WorldWideScience

Sample records for aneurisma da aorta

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

    Directory of Open Access Journals (Sweden)

    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. Tratamento cirúrgico dos aneurismas toracoabdominais da aorta Surgical treatment of thoracoabdominal aortic aneurysms

    Directory of Open Access Journals (Sweden)

    Januário M Souza

    1991-04-01

    Full Text Available Foram operados, em nosso Serviço, 161 aneurismas da aorta, sendo 99 por dissecção e 62 por outras causas. Em cinco pacientes, os aneurismas eram de localização toracoabdominal, sendo três por degeneração aterosclerótica e dois por dissecção; três pacientes eram do sexo feminino e a idade variou de 31 a 71 anos. Dois pacientes submeteram-se a aneurismectomia previamente (um da aorta ascendente e outro da porção proximal da aorta torácica. Revascularização miocárdica foi feita em um paciente, 40 dias antes da aneurismectomia. A indicação em todos os pacientes foi dor, causada por compressão do aneurisma, sendo que, em dois, havia insuficiência respiratória associada. Todos os pacientes foram operados através de incisão toracoabdominal e abertura do diafragma. A aorta foi substituída por tubo de Dacron, desde sua porção proximal até sua bifurcação, e as artérias viscerais foram implantadas no tubo. Quatro pacientes foram operados com pinçamento da aorta; um paciente necessitou emprego de circulação extracorpórea e parada circulatória, por impossibilidade de pinçamento da aorta junto à artéria subclávia. Todos os pacientes sobreviveram ao ato cirúrgico, ocorrendo dois óbitos no pós-operatório, um subitamente no 12º dia e outro por coma neurológico secundário a parada cardíaca causada por hipoxia.Five patients have been operated on of thoracoabdominal aortic aneurysms. The mean age was 53 years (range 31-71 and three were women. All the patients were symptomatic, three of them had arteriosclerotic aneurysms, and the other two had dissecting aneurysms. Three patients had been operated on previously. The exposure of aneurysm was made through a thoracoabdominal incision, in four patients clamps were placed above and below the aneurysm and it was incised longitudinally. Bypass between left atrium and left femoral artery with hypothermia and circulatory arrest was used in the other patients, since the

  3. Tratamento farmacológico e interações medicamentosas em pacientes com aneurisma da aorta abdominal

    Directory of Open Access Journals (Sweden)

    Heverton Alves Peres

    2015-01-01

    Full Text Available O aneurisma da aorta abdominal (AAA ocorre quando há uma dilatação anormal e irreversível da artéria superior a 50% do calibre esperado para o vaso e associa-se a uma mortalidade de 80 a 90%. O controle dos principais fatores de risco como a hipertensão, dislipidemia, tabagismo e doenças trombóticas em aneurismas pequenos é feito por vários medicamentos que evitam o desenvolvimento e ruptura do aneurisma, no entanto, o uso destes associados a outros medicamentos pode desencadear interações medicamentosas relevantes sendo crucial o conhecimento sobre estas. Atualmente, há poucos dados na literatura sobre o tratamento farmacológico e interações medicamentosas em pacientes com AAA, sendo o objetivo desta revisão, descrever a farmacoterapia e interações medicamentosas em pacientes com AAA.

  4. Aneurismas e dissecções da aorta: progresso nos resultados imediatos do tratamento cirúrgico

    Directory of Open Access Journals (Sweden)

    FONTES Ronaldo D.

    1998-01-01

    Full Text Available Após 1989, introduzimos algumas alterações no tratamento cirúrgico dos aneurismas e dissecções da aorta, em nosso Serviço, entre elas maior rapidez no diagnóstico, uso de parada circulatória, hipotermia profunda, parada circulatória total, monitorização hemodinâmica, controle dos distúrbios de coagulação, controle da pressão liquórica, implantação das artérias intercostais. Entre janeiro de 1980 e julho de 1994, 520 pacientes foram submetidos a tratamento cirúrgico de aneurismas ou dissecções da aorta, de forma consecutiva e não selecionados. Os pacientes foram divididos em três grupos, de acordo com o diagnóstico: ? Aneurisma de aorta ascendente (AAAS ? Aneurisma de arco aórtico (AAAO ? Dissecção aguda da aorta tipos I e II (DAAO I e II Nos três grupos, a mortalidade foi significativamente inferior para pacientes operados no período após 1989. Variáveis preditivas de mortalidade para AAAS foram: complicações pulmonares (p = 0,0210, renais (p = 0,0310, neurológicas (p < 0,0001. Para DAAO I e II, a hipertensão arterial (p < 0,0001, complicações cardíacas (p < 0,0001, neurológicas (p < 0,0001, renais (p < 0,0001 e a rotura (p < 0,0001 foram preditivas de óbito, e para AAAO foram as variáveis: idade (p = 0,0001 e complicações renais (p = 0,0015. Os autores concluem que as modificações introduzidas no método de tratamento cirúrgico dos aneurismas e dissecções da aorta contribuíram significativamente para a melhora dos resultados.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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

  9. Análise da correlação entre síndrome de pseudo-exfoliação e aneurisma de aorta abdominal Analysis of correlation between pseudoexfoliation syndrome and aneurysm of the abdominal aorta

    Directory of Open Access Journals (Sweden)

    Paulo de Tarso Ponte Pierre Filho

    2004-06-01

    Full Text Available OBJETIVO: Examinar a correlação sugerida entre síndrome de pseudo-exfoliação e aneurisma de aorta abdominal. MÉTODOS: Sessenta e cinco pacientes recentemente operados por aneurisma de aorta abdominal e 51 controles com aterosclerose periférica, sem aneurisma, submeteram-se ao exame oftalmológico sob dilatação pupilar para investigar a presença de síndrome de pseudo-exfoliação. RESULTADOS: Não houve diferenças estatisticamente significantes entre a média de idade, distribuição por sexo e raça entre os 2 grupos (p > 0,05. Dois dos 65 pacientes com aneurisma de aorta e um dos 51 controles apresentaram síndrome de pseudo-exfoliação (p = 1,00. CONCLUSÃO: A prevalência de síndrome de pseudo-exfoliação em pacientes operados por aneurisma de aorta abdominal e em pacientes com aterosclerose periférica foi similar. Este achado não confirma a associação proposta entre síndrome de pseudo-exfoliação e aneurisma de aorta abdominal.PURPOSE: To investigate the suggested association between pseudoexfoliation syndrome and aneurysm of the abdominal aorta. METHODS: 65 patients recently operated for abdominal aortic aneurysm and 51 controls with peripheral atherosclerosis, without aneurysm, underwent an ophthalmologic examination under pupillary dilatation to detect the presence of pseudoexfoliation syndrome. RESULTS: There were no significant differences regarding mean age and distribution by gender and race between the groups (p > 0.05. Two of 65 patients with aortic aneurysm and one of 51 controls presented pseudoexfoliation syndrome (p = 1.00. CONCLUSION: The prevalence of pseudoexfoliation syndrome in patients operated for abdominal aortic aneurysm and in patients with peripheral atherosclerosis were similar. This finding does not support the proposed association between pseudoexfoliation syndrome and abdominal aortic aneurysm.

  10. Aneurisma de aorta abdominal infectado por Salmonella species

    Directory of Open Access Journals (Sweden)

    Marina Helena Fernandes de Aguiar Alioti

    2016-03-01

    Full Text Available Resumo Os aneurismas de aorta abdominal infecciosos (AAAIs são raros e apresentam uma alta mortalidade devido à septicemia e ao risco de ruptura. A opção terapêutica consagrada consiste na correção aberta com ressecção do aneurisma, debridamento e reconstrução com veia autóloga. Mais recentemente, alguns grupos vêm relatando séries de casos nas quais se realizou tratamento endovascular. Em ambas as opções, a antibioticoterapia adjuvante é imperativa. Relatamos um caso ilustrativo em que o tratamento de escolha foi a cirurgia aberta com reconstrução utilizando-se veia autóloga.

