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Sample records for aneurisma da aorta

  1. Screening for abdominal aortic aneurysms Rastreamento de aneurismas da aorta abdominal

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    Telmo Pedro Bonamigo

    2003-01-01

    Full Text Available OBJECTIVE AND METHODS: Screening for abdominal aortic aneurysms may be useful to decrease mortality related to rupture. We conducted a study to assess the prevalence of abdominal aortic aneurysms in southern Brazil and to define risk factors associated with high prevalence of this disorder. The screening was conducted using abdominal ultrasound. Three groups were studied: Group 1 - cardiology clinic patients; Group 2 - individuals with severe ischemic disease and previous coronary surgery, or important lesions on cardiac catheterism; Group 3 - individuals without cardiac disease selected from the general population. All individuals were male and older than 54 years of age. The ultrasonographic diagnosis of aneurysm was based on an anteroposterior abdominal aorta diameter of 3 cm, or on an abdominal aorta diameter 0.5 cm greater than that of the supra-renal aorta. RESULTS: A total of 2.281 people were screened for abdominal aortic aneurysms in all groups: Group 1 - 768 individuals, Group 2 - 501 individuals, and Group 3 - 1012 individuals. The prevalence of aneurysms was 4.3%, 6.8% and 1.7%, respectively. Age and cigarette smoking were significantly associated with increased prevalence of aneurysms, as was the diagnosis of peripheral artery disease. DISCUSSION: We concluded that screening may be an important tool to prevent the mortality associated with abdominal aortic aneurysms surgery. Additionally, the cost of screening can be decreased if only individuals presenting significant risk factors, such as coronary and peripheral artery disease, smokers and relatives of aneurysm patients, are examined.OBJETIVO E MÉTODOS: O rastreamento de aneurisma da aorta abdominal infra-renal é importante pois pode diminuir a mortalidade relacionada à ruptura. Realizamos um estudo para definir a prevalência desses aneurismas em diversos segmentos da população em nossa região do Brasil. O rastreamento foi realizado utilizando-se a ecografia de abdômen. Tr

  2. Correção endovascular do aneurisma da aorta abdominal: análise dos resultados de único centro

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    Eduardo Rafael Novero

    2012-02-01

    Full Text Available OBJETIVO: Avaliar os resultados clínicos imediatos e em médio prazo do tratamento endovascular em pacientes portadores de aneurisma da aorta abdominal em um centro de referência para doenças cardiovasculares. MATERIAIS E MÉTODOS: Estudo retrospectivo de uma série de pacientes submetidos a tratamento endovascular de aneurisma da aorta abdominal, no período de janeiro de 2009 a julho de 2010. Foram avaliados as características demográficas, o sucesso técnico, o sucesso terapêutico, a morbimortalidade, as complicações e a taxa de reintervenções perioperatórias imediatos, e após um ano de acompanhamento. RESULTADOS: Foram analisados 102 pacientes consecutivos com idade média de 72 ± 9 anos, sendo 79% deles do sexo masculino. Houve sucesso técnico em 97,1% e êxito terapêutico em 81% dos casos. A mortalidade perioperatória foi de 0,9% e a anual, de 7,8%. Foram necessárias reintervenções em 18,8% dos pacientes durante o seguimento. CONCLUSÃO: Em nosso estudo, os resultados obtidos justificam a realização desse procedimento nos pacientes com anatomia adequada.

  3. Tratamento de aneurismas da parte torácica da aorta pela introdução de "stents" sob visão endoscópica

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    José Honório PALMA

    1998-01-01

    Full Text Available Tratamento de paciente com dois aneurismas saculares da aorta descendente, utilizando dois "stents" distintos, manufaturados sob medida tanto em comprimento quanto em diâmetro. Inseridos sob visão endoscópica com aparelho da marca "Olimpus" esterilizado com óxido de etileno, através de abertura na croça da aorta. O procedimento foi realizado por esternotomia mediana, com circulação extracorpórea, em hipotermia profunda e parada circulatória total. A manipulação endoscópica da aorta descendente, sem sangue, permitiu a identificação dos dois aneurismas, assim como a visão dos ramos principais da aorta e a inserção com expansão , na posição exata, dos dois "stents". A evolução pós- operatória foi satisfatória, sendo que este procedimento, inédito, abre uma nova perspectiva no tratamento dos aneurismas torácicos, toracoabdominais e abdominais.This is a case report of a patient with two saccular aneurysms in the thoracic descending aorta. Treatment consisted of the positioning, through an opening in the aortic arch under deep hipothermia and total circulatory arrest, of two auto expandable stents, guided an Olympus endoscope. The bloodless field made possible the identification of the main thoracic and abdominal aortic branches facilitating the positioning and expansion of both stents. Immediate postoperative recovery was excellent. This is a previously unreported way of placing stents and could open a new perspective in the treatment of thoraco, abdominal and thoracic abdominal aortic aneurysms.

  4. Superinfecção e rotura de aneurisma da aorta abdominal por Salmonella dublin: relato de caso Superinfection and rupture of abdominal aortic aneurysm after Salmonella dublin septicemia: a case report

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    Anibal Basile Filho; Albert Jaeger; Antônio Capone Neto; Mário Mantovani

    1988-01-01

    Os autores relatam o caso de paciente de 66 anos, que apresentou superinfecção e rotura de aneurisma da aorta abdominal, após septicemia por Salmonella dublin. As infecções endovasculares associadas à rotura de aneurisma pré-existentes são um rico potencial nos pacientes com mais de 50 anos de idade, que apresentam bacteremia ou septicemia por Salmonella sp. A alta mortalidade da aortite por salmonelose é devida à septicemia grave ou à rotura desses aneurismas. Qualquer tecido orgânico pode s...

  5. Proposta para padronização do relatório de tomografia computadorizada nos aneurismas da aorta abdominal A proposal for standardizing computed tomography reports on abdominal aortic aneurysms

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    Fabiola Goda Torlai; Gustavo S. Portes Meirelles; Fausto Miranda Jr; José Honório A.P. da Fonseca; Sérgio Ajzen; Giuseppe D'Ippolito

    2006-01-01

    OBJETIVO: Propor um modelo de padronização de relatório para aneurisma da aorta abdominal na tomografia computadorizada. MATERIAIS E MÉTODOS: Foram realizadas, no período de abril a outubro de 2004, entrevistas com integrantes da Disciplina de Cirurgia Vascular da nossa instituição, para elaboração de um modelo de padronização de relatório de tomografia computadorizada para o estudo do aneurisma da aorta abdominal. A partir deste modelo foi elaborado um questionário, enviado a nove outros cir...

  6. Aneurisma adquirido de aorta ascendente em criança Acquired neurysm of the ascending aorta in children

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    Danton R. da Rocha Loures

    1989-04-01

    Full Text Available O aneurisma adquirido da aorta ascendente é uma rara condição na faixa pediátrica. Os autores apresentam 2 casos de crianças de 6 e 12 anos de idade com aneurisma sacular da aorta ascendente e estenose aórtica, os quais foram submetidos a correção cirúrgica, com sucesso.Acquired aneurysm of the ascending aorta is a rare condition in the pediatric age group. The authors present two cases of 6 and 12 year old boys with saccular aneurysm of the ascending aorta and aortic stenosis, which underwent successful surgical correction.

  7. Aneurisma adquirido de aorta ascendente em criança Acquired neurysm of the ascending aorta in children

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    Danton R. da Rocha Loures; Maria João Amorim Ferreira; Rui Sequeira de Almeida; Ronaldo Loures Bueno; Antoninho Krichenko; Paulo R. Brofman; Edison José Ribeiro; Lauro Linhares; Mário Lobato da Costa; Edimara Seegmuller

    1989-01-01

    O aneurisma adquirido da aorta ascendente é uma rara condição na faixa pediátrica. Os autores apresentam 2 casos de crianças de 6 e 12 anos de idade com aneurisma sacular da aorta ascendente e estenose aórtica, os quais foram submetidos a correção cirúrgica, com sucesso.Acquired aneurysm of the ascending aorta is a rare condition in the pediatric age group. The authors present two cases of 6 and 12 year old boys with saccular aneurysm of the ascending aorta and aortic stenosis, which underwen...

  8. Resultados da cirurgia do aneurisma da aorta abdominal em pacientes jovens Outcomes after surgical repair of abdominal aortic aneurysms in young patients

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    Telmo P. Bonamigo

    2009-06-01

    Full Text Available CONTEXTO: A presença de aneurisma da aorta abdominal (AAA é rara em pacientes jovens. OBJETIVO: Avaliar os resultados da cirurgia do AAA em pacientes com idade BACKGROUND: Abdominal aortic aneurysms (AAA are rare in young patients. OBJECTIVE: To evaluate outcomes after AAA repair in patients aged < 50 years. METHODS: Between June 1979 and January 2008, 946 patients underwent elective repair for an infrarenal AAA performed by the first author. Of these, 13 patients (1.4% were < 50 years old at surgery. Demographic characteristics and surgical data were analyzed, as well as early and late outcomes after surgical intervention. RESULTS: Mean age was 46±3.4 years (ranging from 43 to 50 years. Most patients were men (76.9%, hypertensive (76.9% and smokers (61.5%. Perioperative morbidity and mortality rates were low (15.4% and 0%, respectively; one patient had respiratory infection and another patient had unstable angina. Median follow-up was 85.5 months, and two patients died due to ischemic cardiopathy and cerebrovascular accident during the follow-up period. CONCLUSION: AAA repair in young patients is a safe procedure, with good long-term results. In our study, there were no perioperative deaths, and a good long-term survival was observed.

  9. Tratamento do aneurisma da aorta toracoabdominal com endoprótese ramificada para as artérias viscerais Branched endovascular stent graft for thoracoabdominal aortic aneurysm repair

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    André Simi

    2007-03-01

    Full Text Available Apresentamos um caso de aneurisma da aorta toracoabdominal (AATA tratado, exclusivamente, pela técnica endovascular, utilizando uma endoprótese ramificada e customizada. Paciente do sexo feminino, 68 anos de idade, tabagista, hipertensa, portadora de extenso AATA e múltiplas comorbidades que restringiam a indicação de cirurgia convencional. O aneurisma iniciava-se na aorta torácica descendente, estendendo-se até a aorta abdominal infra-renal, envolvendo as emergências das artérias viscerais, tronco celíaco, artérias mesentérica superior e renais. O AATA foi tratado pela técnica endovascular com implante de uma endoprótese ramificada. Essa endoprótese ramificada foi customizada com base nas características anatômicas da aorta e no posicionamento dos ramos viscerais, obtidos em angiotomografia, objetivando excluir o aneurisma, mantendo a perfusão das artérias viscerais. O procedimento foi realizado em centro cirúrgico, sob anestesia combinada, regional e geral, antecedido de drenagem liquórica e sob orientação fluoroscópica. O acesso para o implante do corpo principal da endoprótese ramificada e o controle radiológico foram realizados através das artérias femorais, previamente dissecadas. Através das ramificações da endoprótese, foram implantadas extensões secundárias, com stents revestidos, para as respectivas artérias viscerais, cujo acesso foi realizado via artéria axilar esquerda. O tempo total do procedimento foi de 14 horas, com 4 horas e 30 minutos de fluoroscopia, e foram utilizados 120 mL de contraste iodado. No pós-operatório, a paciente apresentou instabilidade hemodinâmica. Ecocardiograma transesofágico mostrou dissecção retrógrada da aorta torácica, tipo A, seguida de trombose espontânea da falsa luz. A tomografia de controle mostrou exclusão do AATA e perviedade das pontes para os ramos viscerais, sem vazamentos. A alta ocorreu no 13º dia de pós-operatório. O tratamento endovascular do

  10. Fatores de morbimortalidade na cirurgia eletiva do aneurisma da aorta abdominal infra-renal: experiência de 134 casos Morbidity and mortality factors in the elective surgery of infrarenal abdominal aortic aneurysm: a case study with 134 patients

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    Aquiles Tadashi Ywata de Carvalho; Vanessa Prado dos Santos; Álvaro Razuk Filho; Walter Karakhaian; Henrique Jorge Guedes Neto; Valter Castelli Jr.; Roberto Augusto Caffaro

    2008-01-01

    CONTEXTO: O tratamento cirúrgico convencional do aneurisma da aorta abdominal (AAA) infra-renal pode resultar em complicações graves. A fim de otimizar os resultados na evolução do tratamento, é importante que sejam identificados os pacientes predispostos a determinadas complicações e instituídas condutas preventivas. OBJETIVOS: Avaliar a taxa de mortalidade operatória precoce, analisar as complicações pós-operatórias e identificar os fatores de risco relacionados com a morbimortalidade. MÉTO...

  11. Associação de paralisia diafragmática bilateral e paralisia da cintura escapular após correção de aneurisma de aorta: relato de caso

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    Luiz Marcelo Sá MALBOUISSON; Denise PERES; Ayama, Sérgio; Carmona, Maria José Carvalho; AULER Jr. José Otávio Costa

    2001-01-01

    A associação de paralisia diafragmática bilateral e paralisia da cintura escapular é uma complicação rara após correção de aneurisma de aorta ascendente. Esta associação leva à uma forma grave de insuficiência respiratória cujo sucesso do desmame da ventilação mecânica é dependente da capacidade da musculatura respiratória remanescente em compensar o trabalho respiratório excedente. Fisioterapia respiratória intensiva com treinamento da musculatura, correção dos distúrbios metabólicos, tratam...

  12. Nota técnica: avaliação ultrassonográfica de aneurismas da aorta tratados com endopróteses Technical note: ultrasonography evaluation of aortic aneurysms treated with endoprosthesis

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    Sergio Xavier Salles Cunha

    2012-06-01

    Full Text Available Aneurismas da aorta tratados com endopróteses podem desenvolver endoleaks. Esses endoleaks devem ser classificados com base nos tipos de fluxo, além da localização anatômica. Enfatizamos tipos de fluxo dos endoleaks detectados pela ultrassonografia com Doppler: fluxo entra-e-sai como "pseudoaneurisma", fluxo de canal e fluxo direto. Ao se notar a possibilidade de endoleaks intermitentes, salientamos o conceito de endoseepage detectáveis por crescimento de dimensões sem fluxo entrante aparente. Sugerimos o uso da histologia virtual ultrassonográfica para detecção de infiltrações. Quantidade relativa e localização de sangue ou líquido dentro do saco aneurismático pode ser detectado pela avaliação dos níveis de brilho da ultrassonografia modo B. Essa informação permite um seguimento compreensivo do aneurisma tratado com endoprótese e salienta o risco maior deum endoleak de fluxo direto entrante no aneurisma.Aortic aneurysms treated with endovascular techniques may develop endoleaks. In addition to anatomic location, these endoleaks should be classified based on the type of blood flow. We describe the types of blood flow into the endoleaks as detected by Doppler ultrasonography: in-and-out flow as a "pseudoaneurysm", channel flow through the aneurysm, and direct flow into the aneurysm. Endoleaks may be intermittent and actually be endoseepage, detected by aneurysmal growth without an apparent inflow. Ultrasound virtual histology is suggested to detect endoseepage. Relative quantity and location of blood/liquid in the aneurysm can be detected by evaluating pixel brightness of the ultrasonographic B-mode image. Such anatomofunctional information allows for quantitative follow-up and emphasizes the risk of an endoleak with direct flow into the aneurysm.

  13. Superinfecção e rotura de aneurisma da aorta abdominal por Salmonella dublin: relato de caso Superinfection and rupture of abdominal aortic aneurysm after Salmonella dublin septicemia: a case report

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    Anibal Basile Filho

    1988-12-01

    Full Text Available Os autores relatam o caso de paciente de 66 anos, que apresentou superinfecção e rotura de aneurisma da aorta abdominal, após septicemia por Salmonella dublin. As infecções endovasculares associadas à rotura de aneurisma pré-existentes são um rico potencial nos pacientes com mais de 50 anos de idade, que apresentam bacteremia ou septicemia por Salmonella sp. A alta mortalidade da aortite por salmonelose é devida à septicemia grave ou à rotura desses aneurismas. Qualquer tecido orgânico pode ser a sede de infecções metastáticas, porém os locais mais susceptíveis são os tecidos necróticos e as lesões crônicas degenerativas. Os autores discutem a importância do diagnóstico precoce para reduzir a mortalidade dessa entidade.The authors present a case of a 66 year-old woman with a dissection and rupture of abdominal aortic aneurysm after Salmonella dublin septicemia. Endovascular infection and rupture of atherosclerotic aneurysm is a substantial risk in patients older than 50 years of age who have bacteremia or sepsis due to Salmonella sp. The high mortality is the resultant of Salmonella aortitis due either to septicemia or rupture. Tissue anywhere may be seeded, but damage tissues appear to be particularly susceptible to abscess and chronic destructive lesions. The significance of early diagnosis to decrease the fatal outcome is discussed.

  14. Aneurisma de aorta com ruptura para esôfago Aortic aneurysm rupture into the esophagus

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    Christiano da Silveira de Barcellos; Paulo Ceratti de Azambuja; Marcelo Kunh Momolli; Clóvis Manfredini Rigoni; Marcelo Lopes; Henrique Biavatti; Wagnes Franceschi; Claudio Borges Fortes

    2008-01-01

    Apresentamos o caso de uma paciente portadora de aneurisma de aorta descendente com ruptura para o esôfago que, após aortoplastia com interposição de tubo de dacron e rafia da laceração esofágica, evoluiu com fístula esôfago pleural no terceiro dia pós-operatório. A paciente necessitou de reintervenção e cuidados intensivos, reabilitando-se adequadamente. A propósito deste caso incomum e do aprendizado adquirido no seu manejo, revisamos a literatura a fim de discutir a melhor alternativa de c...

  15. Ruptured thoracic aortic aneurysm in patient with systemic lupus erythematosus Aneurisma roto da aorta descendente em paciente com lúpus eritematoso sistêmico

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    Daniel Oliveira De Conti

    2011-03-01

    Full Text Available It is reported a ruptured descending thoracic aortic aneurysm in a 25-year-old systemic lupus erythematosus woman who underwent 19 years steroid therapy. She was treated with 2 endovascular stent-grafts, discharged from hospital 13 days after the procedure in good health. Three months later she returned with hemorrhagic shock due to high digestive hemorrhage secondary to an aortic-esophageal fistula. She underwent to an open emergency surgery, and died during the post-operative period.Paciente de 25 anos, do sexo feminino, portadora de lúpus eritematoso sistêmico, fazendo uso de corticoesteroide havia 19 anos, deu entrada em unidade de emergência com aneurisma roto de aorta torácica descendente. Foi submetida a tratamento endovascular com 2 stents, recebeu alta hospitalar no 13º dia de pós-operatório, em boas condições de saúde. Três meses depois, retornou em choque hemorrágico secundário a hemorragia digestiva alta. Feito o diagnóstico de fístula aorto-esofágica, foi submetida à cirurgia aberta de emergência, indo a óbito durante o período pós-operatório.

  16. Correção cirúrgica dos aneurismas da aorta: novo dispositivo que transforma qualquer tipo de prótese em prótese intraluminal Surgical correction of aortic aneurysms: a new device for conversion of any graft of intraluminal one

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    Rodrigo de Castro Bernardes

    1994-03-01

    Full Text Available Os autores propõem o tratamento dos aneurismas da aorta com prótese intraluminal. É usado um novo dispositivo que transforma prótese de tipo, tamanho e diâmetro diferentes em prótese intraluminal, excluindo qualquer tipo de sutura para a fixação, e usando apenas uma ligadura circunferencial extravascular. Entre maio de 1989 e janeiro de 1993, 22 pacientes foram submetidos a aneurismectomia da aorta usando esta técnica: 12 pacientes com dissecção aguda da aorta tipo I e II de DeBAKEY, 1 paciente com dissecção aguda da aorta tipo III de DeBAKEY, 2 pacientes com aneurisma da aorta descendente, 2 pacientes com aneurisma da aorta toracoabdominal e 5 pacientes com aneurisma da aorta abdominal. Três pacientes evoluíram para o óbito no pós-operatório por acidente vascular cerebral, trombose mesentérica e infecção pulmonar, respectivamente. Os pacientes sobreviventes estão sendo seguidos trimestralmente em ambulatório e encontram-se assintomáticos. O uso do anel rígido sulcado de Delrin (R simplifica a técnica cirúrgica, reduzindo o tempo de circulação extracorpórea e de parada cardíaca, dispensando o uso de hipotermia profunda e reduzindo o sangramento. Permite ainda o seu uso em qualquer local da aorta de maneira rápida, fácil e a baixo custo.The authors propose the treatment of aortic aneurysms by using an intraluminal graft. A new device which transforms any kind of graft of different sizes and diameters into an intraluminal one is described. This new device just needs an extra-vascular circunferential ligature and does not require any fixation suture. The use of the rigid, sulcated DELRIN (R ring simplifies the technique shortening the duration of the surgery, reducing surgical bleeding and dispensing the use of profound hypothermia and platelet transfusion. Between May 1989 and January 1993, 22 patients were submited to aneurysmectomy of the aorta using this technique. Twelve patients exhibited acute aortic

  17. Rotura de aneurismas da aorta torácica: evidência para a endo-solução Rupture of thoracic aortic aneurism: evidence for endovascular approach

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    Frederico Bastos Gonçalves

    2011-09-01

    Full Text Available A rotura de aneurismas da aorta torácica descendente é uma situação rara mas frequentemente fatal, apesar do tratamento adequado. Esta revisão pretende resumir a evidência actual para o tratamento endovascular desta patologia. Na última década, a introdução de técnicas endovasculares para tratar aneurismas torácicos em rotura levou a significativas mudanças no paradigma terapêutico, associadas a uma importante redução na mortalidade peri-operatória. Estudos comparativos revelam uma redução para metade na mortalidade aos 30 dias, assim como uma redução nas complicações precoces, nomeadamente pulmonares e renais. Apesar do benefício precoce, o tratamento endovascular associa-se a uma maior taxa de complicações relacionadas com o procedimento, nomeadamente endoleaks. O seguimento imagiológico rigoroso permite a detecção precoce destas complicações permitindo a sua resolução electiva. Assim, conclui-se que o tratamento preferencial da rotura da aorta torácica descendente é a implantação de uma endoprótese aórtica, desde que anatomicamente exequível.Ruptured descending thoracic aneurysms are rare but frequently fatal conditions, despite adequate treatment. This revision aims to summarize the current evidence for endovascular repair of this pathology. In the last decade, introduction of endovascular techniques to treat ruptured thoracic aneurysms resulted in significant changes in the treatment paradigm, associated with important reductions in peri-operative mortality. Comparative studies have shown a two-fold reduction in 30-day mortality, and also a reduction in early morbidity, especially pulmonary and renal complications. Despite the early benefit, endovascular repair is associated with a higher device-related complication rate, particularly endoleaks. Rigorous follow-up allows for early detection and elective treatment of these complications. In conclusion, the preferential treatment for ruptured descending

  18. Aneurisma de aorta com ruptura para esôfago Aortic aneurysm rupture into the esophagus

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    Christiano da Silveira de Barcellos

    2008-12-01

    Full Text Available Apresentamos o caso de uma paciente portadora de aneurisma de aorta descendente com ruptura para o esôfago que, após aortoplastia com interposição de tubo de dacron e rafia da laceração esofágica, evoluiu com fístula esôfago pleural no terceiro dia pós-operatório. A paciente necessitou de reintervenção e cuidados intensivos, reabilitando-se adequadamente. A propósito deste caso incomum e do aprendizado adquirido no seu manejo, revisamos a literatura a fim de discutir a melhor alternativa de correção desta rara e, freqüentemente, fatal forma de apresentação das doenças da aorta.We present the case of a patient with a descending aorta aneurysm rupture into the esophagus, which, after aortoplasty with Dacron tube interposition and suture of esophageal laceration, developed a pleural-esophagus fistula on the 3rd postoperative day. She needed re-intervention and intensive care, followed by adequate recovery. Considering this unusual case and the knowledge acquired through its management, we reviewed the literature in order to discuss the best alternative for the correction of this rare and often fatal form of presentation of aortic diseases.

  19. Associação de paralisia diafragmática bilateral e paralisia da cintura escapular após correção de aneurisma de aorta: relato de caso Association between bilateral diaphragmatic paralysis and scapular girdle paralysis after aortic aneurysm correction: case report

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    Luiz Marcelo Sá MALBOUISSON; Denise PERES; Ayama, Sérgio; Carmona, Maria José Carvalho; José Otávio Costa AULER Jr.

    2001-01-01

    A associação de paralisia diafragmática bilateral e paralisia da cintura escapular é uma complicação rara após correção de aneurisma de aorta ascendente. Esta associação leva à uma forma grave de insuficiência respiratória cujo sucesso do desmame da ventilação mecânica é dependente da capacidade da musculatura respiratória remanescente em compensar o trabalho respiratório excedente. Fisioterapia respiratória intensiva com treinamento da musculatura, correção dos distúrbios metabólicos, tratam...

  20. Fatores de morbimortalidade na cirurgia eletiva do aneurisma da aorta abdominal infra-renal: experiência de 134 casos Morbidity and mortality factors in the elective surgery of infrarenal abdominal aortic aneurysm: a case study with 134 patients

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    Aquiles Tadashi Ywata de Carvalho

    2008-09-01

    Full Text Available CONTEXTO: O tratamento cirúrgico convencional do aneurisma da aorta abdominal (AAA infra-renal pode resultar em complicações graves. A fim de otimizar os resultados na evolução do tratamento, é importante que sejam identificados os pacientes predispostos a determinadas complicações e instituídas condutas preventivas. OBJETIVOS: Avaliar a taxa de mortalidade operatória precoce, analisar as complicações pós-operatórias e identificar os fatores de risco relacionados com a morbimortalidade. MÉTODO: Foram analisados 134 pacientes com AAA infra-renal submetidos a correção cirúrgica eletiva no período de fevereiro de 2001 a dezembro de 2005. RESULTADOS: A taxa de mortalidade foi de 5,2%, sendo secundária principalmente a infarto agudo de miocárdio (IAM e isquemia mesentérica. As complicações cardíacas foram as mais freqüentes, seguidas das pulmonares e renais. A presença de diabetes melito (DM, insuficiência cardíaca congestiva (ICC, insuficiência coronariana (ICO e cintilografia miocárdica positiva para isquemia estiveram associadas às complicações cardíacas. A idade avançada, a doença pulmonar obstrutiva crônica (DPOC e a capacidade vital forçada reduzida aumentaram os riscos de atelectasia e pneumonia. História de nefropatia, tempo de pinçamento aórtico prolongado e níveis de uréia elevados aumentaram os riscos de insuficiência respiratória aguda (IRA. A isquemia dos membros inferiores esteve associada ao tabagismo e à idade avançada, e a maior taxa de mortalidade, à presença de coronariopatia, tempos prolongados de pinçamento aórtico e de cirurgia. CONCLUSÃO: A taxa de morbimortalidade esteve compatível com a literatura nacional e internacional, sendo secundária às complicações cardíacas, respiratórias e renais. Os fatores de risco identificados no pré e transoperatório estiveram relacionados com essas complicações.BACKGROUND: Conventional surgical treatment of infrarenal abdominal

  1. Associação de paralisia diafragmática bilateral e paralisia da cintura escapular após correção de aneurisma de aorta: relato de caso Association between bilateral diaphragmatic paralysis and scapular girdle paralysis after aortic aneurysm correction: case report

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    Luiz Marcelo Sá MALBOUISSON

    2001-06-01

    Full Text Available A associação de paralisia diafragmática bilateral e paralisia da cintura escapular é uma complicação rara após correção de aneurisma de aorta ascendente. Esta associação leva à uma forma grave de insuficiência respiratória cujo sucesso do desmame da ventilação mecânica é dependente da capacidade da musculatura respiratória remanescente em compensar o trabalho respiratório excedente. Fisioterapia respiratória intensiva com treinamento da musculatura, correção dos distúrbios metabólicos, tratamento das infecções respiratórias associadas à ventilação mecânica e otimização do suporte nutricional foram fundamentais para o sucesso do desmame.The association of bilateral diaphragmatic paralysis and scapular girdle paralysis is a rare complication after aortic aneurysm correction. Such a complication induces to a severe form of hypercapnic respiratory failure in which the success of weaning from mechanical ventilation depends on the capacity of remaining respiratory muscles to compensate extra respiratory work load. Intensive respiratory physiotherapy with muscle training, hydroelectrolityc inbalances correction, treatment of ventilation associated infections and a well planned nutritional support were essential to the successful weaning of mechanical ventilation.

  2. Tratamento endovascular do aneurisma da aorta abdominal infrarrenal em pacientes com anatomia favorável para o procedimento: experiência inicial em um serviço universitário Endovascular treatment of infrarenal abdominal aortic aneurysm in patients with favorable anatomy for the repair: initial experience in a university hospital

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    José Manoel da Silva Silvestre

    2011-03-01

    Full Text Available CONTEXTO: Desde sua introdução, em 1991, o reparo endovascular do aneurisma da aorta abdominal infrarrenal tem se tornado uma alternativa atraente para o tratamento dessa doença. Avaliar nossos resultados iniciais quanto à segurança e eficácia dessa técnica nos levou à realização deste estudo. OBJETIVOS: Analisar a mortalidade perioperatória, a sobrevida tardia, as reoperações, as taxas de perviedade e o comportamento do saco aneurismático em pacientes com anatomia favorável para a realização do procedimento. MÉTODOS: Trata-se de um estudo longitudinal, observacional e retrospectivo realizado entre outubro de 2004 e janeiro de 2009 com 41 pacientes que foram submetidos à correção endovascular do aneurisma de aorta abdominal infrarrenal por apresentarem anatomia favorável para o procedimento. Foram analisados os achados dos exames diagnósticos, o tratamento e o seguimento em todos os pacientes. RESULTADOS: Foram implantadas, com sucesso, 31 (75,6% próteses bifurcadas e 10 (24,5% monoilíacas, de 5 diferentes marcas. O diâmetro médio dos aneurismas fusiformes era de 62 mm. A mortalidade perioperatória foi de 4,8% e a sobrevida tardia, 90,2%. Durante o acompanhamento médio de 30 meses, 2 (4,8% pacientes necessitaram de reintervenção, um por migração da endoprótese e outro por vazamento tipo II. Dois (4,8% pacientes apresentaram oclusão de ramo da prótese. Oito (19,5% vazamentos foram diagnosticados e não houve nenhuma rotura dos aneurismas. CONCLUSÃO: Apesar do pequeno número de pacientes, os resultados observados parecem justificar a realização do procedimento endovascular nos pacientes com anatomia favorável.BACKGROUND: Since its introduction in 1991, endovascular repair of infrarenal aortic aneurysms has become an attractive option to treat this disease. The evaluation of our initial results about safety and efficacy of this technique has led us to carry out this study. OBJECTIVES: To analyze

  3. Resultados da microcirurgia em 54 aneurismas intracranianos

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    Paulo Niemeyer

    1974-09-01

    Full Text Available O autor apresenta sua experiência em 54 aneurismas arteriais intracranianos operados com técnica microcirúrgica, no período de janeiro de 1971 a março de 1974. Em 40 doentes classificados nos grupos I, II e III, não houve mortalidade. Incluindo 8 doentes do grupo IV, onde ocorreram 3 óbitos, a mortalidade foi de 6,2%. Nos doentes do grupo V, a mortalidade continua proibitiva, seja qual for a técnica usada. Os doentes foram operados com microscópio cirúrgico de fabricação brasileira, sendo usados clips de Yasargil, Scoville, Mayfield e de modelo do autor. Comparando os resultados atuais de microcirurgia (1971-1974, com a experiência anterior, baseada em cerca de 400 casos, no período de 1949 a 1970, o autor conclui que a cirurgia dos aneurismas com auxílio do microscópio é benigna e sem mortalidade nos doentes de bom risco cirúrgico. Considera a existência de espasmo o maior problema e julga que o momento mais oportuno de operar é quando surgem as melhoras clínicas, coincidindo com o desaparecimento do espasmo, entre o 7º e 10º dia, geralmente.

  4. Aneurisma da Artéria Renal: caso clínico Renal Artery Aneurysm

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    Joana Moreira

    2011-12-01

    Full Text Available Apresenta-se o caso clínico de um doente com volumoso aneurisma da artéria renal esquerda. Do sexo masculino, de 22 anos de idade, com lombalgia à esquerda com algumas semanas de evolução. Recorreu ao médico assistente que solicitou estudo imagiológico por ecografia abdominal. Detectada imagem sugestiva de aneurisma da aorta abdominal. Este achado motivou a transferência para o nosso Hospital onde foi admitido consciente e orientado, hemodinamicamente estável, apresentando uma massa pulsátil epigástrica, com frémito e sopro sistólico à auscultação. Angio-TC revelou um aneurisma da artéria renal esquerda com 16 cm de diâmetro. Dada a estabilidade clínica e topografia lesional optou-se por tentar embolizar, sem sucesso, o tronco da artéria renal esquerda antes da abordagem cirúrgica. O doente foi então submetido a Nefrectomia total esquerda por via toraco-abdominal. Pós-operatório sem complicações, locais ou sistémicas. Alta ao 8ºdia, mantendo boa função renal e com níveis normais de hemoglobina. Diagnóstico de aneurisma da artéria renal confirmado por estudo anátomo-patológico da peça operatória.One case of a large left renal artery aneurysm in a young patient 22 years old is presented. He appealed to his assistant physician a few weeks after development of left back pain. Abdominal ultrasound imaging study has been requested. Suggestive abdominal aortic aneurysm was detected. This finding led to the transfer to our hospital where he was admitted conscious and hemodynamically stable. A pulsatile epigastric mass with a systolic murmur on auscultation and thrill were detected. Angio-CT scan revealed a left renal artery aneurysm, 16 cm in diameter. Given the clinical stability and lesional topography we decide a previous embolization of left renal artery, unsuccessfully. The patient underwent then left total nephrectomy, through thoraco-abdominal incision. No local or systemic complications in the postoperative

  5. Modelos animais de aneurisma de aorta Animal models of aortic aneurysm

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    Rodrigo Argenta

    2009-06-01

    Full Text Available Os modelos experimentais em animais vêm sendo utilizados em cirurgia vascular há décadas. O desenvolvimento de novas técnicas para tratamento endovascular dos aneurismas requer a criação de bons modelos experimentais para testar esses dispositivos e estudar seu impacto sobre a progressão da doença. Este artigo tem por objetivo revisar os modelos de aneurisma arterial descritos atualmente. Entre os diversos modelos descritos, nenhum reúne todas as características de um modelo ideal de aneurisma. Os modelos em animais de grande porte são adequados para treino, estudo de alterações em parâmetros fisiológicos durante e após a liberação dos dispositivos e integração do mesmo à parede do vaso. Algumas desvantagens significantes incluem dificuldade do manejo, alto custo, difícil manutenção e regulamentações legais, dificultando a disponibilidade de diversas espécies animais. Modelos em animais menores, como os coelhos e camundongos, embora sejam menos caros e de fácil obtenção, não são adequados para estudos de técnicas endovasculares pelas pequenas dimensões de seus vasos. Nenhum modelo descrito até o momento consegue reproduzir todas as características dos aneurismas observados em humanos. Modelos disponíveis são descritos nesta revisão, e suas vantagens e desvantagens são discutidas.Experimental animal models have been used in vascular surgery for decades. The development of new interventional techniques in the endovascular treatment of aneurysms requires the creation of good experimental models to test these devices and study their impact on disease progression. The aim of this article was to review arterial aneurysm models currently available. Several distinct models have been described but none of them satisfies all the requirements of an ideal aneurysm model. Large animal models are appropriate for training, study of alterations in physiological parameters during and after device delivery, and integration

  6. Aneurismas complejos de la aorta abdominal: cirugía abierta frente a exclusión endovascular avanzada. Estudio comparativo.

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    Sala Almonacil, Vicente Andrés

    2015-01-01

    Justificación del estudio e hipótesis de trabajo: la enfermedad aneurismática de la aorta se estima que afecta al 2%-7% de los varones mayores de 60 años. Dichas estimaciones, extrapoladas a la población de España, se corresponderían con 140.000-350.000 personas portadoras de una aneurisma de aorta abdominal. En siete de cada cien personas acaece la rotura del aneurisma, siendo actualmente la décima causa de muerte en varones mayores de 55 años. En aquellos pacientes de alto riesgo para la ci...

  7. Incidência de isquemia miocárdica no pós-operatório de pacientes submetidos à cirurgia para correção de aneurisma de aorta abdominal: estudo retrospectivo

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    Domingos Dias Cicarelli; Cristina Keiko Marumo; Ricardo Gonçalves Esteves

    2001-01-01

    JUSTIFICATIVA E OBJETIVOS: Muitos pacientes submetidos à cirurgia para correção de aneurisma de aorta abdominal apresentam doença coronariana, podendo evoluir com complicações cardíacas perioperatórias. A grande dificuldade é avaliar, no pré-operatório, o risco de complicações cardíacas isquêmicas que ocorrem no período pós-operatório de modo confiável. O objetivo deste estudo foi verificar a incidência de isquemia cardíaca pós-operatória em pacientes submetidos à correção de aneurisma da aor...

  8. Aneurisma aterosclerótico da artéria axilar. Um caso clínico raro Atherosclerotic axillary artery aneurysm of a rare case

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    Luís F. Antunes

    2011-06-01

    Full Text Available Os aneurismas da artéria axilar de origem aterosclerótica são raros, mas podem originar complicações vasculares e neurológicas graves no membro superior, pelo que o seu tratamento deve ser precoce. Apresentamos o caso clínico de um homem de 64 anos com aneurisma da artéria axilar direita. O doente tinha antecedentes de aneurisma da aorta torácica já excluído por via endovascular. Devido ao crescimento súbito do aneurisma com sintomas neurológicos, foi submetido a aneurismectomia total com interposição de prótese PTFE 8 não aneladada (axilo-axilar. O estudo histológico revelou tratar-se de um aneurisma de origem aterosclerótica. Em consulta de follow-up o doente apresenta melhoria clínica e prótese permeável. O presente caso clínico realça a importância e os bons resultados que o tratamento cirúrgico tem nestes doentes.Atherosclerotic axillary artery aneurysms are very rare, but they can cause severe vascular or neurologic complications in the upper limb. Early treatment is mandatory. The authors report a case of a 64 years man with a right axillary artery aneurysm. The patient has had a previous exclusion of thoracic aortic aneurysm by endograft (TEVAR. Due to the sudden growth of aneurysm and neurologic symptoms, he was submitted to total aneurismectomy and interposition of axillary-axillary prosthetic graft (PTFE 8 without rings. The histological study shows an atherosclerotic aneurysm. In the follow-up the patient presented an improving clinical status of the upper limb and a patent graft. Present case report shows the importance and good outcome of surgical treatment in such patients.

  9. Onze anos de experiência com emprego do anel intraluminal para tratamento das doenças da aorta

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    BERNARDES Rodrigo de Castro

    1999-01-01

    Full Text Available O tratamento cirúrgico das doenças da aorta é geralmente acompanhado de altas taxas de morbimortalidade. O paciente que tem média de idade avançada geralmente é apresentado ao cirurgião em estado grave, com má condição nutricional, muitas vezes com alterações em vários órgãos e sistemas causados pela própria doença aguda. A correção convencional exige técnicas coadjuvantes complexas e agressivas como a circulação extracorpórea prolongada, hipotermia profunda, parada circulatória total além de prolongados tempos de pinçamento de aorta. Na tentativa de reduzir a agressão cirúrgica no paciente já intensamente debilitado pela própria doença, desenvolvemos, em 1988, um anel intraluminal (1, 2 que tem medidas projetadas e experimentadas para facilitar a sua manipulação e anastomose, proporcionando uma diminuição acentuada no tempo de operação, tempo de CEC, tempo de pinçamento de aorta, excluindo muitas vezes a circulação extracorpórea e a hipotermia, obtendo uma anastomose fácil, rápida, segura e hemostática. Entre março de 1988 e janeiro de 1999, 432 pacientes foram submetidos a tratamento cirúrgico de dissecções ou aneurismas da aorta em nosso Serviço. Em 328 pacientes empregamos o anel intraluminal como técnica de anastomose. Usamos 489 anéis. Cento e vinte e cinco pacientes eram portadores de dissecção aguda de aorta do tipo A, 29 eram portadores de dissecção aguda de aorta do tipo B, 81 de aneurisma de aorta ascendente, 8 de aneurisma de arco aórtico, 28 pacientes eram portadores de aneurisma de aorta torácica descendente, 17 eram portadores de aneurisma toracoabdominal e 40 pacientes de aneurisma de aorta abdominal infra-renal. A mortalidade global foi de 13,41%. O seguimento ambulatorial destes pacientes variou de 11 anos a 25 dias. A curva actuarial de sobrevivência em 11 anos mostra 67,3%. Em nenhum caso observamos as complicações descritas na literatura, como embolia, formação de

  10. Aneurisma de la aorta abdominal: Tratamiento endovascular con una endoprótesis fenestrada Abdominal aortic aneurysm: Endovascular treatment with fenestrated endoprothesis

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    Román Rostagno

    2008-12-01

    Full Text Available El tratamiento endovascular de los aneurismas de aorta abdominal es una alternativa a la cirugía abierta para pacientes de alto riesgo. Consiste en la exclusión del saco aneurismático mediante la interposición de una endoprótesis colocada por vía femoral. El tratamiento endovascular no puede ser utilizado en todos los pacientes. Una limitación frecuente la constituye el nacimiento de una arteria visceral desde el saco aneurismático. Para contrarrestar esta limitación recientemente se han desarrollado endoprótesis fenestradas que presentan orificios que se corresponden con el nacimiento de las arterias involucradas en el aneurisma evitando su oclusión, permitiendo de esta manera el tratamiento endovascular. En esta comunicación se presenta un caso de tratamiento endovascular de un aneurisma de aorta abdominal mediante la colocación de una endoprótesis fenestrada en un paciente cuya arteria renal izquierda nacía directamente del saco aneurismático.Endovascular treatment of the abdominal aortic aneurysm is consider an alternative to open surgery for high risk patients. Its goal is to exclude the aneurysm from the circulation by using an endoprothesis introduced from a femoral approach. Patients must be strictly selected to avoid possible complications. The most frequent limitation is related to anatomic contraindications such as visceral arteries involved in the aneurysm. Fenestrated endograft have been recently developed to allow endovascular treatment when anatomic features contraindicate classic endovascular procedures. Fenestrated endograft have holes that match with the origin of the visceral arteries maintaining its potency. In this paper we report the endovascular treatment of an abdominal aortic aneurysm by using a fenestrated endoprothesis in a patient whose left renal artery is originated from the aneurysm.

  11. Cirurgia da aorta descendente e tóraco-abdominal com técnica de oclusão proximal isolada da aorta ("open distal" Surgical treatment of descending thoracic and thoracoabdominal aorta with the "open distal" technique

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    Bayard Gontijo Filho

    1995-09-01

    Full Text Available O presente relato apresenta a experiência obtida em um período de 4 anos (jan/91 - jan/95 com a técnica "open distal" descrita por Cooley, em 1990³, para tratamento cirúrgico de doenças da aorta torácica descendente e aorta tóraco-abdominal. Nesse período foram realizadas 35 operações (25 para aorta descendente e 10 para aorta tóraco-abdominal. Os aneurismas de origem degenerativa e as dissecções aórticas ocorreram em freqüência semelhante (48,5% e 40%, respectivamente; em 8 pacientes havia rotura da aorta, parcialmente tamponada pelo pulmão (5 casos, órgãos abdominais (2 casos e esófago (1 caso. O acesso cirúrgico foi obtido por toracotomia póstero-lateral esquerda ou tóraco-freno-laparotomia. Heparina foi usada na dose de 1,5 mg/kg e todo sangue do campo cirúrgico foi coletado a um reservatório e reinfundido pela veia femoral. Houve 4 (11.4% óbitos hospitalares e 2 (5,8% pacientes portadores de aneurisma tóraco-abdominal desenvolveram paraplegia. A morbi-mortalidade do grupo foi diretamente relacionada à condição clínica per-operatória e à extensão do segmento aórtico acometido. Na nossa opinião, a técnica "open distal" é um método alternativo simples e eficaz no tratamento cirúrgico das doenças da aorta descendente e tóraco-abdominal. Em casos de ressecções extensas com períodos longos de oclusão aórtica, métodos para proteção medular deverão ser avaliadosSince Jan/91 we have been using the "open distal" technique (ODT described by Cooley, for surgical treatment of diseases of the descending thoracic and thoracoabdominal aorta. From jan/91 to jan/95, the technique was used in 35 instances (25 for descending aorta and 10 for thoracoabdominal aorta. Degenerative aneurysms and aortic dissections had similar incidence in this group (48.5% and 40.0%, respectively. In 8 patients the aorta was ruptured which was partially occluded by the lung (5 cases, abdominal organs (2 cases and esophagus (1

  12. Detección de aneurisma de la aorta abdominal en una población derivada para ecocardiografía transtorácica

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    Clotilde S. Berensztein

    2006-01-01

    Full Text Available Se evaluó: 1 la factibilidad de realizar una ecografía limitada a la aorta abdominal en pacientes a quienes se indica un ecocardiograma transtorácico, 2 las variables clínicas y ecocardiográficas que se correlacionan con el diámetro de la aorta abdominal, 3 la prevalencia de aneurisma de la aorta abdominal (AAA y 4 los factores de riesgo clínicos para AAA. Se evaluaron prospectivamente 280 pacientes consecutivos (media de edad: 68, rango 18 a 93 años, 118 de sexo masculino [42%]. Se verificó que: 1 el examen ecográfico de la aorta abdominal es factible en la mayoría de los pacientes (95,36% [IC 95% 92,88-97,84%], 2 el diámetro de la aorta abdominal se correlaciona con el sexo masculino, la edad, los antecedentes personales de enfermedad vascular periférica y los antecedentes de familiares de primer grado con AAA; también se correlaciona con el diámetro de la raíz aórtica (RA y con el grosor parietal relativo (GPR, 3 existe una prevalencia alta de AAA en la población estudiada (4,49% [IC 95% 1,99-7,00%], particularmente en los varones = 65 años (12,33% [IC 95% 4,60-20,05%] y 4 el sexo masculino, la hipertensión arterial, la dislipemia, el tabaquismo, la diabetes, los antecedentes personales de cardiopatía isquémica o de vasculopatía periférica y los antecedentes de familiares de primer grado con AAA son factores de riesgo para AAA. En conclusión, estaría justificada la realización de una ecografía abdominal como extensión de la ecocardiografía transtorácica en varones = 65 años, en particular si coexisten otros factores de riesgo para AAA.

  13. Evaluación del riesgo de ruptura de aneurismas de aorta abdominal personalizados mediante factores biomecánicos/Patient-specific abdominal aortic aneurysms rupture risk assessment by means of biomechanical factors

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    Ariel Zúñiga‐Reyes

    2014-05-01

    Full Text Available El Aneurisma de Aorta Abdominal es la dilatación localizada, irreversible y progresiva que experimenta la pared aortica. Esta patología ha sido reconocida como un importante problema de salud, puesto que su ruptura está asociada mayormente a consecuencias fatales. La falta de criterios fiables, respecto a los actualmente utilizados, para la evaluación del riesgo de ruptura, constituye un inconveniente en la gestión clínica de la enfermedad. El presente trabajo tiene como objetivo evaluar el riesgo de ruptura de Aneurismas de Aorta Abdominal, mediante indicadores numéricos, como es previsto por el enfoque biomecánico. Fueron utilizadas técnicas de modelación por elementos finitos para determinar el comportamiento del flujo sanguíneo y el estado tensional de la pared arterial. Los resultados mostraron que ninguno de los aneurismas analizados presenta riesgo de ruptura elevado y que la evaluación del riesgo de ruptura mediante índices numéricos, es un camino viable para prever la ruptura de un aneurisma específico.Palabras claves: aneurisma de aorta abdominal, factores biomecánicos, interacción fluido-sólido, riesgo de ruptura.______________________________________________________________________________AbstractAbdominal Aortic Aneurysm is a localized, progressive and permanent dilation of the infra-renal aorta.AAA has increasingly been recognized as an important health problem in the last decades. The AAA rupture is mostly associated with fatal consequences. The lack of more reliable criteria for rupture riskassessing, results in a problem in the clinical management of the disease. This paper aims to assess the rupture risk of abdominal aortic aneurysms by means of numerical indexes, as envisaged by the biomechanical approach. Finite Volume Techniques were used to determine the blood flow behavior within aneurysmatic sac and the structural state of the arterial wall. The results showed that none of the assessed aneurysms is at

  14. Reconstrução da aorta com conduto de pericárdio bovino corrugado

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    Claudio A. Salles

    1998-04-01

    Full Text Available No período de outubro de 1989 a maio de 1997, 40 pacientes portadores de dissecção aórtica, aneurisma da aorta, coarctação da aorta ou doença oclusiva aorto-ilíaca foram submetidos a reconstrução da aorta utilizando-se conduto de pericárdio bovino corrugado processado em glutaraldeído. A reconstrução total da aorta ascendente com substituição da valva aórtica e reimplante das artérias coronárias foi realizada em 9 pacientes, a simples substituição da aorta ascendente em 6, aorta torácica descendente em 2, arco aórtico em 1, aorta toracoabdominal em 1 e a aorta abdominal foi reconstruída em 21, incluindo pacientes submetidos a reconstrução aorto-ilíaca ou aorto-femoral. A mortalidade hospitalar foi de 8 (20% pacientes e as causas de óbito foram baixo débito cardíaco, recidiva da dissecção aórtica, falência de múltiplos órgãos e sangramento. O seguimento total foi de 128,4 pacientes-anos, com um seguimento médio de 4 anos por paciente. Complicações tardias relacionadas ao conduto vascular foram observadas em 4 pacientes, incluindo obstrução de um dos ramos do tubo bifurcado utilizado para reconstrução aorto-femoral e infecção em 3, resultando em degeneração secundária do conduto e formação de pseudo-aneurisma. Os 4 pacientes foram submetidos a reoperações, correspondendo a uma incidência de 3,1% ± 1,6% por paciente/ano. Ocorreram 5 óbitos tardios e as causas foram morte súbita, doença coronariana, pneumonia, septicemia e complicações metabólicas resultantes de diabetes e insuficiência renal crônica, correspondendo a uma incidência de 3,9% ± 1,7% por paciente/ano. A sobrevida atuarial em 9 anos foi 61,5% ± 9,2%, incluindo a mortalidade cirúrgica e a sobrevida atuarial livre de degeneração tissular estrutural primária do conduto biológico foi de 100%. O corrugamento do pericárdio, resultante da incorporação do princípio crimping utilizado nas próteses vasculares sint

  15. Desarrollo de un modelo predictivo de mortalidad a largo plazo y complicaciones relacionadas con la endoprótesis, en la reparacion endovascular de aneurismas de aorta abdominal infrarrenal

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    Gómez Palonés, Francisco Julián

    2015-01-01

    Desde el inicio de la reparación endovascular de aneurismas de aorta abdominal infra renal, la progresión de dicho tratamiento ha superado en numero al realizado anualmente mediante cirugía abierta convencional, en la mayoría de servicios de Cirugía Vascular. A ello ha contribuido principalmente la menor mortalidad operatoria los 30 días y al atractivo que supone para pacientes un procedimiento menos agresivo y para los profesionales, el ofrecer una alternativa en casos en los que la cirugía...

  16. Vein of Galen aneurysm in an adult: case report Aneurisma da veia de Galeno em adulto: relato de caso

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    Robinson M. Marques

    2006-09-01

    Full Text Available Vein of Galen aneurysm is a rare pathology, representing less than 1% of intracranial vascular malformations. We report on a 65 years-old man who experienced a generalized tonic-clonic seizure. Brain imaging showed a large calcified expanding mass in the pineal region, confirming the diagnosis of a vein of Galen aneurysm. Because of the spontaneous thrombosis of the malformation, there was no need for microsurgical or endovascular treatment and he is been regularly followed since that.Aneurisma da veia de Galeno é patologia rara, representando menos de 1% das malformações vasculares intracranianas. Apresentamos o caso de um homem de 65 anos que teve episódio de crise convulsiva tônico-clônica generalizada. Exames de imagem evidenciaram grande processo expansivo calcificado na região pineal, confirmando o diagnóstico de aneurisma trombosado de veia de Galeno. Devido à trombose espontânea da malformação, foi excluída a possibilidade de tratamento endovascular bem como microcirúrgico, mantendo-se o acompanhamento clínico.

  17. Correção endovascular de aneurisma de aorta abdominal e artéria ilíaca comum esquerda em paciente com hemofilia C grave Endovascular repair of abdominal aortic aneurysm and left common iliac artery in a patient with severe hemophilia C

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    Sergio Quilici Belczak

    2012-03-01

    Full Text Available A deficiência do fator XI, também conhecida como hemofilia C, é uma doença hematológica hereditária rara, que se manifesta clinicamente com hemorragia persistente após cirurgias, traumas, menorragias e extrações dentárias. Neste artigo, relatou-se a correção endovascular de um paciente com aneurisma de aorta e de artéria ilíaca comum esquerda em um paciente portador de deficiência major do fator XI (atividade do fator XI inferior a 20%. O procedimento foi realizado com sucesso, com o manuseio do distúrbio da coagulação por meio da infusão de plasma fresco no pré-operatório imediato e no pós-operatório, e controle laboratorial da coagulação do paciente.Factor XI deficiency, also known as hemophilia C, is a rare hereditary blood disease that manifests with persistent bleeding after surgery, trauma, menorrhagia, and dental extractions. This article reports an endovascular repair of a patient diagnosed with an aortic and left common iliac aneurysm, with severe factor XI deficiency (factor XI activity below 20%. The procedure was successfully performed with management of the coagulation disorder by preoperative and postoperative infusion of plasma and laboratory control of the coagulation.

  18. Prevalência e fatores de risco na associação entre doença arterial coronariana e aneurisma de aorta Prevalence and risk factors for combined coronary artery disease and aortic aneurysm

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    Carlos Romério Costa Ferro

    2007-01-01

    Full Text Available OBJETIVO: Avaliar a prevalência da doença arterial coronariana (DAC em portadores de aneurisma de aorta (AA, bem como as diferenças relacionadas às diferentes topografias. Descrever os principais fatores de risco para DAC relacionados a esta associação e suas eventuais diferenças de acordo com as diferentes topografias. MÉTODOS: Estudo prospectivo, aberto, não randomizado que avaliou 95 pacientes (62 homens, 33 mulheres, idade 63 ± 11,8 anos com AA. Todos os pacientes, assintomáticos para DAC, possuíam tomografia computadorizada de aorta e angiografia coronariana. De acordo com a topografia do AA, eles foram divididos em três grupos: 1 pacientes com AA torácica (AAT; 2 com AA toracoabdominal (ATA e 3 com AA abdominal (AAA. Foi criado um banco de dados com as informações clínicas e de exames complementares. A análise estatística realizada com o teste t de Student ou análise de variância (ANOVA para as variáveis contínuas e qui-quadrado para as categóricas, sendo considerado p significante quando 70% e 19 (31,6% > 50%. Quinze pacientes (25% eram uniarteriais, 11 (18% biarteriais e 34 (57% triarteriais. CONCLUSÃO: Em portadores de AA a prevalência de DAC assintomática é elevada, principalmente naqueles com AAA. Os resultados deste estudo sugerem a necessidade de uma estratificação diagnóstica para DAC nos portadores de AA, principalmente nos com AAA.OBJECTIVE: To evaluate CAD prevalence in patients with aortic aneurysm, as well as differences related to aneurysm topographies. To describe the primary risk factors for CAD related to this association and their occasional differences according to AA topographies. METHODS: This was an open, prospective, nonrandomized study that evaluated 95 patients (66 men and 33 women, mean age 63 ± 11.8. All patients, asymptomatic for CAD, had undergone aortic CT and coronary angiography. According to the AA topography, they were classified into three groups: 1 patients with thoracic

  19. Os ramos colaterais da aorta abdominal em jaguatirica (Leopardus pardalis)

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    Luane L. Pinheiro; Elenara B. Araújo; Ana Rita de Lima; Danielli M. Martins; Raysa Melul; Ana Carla B. Souza; Luiza C. Pereira; Érika Branco

    2014-01-01

    A jaguatirica (Leopardus pardalis) é uma das espécies de felino silvestre que pouco foi investigada quanto a sua morfologia. Assim, o estudo objetivou detalhar a origem e distribuição dos ramos colaterais da aorta abdominal deste animal. Avaliou-se dois exemplares, sendo um macho e uma fêmea, jovens, provenientes de Paragominas-PA, doados ao Laboratório de Pesquisa Morfológica Animal (LaPMA) da Universidade Federal Rural da Amazônia (UFRA). O sistema arterial foi preenchido com látex pigmenta...

  20. Estudo comparativo entre tratamento endovascular e cirurgia convencional na correção eletiva de aneurisma de aorta abdominal: revisão bibliográfica Endovascular elective treatment of the abdominal aortic aneurysm versus conventional open repair: a comparative study

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    Ana Carolina P. Simão

    2009-12-01

    Full Text Available O tratamento eletivo do aneurisma de aorta abdominal é recomendado pela alta morbiletalidade decorrente da eventual ruptura. O objetivo deste trabalho foi comparar o reparo endovascular eletivo com a cirurgia aberta e avaliar as mortalidades hospitalar e perioperatória, em 1 ano, por todas as causas e relacionadas ao aneurisma, a permanência hospitalar, as complicações, as taxas de sobrevida, conversão e reintervenção, a durabilidade do enxerto, o custo-benefício e a relação desses dados com o treinamento da equipe médica responsável pelo tratamento. Realizou-se uma revisão da literatura sobre reparo endovascular versus cirurgia convencional. Foram observados vantagem na sobrevivência perioperatória e menor estresse pós-cirúrgico; no entanto, os benefícios iniciais são perdidos por complicações e reintervenções tardias. Trabalhos baseados nas primeiras gerações de endopróteses superestimam as taxas de mortalidade em curto prazo, complicações e reintervenções. A durabilidade do enxerto, a real vantagem na sobrevida e o custo-benefício são incertos, e outros estudos são necessários para o seguimento em longo prazo.The elective treatment of the abdominal aortic aneurysm is recommended due to the high morbidity and mortality of a possible rupture. The objective of this study was to compare the elective endovascular aneurysm repair with open repair and to analyze the in-hospital and perioperative mortality rate during 1 year related to all causes and to the aneurysm, as well as the postoperative length of hospital stay, complications, survival rates, conversion and reintervention, graft durability, cost-benefit ratio, and relation with the medical team’s experience. A review of the scientific literature about endovascular versus open repair was carried out. We found a higher rate of perioperative survival and less postoperative stress; nevertheless, the initial benefits were lost due to late complications and

  1. Os ramos colaterais da aorta abdominal em jaguatirica (Leopardus pardalis

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    Luane L. Pinheiro

    2014-05-01

    Full Text Available A jaguatirica (Leopardus pardalis é uma das espécies de felino silvestre que pouco foi investigada quanto a sua morfologia. Assim, o estudo objetivou detalhar a origem e distribuição dos ramos colaterais da aorta abdominal deste animal. Avaliou-se dois exemplares, sendo um macho e uma fêmea, jovens, provenientes de Paragominas-PA, doados ao Laboratório de Pesquisa Morfológica Animal (LaPMA da Universidade Federal Rural da Amazônia (UFRA. O sistema arterial foi preenchido com látex pigmentado de vermelho e os cadáveres foram preservados com solução de formaldeído tamponado a 10%. A aorta abdominal do L. pardalis teve origem entre T12 e L1, sendo a artéria celíaca o primeiro ramo visceral no sentido crânio-caudal, resultando nas artérias hepática, gástrica esquerda e esplênica. A artéria mesentérica cranial surgiu como segundo ramo da aorta abdominal, originando as artérias jejunais. Na sequência localizamos artéria pancreáticoduodenal caudal, artérias ileais, artérias ileocólicas, artérias renais direita e esquerda, artérias adrenais direita e esquerda e artérias ováricas ou testiculares direita e esquerda. Parietalmente, a aorta abdominal originou em média seis ramos lombares, bem como a artéria frenicoabdominal, as artérias circunflexas ilíacas profundas e artérias ilíacas externa e interna. A aorta abdominal gerou ainda a artéria mesentérica caudal, a qual dividiu-se em artérias cólica esquerda e retal cranial. A artéria cólica esquerda seguiu cranialmente paralela ao cólon descendente irrigando-o, originando em média 18 ramos, e anastomosando-se com a artéria cólica média. A artéria retal cranial seguiu em direção caudal distribuindo oito ramos à porção final do cólon descendente e ao reto, e uniu-se com a artéria retal média. Por fim, a aorta abdominal emitiu como ramo terminal a artéria sacral mediana. A vascularização arterial abdominal desta espécie é bastante semelhante ao

  2. Valva aórtica bicúspide: fundamentos teóricos e clínicos para substituição simultânea da aorta ascendente Bicuspid aortic valve: theoretical and clinical aspects of concomitant ascending aorta replacement

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    Mauro Paes Leme De Sá

    2009-06-01

    Full Text Available A valva aórtica bicúspide (VAB está associada à ectasia ânulo-aórtica, aneurisma e dissecção da aorta ascendente. A alta incidência desta malformação congênita e doença da aorta sugere íntima relação entre os fenômenos. Anormalidades ocorrendo em diferentes fases da migração das células da crista neural podem ser responsáveis pela ocorrência em anormalidades na valva aórtica, na camada média da aorta ascendente e nos vasos do arco aórtico. Estudos prévios revelam que mesmo indivíduos com VAB normal ou com disfunção leve podem apresentar dilatação da raiz aórtica. Os autores acreditam que somente as alterações hemodinâmicas produzidas por uma VAB sem estenose ou insuficiência parecem ser insuficientes para as graves complicações vasculares observadas nos portadores de VAB. Vários mecanismos têm sido propostos para explicar os achados moleculares e histológicos desta doença. Encontramos a redução da fibrilina-1 na aorta ascendente e artéria pulmonar como possível causa. Histologicamente, a aorta ascendente pode apresentar necrose cística da média e fragmentação elástica, semelhante àquela encontrada em portadores de síndrome de Marfan. Vários autores atualmente recomendam que em se operando um paciente com VAB, especialmente aqueles com insuficiência aórtica, mesmo na presença de uma discreta dilatação (45 mm deve-se substituir a valva aórtica e a aorta ascendente concomitantemente quando a expectativa de vida exceder 10 anos, para se prevenir futuros aneurismas ou rupturas.Bicuspid aortic valve (BAV is associated with annuloaortic ectasia, dissection and ascending aortic aneurysm. The high incidence of this congenital malformation and aortic disease suggests a close correlation between the two phenomena. Abnormalities in different phases of cell migration of the neural crest might be responsible for the occurrence of abnormalities in the aortic valve, media layer of the ascending aorta

  3. Tratamiento endovascular exitoso de aneurisma de aorta torácica secundario a infección de catéter de arteria umbilical en un recién nacido pretérmino

    OpenAIRE

    Evelyn Borchert; Guillermo Lema; Daniel Springmuller; Katia González; Win T Chang; Rodrigo González; Francisco Garay

    2015-01-01

    Los aneurismas aórticos en la población pediátrica son poco frecuentes. El uso de catéteres de arteria umbilical en neonatos se ha asociado a infección y en algunas oportunidades a formación de aneurismas aórticos. La reparación quirúrgica de estos aneurismas es una forma de terapia; sin embargo, la intervención percutánea con stents pudiese proveer una vía alternativa de tratamiento con menores complicaciones. El objetivo de este reporte es dar a conocer el alcance terapéutico de un procedim...

  4. Diagnóstico dos aneurismas cerebrais por angiotomografia tridimensional

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    Andrade Guilherme Cabral de

    2003-01-01

    Full Text Available A angiotomografia é método diagnóstico rápido e minimamente invasivo que passou a ser utilizado recentemente nos casos de aneurisma intracraniano, possuindo 100% de especificidade e podendo atingir 95% de sensibilidade, na avaliação dos aneurismas do círculo de Willis, substituindo a angiografia digital, mas não em todos os casos. Apresentamos nossa experiência na avaliação do exame de angiotomografia tridimensional em período de 2 anos, comprendido entre junho de 1997 e junho 1999, em que foram realizados exames de angiotomografia tridimensional para detecção de aneurismas intracranianos em 136 pacientes Em 118 pacientes foi realizada apenas angiotomografia e em 18 casos foi realizada além da angiotomografia tridimensional, também a angiografia digital convencional. O exame de angiotomografia tridimensional possui baixo risco, sendo melhor utilizada na detecção dos aneurismas com diâmetro maior que 3mm. Possui algumas limitações, como os aneurismas muito pequenos <3mm aneurismas da carótida cavernosa e da circulação posterior, como também a não realização do exame dinâmico.

  5. Rotura traumática da aorta torácica: tratamento cirúrgico

    OpenAIRE

    SAMPAIO Dielson Teixeira; SANTOS João Marcos de Vasconcellos; LOBO Jr Nílcio Cunha; João Virgílio Uchoa FIGUERÓ; LOPES Caetano S; NOVAES Fernando R; PAULA FILHO Maurício Cleber de; Giovani Cardoso VERSIANI; FIGUEROA Carlos Camilo Smith

    1997-01-01

    No período de julho de 1986 a dezembro de 1995, foram operados 12 pacientes com rotura traumática da aorta torácica. Nove pacientes apresentavam rotura aguda da aorta e 3 rotura crônica. Em todos os pacientes a lesão localizava-se logo abaixo da emergência da artéria subclávia esquerda (istmo). Onze pacientes foram operados sob pinçamento aortico simples e em apenas 1 associamos shunt não heparinizado entre a artéria subclávia esquerda e a aorta descendente. O tempo médio de pinçamento aórtic...

  6. Influencia de la geometría de aneurismas de aorta abdominal en la dinámica del flujo sanguíneo y en su riesgo de ruptura // Influence of abdominal aortic aneurysms geometry in the blood flow dynamics and in its rupture risk.

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    G. Vilalta

    2009-05-01

    Full Text Available La ruptura de aneurisma de aorta abdominal (AAA representa un evento clínico muy importante,con una tasa de mortalidad relativamente elevada. En un esfuerzo por aumentar la comprensiónsobre este complejo fenómeno, en el presente trabajo se estudia la influencia de la geometría delos aneurismas de aorta abdominal en el riesgo de ruptura. Para esto se ha utilizado un modelogeométrico realista, obtenido por la transformación de imágenes 2D de tomografía computarizada(CT, sometido a un flujo pulsátil fisiológicamente realista, con el objetivo de evaluar e identificarlas regiones donde ocurren las principales perturbaciones en los patrones de flujo, cómo éstamodifica los campos de velocidades y de tensiones hemodinámicas en el interior del sacoaneurismático, así como la influencia de los diferentes factores biomécanicos relacionados con lageometría que caracterizan el aneurisma. Se presenta una explicación de las modificaciones de lasestructuras vorticales y de la distribución de tensiones durante el ciclo cardíaco. Igualmente sedetermina un indicador numérico (Parámetro de Severidad que integra los 3 factoresbiomecánicos geométricos y que permite evaluar el riesgo de ruptura del aneurisma para un estadode desarrollo determinado. Los resultados confirman que la asimetría de los aneurismas de aortaabdominal es uno de los principales factores que influyen en su ruptura.Palabras claves: AAA, asimetría, riesgo de ruptura, factores biomecánicos.__________________________________________________________________________AbstractThe rupture of abdominal aortic aneurysm (AAA represents an important clinical event, with arelatively high mortality rate. In an effort to increase understanding about this complexphenomenon, this paper studies the influence of abdominal aortic aneurysms geometry on the riskof rupture. Patient specific AAA model, created by 2D reconstruction of computed tomographyimage, was used to identify regions of

  7. Pseudo-aneurisma de artéria tibial posterior pós-tratamento de fratura de perna com fixador externo: relato de caso e revisão da literatura Pseudoaneurysm of the posterior tibial artery after external fixation for leg fracture: case report and review of the literature

    OpenAIRE

    Domingos de Morais Filho; Ramzi Abdallah El Hosni Jr.; Carlos Alberto Morselli Diniz; Igor Schincariol Perozin; Juliana Palmeira Gonçalves; José Antônio Morselli Diniz

    2007-01-01

    Este trabalho descreve um caso de pseudo-aneurisma da artéria tibial posterior devido ao uso de fixador externo para tratamento de fratura dos ossos da perna (técnica de Ilizarov), bem como as técnicas utilizadas para seu tratamento. A compressão guiada por ultra-som e a injeção de trombina guiada por ultra-som foram realizadas, sem sucesso. O tratamento definitivo do pseudo-aneurisma e reconstrução arterial foi conseguido através do tratamento cirúrgico clássico, usando enxerto interposto de...

  8. Aneurisma sacular da artéria radial: a propósito de um caso clínico Sacular aneurysm of the radial artery: a case report

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    Nádia Duarte

    2011-06-01

    Full Text Available Os aneurismas da artéria radial são raros e esporádicos, sendo que os pseudoaneurismas são mais frequentes do que os aneurismas verdadeiros e maioritariamente de configuração sacular. A etiologia é variada e diferenciam-se de outros diagnósticos pela pulsação e frémito. Raramente se complicam de ruptura, sendo a trombose e embolização as principais complicações. Dos casos publicados sobre aneurismas verdadeiros da artéria radial, apenas um está descrito como sendo secundário a lesão ocupacional repetitiva, sendo a maioria de causa idiopática. Os autores descrevem um caso de uma mulher de 63 anos, referenciada à consulta de Cirurgia Vascular por crescimento de massa pulsátil na tabaqueira anatómica da mão esquerda. O estudo por eco-doppler e angiografia, confirmaram o diagnóstico de aneurisma sacular da artéria radial, com 20 mm de maior eixo, arcada palmar permeável e sem sinais de embolização distal. Foi submetida a aneurismectomia parcial com laqueação dupla proximal e distal e endoaneurismorrafia. A cirurgia e pós-operatório decorreram sem complicações, nomeadamente complicações isquémicas. A propósito desde caso clínico, discute-se a abordagem diagnóstica e opções terapêuticas.Radial artery aneurysms are sporadic and rare, pseudoaneurysms are more common than true aneurysms, mainly in saccular configuration. The etiology is varied and difference from other diagnostics is done by the presence of pulse and thrill. Thrombosis and embolization are the main complications, while rupture is rare. From the reported cases of true aneurysms of the radial artery, only one is described as being secondary to repetitive occupational injury, the majority being idiopathic. The authors describe the case of a 63 year old woman, referred to a Vascular Surgery consultation because of a growing pulsatile mass in the anatomical snuffbox of the left hand. The Doppler and Angiography studies confirmed the diagnosis of

  9. Aneurisma idiopático da artéria radial na região da tabaqueira anatômica: relato de caso Idiopathic radial aneurysm in the anatomical snuffbox: case report

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    Aline Cristine Barbosa Santos

    2008-12-01

    Full Text Available Paciente do sexo feminino, 73 anos, negra, lavadeira/lavradora, hipertensa, apresentava tumor pulsátil de 1,5 x 0,5 cm em região de tabaqueira anatômica da mão direita há 10 anos, de crescimento lento e progressivo, associado a dor local. Não apresentava alterações neurológicas, cianose de extremidades, sinais de infecção ou trauma local. O teste de Allen resultou negativo, e o Eco-Doppler colorido demonstrou aneurisma de artéria radial na tabaqueira anatômica. Procedeu-se a aneurismectomia de artéria radial na tabaqueira anatômica com ligadura dupla proximal e distal. Houve boa evolução operatória, sem sinais de isquemia digital. O exame anatomopatológico confirmou diagnóstico de parede arterial (aneurisma verdadeiro. O paciente encontra-se em acompanhamento ambulatorial, no momento assintomático. Não há definição de quais aneurismas distais à artéria axilar possam ser acompanhados sem conduta cirúrgica. Como a paciente, neste caso, apresentava teste de Allen normal e dor local, optou-se pela ligadura proximal e distal, com bom resultado.We report a case of a 73-year-old female, laundress/farmer, hypertensive, with symptomatic pulsatile lump of 1.5 x 0.5 cm at the right anatomical snuffbox of the right hand, with slow and progressive growth and local pain in the past 10 years. The patient presented no neurological symptoms, cyanosis, infection or local trauma history. Allen"s test was negative, and color Doppler ultrasound confirmed presence of radial artery aneurysm in the anatomical snuffbox. Surgical treatment via aneurysmectomy of radial artery in the snuffbox with proximal and distal ligation was carried out. She had good operative course with no signs of digital ischemia. Histopathological test confirmed diagnosis of arterial wall (true aneurysm. She remains asymptomatic in outpatient follow-up. There is no definition as to which aneurysms distal to the axillary artery could be followed without a surgical

  10. Pseudoaneurismas em associacao com infeccao pelo virus da imunodeficiencia humana: relato de dois casos

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    Guilon Otavio Santos Tenorio

    2013-09-01

    Full Text Available Os autores descrevem os casos de dois pacientes que apresentaram pseudoaneurismas e ressaltam a dificuldade diagnóstica e terapêutica por apresentar associação com a infecção pelo vírus da imunodeficiência humana, e também demonstram a semelhança com aneurisma sacular aterosclerótico da aorta abdominal

  11. Correção de doenças da aorta torácica com utilização de hipotermia profunda e parada circulatória Surgical treatment of thoracic aortic lesions with deep hypothermia and circulatory arrest

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    Bayard Gontijo Filho

    1991-04-01

    Full Text Available São apresentados 14 casos de aneurismas e/ou dissecções da aorta torácica submetidos a correção cirúrgica com o emprego de hipotermia profunda e parada circulatória. Entre os 14 pacientes, seis eram portadores de aneurismas da aorta (um de aorta ascendente, três do arco aórtico, um de aorta ascendente + arco aórtico, um de aorta descendente e oito eram portadores de dissecção aórtica. A hipotermia foi induzida gradualmente até atingir 18ºC de temperatura nasofaríngea. O período médio de parada circulatória foi de 35 minutos. Houve quatro óbitos hospitalares, sendo um por problemas hemorrágicos, um por arritmia ventricular pós IAM, um por insuficiência renal aguda já existente no pré-operatório e um por AVC e infecção pulmonar secundária. Dos 10 pacientes, dois apresentaram insuficiência respiratória com assistência ventilatória prolongada e quatro apresentaram distúrbios neurológicos transitórios, com recuperação total. A técnica de hipotermia profunda e parada circulatória mostrou-se como boa alternativa na abordagem cirúrgica de lesões graves da aorta torácica.The authors report 14 cases of aneurysms and/or dissections of the thoracic aorta, treated with deep hypothermia and circulatory arrest. There were 6 aneurysms of the aorta (1 of the ascending aorta, 3 of the aortic arch, 1 of the ascending aorta and aortic arch, 1 of the descending aorta and 8 cases of aortic dissections. The patients were gradually colled down to 18ºC of nasopharingeal temperature. The mean circulatory arrest time was 35 minutes. There were 4 hospital deaths; 1 patient died in the operating room, from persistent surgical bleeding; 1 patient died from acute renal failure, which was already present in the pre-operative period; 1 patient died after an acute myocardial infarction followed by ventricular fibrillation; 1 patient died from pulmonary infection following a carebro-vascular accident. This was the only death directly

  12. Efeitos da remoção da túnica adventícia da aorta descendente em suínos

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    Almondi Fagundes

    2012-04-01

    Full Text Available OBJETIVO: Investigar os efeitos da remoção da adventícia da aorta em suínos. MÉTODOS: O experimento foi realizado com oito suínos. Removeu-se a camada adventícia da aorta descendente. Após a eutanásia com duas, quatro, seis e oito semanas, o segmento aórtico era removido. Após, eram feitos cortes histológicos com a coloração de hematoxilina e eosina (HE e pelo método de Weigert - Van Gieson. RESULTADOS: Após duas semanas identificou-se um leve desarranjo do terço externo da túnica média. Nos animais sacrificados após quatro semanas observou-se um desarranjo estrutural dos terços externos da túnica média. Após seis semanas observou-se necrose da parede aórtica. Finalmente, após oito semanas além da fibrose da parede aórtica identificou-se a destruição da lâmina elástica interna. CONCLUSÃO: A remoção da adventícia da aorta em suínos levou à alterações degenerativas da média, determinando perda da estrutura da parede aórtica que é variável em sua localização, intensidade e forma, dependendo do tempo a partir do qual se estabeleceu a lesão isquêmica.

  13. Persistência da artéria trigeminal primitiva associada com aneurisma da artéria cerebral média: relato de caso e revisão da literatura Persistent trigeminal artery associated with aneurysm of the middle cerebral artery: case report and literature review

    OpenAIRE

    Mauro Augusto de Oliveira; Caio C. D. Grotta; Marushcka S. F. Assis

    1997-01-01

    Os autores apresentam um caso, demonstrado angiograficamente, de achado incidental de artéria trigeminal primitiva persistente associada com aneurisma do polígono de Willis no território da artéria cerebral média. A propósito, a literatura é revisada e a embriologia envolvida relatada.The authors report a case of persistent primitive trigeminal artery angiographically demonstrated as an incidental finding. The persistent primitive trigeminal artery was associated with an aneurysm arising from...

  14. Persistência da artéria trigeminal primitiva associada com aneurisma da artéria cerebral média: relato de caso e revisão da literatura Persistent trigeminal artery associated with aneurysm of the middle cerebral artery: case report and literature review

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    Mauro Augusto de Oliveira

    1997-01-01

    Full Text Available Os autores apresentam um caso, demonstrado angiograficamente, de achado incidental de artéria trigeminal primitiva persistente associada com aneurisma do polígono de Willis no território da artéria cerebral média. A propósito, a literatura é revisada e a embriologia envolvida relatada.The authors report a case of persistent primitive trigeminal artery angiographically demonstrated as an incidental finding. The persistent primitive trigeminal artery was associated with an aneurysm arising from the circle of Willis in the middle cerebral artery territory. The literature is reviewed and the embryology involved is related.

  15. Estrutura, ultraestrutura e morfometria da aorta de paca (Cuniculus paca, Linnaeus, 1766 criada em cativeiro

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    S.P. Garcia Filho

    2012-06-01

    Full Text Available Descreveram-se a morfologia, morfometria e ultraestrutura de segmentos das porções torácica e abdominal da aorta de quatro pacas (Cuniculus paca adultas. Os segmentos aórticos foram analisados à microscopia de luz e à microscopia eletrônica de varredura. Mensuraram-se as espessuras do complexo formado pelas túnicas íntima e média, além da túnica adventícia. Os valores referentes à espessura do complexo formado pelas túnicas íntima e média da aorta torácica cranial foram significativamente maiores (média: 702,19µm que os valores de outros segmentos aórticos analisados (médias: 354,18µm; 243,55µm. As camadas das paredes do vaso apresentaram variações entre si quanto à estrutura e espessura, supostamente em razão de adaptação à exigência funcional.

  16. Tratamento endovascular de pseudo-aneurisma da artéria subclávia em criança hemofílica Endovascular treatment of subclavian artery pseudoaneurysm in a hemophiliac child

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    Emanuella Galvão de Sales e Silva

    2006-06-01

    Full Text Available O uso de cateteres venosos centrais em pacientes hemofílicos é muito freqüente, devido às próprias características terapêuticas da doença. As complicações desses procedimentos, tais como pseudo-aneurisma, geralmente são mais graves nesses pacientes. A correção cirúrgica do pseudo-aneurisma que acomete a artéria subclávia constitui um dos maiores desafios da cirurgia vascular. Em pacientes hemofílicos, à dificuldade habitual de exposição cirúrgica somam-se os problemas de alteração no processo normal de coagulação. Como alternativa ao tratamento cirúrgico convencional, a utilização de técnicas endovasculares constitui uma solução segura e com bons resultados.The placement of central venous catheters in hemophiliac patients is very frequent, due to the specific treatment characteristics of the disease. The complications of these procedures, such as pseudoaneurysm, are generally worse in such patients. Surgical treatment of subclavian artery pseudoaneurysm is known to be one of the greatest surgical challenges in vascular surgery. In hemophiliac patients, the alterations in the normal cascade of coagulation are added to the difficult surgical exposure. As an alternative to the usual surgical treatment, the use of endovascular techniques is a safe method and has good outcomes.

