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J Card Surg 2022 May 17. Epub 2022 May 17.

Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.

Objective: To determine the long-term impact of developing acute renal failure (ARF) on survival after open aortic arch reconstruction for acute type A aortic dissection (ATAAD).

Methods: This was an observational study of consecutive aortic surgeries from 2007 to 2021. Patients with ATAAD were identified via a prospectively maintained institutional database and were stratified by the presence or absence of postoperative ARF (by RIFLE criteria). Read More

World J Cardiol 2022 Apr;14(4):231-238

Department of Adult Cardiac Surgery, Onassis Cardiac Surgery Center, Athens 17674, Greece.

Background: Acute type A aortic dissection (ATAAD) is a life-threatening disease associated with high morbidity and mortality.

Aim: To evaluate the diameter of dissected ascending aorta in patients diagnosed with ATAAD and whether the aortic diameter is associated with preoperative adverse events.

Methods: A total of 108 patients diagnosed with ATAAD who underwent emergency operation under hypothermic circulatory arrest were enrolled in this study. Read More

Clin Case Rep 2022 May 9;10(5):e05820. Epub 2022 May 9.

University Hospitals of Leicester NHS Foundation Trust Glenfield Hospital Leicester UK.

Spontaneous or non-traumatic rupture of the renal tract is an infrequent presentation, and it is most frequently caused by ureteric obstruction. Rupture could occur at any level of the upper urinary tract. However, it is most common at the renal calyces and complications that could arise include; urinoma, and or hematoma collection which could progress to abscess formation and sepsis. Read More

Interv Neuroradiol 2022 May 17:15910199211070900. Epub 2022 May 17.

Department of Neurosurgery, 56697Tangdu Hospital, Air Force Medical University (The Fourth Military Medical University), Xi'an, China.

Background: More data is needed on the short- and medium-term efficacy and safety of the Willis covered stent in treating distal internal carotid artery (DICA) aneurysms and vertebral artery dissecting aneurysms (VADAs).

Methods: Records of all 42 patients with DICA aneurysms or VADAs treated with the Willis covered stents at our institute between July 2014 and January 2019 were retrospectively examined. The patients' demographic information, symptoms, diagnosis, treatment procedure, immediate and follow-up clinical and angiographic outcomes were extracted. 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 Cardiothorac Surg 2022 May 16;17(1):118. Epub 2022 May 16.

Department of Cardiothoracic Surgery, John Hunter Hospital, Newcastle, NSW, 2305, Australia.

Background: The outcomes of surgery for acute Stanford Type A aortic dissection (ATAAD) extend beyond mortality and morbidity. The aim of this systematic review was to summarise the literature surrounding health related quality of life (HR-QOL) following ATAAD, compare the outcomes to the standardised population, and to assess the impact of advanced age on HRQOL outcomes following surgery.

Methods: A systematic review of studies after January 2000 was performed to identify HR-QOL in patients following surgery for ATAAD. Read More

J Card Surg 2022 May 16. Epub 2022 May 16.

First Department of Adult Cardiac Surgery, Onassis Cardiac Surgery Center, Athens, Greece.

Acute type A aortic dissection (ATAAD) is a life-threatening aortic disease. Many systems and organs are affected by malperfusion which presents preoperatively and postoperatively. Postoperative acute renal failure after ATAAD constitutes a severe and insidious complication. Read More

J Card Surg 2022 May 16. Epub 2022 May 16.

First Department of Adult Cardiac Surgery, Onassis Cardiac Surgery Center, Athens, Greece.

A hypothermic circulatory arrest is usually used to correct thoracic aorta pathologies. The emergency treatment of acute type A aortic dissection and elective repair of aortic arch pathologies are the most common indications for using hypothermic circulatory arrest. A hypothermic circulatory arrest can also be used for surgical pulmonary thromboendarterectomy in patients with chronic thromboembolic pulmonary hypertension. Read More

Curr Probl Cardiol 2022 May 13:101253. Epub 2022 May 13.

The University of Texas M.D. Anderson, Department of Cardiovascular Medicine, 1515 Holcombe Boulevard, Houston TX 77030, USA. Electronic address:

J Stroke Cerebrovasc Dis 2022 May 13;31(8):106487. Epub 2022 May 13.

Department of Neurosurgery, Kitano Hospital, Tazuke Kofukai Medical Research Institute, Osaka 530-8480, Japan.

Objectives: An elongated styloid process may cause vascular Eagle syndrome that includes cervical carotid artery (CCA) dissection with stenosis and aneurysm formation. There are only four reported cases with vascular Eagle syndrome-related CCA dissecting aneurysm treated with carotid artery stenting (CAS). This is the first report of applying a dual-layer nitinol micromesh stent (CASPER) for vascular Eagle syndrome-related CCA dissecting aneurysm. Read More

Perfusion 2022 May 16:2676591221092313. Epub 2022 May 16.

Department of Cardiac Surgery, Glenfield Hospital, Leicester, UK.

