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Heart Lung Circ 2022 May 18. Epub 2022 May 18.

Department of Cardiothoracic Surgery, Waikato District Health Board, Hamilton, New Zealand; Waikato Institute of Surgical Education and Research (WISER), Hamilton, New Zealand; Department of Surgery, University of Auckland, Hamilton, New Zealand.

Objectives: Type A aortic dissection (ATAAD) is hypothesised as a progression of aneurysmal dilation, but 60% of patients in the International Registry of Acute Aortic Dissection (iRAD) registry had a maximum aortic diameter (MAD)<55 mm. We aim to demonstrate that size ratios and aortic wall stress, assessed using a simplified markers, are unique to aortic patients who have had adverse events (ATAAD) compared to those who have not (thoracic aortic aneurysm [TAA]).

Methods: A retrospective cohort analysis of patients who underwent aortic intervention at Waikato Hospital, New Zealand between 2015-2020, comparing dissection (ATAAD) to TAA patients. Read More

Vascular 2022 May 20:17085381221100384. Epub 2022 May 20.

Department of Rheumatology and Immunology, Zhuzhou Hospital Affiliated to Xiangya Medical College, 12570Central South University, Zhuzhou, China.

Introduction: ANCA-associated vasculitis is an autoimmune disease that usually involves the small vessel walls. It is difficult to find the presence of ANCA-associated vasculitis in the great arteries, especially the thoracic and abdominal aorta.

Methods: This is an 86-year-old Chinese man with ANCA-associated vasculitis and abdominal aortic aneurysm who presented with epigastric pain. Read More

J Thorac Cardiovasc Surg 2022 May 9. Epub 2022 May 9.

Department of Thoracic and Cardiovascular Surgery, Heart, Vascular & Thoracic Institute, Cleveland Clinic, Cleveland, Ohio. Electronic address:

Objective: Managing patients with thoracoabdominal aneurysms is demanding yet fascinating, and requires a team effort. This invited talk presents lessons learned as our history with open and endovascular procedures evolved for 2578 descending and thoracoabdominal repairs over the past 20 years.

Methods: Beginning in 1985 with an analysis of 596 traumatic aortic ruptures and the risk of spinal cord ischemia, the evolution of research and procedures for thoracoabdominal aneurysms progressed. Read More

Cold Spring Harb Mol Case Stud 2022 May 19. Epub 2022 May 19.

Universidade Estadual do Norte Fluminense Darcy Ribeiro

Aortic diseases arising in Marfan Syndrome (MFS), such as in aneurysms and dissections of the thoracic aorta, are related to genetic alterations in the FBN1 gene. Databases, such as Universal Mutations-FBN1, ClinVar and The Human Gene Mutation, contain more than a thousand FBN1 mutations associated with MFS. The FBN1 gene, which encodes fibrillin-1, is responsible for the integral production of different protein domains. Read More

Arterioscler Thromb Vasc Biol 2022 May 19:101161ATVBAHA121316237. Epub 2022 May 19.

A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio. (S.J., M.K., J.P.L.).

Smooth muscle cells and endothelial cells have a remarkable level of plasticity in vascular pathologies. In thoracic and abdominal aortic aneurysms, smooth muscle cells have been suggested to undergo phenotypic switching and to contribute to degradation of the aortic wall structure in response to, for example, inflammatory mediators, dysregulation of growth factor signaling or oxidative stress. Recently, endothelial-to-mesenchymal transition, and a clonal expansion of degradative smooth muscle cells and immune cells, as well as mesenchymal stem-like cells have been suggested to contribute to the progression of aortic aneurysms. Read More

J Oleo Sci 2022 May 18. Epub 2022 May 18.

Graduate School of Agriculture, Kindai University.

Women are more resistant to vascular diseases; however, the resistance is reduced after menopause. It has been reported that the risk of vascular diseases such as atherosclerosis and abdominal aortic aneurysm is increased in postmenopausal women. Currently, methods to prevent vascular disease in postmenopausal women have not been established. Read More

Int Angiol 2022 May 18. Epub 2022 May 18.

Vascular Center, Department of Thoracic Surgery and Vascular Diseases, Skane University Hospital, Malmö, Sweden.

Background: The aim of this study is to evaluate if ilio-femoral calcium score (CS) combined with Glasgow Aneurysm Score (GAS) can improve the prediction of long-term survival after EVAR.

