1/46. A surgical case of atypical aortic coarctation using cardiopulmonary bypass.We report a 44-year-old woman with atypical aortic coarctation accompanied by cerebral artery disease. She was hospitalized for vertigo. An extra-anatomic bypass between the ascending aorta and abdominal aorta was performed using partial cardiopulmonary bypass under moderate hypothermia to reduce the after load of the left ventricle and maintain cerebral blood flow and cerebral perfusion pressure. The postoperative course was uneventful and there was no postoperative neurological deficiency.- - - - - - - - - - ranking = 1keywords = artery (Clic here for more details about this article) |
2/46. Ten years' experience of aortic aneurysm associated with systemic lupus erythematosus.BACKGROUND: aortic aneurysm is a rare but life-threatening cardiovascular complication in patients with systemic lupus erythematosus (SLE). The purpose of this study was to clarify the characteristic clinical features and the pathological mechanism of aneurysmal formation in these patients. methods: among 429 patients operated on for abdominal aortic aneurysm (AAA) during the past 10 years, five cases with SLE were treated surgically. Their clinical data were reviewed, and the resected aneurysmal wall of the five patients was also examined histologically. RESULTS: the mean age of the patients with SLE was 55 years, which was statistically younger than that of the other patients (mean 77 years, s.d. 7.9, p <0.05). They had received long-term corticosteroid therapy for the treatment of SLE for a mean of 23 years. Histologically, destruction of the medial elastic lamina was characteristic. Four patients had no complications in the postoperative follow-up period (mean 4 years), while the remaining patient died of rupture of a dissecting aneurysm two years after operation. CONCLUSION: prolonged steroid therapy may play a major role in accelerating atherosclerosis, which can result in aortic aneurysmal enlargement, possibly together with primary aortic wall involvement and/or vasculitic damage in patients with SLE.- - - - - - - - - - ranking = 20.504910141378keywords = atherosclerosis (Clic here for more details about this article) |
3/46. Management of inflammatory aneurysm of the infrarenal aorta using retroperitoneal exposure, open aneurysmorrhaphy and descending aorta-to-femoral artery bypass.The authors present a technique consisting of retroperitoneal exposure, but not dissection of the inflammatory aneurysm, anastomosis of a bypass graft through a short thoracotomy to the lowermost thoracic aorta, carrying it down retroperitoneally to both femoral arteries and under brief occlusion of the descending thoracic aorta, opening of the aneurysm and intra-aneurysmal occlusion of the inflow and outflow to the aneurysm. An illustrative case is presented.- - - - - - - - - - ranking = 4keywords = artery (Clic here for more details about this article) |
4/46. Stanford type A aortic dissection in a hypertensive patient with atherosclerosis of aorta and aortitis.dissection of aorta is a serious condition; the main factors are hypertension and diseases of the connective tissue or of collagen. aortitis syndrome in combination with hypertension and atherosclerosis in association with ascending aortic dissection is rarely seen. We present the case of a 53-year-old hypertensive patient whose ascending aortic dissection was associated with pericardial effusion without rupture of the aorta and with pleural effusion. Several unusual aspects of transesophageal echocardiography are described. The intraoperative biopsy revealed inflammatory aortitis with mural hematoma, without giant cells. The literature concerning aortic dissection and aortitis is reviewed.- - - - - - - - - - ranking = 102.52455070689keywords = atherosclerosis (Clic here for more details about this article) |
5/46. An unusual case of vegetative aortitis diagnosed by transesophageal echocardiography.We report a case of staphylococcus aureus aortitis in a 42-year-old man who had a fever, an embolus to the left upper arm, and positive blood cultures. Transesophageal echocardiography re-vealed a 3 x 1-centimeter polypoid mass attached to the intima of the medial wall of the aorta, just distal to the origin of the left subclavian artery. The clinical presentation and the transesophageal echocardiography findings led to the diagnosis of vegetative aortitis. Antibiotic therapy was begun, and 5 days later the mass was surgically excised to prevent the possible formation of an infective aortic aneurysm and embolization to the vital organs.- - - - - - - - - - ranking = 1keywords = artery (Clic here for more details about this article) |