  17. Doença de Chagas em Virgem da Lapa, Minas Gerais, Brasil. IV. Aspectos clínicos e epidemiológicos do aneurisma ventricular esquerdo Chagas' disease in Virgem da Lapa County, Minas Gerais State, Brazil. IV. Clinical and epidemiological aspects of the left ventricle aneurism

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    José Borges-Pereira

    1998-10-01

    Full Text Available Com o objetivo de avaliar as características clínicas e epidemiológicas do aneurisma ventricular esquerdo na doença de Chagas crônica, 388 indivíduos não selecionados: 298 chagásicos e 90 não-chagásicos, foram submetidos ao exame ecocardiográfico. A função ventricular foi avaliada ao modo M através do cálculo da fração de ejeção e ao bidimensional através da análise subjetiva da função sistólica global e a contratilidade regional foi avaliada pelo modelo da Sociedade Americana de Ecocardiografia. Foram diagnosticados 56 (18,8% aneurismas do ventrículo esquerdo, todos entre os chagásicos, sendo 38 (12,7% no segmento apical, 10 (3,4% no septo interventricular, 2 (0,7% ápico-septal, 2 (0,7% na parede posterior, 2 (0,7% na parede inferior e 2 (0,7% no segmento ínfero-posterior. Não houve diferença significativa nas freqüências dos aneurismas em relação à faixa etária, ao sexo e à etnia. Não houve associação entre aneurismas e hipertensão arterial. Dos 56 indivíduos com aneurismas, 55 (98,2% eram sintomáticos com predominância de palpitações, 53 (94,6,% apresentaram ECG anormais, com predominância de extra-sístoles ventriculares, seguidas de alterações da condução e 34 (60,7% apresentaram comprometimento da função ventricular, sem diferença quanto ao segmento acometido. Diante destes resultados podemos considerar o aneurisma ventricular esquerdo, principalmente apical, como um marcador de doença de Chagas e um indicador da alta morbidade da infecção humana pelo T. cruzi em Virgem da Lapa.The study aimed at the evaluation of the clinical and epidemiological characteristics of the aneurism found in the left ventricle in chronic Chagas' disease patients. Three handred, eighty eight people (298 chagasic patients and 90 randomly selected healthy individuals were submitted to echocardiography. The ventricular function was assessed in the M mode by calculating the fraction of ejection, and in the

  18. Aortoscopia no tratamento das dissecções agudas da aorta Aortoscopy in the treatment of acute dissecting aneurysms of the aorta

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    Gladyston SOUTO

    1999-07-01

    Full Text Available No período de janeiro a dezembro de 1998 , foram operados 10 pacientes portadores de dissecção aguda da aorta (DA Ao 4 do tipo A e 6 do tipo B. O sexo masculino predominou e a idade dos pacientes variou de 34 a 78 anos. Em todos foram realizadas aortoscopias usando hipotermia profunda com parada circulatória total. Usou-se um gastroscópio, obtendo visão do lume da Ao, sendo que todos os pacientes tinham menos que 15 dias da doença. No tipo A, havia re-entrada abaixo da subclávia esquerda em 2 pacientes e, nos outros 2, na bifurcação das ilíacas. No tipo B, havia re-entrada ao nível das renais em 2 pacientes e, ao nível da bifurcação da Ao e das ilíacas, em 4. Em 2 pacientes do tipo A, a aortoscopia orientou na colocação de uma "Tromba de Elefante" como complemento. Nos outros 2, orientou na inversão do sentido da linha arterial. No tipo B, orientou na perfeita colocação da "Tromba de Elefante" e, em 4 pacientes, utilizamos a aortoscopia como complemento diagnóstico. O tempo utilizado na aortoscopia não alterou a morbimortalidade. Podemos concluir que a aortoscopia é um método de diagnóstico rápido, com boa definição das alterações anatômicas da Ao, permitindo um tratamento efetivo. Nos casos agudos instáveis podemos dispensar alguns exames pré-operatórios para não retardarmos a operação. O diagnóstico da re-entrada nos seguimentos inferiores da Ao ajuda a evitar a dissecção retrógrada. Acreditamos que a aortoscopia poderá, no futuro, ser de grande ajuda no diagnóstico e tratamento das DA Ao, bem como de outras lesões da Ao.From January to December 1998, ten patients with dissecting aneurysms of the Aorta (ADA Ao were operated on, 4 type A and 6 type B. Males predominated and ages ranged from 34 to 78 years. In all of them aortoscopy was performed with deep hypothermia and circulatory arrest. A gastroscope was used with visualization of the aortic lumen and all patients had less than 15 days of disease

  19. Prevalência de dilatação da aorta abdominal em coronariopatas idosos Prevalence of abdominal aortic dilatation in patients aged 60 years or older with coronary disease

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    Guilherme Vieira Meirelles

    2007-06-01

    Full Text Available CONTEXTO: A realização de programas de triagem para o aneurisma da aorta abdominal de forma indiscriminada auxiliará uma pequena porcentagem de indivíduos, mas ao considerarmos grupos com fatores de risco relacionados à dilatação da aorta, aumentando a probabilidade da doença, este permitirá um direcionamento adequado dos recursos e um benefício maior à população. Programas direcionados pelas sociedades médicas, permitindo um diagnóstico precoce das doenças vasculares e conseqüentemente um melhor preparo do doente, promoveriam melhores taxas de sobrevida com menor morbidade. OBJETIVO: Avaliar a prevalência da dilatação da aorta abdominal em uma amostra de pacientes idosos com mais de 60 anos de idade, portadores de coronariopatia aterosclerótica diagnosticada por cineangiocoronariografia. MÉTODOS: Para a seleção dessa amostra, levou-se em consideração o fato de que a avaliação pré-operatória de cirurgia vascular não tenhasido a indicação do cateterismo. Procedeu-se então a avaliação, baseada na anamnese, exame físico e Doppler ultra-som da aorta abdominal. A análise estatística iniciou-se com o teste qui-quadrado, com a posterior análise de regressão logística multivariada e regressão logística univariada, considerando significativo um p BACKGROUND: Indiscriminate screening programs for abdominal aortic aneurysm will help a small percentage of individuals. However, when considering groups with risk factors associated with aortic dilatation, which increases the probability of the disease, such programs will provide an adequate allocation of resources and a greater benefit to the population. Programs guided by medical societies, providing an early diagnosis of vascular diseases and consequently a better preparation of patients, would result in better survival rates with lower morbidity. OBJECTIVE: To evaluate the prevalence of abdominal aortic dilatation in patients aged 60 years or older with

  20. Ultra-sonografia da aorta abdominal e de seus ramos em cães Ultrasonography of abdominal aorta and its branches in dogs

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    Lilian Kamikawa

    2007-04-01

    Full Text Available O ultra-som bidimensional e o ultra-som Doppler foram utilizados para avaliar a biometria e a hemodinâmica da aorta abdominal e artérias ilíacas externas de 131cães clinicamente normais. Os resultados da avaliação biométrica da aorta abdominal indicaram um diâmetro médio de 0,80cm para o seu segmento diafragmático (AOD; 0,74cm para o seu segmento caudal às artérias renais (AOR e 0,69cm para o segmento cranial à sua bifurcação (AOT. A artéria ilíaca externa direita (AIED apresentou o diâmetro médio de 0,42cm e a artéria ilíaca externa esquerda (AIEE o diâmetro médio de 0,39. O estudo hemodinâmico da aorta abdominal apresentou velocidade de pico sistólico médio de 104,00cm/s para AOR; 99,61cm/s para AOT; 85,47cm/s para AIED e 99,51cm/s para AIEE. Verificaram-se correlações de diferentes intensidades entre os diâmetros vasculares em diferentes pontos de tomadas e os fatores biométricos corpóreos (CRL. Correlações baixas foram observadas quando esses diâmetros foram confrontados com a idade.A duplex ultrasound system incorporating a pulsed wave Doppler ultrasound probe with conventional B-mode real-time imaging was used to evaluate the biometric and the hemodynamic of abdominal aorta and external iliac arteries of a hundred and thirty one normal dogs. Results of biometrics of abdominal aorta, presented a mean diameter of 0.80cm in its diaphragmatic segment (AOD; 0.74cm in its segment caudal to the renal arteries (AOR and 0.69cm in the segment cranial to its termination (AOT. The right-external-iliac artery (AIED presented a mean diameter of 0.42cm and the left-external iliac artery (AIEE a mean diameter of 0.39cm. The hemodynamic study of the abdominal aorta presented a medium systolic peak velocity to AOR of 104cm per sec.; to AOT of 99.61cm per sec.; to AIED of 85.47cm per sec. and to AIEE of 99.51cm per sec. Correlations of different intensities between the vascular diameters have been verified between the

  1. Falso aneurisma da artéria meníngea média importância do diagnóstico angiográfico: relato de caso

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    Carlos A. M. Melro

    1993-09-01

    Full Text Available É objetivo deste artigo relatar o caso de um paciente com falso aneurisma da artéria meníngea média e fazer breve revisão da literatura sobre o assunto. O paciente, etilista e vítima de quedas frequentes, foi internado para investigação de sindrome convulsiva. Dentre os exames realizados observou-se, ao raio-X do crânio, fratura do osso temporal e, na carótido-angiografia comum, presença de dilatação aneurismática na artéria meníngea média em íntima relação com a fratura. O relato do caso se justifica visto a baixa frequência desta patologia e sua analogia com hematomas intracranianos de evolução atípica, bem como para salientar o papel da carótido-angiografia na avaliação de alguns casos de traumatismo crânio-encefálico.

  2. Tratamento cirúrgico da coarctação de aorta pela aortoplastia trapezoidal Surgical treatment of coarctation of the aorta using trapezoidal aortoplasty

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    Jarbas Jakson Dinkhuysen

    2004-01-01

    Full Text Available OBJETIVO: A aortoplastia trapezoidal é uma variante técnica da anastomose término-terminal que, amparada em elementos da geometria, objetiva aumentar o diâmetro da aorta ao nível da sutura reduzida e, consequentemente, a manutenção de gradientes pressóricos residuais ou recorrentes indesejáveis a curto e a longo prazo. MÉTODOS: Após a ressecção da área coarctada e tecido ductal, são confeccionados em cada coto aórtico 3 trapezóides que, ao serem confrontados, criam linha de sutura com aspecto sinusoidal (zigue-zague. Foram operados por esta técnica 33 pacientes, a maioria homens, com idades variando de 3 meses a 36 anos (m 9,5 ± 9,7. RESULTADOS: Não ocorreu mortalidade imediata ou tardia e o tempo de evolução a longo prazo foi de 1,1 a 7,6 anos (m 3,6 ± 3,4. A maioria dos pacientes ficou assintomática com níveis normais de pressão arterial, possibilitando a descontinuação da terapêutica antihipertensiva (pOBJECTIVE: Trapezoidal aortoplasty is a technical variant of end-to-end anastomosis, which, based on elements of geometry, aims at increasing the diameter of the aorta at the level of the suture, therefore reducing the occurrence of residual or recurrent pressure gradients in the short and long run. METHODS: After resecting the coarcted area and ductal tissue, 3 trapezoids are confected in each aortic stump, which, when confronted, create a suture line with a sinusoidal aspect (zigzag. Thirty-three patients underwent surgery with this technique, 22 (66.7% males, with ages ranging from 3 months to 36 years (mean of 9.84 ± 9.69. RESULTS: No immediate or late deaths occurred. Follow-up ranged from 1.1 to 7.6 years (mean of 3.6 ± 3.4. Most patients became asymptomatic with normal blood pressure levels, enabling the discontinuation of antihypertensive therapy (P<0.0001. A significant reduction in the pressure gradients was observed on Doppler echocardiography and during cardiac catheterization (P<0.001. The analysis of

  3. Ruptured thoracic aortic aneurysm in patient with systemic lupus erythematosus Aneurisma roto da aorta descendente em paciente com lúpus eritematoso sistêmico

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    Daniel Oliveira de Conti; Ricardo Ribeiro Dias; Alfredo Inácio Fiorelli; Noedir A. G Stolf

    2011-01-01

    It is reported a ruptured descending thoracic aortic aneurysm in a 25-year-old systemic lupus erythematosus woman who underwent 19 years steroid therapy. She was treated with 2 endovascular stent-grafts, discharged from hospital 13 days after the procedure in good health. Three months later she returned with hemorrhagic shock due to high digestive hemorrhage secondary to an aortic-esophageal fistula. She underwent to an open emergency surgery, and died during the post-operative period.Pacient...

  4. A proposal for standardizing computed tomography reports on abdominal aortic aneurysms; Proposta para padronizacao do relatorio de tomografia computadorizada nos aneurismas da aorta abdominal

    Energy Technology Data Exchange (ETDEWEB)

    Torlai, Fabiola Goda; Meirelles, Gustavo S. Portes [Universidade Federal de Sao Paulo (UNIFESP/EPM), SP (Brazil); Miranda Junior, Fausto; Fonseca, Jose Honorio A.P. da [Universidade Federal de Sao Paulo (UNIFESP/EPM), SP (Brazil). Dept. de Cirurgia; Ajzen, Sergio; D' Ippolito, Giuseppe [Universidade Federal de Sao Paulo (UNIFESP/EPM), SP (Brazil). Dept. de Diagnostico por Imagem]. E-mail: giuseppe_dr@uol.com.br

    2006-07-15

    Objective: to propose a model to standardize computed tomography reports on abdominal aortic aneurysms. Materials and methods: interviews were carried out with members of the Vascular Surgery Division of our institution, in the period between April and October 2004, aiming at developing a standardized model of computed tomography reports on abdominal aortic aneurysms. Based on this model, a questionnaire was elaborated and sent to other nine surgeons, all of them experienced in the field of abdominal aortic surgery. The questionnaires response rate was 55.5% (5/9). Results: the most frequently mentioned parameters of interest for evaluation of abdominal aortic aneurysms were: maximum diameter of proximal aortic neck, proximal aortic neck length to lower renal arteries, shape of proximal aortic neck, maximum diameter of the aneurysm and diameter of the common iliac arteries. These data allowed the development of a proposal for a model to standardize computed tomography reports. Conclusion: a model for standardized tomographic analysis of abdominal aortic aneurysms has met vascular surgeons' needs for following-up patients and planning their treatment. (author)

  5. Aneurisma gigante do segmento intracavernoso da carótida interna associado a doença renal policística autossômica dominante: relato de caso Giant aneurysm of the intracavernous internal carotid artery associated with autosomal dominant polycystic kidney disease: case report

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    Keven F. Ponte

    2006-09-01

    Full Text Available Apresenta-se o caso de mulher de 60 anos com doença renal policística autossômica dominante (DRPAD que desenvolveu quadro de cefaléia e oftalmoplegia completa à direita. A TC levantou a hipótese de um aneurisma gigante do segmento intracavernoso da carótida interna direita, o que foi confirmado pela arteriografia. Realizou-se, então, tratamento endovascular por oclusão do vaso parental com molas destacáveis no segmento supraclinóideo. A paciente evoluiu com a interrupção da cefaléia e com redução parcial da ptose e da oftalmoplegia. Neste artigo, enfatiza-se a relação entre DRPAD e aneurismas intracranianos. Comenta-se a história natural dos aneurismas originados no segmento intracavernoso da artéria carótida interna e comparam-se as opções terapêuticas no manejo destas lesões.We report the case of a 60 years-old woman with autosomal dominant polycystic kidney disease (ADPKD that presented with headache and right complete ophthalmoplegia. The CT scan raised the possibility of a giant aneurysm of the right intracavernous internal carotid artery, confirmed by angiography. The patient underwent endovascular occlusion of parent vessel with detachable coils, then she presented interruption of headache and partial recovery of ptosis and ophthalmoplegia. We emphasize the relationship between ADPKD and intracranial aneurysms. We also discuss the natural history and compare the therapeutic options for the management of giant aneurysms of the cavernous portion of the carotid artery.

  6. Tratamento híbrido das doenças complexas da aorta torácica Hybrid procedures for complex thoracic aortic diseases

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    José Carlos Ingrund

    2010-09-01

    Full Text Available INTRODUÇÃO: O tratamento híbrido das lesões complexas da aorta torácica (LCAT requer a revascularização de uma ou mais artérias supra-aórticas, seguida do implante de endoprótese, com morbidade e mortalidade presumidamente mais baixas que a cirurgia convencional. OBJETIVOS: Avaliar a técnica e resultados do tratamento híbrido das LCAT. MÉTODOS: Durante dois anos, 12 pacientes com LCAT foram submetidos a procedimentos híbridos, incluindo aneurismas do arco aórtico e dissecções aórticas agudas Stanford A e B. Todos possuíam indicação de tratamento invasivo, além de zona de ancoragem proximal inadequada (menor que 20 mm. Metade era do sexo masculino e a média de idade de 55,5 anos (42 a 78. Pelo menos três fatores de risco cardiovascular estavam presentes em 75% dos pacientes. A média de seguimento foi de 10,9 meses (2 a 25, com acompanhamento clínico e tomográfico. RESULTADOS: O sucesso técnico inicial foi alcançado em 10 pacientes. Todas as derivações dos vasos supra-aórticos foram realizadas em ambiente cirúrgico e os procedimentos endovasculares em sala de radiologia vascular. A "técnica do varal" foi empregada em seis casos. Dois óbitos ocorreram nos primeiros 30 dias do procedimento. Nenhuma migração da endoprótese foi observada. Nenhum paciente apresentou paraplegia, acidente vascular cerebral, insuficiência renal, hemorragia ou coagulopatia, conversão cirúrgica eletiva ou de emergência. CONCLUSÃO: O tratamento híbrido das LCAT é viável, especialmente em pacientes de alto risco. Uma adequada integração das técnicas cirúrgica e endovascular, além do acompanhamento clínico e radiológico adequado, tornam esta técnica uma ótima opção à cirurgia convencional.BACKGROUND: Hybrid procedures for the treatment of complex thoracic aortic diseases (CTAD require the revascularization of one or more supra-aortic arteries, followed by the deployment of one or more aortic endoprosthesis, with lower

  7. Aneurisma intracraniano na síndrome de Marfan: a case report

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    José Geraldo Speciali

    1971-12-01

    Full Text Available Citam-se as várias alterações vasculares nas moléstias hereditárias do tecido coinjuntivo. É relatado um caso de síndrome de Marfan associado a aneurisma intracavernoso da artéria carótida interna.

  8. Pseudo-aneurisma de artéria tibial posterior pós-tratamento de fratura de perna com fixador externo: relato de caso e revisão da literatura Pseudoaneurysm of the posterior tibial artery after external fixation for leg fracture: case report and review of the literature

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    Domingos de Morais Filho

    2007-06-01

    Full Text Available Este trabalho descreve um caso de pseudo-aneurisma da artéria tibial posterior devido ao uso de fixador externo para tratamento de fratura dos ossos da perna (técnica de Ilizarov, bem como as técnicas utilizadas para seu tratamento. A compressão guiada por ultra-som e a injeção de trombina guiada por ultra-som foram realizadas, sem sucesso. O tratamento definitivo do pseudo-aneurisma e reconstrução arterial foi conseguido através do tratamento cirúrgico clássico, usando enxerto interposto de veia safena magna homóloga invertida. As indicações, vantagens e desvantagens das técnicas de tratamento não invasivo (compressão guiada por ultra-som e injeção de trombina guiada por ultra-som e as possíveis causas de sua incapacidade na obliteração do pseudo-aneurisma são discutidas. Também foi realizada a revisão de casos de pseudo-aneurisma da artéria tibial posterior na literatura médica, encontrando-se apenas um caso semelhante, entre 24 publicados.We describe a case of pseudoaneurysm in the posterior tibial artery following treatment for tibial and fibula fractures using external fixation (Ilizarov technique, as well as the techniques used for its treatment. Ultrasound-guided compression and ultrasound-guided thrombin injection were unsuccessfully performed. Definite treatment of pseudoaneurysm and arterial reconstruction was achieved through the traditional surgical treatment, using interposed graft of inverted homologous great saphenous vein. Indications, advantages and disadvantages of noninvasive treatment techniques (ultrasound-guided compression and ultrasound-guided thrombin injection and the possible causes of their inability in obliterating the pseudoaneurysm are discussed. A literature review of pseudoaneurysms of the posterior tibial artery was also carried out, resulting in only one similar case out of 24 published cases.

  9. Complex paraclinoidal and giant cavernous aneurysms: importance of preoperative evaluation with temporary balloon occlusion test and SPECT Aneurismas paraclinoideos complexos e cavernosos gigantes: importância da avaliação pré-operatória com teste de oclusão temporária com balão e SPECT

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    Antônio Aversa do Souto

    2006-09-01

    Full Text Available In the treatment of complex paraclinoidal and giant cavernous aneurysms, preservation of the patency of the internal carotid artery (ICA is not always possible, and therapeutic occlusion of the carotid is still an important option for their management. A complete preoperative evaluation of the carotid reserve circulation, including the use of temporary balloon occlusion test and single photon emission computerized tomography (SPECT should be included in the current paradigms of paraclinoidal and intracavernous aneurysms management. We present a series of fifteen patients with sixteen giant or complex carotid cavernous or ophthalmic aneurysms that were treated following a protocol for our preoperative decision-making analysis. Extracranial to intracranial saphenous vein bypass was reserved to the cases where carotid occlusion would be associated with high risk of ischemic complications and was performed in three patients. Besides the difficulties in dealing with those complex aneurysms, good clinical outcome was possible in our experience with the designed paradigm.No tratamento de aneurismas paraclinoideos complexos e cavernosos gigantes, a preservação da patência vascular nem sempre é possível, e a oclusão terapêutica da carótida ainda é uma opção importante no seu manejo. Uma avaliação pré-operatória completa da reserva circulatória carotídea, incluindo o uso do teste de oclusão temporária por balão associado à tomografia computadorizada por emissão de fóton único (SPECT podem ser de grande utilidade para definir a opção terapêutica a ser adotada. Nós apresentamos uma série de quinze pacientes com dezesseis aneurismas complexos ou gigantes do segmento oftálmico e cavernoso da artéria carótida, que foram tratados de acordo com determinado protocolo de investigação pré-operatória. Anastomose com enxerto de veia safena entre a carótida extra e intracraniana foi reservada para os casos em que a oclusão carot

  10. Evaluation of the normal thoracic and abdominal aorta diameters by computerized tomography; Avaliacao dos diametros normais da aorta toracica e abdominal pela tomografia computadorizada

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    Lucarelli, Claudio Luiz

    1995-07-01

    The study was undertaken to evaluate, through computerized tomography, the diameters of the normal thoracic and abdominal aorta, as well as they are connected to gender, age and body surface area; and the ratio between measurements obtained at the ascending and descending limbs of the thoracic aorta, and between the abdominal aortic diameters. For that reason, we measured the widest anteroposterior diameters of the thoracic aortas at the levels of the arch, the root, the pulmonary artery, and the thoracic-abdominal transition, as well as the level of the emergence of the superior mesenteric artery, of the renal hila and just cephalad to the bifurcation of the abdominal aortas of 350 patients without cardiovascular diseases who had undergone computerized tomography of the thorax and/or abdomen for any other reasons. Observation and statistic analyses led us to conclude that: 1) both the thoracic and abdominal aortic diameters are reduced from their proximal to their distal portions; 2) the body surface influences the size of the aorta, although only extreme variations alter the vessel's caliber; 3) vessel diameter was observed to gradually increase with age; 4) men were found to have larger diameters than age matched women; 5) the ratio between the ascending and descending aortic diameters varies according to gender and age; 6) the relations between abdominal aortic diameters measured at the level of renal hila and cephalad to the bifurcation are independent from gender and age. But the relation between those measured at the level of the superior mesenteric artery and cephalad to the bifurcation are linked to gender, but not to age. (author)

  11. Aneurisma de artéria pulmonar como manifestação da doença de Behçet

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    SAMANO MARCOS NAOYUKI

    2002-01-01

    Full Text Available A doença de Behçet pode ser acompanhada de manifestações pulmonares, às vezes letais se não tratadas adequadamente. Descreve-se o caso de um homem de 53 anos com história de episódios de aftas orais e febre havia vários anos, dois quadros febris prolongados nos últimos dois anos, uveíte tratada com corticóide havia 21 meses, hemoptise havia um mês e emagrecimento de 7kg. Ao exame físico apresentava aftas orais, pseudofoliculite e turvação visual. Os estudos radiológicos evidenciaram dilatação aneurismática de artéria pulmonar. Tratado com corticóide, foi feita lobectomia inferior esquerda e o exame anatomopatológico foi compatível com arterite de artéria pulmonar. O paciente foi tratado com clorambucil por oito meses e mantém-se bem, decorridos 18 meses da cirurgia.

  12. Uso de dexmedetomidina em anestesia geral para tratamento cirúrgico de aneurisma cerebral, em paciente gestante, portadora de doença hipertensiva específica da gestação: relato de caso Uso de dexmedetomidina en anestesia general para tratamiento quirúrgico de aneurisma cerebral, en paciente embarazada, portadora de enfermedad hipertensiva específica del embarazo: relato de caso Dexmedetomidine in general anesthesia for surgical treatment of cerebral aneurysm in pregnant patient with specific hypertensive disease of pregnancy: case report

    OpenAIRE

    Kleber Machareth de Souza; Luiz César Anzoategui; Washington Cássio Justino Pedroso; Werner Alfred Gemperli

    2005-01-01

    JUSTIFICATIVA E OBJETIVOS: A incidência de cirurgias não obstétricas em pacientes gestantes é de 0,36% a 2%. No entanto, cirurgias visando o tratamento cirúrgico de aneurisma cerebral em gestantes são extremamente raras. A doença hipertensiva específica da gestação, apresenta prevalência clínica de 10% na população gestante. Trata-se de uma doença de elevada complexidade clínica, acometendo múltiplos órgãos e sistemas. A dexmedetomidina, fármaco agonista alfa2, apresenta importante seletivida...

  13. Características ultraestruturais do segmento abdominal da aorta de rato albino = Mural features of the abdominal aortic segment of albino rat

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    2007-10-01

    Full Text Available O objetivo da presente pesquisa foi investigar as peculiaridades ultraestruturais da parede da aorta de rato. Foram utilizados sete ratos albinos, adultos jovens, dos quais foram coletados fragmentos da aorta abdominal infra-renal. Após a coleta, os segmentosvasculares foram fixados e encaminhados para a rotina de microscopia eletrônica de transmissão e varredura. As lamelas elásticas aparecem interpostas às fibras musculares lisas, sendo essa disposição principalmente notada na túnica média da parede vascular. Entre asfibras musculares lisas e as lamelas elásticas, observa-se um inter-relacionamento aparentemente estreito, feito por conexão e ancoramento entre ambos os elementos murais por meio de lamelas de colágeno. A túnica íntima da aorta abdominal do rato mostraalgumas peculiaridades ultraestruturais marcantes, tais como a interrupção, em certos locais da parede, de continuidade da lâmina elástica interna, interrupção acompanhada por poros endoteliais, de certa extensão, suprajacentes à falha na estrutura elástica intimal. Este padrão de constituição mural, com destaque aos ancoramentos elástico-musculares, via o colágeno, parece garantir propriedades fundamentais da parede vascular, concernentes à hemodinâmica, tal como o cisalhamento, normalmente notado entre os estratos superpostosda parede vascular, bem como a contratilidade e a visco-elasticidade da parede arterial.The objective of the present research was to investigate the ultrastructural peculiarities of the aortic wall of the rat. Seven young adult rats were used, from which fragments of theinfrarenal abdominal aorta were collected. After collection, the vascular segments were fixed and sent for analysis by scanning electron microscope. The elastic lamellae appear interposed with smooth muscular fibers; this pattern was verified mainly at the medial layer structure. Among the mural elements a well defined interrelationship was established through

  14. Nonthyroidal illness syndrome in patients with subarachnoid hemorrhage due to intracranial aneurysm Sindrome da doença não tiroideana em pacientes com hemorragia subaracnoidea devida a aneurisma cerebral

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    Luiz Augusto Casulari

    2004-03-01

    Full Text Available We have previously reported that subarachnoid hemorrhage due to ruptured intracranial aneurysm (SH is associated with changes in the hormonal profile in the first 24 hours after the event. We proposed that the hormonal changes observed are due to the intense stress to which the patients are exposed. However, the thyroidal hormonal profile is indicative of the presence of a nonthyroidal illness syndrome (NTIS. In this paper, we examined whether the change in the thyroid hormone profile is compatible with a NTIS. Two groups of patients were included in the study: A 30 patients with SH (21 females and 9 males; 41.7±11.4 years and B a control group including 25 patients with benign diseases of the spine (BDS (lumbar disc hernia or stable spinal trauma (8 females and 17 males; 41.3±14.2 years. In a subgroup of eight patients of each group serum triiodothyronine (T3 and reverse T3 levels were measured. The blood samples were obtained between 8:00 and 9:00 AM. The following results were obtained: The SH group had smaller serum T3 and free T4 levels than the BDS group (pNós apresentamos previamente que a hemorragia subaracnoidea devido à ruptura de aneurisma intracraniano (SH está associada com alterações no perfil hormonal nas primeiras 24 horas após o evento. Nós propusemos que as alterações hormonais observadas são devidas ao intenso estresse ao qual os pacientes estão expostos. Contudo, o perfil hormonal tireoidiano é indicativo da presença da síndrome da doença não tireoidiana (NTIS. Neste trabalho, examinamos se as alterações no perfil dos hormônios tireoidianos são compatíveis com a NTIS. Dois grupos de pacientes foram incluídos no estudo: A 30 pacientes com SH (21 mulheres e 9 homens; 41,7±11,4 anos e B um grupo controle incluindo 25 pacientes com doenças benignas da coluna (BDS (hérnia de disco lombar ou estável trauma da coluna (8 mulheres e 17 homens; 41,3±14,2 anos. Em um subgrupo de oito pacientes de cada grupo

  15. Estenose carotídea acima de 70% em pacientes no pré-operatório de cirurgia da aorta abdominal: freqüência e fatores de risco Frequency and risk factors for carotid stenosis above 70% in patients undergoing abdominal aortic surgery

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    André Ventura Ferreira

    2006-03-01

    Full Text Available OBJETIVO: Analisar a freqüência e os fatores de risco associados à estenose carotídea acima de 70% em pacientes que serão submetidos a cirurgias de aorta abdominal. MATERIAL E MÉTODO: Foram analisados 94 pacientes que realizaram ultra-som Doppler de carótidas no pré-operatório de cirurgias de aorta abdominal entre janeiro de 2000 e janeiro de 2003, pela disciplina de Cirurgia Vascular da Santa Casa de São Paulo. RESULTADOS: Sessenta e sete pacientes (71% eram homens. Dentre os 94 pacientes, 42 (44,6% tinham doença oclusiva aorto-ilíaca, e 52 (53,4%, aneurismas da aorta abdominal (AAA. A análise dos dados mostrou uma prevalência de estenose de carótidas acima de 70% em 8,33% dos pacientes com AAA e em 13,51% dos pacientes com doença oclusiva aorto-ilíaca, diferença esta sem significância estatística (P = 0,5. Nos pacientes que apresentavam antecedente de isquemia cerebral - acidente vascular cerebral (AVC ou ataque isquêmico transitório (AIT -, houve uma prevalência estatisticamente maior de estenose carotídea entre 70 e 99%. Outros fatores de risco para aterosclerose, como sexo masculino, diabetes, hipertensão arterial e tabagismo, não foram preditivos da presença de estenose carotídea acima de 70%. CONCLUSÃO: A freqüência de estenose da carótida acima de 70% em pacientes no pré-operatório de cirurgia de aorta foi de 9,57%, e a presença de antecedente de AVC ou AIT na história foi preditiva de estenose acima de 70% neste grupo de pacientes.OBJECTIVE: To analyze the frequency and risk factors of carotid stenosis above 70% in patients undergoing abdominal aortic reconstruction. MATERIAL AND METHOD: Ninety-four patients who underwent Doppler ultrasound preoperative screening for abdominal aortic surgery between January 2000 and January 2003 were analyzed by the Vascular Surgery Unit of the Santa Casa of São Paulo (Faculty of Medical Sciences. RESULTS: Sixty-seven (71% patients were male. Of the 94 patients, 42

  16. Dysfunction of the temporalis muscle after pterional craniotomy for intracranial aneurysms: comparative, prospective and randomized study of one flap versus two flaps dieresis Disfunção do músculo temporal após craniotomia pterional para tratamento de aneurismas intracranianos: estudo comparativo, prospectivo e aleatório da diérese em camada única versus camada dupla

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    FRANCISCO CARLOS DE ANDRADE JR.

    1998-06-01

    Full Text Available Patients with intracranial aneurysm(s of the carotid artery territory, treated with pterional craniotomy, were prospectively and randomly addressed to one layer flap (n=36 or myocutaneous (MC versus two layers' dieresis (n=32 or interfascial (IF. The study protocol included the patient's sex, age, area of craniotomy, time of flap dieresis and synthesis, time of bone dieresis and synthesis, the intracranial time, including dura mater dieresis and synthesis and time of flap retraction. Before and after surgery, the patients were evaluated with examination specially oriented to V and VII cranial nerves, bi-temporal diameter measurement, the symmetry of the temporal region, tempora-mandibularis joint (TMJ movements and cranial CT scan. The evaluations of the TMJ dysfunctions were postoperative pain, movement limitations at mastication, occlusion, mouth aperture and lateral movements of the jaw. The statistical analysis showed that the incidence of pain at TMJ and moderate and severe temporalis muscle atrophy was observed, comparing MC and IF, and there were significant differences among these ones, being greater in IF group. We concluded that both techniques permit equivalent access to the studied intracranial aneurysm(s, and the atrophy of temporalis muscle, pain and movement limitations of the temporomandibularis joint were prevalent, worse and more long-lasting in two-layers flap dieresis than in one-layer flap dieresis.Pacientes com aneurisma(s intracraniano(s foram tratados pela via pterional e de modo prospectivo e aleatório submetidos às variantes técnicas, miocutânea (MC(n=36 ou em retalho único e interfascial (IF (n=32 ou em retalho duplo. No protocolo foram anotados o sexo, idade, área da craniotomia, período de diérese e síntese do retalho, período de diérese e síntese óssea, o período do procedimento intracraniano, incluindo o tempo de diérese e síntese da dura-máter e o período de retração do retalho. Os pacientes

  17. Avaliação da Velocidade Média na Aorta Torácica Descendente em Fetos com Anemia

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    Taveira Marcos Roberto

    2001-01-01

    Full Text Available Objetivo: verificar se existe correlação significativa entre a velocidade média na dopplerfluxometria da artéria aorta torácica descendente e o grau de anemia fetal. Métodos: estudo prospectivo, transversal, no qual foram analisados 66 fetos de gestantes isoimunizadas, em que se realizou a cordocentese para a realização de transfusões intra-uterinas pela via intravascular (66,7%. Nos fetos que foram submetidos à transfusão intra-uterina pela via intraperitoneal, ou naqueles casos em que não houve necessidade de tratamento intra-uterino (33,3%, a determinação da concentração de hemoglobina do cordão foi realizada pela punção do cordão umbilical, no momento da interrupção da gestação. Neste grupo de fetos estudados, foi realizado exame dopplerfluxométrico da artéria aorta torácica descendente, sendo calculada a velocidade média de fluxo. Foi realizado estudo de associação entre as variáveis. Foram também calculados os valores de sensibilidade, especificidade, valores preditivos positivo e negativo. Resultados: observou-se correlação significativa e inversa entre a velocidade média na artéria aorta torácica descendente e o nível de hemoglobina fetal. A velocidade média na dopplerfluxometria da artéria aorta torácica descendente apresentou sensibilidade de 47,5% para anemia fetal moderada (Hg<10 g/dL, com o teste exato de Fisher apresentando valor de p<0,01, e de 54,5% para anemia fetal grave (Hg<7,0 g/dL, com um valor de p=0,01. Conclusões: houve associação significativa entre a velocidade média na aorta torácica descendente e o grau de diagnóstico de anemia fetal.

  18. Aneurisma de artéria ilíaca interna roto: relato de caso Ruptured internal iliac artery aneurysm: case report

    OpenAIRE

    Cristina Toledo Afonso; Ricardo Jayme Procópio; Túlio Pinho Navarro; Gustavo Henrique Dumont Kleinsorge; Beatriz Deoti e Silva Rodrigues; Marco Antônio Gonçalves Rodrigues

    2009-01-01

    Aneurismas isolados da artéria ilíaca interna são raros, acometem 0,1% da população e correspondem a 1% dos aneurismas aorto-ilíacos. Na maioria das vezes, os pacientes são assintomáticos, mas podem apresentar dor abdominal, massa pulsátil no hipogástrio ou na fossa ilíaca, sintomas compressivos urinários, gastrointestinais ou neurológicos. Podem ocasionar quadro de abdome agudo, principalmente quando há ruptura. O diagnóstico precoce dos aneurismas isolados de artéria ilíaca interna é incomu...

  19. Correção cirúrgica de aneurismas saculares de fístula arteriovenosa para hemodiálise utilizando a técnica de aneurismorrafia Surgical repair of saccular aneurysms of an arteriovenous fistula for hemodialysis using aneurismorraphy technique

    OpenAIRE

    Ricardo Wagner da Costa Moreira; David Domingos Rosado Carrilho; Kellen Micheline Alves Henrique Costa; Rafaela Brito Bezerra Pinheiro

    2011-01-01

    Uma das complicações mais frequentes da fístula arteriovenosa (FAV) para hemodiálise é o desenvolvimento de um aneurisma. A formação de aneurismas geralmente decorre de um enfraquecimento da parede venosa devido às repetidas punções, e sua rotura causa hemorragia intensa que pode levar à morte. Descrevemos o caso de uma paciente com dois aneurismas saculares de FAV, tratados através de aneurismorrafia, detalhando a técnica cirúrgica utilizada e a evolução pós-operatória. A técnica de rafia si...

  20. Aneurisma do ducto arterioso associado a interrupção do arco aórtico Aneurysm of the arterial duct associated to aortic arch interruption

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    Paulo Zielinsky

    1998-07-01

    Full Text Available É relatado um caso de aneurisma de ducto arterioso, com diagnóstico pré-natal, o que é muito raro, numa gestante com 33 semanas, onde o feto apresentou uma dilatação aneurismática do canal arterial, com calibre uniformemente aumentado, inserindo-se na aorta descendente, associado à interrupção do arco aórtico. A criança nasceu de parto cesáreo e manteve-se estável com o uso de prostaglandina até o 9º dia de vida, quando foi levada à cirurgia, tendo falecido durante o procedimento por falência biventricular. Este é o primeiro relato da associação desta anomalia com outra malformação cardiovascular intra-uterina, mostrando que este achado nem sempre é associado a uma evolução benigna.Aneurysm of the arterial duct is an infrequent finding, which is very rarely detected prenatally. A case of antenatal diagnosis in a pregnant patient (33 weeks is reported. The fetus presented an aneurysmatic dilation of the arterial duct with uniformly enlarged diameter, inserting into the descending aorta, which was interrupted. The neonate was born by cesarean section and was kept on postaglandins till the 9th day of life, when he was sent to surgery. During the surgical procedure, the baby died as a result of biventricular failure. This is the first report of prenatal association of aneurysm of the ducts anteriosus with other cardiovascular malformations and emphasizes that this finding does not always have a benign course.

  1. Ressecção de aneurisma venoso em veia jugular externa direita Resection of right external jugular vein aneurysm

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    Eduardo Pereira Savi

    2010-12-01

    Full Text Available O aneurisma venoso é uma anomalia rara, cujo diagnóstico pode ser realizado a partir de exames físicos e complementares. Sua raridade justifica a necessidade de investigação e de publicações de estudos de caso, objetivo maior deste estudo. Relata-se aqui o caso de uma paciente que apresentava um abaulamento cervical anterior assintomático, progressivo e com seis meses de evolução. A paciente foi submetida à cervicotomia anterior, sob anestesia geral, com ressecção do segmento venoso acometido e ligadura da veia jugular externa. Realizado o estudo, verificou-se que aneurismas venosos podem causar tromboflebite, embolia pulmonar ou rotura. Cirurgia profilática, quando oferece baixo risco, é cuidadosamente recomendada para pacientes com aneurismas abdominais e altamente recomendada para aneurismas do sistema venoso profundo dos membros inferiores. Outros aneurismas venosos devem ser tratados cirurgicamente quando sintomáticos, desfigurantes ou se apresentarem aumento progressivo.Venous aneurysms are a rare abnormality, usually found in physical or complementary exams. We report a case of a 43-year old female with an asymptomatic and progressive enlarging mass in the neck. She had no history of trauma or cervical puncture. Vascular ultrasound showed a right jugular veins aneurysm with 1,81 x 1,62 cm of diameter. She was undergone resection and ligation of right external jugular vein, under general anesthesia. Venous aneurysm can cause thrombophlebitis, pulmonary embolism or spontaneous rupture. Prophylactic surgery is cautiously recommended for low-risk patients with venous aneurysms of the abdomen and strongly recommended for most patients with lower extremity deep venous aneurysms. Other venous aneurysms should be excised only if they are symptomatic, enlarging, or disfiguring

  2. Rendimientos cognitivos en pacientes con aneurisma cerebral

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    Pastor Zapata, Ana

    2015-01-01

    [ES] La mortalidad y morbilidad entre los pacientes que han tenido una hemorragia subaracnoidea aneurismática son elevadas. Así mismo, los déficits cognitivos a largo plazo asociados a la hemorragia subaracnoidea aneurismática han sido descritos y afectan principalmente a funciones cognitivas como la memoria, la atención, la percepción, las praxias visoespaciales y la función ejecutiva. El tratamiento quirúrgico mediante craneotomía y clipaje del aneurisma cerebral era la única estrategia ...

  3. Correção cirúrgica da coarctação da aorta em adultos sob assistência circulatória extracorpórea esquerda Surgical repair of coarctation of aorta in adults under left heart bypass

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    Eduardo Carvalho Ferreira

    2012-03-01

    Full Text Available OBJETIVO: Descrever a experiência do serviço com a correção da coarctação da aorta em adultos utilizando assistência circulatória esquerda. MÉTODOS: De novembro de 2007 a outubro de 2009, oito pacientes adultos com coarctação da aorta foram submetidos a correção cirúrgica com interposição de enxerto tubular através de toracotomia póstero-lateral esquerda e uso de assistência circulatória com uso de circuito átrio esquerdo e artéria femoral. Cinco pacientes eram do sexo feminino e tinham idade média de 31,5 ± 13,1 anos. Todos tinham hipertensão arterial sistêmica (HAS e apresentavam doenças cardiovasculares associadas. RESULTADOS: Não houve óbitos ou complicações neurológicas. O tempo médio cirúrgico foi de 308 minutos, o tempo médio de assistência circulatória de 73 minutos e o de pinçamento aórtico médio de 65 minutos. O sangramento médio no pós-operatório foi de 696 ml. Seis pacientes evoluíram com HAS grave no pós-operatório, sendo necessário uso de vasodilatadores endovenosos. As altas hospitalares ocorreram em média no 9º dia pós-operatório. Houve redução significativa do gradiente médio da pressão arterial sistêmica. O seguimento ambulatorial com ecocardiograma até dois meses de pós-operatório demonstrou gradiente aorta/enxerto médio de 20,3 mmHg. CONCLUSÃO: O uso da assistência circulatória esquerda pode ser uma opção na correção cirúrgica da coarctação da aorta em adultos, principalmente em pacientes com alterações parede da aorta, não sendo observada isquemia medular nos casos estudados.OBJECTIVE: To describe our experience with repair of coarctation of the aorta in adults using left heart bypass. METHODS: From November 2007 to October 2009, eight adult patients with coarctation of the aorta underwent surgical repair under circulatory support using a left atrium to femoral artery bypass circuit, with graft interposition tube through left posterolateral thoracotomy

  4. Aneurisma intracraniano na síndrome de Marfan: a case report Intracranial aneurysm in Marfan's syndrome

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    José Geraldo Speciali

    1971-12-01

    Full Text Available Citam-se as várias alterações vasculares nas moléstias hereditárias do tecido coinjuntivo. É relatado um caso de síndrome de Marfan associado a aneurisma intracavernoso da artéria carótida interna.Vascular malformations in hereditary connective tissue diseases are reviewed. Intracavernous aneurysm of the internal carotid artery in a patient with Marfan's syndrome is reported.

  5. O uso de recursos virtuais na preparação pré-operatória de aneurismas infrarrenais: explorando o potencial do OsiriX

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    Giovani Jose Dal Poggetto Molinari

    2014-04-01

    Full Text Available Introdução: Desde os últimos anos, tem crescido o interesse dos cirurgiões vasculares com prática em cirurgia endovascular na utilização de softwares de manipulação de imagens tomográficas, principalmente quando se refere à sua utilização no reparo endovascular dos aneurismas de aorta abdominal infrarrenais. Assim, o pós-processamento das imagens tornou-se uma grande ferramenta na interpretação e documentação das alterações, melhorando a produtividade e a precisão das informações, utilizando volumes cada vez menores de contraste iodado no planejamento e execução do tratamento endovascular. Da mesma forma, menor é a exposição à radiação ionizante no intraoperatório. Divulgam-se os resultados iniciais da análise da viabilidade da manipulação de imagens tomográficas no software OsiriX por meio da fluoroscopia virtual. Métodos: Através da manipulação de imagens de cortes tomográficos finos sob-reconstrução tridimensional por volume, foi possível manipular valores de projeção da distribuição de dose irradiada. A esta configuração, foi atribuído o nome de Virtual Fluoroscopy, formato reprodutível em qualquer plataforma OsiriX. Com isto, obteve-se uma imagem biplanar aparentemente a uma fluoroscopia operatória do doente. Quando comparadas à angiografia e fluoroscopia intraoperatória, estas imagens revelaram-se equivalentes. DISCUSSÃO: A manipulação de dados de distribuição da dose irradiada em uma superfície permite que se visualizem como opacas áreas de alto contraste (como superfícies ósseas e como transparentes valores de baixa atenuação (partes moles. Orientados por marcações nas artérias renais, pode-se prever minuciosamente o seu posicionamento anatômico em relação à sua visualização sob fluoroscopia. Outrossim, a antecipação do correto posicionamento do aparelho de radioscopia com o uso desta técnica permite a obtenção da imagem com o mínimo de interferência do

  6. Aneurisma verdadeiro bilateral de artéria tibial posterior True bilateral aneurysm of the posterior tibial artery

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    Silvio Romero de Barros Marques

    2006-03-01

    Full Text Available Neste artigo, faz-se o relato de um caso de aneurisma verdadeiro bilateral da artéria tibial posterior em paciente de 57 anos. Os aneurismas surgiram em épocas diferentes. Os aspectos clínicos, diagnósticos e terapêuticos deste caso são discutidos. Este relato é importante, pois os autores não têm conhecimento de caso semelhante na literatura consultada.This article reports a case of true bilateral aneurysm of the tibial posterior artery in a 57 year-old patient. The aneurysms occurred at different times. The clinical, diagnostic and therapeutic aspects of this case are discussed. This report is important because the authors did not find a similar description in the literature.

  7. Aneurisma idiopático de artéria radial: relato de caso Idiopathic radial artery aneurysm: case report

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    Luiz Ernani Meira Jr.

    2011-12-01

    Full Text Available Os aneurismas da artéria radial são extremamente raros. Em sua maioria, consistem de pseudoaneurismas pós-traumáticos. Os aneurismas da artéria radial verdadeiros podem ser idiopáticos, congênitos, pós-estenóticos ou associados a patologias, tais como vasculites e doenças do tecido conjuntivo. Foi relatado um caso de aneurisma idiopático de artéria radial em uma criança de três anos, que, após completa investigação diagnóstica complementar, foi submetida à ressecção cirúrgica.Radial artery aneurysms are extremely rare. Post-traumatic pseudoaneurysms are the vast majority. True radial artery aneurysms can be idiopathic, congenital, poststenotic, or associated with some pathologies, such as vasculitis and conjunctive tissue diseases. We report a case of an idiopathic aneurysm of the radial artery in a three-year-old child who was submitted to surgical resection after a complete diagnostic approach.

  8. Cirurgia das dissecções crónicas da aorta ascendente com insuficiência valvar Surgery of chronic aortic dissection with aortic insufficiency

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    Paulo M Pêgo-Fernandes

    1990-12-01

    Full Text Available No período de janeiro de 1980 a dezembro de 1988, foram operados 44 pacientes com dissecções aórticas crônicas e insuficiência aórtica. Esse grupo foi analisado para se avaliar a evolução comparativa dos doentes em que a valva aórtica foi preservada em relação àqueles em que houve substituição valvar. As características pré-operatórias eram semelhantes, sendo efetuada troca da valva quando havia degeneração valvar ou ectasia ânulo-aórtica. Nos casos de desabamento de válvulas com alargamento do anel realizou-se plástica valvar. Em 48% dos casos foi possível a preservação valvar através de suspensão da valva aórtica. Nos 23 doentes em que foi realizada a substituição valvar, a técnica de Bentall e De Bono foi utilizada em 16. Em seis pacientes foram associados outros procedimentos cirúrgicos. Em todos os doentes operados a partir de 1986 foi utilizada cola biológica. Em 41 (93% pacientes a aorta proximnal foi substituída e nos três restantes realizou-se aortoplastia. Cinco pacientes (11% tiveram morte hospitalar, três por baixo débito, um por sangramento e um por complicação neurológica. Dois pacientes (4% apresentaram morte tardia. O seguimento dos 37 sobreviventes variou de dois a 108 meses, com média de 18: 78% estavam em classe I e os demais em classe II. Dois pacientes que tiveram a valva preservada apresentaram insuficiência aórtica discreta. Três doentes que receberam válvula biológica necessitaram reoperaçáo tardiamente, por disfunção da válvula. Um doente submetido, inicialmente, a aortoplastia e plástica valvar apresentou redissecção e insuficiência aórtica após 60 meses, sendo reoperado pela técnica de Bentall. No estudo com curva atuarial de sobrevida notamos que os pacientes submetidos a plástica valvar tiveram maior sobrevida. Podemos concluir que: 1 a suspensão valvar é uma técnica satisfatória em pacientes com dissecções crônicas da aorta, com baixa mortalidade e

  9. Prevalencia del aneurisma aórtico abdominal en el área urbana de Medellín, Colombia

    OpenAIRE

    María Isabel Villegas; Jairo Patiño; Fernando Mejía; Ignacio Tobón; José Andrés Uribe; René Fernando Timarán R.; Carlos Diaz; William Ramírez Herrán; William Calle Cayón; Giovanni García Martínez; Ada María Villalba; Lina María Vélez.; Cristina Ángel

    2008-01-01

    INTRODUCCIÓN: el aneurisma de la aorta abdominal (AAA) constituye una importante causa de muerte en todo el mundo; causa más de 15.000 muertes por año en los Estados Unidos y 6.000 a 10.000 en el Reino Unido. Es la causa del 1,2% de las muertes en mayores de 60 años. La mayoría de ellos cursan asintomáticamente, y es evidente la diferencia en la tasa de mortalidad según que su tratamiento se haga de forma urgente o electiva. Estudios poblacionales a escala mundial utilizando para tamización l...

  10. Tratamento endovascular de aneurismas cirsoideos do couro cabeludo Endovascular treatment of scalp cirsoid aneurysms

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    Eduardo Wajnberg

    2010-08-01

    Full Text Available OBJETIVO: Relatar os resultados da aplicação de técnicas endovasculares no tratamento de aneurismas cirsoideos do couro cabeludo. MATERIAIS E MÉTODOS: Quatro pacientes com diagnóstico de aneurismas cirsoideos foram submetidos ao tratamento por via endovascular. Todos os quatro pacientes incluídos nesta série tinham malformações arteriovenosas e foram tratados apenas com embolização. RESULTADOS: Três pacientes foram submetidos a tratamento endovascular mediante embolização transarterial e um foi tratado por punção direta da porção venosa. Os resultados clínicos e cosméticos foram satisfatórios em todos os pacientes. Não houve recidiva clínica durante o período de acompanhamento. CONCLUSÃO: A via endovascular é uma alternativa segura e eficaz no tratamento dos aneurismas cirsoideos. Embora possa ser efetivamente utilizado como uma alternativa adjuvante ou complementar à cirurgia, especialmente quando é necessário lidar com aferências profundas, a maioria dos casos pode ser totalmente curada apenas com a terapêutica endovascular. A escolha do método de tratamento deve ser baseada em uma variedade de características próprias da lesão, incluindo sua angioarquitetura, tamanho e apresentação clínica.OBJECTIVE: To report results of the application of endovascular techniques in the management of scalp cirsoid aneurysms. MATERIALS AND METHODS: Four patients diagnosed with cirsoid aneurysms were submitted to treatment by endovascular approach. All the four patients included in the present series had arteriovenous malformations and were treated solely by embolization. RESULTS: Three of the patients underwent endovascular treatment by transarterial embolization and one was treated by direct puncture of the venous segment. Both clinical and cosmetic outcomes were satisfactory in all of the patients. Clinical relapse was not observed along the follow-up period. CONCLUSION: The endovascular approach is safe and effective in

  11. Aneurisma de artéria cerebral em criança com síndrome da imunodeficiência adquirida: relato de caso Cerebral arterial aneurysm in a child with acquired immunodeficiency syndrome: case report

    OpenAIRE

    Arnolfo de Carvalho Neto; Isac Bruck; Luiz Otávio de Mattos Coelho; Cristina Rodrigues da Cruz; Cristian Bark Liu; André Francisco Gomes; Sílvio Atsushi Ogata; Tony Tannous Tahan

    2001-01-01

    A dilatação aneurismática dos vasos do polígono de Willis é manifestação incomum da infecção pelo vírus da imunodeficiência adquirida (HIV), tendo sido relatados, até o momento, 15 casos na literatura. O presente estudo tem por objetivo relatar um novo caso dessa apresentação rara, além de revisar aspectos importantes relacionados à mesma. Um paciente, do sexo masculino, 6 anos de idade, com síndrome da imunodeficiência adquirida (AIDS) de transmissão perinatal e tetraparesia, desenvolveu sin...

  12. Endovascular treatment of aortic arch aneurysms Tratamento endovascular dos aneurismas de arco aórtico

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    Roberto Chiesa

    2008-06-01

    dos aneurismas do arco aórtico é uma solução interessante para pacientes selecionados. OBJETIVO: Comparar os sucessos técnico e clínico registrados nas diferentes regiões anatômicas do arco aórtico após a colocação de endoprótese. MÉTODOS: Entre junho de 1999 e outubro de 2006, 178 pacientes foram tratados na nossa instituição devido a doenças da aorta torácica com a colocação de endoprótese, sendo que o arco aórtico estava envolvido em 64 casos. De acordo com a classificação proposta por Ishimaru, a zona aórtica 0 estava envolvida em 14 casos, zona 1 em 12 casos e zona 2 em 38 casos. Procedimentos de debranching do arco aórtico e revascularização extra-anatômica dos troncos supra-aórticos foram realizados em 37 casos para obter um adequado colo aórtico proximal. RESULTADOS: Zona 0. Comprimento do colo proximal: 44±6 mm. Sucesso clínico inicial de 78,6%: dois óbitos (acidente vascular cerebral, um vazamento do tipo Ia. Seguimento médio de 16,4±11 meses com sucesso clínico a médio prazo de 85,7%. Zona 1. Comprimento do colo proximal: 28±5 mm. Sucesso clínico inicial de 66,7%: 0 óbitos, quatro vazamentos do tipo Ia. Seguimento médio de 16,9±17,2 meses com sucesso clínico a médio prazo de 75%. Zona 2. Comprimento do colo proximal: 30±5 mm. Sucesso clínico inicial de 84,2%: dois óbitos (um infarto cardíaco e uma embolização de múltiplos órgãos, três vazamentos do tipo Ia, um caso de conversão para operação aberta. Dois casos de paraparesia/paraplegia transitória tardia foram observados. Seguimento médio de 28,0±17,2 meses com sucesso clínico a médio prazo de 89,5%. CONCLUSÃO: Este estudo e a análise da literatura demonstram que o procedimento híbrido para moléstia do arco aórtico é factível em pacientes selecionados com alto risco para a operação convencional. Nossa experiência ainda é limitada pelo tamanho relativamente pequeno da amostra. Sugerimos reservar a zona 1 para pacientes inadequados para

  13. Uso de dexmedetomidina em anestesia geral para tratamento cirúrgico de aneurisma cerebral, em paciente gestante, portadora de doença hipertensiva específica da gestação: relato de caso Uso de dexmedetomidina en anestesia general para tratamiento quirúrgico de aneurisma cerebral, en paciente embarazada, portadora de enfermedad hipertensiva específica del embarazo: relato de caso Dexmedetomidine in general anesthesia for surgical treatment of cerebral aneurysm in pregnant patient with specific hypertensive disease of pregnancy: case report

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    Kleber Machareth de Souza

    2005-04-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A incidência de cirurgias não obstétricas em pacientes gestantes é de 0,36% a 2%. No entanto, cirurgias visando o tratamento cirúrgico de aneurisma cerebral em gestantes são extremamente raras. A doença hipertensiva específica da gestação, apresenta prevalência clínica de 10% na população gestante. Trata-se de uma doença de elevada complexidade clínica, acometendo múltiplos órgãos e sistemas. A dexmedetomidina, fármaco agonista alfa2, apresenta importante seletividade para estes receptores, quando utilizada em doses clínicas terapêuticas e promove adequada estabilidade hemodinâmica, se empregada no período peri-operatório. O objetivo deste relato foi apresentar uma técnica com a qual fosse possível a manutenção da homeostase materna, preservando ao máximo o fluxo sangüíneo útero-placentário e a vitalidade fetal, sem deixar de lado aspectos fundamentais relativos à otimização da relação oferta/demanda de oxigênio cerebral e adequação das condições do tecido cerebral propícias ao manuseio cirúrgico. RELATO DO CASO: Gestante com 19 anos encaminhada para tratamento cirúrgico de aneurisma cerebral, estando na vigésima sétima semana de gestação. No pré-operatório, apresentava-se consciente, orientada, com presença de déficit à esquerda e quadro clínico compatível com toxemia gravídica. Foi administrada dexmedetomidina (1 µg.kg-1 em 20 minutos, seguida de indução anestésica com propofol (2,5 mg.kg-1, fentanil (7,5 µg.kg-1, lidocaína (1 mg.kg-1 e rocurônio (2 mg.kg-1 em seqüência rápida. A manutenção da anestesia foi obtida com propofol (50 µg.kg-1.min-1, alfentanil (1 µg.kg-1.min-1 e dexmedetomidina (0,7 µg.kg-1.min-1. A cirurgia foi realizada sem qualquer intercorrência, não havendo seqüela neurológica subjacente. CONCLUSÕES: Neste caso o uso da dexmedetomidina tornou possível um adequado manuseio hemodinâmico, mantendo otimizado o fluxo sang

  14. Osteopontin expression and its possible functions in the aortic disorders and coronary artery disease A expressão da osteopontina e as suas funções possíveis nas desordens aórticas e doença arterial coronariana

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    Shi-Min Yuan

    2011-06-01

    level of the patients with coronary artery disease was much lower than those with aortic dissection (P = 0.033 or with aortic aneurysm (P = 0.019. By unparametric tests, there were significant differences in the aortic OPN contents among aortic dissection, aortic aneurysm and coronary artery disease groups (P OBJETIVOS: A osteopontina (OPN está estreitamente associada com os processos de oncogênese e remodelação. Entretanto, essa citocina era raramente avaliada na presença de aortopatias, especialmente na dissecção aórtica aguda. O objetivo do presente estudo foi avaliar a expressão de OPN por meio de abordagens moleculares biológicas, de modo a oferecer uma melhor compreensão dos possíveis mecanismos das aortopatias. MÉTODOS: Pacientes consecutivos com um tipo de dissecção aguda da aorta (20 pacientes, aneurisma da aorta (nove pacientes ou doença arterial coronária (21 pacientes foram incluídos neste estudo. As amostras de sangue depois da heparinização sistemática e de 21 voluntários jovens e saudáveis não apontaram nenhuma evidência de qualquer problema ao serem investigados por ensaio imunoenzimático (ELISA. Os espécimes cirúrgicos dos tecidos aórtica coletados dos pacientes durante as operações foram obtidos para a reação de transcrição reversa quantitativa em tempo real em cadeia da polimerase (RT-PCR para OPN mRNA, técnica de Western blot para a proteína OPN, e imunohistoquímica de OPN. Amostras da aorta de indivíduos saudáveis que morreram de acidente foram obtidos para controle imunohistoquímico. RESULTADOS: Com uso do RT-PCR quantitativo, as expressões de OPN mRNA foram suprarreguladas em todos os três grupos cirúrgicos. Os resultados quantitativos não revelaram quaisquer diferenças intergrupais. Western blot revelou que OPN foi positiva com intensidade semelhante de expressões em todos os três grupos. As análises quantitativas Western blot de expressões OPN não apresentaram significâncias entre os grupos. As

  15. Aneurisma da artéria vertebral extracraniana em puérpera portadora de neurofibromatose clássica Extracranial vertebral artery aneurysm during the puerperium in women with neurofibromatosis type 1

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    Carla Aparecida Faccio Bosnardo

    2005-09-01

    Full Text Available Paciente de 26 anos, no 10º dia de puerpério, apresentou dor súbita em região cervical esquerda irradiada para região supraclavicular do mesmo lado, seguida de aparecimento de massa pulsátil. Relatava hipertensão sistólica média de 160 mmHg, e diastólica média de 130 mmHg na gravidez e neurofibromatose. Ao exame físico, apresentava massa pulsátil em região supraclavicular esquerda, sem frêmitos e/ou sopros. Um alargamento do mediastino foi detectado através de raio-x de tórax. Uma tomografia computadorizada (região cervical e torácica evidenciou tumoração em território de artéria subclávia esquerda na sua porção proximal, sem limites definidos pelo extravasamento de contraste, além de hemotórax gigante à esquerda. A paciente evoluiu com choque hipovolêmico, sendo submetida à cirurgia de urgência, com toracotomia seguida de cervicotomia, onde se evidenciou lesão aneurismática rota da artéria vertebral esquerda logo após sua emergência. Após controle do sangramento, procedeu-se à sua ligadura. A paciente evoluiu satisfatoriamente, estando em acompanhamento ambulatorial.A 26-year-old patient, on the 10th day of the puerperium, presented sudden pain in the left cervical region irradiated to the supraclavicular region on the same side, followed by the presence of a pulsatile mass. She reported a mean systolic hypertension of 160 mmHg, and mean diastolic hypertension of 130 mmHg in pregnancy and neurofibromatosis. At physical examination, she presented a pulsatile mass in the left supraclavicular region, without thrill and/or murmur. A widening of the mediastinum was detected by a thoracic X-ray. A computed tomography (cervical and thoracic region showed a pulsatile mass in the territory of the left subclavian artery in its proximal portion, without having limits defined by contrast extravasation, besides a giant hemothorax on the left. The patient evolved with hypovolemic shock and was submitted to an urgent

  16. Correção cirúrgica de aneurismas saculares de fístula arteriovenosa para hemodiálise utilizando a técnica de aneurismorrafia Surgical repair of saccular aneurysms of an arteriovenous fistula for hemodialysis using aneurismorraphy technique

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    Ricardo Wagner da Costa Moreira

    2011-06-01

    Full Text Available Uma das complicações mais frequentes da fístula arteriovenosa (FAV para hemodiálise é o desenvolvimento de um aneurisma. A formação de aneurismas geralmente decorre de um enfraquecimento da parede venosa devido às repetidas punções, e sua rotura causa hemorragia intensa que pode levar à morte. Descrevemos o caso de uma paciente com dois aneurismas saculares de FAV, tratados através de aneurismorrafia, detalhando a técnica cirúrgica utilizada e a evolução pós-operatória. A técnica de rafia simples da parede constitui uma boa alternativa no reparo da parede da FAV quando o aneurisma é de curta extensão, evitando a colocação de um material protético e a confecção de duas anastomoses.One of the most common complications of arteriovenous fistulas (AVF is aneurysm formation due to weakening of the venous wall after repeated punctures. Its rupture causes severe bleeding that can lead to death. We report the case of a patient with two AVF saccular aneurysms treated by aneurysmorrhaphy. The technique and the postoperative follow-up are presented in detail. Aneurysmorrhaphy is a good option to repair the AVF wall when the aneurysmal segment is short, thus avoiding the placement of prosthetic grafts and the performance of two anastomoses.

  17. Aneurisma de artéria ilíaca interna roto: relato de caso Ruptured internal iliac artery aneurysm: case report

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    Cristina Toledo Afonso

    2009-03-01

    Full Text Available Aneurismas isolados da artéria ilíaca interna são raros, acometem 0,1% da população e correspondem a 1% dos aneurismas aorto-ilíacos. Na maioria das vezes, os pacientes são assintomáticos, mas podem apresentar dor abdominal, massa pulsátil no hipogástrio ou na fossa ilíaca, sintomas compressivos urinários, gastrointestinais ou neurológicos. Podem ocasionar quadro de abdome agudo, principalmente quando há ruptura. O diagnóstico precoce dos aneurismas isolados de artéria ilíaca interna é incomum, sendo identificados quando mais volumosos ou rotos, o que aumenta significativamente sua morbimortalidade e torna seu prognóstico mais reservado. Dessa forma, representam um desafio terapêutico. A ligadura cirúrgica tem sido o tratamento mais comum, entretanto a cirurgia endovascular tem mostrado bons resultados, inclusive nos aneurismas rotos. É relatado caso de aneurisma de artéria ilíaca interna isolado roto diagnosticado durante laparotomia para abordagem de abdome agudo.Isolated internal iliac artery aneurysms are rare. They affect 0.1% of the population, and account for 1% of aortoiliac aneurysms. Patients are mostly asymptomatic, yet they can have abdominal pain, pulsatile mass in the hypogastrium or iliac fossa, or urinary, gastrointestinal or neurological compressive symptoms. Such aneurysms are likely to course with an acute abdomen, especially when ruptured. Early diagnosis of isolated internal iliac artery aneurysms is difficult, as they are more easily detected when larger or ruptured, which significantly raises their morbidity and mortality rate and determines a poor prognosis. Therefore, they are a therapeutic challenge. Surgical ligation has been the most common treatment; however, the endovascular approach has presented good outcomes, even in the event of ruptured aneurysms. A case of ruptured isolated iliac artery aneurysm diagnosed during a laparotomy (acute abdomen approach is reported.

  18. Prevalencia del aneurisma aórtico abdominal en el área urbana de Medellín, Colombia

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    María Isabel Villegas

    2008-11-01

    Full Text Available INTRODUCCIÓN: el aneurisma de la aorta abdominal (AAA constituye una importante causa de muerte en todo el mundo; causa más de 15.000 muertes por año en los Estados Unidos y 6.000 a 10.000 en el Reino Unido. Es la causa del 1,2% de las muertes en mayores de 60 años. La mayoría de ellos cursan asintomáticamente, y es evidente la diferencia en la tasa de mortalidad según que su tratamiento se haga de forma urgente o electiva. Estudios poblacionales a escala mundial utilizando para tamización la ecografía abdominal han demostrado tasas globales de prevalencia de 2-4%. Este método es la forma más económica y efectiva de hacer oportunamente el diagnóstico. En Colombia no existen estudios poblacionales que permitan definir la prevalencia de esta enfermedad y hacer oportunamente su tratamiento con miras a mejorar la probabilidad de supervivencia de estos pacientes. OBJETIVO: determinar la tasa de prevalencia del AAA en personas mayores de 55 años, en el área urbana de Medellín, mediante la evaluación con ecografía abdominal simple, y describir las enfermedades asociadas. MÉTODOS: se llevó a cabo un estudio descriptivo de corte transversal. Se calculó la población mayor de 55 años de la ciudad de Medellín en el año 2002 en 238.231 personas y se calculó una muestra representativa de 650 individuos. Se tuvieron en cuenta el número de barrios de cada comuna y el de personas para evaluar por zona, se aplicará una encuesta y se les hará ecografía abdominal a todos los encuestados determinando los diámetros AP y transversal de la aorta abdominal infrarrenal para detectar los individuos con AAA. RESULTADOS: la muestra total fue de 532 individuos correspondientes al 81,8% de la muestra establecida en la metodología. Por sexo hubo 354 mujeres (66,5% y 178 hombres (33,5%; la edad promedio fue de 66,6 años. Trescientos sesenta y siete individuos (69% presentaban al menos un antecedente patológico: hipertensión arterial en 41

  19. Aneurisma do arco aórtico com fístula aorto-pulmonar: tratamento cirúrgico com sucesso Aortic arch aneurysm with aorto-pulmonary fistula: successful surgical repair

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    Marcelo Luiz Peixoto Sobral; Luis Alberto Saraiva Santos; Gilmar Geraldo dos Santos; Noedir Antonio Groppo Stolf

    2004-01-01

    Aneurisma de arco aórtico com fístula aorto-pulmonar aguda é uma afecção rara e, geralmente, diagnosticada postmortem. Poucos relatos de sucesso cirúrgico foram realizados e persiste uma alta taxa de mortalidade. Os autores relatam o caso de um paciente de 78 anos, com comunicação aguda entre aneurisma de arco aórtico e artéria pulmonar com precordialgia, instabilidade hemodinâmica e congestão pulmonar. A operação foi realizada com sucesso, sendo realizada a substituição da porção proximal da...

  20. Conduta anestésica em cesariana em gestante com aneurisma intracraniano não roto Conducta anestésica en cesárea en embarazada con aneurisma cerebral íntegro Anesthetic conduct in cesarean section in a parturient with unruptured intracranial aneurysm

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    Luciana de Souza Cota Carvalho

    2009-12-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O manuseio anestésico para cesariana programada em gestante com aneurisma intracraniano não roto é particularmente interessante, pois apresenta diversas particularidades relacionadas às alterações fisiológicas da gestação acrescida dos riscos de ruptura do aneurisma durante o procedimento anestésico. A literatura é escassa nesse assunto, sendo assim importante a divulgação dos casos. RELATO DO CASO: Gestante de termo, 31 anos, com aneurisma intracraniano não roto submetida à cesariana programada sob anestesia peridural simples. O procedimento evoluiu sem intercorrências para mãe e filho. CONCLUSÕES: Recomendações baseadas em evidências para anestesia obstétrica em pacientes portadoras de aneurisma intracraniano não roto não existem. Não há dados experimentais ou clínicos que confirmem ou refutem anestesia geral ou regional nesse contexto. Dessa forma, a decisão de qual técnica utilizar deve ser feita com bases individuais, ponderando os riscos e benefícios de cada procedimento e a experiência do profissional que irá conduzi-la.JUSTIFICATIVA Y OBJETIVOS: El manejo anestésico para la cesárea programada en embarazada con aneurisma cerebral íntegro es particularmente interesante, porque presenta diversas particularidades relacionadas con las alteraciones fisiológicas del embarazo y por añadidura, con los riesgos de ruptura del aneurisma durante el procedimiento anestésico. La literatura es parca en ese asunto, siendo muy importante la divulgación de los casos. RELATO DEL CASO: Embarazada de término, 31 años, con aneurisma cerebral no roto y sometida a la cesárea programada bajo anestesia epidural simple. El procedimiento evolucionó sin intercurrencias para la madre y el hijo. CONCLUSIONES: No existen recomendaciones basadas en evidencias, para la anestesia obstétrica en pacientes portadoras de aneurisma cerebral no roto. No hay datos experimentales o clínicos que confirmen o que

  1. Pré-condicionamento isquêmico e monitorização da função medular na abordagem da aorta torácica descendente Ischemic preconditioning and spinal cord function monitoring in the descending thoracic aorta approach

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    Bernardo Assumpção de Mônaco

    2007-03-01

    Full Text Available OBJETIVOS: Avaliar a eficácia do pré-condicionamento isquêmico (PI agudo, guiado por potenciais evocados somatossensoriais (PESS, como método de proteção medular em cães e analisar o valor dos PESS na monitorização da função medular. MÉTODOS: Foram utilizados 28 cães submetidos à isquemia medular obtida pelo pinçamento da aorta torácica descendente. No grupo C45, o tempo de oclusão aórtica foi de 45 min (n = 7; no grupo PI45, os cães foram submetidos ao PI antes do pinçamento aórtico por 45 min (n = 7. No grupo C60, os cães foram submetidos a 60 min de oclusão aórtica (n = 7 e no grupo PI60, os cães foram submetidos ao PI, seguido pelo pinçamento aórtico por 60 min. Os ciclos de PI foram determinados pelas alterações dos PESS. RESULTADOS: Os índices de Tarlov dos grupos pré-condicionados foram significativamente melhores que os dos grupos de controle (p = 0,005. Observou-se paraplegia em três cães do C45 e em seis do C60, enquanto todos os cães do PI45 permaneceram neurologicamente normais, assim como quatro do grupo PI60. Houve correlação entre o tempo de recuperação dos PESS após a reperfusão aórtica e o estado neurológico pós-operatório (p = 0,011, com sensibilidade e especificidade de 0,75 e 0,83, respectivamente. CONCLUSÃO: O PI agudo repetitivo, baseado na monitorização do PESS, induziu proteção à isquemia medular causada pelo pinçamento aórtico prolongado. A monitorização do PESS parece ser um bom método de detecção precoce do comprometimento isquêmico medular.OBJECTIVES: To evaluate the effectiveness of acute ischemic preconditioning (IP, based on somatosensory evoked potentials (SSEP monitoring, as a method of spinal cord protection and to asses SSEP importance in spinal cord neuromonitoring. METHODS: Twenty-eight dogs were submitted to spinal cord ischemic injury attained by descending thoracic aorta cross-clamping. In the C45 group, the aortic cross-clamping time was 45 min (n

  2. Aneurisma ilíaco associado a fístula arteriovenosa Iliac aneurysm associated with arteriovenous fistula

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    Daniel Mendes Pinto

    2007-09-01

    Full Text Available A ruptura dos aneurismas aorto-ilíacos para a veia ilíaca ou veia cava é uma complicação pouco comum. A hipertensão venosa leva a vários sinais e sintomas, o que dificulta o diagnóstico pré-operatório, tais como edema do membro inferior, dispnéia, hematúria, sinais de insuficiência renal ou cardíaca. Sopro abdominal é a chave do diagnóstico clínico, associado à massa pulsátil e dor abdominal. O reconhecimento da fístula arteriovenosa no pré-operatório é importante para o planejamento cirúrgico. Relatamos um caso de aneurisma da artéria ilíaca comum e interna direita associado a fístula para veia ilíaca comum, cursando, inicialmente, com edema do membro inferior direito e dispnéia, o que levou ao diagnóstico incorreto de trombose venosa profunda.Rupture of aortoiliac aneurysms into the iliac vein or vena cava is an uncommon complication. Many signs and symptoms develop as a result of venous hypertension, which makes preoperative diagnosis difficult, such as leg edema, dyspnea, hematuria, signs of renal or cardiac insufficiency. Abdominal bruit, associated with pulsatile mass and abdominal pain, is the key for clinical diagnosis. Preoperative recognition of arteriovenous fistula is important for surgical planning. We report a case of right internal and common iliac artery aneurysm associated with fistula into the common iliac vein. Initial symptoms were right leg edema and dyspnea, which induced to the incorrect diagnosis of deep vein thrombosis.

  3. Análise do tratamento cirúrgico da raiz da aorta com o tubo valvulado e com a preservação da valva aórtica Analysis of aortic root surgery with composite mechanical aortic valve conduit and valve-sparing reconstruction

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    Ricardo Ribeiro Dias

    2010-12-01

    Full Text Available OBJETIVO: Análise comparativa dos resultados imediatos e tardios da reconstrução da raiz da aorta com o tubo valvulado e com a preservação da valva aórtica. MÉTODOS: No período de novembro de 2002 a setembro de 2009, 164 pacientes com idade média de 54 ± 15 anos, sendo 115 do sexo masculino, foram submetidos ao tratamento cirúrgico da raiz da aorta. Foram 125 tubos valvulados e 39 reconstruções da raiz da aorta com preservação da valva aórtica. Dezesseis por cento dos pacientes eram portadores de síndrome de Marfan e 4,3% apresentavam valva aórtica bivalvulada. Cento e quarenta e quatro (88% pacientes foram acompanhados durante tempo médio de seguimento de 41,1 ± 20,8 meses. RESULTADOS: A mortalidade hospitalar total foi de 4,9%; sendo 5,6% nas operações com tubo valvulado e 2,6% nas preservações da valva aórtica (POBJECTIVE: Comparative analysis of early and late results of aortic root reconstruction with aortic valve sparing operations and the composite mechanical valve conduit replacement. METHODS: From November 2002 to September 2009, 164 consecutive patients with mean age 54 ± 15 years, 115 male, underwent the aortic root reconstruction (125 mechanical valve conduit replacements and 39 valve sparing operations. Sixteen percent of patients had Marfan syndrome and 4.3% had bicuspid aortic valve. One hundred and forty-four patients (88% were followed for a mean period of 41.1 ± 20.8 months. RESULTS: The hospital mortality was 4.9%, 5.6% in operations with valved conduits and 2.6% in the valve sparing procedures (P <0.05. There was no difference neither in survival (95% CI = 86% - 96%, P= 0.1 nor in reoperation-free survival (95% CI = 85% - 90%, P = 0.29. The survival free of complications such as bleeding, thromboembolism and endocarditis were favorable to the valve sparing operations, respectively (95% CI = 70% - 95%, P = 0.001, (95% CI = 82% - 95% P = 0.03 and (95% CI = 81% - 95%, P = 0.03. Multivariate analysis

  4. Há espaço para o tratamento endovascular nas dissecções crônicas da aorta descendente? Is the endovascular procedure an option for treatment of cronic type B aortic dissections?

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    Ricardo Ribeiro Dias; Gustavo Judas; Marco A. P. Oliveira; Luiz M. S. Malbouisson; Alfredo I. FIORELLI; Noedir A. G Stolf

    2007-01-01

    OBJETIVO: Questões relativas a quais pacientes/doenças que efetivamente deveriam ser submetidos ao tratamento endovascular ainda geram controvérsias. O objetivo deste trabalho visa a questionar o tratamento endovascular nas dissecções crônicas tipo B de Stanford. MÉTODOS: No período de 2003 a 2006, 11 pacientes portadores de dissecção crônica da aorta tipo B de Stanford com dilatação somente no tórax (diâmetro > 5,5cm), foram submetidos à colocação de prótese endovascular autoexpansível pela ...

  5. Tratamento cirúrgico dos aneurismas e dissecções do arco aórtico Surgical treatment of aneurysms and dissections of the aortic arch

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    Bayard GONTIJO FILHO

    1999-10-01

    Full Text Available No período de jan/1990 a mar/1999, foram realizados 354 operações para tratamento de lesões da aorta torácica em nosso Serviço. Destas, 47 foram relacionadas a procedimentos no arco aórtico; 31 (66,0% pacientes eram do sexo masculino e a idade variou de 26 a 74 anos (m = 54,9 ± 10,9. A dissecção aórtica foi responsável pela indicação cirúrgica em 33 (70,2% pacientes e os aneurismas fusiformes ou saculares em 14 (29,8%. A operação foi indicada em caráter de urgência em 10 (21,3% pacientes, havendo 4 casos com sinais de rotura; 11 (23,4% pacientes já haviam sido submetidos a operação cardíaca prévia. O acesso cirúrgico foi a esternotomia mediana (42 casos ou a toracotomia esquerda ou bilateral (5 casos. Hipotermia profunda com parada circulatória (PC foi empregada em 97,8% dos casos com o tempo PC variando de 15 a 60 minutos (m = 30,6 ± 12,6. A técnica do tipo hemiarco anterior foi empregada em 19 (40,4% pacientes, o hemiarco posterior em 5 (10,6%, a substituição total em 18 (38,3%, plastia em 4 (8,5% e derivação extra-anatômica em 1 (2,1%. Foram realizados os seguintes procedimentos concomitantes: substituição da aorta ascendente por conduto valvulado (15, revascularização miocárdica (9, tromba de elefante (5 e troca valvar aórtica (3. A mortalidade hospitalar foi de 12,3% (6 pacientes sendo a complicação não fatal mais freqüente a insuficiência respiratória (7 casos. A análise dos fatores determinantes de mortalidade hospitalar demonstraram tendência estatística para idade acima de 60 anos (p = 0,17 e para portadores de dissecção aguda (p = 0,07. Dos 41 pacientes que receberam alta, 39 foram seguidos por um período de 1 mês a 9 anos. Houve 3 óbitos, sendo 1 por AVC e 2 em reoperações, necessárias em 5 pacientes. A sobrevida de 9 anos é de 80,85%.From Jan/1990 to Mar/1999 we performed 354 operations on the thoracic aorta in our hospital. Among these, 47 procedures involved the aortic arch

  6. Correção cirúrgica com sucesso de aneurisma subaórtico: relato de caso

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    Ronaldo Machado BUENO

    1998-01-01

    Full Text Available Os aneurismas subaórticos são pouco comuns, localizando-se geralmente na fibrosa intervalvar mitro-aórtica (FIMA. Podem ser assintomáticos ou causar sintomas como: dor torácica, palpitação, sopros, insuficiência cardíaca, disfunção valvar mitral e aórtica, angina, IAM, BAVT, infarto agudo do miocárdio, bloqueio atrioventricular total, tamponamento cardíaco, ou morte súbita. Apresentamos o caso de paciente de 18 anos de idade que desenvolveu quadro séptico em maio de 1996, com meningite e coagulação intravascular disseminada com Staphylococcus aureus em hemocultura, sem evidências ecocardiográficas de endocardite bacteriana. Em março de 1997, foi observada presença de sopro sistólico mitral. Os ecocardiogramas transtorácico e transesofágico mostraram valva aórtica bivalvulada, prolapso da cúspide anterior da valva mitral e presença de aneurisma subaórtico em região da FIMA com shunt da via de saída do ventrículo esquerdo para o átrio esquerdo. O estudo hemodinâmico evidenciou refluxo do ventrículo esquerdo para o átrio esquerdo, sem definir estrutura aneurismática. Submetido a cirurgia com auxílio da CEC em maio de 1997. Abordagem do aneurisma subaórtico por atriotomia esquerda evidenciando-se formação sacular aneurismática com 1,8 cm de extensão e colo com 1,0 cm de diâmetro, ao nível da FIMA. Realizada resecção do tecido aneurismático com plicatura ao nível do colo de aneurisma, mantendo-se a integridade valvar aórtica e mitral. Paciente apresentou excelente evolução, com alta hospitalar no 7º dia de pós-operatório. O ecocardiograma no pós-operatório demonstrou pequena dilatação sacular em FIMA, sem shunt residual, com boa função mitral e aórtica. Concluindo, o tratamento cirúrgico do aneurisma subaórtico pode ser realizado com sucesso, com interrupção do trajeto fistuloso e preservação das valvas mitral e aórtica.Annular subaortic aneurysms are not common, and are usually

  7. Características ultraestruturais do segmento abdominal da aorta de rato albino - DOI: 10.4025/actascibiolsci.v29i4.825 Mural features of the abdominal aortic segment of albino rat - DOI: 10.4025/actascibiolsci.v29i4.825

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    Karina Simões

    2008-02-01

    Full Text Available O objetivo da presente pesquisa foi investigar as peculiaridades ultraestruturais da parede da aorta de rato. Foram utilizados sete ratos albinos, adultos jovens, dos quais foram coletados fragmentos da aorta abdominal infra-renal. Após a coleta, os segmentos vasculares foram fixados e encaminhados para a rotina de microscopia eletrônica de transmissão e varredura. As lamelas elásticas aparecem interpostas às fibras musculares lisas, sendo essa disposição principalmente notada na túnica média da parede vascular. Entre as fibras musculares lisas e as lamelas elásticas, observa-se um inter-relacionamento aparentemente estreito, feito por conexão e ancoramento entre ambos os elementos murais por meio de lamelas de colágeno. A túnica íntima da aorta abdominal do rato mostra algumas peculiaridades ultraestruturais marcantes, tais como a interrupção, em certos locais da parede, de continuidade da lâmina elástica interna, interrupção acompanhada por poros endoteliais, de certa extensão, suprajacentes à falha na estrutura elástica intimal. Este padrão de constituição mural, com destaque aos ancoramentos elástico-musculares, via o colágeno, parece garantir propriedades fundamentais da parede vascular, concernentes à hemodinâmica, tal como o cisalhamento, normalmente notado entre os estratos superpostos da parede vascular, bem como a contratilidade e a visco-elasticidade da parede arterial.The objective of the present research was to investigate the ultrastructural peculiarities of the aortic wall of the rat. Seven young adult rats were used, from which fragments of the infrarenal abdominal aorta were collected. After collection, the vascular segments were fixed and sent for analysis by scanning electron microscope. The elastic lamellae appear interposed with smooth muscular fibers; this pattern was verified mainly at the medial layer structure. Among the mural elements a well defined interrelationship was established through

  8. Coarctation of the aorta

    International Nuclear Information System (INIS)

    Full text: Coarctation of the aorta is a congenital malformation representing a zone of strong narrowing of the aortic lumen, leading to impaired blood flow. In 90% of cases it affects isthmus vessel - the part between the separation of the left Ater subclavian and ductus arteriosus and it is often combined with other congenital heart defects and occurs more frequently in males. A case of juvenile isthmus type coarctation of the aorta at a young woman suffering from long hard to control hypertension, with intermittent discomfort in precordium and heart murmur is presented. Upon receipt of the patient a conventional radiography of organs in the chest front projection, which establishes a typical disease finding is carried out. After that a noninvasive computer-tomography angiography of the thoracic aorta, with CT Siemens Definition AS with a slice thickness 5 mm, subsequent reconstruction of 0,75 mm and postreconstruction were conducted. CT angiography study demonstrates the pathological constriction, the state of the aorta before and after constriction as well as the rich collateral vasculature of the intercostal and internal thoracic arteries. The available 3D reconstructions and postprocessing have been supported the establishment of optimal preoperative plan. The patient was subjected to surgery with vessel recovery and at the moment the patient is with excellent postoperative results

  9. Lesão de aorta simulando doença pulmonar: relato de caso

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    Ricardo Holderbaum do Amaral

    2014-10-01

    Full Text Available Relatamos o caso de uma paciente idosa avaliada por apresentar dispneia e dor na borda costal direita, em que a radiografia de tórax demonstrou opacidade simulando lesão pulmonar e a tomografia computadorizada revelou ser de origem vascular. A síndrome aórtica aguda por ulceração de placa ateromatosa, penetrando através da lâmina elástica, associada a hematoma aórtico e aneurisma constitui importante diagnóstico diferencial nesses casos.