Methods: All the patients who underwent infrarenal endovascular aortic repair (EVAR) for non-ruptured AAA between January 2004 and December 2012 at a tertiary referral center were retrospectively included if the preoperative imaging was of sufficient quality and they had survived for more than 30 days. Pre-operative non-contrast enhanced CT were used to measure ilio-femoral calcium score using dedicated postprocessing software. Read More

J Endovasc Ther 2022 May 18:15266028221095390. Epub 2022 May 18.

Department of Diagnostic and Interventional Radiology and Neuroradiology, Bundeswehr Central Hospital Koblenz, Koblenz, Germany.

Purpose: Endoleaks are a common complication after endovascular aortic repair (EVAR) and thoracic endovascular aortic repair (TEVAR). The detection and correct classification of endoleaks is essential for the further treatment of affected patients. However, standard computed tomography angiography (CTA) provides no hemodynamic information on endoleaks, which can result in misclassification in complex cases. Read More

Vascular 2022 May 16:17085381221102785. Epub 2022 May 16.

Division of Vascular and Endovascular Surgery, 12235University of Miami, Miami, FL, USA.

Objectives: The indication, timing, and choice of the treatment modality for penetrating aortic ulcers (PAUs) and intramural hematoma (IMH) are frequently challenging. This article reviews these pathologies and their relation to aortic dissection and proposes a diagnostic and treatment algorithm.

Methods: A review of literature on diagnosis and treatment of PAU and IMH was conducted. Read More

J Thorac Cardiovasc Surg 2022 Apr 9. Epub 2022 Apr 9.

Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minn.

Objective: To evaluate expansion of degenerative thoracic aortic aneurysms (TAAs) and compare results between ascending and descending TAAs.

Methods: Among patients with diagnosis of degenerative TAA (1995-2015) in Olmsted County, we studied those having at least 2 computed tomography scans of TAA throughout the follow-up. Patients were classified as ascending or descending groups according to the segment where the maximal aortic diameter was measured. Read More

J Mol Cell Cardiol 2022 May 13;169:41-56. Epub 2022 May 13.

Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Peking University; Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing 100191, China.. Electronic address:

Aortic aneurysms, including thoracic aortic aneurysms and abdominal aortic aneurysms, are life-threatening macrovascular diseases with high mortality. The already known key mechanisms implicated in aortic aneurysm pathogenesis involve the remodeling of the extracellular matrix and a set of cellular responses, such as inflammation, oxidative stress and vascular smooth muscle cell dysfunction. Matricellular proteins constitute a group of nonstructural extracellular proteins that link the interaction between cells and their extracellular microenvironment and have been widely reported in different diseases, including aortic aneurysms. Read More

JACC Case Rep 2022 May 4;4(9):529-532. Epub 2022 May 4.

DeBakey Heart and Vascular Institute, Houston Methodist Hospital, Houston, Texas, USA.

Giant cell arteritis (GCA) is an inflammatory cranial and/or extracranial vasculitis. Although cranial GCA is widely recognized, extracranial GCA is underdiagnosed because of its nonspecific and atypical presentations. We report a case of asymptomatic extracranial GCA with ascending thoracic aortopathy discovered incidentally during surgical mitral valve repair. Read More

Front Cardiovasc Med 2022 27;9:874912. Epub 2022 Apr 27.

Department of Cardiac Surgery, Fujian Medical University Union Hospital, Fuzhou, China.

Circulating proteins play functional roles in various biological processes and disease pathogenesis. The aim of this study was to highlight circulating proteins associated with aortic aneurysm and dissection (AAD) and spontaneous coronary artery dissection (SCAD). We examined the associations of circulating molecule levels with SCAD by integrating data from a genome-wide association study (GWAS) of CanSCAD and 7 pQTL studies. Read More

Am J Med Genet A 2022 May 14. Epub 2022 May 14.

Division of Medical Genetic, Department of Internal Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, USA.

Pathogenic variants in ACTA2, encoding smooth muscle α-actin, predispose to thoracic aortic aneurysms and dissections. ACTA2 variants altering arginine 179 predispose to a more severe, multisystemic disease termed smooth muscle dysfunction syndrome (SMDS; OMIM 613834). Vascular complications of SMDS include patent ductus arteriosus (PDA) or aortopulmonary window, early-onset thoracic aortic disease (TAD), moyamoya-like cerebrovascular disease, and primary pulmonary hypertension. Read More

J Clin Med 2022 Apr 27;11(9). Epub 2022 Apr 27.

Department of Vascular and Endovascular Surgery, Heidelberg University Hospital, 69120 Heidelberg, Germany.