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

    Directory of Open Access Journals (Sweden)

    Fabiola Goda Torlai

    2006-08-01

    Full Text Available 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 cirurgiões, todos com experiência em cirurgia da aorta abdominal. O índice de resposta aos questionários foi de 55,5% (5/9. RESULTADOS: Os parâmetros de interesse citados mais freqüentemente para a avaliação dos aneurismas de aorta abdominal foram: diâmetro máximo do colo proximal, extensão do colo proximal até a artéria renal mais baixa, forma do colo proximal, diâmetro máximo do aneurisma e diâmetro das artérias ilíacas comuns. Estes dados permitiram elaborar uma proposta de modelo para padronização de relatório na tomografia computadorizada. CONCLUSÃO: Um modelo para a análise tomográfica padronizada do aneurisma de aorta abdominal permite atender às necessidades dos cirurgiões vasculares para acompanhar a evolução e planejar o tratamento destes pacientes.OBJECTIVE: To propose a model to standardize computed tomography reports on abdominal aortic aneurysms. MATERIALS AND METHODS: Interviews were carried out with members of 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

  12. 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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  14. Mortalidade relacionada ao tratamento endovascular do aneurisma da aorta abdominal com o uso dos modelos revisados Procedure-related mortality of endovascular abdominal aortic aneurysm repair using revised reporting standards

    Directory of Open Access Journals (Sweden)

    Gosen Gabriel Konig

    2007-03-01

    Full Text Available OBJETIVO: O objetivo do estudo foi avaliar a definição da mortalidade relacionada ao procedimento após tratamento endovascular do aneurisma de aorta abdominal (EVAR como definido pelo Committee for Standardized Reporting Practices in Vascular Surgery. MÉTODO: Dados de pacientes com aneurisma de aorta abdominal foram analisados do banco de dados EUROSTAR. Os pacientes foram submetidos ao EVAR entre junho de 1996 a fevereiro de 2004 e foram estudados retrospectivamente. A probabilidade explicita da causa de morte foi registrada. O intervalo entre a operação, alta hospitalar ou intervenção secundária até a morte foi registrado. RESULTADOS: De um total de 5612 pacientes, 589 (10,5% faleceram após o EVAR em acompanhamento total e qualquer causa de morte foi inclusa. Cento e quarenta e um pacientes (12,5% morreram devido a causa relacionada ao aneurisma, sendo que 28 (4,8% foram rupturas, 25 (4,2% infecções do implante e 88 (14,9% foram pacientes que morreram num prazo de 30 dias após o procedimento inicial (definição atualmente utilizada, também conhecido como resultado clínico a curto prazo. Além disso, 25 pacientes faleceram após 30 dias, mas continuavam ainda hospitalizados (ou transferidos a home-care para reavaliação posterior, ou necessitaram intervenção secundária. Levando em conta a duração da admissão ao hospital e a mortalidade imediata após o procedimento relacionada a intervenções secundárias, 49 mortes tardias também podem ser relacionadas ao EVAR. CONCLUSÃO: Morte tardia compõe uma proporção considerável da mortalidade relacionada ao EVAR dentro do tempo de análise revisado.OBJECTIVE: The aim of this study was to evaluate the definition of Procedure-related mortality after endovascular aneurysm repair (EVAR as defined by the Committee for Standardized Reporting Practices in Vascular Surgery. METHODS: Data on patients with an AAA were taken from the EUROSTAR database. The patients underwent EVAR

  15. Hérnias incisionais no pós-operatório de correção de aneurisma de aorta abdominal

    OpenAIRE

    Menezes,Fábio Hüsemann; Guillaumon,Ana Terezinha

    2012-01-01

    CONTEXTO: A incidência de hérnia incisional no pós-operatório da correção aberta de aneurisma de aorta abdominal é alta, variando de 10 a 37% e mais de três vezes mais comum do que em pacientes submetidos à correção para doença obstrutiva aorto-ilíaca. OBJETIVO: Apresentar a incidência de hérnia incisional em um grupo de pacientes acompanhados no pós-operatório da correção aberta de aneurisma de aorta abdominal. MÉTODOS: Série de casos em uma população de 144 pacientes operados por aneurisma ...

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

    Directory of Open Access Journals (Sweden)

    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.

  17. Tratamento endovascular de aneurismas da aorta em pacientes com doença de Behçet: relato de dois casos Endovascular treatment of aortic aneurysms in patients with Behcet's disease: report of two cases

    Directory of Open Access Journals (Sweden)

    Sergio Quilici Belczak

    2010-06-01

    Full Text Available A doença de Behçet, uma vasculite sistêmica de causa desconhecida, pode ser causa de doença aneurismática da aorta em alguns portadores dessa patologia. Nós apresentamos nossa experiência com dois casos de aneurismas aórticos em pacientes com doença de Behçet submetidos à terapêutica endovascular, descrevendo seus respectivos seguimentos. A terapêutica atual, a patofisiologia e os critérios diagnósticos vigentes foram revisados. Concluímos que a técnica endovascular é uma excelente opção terapêutica para certos pacientes com doença de Behçet e que esta deve ser acompanhada de tratamento imunossupressivo adequado.Behcet's disease, a systemic vasculitis of unknown etiology, may be the cause of aortic aneurysmal diseases in some patients. We report our experience with two Behcet's disease patients who presented with aortic aneurysms and were submitted to endovascular therapy, and describe their respective follow-ups. Current pathophysiology, diagnosis, and treatment approaches were reviewed. Our experience suggests that the endovascular approach, combined with adequate immunosuppressive treatment, is an excellent therapeutic option for some patients with Behcet's disease suffering from aneurysms.

  18. Avaliação pós-operatória do tratamento endovascular de aneurismas da aorta abdominal por angiotomografia com multidetectores Post-operative evaluation of endovascularly treated abdominal aortic aneurysms by multidetector computed tomography angiography

    Directory of Open Access Journals (Sweden)

    Fabiana Barroso Thomaz

    2008-08-01

    Full Text Available OBJETIVO: Este estudo tem como objetivo a avaliação pós-operatória do tratamento endovascular de aneurismas da aorta abdominal por angiotomografia com multidetectores. MATERIAIS E MÉTODOS: Foram analisadas, retrospectivamente, angiotomografias de 166 pacientes (137 homens e 29 mulheres com idade média de 73 anos portadores de aneurisma da aorta abdominal submetidos a terapêutica endovascular, no período de junho de 2005 a agosto de 2006. Os exames foram feitos em tomógrafo multidetector de 64 canais e os parâmetros adotados foram: colimação, 0,625 mm; pitch, 0,6-1; mAs, 300-400; kV, 120. Em todos os casos foi utilizado meio de contraste iodado não-iônico (350 mg/ml administrado por meio de bomba infusora, com fluxo de 4 ml/s a 5 ml/s e com volume variável de 70 ml a 100 ml. Os exames foram avaliados quanto à presença de complicações. RESULTADOS: Dos 166 exames realizados, 93 pacientes não apresentaram complicações e 73 apresentaram os seguintes achados: endoleak (n=37, trombose circunferencial da endoprótese (n=29, angulação (n=17, coleção no sítio de punção (n=10, migração da prótese (n=7, dissecção dos vasos de acesso (n=7 e oclusão (n=6. CONCLUSÃO: O endoleak foi a complicação mais prevalente em nosso estudo, sendo o tipo II o mais comum.OBJECTIVE: The present study was aimed at evaluating endovascularly treated abdominal aortic aneurysms by multidetector computed tomography angiography. MATERIALS AND METHODS: Multidetector computed tomography angiography studies of 166 patients were retrospectively analyzed. The sample included 137 men and 29 women with mean age of 73 years who had undergone endovascular treatment for abdominal aortic aneurysm in the period between June 2005 and August 2006. Images were acquired in a 64-channel multidetector tomograph adopting the following parameters: 0.625 mm collimation, pitch 0.6-1, 300-400 mAs, and 120 kV. A nonionic iodinated contrast agent (350 mg/ml was injected

