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Markers of Atherosclerosis in Hypertensive Patients with Less Advanced Chronic Kidney Disease

. Verdoia M, Barbieri L, Di Giovine G et al. Neutrophil to Lymphocyte Ratio and the Extent of Coronary Artery Disease: Results From a Large Cohort Study. Angiology. 2016;67(1):75-82. 17. Zhou S, Cai B, Zhang Y, Wang L, Liu X, Xu G. The Relationship between Neutrophil-to-Lymphocyte Ratio and Aortic Arch Calcification in Ischemic Stroke Patients. J Stroke Cerebrovasc Dis. 2017;26(6):1228-32. 18. Yoshitomi R, Nakayama M, Sakoh T et al. High neutrophil/lymphocyte ratio is associated with poor renal outcomes in Japanese patients with chronic kidney disease. Ren

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Left main stenting induced flow disturbances on ascending aorta and aortic arch

. Noticeably, higher WSS within the ascending aorta have been suspected to be involved in aortic aneurysm and dissection. [ 4 , 5 ] The aim of our study is to investigate, by means of computation fluid dynamic analysis (CFD), the presence and potential impact of turbulences induced by ostial LM stenting, not only in the LM but also within the ascending aorta and arch. Methods Construction of the virtual model For the computational domain analysis, we reconstructed the ascending aortic arch from the plane of the aortic valve to the left subclavian artery. Both

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Aberrant right subclavian artery - a marker for chromosomal abnormalities?

-221. 4. Goldstein, W.B. (1965). Aberrant right subclavian artery in Mongolism. Am J Roentgoenol Radium Ther Nucl Med. 95, 131-134. 5. Yoo, S.J., Bradley, T. & Lee, Y.H., et al. (2003). Sonographic diagnosis of aortic arch anomalies. Ultrasound Obstet Gynecol. 22, 535-546. 6. Chaoui, R., Thiel, G. & Heling, K.S. (2006). Prevalence of an aberrant right subclavian artery in fetuses with chromosomal aberrations. Ultrasound Obstet Gynecol. 28, 414. 7. Nicolaides, K.H., Spencer, K., Avigidou, K., Faiola, S. & Falcon, O

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Anatomical Considerations of the Ostium of the Subclavian Artery

thorax. Paris: Simep; 1991 6. Kamina P. Anatomie clinique. Tome 3. Thorax. Abdomen. Paris: Maloine; 2007 7. Testut L. Traité d’anatomie humaine. Angéiologie, livre IV, Paris: Gaston Doin; 1921 8. Shin IY, Chung YG, Shin WH, Im SB, Hwang SC, Kim BT. A morphometric study on cadaveric aortic arch and its major branches in 25 Korean adults: the perspective of endovascular surgery. Journal of Korean Neurosurgical Society. 2008 Aug;44(2):78. 9. Malik S. The morphology of the abdominal aorta. Doctoral thesis, Constanţa: University “Ovidius” of

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Transthoracic 3D Echocardiographic Imaging of Type A Aortic Dissection – Case Presentation

Abstract

In type A aortic dissection (AoD) an early and accurate diagnosis is essential to improve survival, by applying urgent surgical repair. 3D transthoracic echocardiography (3D-TTE), an advanced noninvasive imaging technique, could offer a comprehensive evaluation of the ascending aorta and aortic arch in this regard. Both modalities of real-time 3D imaging – live 3D and full-volume aquisition – proved to be useful in evaluating the localization and extent of AoD. Our case illustrates the utility of 3D-TTE in the complex assessment AoD. By providing the proper anatomical dataset, 3D-TTE could facilitate considerably the diagnosis of type A AoD.

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Hyperbaric Oxygen Therapy in Treating a Poorly Healing Wound Following Cardiac Surgery in a Patient with Congenital Connective Tissue Defect – Case Report

Abstract

We hereby present the case of a female patient with recurrent aortic aneurysms. In order to treat aneurysms of the ascending aorta, aortic arch and aneurysms of the aortic arch branches, the debranching procedure was used. Following the surgery, a deep sternal wound infection occurred characterised by impaired healing. The infection was treated with targeted antibiotic therapy and hyperbaric oxygen therapy.

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Comparative Measurements of Aortic Diameters Using Transthoracic Echocardiography and Thoracic Computed Tomography Angiography in Neonatal Aortic Coarctation

Abstract

Background: Critical aortic coarctation is defined as the severe narrowing of the isthmic aortic lumen, representing a neonatal cardiac emergency, part of the congenital heart diseases with duct-dependent systemic circulation.

Aim of the study: To assess the correlation between transthoracic echocardiography and computed tomography angiography (CTA) in the measurement of aortic diameters in a group of newborns diagnosed with duct-dependent aortic coarctation and/or associated hypoplastic aortic arch.

Material and method: We performed a retrospective study on neonates diagnosed with duct-dependent aortic coarctation and/or associated hypoplastic aortic arch between January 1, 2015 and March 1, 2017. The studied parameters were diameters of the aorta at the level of the aortic annulus, coronary sinuses, sinotubular junction, ascending aorta, proximal and distal aortic arch, and the aortic isthmus. Measurements were obtained by transthoracic echocardiography and thoracic CTA.