The aim of this study was to investigate sex-dependent aneurysm distributions. A total of 3107 patients with arterial aneurysms were diagnosed from 2006 to 2016. Patients with anything other than true aneurysms, hereditary connective tissue disorders or vasculitides ( = 918) were excluded. Read More

Int J Mol Sci 2022 Apr 25;23(9). Epub 2022 Apr 25.

Department of General Surgery, Medical University of Vienna, 1090 Vienna, Austria.

A hallmark of thoracic aortic aneurysms (TAA) is the degenerative remodeling of aortic wall, which leads to progressive aortic dilatation and resulting in an increased risk for aortic dissection or rupture. Telocytes (TCs), a distinct type of interstitial cells described in many tissues and organs, were recently observed in the aortic wall, and studies showed the potential regulation of smooth muscle cell (SMC) homeostasis by TC-released shed vesicles. The purpose of the present work was to study the functions of TCs in medial degeneration of TAA. Read More

J Am Coll Cardiol 2022 May;79(19):1898-1900

Aortic Center, the Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA.

J Am Coll Cardiol 2022 May;79(19):1890-1897

Department of Surgery, Division of Cardiovascular and Thoracic Surgery, Duke University Medical Center, Durham, North Carolina, USA. Electronic address:

Background: Previous work has demonstrated that more than one-half of acute type A aortic dissections (ATADs) occur at a maximal aortic diameter (MAD) of <5.5 cm. However, no analysis has investigated whether ATAD risk at smaller MADs is more common with modest dilation of the aortic root (AR) or supracoronary ascending aorta (AA) in patients without genetically triggered aortopathy. Read More

Front Cardiovasc Med 2022 25;9:839743. Epub 2022 Apr 25.

LVTS, INSERM, U1148, Paris, France.

Glycosaminoglycans (GAGs) pooling has long been considered as one of the histopathological characteristics defining thoracic aortic aneurysm (TAA) together with smooth muscle cells (SMCs) apoptosis and elastin fibers degradation. However, little information is known about GAGs composition or their potential implication in TAA pathology. Syndecan-1 (SDC-1) is a heparan sulfate proteoglycan that is implicated in extracellular matrix (ECM) interaction and assembly, regulation of SMCs phenotype, and various aspects of inflammation in the vascular wall. Read More

Scand Cardiovasc J 2022 12;56(1):91-99

Department of Cardiac, Thoracic and Vascular Surgery, National University Heart Centre, National University Health System, Singapore.

. Composite frozen elephant trunk is an increasingly popular solution for complex aortic pathologies. This review aims to compare outcomes of zone 0 type II hybrid (hybrid II) with the composite frozen elephant trunk (FET) technique in managing acute Stanford type A aortic dissections. Read More

Am J Med Genet A 2022 May 11. Epub 2022 May 11.

Department of Cardiovascular Medicine, The University of Tokyo Hospital, Tokyo, Japan.

Vascular Ehlers-Danlos syndrome (vEDS) is an autosomal dominant genetic disorder characterized by soft connective tissue vulnerability due to dysfunction of Type III collagen and caused by the pathogenic variants in COL3A1 gene. In the era of next-generation sequencing, multiple genes including COL3A1 can be simultaneously analyzed, and among patients suffering from aortopathy even without any other clinical features suggestive of vEDS, pathogenic COL3A1 variants have been increasingly identified. Here, we briefly summarize the characteristics of 12 Japanese patients from 11 families with arteriopathy and pathogenic or likely pathogenic COL3A1 variants in our hospital. Read More

Hypertension 2022 May 11:HYPERTENSIONAHA12217963. Epub 2022 May 11.

Department of Physiology, Cardiovascular Research Center, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada (T.K., Z.K.).

Aortic aneurysm is a complex pathology that can be lethal if not detected in time. Although several molecular mechanisms and pathways have been identified to be involved in aortic aneurysm development and growth, the current lack of an effective pharmacological treatment highlights the need for a more thorough understanding of the factors that regulate the remodeling of the aortic wall in response to triggers that lead to aneurysm formation. This task is further complicated by the regional heterogeneity of the aorta and that thoracic and abdominal aortic aneurysm are distinct pathologies with different risk factors and distinct course of progression. Read More

J Card Surg 2022 May 9. Epub 2022 May 9.

Department of Cardiothoracic Surgery, Mount Sinai Medical Center, Icahn School of Medicine at Mount Sinai, New York City, New York, USA.