Non-bacterial thrombotic endocarditis (NBTE) is a rare, often asymptomatic, condition. A 55-year-old woman presented with hemiparesis, facial palsy and chest pain. After urgent investigation, she was referred as a case of type A aortic dissection complicated by tamponade, myocardial infarction and stroke. Read More

Perfusion 2022 May 16:2676591221095468. Epub 2022 May 16.

Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, London, UK.

Objectives: The aim of the study is to compare the safety and efficacy of unilateral anterograde cerebral perfusion (UACP) and bilateral anterograde cerebral perfusion (BACP) for acute type A aortic dissection (ATAAD).

Methods: A systematic review of the MEDLINE (PubMed), Scopus, and Cochrane Library databases (last search: August 7th, 2021) was performed according to the PRISMA statement. Studies directly comparing UACP versus BACP for ATAAD were included. Read More

Front Surg 2022 28;9:902108. Epub 2022 Apr 28.

Division of Nephrology, Department of Medicine, West China Hospital of Sichuan University, Chengdu, China.

Background: Acute type A aortic coarctation (AAAD) is a highly deadly and serious life-threatening disease. The purpose of this study was to estimate the predictive value of peak procalcitonin, interleukin-6, and C-reactive protein levels on adverse renal outcomes and mortality in patients undergoing surgery for AAAD.

Methods: Perioperative peak PCT, CRP, and IL-6 levels were retrospectively collected in 331 patients hospitalized with AAAD from 2009 to 2021. Read More

Front Endocrinol (Lausanne) 2022 29;13:844787. Epub 2022 Apr 29.

Department of Cardiac Surgery, Beijing Anzhen Hospital,Capital Medical University, Beijing, China.

Background: Subclinical hypothyroidism can negatively affect the cardiovascular system and increase the risk of mortality, especially for individuals with thyroid-stimulating hormone (TSH) levels above 10 mU/L. We investigated the relationship between high-TSH subclinical hypothyroidism and postoperative mortality in acute type A aortic dissection (ATAAD) patients.

Method: We enrolled 146 patients with ATAAD who underwent aortic surgery in Beijing Anzhen Hospital from July 2016 to November 2018. Read More

J Thorac Dis 2022 Apr;14(4):1031-1041

Department of Cardiovascular Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.

Background: The frozen elephant trunk technique is useful in aortic arch repair; however, some adverse events are associated with the Frozenix J-graft. We designed a technique to prevent these adverse events and achieve easy anastomosis (Total Exclusion of the Non-Stent part of Frozenix using an Everting anastomosis [TENSE]), and we assessed the outcomes of this technique in the present study.

Methods: From April 2017 to May 2021, 44 patients with aortic arch disease underwent TENSE, in which the proximal stump of the stent part of Frozenix was matched to the distal anastomosis end between the left common carotid and left subclavian arteries. Read More

Ann Transl Med 2022 Apr;10(8):500

[This corrects the article DOI: 10.21037/atm-21-605.]. Read More

Front Cardiovasc Med 2022 27;9:912071. Epub 2022 Apr 27.

Vascular & Endovascular Surgery, Velindre University NHS Trust, Health Education & Improvement Wales (HEIW), Cardiff, United Kingdom.

Introduction: Kinking of the Frozen Elephant Trunk (FET) stent graft is one of the most devastating complications of the FET procedure. It can present post-operatively with reduced arterial pressures in the lower limbs and intermittent claudication. However, it can also be visualized intra-operatively by the surgeons. 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

J Biomech 2022 May 10;138:111133. Epub 2022 May 10.

Laboratory of Biomechanics, Center of Clinical, Experimental Surgery, and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece. Electronic address:

Aortic dissection often initiates a few centimeters distal to the coronary ostia in the right lateral wall, with an intimal-medial tear that tends to be transversely directed and occupy half of the aortic circumference, sometimes less, but seldom the entire circumference. To elucidate these clinical observations, tear tests were presently used to determine the layer-specific resistance to tear propagation in ascending thoracic aortic aneurysms, assessing variations over the four circumferential quadrants and two directions. Aneurysmal tissue strips of standardized dimensions from sixteen patients were anatomically separated into layers (seven hundred and twelve) and an incision made along one-third of their length. Read More

Heart Vessels 2022 May 15. Epub 2022 May 15.

Departments of Clinical Imaging, Tohoku University Graduate School of Medicine, Seiryo 1-1, Sendai, 980-8574, Japan.

Purpose: For patients with aortic dissection (AD) and intramural hematoma (IMH), the optimal cardiac phase to detect intimal tears (IT) and ulcer-like projections (ULP) on retrospective electrocardiogram (ECG)-gated computed tomography angiography (CTA) remains unclear. The purpose of this study was to compare the accuracy of retrospective ECG-gated CTA for detecting IT in AD and ULP in IMH between each cardiac phase.

Materials And Methods: A total of 75 consecutive patients with AD and IMH of the thoracic aorta were enrolled in this single-center retrospective study. Read More

Asian J Surg 2022 May 11. Epub 2022 May 11.