  19. Tratamento cirúrgico da insuficiência aórtica nos aneurismas e dissecções da aorta ascendente pela técnica de Tirone David

    Directory of Open Access Journals (Sweden)

    Wagner M PEREIRA

    1997-01-01

    Full Text Available Aneurismas da aorta ascendente (AAA e dissecções agudas da aorta (DAA são defeitos que cursam com insuficiência valvar aórtica (IAo na maioria dos pacientes, geralmente causada por vários mecanismos. Em 30% a 50% dos casos, os folhetos aórticos são morfologicamente normais, possibilitando a reconstrução através do reimplante da valva e das artérias coronárias em um tubo corrugado de Dacron e pericárdio bovino. Descrita por Tirone David, esta técnica evita a prótese valvular e, provavelmente, nos casos de AAA, corrige definitivamente os mecanismos envolvidos. No período de novembro de 1994 a dezembro de 1995 operamos 11 pacientes, que foram assim divididos: Grupo I: DAA, 5 pacientes, todos com o Tipo 1 de DeBakey, sendo 4 agudos e 1 crônico; Grupo II: AAA, 6 pacientes, a maioria com idade acima de 50 anos. No Grupo I empregamos hipotermia profunda, parada circulatória total e perfusão cerebral retrógrada. No Grupo II usamos hipotermia moderada a 28oC. Em ambos a proteção miocárdica foi realizada através de infusão anterógrada intermitente e isotérmica de solução cardioplégica sangüínea associada a solução salina gelada no pericárdio. Dois (18,2% pacientes faleceram na fase hospitalar e 1 (9% tardiamente, todos do Grupo I, e 8 vêm sendo acompanhados, com tempo máximo de 13 meses de seguimento. Todos os pacientes sobreviventes (9/11 foram submetidos a estudo ecocardiográfico antes da alta e nenhum apresentou disfunção valvar aórtica. Em dezembro de 1995, todos que sobreviviam (8/11 foram reavaliados por ecocardiografia e os resultados são mostrados neste trabalho. Concluímos que o reimplante da valva aórtica descrito por David é um método efetivo de tratamento da IAo associada aos AAA e DAA. Mesmo sendo pequeno o número de pacientes e o seguimento desta série, acreditamos que a tentativa de evitar o implante de próteses valvulares é encorajadora para ambos, cirurgião e paciente, em um seleto n

  20. Resultados del tratamiento quirúrgico de los aneurismas de aorta abdominal infrarrenal

    Directory of Open Access Journals (Sweden)

    Marcos M. Tarazona

    2015-01-01

    Conclusiones: La implemetación de la terapia endovascular ha contribuido a aumentar el número de pacientes tratados con aneurisma de aorta abdominal en nuestra institución. El aumento del volumen se tradujo en disminución efectiva de la mortalidad.

  1. Fatores envolvidos na migração das endopróteses em pacientes submetidos ao tratamento endovascular do aneurisma da aorta abdominal Factors involved in the migration of endoprosthesis in patients undergoing endovascular aneurysm repair

    Directory of Open Access Journals (Sweden)

    Marcelo José de Almeida

    2010-06-01

    Full Text Available A migração da endoprótese é complicação do tratamento endovascular definida como deslocamento da ancoragem inicial. Para avaliação da migração, verifica-se a posição da endoprótese em relação a determinada região anatômica. Considerando o aneurisma da aorta abdominal infrarrenal, a área proximal de referência consiste na origem da artéria renal mais baixa e, na região distal, situa-se nas artérias ilíacas internas. Os pacientes deverão ser monitorizados por longos períodos, a fim de serem identificadas migrações, visto que estas ocorrem normalmente após 2 anos de implante. Para evitar migrações, forças mecânicas que propiciam fixação, determinadas por características dos dispositivos e incorporação da endoprótese, devem predominar sobre forças gravitacionais e hemodinâmicas que tendem a arrastar a prótese no sentido caudal. Angulação, extensão e diâmetro do colo, além da medida transversa do saco aneurismático, são importantes aspectos morfológicos do aneurisma relacionados à migração. Com relação à técnica, não se recomenda implante de endopróteses com sobredimensionamento excessivo (> 30%, por provocar dilatação do colo do aneurisma, além de dobras e vazamentos proximais que também contribuem para a migração. Por outro lado, endopróteses com mecanismos adicionais de fixação (ganchos, farpas e fixação suprarrenal parecem apresentar menos migrações. O processo de incorporação das endopróteses ocorre parcialmente e parece não ser suficiente para impedir migrações tardias. Nesse sentido, estudos experimentais com endopróteses de maior porosidade e uso de substâncias que permitam maior fibroplasia e aderência da prótese à artéria vêm sendo realizados e parecem ser promissores. Esses aspectos serão discutidos nesta revisão.Migration of the endoprosthesis is defined as the misplacement of its initial fixation. To assess the migration, the position of the

  2. Tratamento cirúrgico dos aneurismas da aorta abdominal: existe diferença dos resultados entre homens e mulheres? Surgical treatment of abdominal aortic aneurysms: is there difference in the results obtained in men and women?

    Directory of Open Access Journals (Sweden)

    Telmo Pedro Bonamigo

    2006-06-01

    Full Text Available OBJETIVO: Avaliar os resultados cirúrgicos após o tratamento convencional e eletivo do aneurisma da aorta abdominal, verificando se existe diferença entre homens e mulheres na mortalidade e morbidade cirúrgicas, bem como nos resultados a longo prazo. PACIENTES E MÉTODOS: Entre dezembro de 1983 e dezembro de 2003, 675 pacientes foram submetidos ao tratamento cirúrgico do aneurisma da aorta abdominal infra-renal, sendo divididos em dois grupos: homens (n = 575 e mulheres (n = 100. Os dados demográficos e aqueles relacionados ao procedimento cirúrgico, bem como os resultados perioperatórios, foram coletados pela revisão dos prontuários. Os pacientes com alta hospitalar formaram uma coorte retrospectiva, onde foram avaliadas as causas tardias de óbito e a sobrevida. RESULTADOS: A média das idades foi similar, sem diferença estatística entre mulheres e homens (68,9 ± 9,1 versus 67,4 ± 7,1 anos; P = 0,089. A presença de hipertensão arterial foi significativamente superior nas mulheres (73 versus 62,4%; P = 0,042, e a cardiopatia isquêmica e história de tabagismo foram mais freqüentes nos homens (P OBJECTIVE: To evaluate perioperative results in patients submitted to elective conventional open repair of abdominal aortic aneurysm, comparing the results between women and men in relation to perioperative mortality and morbidity, as well as long term outcomes. PATIENTES AND METHODS: Between December 1983 and December 2003, 675 patients were submitted to infrarenal abdominal aortic aneurysm repair. We divided these patients into two groups: men (n = 575 and women (n = 100. Demographic and operative data, as well as perioperative outcomes were obtained from chart review. Discharged patients formed a retrospective cohort, in which the late causes of death and survival were evaluated. RESULTS: The mean age was similar, but no statistical difference was observed between men and women (68.9 ± 9.1 versus. 67.4 ± 7.1 years; P = 0.089. The

  3. Estudo comparativo entre tratamento endovascular e cirurgia convencional na correção eletiva de aneurisma de aorta abdominal: revisão bibliográfica

    OpenAIRE

    Simão,Ana Carolina P.; Gonçalves,Ana Carolina de Alencar; Paulino,Milena Miguita; Oliveira,Renata Barbosa de; Polli,Camila Aparecida; Fratezi,Ayrton Cássio

    2009-01-01

    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 ...

