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Anat Cell Biol 2022 Jun;55(2):259-263

Department of Normal Anatomy, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine.

Situs inversus totalis is a rare condition of visceral transposition in thoracic and abdominal cavities. Computed tomography (CT)-based morphometric analysis of the cardiovascular system prior to the surgery helps to describe vessel topography and size, choose the right surgical insertion site, avoid vessel trauma, and prevent hemorrhage during surgical intervention. We present a case report of situs inversus totalis detected incidentally in a 74-year-old male with the acute abdominal syndrome. Read More

Interact Cardiovasc Thorac Surg 2022 Jun 30. Epub 2022 Jun 30.

Department of Cardiovascular Surgery, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan.

An 81-year-old man with multiple comorbidities developed infected thoracic aortic aneurysm, and we employed a strategic two-step surgical approach combining thoracic endovascular aortic repair and local debridement with an omental flap during the active phase of infection. No signs of reinfection were observed at the 1-year follow-up. This strategy can be a safe and less invasive alternative to conventional open surgery in patients with high surgical risk. Read More

J Biomed Mater Res A 2022 Jun 30. Epub 2022 Jun 30.

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

Pericytes are essential components of small blood vessels and are found in human aortic vasa vasorum. Prior work uncovered lower vasa vasorum density and decreased levels of pro-angiogenic growth factors in adventitial specimens of human ascending thoracic aortic aneurysm. We hypothesized that adventitial extracellular matrix (ECM) from normal aorta promotes pericyte function by increasing pericyte contractile function through mechanisms deficient in ECM derived from aneurysmal aortic adventitia. Read More

J Endovasc Ther 2022 Jun 29:15266028221107879. Epub 2022 Jun 29.

Division of Cardiothoracic Surgery, Department of Surgery, Medical University of South Carolina, Charleston, SC, USA.

Purpose: Open aortic arch repair is the gold standard in the treatment of diseases involving the ascending aorta and aortic arch. However, due to the invasive nature of open repair, high-risk patients with multiple comorbidities are often not suitable candidates for open surgical repair. While endovascular aortic repair is far less invasive, endovascular arch repair remains a difficult challenge due to the aortic arch diameter and angulation, origin of the supra-aortic arteries, and the lack of commercially available thoracic branched devices in the United States. Read More

J Am Heart Assoc 2022 Jun 29:e025026. Epub 2022 Jun 29.

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

Background Acute aortic syndromes may be prone to misdiagnosis by nonreferral aortic centers with less diagnostic experience. We evaluated regional variability in these misdiagnosis trends among patients transferred to different regional quaternary care centers with presumed acute aortic syndromes. Methods and Results Two institutional aortic center databases were retrospectively reviewed for emergency transfers in patients diagnosed with acute aortic dissection, intramural hematoma, penetrating aortic ulcer, thoracic aortic aneurysm, or aortic pseudoaneurysm between 2008 and 2020. Read More

Acta Biomater 2022 Jun 24. Epub 2022 Jun 24.

Department of Mechanical Engineering, and Iowa Technology Institute The University of Iowa, Iowa City, IA 52242, USA. Electronic address:

We propose a new approach for constructing strain-based rupture criterion for ascending thoracic aortic aneurysm. The rupture metric is formulated using an effective strain, which is a measure of net strain that the collagen bundles experience after fiber uncrimping. The effective strain is a function of the total strain and the waviness properties of the collagen fibers. Read More

Radiologie (Heidelb) 2022 Jul 27;62(7):551-555. Epub 2022 Jun 27.

Ärztliche Leitung Angiographie/Interventionsradiologie CCM, Klinik für Radiologie - Arbeitsbereich Interventionelle Radiologie, Campus Charité Mitte, Campus Virchow-Klinikum, CC 06 Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Charité - Universitätsmedizin Berlin, Berlin, Deutschland.

Background: In the last decade, new stent graft designs have evolved to tackle challenges in thoracic endovascular aortic repair. A specific focus on access vessel issues has led to the introduction of new low-profile endograft designs for most of the major products.

Objective: The main objective of this article is to provide an overview of the available publications on new stent graft designs. Read More

Eur J Radiol Open 2022 16;9:100427. Epub 2022 Jun 16.

Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany.

Purpose: To assess the diagnostic precision of three different workstations for measuring thoracic aortic aneurysms (TAAs) in vivo and ex vivo using either pre-interventional computed tomography angiography scans (CTA) or a specifically designed phantom model.

