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Eur J Cardiothorac Surg 2021 May 15. Epub 2021 May 15.

Division of Cardiac Surgery, Massachusetts General Hospital, Boston, MA, USA.

Sci Rep 2021 May 14;11(1):10371. Epub 2021 May 14.

Division of Experimental Surgery, Department of Cardiovascular Surgery, Institute Insure, German Heart Center Munich, Lazarettstrasse 36, 80636, Munich, Germany.

Acute type A aortic dissection (ATAAD) constitutes a life-threatening aortic pathology with significant morbidity and mortality. Without surgical intervention the usual mortality rate averages between 1 and 2% per hour. Thus, an early diagnosis of ATAAD is of pivotal importance to direct the affected patients to the appropriate treatment. Read More

J Cardiovasc Pharmacol 2021 May 10. Epub 2021 May 10.

Department of Cardiac Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital Fudan University, Shanghai 200032, China.

Abstract: Aortic aneurysm (AA) remains one of the primary causes of death worldwide. Of the major treatments, prophylactic operative repair is used for AA to avoid potential aortic dissection (AD) or rupture. To halt the development of AA and alleviate its progression into AD, pharmacological treatment has been investigated for years. Read More

Can J Cardiol 2021 May 11. Epub 2021 May 11.

Department of Vascular and Endovascular Surgery, Changzheng Hospital, Naval Medical University, Shanghai, 200001, China. Electronic address:

Background: In situ fenestration (ISF) is an effective approach for reconstructing supra-aortic branches during thoracic endovascular aortic repair (TEVAR). A dedicated device is needed for ISF.

Methods: The "Quick Fenestrater" (QF) underwent in vitro, animal-based, and initial clinical testing. Read More

Semin Cardiothorac Vasc Anesth 2021 May 14:10892532211012976. Epub 2021 May 14.

University of Colorado, Aurora, CO, USA.

COVID-19 has affected every aspect of life over the last year. This article reviews some of the effects that the pandemic had on cardiac surgery including volumes, ethical concerns with resource-intense procedures like dissection and transplant, and ECMO for COVID-19-derived refractory respiratory failure. Read More

Ann Transl Med 2021 Apr;9(8):667

National Clinical Research Center for Child Health, The Children's Hospital Zhejiang University School of Medicine, Hangzhou, China.

Background: The aim of the present study was to use a numerical simulation based on computational fluid dynamics (CFD) to analyze the difference of different cannulation methods on hemodynamics characteristic in a type A aortic dissection (TAAD) model.

Methods: A finite-element analysis based on the CFD model of a TAAD patient was used, and axillary artery cannulation (AAC), innominate artery cannulation (IAC), and femoral artery cannulation (FAC) were analyzed under different situations, including a cardiac output (CO) of 2.5 L/min and cardiopulmonary bypass (CPB) of 2. Read More

Cureus 2021 Apr 7;13(4):e14355. Epub 2021 Apr 7.

Cardiology, Texas Tech University Health Sciences Center, Lubbock, USA.

Aortic dissections (ADs) are uncommon but they are highly lethal. Due to atypical signs and symptoms, diagnosis of type B AD can be easily missed or delayed. Our patient presented to the emergency center with dizziness and fall for which he was evaluated and treated for hypertension. Read More

Heart Views 2020 Oct-Dec;21(4):305-308. Epub 2021 Jan 14.

Department of Medical Education, Saint Michael's Medical Center, New York Medical College, Newark, New Jersey, USA.

Aortic dissection is a life-threatening condition that may present as severe acute chest or abdominal pain, especially in high-risk patients, and should raise a high index of suspicion for aortic dissection when occurring after moderate-to-high-intensity activities, such as sexual intercourse. Sexual intercourse leads to physiological stress on the body causing an abrupt elevation in blood pressure and shearing force against the vessel wall. This shearing force increases the risk of vessel wall dissection. Read More

J Cardiothorac Vasc Anesth 2021 Mar 26. Epub 2021 Mar 26.

Department of Anesthesiology, Department of Medicine, Division of Intensive Care Medicine, Institut universitaire de cardiologie et de pneumologie de Québec - Université Laval, Quebec, Canada.

In this report, the clinical evolution of a 72-year-old patient transferred to the surgical intensive care unit after cardiac surgery is described. The presence of a pulsatile Doppler signal of the common femoral vein was noted after surgery. On postoperative day 5, diuretics in addition to a combination of inhaled epoprostenol and milrinone were associated with normalization of femoral vein pulsatility. Read More

J Thorac Cardiovasc Surg 2021 Apr 16. Epub 2021 Apr 16.