  4. Estudo prospectivo da morbi-mortalidade precoce e tardia da cirurgia do aneurisma da aorta abdominal Prospective study of early and late morbidity and mortality in the abdominal aortic aneurysm surgical repair

    Directory of Open Access Journals (Sweden)

    Francine C. de Carvalho

    2005-04-01

    Full Text Available OBJETIVO: Avaliar, prospectivamente, a morbidade e mortalidade precoce e tardia de pacientes submetidos a correção cirúrgica eletiva de aneurisma de aorta abdominal infra-renal e determinar os preditores independentes de eventos cardiológicos. MÉTODOS: Estudados 130 pacientes durante seis anos consecutivos, submetidos a rotina de avaliação pré-operatória padronizada e cirúrgica, sempre pela mesma equipe clínica, cirúrgica e anestesiológica. RESULTADOS: A mortalidade hospitalar foi de 3,1% (4 pacientes, sendo a principal causa de óbito isquemia mesentérica, ocorrida em três pacientes. Houve 48 (37% complicações não-operatórias, 8,5% consistiram em complicações cardíacas e 28,5% em complicações não cardíacas. As complicações pulmonares foram as mais comuns, ocorridas em 14 (10,8% pacientes. A sobrevida no 1º, 3º e 6º ano pós-operatório foi, respectivamente, de 95%, 87% e 76%. As variáveis que se correlacionaram significativamente com a morbimortalidade foram preditor clínico, idade média de 70,5 anos, presença de insuficiência cardíaca e insuficiência renal crônica. Não foi identificado nenhum preditor de morbimortalidade tardia. CONCLUSÃO: Apesar de ser uma cirurgia considerada de alta complexidade, a mortalidade é baixa, as complicações cardíacas são de pequena monta e os pacientes apresentam boa evolução a longo prazo.OBJECTIVE: To prospectively assess early and late morbidity and mortality of patients undergoing elective surgical repair of abdominal infrarenal aortic aneurysms and to determine the independent predictors of cardiac events. METHODS: For 6 consecutive years, this study analyzed 130 patients, who underwent routine standardized preoperative assessment always with the same clinical, surgical, and anesthesia teams. RESULTS: In-hospital mortality was 3.1% (4 patients, and the major cause of death was mesenteric ischemia, which occurred in 3 patients. Forty-eight (37% nonsurgical

  5. Pseudo-aneurisma em tubo valvulado de pericárdio bovino corrugado após reconstrução da aorta ascendente: relato de caso False aneurysm of crimped bovine pericardial conduit after reconstruction of the ascending aorta: case report

    Directory of Open Access Journals (Sweden)

    Noedir A. G. STOLF

    1999-10-01

    Full Text Available Os autores descrevem o caso de paciente que, 9 anos após a correção cirúrgica de um aneurisma de aorta ascendente com tubo valvulado de pericárdio bovino corrugado, evoluiu com a formação de um pseudo-aneurisma de aorta localizado, posteriormente, sobre a linha de sutura do tubo de pericárdio bovino. Foi realizada substituição do tubo de pericárdio bovino por tubo de Dacron valvulado (com prótese mecânica e reimplante dos óstios coronários utilizando-se a técnica de hemi-Cabrol. O tempo de seguimento pós-operatório do paciente é de 12 meses, permanecendo assintomático.The authors describe the case of a patient who had an aneurysm of the ascending aorta repaired with biologic valved crimped bovine pericardial conduit. Nine years after the surgery he presented a false aneurysm of the ascending aorta, located posteriorly on the suture line of the pericardial tube. The patient was reoperated and the pericardial tube was replaced by a valved Dacron composite graft using the hemi- Cabrol technique for the reimplantation of the coronary ostia. At 12 months follow-up the patient remains free of symptoms.

  6. Tratamento endovascular de aneurisma de aorta abdominal com fístula aorto-cava utilizando oclusor vascular concomitante a endoprótese bifurcada: relato de caso

    Directory of Open Access Journals (Sweden)

    Bruno Lorenção de Almeida

    2017-06-01

    Full Text Available Resumo As fístulas aorto-cava são entidades raras e de etiologia variada, estando frequentemente associadas a significativa morbimortalidade. Acredita-se que o aumento da tensão da parede nos grandes aneurismas resulte em reação inflamatória e aderência à veia adjacente, culminando na erosão das camadas aderidas e na formação da fístula. O tratamento cirúrgico convencional tem altas taxas de mortalidade. Embolia pulmonar paradoxal e o vazamento são complicações temidas do tratamento endovascular. O uso de oclusor vascular associado a endoprótese bifurcada é boa opção no tratamento do aneurisma de aorta abdominal com fístula aorto-cava.

  7. 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

    Directory of Open Access Journals (Sweden)

    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

  8. Avaliação da incidência e de fatores de risco para a colite isquêmica após reparo de aneurisma de aorta abdominal Avaliation of Incidence and risk factors for ischemic colitis following abdominal aortic aneurism repair

    Directory of Open Access Journals (Sweden)

    Gilmara Pandolfo

    2007-09-01

    Full Text Available Este estudo teve como objetivo principal determinar a incidência da colite isquêmica após o reparo de aneurisma de aorta abdominal, bem como identificar fatores de risco para o desenvolvimento da mesma. Foram estudados 11 pacientes submetidos a reparo cirúrgico eletivo de aneurisma de aorta abdominal no Serviço de Cirurgia Cardiovascular do HSL-PUCRS. A incidência de colite isquêmica foi determinada através de retossigmoidoscopia flexível, com biópsia, realizada em todos os pacientes no 7º pós-operatório. A incidência da doença foi comparada com variáveis clínicas como: sexo; idade; presença de comorbidades associadas; choque trans-operatório; fluxo na artéria mesentérica inferior (AMI; complicações pós-operatórias; e o desfecho final. Em nossa amostra, a incidência da colite isquêmica após o reparo de aneurisma de aorta abdominal foi 36%, sendo destes 25% da forma gangrenosa. A ocorrência de isquemia do cólon foi mais freqüente em associação com o diagnóstico de doença pulmonar obstrutiva crônica, e em pacientes que apresentavam fluxo na artéria mesentérica inferior no pré-operatório (pIschemic colitis is a relatively uncommon complication following abdominal aortic aneurism repair. However, patients with this disease have higher rates of mortality when compared to ischemic colitis alone. The objective of our study is to investigate the incidence and risk factors associated with the occurrence of ischemic colitis following abdominal aortic aneurism repair. We studied eleven patients treated by surgery for aortic aneurism at Hospital São Lucas da PUCRS (HSL-PUCRS. The patients were evaluated for other clinical conditions and were submitted to flexible reto-sigmoidoscopy at the seventh day after surgery. Incidence of ischemic colitis was 36% and it was associated with chronic obstructive pulmonar disease and the presence of blood flow through the inferior mesenteric artery before surgery. Among the

  9. 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

    Directory of Open Access Journals (Sweden)

    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

  10. Tratamiento endovascular de los aneurismas ateroscleróticos de aorta torácica descendente

    Directory of Open Access Journals (Sweden)

    Carlos Velázquez

    2009-09-01

    Full Text Available El abordaje del aneurisma degenerativo de la aorta torácica descendente debe basarse en el conocimiento de su historia natural. Este diagnóstico, cada vez más frecuente, no precisa de tratamiento en su fase asintomática hasta que el aneurisma no alcanza un diámetro que preconiza un riesgo de complicación considerable. El abordaje endovascular permite reducir la morbimortalidad en población añosa y con enfermedad respiratoria asociada. En jóvenes sin comorbilidad, la cirugía convencional debería ser todavía el patrón oro por su menor tasa de complicaciones a medio-largo plazo. A pesar de ello, la técnica se extenderá ampliamente por su mayor aceptación en los pacientes. La correcta indicación y realización de derivaciones a los troncos supraaórticos, así como el buen manejo del drenaje del líquido cefalorraquídeo, permitirán mejorar las zonas de sellado y reducir al mínimo las complicaciones neurológicas de la técnica endovascular.