Methods: This retrospective study included 23 patients with confirmed TAA on routinely performed CTAs. In addition to phantom tube diameters, one experienced blinded radiologist evaluated the dimensions of TAAs on three different workstations in two separate rounds. Read More

Zhong Nan Da Xue Xue Bao Yi Xue Ban 2022 May;47(5):650-654

Department of Cardiovascular Surgery, Xiangya Hospital, Central South University, Changsha 410008.

Objectives: After cardiac surgery involving the aortic arch, the incidence of neurological complications remains high, therefore it is very important to take measures to protect brain. This study is to investigate the safety and effectiveness of deep hypothermic circulatory arrest and retrograde cerebral perfusion for aortic root combined with right half aortic arch replacement.

Methods: Clinical data of 31 patients, who underwent aortic root and right half aortic arch replacement with deep hypothermic circulatory arrest and retrograde cerebral perfusion in Xiangya Hospital, Central South University, were retrospectively analyzed. Read More

J Vasc Surg 2022 Jun 22. Epub 2022 Jun 22.

Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Case Western Reserve University School of Medicine/University Hospitals, Cleveland Medical Center, Cleveland, OH. Electronic address:

Objectives: Interfacility transfer (IT) of patients with ruptured (r) abdominal aortic aneurysm (AAA) occurs not infrequently for a higher level of care. This study evaluates using contemporary administrative database the impact of IT on mortality after rAAA repair.

Methods: Healthcare Cost and Utilization Project Database for NY (2016) and NJ/MD/FL (2016-2017) were queried using ICD-10 edition to identify patients who underwent open and endovascular repair of AAA. Read More

Interact Cardiovasc Thorac Surg 2022 Jun 24. Epub 2022 Jun 24.

Department of Cardiovascular Surgery, Nagoya City University Graduate School of Medical Sciences.

Takayasu arteritis (TA) results in a variety of vascular symptoms, and there are some cases in which progressive vascular lesions require surgical intervention. We present a case with ascending aortic aneurysm, right common carotid artery stenosis, left common carotid artery occlusion, and left subclavian artery stenosis caused by TA that was successfully treated with total arch replacement and ascending aorta to right internal carotid artery bypass. Read More

J Clin Med 2022 Jun 16;11(12). Epub 2022 Jun 16.

Department of Vascular and Endovascular Surgery, University Hospital Muenster, 48149 Muenster, Germany.

There are different surgical options for the treatment of proximal lesions of the descending thoracic aorta. The aim of this study was to compare the outcome of physician-modified TEVAR (pmTEVAR) vs. hybrid repair of the thoracic aorta in terms of TEVAR with carotid-subclavian bypass (hdTEVAR). Read More

Int J Mol Sci 2022 Jun 17;23(12). Epub 2022 Jun 17.

National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA.

Lysyl oxidase () is a copper-binding enzyme that cross-links elastin and collagen. The dominant variation contributes to familial thoracic aortic aneurysm. Previously reported murine mutants had a mild phenotype and did not dilate without drug-induced provocation. Read More

J Cardiothorac Surg 2022 Jun 23;17(1):166. Epub 2022 Jun 23.

Department of Cardiovascular Surgery, Fujian Provincial Hospital, Fuzhou, 350001, China.

Background: The goal of this study was to determine the clinical outcomes of total arch replacement with frozen elephant trunk surgery and hybrid debranching surgery for acute type A aortic dissection patients.

Methods: From January 2017 to December 2019, the clinical data of acute type A aortic dissection patients were retrospectively collected and analyzed. There were 142 patients underwent total arch replacement with frozen elephant trunk surgery and 35 patients underwent hybrid debranching surgery. Read More

Radiologie (Heidelb) 2022 Jul 23;62(7):556-562. Epub 2022 Jun 23.

Klinik für Diagnostische und Interventionelle Radiologie, UKGM Marburg, Philipps-Universität Marburg, Marburg, Deutschland.

Background: Chronic type B aortic dissection requires optimal medical therapy. However, secondary complications like organ or extremity malperfusion or development of aneurysmal dilatation require interventional therapy.

Objectives: Presentation of different endovascular treatment options for complications of chronic type B aortic dissection. Read More

Rev Med Chil 2021 Dec;149(12):1707-1715

Departamento de Cirugía Vascular y Endovascular, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.

