prevalence of AAC was 230 (57%). Non-dipper group had significantly higher prevalence of AAC (70% vs. 33%, p < 0.0001) as compared to the dipper group. Presence of AAC was a strong and independent predictor of NDBP pattern (OR 3.919, 95%CI 2.39 to 6.42) in multivariate analysis. Conclusions: Presence of AAC on plain chest radiography is strongly and independently associated with the presence of NDBP pattern.


Resumo Fundamento: A pressão arterial não-dipper é uma das causas mais importantes de lesão de órgão-alvo da hipertensão e de eventos cardiovasculares futuros. Atualmente, não há uma ferramenta prática para prever o padrão não-dipper de pressão arterial. Objetivos: O objetivo deste estudo foi investigar a relação entre a calcificação no arco aórtico detectada no raio de tórax e o padrão não-dipper de pressão arterial. Métodos: Todos os pacientes encaminhados para monitorização ambulatorial da pressão arterial foram abordados para participação no estudo. A pressão arterial não-dipper foi definida como a redução de ≤10% da pressão arterial sistólica noturna quando comparada com os valores diários. A calcificação no arco aórtico foi avaliada através de radiografia do tórax e a concordância interobservador foi analisada utilizando a estatística kappa. Análises de regressão logística uni e multivariada foram realizadas para avaliar a associação entre a calcificação no AA e o padrão PADV. Valores de p bicaudais < 0,05 foram considerados estatisticamente significativos. Resultados: Ao todo, 406 pacientes (idade mediana: 51,3) foram incluídos. Desses, 261(64%) apresentavam padrão não-dipper de pressão arterial. De modo geral, a prevalência de calcificação no arco aórtico foi de 230 (57%). O grupo não-dipper apresentou prevalência significativamente maior de calcificação no arco aórtico (70% vs. 33%, p < 0,0001) em relação ao grupo dipper. A presença de calcificação no arco aórtico foi um preditor forte e independente de padrão não-dipper de pressão arterial (OR = 3,919; IC: 95% 2,39-6,42) em análise multivariada. Conclusões: A presença de calcificação no arco aórtico em raio-x de tórax simples está forte e independentemente associada à presença de padrão não-dipper de pressão arterial.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aortic Diseases/diagnostic imaging , Blood Pressure/physiology , Vascular Calcification/diagnostic imaging , Aortic Diseases/physiopathology , Severity of Illness Index , Radiography, Thoracic , Risk Factors , Circadian Rhythm , Blood Pressure Monitoring, Ambulatory , Vascular Calcification/physiopathology
9.
MedUNAB ; 23(2): 301-306, 22-07-2020.
Article in Spanish | LILACS | ID: biblio-1118424

ABSTRACT

Introducción. El síndrome de Leriche fue definido en 1940 por René Leriche como una enfermedad oclusiva aorto-ilíaca. Su importancia radica en que ocupa el segundo lugar en incidencia dentro de las enfermedades oclusivas arteriales, después de la enfermedad de la arteria femoral superficial. Objetivo. Presentar el caso clínico de un paciente con Síndrome de Leriche cuyo diagnóstico trombótico fue confirmado por una angiotomografía computarizada con su respectiva reestructuración en 3D. Adicionalmente, se informa al lector sobre los datos propios de la patología a través de una breve revisión de la literatura. Caso clínico. Paciente masculino con síntomas clínicos agudos de enfermedad oclusiva aorto-ilíaca o síndrome de Leriche en una extremidad. Se realiza el respectivo procesamiento de imagen asistida por computador (reconstrucción tridimensional) que evidencia la patología a pesar de que la ecografía Doppler no determinó trombosis inicial. Discusión. En procesos oclusivos arteriales se emplean técnicas no invasivas como la ecografía y la angiotomografía. Sin embargo, esta última es la técnica por excelencia, sobre todo para procesos trombóticos, pues agiliza la anticoagulación, así como el abordaje terapéutico. Conclusiones. La angiotomografía es una técnica no invasiva con alta sensibilidad y especificidad para detectar estenosis aorto-ilíaca. Se ha convertido en una gran herramienta diagnostica por sus alcances imagenológicos, como la obtención de imágenes iso volumétricas, que permiten evaluar todo el trayecto arterial en los diferentes planos, por medio del uso de medios de contraste, superando en resultados a la ecografía. Cómo citar: Picón-Jaimes YA, Díaz-Jurado JJ, Orozco-Chinome JE, Ramírez-Rodríguez PA, Arciniegas-Torres NA, Hernández-Sarmiento MA, Villabona-Rosales SA. Angiotomografía en sospecha de enfermedad oclusiva aorto-ilíaca (o síndrome de Leriche). MedUNAB. 2020;23(2): 301-306. doi: 10.29375/01237047.3732.