  11. ROTURA DE ANEURISMA DE AORTA ABDOMINAL: SU IMPORTANCIA COMO DIAGNOSTICO DIFERENCIAL EN ABDOMEN AGUDO

    Directory of Open Access Journals (Sweden)

    Vanessa Orellana-Villazón

    2012-02-01

    Full Text Available El aneurisma aórtico abdominal (AAA roto es una forma de presentación poco frecuente de los AAA. Presentamos un caso de rotura de aneurisma de aorta abdominal (AAAr de un paciente varón de 76 años de edad que ingresa al servicio de emergencias del Hospital Elizabeth Setón por presentar dolor abdominal punzante en región lumbar derecha de inicio súbito e intensidad creciente, llegando a perder el conocimiento. La impresión diagnóstica inicial incluye cólico ureteral e hipertensión arterial; sin embargo después realizar una ecografía abdominal y posteriormente una tomografía abdominal se concluye con el diagnostico de AAAr. El paciente es sometido a cirugía de emergencia, y después de permanecer tres días en terapia intensiva y tres días en sala, es dado de alta. Consideramos importante informar este caso clínico por la frecuencia con que se le confunde con patologías renales o abdomen agudo, pese a la sintomatología característica que presenta, que en muchos casos lleva a un diagnostico retrasado y posteriormente a la muerte.

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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

  14. Tratamiento endovascular simultáneo de la estenosis aórtica grave y aneurisma de aorta abdominal. Reporte de dos casos

    OpenAIRE

    Zaefferer, Patricio; Chikiar, Darío S.; Castelli, Mariano A.; de Luca, Ignacio J.; Cura, Fernando; Belardi, Jorge

    2017-01-01

    Introducción: Los pacientes con estenosis aórtica grave y aneurisma de la aorta abdominal con alto riesgo quirúrgico pueden beneficiarse del abordaje endovascular. El tratamiento de la estenosis valvular aórtica aumenta el riesgo de rotura del aneurisma de aorta abdominal, por lo que retrasar la reparación del mismo puede poner en riesgo la vida del paciente. El enfoque endovascular simultáneo de ambas patologías es una alternativa posible. Material y método: Presentamos dos casos de impla...

  15. Aneurisma da aorta abdominal infrarrenal: importância do rastreamento em hospitais do Sistema Único de Saúde na região metropolitana de Salvador - Bahia Infrarenal abdominal aortic aneurysm: significance of screening in patients of public hospitals in the metropolitan region of Salvador - Bahia, Brazil

    Directory of Open Access Journals (Sweden)

    Aquiles Tadashi Ywata de Carvalho

    2012-12-01

    Full Text Available INTRODUÇÃO: O aneurisma da aorta abdominal infrarrenal (AAA representa doença vascular que merece constante atenção, tanto para os estudos de rastreamento como de aperfeiçoamento terapêutico. Sua importância clínica se baseia na alta taxa de mortalidade que ocorre com a sua ruptura, em contraste com a baixa taxa de mortalidade descrita com a correção cirúrgica eletiva em serviços especializados. Na região metropolitana de Salvador, não se encontram dados relativos à identificação desses indivíduos. Esse fato encorajou nosso estudo. OBJETIVOS: (1 determinar a prevalência do AAA infrarrenal nos pacientes com fatores de risco; (2 identificar esses fatores de risco; e (3 a população que deve ser rotineiramente rastreada. MÉTODOS: Em estudo de rastreamento do AAA realizado pelos Serviços de Cirurgia Vascular do Hospital Geral Roberto Santos (HGRS e do Hospital Geral de Camaçari (HGC de setembro de 2008 a outubro de 2009, foram selecionados 1350 indivíduos com 50 anos ou mais que apresentavam fatores de risco para o aneurisma da aorta. A triagem incluiu o preenchimento de protocolo e a realização de ultrassom doppler colorido. RESULTADOS: A prevalência do AAA infrarrenal nesta amostra foi 3,9%. Os fatores de risco mais frequentemente associados foram: média de idade de 72 anos, gênero masculino, tabagismo, antecedente de AAA e portadores de doença arterial oclusiva periférica, insuficiência coronariana e doença pulmonar obstrutiva crônica. O rastreamento do AAA deve ser considerado em homens com idade superior a 65 anos, principalmente quando presente um desses fatores de risco.BACKGROUND: Infrarenal abdominal aortic aneurysm (AAA is a vascular disease requiring continuous attention both in terms of screening and therapeutic improvement. Infrarenal AAA is a major condition because of its high mortality rate due to AAA rupture, as opposite to the low mortality rate related to elective surgical repair conducted in

  16. Evaluación del impacto de las técnicas de control del daño en el tratamiento de los pacientes con aneurisma roto de la aorta abdominal. Hospital Universitario San Vicente de Paúl, Medellín, Colombia, enero de 2000 a octubre de 2007

    OpenAIRE

    John Fernando García V.; Iván Ramiro Arismendi O.; René Fernando Timarán R.; Carolina Bravo C.; José Andrés Uribe M.; Giovanni García M.

    2008-01-01

    La mortalidad quirúrgica atribuible al aneurisma de la aorta abdominal (AAA) roto oscila entre 40 y 70% según los diversos informes de la literatura; la principal causa de ello es la falla orgánica múltiple (FOM), la que a su vez corresponde, en un porcentaje importante de casos, al complejo de hipertensión abdominal/síndrome del compartimento abdominal (HTA/SCA). A principios de la década de los años 90 aparecieron algunos artículos informando que los pacientes tratados con laparostomía, con...

  17. Aneurisma de artéria femoral superficial roto: relato de caso e revisão de literatura

    OpenAIRE

    Oliveira,Alexandre Faraco de; Oliveira Filho,Horácio de

    2009-01-01

    O aneurisma de artéria femoral superficial é um evento raro que costuma manifestar-se em pacientes com idade avançada, frequentemente associado a outros aneurismas, periféricos ou de aorta abdominal. O caso relatado refere-se a um paciente cujo aneurisma de artéria femoral superficial se apresentou roto e associado a um aneurisma de aorta abdominal. Foi submetido à revascularização cirúrgica fêmoro-poplítea mediante prótese de politetrafluoretileno, com sucesso. A revisão da literatura demons...

  18. Quantificação morfométrica de Chlamydia pneumoniae e Mycoplasma pneumoniae em aneurismas de aorta abdominal humana Morphometrical quantification of Chlamydia pneumoniae and Mycoplasma pneumoniae in human atherosclerotic abdominal aortic aneurysms

    Directory of Open Access Journals (Sweden)

    Lucas José Tachotti Pires

    2007-09-01

    Full Text Available OBJETIVO: A inflamação aterosclerótica, com possível papel de agentes infecciosos, pode contribuir na patogênese dos aneurismas da aorta abdominal (AAA. O achado de Chamydia pneumoniae (CP nessas lesões, em estudos prévios, sem quantificação, variou de 0-100%. O objetivo é quantificar a presença de CP e de Mycoplasma pneumoniae (MP nos AAA. MÉTODO: A espessura, o número de células positivas para CP detectadas por imunoperoxidase e a porcentagem de área ocupada por MP detectada por hibridização "in situ", nas três camadas da aorta, foram medidos com sistema de análise de imagens, em 10 aortas abdominais aneurismáticas. Usouse três grupos-controle: 1 amostras das mesmas aortas, fora do aneurisma, exceto se a dilatação tomasse toda a porção sub-renal da artéria (n=7; 2 aortas com aterosclerose grave, mas sem aneurismas (n=10; 3 aortas sem aterosclerose ou com grau leve da doença (n=10. Todos os espécimes foram obtidos em necropsias. Usou-se o teste de Wald para comparar os grupos; fixou-se o nível de significância em 5%. RESULTADOS: A íntima era mais fina e a média mais espessa nos casos normais que nos outros grupos (p0,05. Também se detectou MP em todos os grupos. Este agente predominou no grupo de pacientes com aterosclerose, mas sem aneurisma na íntima e na adventícia; entretanto, as diferenças entre os grupos não foram significativas (p>0,05. CONCLUSÕES: Nossos dados sugerem que os agentes enfocados não têm papel importante na patogênese dos AAA.OBJECTIVE: Atherosclerotic inflammation, with a possible role of infectious agents, could contribute to the pathogenesis of abdominal aortic aneurysms (AAA. Finding of Chlamydia pneumoniae (CP in these lesions in previous, non-quantifying studies ranged from 0-100%. The objective is to quantify the presence of CP and Mycoplasma pneumoniae (MP in AAA. METHODS: Thickness, number of cells positive for CP by immunohistochemistry and percent area occupied by MP