  10. Diagnóstico y tratamiento de los aneurismas saculares de la arteria cerebral anterior

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    Raúl F. Matera

    1956-12-01

    Full Text Available Hacemos un estudio anátomo-funcional de la arteria cerebral anterior recalcando la importancia que tiene la ligadura de esta arteria. Sintetizamos la patogenia de los aneurismas en cuatro hechos fundamentales: los aneurismas vestigiales originados en brotes vasculares no desarrollados o que no han involucionado normalmente; la falta de desarrollo de la túnica elástica en la zona de bifurcación de los grandes vasos; la arterioesclerosis; los procesos inflamatorios de la túnica media (sífilis y micosis. Hacemos un estudio clínico de los aneurismas del complejo cerebral-comunicante anterior, llamando la atención sobre aquellos en los que, a las hemorragias subaracnoidales, se asocian manifestaciones en el fondo de ojo, trastornos psíquicos y fenómenos motores. Llamamos la atención sobre las formas pseudo-tumorales quiasmáticas y los denominados aneurismas trombosantes que originan el síndrome progresivo fronto-cíngulo-calloso. Estudiamos la radiología simple de los aneurismas de esta región, llamando la atención sobre las calcificaciones cirsoideas suprasellares y los fenómenos de erosión de la silla turca. Llamamos la atención sobre la importancia de la arteriografía para confirmar el diagnóstico, estudiar la circulación colateral, el tamaño, la forma y el pedículo del aneurisma, elementos fundamentales para el plan operatório. En el tratamiento quirúrgico descartamos, por ineficaz, la ligadura de la carótida interna en el cuello. Es fundamental el abordaje intracraneano por vía subfrontal en los aneurismas de la porción précomunicante y comunicante con desarrollo hacia abajo, mientras que, la via sagital-frontal se utilizará en los aneurismas de desarrollo hacia arriba ya sea de la comunicante o de la porción distal de la arteria cerebral anterior o sus ramas. Insistimos sobre un hecho muy importante cual es la anestesia y, en especial, el uso de la hipotensión controlada, insistiendo de que la tensión se

  11. Aneurisma do ventrículo esquerdo em paciente com lupus eritematoso sistêmico: relato de caso Left ventricular aneurysm in a patient with systemic lupus erythematosus: case report

    OpenAIRE

    Edmilson Cardoso; Fernando Moraes; Diana Lampreia; Carlos R. Moraes

    2006-01-01

    Descrevemos o caso de uma paciente do sexo feminino, de 36 anos de idade, portadora de lupus eritematoso sistêmico, que sofreu infarto do miocárdio e, posteriormente, desenvolveu aneurisma da parede inferior do ventrículo esquerdo e insuficiência cardíaca. A paciente foi tratada cirurgicamente com bons resultados. A raridade dessa condição é realçada.We describe the case of a 36-year-old woman with systemic lupus erythematosus, who suffered myocardial infarction and, subsequently, developed a...

  12. Aneurisma toracoabdominal roto: modificação do circuito de perfusão visceral Thoracoabdominal aneurysm rupture: a modification of the visceral perfusion circuit

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    Eduardo Faccini Rocha

    2004-12-01

    Full Text Available Paciente portador de aneurisma toracoabdominal (ATA tipo lV, roto, submetido a tratamento cirúrgico utilizando perfusão visceral assistida por bomba centrífuga e oxigenador de membrana neonatal. Este circuito permite a perfusão visceral com sangue oxigenado, durante o período de isquemia, e infusão de volume rápido via venosa após a retirada da pinça.A patient with ruptured type IV thoracoabdominal aortic aneurysm (TAAA, underwent surgical treatment utilizing visceral perfusion assisted by a centrifugal pump and neonatal membrane oxygenator. This circuit allows visceral perfusion with oxygenated blood during the ischemic period and the fast infusion of intravenous volume after clamp removal.

  13. Resolución microquirúrgica de aneurisma de arteria cubital en paciente pediátrico

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    A. Aguilera-Salgado

    2015-09-01

    Full Text Available Presentamos el caso clínico de un paciente varón de 6 años de edad con antecedente de caída desde su propia altura un mes antes de su valoración en consulta, en donde se identifica una tumoración pulsátil en región hipotenar de mano derecha, no dolorosa y no fija a planos profundos. El ultrasonido doppler informa de una tumoración con pared definida, heterogénea, con flujo sanguíneo a través de la misma. En base a los antecedentes y a los resultados del ultrasonido se decide intervenir quirúrgicamente para evitar posibles complicaciones, encontrando un aneurisma de la arteria cubital de 3 x 3 cm de diámetro, no trombosado, que resecamos, practicando reconstrucción mediante injerto venoso término-terminal. El paciente evolucionó sin complicaciones.

  14. Intraluminal Ascending Aorta Fibroma

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    Kambiz Mozaffari

    2011-02-01

    Full Text Available Primary cardiac tumors are quite rare, especially in the pediatric age group, and their atypical presentations often prevent a timely diagnosis. Most primary cardiac tumors in the pediatric age group are benign. Fibromas are generally reported as the second most common primary cardiac tumors in the pediatric age group. These neoplasms are often intramural and involve the left ventricular free wall or the interventricular septum. Although benign, fibromas may become life-threatening by causing arrhythmias or obstruction to the blood flow. A case of supravalvular intraluminal ascending aorta fibroma in a 23-month-old girl, presenting with syncope, is described here; the location is rare and the presentation atypical for this type of tumor. Transesophageal echocardiography helped us to evaluate the anatomic details of the tumor and plan surgery.

  15. Modelo experimental estável de aneurisma sacular em artéria carótida de suínos utilizando veia jugular interna Stable experimental model of carotid artery saccular aneurysm in swine using the internal jugular vein

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    Severino Lourenço da Silva Júnior

    2013-04-01

    Full Text Available OBJETIVO: Desenvolver um modelo experimental estável de aneurisma sacular em carótida de suínos utilizando veia jugular interna. MÉTODOS: Em 12 suínos sadios, com peso variando entre 25 e 50kg, cinco machos e sete fêmeas, foi confeccionado aneurisma na artéria carótida comum direita. Após arteriotomia elíptica, foi realizada anastomose terminolateral com coto distal de veia jugular interna. O volume do aneurisma era calculado de maneira que o valor não excedesse em 27 vezes o valor da área da arteriotomia. Após seis dias, era realizada angiografia e análise microscópica do aneurisma para avaliar perviedade e trombose parcial ou total. RESULTADOS: Houve ganho de peso significante dos suínos no intervalo de tempo entre a confecção do aneurisma e a angiografia (p = 0,04. Foi observada perviedade aneurismática em dez suínos (83%. Ocorreram infecções de feridas operatórias em dois animais (16,6%, ambas com início de aparecimento em três dias após a confecção do aneurisma. Análise histológica dos aneurismas mostrou trombos ocluindo parcialmente a luz em nove suínos (75%. Nesses animais, observou-se que, em média, 9% da luz aneurismática estava preenchida por trombos. CONCLUSÃO: Pôde ser desenvolvido um modelo experimental estável de aneurisma sacular em carótida de suínos utilizando veia jugular interna.OBJECTIVE: To develop an experimental model of stable saccular aneurysm in carotid of pigs using the internal jugular vein. METHODS: In 12 healthy pigs, weighing between 25 and 50kg, five males and seven females, we made a right common carotid artery aneurysm. After elliptical arteriotomy, we carried out a terminolateral anastomosis with the distal stump of the internal jugular vein. Aneurysm volume was calculated so that the value did not exceed 27 times the area of the arteriotomy. After six days angiography and microscopic examination were performed to assess patency of the aneurysm and the presence of total or

  16. Pseudoaneurisma da artéria poplítea em um paciente com Síndrome de Ehlers-Danlos Tipo VI

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    Fábio Linardi

    2015-12-01

    Full Text Available Resumo A Síndrome de Ehlers-Danlos (EDS é uma rara doença hereditária do tecido conjuntivo proveniente de uma alteração da síntese do colágeno. A principal característica da EDS é a extrema fragilidade do tecido conjuntivo, que pode resultar em rotura uterina, perfuração intestinal espontânea e várias doenças vasculares como aneurismas, pseudoaneurismas, dissecções arteriais e roturas espontâneas. Os autores relatam o caso de um paciente de 11 anos de idade que apresentava tumor pulsátil na fossa poplítea esquerda após trauma leve com bola de futebol. Diagnosticado pseudoaneurisma de artéria poplítea pelo doppler arterial, confirmado através da angiografia, optou-se pela exploração arterial e devido à fragilidade da parede não foi possível a sua reconstrução. Realizada a ligadura simples da artéria proximal. Evoluiu com isquemia grave do membro e após autorização da família foi realizada a sua amputação. No segundo dia do pós-operatório o paciente apresentou uma dissecção aguda da aorta torácica, evoluindo a óbito.

  17. Surgical treatment of intracranial aneurysms: six-year experience in Belo Horizonte, MG, Brazil Tratamento cirúrgico dos aneurismas intracranianos: experiência de seis anos em Belo Horizonte, MG, Brasil

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    Leodante Batista da Costa Jr

    2004-06-01

    Full Text Available Spontaneous subarachnoid hemorrhage accounts for 5 to 10 % of all strokes, with a worldwide incidence of 10.5 / 100000 person/year, varying in individual reports from 1.1 to 96 /100000 person/year. Angiographic and autopsy studies suggest that between 0.5% and 5% of the population have intracranial aneurysms. Approximately 30000 people suffer aneurysmal subarachnoid hemorrhage in the United States each year, and 60% die or are left permanently disabled. We report our experience in the surgical treatment of intracranial aneurysms in a six year period, in Belo Horizonte, Minas Gerais, Brazil. We reviewed the hospital files, surgical and out-patient notes of all patients operated on for the treatment of intracranial aneurysms from January 1997 to January 2003. Four hundred and seventy-seven patients were submitted to 525 craniotomies for treatment of 630 intracranial aneurysms. The majority of patients were female (72.1% in the fourth or fifth decade of life. Anterior circulation aneurysms were more common (94.4%. The most common location for the aneurysm was the middle cerebral artery bifurcation. The patients were followed by a period from 1 month to 5 years. The outcome was measured by the Glasgow Outcome Scale (GOS. At discharge, 62.1% of the patients were classified as GOS 5, 13.9% as GOS 4, 8.7% as GOS 3, 1.7% as GOS 2 and 14.8% as GOS 1.A hemorragia subaracnóidea espontânea é responsável por cerca de 5 a 10% de todos os acidentes vasculares cerebrais, com uma incidência mundial de 10,5 / 100000 pessoas/ano, variando em estudos individuais de 1,1 a 96 / 100000 pessoas / ano, de acordo com diferenças étnicas e geográficas. Estudos angiográficos e de necropsia sugerem que a presença de aneurismas intracranianos ocorre em 0,5-5% da população mundial. De acordo com estatísticas norte-americanas, ocorrem cerca de 30000 rupturas de aneurisma cerebral por ano naquele país, com conseqüências desastrosas para grande parte dos pacientes

  18. Pseudo-aneurisma post-traumático de tronco de arteria coronaria izquierda

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    Melina M. Gallo

    2011-08-01

    Full Text Available El pseudo-aneurisma de arteria coronaria es extremadamente raro. Su historia natural es poco conocida y su tratamiento discutido. Se presenta el caso de un paciente con pseudo-aneurisma de tronco de la coronaria izquierda e infarto antero-apical del ventrículo izquierdo cinco años después de un paro cardíaco secundario a un traumatismo no penetrante de tórax. Se consideró entonces que la lesión no era pasible de corrección percutánea o quirúrgica por lo que se optó por tratamiento médico conservador. Una angiografía coronaria por tomografía computarizada multicorte realizada 10 años después del evento inicial mostró ausencia de progresión de la lesión.

  19. A compreensão do significado cultural do aneurisma cerebral e do tratamento atribuídos pelo paciente e familiares: um estudo etnográfico La comprensión del significado cultural del aneurisma cerebral y del tratamiento atribuídos por el paciente y los familiares: un estudio etnográfico The cultural meaning of cerebral aneurysm and its treatment for the patient and relatives: an ethnographic study

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    Maria Helena Pinto

    2000-01-01

    Full Text Available Este trabalho consiste de um estudo etnográfico descritivo, com 13 pacientes acometidos pelo aneurisma cerebral e seus familiares, com o objetivo de compreender o significado da doença e do tratamento. Os dados foram coletados por entrevistas e observações durante a hospitalização e depois da alta, no ambulatório e na residência. O tema central obtido do estudo foi "Tinha que ser para mim. Deus sabe o que faz". Este tema revela uma interpretação religiosa para a doença e uma fundamentação mágica para o tratamento. Assim, o aneurisma cerebral é interpretado como uma doença material (corpo e uma doença espiritual (alma.Esta investigación consiste en un estudio etnográfico de los pacientes afectados por aneurisma cerebral y sus familiares, con el objetivo de objetivo de comprender el significado de la enfermedad y el tratamiento. Los datos fueron recolectados por entrevistas y observaciones durante la hospitalización y después del alta en la consulta externa y en la residencia. El tema central obtenido del estudio fue: "Tenia que ser para mi. Dios sabe lo que hace". Este tema manifiesta una interpretación religiosa para la enfermedad y una fundamentación mágica para el tratamiento. Así, el aneurisma cerebral es comprendido como una enfermedad material (del cuerpo y una enfermedad espiritual (del alma.This is a descriptive ethnographic study with 13 patients with cerebral aneurysm and their relatives aiming at understanding the meaning of the illness and the treatment. The data were collected by interviews and observations during the hospitalization and, after the discharge, in the outpatient clinic and at home. The central theme obtained from the study was "It had to be for me! God knows what He does". This theme reveals a religious interpretation for the illness and a magic basis for its cure.Thus, cerebral aneurysm is interpreted as a material illness (body and a spiritual illness (soul.

  20. Is subdiaphragmatic aortic cross-clamping a suitable model for spinal cord ischemia/reperfusion injury study in rats? O pinçamento sub-diagragmático da aorta é um modelo adequado para o estudo da lesão medular de isquemia/reperfusão em ratos?

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    Sonia Elizabeth Lopez Carrillo

    2006-08-01

    Full Text Available PURPOSE: To evaluate the efficacy of subdiaphragmatic aortic cross-clamping in an experimental model of ischemia/reperfusion injury of the spinal cord in albino rats. METHODS: Thirty-six male Wistar rats were randomized in two groups (n=18: G-1 (Sham and G-2 (Ischemia/Reperfusion, I/R. G-2 rats were submitted to 30 min subdiafragmatic aortic cross-clamping. G-1 rats served as controls and were submitted to surgical trauma (laparotomy without ischemia. Samples (spinal cord and arterial blood were collected at the end of ischemic period and 10 (T-10 and 20 (T-20 min later in G-2 rats. Sham rats (G-1 samples were collected at the same time-points. Blood and tissue metabolites concentrations of pyruvate, lactate, glucose and medullary adenosine triphosphate (ATP were assayed. RESULTS: Blood and tissue concentrations of pyruvate and glucose as well as lactate and medullary ATP were not different when comparing G1 to G2. Lactacemia was significantly elevated in G-2 compared with G-1 rats during reperfusion (T-10. CONCLUSION: Subdiaphragmatic aortic cord cross-clamping is not a suitable rat model for spinal cord ischemia/reperfusion injury study as it does not ensure changes in in vivo tissue metabolites concentrations similar to those found in tissues subjected to ischemia/reperfusion.OBJETIVO: Avaliar a eficácia do pinçamento da aorta subdiafragmática no modelo experimental de isquemia/reperfusão da medula espinhal em ratos. MÉTODOS: Trinta e seis ratos Wistar, machos, foram aleatoriamente distribuídos em 2 grupos (n=18 e submetidos ao pinçamento subdiafragmático da aorta, durante 30 minutos (Grupo-2 -Isquemia/Reperfusão. Os ratos do Grupo-1 (G-1 - Sham foram utilizados como controles e submetidos a laparotomia sem pinçamento arterial. As amostras (medula e sangue arterial foram coletadas ao término do período de isquemia (T-0 e 10 (T-10 e 20 (T-20 minutos mais tarde e nos mesmos intervalos, no grupo G-1. As concentrações teciduais e

  1. Endovascular therapy for selected (most non-surgical intracranial aneurysms in a Brazilian University Hospital Tratamento endovascular de aneurismas selecionados (maioria não cirúrgicos em um hospital universitário brasileiro

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    Daniel G Abud

    2010-10-01

    Full Text Available OBJECTIVE: The objective of this study was to evaluate technical, clinical and angiographic results of a nonsurgical series of intracranial aneurysms treated by endovascular approach at Hospital das Clínicas of Medical School of Ribeirão Preto - University of São Paulo. METHOD: Between August 2005 and November 2008, 137 aneurysms in 106 patients were endovascularly treated. Of these, 101 were unruptured in 75 patients and 36 aneurysms in 31 patients were treated during the acute phase. The data were prospectively studied. RESULTS: Sixty three aneurysms (46% were treated with coils alone, 52 (38% with balloon remodeling, 15 (10.9% with stent remodeling, and 7 (5.1% with therapeutic occlusion of the internal carotid artery. Six clinical complications (5.7% were related to the procedures, 3 (2.8% transitory and 3 (2.8% permanent. Angiographic follow-up was available for 97 aneurysms (70.8%, clinical monitoring for 77 patients (72.6% and telephone contact for 97 (91.5%. CONCLUSION: The technical, clinical and angiographic results found in this study are similar to those reported in the literatureOBJETIVO: Nosso objetivo foi avaliar os resultados técnicos, clínicos e angiográficos de uma série de aneurismas intracranianos não cirúrgicos tratados por via endovascular no Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo e comparar com os dados disponíveis na literatura atualmente. MÉTODO: Entre agosto de 2005 e novembro de 2008, 137 aneurismas foram tratados por via endovascular em 106 pacientes. Destes, 101 eram não rotos em 75 pacientes e 36 aneurismas foram tratados em 31 pacientes durante a fase aguda de ruptura. Os dados foram incluídos de maneira prospectiva. RESULTADOS: Sessenta e três aneurismas (46% foram tratados com técnica simples, 52 (38% com remodelagem por balão, 15 (10,9% com remodelagem por stent e 7 (5,1% por oclusão terapêutica da carótida interna. Seis complica

  2. Propuesta de Plan de Cuidado a la Persona con Aneurisma Cerebral

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    Jully Catherine Acevedo Arguello

    2012-08-01

    Full Text Available Objetivo: Describir el plan de cuidado a la persona con Aneurisma Cerebral. Métodos: Se identificaron los dominios de Enfermería alterados y las necesidades frecuentes en el proceso de salud-enfermedad (Aneurisma Cerebral; también se estableció el juicio (Diagnóstico de enfermería NANDA que orientó la implementación de objetivos (NOC y desarrollo de actividades e intervenciones de enfermería (NIC; todo ello con el fin de brindar cuidados integrales a la persona, la familia y la comunidad, conservar el funcionamiento neurológico y prevenir el riesgo de complicaciones en la persona al cuidado de enfermería con una enfermedad cerebrovascular. Resultados y Conclusiones: Los aneurismas cerebrales son dilataciones localizadas de la pared del vaso arterial y por lo general se encuentran en puntos de bifurcación o en relación con el origen de una rama arterial; todos los aneurismas cerebrales tienen potencial de ruptura y causan complicaciones serias como el accidente cerebro-vascular hemorrágico, situación clínica crítica conocida como hemorragia subaracnoidea. Debido al impacto que tiene dicha patología tanto en la persona, la familia y la comunidad, el profesional de Enfermería requiere fortalecer los conocimientos acerca de la patología, el cuidado propio de Enfermería y desarrollar las habilidades que permitan un cuidado integral de éste tipo de personas. El PAE es una herramienta fundamental utilizada en la práctica asistencial de la disciplina de enfermería. Éste fa vorece la perspectiva del profesional de enfermería hacia la planificación y el desarrollo de cuidados sistematizados, lógicos y racionales centrados en respuestas humanas dentro del proceso de salud-enfermedad, estos cuidados buscan obtener logros tanto en la persona, la familia y la comunidad sana o enferma, permitiendo tener una visión holística en el proceso del cuidado diario tanto en áreas clínicas como comunitarias.

  3. Sequential PTA of abdominal aorta

    International Nuclear Information System (INIS)

    A case of sequential dilatation of a subtotal stenosis of the abdominal aorta in a young subject is reported. Initial and long-term success of the procedure is recorded using haemodynamic evaluation and intravenous digital subtraction angiography (IV-DSA) follow-up on an outpatient basis. In addition, the significance of biplane aortography with IV-DSA is illustrated. (orig.)

  4. Cirurgia de revascularização coronariana esquerda sem CEC e sem manuseio da aorta em pacientes acima de 75 anos: análise das mortalidades imediata e a médio prazo e das complicações neurológicas no pós-operatório imediato

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    José Glauco LOBO FILHO

    2002-09-01

    Full Text Available INTRODUÇÃO: A circulação extracorpórea (CEC e o manuseio da aorta ascendente (MAA estão associados a alta incidência de acidente vascular cerebral (AVC na cirurgia de revascularização do miocárdio (RM em pacientes idosos. Esta complicação deve-se, sobretudo, ao MAA, por ocasião do pinçamento e despinçamento, quer para isolamento do coração do circuito de CEC, quer para realização das anastomoses dos enxertos na aorta ascendente. OBJETIVOS: Verificar mortalidades imediata e a médio prazo e a ocorrência de AVC no pós-operatório imediato (POI em pacientes acima de 75 anos submetidos a cirurgia de revascularização do sistema coronariano esquerdo (SCE, sem CEC e sem MAA. MÉTODO: De janeiro de 2000 a abril de 2002, 40 pacientes acima de 75 anos (média 79,1 anos foram submetidos a cirurgia de revascularização do SCE, com enxerto de artéria torácica interna esquerda (ATIE para a artéria descendente anterior (DA, e enxerto(s de veia safena magna oriundo(s da ATIE para outro(s ramo(s da coronária esquerda (enxerto composto, sem CEC e sem MAA. Houve predominância do sexo masculino (67,5%. Foram realizados 89 enxertos (média 2,22 pontes por paciente, sendo 40 (44,94% de ATIE e 49 (55,06% de veia safena. A ocorrência de AVC foi avaliada por exames clínico e neurológico. RESULTADOS: Não foi observada ocorrência de AVC no grupo estudado. Não houve óbitos no POI. CONCLUSÃO: A cirurgia de revascularização do SCE em pacientes acima de 75 anos sem CEC e sem MAA pode ser realizada sistematicamente de modo a evitar a ocorrência de AVC, com baixa mortalidade.INTRODUCTION: Cardiopulmonary bypass (CPB and Ascending Aorta manipulation (AAM are associated with a high incidence of stroke in coronary surgery in patients older than 75 years. This complication is due, mostly, to the handling of the aorta by the time of the cross-clamping, either for heart isolation from CPB, or to perform saphenous vein graft anastomosis to the

  5. Defeito do anel fibroso mitral posterior com aneurisma de átrio esquerdo e insuficiência mitral: tratamento cirúrgico com sucesso Defect of the posterior mitral fibrous ring with left atrial aneurysm and mitral insufficiency: successful surgical treatment

    Directory of Open Access Journals (Sweden)

    Ronaldo Machado BUENO

    1999-10-01

    Full Text Available Aneurismas em átrio esquerdo são pouco comuns, podendo ocorrer na aurícula ou na parede do átrio esquerdo. Freqüentemente, são assintomáticos, podendo ocorrer arritmias, fenômenos tromboembólicos ou insuficiência cardíaca como complicação da sua evolução. Apresentamos paciente de 39 anos, do sexo feminino, com defeito do anel posterior da valva mitral levando a grande dilatação aneurismática da parede posterior do átrio esquerdo com insuficiência mitral. O diagnóstico foi feito pela radiografia de tórax (abaulamento de silhueta cardíaca esquerda e ecocardiograma (grande aneurisma do átrio esquerdo posteriormente à parede posterior do ventrículo esquerdo com insuficiência mitral. O estudo hemodinâmico sugeriu pseudo-aneurisma de ventrículo esquerdo. Submetida a tratamento cirúrgico com auxílio da circulação extracorpórea, realizou-se anuloplastia mitral e exclusão do aneurisma com reconstrução do assoalho do átrio esquerdo com retalho de pericárdio bovino. A paciente apresentou boa evolução pós-operatória, recebendo alta hospitalar no oitavo dia em boas condições clínicas.Atrial aneurysm is a rare condition and can be found on the atrial appendage or on the atrial wall. Most patients are asymptomatic, but arrhythmias, thromboembolism, and heart failure are common complications. We present a 39 years old female patient with posterior mitral ring defect causing a great aneurysm of the left posterior atrial wall with mitral insufficiency. The diagnosis was achieved by chest roentgenogram (marked prominence of the upper left heart border and echocardiography (great left atrial aneurysm behind the left posterior ventricular wall with mitral insufficiency. Left ventricular cineangiogram suggested the presence of a false aneurysm of the left ventricle. The patient subsequently underwent surgical treatment with cardiopulmonary bypass. Posterior mitral valve annuloplasty was performed with aneurysm exclusion

  6. Fístula aortoesofágica após correção endovascular da dissecção de aorta torácica tipo B de Stanford Aortic-esophageal fistula after endovascular repair of Stanford type B thoracic aortic dissection

    Directory of Open Access Journals (Sweden)

    Cláudia Gurgel Marques

    2010-01-01

    Full Text Available A correção endovascular da dissecção de aorta tipo B tem se mostrado como uma nova alternativa para reduzir o trauma cirúrgico. No entanto, as complicações de médio e longo prazo, tais como a fístula aortoesofágica, são ainda pouco conhecidas e pouco relatadas. O objetivo deste trabalho é descrever três casos de fístula aortoesofágica após o tratamento endovascular de 23 casos de dissecção de aorta descendente conduzidos pela equipe de Cirurgia Vascular da Santa Casa de São Paulo em um estudo retrospectivo. Esses pacientes apresentavam características em comum, como dissecção crônica, pós-operatório imediato sem intercorrências, necessidade de reintervenções, oclusão de troncos arteriais como a artéria subclávia, mesentérica, tronco celíaco, e, ainda, uma rápida evolução para o óbito após os primeiros sinais de fístula. Portanto, embora raramente descrita na literatura, a ocorrência de fístula aortoesofágica é uma complicação de causa até o momento indefinida do tratamento endovascular da dissecção de aorta descendente que merece atenção, dada sua recorrência e evolução fatal.Endoluminal stent-graft for type B aortic dissection is a new alternative to reduce surgical trauma. However, medium- and long-term complications are still little known and poorly reported, such as the aortic-esophageal fistula. The objective of this study is to describe three cases of aortic-esophageal fistula after the endovascular treatment of 23 cases of descending aortic dissection conducted by the vascular surgery team of Santa Casa de São Paulo in a retrospective study. These patients presented some common characteristics: chronic dissection, successful early outcome, need of reinterventions, occlusion of arterial trunks such as subclavian artery, mesenteric artery, celiac trunk, and finally, a fast fatal course after the first fistula-related symptoms. Therefore, despite rarely described in the literature, aortic

  7. Regeneração aberrante do nervo oculomotor secundária a aneurisma intracraniano: relato de caso Aberrant regeneration of the oculomotor nerve followed by intracranial aneurysm: case report

    Directory of Open Access Journals (Sweden)

    Renato Wendell Ferreira Damasceno

    2008-06-01

    Full Text Available Relatar um caso de regeneração aberrante secundária à paralisia aguda do nervo oculomotor causada por aneurisma intracraniano. Paciente atendida em fevereiro de 2006 queixando-se de dor de cabeça acompanhada de visão dupla e queda da pálpebra no olho direito. Na avaliação da motilidade ocular extrínseca, verificou-se incapacidade da adução, da supradução e da infradução associada à blefaroptose no olho direito. Com relação à motilidade intrínseca, midríase paralítica no olho direito. Formulou-se diagnóstico de paralisia aguda de nervo oculomotor no olho direito e solicitou-se avaliação neurológica. No Departamento de Neurocirurgia, após ser diagnosticada presença de aneurisma de artéria comunicante posterior, a paciente foi submetida a tratamento cirúrgico. Em dezembro de 2006, observou-se melhora relativa da adução, mantendo a incapacidade da supradução e da infradução com blefaroptose melhorada à adução do olho direito. Com relação à motilidade intrínseca, miose no olho afetado. O diagnóstico de regeneração aberrante do nervo oculomotor pós-paralisia aguda foi formulado baseando-se na anamnese e nos exames oftalmológicos seqüenciais.To report a case of aberrant regeneration followed by acute palsy of the oculomotor nerve caused by intracranial aneurysm. A 59-year-old patient was attended in February 2006 complaining of headache with diplopia and blepharoptosis in the right eye. At the external ocular motility exam. Aduction, supraduction and infraduction defects with blepharoptosis in the right eye were observed. Regarding the internal ocular motility, mydriasis in the right eye. Acute palsy of the oculomotor nerve in the right eye was diagnosed and neurological examination was requested. At the Department of Neurosurgery, after having diagnosed aneurysm of the posterior communicating artery, the patient was submitted to an operation. In December 2006, it improvement of the aduction was

  8. Dissection of the aorta in Turner's syndrome.

    OpenAIRE

    Price, W H; Wilson, J.

    1983-01-01

    Three deaths from dissection of the aorta in a series of 157 adult women with Turner's syndrome are reported. These are greatly in excess of the numbers expected. None of the three patients had a coarctation of the aorta. One had aortic regurgitation but there was no reason to believe that the aorta in the other two patients had been subjected to unusual haemodynamic stresses. Cystic medial necrosis of the aorta was described in two patients on whom necropsies were carried out. It is conclude...

  9. [Aging of the aorta: a morphological study].

    Science.gov (United States)

    Pentimone, F; Del Corso, L; Meola, M; Giuliano, G; Borelli, A; Riccioni, S

    1994-05-01

    Aim of this study was to evaluate the aging of aorta with respect to atherosclerotic modifications: abdominal aorta echotomography is the preferred approach for this study. In 354 elderly patients, 65 and over, we have evaluated the diameter and the course of the aorta, the presence of atherosclerotic plaques in the aorta and iliac vessels, and the presence of aneurysms. Two kinds of findings could be identified by echotomography: age-related physiologic modifications, represented essentially by an increase of the aortic diameter; pathologic changes, characteristic for atherosclerosis, of which aneurysms are the most dangerous complications. PMID:7924179

  10. Presentación tardía de aneurisma ventricular post-infarto. Caracterización por múltiples modalidades de imagen

    Directory of Open Access Journals (Sweden)

    Julio Oscar Cabrera Rego

    2011-10-01

    Full Text Available El aneurisma ventricular verdadero a nivel de la pared posteroinferior es infrecuente. Se presenta el caso de un paciente con episodios de taquicardia ventricular sostenida como primera manifestación de aneurisma ventricular post-infarto diagnosticado por ecocardiografía transtorácica y tridimensional, coronariografía invasiva y tomografía computarizada multicortes. La situación se resolvió favorablemente con optimización del tratamiento médico e implantación de un desfibrilador automático.

  11. Human Aorta Is a Passive Pump

    Science.gov (United States)

    Pahlevan, Niema; Gharib, Morteza

    2012-11-01

    Impedance pump is a simple valveless pumping mechanism that operates based on the principles of wave propagation and reflection. It has been shown in a zebrafish that a similar mechanism is responsible for the pumping action in the embryonic heart during early stages before valve formation. Recent studies suggest that the cardiovascular system is designed to take advantage of wave propagation and reflection phenomena in the arterial network. Our aim in this study was to examine if the human aorta is a passive pump working like an impedance pump. A hydraulic model with different compliant models of artificial aorta was used for series of in-vitro experiments. The hydraulic model includes a piston pump that generates the waves. Our result indicates that wave propagation and reflection can create pumping mechanism in a compliant aorta. Similar to an impedance pump, the net flow and the flow direction depends on the frequency of the waves, compliance of the aorta, and the piston stroke.

  12. Facts about Coarctation of the Aorta

    Science.gov (United States)

    ... Other tests to measure the function of the heart may be used including chest x-ray, electrocardiogram (EKG) , magnetic resonance imaging (MRI) , and cardiac catheterization . Coarctation of the aorta ...

  13. Coarctation of the Aorta (For Parents)

    Science.gov (United States)

    ... Atrial Septal Defect Ventricular Septal Defect Heart and Circulatory System ECG (Electrocardiogram) Congenital Heart Defects The Heart Your Heart & Circulatory System Heart Murmurs Arrhythmias Coarctation of the Aorta Atrial ...

  14. Síndrome de atrapamiento de la arteria poplítea con aneurisma: reporte de un caso Popliteal entrapment syndrome caused by an aneurism: Case report

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    Tania Buccolini

    2010-06-01

    Full Text Available La verdadera prevalencia del síndrome de atrapamiento de la arteria poplítea es desconocida; se estima en un 0.16%. Se considera la principal causa de claudicación intermitente en jóvenes deportistas sin factores de riesgo cardiovasculares. Se caracteriza por la compresión extrínseca de la arteria poplítea, ya sea por defecto anatómico de las estructuras músculo-tendinosas o por hipertrofia de los músculos gemelos, lo cual ocasiona el atrapamiento y síntomas de parestesias, frialdad y claudicación intermitente en la extremidad comprometida. La compresión crónica de la arteria puede llevar a daño irreversible con formación de trombos y aneurismas y a la consiguiente amputación de la extremidad, por lo que el diagnóstico y el tratamiento oportunos son de gran importancia para el paciente.The true prevalence of the popliteal artery entrapment syndrome is unknown, it is estimated to be 0.16%. It is considered as the main cause of intermittent claudication in young athletes without cardiovascular risk factors. It is characterized by the extrinsic compression of the popliteal artery either caused by defects of the muscle-tendon structures or by the hypertrophy of the gastrocnemius muscle leading to the arterial entrapment and symptoms of paresthesia, intermittent claudication and coldness of the affected limb. Chronic compression of the artery may lead to irreversible damage with formation of thrombi and aneurysms and the subsequent amputation of the limb. Therefore, correct diagnosis and treatment are of great importance for the patient.

  15. Utilização da técnica do varal para angioplastia de estenose de veia central com stent-graft Utilization of the through-and-through technique for central vein angioplasty using stent-graft

    Directory of Open Access Journals (Sweden)

    Ricardo Wagner da Costa Moreira

    2012-09-01

    Full Text Available A estenose de veia central é uma das situações mais frequentes em pacientes com insuficiência renal crônica em hemodiálise. A angioplastia com o uso de stent-graft tem obtido bons resultados nestes casos. O sistema de liberação dos stents é de calibre maior, podendo dificultar sua navegabilidade em áreas de estenose ou tortuosidade acentuadas. A técnica do varal é comumente utilizada para o tratamento endovascular do aneurisma de aorta, permitindo atingir bom mecanismo de estiramento e facilitando a navegação do sistema de entrega da endoprótese. Descrevemos o caso de uma angioplastia de veia central com stent-graft na qual foi utilizada a técnica do varal para permitir a transposição da área de estenose.The central vein stenosis is one of the most common conditions in patients with chronic kidney failure in a hemodialysis program. In these cases, angioplasty using stent-grafts has obtained good results. The stent-graft delivery system is generally of large diameter what can hinder its navigability in very severe stenosis or tortuosities. The through-and-through technique is commonly used for endovascular treatment of aortic aneurysms, making possible to achieve a good mechanism of stretch and easy navigation of the endograft delivery system. We report a case of a central venous stenosis in wich a stent-graft was inserted using the through-and-through technique in order to cross the lesion.

  16. Pseudoaneurisma de aorta como causa de síndrome da veia cava superior: relato de caso Aortic pseudoaneurysm as cause of superior vena cava syndrome: a case report

    Directory of Open Access Journals (Sweden)

    Katsuro Harada Júnior

    2012-09-01

    Full Text Available A síndrome da veia cava superior representa o conjunto de sinais e sintomas decorrentes da sua obstrução. A síndrome tem como principais etiologias tumores malignos, como o carcinoma broncogênico, o linfoma e a metástase mediastinal. O câncer de pulmão é responsável por 80% dos casos, os linfomas mediastinais por 15%, e 5% correspondem às demais causas. Este relato de caso objetiva apresentar um caso incomum dessa síndrome, ocorrido em um paciente do sexo masculino após ferimento penetrante no tórax, resultando em pseudoaneurisma de arco aórtico e a síndrome da veia cava superior.The superior vena cava syndrome represents the set of signs and symptoms resulting from obstruction of superior vena cava. The syndrome has as main causes malignant tumors such as bronchogenic carcinoma, lymphoma and mediastinal metastases. Lung cancer accounts for 80% of cases, mediastinal lymphomas by 15% and 5% correspond to other causes. This case report aims to present an unusual case of this syndrome, which occurred in a male patient after penetrating wound in the chest, which developed a pseudoaneurysm of the aortic arch and superior vena cava syndrome.

  17. The intestinal tract as the major source of interleukin 6 production during abdominal aortic clamping and hind limb ischaemia-reperfusion injury O trato intestinal como a principal fonte na producao de interleucina 6 durante clampeamento da aorta abdominal e lesão de isquemia/rererfusão de membros inferiores

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    Márcio Benedito Palma Pimenta

    2007-01-01

    Full Text Available PURPOSE: The aim of this study was to investigate whether the hind limbs or intestinal tract is the most important initiator of the inflammatory response secondary aortic clamping and hind limb ischemia/reperfusion injury. METHODS: Blood samples of Wistar rats obtained from posterior cava vein, portal vein, and heart cavity during either laparotomy (control group, n=8 or laparotomy + 2 h of aortic clamping and bilateral hind limb ischemia (ischemia group, n=8, or 2 h after ischemia and 2 h of reperfusion (ischemia-reperfusion group, n=8 were assayed for interleukin 6 (IL-6 and C-reactive protein (CRP. RESULTS: Serum IL-6 at the heart (223.6±197.9 [10-832] pg/mL was higher (pOBJETIVO: Investigar qual o principal mediador da resposta inflamatória na lesao de isquemia/reperfusão após clampeamento da aorta abdominal e isquemia dos membros inferiores: o intestine ou as extremidades inferiores. MÉTODOS: amostra de sangue de ratos Wistar coletados da cava posterior, porta e cavidade cardíaca during tanto laparotomia (grupo controle n=8 ou laparotomia + 2 horas de clampeamento aórtico e isquemia bilateral de membros posteriores (grupo isquemia n=8, ou 2 h de isquemia seguido por 2 horas de reperfusão (grupo isquemia/reperfusão n=8, onde foram dosados interleucina 6 e proteína C-reativa. RESULTADOS: Il-6 no coração (223.6±197.9 [10-832] pg/mL foi maior (p<0.001 tanto na veia porta (133.08±108.52 [4-372] pg/mL quanto na veia cava posterior (127.58±109.15 [8-388] pg/mL. PCR não foi significativamente diferente entre os grupos. CONCLUSÃO: o trato intestinal foi responsável pela resposta inflamatória secundária a lesão de isquemia/reperfusão.

  18. Aorta Atherosclerosis Lesion Analysis in Hyperlipidemic Mice

    Science.gov (United States)

    Mohanta, Sarajo; Yin, Changjun; Weber, Christian; Hu, Desheng; Habenicht, Andreas JR

    2016-01-01

    Atherosclerosis is a chronic inflammatory disease of large and medium-sized arteries. Apolipoprotein E-deficient (ApoE-/-) mice are used as experimental models to study human atherosclerosis. ApoE-/- mice are constitutively hyperlipidemic and develop intima plaques that resemble human plaques. Various issues including experimental design for lesion analysis, dietary conditions, isolation of the aorta, staining methods, morphometry, group size, age, the location within the arterial tree, and statistical analyses are important parameters that need to be addressed to obtain robust data. Here, we provide detailed methods to quantify aorta atherosclerosis. PMID:27366759

  19. Digital subtraction angiography of the thoracic aorta

    Energy Technology Data Exchange (ETDEWEB)

    Grossman, L.B.; Buonocore, E.; Modic, M.T.; Meaney, T.F.

    1984-02-01

    Forty-three patients with acquired and congenital abnormalities of the thoracic aorta were studied using digital subtraction angiography (DSA) after an intravenous bolus injection of 40 ml of contrast material. Abnormalities studied included coarctation, pseudocoarctation, Marfan syndrome, cervical aorta, double aortic arch, aneurysm, dissection, and tumor. Twenty-four patients also had conventional angiography. DSA was accurate in 95% of cases; in the other 5%, involving patients with acute type I dissection, the coronary arteries could not be seen. The authors concluded that in 92% of their patients, DSA could have replaced the standard aortogram.

  20. Digital subtraction angiography of the thoracic aorta

    International Nuclear Information System (INIS)

    Forty-three patients with acquired and congenital abnormalities of the thoracic aorta were studied using digital subtraction angiography (DSA) after an intravenous bolus injection of 40 ml of contrast material. Abnormalities studied included coarctation, pseudocoarctation, Marfan syndrome, cervical aorta, double aortic arch, aneurysm, dissection, and tumor. Twenty-four patients also had conventional angiography. DSA was accurate in 95% of cases; in the other 5%, involving patients with acute type I dissection, the coronary arteries could not be seen. The authors concluded that in 92% of their patients, DSA could have replaced the standard aortogram

  1. Risk factors of atheromatous aorta in cardiovascular surgery

    OpenAIRE

    Fernando A. Atik; Silva, Isaac Azevedo; da Cunha, Claudio Ribeiro

    2014-01-01

    Objective To determine the prevalence and profile of ascending aorta or aortic arch atheromatous disease in cardiovascular surgery patients, its risk factors and its prognostic implication early after surgery. Methods Between January 2007 and June 2011, 2042 consecutive adult patients were analyzed, with no exclusion criteria. Atheromatous aorta diagnosis was determined intraoperatively by surgeon palpation of the aorta. Determinants of atheromatous aorta, as well as its prognostic implicatio...

  2. Retrograde replacement of the thoracic aorta.

    OpenAIRE

    Cooley, D A

    1995-01-01

    A technique is described for replacement of the entire thoracic aorta. In this "pull-through" technique, which utilizes hypothermic circulatory arrest, the graft is implanted in a retrograde fashion, thus providing protection for the spinal cord and brain and avoiding injury to the vagus and phrenic nerves.

  3. The normal distribution of thoracoabdominal aorta small branch artery ostia

    International Nuclear Information System (INIS)

    The purpose of this study was to determine the normal distribution of aortic branch artery ostia. CT scans of 100 subjects were retrospectively reviewed. The angular distributions of the aorta with respect to the center of the T3 to L4 vertebral bodies, and of branch artery origins with respect to the center of the aorta were measured. At each vertebral body level the distribution of intercostal/lumbar arteries and other branch arteries were calculated. The proximal descending aorta is posteriorly placed becoming a midline structure, at the thoracolumbar junction, and remains anterior to the vertebral bodies within the abdomen. The intercostal and lumbar artery ostia have a distinct distribution. At each vertebral level from T3 caudally, one intercostal artery originates from the posterior wall of the aorta throughout the thoracic aorta, while the other intercostal artery originates from the medial wall of the descending thoracic aorta high in the chest, posteromedially from the mid-thoracic aorta, and from the posterior wall of the aorta low in the chest. Mediastinal branches of the thoracic aorta originate from the medial and anterior wall. Lumbar branches originate only from the posterior wall of the abdominal aorta. Aortic branch artery origins arise with a bimodal distribution and have a characteristic location. Mediastinal branches of the thoracic aorta originate from the medial and anterior wall. Knowing the location of aortic branch artery ostia may help distinguish branch artery pseudoaneurysms from penetrating ulcers.

  4. Aneurisma intracraniano gigante em menino de três anos: relato de caso Giant intracranial aneurysm in three years old boy: case report

    OpenAIRE

    Osvaldo Inácio de Tella Jr; João Francisco Crosera; Marco Antonio Herculano; Manoel Antonio de Paiva Neto

    2006-01-01

    Aneurismas cerebrais são raros na faixa etária pediátrica. A apresentação destas lesões difere significativamente em relação á população adulta no que se refere a tamanho, localização e incidência. Relatamos caso de menimo de três anos de idade que apresentou quadro de hemorragia subaracnóidea sem história de infecções ou traumatismos prévios sendo, posteriormente, diagnosticado aneurisma gigante localizado na artéria cerebral média. Foi submetido a tratamento cirúrgico com boa evolução pós-o...

  5. Traumatic pseudoaneurysm of the abdominal aorta.

    Science.gov (United States)

    Barchiche, R; Bové, T; Demanet, H; Goldstein, J P; Deuvaert, F E

    1999-08-01

    A traumatic pseudoaneurysm of the abdominal aorta is a rare entity, occurring as the result of a missed aortic lesion at the time of the initial injury. Therefore, clinical suspicion and careful abdominal exploration at first laparotomy is mandatory to prevent aortic pseudoaneurysm formation and its risk of delayed rupture. We present a case of successful surgical treatment of a suprarenal aortic false aneurysm, presenting 4 weeks after a life-threatening gunshot wound in a 13-year-old child. PMID:10499389

  6. Diagnosis of supravalvar stenosis of aorta

    International Nuclear Information System (INIS)

    The authors analyzed the potentialities of combined radiodiagnosis of supravalvar stenosis (SS) and concomitant diseases of the heart and major vessels (Williams-Beuren syndrome) in 7 patients aged 7 mos. to 24 yrs. Polypositional chest and heart X-ray procedure, catheterization of the cardiac cavities, pulmonary artery and aorta, left ventriculography (6), right ventriculography (4) and angiopulmonography were used. The diagnostic potentialities of each method were defined

  7. Dynamic biaxial tissue properties of the human cadaver aorta.

    Science.gov (United States)

    Shah, Chirag S; Hardy, Warren N; Mason, Matthew J; Yang, King H; Van Ee, Chris A; Morgan, Richard; Digges, Kennerly

    2006-11-01

    This study focuses on the biaxial mechanical properties of planar aorta tissue at strain rates likely to be experienced during automotive crashes. It also examines the structural response of the whole aorta to longitudinal tension. Twenty-six tissue-level tests were conducted using twelve thoracic aortas harvested from human cadavers. Cruciate samples were excised from the ascending, peri-isthmic, and descending regions. The samples were subjected to equibiaxial stretch at two nominal speed levels using a new biaxial tissue-testing device. Inertia-compensated loads were measured to facilitate calculation of true stress. High-speed videography and regional correlation analysis were used to track ink dots marked on the center of each sample to obtain strain. In a series of component-level tests, the response of the intact thoracic aorta to longitudinal stretch was obtained using seven aorta specimens. The aorta fails within the peri-isthmic region. The aorta fails in the transverse direction, and the intima fails before the media or adventitia. The aorta tissue exhibits nonlinear behavior. The aorta as complete structure can transect completely from 92 N axial load and 0.221 axial strain. Complete transection can be accompanied by intimal tears. These results have application to finite element modeling and the better understanding of traumatic rupture of the aorta. PMID:17311166

  8. Combined procedure of heart transplantation and ascending aorta replacement.

    Science.gov (United States)

    de Castro, João Gonçalves; Estefanía, Rafael Hernández; Delgado, Cristian; Del Barrio, Loreto García; Rábago, Gregorio

    2016-06-01

    Concomitant heart transplantation and ascending aorta replacement is infrequent. In the few cases where this simultaneous procedure was performed, most patients were diagnosed with Marfan syndrome. We report the combined procedure of heart transplantation and ascending aorta replacement using the donor's ascending aorta, in a 70-year-old man who was not diagnosed with Marfan syndrome. This combined procedure can be performed successfully, providing a potentially life-saving heart transplant for patients with aortic disease of different etiologies. PMID:25737588

  9. MR imaging of the toracic aorta

    International Nuclear Information System (INIS)

    Various pathological conditions of the thoracic aorta were studied by MR Imaging in 31 patients: 23 were aneurysms (branching and non-branching), 2 artero-venous fistulae, 2 aortic prostheses, 2 Marfan's syndromes, 1 coronary sinus aneurysm, and 1 isthmic stenosis. MRI studies were always performed on patients who had been examined by other imaging procedures. A comparative study was carried out on the results of MRI, angiography, computerized tomography, and ultrasounds. The possibility of propedeutic protocol was explored. Our experience, in accordance with the literature on the subject, indicates MRI as the procedure of choice in the study of aneurysms of the toracic aorta. The advantages offered by MRI-the high natural contrast between circulating blood and the supporting structures, the possibility of obtaining multiplanar images as well as data on intraluminal, parietal, and extraparietal conditions-make it a highly competitive procedure if compared to either CT or angiography. While awaiting further evidence, the use of a propedeutic protocol in non-aneurysmatic diseases is still not advisable, due to insufficient patient population, and to the lack of a consistent literature on the subject

  10. Morphological description of collateral branches from the abdominal aorta of lesser anteater (Tamandua tetradactyla

    Directory of Open Access Journals (Sweden)

    Breno Costa Macedo

    2013-03-01

    Full Text Available Tamandua tetradactyla, Xenarthra, is a native species from South America which, due to the few number of studies on its biology, still has many unknown aspects in its morphology. Taking into account the importance of morphological data for various studies, this paper aimed to elucidate the branching of the abdominal aorta in this species to foster the development of further studies. To do this, 4 specimens were used, 2 male and 2 female, all young, from the Bauxite Mine – Paragominas, Para, Brazil, donated after death due to running over to the Animal Morphology Research Laboratory (LaPMA of Universidade Federal Rural da Amazonia (UFRA. The arterial system was filled with contrasted latex and the animals were fixed in a formaldehyde solution (10%, and then dissected, in order to evidence the abdominal aorta and its collateral branches. The parietal branches consisted of 1 pair of caudal phrenic arteries, 2 pairs of intercostal arteries, and 3 pairs of lumbar arteries. Among the visceral branches, stood out: celiac artery; cranial mesenteric artery; adrenal arteries; renal arteries; caudal mesenteric artery; and external, internal, and median sacral iliac arteries, formed from the final portion of the abdominal aorta. Testicular and ovarian arteries originated from the renal arteries, differing from that described in various species.

  11. AORTA: Adding Organizational Reasoning to Agents

    DEFF Research Database (Denmark)

    Jensen, Andreas Schmidt; Dignum, Virginia

    2014-01-01

    Open systems are characterized by a diversity of heterogeneous and autonomous agents that act according to private goals, and with a behavior that is hard to predict. They can be regulated through organizations similar to human organizations, which regulate the agents’ behavior space and describe...... the expected behavior of the agents. Agents need to be able to reason about the regulations, so that they can act within the expected boundaries and work towards the objectives of the organization. This extended abstract introduces AORTA, a component that can be integrated into agents’ reasoning...... mechanism, allowing them to reason about (and act upon) regulations specified by an organizational model using simple reasoning rules. The added value is that the organizational model is independent of that of the agents, and that the approach is not tied to a specific organizational model....

  12. Aneurisma venoso gigante de veia ilíaca externa secundário a fístula arteriovenosa traumática: relato de caso Giant external-iliac-vein aneurysm secondary to traumatic arteriovenous fistula: a case report

    OpenAIRE

    Patrick Bastos Metzger; Heraldo Antonio Barbato; Fernanda Maria Resegue Angelieri; Camila Baumann Beteli; Ana Claudia Gomes Petisco; Jose Eduardo Martins Barbosa; Mohamed Hassan Saleh; Fábio Henrique Rossi; Nilo Mitsuru Izukawa

    2011-01-01

    Aneurismas venosos abdominais são raros. Os localizados nas veias ilíacas externas estão entre os mais infrequentes aneurismas venosos publicados na literatura. Relatamos o caso de um paciente jovem com aneurisma venoso gigante de veia ilíaca externa secundário a uma fístula arteriovenosa adquirida há 20 anos, tratado pelos métodos convencional e endovascular com sucesso.Venous abdominal aneurysms are rare entities, especially at the external iliac vein. We report the case of a young male pat...

  13. 大鼠主动脉和肠系膜动脉多巴胺受体DA1 亚型和年龄变化的关系%Age-dependent changes of dopamine DA1 receptors in aortas and mesenteric arteries of rats

    Institute of Scientific and Technical Information of China (English)

    鲍荣凤; 鲍萍萍; 赵荣瑞

    2003-01-01

    目的和方法采用离体血管环方法,用DA1受体的特异性激动剂Fenoldpam(FODA)和特异性拮抗剂Sch-23390,检测和分析了DA1受体在大鼠不同年龄段的生长发育和演变情况,借以阐明外周DA1受体与年龄变化的关系.结果 FODA引起的离体主动脉的舒张反应,以3月龄大鼠的舒张反应最强, 10 d龄和18月龄大鼠主动脉较3月龄大鼠的主动脉的舒张百分比均有明显下降趋势,三组大鼠的最大舒张百分比(Emax)分别为10 d龄48.77±6.03(P<0.05)、3月龄98.11±7.02、18月龄56.23±5.79(P<0.05).10 d龄及18月大鼠的FODA累积浓度-舒张反应曲线均明显右移.其主动脉的ED50分别为5.62×10-4 mol/L和1.58×10-4 mol/L明显大于3月龄组大鼠的ED50 (P<0.05).10 d龄及18月龄大鼠肠系膜动脉的最大舒张百分比(Emax)显著小于3月龄大鼠,分别为60.32±7.02(P<0.05)和69.59±10.71(P<0.05),ED50分别为6.65×10-4(P<0.05)和3.98×10-5(P<0.05),明显大于3月龄组大鼠的ED50.结论①外周DA1受体在新生及幼鼠数量较少,可能与个体发育尚未成熟有关.②外周DA1受体与中枢多巴胺受体相似,也有明显的年龄依赖性特征,也随着老龄化而有明显下调趋势.③外周多巴胺受体的年龄相关性影响,提示多巴胺类药物对不同年龄段患者的效果可能有所不同,应引起临床用药的注意.

  14. Biaxial tensile tests of the porcine ascending aorta.

    Science.gov (United States)

    Deplano, Valérie; Boufi, Mourad; Boiron, Olivier; Guivier-Curien, Carine; Alimi, Yves; Bertrand, Eric

    2016-07-01

    One of the aims of this work is to develop an original custom built biaxial set-up to assess mechanical behavior of soft tissues. Stretch controlled biaxial tensile tests are performed and stereoscopic digital image correlation (SDIC) is implemented to measure the 3D components of the generated displacements. Using this experimental device, the main goal is to investigate the mechanical behavior of porcine ascending aorta in the more general context of human ascending aorta pathologies. The results highlight that (i) SDIC arrangement allows accurate assessment of displacements and so stress strain curves, (ii) porcine ascending aorta has a nearly linear and anisotropic mechanical behavior until 30% of strain, (iii) porcine ascending aorta is stiffer in the circumferential direction than in the longitudinal one, (iv) the material coefficient representing the interaction between the two loading directions is thickness dependent, (v) taking into account the variability of the samples the stress values are independent of the stretch rate in the range of values from 10(-3) to 10(-1)s(-1) and finally, (vi) unlike other segments of the aorta, 4-month-old pigs ascending aorta is definitely not a relevant model to investigate the mechanical behavior of the human ascending aorta. PMID:27211783

  15. Evaluation of diseases of the aorta with ultrafast CT

    International Nuclear Information System (INIS)

    Ultrafast CT offers several advantages over standard CT for imaging of various congenital and acquired diseases of the aorta. Scan acquisition rates of 50 msec permit evaluation of the entire aorta following a single peripheral intravenous injection of iodinated contrast medium. Pathologic aortic flow patterns may also be defined using an ECG triggered ''flow'' mode, adding another dimension to CT evaluation of the aorta. The papers shows examples of a variety of aortic diseases, including coarctation, Marfan syndrome, atherosclerotic aneurysm, dissection, and postoperative abnormalities. The advantages of the modality are stressed

  16. Transluminar catheter angioplasty of abdominal aorta in Takayasu's arteritis

    International Nuclear Information System (INIS)

    Nine patients with Takayasu's arteritis and a long stenotic segment of the abdominal aorta were treated by percutaneous transluminal angioplasty (PTA). Intermittent claudication dissappeared in six of seven cases, the femoral pulse reappeared in all five; ankle/arm indices increased in seven cases; elevated blood pressure normalized in seven of eight cases. Seven patients were followed for 3 to 28 months. They were all free of symptoms from the lower extremities. In three patients with or without renal artery stenosis and with hypertension, the blood pressure decreased after PTA of the abdominal aorta only. PTA may be a valuable treatment in Takayasu's arteritis and stenosis of the abdominal aorta. (orig.)

  17. Presentación tardía de aneurisma ventricular post-infarto. Caracterización por múltiples modalidades de imagen

    Directory of Open Access Journals (Sweden)

    Julio Oscar Cabrera Rego

    2011-12-01

    Full Text Available El aneurisma ventricular verdadero a nivel de la pared posteroinferior es infrecuente. Se presenta el caso de un paciente con episodios de taquicardia ventricular sostenida como primera manifestación de aneurisma ventricular post-infarto diagnosticado por ecocardiografía transtorácica y tridimensional, coronariografía invasiva y tomografía computarizada multicortes. La situación se resolvió favorablemente con optimización del tratamiento médico e implantación de un desfibrilador automático.Late Ventricular Post-myocardial Infarction Aneurysm. Characterization through Several Imaging TestsTrue ventricular aneurysm in the low posterior wall is uncommon. The case of a patient with sustained ventricular tachycardia as first symptom of a post-myocardial left ventricular aneurysm, finally diagnosed through transthoracic 2D and 3D-echocardiography, invasive coronary angiography and multislice computed tomography is presented. Medical treatment was optimized and an automatic implantable cardioverter defibrillator was used. Thus, the patient evolved favourably.

  18. Pseudo-aneurisma post-traumático de tronco de arteria coronaria izquierda Post-traumatic false (pseudo aneurysm of the left main coronary artery

    Directory of Open Access Journals (Sweden)

    Melina M. Gallo

    2011-08-01

    Full Text Available El pseudo-aneurisma de arteria coronaria es extremadamente raro. Su historia natural es poco conocida y su tratamiento discutido. Se presenta el caso de un paciente con pseudo-aneurisma de tronco de la coronaria izquierda e infarto antero-apical del ventrículo izquierdo cinco años después de un paro cardíaco secundario a un traumatismo no penetrante de tórax. Se consideró entonces que la lesión no era pasible de corrección percutánea o quirúrgica por lo que se optó por tratamiento médico conservador. Una angiografía coronaria por tomografía computarizada multicorte realizada 10 años después del evento inicial mostró ausencia de progresión de la lesión.Coronary pseudo-aneurysm is an extremely rare entity. Its natural history is scarcely known and its treatment is controversial. We report a case of pseudo-aneurysm of the left main coronary artery associated with an antero-apical infarct of the left ventricle diagnosed five years after a cardiac arrest following a non-penetrating thoracic trauma. The patient was treated conservatively because percutaneous or surgical correction were not considered suitable for this lesion. A multidetector computed tomography coronary angiogram performed 10 years after the initial event showed no evidence of progression.

  19. Aneurisma infectado de artéria braquial após endocardite infecciosa de valva mitral Infected aneurysm of brachial artery after mitral valve infective endocarditis

    Directory of Open Access Journals (Sweden)

    Heraldo Guedis Lobo Filho

    2011-03-01

    Full Text Available Apresentamos um caso de aneurisma infectado de artéria braquial em paciente com endocardite infecciosa por Streptococcus bovis. Homem de 49 anos de idade se apresentou com febre, dispnéia e sopro regurgitativo em foco mitral com irradiação para axila. O ecocardiograma demonstrou vegetação em valva mitral nativa. Após troca valvar mitral com implante de prótese biológica, observou-se massa pulsátil de cinco centímetros de diâmetro em fossa antecubital direita. Foi feito o diagnóstico de aneurisma infectado de artéria braquial, e o tratamento cirúrgico foi realizado com sucesso. O objetivo desse relato de caso é apresentar uma complicação pouco comum após endocardite infecciosa.We present a case of brachial artery infected aneurysm in a patient with infective endocarditis caused by Streptococcus bovis. A 49-year-old man presented with fever dyspnea and a pansystolic murmur with irradiation to axilla. The echocardiogram revealed vegetation in native mitral valve. After mitral valve replacement with bioprosthesis, it was observed pulsatile mass of five centimeters in diameter at antecubital fossa of right upper limb. It was made the diagnosis of infected aneurysm of the brachial artery, and the surgery was performed successfully. The aim of this case report is to show a rare complication after infective endocarditis.

  20. An unusual combination of a tuberculous aneurysm of the thoracic aorta and a degenerative aneurysm of the infrarenal abdominal aorta.

    Science.gov (United States)

    Avaro, Jean-Philippe; Amabile, Philippe; Paule, Philippe; Peloni, Jean-Michel; Piquet, Philippe

    2011-07-01

    Tuberculous aneurysms of the aorta are rare and give rise to various issues related to their diagnosis and treatment. In this article, we report on an exceptional case concerning a patient who presented with a false tuberculous aneurysm of the thoracic aorta and a degenerative aneurysm of the infrarenal abdominal aorta concomitantly. A discussion on how we approached the diagnosis and devised a therapeutic strategy that allowed us to treat this dual aortic disease effectively has also been provided. The discussion includes details of the order of treatment and the choice between an endovascular and a surgical approach. PMID:21724110

  1. Effect of endothelium on glycosaminoglycan accumulation in injured rabbit aorta.

    OpenAIRE

    Wight, T N; Curwen, K. D.; Litrenta, M. M.; Alonso, D. R.; Minick, C. R.

    1983-01-01

    Previous studies have indicated that reendothelialized regions of injured rabbit aortas are more susceptible to diet-induced atherosclerosis than persistently deendothelialized regions or uninjured aortas. However, the mechanism responsible for this selective lipid deposition is not understood. One possibility is that these regions differ with respect to the quantity and type of glycosaminoglycan-containing proteoglycans which are known to interact with lipoproteins. To determine whether thes...

  2. Dynamic morphology of the Aorta, pre- and postoperative imaging

    OpenAIRE

    Prehn, J

    2009-01-01

    With endovascular treatment of the aorta a folded covered stentgraft is introduced in the aorta via the femoral arteries. Adequate pre-operative planning is necessary to allow for proper stentgraft sizing. Stentgrafts should be adequately oversized to ensure good apposition to the aortic wall and provide sufficient fixation. An adequate proximal seal and fixation prevents complications such as endoleakage and stentgraft migration. Stentgrafts are most commonly sized on static computed tomogra...

  3. Palpation Simulator of Beating Aorta for Cardiovascular Surgery Training

    Science.gov (United States)

    Yamamoto, Yasuhiro; Nakao, Megumi; Kuroda, Tomohiro; Oyama, Hiroshi; Komori, Masaru; Matsuda, Tetsuya; Sakaguchi, Genichi; Komeda, Masashi; Takahashi, Takashi

    In field of cardiovascular surgeries, palpation of aorta plays important roles in decision of surgical site.This paper develops palpation simulator of aorta based on a finite element based physical model.The proposed model calculates soft tissue deformation according to the affection of inner pressure and the operation of a surgeon.The proposed method is implemented on a prototype with dual PHANToM device.Experimental results confirmed our model achieves real time simulation of the surgical palpation.

  4. RIGHT SUPERIOR POLAR ARTERY ARISING FROM AORTA

    Directory of Open Access Journals (Sweden)

    Sreekanth

    2013-05-01

    Full Text Available ABSTRACT: The renal vasculature was always a subject of varia tions both in the number and pattern of portal of entry into kidney and Perihilar placement of the artery, vein and pelvis. Good anatomical insight is an essential prerequisite besides the surgical expertise. The cadaveric dissection at Shadan Institute of Medical Sciences, Teaching Hospital and Research Centre, revealed superior / upper polar artery arising from the lateral aspect of the aorta just proximal to the origin of Main Renal Artery (MRA. T he main renal artery and the accessory renal artery had almost a common point of origin. Th e peri-hilar segmentation of the main renal artery was a fork like pattern. One of the segmental arteries was long and had its portal of entry into the kidney by perforating the capsule of the ant erior substance of the kidney. The remaining segmental branches had their portal of ent ry through the hilum. The lower two segmental branches were placed anterior to the main renal vein causing altered hilar anatomy. A thorough knowledge of the frequently to the rarel y occurring wide range of variations of renal vasculature has significance in exploration and trea tment of renal trauma, renal transplantation, renal artery embolization, surgery for abdominal ao rtic aneurysm and conservative or radical renal surgery. Such a rare variation including the combination of extra renal peri-hilar segmentation of MRA with superior polar artery is wor thy of concern to the urologists harvesting kidneys from the live donors for performi ng transplantation procedures, partial nephrectomies for the hilar tumors and for Radiologi sts during interpretation of the angiograms

  5. Morphological Evidence of Telocytes in Mice Aorta

    Institute of Scientific and Technical Information of China (English)

    Hong-Qi Zhang; Shan-Shan Lu; Ting Xu; Yan-Ling Feng; Hua Li; Jun-Bo Ge

    2015-01-01

    Background:Telocytes (TCs) are a novel type of interstitial cells,which have been recently described in a large variety of cavitary and noncavitary organs.TCs have small cell bodies,and remarkably thin,long,and moniliform prolongations called telopodes (Tps).Until now,TCs have been found in various loose connective tissues surrounding the arterioles,venules,and capillaries,but as a histological cellular component,whether TCs exist in large arteries remains unexplored.Methods:TCs were identified by transmission electron microscope in the aortic arch of male C57BL/6 mice.Results:TCs in aortic arch had small cell bodies (length:6.06-13.02 μm; width:1.05-4.25 μm) with characteristics of specific long (7.74-39.05 μm),thin,and moniliform Tps; TCs distributed in the whole connective tissue layer of tunica adventitia:TCs in the innermost layer of tunica adventitia,located at the juncture between media and adventitia,with their long axes oriented parallel to the outer elastic membrane; and TCs in outer layers oftunica adventitia,were embedded among transverse and longitudinal oriented collagen fibers,forming a highly complex three-dimensional meshwork.Moreover,desmosomes were observed,serving as pathways connecting neighboring Tps.In addition,vesicles shed from the surface of TCs into the extracellular matrix,participating in some biological processes.Conclusions:TCs in aorta arch are a newly recognized complement distinct from other interstitial cells in large arteries,such as fibroblasts.And further biologically functional correlations need to be elucidated.

  6. Investigation of pulsatile flowfield in healthy thoracic aorta models.

    Science.gov (United States)

    Wen, Chih-Yung; Yang, An-Shik; Tseng, Li-Yu; Chai, Jyh-Wen

    2010-02-01

    Cardiovascular disease is the primary cause of morbidity and mortality in the western world. Complex hemodynamics plays a critical role in the development of aortic dissection and atherosclerosis, as well as many other diseases. Since fundamental fluid mechanics are important for the understanding of the blood flow in the cardiovascular circulatory system of the human body aspects, a joint experimental and numerical study was conducted in this study to determine the distributions of wall shear stress and pressure and oscillatory WSS index, and to examine their correlation with the aortic disorders, especially dissection. Experimentally, the Phase-Contrast Magnetic Resonance Imaging (PC-MRI) method was used to acquire the true geometry of a normal human thoracic aorta, which was readily converted into a transparent thoracic aorta model by the rapid prototyping (RP) technique. The thoracic aorta model was then used in the in vitro experiments and computations. Simulations were performed using the computational fluid dynamic (CFD) code ACE+((R)) to determine flow characteristics of the three-dimensional, pulsatile, incompressible, and Newtonian fluid in the thoracic aorta model. The unsteady boundary conditions at the inlet and the outlet of the aortic flow were specified from the measured flowrate and pressure results during in vitro experiments. For the code validation, the predicted axial velocity reasonably agrees with the PC-MRI experimental data in the oblique sagittal plane of the thoracic aorta model. The thorough analyses of the thoracic aorta flow, WSSs, WSS index (OSI), and wall pressures are presented. The predicted locations of the maxima of WSS and the wall pressure can be then correlated with that of the thoracic aorta dissection, and thereby may lead to a useful biological significance. The numerical results also suggest that the effects of low WSS and high OSI tend to cause wall thickening occurred along the inferior wall of the aortic arch and the

  7. Cierre espontáneo de la comunicación interventricular muscular aislada y la perimembranosa con aneurisma del septum

    Directory of Open Access Journals (Sweden)

    Abdón Castro B

    2006-09-01

    Full Text Available Introducción y objetivo: La comunicación interventricular (CIV es la cardiopatía congénita más frecuente en todas las edades. El presente estudio se realizó con el fin de conocer el porcentaje de CIVs musculares aisladas y perimembranosas con aneurisma del septum que se cierran espontáneamente y en cuánto tiempo lo hacen. Métodos: De febrero 2003 a diciembre 2005 se recolectaron 75 casos de neonatos diagnosticados con CIV muscular aislada y 10 con CIV perimembranosa aislada y con formación de aneurisma, quienes fueron seguidos por un periodo de al menos 30 meses. Se usó como método de diagnóstico la ecocardiografía bidimensional y el mapeo con Doppler color Resultados: Al año de seguimiento, el 68% de las CIV musculares se cerró espontáneamente y 90% a los 2 años. Solo un 10% de las CIV perimembranosas con aneurisma del septum se cerraron a los 2 años de seguimiento. El tamaño de las comunicaciones varió de 1,5 a 6 mm en ambos grupos. Conclusión: Las CIV musculares cierran espontáneamente en el 90% de los casos a los 2 años de edad, no así las perimembranosas en que lo hacen solo en un 10% de los casos.Introduction and objective: Ventricular septal defect (VSD is the most frequent congenital heart anomaly. This study was planned to establish the percentage of spontaneous closure of isolated muscular and isolated perimembranous (with septal aneurysm VSD and their time of closure. Methods: From February 2003 to December 2005, we collected 75 neonates with muscular VSD and 10 with perimembranous VSD with septal aneurysm, who had a follow up period of at least 30 months. Two D echo and color Doppler mapping were utilized as diagnostic method. Results: after 1 year of follow-up, 68% of all muscular VSDs had closed and 90% had done so at the age of 2, however only 10% of perimembranous VSDs with septal aneurysm had closed at 2 years of age. The size of the defects varied from 1,5 to 6 mm in both groups. Conclusion: a muscular

  8. Radiotherapy-induced aortic valve disease associated with porcelain aorta

    International Nuclear Information System (INIS)

    Mediastinal irradiation has been reported to induce cardiac disease such as pericarditis, valvular dysfunction, conduction abnormalities, accelerated arteriosclerosis of the coronary arteries, and also calcifications of the ascending aorta. We herein describe a case of radiotherapy-induced porcelain aorta and aortic valve disease and their surgical treatment. The patient was diagnosed with myasthenia gravis (MG) in 1965 (Osserman's type II), and mediastinal irradiation was performed in 1970 for treatment of thymic tumor associated with MG. Thirty years after radiation therapy, complete atrioventricular block and aortic valve disease with severe calcification of the ascending aorta and aortic arch (porcelain aorta) were detected on echo cardiogram and cardiac catheterization. A permanent pacemaker was implanted via the left subclavian vein and aortic valve replacement was performed under extracorporeal circulation established by selective cerebral perfusion and balloon occlusion instead of aortic cross-clamping. As no risk factors of arteriosclerosis such as hypercholesterolemia, hyperglycemia and hypertension were apparent, we concluded that the aortic valve disease and porcelain aorta were primarily induced by radiotherapy. (author)

  9. Spiral blood flow in aorta-renal bifurcation models.

    Science.gov (United States)

    Javadzadegan, Ashkan; Simmons, Anne; Barber, Tracie

    2016-07-01

    The presence of a spiral arterial blood flow pattern in humans has been widely accepted. It is believed that this spiral component of the blood flow alters arterial haemodynamics in both positive and negative ways. The purpose of this study was to determine the effect of spiral flow on haemodynamic changes in aorta-renal bifurcations. In this regard, a computational fluid dynamics analysis of pulsatile blood flow was performed in two idealised models of aorta-renal bifurcations with and without flow diverter. The results show that the spirality effect causes a substantial variation in blood velocity distribution, while causing only slight changes in fluid shear stress patterns. The dominant observed effect of spiral flow is on turbulent kinetic energy and flow recirculation zones. As spiral flow intensity increases, the rate of turbulent kinetic energy production decreases, reducing the region of potential damage to red blood cells and endothelial cells. Furthermore, the recirculation zones which form on the cranial sides of the aorta and renal artery shrink in size in the presence of spirality effect; this may lower the rate of atherosclerosis development and progression in the aorta-renal bifurcation. These results indicate that the spiral nature of blood flow has atheroprotective effects in renal arteries and should be taken into consideration in analyses of the aorta and renal arteries. PMID:26414530

  10. Increased RhoA translocation in aorta of diabetic rats

    Institute of Scientific and Technical Information of China (English)

    Jiping TANG; Ikuyo KUSAKA; Amber R MASSEY; Shadon ROLLINS; John H ZHANG

    2006-01-01

    Aim: To analyze RhoA expression and activation in the aorta of diabetic rats. Methods: Male SD rats (n=70) were divided into 2 groups: the diabetic group and the control group. Diabetes was induced by intravenous injection of streptozotocin (55 mg/kg). The Rats were studied 3 weeks after the induction of diabetes. Western blotting was used to measure the expression and activation of Rho. Results: Heart rate was measured 24 h/d; it decreased by 58±13 beats/min in the diabetic rats. Isometric tension showed that the contraction of diabetic aorta was significantly reduced compared with that of control aorta when stimulated by KCl and serotonin. The relaxation of the diabetic aorta was reduced when stimulated by acetylcholine. An enhanced RhoA translocation in the aortic tissues of diabetic rats was determined by a 90% increase in membrane-bound RhoA, indicating that the activation of RhoA is markedly increased in the diabetic aorta. Conclusion: Our data suggest that upregulated RhoA could be involved in the vascular dysfunction of diabetic rats.

  11. Estudo prospectivo das complicações da Doença de Kawasaki: análise de 115 casos Prospective study of Kawasaki Disease complications: review of 115 cases

    Directory of Open Access Journals (Sweden)

    Natália Ribeiro de M. Alves

    2011-06-01

    Full Text Available OBJETIVO: Chamar a atenção para as complicações, que podem surgir em qualquer fase da Doença de Kawasaki (DK, para os fatores de risco que contribuem para o aparecimento dessas complicações e para as possíveis sequelas da doença, sejam elas transitórias ou permanentes. MÉTODOS: Estudo prospectivo (coorte clínica realizado entre abril de 2002 e abril de 2009 de 115 pacientes com DK internados no serviço de Reumatologia Pediátrica do Hospital Geral do Distrito Federal. Todos os pacientes foram sequencialmente avaliados com exames clínicos e laboratoriais, ecocardiogramas com Doppler, imitanciometria, potenciais evocados auditivos, avaliação psicológica, exame oftalmológico e, em um paciente com coreia, angiorressonância magnética cerebral. Em todos os pacientes foram aplicados questionários avaliando a possível presença de dificuldades cognitivas, emocionais, comportamentais e sociais. RESULTADOS: Vinte e cinco pacientes (21,7% apresentaram aneurismas de coronárias. Trinta e oito pacientes (33% apresentaram perda auditiva neurossensorial durante a doença aguda e subaguda, e 13 pacientes (11,3% mantiveram a perda auditiva seis meses após a primeira avaliação. Outras complicações observadas foram: paralisia facial em um paciente (0,9%, ataxia na fase aguda e subaguda em 11 pacientes (9,5%, complicações oftalmológicas em 15 pacientes (13,2%, constatando-se uveíte em 13, edema de papila em um paciente e hemorragia conjuntival em outro. Um paciente apresentou coreia (0,9% sendo que a angioressonância magnética evidenciou alterações compatíveis com isquemia cerebral. Em um paciente constatou-se a presença de aneurisma de aorta torácica (0,9%, e outro apresentou vasculite necrosante que evoluiu com gangrena periférica e perda da ponta da língua (0,9%. Alterações de comportamento durante a convalescença (20% foi observada em 23 crianças. CONCLUSÃO: A DK pode evoluir com complicações diversas, mesmo meses

  12. Tratamento cirúrgico dos aneurismas de ventrículo esquerdo e isquemia coronária

    Directory of Open Access Journals (Sweden)

    Danton R. da Rocha LOURES

    1997-04-01

    Full Text Available Desde os primeiros relatos sobre aneurismectomia do ventrículo esquerdo, vários aspectos foram estabelecidos. Existem controvérsias relacionadas à técnica ideal de reconstrução ventricular, seus efeitos na morfolofia, função ventricular, estado sintomático pós-operatório e sobrevida a longo prazo. Este estudo visa levantar a casuística do Serviço, observando as principais indicações e tratamento cirúrgico, o estado sintomático pré e pós-operatório e a sobrevida imediata e tardia dos pacientes. Foram avaliados 12 portadores de aneurisma do ventrículo esquerdo, 9 masculinos, idade média de 60 anos, cujas principais indicações cirúrgicas foram angina (58% e angina + insuficiência cardíaca (42%. O cateterismo cardíaco demonstrou acinesia/discinesia segmentar em 92% dos pacientes, aneurisma apical ou ântero-apical em 83% e doença coronária obstrutiva em 100%, acometendo 3 ou mais vasos em 75%; a artéria interventricular anterior foi mais comprometida (29%. A fração de ejeção variou de 32% a 66% e o encurtamento percentual de 15% a 36%. Todos foram submetidos a revascularização do miocárdio, 9 sofreram aneurismectomia do ventrículo esquerdo, 7 com sutura linear e 2 com reconstrução geométrica. O tempo médio de circulação extracorpórea e clampeamento aórtico foi 96 e 50 minutos para sutura linear e 180 e 86 para reconstrução geométrica. As principais intercorrências pós-operatórias foram síndrome de baixo débito cardíaco e fibrilação atrial (16%. A mortalidade hospitalar foi de 16%. Os pacientes encontram-se com seguimento médio de 15 meses, sobrevida geral de 75%; estão livres de angina 89%, aqueles operados por ICC estão em classe II. Esses fatores melhorando a qualidade de vida justificam a aneurismectomia.Since the first reports about left ventricular aneurysmectomy, many features have been established, but there are controversies concerning the ideal technique of left ventricular

  13. Infected aneurysm of abdominal aorta: early CT finding

    International Nuclear Information System (INIS)

    Infected abdominal aortic aneurysm is an uncommon but life-threatening disease, especially in case of salmonella infection. Early CT findings should be well known in order to allow immediate diagnosis and accurate management. The authors present an early CT finding of a salmonella infected aneurysm of abdominal aorta in an HIV-infected patient. This pattern consists in a slight-enhancing focal densification of peri-aortic soft-tissue, while aorta remains of normal size. Within two weeks, infection progressed to the constitution of an infected aneurysm. This CT finding seems to be initial to previously described signs. (author)

  14. Pseudoaneurysm of the ascending aorta after aortic valve replacement

    Directory of Open Access Journals (Sweden)

    Osvaldo Valdés Dupeyrón

    2010-07-01

    Full Text Available Postsurgical pseudoaneurysms of the ascending aorta are a rare and serious complication of cardiovascular surgery that requires a surgical solution of urgency due to its high complexity. A case of a 40 year old female, white skin color, that due to severe aortic regurgitation underwent surgical treatment for aortic valve replacement. During the immediate postoperative period began with a fever, he made a meticulous study that included contrast computed tomography, through which diagnosed the presence of a pseudoaneurysm of the ascending aorta, was taken to the operating room, they found two sacks pseudoaneurismatics at the site where the suture was carried out previous.

  15. Estresse Isolado ou Associado ao Etanol Libera Prostanóides em Aorta de Ratos via ?2-Adrenoceptores

    Directory of Open Access Journals (Sweden)

    Rafaela de Fátima Ferreira Baptista

    2014-04-01

    Full Text Available Fundamento: Estresse e etanol são ambos, independentemente, importantes fatores de risco cardiovascular. Objetivo: avaliar o risco cardiovascular do consumo de etanol e exposição ao estresse, isolados e em associação, em ratos machos adultos. Métodos: Os ratos foram separados em quatro grupos: controle, etanol (20% na água de beber durante seis semanas, estresse (imobilização 1h dia/5 dias por semana/ 6 semanas e estresse/etanol. As curvas de concentração-resposta à noradrenalina - na ausência e na presença de ioimbina, L-NAME ou indometacina - ou fenilefrina foram determinadas em aortas torácicas com e sem endotélio. EC50 e resposta máxima (n = 8-12 foram comparadas através de ANOVA de dois fatores (two-way / método de Bonferroni. Resultados: Estresse ou estresse em associação com o consumo de etanol aumentaram as respostas máximas de noradrenalina em aortas intactas. Essa hiper-reatividade foi eliminada pela remoção do endotélio, ou pela presença da indometacina ou ioimbina, mas não foi alterada pela presença de L-NAME. Enquanto isso, o consumo de etanol não alterou a reatividade à noradrenalina. As respostas da fenilefrina em aortas com e sem endotélio também permaneceram inalteradas independentemente do protocolo. Conclusão: O estresse crônico aumentou as respostas aórticas dos ratos à noradrenalina. Esse efeito é dependente do endotélio vascular e envolve a liberação de prostanóides vasoconstritores através da estimulação de α-2 adrenoceptores endoteliais. Além disso, o consumo crônico de etanol pareceu não influenciar as respostas de noradrenalina em aorta de rato, nem modificar o aumento de tais respostas observadas em consequência da exposição ao estresse.