Introduction. Leriche syndrome was defined in 1940 by René Leriche as an aortoiliac occlusive disease. Its importance lies in it occupying second place in the incidence of occlusive arterial diseases, after superficial femoral artery disease. Objective. Present the clinical case of a patient with Leriche syndrome whose diagnosis of thrombosis was confirmed by a computed tomography angiography with its respective 3D reconstruction. Additionally, the reader is given information about the pathology through a brief summary of the literature. Clinical case. Male patient with acute clinical symptoms of aortoiliac occlusive disease or Leriche syndrome in one limb. The respective computer-assisted image processing (three-dimensional reconstruction) is carried out, which shows the pathology, despite the Doppler ultrasound not initially establishing thrombosis. Discussion. Non-invasive techniques are used in procedures for occlusive arteries, such as ultrasound and CT angiography. However, the latter is a technique par excellence, above all for thrombosis procedures, as well as the therapeutic approach. Conclusions. CT angiography is a non-invasive technique with high sensitivity and specificity in the detection of aortoiliac stenosis. It has become a great diagnostic tool because of its imagery scope, such as obtaining isovolumic images, which enable the assessment of the entire arterial route in different planes, through the use of contrast media, producing more results than the ultrasound. Cómo citar: Picón-Jaimes YA, Díaz-Jurado JJ, Orozco-Chinome JE, Ramírez-Rodríguez PA, Arciniegas-Torres NA, Hernández-Sarmiento MA, Villabona-Rosales SA. Angiotomografía en sospecha de enfermedad oclusiva aorto-ilíaca (o síndrome de Leriche). MedUNAB. 2020;23(2): 301-306. doi: 10.29375/01237047.3732.


Introdução. A síndrome de Leriche foi definida em 1940 por René Leriche como uma doença oclusiva aorto-ilíaca. Sua importância reside no fato de ocupar o segundo lugar em incidência dentro das doenças arteriais obstrutivas, após a doença na artéria femoral superficial. Objetivo. Apresentar o caso clínico de um paciente com síndrome de Leriche cujo diagnóstico trombótico foi confirmado por uma angiotomografia computadorizada (angio-TC) com reestruturação em 3D. Adicionalmente, o leitor é informado sobre os dados próprios da patologia através de uma breve revisão de literatura. Caso clínico. Paciente de sexo masculino com sintomas clínicos agudos da doença oclusiva aorto-ilíaca ou síndrome de Leriche em uma extremidade. Foi realizado o processamento da imagem assistida por computador (reconstrução tridimensional), evidenciando a patologia, ainda que a ultrassonografia Doppler não determinou trombose inicial. Discussão. Em processos oclusivos arteriais são utilizadas técnicas não invasivas como a ultrassonografia e a angiotomografia. No entanto, a angiotomografia é a técnica padrão ouro, principalmente para processos trombóticos, pois acelera a anticoagulação e a abordagem terapêutica. Conclusão. A angiotomografia é uma técnica não invasiva com alta sensibilidade e especificidade para detectar estenose aorto-ilíaca. Tornou-se uma ótima ferramenta de diagnóstico por suas características imagenológicas, como a obtenção de imagens isovolumétricas que permitem avaliar todo o trajeto arterial nos diferentes planos, através do uso de meios de contraste, superando os resultados da ultrassonografia. Cómo citar: Picón-Jaimes YA, Díaz-Jurado JJ, Orozco-Chinome JE, Ramírez-Rodríguez PA, Arciniegas-Torres NA, Hernández-Sarmiento MA, Villabona-Rosales SA. Angiotomografía en sospecha de enfermedad oclusiva aorto-ilíaca (o síndrome de Leriche). MedUNAB. 2020;23(2): 301-306. doi: 10.29375/01237047.3732.


Subject(s)
Leriche Syndrome , Aorta, Abdominal , Aortic Diseases , Iliac Artery , Intermittent Claudication
10.
Article in Chinese | WPRIM | ID: wpr-880781