  19. Tratamento do aneurisma aterosclerótico da artéria temporal superficial: relato de caso

    Directory of Open Access Journals (Sweden)

    Paula Dayana Matkovski

    2015-09-01

    Full Text Available ResumoAneurismas da artéria temporal superficial são incomuns segundo a literatura. A grande maioria é secundária a traumatismos ou cirurgia na região temporal, sendo que 95% dos casos evoluem para pseudoaneurismas. Entretanto, os aneurismas verdadeiros ou espontâneos são extremamente raros e representam 8% dos casos de aneurismas da artéria temporal superficial, sendo estes, geralmente, de origem aterosclerótica. Aneurismas temporais espontâneos podem coexistir com outras lesões vasculares, incluindo aneurismas intracranianos. Nosso relato trata de um paciente com aneurisma de artéria temporal superficial esquerda, de origem aterosclerótica, no qual foi realizada a excisão cirúrgica, sob anestesia geral.

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

    Directory of Open Access Journals (Sweden)

    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.

  1. Aneurismas de la aorta toracoabdominal. Indicaciones de tratamiento. Cirugía abierta

    Directory of Open Access Journals (Sweden)

    Antonio García-Valentín

    2015-09-01

    Full Text Available El tratamiento quirúrgico abierto de los aneurismas toracoabdominales supone un reto muy importante para cirujanos, anestesistas y perfusionistas. Se trata de una intervención agresiva, sujeta a multitud de variables no habituales y normalmente poco estandarizada en nuestro medio por su baja incidencia. El objetivo de este artículo es realizar una revisión de las indicaciones actuales de tratamiento de los aneurismas toracoabdominales, así como exponer la vía de abordaje para cirugía abierta, referencias anatómicas y técnicas quirúrgicas y de perfusión más reproducibles en la actualidad. Se expone la técnica quirúrgica paso a paso, así como las estrategias de protección medular y visceral. Por último, se discuten cuáles son resultados postoperatorios de estas técnicas y las alternativas futuras.

  2. Hérnias incisionais no pós-operatório de correção de aneurisma de aorta abdominal Postoperative incisional hernias after open abdominal aortic aneurysm repair

    Directory of Open Access Journals (Sweden)

    Fábio Hüsemann Menezes

    2012-09-01

    Full Text Available CONTEXTO: A incidência de hérnia incisional no pós-operatório da correção aberta de aneurisma de aorta abdominal é alta, variando de 10 a 37% e mais de três vezes mais comum do que em pacientes submetidos à correção para doença obstrutiva aorto-ilíaca. OBJETIVO: Apresentar a incidência de hérnia incisional em um grupo de pacientes acompanhados no pós-operatório da correção aberta de aneurisma de aorta abdominal. MÉTODOS: Série de casos em uma população de 144 pacientes operados por aneurisma de aorta abdominal, entre junho de 1989 e junho de 2010, e que estão em acompanhamento regular no Ambulatório de Moléstias Vasculares. RESULTADOS: O seguimento médio dos pacientes foi de 63 meses (1 a 238. A idade média foi de 67 anos (45 a 91 e o tamanho médio dos aneurismas foi de 6,54 cm. Foram realizadas 130 laparotomias medianas xifo-púbicas e 13 acessos extraperitoniais pelo flanco esquerdo. Nestes pacientes, a incidência de hérnia incisional foi de 18,5 e 7,7%, respectivamente, para incisões na linha média ou no flanco (p=0,315. Um paciente apresentou abaulamento da musculatura oblíqua por denervação. Foi realizada uma laparotomia transversa, que não apresentou hérnia no pós-operatório tardio. CONCLUSÕES: A incidência de hérnia incisional na cirurgia aberta para correção de aneurisma de aorta abdominal é alta, ocorre com maior frequência em incisões da linha média e tem relação direta com a técnica empregada para o fechamento da aponeurose, exigindo do cirurgião atenção especial para este tempo cirúrgico para evitar a causa mais comum de reoperação em tal grupo de pacientes.BACKGROUND: The incidence of incisional hernia in the post operatory of patients submitted to open abdominal aortic aneurysm repair is high, ranging from 10 to 37%, and is more than three times higher than the incidence of hernias in patients operated for aorto-iliac occlusion. OBJECTIVE: To evaluate the incidence of

  3. Aneurismas da artéria e da veia braquial induzidos por uso contínuo de muleta: relato de caso

    Directory of Open Access Journals (Sweden)

    Débora Louise Lopes da Costa

    2017-11-01

    Full Text Available Resumo O aneurisma arterial induzido por uso de muleta é um evento raro, e a associação com aneurismas venosos não está descrita na literatura. Relatamos o caso de uma paciente que, após o uso prolongado dessa órtese, apresentou quadro de isquemia aguda de membro superior secundária à trombose de um aneurisma da artéria braquial, associado ao achado incidental de aneurismas da veia braquial. Embora a principal causa de oclusão arterial aguda de membro superior seja a embolização de fonte cardíaca, deve-se considerar a possibilidade de embolização arterioarterial por aneurismas provocados pelo uso prolongado de muletas. Os aneurismas venosos também devem ser suspeitados, uma vez que podem ser sede de trombos e fonte de êmbolos pulmonares.

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

    Directory of Open Access Journals (Sweden)

    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

  5. 211. Cardiogene profile v2 en aneurisma de aorta torácica familiar. estudio genético y prevención

    OpenAIRE

    Santillán, S.; Cantalapiedra, D.; Pérez-Carbonero, L.; Romera, A.; Fernández-Pedrosa, V.; Collado, C.; Rodríguez de Pablos, R.; Zúñiga-Trejos, S.; Triviño, J.C.; Rosa-Rosa, J.M.; Gil, M.; Miñambres, R.; Felipe, V.; Fernández, P.; Buades, C.

    2012-01-01

    Detectar mutaciones en 13 genes que producen aneurisma de aorta torácica familiar (F-TAAD) a través de secuenciación masiva de genes preseleccionados, para prevenir su ruptura y disminuir mortalidad. Material y métodos: Se ha actualizado un panel de resecuenciación masiva de 90 genes asociados a enfermedades heterogéneas cardíacas que producen muerte súbita. Dentro de este grupo, se han incluido 13 genes que originan F-TAAD: ACTA2, COL3A1, EFEMP2, FBLN5, FBN1, FBN2, MYH11, MYLK, NOTCH1, SL...