6/46. Neonatal aortic arch thrombosis as a result of congenital cytomegalovirus infection.Thrombotic disease is rare in neonates. The main risk factors at this age are perinatal asphyxia, maternal diabetes, sepsis, polycythemia, dehydration, a low cardiac output, and in primis the catheterization of central lines. Another important risk factor is inherited thrombophilia. Arterial thrombosis is even more rare than venous thrombosis and less related to most of the risk factors listed above; it occurs more frequently in the iliac, femoral, and cerebral arteries but very rarely in the aorta. Most of the described cases of aortic thrombosis are associated with the catheterization of an umbilical artery and involve the descending tract and the renal arteries; very few relate to the ascending tract and the aortic arch. The possible role of virus-induced primary vascular endothelium damage in the etiopathogenesis of neonatal arterial thrombosis has been previously hypothesized. Herpesviruses, particularly human cytomegalovirus (HCMV), can infect endothelial cells and directly damage intact vascular endothelium, altering its thromboresistant surface as a result of procoagulant activity mediated by specific viral surface phospholipids, necessary for the coagulation enzyme complex assembly that leads to thrombin generation. We describe a case of congenital aortic arch thrombosis. The clinical, laboratory, and virologic pictures; the anatomopathologic findings (fully compatible with viral infection); the detection of HCMV in various tissues (including the aorta); and the absence of other causes of aortic thrombosis make it possible to attribute the case to a severe congenital HCMV infection with multiple organ involvement, after the primary infection of the mother. The hemostatic system disorders and hemodynamic disturbances related to viral cardiac damage explain the clinical features of the case and indicate that congenital HCMV infection should be included among the causes of neonatal aortic thrombosis.- - - - - - - - - - ranking = 1keywords = artery (Clic here for more details about this article) |
7/46. "Y" graft bypass for bilateral coronary ostial aortoarteritis.A case of bilateral coronary ostial aortoarteritis, which presented with angina pectoris, is reported. Emergency total arterial revascularization was performed using the bilateral mammary artery and radial artery, and the radial artery was hanged "Y" on the left internal mammary artery. The patient was discharged on low-dose steroid. He was asymptomatic at 1-year follow-up.- - - - - - - - - - ranking = 4keywords = artery (Clic here for more details about this article) |
8/46. Progression of Takayasu's aortitis in a young Japanese woman: serial angiographic study.Progression of Takayasu's aortitis was observed by serial angiography over 2 years. Acute aortic regurgitation due to marked dilatation of the proximal ascending aorta was followed by aneurysmal dilatation of the distal ascending aorta. Aneurysmal dilatation of the carotid arteries then developed, with subsequent obstruction of both the bilateral vessels by thrombosis.- - - - - - - - - - ranking = 1.7123857824465keywords = carotid (Clic here for more details about this article) |
9/46. Early venous coronary bypass graft occlusion in a patient with non-specific aortitis: a case report.A 58-year-old woman with aortic valve regurgitation and bilateral ostial coronary artery stenosis due to non-specific aortitis is presented. Four months after aortic valve surgery and venous bypass surgery, orificial occlusion or high grade stenosis of the bypass grafts occurred. Repeat coronary arteriography was followed by cardiac arrest and emergency surgery but patient did not survive. The etiology, pathological findings and surgical approach are discussed.- - - - - - - - - - ranking = 1keywords = artery (Clic here for more details about this article) |
10/46. Inflammatory aortic arch aneurysm with total occlusion of cervical branches.We surgically replaced the aortic root and the complex arch in a patient with aortitis syndrome with total occlusion of the cervical branches. Cerebral perfusion was being maintained through the reversed flow of the vertebral artery from the bilateral mammary arteries. Though cerebral perfusion was continued through the prosthetic grafts attached to the subclavian arteries during the procedure, bilateral watershed cerebral infarction corresponding to the most distal part of the anterior- and middle cerebral arterial system developed. With regard to the near infrared spectroscopy as a brain monitoring method, we sought to discuss the limitations.- - - - - - - - - - ranking = 1keywords = artery (Clic here for more details about this article) |
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