  16. Xanthorrhizol induces endothelium-independent relaxation of rat thoracic aorta.

    Science.gov (United States)

    Campos, M G; Oropeza, M V; Villanueva, T; Aguilar, M I; Delgado, G; Ponce, H A

    2000-06-01

    Xanthorrhizol, a bisabolene isolated from the medicinal plant Iostephane heterophylla, was assayed on rat thoracic aorta rings to elucidate its effect and likely mechanism of action, by measuring changes of isometric tension. Xanthorrhizol (1, 3, 10, 30 and 100 microg/mL) significantly inhibited precontractions induced by KCI-; (60mM), noradrenaline (10(-6) M) or CaCl2 (1.0 mM). Increasing concentrations of external calcium antagonized the inhibitory effect on KCl-induced contractions. The vasorelaxing effect of xanthorrhizol was not affected by indomethacin (10 microM) or L-NAME (100 microM) in intact rat thoracic aorta rings precontracted by noradrenaline, which suggested that the effect was not mediated through either endothelium-derived prostacyclin (PGI2) or nitric oxide release from endothelial cells. Endothelium removal did not affect the relaxation induced by xanthorrhizol on rat thoracic aorta rings, discarding the participation of any substance released by the endothelium. Xanthorrhizol inhibitory effect was greater on KCI- and CaCl2-induced contractions than on those induced by noradrenaline. Xanthorrhizol inhibitory effect in rat thoracic aorta is likely explained for interference with calcium availability by inhibiting calcium influx through both voltage- and receptor-operated channels. PMID:10983876

  17. Marfan's syndrome and isolated aneurysm of the abdominal aorta.

    OpenAIRE

    Van Ooijen, B.

    1988-01-01

    A 43 year old woman presented with an aneurysm of the abdominal aorta. Marfan's syndrome was diagnosed as the underlying cause of the aneurysm. An isolated aneurysm as presenting sign of Marfan's syndrome is rare. In a review of published reports about 30 cases were found.

  18. Variations in atherosclerosis and remodeling patterns in aorta and carotids

    Directory of Open Access Journals (Sweden)

    Fuster Valentin

    2010-03-01

    Full Text Available Abstract Background Atherosclerosis is a progressive disease that causes vascular remodeling that can be positive or negative. The evolution of arterial wall thickening and changes in lumen size under current "standard of care" in different arterial beds is unclear. The purpose of this study was to examine arterial remodeling and progression/regression of atherosclerosis in aorta and carotid arteries of individuals at risk for atherosclerosis normalized over a 1-year period. Methods In this study, 28 patients underwent at least 2 black-blood in vivo cardiovascular magnetic resonance (CMR scans of aorta and carotids over a one-year period (Mean 17.8 ± 7.5 months. Clinical risk profiles for atherosclerosis and medications were documented and patients were followed by their referring physicians under current "standard of care" guidelines. Carotid and aortic wall lumen areas were matched across the time-points from cross-sectional images. Results The wall area increased by 8.67%, 10.64%, and 13.24% per year (carotid artery, thoracic aorta and abdominal aorta respectively, p Conclusions Results of this study of multiple vascular beds indicated that different vascular locations exhibited varying progression of atherosclerosis and remodeling as monitored by CMR.

  19. Aneurysm of the Ascending Aorta after Cardiac Transplantation

    OpenAIRE

    Defraigne, Jean-Olivier; Vahdat, Olivier; LAVIGNE, Jean-Paul; Demoulin, Jean-Claude; Limet, Raymond

    1992-01-01

    We report the case of a 57-year-old female cardiac transplant patient in whom an aneurysm of the recipient side of the ascending aorta developed 1 year after transplantation. Although a mycotic origin was the likely cause, histologic examination diagnosed an atherosclerotic aneurysm. Peer reviewed

  20. Skeleton Graph Matching vs. Maximum Weight Cliques aorta registration techniques.

    Science.gov (United States)

    Czajkowska, Joanna; Feinen, C; Grzegorzek, M; Raspe, M; Wickenhöfer, R

    2015-12-01

    Vascular diseases are one of the most challenging health problems in developed countries. Past as well as ongoing research activities often focus on efficient, robust and fast aorta segmentation, and registration techniques. According to this needs our study targets an abdominal aorta registration method. The investigated algorithms make it possible to efficiently segment and register abdominal aorta in pre- and post-operative Computed Tomography (CT) data. In more detail, a registration technique using the Path Similarity Skeleton Graph Matching (PSSGM), as well as Maximum Weight Cliques (MWCs) are employed to realise the matching based on Computed Tomography data. The presented approaches make it possible to match characteristic voxels belonging to the aorta from different Computed Tomography (CT) series. It is particularly useful in the assessment of the abdominal aortic aneurysm treatment by visualising the correspondence between the pre- and post-operative CT data. The registration results have been tested on the database of 18 contrast-enhanced CT series, where the cross-registration analysis has been performed producing 153 matching examples. All the registration results achieved with our system have been verified by an expert. The carried out analysis has highlighted the advantage of the MWCs technique over the PSSGM method. The verification phase proves the efficiency of the MWCs approach and encourages to further develop this methods. PMID:26099640

  1. Expiration induced femoral flow in neonatal coarctation of aorta.

    OpenAIRE

    McNicholl, B.; Kennedy, J. D.

    1983-01-01

    In a 3 day old infant with coarctation of the aorta a loud Doppler signal synchronous with expiration was present for some hours in the femoral vessels, with only barely audible signals synchronous with cardiac systole. It is suggested that in the presence of severe aortic constriction and temporary ductal closure, blood was pumped through the infradiaphragmatic arteries by increased intrathoracic expiratory pressure.

  2. Surgical exclusion of postsurgical pseudoaneurysm of the ascending aorta

    International Nuclear Information System (INIS)

    Pseudoaneurysm of ascending aorta after cardiac surgery is rare in children. We report a case of successful surgical exclusion of ascending aortic pseudoaneurysm in a 15-year-old boy. The neck of the aneurysm was in close proximity to the right coronary artery (RCA)

  3. Methodologic aspects of acetylcholine-evoked relaxation of rabbit aorta.

    Science.gov (United States)

    Hansen, K; Nedergaard, O A

    1999-08-01

    The acetylcholine-evoked relaxation of rabbit isolated thoracic aorta precontracted by phenylephrine was studied. Phenylephrine caused a steady contraction that was maintained for 6 h. In the presence of calcium disodium ethylenediaminetetraacetate (EDTA) and ascorbic acid the contraction decreased with time. N(G)-Nitro-L-arginine abolished the inhibitory effect of EDTA and ascorbic acid. Acetylcholine evoked a rapid concentration-dependent relaxation that recovered spontaneously and slowly, but fully, with time. Relaxation evoked by equieffective concentrations of carbachol and acetylcholine had the same time course. Cumulative addition of acetylcholine (10(-7)-3 x 10(-5) M) caused a marked relaxation that was reverted slightly at high concentrations. The relaxation was the same with rings derived from the upper, middle, and lower part of the thoracic aorta. Two consecutive concentration-response curves for acetylcholine obtained at a 2-h interval demonstrated a slight development of tachyphylaxis. The relaxation was inversely related to precontractile tension evoked by phenylephrine when expressed as a percentage, but independent when expressed as g tension. Storage of aorta in cold salt solution for 24 h did not alter the relaxation. EDTA and ascorbic acid did not alter the relaxation. It is concluded that (1) EDTA and ascorbic acid can not be used with impunity to stabilize catecholamines used as preconstriction agents; (2) the reversal of the acetylcholine-evoked relaxation is not due to hydrolysis of acetylcholine; (3) the relaxation is uniform in all segments of thoracic aorta; (4) cold storage of aorta does not alter the relaxation; and (5) acetylcholine releases the same amount of relaxing factor, irrespective of the precontractile tension. PMID:10691020

  4. Complicações arteriais da síndrome do desfiladeiro torácico Arterial complications of thoracic outlet syndrome

    Directory of Open Access Journals (Sweden)

    Fernando Thomazinho

    2008-06-01

    Full Text Available As manifestações clínicas da síndrome do desfiladeiro torácico são predominantemente neurológicas, sendo as complicações arteriais raras, mas potencialmente graves. Entre elas, devemos citar os aneurismas com complicações embólicas e a trombose. Os autores relatam o caso de uma mulher de 37 anos com costela cervical bilateral que apresentou embolia no membro superior direito originada de um aneurisma pós-estenótico da artéria subclávia direita, além de apresentar ectasia da subclávia esquerda também por compressão.The clinical manifestations of thoracic outlet syndrome are mainly neurological. Although arterial complications are rare, they are potentially severe. Among these are aneurysms associated with embolism and thrombosis. The authors report a case of a 37 year-old woman with bilateral cervical rib that developed embolism in the right upper limb from a poststenotic right subclavian artery aneurysm and dilatation of the left subclavian artery, both due to compression.

  5. Congenital abnormalities of the aorta in children and adolescents; Angeborene Fehlbildungen der Aorta im Kindes- und Jugendalter

    Energy Technology Data Exchange (ETDEWEB)

    Eichhorn, J.G. [Universitaetskinderklinik Heidelberg, Abt. Paediatrische Kardiologie, Heidelberg (Germany); Ley, S. [Deutsches Krebsforschungszentrum (DKFZ) Heidelberg, Abt. Radiologie, Heidelberg (Germany); Radiologische Universitaetsklinik Heidelberg, Abt. Paediatrische Radiologie, Heidelberg (Germany)

    2007-11-15

    Aortic abnormalities are common cardiovascular malformations accounting for 15-20% of all congenital heart disease. Ultrafast CT and MR imaging are noninvasive, accurate and robust techniques that can be used in the diagnosis of aortic malformations. While their sensitivity in detecting vascular abnormalities seems to be as good as that of conventional catheter angiocardiography, at over 90%, they are superior in the diagnosis of potentially life-threatening complications, such as tracheal, bronchial, or esophageal compression. It has been shown that more than 80% of small children with aortic abnormalities benefit directly from the use of noninvasive imaging: either cardiac catheterization is no longer necessary or radiation doses and periods of general anesthesia for interventional catheterization procedures can be much reduced. The most important congenital abnormalities of the aorta in children and adolescents are presented with reference to examples, and the value of CT and MR angiography is documented. (orig.) [German] Fehlbildungen der Aorta gehoeren zu den haeufigen kongenitalen kardiovaskulaeren Malformationen (15-20% aller angeborenen Herzfehler). Die raeumlich und zeitlich hochaufloesenden Methoden der Computer- (CT-) und Magnetresonanztomographie (MRT) sind nichtinvasive, hochwertige und aussagekraeftige Methoden zur Diagnostik angeborener Fehlbildungen der Aorta. Sie zeigen sich in der Diagnostik der Gefaessanomalien gleichwertig zur konventionellen Angiographie mit Sensitivitaeten von mehr als 90%. In der Diagnostik assoziierter Komplikationen, wie trachealen, bronchialen oder oesophagialen Kompressionen, sind sie ueberlegen. Es konnte gezeigt werden, dass 80% der Kleinkinder mit Fehlbildungen der Aorta einen direkten Vorteil von der nichtinvasiven Bildgebung hatten: Entweder war eine Herzkatheterung fuer die Therapieplanung nicht mehr erforderlich oder die Durchleuchtungs- und Narkosezeiten bei der Katheterintervention konnten deutlich verkuerzt

  6. Preparation of Single Cell Suspensions from Mouse Aorta

    Science.gov (United States)

    Hu, Desheng; Yin, Changjun; Mohanta, Sarajo K.; Weber, Christian; Habenicht, Andreas J. R.

    2016-01-01

    Atherosclerosis is a chronic inflammatory disease of the arterial wall characterized by lipid deposition, plaque formation, and immune cell infiltration. Innate and adaptive immune cells infiltrate the artery during development of the disease. Moreover, advanced disease leads to formation of artery tertiary lymphoid organs in the adventitia (Grabner et al., 2009; Hu et al., 2015). Various and diverse types of immune cells have been identified in the aorta adventitia vs atherosclerotic plaques (Elewa et al., 2016; Galkina et al., 2006; Lotzer et al., 2010; Mohanta et al., 2016; Mohanta et al., 2014; Moos et al., 2005; Srikakulapu et al., 2016; Zhao et al., 2004). There are conflicting reports on the number and subtypes of immune cells in the aorta depending on the age of the animals, the protocol that is used to obtain single cell suspensions, and the dietary conditions of the mice (Campbell et al., 2012; Clement et al., 2015; Galkina et al., 2006; Kyaw et al., 2012). The number of immune cells in the aorta differs as much as tenfold using different protocols (Butcher et al., 2012; Galkina et al., 2006; Gjurich et al., 2015; Grabner et al., 2009; Hu et al., 2015). These discrepant results call for a protocol that robustly documents bona fide aorta cells rather than those in the surrounding tissues or blood. Critical methodological hurdles include the removal of adjacent adipose tissue and small paraaortic lymph nodes lining the entire aortic tree that are not visible by the naked eye. A dissection microscope is therefore recommended. Moreover protocols of aorta preparations should ascertain that lymphocyte aggregates referred to as fat associated lymphoid clusters (FALCs) (Benezech et al., 2015; Elewa et al., 2015) that are often present at the border between the adipose tissue and the adventitia are removed before enzyme digestion. We propose - besides other approaches (Hu et al., 2015; Mohanta et al., 2014) - a combination of immunohistochemical staining and

  7. Gadolinium-enhanced three-dimensional breath-hold MR angiography of the thoracic aorta; Angiografia con Risonanza Magnetica tridimensionale nell'apnea con infusione rapida di mezzo di contrasto paramagnetico nello studio dell'aorta toracica

    Energy Technology Data Exchange (ETDEWEB)

    Di Cesare, E.; Giordano, A.V.; Cerone, G.; Splendiani, A.; Michelini, O; Masciocchi, C. [L' Aquila Univ., L' Aquila (Italy). Ist. di Radiologia

    1999-11-01

    In this paper it is investigated the diagnostic accuracy of gadolinium-enhanced 3D MRA in the assessment of thoracic aortic diseases. Thirty-eight patients with diagnosed or suspected conditions of thoracic aorta were examined with contrast-enhanced MRA. All the examinations were performed with a 1.5 T superconductive magnet acquiring breath-hold 3D fast Gradient-Echo (GE) sequences (TR=5.9 ms; TE=1.2 ms; FA=45 degrees; FOV=48 cm; thickness=2-2.5 mm; locs=30-32; TA=22-24s; MA=512) on the coronal plane. The contrast agent was injected bolus after a bolus-test to evaluate circulation time. In the experts opinion contrast-enhanced three dimensional MR angiography should be the screening technique of choice in the evaluation of thoracic aorta thanks to its low invasiveness, short acquisition time, large field of view and morphologica resolution ECG gating is not needed. Limitations are found in the study of wall and periaortic region which are better evaluated with conventional MR imaging. [Italian] Scopo di questo lavoro e' stato verificare le potenzialita' della tecnica di angiografia con Risonanza Magnetica tridimensionale (angio-RM tridimensionale) nell'apnea con bolo di mdc paramagnetico nello studio delle malattie dell'aorta toracica. Sono stati sottoposti ad angio-RM con mdc trentotto pazienti con diagnosi o sospetta malattia dell'aorta toracica. E' stato utilizzato un magnete superconduttivo operante a 1,5 tesla (GE) impiegando una sequenza 3D Fast Gradient-Echo (TR=5,9 ms; TE=1,2 ms; FA=45 degrees; FOV=48 cm; thickness=2-2.5 mm; locs=30-32; TA=22-24s; matrice=512) acquista in apnea sul piano coronale. Il mdc e' stato somministrato a bolo con ritardo calcolato sulla base del bolo-test che ha sempre preceduto l'acquisizione volumetrica. La valutazione con angio-RM tridimensionale con bolo di mdc rappresenta a nostro avviso la tecnica di scelta nello studio dell'aorta toracica in ragione della scarsa invasivita

  8. Aneurisma venoso gigante de veia ilíaca externa secundário a fístula arteriovenosa traumática: relato de caso Giant external-iliac-vein aneurysm secondary to traumatic arteriovenous fistula: a case report

    Directory of Open Access Journals (Sweden)

    Patrick Bastos Metzger

    2011-09-01

    Full Text Available Aneurismas venosos abdominais são raros. Os localizados nas veias ilíacas externas estão entre os mais infrequentes aneurismas venosos publicados na literatura. Relatamos o caso de um paciente jovem com aneurisma venoso gigante de veia ilíaca externa secundário a uma fístula arteriovenosa adquirida há 20 anos, tratado pelos métodos convencional e endovascular com sucesso.Venous abdominal aneurysms are rare entities, especially at the external iliac vein. We report the case of a young male patient who presented with a giant external-iliac-vein aneurysm secondary to an arteriovenous fistula acquired 20 years earlier, and treated successfully by conventional and endovascular methods in our service.

  9. Estudo da macrovasculatura por ultra-sonografia Doppler na esclerose sistêmica Study of macrovasculature by Doppler ultrasound in systemic sclerosis

    Directory of Open Access Journals (Sweden)

    Emmanuelle Tenório Albuquerque Madruga Godoi

    2008-04-01

    Full Text Available OBJETIVO: Avaliar a ocorrência e a distribuição das alterações macrovasculares em uma população com esclerose sistêmica (ES por meio da ultra-sonografia Doppler (USG Doppler e do índice tornozelo-braço (ITB. Foi investigada a associação destes achados com as características demográficas e clínicas dos pacientes, bem como fatores de risco e antecedentes da doença ateromatosa. MÉTODOS: Estudo prospectivo, tipo série de casos, constituído de 20 pacientes, sendo 19 do sexo feminino, com idade média de 46,30 anos. A forma clínica difusa esteve presente em 85% dos pacientes. Todos tinham fenômeno de Raynaud (FR, 55% apresentaram alteração de polpas digitais, 15% úlcera atual de membros e 25% reabsorção de falange. Não houve amputação e 70% apresentaram de um a quatro fatores de risco de aterosclerose. A aorta, as carótidas, bem como as artérias dos membros superiores (MMSS e inferiores (MMII foram estudadas por USG Doppler para a avaliação de espessamento do complexo íntima-medial (CIM, presença de placas e aneurismas. Nas artérias dos MMII, foi também realizado o ITB. RESULTADOS: O ITB foi normal em todos os pacientes, entretanto 12 (60% destes apresentaram doença macrovascular (DMV, sendo 9 (45% na aorta, 7 (35% nos MMII, 6 (30% nas carótidas e 1 (5% nas artérias dos MMSS. Observou-se associação entre DMV e alterações de polpas digitais (p = 0,0045. CONCLUSÕES: A USG Doppler identificou DMV em 60% dos pacientes com ES. Nenhum paciente apresentou ITB anormal. Verificou-se associação significante da DMV com as alterações atuais de polpas digitais. As alterações macrovasculares encontradas não estão necessariamente associadas à esclerose sistêmica e podem decorrer do processo aterosclerótico.OBJECTIVE: To assess the occurrence and distribution of the macrovascular alterations in a population with Systemic Sclerosis (SS by means of Doppler ultrasound (Doppler US and ankle-arm index (AAI. To

  10. Mycotic aneurysm of the thoracic aorta presenting as pneumonia

    Energy Technology Data Exchange (ETDEWEB)

    Mengozzi, E. [Dept. of Radiology, Maggiore Hospital, Bologna (Italy); Sartoni Galloni, S. [Dept. of Radiology, San Salvatore Hospital, Bologna (Italy); Giovannini, G. [Dept. of Paediatrics, Maggiore Hospital, Bologna (Italy); Bronzetti, G. [Dept. of Paediatric Cardiology, Sant' Orsola-Malpighi University Medical Centre, Bologna (Italy)

    2001-07-01

    Mycotic aneurysms of the thoracic aorta rarely occur in children. We report an unusual case of a mycotic aneurysm of the descending aorta in a 4-year-old boy presenting with respiratory tract infection, which was rapidly complicated by atelectasis of the left lung. The patient's mycotic aortic aneurysm was diagnosed by contrast-enhanced spiral CT, whereas conventional chest radiographs did not detect its presence. An unsuspected mild aortic coarctation was also diagnosed at the time of admission. This case demonstrates that an aortic aneurysm may clinically and radiologically manifest itself with respiratory tract infection and atelectasis and that contrast-enhanced spiral CT is a fast and powerful tool for establishing the diagnosis. (orig.)

  11. MagnetoHemoDynamics in the aorta and electrocardiograms

    Science.gov (United States)

    Martin, Vincent; Drochon, Agnès; Fokapu, Odette; Gerbeau, Jean-Frédéric

    2012-05-01

    This paper addresses a complex multi-physical phenomenon involving cardiac electrophysiology and hemodynamics. The purpose is to model and simulate a phenomenon that has been observed in magnetic resonance imaging machines: in the presence of a strong magnetic field, the T-wave of the electrocardiogram (ECG) gets bigger, which may perturb ECG-gated imaging. This is due to a magnetohydrodynamic (MHD) effect occurring in the aorta. We reproduce this experimental observation through computer simulations on a realistic anatomy, and with a three-compartment model: inductionless MHD equations in the aorta, bi-domain equations in the heart and electrical diffusion in the rest of the body. These compartments are strongly coupled and solved using finite elements. Several benchmark tests are proposed to assess the numerical solutions and the validity of some modeling assumptions. Then, ECGs are simulated for a wide range of magnetic field intensities (from 0 to 20 T).

  12. Lipid synthesis in the aorta of chick and other species

    International Nuclear Information System (INIS)

    The relative rate of fatty acid biosynthesis from labelled acetate in the adipose tissue of chicken is much lower than that in the rat (O'Hea and Leveille, 1968). To determine similar species differences in lipid synthesis in the aortas of cock, rat, rabbit and monkey, thoracic and abdominal segments of fresh aortas were incubated in vitro with (1-14C)-acetate for 3 h. Total lipids and their fractions (free and total cholesterol, free fatty acids, triglycerides and phospholipids) were counted for radioactivity. Incorporation of radioactivity into total as well as all classes of lipids was several times greater in chicken than in other species. Significant and consistent incorporation into cholesterol occurred only in chicks. Synthesis into total lipids and triglycerides was greater in the thoracic segment of chicks. These findings (Rao and Rao, 1968) are consistent with the ready susceptibility of chicken to atherosclerosis. (author)

  13. Contractile reaction of isolated frog aorta after X-irradiation

    International Nuclear Information System (INIS)

    The action of X-rays (50 kV, filtered by 0.3 mm Al) on helical strip of frog aorta (rana esculenta) has been investigated. The isolated preparations have a stable basal tone and are radio-sensitive to X-rays which induce reversible, dose-dependent, contractile responses. After repeated irradiational tachyphylaxis appears. The threshold doses are about 250 R at 3 to 6 kR/min, antiadrenergic (phentolamine, propranolol), anticholinergic (atropin), antihistaminic (Neo-Bridal) and serotoninergic (Deseril) drugs have no visible influence on the X-ray induced reaction, i.e. these action mechanisms of the irradiation-induced contraction do not seem probable. Theophylline and cAMP inhibit the X-ray contraction probably non-specifically. Indometacin also inhibits the X-ray contraction: this suggests participation of prostaglandin-mechanism on the contraction of frog aorta after irradiation. (orig.)

  14. Mycotic aneurysm of the thoracic aorta presenting as pneumonia

    International Nuclear Information System (INIS)

    Mycotic aneurysms of the thoracic aorta rarely occur in children. We report an unusual case of a mycotic aneurysm of the descending aorta in a 4-year-old boy presenting with respiratory tract infection, which was rapidly complicated by atelectasis of the left lung. The patient's mycotic aortic aneurysm was diagnosed by contrast-enhanced spiral CT, whereas conventional chest radiographs did not detect its presence. An unsuspected mild aortic coarctation was also diagnosed at the time of admission. This case demonstrates that an aortic aneurysm may clinically and radiologically manifest itself with respiratory tract infection and atelectasis and that contrast-enhanced spiral CT is a fast and powerful tool for establishing the diagnosis. (orig.)

  15. Ascending Aorta Elastography After Kawasaki Disease Compared to Systemic Hypertension.

    Science.gov (United States)

    Nandlall, Ian; Maurice, Roch L; Fournier, Anne; Merouani, Aïcha; Dahdah, Nagib

    2015-10-01

    Kawasaki disease (KD) is a systemic vasculitis, classically affecting large- and medium-size arteries. The coronary arteries draw most of the clinical attention, whereas few studies have taken interest in the ascending aorta. Using a proprietary imaging-based mechanical biomarker (ImBioMark), we sought to determine aortic stiffness in KD compared to systemic hypertension (HTN) and healthy children. We evaluated parasternal long-axis views focused on the ascending aorta in 20 controls, 12 KD, and 8 HTN as a comparative clinical model of vascular stiffness. We calculated systolic and diastolic aortic wall strain with ImBioMark. Strain was tested for normality against height, systolic, and diastolic blood pressure in normal subjects. Strain from KD and HTN was normalized (Z score) accordingly. Z score comparisons were performed using nonparametric statistics. Age was similar between KD and HTN (9.1 ± 5.3 and 9.9 ± 5.3 years old; p = NS). Systolic and diastolic strain values were normally distributed against height, systolic blood pressure, and diastolic blood pressure in healthy subjects. HTN subjects had abnormal systolic and diastolic strain values (p < 0.0001). Whereas KD subjects had normal diastolic strain, systolic strain was significantly lower (p < 0.001), and systolic strain was intermediate between controls and HTN. There were no significant differences in aortic strain among KD, however, according to the presence of coronary artery aneurysms. Despite normal blood pressure, the ascending aorta in KD exhibits reduced strain during systole. This may reflect in situ rigidity of the aorta. The normal diastolic strain in KD may, in contrast, reflect normal peripheral vascular resistance. PMID:25921428

  16. Relaxant effects of selected sildenafil analogues in the rat aorta.

    Science.gov (United States)

    Mojzych, Mariusz; Kubacka, Monika; Mogilski, Szczepan; Filipek, Barbara; Fornal, Emilia

    2016-06-01

    A new series of sulfonamide derivatives of pyrazolo[4,3-e][1,2,4]triazine with chiral amino group has been synthesized and characterized. The compounds were tested for their relaxant effects in the rat aorta. Evaluation of prepared derivatives demonstrated that compound (8a) is probably a non-selective phosphodiesterase (PDE) inhibitor, as it induced aortic relaxation through endothelium-independent mechanism. PMID:25798686

  17. Comparative hemodynamics in an aorta with bicuspid and trileaflet valves

    Science.gov (United States)

    Gilmanov, Anvar; Sotiropoulos, Fotis

    2016-04-01

    Bicuspid aortic valve (BAV) is a congenital heart defect that has been associated with serious aortopathies, such as aortic stenosis, aortic regurgitation, infective endocarditis, aortic dissection, calcific aortic valve and dilatation of ascending aorta. There are two main hypotheses to explain the increase prevalence of aortopathies in patients with BAV: the genetic and the hemodynamic. In this study, we seek to investigate the possible role of hemodynamic factors as causes of BAV-associated aortopathy. We employ the curvilinear immersed boundary method coupled with an efficient thin-shell finite-element formulation for tissues to carry out fluid-structure interaction simulations of a healthy trileaflet aortic valve (TAV) and a BAV placed in the same anatomic aorta. The computed results reveal major differences between the TAV and BAV flow patterns. These include: the dynamics of the aortic valve vortex ring formation and break up; the large-scale flow patterns in the ascending aorta; the shear stress magnitude, directions, and dynamics on the heart valve surfaces. The computed results are in qualitative agreement with in vivo magnetic resonance imaging data and suggest that the linkages between BAV aortopathy and hemodynamics deserve further investigation.

  18. Hemodynamics in an Aorta with Bicuspid and Trileaflet Valves

    Science.gov (United States)

    Gilmanov, Anvar; Sotiropoulos, Fotis

    2015-11-01

    Bicuspid aortic valve (BAV) is a congenital heart defect that has been associated with serious aortopathies, such as ascending aortic aneurysm, aortic stenosis, aortic regurgitation, infective endocarditis, aortic dissection, calcific aortic valve and dilatation of ascending aorta. Two main hypotheses - the genetic and the hemodynamic are discussed in literature to explain the development and progression of aortopathies in patients with BAV. In this study we seek to investigate the possible role of hemodynamic factors as causes of BAV-associated aortopathy. We employ the Curvilinear Immersed Boundary (CURVIB) method coupled with an efficient thin-shell finite element (TS-FE) formulation for tissues to carry out fluid-structure interaction simulations of a healthy tri-leaflet aortic valve (TAV) and a BAV placed in the same anatomic aorta. The computed results reveal major differences between the TAV and BAV flow patterns. These include: the dynamics of the aortic valve vortex ring formation and break up; the large scale flow patterns in the ascending aorta; and the shear stress magnitude on the aortic wall. The computed results are in qualitative agreement with in vivo Magnetic Resonance Imaging (MRI) data and suggest that the linkages between BAV aortopathy and hemodynamics deserve further investigation. This work is supported by the Lillehei Heart Institute at the University of Minnesota and the Minnesota Supercomputing Institute.

  19. Analysis of human aorta using fluorescence lifetime imaging microscopy (FLIM)

    Science.gov (United States)

    Vieira-Damiani, Gislaine; Adur, J.; Ferro, D. P.; Adam, R. L.; Pelegati, V.; Thomáz, A.; Cesar, C. L.; Metze, K.

    2012-03-01

    The use of photonics has improved our understanding of biologic phenomena. For the study of the normal and pathologic architecture of the aorta the use of Two-Photon Excited Fluorescence (TPEF) and Second Harmonic Generation showed interesting details of morphologic changes of the elastin-collagen architecture during aging or development of hypertension in previous studies. In this investigation we tried to apply fluorescence lifetime imaging (FLIM) for the morphologic analysis of human aortas. The aim of our study was to use FLIM in non-stained formalin-fixed and paraffin-embedded samples of the aorta ascendants in hypertensive and normotensive patients of various ages, examining two different topographical regions. The FLIM-spectra of collagen and elastic fibers were clearly distinguishable, thus permitting an exact analysis of unstained material on the microscopic level. Moreover the FLIM spectrum of elastic fibers revealed variations between individual cases, which indicate modifications on a molecular level and might be related to FLIM age or diseases states and reflect modifications on a molecular level.

  20. Abdominal aorta coarctation: The first three case reports in our literature

    OpenAIRE

    Gajin Predrag; Tanasković Slobodan; Nenezić Dragoslav; Ilijevski Nenad; Radak Đorđe

    2010-01-01

    Introduction. Congenital coarctation of the thoracic aorta at the ligamentum arteriosum or the aortic arch is well recognized. But a much less common variety (0.5-2.0%) of aortic coarctation is located in the distal thoracic aorta or abdominal aorta or both and is often called 'middle aortic syndrome' or 'midaortic dysplastic syndrome'. This represents serious pathological condition and indicates multidisciplinary therapy approach. Outline of Cases. From 1996 to 2007, at the Vascular Surgery ...

  1. [Antiatherogenic characteristics of korvitin: effect on proteasome activity of the aorta, heart, and blood cells].

    Science.gov (United States)

    Pashevin, D O; Dosenko, B Ie; Byts', Iu V; Moĭbenko, O O

    2009-01-01

    We studied the changes in proteasomal proteolisis during modelling of rabbit cholesterol-induced atherosclerosis. It was determined that in aorta the TL activity of proteasome increased 2.4-fold (P quercetine) followed by considerable decrease of proteasomal activity both in tissues (aorta and heart) and leucocytes. The intensity ofatherosclerotic changes in aorta was significantly smaller. Obtained data suggest that "Korvitin" reveales angioprotective properties mediated by it effect on proteasomal proteolisis. PMID:19827630

  2. Tratamento cirúrgico da taquicardia ventricular refratária: nova proposta técnica

    Directory of Open Access Journals (Sweden)

    BRICK Alexandre Visconti

    1997-01-01

    Full Text Available A miocardiopatia provocada pela doença de Chagas cria, freqüentemente, circuitos elétricos de reentrada, possibilitando o desencadeamento de taquicardia ventricular, geralmente refratária (TVR às drogas antiarrítmicas. Muitas vezes, este quadro desorganiza eletricamente os ventrículos, provocando a morte do paciente. Nova proposta técnica para tratamento da (TVR foi empregada em 9 pacientes, portadores da doença de Chagas com esta arritimia, sendo 8 com aneurisma de ponta e 1 da região infero-basal. Na maioria dos casos, o foco da taquicardia encontrava-se fora da borda do aneurisma ou da área de fibrose, geralmente na região basal ou póstero-lateral do ventrículo esquerdo. A idade variou entre 34 e 62 anos, com média de 48. Quatro eram do sexo masculino e 5 do feminino. Todos encontravam-se no grau funcional III e IV e a maioria apresentava episódios freqüentes de síncope, provocados pela taquicardia. Em 2 dos pacientes havia relato de AVC prévio e foi encontrado aneurisma de ponta em 8, aneurisma póstero-basal com extensa fibrose em 1 e trombo intracavitário em 6. Durante o ato cirúrgico foram induzidas as taquicardias clínicas em todos os pacientes. Na região em que o toque do instrumental cirúrgico conseguiu interrompê-las, foram realizadas aplicações de radiofreqüência, através de cateteres de ablação, no centro e nas bordas do foco. Logo após, e no sétimo dia de pós-operatório, nenhuma taquicardia pôde ser induzida com os protocolos de estimulação ventricular programada. A evolução de 13 +/- 7 meses, sem uso de drogas antiarrítmicas, mostra que 8 estão assintomáticos e em classe funcional I e II. Um paciente, com doença pulmonar obstrutiva crônica, faleceu de insuficiência respiratória no pós-operatório tardio (3 meses, sem ter apresentado taquicardia. Em conclusão, esta técnica é facilmente reprodutível, podendo ser realizada com simplicidade, sem necessidade de aparelhagem

  3. Pseudo-dissection of ascending aorta in inferior myocardial infarction.

    Directory of Open Access Journals (Sweden)

    Grahame K. Goode

    2011-06-01

    Full Text Available Acute aortic dissection is a cardiac emergency which can present as inferior myocardial infarction. It has high morbidity and mortality requiring prompt diagnosis and treatment. Rapid advances in noninvasive imaging modalities have facilitated the early diagnosis of this condition and in ruling out this potentially catastrophic illness. We report an interesting case of a 57 year- old -man who presented with inferior myocardial infarction requiring thrombolysis and temporary pacing wire for complete heart block. An echocardiogram was highly suspicious of aortic dissection. CT scan confirmed that the malposition of the temporary pacing wire through the aorta mimicked aortic dissection.

  4. Pharmacological characterization of the sulphonylurea receptor in rat isolated aorta

    OpenAIRE

    Löffler, Cornelia; Quast, Ulrich

    1997-01-01

    The binding of the sulphonylurea [3H]-glibenclamide, a blocker of adenosine 5′-triphosphate (ATP)-sensitive K+ channels (KATP channels), was studied in endothelium-denuded rings from rat aorta.[3H]-glibenclamide labelled two classes of binding sites with KD values of 20±5 nM and 32±1 μM. The high affinity component, which comprised 17% of total binding at 1 nM [3H]-glibenclamide, had an estimated binding capacity of 150 fmol mg−1 wet weight.Other sulphonylureas such as glipizide and glibornur...

  5. Gunshot injuries of the abdominal aorta: a continuing challenge.

    Science.gov (United States)

    Degiannis, E; Levy, R D; Florizoone, M G; Badicel, T V; Badicel, M; Saadia, R

    1997-04-01

    This is a retrospective study of 57 patients with gunshot injuries of the abdominal aorta. The aortic repair was achieved by various means: lateral aortorraphy, patch aortoplasty and graft insertion. There was an 85 per cent mortality rate from bleeding or secondary coagulopathy directly related to the aortic injuries. The need for resuscitative thoracotomy, shock, lack of response to fluid resuscitation and intraperitoneal bleeding were directly related to mortality. We feel that shortening of prehospital transfer time will increase the absolute number of patients surviving this grave injury. PMID:9274736

  6. Aneurisma de artéria pulmonar como manifestação da doença de Behçet

    OpenAIRE

    SAMANO MARCOS NAOYUKI; LADEIRA RENATA TEIXEIRA; MEIRELES LUIZ PEDRO; PÊGO-FERNANDES PAULO MANUEL

    2002-01-01

    A doença de Behçet pode ser acompanhada de manifestações pulmonares, às vezes letais se não tratadas adequadamente. Descreve-se o caso de um homem de 53 anos com história de episódios de aftas orais e febre havia vários anos, dois quadros febris prolongados nos últimos dois anos, uveíte tratada com corticóide havia 21 meses, hemoptise havia um mês e emagrecimento de 7kg. Ao exame físico apresentava aftas orais, pseudofoliculite e turvação visual. Os estudos radiológicos evidenciaram dilatação...

  7. Preliminary evaluation of the endovascular treatment of intracranial aneurysms with detachable coils in vigil patients Avaliação preliminar do tratamento endovascular de aneurismas intracranianos com espirais destacáveis em pacientes no estado de vigília

    Directory of Open Access Journals (Sweden)

    José Roberto Falco Fonseca

    2006-12-01

    Full Text Available Endovascular treatment of intracranial aneurysms with coil embolization became the most important therapeutic option with better morbidity and mortality rates and quality of life. Following immobility, patients are treated with general anaesthesia. OBJECTIVE: To test viability of endovascular treatment on wake patients. METHOD: Considering clinical symptoms, psychological characteristics and aneurysmal morphology, four patients with five intracranial aneurysms were selected. RESULTS: Four among five cases were completed with this technique. Patient 1 was partially treated after 75 minutes presenting vesical stress. Patient 2 presented subarachnoid hemorrhage after aneurysmal re-rupture, and the procedure was completed under general anaesthesia. The other three patients presented no intercurrences during the treatment. CONCLUSION: Endovascular treatment on wake patients with intracranial aneurysm can be an alternative to a selected group of patients.O tratamento endovascular de aneurismas intracranianos com espirais destacáveis estabeleceu-se como principal opção terapêutica na maioria dos pacientes, por menores taxas de morbidade e mortalidade. De forma geral, os pacientes são tratados sob anestesia geral, pela necessidade de imobilidade. OBJETIVO: Avaliar a viabilidade do tratamento endovascular de aneurismas intracranianos em pacientes no estado de vigília. MÉTODO: Cinco aneurismas foram tratados em quatro pacientes selecionados, considerando-se quadro clínico, a intenção de colaboração do paciente e características morfológicas do aneurisma. RESULTADOS: A abordagem proposta foi possível em quatro dos cinco casos. O paciente 1 obteve compactação parcial do aneurisma, pois o tratamento foi interrompido por desconforto vesical. O paciente 2 apresentou hemorragia subaracnóidea por re-ruptura do aneurisma, e o tratamento foi completado no mesmo tempo sob anestesia geral. Nos demais casos, não houve intercorrências. CONCLUS

  8. Evaluation of atherosclerotic change of the aorta by enhanced computed tomography

    International Nuclear Information System (INIS)

    Intimal atherosclerotic changes of the aorta were quantified by enhanced computed tomography (enhanced CT) and were examined in terms of their relation to other atherosclerotic characteristics, including calcification and aortic pulse wave velocity, diameter of the aorta, and arteriosclerotic risk factors. A total of 413 subjects were studied, consisting of normal volunteers and patients with cardiovascular diseases. Enhanced CT revealed the atheromatous intima as a projecting and thickened wall. Thus, the ratio of the intimal atherosclerotic change to the whole round was determined in various aortic sites. The diameter of the aorta decreased in accordance with the location from the ascending aorta to aortic ending. The diameter of the infrarenal abdominal aorta was 1.5 times larger than that of the ascending aorta, irrespective of age. The diameter of each region of the aorta increased with advancing age; in the age group of 70 years or older, it was 1.5 times larger that that in the age group of 40 years or younger. The intimal change was noted in the middle descending thoracic aorta and infrarenal abdominal aorta. It was proportional to an increase in the aortic pulse wave velocity, the diameter of the aorta, and the intimal calcification. Intimal changes of the aorta were increased in cerebrovascular disease, ischemic heart disease, arteriosclerosis obliterans, hypertension and diabetes mellitus. In particular, hypertension accompanied by diabetes mellitus or high cholesterolemia tended to accelerate the intimal change. In conclusion, aortic intimal changes, as detected on enhanced CT, is useful for the noninvasive diagnosis of arteriosclerosis. (N.K.)

  9. Evaluation of atherosclerotic change of the aorta by enhanced computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Takasu, Junichiro (Chiba Univ. (Japan). School of Medicine)

    1990-10-01

    Intimal atherosclerotic changes of the aorta were quantified by enhanced computed tomography (enhanced CT) and were examined in terms of their relation to other atherosclerotic characteristics, including calcification and aortic pulse wave velocity, diameter of the aorta, and arteriosclerotic risk factors. A total of 413 subjects were studied, consisting of normal volunteers and patients with cardiovascular diseases. Enhanced CT revealed the atheromatous intima as a projecting and thickened wall. Thus, the ratio of the intimal atherosclerotic change to the whole round was determined in various aortic sites. The diameter of the aorta decreased in accordance with the location from the ascending aorta to aortic ending. The diameter of the infrarenal abdominal aorta was 1.5 times larger than that of the ascending aorta, irrespective of age. The diameter of each region of the aorta increased with advancing age; in the age group of 70 years or older, it was 1.5 times larger that that in the age group of 40 years or younger. The intimal change was noted in the middle descending thoracic aorta and infrarenal abdominal aorta. It was proportional to an increase in the aortic pulse wave velocity, the diameter of the aorta, and the intimal calcification. Intimal changes of the aorta were increased in cerebrovascular disease, ischemic heart disease, arteriosclerosis obliterans, hypertension and diabetes mellitus. In particular, hypertension accompanied by diabetes mellitus or high cholesterolemia tended to accelerate the intimal change. In conclusion, aortic intimal changes, as detected on enhanced CT, is useful for the noninvasive diagnosis of arteriosclerosis. (N.K.).

  10. A natação forçada induz subsensibilidade à fenilefrina em aorta torácica de rato Forced-swim induces subsensitivity to phenylephrine in the rat thoracic aorta

    Directory of Open Access Journals (Sweden)

    Maria José C. Sampaio Moura

    2003-12-01

    Full Text Available O estresse pode alterar a função vascular. O objetivo deste trabalho foi estudar a sensibilidade à fenilefrina (FE em aorta torácica de ratos submetidos à natação forçada. Ratos Wistar (200-250 g foram submetidos a três sessões de natação aplicadas em dias consecutivos (15, 30 e 30 min respectivamente. Imediatamente após a última sessão, os animais foram sacrificados e, da aorta torácica foram obtidos anéis (3-5 mm com e sem endotélio. Os anéis foram mantidos em solução de Krebs-Henseleit (37 ºC; 95% O2-5% CO2. A integridade do endotélio foi avaliada pelo relaxamento em resposta à acetilcolina (10 µM, após indução de contração por FE (0,1 µM. Curvas concentração-efeito à FE foram obtidas (n=5/grupo. Não houve diferença na resposta máxima à FE entre os tratamentos controle e estresse, em anéis com e sem endotélio (p>0,05. A natação forçada induziu subsensibilidade à FE em anéis com endotélio de aorta torácica isolada de ratos submetidos à natação (pD2= 6,89 ± 0,07, pStress may change vascular function. The aim of this report was to study the sensitivity to phenylephrine (PHE in the thoracic aorta from rats submitted to forced-swim. Male Wistar rats (200-250 g were submitted to three swimming sessions, one session/day (15, 30 and 30 min, respectively. Immediately after the last swimming session, the animals were sacrificed and thoracic aorta was isolated. Aortic rings (3-5 mm, with and without endothelium, were carefully obtained and were main-tained in Krebs-Henseleit solution (95% O2- 5% CO2, 37 ºC. Endothelial integrity was assessed by relaxation to acetylcholine (10 µM in pre-contracted rings (PHE 0.1 µM. Concentration-effect curves to PHE were obtained (n = 5/group. There was no difference between control and stress groups in the maximum response to PHE of aortic rings with and without endothelium (p>0.05. Forced-swim induced subsensitivity to PHE in aortic rings with endothelium isolated

  11. Simulation of Aorta Artery Aneurysms Using Active Electronic Circuit

    Directory of Open Access Journals (Sweden)

    Kamran Hassani

    2007-01-01

    Full Text Available The fusiform and saccular aneurysms in different aorta artery sections were studied using an electronic circuit of cardiovascular system. The geometrical model of each artery section including thoracic and abdominal were generated in accordance with original anatomical data. By increasing the rate of aneurysm in each studied section, the pressure drop were calculated using CFD method, furthermore the compliance variations due to aneurysms were determined by mathematical method. The equivalent electronic circuit was then used to study the effects of the pressure drops and compliance variations on whole cardiovascular system. The results of the simulation exhibited the features of the pathology, including hypertension, the increase of the pulse pressure with the rate of aneurysm and the large magnitude of back flow during systole. Finally, the obtained results were compared with relevant clinical data .We have concluded from the study that aorta aneurysms in both fusiform and saccular, especially at highest diameters, may be the most important determinant of the artery rapture and heart failure.

  12. Vasorelaxation Effect of Estrone Derivate EA204 in Rabbit Aorta

    Science.gov (United States)

    Li, Wei-Qi

    2016-01-01

    Estrogen and its derivatives exert vascular protective effects, but the underlying mechanisms remain to be studied fully. Objective. To investigate the vasorelaxation effect and related mechanisms of an estrone derivate EA204[3-(2-piperidin-1-yl)-ethoxy-estra-1, 3, 5 (10)-trien-17-one] on isolated arterial preparation from rabbit thoracic aorta. Methods. Aortic rings from rabbit thoracic aorta were prepared and held in small organ bath filled with Krebs solution; tension change was recorded by a multichannel physiological signal collection and handling system. Results. EA204 (10−5 to 10−3 M) induced a concentration-dependent relaxation of aortic rings with endothelium and without endothelium. In denuded arterial preparations, EA204 had a potent relaxing effect on isolated arterial preparations contracted with phenylephrine, norepinephrine, and high-K+ solution or BaCl2. Mechanism study indicates that EA204 relaxes aortic rings by inhibiting Ca2+ channels (both receptor-operating Ca2+ channels and the voltage-dependent Ca2+ channels were involved) to decrease extracellular Ca2+ influx and intracellular Ca2+ release. EA204 is different from verapamil, which is a noncompetitive inhibitor of Ca2+ channels. In addition, K+ channels opening may contribute to this vasorelaxation effect. Conclusion. EA204 had a potent endothelium-independent relaxing effect on isolated arterial preparation by inhibiting Ca2+ channels and opening K+ channels. The results suggest that EA204 is a potential compound for treatment of cardiovascular diseases in postmenopausal women. PMID:27190689

  13. Coarctation of the aorta:Management from infancy to adulthood

    Institute of Scientific and Technical Information of China (English)

    Rachel; D; Torok; Michael; J; Campbell; Gregory; A; Fleming; Kevin; D; Hill

    2015-01-01

    Coarctation of the aorta is a relatively common form of congenital heart disease, with an estimated incidence of approximately 3 cases per 10000 births. Coarctation is a heterogeneous lesion which may present across all age ranges, with varying clinical symptoms, in isolation, or in association with other cardiac defects. The first surgical repair of aortic coarctation was described in 1944, and since that time, several other surgical techniques have been developed and modified. Additionally, transcatheter balloon angioplasty and endovascular stent placement offer less invasive approaches for the treatment of coarctation of the aorta for some patients. While overall morbidity and mortality rates are low for patients undergoing intervention for coarctation, both surgical and transcatheter interventions are not free from adverse outcomes. Therefore, patients must be followed closely over their lifetime for complications such as recoarctation, aortic aneurysm, persistent hypertension, and changes in any associated cardiac defects. Considerable effort has been expended investigating the utility and outcomes of various treatment approaches for aortic coarctation, which are heavily influenced by a patient’s anatomy, size, age, and clinical course. Here we review indications for intervention, describe and compare surgical and transcatheter techniques for management of coarctation, and explore the associated outcomes in both children and adults.

  14. Value of helical computed tomography in diagnosis abdominal aorta aneurysms

    International Nuclear Information System (INIS)

    Civilization progress and achievements of medicine makes the human life longer. The exposure on vessel injuring factors such as smoking and improper diet is still growing. For those reasons the number of abdominal aorta aneurysms also increased. Early detection of this pathology, its therapy and follow up considering the most sophisticated diagnostic methods is very important. In years 2000-2002 2989 helical computed tomography (HCT) examinations of the abdomen were performed in Dolnoslaski Osrodek Diagnostyki Obrazowej. In 173 patients (141 M and 32 F) aneurysms of abdominal aorta have been found. From this group 127 (101 M and 26 F) were patients of Surgical Ward of our hospital. 73 (63 M and 10 F) underwent the surgical operation of prosthesis implantation. 13 persons (11M and 2 F) were primarily qualified for endovascular stent-graft implantation, in 7 male this procedure was performed. In 159 patients AAA was primarily diagnosed in ultrasound (USG) examination (100%). In 10 cases additional MR examination was performed. In 13 patients qualified for stent-grafting we also performed DSA. USG examination revealed high sensitivity in establishing aneurysm diameter. HCT is characterized by significantly higher sensitivity and specificity in evaluation of renal and iliac pervasion, in comparison to USG. HCT allows for detection of concomitant pathologies and complications. HCT is necessary before stent-graft implantation and in the follow-up. There is no significant prevalence of MR over HCT. It should be performed in cases with doubtful renal arteries location, or when HCT is contraindicated. (author)

  15. Aortography delays surgery of CT proven acute traumatic rupture of the thoracic aorta; Case report

    Energy Technology Data Exchange (ETDEWEB)

    Munoz, A.; Moreno, R.; Martin, V.; Iniguez, A.; Alvarez, J. (Hospital Universitario de San Carlos, Madrid (Spain). Dept. de Radiodiagnostico, Servicio de Cirurgia Vascular, Servicio de Exploracion Cardiopulmonar, and Unidad de Cuidados Intensivos)

    1991-09-01

    A case of acute traumatic rupture of the thoracic aorta was diagnosed by dynamic CT. Angiographic confirmation was required, delaying surgical repair and contribution to the fatal outcome. If reliable findings of acute traumatic rupture of the thoracic aorta are shown by CT, we question the usefulness of angiographic confirmation in such cases. (orig.).

  16. MR imaging of the thoracic aorta in patients with Marfan syndrome

    International Nuclear Information System (INIS)

    Gated MR imaging was used to evaluate the thoracic aorta in 11 with Marfan syndrome, eight patients with aneurysm of the ascending aorta, and 20 healthy subjects. The aortic diameter was measured on transverse and sagittal images at the levels of the sinuses of Valsalva, the caudal portion of the ascending aorta, the prearch region, the middle arch, and the descending aorta. The sinus of Valsalva-prearch region aortic diameter ratio in patients with Marfan syndrome was significantly greater than in the two other groups, indicating the characteristic shape of the Maranoid aorta. MR imaging allows definitive measurements' of aortic dimensions and is a valuable noninvasive method for monitoring the course of aortic enlargement

  17. Protective effect of zingerone on increased vascular contractility in diabetic rat aorta.

    Science.gov (United States)

    Ghareib, Salah A; El-Bassossy, Hany M; Elberry, Ahmed A; Azhar, Ahmad; Watson, Malcolm L; Banjar, Zainy M; Alahdal, Abdulrahman M

    2016-06-01

    The aim of the present study was to investigate the effect and possible mechanism of action of zingerone, the main constituent of ginger, on vascular reactivity in isolated aorta from diabetic rats. The results show that incubation of aortae with zingerone alleviates the exaggerated vasoconstriction of diabetic aortae to phenylephrine, as well as the impaired relaxatory response to acetylcholine in a concentration-dependent manner. Furthermore, Zingerone directly relax phenylephrine-precontracted aortae. The vasorelaxatory response is significantly attenuated by the nitric oxide synthase inhibitor Nω-nitro-l-arginine methyl ester hydrochloride and the guanylate cyclase inhibitor methylene blue but no effect of either the potassium channels blocker tetraethylammonium chloride, or the cyclooxygenase inhibitor indomethacin was observed. Zingerone had no effect on advanced glycation end product formation as well. In conclusion, zingerone ameliorates enhanced vascular contraction in diabetic aortae which may be mediated by its vasodilator effect through NO- and guanylate cyclase stimulation. PMID:27020549

  18. [A case report of emergency surgical repair of traumatic transection of thoracic descending aorta].

    Science.gov (United States)

    Noguchi, K; Sudo, K; Kodama, J; Unno, T; Hayashi, N; Tadokoro, M; Kokubo, J; Ikeda, K; Mizuno, A; Tanaka, H

    1991-10-01

    The injury to the thoracic aorta caused by blunt chest trauma is often fatal. This case is 22-year-old male suffering from transection of the thoracic descending aorta caused by traffic accident. He was transported to our emergency room by an ambulance 15 minutes after the accident. Hundred fifty minutes after arrival to the hospital, we were rush to bring him to the operation theater suspecting serious injury of the thoracic organs in association with left hemothorax. The left standard thoracotomy disclosed the injury of the thoracic descending aorta. Simple cross clamp was applied to the thoracic descending aorta distal to the left subclavian artery for 20 minutes. Completely transected aorta was reapproximated using monofilament 3-0 polypropylene sutures with running manner. He tolerated the procedure well without any complication. His postoperative course was uneventful. He was followed up at the orthopedic department for associated hip fracture thereafter. PMID:1942696

  19. Endovascular treatment of thoracic aorta aneurysm and dissection

    International Nuclear Information System (INIS)

    Full text: The aim is to give up to date information about modern endovascular treatment of aortic pathology Dissection and aneurysms of the aorta are life threatening condition requiring in most of the cases prompt surgical or endovascular treatment because of the poor natural evolution. Purpose: to assess the immediate and 1-year outcome of endovascular treatment in broad spectrum of acute and subacute aortic syndrome during the last 3 years (November 2012 - August 2015) in City Clinic (Sofia, Bulgaria). We performed endovascular treatment of 47 patients (43 men, 4 women) at average age 54 y. with dissection (24) and aneurysms (23) of the aortic arch and thoracic aorta (in 5 emergent treatment was performed for aortic rupture). All patients were treated with minimal surgical femoral approach. In 4 (9%) of them initial carotid to carotid bypass was performed in order to provide a sufficient landing zone for the endograft implantation.the last 9 patients (19%) were treated without general anesthesia with either deep sedation or epidural anesthesia. Results: In all patients successful endograft implantation was achieved. Additional stent-graft or open cell stent was implanted in 4 cases in order to centralize the flow in the compressed true lumen. In 5 cases additional vascular plug or large coil was delivered in the left subclavian arteryostium in order to interrupt retrograde aneurysm or false lumen filling. Complications: 30 days mortality-2.2%, neurologic disorders (4.4%). one year survival- 45 (90.5%). 3 and 6 mo control CT scan showed no migration of the graft in 100%, full false lumen isolation in 19 out of 24 dissections (80%) and aneurysm free of expansion in 20 out of 23 (86%), patent carotid bay-pass graft in 4 of 4 (100%). This one center study showed excellent immediate and 1 year clinical and device results from endovascular repair of potentially fatal disease. Endovascular treatment is a method of choice for broad spectrum of aortic pathology

  20. MR angiography of the abdominal aorta: Preliminary results

    International Nuclear Information System (INIS)

    Flowing blood can be demonstrated as bright signal in MR-imaging resulting in MR-angiography (MRA). This study presents the results of MRA using the 'time of flight'-effect in which projection angiograms along the longitudinal axis were established by a row of 2D-gradient echo (GE) images (FLASH) in breathhold technique. The method was proven in 5 normal volunteers and evaluated against DSA in 21 patients with aortic diseases. The preliminary results demonstrate a satisfactory flow signal in the normally perfused aorta; thus occlusions, stenoses, and aneurysms could be defined clearly. In smaller vessels the signal was still insufficient. Diagnostic problems of vascular overlapping can be solved in most cases by rotating the angiograms, and by additional analysis of individual 2D-GE images. In the present form the quality of MRA is still inferior to that of DSA. (orig.)

  1. The AORTA Reasoning Framework - Adding Organizational Reasoning to Agents

    DEFF Research Database (Denmark)

    Jensen, Andreas Schmidt

    Intelligent agents are entities defined by, among other things, autonomy. In systems of many agents, the agents’ individual autonomy can lead to uncertainty since their behavior cannot always be predicted. Usually, this kind of uncertainty is accommodated by imposing an organization upon the system......; an organization that defines expected behavior of the agents and attempts to restrict the agents’ behavior to let it match the expectations. Restrictions can lead to a decrease in autonomy, contradicting one of the pillars of intelligent agents. This thesis presents the AORTA reasoning framework......, which is a practical component (founded in logic) that enriches intelligent agents with organizational reasoning capabilities. We take the agent’s perspective by devising a component that integrates with the agent’s usual reasoning capabilities in a non-intrusive way. This results in agents that are...

  2. Ayahuasca Alters Structural Parameters of the Rat Aorta.

    Science.gov (United States)

    Pitol, Dimitrius L; Siéssere, Selma; Dos Santos, Rafael G; Rosa, Maria L N M; Hallak, Jaime E C; Scalize, Priscilla H; Pereira, Bruno F; Iyomasa, Melina M; Semprini, Marisa; Riba, Jordi; Regalo, Simone C H

    2015-07-01

    Ayahuasca is a hallucinogenic brew traditionally used by Northwestern Amazonian indigenous groups for therapeutic purposes. It is prepared by the decoction of Banisteriopsis caapi with the leaves of Psychotria viridis. Banisteriopsis caapi contains β-carbolines that are inhibitors of monoamine oxidase and P. viris is rich in dimethyltryptamine, a 5-HT(1A/2A/2C) agonist. Acute ayahuasca administration produces moderate cardiovascular effects in healthy volunteers, but information regarding long-term use is lacking. This study investigated the effects of ayahuasca (2-4 mL/kg) in the rat aorta after acute and chronic (14 days) administration. Ayahuasca caused flattening and stretching of vascular smooth muscle cells and changes in the arrangement and distribution of collagen and elastic fibers. Chronic treatment with the higher dose significantly increased media thickness and the ratio of media thickness to lumen diameter. More research is needed on the cardiovascular function of long-term ayahuasca consumers. PMID:25714595

  3. MR imaging of the aorta following coarctation repair

    International Nuclear Information System (INIS)

    Electrocardiographically gated, spin-echo MR imaging was performed in 13 children, aged 1 year to 19 years (mean, 8.7 years), who had previous coarctation repair from 4 months to 15 years (mean, 3 years) prior to imaging. Nine had end-to-end anastomotic repairs, two had subclavian flaps, and two had Dacron patch aortoplasties. Initial axial localizing scans (echo time, 20 msec) followed by direct sagittal scanning were used to obtain images through the repair site. Comparison was made between cross-sectional dimensions at, and just distal to, the site of anastomosis. There was good correlation between clinical findings, catheterization data, and MR imaging. MR imaging offers a useful technique to evaluate the aorta following coarctation repair

  4. Percutaneous transluminal angioplasty (PTA) of the infrarenal abdominal aorta

    International Nuclear Information System (INIS)

    The results of percutaneous transluminal angioplasty (PTA) (n=13) of the lower abdominal aorta are reported in 12 patients. The mean patient age was relatively low (46 years). In 7 cases there were isolated aortic obstructions (6 stenoses, 1 occlusion). In the remaining 6 aortic stenoses, there were also major atherosclerotic lesions distally. The mean diameter of the aortic section in which PTA was performed, measured 8.2 mm. The total diameter of the PTA balloon(s) averaged 19.1 mm. The arterial gradient dropped significantly from 41.4 mm Hg (mean) to 2 mm Hg after PTA. The arm-ankle index increases significantly from 0.64 to 0.97. The follow-up included 9 patients; 1 showed restenosis 38 month after PTA. There were no clinically relevant complications. The data published on abdominal PTA in atherosclerotic lesions are summarized. (orig.)

  5. Resolución microquirúrgica de aneurisma de arteria cubital en paciente pediátrico

    OpenAIRE

    A. Aguilera-Salgado; C. Gargollo-Orvañanos; J. López-Mendoza; P. Arrieta-Joffe; D. Palafox-Vidal

    2015-01-01

    Presentamos el caso clínico de un paciente varón de 6 años de edad con antecedente de caída desde su propia altura un mes antes de su valoración en consulta, en donde se identifica una tumoración pulsátil en región hipotenar de mano derecha, no dolorosa y no fija a planos profundos. El ultrasonido doppler informa de una tumoración con pared definida, heterogénea, con flujo sanguíneo a través de la misma. En base a los antecedentes y a los resultados del ultrasonido se decide intervenir quirúr...

  6. Avaliação por imagem da paralisia de pregas vocais Imaging evaluation of vocal cord paralysis

    OpenAIRE

    Marcelo de Mattos Garcia; Fabiana Pizanni Magalhães; Gabriela Bijos Dadalto; Marina Vimieiro Timponi de Moura

    2009-01-01

    Paralisia das pregas vocais é causa frequente de rouquidão, podendo ser secundária a várias lesões ao longo do trajeto do X par craniano e seus ramos, particularmente os nervos laríngeos recorrentes. Apesar de grande parte dos casos ser idiopática, os métodos de imagem são muito importantes na pesquisa de fatores etiológicos, tais como lesões neoplásicas da tireoide e esôfago com invasão secundária dos nervos laríngeos recorrentes. Além destas, outras anormalidades como aneurismas do arco aór...

  7. Hemoptise e hemotórax como apresentação de ruptura de aorta torácica Hemoptysis and hemothorax as presentation of thoracic aortic rupture

    Directory of Open Access Journals (Sweden)

    Márcio Silva Miguel Lima

    2009-06-01

    Full Text Available Dissecção da aorta torácica é doença de grande mortalidade em sua fase inicial, mas pode, em alguns casos, se cronificar. Relatamos caso de paciente com dissecção crônica de aorta tipo B (Stanford, admitido na Emergência com confusão mental, dispnéia e relato de hemoptise importante. O eletrocardiograma mostrava alterações inespecíficas e a radiografia de tórax revelou opacificação do hemitórax esquerdo. O ecocardiograma transtorácico não evidenciou dissecção aórtica, mas demonstrou imagem compatível com hemotórax, ocasionando a suspeita de ruptura da aorta. O paciente evoluiu em colapso cardiovascular e óbito. Este caso descreve duas apresentações atípicas da dissecção de aorta: hemotórax e hemoptise importante.Thoracic aortic dissection is a disease of great mortality in its initial phase, but in some cases it can assume chronic course. We report a case of a patient with Stanford type A1 aortic dissection, admitted with mental confusion, dyspnea and event of severe hemoptysis. Electrocardiogram showed unspecific change and chest X-ray revealed opacification of the left hemithorax. Transthoracic echocardiogram did not show aortic dissection, but showed image similar to hemithorax leading to the suspicion of aortic rupture. The patient developed cardiovascular collapse and evolved to death. This case describes two unusual presentations of aortic dissection: hemothorax and severe hemoptysis.

  8. Experiência inicial com o uso de adesivo tissular contendo trombina para tratamento do pseudo-aneurisma femoral Treatment of femoral pseudoaneurysm with thrombin tissue adhesive: initial experience

    OpenAIRE

    Daniel Mendes Pinto; José Olimpio Dias Júnior; Bernardo Lopes Cançado Fonseca; Rodrigo Daniel Moreialvar; Leonardo Ghizoni Bez; Caetano de Sousa Lopes

    2006-01-01

    O pseudo-aneurisma (PSA) após cateterização femoral tem sido diagnosticado com regularidade em serviços com grande movimento de intervenções percutâneas, com incidência variando de 0,05 a 6%. PSA femorais pequenos podem ser acompanhados até a resolução espontânea. As opções de tratamento são: compressão guiada por ultra-som, injeção de trombina para trombose do PSA e tratamento cirúrgico. A injeção percutânea de trombina tem a vantagem de ser um procedimento indolor e rápido. Podem ser utiliz...

  9. Epiaortic fat pad area: A novel index for the dimensions of the ascending aorta.

    Science.gov (United States)

    Toufan, Mehrnoush; Pourafkari, Leili; Boudagh, Shabnam; Nader, Nader D

    2016-06-01

    We sought to investigate the possible association between the area of the epiaortic fat pad (EAFP) and dimensions of the ascending aorta. A total of 193 individuals underwent transthoracic echocardiography (TTE) prospectively. The area of the EAFP was traced anterior to the aortic root and correlated with the diameter of the aorta. The mean area of the EAFP was 5.16 ± 2.28 cm(2) Absolute and indexed dimensions of the ascending aorta had a significant correlation with the area of the EAFP (p 65 (p 30 kg/m(2) (p = 0.02) and a history of hyperlipidemia (p = 0.003) were identified as independent predictors of the area for EAFP. In conclusion, both the absolute and indexed diameters of the ascending aorta at the different segments that directly come into contact with the EAFP linearly correlate with the area of the EAFP measured by TTE. PMID:27013643

  10. Pharmacology of Endothelium-Dependent and Independent Relaxation of Rabbit Aorta

    DEFF Research Database (Denmark)

    Larsen, Kirsten Vendelbo

    2001-01-01

    adrenergic drugs was studied with regard to the possible dependence on endothelium and possible release of nitric oxide (NO). Isolated rabbit thoracis aorta was used for isometric tension measurements; measurements of NO metabolites (Griess Reaction); and eNOS activity measurements (L-citrulline assay). The...... acetylcholine-evoked relaxation of rabbit thoracic aorta was: independent of EDTA and ascorbic acid; the same whether the physiological salt solution (PSS) was oxygenated with 95% or 21 % O2; independent of the phenylephrine-evoked precontractile tension; and did not differ in unstored or cold strored aorta. It...... concluded that phenylephrine-evoked precontraction of rabbit aorta causes a basal release of NO. The amount of basally released NO is the same independent of gender and it is inactivated by oxygen radicals and divalent metal ions. The acetylcholine-evoked relaxation was uniform along the length of rabbit...

  11. A pathophysiologic enigma. Association of severe central cyanosis and dilatation of the ascending aorta

    International Nuclear Information System (INIS)

    This article is about two cases of severe central cyanosis with ascending dilated aorta presence. It highlights the role of echocardiography in the trans thoracic and trans esophageal modes as methods of definitive diagnosis

  12. Anatomic radiological study of transverse diameter of abdominal aorta by computerized tomography

    International Nuclear Information System (INIS)

    The transverse diameter of abdominal aorta by computerized tomography is studied. The purpose is establish the frequent standard diameters and then diagnose early pathologies, mainly aneurisms. (M.A.C.)

  13. Cardiovascular magnetic resonance of quinticuspid aortic valve with aortic regurgitation and dilated ascending aorta

    OpenAIRE

    Zhang Zhaoqi; Zhang Lijun; Meng Yanfeng; Wang Yongmei; Yang Xiaoming

    2009-01-01

    Abstract We report a rare case of a quinticuspid aortic valve associated with regurgitation and dilation of the ascending aorta, which was diagnosed and post-surgically followed up by cardiovascular magnetic resonance and dual source computed tomography.

  14. Vector flow imaging of the ascending aorta. Are systolic backflow and atherosclerosis related?

    DEFF Research Database (Denmark)

    Hansen, Kristoffer Lindskov; Møller-Sørensen, Hasse; Kjaergaard, Jesper; Jensen, Maiken Brit; Lund, Jens Teglgaard; Nielsen, Michael Bachmann; Jensen, Jørgen Arendt

    2015-01-01

    the ascending aorta in long axis view. The presence of systolic backflow, visualized with TO, was correlated to aortic atherosclerosis, to systolic velocities obtained with transesophageal echocardiography and cardiac output obtained with pulmonary artery catheter thermodilution, to gender, age...

  15. Left Anterolateral Thoracotomy for Simultaneous Correction of Ventricular Septal Defect and Coarctation of the Aorta

    OpenAIRE

    Chu, Shu-Hsun; Chou, Nai-Kuan; Chou, Tsai-Fwu; Wang, Shoei-Shen

    1994-01-01

    Three patients with ventricular septal defect and coarctation of the aorta were treated successfully by simultaneous correction of both anomalies through a single incision via a left transsternal anterolateral thoracotomy. (Texas Heart Institute Journal 1994; 21:158-60)

  16. Calcified congenital aneurysm of the left sinus of Valsalva associated with coarctation of the aorta

    International Nuclear Information System (INIS)

    A case of calcified unruptured congenital aneurysm of the left sinus of Valsalva associated with coarctation of the aorta is presented. Routine chest radiographs demonstrated unusual curvilinear calcifications at the cardiac base which were subsequently demonstrated within the aneurysm. (orig.)

  17. [Aneurysm of the abdominal aorta and preoperative disseminated intravascular coagulation].

    Science.gov (United States)

    Chauvet, V; Bussac, J J; Jullian, H; Juhan-Vague, I; Branchereau, A

    1991-01-01

    A case of abdominal aortic aneurysm associated with preoperative signs of disseminated intravascular coagulation is reported. The 69-year-old female patient presented with spontaneously appearing petechiae and bruising. She had 0.95 g.l-1 fibrinogen, 105 G.l-1 platelets, and 100 micrograms.ml-1 fibrin and fibrinogen degradation products. Investigations revealed an 80 mm diameter aneurysm of the abdominal aorta, extending from the coeliac trunk to the iliac arteries. Heparin 7,000 IU.day-1 resulted in a biological improvement for a week only. At that time, levels of coagulation factors were: 92% factor II, 88% factor V, 100% factors VII and X, 100% antithrombin III. Surgical cure of the aneurysm was nevertheless carried out. Twenty standard units of platelets, 8 g fibrinogen, four units of fresh frozen plasma, five homologous and two autologous red cell units were transfused during the procedure. No coagulation factors were necessary during the postoperative course, which was uneventful. The management of coagulation factor infusions, before or after aortic cross-clamping, is discussed. PMID:2058833

  18. Ruptured Sinus of Valsalva Aneurysm and Coarctation of Aorta in a Woman at Early Postpartum Period

    Directory of Open Access Journals (Sweden)

    Erol Sener

    2014-01-01

    Full Text Available Coarctation of aorta and sinus of Valsalva aneurysm are frequently missed congenital cardiac defects that their diagnosis might be delayed. To our knowledge, coincidence of these cardiac defects is unusual and has not been reported in the literature before. Here, we present a patient with coarctation of aorta and ruptured noncoronary sinus of Valsalva aneurysm leading to aorto-right atrial fistula in the early postpartum period and our management of this unusual case.

  19. Excitatory effect of Clostridium perfringens alpha toxin on the rat isolated aorta.

    OpenAIRE

    Fujii, Y.; Nomura, S; Oshita, Y.; Sakurai, J

    1986-01-01

    Clostridium perfringens alpha toxin caused contraction of the isolated aorta of the rat in a dose-dependent manner. The contractile action caused by the toxin was inhibited or abolished by calcium antagonists such as nifedipine, verapamil and cinnarizine, or a Ca-free medium, but was not affected by phentolamine, chlorpheniramine, atropine, tetrodotoxin or a low Na medium. The toxin stimulated Ca uptake into the aorta in a dose-dependent manner. 8-N,N'-diethylaminooctyl-3,4,5-trimethoxybenzoa...

  20. Aorta-to-right atrium fistula, an unusual complication of endocarditis

    OpenAIRE

    Chen, Miao-yan; Zhong, Dan-dan; Ying, Zhi-qiang

    2009-01-01

    Infective endocarditis (IE) remains a serious disease. Aorta-to-right atrium fistula is a rare but very serious complication of IE and predicts a higher mortality. This report describes a 50-year-old man with endocarditis, vegetation, perforation of noncoronary sinus, and formation of two aorta-to-right atrium fistulas with native valves detected by transthoracic echocardiography. This disease is lethal despite developments in cardiac imaging and antibacterial therapy. Early diagnosis, aggres...

  1. Selective inhibition of NADPH oxidase reverses the over contraction of diabetic rat aorta

    Directory of Open Access Journals (Sweden)

    Atif ur Rehman

    2014-01-01

    Male Wistar rats were injected intraperitoneally with 65 mg/kg STZ and development of diabetes was confirmed by testing blood glucose levels. Rats were killed by CO2 asphyxiation, and the thoracic aorta removed and mounted in an organ bath under a tension of 1 g. Diabetic rat aortas exhibit a greatly increased response to phenylephrine, which was reduced to a level consistent with control rat aorta by 10−5 M VAS2870 and 150 U/ml SOD. Incubation with VAS2870 led to an increase in normal rat aorta contraction, but led to a significant reduction in phenylephrine and U46619 induced tone in diabetic rat aorta, which indicates that ROS in diabetic rats directly contributes to these contractile responses. Apocynin and allopurinol had no effect on contraction in diabetic or normal rat aorta. This data is the first to show that selective inhibition of NOX reduces diabetic arterial contraction in direct comparison with inhibition of other known contributors of ROS.

  2. Prospective ECG-gated 320-row CT angiography of the whole aorta and coronary arteries

    Energy Technology Data Exchange (ETDEWEB)

    Li, Yu.; Fan, Zhanming; Xu, Lei; Yang, Lin; Xin, Haiyan; Zhang, Nan [Capital Medical University, Department of Radiology, Beijing An Zhen Hospital, Beijing (China); Capital Medical University, Ministry of Education, The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Beijing An Zhen Hospital, Beijing (China); Zhang, Zhaoqi [Capital Medical University, Department of Radiology, Beijing An Zhen Hospital, Beijing (China)

    2012-11-15

    To investigate the feasibility of using a prospective ECG-gated wide-volume protocol in CT angiography (CTA) of the whole aorta and coronary arteries (CA). A total of 61 consecutive patients with suspected acute aortic diseases underwent CTA of the whole aorta using a prospective ECG-gated wide-volume CT protocol without heart rate (HR) control. The exposure window was set at 40-50 % of R-R interval (HR {>=}70 bpm) or 70-80 % of R-R interval (HR <70 bpm) in a single heartbeat. The image quality of the ascending aorta, aortic valve and CA was evaluated for motion artefacts. The mean attenuation was measured at different levels of the aorta. The radiation dose and contrast medium volume were recorded. All of the examinations were performed successfully. The image quality was acceptable in the ascending aorta, aortic valve (100 %) and CA (94.4 %). The mean radiation dose was 18.42 {+-} 5.02 mSv. Of 61 patients, 14 were diagnosed with aortic aneurysm and 35 were diagnosed with aortic dissection or intramural haematoma. Coronary artery stenosis was detected in 12 patients. For patients with aortic diseases, CTA of the whole aorta using a prospective ECG-gated wide-volume protocol has the potential to provide additional information about the CA and aortic valve with lower radiation exposure. (orig.)

  3. Effect of coarctation of the aorta and bicuspid aortic valve on flow dynamics and turbulence in the aorta using particle image velocimetry

    Science.gov (United States)

    Keshavarz-Motamed, Zahra; Garcia, Julio; Gaillard, Emmanuel; Maftoon, Nima; Di Labbio, Giuseppe; Cloutier, Guy; Kadem, Lyes

    2014-03-01

    Blood flow in the aorta has been of particular interest from both fluid dynamics and physiology perspectives. Coarctation of the aorta (COA) is a congenital heart disease corresponding to a severe narrowing in the aortic arch. Up to 85 % of patients with COA have a pathological aortic valve, leading to a narrowing at the valve level. The aim of the present work was to advance the state of understanding of flow through a COA to investigate how narrowing in the aorta (COA) affects the characteristics of the velocity field and, in particular, turbulence development. For this purpose, particle image velocimetry measurements were conducted at physiological flow and pressure conditions, with three different aorta configurations: (1) normal case: normal aorta + normal aortic valve; (2) isolated COA: COA (with 75 % reduction in aortic cross-sectional area) + normal aortic valve and (3) complex COA: COA (with 75 % reduction in aortic cross-sectional area) + pathological aortic valve. Viscous shear stress (VSS), representing the physical shear stress, Reynolds shear stress (RSS), representing the turbulent shear stress, and turbulent kinetic energy (TKE), representing the intensity of fluctuations in the fluid flow environment, were calculated for all cases. Results show that, compared with a healthy aorta, the instantaneous velocity streamlines and vortices were deeply changed in the presence of the COA. The normal aorta did not display any regions of elevated VSS, RSS and TKE at any moment of the cardiac cycle. The magnitudes of these parameters were elevated for both isolated COA and complex COA, with their maximum values mainly being located inside the eccentric jet downstream of the COA. However, the presence of a pathologic aortic valve, in complex COA, amplifies VSS (e.g., average absolute peak value in the entire aorta for a total flow of 5 L/min: complex COA: = 36 N/m2; isolated COA = 19 N/m2), RSS (e.g., average peak value in the entire aorta for a total flow of 5

  4. Abdominal aorta coarctation: The first three case reports in our literature

    Directory of Open Access Journals (Sweden)

    Gajin Predrag

    2010-01-01

    Full Text Available Introduction. Congenital coarctation of the thoracic aorta at the ligamentum arteriosum or the aortic arch is well recognized. But a much less common variety (0.5-2.0% of aortic coarctation is located in the distal thoracic aorta or abdominal aorta or both and is often called 'middle aortic syndrome' or 'midaortic dysplastic syndrome'. This represents serious pathological condition and indicates multidisciplinary therapy approach. Outline of Cases. From 1996 to 2007, at the Vascular Surgery Clinic of the Institute for Cardiovascular Diseases 'Dedinje', Belgrade, three patients were treated due to abdominal aorta coarctation, two females aged 55 and 50 and a 4-year-old child. The patients were treated surgically (by-pass with a prosthetic graft and patch angioplasty and endovascular-percutaneous transluminal angioplasty (PTA with and without a stent. The follow-up period was 3-70 months. In the 50-year-old patient, angiography showed severe narrowing of the suprarenal segment of the abdominal aorta. Thoraco-abdominal bypass with a 16 mm dacronic tubular graft was performed. In the 4-year-old patient angiography also showed a suprarenal aorta narrowing. In the first act patch angioplasty was performed and after PTA of the visceral arteries was done on several occasions. In the 55-year-old patient, after diagnostic angiography, infrarenal aorta coarctation was registered. PTA was performed with stent placement. All patients were asymptomatic on control check-ups. Conclusion. Abdominal coarctation is a pathological disease which is seldom found in vascular surgery. Angiography is of major importance for setting the diagnosis and for the control of the results of surgical and nonsurgical treatment. The combination of surgical and endovascular treatment in our patients showed very good results in the studied period.

  5. Remote hemorrhage from the site of craniotomy Hemorragia à distância da área da craniotomia

    Directory of Open Access Journals (Sweden)

    José Alberto Landeiro

    2004-09-01

    Full Text Available Postoperative intracranial hemorrhage is a serious and sometimes a fatal neurosurgical complication. Hemorrhage occurring at regions remote from the site of intracranial operations comprises an uncommon affection, most ignored by the assistant physicians. It bares a still incomprehensive pathophysiology, despite several theories trying to explain it. Looks like a common sense that the presence of the remote site hemorrhage cannot be related to concomitant presence of hypertension, coagulopathy or undiscovered lesions. We report three cases of postoperative hemorrhages occurring in a remote site of supratentorial craniotomies, two patients presented cavernous sinus meningeoma and one patient was submitted to intracranial vascular surgery.Hemorragia intracraniana de ocorrência em pós-operatório é grave complicação das cirurgias intracranianas. O aparecimento de foco hemorrágico em regiões distantes ao sítio operatório original é considerado incomum, e muitas vezes ignorado pelos médicos assistentes. A fisiopatologia envolvida no processo não é de todo compreendida, apesar das diversas teorias já propostas. São apresentados três casos de hemorragia á distancia da área cirúrgica, no pós-operatório de dois pacientes portadores de meningeoma do seio cavernoso e de um submetido à clipagem de aneurisma intracraniano.

  6. Tratamento da síndrome da veia cava superior Treatment of superior vena cava syndrome

    OpenAIRE

    Luís Marcelo Inaco Cirino; Rafael Ferreira Coelho; Ivan Dias da Rocha; Bernardo Pinheiro de Senna Nogueira Batista

    2005-01-01

    A veia cava superior é formada pela união das duas veias inominadas, direita e esquerda, e localiza-se no mediastino médio, à direita da artéria aorta e anteriormente à traquéia. A síndrome da veia cava superior representa um conjunto de sinais (dilatação das veias do pescoço, pletora facial, edema de membros superiores, cianose) e sintomas (cefaléia, dispnéia, tosse, edema de membro superior, ortopnéia e disfagia) decorrentes da obstrução do fluxo sanguíneo através da veia cava superior em d...

  7. Composition of proteoglycans in the aortas of copper-deficient rats

    Energy Technology Data Exchange (ETDEWEB)

    Radhakrishnamurthy, B.; Ruiz, H.; Dalferes, E.R. Jr.; Klevay, L.M. (Louisiana State Univ. Medical Center, New Orleans (USA)); Berenson, G. (Department of Agriculture, Grand Forks, ND (USA))

    1989-01-01

    Copper deficiency adversely affects the extracellular matrix of the arterial wall, leading to cardiovascular lesions. To study the lesions resulting from copper deficiency, the composition of proteoglycans from aortas of copper-deficient rats was compared with proteoglycans of aortas from copper-supplemented rats. Copper deficiency in rats was verified by copper levels in adrenal glands (mean {plus minus} SE, 0.37 {plus minus} 0.07 vs 1.03 {plus minus} 0.17 {mu}g/g wet wt in supplemented rats). Total uronate in the aortas from copper-deficient rats was 25% greater than in aortas from copper-supplemented rats, and the proteoglycans from copper-deficient rat aortas were of greater molecular size. Among the glycosaminoglycans the concentration ({mu}g/mg tissue) of isomeric chondroitin sulfates, particularly dermatan sulfate, was greater in copper-deficient animals than in copper-supplemented animals. These observations are similar to earlier findings in experimental atherosclerosis and to a response of cardiovascular connective tissue to injury.

  8. Shape of the dilated aorta in children with bicuspid aortic valve

    International Nuclear Information System (INIS)

    The dilated aorta in adults with bicuspid aortic valve has been shown to have different shapes, but it is not known if this occurs in children. This observational study was performed to determine if there are different shapes of the dilated aorta in children with bicuspid aortic valve and their association with age, gender, hemodynamic alterations, and degree of aortic enlargement. One hundred and eighty-seven echocardiograms done on pediatric patients (0 – 18 years) for bicuspid aortic valve, during 2008, were reviewed. Aortic valve morphology, shape/size of the aorta, and pertinent hemodynamic alterations were documented. Aortic dilation was felt to be present when at least one aortic segment had a z-score > 2.0; global aortic enlargement was determined by summing the aortic segment z-scores. The aortic shape was assessed by age, gender, valve morphology, and hemodynamic alterations. Aortic dilation was present in 104/187 patients. The aorta had six different shapes designated from S1 through S6. There was no association between the aortic shape and gender, aortic valve morphology, or hemodynamic abnormalities. S3 was the most common after the age of six years and was associated with the most significant degree of global aortic enlargement. The shape of the dilated aorta in children with bicuspid aortic valve does not occur in a uniform manner and multiple shapes are seen. S2 and S3 are most commonly seen. As aortic dilation becomes more significant, a single shape (S3) becomes the dominant pattern

  9. Polydimethylsiloxane embedded mouse aorta ex vivo perfusion model: proof-of-concept study focusing on atherosclerosis

    Science.gov (United States)

    Wang, Xueya; Wolf, Marc P.; Keel, Rahel Bänziger; Lehner, Roman; Hunziker, Patrick R.