  6. Tratamiento endovascular de urgencia con endoprótesis de aneurisma roto disecado de aorta torácica: A propósito de un caso Emergency endovascular treatment with endoprosthesis of ruptured dissected aneurysm of thoracic aorta: Report of one case

    Directory of Open Access Journals (Sweden)

    José Lugo

    2007-12-01

    Full Text Available Los aneurismas de aorta torácica son menos comunes que los aneurismas de aorta abdominal y pueden encontrarse en aorta ascendente, arco aórtico, aorta descendente o en una combinación de estos segmentos. De estos aneurismas el 30% al 40% se originan en la aorta torácica descendente. En los aneurismas de aorta torácica existe una debilidad estructural de la pared de la aorta, que conlleva una dilatación arterial progresiva con eventual ruptura o disección. Aproximadamente, 50% de los aneurismas de aorta torácica son ateroscleróticos y ocurren como resultado de remodelado arterial y dilatación o a raíz de un metabolismo anormal del colágeno. La mayoría de los aneurismas de aorta torácica se descubren por casualidad durante la evaluación de otros problemas médicos. La meta del tratamiento de los aneurismas de aorta torácica, es prevenir la muerte debido a su ruptura. El riesgo de ruptura de los no tratados oscila entre 46% a 74% y la tasa de mortalidad por su ruptura es extremadamente alta. Los aneurismas de gran tamaño, en especial aquellos mayores de 6 cm, son más susceptibles de rupturas que los aneurismas de menor tamaño. El tratamiento endovascular, inicialmente desarrollado para los aneurismas de aorta abdominal, se introdujo en 1992 como una alternativa menos invasiva al tratamiento de cirugía abierta para los aneurismas de la aorta torácica descendente. En la actualidad, el injerto de stent endovascular en la aorta descendente o endoprótesis, recibe mayor atención como alternativa al reparo quirúrgico de los aneurismas de aorta torácica.Thoracic aortic aneurysms are less common than abdominal aortic aneurysms and can be found in ascending aorta, aortic arch, descending aorta or in a combination of these segments. 30% to 40% of these aneurysms are originated in thoracic descending aorta. In thoracic aortic aneurysms there exists a structural wall weakness that leads to a progressive arterial dilation with eventual

  7. Uso da prótese endovascular auto-expansível para tratamento das doenças da aorta torácica descendente

    Directory of Open Access Journals (Sweden)

    STOLF Noedir A. G.

    1998-01-01

    Full Text Available Os autores relatam a experiência com o tratamento de aneurisma e dissecção da aorta descendente associada ou não a comprometimento do arco aórtico com o uso de prótese intraluminal auto-expansível introduzida cirurgicamente através do arco aórtico. Foram operados 11 pacientes, 9 do sexo masculino e com idades variando de 49 a 78 anos. O diagnóstico era de aneurisma em 6, sendo 2 rotos e dissecção em 5, sendo aguda em 2. Quatro doentes apresentavam afecções cirúrgicas associadas: aneurisma de aorta ascendente (1, aneurisma de arco (1, insuficiência coronária (1 e insuficiência da valva aórtica (1. Os pacientes foram operados com colocação de prótese intraluminal auto-expansível cirurgicamente através do arco aórtico sob hipotermia profunda e parada circulatória total. Em 4 pacientes foram realizadas operações associadas: troca da valva aórtica (1, substituição da aorta ascendente (2, troca do arco aórtico (1 e revascularização miocárdica (1. Houve um óbito intra-operatório por dissecção da aorta ascendente e dois óbitos hospitalares por associação de complicações. Oito pacientes tiveram alta sendo que 1 faleceu no terceiro mês de pós-operatório. Os sobreviventes estavam bem clinicamente e o estudo por imagem mostrou adequada correção da doença. Os autores concluem que o uso da prótese intraluminal simplifica e corrige adequadamente as afecções da aorta descendente. A morbimortalidade observada nessa série deve-se a outros fatores independentes da técnica.

  8. Ruptura de aneurismas de aorta abdominal. Herramienta informática para su predicción // Rupture of abdominal aortic aneurysm. Software for its prediction

    Directory of Open Access Journals (Sweden)

    Guillermo Villalta‐Alonso

    2011-01-01

    Full Text Available La ruptura de los aneurismas de aorta abdominal representa un evento clínico muy importantedebido a su alta tasa de mortalidad. Los indicadores empleados actualmente para decidir eltratamiento a pacientes con aneurismas son el diámetro máximo transversal y la tasa de crecimiento,los que pueden ser considerados insuficientes, pues no tienen una base teórica físicamentefundamentada. En el presente artículo se definen los fundamentos para el diseño de una herramientainformática para PC que permita predecir, con suficiente precisión para ser clínicamente relevante, elriesgo de ruptura de aneurismas de aorta abdominal sobre bases personalizadas del paciente. Laherramienta consta de 3 módulos, que están diseñados para procesar toda la información delpaciente e integrarla mediante un modelo que incorpora la interrelación de los factores biomecánicosde diferentes naturalezas (biológicos, estructurales y geométrico y escalas (temporal y dimensional,con el objetivo de calcular un indicador numérico y personalizado del riesgo de ruptura. Estaherramienta debe constituir un elemento auxiliar del facultativo médico en la toma de decisionesrespecto del tratamiento adecuado a pacientes con aneurisma.Palabras claves: AAA, riesgo de ruptura, modelo multiescala, predicción, herramienta informática.___________________________________________________________________AbstractThe rupture of abdominal aortic aneurysm (AAA represents an important clinical event due to its highmortality rate. Currently the criteria to decide on the treatment of AAA patients are the peaktransverse diameter and the growth rate which can be considered insufficient because they have nota reasonable physical base. The foundations for the design of PC software to predict, with sufficientaccuracy to be clinically relevant, the risk of AAA rupture on patient-specific basis are defined in thispaper. The software consists of 3 modules which are designed for processing all

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

    Directory of Open Access Journals (Sweden)

    Domingos Dias Cicarelli

    2001-01-01

    Full Text Available 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 aorta abdominal, sua correlação com o índice de risco cardíaco de Goldman modificado, com alterações no teste do tálio-dipiridamol e os fatores de risco nessa população. MÉTODO: Foram analisados retrospectivamente 65 pacientes submetidos à correção de aneurisma da aorta abdominal e a incidência dos fatores de risco como tabagismo, insuficiência coronariana, hipertensão arterial sistêmica e Diabetes mellitus. Foi analisada a correlação entre a insuficiência coronariana no pré-operatório, o índice de Goldman modificado e as complicações isquêmicas pós-operatórias. Foi avaliada a correlação do teste tálio-dipiridamol pré-operatório e eventos isquêmicos no pós-operatório. RESULTADOS: Cerca de 80% dos pacientes apresentavam antecedente de tabagismo, 55% de hipertensão arterial, 8% de Diabetes mellitus, 25% de insuficiência coronariana. Entre os pacientes com insuficiência coronariana, cinco possuíam angina pré-operatória e apresentaram uma incidência de 40% de isquemia miocárdica no pós-operatório, sendo a incidência de infarto agudo do miocárdio de 6,2%. No nosso estudo, 14% dos pacientes Goldman modificado II e 33% dos pacientes Goldman modificado III apresentaram isquemia miocárdica pós-operatória. Dezesseis pacientes (24% foram submetidos ao tálio dipiridamol no pré-operatório, sendo que 10 (62% apresentaram defeitos de captação cintilográfica. O valor preditivo positivo do exame

  10. Tratamiento endovascular del aneurisma de aorta descendente en el adolescente con síndrome de Marfan. Reporte de un caso

    Directory of Open Access Journals (Sweden)

    Juan G. Barrera, MD

    2012-01-01

    Full Text Available Se expone el caso de un adolescente de 14 años de edad, con síndrome de Marfan y antecedente de tres cirugías cardiovasculares previas: valvuloplastia aórtica y mitral a los cinco años y valvuloplastia aórtica y reconstrucción de la aorta torácica con tubo de pericardio bovino a sus diez años. En primer tiempo quirúrgico se realizó reemplazo valvular aórtico por válvula mecánica y valvuloplastia mitral y tricuspidea, y en segundo tiempo quirúrgico, durante la misma hospitalización, exclusión endovascular de aneurisma de aorta descendente asintomático sin complicaciones. Antes del egreso se diagnosticó una endofuga tipo II que se manejó con observación clínica. Luego de un año del procedimiento, los controles clínico y tomográfico son satisfactorios.