Department of Nursing, General Hospital of Ningxia Medical University, Yinchuan, 750000, China. Electronic address:

Curr Probl Cardiol 2022 May 11:101249. Epub 2022 May 11.

Department of Cardiovascular Surgery, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University); The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, 518020, Guangdong, China. Electronic address:

Aortic dissection (AD) is a critical cardiovascular disease due to the separation of media and adventitia caused by the rupture of vascular wall intima. The disease has a high mortality rate of about 1% to 3% for each additional hour, since the adventitia of the aorta can rupture and bleed to death at any time. Although great progress has been made in clinical treatment of aortic dissection, and the mortality rate has been significantly reduced, the pathogenesis is still not very clear. Read More

Int J Environ Res Public Health 2022 May 6;19(9). Epub 2022 May 6.

School of Automation, Central South University, Changsha 410083, China.

Aortic dissection (AD) is a rare and high-risk cardiovascular disease with high mortality. Due to its complex and changeable clinical manifestations, it is easily missed or misdiagnosed. In this paper, we proposed an ensemble learning model based on clustering: Cluster Random under-sampling Smote-Tomek Bagging (CRST-Bagging) to help clinicians screen for AD patients in the early phase to save their lives. Read More

Int J Mol Sci 2022 Apr 30;23(9). Epub 2022 Apr 30.

Department of Pediatrics III, Faculty of Medicine in English, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540136 Târgu Mureș, Romania.

Dilatation of the aorta is a constantly evolving condition that can lead to the ultimate life-threatening event, acute aortic dissection. Recent research has tried to identify quantifiable biomarkers, with both diagnostic and prognostic roles in different aortopathies. Most studies have focused on the bicuspid aortic valve, the most frequent congenital heart disease (CHD), and majorly evolved around matrix metalloproteinases (MMPs). 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

BMC Cardiovasc Disord 2022 May 13;22(1):216. Epub 2022 May 13.

Department of Cardiovascular Surgery, Juntendo University, Hongo 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan.

Background: In patients with systemic lupus erythematosus (SLE), lengthy treatment and long-term steroid use are the main risk factors for developing aortic aneurysms or aortic dissections. In patients with cardiac tamponade, hemodynamic collapse may lead to acute renal and hepatic failure.

Case Presentation: We report the successful treatment of a 55-year-old woman with SLE since the age of 21. Read More

Cardiovasc Intervent Radiol 2022 May 13. Epub 2022 May 13.

Neuroradiologische Klinik, Kopf- und Neurozentrum, Klinikum Stuttgart, Stuttgart, Germany.

Purpose: To assess the safety and short-term occlusion rates in procedures using the p64 MW hydrophilic polymer-coated (HPC) flow diverter (FD) with prasugrel single antiplatelet therapy (SAPT) for the treatment of anterior circulation saccular aneurysms.

Methods: We retrospectively identified patients who underwent treatment of one or more intracranial anterior circulation saccular aneurysms between March 2020 and December 2021 with a p64 MW HPC FD and prasugrel SAPT with verified P2Y12 platelet receptor inhibition. Patients diagnosed with fusiform, dissecting, or recently ruptured aneurysms were excluded. Read More

Interact Cardiovasc Thorac Surg 2022 May 13. Epub 2022 May 13.

Department of Cardiovascular Surgery, University Heart Centre Freiburg, University of Freiburg, Freiburg, Germany.

Objectives: We aimed to determine whether non-A non-B aortic dissection differs in morphologic and haemodynamic properties from type B aortic dissection.

Methods: We simulated and compared haemodynamics of patients with acute type B or acute non-A non-B aortic dissection by means of computational fluid dynamics. Wall pressure and wall shear stress in both the true lumen and false lumen at early, mid-, and late systole were evaluated. Read More

World Neurosurg 2022 May 9. Epub 2022 May 9.

Department of Neurology, Neurovascular Division, University of California San Francisco.

Background: Methamphetamine (MA) use is associated with poor outcomes after aneurysmal subarachnoid hemorrhage (aSAH). MA exerts both hemodynamic and inflammatory effects, but whether these manifest with altered intracranial aneurysm (IA) remodeling is unknown. The objective of this study was to compare IA geometric and morphologic features in patients with and without MA detected on urine toxicology (Utox) at presentation. Read More

Nucl Med Commun 2022 May 13. Epub 2022 May 13.

Department of Radiology, Mie University Hospital, Edobashi, Tsu.

Objectives: In the selection of thoracic endovascular repair for aortic dissection (AD), it is important to distinguish between the subacute and chronic phases, but there is no reliable way to distinguish between them in patients with unknown onset of AD. The purpose of this study was to assess the diagnostic performance of 2-[18F] fluoro-2-deoxy-d-glucose (18F-FDG)-PET/computed tomography (PET/CT) for discriminating subacute AD from chronic AD.

Methods: Thirteen patients with AD who were medically treated and followed up for 6 months were studied. Read More