Background And Aim: The American Association of Thoracic Surgery published guidelines in 2018 encouraging regular surveillance rather than surgical intervention for ascending aortic aneurysms under 5.5 cm in both bicuspid aortic valve (BAV) and tricuspid aortic valve (TAV) patients. Since then, there have been limited studies reporting outcomes, especially by valve type. Read More

J Thorac Cardiovasc Surg 2022 Apr 6. Epub 2022 Apr 6.

Division of Cardiovascular and Interventional Radiology, Department of Bio-medical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria. Electronic address:

Objective: For thoracic endovascular aortic repair of the arch, branched and fenestrated endografts are available with different limitations regarding anatomy and extent of the pathology. Comparisons are lacking in the literature. The aim of this study was to compare the results of 2 currently commercially available devices for branched thoracic endovascular aortic repair and fenestrated thoracic endovascular aortic repair. Read More

Asian Cardiovasc Thorac Ann 2022 May 9:2184923221099771. Epub 2022 May 9.

Institute of Cardiac and Aortic Disorders (ICAD), 363954SRM Institutes for Medical Science (SIMS Hospital), Chennai, Tamil Nadu, India.

Background: Uncomplicated type B aortic dissection (unTBAD) comprises the estimated majority of type B aortic dissection (TBAD), presenting without any of the complications associated with complicated TBAD (coTBAD). Although first-line treatment for coTBAD is thoracic endovascular aortic repair (TEVAR), and despite the fact that TEVAR has proven its safety and effectiveness in the treatment of unTBAD, unTBAD is still being predominantly managed conservatively with medical therapy, with a small proportion of patients being offered TEVAR.

Aims: The main scope of this review is to highlight the evidence in the literature of the demographic characteristics and associated co-morbidities of unTBAD patients undergoing TEVAR in order to produce a risk stratification system to achieve favourable outcomes. Read More

Ann Pediatr Cardiol 2021 Oct-Dec;14(4):496-500. Epub 2022 Mar 25.

Department of Cardiology, Bombay Hospital and Medical Research Centre, Mumbai, Maharashtra, India.

Background And Objectives: Infective endocarditis (IE) involving the native pulmonary valve (PV) is extremely rare, with no data in Indian literature. The objective of this communication is to describe the clinical and diagnostic characteristics, underlying risk factors, microbiological features, and management of PVIE.

Methods: This is a retrospective analysis of 8 cases of PVIE managed in a tertiary care center from 1992 to 2020. Read More

EJVES Vasc Forum 2022 13;55:48-51. Epub 2022 Apr 13.

Department of Cardiovascular Surgery, Hyogo Brain and Heart Centre at Himeji, Hyogo, Japan.

Introduction: A pseudoaneurysm arising from the side branch of the prosthesis, following ascending aortic replacement, is extremely rare. Re-intervention usually involves open surgery, replacement of the ascending aorta, or ligation of the side branch. Redo surgery with an additional sternotomy carries the risk of cardiac and vascular injuries, and endovascular treatment can reduce such adverse events. Read More

J Endovasc Ther 2022 May 6:15266028221092980. Epub 2022 May 6.

Department of Vascular Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.

Objective: Percutaneous femoral artery access is being increasingly used in endovascular aortic repair (EVAR). The technique can be challenging in patients with previously surgically exposed or repaired femoral arteries because of excessive scar tissue. However, a successful percutaneous approach may cause less morbidity than a "re-do" open femoral approach. Read More

Hum Mol Genet 2022 May 5. Epub 2022 May 5.

Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.

Isolated thoracic aortic aneurysms (TAAs) are asymptomatic before dissection or rupture and heterogeneous in clinical phenotype. It is urgent need but difficult to identify individuals at high risk to enable enhanced screening or preventive therapies. Because TAAs have a genetic component, one possible approach is to stratify individuals based on inherited DNA variations. Read More

Arterioscler Thromb Vasc Biol 2022 May 5:101161ATVBAHA122317643. Epub 2022 May 5.

Department of Internal Medicine, University of Michigan, Ann Arbor. (D.J.T., J.C., B.Y.L., S.C.W., D.R.G.).

Background: Aging enhances most chronic diseases but its impact on human aortic tissue in health and in thoracic aortic aneurysms (TAA) remains unclear.

Methods: We employed a human aortic biorepository of healthy specimens (n=17) and those that underwent surgical repair for TAA (n=20). First, we performed proteomics comparing aortas of healthy donors to aneurysmal specimens, in young (ie, <60 years of age) and old (ie, ≥60 years of age) subjects. Read More