Department of Cardiac Surgery, European Hospital, Rome, Italy; Cardiac Surgery, UniCamillus International University of Health Sciences, Rome, Italy. Electronic address:

Objective: During the last decade, special concerns have been raised about the anatomic relationships among the sinotubular junction, ventricular-aortic junction, and virtual basal ring to improve the results of root reconstruction. The aim of this study is to evaluate the in vivo anatomy of the aortic root after reimplantation with the Valsalva graft and the anatomic relationship between its components.

Methods: We analyzed 10 consecutive patients with tricuspid aortic valves who underwent reimplantation with the Valsalva graft between September and December 2019. Read More

J Thorac Cardiovasc Surg 2021 Apr 20. Epub 2021 Apr 20.

Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa. Electronic address:

Semin Thorac Cardiovasc Surg 2021 May 10. Epub 2021 May 10.

Department of Cardiac Surgery, Michigan Medicine, Ann Arbor, Michigan. Electronic address:

This study aimed to determine how acute type A aortic dissection (ATAAD) impacts patients' quality of life. The 36-Item Short Form Survey (SF-36) was used to measure quality of life. The eight SF-36 scales were aggregated into a two-factor summary: physical and mental component summary scales (PCS and MCS). Read More

Semin Thorac Cardiovasc Surg 2021 May 10. Epub 2021 May 10.

Department of Cardiac Surgery, University of Michigan, Ann Arbor, Mich.

Aortic valve replacement (AVR) is common in the setting of type A aortic dissection (TAAD) repair. Here, we evaluated the association between prosthesis choice and patient outcomes in an international patient cohort. We reviewed data from the International Registry of Acute Aortic Dissection (IRAD) interventional cohort to examine the relationship between valve choice and short- and mid-term patient outcomes. Read More

Semin Thorac Cardiovasc Surg 2021 May 10. Epub 2021 May 10.

Department of Cardiac Surgery, University Hospital Zürich, Zürich, Switzerland. Electronic address:

Coronary Artery Bypass Grafting (CABG) is sometimes necessary in acute Type A Aortic Dissection (AAAD) repair. The aim of this study is to analyze the incidence, indications and influence in-hospital outcomes of AAAD repair requiring concomitant CABG in a high-volume single-center experience. Retrospective study of all consecutive AAAD patients. Read More

J Card Surg 2021 May 12. Epub 2021 May 12.

Division of Cardiovascular Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Objective: Surgeon procedural volume for complex cardiac procedures have become important quality metrics. The objective is to determine the association of surgeon and hospital case volume on patient outcomes after an aortic root replacement for aortic root aneurysms.

Methods: From 2009 to 2014, 4629 Medicare patients underwent an aortic root replacement for a root aneurysm. Read More

J Card Surg 2021 May 12. Epub 2021 May 12.

Departments of Cardiothoracic Surgery, University Hospital Southampton, Southampton, UK.

Objective: The coronavirus disease (COVID-19) increases the respiratory complications and carries a higher mortality in the immediate postoperative period. The aim of this study was to analyze the outcomes of patients with type A acute aortic syndromes (AAS) diagnosed with COVID-19 in the perioperative period.

Methods: Retrospective analysis of prospectively collected data between March and August 2020 from 20 participating cardiac surgery centers in the United Kingdom. Read More

Kyobu Geka 2021 May;74(5):388-391

Department of Cardiovascular Surgery, Kobe City Medical Center General Hospital, Kobe, Japan.

A 50-year-old man presented with abdominal pain and numbness in the right leg. He was diagnosed with type A acute aortic dissection with malperfusion of the superior mesenteric artery(SMA) and the right external iliac artery. Before median sternotomy, we made median celiotomy and anastomosed a saphenous vein graft to SMA. Read More

Kyobu Geka 2021 May;74(5):366-369

Department of Cardiovascular Surgery, Hokkaido Kitami Hospital, Kitami, Japan.

A 68-year-old man with acute chest pain was transported into the emergency room in our hospital. He was in shock, with a systolic blood pressure of 63 mmHg and a heart rate of 115 beats per minute. Echocardiography revealed a cardiac tamponade, but no signs of acute aortic dissection were found by computed tomography. Read More

Kyobu Geka 2021 May;74(5):327-330

Department of Cardiovascular Surgery, Mito Saiseikai General Hospital, Mito, Japan.

Twenty-six patients underwent total arch replacement for Stanford type A aortic dissection, including that with elephant trunk technique (ET group, n=10) or with frozen elephant trunk technique (FET group, n=16). We compared preoperative and intraoperative findings, postoperative results and distal aortic arch remodeling between the two groups. In FET group, anesthesia time, operation time, cardiopulmonary bypass time, cardiac arrest time and circulatory arrest time were significantly shorter than ET group. Read More

Circ J 2021 May 11. Epub 2021 May 11.

Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine.

J Cardiovasc Magn Reson 2021 May 13;23(1):51. Epub 2021 May 13.

Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA.

Background: Chronic type B aortic dissection (TBAD) is associated with poor long-term outcome, and accurate risk stratification tools remain lacking. Pressurization of the false lumen (FL) has been recognized as central in promoting aortic growth. Several surrogate imaging-based metrics have been proposed to assess FL hemodynamics; however, their relationship to enlarging aortic dimensions remains unclear. Read More

Semin Thorac Cardiovasc Surg 2021 May 9. Epub 2021 May 9.

Aortic Institute at Yale New-Haven, Yale University School of Medicine, New Haven, CT, USA. Electronic address:

We examined the long-term fate of the preserved aortic root after emergent repair of acute Type A aortic dissection. 144 patients (60% males, mean age 60.5 years) underwent supracoronary ascending aortic replacement for acute Type A aortic dissection. Read More

Surg Case Rep 2021 May 12;7(1):120. Epub 2021 May 12.

Department of Cardiovascular Surgery, Akita University Graduate School of Medicine, Hondo 1-1-1, Akita, 010-8543, Japan.

Background: Left atrial dissection is a rare complication of cardiac surgery, most commonly associated with mitral valve surgery. Herein, we report on the successful conservative treatment of left atrial dissection while avoiding anticoagulation therapy.

Case Presentation: A 64-year-old man developed left atrial dissection during operation for acute type A aortic dissection, most likely due to retrograde cardioplegia cannulation. Read More

Clin Sci (Lond) 2021 May 12. Epub 2021 May 12.

University of Toronto, Toronto, Canada.

Objective: Aortic macrophage accumulation is characteristic of the pathogenesis of abdominal aortic aneurysm (AAA) but the mechanisms of macrophage accumulation and their phenotype are poorly understood. Lyve-1+ resident aortic macrophages independently self-renew and are functionally distinct from monocyte-derived macrophages recruited during inflammation. We hypothesized that Lyve-1+ and Lyve-1- macrophages differentially contribute to aortic aneurysm. Read More

Nat Commun 2021 May 11;12(1):2628. Epub 2021 May 11.

Gene regulation in cardiovascular remodeling and inflammation group, Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain.

Thoracic aortic aneurysm, as occurs in Marfan syndrome, is generally asymptomatic until dissection or rupture, requiring surgical intervention as the only available treatment. Here, we show that nitric oxide (NO) signaling dysregulates actin cytoskeleton dynamics in Marfan Syndrome smooth muscle cells and that NO-donors induce Marfan-like aortopathy in wild-type mice, indicating that a marked increase in NO suffices to induce aortopathy. Levels of nitrated proteins are higher in plasma from Marfan patients and mice and in aortic tissue from Marfan mice than in control samples, indicating elevated circulating and tissue NO. Read More

Kyobu Geka 2021 Feb;74(2):142-145

Department of Cardiovascular Surgery, Shin-Kuki General Hospital, Kuki, Japan.

We report a case of a 65-year-old man, who was transported as an emergency case to our institution because of Stanford type B dissection. He received conservative therapy, but follow-up computed tomography(CT) revealed dilatation of descending aorta and low-enhanced range from abdominal aorta to right common iliac artery due to the expansion of the false lumen on day 11 of hospitalization. So, we attempted to perform debranch thoracic endovascular aortic repair (TEVAR), but we could not delivery the stentgraft through occluded right iliac artery. Read More

Kyobu Geka 2021 Feb;74(2):139-141

Department of Cardiovascular Surgery, Otakanomori Hospital, Kashiwa, Japan.

The patient was a 76-year-old man with myasthenia gravis (MG). He suffered from a sudden back pain, and was diagnosed with Stanford type A acute aortic dissection. We performed emergency graft replacement of the ascending aorta under cardiopulmonary bypass with hypothermic circulatory arrest. Read More

BMJ Case Rep 2021 May 11;14(5). Epub 2021 May 11.

Cardiothoracic Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.

J Card Surg 2021 May 11. Epub 2021 May 11.

Division of Cardiac Surgery, Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA.

J Card Surg 2021 May 11. Epub 2021 May 11.

Department of Cardiovascular Surgery, Saitama Medical Center, Jichi Medical University, Shimotsuke, Japan.

Objective: Although elderly patients undergoing surgery for acute type A aortic dissection (ATAAD) is increasing, their physical activities are not fully understood. We report the physical activities and surgical outcomes in elderly patients who underwent ATAAD.

Methods: From 2009 to 2019, 103 consecutive patients underwent surgery for ATAAD at our institution. Read More