Background: Thoracoabdominal aortic aneurysm (TAAA) is an infrequent disease and demands a highly specialized and experienced management. Open repair (OR) is the gold standard but it is associated with significant morbidity and mortality. Paraplegia and renal failure are the most important complications. Read More

J Endovasc Ther 2022 Jun 23:15266028221105183. Epub 2022 Jun 23.

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

Purpose: To evaluate the impact of cava balloon occlusion on the myocardium during endovascular repair of thoracic aortic pathologies.

Material And Methods: A prospective observational cohort study of 21 patients who underwent endovascular repair of aortic arch and thoracic aorta in a single tertiary referral center with use of inferior vena cava (IVC) balloon occlusion as a method of intraoperative cardiac output reduction. Pre-, intra-, and postoperative measurements of heart rate, blood pressure, stroke volume index, and central venous oxygen saturation were noted. Read More

J Cardiothorac Surg 2022 Jun 22;17(1):165. Epub 2022 Jun 22.

Department of Cardiovascular Surgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China (USTC), Hefei, 230001, Anhui, China.

Background: This study aimed to investigate the safety of direct innominate arterial (IA) cannulation using a pediatric arterial cannula to establish selective antegrade cerebral perfusion (ACP) during total arch replacement (TAR) for acute Stanford type A aortic dissection (ATAAD).

Methods: This retrospective study included patients with ATAAD who underwent TAR with the frozen elephant trunk (FET) technique between October 2020 and November 2021. Patients treated with direct IA cannulation using a pediatric arterial cannula for selective anterograde cerebral perfusion were included in the study. Read More

ESC Heart Fail 2022 Jun 21. Epub 2022 Jun 21.

Department of Cardiovascular Surgery, Shengli Oilfield Central Hospital, Dongying, China.

Aims: Recently, long non-coding RNAs (lncRNAs) have been revealed to mediate smooth muscle dysfunction in thoracic aortic aneurysm (TAA). LncRNA HOXA-AS2 has been proposed to engage in the regulation of diverse diseases. However, its function in TAA remains unknown. Read More

Radiologie (Heidelb) 2022 Jul 20;62(7):586-591. Epub 2022 Jun 20.

Abteilung für Kardiovaskuläre und Interventionelle Radiologie, Universitätsklinik für Radiologie und Nuklearmedizin, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich.

Background: Today, complex abdominal aortic pathologies involving the visceral arteries and without an adequate proximal neck can be treated using fenestrated/branched endovascular aortic repair (FEVAR/BEVAR) with similar safety and success rates as infrarenal aortic pathologies treated with tubular EVAR.

Methodical Innovations And Challenges: Fenestrations (if the vessel originates from a nondilated aorta) or branches (if the vessel originates from a dilated aorta) may be used for the visceral arteries. Both types of openings are sealed via bridging stent grafts that connect to the target vessel. Read More

JA Clin Rep 2022 Jun 21;8(1):46. Epub 2022 Jun 21.

Department of Anesthesiology and Critical Care Medicine, Asahikawa Medical University, Midorigaoka-higashi 2-1-1-1, Asahikawa, Hokkaido, 078-8510, Japan.

Background: Anesthetic management of thoracic aortic aneurysms (TAAs) is sometimes difficult due to fatal complications, including hypovolemic shock secondary to aneurysm rupture. We report the successful management of an impending rupture of a TAA with associated esophageal stenosis and compression of the pulmonary artery and left bronchi.

Case Presentation: An 83-year-old woman, diagnosed with an impending rupture of the ascending TAA, was scheduled to undergo emergency total aortic arch replacement. Read More

Front Med (Lausanne) 2022 26;9:882697. Epub 2022 May 26.

Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

Background: Thoracic aortic pseudoaneurysm associated with spinal tuberculosis is a rare but fatal condition. The risk of pseudoaneurysm rupture is extremely high and this disease needs greater awareness. The present study reported a case of thoracic aortic pseudoaneurysm caused by paravertebral cold abscess with spinal tuberculosis. Read More

J Formos Med Assoc 2022 Jun 15. Epub 2022 Jun 15.