ABSTRACT

OBJECTIVE@#To explore genetic mutation types and their correlation with clinical phenotypes in Uighur patients with aortic disease in Kashgar (Xinjiang Uighur Autonomous Region, China).@*METHODS@#We examined 37 pathogenic genes in 19 Uighur families with aortic diseases including Marfan syndrome from Kashgar using next generation sequencing, and the results were confirmed by Sanger sequence in the first relatives.@*RESULTS@#This study included 19 families with aortic diseases, in whom a total of 23 variants were identified, and 11 (57.89%) probands had one or more variants. Among them, definite pathogenic mutation was detected in one patient (5.26%), variants of uncertain significance (VUS) were found in 8 (42.11%), and benign/likely benign variants were detected in 7 (36.84%). The 23 variants identified included one (5.26%) pathogenic variant, 14 (60.87%) VUS, and 8 (34.78%) benign/likely benign variants. The 14 VUS were analyzed by prediction with SIFT and Polyphen2 HDIV, which identified 6 (42.86%) variants as deleterious/possibly damaging; all the 8 benign/likely benign variants were predicted to be deleterious/possibly damaging.@*CONCLUSIONS@#We detected 23 genetic variants in the 19 Uighur families with aortic diseases, and 22 of these variants remain to be verified by more patient data in future studies.


Subject(s)
Aortic Diseases , China , Genetic Predisposition to Disease/genetics , High-Throughput Nucleotide Sequencing , Humans , Mutation , Phenotype
11.
Rev. chil. cardiol ; 38(3): 210-212, dic. 2019. ilus
Article in Spanish | LILACS | ID: biblio-1058065

ABSTRACT

ABSTRACT: Bicuspid aortic valve (BAV) disease is generally associated with thoracic aortic dilatation (TAD). Related factors include; genetical, morphological (valvular phenotype) and most recently, hemodynamic profiles associated with flow pattern and wall shear stress. Cardiac magnetic resonance 4D Flow (4DF) can give an integral evaluation of these later flow variables. Remarkable, different spectrums of flow and vortex direction exist in BAV that are related to the site of TAD (proximal or distal). Therefore, we present a 57 years old patient with BAV (Sievers 0) with anteroposterior leaflets distribution in which 4DF depicted an anteriorly and righthand oriented jet that correlated with the zone of grater AD; also, vortex rotation was counterclockwise, corresponding to the most frequent vortex type in BAV. In conclusion, 4DF is a powerful and ground-breaking tool that enhances our knowledge of BAV related aortopathy.


Subject(s)
Magnetic Resonance Imaging, Cine/methods , Bicuspid Aortic Valve Disease , Aortic Aneurysm , Aortic Diseases/physiopathology , Image Interpretation, Computer-Assisted , Cardiovascular Diseases/diagnostic imaging , Imaging, Three-Dimensional , Cardiac-Gated Imaging Techniques/methods
12.
Rev. méd. Chile ; 147(12): 1579-1593, dic. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1094193

ABSTRACT

Acute aortic syndromes include a spectrum of life-threatening aortic conditions. A review of the diagnostic aspects of the acute aortic syndrome was made, from the perspective of the imaging techniques available for this purpose. The advantages and disadvantages of each technique and its diagnostic performance were evaluated. Emphasis was placed on the relevance of clinical information as a fundamental tool for suspecting this syndrome and appropriately choosing the imaging technique. Our main objective is to provide information about the diagnosis of this condition, especially in the context of emergency services.


Subject(s)
Humans , Aortic Diseases/diagnostic imaging , Aortic Diseases/classification , Syndrome , Acute Disease , Risk Factors , Emergency Medical Services
13.
Rev. bras. cir. cardiovasc ; 34(6): 759-764, Nov.-Dec. 2019. tab, graf
Article in English | LILACS | ID: biblio-1057495

ABSTRACT

Abstract Regardless the successful treatment of the descending aorta with endovascular prosthesis, for the ascending aorta segment, because of several anatomic and physiologic issues, this technique has been considered an alternative only for high-risk or inoperable patients. Despite restricted indications, hundreds of treatments have been performed worldwide, demonstrating its safety and reproducibility if it is done in high-quality centers. Therefore, understanding patients' selection criteria and technique limitations are critical to its application.


Subject(s)
Humans , Aortic Diseases/surgery , Endovascular Procedures/methods , Aorta, Thoracic/surgery , Aortic Diseases/diagnostic imaging , Aortic Aneurysm, Thoracic/surgery , Blood Vessel Prosthesis Implantation/methods , Computed Tomography Angiography
14.
Rev. colomb. cardiol ; 26(3): 153-158, May-Jun. 2019. tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1058402