    2012-07-01

    Existing mouse artery ex vivo perfusion models have utilized arteries such as carotid, uterine, and mesenteric arteries, but not the aorta. However, the aorta is the principal vessel analyzed for atherosclerosis studies in vivo. We have devised a mouse aorta ex vivo perfusion model that can bridge this gap. Aortas from apoE(-/-) mice are embedded in a transparent, gas-permeable, and elastic polymer matrix [polydimethylsiloxane (PDMS)] and artificially perfused with cell culture medium under cell culture conditions. After 24 h of artificial ex vivo perfusion, no evidence of cellular apoptosis is detected. Utilizing a standard confocal microscope, it is possible to image specific receptor targeting of cells in atherosclerotic plaques during 24 h. Imaging motion artifacts are minimal due to the polymer matrix embedding. Re-embedding of the aorta enables tissue sectioning and immuno-histochemical analysis. The ex vivo data are validated by comparison with in vivo experiments. This model can save animal lives via production of multiple endpoints in a single experiment, is easy to apply, and enables straightforward comparability with pre-existing atherosclerosis in vivo data. It is suited to investigate atherosclerotic disease in particular and vascular biology in general.

  10. Aortic dissection with the entrance tear in transverse aorta: analysis of 12 autopsy patients.

    Science.gov (United States)

    Roberts, C S; Roberts, W C

    1990-11-01

    Clinical and autopsy findings are described in 12 patients who had fatal aortic dissection with the entrance tear in the transverse aorta. The 12 patients represent 7% of 182 autopsies of spontaneous aortic dissection studied by us. The ages of the 12 patients at death ranged from 37 to 87 years (mean, 67 years). Eight were men; 8 had a history of systemic hypertension, and 10 had hearts of increased weight. Diagnosis of aortic dissection was made during life in only 4 of the 12 patients. All 12 patients died of rupture of the false channel within 2 weeks of onset of signs or symptoms compatible with dissection. The direction of aortic dissection from the entrance tear was entirely retrograde in 4 patients, entirely anterograde in 4 patients, and in both directions in 4 patients. Hemopericardium occurred in the first group, left hemothorax in the second group, and either in the last group. Of the 8 patients in whom the ascending aorta was involved, the retrograde dissection in each extended to the aortic root, 6 had pulmonary adventitial hemorrhage, and 4 had involvement of the arch arteries by dissection. In the 4 patients with strictly anterograde dissection, none had dissection in the arch arteries. Thus, tear in the transverse aorta causes a dissection that is usually fata, that often dissects retrogradely, and that may mimic dissection from a tear in ascending aorta. Aortic dissection from a tear in transverse aorta requires early operative intervention. PMID:2241339

  11. Beat Pressure and Comparing it with Ascending Aorta Pressure in Normal and Abnormal Conditions

    CERN Document Server

    Ghasemalizadeh, Omid; Firoozabadi, Bahar; Sajadi, Behrang; Zolfonoon, Ali

    2014-01-01

    Lumped method (Electrical analogy) is a quick and easy way to model human cardiovascular system. In this paper Lumped method is used for simulating a complete model. It describes a 36-vessel model and cardiac system of human body with details that could show hydrodynamic parameters of cardiovascular system. Also this paper includes modeling of pulmonary, atrium, left and right ventricles with their equivalent circuits. Exact modeling of right and left ventricles pressure with division of ascending aorta into 27 segments increases the accuracy of our simulation. In this paper we show that a calculated pressure for aorta from our complex circuit is near to measured pressure by using advanced medical instruments. Also it is shown that pressure graph from brachial is so near to aortic pressure because of this its pressure signal is usable instead of aortic pressure. Furthermore, obstruction in ascending aorta, brachial and its effects has been showed in different figures.

  12. Huge Dissected Ascending Aorta Associated with Pseudo Aneurysm and Aortic Coarctation Feridoun

    Directory of Open Access Journals (Sweden)

    Feridoun Sabzi

    2015-10-01

    Full Text Available We report a unique case of chronic dissection of the ascending aorta complicated with huge and thrombotic pseudoaneurysm in a patient with coarctation of descending aorta. Preoperative investigations such as transesophageal echocardiography (TEE confirmed the diagnosis of dissection. Intraoperative findings included a12 cm eccentric bulge of the right lateral side of dilated the ascending aorta filled with the clot and a circular shaped intimal tear communicating with an extended hematoma and dissection of the media layer. The rarity of the report is an association of the chronic dissection with huge pseudoaneurysm and coarctation. The patient underwent staged repair of an aneurysm and coarctation and had an uneventful postoperative recovery period.

  13. Thrombosis of abdominal aorta during cisplatin-based chemotherapy of testicular seminoma - a case report

    Directory of Open Access Journals (Sweden)

    Gehrckens Ralf

    2009-12-01

    Full Text Available Abstract Background Vascular complications occurring during cisplatin-based chemotherapy of germ cell tumours are inadequately recognized to date. Case Presentation A 49 year old man with advanced seminoma underwent two courses of chemotherapy according to the PEB regimen. Upon restaging, two thrombotic deposits were noted in the descending part of the thoracic aorta and in the infrarenal abdominal aorta, respectively. Although thrombotic plaques caused aortic occlusion of about 30%, no clinical signs of malperfusion of limbs were registered. The patient was placed on anticoagulant therapy. Six months after completion of chemotherapy, thrombotic deposits had completely resolved. In the absence of other predisposing factors, it must be assumed that cisplatin-based chemotherapy represented a strong stimulus for arterial thrombosis in the aorta. Conclusions This is the first case of endo-aortic thrombosis during chemotherapy for testicular germ cell cancer. Providers of chemotherapy must be aware of arterial thrombosis even in young patients with testicular cancer.

  14. [Surgical Repair of Coarctation of the Aorta in an Adult;Report of a Case].

    Science.gov (United States)

    Hara, Masanori; Kawasaki, Muneyasu; Tokuhiro, Keiichi; Niitsu, Katsushi; Katayanagi, Tomoyuki; Watanabe, Yoshinori

    2015-06-01

    We present a case of 30-year-old man with successful bypass grafting for coarctation of the aorta. Hypertension was identified during a health examination. Blood pressure difference between the upper and lower limbs was about 60 mmHg. Computed tomography( CT) revealed stenosis of the distal aortic arch and development of collateral arteries. The pressure gradient across the coarctation by catheterization was 56 mmHg. After left thoracotomy through the 4th intercostal space, a bypass graft using a 14-mm woven Dacron graft was placed between the left subclavian artery and descending aorta without the use of extracorporeal circulation. Postoperative course was satisfactory, with minimal pressure difference between the upper and lower extremities. The patient was discharged 16 days postoperatively. As of 7 years later, he remains asymptomatic, and CT has revealed no marked changes of the aorta or bypass graft. PMID:26066879

  15. Ovariectomy increases the participation of hyperpolarizing mechanisms in the relaxation of rat aorta.

    Directory of Open Access Journals (Sweden)

    Ana Sagredo

    Full Text Available This study examines the downstream NO release pathway and the contribution of different vasodilator mediators in the acetylcholine-induced response in rat aorta 5-months after the loss of ovarian function. Aortic segments from ovariectomized and control female Sprague-Dawley rats were used to measure: the levels of superoxide anion, the superoxide dismutases (SODs activity, the cGMP formation, the cGMP-dependent protein kinase (PKG activity and the involvement of NO, cGMP, hydrogen peroxide and hyperpolarizing mechanisms in the ACh-induced relaxation. The results showed that ovariectomy did not alter ACh-induced relaxation; incubation with L-NAME, a NO synthase inhibitor, decreased the ACh-induced response to a lesser extent in aorta from ovariectomized than from control rats, while ODQ, a guanylate cyclase inhibitor, decreased that response to a similar extent; the blockade of hyperpolarizing mechanisms, by precontracting arteries with KCl, decreased the ACh-induced response to a greater extent in aortas from ovariectomized than those from control rats; catalase, that decomposes hydrogen peroxide, decreased the ACh-induced response only in aorta from ovariectomized rats. In addition, ovariectomy increased superoxide anion levels and SODs activity, decreased cGMP formation and increased PKG activity. Despite the increased superoxide anion and decreased cGMP in aorta from ovariectomized rats, ACh-induced relaxation is maintained by the existence of hyperpolarizing mechanisms in which hydrogen peroxide participates. The greater contribution of hydrogen peroxide in ACh-induced relaxation is due to increased SOD activity, in an attempt to compensate for increased superoxide anion formation. Increased PKG activity could represent a redundant mechanism to ensure vasodilator function in the aorta of ovariectomized rats.

  16. Intraindividual assessment of the thoracic aorta using contrast and non-contrast-enhanced MR angiography

    Energy Technology Data Exchange (ETDEWEB)

    Tengg-Kobligk, Hendrik von; Gruenberg, K.M.; Giesel, F.L. [Deutsches Krebsforschungszentrum Heidelberg (Germany). Radiologie; Ley-Zaporozhan, J.; Ley, S. [Radiologische Universitaetsklinik Heidelberg (Germany). Diagnostische und Interventionelle Radiologie; Henninger, V.; Kauczor, H.U. [Deutsches Krebsforschungszentrum Heidelberg (Germany). Radiologie; Radiologische Universitaetsklinik Heidelberg (Germany). Diagnostische und Interventionelle Radiologie; Boeckler, D. [Heidelberg Univ. (Germany). Vaskulaere und Endovaskulaere Chirurgie; Krummenauer, F. [Dresden Univ. (Germany). Klinik und Poliklinik fuer Orthopaedie, Funktionsbereich Rehabilitations- und Sportmedizin

    2009-03-15

    To avoid intravenous contrast media application, new MRA sequences using inherent blood contrast are available. The clinical use of these non-contrast-enhanced MRA (non-CE-MRA) sequences is still limited for the aorta. Thus, the goal was to compare a standard CE-MRA with a non-CE-MRA for the thoracic aorta. Ethics committee approval and informed consent were obtained. CE-MRA and non-CE-MRA (1.5T) were performed in the same 50 healthy volunteers (mean age: 48). CE-MRA: GRE-Turbo-Flash-3D (1.2 x 1.2 x 1.6 mm{sup 3}), 0.15 mmol Gd/kg, TA 22 {+-} 2sec. Non-CE-MRA: Respiratory-and cardiac-gated, T 2-prepared 3D-trueFISP (1.2 x 1.2 x 1.3 mm{sup 3}), TA 14 {+-} 5 min. Assessment included (3 readers, consensus): image quality (sharpness of vessel wall, signal homogeneity, artifacts) at the ascending aorta, arch, descending aorta and supra-aortic vessels. The image quality in the ascending aorta was rated 'excellent' in 78 %, 'moderate' in 22 %, 'poor' in 0 % for non-CE-MRA versus 22 %, 50 %, and 28 % for CE-MRA (Cohen's kappa = 29 %, McNemar p < 0.001). In a comparison of non-CE-MRA versus CE-MRA, the aortic arch and descending aorta showed no significant difference (kappa = 58 %/p = 0.250 and kappa = 100 %/p = 1.000, respectively). Supra-aortic vessels were rated 'excellent' 45 %/49 %, 'moderate' 30 %/49 % and 'poor' 13 %/2 %, 12 % of supra-aortic vessels were visualized < 1 cm at non-CE-MRA. (orig.)

  17. Intraindividual assessment of the thoracic aorta using contrast and non-contrast-enhanced MR angiography

    International Nuclear Information System (INIS)

    To avoid intravenous contrast media application, new MRA sequences using inherent blood contrast are available. The clinical use of these non-contrast-enhanced MRA (non-CE-MRA) sequences is still limited for the aorta. Thus, the goal was to compare a standard CE-MRA with a non-CE-MRA for the thoracic aorta. Ethics committee approval and informed consent were obtained. CE-MRA and non-CE-MRA (1.5T) were performed in the same 50 healthy volunteers (mean age: 48). CE-MRA: GRE-Turbo-Flash-3D (1.2 x 1.2 x 1.6 mm3), 0.15 mmol Gd/kg, TA 22 ± 2sec. Non-CE-MRA: Respiratory-and cardiac-gated, T 2-prepared 3D-trueFISP (1.2 x 1.2 x 1.3 mm3), TA 14 ± 5 min. Assessment included (3 readers, consensus): image quality (sharpness of vessel wall, signal homogeneity, artifacts) at the ascending aorta, arch, descending aorta and supra-aortic vessels. The image quality in the ascending aorta was rated 'excellent' in 78 %, 'moderate' in 22 %, 'poor' in 0 % for non-CE-MRA versus 22 %, 50 %, and 28 % for CE-MRA (Cohen's kappa = 29 %, McNemar p < 0.001). In a comparison of non-CE-MRA versus CE-MRA, the aortic arch and descending aorta showed no significant difference (kappa = 58 %/p = 0.250 and kappa = 100 %/p 1.000, respectively). Supra-aortic vessels were rated 'excellent' 45 %/49 %, 'moderate' 30 %/49 % and 'poor' 13 %/2 %, 12 % of supra-aortic vessels were visualized < 1 cm at non-CE-MRA. (orig.)

  18. Morphological analysis of the hagfish heart. I. The ventricle, the arterial connection and the ventral aorta.

    Science.gov (United States)

    Icardo, José M; Colvee, Elvira; Schorno, Sarah; Lauriano, Eugenia R; Fudge, Douglas S; Glover, Chris N; Zaccone, Giacomo

    2016-03-01

    We have studied the heart in three species of hagfish: Myxine glutinosa, Eptatretus stoutii, and Eptatretus cirrhatus and report about the morphology of the ventricle, the arterial connection and the ventral aorta. On the whole, the hagfish heart lacks outflow tract components, the ventricle and atrium adopt a dorso-caudal rather than a ventro-dorsal relationship, and the sinus venosus opens into the left side of the atrium. This may indicate a "defective" cardiac looping during embryogenesis. The ventral aorta is elongated in M. glutinosa and E. stoutii but sac-like in E. cirrhatus. The ventricles are entirely trabeculated. The myocytes show a low myofibrillar content and junctional complexes formed by fascia adherens and desmosomes. Gap junctions could not be demonstrated. Myocardial cells in M. glutinosa contain numerous lipid droplets. These droplets are less numerous in E. stoutii and practically absent in E. cirrhatus, suggesting different metabolic requirements. Other cell types present in the ventricle are chromaffin cells and granular leukocytes that contain rod-shaped granules. The ventricle-aorta connection is guarded by a bicuspid valve with left and right, pocket-like leaflets. The leaflets extend from the cranial end of the ventricle into the aorta but the junction is asymmetrical. This junction contains a ganglion-like structure in E. cirrhatus. The ventral aorta shows endothelial, media, and adventitial layers. The media contains smooth muscle cells surrounded by dense bands formed by tightly-packed extracellular filaments. In addition, a short number of elastic fibers are observed in M. glutinosa and E. stoutii. Cellular and extracellular elements are more loosely organized in the aorta of E. cirrhatus. The collagenous adventitia contains ganglion-like cells in the three species. In the absence of nerves, chromaffin and ganglion-like cells may control the activity of the myocardium and that of the aortic smooth muscle cells, respectively. PMID

  19. Repair of ascending aorta pseudoaneurysm without circulatory arrest in redo patient

    Directory of Open Access Journals (Sweden)

    Auriemma Stefano

    2006-03-01

    Full Text Available Abstract A pseudoaneurysm of the ascending aorta is an unusual and potentially fatal complication after aortic surgical operations. TEE and CT scan are the investigations of choice. Surgical treatment is mandatory. We describe the successful management of a pseudoaneurysm of the ascending aorta, with aorto-sternal-cutaneous fistula requiring right axillary and femoral artery cannulation with Remote Access Perfusion® aortic cannula (Estech®, California, USA. Behaving like this we avoid hypotermic circulatory arrest, provide safe reentry and prevent an impending rupture.

  20. On the differential diagnosis of the abdominal aorta aneurysm and retroperitoneal paraaortal hematoma

    International Nuclear Information System (INIS)

    Chronic retroperitoneal paraaortal hematoma appeared to be a rare disease. Paraaortal hematoma should be differentiated from abdomen aorta aneurysm and retroperitoneal tumor, for it requires no surgical intervention. Computerized tomography CT was shown to be the most sensitive method in differential diagnosis. CT with intravenous contrast intensification displayed complete information on aorta size, its aneurysms, extention of the disease, degree of dissemination into adjacent blood vessels and tissues. Retention of contrast media in the vessels occurred with 5 min delay and the blood was shown to free from the contrast substance up to that moment. The phenomenon permitted to distinguish thrombosed aneurysm from paraaortal tumor or hematoma

  1. Coarctation of the aorta and renal artery stenosis in tuberous sclerosis

    International Nuclear Information System (INIS)

    Among neurocutaneous disorders, coarctation of the abdominal aorta and renal artery stenosis have traditionally been associated with neurofibromatosis. We report a 5-year-old girl who was discovered to have bilateral renal artery stenosis, coarctation of the abdominal aorta, renal cysts and typical skin lesions of tuberous clerosis during the evaluation of asymptomatic hypertension. Renal vascular hypertension has not been reported previously in tuberous sclerosis. We conclude that the tuberous sclerosis complex should be expanded to include vascular malformations and the hypertension should not be assumed to be secondary to renal hamartomata or cysts in patients with tuberous sclerosis. (orig.)

  2. Aorta-to-right atrium fistula, an unusual complication of endocarditis

    Institute of Scientific and Technical Information of China (English)

    Miao-yan CHEN; Dan-dan ZHONG; Zhi-qiang YING

    2009-01-01

    Infective endocarditis (IE) remains a serious disease. Aorta-to-right atrium fistula is a rare but very serious compli-cation of IE and predicts a higher mortality. This report describes a 50-year-old man with endocarditis, vegetation, perforation of noncoronary sinus, and formation of two aorta-to-right atrium fistulas with native valves detected by transthoracic echocardi-ography. This disease is lethal despite developments in cardiac imaging and antibacterial therapy. Early diagnosis, aggressive antibacterial therapy, and surgical treatment may improve the prognosis.

  3. Metabolism of arachidonic acid in 1 yr old New Zealand white (NZW) and watanabe heritable hyperlipidemic (WHHL) rabbit aortas

    International Nuclear Information System (INIS)

    This study was designed to characterize the metabolism of arachidonic acid (AA) in normal and atherosclerotic aortas. Segments of aortas were obtained from 1 yr old NZW rabbits, and WHHL rabbits, a genetic model of athero-sclerosis resembling familial hypercholesterolemia. Aortas were incubated at 370C for 15 min with 14C-AA (5 x 10-5M) during stimulation by A23187. The media was extracted using octadecylsilica columns and resolved into metabolites by reverse-phase HPLC. Prostaglandins (PGs) were identified by comigration of 14C-metabolites with standards. The monoxygenated metabolites of AA (HETEs) were resolved by normal-phase HPLC, and their structures confirmed by GC-MS. In extracts from NZW and WHHL aortas, approximately 14% and 6% of the total radioactivity was converted to PGs and HETEs, respectively. The major PG produced by NZW and WHHL aortas was 6-keto PGF/sub 1α/ with lesser amounts of PGE2. Similarly, NZW and WHHL aortas produced primarily 12- and 15-HETE with lesser amounts of 11-, 9-, 8-, and 5-HETE. There were no qualitative differences between NZW and WHHL aortas in PG and HETE production. Therefore, despite extensive atherosclerosis in aortas of WHHL rabbits, the vessels maintain the ability to synthesize PGs and HETEs

  4. Bupivacaine-induced Vasodilation Is Mediated by Decreased Calcium Sensitization in Isolated Endothelium-denuded Rat Aortas Precontracted with Phenylephrine

    Science.gov (United States)

    Ok, Seong Ho; Bae, Sung Il; Kwon, Seong Chun; Park, Jung Chul; Kim, Woo Chan; Park, Kyeong Eon; Shin, Il Woo; Lee, Heon Keun; Chung, Young Kyun; Choi, Mun Jeoung

    2014-01-01

    Background A toxic dose of bupivacaine produces vasodilation in isolated aortas. The goal of this in vitro study was to investigate the cellular mechanism associated with bupivacaine-induced vasodilation in isolated endotheliumdenuded rat aortas precontracted with phenylephrine. Methods Isolated endothelium-denuded rat aortas were suspended for isometric tension recordings. The effects of nifedipine, verapamil, iberiotoxin, 4-aminopyridine, barium chloride, and glibenclamide on bupivacaine concentration-response curves were assessed in endothelium-denuded aortas precontracted with phenylephrine. The effect of phenylephrine and KCl used for precontraction on bupivacaine-induced concentration-response curves was assessed. The effects of verapamil on phenylephrine concentration-response curves were assessed. The effects of bupivacaine on the intracellular calcium concentration ([Ca2+]i) and tension in aortas precontracted with phenylephrine were measured simultaneously with the acetoxymethyl ester of a fura-2-loaded aortic strip. Results Pretreatment with potassium channel inhibitors had no effect on bupivacaine-induced relaxation in the endothelium-denuded aortas precontracted with phenylephrine, whereas verapamil or nifedipine attenuated bupivacaine-induced relaxation. The magnitude of the bupivacaine-induced relaxation was enhanced in the 100 mM KCl-induced precontracted aortas compared with the phenylephrine-induced precontracted aortas. Verapamil attenuated the phenylephrine-induced contraction. The magnitude of the bupivacaine-induced relaxation was higher than that of the bupivacaine-induced [Ca2+]i decrease in the aortas precontracted with phenylephrine. Conclusions Taken together, these results suggest that toxic-dose bupivacaine-induced vasodilation appears to be mediated by decreased calcium sensitization in endothelium-denuded aortas precontracted with phenylephrine. In addition, potassium channel inhibitors had no effect on bupivacaine-induced relaxation

  5. Protective effect of soybeans as protein source in the diet against cadmium-aorta redox and morphological alteration

    International Nuclear Information System (INIS)

    We investigated the effects of cadmium exposition on thoracic aorta redox status and morphology, and the putative protective effect of soybeans in the diet. Male Wistar rats were separated into 6 groups: 3 fed with a diet containing casein and 3 containing soybeans, as protein source. Within each protein group, one was given tap water (control) and the other two tap water containing 15 and 100 ppm of Cd2+, respectively, for two months. In rats fed with casein diet, 15 ppm of Cd induced an increase of thiobarbituric acid-reactive substances (TBARS), and of the catalase (CAT) and glutathione peroxidase (GPx) activities, which were even higher with 100 ppm of Cd2+, in aorta. Also, 100 ppm Cd2+ exposure increased superoxide dismutase (CuZnSOD) activity; CAT, GPX, SOD, Nrf2 and metallothioneine II mRNA expressions and CAT, GPx and NOX-2 protein levels, compared with control. Aorta endothelial and cytoplasmic alterations were observed. However, with the soybeans diet, 15 and 100 ppm of Cd2+ did not modify TBARS levels; CAT, GPX and Nrf2 mRNA expressions; CAT, GPx and NOX-2 protein; and the aorta morphology, compared with control. The soybean diet attenuates the redox changes and protects against morphological alterations induced, in a dose-dependent way, by Cd in aorta. - Highlights: • Under casein diet, 100 ppm Cd2+ in drinking water induces oxidative stress in aorta. • Under casein diet, 100 ppm Cd2+ increases Nrf2, MT II and NOX2 expressions in aorta. • Under casein diet, 100 ppm Cd2+ induces morphological changes in rat aorta. • The soybean diet attenuates the redox changes induced by Cd in rat aorta. • The soybean diet attenuates morphological alterations induced by Cd in rat aorta

  6. Protective effect of soybeans as protein source in the diet against cadmium-aorta redox and morphological alteration

    Energy Technology Data Exchange (ETDEWEB)

    Pérez Díaz, Matías F.F.; Acosta, Mariano; Mohamed, Fabián H.; Ferramola, Mariana L.; Oliveros, Liliana B.; Gimenez, María S., E-mail: marisofigime44@gmail.com

    2013-11-01

    We investigated the effects of cadmium exposition on thoracic aorta redox status and morphology, and the putative protective effect of soybeans in the diet. Male Wistar rats were separated into 6 groups: 3 fed with a diet containing casein and 3 containing soybeans, as protein source. Within each protein group, one was given tap water (control) and the other two tap water containing 15 and 100 ppm of Cd{sup 2+}, respectively, for two months. In rats fed with casein diet, 15 ppm of Cd induced an increase of thiobarbituric acid-reactive substances (TBARS), and of the catalase (CAT) and glutathione peroxidase (GPx) activities, which were even higher with 100 ppm of Cd{sup 2+}, in aorta. Also, 100 ppm Cd{sup 2+} exposure increased superoxide dismutase (CuZnSOD) activity; CAT, GPX, SOD, Nrf2 and metallothioneine II mRNA expressions and CAT, GPx and NOX-2 protein levels, compared with control. Aorta endothelial and cytoplasmic alterations were observed. However, with the soybeans diet, 15 and 100 ppm of Cd{sup 2+} did not modify TBARS levels; CAT, GPX and Nrf2 mRNA expressions; CAT, GPx and NOX-2 protein; and the aorta morphology, compared with control. The soybean diet attenuates the redox changes and protects against morphological alterations induced, in a dose-dependent way, by Cd in aorta. - Highlights: • Under casein diet, 100 ppm Cd{sup 2+} in drinking water induces oxidative stress in aorta. • Under casein diet, 100 ppm Cd{sup 2+} increases Nrf2, MT II and NOX2 expressions in aorta. • Under casein diet, 100 ppm Cd{sup 2+} induces morphological changes in rat aorta. • The soybean diet attenuates the redox changes induced by Cd in rat aorta. • The soybean diet attenuates morphological alterations induced by Cd in rat aorta.

  7. Effect of calmodulin antagonists on contraction and45Ca movements in rat aorta

    NARCIS (Netherlands)

    Wermelskirchen, D.; Koch, P.; Wilhelm, D.; Nebel, U.; Leidig, A.; Wilffert, B.; Peters, Thies

    1989-01-01

    To study the selectivity of calmodulin antagonists it was assumed that they should inhibit noradrenaline (NA)- and K+-induced contractions similarly without an accompanying inhibition of45Ca uptake. Therefore, in isolated rat aorta the effects of W-7, calmidazolium and trifluoperazine on contraction

  8. Sequential PTA of abdominal aorta. Haemodynamic evaluation and IV-DSA follow-up.

    Science.gov (United States)

    Walstra, B R; Janevski, B K

    1987-04-01

    A case of sequential dilatation of a subtotal stenosis of the abdominal aorta in a young subject is reported. Initial and long-term success of the procedure is recorded using haemodynamic evaluation and intravenous digital subtraction angiography (IV-DSA) follow-up on an outpatient basis. In addition, the significance of biplane aortography with IV-DSA is illustrated. PMID:3033770

  9. Sequential PTA of abdominal aorta. Haemodynamic evaluation and IV-DSA follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Walstra, B.R.J.; Janevski, B.K.

    1987-04-01

    A case of sequential dilatation of a subtotal stenosis of the abdominal aorta in a young subject is reported. Initial and long-term success of the procedure is recorded using haemodynamic evaluation and intravenous digital subtraction angiography (IV-DSA) follow-up on an outpatient basis. In addition, the significance of biplane aortography with IV-DSA is illustrated.

  10. Feasibility of low contrast media volume in CT angiography of the aorta

    Directory of Open Access Journals (Sweden)

    Anna Seehofnerová

    2015-01-01

    Conclusions: A straightforward low volume CM protocol proved to be technically feasible and led to CTA examinations reaching diagnostic image quality of the aorta at 100 kV. Based on these findings, the use of a relatively small CM bolus can be incorporated into routine clinical imaging.

  11. Barium responsiveness of the rat aorta and femoral artery during pregnancy.

    Science.gov (United States)

    Hart, J L

    1982-01-11

    The barium responses of isolated aortic strips and femoral arteries from non-pregnant and pregnant rats were investigated. Barium caused concentration-related increases in tension of vessels from both pregnant and non-pregnant rats. The concentration-response curves of femoral arteries from non-pregnant and 3 week pregnant rats were not different; however contractility and slopes of concentration-response lines for thoracic aortas from 1, 2 and 3 week pregnant rats were significantly less than those of aortas from non-pregnant rats. In addition, barium caused rhythmic contractions to develop in both femoral arteries and aortas of 3 week pregnant rats more frequently than vessels from non-pregnant rats. Rhythmic contractions did not develop in aortas from 3 week pregnant rats in calcium-free Krebs. Since the effects of barium on the electrical and mechanical activity of various muscles have been postulated to be similar to and/or dependent on calcium, these results may indicate that changes in calcium sensitivity of vascular smooth muscle occur during pregnancy. Such changes may contribute to the blood flow redistribution and other cardiovascular adaptations of pregnancy. PMID:7054642

  12. Stress Alone or associated with Ethanol Induces Prostanoid Release in Rat Aorta via α2-Adrenoceptor

    International Nuclear Information System (INIS)

    Stress and ethanol are both, independently, important cardiovascular risk factors. To evaluate the cardiovascular risk of ethanol consumption and stress exposure, isolated and in association, in male adult rats. Rats were separated into 4 groups: Control, ethanol (20% in drinking water for 6 weeks), stress (immobilization 1h day/5 days a week for 6 weeks) and stress/ethanol. Concentration-responses curves to noradrenaline - in the absence and presence of yohimbine, L-NAME or indomethacin - or to phenylephrine were determined in thoracic aortas with and without endothelium. EC50 and maximum response (n=8-12) were compared using two-way ANOVA/Bonferroni method. Either stress or stress in association with ethanol consumption increased the noradrenaline maximum responses in intact aortas. This hyper-reactivity was eliminated by endothelium removal or by the presence of either indomethacin or yohimbine, but was not altered by the presence of L-NAME. Meanwhile, ethanol consumption did not alter the reactivity to noradrenaline. The phenylephrine responses in aortas both with and without endothelium also remained unaffected regardless of protocol. Chronic stress increased rat aortic responses to noradrenaline. This effect is dependent upon the vascular endothelium and involves the release of vasoconstrictor prostanoids via stimulation of endothelial alpha-2 adrenoceptors. Moreover, chronic ethanol consumption appeared to neither influence noradrenaline responses in rat thoracic aorta, nor did it modify the increase of such responses observed as a consequence of stress exposure

  13. Age-related increase in prostacyclin production in the rat aorta.

    Science.gov (United States)

    Panganamala, R V; Hanumaiah, B; Merola, A J

    1981-02-01

    Normal Sprague-Dawley rats convert a substantial percentage of exogenous arachidonic acid to prostacyclin. This conversion can be quantitated by an aqueous sampling technique utilizing thin layer chromatography and liquid scintillation counting. There is a clear age-related increase in this conversion that can be demonstrated in aortas from rats of 3 weeks to 20 weeks of age. PMID:7017783

  14. CT angiography for the pre- and postoperative evaluation of the thoracic aorta

    International Nuclear Information System (INIS)

    CT angiography is the imaging modality of choice for the pre- and postsurgical evaluation of patients with pathologies of the thoracic aorta. The purpose of this review is to familiarize the reader with the technical principle, recent technical developments and requirements for specific examination protocols and image interpretation, and to highlight common pathologies and findings. (orig.)

  15. Diagnosis of the posttraumatic rupture of the thoracic aorta in plain film and angiography

    International Nuclear Information System (INIS)

    In the diagnosis of acute and chronic posttraumatic false aneurysms of the thoracic aorta the importance of imaging methods can't be overemphasized, especially, since clinical signs often are of no help. The findings in plain films and angiography in 17 patients with posttraumatic aortic rupture are described and discussed. The importance of angiography is stressed. (orig.)

  16. Factors influencing the mechanical behaviour of healthy human descending thoracic aorta

    International Nuclear Information System (INIS)

    In recent times, significant effort has been made to understand the mechanical behaviour of the arterial wall and how it is affected by the different vascular pathologies. However, to be able to interpret the results correctly, it is essential that the influence of other factors, such as aging or anisotropy, be understood. Knowledge of mechanical behaviour of the aorta has been customarily constrained by lack of data on fresh aortic tissue, especially from healthy young individuals. In addition, information regarding the point of rupture is also very limited. In this study, the mechanical behaviour of the descending thoracic aorta of 28 organ donors with no apparent disease, whose ages vary from 17 to 60 years, is evaluated. Tensile tests up to rupture are carried out to evaluate the influence of age and wall anisotropy. Results reveal that the tensile strength and stretch at failure of healthy descending aortas show a significant reduction with age, falling abruptly beyond the age of 30. This fact places age as a key factor when mechanical properties of descending aorta are considered

  17. Mycotic aneurysm of the aorta as an unusual complication of coronary angiography

    NARCIS (Netherlands)

    van der Wal, H.; van Geel, P. P.; de Boer, R. A.

    2008-01-01

    Introduction: Mycotic aneurysm of the aorta is a rare diagnosis with high mortality. Report: Percutaneous coronary intervention was complicated by bacteraemia with Staphylococcus aureus and a mycotic aortic aneurysm, an unusual complication of coronary angiography. Combining CT and PET scan showed a

  18. TAVR Through Heavily Calcified Aorta Following Atheroma Retrieval With the "Elevator" Technique.

    Science.gov (United States)

    Senguttuvan, N Boopathy; Ellozy, Sharif; Tejani, Furqan; Kovacic, Jason; Kini, Annapoorna S; Sharma, Samin K; Dangas, George D

    2015-10-01

    An 86-year-old Caucasian female with severe symptomatic, inoperable aortic stenosis was accepted for high-risk transfemoral transcatheter aortic valve replacement (TAVR) approach due to severe calcification of the aorta. During initial passage of a 22 Fr sheath, there was dislodgment with proximal migration of a circumferential tunnel of calcium from the infrarenal aorta. A novel "elevator" technique was used to secure and retrieve the dislodged aorta en bloc back to its original infrarenal aortic position and allow in situ fixation with stenting. A new TAVR system was then successfully placed through the stent and a 23 mm Edwards Sapien valve (Edwards Lifesciences) was implanted as planned. In case of calcification protruding into the lumen of the aorta and limiting the passage of the large valve delivery system sheath, the obstruction can be managed by stenting the calcification against the luminal wall under fluoroscopic and intravascular-ultrasound guidance, allowing successful passage of the valve delivery system. The elevator technique allows axial transportation of any calcified vascular fragments, should they become dislodged. PMID:26429853

  19. Atherosclerosis of the descending aorta predicts cardiovascular events: a transesophageal echocardiography study

    Directory of Open Access Journals (Sweden)

    Havasi Kálmán

    2004-10-01

    Full Text Available Abstract Purpose Previous studies have shown that atherosclerosis of the descending aorta detected by transesophageal echocardiography (TEE is a good marker of coexisting coronary artery disease. The aim of our study was to evaluate whether the presence of atherosclerosis on the descending aorta during TEE has any prognostic impact in predicting cardiovascular events. Material and Methods The study group consisted of 238 consecutive in-hospital patients referred for TEE testing (135 males, 103 females, mean age 58 +/- 11 years with a follow up of 24 months. The atherosclerotic lesions of the descending aorta were scored from 0 (no atherosclerosis to 3 (plaque >5 mm and/or "complex" plaque with ulcerated or mobile parts. Results Atherosclerosis was observed in 102 patients, (grade 3 in 16, and grade 2 in 86 patients whereas 136 patients only had an intimal thickening or normal intimal surface. There were 57 cardiovascular events in the follow-up period. The number of events was higher in the 102 patients with (n = 34 than in the 136 patients without atherosclerosis (n = 23, p =2 (HR 2.4, CI 1.0–5.5 predicted hard cardiovascular events. Conclusion Atherosclerosis of the descending aorta observed during transesophageal echocardiography is a useful predictor of cardiovascular events.

  20. Evaluation of the atherosclerotic change in the ascending aorta using helical CT

    International Nuclear Information System (INIS)

    The purpose of this study is to investigate the clinical usefulness of helical computed tomography (CT) for the evaluation of atherosclerotic changes in the ascending aorta. Eighteen subjects are examined. Contrast-enhanced helical CT was performed before and after the operation of the coronary artery bypass graft (CABG). Forty six histological samples of the ascending aorta were obtained from the sites where the saphenous grafts were anastomosed and classified microscopically into 3 histological grade; grade 1: mainly intimal fibrosis (n=38), grade 2: mainly atheroma (n=6) and grade 3: mainly calcification (n=2). In comparison with CT images, all the portions of the aortic walls with grade 2 and 3 showed low density areas, while any of those with grade 1 did not reveal the low density areas along the inner margin of the aortic wall. However, the walls with grade 2 and those with grade 3 were not able to be differentiated on CT images. Three dimensional reconstructed images clearly demonstrated the spatial distribution of atheromatous changes and calcification in the ascending aorta. In conclusion, helical CT is clinically useful for the evaluation of the atherosclerotic changes in the ascending aorta. (author)

  1. Changes in finger-aorta pressure transfer function during and after exercise

    NARCIS (Netherlands)

    W.J. Stok; B.E. Westerhof; J.M. Karemaker

    2006-01-01

    Changes in finger-aorta pressure transfer function during and after exercise. J Appl Physiol 101: 1207-1214, 2006. First published June 1, 2006; doi:10.1152/japplphysiol.00876.2005.-Noninvasive finger blood pressure has become a surrogate for central blood pressure under widely varying circumstances

  2. Relationship between aneurism of ascending part of aorta and syndrome of connective tissue dysplasia

    Directory of Open Access Journals (Sweden)

    Osovska N.Yu.

    2014-11-01

    Full Text Available The paper identifies the main reasons for the development of an aneurysm of the ascending aorta and predictors of its complications in patients of all ages. To determine the cause and age-associated risk factors for aneurysms there were examined 154 patients with the presence of the expansion of the root and / or ascending aorta of more than 40 mm, according to echocardiographic examination. Patients were divided into 4 categories by age: 18-29 years, 30-44 years 45-59 years 60-74 years. Instrumental methods of examination: echocardiography, ECG, ECG monitoring and blood pressure, heart rate variability, ultrasound of internal organs were used. Syndrome of connective tissue dysplasia was established according to the criteria of the working group of the British Society of Rheumatology. Joint hypermobility syndrome was determined according to the Brayton criteria. Statistical processing was carried out by methods of variation statistic program StatSoft "Statistica" v.10.0. It was established that in young and middle aged patients the cause of aneurysm of ascending aorta more often is connective tissue dysplasia syndrome. In older patients the main cause of aneurysm of ascending aorta is associated with left ventricular hypertrophy and decreased contractile function of the heart.

  3. Medical image of the week: atherosclerotic aneurysm of aortic arch and decsecnding thoracic aorta

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    Parasram M

    2016-02-01

    Full Text Available No abstract available. Article truncated after 150 words. A 94-year-old Spanish-speaking woman presented to the hospital with intermittent episodes of dyspnea and abdominal pain for one week. Her past medical history was notable for 30 pack-year smoking history and hypertension, which was reportedly controlled with medical therapy. Physical exam showed trace peripheral edema bilaterally, intact peripheral pulses, and a mild abdominal bruit. Work up at the emergency department revealed a non-ST elevation myocardial infarction with troponin T of 0.34 ng/mL but no ST-wave abnormality on electrocardiography. Chest x-ray displayed an incidental thoracic aneurysm (Figure 1. Chest computed tomography with contrast demonstrated a continuous aneurysm of the aortic arch and descending thoracic aorta with diameters measuring 6.8 cm and 6 cm, respectively (Figure 2A and 2B. Eccentric thrombi are noted in the aortic arch and the descending aorta. Interestingly, the distal descending thoracic aorta curves as it transitions to the abdominal aorta, which is evidence of a tortuous descending ...

  4. Stress Alone or associated with Ethanol Induces Prostanoid Release in Rat Aorta via α2-Adrenoceptor

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    Baptista, Rafaela de Fátima Ferreira [Departamento de Farmacologia - Instituto de Biociências - Universidade Estadual Paulista - UNESP - São Paulo, SP (Brazil); Laboratório de Farmacologia - Faculdade de Medicina de Marília - FAMEMA, SP (Brazil); Taipeiro, Elane de Fátima [Laboratório de Farmacologia - Faculdade de Medicina de Marília - FAMEMA, SP (Brazil); Queiroz, Regina Helena Costa [Departamento de Análise Clínica - Toxicológica e Ciência de Alimentos - Faculdade de Ciências Farmacêuticas - USP, São Paulo, SP (Brazil); Chies, Agnaldo Bruno [Departamento de Farmacologia - Instituto de Biociências - Universidade Estadual Paulista - UNESP - São Paulo, SP (Brazil); Laboratório de Farmacologia - Faculdade de Medicina de Marília - FAMEMA, SP (Brazil); Cordellini, Sandra, E-mail: cordelli@ibb.unesp.br [Departamento de Farmacologia - Instituto de Biociências - Universidade Estadual Paulista - UNESP - São Paulo, SP (Brazil)

    2014-03-15

    Stress and ethanol are both, independently, important cardiovascular risk factors. To evaluate the cardiovascular risk of ethanol consumption and stress exposure, isolated and in association, in male adult rats. Rats were separated into 4 groups: Control, ethanol (20% in drinking water for 6 weeks), stress (immobilization 1h day/5 days a week for 6 weeks) and stress/ethanol. Concentration-responses curves to noradrenaline - in the absence and presence of yohimbine, L-NAME or indomethacin - or to phenylephrine were determined in thoracic aortas with and without endothelium. EC50 and maximum response (n=8-12) were compared using two-way ANOVA/Bonferroni method. Either stress or stress in association with ethanol consumption increased the noradrenaline maximum responses in intact aortas. This hyper-reactivity was eliminated by endothelium removal or by the presence of either indomethacin or yohimbine, but was not altered by the presence of L-NAME. Meanwhile, ethanol consumption did not alter the reactivity to noradrenaline. The phenylephrine responses in aortas both with and without endothelium also remained unaffected regardless of protocol. Chronic stress increased rat aortic responses to noradrenaline. This effect is dependent upon the vascular endothelium and involves the release of vasoconstrictor prostanoids via stimulation of endothelial alpha-2 adrenoceptors. Moreover, chronic ethanol consumption appeared to neither influence noradrenaline responses in rat thoracic aorta, nor did it modify the increase of such responses observed as a consequence of stress exposure.

  5. Ascending aorta false aneurysm as a late complication of aortic valve surgery

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    Bilbija Ilija

    2012-01-01

    Full Text Available Introduction. False aneurysms of the ascending aorta represent a rare but potentially fatal complication of cardiac surgical procedures. Predisposing factors are aortic dissection, infection, connective tissue disorders, chronic hypertension, aortic calcifications and aortotomy dehiscence. At the beginning they are usually asymptomatic, but later various symptoms arise as a consequence of vital structures compression. Potential risk of rupture rises with time and pseudoaneurysm enlargement. From surgical point of view treatment of such cases represents a unique challenge because of the great danger of inadvertent opening of the aneurysm during resternotomy. Case Outline. A 58-year-old female patient underwent aortic valve replacement due to severe aortic stenosis in 2004. Operation and postoperative recovery were uneventful. Three years later she started complaining about chest pain. On chest X-ray there was upper mediastinal widening. CT scan showed a pseudoaneurysm of the ascending aorta located in front of the right atrium and right ventricle, which was subsequently verified by angiography. During redo operation the pseudoaneurysm was successfully resected and aorta closed with separate ethybond sutures with pledgets. Conclusion. Postoperative pseudoaneurysms of the ascending aorta mostly arise from the suture lines. The most useful diagnostic procedures are contrast CT scan, echocardiography, angiography and MRI. Surgical intervention is absolutely indicated. The institution of cardiopulmonary bypass by alternative ways before chest opening is strongly recommended.

  6. Endovascular Repair of Localized Pathological Lesions of the Descending Thoracic Aorta: Midterm Results

    International Nuclear Information System (INIS)

    The endoluminal stent-graft represents an attractive and a less invasive technique for treatment of various diseases of the descending thoracic aorta. The purpose of this study was to evaluate the Talent endovascular stent-graft for the treatment of various localized diseases of the descending thoracic aorta. Over a 3-year period, Talent thoracic endografts were placed in 40 patients with a high surgical risk, presenting a localized lesion of the descending thoracic aorta: degenerative aneurysm (n = 13), acute traumatic rupture (n = 11), acute Stanford type B aortic dissection (n = 6), false aneurysm (n = 7), and penetrating atherosclerotic ulcer (n = 3). Fifteen patients (37.5%) were treated as emergencies. The feasibility of endovascular treatment and sizing of the aorta and stent-grafts were determined preoperatively by magnetic resonance angiography (MRA) and intraoperative angiography. Immediate and mid-term technical and clinical success was assessed by clinical and MRA follow-up. Endovascular treatment was completed successfully in all 40 patients, with no conversion to open repair or intraoperative mortality. The mean operative time was 37.5 ± 7 min. The overall 30-day mortality rate was 10% (n = 4), all in emergency cases, for causes not related to the endograft. The primary technical success was 92.5%. The mean follow-up period was 15 ± 5 months. The survival rate was 95% (n = 35). Diminution of the aneurismal size was observed in 47.5% (n = 19). We conclude that endovascular treatment of the various localized diseases of the descending thoracic aorta is a promising, feasible, alternative technique to open surgery in well-selected patients

  7. MRI and ultrasonography of atherosclerosis of the thoracic aorta and carotid arteries in elderly hypercholesterolemic patients

    International Nuclear Information System (INIS)

    In 53 elderly participants aged more than 60 the thoracic aorta and bilateral carotid arteries were observed with noninvasive techniques, MRI and ultrasonography, in order to elucidate the relationship between hypercholesterolemia and atherosclerosis in the elderly. Hypercholesterolemic subjects were classified as group H (serum total cholesterol (TC)>220 mg/dl), group H-I (220 mg/dl< TC<250 mg/dl) and group H-II (TC≥250 mg/dl). Atherosclerotic changes of the thoracic aorta were observed in 46% of group H, 27% of group H-I, 60% of group H-II and 37% of normolipidemic subjects (group NL). Carotid atherosclerotic changes were observed in 19% of group H, 9% of group H-I, 27% of group H-II and 18% of group NL. In group H-I, the percentages of atherosclerotic changes in both thoracic aorta and carotid arteries were lower than those in group NL. However, atherosclerotic changes of thoracic aorta and carotid arteries were detected in 43% and 29% of the subjects showing higher apo B/Apo A1 ratio than 1.0 among group H-I+NL (TC<250 mg/dl). These changes occurred in 32% and 13% of the subjects showing lower apo B/Apo A1 ratio than 1.0 among the same groups. Namely, atherosclerotic changes of the thoracic aorta and carotid arteries were observed more frequently in the subjects showing a higher apo B/Apo A1 ratio than 1.0 even if their serum cholesterol values were not higher than 250 mg/dl. We should use not only the serum cholesterol value but also the apo B/Apo A1 ratio as an indicator to evaluate the roles of lipids in the development of atherosclerosis. (author)

  8. The role of extracellular and intracellular proteolytic systems in aneurysms of the ascending aorta.

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    Werner, Isabella; Schack, Stephanie; Richter, Manfred; Stock, Ulrich A; Ahmad, Ali El-Sayed; Moritz, Anton; Beiras-Fernandez, Andres

    2016-05-01

    Aneurysms of the ascending aorta are an outstanding challenge to clinicians as they may persist asymptomatic until they present with dissection or rupture. Intensive research is performed to reveal the molecular mechanisms causing aneurysm formation. Calpains are ubiquitous non-lysosomal cysteine proteases which are classically activated by calcium signaling. The two major forms of the calpain-family are calpain-I and calpain-II. Calpastatin specifically inhibits the proteolytic activity of calpain-I and -II. Recently it has been demonstrated in aneurysm tissues from ascending aortas obtained from Marfan syndrome patients that calpain-II expression is increased and calpastatin expression is decreased. Thus, we were interested in the probable role of calpains in aneurysms of ascending aorta in non-Marfan patients. Therefore, ascending aortic samples of dilated and non-dilated aortas were analyzed according to their calpain-I, -II and calpastatin content as well as the expression levels of MMPs and elastin as well as the infiltration of inflammatory cells. We have found significant differences in calpain-I and calpastatin protein expression and serum levels in patients with aneurysm of the ascending aorta. Furthermore, MMP-1 and MMP-3 expression levels correlate with calpain-I protein levels. Due to our findings we conclude that calpain-1 seems to be related to fibrotic alteration in aortic aneurysm tissue in our experimental group. The change in calpain-1 modulates the structure of aortic tissue causing alteration in elastin structure, thus enabling macrophage infiltration and elevation of MMP levels. Circulating levels of calpain-1 may be used as a prognostic marker in the future if further correlation analyses are done. PMID:26582478

  9. Evaluation of the normal thoracic and abdominal aorta diameters by computerized tomography

    International Nuclear Information System (INIS)

    The study was undertaken to evaluate, through computerized tomography, the diameters of the normal thoracic and abdominal aorta, as well as they are connected to gender, age and body surface area; and the ratio between measurements obtained at the ascending and descending limbs of the thoracic aorta, and between the abdominal aortic diameters. For that reason, we measured the widest anteroposterior diameters of the thoracic aortas at the levels of the arch, the root, the pulmonary artery, and the thoracic-abdominal transition, as well as the level of the emergence of the superior mesenteric artery, of the renal hila and just cephalad to the bifurcation of the abdominal aortas of 350 patients without cardiovascular diseases who had undergone computerized tomography of the thorax and/or abdomen for any other reasons. Observation and statistic analyses led us to conclude that: 1) both the thoracic and abdominal aortic diameters are reduced from their proximal to their distal portions; 2) the body surface influences the size of the aorta, although only extreme variations alter the vessel's caliber; 3) vessel diameter was observed to gradually increase with age; 4) men were found to have larger diameters than age matched women; 5) the ratio between the ascending and descending aortic diameters varies according to gender and age; 6) the relations between abdominal aortic diameters measured at the level of renal hila and cephalad to the bifurcation are independent from gender and age. But the relation between those measured at the level of the superior mesenteric artery and cephalad to the bifurcation are linked to gender, but not to age. (author)

  10. Origem anômala da artéria circunflexa da artéria pulmonar direita Anomalous origin of circunflex artery from the right pulmonary artery

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    José Carlos R Iglézias

    1989-08-01

    Full Text Available É relatado, pela primeira vez na literatura, o caso de paciente adulto de 35 anos, com queixa de dor precordial aos esforços desde há 17 anos e que, após ter sido submetido a correção de coarctação de aorta, foi investigado e teve como diagnóstico: origem anômala da artéria circunflexa. No intra-operatório, constatou-se que a mesma tinha origem na artéria pulmonar direita. Foi realizada a sutura do óstio anômalo e um enxerto livre da artéria torácica interna direita para a coronária circunflexa. Além da raridade da lesão, são possíveis considerações fisiopatológicas relacionadas com a coarctação da aorta, neste caso específico.A case never described in adults before is here reported. A 35-year-old patient who had referred precordial pain in effort for seventeen years was investigated after having been submitted to correction of coarctation of the aorta, and had the following diagnosis: anomalous origin of the circunflex artery. In the intraoperatory, the latter was found to proceeed from the right pulmonary artery. The anomalous ostio was sutured and a free graft was made, from the right internal thoracic artery to the circunflex coronary. In addition to the unusualness of such pathology, some physiopatologic considerations related to the coarctation of the aorta may be made, in this particular case.

  11. Operação de Bentall e De Bono para correção das doenças da raiz aórtica: análise de resultados a longo prazo Bentall and De Bono surgery for correction of valve and ascending aortic disease: long-term results

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    Virgílio Figueiredo Silva

    2008-06-01

    Full Text Available OBJETIVO: Um estudo retrospectivo foi desenhado tendo como fator de inclusão a cirurgia de Bentall e De Bono. MÉTODOS: Dados foram retirados de prontuários médicos e informações de seguimento a longo prazo obtidas por meio de retornos ambulatoriais e contatos diretos com o paciente. Trinta e nove pacientes foram acompanhados no período de janeiro de 1996 a dezembro de 2005. RESULTADOS: A mediana de idade foi 47 anos, sendo 85% dos pacientes do sexo masculino. Onze (25,5% pacientes apresentavam síndrome de Marfan e um (2,5% síndrome de Turner. Entre os fatores de risco, listaram-se: hipertensão em 19 (48,5% pacientes, tabagismo em oito (20,5%, etilismo em seis (15,5%, dislipidemia em oito (20,5%, diabetes melito em dois (5% e presença de IAM prévio em um (2,5%. Vinte e oito (72% pacientes estavam em classe II-III NYHA ao momento da operação. Ectasia ânulo-aórtica era diagnóstico em 14 (36% pacientes e aneurisma da aorta em 16 (41%. O tempo médio de permanência na UTI foi 8,8 dias, com intervalo de 2-23 dias. A taxa de sobrevida em 30 dias (intra-hospitalar foi de 94,87% (2/39. Em um ano, 37 (94,87% pacientes estavam vivos, e em 5 e 10 anos, 33 (84,61%. O tempo de acompanhamento médio foi de 46,5 meses, com intervalo de 14-120 meses. CONCLUSÃO: A técnica descrita por Bentall e De Bono obteve excelentes resultados a curto e longo prazo, sendo eficaz e segura no tratamento de doenças da valva aórtica e aorta ascendente em nosso serviço. Nossos resultados são condizentes com dados atuais da literatura.OBJECTIVE: A retrospective study was perfomed in a series of consecutive patients who underwent a Bentall and De Bono procedure. Methods: Data were removed of medical records and follow-up data were obtained from clinical records and direct contact with patients. A total of 39 patients were studied between January 1996 and December 2005. RESULTS: The median age was 47 years (range 14-70. There were 33 males and six females

  12. Pseudoaneurysm of the ascending aorta after aortic valve replacement Pseudoaneurisma de la aorta ascendente después de sustitución valvular aórtica

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    Pedro Pupo Suárez

    2010-07-01

    Full Text Available Postsurgical pseudoaneurysms of the ascending aorta are a rare and serious complication of cardiovascular surgery that requires a surgical solution of urgency due to its high complexity. A case of a 40 year old female, white skin color, that due to severe aortic regurgitation underwent surgical treatment for aortic valve replacement. During the immediate postoperative period began with a fever, he made a meticulous study that included contrast computed tomography, through which diagnosed the presence of a pseudoaneurysm of the ascending aorta, was taken to the operating room, they found two sacks pseudoaneurismatics at the site where the suture was carried out previous.Los pseudoaneurismas postquirúrgicos ascendentes de la aórtica, son una rara y grave complicación de la cirugía cardiovascular que requiere de una solución quirúrgica de máxima urgencia debido a su alta complejidad. Se presenta el caso de una paciente de 40 años de edad, de sexo femenino, de color de piel blanca, que producto de una insuficiencia aórtica severa se sometió a tratamiento quirúrgico, para realizar una sustitución valvular aórtica. Durante el periodo postoperatorio mediato comenzó con un cuadro febril, se le realizó un estudio minucioso que incluyó tomografía axial computarizada contrastada, por medio de la cual se diagnosticó la presencia de un pseudoaneurisma de la aorta ascendente, fue llevada al quirófano, se encontraron dos sacos pseudoaneurismáticos en el sitio donde se realizó de la aortorrafía anterior.

  13. Modificação técnica na cirurgia da estenose aórtica supravalvar Technical modifications in the surgery of supravalvar aortic stenosis

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    Magaly Arrais dos Santos

    1996-12-01

    Full Text Available Com o objetivo de evitar complicações de reestenose da aorta na evolução tardia dos pacientes submetidos ao tratamento cirúrgico da estenose supravalvar aórtica localizada, provocada por calcificação e enrijecimento de material protético utilizado para ampliação de um ou mais seios de Valsalva, com ou sem secção transversal da aorta, desenvolvemos, de outubro de 1991 a dezembro de 1995, uma modificação técnica, que, sem utilização de enxertos artificiais, apenas com tecido sadio da aorta ascendente, permite ampliação adequada da porção inicial da aorta. Neste período, foram operados 10 pacientes, com diagnóstico clínico e hemodinâmico de estenose supravalvar aórtica localizada. As idades variaram de 11 meses a 38 anos (m = 13,2 anos, o peso variou de 7,500 kg a 56 kg (m = 29,1 kg e a altura variou de 72 cm a 1,68 m (m = 1,5 m. Seis pacientes eram do sexo masculino. Três eram assintomáticos, 4 tinham dispnéia, 2 cansaço aos esforços, 2 palpitações, 1 parestesia de membros inferiores e 1 cianose ao choro. Seis pacientes eram portadores de síndrome de Williams. O gradiente sistólico entre a cavidade livre do ventrículo esquerdo e aorta variou de 50 mmHg a 100 mmHg (m = 73,5. Os pacientes foram operados com auxílio de circulação extracorpórea, hipotermia moderada, cardioplegia cristalóide, nos 7 primeiros casos, e cardioplegia sangüínea nos 3 últimos. A aorta ascendente foi amplamente dissecada até os vasos da base. Após a transecção total da aorta e ressecção do tecido fibrótico estenosante, realizamos incisões longitudinais do bordo da porção proximal da aorta até o fundo dos seios de Valsalva; a seguir, foram feitas incisões longitudinais na porção distai, nas regiões correspondentes aos postes comissurais, de maneira que cada prolongamento da aorta distai ampliasse um fundo de seio de Valsalva, obtendo uma aorta inicial de aspecto anatômico e dimensões normais.Atualmente, com um per

  14. Tuberculous Pseudoaneurysm of the Descending Thoracic Aorta from Tuberculous Aortitis: CT Findings and Treatment with an Endovascular Stent Graft

    International Nuclear Information System (INIS)

    Tuberculous pseudoaneurysms of the aorta are rare entities that have been reported as fatal complications requiring early diagnosis and treatment. Here, we describe a case of a tuberculous pseudoaneurysm of the descending thoracic aorta in a patient with miliary tuberculosis. The computed tomography findings of a tuberculous pseudoaneurysm and outcomes of treatment with endovascular stent graft are described. Tuberculous pseudoaneurysms of the descending thoracic aorta were treated with endovascular stent graft. However, perigraft recurrence of tuberculosis after cessation of antituberculous drugs led to surgical treatment.

  15. Evolução da cardiopatia experimentalmente induzida em coelhos infectados com Trypanosoma cruzi

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    Florêncio Figueiredo

    1985-09-01

    Full Text Available Coelhos jovens de ambos os sexos (1-2 meses de idade, outbred, inoculados com tripomastigotas da cepa Colômbia de Trypanosoma cruzi desenvolveram lesões cardíacas, macro e microscópicas, além de características parasitológicas e imunológicas, muito semelhantes às observadas na doença de Chagas humana, tanto na fase aguda como na fase crônica. Na fase aguda a síndrome cardíaca caracteriza-se macroscopicamente por discreta cardiomegalia, com dilatação de câmaras direitas, e miscroscopicamente por miocardite focal pouco acentuada; na fase crônica, por cardiomegalia moderada ou acentuada, com hipertrofia e dilatação de câmaras e adelgaçamento da ponta (aneurisma apical, predominantemente do ventrículo esquerdo, e por miocardite focal, cóm áreas de necrose miocitolítica e degeneração de miocélulas, associadas a infiltrado inflamatório, principalmente composto de linfócitos, e fibrose intersticial. Devido à reprodução de aspectos da doença cardíaca chagásica humana em tempo relativamente curto, à simplicidade, à disponibilidade para múltiplos pesquisadores e ao baixo custo, o modelo representado pelo coelho constitui uma alternativa para estudos dos mecanismos, patologia e tratamento da cardiopatia chagásica.

  16. Forensic expertise of thoracic aorta, heart and pericardial injuries in car-occupant fatalities

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    Nikolić Slobodan

    2009-01-01

    Full Text Available Introduction. Forensic expertise has not specified with certainty any specific injury among fatally injured frontal car-occupants in frontal car collisions. Objective. To establish if blunt injuries of thoracic aorta, heart, and pericardium could be used as predictors where the fatally injured car-occupant was at the moment of car-collision. Methods. A retrospective autopsy study was performed. The subjects were fatally injured car-drivers, front-seat and rearseat passengers in head-on car collisions. In each of them we analyzed the injuries of thoracic aorta, heart and pericardium. Results. 492 subjects were analyzed (378 male and 104 female: 239 car-drivers, 194 front-seat and 49 rear-seat passengers. The isthmus of aorta was the commonest site of simple blunt rupture among car-drivers and front-seat passengers. Among more than half of the observed subject, there was aortic blunt rupture as concomitant injury with heart and pericardium injuries. Heart and pericardium ruptures were most common among fatally injured car-drivers. Most frequently injured part of the heart was the right atrium. Injuries of thoracic aorta, heart and pericardium indicated a higher probability that the fatally injured would be the car-driver (λ=0.818; df=2; p=0.011, λ=0.906; df=2; p=0.000, and λ=0.951; df=2; p=0.000; this was also pointed out by the rupture of the right atrium and multiple ruptures of the thoracic aorta (λ=0.966; df=2; p=0.000 and λ=0.918; df=2; p=0.009. The concomitant injuries of the thoracic aorta with thoracic spine, sternum and heart pointed out that the injured person was the car-driver (λ=0.971; df=4; p=0.007, λ=0.974; df=4; p=0.013 and λ=0.958; df=4; p=0.000, as well as the concomitant injuries of heart and sternal fracture (λ=0.960; df=4; p=0.001. The probability of about 80% that the fatally injured person in head-on collisions was a car-driver was pointed out by concomitant blunt thoracic aorta rupture with fractured sternum and

  17. Plaque of atherosclerosis in aorta: review on atherogenesis, formation of plaque, clinical significance, methods of imaging and treatment; Placa de aterosclerose em aorta: revisao sobre aterogenese, formacao de placa, significado clinco, metodos de imagens e tratamento

    Energy Technology Data Exchange (ETDEWEB)

    Furtado, Rogerio Gomes; Nunes, Colandy G. de Oliveira; Rassi Junior, Luis; Melato, Luciano Henrique; Turco, Fabio de Paula; Borges, Moises Marcos, E-mail: rogerinhofurtado@gmail.com [Centro de Diagnostico por Imagem (CDI), Goiania, GO (Brazil); Sara, Leonardo [Instituto do Coracao (InCor/FM/USP), Sao Paulo, SP (Brazil)

    2009-04-15

    There is a certain consensus in the literature that the earliest stage of atherogenesis is characterized by the accumulation of spongy cells in the region of the intimal artery. Risk factors such as arterial hypertension, smoking, diabetes mellitus, hypercholesterolemia, male gender and advanced age predispose a person to the formation of plaques in the coronaries and aorta. A greater number of acute coronary events as well as strokes have been observed in people with these risk factors. Strokes are the third cause of death in the USA, with about 40% of the cases being of cryptogenic origin. Since 1989 the atheroma plaques which develop in the thoracic aorta have been considered to be responsible for cerebral and peripheral strokes which were previously considered cryptogenic because imaging techniques such as electrocardiogram transesophageal, computerized tomogram, nuclear magnetic angio-resonance have visualized and characterized the lesions with plaques of arteriosclerosis in the thoracic aorta. The authors of this article made a systematic review in the PUBMED about arteriosclerosis in the aorta and its diagnostic methods. This review includes the physiopathology of the formation of atheroma to the aorta and its consequences, diagnostic methods such as echo transesophageal, computerized tomogram and angio resonance, as well as the advantages and disadvantages of each method of identification of the lesions. An analysis of the clinical significance of the size, form and location of the atheroma plaques in the thoracic aorta were made based on clinical studies, as well as their treatment with anticoagulants, antiplatelet and drugs to reduce cholesterol. (author)

  18. Simultaneous stent implantation for coarctation of the aorta and closure of patent ductus arteriosus using the Amplatzer duct occluder.

    Science.gov (United States)

    Hakim, F; Hawelleh, A A; Goussous, Y; Hijazi, Z M

    1999-05-01

    We report on a 13-year-old girl with coarctation of the aorta and patent ductus arteriosus who underwent successful simultaneous stent implantation for the coarctation and catheter closure of the ductus using an Amplatzer duct occluder. PMID:10385155

  19. The effects of Vigna unguiculata on cardiac oxidative stress and aorta estrogen receptor-β expression of ovariectomized rats

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    Etik Khusniyati

    2014-12-01

    Conclusions: V. unguiculata is an alternative therapy in decreasing cardiac oxidative stress in ovariectomized rats. Besides, high dose of V. unguiculata also able to increase aorta estrogen receptor-β expression in ovariectomized rats.

  20. Endogenous regulation of angiogenesis in the rat aorta model. Role of vascular endothelial growth factor.

    OpenAIRE

    Nicosia, R F; Lin, Y. J.; Hazelton, D.; Qian, X.

    1997-01-01

    The purpose of this study was to investigate the role of vascular endothelial growth factor (VEGF) in the rat aorta model of angiogenesis. Freshly cut aortic rings generated microvascular outgrowths in serum-free collagen gel culture. Angiogenesis was reduced to 10% when the explants were embedded in collagen 10 to 14 days after excision from the animal. Immunochemical studies of conditioned medium demonstrated secretion of VEGF by the aortic cultures. Levels of VEGF decreased during the seco...

  1. Doppler echocardiographic measurement of flow velocity in the ascending aorta during supine and upright exercise.

    OpenAIRE

    Daley, P J; Sagar, K B; Wann, L S

    1985-01-01

    Doppler echocardiography was used to measure stroke volume, peak flow velocity, and acceleration of flow in the ascending aorta in 10 healthy young volunteers during unlimited supine bicycle exercise and upright treadmill exercise. High quality studies were obtained in all subjects through the suprasternal notch acoustic window; there was no appreciable degradation in Doppler signal caused by interference by increased respiration or chest wall motion. Stroke volume index increased from 54 ml/...

  2. Traumatic rupture of the thoracic aorta: computed tomography may be a dangerous waste of time.

    OpenAIRE

    Unsworth-White, M. J.; Buckenham, T.; Treasure, T

    1994-01-01

    Traumatic rupture of the thoracic aorta is a justifiably feared condition. Some authors have proposed the use of computed tomography as a non-invasive means of diagnosis. We report two cases where computed tomographic scans were misinterpreted, leading to erroneous diagnoses and inappropriate referrals. The pitfalls of using a cross-sectional imaging technique to diagnose a transverse lesion and the relative ease and accuracy of aortography are discussed.

  3. In vitro vasorelaxation mechanisms of bioactive compounds extracted from Hibiscus sabdariffa on rat thoracic aorta

    OpenAIRE

    Gueye Lamine; Sarr Bocar; Diop Doudou; Wele Alassane; Kane Modou O; Ngom Saliou; Sarr Mamadou; Andriantsitohaina Ramaroson; Diallo Aminata S

    2009-01-01

    Abstract Background In this study, we suggested characterizing the vasodilator effects and the phytochemical characteristics of a plant with food usage also used in traditional treatment of arterial high blood pressure in Senegal. Methods Vascular effects of crude extract of dried and powdered calyces of Hibiscus sabdariffa were evaluated on isolated thoracic aorta of male Wistar rats on organ chambers. The crude extract was also enriched by liquid-liquid extraction. The various cyclohexane, ...

  4. Successful treatment of persistent chylopericardium with somatostatin after operation on ascending aorta.

    Science.gov (United States)

    Karaca, Saziye; Rager, Olivier; Kalangos, Afksendiyos

    2014-04-01

    Chylopericardium after intrathoracic surgical procedures rarely occurs. Optimal guidelines for the management of chylopericardium are lacking. In this case report, we describe our experience in treating chylopericadium with somatostatin in a 47-year-old man who underwent replacement of the ascending aorta and aortic valvuloplasty after aortic rupture. Postoperatively, a late tamponade was drained, and microbiologic analyses confirmed chyle. Conservative treatment including total parental nutrition failed, so we initiated somatostatin treatment as a continuous perfusion, with good results. PMID:24694457

  5. Estimation of prenatal aorta intima-media thickness from ultrasound examination

    International Nuclear Information System (INIS)

    Prenatal events such as intrauterine growth restriction and increased cardiovascular risk in later life have been shown to be associated with an increased intima-media thickness (aIMT) of the abdominal aorta in the fetus. In order to assess and manage atherosclerosis and cardiovascular disease risk in adults and children, in recent years the measurement of abdominal and carotid artery thickness has gained a growing appeal. Nevertheless, no computer aided method has been proposed for the analysis of prenatal vessels from ultrasound data, yet. To date, these measurements are being performed manually on ultrasound fetal images by skilled practitioners. The aim of the presented study is to introduce an automatic algorithm that identifies abdominal aorta and estimates its diameter and aIMT from routine third trimester ultrasonographic fetal data. The algorithm locates the aorta, then segments it and, by modeling the arterial wall longitudinal sections by means of a gaussian mixture, derives a set of measures of the aorta diameter (aDiam) and of the intima-media thickness (aIMT). After estimating the cardiac cycle, the mean diameter and the aIMT at the end-diastole phase are computed. Considering the aIMT value for each subject, the correlation between automatic and manual end-diastolic aIMT measurements is 0.91 in a range of values 0.44-1.10 mm, corresponding to both normal and pathological conditions. The automatic system yields a mean relative error of 19%, that is similar to the intra-observer variability (14%) and much lower that the inter-observer variability (42%). The correlation between manual and automatic measurements and the small error confirm the ability of the proposed system to reliably estimate aIMT values in prenatal ultrasound sequences, reducing measurement variability and suggesting that it can be used for an automatic assessment of aIMT. (paper)

  6. Experimental Gestational Diabetes Mellitus Induces Blunted Vasoconstriction and Functional Changes in the Rat Aorta

    OpenAIRE

    Cecilia Tufiño; Cleva Villanueva-López; Maximiliano Ibarra-Barajas; Ismael Bracho-Valdés; Rosa Amalia Bobadilla-Lugo

    2014-01-01

    Diabetic conditions increase vascular reactivity to angiotensin II in several studies but there are scarce reports on cardiovascular effects of hypercaloric diet (HD) induced gestational diabetes mellitus (GDM), so the objective of this work was to determine the effects of HD induced GDM on vascular responses. Angiotensin II as well as phenylephrine induced vascular contraction was tested in isolated aorta rings with and without endothelium from rats fed for 7 weeks (4 before and 3 weeks duri...

  7. Effects of the pregnant uterus on the abdominal aorta and its branches

    International Nuclear Information System (INIS)

    The pregnant uterus was found to exert pressure upon the lumbar region with a maximum over the midline of the lordosis and diminishing laterally. Those parts of the arterial system formed by the aorta and its dorsal branches and displaceable at autopsy, were accordingly dislodged by the uterus, whereas the fixed parts were compressed. The pressure effects extended cranially during pregnancy. Symptoms of compression can be relieved by avoiding supine and prone positions. (Auth.)

  8. Role of surgery in the management of the adult patient with coarctation of the aorta

    OpenAIRE

    Ramnarine, I

    2005-01-01

    Adult patients with coarctation of the aorta have a range of clinical presentations. These include the presence of additional cardiovascular anomalies (predominantly aortic valve abnormality) and presentation with complications after coarctation repair in childhood (such as recurrent coarctation or aneurysm formation). Developments in endovascular technology over the past decade may potentially reduce the morbidity from open surgical repair. However, some cases are unsuitable for endovascular...

  9. Forensic expertise of thoracic aorta, heart and pericardial injuries in car-occupant fatalities

    OpenAIRE

    Nikolić Slobodan

    2009-01-01

    Introduction. Forensic expertise has not specified with certainty any specific injury among fatally injured frontal car-occupants in frontal car collisions. Objective. To establish if blunt injuries of thoracic aorta, heart, and pericardium could be used as predictors where the fatally injured car-occupant was at the moment of car-collision. Methods. A retrospective autopsy study was performed. The subjects were fatally injured car-drivers, front-seat and rearseat passengers in head-on car co...

  10. An isolated left subclavian artery supplied by a collateral artery from the abdominal aorta

    Energy Technology Data Exchange (ETDEWEB)

    Ming, Zhu; Qian, Wang [Shanghai Jiaotong University School of Medicine, Department of Radiology, Shanghai Children' s Medical Center, Shanghai (China)

    2009-08-15

    An isolated left subclavian artery is a rare anomaly. We report a 9-month-old boy with an isolated left subclavian artery associated with tetralogy of Fallot and the right aortic arch. MRI and angiography show that the blood supply through the left subclavian artery was maintained by a large tortuous collateral artery from the abdominal aorta. This type of collateral artery structure is unique. (orig.)

  11. An isolated left subclavian artery supplied by a collateral artery from the abdominal aorta

    International Nuclear Information System (INIS)

    An isolated left subclavian artery is a rare anomaly. We report a 9-month-old boy with an isolated left subclavian artery associated with tetralogy of Fallot and the right aortic arch. MRI and angiography show that the blood supply through the left subclavian artery was maintained by a large tortuous collateral artery from the abdominal aorta. This type of collateral artery structure is unique. (orig.)

  12. An unusual origin of proximal coronary bypass anastomosis in a patient with porcelain aorta: How we solved the problem

    OpenAIRE

    Kovačević Pavle; Velicki Lazar; Redžek Aleksandar; Golubović Miodrag; Till Viktor; Ivanović Vladimir

    2011-01-01

    Severe calcification of the ascending aorta (porcelain aorta) is a very difficult condition in cardiac surgery because of a high embolization potential during the process of cannulation, aortic cross-clamping and a particular difficulty to suture the proximal anastomosis. We described a case of a 68-year-old female referred to our Institute due to unstable angina. Further diagnostics revealed a severe high grade, multilevel fibrolipid symptomatic carotid stenosis and ostial left main co...

  13. Ultrasonographic assessment of inferior vena cava/abdominal aorta diameter index: a new approach of assessing hypovolemic shock class 1

    OpenAIRE

    Rahman, Nik Hisamuddin NA; Ahmad, Rashidi; Kareem, Meera Mohaideen; Mohammed, Mohammad Iqhbal

    2016-01-01

    Background We designed this study to expand the usage of ultrasound to detect early occurrence of hypovolemia. We explore the potential use of inferior vena cava (IVC) and abdominal aorta (AA) diameter index (IVC:AA) measured ultrasonographically to detect class 1 hypovolemic shock with blood loss less than 15%.ᅟ Methods The aim of this study was to determine the changes in the diameter of inferior vena cava and abdominal aorta in blood donors by using ultrasound, pre and post blood donation....

  14. Bolus timing in high-pitch CT angiography of the aorta

    Energy Technology Data Exchange (ETDEWEB)

    Beeres, Martin, E-mail: beeres@gmx.net [Clinic of the Goethe University, Department of Diagnostic and Interventional Radiology, Theodor-Stern-Kai 7, 60590 Frankfurt (Germany); Loch, Matthias, E-mail: MatthiasLoch@gmx.net [Clinic of the Goethe University, Department of Diagnostic and Interventional Radiology, Theodor-Stern-Kai 7, 60590 Frankfurt (Germany); Schulz, Boris, E-mail: boris.schell@googlemail.com [Clinic of the Goethe University, Department of Diagnostic and Interventional Radiology, Theodor-Stern-Kai 7, 60590 Frankfurt (Germany); Kerl, Matthias, E-mail: matthias.kerl@gmail.com [Clinic of the Goethe University, Department of Diagnostic and Interventional Radiology, Theodor-Stern-Kai 7, 60590 Frankfurt (Germany); Al-Butmeh, Firas, E-mail: Firas.Albutmeh@gmail.com [Clinic of the Goethe University, Department of Diagnostic and Interventional Radiology, Theodor-Stern-Kai 7, 60590 Frankfurt (Germany); Bodelle, Boris, E-mail: bbodelle@googlemail.com [Clinic of the Goethe University, Department of Diagnostic and Interventional Radiology, Theodor-Stern-Kai 7, 60590 Frankfurt (Germany); Herrmann, Eva, E-mail: Herrmann@Med.Uni-Frankfurt.de [Clinic of the Goethe University, Department of Biostatistics, Theodor-Stern-Kai 7, 60590 Frankfurt (Germany); Gruber-Rouh, Tatjana, E-mail: tatjanagruber2004@yahoo.de [Clinic of the Goethe University, Department of Diagnostic and Interventional Radiology, Theodor-Stern-Kai 7, 60590 Frankfurt (Germany); Lee, Clara, E-mail: Clara.Lee@kgu.de [Clinic of the Goethe University, Department of Diagnostic and Interventional Radiology, Theodor-Stern-Kai 7, 60590 Frankfurt (Germany); Jacobi, Volkmar, E-mail: Volkmar.Jacobi@kgu.de [Clinic of the Goethe University, Department of Diagnostic and Interventional Radiology, Theodor-Stern-Kai 7, 60590 Frankfurt (Germany); Vogl, Thomas J., E-mail: T.Vogl@em.uni-frankfurt.de [Clinic of the Goethe University, Department of Diagnostic and Interventional Radiology, Theodor-Stern-Kai 7, 60590 Frankfurt (Germany); and others

    2013-06-15

    Objective: To investigate the bolus geometry in high-pitch CT angiography (CTA) of the aorta without ECG synchronisation in comparison to single-source CT. Methods: Overall 160 consecutive patients underwent CTA either in conventional single-source mode with a pitch of 1.2 (group 1), or in dual-source mode with a pitch of 3.0 (groups 2, 3 and 4) using different contrast media timings with bolus triggering at 140 HU (5 s, group 1; 10 s, group 2; 12 s, group 3; 14 s, group 4). Contrast material, saline flush, flow rate and kV/mAs settings were kept equal for optimum comparability. Aortic attenuation was measured along the z-axis of the patient at different anatomic landmarks and subjective image quality was compared. Results: The most homogeneous enhancement of the aorta was reached with a delay of 10 s after reaching the trigger threshold. The imaging length was not significantly different, but the examination time was significantly (p < 0.001) shorter in the high-pitch group (7.7 s vs. 1.7 s for group 1 vs. 2, 3 and 4). Conclusion: In high-pitch CT angiography using a start delay of 10 s after a trigger threshold of 140 HU in the descending aorta is reached, a homogenous contrast along the z-axis is accomplished.

  15. Clinical analysis of abdominal aorta block in operation of gynecologic tumor

    Institute of Scientific and Technical Information of China (English)

    MU Yu-lan; TANG Chun-sheng; WEN Ze-qing; YIN Fu-bo; LIU Ming

    2006-01-01

    Objective:To evaluate the clinical effects of the abdominal aorta block in controlling haemorrhage during operations of the gynecologic tumor. Methods: From July 1965 to January 2005, we collected patients (n= 49) of gynecologic tumor complicated with haemorrhage during operations, who were divided into 3 groups: preventive blocking group (PG, n= 12), treatment blocking group (TG, n= 20) used abdominal aorta block technique with sterilized cotton band and silica gel tube, and control group (CG, n=17) which were used the regular haemostatic methods, such as ligature, suture and ribbon gauze packing.During operations, the vital signs including the amount of bleeding and transfusion were measured. Results: Compared with the CG, the amount of bleeding and transfusion in the PG and TG decreased significantly (P<0.01). After using the technique, 32 cases of haemorrhage were controlled completely. All patients finished operation smoothly in the end and the vital signs were stable. The vision field of operation was clear and the operating time was shortened dramatically (3.0 h vs 5.7 h and 3.8 h vs 5.7 h, P<0.01). No complications caused by the block occurred in the post-operation. Conclusion: Lower abdominal aorta block is safe and effective in controlling haemorrhage during operations of the gynecologic tumor.

  16. Thymoquinone protects end organs from abdominal aorta ischemia/reperfusion injury in a rat model

    Directory of Open Access Journals (Sweden)

    Mehmet Salih Aydin

    2015-02-01

    Full Text Available Introduction: Previous studies have demonstrated that thymoquinone has protective effects against ischemia reperfusion injury to various organs like lungs, kidneys and liver in different experimental models. Objective: We aimed to determine whether thymoquinone has favorable effects on lung, renal, heart tissues and oxidative stress in abdominal aorta ischemia-reperfusion injury. Methods: Thirty rats were divided into three groups as sham (n=10, control (n=10 and thymoquinone (TQ treatment group (n=10. Control and TQ-treatment groups underwent abdominal aorta ischemia for 45 minutes followed by a 120-min period of reperfusion. In the TQ-treatment group, thymoquinone was given 5 minutes. before reperfusion at a dose of 20 mg/kg via an intraperitoneal route. Total antioxidant capacity, total oxidative status (TOS, and oxidative stress index (OSI in blood serum were measured and lung, kidney, and heart tissue histopathology were evaluated with light microscopy. Results: Total oxidative status and oxidative stress index activity in blood samples were statistically higher in the control group compared to the sham and TQ-treatment groups (P<0.001 for TOS and OSI. Control group injury scores were statistically higher compared to sham and TQ-treatment groups (P<0.001 for all comparisons. Conclusion: Thymoquinone administered intraperitoneally was effective in reducing oxidative stress and histopathologic injury in an acute abdominal aorta ischemia-reperfusion rat model.

  17. Aorta Structural Alterations in Term Neonates: The Role of Birth and Maternal Characteristics

    Directory of Open Access Journals (Sweden)

    Marco Matteo Ciccone

    2013-01-01

    Full Text Available Aim. To evaluate the influence of selected maternal and neonatal characteristics on aorta walls in term, appropriately grown-for-gestational age newborns. Methods. Age, parity, previous abortions, weight, height, body mass index before and after delivery, smoking, and history of hypertension, of diabetes, of cardiovascular diseases, and of dyslipidemia were all assessed in seventy mothers. They delivered 34 males and 36 females healthy term newborns who underwent ultrasound evaluation of the anteroposterior infrarenal abdominal aorta diameter (APAO, biochemical profile (glucose, insulin, total cholesterol, HDL and LDL cholesterol, triglycerides, fibrinogen, and D-dimers homeostasis model assessment [HOMAIR]index, and biometric parameters. Results. APAO was related to newborn length (r=+0.36; P=0.001, head circumference (r=+0.37; P=0.001, gestational age (r=+0.40, P=0.0005, HOMA index (r=+0.24; P=0.04, and D-dimers (r=+0.33, P=0.004. Smoke influenced APAO values (odds ratio: 1.80; confidence interval 95%: 1.05–3.30, as well as diabetes during pregnancy (r=+0.42, P=0.0002. Maternal height influenced neonatal APAO (r=+0.47, P=0.00003. Multiple regression analysis outlined neonatal D-dimers as still significantly related to neonatal APAO values. Conclusions. Many maternal and neonatal characteristics could influence aorta structures. Neonatal D-dimers are independently related to APAO.