Results: Fifteen newborns diagnosed with duct-dependent aortic coarctation and/or associated hypoplastic aortic arch were included in this study. There was no statistically significant difference between the two imaging methods, the T test highlighting differences only between the measurements of the aortic annulus (p <0.016) and coronary sinuses (p <0.008). The patients included in the study associated other cardiovascular abnormalities: persistent ductus arteriosus (100%), atrial septal defect (100%), aortic arch hypoplasia (80%), bicuspid aortic valve (73.3%).

Conclusions: These methods reveal important information on the anatomy of the cardiovascular malformation and its impact on the clinical and paraclinical status of the patient, being fundamental for establishing an optimal therapeutic approach.

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Left Pulmonary Artery Agenesis in a Pediatric Patient – Case Report

Abstract

Unilateral pulmonary artery agenesis is a rare congenital anomaly, that may develop in isolation, or in association with other congenital cardiovascular anomalies, such as tetralogy of Fallot, septal defects, right-sided aortic arch, or pulmonary atresia. Left-sided pulmonary artery agenesis is less frequent than the right-sided one. Diagnosis of unilateral pulmonary artery agenesis can be difficult. We report the case of a 15 year-old boy who presented with reduced exercise tolerance, shortness of breath and cyanosis. He was diagnosed with left pulmonary artery agenesis, associated with subaortic-ventricular septal defect, right-sided aortic arch, and severe pulmonary arterial hypertension (PAH), that precluded the surgical repair. Pulmonary vasodilator therapy was initiated in this case. The mortality rate of this rare anomaly is high due to its complications. It is essential to establish an early and correct diagnosis, in order to provide adequate treatment and prevent complications in this disease.

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Cases Report. Missed Diagnoses in Prenatal Evaluation by Ultrasound: A Retrospective Analysis of four Cases from a Tertiary Center for Fetal Malformations

Abstract

Four cases of missed prenatal diagnosis by an experienced ultrasonographer and a fetal cardiologist from a tertiary teaching hospital are presented: 3-mm peri-membrane ventricular septal defect; hypoplastic aortic arch requiring prostin infusion after delivery; esophageal atresia with tracheal fistula; and right-sided diaphragmatic hernia. Freezed frames and cine loops of the prenatal ultrasound scans indicated that the missed anomalies were not visible in midgestation, suggesting that in the future, repeat ultrasound scans should be performed before delivery to reduce the occurrence of such diagnostic errors.

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Early ischemic brain lesions after carotid angioplasty and stenting on diffusion-weighted magnetic resonance imaging study

Summary

Aim: The aim of the paper is to evaluate the appearance of the new early ischemic lesions in the brain after carotid angioplasty and stenting on diffusion-weighted magnetic resonance imaging, and their relationship with clinical and procedural factors.

Methods: Carotid artery stenting (CAS) procedures performed by a single interventional cardiologist in years November 2006 to January 2013 were evaluated retrospectively. In total, 227 procedures for 211 patients (mean age 69.8 ± 8.5 years) were performed, from which 171 (75.3%) for male and 56 (24.7%) for female patients. Seventy-two (34.1%) patients had symptomatic stenosis of carotid artery. The following protection systems to avoid the distal microembolism were used during the CAS: (1) Filters: FilterWire EZ (Boston Scientific Corporation); Emboshield NAV (Abbott Vascular); SpideRX (EV3); Defender (Medtronic); FiberNet Filter (Invatec-Medtronic); (2) Occlusion MoMa Baloon System (Invatec-Medtronic). Acute ischemic damages of the brain before and after CAS procedure were diagnosed using magnetic resonance imaging (MRI) with diffusion-weighted imaging (DWI) sequences. Sixty-five (30.8%) patients underwent MRI test. Exact and asymptomatic χ2 criteria were applied for testing the hypothesis of inter-dependency of the symptoms.

Results: Forty-six (70.8%) patients had new ischemic foci in the brain on MRI DWI after CAS procedures. Among those patients, focal damage of the brain was diagnosed in 36 (78.3%) cases; linear damage of the brain - in 9 (19.6%) patients; ipsilateral damage of the brain - in 37 (80.4%) patients; bilateral damage of the brain - in 16 (34.8%) patients, 38 (82.6%) patients were diagnosed with forebrain damage; 4 (8.7%) patients were diagnosed with damage of brainstem; 5 (10.9%) patients were diagnosed with cerebellum damage. Clinical symptoms of brain damage were diagnosed only for 2 (4.3%) patients. Focal damage of the brain was significantly less frequent only for aortic arch type 1, if compared with aortic arch type 2 and 3: 64.3%, 93.3% and 100.0%, respectively (p < 0.05). Focal damage of the brain occurred least in patients (28.6%) with Emboshield NAV protection type, if compared to other types of protection (71.4-100.0%). Linear >10mmbrain damage was less frequent when using FilterWire EZ, Emboshield NAV and SpideRX protection type. Ipsilateral ischemic brain damage also occurred less frequent when using Emboshield NAV protection type; bilateral damage occurred less frequent when using FilterWire EZ, Emboshield NAV and SpideRX protection type. Ischemic forebrain damage was also diagnosed less often in patients for whom protection type FilterWire EZ and Emboshield NAV was applied.

Conclusions: Most frequent findings by MRI after CAS procedures were focal, ipsilateral and forebrain damage (about 80%), but less than 5% patients had clinical symptoms. In the case of aorta arch type 1 focal ischemic damage of the brain was significantly less frequent, then in aortic arch type 2 and 3. The localization and extent of brain damage was associated with the type of protection systems that have been used.

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