ABSTRACT

Resumen Introducción: El manejo endovascular para patologías de la aorta ha aumentado como opción para pacientes de alto riesgo quirúrgico de cirugía convencional abierta. Los resultados a corto plazo para mortalidad, libertad de enfermedad y reintervención, evidencian resultados favorables respecto a la cirugía abierta, pero a mediano (1-12 meses) y largo plazo (>1 año) no existen resultados en nuestro medio. Métodos: Estudio de cohorte bidireccional, en el cual se realizó el segmento retrospectivo en pacientes sometidos a manejo endovascular con prótesis aórtica y el segmento prospectivo en el seguimiento de los pacientes. Resultados: Se identificaron 194 pacientes entre abril de 2002 y diciembre de 2015 sometidos a tratamiento endovascular, que cumplían con los criterios de inclusión. El seguimiento se completó en el 82,2%. 92 casos (56.8%) de aorta abdominal con un seguimiento de 4,9 años (RIC 2,5-8,9. La sobrevida calculada fue 92% al año, 86% 2 años y 66.4% a los 5 años. El periodo libre de enfermedad fue 88.7% al año, 86.4% 2 años y 78.5% a los 10 años y 13 pacientes requirieron reintervención. 67 casos de aorta torácica con un seguimiento de 5,3 años (RIC 2,9-10.2), la sobrevida calculada 94% al año, 90.7% 2 años y 75.2% a los 5 años. El periodo libre de enfermedad fue 88.7% al año, 86.4% 2 años y 78.5% a los 10 años y 9 pacientes requirieron reintervención. Conclusiones: Los resultados obtenidos son favorables e incentivan para continuar ofreciendo el abordaje endovascular ya que la supervivencia y la libertad de reoperación se encuentran de acuerdo con lo reportado en la literatura.


Abstract Introduction: The endovascular management for diseases of the aorta has increased as an option for patients of high risk for conventional open surgery. The short-term mortality, disease-free and reoperation results, show favourable outcomes compared to open surgery, but there are no results available in this country for the medium (1-12 months) and long-term (>1 year). Methods: A bi-directional cohort study, in which the retrospective segment was conducted on patients subjected to endovascular management with an aortic replacement, and the prospective segment on the follow-up of the patients. Results: A total of 194 patients, subjected to endovascular treatment and met the inclusion criteria, were identified between April 2002 and December 2015. The follow-up was completed in 82.2% of cases. There were 92 (56.8%) cases of abdominal aorta with a mean follow-up of 4.9 years (95% range; 2.5-8.9). The calculated survival was 92% at one year, 86% at 2 years, and 66.4% at 5 years. The period free of disease was 88.7% at one year, 86.4% at 2 years, and 78.5% at 10 years, with 13 patients requiring re-operation. There were 67 cases of thoracic aorta, with a mean follow-up of 5.3 years (95% range; 2.9-10.2). The calculated survival was 94% at one year, 90.7% at 2 years, and 75.2% at 5 years. The period free of disease was 88.7% at one year, 86.4% at 2 years, and 78.5% at 10 years, and 9 patients required re-operation. Conclusions: The results obtained are favourable and are encouraging to continue offering the endovascular approach since the re-operation survival is similar to that reported in the literature.


Subject(s)
Humans , Male , Middle Aged , Aorta, Abdominal , Aorta, Thoracic , Aortic Diseases , Aortic Aneurysm , Survival , Endovascular Procedures
15.
Rev. bras. cir. cardiovasc ; 34(2): 233-236, Mar.-Apr. 2019. tab, graf
Article in English | LILACS | ID: biblio-990577

ABSTRACT

Abstract Ventricular assist devices (VADs) are an important technological development for patients with end-stage heart failure, and approximately 50% of these patients require various additional cardiac procedures. Here we presente the case of a patient suffering from severe aortic insufficiency, aortic root dilatation, and an ascending aortic aneurysm with end-stage decompensated heart failure. We performed the Bentall procedure combined with a left VAD implantation during the same session. The postoperative period was uneventful for this patient, and he was discharged on the 32nd postoperative day. The heart failure symptoms of the patient are reasonable, and he is still on the heart transplantation waiting list.


Subject(s)
Humans , Male , Middle Aged , Heart-Assist Devices , Heart Valve Prosthesis Implantation/methods , Heart Failure/surgery , Aortic Diseases/surgery , Radiography, Thoracic , Tomography, X-Ray Computed , Treatment Outcome
16.
Rev. bras. cir. cardiovasc ; 34(1): 101-103, Jan.-Feb. 2019. tab, graf
Article in English | LILACS | ID: biblio-985240

ABSTRACT

Abstract Aorto-atrial fistulas due to cardiac trauma are rare, and survivors require immediate surgical correction. Here, we report a case of an aorto-right atrial fistula due to penetrating trauma after a 16-year evolution, which developed symptoms of acute coronary syndrome and was treated with myocardial revascularization and correction of the aorto-cameral fistula.