  18. Decellularized aorta of fetal pigs as a potential scaffold for small diameter tissue engineered vascular graft

    Institute of Scientific and Technical Information of China (English)

    LIU Guo-feng; HE Zhi-juan; YANG Da-ping; HAN Xue-feng; GUO Tie-fang; HAO Chen-guang; MA Hui; NIE Chun-lei

    2008-01-01

    Background For cardiovascular tissue engineering, acellularized biomaterials from pig have been widely investigated. Our purpose was to study mechanical properties and biocompatibility of decellularized aorta of fetal pigs (DAFP) to determine its potential as scaffold for small diameter tissue engineered vascular graft.Methods Descending aorta of fetal pigs was removed cells using trypsin, ribonuclease and desoxyribonuclease. Mechanical properties of DAFP were evaluated by tensile stress-strain and burst pressure analysis. Assessment of cell adhesion and compatibility was conducted by seeding porcine aortic endothelial cells. To evaluate biocompatibility in vivo, DAFP was implanted subcutaneously into adult male Sprague Dawley rats for 2, 4 and 8 weeks.Results Histochemistry and scanning electron microscopy examination of DAFP revealed well-preserved extracellular matrix proteins and porous three-dimensional structures. Compared with fresh aorta, DAFP had similar ultimate tensile strength, axial compliance and burst pressure. Cell culture studies in vitro showed that porcine aortic endothelial cells adhered and proliferated on the surfaces of DAFP with excellent cell viability. Subdermal implantation demonstrated that the DAFP did not show almost any immunological reaction and exhibited minimal calcification during the whole follow-up period.Conclusion The DAFP has the potential to serve as scaffolds for small diameter tissue engineered vascular graft.

  19. Procyanidins in crataegus extract evoke endothelium-dependent vasorelaxation in rat aorta.

    Science.gov (United States)

    Kim, S H; Kang, K W; Kim, K W; Kim, N D

    2000-01-01

    The extract of Crataegus, a mixture of flavonoids and procyanidins extracted from hawthorn, Crataegus oxyacantha, L. and C. monogyna Jacq., relaxed vascular tone or increased production of cyclic GMP in the rat aorta, but flavonoid components of Crataegus extract, hyperoside, rutin and vitexin, did not affect the vascular tone. The aim of the present study was to characterize the endothelium-dependent relaxation elicited by procyanidins fractionated from Crataegus extract in isolated rat aorta. Procyanidins caused endothelium-dependent relaxation which was associated with the production of cyclic GMP. Both responses to these procyanidins were inhibited by methylene blue or N(G)-nitro-L-arginine, but not by indomethacin. Relaxation in response to procyanidins was not affected by atropine, diphenhydramine, [D-Pro2,D-Trp7,9]substance P, propranolol, nifedipine, verapamil and glibenclamide, but were markedly reduced by tetraethylammonium. These findings showed that procyanidins in Crataegus extract may be responsible for the endothelium-dependent nitric oxide-mediated relaxation in isolated rat aorta, possibly via activation of tetraethylammonium-sensitive K+ channels. PMID:10901280

  20. Lung, aorta, and platelet metabolism of 14C-arachidonic acid in vitamin E deficient rats

    International Nuclear Information System (INIS)

    14C-arachidonic acid metabolism was determined in aortas, platelets, and perfused lungs from rats pair fed a basal diet supplemented with 0 or 100 ppm vitamin E for 11 weeks. Spontaneous erythrocyte hemolysis tests showed 92% and 8% hemolysis for the 0 and 100 ppm vitamin E groups, respectively. Elevated lung homogenate levels of malonaldehyde in the 0 ppm group confirmed its deficient vitamin E status. Aortas from the vitamin E deficient group synthesized 54% less prostacyclin than aortas from the supplemented group (p less than 0.05). Although thromboxane generation by platelets from the vitamin E deficient group exhibited a 37% increase, this difference was not statistically significant compared to the supplemented animals. Greater amounts of PGE2, PGF2 alpha, TXB2, and 6-keto-PGF1 alpha were obtained in albumin buffer perfusates from lungs of vitamin E deficient rats than in those from supplemented rats. Significant differences (p less than 0.05) were noticed, however, only for PGE2 and PGF2 alpha. These studies indicate that vitamin E quantitatively alters arachidonic acid metabolism in aortic and lung tissue but its effect on thromboxane synthesis by platelets is less marked

  1. Plaque of atherosclerosis in aorta: review on atherogenesis, formation of plaque, clinical significance, methods of imaging and treatment

    International Nuclear Information System (INIS)

    There is a certain consensus in the literature that the earliest stage of atherogenesis is characterized by the accumulation of spongy cells in the region of the intimal artery. Risk factors such as arterial hypertension, smoking, diabetes mellitus, hypercholesterolemia, male gender and advanced age predispose a person to the formation of plaques in the coronaries and aorta. A greater number of acute coronary events as well as strokes have been observed in people with these risk factors. Strokes are the third cause of death in the USA, with about 40% of the cases being of cryptogenic origin. Since 1989 the atheroma plaques which develop in the thoracic aorta have been considered to be responsible for cerebral and peripheral strokes which were previously considered cryptogenic because imaging techniques such as electrocardiogram transesophageal, computerized tomogram, nuclear magnetic angio-resonance have visualized and characterized the lesions with plaques of arteriosclerosis in the thoracic aorta. The authors of this article made a systematic review in the PUBMED about arteriosclerosis in the aorta and its diagnostic methods. This review includes the physiopathology of the formation of atheroma to the aorta and its consequences, diagnostic methods such as echo transesophageal, computerized tomogram and angio resonance, as well as the advantages and disadvantages of each method of identification of the lesions. An analysis of the clinical significance of the size, form and location of the atheroma plaques in the thoracic aorta were made based on clinical studies, as well as their treatment with anticoagulants, antiplatelet and drugs to reduce cholesterol. (author)

  2. Trombólise intra-arterial pulmonar no pós-operatório de clipagem de aneurisma cerebral: relato de caso Intra-arterial pulmonary thrombolysis at the postoperative period of brain aneurysm clamping: case report

    Directory of Open Access Journals (Sweden)

    Salomón Soriano Ordinola Rojas

    2008-09-01

    Full Text Available O tromboembolismo pulmonar (TEP é uma importante causa de morbimortalidade nos pacientes submetidos a procedimentos neurocirúrgicos. O objetivo deste estudo foi apresentar um caso de trombólise intra-arterial pulmonar em pós-operatório recente de neurocirurgia. Paciente do sexo masculino, sendo submetido a clipagem de aneurisma de artéria comunicante anterior, apresentou como complicação no sétimo dia de pós-operatório, tromboembolismo pulmonar maciço, apresentando instabilidade hemodinâmica, sendo optado pela trombólise intra-arterial pulmonar com alteplase. Apresentou evolução satisfatória, sem complicações hemorrágicas, recebendo alta hospitalar. O tromboembolismo pulmonar é uma condição com alta morbi-mortalidade no pós-operatório de neurocirurgia, devendo ser a trombólise ser uma alternativa terapêutica nos casos refratários ao tratamento clínico.Pulmonary thromboembolism is a major cause of morbidity and mortality of patients undergoing neurosurgical procedures. The purpose of this study was to present a case of intra-arterial pulmonary thrombolysis in recent neurosurgery postoperative period. Male patient, undergoing neurosurgery, presented as a complication on the seventh day of postoperative massive pulmonary embolism with hemodynamic instability and intraarterial pulmonary thrombolysis with alteplase was indicated. Evolution was satisfactory without bleeding complications and patient was discharged. Pulmonary thromboembolism is a high morbidity and mortality condition at neurosurgical postoperative period and thrombolysis should be an alternative therapy in cases refractory to clinical treatment.

  3. Úlcera penetrante de aorta ascendente en un paciente asintomático Penetrating ascending aortic ulcer in an asymptomatic patient

    Directory of Open Access Journals (Sweden)

    A. Bayona

    2012-08-01

    Full Text Available La úlcera penetrante de aorta (UPA es la ulceración de una placa aterosclerótica que afecta a la lámina elástica interna de la aorta, y que puede evolucionar hacia un hematoma de pared o una disección aórtica si se produce el paso de sangre hacia la capa media. A pesar de que se localiza más frecuentemente en la aorta descendente, puede presentar una alta mortalidad en caso de situarse en la aorta ascendente, donde la cirugía está indicada aunque el paciente se encuentre asintomático. Presentamos el caso de un paciente sin sintomatología con úlcera penetrante de aorta ascendente (UPAA ascendente sometido a sustitución de aorta ascendente por una prótesis vascular.Penetrating aortic ulcer (PAU has been defined as an atherosclerotic plaque ulceration that breaks the internal elastic lamina of the aorta, which may progress to a wall hematoma or aortic dissection in case of blood seeping into the middle layer. Although PAU is commonly located in the descending aorta, the involvement of the ascending aorta can be fatal. Therefore, surgery is indicated even in asymptomatic patients presenting an ascending PAU. We report on an asymptomatic patient with ascending PAU referred for replacement of the ascending aorta with a composite prosthetic graft.

  4. Analysis of the thoracic aorta using a semi-automated post processing tool

    Energy Technology Data Exchange (ETDEWEB)

    Entezari, Pegah, E-mail: p-entezari@northwestern.edu [Department of Radiology, Cardiovascular Imaging, Northwestern University, Chicago, IL (United States); Kino, Aya, E-mail: ayakino@gmail.com [Department of Radiology, Cardiovascular Imaging, Northwestern University, Chicago, IL (United States); Honarmand, Amir R., E-mail: arhonarmand@yahoo.com [Department of Radiology, Cardiovascular Imaging, Northwestern University, Chicago, IL (United States); Galizia, Mauricio S., E-mail: maugalizia@yahoo.com.br [Department of Radiology, Cardiovascular Imaging, Northwestern University, Chicago, IL (United States); Yang, Yan, E-mail: yyang@vitalimages.com [Vital images Inc, Minnetonka, MN (United States); Collins, Jeremy, E-mail: collins@fsm.northwestern.edu [Department of Radiology, Cardiovascular Imaging, Northwestern University, Chicago, IL (United States); Yaghmai, Vahid, E-mail: vyaghmai@northwestern.edu [Department of Radiology, Cardiovascular Imaging, Northwestern University, Chicago, IL (United States); Carr, James C., E-mail: jcarr@northwestern.edu [Department of Radiology, Cardiovascular Imaging, Northwestern University, Chicago, IL (United States)

    2013-09-15

    Objective: To evaluates a semi-automated method for Thoracic Aortic Aneurysm (TAA) measurement using ECG-gated Dual Source CT Angiogram (DSCTA). Methods: This retrospective HIPAA compliant study was approved by our IRB. Transaxial maximum diameters of outer wall to outer wall were studied in fifty patients at seven anatomic locations of the thoracic aorta: annulus, sinus, sinotubular junction (STJ), mid ascending aorta (MAA) at the level of right pulmonary artery, proximal aortic arch (PROX) immediately proximal to innominate artery, distal aortic arch (DIST) immediately distal to left subclavian artery, and descending aorta (DESC) at the level of diaphragm. Measurements were performed using a manual method and semi-automated software. All readers repeated their measurements. Inter-method, intra-observer and inter-observer agreements were evaluated according to intraclass correlation coefficient (ICC) and Bland–Altman plot. The number of cases with manual contouring or center line adjustment for the semi-automated method and also the post-processing time for each method were recorded. Results: The mean difference between semi-automated and manual methods was less than 1.3 mm at all seven points. Strong inter-method, inter-observer and intra-observer agreement was recorded at all levels (ICC ≥ 0.9). The maximum rate of manual adjustment of center line and contour was at the level of annulus. The average time for manual post-processing of the aorta was 19 ± 0.3 min, while it took 8.26 ± 2.1 min to do the measurements with the semi-automated tool (Vitrea version 6.0.0.1 software). The center line was edited manually at all levels, with most corrections at the level of annulus (60%), while the contour was adjusted at all levels with highest and lowest number of corrections at the levels of annulus and DESC (75% and 0.07% of the cases), respectively. Conclusion: Compared to the commonly used manual method, semi-automated measurement of vessel dimensions is

  5. The implantation of separating aortic stent-graft into the canine thoracic aorta: an experimental study

    International Nuclear Information System (INIS)

    Objective: to assess the technical feasibility of implanting separating stent-graft into the canine thoracic aorta and to study its biocompatibility. Methods: Twelve adult dogs were randomly and equally divided into three groups. The right femoral artery was cut open, through which the separating stent-graft was inserted and deployed in the canine thoracic aorta, with the proximal end of the graft being quite close to the origin of the left subclavian artery. the technical feasibility of the deployment process was assessed. Angiography was performed at 4, 8 and 12 weeks after stent-graft placement to evaluate the position and patency of the stent-graft. Then the dogs were sacrificed and the specimens were collected for pathologic study. Both gross and microscopic examinations were made to evaluate the fixation of the stent-graft with the vessel wall, the endothelialization of stent-graft surface and the pathologic changes of the vascular wall. Results: A total of ten separating stent-grafts were successfully deployed in the canine thoracic aorta, no migration or deformation occurred. One dog died of massive bleeding due to the rupture of the right femoral artery which occurred when the delivery system containing the inner bare stent was inserted through the right femoral artery. Death occurred in another dog as a result of the ascending aorta rupture caused by the migration of outer-layer stent-graft. Angiography was conducted at 4, 8 and 12 weeks after stent-graft placement. No migration, deformation, rupture or stenosis of the implanted stent-grafts were observed. The formation of intima on the inner surface of the bare stent appeared at 4 weeks, which became more and more obvious with the time passing, and at 12 weeks complete endothelialization of stent-graft surface was observed. Conclusion: Technically, it is feasible to deploy the separating aortic stent-graft into the canine thoracic aorta. Moreover, the separating aortic stent-graft carries excellent

  6. Estimation of prenatal aorta intima-media thickness from ultrasound examination

    Science.gov (United States)

    Veronese, E.; Tarroni, G.; Visentin, S.; Cosmi, E.; Linguraru, M. G.; Grisan, E.

    2014-10-01

    Prenatal events such as intrauterine growth restriction and increased cardiovascular risk in later life have been shown to be associated with an increased intima-media thickness (aIMT) of the abdominal aorta in the fetus. In order to assess and manage atherosclerosis and cardiovascular disease risk in adults and children, in recent years the measurement of abdominal and carotid artery thickness has gained a growing appeal. Nevertheless, no computer aided method has been proposed for the analysis of prenatal vessels from ultrasound data, yet. To date, these measurements are being performed manually on ultrasound fetal images by skilled practitioners. The aim of the presented study is to introduce an automatic algorithm that identifies abdominal aorta and estimates its diameter and aIMT from routine third trimester ultrasonographic fetal data. The algorithm locates the aorta, then segments it and, by modeling the arterial wall longitudinal sections by means of a gaussian mixture, derives a set of measures of the aorta diameter (aDiam) and of the intima-media thickness (aIMT). After estimating the cardiac cycle, the mean diameter and the aIMT at the end-diastole phase are computed. Considering the aIMT value for each subject, the correlation between automatic and manual end-diastolic aIMT measurements is 0.91 in a range of values 0.44-1.10 mm, corresponding to both normal and pathological conditions. The automatic system yields a mean relative error of 19%, that is similar to the intra-observer variability (14%) and much lower that the inter-observer variability (42%). The correlation between manual and automatic measurements and the small error confirm the ability of the proposed system to reliably estimate aIMT values in prenatal ultrasound sequences, reducing measurement variability and suggesting that it can be used for an automatic assessment of aIMT. Preliminary results have been presented in E Veronese, E Cosmi, S Visentin, E Grisan: 'Semiautomatic estimation

  7. Analysis of the thoracic aorta using a semi-automated post processing tool

    International Nuclear Information System (INIS)

    Objective: To evaluates a semi-automated method for Thoracic Aortic Aneurysm (TAA) measurement using ECG-gated Dual Source CT Angiogram (DSCTA). Methods: This retrospective HIPAA compliant study was approved by our IRB. Transaxial maximum diameters of outer wall to outer wall were studied in fifty patients at seven anatomic locations of the thoracic aorta: annulus, sinus, sinotubular junction (STJ), mid ascending aorta (MAA) at the level of right pulmonary artery, proximal aortic arch (PROX) immediately proximal to innominate artery, distal aortic arch (DIST) immediately distal to left subclavian artery, and descending aorta (DESC) at the level of diaphragm. Measurements were performed using a manual method and semi-automated software. All readers repeated their measurements. Inter-method, intra-observer and inter-observer agreements were evaluated according to intraclass correlation coefficient (ICC) and Bland–Altman plot. The number of cases with manual contouring or center line adjustment for the semi-automated method and also the post-processing time for each method were recorded. Results: The mean difference between semi-automated and manual methods was less than 1.3 mm at all seven points. Strong inter-method, inter-observer and intra-observer agreement was recorded at all levels (ICC ≥ 0.9). The maximum rate of manual adjustment of center line and contour was at the level of annulus. The average time for manual post-processing of the aorta was 19 ± 0.3 min, while it took 8.26 ± 2.1 min to do the measurements with the semi-automated tool (Vitrea version 6.0.0.1 software). The center line was edited manually at all levels, with most corrections at the level of annulus (60%), while the contour was adjusted at all levels with highest and lowest number of corrections at the levels of annulus and DESC (75% and 0.07% of the cases), respectively. Conclusion: Compared to the commonly used manual method, semi-automated measurement of vessel dimensions is

  8. 6-Gingerol alleviates exaggerated vasoconstriction in diabetic rat aorta through direct vasodilation and nitric oxide generation

    Directory of Open Access Journals (Sweden)

    Ghareib SA

    2015-11-01

    Full Text Available Salah A Ghareib,1 Hany M El-Bassossy,1,2 Ahmed A Elberry,3,4 Ahmad Azhar,5 Malcolm L Watson,6 Zainy Mohammed Banjar7 1Department of Pharmacology and Toxicology, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia; 2Department of Pharmacology, Faculty of Pharmacy, Zagazig University, Zagazig, Egypt; 3Department of Clinical Pharmacy, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia; 4Department of Pharmacology, Faculty of Medicine, Beni Suef University, Beni Suef, Egypt; 5Department of Pediatric Cardiology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; 6Department of Pharmacy and Pharmacology, University of Bath, Bath, UK; 7Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia Abstract: The aim of the present study is to investigate the effect and potential mechanism of action of 6-gingerol on alterations of vascular reactivity in the isolated aorta from diabetic rats. Male Wistar rats were divided into two experimental groups, control and diabetics. Diabetes was induced by a single intraperitoneal injection of streptozotocin (50 mg kg-1, and the rats were left for 10 weeks to develop vascular complications. The effect of in vitro incubation with 6-gingerol (0.3–3 µM on the vasoconstrictor response of the isolated diabetic aortae to phenylephrine and the vasodilator response to acetylcholine was examined. Effect of 6-gingerol was also examined on aortae incubated with methylglyoxal as an advanced glycation end product (AGE. To investigate the mechanism of action of 6-gingerol, the nitric oxide synthase inhibitor Nω-nitro-L-arginine methyl ester hydrochloride (100 µM, guanylate cyclase inhibitor methylene blue (5 µM, calcium-activated potassium channel blocker tetraethylammonium chloride (10 mM, and cyclooxygenase inhibitor indomethacin (5 µM were added 30 minutes before assessing the direct vasorelaxant effect of 6

  9. A theory for water and macromolecular transport in the pulmonary artery wall with a detailed comparison to the aorta.

    Science.gov (United States)

    Zeng, Zhongqing; Jan, Kung-Ming; Rumschitzki, David S

    2012-04-15

    The pulmonary artery (PA) wall, which has much higher hydraulic conductivity and albumin void space and approximately one-sixth the normal transmural pressure of systemic arteries (e.g, aorta, carotid arteries), is rarely atherosclerotic, except under pulmonary hypertension. This study constructs a detailed, two-dimensional, wall-structure-based filtration and macromolecular transport model for the PA to investigate differences in prelesion transport processes between the disease-susceptible aorta and the relatively resistant PA. The PA and aorta models are similar in wall structure, but very different in parameter values, many of which have been measured (and therefore modified) since the original aorta model of Huang et al. (23). Both PA and aortic model simulations fit experimental data on transwall LDL concentration profiles and on the growth of isolated endothelial (horseradish peroxidase) tracer spots with circulation time very well. They reveal that lipid entering the aorta attains a much higher intima than media concentration but distributes better between these regions in the PA than aorta and that tracer in both regions contributes to observed tracer spots. Solutions show why both the overall transmural water flow and spot growth rates are similar in these vessels despite very different material transport parameters. Since early lipid accumulation occurs in the subendothelial intima and since (matrix binding) reaction kinetics depend on reactant concentrations, the lower intima lipid concentrations in the PA vs. aorta likely lead to slower accumulation of bound lipid in the PA. These findings may be relevant to understanding the different atherosusceptibilities of these vessels. PMID:22198178

  10. Relaxation of Rat Aorta by Farrerol Correlates with Potency to Reduce Intracellular Calcium of VSMCs

    Directory of Open Access Journals (Sweden)

    Xiaojiang Qin

    2014-04-01

    Full Text Available Farrerol, isolated from Rhododendron dauricum L., has been proven to be an important multifunctional physiologically active component, but its vasoactive mechanism is not clear. The present study was performed to observe the vasoactive effects of farrerol on rat aorta and to investigate the possible underlying mechanisms. Isolated aortic rings of rat were mounted in an organ bath system and the myogenic effects stimulated by farrerol were studied. Intracellular Ca2+ ([Ca2+]in was measured by molecular probe fluo-4-AM and the activities of L-type voltage-gated Ca2+ channels (LVGC were studied with whole-cell patch clamp in cultured vascular smooth muscle cells (VSMCs. The results showed that farrerol significantly induced dose-dependent relaxation on aortic rings, while this vasorelaxation was not affected by NG-nitro-l-arginine methylester ester or endothelium denudation. In endothelium-denuded aortas, farrerol also reduced Ca2+-induced contraction on the basis of the stable contraction induced by KCl or phenylephrine (PE in Ca2+-free solution. Moreover, after incubation with verapamil, farrerol can induce relaxation in endothelium-denuded aortas precontracted by PE, and this effect can be enhanced by ruthenium red, but not by heparin. With laser scanning confocal microscopy method, the farrerol-induced decline of [Ca2+]in in cultured VSMCs was observed. Furthermore, we found that farrerol could suppress Ca2+ influx via LVGC by patch clamp technology. These findings suggested that farrerol can regulate the vascular tension and could be developed as a practicable vasorelaxation drug.

  11. Factors associated with calcification of the thoracic aorta determined by three-dimensional computed tomography

    International Nuclear Information System (INIS)

    The objective of this study is to examine factors associated with the development of vascular calcification of the thoracic aorta determined by three-dimensional computed tomography. Computed tomography (Light Speed 16 from General Electric Company) using contrast medium was performed in 46 hemodialysis patients (29 males and 17 females). The volume of the thoracic aorta, 10 cm caudal part from the bifurcation of the trachea, and the volume of the vascular calcification were determined using the software, Advantage Workstation 4.2. Calcification index (CS) was defined as the ratio of the volume of the vascular calcification to the volume of the thoracic aorta. The association of annual changes in CS (ΔCS) with multiple factors was examined. ΔCS showed positive correlation with the product of average corrected serum calcium (Ca) and phosphorus (P) for one year, Whole parathyroid hormone (PTH), maximal thickness of the intima-media complex of the carotid artery (Max IMT), pulse-wave velocity, and age. Stepwise multiple regression analysis disclosed that ΔCS was predictable from Whole PTH, Max IMT, and Ca·P product. ΔCS did not correlate with average serum Ca, P, undercarboxylated osteocalcin (ucOC), osteocalcin (OC), ucOC/OC, pentosidine, low-density lipoprotein (LDL) cholesterol, average systolic blood pressure for one year, radial cortical bone density, or dialysis duration. ΔCS was not significantly different between males and females, diabetics and non-diabetics, smokers and non-smokers, patients with and without vitamin D injection, or patients with and without cinacalcet hydrochloride. Our data suggest that the important factors associated with development of vascular calcification are Ca·P product, PTH, and Max IMT. (author)

  12. Intramural haematoma of the thoracic aorta: who's to be alerted the cardiologist or the cardiac surgeon?

    Directory of Open Access Journals (Sweden)

    Papadopoulos Georgios S

    2009-10-01

    Full Text Available Abstract This review article is written so as to present the pathophysiology, the symptomatology and the ways of diagnosis and treatment of a rather rare aortic disease called Intra-Mural Haematoma (IMH. Intramural haematoma is a quite uncommon but potentially lethal aortic disease that can strike as a primary occurrence in hypertensive and atherosclerotic patients to whom there is spontaneous bleeding from vasa vasorum into the aortic wall (media or less frequently, as the evolution of a penetrating atherosclerotic ulcer (PAU. IMH displays a typical of dissection progress, and could be considered as a precursor of classic aortic dissection. IMH enfeebles the aortic wall and may progress to either outward rupture of the aorta or inward disruption of the intima layer, which ultimately results in aortic dissection. Chest and back acute penetrating pain is the most commonly noticed symptom at patients with IMH. Apart from a transesophageal echocardiography (TEE, a tomographic imaging such as a chest computed tomography (CT, a magnetic resonance (MRI and most lately a multy detector computed tomography (MDCT can ensure a quick and accurate diagnosis of IMH. Similar to type A and B aortic dissection, surgery is indicated at patients with type-A IMH, as well as at patients with a persistent and/or recurrent pain. For any other patient (with type-B IMH without an incessant pain and/or without complications, medical treatment is suggested, as applied in the case of aortic dissection. The outcome of IMH in ascending aorta (type A appears favourable after immediate (emergent or urgent surgical intervention, but according to international bibliography patients with IMH of the descending aorta (type B show similar mortality rates to those being subjected to conservative medical or surgical treatment. Endovascular surgery and stent-graft placement is currently indicated in type B IMH.

  13. Heartbeat-related distension and displacement of the thoracic aorta in healthy volunteers

    International Nuclear Information System (INIS)

    Purpose: To test our hypothesis that distension and displacement in various segments of the healthy thoracic aorta are significant and can be predicted based on clinical characteristics. Materials and methods: Sixty-one Caucasian volunteers without cardiovascular disease (49 ± 16 years, range 19–82; 28 men, 33 women) divided into two age groups (A: <50, B: ≥50 years) underwent 1.5-T MRI. ECG-gated dynamic data sets were acquired at five locations perpendicular to the thoracic aorta. Aortic distension and Centre of Mass (CoM) displacement were determined as percentages of diastolic aortic diameter. A multiple linear regression model including age group, gender, location, mean arterial blood pressure, heart rate and body mass index was tested. Results: Mean aortic distension averaged over all locations was 11.2 ± 4.1% (age group A) and 6.7 ± 3.3% (age group B), mean displacement 15.1 ± 8.3% (A) and 11.0 ± 6.2% (B). Systolic and diastolic aortic diameter and CoM position significantly differed at all locations (p < 0.001). Distension and displacement could be predicted based on the regression model (p < 0.001). Age group A and women exhibited significantly greater distension and displacement compared to age group B (p < 0.001) and men (p < 0.01), respectively. Distension increased, displacement decreased from proximal to distal. Conclusion: Distension and translational displacement are significant at all levels of the thoracic aorta and can be predicted based on clinical characteristics.

  14. Vasa vasorum in the tunica media and tunica adventitia of the porcine aorta.

    Science.gov (United States)

    Tonar, Zbyněk; Tomášek, Petr; Loskot, Petr; Janáček, Jiří; Králíčková, Milena; Witter, Kirsti

    2016-05-01

    Vasa vasorum supply both the tunica adventitia and the tunica media of major arteries with nutrients and oxygen. We estimated the density of von Willebrand factor-positive profiles of vasa vasorum visible in transversal histological sections of 123 tissue samples collected from five anatomical positions in the porcine aortae of growing pigs (n=25). The animals ranged in age from 0 to 230 days. The tunica media of the thoracic aorta had a greater vasa vasorum density, with microvessels penetrating deeper towards the lumen than in the abdominal aorta. The density of vasa vasorum gradually decreased with age in both the media and the adventitia. The relative depth into which the vasa vasorum penetrated and where they branched remained constant during the ageing and growth of the media. The ratio of the tunica media and tunica adventitia thicknesses did not change in the single aortic segments during ageing. The media of older animals received fewer but equally distributed vasa vasorum. A greater density of vasa vasorum in the media was correlated with greater media thickness and a greater elastin fraction (data on elastin taken from another study on the same samples). Immunohistochemical quantification revealed deeper penetration of vasa vasorum towards the adluminal layers of the tunica media that were hitherto reported to be avascular. The complete primary morphometric data, in the form of continuous variables, have been made available as a supplement. Mapping of the vasa vasorum profile density and position has promising illustrative potential for studies on atherosclerotic and inflammatory neovascularization, aortic aneurysms, and drug distribution from arterial stents in experimental porcine models. PMID:26844625

  15. Intramural haematoma of the thoracic aorta: who's to be alerted the cardiologist or the cardiac surgeon?

    Science.gov (United States)

    Baikoussis, Nikolaos G; Apostolakis, Efstratios E; Siminelakis, Stavros N; Papadopoulos, Georgios S; Goudevenos, John

    2009-01-01

    This review article is written so as to present the pathophysiology, the symptomatology and the ways of diagnosis and treatment of a rather rare aortic disease called Intra-Mural Haematoma (IMH). Intramural haematoma is a quite uncommon but potentially lethal aortic disease that can strike as a primary occurrence in hypertensive and atherosclerotic patients to whom there is spontaneous bleeding from vasa vasorum into the aortic wall (media) or less frequently, as the evolution of a penetrating atherosclerotic ulcer (PAU). IMH displays a typical of dissection progress, and could be considered as a precursor of classic aortic dissection. IMH enfeebles the aortic wall and may progress to either outward rupture of the aorta or inward disruption of the intima layer, which ultimately results in aortic dissection. Chest and back acute penetrating pain is the most commonly noticed symptom at patients with IMH. Apart from a transesophageal echocardiography (TEE), a tomographic imaging such as a chest computed tomography (CT), a magnetic resonance (MRI) and most lately a multy detector computed tomography (MDCT) can ensure a quick and accurate diagnosis of IMH. Similar to type A and B aortic dissection, surgery is indicated at patients with type-A IMH, as well as at patients with a persistent and/or recurrent pain. For any other patient (with type-B IMH without an incessant pain and/or without complications), medical treatment is suggested, as applied in the case of aortic dissection. The outcome of IMH in ascending aorta (type A) appears favourable after immediate (emergent or urgent) surgical intervention, but according to international bibliography patients with IMH of the descending aorta (type B) show similar mortality rates to those being subjected to conservative medical or surgical treatment. Endovascular surgery and stent-graft placement is currently indicated in type B IMH. PMID:19793400

  16. A practical MRI technique for detecting Abdominal Aorta Aneurism and Peripheral Arterial Disease

    Directory of Open Access Journals (Sweden)

    Aykut Aktas

    2014-12-01

    Full Text Available Aim: Peripheral Arterial Disease(PAD and abdominal aorta aneurysm(AAA are frequent problems in geriatric population. In DSA, CTA or MRA techniques contrast agents has to be used for diagnosis that can be nephrotoxic for elderly patients. Magnetic resonans imaging (MRI is the most powerful, non-ionising radiological diagnostic tool that has the highest soft tissue contrast resolution. The aim of our study was to investigate the effectivity of MRI by the means of detecting the AAA and PAD in comparison with DSA. Material and Method: After getting ethical commitee approvel and informed consent, we have performed Balanced turbo field echo(B-TFE MRI technique without contrast agent in 1.5 Tesla MRI device before DSA examination. The luminal diameters of renal arteries, infrarenal abdominal aorta, iliac and femoral arteries was measured by using Philips DICOM Viewer R2.2 application. The intraclass corelation coefficient and reliability used to check if the techniques could be used for each other and the t-test was used to measure the differences between them. Results: There has been a high relationship between B-TFE and DSA in detecting the pathologies of larger arteries like aorta. In the case of small arterial pathologies, there is relatively lower relationship between BTFE and DSA. Discussion: For the diagnosis of AAA and PAD, DSA is the gold standart technique but it is invasive and patients have radiation exposure. In the follow up of geriatric patients with larger arterial pathologies B-TFE can be used instead of contrast enhanced MRA and invasive DSA.

  17. Iterative Otsu's method for OCT improved delineation in the aorta wall

    Science.gov (United States)

    Alonso, Daniel; Real, Eusebio; Val-Bernal, José F.; Revuelta, José M.; Pontón, Alejandro; Calvo Díez, Marta; Mayorga, Marta; López-Higuera, José M.; Conde, Olga M.

    2015-07-01

    Degradation of human ascending thoracic aorta has been visualized with Optical Coherence Tomography (OCT). OCT images of the vessel wall exhibit structural degradation in the media layer of the artery, being this disorder the final trigger of the pathology. The degeneration in the vessel wall appears as low-reflectivity areas due to different optical properties of acidic polysaccharides and mucopolysaccharides in contrast with typical ordered structure of smooth muscle cells, elastin and collagen fibers. An OCT dimension indicator of wall degradation can be generated upon the spatial quantification of the extension of degraded areas in a similar way as conventional histopathology. This proposed OCT marker can offer in the future a real-time clinical perception of the vessel status to help cardiovascular surgeons in vessel repair interventions. However, the delineation of degraded areas on the B-scan image from OCT is sometimes difficult due to presence of speckle noise, variable signal to noise ratio (SNR) conditions on the measurement process, etc. Degraded areas can be delimited by basic thresholding techniques taking advantage of disorders evidences in B-scan images, but this delineation is not optimum in the aorta samples and requires complex additional processing stages. This work proposes an optimized delineation of degraded areas within the aorta wall, robust to noisy environments, based on the iterative application of Otsu's thresholding method. Results improve the delineation of wall anomalies compared with the simple application of the algorithm. Achievements could be also transferred to other clinical scenarios: carotid arteries, aorto-iliac or ilio-femoral sections, intracranial, etc.

  18. [Comparative transcriptome analysis of human aorta atherosclerotic lesions and peripheral blood leukocytes from essential hypertension patients].

    Science.gov (United States)

    Timofeeva, A V; Goriunova, L E; Khaspekov, G L; Il'inskaia, O P; Sirotkin, V N; Andreeva, E R; Tararak, E M; Bulkina, O S; Buza, V V; Britareva, V V; Karpov, Iu A; Bibilashvili, R Sh

    2009-01-01

    One of the major cardiovascular risk factor which predisposes to and accelerates atherosclerosis is arterial hypertension (AH). To determine the molecular basis of the crosslink between AH and atherosclerosis for the development of new treatment strategies large-scale transcriptome analysis of the cells implicated in atherogenesis is needed. We used cDNA microarray technique for simultaneous analysis of gene expression in human abdominal aorta normal sites and atherosclerotic lesions of different histological types, as well as in peripheral blood leukocytes from patients with essential hypertension (EH) and donors. The microarray data were verified by quantitative RT-PCR (reverse transcription coupled with polymerase chain reaction) and immunohistochemical analysis. Differential expression of 40 genes has been found, among which twenty two genes demonstrated up-regulation and 18 genes demonstrated down-regulation in atherosclerotic aorta compared with normal vessel. New gene-candidates, implicated in atherogenesis, have been identified - FPRL2, CD37, CD53, RGS1, LCP1, SPI1, CTSA, EPAS1, FHL1, GEM, RHOB, SPARCL1, ITGA8, PLN, and COL14A1. These genes participate in cell migration and adhesion, phenotypic changes of smooth muscle cells, immune and inflammatory reactions, oxidative processes and extracellular matrix remodeling. We have found increased expression levels of CD53, SPI1, FPRL2, SPP1, CTSD, ACP5, LCP1, CTSA and LIPA genes in peripheral blood leukocytes from EH patients and in atherosclerotic lesions of human aorta. The majority of these genes significantly (p0.5) correlated with AH stage as well as with histological grading of atherosclerotic lesions. PMID:19772500

  19. Efeitos a curto prazo de "stents" não recobertos e recobertos com politetrafluoroetileno em aorta de suínos: um modelo experimental Short-term effects of polytetrafluoroethylene covered and uncovered metallic "stents" in pig aorta: an experimental model

    Directory of Open Access Journals (Sweden)

    Marco Aurélio Grüdtner

    2004-04-01

    Full Text Available OBJETIVO: Descrever um estudo experimental avaliando através da morfometria digital o espessamento intimal na parede arterial após o implante de "stents" metálicos auto-expansíveis recobertos ou não com politetrafluoroetileno (PTFE na aorta de suínos. MÉTODOS: Em três grupos de suínos jovens uma bainha introdutora de 12 F foi inserida na aorta abdominal distal. Os animais do grupo I (n=5 foram considerados controle. Os animais do grupo II (n=10 receberam o implante de um stent metálico auto-expansível não recoberto. No grupo III (n=10 um stent auto-expansível recoberto com PTFE foi inserido. Após quatro semanas os animais foram sacrificados e os espécimes arteriais foram retirados, sendo o espessamento intimal quantificado pela análise morfométrica. RESULTADOS: Na comparação entre os grupos I, II e III quanto às áreas da íntima, média e índice intimal, não foi observada variação estatisticamente significativa. Diferenças foram observadas entre os grupos em relação às áreas luminais proximais (p=0,0036 e distais (p=0,044. Através dos testes de comparação múltipla para Kruskal-Wallis foi identificada uma diferença entre os grupos I e II. Entretanto, quando essas variáveis foram controladas pelo fator peso (relação área luminal/peso, a diferença não foi mais observada. CONCLUSÕES: Nesse estudo a curto prazo, o revestimento de PTFE não esteve associado a adicional espessamento intimal além daquele promovido pelo dispositivo metálico em artérias de grande calibre e condições de alto fluxo.PURPOSE: To report an experimental study evaluating, through digital morphometry, the intimal thickening of the arterial wall after the implant of auto-expandable stainless steel stents covered or not with polytetrafluoroethylene (PTFE in the pig aorta. METHODS: In three groups of pigs a 12 F sheath was inserted in distal abdominal aorta. Group I animals (n=5 served as control. Group II animals (n=10 received an auto

  20. Human fetal aorta-derived vascular progenitor cells: identification and potential application in ischemic diseases

    OpenAIRE

    Invernici, Gloria; Madeddu, Paolo; Emanueli, Costanza; Parati, Eugenio A.; Alessandri, Giulio

    2008-01-01

    Vasculogenesis, the formation of blood vessels in embryonic or fetal tissue mediated by immature vascular cells (i.e., angioblasts), is poorly understood. Here we report a summary of our recent studies on the identification of a population of vascular progenitor cells (VPCs) in human fetal aorta. These undifferentiated mesenchymal cells co-express endothelial and myogenic markers (CD133+, CD34+, KDR+, desmin+) and are localized in outer layer of the aortic stroma of 11–12 weeks old human fetu...

  1. The influence of thyroid states upon responses of the rat aorta to catecholamines.

    OpenAIRE

    Gunasekera, R. D.; Kuriyama, H.

    1990-01-01

    1. Mechanical responses to various stimulants and the distribution of adrenoceptor subtypes were investigated in smooth muscle cells of the rat aorta in eu- (control), hyper- and hypo-thyroid states. 2. Concentration-response relationships for K showed that the KCl EC50 value was slightly higher (28.4 mM K) in hypothyroid than in euthyroid and hyperthyroid states (22.5 mM and 22.8 mM K, respectively). The order of maximum amplitudes of KCl contraction was control greater than hypothyroid grea...

  2. Constrictive responses of aorta in irradiated rats: influence of hypoxia and anoxia

    International Nuclear Information System (INIS)

    The amplification of constrictive responses of vessels after exposure of rats to a low dose gamma radiation (50 cGy at a dose rate of 2.8*10-7 Gy per sec) is defined mainly by decrease in relaxation influences of the endothelium. Vasoactive properties of endothelial cells are the deciding factor of changes of responses of aorta during the action of agonists of adrenergic receptors in conditions of hypoxia and anoxia. During insufficient oxygen supply, as opposed to conditions of oxygenation, post-radiation destabilization of endothelial mechanisms of adrenergic control of arterial vessels tone is observed. (authors)

  3. Glycosaminoglycan-lipoprotein complexes from aortas of hypercholesterolemic rabbits. Part 1. Isolation and characterization.

    Science.gov (United States)

    Mawhinney, T P; Augustyn, J M; Fritz, K E

    1978-10-01

    Glycosaminoglycan-lipoprotein complexes were isolated from rabbit aortas exhibiting nearly confluent cholesterol-induced foam cell lesions by extraction with 0.15 M NaCl. Purification and characterization was achieved by gel chromatography, non-ionic differential flotation and by cellulose polyacetate electrophoresis. Analysis showed that these complexes consisted of very low density lipoproteins, heparan sulfate, chondroitin sulfate-C and hyaluronic acid. The demonstration that rabbit intimal foam cell lesions contain extractable glycosaminoglycan-lipoprotein complexes makes this animal model an excellent tool for further studies on the role of these complexes in the atherogenic process. PMID:215171

  4. Pulsatile flow in the aorta of the LVAD supported heart studied using particle image velocimetry

    Science.gov (United States)

    Moyedi, Zahra

    Currently many patients die because of the end-stage heart failure, mainly due to the reduced number of donor heart transplant organs. Studies show that a permanent left ventricular assist device (LVAD), a battery driven pump which is surgically implanted, increased the survival rate of patients with end-stage heart failure and improved considerably their quality of life. The inlet conduit of the LVAD is attached to the left ventricle and the outflow conduit anastomosed to the ascending aorta. The purpose of LVAD support is to help a weakened heart to pump blood to the rest of the body. However LVAD can cause some alterations of the natural blood flow. When your blood comes in contact with something that isn't a natural part of your body blood clots can occur and disrupt blood flow. Aortic valve integrity is vital for optimal support of left ventricular assist LVAD. Due to the existence of high continuous transvalvular pressure on the aortic valve, the opening frequency of the valve is reduced. To prevent the development of aortic insufficiency, aortic valve closure during LVAD implantation has been performed. However, the closed aortic valve reduces wash out of the aortic root, which causes blood stagnation and potential thrombus formation. So for this reason, there is a need to minimize the risks of occurring blood clot, by having more knowledge about the flow structure in the aorta during LVAD use. The current study focuses on measuring the flow field in the aorta of the LVAD assisted heart with two different types of aortic valve (Flat and Finned) using the SDSU cardiac simulator. The pulsatile pump that mimics the natural pulsing action of the heart also added to the system. The flow field is visualized using Particle Image Velocimetry (PIV). Furthermore, The fluid mechanics of aorta has been studied when LVAD conduit attached to two different locations (proximal and distal to the aortic valve) with pump speeds of 8,000 to 10,000 revolutions per minute (RPM

  5. Identification of 2 novel genes developmentally regulated in the mouse aorta-gonad-mesonephros region

    OpenAIRE

    Orelio, C.; Dzierzak, Elaine

    2003-01-01

    textabstractThe first adult-repopulating hematopoietic stem cells (HSCs) emerge in the mouse aorta-gonad-mesonephros (AGM) region at embryonic day 10.5 prior to their appearance in the yolk sac and fetal liver. Although several genes are implicated in the regulation of HSCs, there are gaps in our understanding of the processes taking place in the AGM at the time of HSC emergence. To identify genes involved in AGM HSC emergence, we performed differential display reverse transcriptase-polymeras...

  6. Experimental myocardial hypertrophy induced by a minimally invasive ascending aorta coarctation

    Directory of Open Access Journals (Sweden)

    Martins A.S.

    2001-01-01

    Full Text Available Ascending aorta coarctation was produced by a minimally invasive technique in rabbits. Animal mortality was 5%. Morphometric and hemodynamic parameters were evaluated. A parabiotically isolated heart model was used to assess the hemodynamic parameters. Left ventricular weight/body weight ratio and muscle area showed clear evidence of hypertrophy when compared to control. The hemodynamic changes in the isolated heart model suggested decreased diastolic and systolic function in the coarcted group. The present model produced hypertrophy with low mortality rates as a result of its less invasive nature.

  7. Three-dimensional modeling and highly refined mesh generation of the aorta artery and its tunics

    International Nuclear Information System (INIS)

    This paper describes strategies and techniques to perform modeling and automatic mesh generation of the aorta artery and its tunics (adventitia, media and intima walls), using open source codes. The models were constructed in the Blender package and Python scripts were used to export the data necessary for the mesh generation in TetGen. The strategies proposed are able to provide meshes of complicated and irregular volumes, with a large number of mesh elements involved (12,000,000 tetrahedrons approximately). These meshes can be used to perform computational simulations by Finite Element Method (FEM).

  8. Vasodilator Activity of the Essential Oil from Aerial Parts of Pectis brevipedunculata and Its Main Constituent Citral in Rat Aorta

    Directory of Open Access Journals (Sweden)

    Gisele Zapata-Sudo

    2013-03-01

    Full Text Available The essential oil of Pectis brevipedunculata (EOPB, a Brazilian ornamental aromatic grass, is characterized by its high content of citral (81.9%: neral 32.7% and geranial 49.2%, limonene (4.7% and α-pinene (3.4%. Vasodilation induced by EOPB and isolated citral was investigated in pre-contracted vascular smooth muscle, using thoracic aorta from Wistar Kyoto (WKY rats which was prepared for isometric tension recording. EOPB promoted intense relaxation of endothelium-intact and denuded aortic rings with the concentration to induce 50% of the maximal relaxation (IC50 of 0.044% ± 0.006% and 0.093% ± 0.015% (p 0.05. In endothelium-intact aorta, EOPB-induced vasorelaxation was significantly reduced by L-NAME, a nitric oxide synthase inhibitor. The vasodilator activity of citral was increased in the KCl-contracted aorta and citral attenuated the contracture elicited by Ca2+ in depolarized aorta. EOPB and citral elicited vasorelaxation on thoracic aorta by affecting the NO/cyclic GMP pathway and the calcium influx through voltage-dependent L-type Ca2+ channels, respectively.

  9. In-vitro investigation of cerebral-perfusion effects of a rotary blood pump installed in the descending aorta.

    Science.gov (United States)

    Rezaienia, Mohammad Amin; Paul, Gordon; Avital, Eldad; Rahideh, Akbar; Rothman, Martin Terry; Korakianitis, Theodosios

    2016-06-14

    This study describes use of a cardiovascular simulator to replicate the hemodynamic responses of the cerebrovascular system with a mechanical circulatory support device operating in the descending aorta. To do so, a cerebral autoregulation unit was developed which replicates the dilation and constriction of the native cerebrovascular resistance system and thereby regulates the cerebral flow rate within defined limits. The efficacy of the replicated autoregulation mechanism was investigated by introducing a number of step alterations in mean aortic pressure and monitoring the cerebral flow. The steady responses of the cerebral flow to changes in mean aortic pressure were in good agreement with clinical data. Next, a rotary pump, modeling a mechanical circulatory support device, was installed in the descending aorta and the hemodynamic responses of the cerebral system were investigated over a wide range of pump operating conditions. Insertion of a mechanical circulatory support device in the descending aorta presented an improved cardiac output as a result of afterload reduction. It was observed that the primary drop in cerebral flow, caused by the pump in the descending aorta, was compensated over the course of five seconds due to a gradual decrease in cerebrovascular resistance. The experimental results suggest that the implantation of a mechanical circulatory support device in the descending aorta, a less invasive procedure than typical mechanical circulatory support implantation, will not have an adverse effect on the cognitive function, provided that the cerebral autoregulation is largely unimpaired. PMID:27155746

  10. As variações da forma do sifão carotídeo na arteriografia cerebral: estudo sobre 120 casos não tumorais

    Directory of Open Access Journals (Sweden)

    A. Mattos Pimenta

    1954-06-01

    Full Text Available O estudo de 120 arteriogramas de pacientes em que foi comprovada a inexistência de lesão que ocupa espaço intracraniano, permitiu o reconhecimento de várias formas de sifão carotídeo normal. Foi assim possível fazer uma classificação anatômica dos vários tipos e concluir que a forma do sifão não permite, sozinha, fazer o diagnóstico topográfico de tumores intracranianos. É importante reconhecer exatamente os limites do sifão, a fim de localizar, precisamente, os aneurismas da carótida interna. Do exposto podemos tirar duas ordens de conclusões: 1 Conclusões anatômicas - O sifão carotídeo normal não apresenta grande número de variações de forma, podendo ser reconhecidos dois tipos básicos: angulados e arredondados. Os primeiros subdividem-se em angulados com ramos oblíquos (ângulo agudo ou ângulo obtuso e angulados com um ramo horizontal (superior ou inferior. Os segundos (arredondados dividem-se em três subtipos: semi-elíptico, em alça (horizontal ou oblíquo e em S (superior, inferior ou duplo. Nos grupos e subgrupos cada segmento do sifão pode apresentar variação no comprimento e espessura, como é evidente à observação dos esquemas. 2 Conclusões neurocirúrgicas - A existência de grande número de formas consideradas como normais de sifão carotídeo leva à conclusão de que não é possível basear o diagnóstico de tumor, ou melhor, de lesão que ocupa espaço intracraniano, exclusivamente pela imagem arteriográfica do sifão. As variações fisiológicas do sifão, somadas às das artérias do grupo silviano e da cerebral anterior, trazem dificuldades diagnosticas que obrigam o neurocirurgião a procurar o maior número de indícios para fazer a interpretação correta do exame. Assim sendo, na rotina neurocirúrgica é aconselhável que os arteriogramas sejam feitos pelo menos em duas posições: perfil e ântero-posterior. E' importante reconhecer bem os limites do sifão para se estabelecer

  11. Aneurisma de artéria pulmonar como manifestação da doença de Behçet Pulmonary artery aneurysm as a manifestation of Behçet disease: case report and review

    OpenAIRE

    MARCOS NAOYUKI SAMANO; RENATA TEIXEIRA LADEIRA; LUIZ PEDRO MEIRELES; PAULO MANUEL PÊGO-FERNANDES

    2002-01-01

    A doença de Behçet pode ser acompanhada de manifestações pulmonares, às vezes letais se não tratadas adequadamente. Descreve-se o caso de um homem de 53 anos com história de episódios de aftas orais e febre havia vários anos, dois quadros febris prolongados nos últimos dois anos, uveíte tratada com corticóide havia 21 meses, hemoptise havia um mês e emagrecimento de 7kg. Ao exame físico apresentava aftas orais, pseudofoliculite e turvação visual. Os estudos radiológicos evidenciaram dilatação...

  12. Experiência inicial com o uso de adesivo tissular contendo trombina para tratamento do pseudo-aneurisma femoral Treatment of femoral pseudoaneurysm with thrombin tissue adhesive: initial experience

    Directory of Open Access Journals (Sweden)

    Daniel Mendes Pinto

    2006-03-01

    Full Text Available O pseudo-aneurisma (PSA após cateterização femoral tem sido diagnosticado com regularidade em serviços com grande movimento de intervenções percutâneas, com incidência variando de 0,05 a 6%. PSA femorais pequenos podem ser acompanhados até a resolução espontânea. As opções de tratamento são: compressão guiada por ultra-som, injeção de trombina para trombose do PSA e tratamento cirúrgico. A injeção percutânea de trombina tem a vantagem de ser um procedimento indolor e rápido. Podem ser utilizados trombina isolada ou preparados contendo trombina associada a fibrinogênio e fatores de coagulação. A experiência inicial dos autores de cinco casos tratados com injeção de adesivo tissular contendo trombina mostrou resultado satisfatório em quatro; um caso necessitou tratamento cirúrgico. Não houve sucesso com uso isolado de trombina humana, porém, ocorreu trombose imediata após injeção de preparado de trombina associada a fibrinogênio/fator XIII. Neste artigo, são discutidas as opções de tratamento dos PSA femorais e a técnica do uso de trombina percutânea.Pseudoaneurysms caused by femoral artery catheterization have been regularly diagnosed in medical units with a great number of percutaneous interventions, with a documented incidence between 0.05 and 6%. Small femoral pseudoaneurysms undergo spontaneous resolution. Treatment options are: ultrasound-guided compression, thrombin injection to induce pseudoaneurysm thrombosis and surgical treatment. Percutaneous thrombin injection has the advantage of being a fast and painless procedure. Both isolated thrombin and thrombin preparations with fibrinogen and coagulation factors can be used. The authors' initial experience with five cases treated with thrombin tissue adhesive showed successful results in four; one case required surgery. There was no success with isolated human thrombin, but immediate thrombosis was achieved after injection of thrombin associated to

  13. An unusual origin of proximal coronary bypass anastomosis in a patient with porcelain aorta: How we solved the problem

    Directory of Open Access Journals (Sweden)

    Kovačević Pavle

    2011-01-01

    Full Text Available Severe calcification of the ascending aorta (porcelain aorta is a very difficult condition in cardiac surgery because of a high embolization potential during the process of cannulation, aortic cross-clamping and a particular difficulty to suture the proximal anastomosis. We described a case of a 68-year-old female referred to our Institute due to unstable angina. Further diagnostics revealed a severe high grade, multilevel fibrolipid symptomatic carotid stenosis and ostial left main coronary artery stenosis and a highly calcified ascending aorta and aortic arch. We performed simultaneous carotid segment replacement with the Dacron prosthesis and revascularisation of the left anterior descending coronary artery. Proximal venous anastomosis was created in the Dacron prosthesis of the right carotid artery. Perfusion of the patient was achieved via the graft sutured at the right subclavian artery due to impossibility of direct aortic cannulation.

  14. Successful Percutaneous Coronary Intervention through a Severely Bent Artificial Ascending Aorta Using the DIO Thrombus Aspiration Catheter

    Directory of Open Access Journals (Sweden)

    Akinori Fujikake

    2016-01-01

    Full Text Available A 66-year-old man was admitted to our institute because of chest pain. He had undergone replacement of the ascending aorta due to aortic dissection 9 years previously. We made a diagnosis of acute coronary syndrome, and coronary artery angiography was performed. Although the right coronary artery was successfully cannulated, a severe bend of the artificial aorta made it very difficult to advance the catheter into the left coronary artery. Ultimately, a DIO thrombus aspiration catheter was used to enter the left coronary artery, and a stent was implanted successfully. The DIO catheter is very useful when the selection of a guiding catheter is complicated, such as in the case of severe vessel tortuosity or a bend of the ascending aorta.

  15. Aortic valve replacement and ascending aorta replacement in ankylosing spondylitis: report of three surgical cases and review of the literature.

    Science.gov (United States)

    Kawasuji, M; Hetzer, R; Oelert, H; Stauch, G; Borst, H G

    1982-10-01

    Out of 887 consecutive patients who underwent aortic valve replacement between January 1976 and December 1981 at Hannover Medical School Hospital, 3 patients had severe aortic valve insufficiency associated with ankylosing spondylitis (Morbus Bechterew). One of them had huge aneurysmatic dilatation of the ascending aorta and successfully underwent replacement of the ascending aorta by a vascular prosthesis. Microscopical examination of the resected aortic wall showed characteristic findings of aortitis in ankylosing spondylitis. The 3 patients are in good clinical condition at 5 and 6 months, and 2 1/2 years, respectively, after uneventful surgery. It is concluded that aortic valve replacement in patients with ankylosing spondylitis can be performed feasibly and clinical results have been satisfactory. The risk of aneurysmatic dilatation of the ascending aorta resulting from aortitis associated with ankylosing spondylitis is emphasized. PMID:6183782

  16. Paraoxon Attenuates Vascular Smooth Muscle Contraction through Inhibiting Ca2+ Influx in the Rabbit Thoracic Aorta

    Directory of Open Access Journals (Sweden)

    Shouhong Zhou

    2010-01-01

    Full Text Available We investigated the effect of paraoxon on vascular contractility using organ baths in thoracic aortic rings of rabbits and examined the effect of paraoxon on calcium homeostasis using a whole-cell patch-clamp technique in isolated aortic smooth muscle cells of rabbits. The findings show that administration of paraoxon (30 μM attenuated thoracic aorta contraction induced by phenylephrine (1 μM and/or a high K+ environment (80 mM in both the presence and absence of thoracic aortic endothelium. This inhibitory effect of paraoxon on vasoconstrictor-induced contraction was abolished in the absence of extracellular Ca2+, or in the presence of the Ca2+ channel inhibitor, verapamil. But atropine had little effect on the inhibitory effect of paraoxon on phenylephrine-induced contraction. Paraoxon also attenuated vascular smooth muscle contraction induced by the cumulative addition of CaCl2 and attenuated an increase of intracellular Ca2+ concentration induced by K+ in vascular smooth muscle cells. Moreover, paraoxon (30 μM inhibited significantly L-type calcium current in isolated aortic smooth muscle cells of rabbits. In conclusion, our results demonstrate that paraoxon attenuates vasoconstrictor-induced contraction through inhibiting Ca2+ influx in the rabbits thoracic aorta.

  17. Dilation of the ascending aorta in Turner syndrome - a prospective cardiovascular magnetic resonance study

    Directory of Open Access Journals (Sweden)

    Pedersen Erik M

    2011-04-01

    Full Text Available Abstract Background The risk of aortic dissection is 100-fold increased in Turner syndrome (TS. Unfortunately, risk stratification is inadequate due to a lack of insight into the natural course of the syndrome-associated aortopathy. Therefore, this study aimed to prospectively assess aortic dimensions in TS. Methods Eighty adult TS patients were examined twice with a mean follow-up of 2.4 ± 0.4 years, and 67 healthy age and gender-matched controls were examined once. Aortic dimensions were measured at nine predefined positions using 3D, non-contrast and free-breathing cardiovascular magnetic resonance. Transthoracic echocardiography and 24-hour ambulatory blood pressure were also performed. Results At baseline, aortic diameters (body surface area indexed were larger at all positions in TS. Aortic dilation was more prevalent at all positions excluding the distal transverse aortic arch. Aortic diameter increased in the aortic sinus, at the sinotubular junction and in the mid-ascending aorta with growth rates of 0.1 - 0.4 mm/year. Aortic diameters at all other positions were unchanged. The bicuspid aortic valve conferred higher aortic sinus growth rates (p Conclusion A general aortopathy is present in TS with enlargement of the ascending aorta, which is accelerated in the presence of a bicuspid aortic valve.

  18. Diagnosis and treatment of type A dissection of the aorta - an interdisciplinary challenge

    International Nuclear Information System (INIS)

    Acute dissection of the ascending aorta is a life-threatening disease. Successful management requires close teamwork of internal medical specialist, radiologist and cardiovascular surgeon. The diagnostic and therapeutic approach is reviewed on the basis of 18 of our own cases - 15 men and 3 women aged from 42 to 88 years. Peculiarities of history, pain and ECG give valuable clues to the differentiation of aortic dissection from myocardial infarction and massive pulmonary embolism. As a non-invasive rapidly available diagnostic method echocardiography may yield decisive information about the aortic root and the presence of pericardial effusion. Definite confirmation of diagnosis is accomplished by aortography and/or computed tomography. Blood pressure and aortic flow must be decreased to the lowest level tolerated by the patient to prevent pericardial tamponade or rupture into the mediastinum. The urgency of surgical repair is underlined by a median survival time of 12 hours from onset of symptoms to death with conservative treatment. 7 of our patients were operated on. In 6 cases surgery was performed by means of extracorporeal circulation and the ascending aorta was replaced by a graft. 3 patients survived the operation (2 for over 2 years and three died in the postoperative period due to cerebral and pulmonary complications). In one case with inoperable dissection an axillo-femoral bypass was performed for relief of complete ischaemia of the left lower limb. Postoperatively, maintainance of the patient's blood pressure at the low normal level is mandatory. (Author)

  19. Analysis of blood flow dynamics in the abdominal aorta based on MR images

    International Nuclear Information System (INIS)

    Images of the abdominal aorta including peri-renal artery by PCMRA (phase contrast magnetic resonance angiography) were analyzed to calculate WSS (wall shear stress) and its OSI (oscillatory shear index) in order to visually elucidate the cause of aneurysm formation. PCMRA was conducted for acquisitions of vascular morphology in one cardiac cycle of a healthy male 30s with cardiac gating, and of blood flow rates from 3 directions. Images were median-filtered to reduce noises and regions of interest of rectangular parallelepiped were defined to involve the aorta. WSS, the parameter representing the intensity of friction stress to the vessel wall of blood flow, and OSI, the degree of oscillatory WSS change, were calculated firstly by the reported Snake model for the vessel morphology and then by applying its local information to blood flow rate information from 3 directions. Color-displayed images revealed that both WSS and OS were high at the highest incidental region of aortic aneurysm formation around the peri-renal artery. The finding was in good agreement with the result of computed bio-dynamic simulation that the strong WSS by elevated swirling of blood flow is generated at the region. Thus WSS and OS can be significant factors of aneurismal formation, which should be further confirmed from aspects of increased case number and precision. (T.T.)

  20. Delayed rupture of thoracic aorta aneurysm following a kick to the abdomen.

    Science.gov (United States)

    Oliva, Antonio; De Giorgio, Fabio; Partemi, Sara; Pascali, Vincenzo L; Carbone, Arnaldo

    2009-03-01

    Several theories have been proposed to explain the Blunt Traumatic Aortic Rupture (BTAR) because different mechanical forces act on the aorta, at anatomically susceptible sites, including shearing, torsion and stretching, but the origin, transduction and relative importance of these forces remain uncertain. We report a case of a 74-year-old man injured by a kick to the abdomen. After 2 days he felt chest pain paroxysm and weakness in his left leg. The patient was admitted to an emergency care department where he experienced sudden and severe hemodynamic deterioration, dying rapidly. The autopsy, performed 3 days later, showed haemorragic infarction of hypogastric subcutaneous tissues and revealed an extended dissecting aneurysm of the thoracic aorta with following haemopericardium. In our case we considered that a low energy compression to the abdomen, in presence of underlying atherosclerosis, caused aortic dissection rather than rupture and then the 48h time span after the traumatic event and the cardiac tamponade was enough to complete the aortic retrograde dissection. We finally emphasise the importance of the careful surveillance of any trauma close to the abdomen in view of initially unpredictable, as well as eventful injuries. The finding of early signs of neointima formation in thoracoabdominal portions of aortic dissection strongly supported our interpretation. The forensic interest of this case is correlated to the voluntary character of the inflicted injury. The culprit was thus charged with manslaughter. PMID:18849182

  1. Ethanol disrupts the formation of hypochord and dorsal aorta during the development of embryonic zebrafish

    Institute of Scientific and Technical Information of China (English)

    QIAN; Linxi; WANG; Yuexiang; JIANG; Qiu; ZHONG; Tao; SONG

    2005-01-01

    Exposure to ethanol during human embryonic period has severe teratogenic effects on the cardiovascular system. In our study, we demonstrated that ethanol of gradient concentrations can interfere with the establishment of circulatory system in embryonic zebrafish. The effective concentration to cause 50% malformations (EC50) was 182.5 mmol/L. The ethanol pulse exposure experiment displayed that dome stage during embryogenesis is the sensitive time window to ethanol. It is found that 400 mmol/L ethanol pulse exposure can induce circulatory defects in 43% treated embryos. We ruled out the possibility that ethanol can interfere with the process of hematopoiesis in zebrafish. By employing in situ hybridization with endothelial biomarker (Flk-1), we revealed that ethanol disrupts the establishment of trunk axial vasculature, but has no effect on cranial vessels. Combined with the results of semi-thin histological sections, the in situ hybridization experiments with arterial and venous biomarkers (ephrinB2, ephB4) suggested that ethanol mainly interrupts the development of dorsal aorta while has little effect on axial vein. Further study indicated the negative influence of ethanol on the development of hypochord in zebrafish. The consequent lack of vasculogenic factors including Radar and Ang-1 partly explains the defects in formation and integrity of dorsal aorta. These results provide important clues to the study of adverse effects of ethanol on the cardiovascular development in human fetus.

  2. Hemodynamics in a Pediatric Ascending Aorta Using a Viscoelastic Pediatric Blood Model.

    Science.gov (United States)

    Good, Bryan C; Deutsch, Steven; Manning, Keefe B

    2016-04-01

    Congenital heart disease is the leading cause of infant death in the United States with over 36,000 newborns affected each year. Despite this growing problem there are few mechanical circulatory support devices designed specifically for pediatric and neonate patients. Previous research has been done investigating pediatric ventricular assist devices (PVADs) assuming blood to be a Newtonian fluid in computational fluid dynamics (CFD) simulations, ignoring its viscoelastic and shear-thinning properties. In contrast to adult VADs, PVADs may be more susceptible to hemolysis and thrombosis due to altered flow into the aorta, and therefore, a more accurate blood model should be used. A CFD solver that incorporates a modified Oldroyd-B model designed specifically for pediatric blood is used to investigate important hemodynamic parameters in a pediatric aortic model under pulsatile flow conditions. These results are compared to Newtonian blood simulations at three physiological pediatric hematocrits. Minor differences are seen in both velocity and wall shear stress (WSS) during early stages of the cardiac cycle between the Newtonian and viscoelastic models. During diastole, significant differences are seen in the velocities in the descending aorta (up to 12%) and in the aortic branches (up to 30%) between the two models. Additionally, peak WSS differences are seen between the models throughout the cardiac cycle. At the onset of diastole, peak WSS differences of 43% are seen between the Newtonian and viscoelastic model and between the 20 and 60% hematocrit viscoelastic models at peak systole of 41%. PMID:26159560

  3. Coronary heart disease and the zinc-to-copper ratio in human aorta and drinking water

    Energy Technology Data Exchange (ETDEWEB)

    Kinard, J.T.; Moses, H.A.; Stackhouse, C.; Fludd, R.; Thompson, R.

    1986-01-01

    Trace levels of zinc and copper have been determined in the aorta from individuals with known histories of coronary heart disease (experimental group) and from individuals without a history of heart disease (control group) or any condition with an alleged or known association with trace zinc and copper. Subjects for the experimental and control groups were matched in terms of age, sex, and race. The zinc-to-copper ratio in the aorta for the experimental group was found to be significantly higher than the zinc-to-copper ratio in the control group at the 90% level of confidence. The results suggest that an imbalance in the zinc-to-copper ratio is a risk factor in coronary artery disease. Data for trace elements in major water sources for different geographical areas of the US from 1962-1967 were compiled and correlations with mortality rates for heart diseases from 1969-1971 were made. The results revealed that there was an extremely high correlation between the zinc-to-copper ratio in water and mortality rates of non-white females with coronary heart disease.

  4. Contraction of rat thoracic aorta strips induced by phorbol 12-myristate 13-acetate

    Energy Technology Data Exchange (ETDEWEB)

    Itoh, H.; Lederis, K.

    1987-02-01

    Phorbol 12-myristate 13-acetate (PMA) induced a slow and progressive increase in tension of rat thoracic aorta strips in the presence of extracellular CaS . Complete relaxation could not be obtained in CaS -free buffer containing 1 mM ethyleneglycol-bis(US -aminoethylether)-N,N'-tetraacetic acid (EGTA) and 10 X M PMA. In the absence of extracellular CaS , PMA (10 X M) induced a small but sustained contraction which was not altered by the addition of another 2 mM EGTA and 3 x 10 V M verapamil. Papaverine (10 U M) relaxed the PMA-induced contraction to the base line, but phentolamine (10 V M), cyproheptadine (10 V M), atropine (10 V M) and tetrodotoxine (10 W M) did not change the contraction. CaS -depleted muscle strips, prepared by four repeated applications of 10 X M norepinephrine in CaS -free buffer, were contracted by 10 X M PMA, but at a lower maximum tension than nontreated strips. The action of PMA on rat aorta strips in CaS -free buffer did not require the presence of the adventitial layer or endothelial cells. These results suggest that PMA may induce activation of protein kinase C and smooth muscle contraction in the absence of extracellular CaS , without an increase in myoplasmic CaS .

  5. Acoustic properties of atherosclerosis of human aorta obtained with high-frequency ultrasound.

    Science.gov (United States)

    Saijo, Y; Sasaki, H; Okawai, H; Nitta, S; Tanaka, M

    1998-09-01

    The ultrasonic properties of the tissue elements in the aorta were measured using a scanning acoustic microscope (SAM). Twelve autopsied aortas were formalin-fixed, frozen and sectioned at 10 microm thickness and mounted on glass slides for SAM investigation. A specially developed SAM system operating in the frequency range of 100-200 MHz was employed, and color-coded images of the two-dimensional (2-D) distributions of attenuation and sound speed were displayed. The region-of-interest (ROI) for attenuation and sound speed measurements was determined by comparison of optical and acoustic images. The average value of the slope of attenuation was 0.61 dB/mm/MHz and the sound speed was 1568 m/s in the normal intima; 2.5 dB/mm/MHz, 1760 m/s in the calcificated lesion; 1.7 dB/mm/MHz and 1677 m/s in the fibrosis; and 0.34 dB/mm/MHz, 1526 m/s in the fatty material, respectively. Acoustic microscopy provides the basic data for understanding the IVUS imaging of atherosclerosis, as well as on the pathological features of atherosclerosis. PMID:9809640

  6. Novel tissue-engineered vascular patches based on decellularized canine aortas and their recellularization in vitro

    Energy Technology Data Exchange (ETDEWEB)

    Tu Qiufen [Key Laboratory Advanced Technologies of Material, Ministry of Education, Southwest Jiaotong University, Chengdu 610031 (China); Zhang Yi; Ge Dongxia; Wu Jiang [Institute of Biomedical Engineering, West China Center of Medical Sciences, Sichuan University, Chengdu 610041 (China); Chen Huaiqing [Institute of Biomedical Engineering, West China Center of Medical Sciences, Sichuan University, Chengdu 610041 (China)], E-mail: chq@scu.edu.cn

    2008-11-15

    Decellularized allo- or xenogeneic vascular grafts have been found to give more promising results than some biodegradable synthetic polymers. However, owing to absence of well-organized cells, especially confluent endothelial cells, their long-term patency is limited. Seeding vessel-originated cells on these grafts may overcome the deficiency. In this study, canine aortas were decellularized and cross-linked. 4',6-Diamidino-2-phenylindole (DAPI) and Masson' trichrome staining showed complete removal of cell debris, while structure integrity of extracellular matrix (ECM) was remained. Human umbilical vein endothelial cells (HUVECs) and human umbilical artery smooth muscle cells (HUASMCs) were seeded on these decellularized aorta patches in three manners, ECs alone (EC/O), SMCs alone (SMC/O) and ECs on SMCs layer (EC/SMC). In EC/O and SMC/O, scanning electron microscopy (SEM) examination indicated both cells could form confluent layers on the decellularized patches when seeded at high density, but their morphology and alignment changed with seeding density. In EC/SMC, ECs could grow well on SMCs layer, but their morphology, alignment, and confluence degree were deeply influenced by the density of SMCs beneath.

  7. Novel tissue-engineered vascular patches based on decellularized canine aortas and their recellularization in vitro

    Science.gov (United States)

    Tu, Qiufen; Zhang, Yi; Ge, Dongxia; Wu, Jiang; Chen, Huaiqing

    2008-11-01

    Decellularized allo- or xenogeneic vascular grafts have been found to give more promising results than some biodegradable synthetic polymers. However, owing to absence of well-organized cells, especially confluent endothelial cells, their long-term patency is limited. Seeding vessel-originated cells on these grafts may overcome the deficiency. In this study, canine aortas were decellularized and cross-linked. 4',6-Diamidino-2-phenylindole (DAPI) and Masson' trichrome staining showed complete removal of cell debris, while structure integrity of extracellular matrix (ECM) was remained. Human umbilical vein endothelial cells (HUVECs) and human umbilical artery smooth muscle cells (HUASMCs) were seeded on these decellularized aorta patches in three manners, ECs alone (EC/O), SMCs alone (SMC/O) and ECs on SMCs layer (EC/SMC). In EC/O and SMC/O, scanning electron microscopy (SEM) examination indicated both cells could form confluent layers on the decellularized patches when seeded at high density, but their morphology and alignment changed with seeding density. In EC/SMC, ECs could grow well on SMCs layer, but their morphology, alignment, and confluence degree were deeply influenced by the density of SMCs beneath.

  8. Novel tissue-engineered vascular patches based on decellularized canine aortas and their recellularization in vitro

    International Nuclear Information System (INIS)

    Decellularized allo- or xenogeneic vascular grafts have been found to give more promising results than some biodegradable synthetic polymers. However, owing to absence of well-organized cells, especially confluent endothelial cells, their long-term patency is limited. Seeding vessel-originated cells on these grafts may overcome the deficiency. In this study, canine aortas were decellularized and cross-linked. 4',6-Diamidino-2-phenylindole (DAPI) and Masson' trichrome staining showed complete removal of cell debris, while structure integrity of extracellular matrix (ECM) was remained. Human umbilical vein endothelial cells (HUVECs) and human umbilical artery smooth muscle cells (HUASMCs) were seeded on these decellularized aorta patches in three manners, ECs alone (EC/O), SMCs alone (SMC/O) and ECs on SMCs layer (EC/SMC). In EC/O and SMC/O, scanning electron microscopy (SEM) examination indicated both cells could form confluent layers on the decellularized patches when seeded at high density, but their morphology and alignment changed with seeding density. In EC/SMC, ECs could grow well on SMCs layer, but their morphology, alignment, and confluence degree were deeply influenced by the density of SMCs beneath

  9. Preparation of vulnerable plaques in abdominal aorta: an experimental study in rabbits

    International Nuclear Information System (INIS)

    Objective: To establish an animal model of vulnerable plaque in abdominal aorta by pharmacological triggering of atherosclerosis in rabbits. Methods: Thirty New Zealand white rabbits were randomly and equally divided into 3 groups: group A, receiving balloon injury together with high lipid diet;group B, receiving high lipid diet only, and group C, receiving regular diet only. After feeding for 12 weeks, all the rabbits in three groups underwent pharmacological triggering with Chinese Russell's viper venom(CRVV) and histamine to induce the rupture of the plaque and the formation of thrombosis. Results: In 8 survival rabbits of group A, ten lesions with the stenotic degree over 50% were found, which had large lipid core with the thickness of fibrous cap being thinner than 65μm, by which these ten lesions were judged as vulnerable plaques. In 9 rabbits of group B, only 3 vulnerable plaques could be determined,while no single vulnerable plaque could be identified in the rabbits of group C. Conclusion: For establishing an animal model of vulnerable plaque in abdominal aorta in rabbits, balloon injury combined with high lipid diet is a feasible and reliable method. (authors)

  10. Mild coarctation of the aorta: to touch or not to touch the patient?

    Science.gov (United States)

    Keshavarz-Motamed, Zahra; Randles, Amanda; Rikhtegar Nezami, Farhad; Partida, Ramon; Nakamura, Kenta; Staziaki, Pedro V.; Ghoshhajra, Brian; Bhatt, Ami; Edelman, Elazer R.

    2015-11-01

    Coarctation of the aorta (COA) is an aortic obstruction. A peak-to-peak trans-coarctation pressure gradient (PKdP) of greater than 20 mmHg warns severe COA and the need for interventional/surgical repair. The optimal method and timing of intervention remain uncertain especially for mild COA (PKdP treatment strategies for mild COA may need to be redefined as transcatheter interventions emerge, benefits of such interventions are unclear. We investigated the effects of transcatheter interventions on the aorta and left ventricle (LV) hemodynamics in 11 patients with mild COA using a developed computational fluid dynamics and lumped parameter modeling framework along with particle image velocimetry and clinical measurements. Such interventions can improve aortic hemodynamics to some extent (e.g., time-averaged wall shear stress and kinetic energy were reduced by about 20%). However there is no concomitant effect on the LV hemodynamics (e.g., stroke work and LV pressure were reduced by only less than 4%). Our computational approach can effectively predict clinical conditions. Herein one must question intervention for mild COA, as it has limited utility in reducing myocardial strain.

  11. Development of early PCLP1-expressing haematopoietic cells within the avian dorsal aorta.

    Science.gov (United States)

    Suonpää, P; Kohonen, P; Koskela, K; Koskiniemi, H; Salminen-Mankonen, H; Lassila, O

    2005-09-01

    The first haematopoietic stem cells (HSC) develop in the dorsal aorta as haematopoietic intra-aortic clusters (HIAC). To evaluate the initial steps of definitive haematopoiesis, we have studied the emergence and the expression profile of podocalyxin-like protein 1 (PCLP1)-expressing cells in early chick embryos. Here we demonstrate that at embryonic day 2 (E2), the PCLP1+ cells are present in the splanchnic mesoderm and in the ventral lining of the paired dorsal aorta. Following aortic fusion at E3, the PCLP1-expressing cells are exclusively found in the aortic floor and as the development proceeds, both the haematopoietic clusters and the aortic endothelial cells express PCLP1. In parallel with the early PCLP1 expression, bone morphogenetic protein 4 (BMP4) expression was detected in the splanchnopleura and thereafter in the densely packed mesenchymal cells beneath the HIAC. The microarray analyses of early E3 PCLP1+ cells revealed elevated expression of genes known to be involved in the stem cell function. These data suggest that splanchnopleura-derived PCLP1-expressing cells give rise to the earliest definitive haematopoietic progenitors. PMID:16179008

  12. Thermally treated wine retains vasodilatory activity in rat and guinea pig aorta.

    Science.gov (United States)

    Mudnić, Ivana; Budimir, Danijela; Jajić, Ivan; Boban, Nataša; Sutlović, Davorka; Jerončić, Ana; Boban, Mladen

    2011-06-01

    In contrast to the intact wine, cardiovascular effects of the thermally treated wine have not been studied, despite widespread habits of cooking with wine and consumption of mulled wine. Vasodilatory effects of the red wine heated at 75 and 125°C were examined in the isolated rat and guinea pig aorta and compared with the intact and wine dealcoholized without thermal stress. Samples were analyzed for their phenolic content, antioxidant capacity, resveratrol and ethanol contents. Heating-induced degradation of individual phenolic fraction was observed only in the samples treated at 125°C, although total phenolic concentration and related antioxidant activity increased in the thermally treated samples due to the reduction in their volume. All wine samples regardless of treatment caused similar maximal relaxation in both species, but the response was stronger in aortas from guinea pigs. At the lowest concentrations up to 1‰, dealcoholized wine produced vasodilation greater than that produced by intact wine and wines treated at 75 and 125°C, which showed similar vasodilating activity at all concentrations. Our results indicate that wine thermally treated under heating conditions applicable to the preparation of a mulled wine and cooking with wine largely retains vasodilatory activity in vitro despite significant heat-induced changes in its composition. PMID:21423027

  13. Resetting of the cardiopulmonary baroreflex 10 years after surgical repair of coarctation of the aorta

    OpenAIRE

    Johnson, D.; Perrault, H; Vobecky, S.; Trudeau, F; Delvin, E; Fournier, A; Davignon, A

    2001-01-01

    OBJECTIVE—To characterise cardiopulmonary baroreflex responses and examine the effects of a 45 minute cycling bout late after successful repair of coarctation of the aorta.
SUBJECTS—10 young adults (mean (SEM) age 18.1 (2.6 years)) operated on for coarctation of the aorta 12.7 (3.5) years earlier, and 10 healthy controls.
DESIGN—Forearm blood flow (venous occlusion plethysmography) and vascular resistance, left ventricular internal diastolic diameter, and central venous pressure estimated fro...

  14. Characterization of receptors mediating contraction of the rat isolated small mesenteric artery and aorta to arginine vasopressin and oxytocin

    OpenAIRE

    Stam, Wiro B; Van der Graaf, Pieter H; Saxena, Pramod R

    1998-01-01

    The exact nature of the receptor subtype(s) involved in the action of arg-vasopressin (AVP) on the rat aorta and small mesenteric artery (SMA) is controversial. Therefore, we have studied the effects of the selective V1A receptor antagonists, OPC 21268 and SR 49059, and the oxytocin (OT) receptor antagonist, atosiban, on the AVP- and OT-induced contractions of the two vessels.AVP and OT displayed similar intrinsic activities in the rat aorta and SMA, but AVP was ∼130 fold and ∼500 fold more p...

  15. Endothelial dysfunction in the early- and late-stage type-2 diabetic Goto-Kakizaki rat aorta

    OpenAIRE

    Kazuyama, Emi; Saito, Motoaki; Kinoshita, Yukako; Satoh, Itaru; Dimitriadis, Fotios; SATOH, Keisuke

    2009-01-01

    As there are increasing evidences that human diabetes induces cardiovascular dysfunction, we investigated the type-2 diabetes-induced endothelial dysfunction in the early and late-stage Goto-Kakizaki (GK) rat aorta. We performed organ bath studies, and examined the changes in expression levels of muscarinic M(3) receptor, endothelial, inducible, and neuronal nitric oxide synthase (eNOS, iNOS, and nNOS, respectively) mRNAs in the rat aorta utilizing real-time polymerase chain reaction in 12-we...

  16. Surgical Treatment of Mitral-Aortic Incompetence and Aneurysm of the Ascending Aorta in a Child with Marfan's Syndrome: Case Report

    OpenAIRE

    Stellin, Giovanni; Bortolotti, Uberto; Faggian, Giuseppe; Livi, Ugolino; Mazzucco, Alessandro; Frigo, Giuseppe; Gallucci, Vincenzo

    1983-01-01

    A 7-year-old girl with Marfan's syndrome developed severe mitral and aortic valve incompetence and aneurysmatic dilatation of the ascending aorta. She underwent successful replacement of the mitral valve, aortic valve, and ascending aorta with coronary reimplantation. After 3 months of follow-up, she continues to be asymptomatic.