Department of Surgery, Cardiovascular Section, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan. Electronic address:

Background: Thoracic endovascular aortic repair (TEVAR) can only promote 55-80% false lumen (FL) thrombosis when only the proximal primary tear is covered during the repair of type B aortic dissection (TBAD). This study evaluated the effectiveness and clinical outcome of tailored exclusion of the primary entry tear with TEVAR and distal fenestrations with ancillary devices in patients with subacute or chronic Crawford type III and IV aortic dissection aneurysm.

Methods: All patients underwent either TEVAR for primary entry tear; subsequently, various ancillary devices were applied on each distal fenestration. Read More

BMC Cardiovasc Disord 2022 Jun 18;22(1):277. Epub 2022 Jun 18.

Division of NeuroSurgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou, Chang Gung University, Taoyuan, Taiwan.

Background: Acute thrombosis of an abdominal aortic aneurysm with acute limb ischaemia is an unusual complication and is associated with high mortality. Dislocation of the intrasaccular mural thrombus could be one of the mechanisms. For the most part, acute limb ischaemia presents with absent pulses, compatible with the clinical findings, which include pain, paraesthesia, and paralysis. Read More

Acta Biomater 2022 Jun 14. Epub 2022 Jun 14.

ImViA laboratory, University of Burgundy, Dijon, France; Department of Medical Imaging, University Hospital of Dijon, Dijon, France.

Ascending aortic aneurysm (AsAA) is a high-risk cardiovascular disease with an increased incidence over years. In this study, we compare different risk factors based on the pre-failure behavior (from a biomechanical point of view) obtained ex-vivo from an equi-biaxial tensile test. A total of 100 patients (63 ± 12 years, 72 males) with AsAA replacement, were recruited. Read More

Front Cardiovasc Med 2022 27;9:883708. Epub 2022 May 27.

Department of Vascular Surgery, The Second Xiangya Hospital, Central South University, Changsha, China.

Coexisting multilevel aortic pathologies were caused by atherosclerosis and hypertension and presented in a small subgroup of patients. Endovascular repair is a safe and effective treatment for a variety of aortic pathologies. However, fewer small series and cases were reported using simultaneous thoracic endovascular repair (TEVAR) and endovascular aneurysm repair (EVAR) for both aortic segments. Read More

JTCVS Tech 2022 Jun 3;13:26-30. Epub 2022 Mar 3.

Department of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, WVa.

Objectives: Isolated right coronary leaflet prolapse is a common cause of nonaneurysmal aortic insufficiency, but can rarely occur in patients with proximal aortic aneurysms. Standardized techniques for routine autologous repair of this disorder are presented.

Methods: Most aortic valve leaflet prolapse is isolated to the right coronary leaflet, with hypertension and annular dilatation being contributory. Read More

Clin Sports Med 2022 Jul;41(3):511-527

Marfan Syndrome and Aortopathy Clinic, Aortopathy and Master Clinician Fellowship Program, Cardiovascular Division, John T. Milliken Department of Medicine, Washington University School of Medicine, 660 South Euclid Avenue, Box 8086, St. Louis, MO 63110, USA. Electronic address:

The evaluation and management of athletes with HTAD and aortopathy conditions requires shared decision-making encompassing the underlying condition, family history, aortic diameter, and type and intensity of sports and exercise. Mouse models of thoracic aortic disease show that low-to-moderate-level aerobic exercise can maintain aortic architecture and attenuate pathologic aortic root dilation. Although controlled trials in human are lacking, recreational physical activities performed at a low-to-moderate aerobic pace are generally low risk for most individuals with aortopathy conditions. Read More

J Am Coll Cardiol 2022 Jun;79(24):2428-2430

Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, California, USA.

J Am Coll Cardiol 2022 Jun;79(24):2415-2427

Departament de Cardiologia, Hospital Vall d'Hebron, CIBERCV, Universitat Autonoma de Barcelona, Barcelona, Spain.

Background: Despite the absence of clinical complications after an acute aortic dissection (AD) with persistent patent false lumen (FL), a high risk for clinical events may persist.

Objectives: The aim of this study was to assess the natural evolution of noncomplicated AD and ascertain whether different FL flow patterns by magnetic resonance imaging (MRI) have independent prognostic value for AD-related events beyond established morphologic parameters.

Methods: One hundred thirty-one consecutive patients, 78 with surgically treated type A dissections and 53 with medically treated type B dissections, were followed up prospectively after acute AD with persistent patent FL in the descending aorta. Read More