Subject(s)
Humans , Male , Aged , Aortic Diseases/diagnostic imaging , Arterio-Arterial Fistula/diagnostic imaging , Acute Coronary Syndrome/diagnostic imaging , Aortic Diseases/surgery , Aortic Diseases/etiology , Wounds, Stab/complications , Aortography/methods , Cineangiography/methods , Echocardiography/methods , Arterio-Arterial Fistula/surgery , Arterio-Arterial Fistula/etiology , Coronary Angiography/methods , Electrocardiography , Acute Coronary Syndrome/surgery , Acute Coronary Syndrome/etiology , Heart Atria/injuries , Heart Atria/diagnostic imaging
17.
Anatomy & Cell Biology ; : 109-114, 2019.
Article in English | WPRIM | ID: wpr-762223

ABSTRACT

Aorta is the largest artery in the human body. Its starting point is the aortic orifice of the aortic valve and it terminates at the level of the fourth lumbar vertebra. The main function of the aorta is to transport oxygenated blood to supply all the organs and cells. With advancing age, the structure and hence the function show progressive changes. Various changes in the aortic morphology include the luminal diameter of aorta, whole length of the aorta, thickness, the microstructural components also change, and these include collagen, elastin and smooth muscle cells. In addition, the dimensions of all segments of the aorta increase with age in both sexes. Since age is a major risk factor for degenerative change and diseases affecting the aorta, understanding the detailed anatomy of the aorta may provide essential information concerning the age-associated process of the aorta. Knowledge of the morphological changes in the aorta is also important for future clinical therapies pertaining to aortic disease. Additionally, the information regarding the structural changes with age may be applied for age determination. This review describes the overview of the anatomy of the aorta, age related changes in the morphology of the aorta and aortic diseases.


Subject(s)
Aorta , Aorta, Abdominal , Aorta, Thoracic , Aortic Diseases , Aortic Valve , Arteries , Collagen , Elastin , Human Body , Humans , Myocytes, Smooth Muscle , Oxygen , Phenobarbital , Risk Factors , Spine
18.
Article in English | WPRIM | ID: wpr-761876

ABSTRACT

BACKGROUND: The endovascular approach to aortic disease treatment has been increasingly utilized in the past 2 decades. This study aimed to determine the long-term results of using the Seal thoracic stent graft. METHODS: We retrospectively reviewed the outcomes of patients who underwent thoracic endovascular aortic repair or a hybrid procedure using the Seal thoracic stent graft (S&G Biotech, Seongnam, Korea) from January 2008 to July 2018 at a single institution. We investigated in-hospital mortality and the incidence of postoperative complications. We also investigated the mid-term survival rate and incidence of aorta-related complications. RESULTS: Among 72 patients with stent grafts, 15 patients underwent the hybrid procedure and 21 underwent emergency surgery. The mean follow-up period was 37.86±30.73 months (range, 0–124 months). Five patients (6.9%) died within 30 days. Two patients developed cerebrovascular accidents. Spinal cord injury occurred in 2 patients. Postoperative renal failure, postoperative extracorporeal membrane oxygenation support, and pneumonia were reported in 3, 1, and 6 patients, respectively. Stent-related aortic complications were observed in 5 patients (6.8%). The 1- and 5-year survival and freedom from stent-induced aortic event rates were 81.5% and 58.7%, and 97.0% and 89.1%, respectively. CONCLUSION: The use of the Seal thoracic stent graft yielded good mid-term results. Further studies are needed to examine the long-term outcomes of this device.


Subject(s)
Aorta, Thoracic , Aortic Diseases , Aortic Rupture , Blood Vessel Prosthesis , Emergencies , Endoleak , Extracorporeal Membrane Oxygenation , Follow-Up Studies , Freedom , Hospital Mortality , Humans , Incidence , Pneumonia , Postoperative Complications , Renal Insufficiency , Retrospective Studies , Spinal Cord Injuries , Stents , Stroke , Survival Rate
19.
Article in Korean | WPRIM | ID: wpr-761387

ABSTRACT

Endovascular aortic repair is often performed for the treatment of aortic disease because of less invasiveness and fewer complications. Cardiac tamponade is a fatal disease that can lead to death if not treated properly. Cardiac puncture by rigid guide wire used in endovascular aortic repair may cause cardiac tamponade. Rapid diagnosis and treatment are needed when cardiac tamponade occurs. Confirmation of the cardiac tamponade can be accomplished with echocardiography. Continuous echocardiography should be monitor for detection of cardiac complications during endovascular aortic repair.


Subject(s)
Aneurysm, Dissecting , Aortic Diseases , Cardiac Tamponade , Diagnosis , Echocardiography , Endovascular Procedures , Punctures , Rupture
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