  17. CT Angiography of the Aorta: Prospective Evaluation of Individualized Low-Volume Contrast Media Protocols.

    Science.gov (United States)

    Higashigaito, Kai; Schmid, Tabea; Puippe, Gilbert; Morsbach, Fabian; Lachat, Mario; Seifert, Burkhardt; Pfammatter, Thomas; Alkadhi, Hatem; Husarik, Daniela B

    2016-09-01

    Purpose To prospectively develop individualized low-volume contrast media (CM) protocols adapted to tube voltage in patients undergoing computed tomographic (CT) angiography of the aorta. Materials and Methods The study was approved by the institutional review board and local ethics committee. All patients provided written informed consent. CT angiography was performed by using automated attenuation-based tube voltage selection (ATVS) (range, 70-150 kVp; 10-kVp increments). Iodine attenuation curves from an ex vivo experiment in a phantom were used to design CM protocols for CT angiography of the thoracoabdominal aorta in 129 consecutive patients (hereafter, cohort A). Further modified CM protocols based on results in cohort A were designed with the aim of homogeneous vascular attenuation of 300-350 HU across tube voltages and were applied to another 61 consecutive patients (cohort B). Three independent blinded radiologists assessed subjective image quality, and one reader determined objective image quality. The Kruskal-Wallis test was performed to test for differences in subjective image quality, and linear regression was performed to test for differences in objective image quality between the automatically selected tube voltages. Results Experiments revealed tube voltage-dependent iodine attenuation curves, which were used to determine the CM protocols in cohort A; these ranged from 68 mL at 110 kVp to 45 mL at 80 kVp. In both cohorts, ATVS selected 80 kVp in 62 patients, 90 kVp in 84, 100 kVp in 33, and 110 kVp in 11. In cohort A, image quality that was satisfactory or better was attained in 126 (98%) of 129 patients who had no significant differences in subjective image quality between tube voltages (P = .106) but who did have significant differences in attenuation and contrast-to-noise ratio (CNR) (P < .001 for both). In cohort B, the further-modified CM protocol (from 33 mL at 80 kVp to 68 mL at 110 kVp) yielded image quality that was satisfactory or better

  18. Mechanisms of relaxation induced by flavonoid ayanin in isolated aorta rings from Wistar rats

    Directory of Open Access Journals (Sweden)

    Rosalía Carrón

    2010-09-01

    Full Text Available Introduction: This study shows the relaxant effect induced by ayanin in aorta rings from Wistar rats linked to nitric oxide/cyclic-GMP pathway.  This flavonoid is the prevalent compound obtained from Croton schiedeanus Schlecht (Euphorbiaceae, specie used in Colombian folk medicine for the treatment of arterial hypertension. Objectives: To identify possible action mechanisms of vascular relaxation induced by ayanin (quercetin 3,4',7-trimethyl ether. Methodology: Isolated aorta rings from Wistar rats obtained at the Animal House of the University of Salamanca were contracted with KCl (80 mM or phenylephrine (PE, 10-6 M and exposed to ayanin (10-6-10-4 M.  Then, the effect of ayanin was assessed in deendothelized rings contracted with PE and in intact rings contracted with PE previously incubated with: ODQ (10-6 M, L-NAME (10-4 M, L-NAME plus D- and L-arginine (10-4 M, indomethacin (5x10-6 M, dipyridamole (3x10-7 M, glibenclamide (10-6 M, propranolol (10-6 M, verapamil (10-7 M or atropine (3x10-5 M.  In addition, the relaxant effect of acetylcholine (Ach, 10-8-3x10-4 M, and sodium nitroprusside (SNP, 10-9-3x10-5 M was assessed in the presence and absence of ayanin (10-6 M. Results: Ayanin induced a greater concentration-dependent relaxation in vessels contracted with phenylephrine (pEC50: 5.84±0.05, an effect significantly reduced by deendothelization and by both ODQ and L-NAME.  L-arginine was able to reverse the effect of L-NAME.  Indomethacin weakly inhibited ayanin response.  Dipyridamole, glibenclamide, propranolol, verapamil, and atropine did not affect ayanin relaxation.  Ayanin did not have any effect on the relaxation elicited by acetylcholine (ACh, while weakly decreasing the relaxation induced by sodium nitroprusside (SNP. Conclusion: Ayanin induces endothelium-dependent relaxation in the rat aorta mainly related to nitric oxide/cGMP pathway, according to the response observed in the presence of L-NAME, L-arginine and ODQ.

  19. Decreased bioavailability of nitric oxide in aorta from ovariectomized senescent mice. Role of cyclooxygenase.

    Science.gov (United States)

    Vidal-Gómez, Xavier; Novella, Susana; Pérez-Monzó, Isabel; Garabito, Manel; Dantas, Ana Paula; Segarra, Gloria; Hermenegildo, Carlos; Medina, Pascual

    2016-04-01

    This study investigates the effects of aging and/or ovariectomy on vascular reactivity to thromboxane A2 (TXA2) receptor stimulation with U46619, and the modulation by nitric oxide (NO) and cyclooxygenase (COX) in aorta from female senescence-accelerated mice (SAMP8) and from senescence resistant mice (SAMR1). Five-month-old female SAMR1 and SAMP8 were divided into three groups: sham-operated, ovariectomized and ovariectomized plus estradiol. Twenty-eight days after surgery, thoracic aortic rings were mounted for isometric recording of tension and concentration-response curves for U46619 (10(-10)-3×10(-7)M) were performed in the absence and in the presence of the NO synthase inhibitor N(G)-nitro-l-arginine methyl ester (L-NAME, 10(-4)M) and/or COX inhibitor indomethacin (10(-5)M). Vascular superoxide production was detected by dihydroethidium staining on sections of thoracic aorta. NO bioavailability in response to U46619 was suppressed by estrogen withdrawn in young and senescent mice and was restored by the administration of estradiol. In the presence of indomethacin, contractions to U46619 decreased in all groups indicating an aging- and estrogen-dependent modulation of contractile prostanoids. The simultaneous incubation of L-NAME and indomethacin did not change the maximal responses and sensitivities to TXA2 in any group in comparison with untreated aortic segments. The superoxide generation induced by TXA2 was greater in aorta from SAMP8 than in SAMR1. Moreover, in ovariectomized groups superoxide production was further increased and treatment with 17β-estradiol reverted the effects of the ovariectomy. Inhibition of COX with indomethacin prevented the U46619-induced increase in superoxide formation. Our results indicate that NO bioavailability in response to TP receptor activation is both estrogen- and aging-dependent. TXA2 induced contractions are partially mediated by COX activation. Both aging and ovariectomy enhanced COX-dependent component of the TXA2

  20. Ministernotomy approach for surgery of the aortic root and ascending aorta.

    Science.gov (United States)

    Perrotta, Sossio; Lentini, Salvatore

    2009-11-01

    Different minimally invasive approaches have been proposed for cardiac surgery. Between those, the ministernotomy finds wide consensus for the treatment of the aortic disease, being both the upper reversed T and the upper J the mostly used type of incisions. The authors review the literature on the use of ministernotomy in the treatment of the ascending aorta and arch pathology. The scientific literature was reviewed by searching Medline, the Cochrane Library and the CINAHL database. A total of 1411 papers were found in Medline, 186 in the Cochrane database and 514 in CINAHL database; 50 papers were used to write the article; of which seven represent the most significant papers on the subject. The authors, journal, date and country of publication, patients group studied, relevant outcomes, and the results of these papers are tabulated. The ministernotomy is gaining consensus among surgeons. The indication to surgery, initially restricted only to selected elective patients, is now extended to more complex surgeries, including both the aortic root and aortic arch, redo-operations and, in minor cases, to emergency patients. Furthermore, the use of ministernotomy in redo aortic surgery with patent left internal mammary artery (LIMA) to left anterior descending (LAD) artery is a promising alternative. However, the use of this technique is still limited to few institutions and there are still a limited number of studies comparing this approach to full sternotomy in a prospective, randomized fashion. Even with those limitations, from the review of the literature, it seems that ministernotomy approach for aortic root and ascending aorta surgery is a feasible alternative, showing some advantages compared to full sternotomy. Those advantages include: reduced postoperative bleeding and pain, lower risk of mediastinitis, better aesthetic results, and faster respiratory function recovery. This is true not only for first time surgery, but also, and especially, for redo cases

  1. RETROGRADE CEREBRAL PERFUSION AS METHOD OF BRAIN PROTECTION DURING OPERATIONS ON ASCENDING AND TRANSVERSE AORTA WITH HYPOTHERMIC CIRCULATORY ARREST

    Directory of Open Access Journals (Sweden)

    N. N. Tarabarko

    2011-01-01

    Full Text Available There is no optimal approach to cerebral protection during ascending and transverse aortic arch repairs in our days. This study was designed to analyze experience of using retrograde cerebral perfusion as method of brain protection during operations on ascending and transverse aorta with hypothermic circulatory arrest. 

  2. Cardiac-synchronized gadolinium-enhanced MR angiography: preliminary experience for the evaluation of the thoracic aorta.

    NARCIS (Netherlands)

    Goldfarb, J.W.; Holland, A.E.; Heijstraten, F.M.J.; Skotnicki, S.H.; Barentsz, J.O.

    2006-01-01

    Gadolinium (Gd)-enhanced three-dimensional breath-hold magnetic resonance cardiac-synchronized angiography was performed in 13 patients suspected or known to have thoracic aortic disease. High-quality angiograms of the ascending/descending thoracic aorta and coronary arteries were obtained with this

  3. Phenotypic and functional heterogeneity of macrophages and dendritic cell subsets in the healthy and atherosclerosis-prone aorta.

    Directory of Open Access Journals (Sweden)

    ElenaVGalkina

    2012-03-01

    Full Text Available Atherosclerosis continues to be the leading cause of cardiovascular disease. Development of atherosclerosis depends on chronic inflammation in the aorta and multiple immune cells are involved in this process. Importantly, resident macrophages and dendritic cells are present within the healthy aorta, but the functions of these cells remain poorly characterized. Local inflammation within the aortic wall promotes the recruitment of monocytes and dendritic cell precursors to the aorta and micro-environmental factors direct the differentiation of these emigrated cells into multiple subsets of macrophages and dendritic cells. Recent data suggest that several populations of macrophages and dendritic cells can co-exist within the aorta. Although the functions of M1, M2, Mox and M4 macrophages are well characterized in vitro, there is a limited set of data on the role of these populations in atherogenesis in vivo. Recent studies on the origin and the potential role of aortic dendritic cells provide novel insights into the biology of aortic dendritic cell subsets and prospective mechanisms of the immune response in atherosclerosis. This review integrates the results of experiments analyzing heterogeneity of dendritic cells and macrophage subsets in healthy and diseased vessels and briefly discusses the known and potential functions of these cells in atherogenesis.

  4. Prosthetic Subclavian-Aortic Bypass as a Safe Surgical Technique for the Coarctation of the Aorta in Adults

    Directory of Open Access Journals (Sweden)

    Ali Refatllari

    2015-12-01

    CONCLUSION: Coarctation of the aorta in adults is treated with optimal early results at our surgical centre. Subclavian-aortic bypass grafting requires less aortic dissection, can be performed with a partially occluding clamp, and does not compromise the spinal cord vascularization.

  5. Two-dimensional echocardiographic and RI angiographic features of aneurysm of the ascending aorta in patients with annuloaortic ectasia

    International Nuclear Information System (INIS)

    The purpose of this study was to compare the diagnostic value of two-dimensional echocardiography with that of other methods in the detection and localization of aneurysm involving the ascending aorta in patients with annuloaortic ectasia. Two-dimensional echocardiography, RI angiography, CT scan and aortography were performed in 19 patients (12 patients with Marfan's syndrome, 4 with aortitis syndrome and 3 with postoperative perivalvular aneurysm). Eight of 12 patients with Marfan's syndrome had dissection in the ascending aorta which was confirmed at surgery or autopsy. The following observations were obtained. 1) Dissection of the ascending aorta was clearly demonstrated on the two-dimensional echocardiogram in 7 patients by recording the intinal tear and flap, and in these cases the short axis two-dimensional echocardiogram of the ascending aorta was more useful in identifying the site and extent of dissection. 2) In patients with postoperative perivalvular aneurysms, RI angiography proved to be a more useful and sensitive technique in differentiating a leakage into the aneurysm from clots in the aneurysm. 3) CT scanning proved to be an insensitive technique to detect dissection of the ascending aneurysm and to differentiate a leakage from clots in the perivalvular aneurysm. From these observations, we concluded that two-dimensional echocardiography and RI angiography proved to be sensitive techniques in detecting dissection of the ascending aneurysm and evaluating a postoperative aneurysm in patients with annuloaortic ectasia. (author)

  6. Two-dimensional echocardiographic and RI angiographic features of aneurysm of the ascending aorta in patients with annuloaortic ectasia

    Energy Technology Data Exchange (ETDEWEB)

    Nakamura, K.; Suzuki, S.; Satomi, G. (Tokyo Women' s Medical Coll. (Japan). Heart Inst. and Hospital)

    1981-03-01

    The purpose of this study was to compare the diagnostic value of two-dimensional echocardiography with that of other methods in the detection and localization of aneurysm involving the ascending aorta in patients with annuloaortic ectasia. Two-dimensional echocardiography, RI angiography, CT scan and aortography were performed in 19 patients (12 patients with Marfan's syndrome, 4 with aortitis syndrome and 3 with postoperative perivalvular aneurysm). Eight of 12 patients with Marfan's syndrome had dissection in the ascending aorta which was confirmed at surgery or autopsy. The following observations were obtained. 1) Dissection of the ascending aorta was clearly demonstrated on the two-dimensional echocardiogram in 7 patients by recording the intinal tear and flap, and in these cases the short axis two-dimensional echocardiogram of the ascending aorta was more useful in identifying the site and extent of dissection. 2) In patients with postoperative perivalvular aneurysms, RI angiography proved to be a more useful and sensitive technique in differentiating a leakage into the aneurysm from clots in the aneurysm. 3) CT scanning proved to be an insensitive technique to detect dissection of the ascending aneurysm and to differentiate a leakage from clots in the perivalvular aneurysm. From these observations, we concluded that two-dimensional echocardiography and RI angiography proved to be sensitive techniques in detecting dissection of the ascending aneurysm and evaluating a postoperative aneurysm in patients with annuloaortic ectasia.

  7. Magnetic Resonance Elastography of the in vivo Abdominal Aorta: A Feasibility Study for Comparing Aortic Stiffness between Hypertensives and Normotensives

    Science.gov (United States)

    Kolipaka, Arunark; Woodrum, David; Araoz, Philip A.; Ehman, Richard L.

    2011-01-01

    Purpose The purpose of this study is to demonstrate feasibility of using magnetic resonance elastography (MRE) to identify hypertensive changes in the abdominal aorta when compared to normotensives based on the stiffness measurements. Methods MRE was performed on 8 volunteers (4 normotensives and 4 hypertensives) to measure the effective stiffness of the abdominal aorta. MRE wave images are directionally filtered and phase gradient analysis was performed to determine the stiffness of the aorta. Student’s t-test was performed to determine significant difference in stiffness measurements between normotensives and hypertensives. Results The normotensive group demonstrated an average abdominal aortic stiffness of 3.7 ± 0.8 kPa, while the controlled-hypertensive demonstrated an average abdominal aortic stiffness of 9.3 ± 1.9kPa. MRE effective stiffness of abdominal aorta in hypertensives was significantly greater than that of normotensives with p=0.02. Conclusion Feasibility of in vivo aortic MRE is demonstrated. Hypertensives have significantly higher aortic stiffness assessed through MRE than normotensives. PMID:22045617

  8. Orientation, anisotropy, clustering and volume fraction of smooth muscle cells within the wall of porcine abdominal aorta

    Czech Academy of Sciences Publication Activity Database

    Tonar, Z.; Kochová, P.; Janáček, Jiří

    2008-01-01

    Roč. 2, č. 1 (2008), s. 145-156. ISSN 1802-680X R&D Projects: GA AV ČR(CZ) IAA100110502 Grant ostatní: GA MZd(CZ) NR8863 Institutional research plan: CEZ:AV0Z50110509 Keywords : aorta * stereology * histology Subject RIV: EA - Cell Biology

  9. Strong correlation between early stage atherosclerosis and electromechanical coupling of aorta

    Science.gov (United States)

    Liu, X. Y.; Yan, F.; Niu, L. L.; Chen, Q. N.; Zheng, H. R.; Li, J. Y.

    2016-03-01

    Atherosclerosis is the underlying cause of cardiovascular diseases that are responsible for many deaths in the world, and the early diagnosis of atherosclerosis is highly desirable. The existing imaging methods, however, are not capable of detecting the early stage of atherosclerosis development due to their limited spatial resolution. Using piezoresponse force microscopy (PFM), we show that the piezoelectric response of an aortic wall increases as atherosclerosis advances, while the stiffness of the aorta shows a less evident correlation with atherosclerosis. Furthermore, we show that there is strong correlation between the coercive electric field necessary to switch the polarity of the artery and the development of atherosclerosis. Thus by measuring the electromechanical coupling of the aortic wall, it is possible to probe atherosclerosis at the early stage of its development, not only improving the spatial resolution by orders of magnitude, but also providing comprehensive quantitative information on the biomechanical properties of the artery.

  10. Patient-Specific Simulation Models of the Abdominal Aorta With and Without Aneurysms

    DEFF Research Database (Denmark)

    Enevoldsen, Marie Sand

    thick-walled cylinder allowing for inspection of the stress distributions inside the wall. The 4FF model characterizes the mechanical behavior. The blood is assumed to be an incompressible Newtonian fluid. The fluid and solid models were implemented in a commercially available finite element software...... computational simulation models incorporating subject-specific geometry of the abdominal aorta (AA) as well as subject-specific blood flow conditions. The geometry was acquired from magnetic resonance imaging, and the blood flow characteristics were acquired from ultrasound. The solid AA wall was modeled as a....... The goal of third study was to evaluate the predictability of the 4FF model. This was achieved by combining subject-specific blood flow and age-matched material parameters of the 4FF model in a fluid-structure interaction (FSI) model. The predicted wall dynamics were compared to in vivo wall dynamics...

  11. The AORTA Architecture: Integrating Organizational Reasoning in Jason

    DEFF Research Database (Denmark)

    Jensen, Andreas Schmidt; Dignum, Virginia; Villadsen, Jørgen

    2014-01-01

    Open systems are characterized by a diversity of heterogeneous and autonomous agents that act according to private goals, and with a behavior that is hard to predict. They can be regulated through organizations similar to human organizations, which regulate the agents’ behavior space and describe...... the expected behavior of the agents. Agents need to be able to reason about the regulations, so that they can act within the expected boundaries and work towards the objectives of the organization. In this paper, we propose the AORTA architecture for making agents organization-aware. It is designed...... such that it provides organizational reasoning capabilities to agents implemented in existing agent programming languages without being tied to a specific organizational model. We show how it can be integrated in the Jason agent programming language, and discuss how the agents can coordinate their...

  12. The AORTA Architecture: Integrating Organizational Reasoning in Jason

    DEFF Research Database (Denmark)

    Jensen, Andreas Schmidt; Dignum, Virginia; Villadsen, Jørgen

    2014-01-01

    the expected behavior of the agents. Agents need to be able to reason about the regulations, so that they can act within the expected boundaries and work towards the objectives of the organization. In this paper, we describe the AORTA (Adding Organizational Reasoning to Agents) architecture for making......Open systems are characterized by a diversity of heterogeneous and autonomous agents that act according to private goals, and with a behavior that is hard to predict. They can be regulated through organizations similar to human organizations, which regulate the agents’ behavior space and describe...... agents organization-aware. It is designed such that it provides organizational reasoning capabilities to agents implemented in existing agent programming languages without being tied to a specific organizational model. We show how it can be integrated in the Jason agent programming language, and discuss...

  13. Promotion of haematopoietic activity in embryonic stem cells by the aorta-gonad-mesonephros microenvironment

    International Nuclear Information System (INIS)

    We investigated whether the in vitro differentiation of ES cells into haematopoietic progenitors could be enhanced by exposure to the aorta-gonadal-mesonephros (AGM) microenvironment that is involved in the generation of haematopoietic stem cells (HSC) during embryonic development. We established a co-culture system that combines the requirements for primary organ culture and differentiating ES cells and showed that exposure of differentiating ES cells to the primary AGM region results in a significant increase in the number of ES-derived haematopoietic progenitors. Co-culture of ES cells on the AM20-1B4 stromal cell line derived from the AGM region also increases haematopoietic activity. We conclude that factors promoting the haematopoietic activity of differentiating ES cells present in primary AGM explants are partially retained in the AM20.1B4 stromal cell line and that these factors are likely to be different to those required for adult HSC maintenance

  14. Deletion of Metallothionein Exacerbates Intermittent Hypoxia-Induced Oxidative and Inflammatory Injury in Aorta

    Directory of Open Access Journals (Sweden)

    Shanshan Zhou

    2014-01-01

    Full Text Available The present study was to explore the effect of metallothionein (MT on intermittent hypoxia (IH induced aortic pathogenic changes. Markers of oxidative damages, inflammation, and vascular remodeling were observed by immunohistochemical staining after 3 days and 1, 3, and 8 weeks after IH exposures. Endogenous MT was induced after 3 days of IH but was significantly decreased after 8 weeks of IH. Compared with the wild-type mice, MT knock-out mice exhibited earlier and more severe pathogenic changes of oxidative damages, inflammatory responses, and cellular apoptosis, as indicated by the significant accumulation of collagen, increased levels of connective tissue growth factor, transforming growth factor β1, tumor necrosis factor-alpha, vascular cell adhesion molecule 1,3-nitrotyrosine, and 4-hydroxy-2-nonenal in the aorta. These findings suggested that chronic IH may lead to aortic damages characterized by oxidative stress and inflammation, and MT may play a pivotal role in the above pathogenesis process.

  15. Automated Detection of Healthy and Diseased Aortae from Images Obtained by Contrast-Enhanced CT Scan

    Directory of Open Access Journals (Sweden)

    Michael Gayhart

    2013-01-01

    Full Text Available Purpose. We developed the next stage of our computer assisted diagnosis (CAD system to aid radiologists in evaluating CT images for aortic disease by removing innocuous images and highlighting signs of aortic disease. Materials and Methods. Segmented data of patient’s contrast-enhanced CT scan was analyzed for aortic dissection and penetrating aortic ulcer (PAU. Aortic dissection was detected by checking for an abnormal shape of the aorta using edge oriented methods. PAU was recognized through abnormally high intensities with interest point operators. Results. The aortic dissection detection process had a sensitivity of 0.8218 and a specificity of 0.9907. The PAU detection process scored a sensitivity of 0.7587 and a specificity of 0.9700. Conclusion. The aortic dissection detection process and the PAU detection process were successful in removing innocuous images, but additional methods are necessary for improving recognition of images with aortic disease.

  16. Abdominal aorta aneurysm: Case report of high radiation dose during stent-graft implantation

    International Nuclear Information System (INIS)

    This study is a case report regarding a possible problem of high radiation dose during stent-graft implantation. Before deciding on how to treat an aneurysm (stent grafting or traditional surgery), possible complications such as difficult anatomical conditions and diseases of the aorta and iliac arteries should be considered to avoid potentially high doses of radiation. In case of this patient, it was very difficult to introduce a guidewire through the contralateral limb into the body of the graft due to tortuosity and kinking of iliac arteries. Because of the long duration of the procedure (68 min), the patient was exposed to a very high radiation dose (4.37 Gy) and DAP (1760.3 Gy cm2)

  17. Trimodality Therapy for an Advanced Thymic Carcinoma With Both Aorta and Vena Cava Invasion.

    Science.gov (United States)

    Momozane, Tohru; Inoue, Masayoshi; Shintani, Yasushi; Funaki, Soichiro; Kawamura, Tomohiro; Minami, Masato; Shirakawa, Yukitoshi; Kuratani, Toru; Sawa, Yoshiki; Okumura, Meinoshin

    2016-08-01

    A case of locally advanced thymic carcinoma that was successfully resected with the great vessels after chemoradiation therapy is reported. A 57-year-old man with Masaoka stage III thymic carcinoma received two cycles of cisplatin/docetaxel and 60 Gy irradiation. The response was stable disease with 19% size reduction, and a radical resection with the ascending aorta and superior vena cava with the patient under circulatory arrest with the use of cardiopulmonary bypass was performed. The postoperative course was uneventful, and the patient has been free of disease for 28 months. Trimodality therapy with use of a cardiovascular surgical procedure might be a valuable option in locally advanced thymic carcinoma. PMID:27449450

  18. Functional interaction between TRP4 and CFTR in mouse aorta endothelial cells

    Directory of Open Access Journals (Sweden)

    Droogmans Guy

    2001-05-01

    Full Text Available Abstract Background This study describes the functional interaction between the putative Ca2+ channel TRP4 and the cystic fibrosis transmembrane conductance regulator, CFTR, in mouse aorta endothelium (MAEC. Results MAEC cells express CFTR transcripts as shown by RT-PCR analysis. Application of a phosphorylating cocktail activated a Cl- current with characteristics similar to those of CFTR mediated currents in other cells types (slow activation by cAMP, absence of rectification, block by glibenclamide. The current is present in trp4 +/+ MAEC, but not in trp4 -/- cells, although the expression of CFTR seems unchanged in the trp4 deficient cells as judged from RT-PCR analysis. Conclusions It is concluded that TRP4 is necessary for CFTR activation in endothelium, possibly by providing a scaffold for the formation of functional CFTR channels.

  19. Elastic characterization of swine aorta by scanning acoustic microscopy at 30 MHz

    Science.gov (United States)

    Blase, Christopher; Shelke, Amit; Kundu, Tribikram; Bereiter-Hahn, Jürgen

    2011-04-01

    The mechanical properties of blood vessel walls are important determinants of physiology and pathology of the cardiovascular system. Acoustic imaging (B mode) is routinely used in a clinical setting to determine blood flow and wall distensibility. In this study scanning acoustic microscopy in vitro is used to determine spatially resolved tissue elastic properties. Broadband excitation of 30 MHz has been applied through scanning acoustic microscopy (SAM) for topographical imaging of swine thoracic aorta in reflection mode. Three differently treated tissue samples were investigated with SAM: a) treated with elastase to remove elastin, b) autoclaving for 5 hours to remove collagen and c) fresh controlled untreated sample as control. Experimental investigations are conducted for studying the contribution of individual protein components (elastin and collagen) to the material characteristics of the aortic wall. Conventional tensile testing has been conducted on the tissue samples to study the mechanical behavior. The mechanical properties measured by SAM and tensile testing show qualitative agreement.

  20. Calcified aneurysm of the abdominal aorta 12 years after umbilical artery catheterization

    Energy Technology Data Exchange (ETDEWEB)

    Blondiaux, Eleonore; Miquel, Julie [Rouen University Hospital Charles Nicolle, Department of Radiology, Rouen (France); Thomas, Pascale; Watelet, Jacques [Rouen University Hospital Charles Nicolle, Department of Vascular Surgery, Rouen (France); Laloum, Denis [Caen University Hospital, Pediatric Intensive Care Unit, Department of Neonatal Medicine, Caen (France); Dacher, Jean-Nicolas [Rouen University Hospital Charles Nicolle, Department of Radiology, Rouen (France); UFR Medecine et Pharmacie, Laboratoire Quant-If, Rouen Cedex 01 (France)

    2008-02-15

    We report a 12-year-old boy who presented with abdominal pain and who was found to have an aneurysm of the abdominal aorta (AAA). The patient was born from a quadruplet pregnancy induced by in vitro fertilization. Postnatal transient respiratory distress required assisted ventilation that had been monitored by two consecutive umbilical arterial catheters (UAC). AAA is a rare condition in childhood. Infection and/or trauma are known to be the most frequent causes. Most of the reported cases have occurred in children in whom a UAC had been placed during the neonatal period. In this patient the delay between UAC placement and diagnosis was considerable. At the time of this report the patient had remained well during a follow-up of 8 years after treatment. (orig.)

  1. Calcified aneurysm of the abdominal aorta 12 years after umbilical artery catheterization

    International Nuclear Information System (INIS)

    We report a 12-year-old boy who presented with abdominal pain and who was found to have an aneurysm of the abdominal aorta (AAA). The patient was born from a quadruplet pregnancy induced by in vitro fertilization. Postnatal transient respiratory distress required assisted ventilation that had been monitored by two consecutive umbilical arterial catheters (UAC). AAA is a rare condition in childhood. Infection and/or trauma are known to be the most frequent causes. Most of the reported cases have occurred in children in whom a UAC had been placed during the neonatal period. In this patient the delay between UAC placement and diagnosis was considerable. At the time of this report the patient had remained well during a follow-up of 8 years after treatment. (orig.)

  2. Modificação técnica na cirurgia da estenose aórtica supravalvar New tecnical modification for supravalvar aortic stenosis surgical treatment

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    Luiz Carlos Bento de Souza

    1992-06-01

    Full Text Available O tratamento cirúrgico convencional da estenose aórtica supravalvar caracteriza-se pela ampliação de um ou mais seios de Valsalva, utilizando-se retalhos de material protético, com ou sem secção transversal da aorta. Uma possível limitação dos resultados deste procedimento é o fato do endurecimento ou calcificação do enxerto, dificultando o desenvolvimento da raiz da aorta, mormente quando a cirurgia é realizada em criaças. Para evitar essa complicação, desenvolvemos uma modificação técnica que, efetivamente, amplia o diâmetro da raiz da aorta, sem o uso de material profético, aproveitando apenas o tecido sadio da parede da aorta ascendente, para reconstruir e ampliar os seios de Vasalva. Com esta técnica foram operados 4 pacientes com diagnósticos clínico e hemodinâmico de estenose aórtica supravalvar, com os seguintes dados clínicos: idades, 1 ano e 11 meses, 3 anos e 9 meses, 15 e 38 anos, sexo masculino três casos, peso corporal de 10, 12, 27 e 56 kg. Dois pacientes tinham dispnéia, um palpitações freqüentes e outro era assintomático. Os gradientes entre a cavidade livre do ventrículo esquerdo e aorta ascendente eram de 50, 70, 100 e 100 mmHg. Os pacientes foram operados com o auxílio da circulação extracorpórea, de hipotermia moderada e emprego de cardioplegia cristalóide. A aorta ascendente foi dissecada em toda sua extensão, preferindo-se canutar a artéria femoral para o retorno arterial, a fim de liberar a aorta ascendente para o procedimento. Após transecção total da aorta e ressecção do tecido fibrótico estenosante, foram feitas incisões na borda livre até o fundo dos seios de Valsalva. Foram realizadas incisões longitudinais na porção distai da aorta, nas regiões correspondentes aos postes comissurais da valva aórtica, de tal forma que, durante a reconstrução por sutura direta, um segmento da parede aórtica ficasse ampliando um seio de Valsalva, obtendo-se, assim, uma raiz de

  3. Approach to the patient with bicuspid aortic valve and ascending aorta aneurysm.

    Science.gov (United States)

    Ortiz, José T; Shin, David D; Rajamannan, Nalini M

    2006-12-01

    Bicuspid aortic valve (BAV) disease is a common congenital heart valve abnormality accounting for a large number of valve replacements in the United States. Although still incompletely understood, the natural history of BAV disease is severe aortic stenosis and associated ascending aortic dilatation. In addition to the increased risk of endocarditis, aortic dissection and severe aortic valve dysfunction are responsible for most fatal complications. Thus, early and precise recognition of this condition is mandatory. The new American College of Cardiology/American Heart Association recommendations highlight the role of MRI and CT as complimentary tools to echocardiography for the diagnosis and surveillance of the morphology of the aortic valve and ascending aorta. Moreover, better understanding of the cellular mechanisms, including inflammation, bone formation, atherosclerotic-like processes, and aortic wall abnormalities, as well as the heritability and genetic predisposition for the disease, will define the potential for targeted medical therapies in the future. Currently, the treatment of this condition is primarily surgical. Although combined valve and ascending aorta replacement has been the most common surgical approach in the past, the increased cumulative risk of thrombotic and embolic events among these young patients has led to more conservative approaches. Several valve-sparing approaches with comparable mid-term results compared with the classic procedures have recently been reported. However, longer follow-up studies will be helpful to better define the advantages of these new surgical options. After a quick overview of the natural history of the BAV, this article provides an updated approximation of the current knowledge of the pathophysiology as well as the recommendations for the management and treatment of this disease. PMID:17078910

  4. Chronic lead exposure decreases the vascular reactivity of rat aortas: the role of hydrogen peroxide.

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    Karolini Zuqui Nunes

    Full Text Available We investigated whether exposure to small concentrations of lead alters blood pressure and vascular reactivity. Male Wistar rats were sorted randomly into the following two groups: control (Ct and treatment with 100 ppm of lead (Pb, which was added to drinking water, for 30 days. Systolic blood pressure (BP was measured weekly. Following treatment, aortic ring vascular reactivity was assessed. Tissue samples were properly stored for further biochemical investigation. The lead concentration in the blood reached approximately 8 μg/dL. Treatment increased blood pressure and decreased the contractile responses of the aortic rings to phenylephrine (1 nM-100 mM. Following N-nitro-L arginine methyl ester (L-NAME administration, contractile responses increased in both groups but did not differ significantly between them. Lead effects on Rmax were decreased compared to control subjects following superoxide dismutase (SOD administration. Catalase, diethyldithiocarbamic acid (DETCA, and apocynin increased the vasoconstrictor response induced by phenylephrine in the aortas of lead-treated rats but did not increase the vasoconstrictor response in the aortas of untreated rats. Tetraethylammonium (TEA potentiated the vasoconstrictor response induced by phenylephrine in aortic segments in both groups, but these effects were greater in lead-treated rats. The co-incubation of TEA and catalase abolished the vasodilatory effect noted in the lead group. The present study is the first to demonstrate that blood lead concentrations well below the values established by international legislation increased blood pressure and decreased phenylephrine-induced vascular reactivity. The latter effect was associated with oxidative stress, specifically oxidative stress induced via increases in hydrogen peroxide levels and the subsequent effects of hydrogen peroxide on potassium channels.

  5. Calcium antagonism and the vasorelaxation of the rat aorta induced by rotundifolone

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    Guedes D.N.

    2004-01-01

    Full Text Available The vasorelaxing activity of rotundifolone (ROT, a major constituent (63.5% of the essential oil of Mentha x villosa, was tested in male Wistar rats (300-350 g. In isolated rat aortic rings, increasing ROT concentrations (0.3, 1, 10, 100, 300, and 500 µg/ml inhibited the contractile effects of 1 µM phenylephrine and of 80 or 30 mM KCl (IC50 values, reported as means ± SEM = 184 ± 6, 185 ± 3 and 188 ± 19 µg/ml, N = 6, respectively. In aortic rings pre-contracted with 1 µM phenylephrine, the smooth muscle-relaxant activity of ROT was inhibited by removal of the vascular endothelium (IC50 value = 235 ± 7 µg/ml, N = 6. Furthermore, ROT inhibited (pD2 = 6.04, N = 6 the CaCl2-induced contraction in depolarizing medium in a concentration-dependent manner. In Ca2+-free solution, ROT inhibited 1 µM phenylephrine-induced contraction in a concentration-dependent manner and did not modify the phasic contractile response evoked by caffeine (20 mM. In conclusion, in the present study we have shown that ROT produces an endothelium-independent vasorelaxing effect in the rat aorta. The results further indicated that in the rat aorta ROT is able to induce vasorelaxation, at least in part, by inhibiting both: a voltage-dependent Ca² channels, and b intracellular Ca2+ release selectively due to inositol 1,4,5-triphosphate activation. Additional studies are required to elucidate the mechanisms underlying ROT-induced relaxation.

  6. Novel Methodology for Characterizing Regional Variations in the Material Properties of Murine Aortas.

    Science.gov (United States)

    Bersi, Matthew R; Bellini, Chiara; Di Achille, Paolo; Humphrey, Jay D; Genovese, Katia; Avril, Stéphane

    2016-07-01

    Many vascular disorders, including aortic aneurysms and dissections, are characterized by localized changes in wall composition and structure. Notwithstanding the importance of histopathologic changes that occur at the microstructural level, macroscopic manifestations ultimately dictate the mechanical functionality and structural integrity of the aortic wall. Understanding structure-function relationships locally is thus critical for gaining increased insight into conditions that render a vessel susceptible to disease or failure. Given the scarcity of human data, mouse models are increasingly useful in this regard. In this paper, we present a novel inverse characterization of regional, nonlinear, anisotropic properties of the murine aorta. Full-field biaxial data are collected using a panoramic-digital image correlation (p-DIC) system. An inverse method, based on the principle of virtual power (PVP), is used to estimate values of material parameters regionally for a microstructurally motivated constitutive relation. We validate our experimental-computational approach by comparing results to those from standard biaxial testing. The results for the nondiseased suprarenal abdominal aorta from apolipoprotein-E null mice reveal material heterogeneities, with significant differences between dorsal and ventral as well as between proximal and distal locations, which may arise in part due to differential perivascular support and localized branches. Overall results were validated for both a membrane and a thick-wall model that delineated medial and adventitial properties. Whereas full-field characterization can be useful in the study of normal arteries, we submit that it will be particularly useful for studying complex lesions such as aneurysms, which can now be pursued with confidence given the present validation. PMID:27210500

  7. Strengths and Limitations of Current Adult Nomograms for the Aorta Obtained by Noninvasive Cardiovascular Imaging.

    Science.gov (United States)

    Cantinotti, Massimiliano; Giordano, Raffaele; Clemente, Alberto; Assanta, Nadia; Murzi, Michele; Murzi, Bruno; Crocetti, Maura; Marotta, Marco; Scalese, Marco; Kutty, Shelby; Iervasi, Giorgio

    2016-07-01

    Normalized measurements for the evaluation of aortic disease severity are preferred to the adoption of generic cutoff values. The purpose of this review is to evaluate the strengths and limitations of currently available aortic nomograms by echocardiography, computed tomography (CT), and magnetic resonance imaging (MRI). A literature search was conducted accessing the National Library of Medicine using the keywords normal values, aorta, echocardiography, CT, and MRI. Addition of these keywords further refined the results: reference values, nomograms, aortic arch, and adults. Thirty studies were included in the final analysis. Despite the strengths noted in the recent investigations, multiple methodological and numerical limitations emerged. The numerical limitations included sample size limitation in most of the studies (only few investigations consisted of >800 subjects and many had 70-300), lack of aortic arch measurements, and paucity of data for non-Caucasian subjects. Methodological limitations consisted of lack of standardization in measurements (systole vs. diastole, internal vs. external border, axial vs. orthogonal planes), heterogeneity and data normalization issues (various age intervals used, body size often not evaluated, data expressed as observed values rather than estimated values by z-score), and study design issues. The designs were mostly retrospective with poorly defined inclusion and exclusion criteria. The nomograms presented range of normality with significant differences, but also with some reproducible pattern. Despite recent advances, multiple methodological or numerical limitations exist in adult nomograms for the aorta. Comprehensive nomograms of aortic dimensions at multiple levels including the aortic arch for different imaging techniques, involving a wide sample size, and using standardized methodology for measurements and data normalization are warranted. The availability of robust nomograms may encourage the use of personalized

  8. Vasorelaxant effect of essential oil isolated from Nigella sativa L. seeds in rat aorta: Proposed mechanism.

    Science.gov (United States)

    Cherkaoui-Tangi, Khadija; Israili, Zafar Hasan; Lyoussi, Badiaâ

    2016-01-01

    The effect of the essential oil extracted from Nigella sativa (L.) seeds (Nigella oil) was investigated for its vasorelaxant activity on isolated rat aorta. Nigella oil at concentrations of 10-100 μg/mL elicited a dose-dependent relaxation of the aorta, which was pre-contracted with noradrenaline (NA, 10(-6) M) or KCl (100mM). In the presence of Nigella oil (75 μg/mL, the dose response curves to increasing concentrations of NA (10(-9) M to 10(-4)M) or KCl (10mM-100mM) were displaced downwards, indicating inhibition of the vasoconstrictive effect. This relaxation effect was independent of the presence of endothelium. In addition, the vasodilatory activity of the Nigella oil was not affected by pre-treatment of the rings with N(G)-nitro-L-Arginine (an inhibitor of endothelial nitric oxide synthase; 0.1mM), suggesting that the vasorelaxant effect is not mediated by nitric oxide. Furthermore, pre-treatment of the rings with Nigella oil (75 μg/mL suppressed the tension increment produced by increasing external calcium concentration (0.25 mM to 1.5mM). Tin conclusion, the essential oil extracted from Nigella sativa seeds produces smooth muscle relaxation, which is independent of endothelium and is not mediated by nitric oxide. The results also suggest that the vasorelaxing effect of the oil results from the blockade of both voltage-sensitive and receptor-operated calcium channels, and this may have therapeutic significance, in that Nigella oil may be useful as an antihypertensive agent in humans. PMID:26826822

  9. Assessment of mechanical properties of porcine aortas under physiological loading conditions using vascular elastography.

    Science.gov (United States)

    Mascarenhas, Edgar J S; Peters, Mathijs F J; Nijs, Jan; Rutten, Marcel C M; van de Vosse, Frans N; Lopata, Richard G P

    2016-06-01

    Non-invasive assessment of the elastic properties of the arterial wall is often performed with ultrasound (US) imaging. The purpose of this study is to estimate mechanical properties of the vascular wall using in vitro inflation testing on biological tissue and two-dimensional (2-D) US elastography, and investigate the performance of the proposed methodology for physiological conditions. An inflation experiment was performed on 12 porcine aortas for (a) a large pressure range (0-140mmHg); and (b) physiological pressures (70-130mmHg) to mimic in vivo hemodynamic conditions. Two-dimensional radiofrequency (RF) data were acquired for one longitudinal and two transverse cross-sections for both experiments, and were analyzed to obtain the geometry and diameter-time behavior. The shear modulus (G) was estimated from these data for each pressure range applied. In addition, an incremental study based on the static data was performed to (1) investigate the changes in G for increasing mean arterial pressure (MAP) for a certain pressure difference (30, 40, 50 and 60mmHg); (2) compare the results with those from the dynamic experiment, for the same pressure range. The resulting stress-strain curves and shear moduli G (94±16kPa) for the static experimentare in agreement with literature and previous work. A linear dependency on MAP was found for G, yet the effect of the pulse pressure difference was negligible. The dynamic data revealed a G of 250±20kPa, whereas the incremental shear modulus (Ginc) was 240±39kPa. For all experiments, no significant differences in the values of G were found between different image planes. This study shows that 2-D US elastography of aortas during inflation testing is feasible and reproducible under controlled and physiological circumstances. In future studies, the in vivo, dynamic experiment should be repeated for a range of MAPs, and pathological vessels should be examined. PMID:26766329

  10. Characteristics of aortic valve dysfunction and ascending aorta dimensions according to bicuspid aortic valve morphology

    International Nuclear Information System (INIS)

    To characterize aortic valve dysfunction and ascending aorta dimensions according to bicuspid aortic valve (BAV) morphology using computed tomography (CT) and surgical findings. We retrospectively enrolled 209 patients with BAVs who underwent transthoracic echocardiography (TTE) and CT. BAVs were classified as anterior-posterior (BAV-AP) or lateral (BAV-LA) orientation of the cusps and divided according to the presence (raphe+) or absence (raphe-) of a raphe. Ascending aortic dimensions were measured by CT at four levels. BAV-AP was present in 129 patients (61.7 %) and raphe+ in 120 (57.4 %). Sixty-nine patients (33.0 %) had aortic regurgitation (AR), 70 (33.5 %) had aortic stenosis (AS), and 58 (27.8 %) had combined AS and AR. AR was more common in patients with BAV-AP and raphe+; AS was more common with BAV-LA and raphe-.Annulus/body surface area and tubular portion/body surface area diameters in patients with BAV-AP (17.1 ± 2.3 mm/m2 and 24.2 ± 5.3 mm/m2, respectively) and raphe+ (17.3 ± 2.2 mm/m2 and 24.2 ± 5.5 mm/m2, respectively) were significantly different from those with BAV-LA (15.8 ± 1.9 mm/m2 and 26.4 ± 5.5 mm/m2, respectively) and raphe- (15.7 ± 1.9 mm/m2 and 26.2 ± 5.4 mm/m2, respectively). The morphological characteristics of BAV might be associated with the type of valvular dysfunction, and degree and location of an ascending aorta dilatation. (orig.)

  11. Vessel wall MRI of the thoracic aorta: correlation to histology and transesophageal ultrasound. Preliminary results

    International Nuclear Information System (INIS)

    Purpose: To visualise the vessel wall of the descending thoracic aorta using magnetic resonance imaging. To evaluate the diagnostic potential of tailored T1-weighted sequences with contrast enhancement to assess systemic atherosclerotic disease. Methods: This study was performed on a clinical 1.5 Tesla scanner using a gradient strength of 30 mT/m and the phased array spine coil. A cadaver was examined to optimise a magnetic resonance imaging (MRI) protocol to evaluate atherosclerotic aortic wall disease. The acquired MR images were compared to gross specimens and histology. Subsequently seven patients who had undergone transesophageal ultrasound (TEU) with detailed assessment of the descending thoracic aorta were examined with MRI. The optimised protocol included untriggered and fat suppressed T2-weighted turbo spin echo sequences and ECG-triggered and fat suppressed T1-weighted spin echo sequences before and after iv administration of Gd-DTPA. Findings of the MR images were compared to the results of TEU. Contrast enhancement measurements were performed in normal and thickened vessel wall segments. Results: For the cadaver study a good correlation of the degree of vessel wall thickening and the extent of plaque imaged with the applied MR protocol was found. Tissue characterisation was limited due to post mortem changes. In vivo ECG-triggered T1-weighted images showed good correlation to TEU in terms of vessel wall thickness and plaque extension as verified by means of consensus reading. Differentiation of the plaque components fat, calcium and fibrous tissue was possible. In thickened aortic wall segments and fibrous caps a mean contrast enhancement of 50.4%±23.5% was measurable while normal wall segments showed an enhancement of 6.7%±3.1%. (orig.)

  12. Aneurysms of the ascending aorta and arch: the role of imaging in diagnosis and surgical management.

    Science.gov (United States)

    Bonnichsen, Crystal R; Sundt, Thoralf M; Anavekar, Nandan S; Foley, Thomas A; Morris, Michael F; Martinez, Matthew W; Williamson, Eric E; Glockner, James F; Araoz, Philip A

    2011-01-01

    Thoracic aortic aneurysms tend to be asymptomatic and were previously often diagnosed only after a complication such as dissection or rupture occurred. Better imaging techniques and an increase in the use of cross-sectional imaging has led to an increase in the diagnosis of aortic aneurysms, which has allowed for elective treatment prior to the development of a complication. The location, size and etiology of an aneurysm all impact the clinical outcomes and these factors are used to determine the appropriate timing of surgical replacement. Surgeons often rely on the information obtained from preoperative imaging to determine when to intervene and what type of procedure will be necessary, making it important for the radiologist to understand these issues in order to provide the necessary information. Postoperative imaging after surgical replacement of the aorta is also important, as there are some common findings that occur in this patient population that can impact how they are treated. The purpose of this article is to review the etiology and associated findings of aneurysms of the ascending aorta and arch, with a focus on how computed tomography angiography and magnetic resonance angiography findings are used to determine the appropriate timing for elective replacement and the type of surgical procedure, as well as the role of follow-up imaging. This will include a review of the most commonly performed types of surgical procedures, to provide an understanding of how the findings of preoperative imaging studies impact what the surgeon does in the operating room, as well as the expected findings of postoperative imaging studies. PMID:21166528

  13. Characteristics of aortic valve dysfunction and ascending aorta dimensions according to bicuspid aortic valve morphology

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Hong Ju [Konkuk University Medical Center, Konkuk University School of Medicine, Department of Cardiovascular Surgery, Seoul (Korea, Republic of); Yonsei University College of Medicine, Department of Cardiovascular Surgery, Seoul (Korea, Republic of); Shin, Je Kyoun; Chee, Hyun Kun; Kim, Jun Suk [Konkuk University Medical Center, Konkuk University School of Medicine, Department of Cardiovascular Surgery, Seoul (Korea, Republic of); Ko, Sung Min [Konkuk University Medical Center, Konkuk University School of Medicine, Department of Radiology, Seoul (Korea, Republic of)

    2015-07-15

    To characterize aortic valve dysfunction and ascending aorta dimensions according to bicuspid aortic valve (BAV) morphology using computed tomography (CT) and surgical findings. We retrospectively enrolled 209 patients with BAVs who underwent transthoracic echocardiography (TTE) and CT. BAVs were classified as anterior-posterior (BAV-AP) or lateral (BAV-LA) orientation of the cusps and divided according to the presence (raphe+) or absence (raphe-) of a raphe. Ascending aortic dimensions were measured by CT at four levels. BAV-AP was present in 129 patients (61.7 %) and raphe+ in 120 (57.4 %). Sixty-nine patients (33.0 %) had aortic regurgitation (AR), 70 (33.5 %) had aortic stenosis (AS), and 58 (27.8 %) had combined AS and AR. AR was more common in patients with BAV-AP and raphe+; AS was more common with BAV-LA and raphe-.Annulus/body surface area and tubular portion/body surface area diameters in patients with BAV-AP (17.1 ± 2.3 mm/m{sup 2} and 24.2 ± 5.3 mm/m{sup 2}, respectively) and raphe+ (17.3 ± 2.2 mm/m{sup 2} and 24.2 ± 5.5 mm/m{sup 2}, respectively) were significantly different from those with BAV-LA (15.8 ± 1.9 mm/m{sup 2} and 26.4 ± 5.5 mm/m{sup 2}, respectively) and raphe- (15.7 ± 1.9 mm/m{sup 2} and 26.2 ± 5.4 mm/m{sup 2}, respectively). The morphological characteristics of BAV might be associated with the type of valvular dysfunction, and degree and location of an ascending aorta dilatation. (orig.)

  14. Puerarin Improves Diabetic Aorta Injury by Inhibiting NADPH Oxidase-Derived Oxidative Stress in STZ-Induced Diabetic Rats

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    Wenping Li

    2016-01-01

    Full Text Available Objective. Puerarin is a natural flavonoid isolated from the TCM lobed kudzuvine root. This study investigated the effect and mechanisms of puerarin on diabetic aorta in rats. Methods. Streptozotocin- (STZ- induced diabetic rats were administered with puerarin for 3 weeks. Levels of serum insulin (INS, PGE2, endothelin (ET, glycated hemoglobin (GHb, H2O2, and nitric oxide (NO in rats were measured by ELISA and colorimetric assay kits. The aortas were stained with H&E. Moreover, the mRNA expression of ICAM-1, LOX-1, NADPH oxidase 2 (NOX2, and NOX4 and the protein expression of ICAM-1, LOX-1, NF-κB p65, E-selectin, NOX2, and NOX4 in aorta tissues were measured by real-time PCR and Western blot, respectively. The localization of ICAM-1, NF-κB p65, NOX2, and NOX4 in the aorta tissues was also determined through immunohistochemistry. Results. Puerarin treatment exerted no effect on fasting blood glucose levels but significantly reduced the serum levels of INS, GHb, PGE2, ET, H2O2, and NO. In addition, puerarin improved the pathological alterations and inhibited the expression of ICAM-1, LOX-1, NOX2, and NOX4 at both mRNA and protein levels. Puerarin also significantly reduced the number of cells showing positive staining for ICAM-1, NOX2, NOX4, and NF-κB p65. Conclusion. Puerarin demonstrated protective effect on the STZ-induced diabetic rat aorta. The protective mechanisms may include regulation of NF-κB and inhibition of NOX2 and NOX4 followed by inhibition of cell adhesion molecule expression.

  15. Tratamento da arterite de Takayasu Takayasu’s arteritis treatment

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    Alexandre Wagner Silva de Souza

    2006-06-01

    Full Text Available A arterite de Takayasu (AT é uma vasculite granulomatosa crônica que envolve a aorta e seus principais ramos. A monitoração da atividade da doença e o melhor esquema terapêutico ainda têm sido um desafio para todos os que tratam estes pacientes. Corticosteróides e imunossupressores vêm sendo utilizados na prática clínica diária com resultados nem sempre animadores. Apesar de não haver estudos controlados que abordem o tratamento da AT, diferentes estudos observacionais descrevem a resposta de pacientes com AT ao uso de corticosteróides, metotrexato (MTX, azatio-prina e ciclofosfamida. Após a introdução da terapia biológica, novas perspectivas têm surgido para os pacientes com AT refratários aos esquemas terapêuticos tradicionais.Takayasus’s arteritis is a chronic granulomatous vasculitis involving the aorta and its main branches. Monitoring disease activity and the choice for the best therapy has been major challenger faced by all physicians who treat these patients. Corticosteroids and immunosuppressive therapy have been used in daily medical practice, but results have not always been encouraging. Although there are no controlled studies evaluating the treatment of Takayasu’s arteritis, observational studies have described the response to the use of corticosteroids, methotrexate, azathioprine and cyclophosphamide. The emerging of biological therapy has brought new perspective for Takayasu’s patients who are refractory to conventional therapy.

  16. Data of the natural and pharmaceutical angiotensin-converting enzyme inhibitor isoleucine-tryptophan as a potent blocker of matrix metalloproteinase-2 expression in rat aorta.

    Science.gov (United States)

    Kopaliani, Irakli; Martin, Melanie; Zatschler, Birgit; Müller, Bianca; Deussen, Andreas

    2016-09-01

    The present data are related to the research article entitled "Whey peptide isoleucine-tryptophan inhibits expression and activity of matrix metalloproteinase-2 in rat aorta" [1]. Here we present data on removal of endothelium from aorta, endothelium dependent aortic relaxation and inhibition of expression of pro-MMP2 by di-peptide isoleucine-tryptophan (IW). Experiments were performed in rat aortic endothelial cells (EC) and smooth muscle cells (SMC) in vitro, along with isolated rat aorta ex vivo. The cells and isolated aorta were stimulated with angiotensin II (ANGII) or angiotensin I (ANGI). ACE activity was inhibited by treatment with either IW or captopril (CA). Losartan was used as a blocker of angiotensin type-1 receptor. IW inhibited MMP2 protein expression induced with ANGI in a dose-dependent manner. IW was effective both in ECs and SMCs, as well as in isolated aorta. Similarly, captopril (CA) inhibited ANGI-induced MMP2 protein expression in both in vitro and ex vivo. Neither IW nor CA inhibited ANGII-induced MMP2 protein expression in contrast to losartan. The data also displays that removal of endothelium in isolated rat aorta abolished the endothelium-dependent relaxation induced with acetylcholine. However, SMC-dependent relaxation induced with sodium nitroprusside remained intact. Finally, the data provides histological evidence of selective removal of endothelial cells from aorta. PMID:27508250

  17. Anteroposterior diameter of the infrarenal abdominal aorta is higher in women with polycystic ovary syndrome

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    Marco Matteo Ciccone

    2009-06-01

    Full Text Available Marco Matteo Ciccone1, Stefano Favale1, Anish Bhuva4, Pietro Scicchitano1, Vito Caragnano1, Cristina Lavopa2, Giovanni De Pergola3, Giuseppe Loverro21Department of Cardiology; 2Department of Gynecology and Obstetrics; 3Section of Internal Medicine, Endocrinology, Andrology, and Metabolic Diseases, University of Bari, DETO, Italy; 4University College of London, London, UKBackground: Women affected by polycystic ovary syndrome (PCOS are known to be at higher risk of cardiovascular disease. The aim of this study was to identify the artery that first is affected by early pre-atherosclerotic changes in PCOS. Methods: Twenty-nine women with PCOS aged 17 to 27 years and 26 healthy nonhyperandrogenic volunteers with regular menses (control women aged 16 to 28 years were enrolled. All PCOS patients were overweight or obese (body mass index [BMI] ≥ 25. Diagnosis of PCOS was performed in line with the 2003 Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Accordingly, PCOS was defined when at least two of the following three features were present after exclusion of other etiologies: 1 oligomenorrhea and or anovulation; 2 hyperandrogenism and/or hyperandrogenemia; and 3 polycystic ovaries visible at ultrasound. Androgen excess or related disorders were excluded. The intima-media thickness (IMT of common carotid arteries and common femoral arteries and the anteroposterior diameter of the infrarenal abdominal aorta were measured by ultrasound. Lutenizing hormone (LH, follicle-stimulating hormone (FSH, estradiol, total testosterone, androstenedione, and sex hormone-binding globulin (SHBG serum levels were measured between the 3rd and the 6th day of spontaneous or progestin-induced menstrual cycle. Our study was performed in the absence of any medical treatment. Results: Women with PCOS showed a higher LH to FSH ratio (p < 0.01, increased fasting insulin (p < 0.001, total testosterone (p < 0.001, and androstenedione (p < 0.001 levels, and lower

  18. Da Kantsa

    OpenAIRE

    Martínez, Alaín; Villalvilla, Camilo; Quintero, Rolando; Echevarria, Juan Carlos; Sanfiel, Jorge Luis San; Copperini, Luis A. P.

    2015-01-01

    Catálogo de las tres exposiciones (La bota rusa, Carne rusa y Da Kantsa/ ?? ?????) que desde 2011 han reunido en la Galería Maroya de Cienfuegos a artistas cubanos bajo la evocación de lo ruso-soviético. Las muestras se han celebrado en colaboración con el Fondo Cubano de Bienes Materiales. Desde Kamchatka agradecemos la colaboración de Miguel Ángel Rodríguez, de la Galería Maroya, y a Camilo Villalvilla. 

  19. Avaliação da flebografia orbitária em oito casos de síndrome de Tolosa-Hunt

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    D.R. Nalli

    1994-06-01

    Full Text Available A Síndrome de Tolosa-Hunt (STH ou oftalmoplegia dolorosa é associada a granulomatose inespecifica de etiologia desconhecida que acomete a fissura orbitária superior. Compromete estruturas nervosas e vasculares causando quadro clínico variável que sempre se associa a dor e apresenta resposta favorável à corticoterapia. Processos inflamatórios, tumores e aneurismas dessa região podem causar sintomas semelhantes. A tomografia computadorizada, a angiografia cerebral e a flebografia orbitária são métodos de imagem indicados para orientar o diagnóstico. Revisamos os resultados destes exames radiológicos de oito pacientes atendidos no Hospital São Paulo no período 1989 a 1991, com diagnóstico de STH segundo os critérios de Hunt e Hannerz. A análise das alterações da flebografia orbitária, de acordo com a sistematização feita por Hannerz e col. mostrou ser este exame inespecífico, porém capaz de orientar melhor o diagnóstico.

  20. Effects of C-reactive protein on the expression of OX40 ligand in mouse aorta endothelial cells

    Institute of Scientific and Technical Information of China (English)

    Fei Wang; Shushu Zhu; Xuefu Han; Jindan Xu; Jinnan Zhang; Di Yang

    2009-01-01

    Objective: To investigate the expression of OX40 ligand(OX40L) on C-reactive protein(CRP)-triggered mouse aorta endothelial cells (MAECs) in vitro. Methods: MAECs from aorta were isolated by digestion with collagenase type Ⅱ. The cell growth was confirmed by morphological characteristics and the immunological marker, factor Ⅷ(or Willebrand factor, vWF). The expression of OX40L by MAECs was detected by RT-PCR and western blot after incubating with 100 μg/ml CRP for 48 hours. Results: Twenty-day cultures of MAECs formed confluent monolayer of a cobblestone pattern. RT-PCR and western blot assay showed that the level of OX40L expression in MAECs receiving CRP treatment was higher than control. Conclusion: A reliable method is described to isolate and propagate MAECs. CRP upregulates OX40L expression in MAECs.

  1. Dietary saffron reduced the blood pressure and prevented remodeling of the aorta in L-NAME-induced hypertensive rats

    Directory of Open Access Journals (Sweden)

    Zohreh Nasiri

    2015-11-01

    Full Text Available Objective(s:The aim of this study was to investigate the effects of nutritional saffron (Crocus sativus L. stigma hydroalcoholic extract on blood pressure (BP and histology of the aorta in normotensive and hypertensive rats. Materials and Methods:   Saffron (200 mg/kg/day was given orally for 5 weeks to normotensive and hypertensive rats. Hypertension was induced by NG-nitro-L-arginine methyl ester (L-NAME; 40 mg/kg/day administration in drinking water, and BP was measured weekly. Histological examination of the thoracic aorta included staining with hematoxylin and eosin, orcein, and periodic acid Schiff methods. Results:  Saffron had no effect on normotensive rats, but on hypertensive rats, prevented BP elevation form the third week of treatment (P

  2. Use of the frozen elephant trunk technique in complicated chronic dissection with porcelain aorta and visceral arteries originating from different lumens.

    Science.gov (United States)

    Zembala, Michal O; Irimie, Vadim; Urbanski, Paul P

    2016-04-01

    A rare case of aortic arch aneurysm combined with chronic aortic dissection is reported. Because the visceral arteries originated from different, equivalently perfused lumens and the descending aorta was circumferentially calcified (porcelain aorta) limiting the possibilities of anastomosing, careful planning of the surgical strategy was of utmost importance. The complex surgery consisted of ascending and total arch replacement using the 'frozen elephant trunk' technique with Thoraflex™ Hybrid Prosthesis (Vascutek, Terumo, Inchinnan, Scotland); however, before insertion of the stent graft, an angioscopic resection of the dissection membrane in the proximal part of the descending aorta was carried out to ensure a complete expansion of the distal edge of the stent within the entire common lumen of the aorta and unimpaired distal flow in both lumens below the stent graft. The surgery and the postoperative course were uneventful. PMID:27002017

  3. An Experimental Study to Replace the Thoracic Descending Aorta for Pigs with a Self-Made Sutureless Blood Vessel

    OpenAIRE

    Song, Fenglin; Zhou, Wenwu; Tang, Tao; Li, Xiaobing; Wu, Xiaoming; Yang, Jinfu

    2014-01-01

    To simplify the procedure of blood vessel replacement operation and shorten the vascular anastomosis time, we developed a special artificial blood vessel which can be connected to native blood vessels without suture. The self-made sutureless blood vessel (SMSBV) was made from two titanium connectors and a Gore-Tex graft. To investigate blood compatibility and histocompatibility of the SMSBV, we carried thoracic descending aorta replacement using either SMSBV or Gore-Tex, respectively, in pigs...

  4. An Experimental Study to Replace the Thoracic Descending Aorta for Pigs with a Self-Made Sutureless Blood Vessel

    OpenAIRE

    2014-01-01

    To simplify the procedure of blood vessel replacement operation and shorten the vascular anastomosis time, we developed a special artificial blood vessel which can be connected to native blood vessels without suture. The self-made sutureless blood vessel (SMSBV) was made from two titanium connectors and a Gore-Tex graft. To investigate blood compatibility and histocompatibility of the SMSBV, we carried thoracic descending aorta replacement using either SMSBV or Gore-Tex,...

  5. Partially thrombosed aneurysm of the abdominal aorta: Unusual cause of chronic inflammation and resistance to recombinant human erythropoietin

    OpenAIRE

    El Amrani, M.; El Kharras, A.; Asserraji, M.

    2014-01-01

    Diagnosis of chronic inflammatory syndrome is often a challenge. In dialysis patients, this condition leads to resistance to recombinant human erythropoietin (rHuEPO). We here report a case of a 72-year-old male undergoing chronic hemodialysis and developed rHuEPO resistance without any obvious etiology. Investigations showed a partially thromosed aneurysm of the infrarenal aorta. Antiplatelet therapy was started with a satisfactory outcome.

  6. The Effect of Concomitant Ethanol and Opium Consumption on Lipid Profiles and Atherosclerosis in Golden Syrian Hamster’s Aorta

    OpenAIRE

    Shahryari, Jahanbanoo; Poormorteza, Moein; Noori-Sorkhani, Arash; Divsalar, Kouros; Abbasi-Oshaghi, Ebrahim

    2013-01-01

    Background Cardiovascular disease (CVD) is the main cause of mortality in the world and is normally argued as the third cause of all mortalities. Opium and alcohol every day consumption can cause people to have many health problems. The present study aimed to assess the effect of ethanol and opium consumption on lipid profiles and atherosclerosis in aorta. Methods Twenty four male golden Syrian hamsters were randomly divided into four treatment groups (n = 6): Control, addicted (40 mg/kg), al...

  7. Cine MRI of the ascending aorta in the elderly with respect to the flow signal void and aortic valve morphology

    International Nuclear Information System (INIS)

    Cine flow MRI was performed on a 1.5 Tesla system to observe signal intensity of blood flow within the ascending aorta in the elderly who had no aortic stenosis and to determine frequency of the flow signal void. Coronal and sagittal imaging planes of the ascending aorta were obtained in 27 aged patients with no known cardiac diseases (14 men and 13 women, mean age of 76) and 7 young volunteers (7 men, mean age of 24), utilizing ECG-gating, GRASS (gradient-recalled acquisition in steady state), and a flow compensation sequence. The young volunteers presented little or no signal void within the ascending aorta. In 26 (96%) of the 27 aged patients, on the other hand, signal void was demonstrated in the blood flow distal to the aortic valve during systole. The maximum length of the signal void that was measured at 318∼632 msec after the R wave of ECG ranged from 33 to 97 mm. Conventional and Doppler echocardiography was used to evaluate motion and morphology of the aortic valve in 19 of the 27 aged patients. Eighteen of these 19 subjects had aortic signal void on cine MRI. Echocardiography showed sclerotic changes of the aortic valve (i.e., increased echogenicity of the cusps and/or commissure fusion) in 10 (53%) of the 19 subjects. The mean maximum length of the signal void in the 10 patients with aortic valve sclerosis was significantly greater than that in the 9 patients with echocardiographically normal valve (68 vs.45 mm, p<0.01). These results suggest that signal void of blood flow in the ascending aorta, which is recognized as one of the characteristic findings in patients with aortic stenosis, is not a specific feature for this disease but rather a commom one in the elderly particularly those with sclerotic changes of the aortic valve. However, the length of the signal void may distinguish between nonstenotic and stenotic aortic valves. (author)

  8. Aorta-LITA Bypass Grafting with Saphenous Vein in a Patient Undergoing Coronary Artery Surgery with Subclavian Artery Stenosis

    Directory of Open Access Journals (Sweden)

    Kerim Çağlı

    2011-12-01

    Full Text Available The internal thoracic artery (ITA is the primary graft for coronary artery bypass grafting and can not be used if there is subclavian artery stenosis (SAS. Aorto-axillary, carotid-subclavian bypass and also angioplasty with stenting or other interventional treatments are acceptable procedures for SAS treatment. Aorta-ITA bypass with saphenous vein can be alternative and simple technique for SAS to save Winslow pathway for patients with peripheral artery disease.

  9. Serelaxin (recombinant human relaxin-2) prevents high glucose-induced endothelial dysfunction by ameliorating prostacyclin production in the mouse aorta.

    Science.gov (United States)

    Ng, Hooi Hooi; Leo, Chen Huei; Parry, Laura J

    2016-05-01

    Diabetes-induced endothelial dysfunction is a critical initiating factor in the development of cardiovascular complications. Treatment with relaxin improves tumour necrosis factor α-induced endothelial dysfunction by enhancing endothelial nitric oxide synthase (eNOS) activity and restoring superoxide dismutase 1 protein in rat aortic rings ex vivo. It is, therefore, possible that relaxin treatment could alleviate endothelial dysfunction in diabetes. This study aimed to test the hypothesis that serelaxin (recombinant human relaxin-2) prevents high glucose-induced vascular dysfunction in the mouse aorta. Abdominal aortae were isolated from C57BL/6 male mice and incubated in M199 media for 3days with either normal glucose (5.5mM) or high glucose (30mM), and co-incubated with placebo (20mM sodium acetate) or 10nM serelaxin at 37°C in 5% CO2. Vascular function was analysed using wire-myography. High glucose significantly reduced the sensitivity to the endothelium-dependent agonist, acetylcholine (ACh) (pEC50; normal glucose=7.66±0.10 vs high glucose=7.29±0.10, n=11-12, Paortae, but had no effect in serelaxin treated aortae. This suggests that high glucose incubation alters the superoxide and COX-sensitive pathway, which was normalized by co-incubation with serelaxin. Neither high glucose incubation nor serelaxin treatment had an effect on cyclooxygenase 1 and 2 (Ptgs1, Ptgs2), prostacyclin synthase (PTGIS) and receptor (Ptgir) as well as thromboxane A2 receptor (Tbxa2r) mRNA expression. Importantly, production of prostacyclin was significantly (Paortae, which was prevented by serelaxin treatment. Our data show that serelaxin treatment for 3 days restores high glucose-induced endothelial dysfunction by ameliorating vasodilator prostacyclin production and possibly through the reduction of superoxide in the mouse aorta. PMID:26993102

  10. Training differentially regulates elastin level and proteolysis in skeletal and heart muscles and aorta in healthy rats

    OpenAIRE

    Anna Gilbert; Aleksandra Wyczalkowska-Tomasik; Malgorzata Zendzian-Piotrowska; Bozena Czarkowska-Paczek

    2016-01-01

    Exercise induces changes in muscle fibers and the extracellular matrix that may depend on elastin content and the activity of proteolytic enzymes. We investigated the influence of endurance training on the gene expression and protein content and/or activity of elastin, elastase, cathepsin K, and plasmin in skeletal and heart muscles and in the aorta. Healthy rats were randomly divided into untrained (n=10) and trained (n=10; 6 weeks of endurance training with increasing load) groups. Gene exp...

  11. The role of cystatin C in vascular remodeling of balloon-injured abdominal aorta of rabbits.

    Science.gov (United States)

    Wu, Xiang-Jun; Dong, Zhao-Qiang; Lu, Qing-Hua

    2014-09-01

    This study aimed to evaluate the role of cystatin C (CysC) in the vascular remodeling of balloon-injured abdominal aorta of rabbits. Forty-eight New Zealand white rabbits were randomly divided into three groups: the balloon-injured injury group (n = 16), the CysC monoclonal antibody group (n = 16), and the sham-operative group (n = 16). Serum CysC levels were detected by enzyme linked immunosorbent assay. Changes in adventitial area, adventitial thickness, lumen area (LA), neointimal area (IA), internal elastic lamina area (IELA), external elastic lamina area (EELA), vascular remodeling index (VRI) and residual stenosis (RS) were measured by the Leica image analysis system. Immunohistochemical analysis of α-smooth muscle actin (α-SMA) and proliferating cell nuclear antigen (PCNA) were performed. Serum CysC levels of rabbits in the balloon-injured injury group were significantly higher than those in the CysC monoclonal antibody group and the sham-operative group (both P IA, IELA and EELA in the balloon-injured injury group were also higher than those in the CysC monoclonal antibody and sham-operative groups (all P rabbits. PMID:24981928

  12. Elastodynamic analysis of the human aorta and the effect of biomechanical parameters on its behavior.

    Science.gov (United States)

    Najarian, Siamak; Dargahi, Javad; Farmanzad, Farhad

    2007-01-01

    In this work, a finite element formulation for the analysis of the elastodynamic behavior of the human aorta is presented. In this formulation, a one-dimensional approach was adopted and a comprehensive computer program was written and employed in the mathematical analysis. All the necessary material and geometrical parameters were appropriately incorporated in the simulation. A comparison was made between the simplified elasticity theory and the one proposed in this study using the poroelasticity theory. The effects of certain parameters including the fluid density and the material permeability of the matrix on the behavior of the aortic tissue were investigated. According to these findings, the higher the density of the liquid in the tissue, the more delay will be observed in the resonance frequencies. It was also concluded that in the poroelasticity theory, the resonance frequencies occur at a later stage compared with the elasticity theory. The permeability of liquid into the pores and its damping effect are the two factors that contributed to the delay in the resonance. It was observed that at a frequency of 10 Hz, up to a permeability of about 10(-8) m(4)/N.s, the effect on the magnitude of the amplitude is negligible. However, from this threshold value up to a point at which the permeability is equal to 10(-5) m(4)/N.s, there is a corresponding increase in the amplitude. PMID:17611299

  13. Validity of Current Stereotactic Body Radiation Therapy Dose Constraints for Aorta and Major Vessels.

    Science.gov (United States)

    Xue, Jinyu; Kubicek, Gregory; Patel, Ashish; Goldsmith, Benjamin; Asbell, Sucha O; LaCouture, Tamara A

    2016-04-01

    Understanding dose constraints for critical structures in stereotactic body radiation therapy (SBRT) is essential to generate a plan for optimal efficacy and safety. Published dose constraints are derived by a variety of methods, including crude statistics, actuarial analysis, modeling, and simple biologically effective dose (BED) conversion. Many dose constraints reported in the literature are not consistent with each other, secondary to differences in clinical and dosimetric parameters. Application of a dose constraint without discriminating the variation of all the factors involved may result in suboptimal treatment. This issue of Seminars in Radiation Oncology validates dose tolerance limits for 10 critical anatomic structures based on dose response modeling of clinical outcomes data to include detailed dose-volume metrics. This article presents a logistic dose-response model for aorta and major vessels based on 238 cases from the literature in addition to 387 cases from MD Anderson Cancer Center at Cooper University Hospital, for a total of 625 cases. The Radiation Therapy Oncology Group (RTOG) 0813 dose-tolerance limit of Dmax = 52.5Gy in 5 fractions was found to have a 1.2% risk of grade 3-5 toxicity, and the Timmerman 2008 limit of Dmax = 45Gy in 3 fractions had 2.3% risk. From the model, the 1% and 2% risk levels for D4cc, D1cc, and D0.5cc are also provided in 1-5 fractions, in the form of a dose-volume histogram (DVH) Risk Map. PMID:27000510

  14. Erkrankungen der thorakalen Aorta: klinische Symptomatik, elektrokardiographische, röntgenologische und echokardiographische Diagnostik

    Directory of Open Access Journals (Sweden)

    Müller S

    2001-01-01

    Full Text Available In der Diagnostik von Aortenerkrankungen ist die transthorakale (TTE und transösophageale (TEE Echokardiographie eine der bedeutendsten bildgebenden Untersuchungsmethoden. Als eine "bedside"-Methode ist sie schnell verfügbar, risikoarm und durch eine hohe Sensitivität und Spezifität charakterisiert. Nach kardiologischen Basisuntersuchungen wie der Röntgen-Thoraxuntersuchung und dem EKG sollte zunächst eine TTE und insbesondere bei Einbeziehung der Aorta descendens eine TEE durchgeführt werden. Obwohl die TEE der TTE überlegen ist, sind beide Methoden als komplementär zu betrachten. Im Rahmen der laborchemischen Diagnostik der Aortendissektion kann sich die Bestimmung des C-reaktiven Proteins als hilfreich erweisen. Mit einem erhöhten Risiko hinsichtlich von Aortenerkrankungen behaftet müssen Patienten mit einer arteriellen Hypertonie, mit Atherosklerose sowie mit Aortenklappenanomalien und genetischen Mißbildungssyndromen angesehen werden. Insbesondere in diesen Fällen sollte bei entsprechender Symptomatik eine Aortenerkrankung ausgeschlossen werden.

  15. Evidence for a requirement of agonist-induced diacylglycerol production during tonic contraction of rat aorta

    International Nuclear Information System (INIS)

    A possible role for protein kinase C during the tonic phase of arterial contraction was examined in rat aorta by observing the effects of the phorbol ester, 12-0-tetradecanoylphorbol-13-acetate (TPA), on angiotensin II (AII)-induced responses. The ability of AII and phenylephrine (PE) to induce diacylglycerol (DAG) production was monitored as agonist-stimulated 32P-labelling of phosphatidic acid (PA). AII (5 x 10-7M) causes only a transient contractile response, while PE (10-5M) causes a sustained tonic contraction. 32P-labelling studies showed that AII caused an initial increase of PA synthesis equal to PE, however, AII failed to sustain this increase at 5 and 10 min while PE was able to do so, indicating the failure of AII to provide DAG to sustain protein kinase C activation. Activation of protein kinase C with TPA prior to and during AII exposure converted the normally transient contraction to a more sustained, tonic pattern. These results suggest that the inability of AII to maintain tension, unlike PE, is due to its inability to produce DAG continuously and activate protein kinase C

  16. In vitro vasorelaxation mechanisms of bioactive compounds extracted from Hibiscus sabdariffa on rat thoracic aorta

    Science.gov (United States)

    Sarr, Mamadou; Ngom, Saliou; Kane, Modou O; Wele, Alassane; Diop, Doudou; Sarr, Bocar; Gueye, Lamine; Andriantsitohaina, Ramaroson; Diallo, Aminata S

    2009-01-01

    Background In this study, we suggested characterizing the vasodilator effects and the phytochemical characteristics of a plant with food usage also used in traditional treatment of arterial high blood pressure in Senegal. Methods Vascular effects of crude extract of dried and powdered calyces of Hibiscus sabdariffa were evaluated on isolated thoracic aorta of male Wistar rats on organ chambers. The crude extract was also enriched by liquid-liquid extraction. The various cyclohexane, dichloromethane, ethyl acetate, butanol extracts obtained as well as the residual marc were subjected to Sephadex LH-20 column chromatography. The different methanolic eluate fractions were then analyzed by Thin Layer (TLC) and High Performance Liquid Chromatography (HPLC) and their vascular effects also evaluated. Results The H. Sabdariffa crude extract induced mainly endothelium-dependent relaxant effects. The endothelium-dependent relaxations result from NOS activation and those who not dependent to endothelium from activation of smooth muscle potassium channels. The phytochemical analysis revealed the presence of phenolic acids in the ethyl acetate extract and anthocyans in the butanolic extract. The biological efficiency of the various studied extracts, in term of vasorelaxant capacity, showed that: Butanol extract > Crude extract > Residual marc > Ethyl acetate extract. These results suggest that the strong activity of the butanolic extract is essentially due to the presence of anthocyans found in its fractions 43-67. Conclusion These results demonstrate the vasodilator potential of hibiscus sabdariffa and contribute to his valuation as therapeutic alternative. PMID:19883513

  17. Inhibitory effects of homeodomain-interacting protein kinase 2 on the aorta-gonad-mapharsen hematopoiesis

    International Nuclear Information System (INIS)

    Definitive hematopoiesis starts in the aorta-gonad-mesonephros (AGM) region of the mouse embryo. Our previous studies revealed that STAT3, a gp130 downstream transcription factor, is required for AGM hematopoiesis and that homeodomain-interacting protein kinase 2 (HIPK2) phosphorylates serine-727 of STAT3. HIPK2 is a serine/threonine kinase known to be involved in transcriptional repression and apoptosis. In the present study, we examined the role of HIPK2 in hematopoiesis in mouse embryo. HIPK2 transcripts were found in fetal hematopoietic tissues such as the mouse AGM region and fetal liver. In cultured AGM cells, HIPK2 protein was detected in adherent cells. Functional analyses of HIPK2 were carried out by introducing wild-type and mutant HIPK2 constructs into AGM cultures. Production of CD45+ hematopoietic cells was suppressed by forced expression of HIPK2 in AGM cultures. This suppression required the kinase domain and nuclear localization signals of HIPK2, but the kinase activity was dispensable. HIPK2-overexpressing AGM-derived nonadherent cells did not form cobblestone-like colonies in cultures with stromal cells. Furthermore, overexpression of HIPK2 in AGM cultures impeded the expansion of CD45lowc-Kit+ cells, which exhibit the immature hematopoietic progenitor phenotype. These data indicate that HIPK2 plays a negative regulatory role in AGM hematopoiesis in the mouse embryo

  18. Reduced contrast medium in abdominal aorta CTA using a multiphasic injection technique

    Energy Technology Data Exchange (ETDEWEB)

    Nijhof, Wouter H., E-mail: w.h.nijhof@student.utwente.nl [University of Twente, MIRA-Institute for Biomedical Technology and Technical Medicine P.O. Box 21 7500 AE Enschede (Netherlands); Vos, Charlotte S. van der, E-mail: v.s.vandervos@student.utwente.nl [University of Twente, MIRA-Institute for Biomedical Technology and Technical Medicine P.O. Box 21 7500 AE Enschede (Netherlands); Anninga, Bauke, E-mail: b.anninga@student.utwente.nl [University of Twente, MIRA-Institute for Biomedical Technology and Technical Medicine P.O. Box 21 7500 AE Enschede (Netherlands); Stegehuis, Paulien L., E-mail: p.l.stegehuis@student.utwente.nl [University of Twente, MIRA-Institute for Biomedical Technology and Technical Medicine P.O. Box 21 7500 AE Enschede (Netherlands); Jager, Gerrit J., E-mail: g.jager@JBZ.nl [Department of Radiology, Jeroen Bosch Hospital, Henri Dunantstraat 1, 5223 GZ ’s-Hertogenbosch (Netherlands); Rutten, Matthieu J.C.M., E-mail: m.rutten@JBZ.nl [Department of Radiology, Jeroen Bosch Hospital, Henri Dunantstraat 1, 5223 GZ ’s-Hertogenbosch (Netherlands)

    2013-02-15

    Purpose: The purpose of this study was to determine if with a multiphasic injection technique the administered amount of contrast medium for abdominal computerized tomographic angiography (CTA) can be decreased, whilst improving CT image quality. Materials and methods: In 30 patients a multiphasic injection method was compared to the standard uniphasic contrast medium injection protocol. Fifteen patients underwent abdominal CTA with a standard uniphasic injection protocol (protocol I) receiving 100 mL of a non-ionic radiopaque contrast agent (Ioversol). The second group of 15 patients underwent CTA with a multiphasic injection protocol (protocol II) receiving a total of 89 mL Ioversol. Vascular contrast enhancement and difference in enhancement uniformity were assessed quantitatively and image quality was assessed by three independent radiologists. Results: Quantitative assessment of the vascular contrast enhancement showed that there was no significant difference in enhancement uniformity for patients between the protocols. The image quality was rated as being good to excellent in 81.8% and 88.0% of the scans, for protocol I and protocol II, respectively. However these differences were not statistically significant. Conclusion: By using a multiphasic injection technique with CTA of the abdominal aorta a reduction of 11 percent of contrast medium can be realized. Enhancement patterns are quantitatively as well as qualitatively comparable to the standard contrast medium injection protocol.

  19. The Effect of Extracts of Andrographis paniculata Aerial Parts on Rat Thoracic Aorta

    Directory of Open Access Journals (Sweden)

    S Raghava Naidu

    2009-01-01

    Full Text Available Andrographis paniculata (AP, (Burf. Nees. of Acanthaceae, has been used for centuries in Asia to treat GI tract and upper respiratory tract infections, fever, herpes, sore throat, and a variety of other chronic and infectious diseases. AP has cardio protective property and is familiarly known as "King of Bitters". The present study was aimed to investigate the vasorelaxant effect of different solvent extracts of AP on rat thoracic aorta. Petroleum ether, chloroform, and methanol extracts of AP are used in this study. Experiments are performed on male Sprague-Dawley (SD rats for possible vasorelaxing activity of AP. Cumulative dose response curves are recorded by using isometric force displacement transducer Model FT-03 and it is connected to Grass Polygraph Model 79D. Additionally, HPLC study of chloroform extract of AP is conducted and compared with commercially available standard andrographolide. Petroleum ether and chloroform extract of AP is first suspended in 1% (v/v DMSO then volume made up with Krebs solution. The average of responses to each concentration of the agonist is plotted on the ordinate the logarithm of the concentration of the agonist on the abscissa. Among all these extracts of AP, chloroform extract 80 and 160 μg/mL is found to be the highly significant (P< 0.001 vasorelaxant effect on norepinephrine induced contraction on rat thoracic aortic ring preparations.

