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Introduction Effects of coronary stenting techniques are generally investigated regarding wall shear stress (WSS) or turbulence of flow at the lesion or bifurcation sites. [ 1 , 2 ] Recently, we speculated that ostial left main (LM) stenting potentially induces turbulence in the aortic wall near to the LM ostium. [ 3 ] Potential impact on the ascendingaorta and arch have never been evaluated despite the fact that it would be logical that any turbulence induced outside the coronary tree can propagate at a certain distance within the aortic vasculature
, et al - Early failure of the tissue engineered porcine heart valve synergraft in pediatric patients. Eur J Cardiothorac Surg. 2003 Jun;23(6):1002-6;discussion 1006. 15. Bentall HH, De Bono A - A technique for complete replacement of the ascendingaorta. Thorax. 1968 Jul;23:338–39. 16. Stewart AS, Takayama H, Smith CR - Modified Bentall operation with a novel biologic valved conduit. Ann Thorac Surg. 2010 Mar;89(3):938-41. 17. Hussain G, Ahmad N, Ahmad S, et al - New modification of modified bentall procedure (A single centre experience). Pak J Med Sci. 2015 Nov
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.
Cardiovascular manifestations of tertiary syphilis infections are uncommon, but represent an important cause of mortality and morbidity. Syphilitic aortitis is characterized by aortic regurgitation, dilatation of ascending aorta and ostial coronary artery lesions.
We report a case of 36 years old man admitted to our hospital for acute anterior ST segment elevation myocardial infarction complicated with cardiogenic shock (hypotension 75/50 mmHg). Transthoracic echocardiography revealed a dilated left ventricle with severe systolic dysfunction (ejection fraction = 25%), severe mitral regurgitation, moderate aortic regurgitation and mildly dilated ascending aorta. Coronary angiography showed a severe ostial lesion of left main coronary artery which was treated by urgent stent implantation and an intra-aortic contrapulsation balloon was implanted. Blood tests for syphilitic infection were positive. The patient was discharged with treatment including benzathine penicillin.
In our case, we present an acute manifestation of a syphilitic ostial left main stenosis treated by primary percutaneous coronary intervention in acute myocardial infarction. Long term follow-up of the patient is crucial as a result of potential rapid in-stent restenosis caused by continuous infection of the ascending aorta.
This case is particular because it shows that syphilitic aortitis can be diagnosed in acute settings, like ST segment elevation myocardial infarction.
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.
peak rate of change of conductivity (r = 0.99). From reference 23. The second component generating a change in transthoracic specific resistance is the transversely or laterally-oriented volume displacement of non-conductive alveolar gas (ρ =10 20 Ω·cm) by stroke volume-induced expansion of the ascendingaorta, principally [ 24 , 25 ], with highly conductive blood (ρ b =100–180 Ω·cm) ΔV b (t) (ΔΩ·cm(t)). As discussed under pulsatile blood flow, in addition to distal vascular hindrance R s , the volumetric expansion of the aorta is due to pressure-induced, compliance
The development of thoracic aortic aneurysms (TAAs) involves a multifactorial process resulting in alterations of the structure and composition of the extracellular matrix (ECM). Recently, modifications in microRNA (miRNA) expression were implicated in the pathogenesis of TAA. This study presents a preliminary miRNA microarray analysis conducted on pooled ascending aorta RNAs obtained from non familial non syndromic TAA patients (five males and five females) compared to matched control pools. Ninety-nine differentially expressed miRNAs with >1.5-foldup- or down-regulation in TAAs compared to controls were identified, 16.0% of which were similarly regulated in the two sexes. Genes putatively targeted by differentially expressed miRNAs belonged preferentially to focal adhesion and adherens junction pathways. The results indicate an altered regulation of miRNA-mediated gene expression in the cellular interactions of aneurysmal aortic wall.
Aortic valve diseases such as aortic stenosis and aortic regurgitation, are the most frequent valvular heart diseases. The lesions in the valves affect circulation in the whole arterial system. We study the effects with the use of a 1-D model in which an arterial segment transmits a single mode of pulse waves. The appropriate reflection coefficient and the form of the stroke pressure are devised to simulate the function of the healthy and morbid aortic valve. The time dependence of the arterial pressure is predicted at the most important locations of the arterial tree. A remarkable result is that little variations of the reflection coefficient of the vale due to the modelled diseases cause significant changes of the pressure profiles, especially at the ascending aorta, the left brachial artery and in the anterior communicating artery.