  20. "I Can't Walk!" Acute Thrombosis of Descending Aorta Causing Paraplegia

    Directory of Open Access Journals (Sweden)

    Matthew L Mitchell

    2013-09-01

    Full Text Available A 50-year-old man presented to the emergency department (ED with acute, bilateral lower extremity weakness and loss of sensation, as well as absent pulses bilaterally. Computed tomography angiography showed complete occlusion of the aorta below the inferior mesenteric artery, extending to the iliac bifurcations. Echocardiographic findings showed severe systolic dysfunction (ejection fraction of 15% and cryptic cardiogenic shock in spite of stable vital signs. Prior to early operative intervention, an early goal-oriented hemodynamic strategy of shock management resulted in the resolution of motor and sensory deficits. After definitive surgical intervention, the patient was discharged neurologically intact. Acute aortic occlusion is frequently accompanied by myocardial dysfunction, which can be from mild to severe. The most severe form can even occur with normalvital signs or occult cardiogenic shock. Early detection and goal-directed preoperative hemodynamic optimization, along with surgical intervention in the ED, is required to optimize outcomes. [West JEmerg Med. 2013;14(5:424–427.

  1. Endothelium protectant and contractile effects of the antivaricose principle escin in rat aorta.

    Science.gov (United States)

    Carrasco, Omar F; Vidrio, Horacio

    2007-07-01

    The triterpene saponin escin is the active component of the extract of seeds of Aesculus hippocastanum used in the treatment of chronic venous insufficiency. Escin is also used experimentally to increase membrane permeability in isolated cells. Since endothelial dysfunction is postulated to be involved in venous insufficiency, the possible endothelium-protectant effect of escin was explored in rat aortic rings, a model widely used to study such effects with cardiovascular agents. Escin enhanced endothelium-dependent relaxation induced by acetylcholine when such relaxation had been reduced by exposure to the superoxide ion generator pyrogallol. This effect was attributed to enhanced nitric oxide production by endothelial nitric oxide synthase, a calcium-dependent enzyme, activated by the increased endothelial cell permeability to calcium induced by escin. Another effect of escin thought to contribute to its therapeutic activity is its ability to produce venous contraction. The compound was found to induce concentration-related contraction also in rat aortic rings. This response was partially inhibited by removal of the endothelium or by preincubation with indomethacin, and was completely abolished by incubation in a calcium-free perfusion fluid. Contraction was considered to be due mainly to the aforementioned effect on calcium permeability, with some mediation by release of endothelial vasoconstrictor prostanoids. It was concluded that, in rat aorta, escin possesses an endothelium-protectant action and a direct contractile effect. The former could contribute to its beneficial effect in the treatment of venous insufficiency, while the latter could constitute a limiting side effect. PMID:17512261

  2. Right sided arcus aorta as a cause of dyspnea and chronic cough

    Directory of Open Access Journals (Sweden)

    Ozkaya Sevket

    2012-10-01

    Full Text Available Abstract Background Right sided arcus aorta (RSAA is a rare condition that is usually asymptomatic. Patients may present with exertional dyspnea and chronic cough. A recent article suggested that RSAA should be included in the differential diagnosis of asthma, especially in patients with intractable exertional dyspnea. We aimed to present the clinical, radiologic and spirometric features of thirteen patients with RSAA observed in four years at the Rize Education and Research Hospital and Samsun Chest Diseases and Thoracic Surgery Hospital. Methods The characteristics of patients with RSAA, including age, gender, symptoms, radiologic and spirometric findings, were retrospectively evaluated. Results A total of thirteen patients were diagnosed with RSAA. Their ages ranged from 17 to 86 years and the male to female ratio was 11:2. Seven of the patients (54% were symptomatic. The most common symptoms were exertional dyspnea, dysphagia and chronic cough. Five patients had received treatment for asthma with bronchodilators. Spirometry showed intrathoracic tracheal obstruction in five patients. Conclusions The RSAA anomaly occurs more frequently than might be estimated from the number of patients who are detected. Patients with intractable exertional dyspnea and chronic cough should be evaluated for the RSAA anomaly by thoracic CT.

  3. In vitro vasorelaxation mechanisms of bioactive compounds extracted from Hibiscus sabdariffa on rat thoracic aorta

    Directory of Open Access Journals (Sweden)

    Gueye Lamine

    2009-11-01

    Full Text Available Abstract Background In this study, we suggested characterizing the vasodilator effects and the phytochemical characteristics of a plant with food usage also used in traditional treatment of arterial high blood pressure in Senegal. Methods Vascular effects of crude extract of dried and powdered calyces of Hibiscus sabdariffa were evaluated on isolated thoracic aorta of male Wistar rats on organ chambers. The crude extract was also enriched by liquid-liquid extraction. The various cyclohexane, dichloromethane, ethyl acetate, butanol extracts obtained as well as the residual marc were subjected to Sephadex LH-20 column chromatography. The different methanolic eluate fractions were then analyzed by Thin Layer (TLC and High Performance Liquid Chromatography (HPLC and their vascular effects also evaluated. Results The H. Sabdariffa crude extract induced mainly endothelium-dependent relaxant effects. The endothelium-dependent relaxations result from NOS activation and those who not dependent to endothelium from activation of smooth muscle potassium channels. The phytochemical analysis revealed the presence of phenolic acids in the ethyl acetate extract and anthocyans in the butanolic extract. The biological efficiency of the various studied extracts, in term of vasorelaxant capacity, showed that: Butanol extract > Crude extract > Residual marc > Ethyl acetate extract. These results suggest that the strong activity of the butanolic extract is essentially due to the presence of anthocyans found in its fractions 43-67. Conclusion These results demonstrate the vasodilator potential of hibiscus sabdariffa and contribute to his valuation as therapeutic alternative.

  4. Assessment of a Polyester-Covered Nitinol Stent in the Canine Aorta and Iliac Arteries

    International Nuclear Information System (INIS)

    Purpose: To evaluate the patency and healing characteristics of a woven polyester fabric-covered stent in the canine model.Methods: Twenty-four self-expanding covered stents were placed in the infrarenal aorta and bilateral common iliac arteries of eight dogs and evaluated at 1 (n = 2), 3 (n = 2), and 6 (n = 4) months. Stent assessment was done using angiography prior to euthanasia, and light and scanning electron microscopy.Results: Angiographically, just prior to euthanasia, 8 of 8 aortic and 14 of 16 iliac endovascular covered stents were patent. Histologically, the stented regions showed complete endothelialization 6 months after graft implantation. A neointima had formed inside the stented vessel regions resulting in complete encasement of the fabric-covered stent by 3 months after graft implantation. Medial compression with smooth muscle cell atrophy was present in all stented regions. Explanted stent wires, examined by scanning electron microscopy, showed pitting but no cracks or breakage.Conclusion: The covered stent demonstrated predictable healing and is effective in preventing stenosis in vessels 10.0 mm or greater in diameter but does not completely preclude stenosis in vessels 6.0 mm or less in diameter

  5. Evaluation of the Vasoplegic impact of Papaverine in the rat aorta

    International Nuclear Information System (INIS)

    Objective: To identify the degree of vasoplegic affinity of papaverine to rat thoracic aortas following constriction caused by adrenalin, serotonin and potassium chloride in an in-vitro model. Methods: The in vitro vasoplegic efficacy of papaverine against adrenalin (10-5 M), serotonin (5HT) (10-4 M), and KCl (60 mM) was assessed, using a rat aortic vasospasm model in an organ bath. First, aortic rings were constricted with a submaximal dose of vasoconstrictor agents. The samples were then incubated with papaverine (3x10-4 M) for 20 minutes, followed by readministration of the same vasoconstrictor agents. The first vasospastic response (before papaverine incubation) and the new vasoconstrictor responses (after papaverine incubation) of the vessels were then compared. Results: The vasoplegic effect of vasoconstrictor agents in decreasing order was observed as adrenalin>KCl>5HT. This different affinity for the vasoplegic effect is considered to be a temporary impact of the drugs and the maximal inhibition of vasoconstriction was detected for the adrenalin receptor. Conclusion: The relevance of the macromolecules is responsible for the permanent efficacy of the drugs. Different degrees of vasoconstriction were also obtained after papaverine administration, which suggests that different responses can occur as a result of different stimulation of receptor modulators. (author)

  6. Experimental Gestational Diabetes Mellitus Induces Blunted Vasoconstriction and Functional Changes in the Rat Aorta

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    Cecilia Tufiño

    2014-01-01

    Full Text Available Diabetic conditions increase vascular reactivity to angiotensin II in several studies but there are scarce reports on cardiovascular effects of hypercaloric diet (HD induced gestational diabetes mellitus (GDM, so the objective of this work was to determine the effects of HD induced GDM on vascular responses. Angiotensin II as well as phenylephrine induced vascular contraction was tested in isolated aorta rings with and without endothelium from rats fed for 7 weeks (4 before and 3 weeks during pregnancy with standard (SD or hypercaloric (HD diet. Also, protein expression of AT1R, AT2R, COX-1, COX-2, NOS-1, and NOS-3 and plasma glucose, insulin, and angiotensin II levels were measured. GDM impaired vasoconstrictor response (P<0.05 versus SD in intact (e+ but not in endothelium-free (e− vessels. Losartan reduced GDM but not SD e− vasoconstriction (P<0.01 versus SD. AT1R, AT2R, and COX-1 and COX-2 protein expression were significantly increased in GDM vessels (P<0.05 versus SD. Results suggest an increased participation of endothelium vasodilator mediators, probably prostaglandins, as well as of AT2 vasodilator receptors as a compensatory mechanism for vasoconstrictor changes generated by experimental GDM. Considering the short term of rat pregnancy findings can reflect early stage GDM adaptations.

  7. Registration of Real-Time 3-D Ultrasound to Tomographic Images of the Abdominal Aorta.

    Science.gov (United States)

    Brekken, Reidar; Iversen, Daniel Høyer; Tangen, Geir Arne; Dahl, Torbjørn

    2016-08-01

    The purpose of this study was to develop an image-based method for registration of real-time 3-D ultrasound to computed tomography (CT) of the abdominal aorta, targeting future use in ultrasound-guided endovascular intervention. We proposed a method in which a surface model of the aortic wall was segmented from CT, and the approximate initial location of this model relative to the ultrasound volume was manually indicated. The model was iteratively transformed to automatically optimize correspondence to the ultrasound data. Feasibility was studied using data from a silicon phantom and in vivo data from a volunteer with previously acquired CT. Through visual evaluation, the ultrasound and CT data were seen to correspond well after registration. Both aortic lumen and branching arteries were well aligned. The processing was done offline, and the registration took approximately 0.2 s per ultrasound volume. The results encourage further patient studies to investigate accuracy, robustness and clinical value of the approach. PMID:27156015

  8. Effects of aortic root motion on wall stress in the Marfan aorta before and after personalised aortic root support (PEARS) surgery.

    Science.gov (United States)

    Singh, S D; Xu, X Y; Pepper, J R; Izgi, C; Treasure, T; Mohiaddin, R H

    2016-07-01

    Aortic root motion was previously identified as a risk factor for aortic dissection due to increased longitudinal stresses in the ascending aorta. The aim of this study was to investigate the effects of aortic root motion on wall stress and strain in the ascending aorta and evaluate changes before and after implantation of personalised external aortic root support (PEARS). Finite element (FE) models of the aortic root and thoracic aorta were developed using patient-specific geometries reconstructed from pre- and post-PEARS cardiovascular magnetic resonance (CMR) images in three Marfan patients. The wall and PEARS materials were assumed to be isotropic, incompressible and linearly elastic. A static load on the inner wall corresponding to the patients' pulse pressure was applied. Cardiovascular MR cine images were used to quantify aortic root motion, which was imposed at the aortic root boundary of the FE model, with zero-displacement constraints at the distal ends of the aortic branches and descending aorta. Measurements of the systolic downward motion of the aortic root revealed a significant reduction in the axial displacement in all three patients post-PEARS compared with its pre-PEARS counterparts. Higher longitudinal stresses were observed in the ascending aorta when compared with models without the root motion. Implantation of PEARS reduced the longitudinal stresses in the ascending aorta by up to 52%. In contrast, the circumferential stresses at the interface between the supported and unsupported aorta were increase by up to 82%. However, all peak stresses were less than half the known yield stress for the dilated thoracic aorta. PMID:27255604

  9. Zinc protects against diabetes-induced pathogenic changes in the aorta: roles of metallothionein and nuclear factor (erythroid-derived 2)-like 2

    OpenAIRE

    Miao, Xiao; Wang, Yonggang; Sun, Jian; Sun, Weixia; Tan, Yi; Cai, Lu; Zheng, Yang; Su, Guanfang; Liu, Quan; Wang, Yuehui

    2013-01-01

    Background Cardiovascular diseases remain a leading cause of the mortality world-wide, which is related to several risks, including the life style change and the increased diabetes prevalence. The present study was to explore the preventive effect of zinc on the pathogenic changes in the aorta. Methods A genetic type 1 diabetic OVE26 mouse model was used with/without zinc supplementation for 3 months. To determine gender difference either for pathogenic changes in the aorta of diabetic mice o...

  10. Predictors for pathologically confirmed aortitis after resection of the ascending aorta: A 12-year Danish nationwide population-based cross-sectional study

    OpenAIRE

    Schmidt, Jean; Sunesen, Kaare; Kornum, Jette B.; Duhaut, Pierre; Thomsen, Reimar W

    2011-01-01

    Introduction Assessing the prevalence of, and predictors for, pathologically-confirmed inflammation of the aorta in Denmark, using a nationwide population-based study design. Methods We identified all adults with first-time surgery on the ascending aorta between January 1, 1997 and March 1, 2009 in Denmark. Presence of aortic inflammation was ascertained through linkage to a nationwide pathology registry. We used logistic regression to compute prevalence odds ratios (ORs) for sex, age at surg...

  11. Occlusion of the abdominal aorta by balloon dilation catheter assisting surgical excision of a sacrum chordoma: case report.

    Science.gov (United States)

    Ozgiray, Erkin; Cağli, Sedat; Zileli, Mehmet; Cinar, Celal; Oran, Ismail

    2009-07-01

    Chordoma is known to be the most common primary tumor of the sacrum. Its surgery is challenging from many aspects. A large amount of bleeding is one of the biggest issues. A 52-year-old woman was admitted to our clinic with a huge mass at sacrum. The mass was diagnosed as chordoma after a needle biopsy. Prior to the surgery, a balloon dilation catheter (BDC) was placed in the distal abdominal aorta via the femoral artery. Just after the skin incision, the BDC was inflated with contrast medium and total occlusion of the aorta was achieved. At the end of the operation we observed that total hemorrhage had decreased dramatically. No complications were recorded except hypertension during the occlusion of the aorta which was expected. The patient was discharged after two weeks of hospitalization post-operatively without any neurological deficit. Our report is the second in the neurosurgical literature to our knowledge. Although this result is preliminary and needs to be replicated and expanded upon, our first experience with this method is effective for decreasing the amount of bleeding. We believe that our method prevents hemo-dynamical problems caused by massive bleeding and complications secondary to massive transfusion. PMID:19621292

  12. Experimental investigation of the flow field past a bileaflet mechanical heart valve in pulsatile flow within an anatomical aorta model

    Science.gov (United States)

    Brown, Laura; Tavoularis, Stavros

    2011-11-01

    A bileaflet mechanical heart valve (BMHV) has been mounted at the inlet of an anatomical model of the human aorta, and placed within a mock circulation loop that simulates physiological flow conditions. The working fluid matches the refractive index of silicone, from which the aorta model and other parts of the test section are made, and the viscosity of blood. Flow characteristics past the BMHV are measured using stereoscopic and planar particle image velocimetry and laser Doppler velocimetry. In contrast to previous experiments, in which heart valves have been tested in simplified aortic geometries, this arrangement permits the study of the dependence of flow past the valve upon recirculation in the sinuses of Valsalva, the flow rate through the coronary arteries, and the aorta curvature. The effect of valve orientation will also be investigated with the objective to determine a hemodynamically optimal configuration with potential benefits to implantation procedures. The measured viscous shear stress distribution will be analyzed towards predicting the initiation of thrombosis in patients and identifying regions of stagnation, which could facilitate thrombus attachment.

  13. Lipolysis of emulsion models of triglyceride-rich lipoproteins is altered in male patients with abdominal aorta aneurysm

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    J.J. Hosni

    2007-03-01

    Full Text Available Disorders of the lipid metabolism may play a role in the genesis of abdominal aorta aneurysm. The present study examined the intravascular catabolism of chylomicrons, the lipoproteins that carry the dietary lipids absorbed by the intestine in the circulation in patients with abdominal aorta aneurysm. Thirteen male patients (72 ± 5 years with abdominal aorta aneurysm with normal plasma lipid profile and 13 healthy male control subjects (73 ± 5 years participated in the study. The method of chylomicron-like emulsions was used to evaluate this metabolism. The emulsion labeled with 14C-cholesteryl oleate and ³H-triolein was injected intravenously in both groups. Blood samples were taken at regular intervals over 60 min to determine the decay curves. The fractional clearance rate (FCR of the radioactive labels was calculated by compartmental analysis. The FCR of the emulsion with ³H-triolein was smaller in the aortic aneurysm patients than in controls (0.025 ± 0.017 vs 0.039 ± 0.019 min-1; P < 0.05, but the FCR of14C-cholesteryl oleate of both groups did not differ. In conclusion, as indicated by the triglyceride FCR, chylomicron lipolysis is diminished in male patients with aortic aneurysm, whereas the remnant removal which is traced by the cholesteryl oleate FCR is not altered. The results suggest that defects in the chylomicron metabolism may represent a risk factor for development of abdominal aortic aneurysm.

  14. Molecular anatomy of ascending aorta in atherosclerosis by MS Imaging: Specific lipid and protein patterns reflect pathology.

    Science.gov (United States)

    Martin-Lorenzo, Marta; Balluff, Benjamin; Maroto, Aroa S; Carreira, Ricardo J; van Zeijl, Rene J M; Gonzalez-Calero, Laura; de la Cuesta, Fernando; Barderas, Maria G; Lopez-Almodovar, Luis F; Padial, Luis R; McDonnell, Liam A; Vivanco, Fernando; Alvarez-Llamas, Gloria

    2015-08-01

    The molecular anatomy of healthy and atherosclerotic tissue is pursued here to identify ongoing molecular changes in atherosclerosis development. Subclinical atherosclerosis cannot be predicted and novel therapeutic targets are needed. Mass spectrometry imaging (MSI) is a novel unexplored ex vivo imaging approach in CVD able to provide in-tissue molecular maps. A rabbit model of early atherosclerosis was developed and high-spatial-resolution MALDI-MSI was applied to comparatively analyze histologically-based arterial regions of interest from control and early atherosclerotic aortas. Specific protocols were applied to identify lipids and proteins significantly altered in response to atherosclerosis. Observed protein alterations were confirmed by immunohistochemistry in rabbit tissue, and additionally in human aortas. Molecular features specifically defining different arterial regions were identified. Localized in the intima, increased expression of SFA and lysolipids and intimal spatial organization showing accumulation of PI, PG and SM point to endothelial dysfunction and triggered inflammatory response. TG, PA, SM and PE-Cer were identified specifically located in calcified regions. Thymosin β4 (TMSB4X) protein was upregulated in intima versus media layer and also in response to atherosclerosis. This overexpression and localization was confirmed in human aortas. In conclusion, molecular histology by MS Imaging identifies spatial organization of arterial tissue in response to atherosclerosis. PMID:26079611

  15. Heartbeat-related displacement of the thoracic aorta in patients with chronic aortic dissection type B: Quantification by dynamic CTA

    Energy Technology Data Exchange (ETDEWEB)

    Weber, Tim F. [University of Heidelberg, Department of Diagnostic and Interventional Radiology, Im Neuenheimer Feld 110, 69120 Heidelberg (Germany)], E-mail: tim.weber@med.uni-heidelberg.de; Ganten, Maria-Katharina [German Cancer Research Center, Department of Radiology, Im Neuenheimer Feld 280, 69120 Heidelberg (Germany)], E-mail: m.ganten@dkfz.de; Boeckler, Dittmar [University of Heidelberg, Department of Vascular and Endovascular Surgery, Im Neuenheimer Feld 110, 69120 Heidelberg (Germany)], E-mail: dittmar.boeckler@med.uni-heidelberg.de; Geisbuesch, Philipp [University of Heidelberg, Department of Vascular and Endovascular Surgery, Im Neuenheimer Feld 110, 69120 Heidelberg (Germany)], E-mail: philipp.geisbuesch@med.uni-heidelberg.de; Kauczor, Hans-Ulrich [University of Heidelberg, Department of Diagnostic and Interventional Radiology, Im Neuenheimer Feld 110, 69120 Heidelberg (Germany)], E-mail: hu.kauczor@med.uni-heidelberg.de; Tengg-Kobligk, Hendrik von [German Cancer Research Center, Department of Radiology, Im Neuenheimer Feld 280, 69120 Heidelberg (Germany)], E-mail: h.vontengg@dkfz.de

    2009-12-15

    Purpose: The purpose of this study was to characterize the heartbeat-related displacement of the thoracic aorta in patients with chronic aortic dissection type B (CADB). Materials and methods: Electrocardiogram-gated computed tomography angiography was performed during inspiratory breath-hold in 11 patients with CADB: Collimation 16 mm x 1 mm, pitch 0.2, slice thickness 1 mm, reconstruction increment 0.8 mm. Multiplanar reformations were taken for 20 equidistant time instances through both ascending (AAo) and descending aorta (true lumen, DAoT; false lumen, DAoF) and the vertex of the aortic arch (VA). In-plane vessel displacement was determined by region of interest analysis. Results: Mean displacement was 5.2 {+-} 1.7 mm (AAo), 1.6 {+-} 1.0 mm (VA), 0.9 {+-} 0.4 mm (DAoT), and 1.1 {+-} 0.4 mm (DAoF). This indicated a significant reduction of displacement from AAo to VA and DAoT (p < 0.05). The direction of displacement was anterior for AAo and cranial for VA. Conclusion: In CADB, the thoracic aorta undergoes a heartbeat-related displacement that exhibits an unbalanced distribution of magnitude and direction along the thoracic vessel course. Since consecutive traction forces on the aortic wall have to be assumed, these observations may have implications on pathogenesis of and treatment strategies for CADB.

  16. Surgical resection and survival of patients with unsuspected single node positive lung cancer (NSCLC invading the descending aorta

    Directory of Open Access Journals (Sweden)

    Wex, Peter

    2009-07-01

    Full Text Available Background: Surgical treatment of non-small cell lung cancer (NSCLC with aortic invasion is still debated.Methods: Thirteen patients with locally advanced (T4 NSCLC and invasion of the descending aorta underwent pneumonectomy (n=9 or lobectomy (n=4 together with aorta en bloc resection and reconstruction (n=8 or subadventitial dissection (n=5, complete lymph node dissection, and had microscopic unsuspected node metastasis at N1 (n=5 and N2/3 (n=8 levels of whom 12 received radiation therapy. Clamp-and-sew was used to resect and reconstruct the aorta.Results: Operative mortality and morbidity rate was 0% and 23%, respectively. Four patients died of systemic tumor relapse and 2 of local recurrence. Six patients were alive after a median follow-up of 40 months (range 15–125 months. Overall 5-year survival rate was 45%. Median survival time and 5-year survival rate of patients after aortic resection was 35 months and 67%, respectively, and was 17 months and 0%, respectively, after aortic subadventi-tial dissection (p=0.001. N1 and N2 nodal status adversely affected survival, but survival difference was not significant (N1 versus N2/3; 52% versus 39% at 5 years; p=0.998.Conclusions: Aortic resection with single station node positive T4 lung cancer can achieve long-term survival. The data indicate that aortic resection-reconstruction is associated with better outcome than subadventitial dissection.

  17. Lung, aorta, and platelet metabolism of /sup 14/C-arachidonic acid in vitamin E deficient rats

    Energy Technology Data Exchange (ETDEWEB)

    Valentovic, M.A.; Gairola, C.; Lubawy, W.C.

    1982-08-01

    /sup 14/C-arachidonic acid metabolism was determined in aortas, platelets, and perfused lungs from rats pair fed a basal diet supplemented with 0 or 100 ppm vitamin E for 11 weeks. Spontaneous erythrocyte hemolysis tests showed 92% and 8% hemolysis for the 0 and 100 ppm vitamin E groups, respectively. Elevated lung homogenate levels of malonaldehyde in the 0 ppm group confirmed its deficient vitamin E status. Aortas from the vitamin E deficient group synthesized 54% less prostacyclin than aortas from the supplemented group (p less than 0.05). Although thromboxane generation by platelets from the vitamin E deficient group exhibited a 37% increase, this difference was not statistically significant compared to the supplemented animals. Greater amounts of PGE2, PGF2 alpha, TXB2, and 6-keto-PGF1 alpha were obtained in albumin buffer perfusates from lungs of vitamin E deficient rats than in those from supplemented rats. Significant differences (p less than 0.05) were noticed, however, only for PGE2 and PGF2 alpha. These studies indicate that vitamin E quantitatively alters arachidonic acid metabolism in aortic and lung tissue but its effect on thromboxane synthesis by platelets is less marked.

  18. Training differentially regulates elastin level and proteolysis in skeletal and heart muscles and aorta in healthy rats.

    Science.gov (United States)

    Gilbert, Anna; Wyczalkowska-Tomasik, Aleksandra; Zendzian-Piotrowska, Malgorzata; Czarkowska-Paczek, Bozena

    2016-01-01

    Exercise induces changes in muscle fibers and the extracellular matrix that may depend on elastin content and the activity of proteolytic enzymes. We investigated the influence of endurance training on the gene expression and protein content and/or activity of elastin, elastase, cathepsin K, and plasmin in skeletal and heart muscles and in the aorta. Healthy rats were randomly divided into untrained (n=10) and trained (n=10; 6 weeks of endurance training with increasing load) groups. Gene expression was evaluated via qRT-PCR. Elastin content was measured via enzyme-linked immunosorbent assay and enzyme activity was measured fluorometrically. Elastin content was significantly higher in skeletal (P=0.0014) and heart muscle (P=0.000022) from trained rats versus untrained rats, but not in the aorta. Although mRNA levels in skeletal muscle did not differ between groups, the activities of elastase (P=0.0434), cathepsin K (P=0.0343) and plasmin (P=0.000046) were higher in trained rats. The levels of cathepsin K (P=0.0288) and plasminogen (P=0.0005) mRNA were higher in heart muscle from trained rats, but enzyme activity was not. Enzyme activity in the aorta did not differ between groups. Increased elastin content in muscles may result in better adaption to exercise, as may remodeling of the extracellular matrix in skeletal muscle. PMID:27069251

  19. Training differentially regulates elastin level and proteolysis in skeletal and heart muscles and aorta in healthy rats

    Directory of Open Access Journals (Sweden)

    Anna Gilbert

    2016-05-01

    Full Text Available Exercise induces changes in muscle fibers and the extracellular matrix that may depend on elastin content and the activity of proteolytic enzymes. We investigated the influence of endurance training on the gene expression and protein content and/or activity of elastin, elastase, cathepsin K, and plasmin in skeletal and heart muscles and in the aorta. Healthy rats were randomly divided into untrained (n=10 and trained (n=10; 6 weeks of endurance training with increasing load groups. Gene expression was evaluated via qRT-PCR. Elastin content was measured via enzyme-linked immunosorbent assay and enzyme activity was measured fluorometrically. Elastin content was significantly higher in skeletal (P=0.0014 and heart muscle (P=0.000022 from trained rats versus untrained rats, but not in the aorta. Although mRNA levels in skeletal muscle did not differ between groups, the activities of elastase (P=0.0434, cathepsin K (P=0.0343 and plasmin (P=0.000046 were higher in trained rats. The levels of cathepsin K (P=0.0288 and plasminogen (P=0.0005 mRNA were higher in heart muscle from trained rats, but enzyme activity was not. Enzyme activity in the aorta did not differ between groups. Increased elastin content in muscles may result in better adaption to exercise, as may remodeling of the extracellular matrix in skeletal muscle.

  20. Resultados em longo prazo de embolização deendoleaks tipo II

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    Eduardo da Silva Eli

    2016-01-01

    Full Text Available Resumo Contexto Endoleaks tipo II são frequentes após o reparo endovascular de aneurismas de aorta. Objetivo O objetivo deste estudo foi comparar o sucesso da embolização deendoleaks tipo II utilizando diferentes técnicas e materiais. Métodos Entre 2003 e 2015, 31 pacientes foram submetidos a embolização deendoleak tipo II, totalizando 41 procedimentos. Esses procedimentos foram conduzidos por acesso translombar, acesso femoral ou uma combinação de ambos, utilizando Onyx®18, Onyx®34,coils, plugue vascular Amplatzer® e trombina como material emboligênico. Sucesso foi definido como ausência de reintervenção. O teste de qui-quadrado e o teste exato de Fisher foram utilizados para a análise estatística. Resultados O tempo médio entre a correção do aneurisma de aorta e a embolização foi de 14 meses. Quinze (36% das intervenções utilizaram Onyx®18; sete (17% utilizaram coils e Onyx®34; seis (14% utilizaram Onyx®34; quatro (10% utilizaramcoils e Onyx®18; quatro (10% usaram Onyx®18 e Onyx®34; e três (7% usaramcoils e trombina; um (2% usou coils e um (2% usou Amplatzer®. Onze pacientes (35% necessitaram de reintervenção. A taxa de sucesso foi de 71,43% (10 para os pacientes com as artérias lombares como fonte do endoleak, 80% (8 quando a fonte era a artéria mesentérica inferior e 40% (2 quando havia combinação de ambas (p & 0,05. Não houve diferença estatisticamente significativa com relação ao tipo de embolização, material emboligênico e tipo de reparo da aorta para a correção do aneurisma. Conclusões A terapia endovascular de endoleaks tipo II é um desafio, sendo necessária reintervenção em até 36% dos casos. A taxa de sucesso é menor quando o endoleak é nutrido pela combinação das artérias lombares e da artéria mesentérica inferior.

  1. Blue toe syndrome Síndrome do dedo azul

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    Paulo Eduardo Ocke Reis

    2005-01-01

    Full Text Available The authors report the case of a man with blue toe syndrome, who developed bilateral foot ischemia and underwent successful repair of an abdominal aortic aneurysm and associated renal artery stenosis. Blue toe syndrome is characterized by tissue ischemia secondary to embolization of cholesterol crystals or atherothrombotic debris. Microembolization most often occurs in elderly men who undergo an invasive vascular procedure or have an aneurysm.Os autores relatam o caso de síndrome do dedo azul em um homem que apresentou um quadro de isquemia bilateral dos pés e foi submetido ao reparo bem sucedido de um aneurisma da aorta abdominal e de estenose da artéria renal associada. A síndrome do dedo azul é caracterizada pela isquemia tecidual, secundária à embolização de cristais de colesterol ou aterotrombose. A microembolização ocorre mais freqüentemente em homens idosos que têm um aneurisma ou são submetidos a um procedimento vascular invasivo.

  2. Estenose aórtica supravalvar em adulto com anomalia de vasos da base e insuficiência aórtica

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    Acrisio Sales Valente

    2013-12-01

    Full Text Available A estenose aórtica supravalvar é uma rara cardiopatia congênita, bastante incomum em adultos. Apresentamos um caso de estenose aórtica supravalvar em adulto com anomalia de vasos do arco aórtico, já com presença de insuficiência aórtica importante, tratado com êxito por meio de plastia da aorta ascendente e troca valvar aórtica.

  3. Morfometria do coração e dos vasos da base e sua implicação no mergulho em Chelonia mydas

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    Janine K.F.S. Braz

    2013-12-01

    Full Text Available Objetivou-se caracterizar a morfologia das câmaras cardíacas e das artérias aortas e pulmonares da espécie Chelonia mydas. Foram avaliados 11 espécimes de C. mydas mortas coletadas no litoral do estado do Rio Grande do Norte, Brasil. Os animais foram necropsiados para a obtenção do coração, fragmentos das artérias aorta e pulmonares direita e esquerda. Os vasos adquiridos foram fixados em formol e submetidos ao processamento histológico de rotina e coloração com Técnica de Verhoff modificada. Enquanto, do coração, os parâmetros largura, altura base-ápice e a circunferência ventricular foram mensurados por meio do paquímetro. Nessa espécie a microscopia das artérias pulmonares e artérias aortas variaram de acordo com o antímero. A maior espessura relativa do Cavum Venosum (CV auxilia no bombeamento cardíaco durante o mergulho e sua menor espessura direita é uma vantagem para a dilatação ventricular durante a imersão profunda enquanto que a quantificação das lâminas elásticas e fibras musculares da túnica média das artérias aortas e pulmonares direita e esquerda comprovaram que a túnica média das aortas predomina o componente elástico vs. muscular, entretanto, nas artérias pulmonares o componente elástico não-predomina. Essa angioarquitetura pode estar relacionada com a capacidade de mergulho, favorecendo um maior aproveitamento do sangue oxigenado armazenado previamente durante o período de apneia.

  4. Evaluation of different techniques for repair of co-arctation of aorta

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    Karimi AA

    1998-08-01

    Full Text Available This study is on different surgical techniques for repair of Co-arctation of aort and their effect for correction of systemic hypertension and lower extremity hypotension. In addition to these, the clinical and paraclinical data were noticed. 50 pt were operated in "SHARIATI" hospital during 1370-1377 with diagnosis of Co-arctation of aorta (30 men, mean age 19.4 years, 20 women, mean age 16.6 years. In addition to older age of our patients which results in more post-op sequela, there was suprrisingly a long-lag between onset of symptoms, diagnosis and operation (mean 4.36 years. 62% of Co-arctation were juxtaductal and the remainder were non-classical forms. 52% of our patients had co-existing cardiac disease which were very high in comparison with other studies (12%. This is due to older age of our patients and more valvular heart diseases. Among complicated cases of co-arctation, 71.9% were in men and 28.1% in women and this difference is due to high incidence of bicuspid aortic valve in men. The mean angiographic gradient were 57.5 mmHg which increases with age. CXR was abnormal in 91.7% and ECG in 74.2% of patients. The different applied surgical techniques include ee-A=26%, TIG=40%, TBG=18%, DPR=14%, FSCR=2%. There is no significant difference regarding post-op complications, BP in post-op period, and increase in pedal pulses, except in TBG group which HTN was more common. Two early deaths occurred which were in DRP group.

  5. Elastic properties of the aorta and factors affecting aortic stiffness in patients with

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    Derya Tok

    2012-09-01

    Full Text Available Objectives: In this study, we evaluated aortic stiffnessand echocardiographic and laboratory factors affectingaortic stiffness in patients with metabolic syndrome(MetS.Materials and methods: Forty-six patients (25 male,mean age 47.3±6.5 years with the diagnosis of MetS accordingto the Adult Treatment Panel III Final Report criteriawere included. Forty-four age and gender matchedhealthy subjects (18 male, mean age 46.0±6.1 yearswere recruited as the control group. Aortic strain, distensibilityand stiffness index were calculated by M-modeechocardiography and diastolic parameters were measured.Results: Left ventricular mass index (LVMI, decelerationtime (DT, isovolumic relaxation time (IVRT wereincreased and mitral E/A ratio was decreased in patientswith MetS compared to controls. In the MetS patients,aortic distensibility was significantly decreased (10.4±3.5cm2.dyn-1.10-6 vs. 12.7±3.4 cm2.dyn-1.10-6, p=0.002,and ASI was significantly increased (6.5±2.0 vs. 3.2±0.8,p<0.001. ASI was positively correlated with triglycerides,fasting glucose, uric acid, hsCRP, LVMI, DT, IVRT andsystolic blood pressure level, and was negatively correlatedwith HDL-cholesterol and mitral E/A ratio. In regressionanalysis, hsCRP (p=0.05 and systolic blood pressurelevel (p<0.001 were independent predictors of ASI.Conclusions: ASI is increased in patients with MetS. Inthese patients; decrease in aortic elasticity properties wasassociated with left ventricular diastolic dysfunction. Highsystolic pressure and hsCRP levels were found to be independentpredictors of ASI.Key words: Metabolic syndrome, Echocardiography,elastic properties of aorta, hsCRP

  6. Endovascular Repair of Traumatic Rupture of the Thoracic Aorta: Single-Center Experience

    International Nuclear Information System (INIS)

    Purpose. Traumatic rupture of the thoracic aorta secondary to blunt chest trauma is a life-threatening emergency and a common cause of death, usually following violent collisions. The objective of this retrospective report was to evaluate the efficacy of endovascular treatment of thoracic aortic disruptions with a single commercially available stent-graft. Methods. Nine men (mean age 29.5 years) were admitted to our institution between January 2003 and January 2006 due to blunt aortic trauma following violent motor vehicle collisions. Plain chest radiography, spiral computed tomography, aortography, and transesophageal echocardiography were used for diagnostic purposes in all cases. All patients were diagnosed with contained extramural thoracic aortic hematomas, secondary to aortic disruption. One patient was also diagnosed with a traumatic thoracic aortic dissection, secondary to blunt trauma. All subjects were poor surgical candidates, due to major injuries such as multiple bone fractures, abdominal hematomas, and pulmonary contusions. All repairs were performed using the EndoFit (LeMaitre Vascular) stent-graft. Results. Complete exclusion of the traumatic aortic disruption and pseudoaneurysm was achieved and verified at intraoperative arteriography and on CT scans, within 10 days of the repair in all patients. In 1 case the deployment of a second cuff was necessary due to a secondary endoleak. In 2 cases the left subclavian artery was occluded to achieve adequate graft fixation. No procedure-related deaths have occurred and no cardiac or peripheral vascular complications were observed within the 12 months (range 8-16 months) follow-up. Conclusions. This is the first time the EndoFit graft has been utilized in the treatment of thoracic aortic disruptions secondary to chest trauma. The repair of such pathologies is technically feasible and early follow-up results are promising

  7. Pulse wave imaging in normal, hypertensive and aneurysmal human aortas in vivo: a feasibility study

    Science.gov (United States)

    Li, Ronny X.; Luo, Jianwen; Balaram, Sandhya K.; Chaudhry, Farooq A.; Shahmirzadi, Danial; Konofagou, Elisa E.

    2013-07-01

    Arterial stiffness is a well-established biomarker for cardiovascular risk, especially in the case of hypertension. The progressive stages of an abdominal aortic aneurysm (AAA) have also been associated with varying arterial stiffness. Pulse wave imaging (PWI) is a noninvasive, ultrasound imaging-based technique that uses the pulse wave-induced arterial wall motion to map the propagation of the pulse wave and measure the regional pulse wave velocity (PWV) as an index of arterial stiffness. In this study, the clinical feasibility of PWI was evaluated in normal, hypertensive, and aneurysmal human aortas. Radiofrequency-based speckle tracking was used to estimate the pulse wave-induced displacements in the abdominal aortic walls of normal (N = 15, mean age 32.5 ± 10.2 years), hypertensive (N = 13, mean age 60.8 ± 15.8 years), and aneurysmal (N = 5, mean age 71.6 ± 11.8 years) human subjects. Linear regression of the spatio-temporal variation of the displacement waveform in the anterior aortic wall over a single cardiac cycle yielded the slope as the PWV and the coefficient of determination r2 as an approximate measure of the pulse wave propagation uniformity. The aortic PWV measurements in all normal, hypertensive, and AAA subjects were 6.03 ± 1.68, 6.69 ± 2.80, and 10.54 ± 6.52 m s-1, respectively. There was no significant difference (p = 0.15) between the PWVs of the normal and hypertensive subjects while the PWVs of the AAA subjects were significantly higher (p pathologies that regionally alter the arterial wall mechanics.

  8. A fileira da cereja da Cova da Beira

    OpenAIRE

    Dias, Cláudia Sofia Lourenço

    2013-01-01

    A Cova da Beira apresenta excelentes condições edafo-climáticas para a cultura da cerejeira, nomeadamente para a produção precoce de cultivares como a Burlat e para a produção tardia como a Saco Cova da Beira. Assim, é natural que a Cova da Beira seja a NUTS III com níveis mais elevados de produção, superfície e produtividade. Apesar de alguns produtores, sobretudo os de menor dimensão, não se terem conseguido adaptar às novas exigências do consumo e enfrentarem constrangimento...

  9. Inhibition of PKC-dependent extracellular Ca2+ entry contributes to the depression of contractile activity in long-term pressure-overloaded endothelium-denuded rat aortas

    International Nuclear Information System (INIS)

    We examined the contractile responsiveness of rat thoracic aortas under pressure overload after long-term suprarenal abdominal aortic coarctation (lt-Srac). Endothelium-dependent angiotensin II (ANG II) type 2 receptor (AT2R)-mediated depression of contractions to ANG II has been reported in short-term (1 week) pressure-overloaded rat aortas. Contractility was evaluated in the aortic rings of rats subjected to lt-Srac or sham surgery (Sham) for 8 weeks. ANG I and II levels and AT2R protein expression in the aortas of lt-Srac and Sham rats were also evaluated. lt-Srac attenuated the contractions of ANG II and phenylephrine in the aortas in an endothelium-independent manner. However, lt-Srac did not influence the transient contractions induced in endothelium-denuded aortic rings by ANG II, phenylephrine, or caffeine in Ca2+-free medium or the subsequent tonic constrictions induced by the addition of Ca2+ in the absence of agonists. Thus, the contractions induced by Ca2+ release from intracellular stores and Ca2+ influx through stored-operated channels were not inhibited in the aortas of lt-Srac rats. Potassium-elicited contractions in endothelium-denuded aortic rings of lt-Srac rats remained unaltered compared with control tissues. Consequently, the contractile depression observed in aortic tissues of lt-Srac rats cannot be explained by direct inhibition of voltage-operated Ca2+ channels. Interestingly, 12-O-tetradecanoylphorbol-13-acetate-induced contractions in endothelium-denuded aortic rings of lt-Srac rats were depressed in the presence but not in the absence of extracellular Ca2+. Neither levels of angiotensins nor of AT2R were modified in the aortas after lt-Srac. The results suggest that, in rat thoracic aortas, lt-Srac selectively inhibited protein kinase C-mediated activation of contraction that is dependent on extracellular Ca2+ entry

  10. Follow-up of patients with previous treatment for coarctation of the thoracic aorta: comparison between contrast-enhanced MR angiography and fast spin-echo MR imaging

    International Nuclear Information System (INIS)

    Regular follow-up is required in patients with previous intervention for coarctation of the aorta to detect recoarctation or aneurysm formation. In this study we describe the findings encountered on routine follow-up exams and we compare the use of contrast-enhanced 3D MR angiography (CE MRA) with fast spin-echo MRI (FSE) to study the thoracic aorta after previous intervention. In 51 consecutive patients previously treated for aortic coarctation, 74 MR studies of the thoracic aorta were performed during a 2-year period using CE MRA and FSE MRI. The thoracic aorta was evaluated for abnormalities of course, caliber, shape, and pathology of side branches. The CE MRA and FSE MRI studies were evaluated side by side by consensus of two reviewers evaluating which MR technique depicted the abnormalities of the thoracic aorta the best. Of 74 exams, six clinically important abnormalities were found: four aneurysms and two restenoses. Two small pseudoaneurysms were missed on the FSE studies. Contrast-enhanced MRA was judged to visualize aortic abnormalities better than FSE (47 of 74 MR studies) especially for the transverse aortic arch, coarctation site, left subclavian artery, and aortic arch configuration. For the ascending aorta and distal descending aorta, CE MRA and FSE performed equally well. Aortic diameters measured at four levels in the first 18 MRI studies showed no significant differences in diameter when measured by FSE or CE MRA (p = not significant). Clinically important abnormalities, such as aneurysm formation and restenosis, can be present years after treatment for aortic coarctation. In the regular follow-up of these patients, CE MRA may provide additional diagnostic information compared with FSE and should be included as part of the routine exam. (orig.)

  11. Collagen-induced arthritis increases inducible nitric oxide synthase not only in aorta but also in the cardiac and renal microcirculation of mice.

    Science.gov (United States)

    Palma Zochio Tozzato, G; Taipeiro, E F; Spadella, M A; Marabini Filho, P; de Assis, M R; Carlos, C P; Girol, A P; Chies, A B

    2016-03-01

    Rheumatoid arthritis (RA) may promote endothelial dysfunction. This phenomenon requires further investigation, especially in collagen-induced arthritis (CIA), as it is considered the experimental model most similar to RA. The objectives of this study were to identify CIA-induced changes in noradrenaline (NE) and acetylcholine (ACh) responses in mice aortas that may suggest endothelial dysfunction in these animals. Moreover, we characterize CIA-induced modifications in inducible nitric oxide synthase (iNOS) expression in the aortas and cardiac and renal tissues taken from these mice that may be related to possible endothelial dysfunction. Male DBA/1J mice were immunized with 100 μg of emulsified bovine collagen type II (CII) plus complete Freund's adjuvant. Twenty-one days later, these animals received a boost of an additional 100 μg plus incomplete Freund's adjuvant. Fifteen days after the onset of the disease, aortic rings from CIA and control mice were challenged with NE and ACh in an organ bath. In these animals, iNOS was detected through immunohistochemical analysis of aorta, heart and kidneys. Plasma nitrite concentration was determined using the Griess reaction. CIA did not change NE or ACh responses in mice aorta but apparently increased the iNOS expression not only in aorta, but also in cardiac and renal microcirculation. In parallel, CIA reduced nitrite plasma concentration. In mice, CIA appears to increase the presence of iNOS in aorta, as well as in heart and in kidney microcirculation. This iNOS increase occurs apparently in parallel to a reduction of the bioavailability of NO. This phenomenon does not appear to change NE or ACh responses in aorta. PMID:26456019

  12. Quantitative X-ray CT analysis of calcification of the abdominal aorta and its relationship to obesity

    International Nuclear Information System (INIS)

    Quantitative analysis of abdominal aorta calcification by X-ray CT is useful method for non-invasive diagnosis of atherosclerosis. We recently examined the relationship between the X-ray CT measurement of abdominal aorta calcification and the degree of obesity. For this purpose, the body mass index (BMI) and the subcutaneous fat thickness (determined by X-ray CT at the umbilical level) were analyzed in relation to the abdominal aorta calcification index (ACI) in 845 patients (453 males and 392 females aged 40-79 years). Patients with BMI under 20 were classified as 'lean', those with BMI between 20-26 as 'normal' and those with BMI over 26 as 'obese'. 1. Among males, the ACI was highest in lean individuals and lowest in obese individuals. The difference in ACI between lean and obese males was significant in the middle aged group (40-65 years). Among females, no relationship was observed between the degree of obesity and ACI. 2. Among males, ACI was higher in individuals with low subcutaneous fat thickness and lower in individuals with greater subcutaneous fat thickness. The difference was significant in the middle aged group. Among females, no relationship was observed between the two parameters. 3. When the visceral fat to subcutaneous fat ratio (V/S) in 85 males and females aged 60-69 years was analyzed in relation to ACI, ACI tended to decrease as the V/S increased, in both males and females. 4. Relationships between BMI and subcutaneous fat thickness, between BMI and lipids and between lipids and ACI were also analyzed. (author)

  13. CD45lowc-Kithigh cells have hematopoietic properties in the mouse aorta-gonad-mesonephros region

    International Nuclear Information System (INIS)

    Long-term reconstituting hematopoietic stem cells first arise from the aorta of the aorta-gonad-mesonephros (AGM) region in a mouse embryo. We have previously reported that in cultures of the dispersed AGM region, CD45lowc-Kit+ cells possess the ability to reconstitute multilineage hematopoietic cells, but investigations are needed to show that this is not a cultured artifact and to clarify when and how this population is present. Based on the expression profile of CD45 and c-Kit in freshly dissociated AGM cells from embryonic day 9.5 (E9.5) to E12.5 and aorta cells in the AGM from E13.5 to E15.5, we defined six cell populations (CD45−c-Kit−, CD45−c-Kitlow, CD45−c-Kithigh, CD45lowc-Kithigh, CD45highc-Kithigh, and CD45highc-Kitverylow). Among these six populations, CD45lowc-Kithigh cells were most able to form hematopoietic cell colonies, but their ability decreased after E11.5 and was undetectable at E13.5 and later. The CD45lowc-Kithigh cells showed multipotency in vitro. We demonstrated further enrichment of hematopoietic activity in the Hoechst dye-effluxing side population among the CD45lowc-Kithigh cells. Here, we determined that CD45lowc-Kithigh cells arise from the lateral plate mesoderm using embryonic stem cell-derived differentiation system. In conclusion, CD45lowc-Kithigh cells are the major hematopoietic cells of mouse AGM.

  14. Reduction of contrast medium volume in abdominal aorta CTA: Multiphasic injection technique versus a test bolus volume

    Energy Technology Data Exchange (ETDEWEB)

    Nijhof, Wouter H., E-mail: w.h.nijhof@student.utwente.nl [University of Twente, MIRA-Institute for Biomedical Technology and Technical Medicine, P.O. Box 21, 7500 AE Enschede (Netherlands); Vos, Charlotte S. van der, E-mail: c.s.vandervos@student.utwente.nl [University of Twente, MIRA-Institute for Biomedical Technology and Technical Medicine, P.O. Box 21, 7500 AE Enschede (Netherlands); Anninga, Bauke, E-mail: b.anninga@student.utwente.nl [University of Twente, MIRA-Institute for Biomedical Technology and Technical Medicine, P.O. Box 21, 7500 AE Enschede (Netherlands); Jager, Gerrit J., E-mail: g.jager@JBZ.nl [Department of Radiology, Jeroen Bosch Hospital, Henri Dunantstraat 1, 5223 GZ ’s-Hertogenbosch (Netherlands); Rutten, Matthieu J.C.M., E-mail: mj.rutten@online.nl [Department of Radiology, Jeroen Bosch Hospital, Henri Dunantstraat 1, 5223 GZ ’s-Hertogenbosch (Netherlands)

    2013-09-15

    Objective: The purpose of this study is to reduce the administered contrast medium volume in abdominal CTA by using a test bolus injection, with the preservation of adequate quantitative and qualitative vessel enhancement. Study design: For this technical efficacy study 30 patients, who were referred for a CTA examination of the abdominal aorta, were included. Randomly 15 patients were assigned to undergo a multiphasic injection protocol and received 89 mL of contrast medium (Optiray 350) (protocol I). Fifteen patients were assigned to the test bolus injection protocol (protocol II), which implies injection of a 10 mL test bolus of Optiray 350 prior to performing CTA with a 40 mL of contrast medium. Quantitative assessment of vascular enhancement was performed by measuring the amount of Hounsfield Units in the aorta at 30 positions from the celiac trunk to the iliac arteries in both groups. Qualitative assessment was performed by three radiologists who scored the images at a 5-point scale. Results: Quantitative assessment showed that there was no significant difference in vascular enhancement for patients between the two protocols, with mean attenuation values of 280.9 ± 50.84 HU and 258.60 ± 39.28 HU, respectively. The image quality of protocol I was rated 4.31 (range: 3.67/5.00) and of protocol II 4.11 (range: 2.67/5.00). These differences were not statistically significant. Conclusion: This study showed that by using a test bolus injection and the administration of 50 mL of contrast medium overall, CTA of the abdominal aorta can reliably be performed, with regard to quantitative and qualitative adequate vessel enhancement.

  15. Low-dose Computed Tomography in a Pregnant Woman with a Ruptured Pseudoaneurysm of the Abdominal Aorta.

    Science.gov (United States)

    Ramac, Jelena Popić; Vidjak, Vinko; Skegro, Dinko; Duić, Zeljko; Blasković, Darko; Erdelez, Lidija; Skopljanac-Macina, Andrija; Suknaić, Slaven; Slavica, Marko; Leder, Nikola Ivan

    2015-09-01

    Imaging the pregnant patient presents a unique challenge to radiologist due to the risk of radiation to the conceptus (embryo/fetus). A rare case of a successfully recognized and treated pseudoaneurysm (PA) of the abdominal aorta is to be presented. The pseudoaneurysm occurred in the third trimester and had a favorable outcome for the mother and the baby. Emergent abdominal ultrasound (US) is the first modality in diagnostic algorithm for the rupture of aortic aneurysm in a pregnant woman. It provides the most rapid diagnostic information, although intestinal gas and abdominal tenderness may limit its accuracy. To confirm the findings, magnetic resonance angiography (MRA) or CT angiography (CTA) can be used. In our case, the diagnosis was established using a color Doppler ultrasonography of the abdomen and was later confirmed by a low dose CT scan of the abdominal aorta. MRA in such cases have some disadvantages. At many health centers, the monitoring of patients with acute ruptures is more difficult in the MR suite than at the CT scanner. MRA angiographic images are also subject to degradation by multiple artifacts and the visualization of the distal vasculature is suboptimal and inferior to the one done by CTA. Due to fetal movements, a small quantity of fresh blood can be overlooked by MR. MRA is often not available on a 24-hours basis, and the time required for making a diagnosis can preclude the use of MRA in an unstable patient. For this reason, we used a low dose CTA protocol to confirm the diagnosis. Low dose scanning protocols in CT can obtain sufficient diagnostic information while reducing the risk of radiation. A particular focus is put on the outline of new concepts for dose management and optimization. We used new approaches based on tube current modulation. The birth was induced by an urgent Caesarean section followed by a resection of a pseudoaneurysm and a reconstruction of the aorta with an end-to-end vascular prosthesis. PMID:26898082

  16. Peroxisome Proliferator-Activated Receptor γ Level Contributes to Structural Integrity and Component Production of Elastic Fibers in the Aorta.

    Science.gov (United States)

    Tai, Haw-Chih; Tsai, Pei-Jane; Chen, Ju-Yi; Lai, Chao-Han; Wang, Kuan-Chieh; Teng, Shih-Hua; Lin, Shih-Chieh; Chang, Alice Y W; Jiang, Meei-Jyh; Li, Yi-Heng; Wu, Hua-Lin; Maeda, Nobuyo; Tsai, Yau-Sheng

    2016-06-01

    Loss of integrity and massive disruption of elastic fibers are key features of abdominal aortic aneurysm (AAA). Peroxisome proliferator-activated receptor γ (PPARγ) has been shown to attenuate AAA through inhibition of inflammation and proteolytic degradation. However, its involvement in elastogenesis during AAA remains unclear. PPARγ was highly expressed in human AAA within all vascular cells, including inflammatory cells and fibroblasts. In the aortas of transgenic mice expressing PPARγ at 25% normal levels (Pparg(C) (/-) mice), we observed the fragmentation of elastic fibers and reduced expression of vital elastic fiber components of elastin and fibulin-5. These were not observed in mice with 50% normal PPARγ expression (Pparg(+/-) mice). Infusion of a moderate dose of angiotensin II (500 ng/kg per minute) did not induce AAA but Pparg(+/-) aorta developed flattened elastic lamellae, whereas Pparg(C/-) aorta showed severe destruction of elastic fibers. After infusion of angiotensin II at 1000 ng/kg per minute, 73% of Pparg(C/-) mice developed atypical suprarenal aortic aneurysms: superior mesenteric arteries were dilated with extensive collagen deposition in adventitia and infiltrations of inflammatory cells. Although matrix metalloproteinase inhibition by doxycycline somewhat attenuated the dilation of aneurysm, it did not reduce the incidence nor elastic lamella deterioration in angiotensin II-infused Pparg(C/-) mice. Furthermore, PPARγ antagonism downregulated elastin and fibulin-5 in fibroblasts, but not in vascular smooth muscle cells. Chromatin immunoprecipitation assay demonstrated PPARγ binding in the genomic sequence of fibulin-5 in fibroblasts. Our results underscore the importance of PPARγ in AAA development though orchestrating proper elastogenesis and preserving elastic fiber integrity. PMID:27045031

  17. Differences in the primary culture, purification and biological characteristics between endothelial cells and smooth muscle cells from rat aorta

    Institute of Scientific and Technical Information of China (English)

    Shaobo Hu; Zifang Song; Qichang Zheng; Jun Nie

    2009-01-01

    Objective: To investigate the differences of primary culture, purification and biological characteristics between endothelial cells and smooth muscle cells from rat aorta. Methods: Endothelial cells were obtained using the vascular ring adherence, collagenase digestion method and an improved vascular ring adherence method, while smooth muscle cells were separated from tissue sections of rat aorta. Clones of endothelial cells were selected by limiting dilution assay. Both cell types were identified using specific cell immunofluorescent markers,and phase contrast microscopy was used to observe the morphological disparity between endothelial cells and smooth muscle cells at the single cell and colony level. Cell proliferation was determined by the cell counting kit-8. Differences between endothelial cells and smooth muscle cells were evaluated in trypsin digestion 6me, attachment time and recovery after cryopreservation. Results: Endothelial cells were obtained by all three methods. The improved vascular ring method provided the most reproducible results. Cells were in good condition, and of high purity. Smooth muscle cells were cultured successfully by the tissue fragment culture method. Clonal expansion of singleendothelial cells was attained. The two cell types expressed their respective specific markers, and the rate of proliferation of smooth muscle cells exceeded that of endothelial cells. Endothelial cells were more sensitive to trypsin digestion than smooth muscle cells. In addition, they had a shorter adherence time and better recovery following cryopreservation than smooth muscle cells. Conclusion: The improved vascular ring method was optimal for yielding endothelial cells. Limiting dilution is a novel and valid method for purifying primary endothelial cells from rat aorta. Primary rat endothelial cell and vascular smooth muscle cell cultures exhibited different morphological characteristics, proliferation rate, adherence time, susceptibility to trypsin

  18. Orientation, anisotropy, clustering, and volume fraction of smooth muscle cells within the wall of porcine abdominal aorta

    Directory of Open Access Journals (Sweden)

    Tonar Z.

    2008-11-01

    Full Text Available We analyzed tissue samples of the normal porcine abdominal aorta using stereological assessment of histological sections through the tunica media layer. The results demonstrated that the local volume fraction of smooth muscle cells within tunica media does not differ among samples taken round the circumference of the artery, and that volume fraction can be assessed in sections stained with green trichrome as well as with immunohistochemistry against actin. The distribution of angles between the long axes of nuclei of the smooth muscle cells and the radial direction was different from normal. The profiles of smooth muscle cells were distributed in an isotropic, but an inhomogeneous manner.

  19. Endothelial cell growth factor and ionophore A23187 stimulation of production of inositol phosphates in porcine aorta endothelial cells.

    OpenAIRE

    Moscat, J; Moreno, F.; Herrero, C.; C. López; García-Barreno, P.

    1988-01-01

    The existence of a bovine brain-derived endothelial cell growth factor has recently been reported, but its mode of action is unknown. We show that the endothelial cell growth factor is a potent stimulant of inositol monophosphate release in porcine aorta endothelial cells. Although the activation of phospholipase C by this factor does not appear to be dependent on Ca2+, the Ca2+ ionophore A23187 stimulates release of inositol phosphates. It is suggested that the inositol 1,4,5-trisphosphate 3...

  20. Differential effects of isoproterenol on the activity of angiotensin-converting enzyme in the rat heart and aorta

    Directory of Open Access Journals (Sweden)

    Busatto V.C.W.

    1999-01-01

    Full Text Available The excessive stimulation of beta-adrenergic receptors in the heart induces myocardial hypertrophy. There are several experimental data suggesting that this hypertrophy may also depend, at least partially, on the increase of local production of angiotensin II secondary to the activation of the cardiac renin-angiotensin system. In this study we investigated the effects of isoproterenol on the activity of angiotensin-converting enzyme (ACE in the heart and also in the aorta and plasma. Male Wistar rats weighing 250 to 305 g were treated with a dose of (±-isoproterenol (0.3 mg kg-1 day-1, N = 8 sufficient to produce cardiac hypertrophy without deleterious effects on the pumping capacity of the heart. Control rats (N = 7 were treated with vehicle (corn oil. The animals were killed one week later. ACE activity was determined in vitro in the four cardiac chambers, aorta and plasma by a fluorimetric assay. A significant hypertrophy was observed in both ventricular chambers. ACE activity in the atria remained constant after isoproterenol treatment. There was a significant increase (P<0.05 of ACE activity in the right ventricle (6.9 ± 0.9 to 8.2 ± 0.6 nmol His-Leu g-1 min-1 and in the left ventricle (6.4 ± 1.1 to 8.9 ± 0.8 nmol His-Leu g-1 min-1. In the aorta, however, ACE activity decreased (P<0.01 after isoproterenol (41 ± 3 to 27 ± 2 nmol His-Leu g-1 min-1 while it remained unchanged in the plasma. These data suggest that ACE expression in the heart can be increased by stimulation of beta-adrenoceptors. However, this effect is not observed on other local renin-angiotensin systems, such as the aorta. Our data also suggest that the increased sympathetic discharge and the elevated plasma concentration of catecholamines may contribute to the upregulation of ACE expression in the heart after myocardial infarction and heart failure.

  1. Dietary saffron reduced the blood pressure and prevented remodeling of the aorta in L-NAME-induced hypertensive rats

    OpenAIRE

    Zohreh Nasiri; Hamid Reza Sameni; Abedin Vakili; Morteza Jarrahi; Mahdi Zahedi Khorasani

    2015-01-01

    Objective(s): The aim of this study was to investigate the effects of nutritional saffron (Crocus sativus L.) stigma hydroalcoholic extract on blood pressure (BP) and histology of the aorta in normotensive and hypertensive rats. Materials and Methods: Saffron (200 mg/kg/day) was given orally for 5 weeks to normotensive and hypertensive rats. Hypertension was induced by NG-nitro-L-arginine methyl ester (L-NAME; 40 mg/kg/day) administration in drinking water, and BP was measured weekly. Histolo...

  2. Atorvastatin inhibits the expression of RAGE induced by advanced glycation end products on aortas in healthy Sprague–Dawley rats

    OpenAIRE

    Xu, Lei; Zang, Panpan; Feng, Bo; Qian, Qiaohui

    2014-01-01

    Background Atorvastatin can downregulate the expression of receptor for advanced glycation end products (RAGE) in the aortas of diabetic rats. However, its effect on healthy rats remains unclear. The aim of this study was to observe the direct impact of atorvastatin on advanced glycation end products- (AGEs) induced RAGE expression in healthy Sprague Dawley (SD) rats. Methods SD rats received AGE-BSA (20 mg/kg/day or 40 mg/kg/day), dual treatment (AGE-BSA 40 mg/kg/day and atorvastatin 20 mg/k...

  3. Comparison of the effect of alpha1- and alpha2-adrenoceptor agonists and antagonists on muscle contractility of the rabbit abdominal aorta in vitro.

    Science.gov (United States)

    Gnus, Jan; Rusiecka, Agnieszka; Czerski, Albert; Zawadzki, Wojciech; Witkiewicz, Wojciech; Hauzer, Willy

    2013-01-01

    The aim of the study was to demonstrate the effect of selected agonists and antagonists of alpha-adrenergic receptors on muscle contractility of the rabbit abdominal aorta in vitro with particular emphasis on alpha2-adrenergic receptor subtypes. The study was conducted on 30 New Zealand breed rabbits from which specimens of the abdominal aorta were collected. The sections were set up in an automatic water bath in a Krebs-Henseleit buffer at 37 degrees C. The experiments showed that alpha1-adrenergic receptors played the main role in the contractile response ofthe rabbit abdominal aorta. Stimulation of alpha1-adrenergic receptor by administration ofphenylephrine resulted in an increase in smooth muscle tonus ofthe rabbit abdominal aorta by an average of 4.75 mN. The reaction after stimulation of alpha2-adrenergic receptors by similar doses of their agonists was much weaker. Prolonged tissue response time and time needed to reach maximum tonus for alpha2-adrenergic receptor agonists were observed. The obtained results confirm the thesis that the alpha1-adrenergic receptor is the most important factor controlling the contractility of the rabbit abdominal aorta, but the alpha2-adrenergic receptor is also involved in maintaining muscle tissue tonus. PMID:23767297

  4. Estimated in vivo postnatal surface growth patterns of the ovine main pulmonary artery and ascending aorta.

    Science.gov (United States)

    Fata, Bahar; Gottlieb, Danielle; Mayer, John E; Sacks, Michael S

    2013-07-01

    Delineating the normal postnatal development of the pulmonary artery (PA) and ascending aorta (AA) can inform our understanding of congenital abnormalities, as well as pulmonary and systolic hypertension. We thus conducted the following study to delineate the PA and AA postnatal growth deformation characteristics in an ovine model. MR images were obtained from endoluminal surfaces of 11 animals whose ages ranged from 1.5 months/15.3 kg mass (very young) to 12 months/56.6 kg mass (adult). A bicubic Hermite finite element surface representation was developed for the each artery from each animal. Under the assumption that the relative locations of surface points were retained during growth, the individual animal surface fits were subsequently used to develop a method to estimate the time-evolving local effective surface growth (relative to the youngest measured animal) in the end-diastolic state. Results indicated that the spatial and temporal surface growth deformation patterns of both arteries, especially in the circumferential direction, were heterogeneous, leading to an increase in taper and increase in cross-sectional ellipticity of the PA. The longitudinal PA growth stretch of a large segment on the posterior wall reached 2.57 ± 0.078 (mean ± SD) at the adult stage. In contrast, the longitudinal growth of the AA was smaller and more uniform (1.80 ± 0.047). Interestingly, a region of the medial wall of both arteries where both arteries are in contact showed smaller circumferential growth stretches-specifically 1.12 ± 0.012 in the PA and 1.43 ± 0.071 in the AA at the adult stage. Overall, our results indicated that contact between the PA and AA resulted in increasing spatial heterogeneity in postnatal growth, with the PA demonstrating the greatest changes. Parametric studies using simplified geometric models of curved arteries during growth suggest that heterogeneous effective surface growth deformations must occur to account for the

  5. Reconstruction of the descending thoracic aorta by multiview compounding of 3-D transesophageal echocardiographic aortic data sets for improved examination and quantification of atheroma burden.

    Science.gov (United States)

    Carminati, Maria Chiara; Piazzese, Concetta; Weinert, Lynn; Tsang, Wendy; Tamborini, Gloria; Pepi, Mauro; Lang, Roberto Miguel; Caiani, Enrico Gianluca

    2015-05-01

    A robust and efficient approach to reconstruction of the descending thoracic aorta from contiguous 3-D transesophageal echocardiographic (TEE) images is proposed. An ad hoc image acquisition protocol was designed to acquire ordered and partially overlapped 3-D TEE data sets, followed by dedicated image processing to align and fuse all acquired data sets. Alignment strategy implemented pairwise rigid registration guided by a priori knowledge, and it was validated using artificially misaligned images. Image fusion was finally performed to enable visualization and analysis of extended field-of-view of the acquired aorta. The application of different fusion techniques was also investigated. The method was applied to a population of 17 consecutive patients. Qualitative and quantitative results supported the feasibility and accuracy of the proposed approach. In a clinical scenario, its application could allow the quantitative assessment of aortic plaque burden in the descending thoracic aorta from 3-D TEE images. PMID:25684644

  6. Study on the dynamic change of endothelin in the development of stenosis of aorta after balloon injury in rabbits

    International Nuclear Information System (INIS)

    Objective: To study the dynamic change of endothelin (ET) in the blood with pathological and immunohistochemical changes of ET(ET-immunoreaction, ET-IR) in the development of stenosis of rabbit aorta after transluminal angioplasty. Methods: According to the different periods of being killed after micro-balloon angioplasty, 30 rabbits were divided randomly into 6 groups including 6-hour group, 1-day group, 3-day group, 7-day group, 15-day group and 22-day group. 3 out of 5 rabbits in each group were created as models of aortic endothelium injury by micro-balloon angioplasty, the rest 2 rabbits were taken as control. ET levels in the plasma were measured by ELISA before, as well as after micro-balloon angioplasty. Pathomorphological examination of the local traumatic aorta was carried out to observe the intimal thickness and the extent of lumen stenosis, and ET-IR was assessed by immunohistochemical technique performed on aortic wall after micro-balloon angioplasty. Results: (1) The major change of vascular stenosis was proliferation of vascular smooth muscle cell (VSMC) and endothelium. (2) ET levels in the plasma and ET-IR on the local aortic wall were significantly increased after micro-balloon angioplasty. Conclusions: The experimental results show that the major pathologic change of vascular stenosis is the obvionus proliferation of VSMC and endothelium. Further more, ET is a key factor in the development of vascular stenosis. (authors)

  7. Anatomical description of arterial branches of thoracic and abdominal aorta in the coati (Nasua nasua (Carnivora, Procyonidae

    Directory of Open Access Journals (Sweden)

    Daniel Arrais Biihrer

    2015-05-01

    Full Text Available The coati (Nasua nasua is a widely distributed species in South America, also in Brazil. This study aimed to observe and describe the branching morphology of the main arterial branches of thoracic and abdominal aorta in the coati, by comparing the findings with existing literature on the other domestic and wild species. For this study, two adult male specimens were used, collected from highways in the state of Minas Gerais, Brazil, victims of roadkill. The specimens were fixed in formalin solution and their aortic branches were filled with latex for subsequent dissection and analysis. It was observed that the left subclavian artery is a direct branch of the aortic arch, there is no formation of a bicarotid or celiac-mesenteric trunk, facts similarly described in domestic carnivores. Thus, it was noticed that the arterial branches of aorta in the coati, both in the thoracic and abdominal cavities, show a distribution very similar to that observed in domestic carnivores, something which reflects their evolutionary closeness within the Carnivora order. Thus, this study proves to be relevant by deepening anatomical knowledge on this wild species, enabling that aspects already known in canine veterinary medicine are applied to the coati.

  8. Aortoesophageal fistula as a complication of thoracic aorta aneurism stent grafting – a case report and literature review

    International Nuclear Information System (INIS)

    Endovascular stent grafting is performed in patients with aneurysms of aorta or other major vessels. The procedure is considered to be generally safe, with a low risk of complications, the most common of which include endoleaks, stenosis or thrombosis at the stagraft and itsmigration. Very rare complications include aortoesophageal and aortobronchial fistulas (0.5–1.7% cases). A 64-year-old patient was admitted to our hospital with suspected aortoesophageal fistula. Two years prior, the patient had undergone a stent graft repair of the thoracic aorta at the local vascular surgery clinic. Both laboratory results and CT angiography revealed aortoesophageal fistula, which was also detected in endoscopic examination. Despite intensive treatment and preparation for surgery, the patient died 6 days after admission. Aortoesophageal and aortobronchial fistulas are among the most dangerous and difficult-to-treat complications in the treatment of thoracic aortic aneurysms by endovascular stent-grafting. This clearly indicates that preventive care and regular medical examinations are important to prevent their occurrence

  9. Sex-specific vascular responses of the rat aorta: effects of moderate term (intermediate stage) streptozotocin-induced diabetes.

    Science.gov (United States)

    Han, Xiaoyuan; Shaligram, Sonali; Zhang, Rui; Anderson, Leigh; Rahimian, Roshanak

    2016-04-01

    Hyperglycemia affects male and female vascular beds differently. We have previously shown that 1 week after the induction of diabetes with streptozotocin (STZ), male and female rats exhibit differences in aortic endothelial function. To examine this phenomenon further, aortic responses were studied in male and female rats 8 weeks after the induction of diabetes (intermediate stage). Endothelium-dependent vasodilation (EDV) to acetylcholine (ACh) was measured in phenylephrine (PE) pre-contracted rat aortic rings. Concentration response curves to PE were generated before and after L-NAME, a nitric oxide synthase (NOS) inhibitor. Furthermore, mRNA expression of endothelial nitric oxide synthase (eNOS) and NADPH oxidase subunit (Nox1) were determined. At 8 weeks, diabetes impaired EDV to a greater extent in female than male aortae. Furthermore, the responsiveness to PE was significantly enhanced only in female diabetic rats, and basal NO, as indicated by the potentiation of the response to PE after L-NAME, was reduced in female diabetic rat aortae to the same levels as in males. In addition, eNOS mRNA expression was decreased, while the Nox1 expression was significantly enhanced in diabetic female rats. These results suggest that aortic function in female diabetic rats after 8 weeks exhibits a more prominent impairment and that NO may be involved. PMID:26845285

  10. Improvement of Endothelium-Dependent Relaxation in Aorta of Rat Models Type 1 and 2 Diabetes by Hespiridin

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    H Mirkhani,

    2008-07-01

    Full Text Available Background: Vascular disease is the principal cause of morbidity and mortality in patients with diabetes. A considerable body of evidence implicates oxidative stress as an important pathogenic factor of diabetic vasculopathies. In the present study, the effect of hesperidin, a flavanone glycoside with antioxidant activity, is studied in endothelium-dependent relaxation of the rat aorta in experimental diabetes mellitus type 1 (DM1 and type 2 (DM2. Patients and Methods: Single dose intraperitoneal injection of streptozocin (60mg/kg and subcutaneous daily injection of dexamethasone (10µg/kg for one month were used to induce DM1 and DM2, respectively. Hesperidin (500mg/kg was administered orally for two months in DM1 and one month in DM2. The effect of acetylcholine (Ach on phenyl ephrine (PE induced. PE contracted aorta was then studied and the EC50 and maximal relaxant effect of Ach were calculated and compared in the two groups.Results: In the experimental DM1, hesperidin restored endothelium-dependent relaxation near to those of normal animals. Its effect on experimental DM2 consisted of a significant reduction of EC50 value of Ach compared to those of diabetic animals. It also showed a great but non-significant effect (P=0.07 on Ach-induced maximum relaxation compared to DM2 untreated animals. Conclusion: These results show that hesperidin can improve vascular endothelial dysfunction in experimental diabetes mellitus.

  11. Contrast-enhanced three-dimensional MR angiography of the thoracic aorta: experiences after 118 examinations with a standard dose contrast administration and different injection protocols

    International Nuclear Information System (INIS)

    The aim of this study was to test three injection protocols for contrast-enhanced magnetic resonance angiography (MRA) of the thoracic aorta with a standard-dose application. Ninety-three patients with a total of 118 examinations underwent MRA of the thoracic aorta at 1.5 T. There were three injection protocols: in 24 cases, no test bolus was performed and contrast was injected manually; in 14 cases, contrast was injected manually after a test bolus; and in 80 cases, a MR-compatible injector was used after a timing examination. All patients received 20 ml of Gd-DTPA. Quantitative signal-to-noise (SNR) measurements were obtained at different locations in the thoracic aorta, the pulmonary arteries, and the superior vena cava. Two readers in conference retrospectively evaluated each examination with respect to overall image quality and quality of bolus timing. Bolus timing was considered optimal in 70 cases, and either too early or too late in 11 cases. In 37 examinations the bolus was broadened. The SNR measurements of the thoracic aorta revealed that examinations after bolus testing were significantly superior to examinations without a test bolus (p<0.001). Signal intensity ratios of the aorta and the pulmonary trunk were significantly higher in examinations with an optimal contrast timing (p<0.001). Magnetic resonance angiograms of the thoracic aorta with a timing run are significantly superior to non-timed examinations with respect to image quality and SNRs. The administration of 20 ml of Gd-DTPA is sufficient for adult patients. (orig.)

  12. Atherosclerosis in coronary artery and aorta in a semi-urban population by applying modified American Heart Association classification of atherosclerosis: An autopsy study

    Science.gov (United States)

    Thej, Mothakapalli Jagadish; Kalyani, Raju; Kiran, Jayaramaiah

    2012-01-01

    Background: Ischemic heart disease (IHD) following atherosclerosis is a giant killer and the incidence of atherosclerosis in coronary arteries is rapidly increasing among Indians. The study was formulated to assess the histomorphological atherosclerotic changes in aorta and coronary arteries at autopsy by applying the modified American Heart Association classification of atherosclerosis based on morphological descriptions to find out the age and sex related prevalence of atherosclerosis in the semi-urban population of Kolar, a district in Southern India. Materials and Methods: Autopsy was conducted on 113 cases whose age ranged from 8-85 years. Autopsy was conducted by the conventional technique; heart and the aorta were removed and fixed in 10% formalin. The heart was dissected along the direction of flow of blood and aorta along the posterior surface. Microscopic assessment of the three main coronary arteries and aorta was done using the modified American Heart Association classification of atherosclerosis. Proportions were analyzed using Chi-square test. Results: The number of males was 78 (69%) and number of females was 35 (31%). Mean age was 37.11 ± 15.69 years. Increased incidence of intermediate lesions was noted in young individuals (15-34 yrs). Atherosclerotic lesions were more in left anterior descending artery compared to other coronary arteries and in abdominal aorta compared to thoracic and ascending aorta. Vulnerable plaques were more in right coronary artery. Conclusion: With cardiovascular disease attaining pandemic proportions, the study of subclinical atherosclerosis is the need of the hour to estimate the disease burden in the asymptomatic population. The increased amount of atherosclerosis (advanced and intermediate lesions) found in the young population in this study gives an indication that anti-atherogenic preventive measures need to be implemented in young individuals, so as to prevent coronary artery disease from causing premature death

  13. Congenital absence of the internal carotid artery and the basilar artery with persistent trigeminal artery associated with coarctation of the aorta

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    Jaeger, H.J.; Mehring, U.M.; Gissler, H.M.; Mathias, K.D. [Dept. of Diagnostic Radiology, Staedtische Kliniken Dortmund (Germany); Dept. of Radiology and MicroTherapy, Univ. of Witten/Herdecke (Germany)

    2000-11-01

    We report a case of congenital absence of the cervical and petrous part of the left internal carotid artery, the middle and proximal part of the basilar artery, and the V4 segment of the left vertebral artery associated with a left persistent trigeminal artery and a coarctation of the aorta. The left cerebral vessels are supplied via the anterior communicating artery and the left persistent trigeminal artery. The coexisting coarctation of the aorta led to a subclavian steal phenomenon. The alteration of the cerebral hemodynamics has to be taken in consideration when performing cerebral angiography and surgical correction in such a case. (orig.)

  14. Congenital absence of the internal carotid artery and the basilar artery with persistent trigeminal artery associated with coarctation of the aorta

    International Nuclear Information System (INIS)

    We report a case of congenital absence of the cervical and petrous part of the left internal carotid artery, the middle and proximal part of the basilar artery, and the V4 segment of the left vertebral artery associated with a left persistent trigeminal artery and a coarctation of the aorta. The left cerebral vessels are supplied via the anterior communicating artery and the left persistent trigeminal artery. The coexisting coarctation of the aorta led to a subclavian steal phenomenon. The alteration of the cerebral hemodynamics has to be taken in consideration when performing cerebral angiography and surgical correction in such a case. (orig.)

  15. Percutaneous Implantation of the self-expanding valve Prosthesis a patient with homozygous familial hypercholesterolemia severe aortic stenosis and porcelain aorta.

    Science.gov (United States)

    Sahiner, Levent; Asil, Serkan; Kaya, Ergün Baris; Ozer, Necla; Aytemir, Kudret

    2016-10-01

    Transcatheter aortic valve implantation (TAVI) has shown favorable outcomes in patients with severe symptomatic aortic valve stenosis who are at high surgical risk or inappropriate for open heart surgery. However, concerns exist over treating patients who have porcelain aorta and familial hypercholesterolemia, due to the potential complications of aortic root and aortic annulus. In this case report, we present a patient with familial hypercholesterolemia, symptomatic severe aortic stenosis, previous coronary artery bypass grafting and porcelain aorta, who was successfully treated with TAVI using a CoreValve. PMID:27393846

  16. Tratamento de angina mesentérica em pacientes com arterite de Takayasu Treatment of mesenteric angina in patients with Takayasu's arteritis

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    Luana Thayse Barros de Lima

    2011-04-01

    Full Text Available Aarterite de Takayasu (AT é uma doença inflamatória crônica do tecido conectivo, idiopática, que acomete preferencialmente a aorta e seus ramos. A terapêutica utilizada baseia-se sobretudo no uso de corticosteroides e imunossupressores. É relatado o caso de uma paciente, 33 anos, com mal-estar, febre, mialgia, cefaleia intensa, pulsátil, holocraniana, resistente a analgésicos, hipertensão arterial sistêmica de difícil controle, claudicação no membro inferior direito e dor abdominal de forte intensidade, a qual piorava após a alimentação. A angiotomografia revelou aneurisma da aorta ascendente, estenose da artéria ilíaca comum direita, estenose das artérias renais e estenose da artéria mesentérica superior, fato que embasou o diagnóstico de angina mesentérica e a conduta intervencionista através da angioplastia transluminal percutânea múltipla com a colocação de stents.Takayasu's arteritis (TA is an idiopathic chronic inflammatory disease of the connective tissue that affects mainly the aorta and its branches. Treatment is mainly based on corticosteroids and immunosuppressants. We report the case of a 33-year-old female complaining of malaise, fever, myalgia, severe pulsing holocranial headache resistant to analgesics, systemic arterial hypertension hard to control, right lower limb claudication, and severe abdominal pain that worsened after the meals. Angiotomography revealed aneurysm of the ascending aorta, and stenosis of the following vessels: right common iliac artery, renal arteries, and superior mesenteric artery. Those findings supported the diagnosis of mesenteric angina and the interventional approach by use of percutaneous transluminal angioplasty with stent placement.

  17. Microsurgical clipping in forty patients with unruptured anterior cerebral circulation aneurysms: an investigation into cognitive outcome Clipagem microcirúrgica em 40 pacientes com aneurisma de circulação cerebral anterior não-roto: uma investigação cognitiva

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    Arthur A Pereira-Filho

    2010-10-01

    Full Text Available OBJECTIVE: It is a consensus that most unruptured intracranial aneurysms (UIA can be treated with acceptably low morbidity. However, some studies recently reported postoperative cognitive impairment, suggesting that it could be attributable to surgical damage. Our goal is to evaluate cognitive function before and after microsurgical clipping in patients with UIA. METHOD: A consecutive series of 40 patients who underwent microsurgical clipping for UIA were studied. The cognitive assessment (Mini Mental State Examination, MMSE was performed immediately before and at least one month after surgery. Paired Student's "t" test and analysis of variance (ANOVA were used for statistical purposes. RESULTS: The mean MMSE score in the preoperative analysis was 28.12 (SD, 1.34. In the postoperative period the mean MMSE score was 28.40 (SD, 1.46. Paired Student's "t" test was applied to the scores and no significant difference was found (p=0.315. ANOVA did not find independent associations between MMSE scores and age, hypertension, smoking, dyslipidemia, education, aneurysm location, number, laterality or size. CONCLUSION: The present study suggests that microsurgical clipping for UIA does not result in major cognitive dysfunction as determined by the MMSEOBJETIVO: É consenso que a maioria dos aneurismas intracranianos não-rotos (AINR podem ser tratados com aceitável taxa de morbidade. Entretanto, alguns estudos reportaram déficits cognitivos no pós-operatório, sugerindo que poderiam ser atribuídos ao dano cirúrgico. O objetivo desse estudo é avaliar a função cognitiva antes e após clipagem microcirúrgica em pacientes com AINR. MÉTODO: Uma série de 40 pacientes com AINR submetidos à clipagem microcirúrgica foi estudada. A avaliação cognitiva (Mini Exame do Estado Mental, MEEM foi realizada antes e após a intervenção cirúrgica. A análise estatística foi realizada com teste "t" de Student e análise de variância (ANOVA. RESULTADOS: A m

  18. Transesophageal access to the cardiac cavities and descending thoracic aorta via echoendoscopy: An experimental study Acceso transesofágico a cavidades cardiacas y aorta torácica descendente mediante ecoendoscopia: Estudio experimental

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