  11. Tratamento microcirúrgico de aneurismas da artéria comunicante anterior

    Directory of Open Access Journals (Sweden)

    Luiz Carlos Mendes Faleiro

    1973-12-01

    Full Text Available Os autores descrevem o tratamento microcirúrgico realizado em oito pacientes que tiveram hemorragia subaracnóidea espontânea por rotura de aneurisma da artéria comunicante anterior. A conduta clínica pré-operatória é apresentada sendo dada ênfase às condições do paciente antes do ato cirúrgico. A técnica cirúrgica é descrita em detalhe, sendo salientado o uso do microscópio binocular. Dos 8 pacientes, dois (25% tinham mais de um aneurisma que foram tratados durante a mesma operação. A única complicação cirúrgica foi meningite pós-operatória em um paciente; esta complicação cedeu completamente ao tratamento. Após a operação 88% dos pacientes retornaram ao seu trabalho, não tendo havido óbito em virtude do tratamento.

  12. Reconstrução da aorta com conduto de pericárdio bovino corrugado

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

  14. Tratamento cirúrgico da dissecção da aorta Surgical treatment of the aortic dissection

    Directory of Open Access Journals (Sweden)

    Marcos Fassheber Berlinck

    1990-04-01

    Full Text Available Entre janeiro de 1979 e dezembro de 1989, foram realizadas 85 operações para o tratamento da dissecção da aorta, sendo 50 na fase aguda e 35 na fase crónica. A mortalidade imediata (hospitalar foi de 21,1% (18 pacientes, tendo como causa principal a síndrome de baixo débito cardíaco. Foi maior nos pacientes operados na fase aguda. Dentre quatro pacientes reoperados por recidiva ou dissecção em outro local, dois faleceram. Com relação à morbidade, uma paciente, reoperada por aneurisma tóraco-abdominal, apresentou paraplegia no período de pós-operatório. O seguimento tardio mostrou boa evolução dos 63 sobreviventes.Between January 1979 and December 1989, eighty five operations were performed to treat aortic dissection, including fifty in the acute phase, and thirty five in a chronic phase. The Hospital mortality was 21.1% (eighteen patients and low cardiac output was the major cause of death. The mortality was higher in the group of patients operated upon in the acute phase. Four patients were operated upon for redissection or dissection in other localization of the aorta, and all of them died. One patient developed paraplegy in the postoperative period. The late follow-up showed good evolution in the survivors group.

  15. Comparison of ultrasonography, computed tomography and magnetic resonance imaging with intraoperative measurements in the evaluation of abdominal aortic aneurysms Comparação entre ultrassonografia, tomografia computadorizada e ressonância nuclear magnética com medidas intra-operatórias na avaliação dos aneurismas de aorta abdominal

    Directory of Open Access Journals (Sweden)

    Francisco das Chagas de Azevedo

    2005-02-01

    angioresonance provided measurements with no significant differences in the statistic view when compared to the intraoperative measures. CONCLUSIONS: Ultrasonography is a reliable method for the diagnosis and follow-up of the aorta abdominal aneurysms, but insufficient for endovascular surgery planning. The conventional computed tomography can provoke distortion in the length measurements of the aorta dilatation. Helical computed tomography and nuclear magnetic angioresonance provided precise measurements of all the studied parameters, being of great utility for surgical planning.OBJETIVO: Estudar os métodos mais freqüentemente empregados na avaliação dos aneurismas de aorta abdominal - ultrassonografia, tomografia computadorizada convencional, tomografia computadorizada helicoidal e angio-ressonância nuclear magnética - comparando as medidas fornecidas por estes exames radiológicos no pré-operatório com medidas realizadas durante a operação. MÉTODO: Foram incluídos no estudo pacientes portadores de aneurisma da aorta abdominal com indicação de tratamento cirúrgico eletivo por via transperitoneal. O diagnóstico inicial da dilatação aórtica foi feito com ultra-sonografia e, uma vez indicado o tratamento cirúrgico, era então solicitado um outro exame radiológico complementar, já que não é nossa rotina operar esses pacientes com base apenas na ultra-sonografia. Sessenta pacientes foram divididos em 3 grupos de acordo com o exame complementar realizado (tomografia computadorizada convencional, tomografia computadorizada helicoidal ou angio-ressonância nuclear magnética. As ultra-sonografias dos 20 primeiros pacientes foram incluídas em um 4° grupo. Analisamos neste estudo as medidas do colo proximal da aorta, o diâmetro transverso máximo e o comprimento do aneurisma, além do diâmetro transverso das artérias ilíacas comuns conseguidos a partir dos exames radiológicos. As mesmas medidas eram realizadas por ocasião da operação com o auxílio de

  16. Aortocaval fistula: an infrequent complication of aneurysm of the abdominal aorta; Fistula aortocava: complicacion infrecuente tras rotura de aneurisma de aorta abdominal

    Energy Technology Data Exchange (ETDEWEB)

    Alpera, R.; Ardoy, F.; Gallego, J. A.

    2002-07-01

    A case is reported of aortocaval fistula (ACF) as an infrequent complication of an aneurysm of the abdominal aorta (AAA) that debuted clinically with pain in the right lumbar fossa and kidney failure. the diagnosis was made by helicoid computed tomography (HCT) and confirmed surgery. HCT findings consisted of an early accentuation of the inferior vena cava (ICV) in the arterial phase, and visualization of the communication between the aorta and inferior vena cava. (Author) 8 refs.

  17. 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

    Directory of Open Access Journals (Sweden)

    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

  18. Tratamiento endovascular del aneurisma de aorta descendente en el adolescente con síndrome de Marfan: Reporte de un caso Endovascular treatment of an aneurysm of the descending aorta in an adolescent with Marfan syndrome

    Directory of Open Access Journals (Sweden)

    Juan G Barrera

    2012-01-01

    Full Text Available Se expone el caso de un adolescente de 14 años de edad, con síndrome de Marfan y antecedente de tres cirugías cardiovasculares previas: valvuloplastia aórtica y mitral a los cinco años y valvuloplastia aórtica y reconstrucción de la aorta torácica con tubo de pericardio bovino a sus diez años. En primer tiempo quirúrgico se realizó reemplazo valvular aórtico por válvula mecánica y valvuloplastia mitral y tricuspidea, y en segundo tiempo quirúrgico, durante la misma hospitalización, exclusión endovascular de aneurisma de aorta descendente asintomático sin complicaciones. Antes del egreso se diagnosticó una endofuga tipo II que se manejó con observación clínica. Luego de un año del procedimiento, los controles clínico y tomográfico son satisfactorios.We describe the case of a 14-year-old adolescent with Marfan syndrome and a history of three previous cardiovascular surgeries: aortic and mitral valve replacement at the age of 5 and aortic valve replacement and reconstruction of the thoracic aorta with a tube of bovine pericardium at the age of ten. In the first surgical procedure the aortic valve was replaced by a mechanical valve, and mitral and tricuspid valvuloplasty was performed. In a second surgical procedure during the same hospitalization, endovascular exclusion of the asymptomatic descending aortic aneurysm was realized without complications. Before discharge, a type II endoleak was diagnosed and managed through clinical observation. After a year of the procedure, clinical and tomographic controls are satisfactory.

  19. Plasmatic vasopressin in patients undergoing conventional infra-renal abdominal aorta aneurysm repair Vasopressina plasmática em pacientes submetidos à correção de aneurisma de aorta infrarrenal

    Directory of Open Access Journals (Sweden)

    Adriana Camargo Carvalho

    2011-09-01

    Full Text Available OBJECTIVES: To evaluate plasmatic arginine vasopressin (AVP levels in patients undergoing scheduled conventional abdominal aortic aneurysm (AAA repair. METHODS: Plasmatic AVP concentrations were measured by radioimmunoassay in 22 non-consecutive adult patients undergoing infra-renal AAA repair. They were under combined general and epidural anesthesia at the following time frames: 1 - pre-operative (T0; 2 - 2h (T1 and 6h (T2 after the surgical procedure; 3 - in the morning at the first (T3, second (T4 and third (T5 post-operative days. Some clinical and laboratory variables were also recorded. RESULTS: The mean age of patients was 68±10 years; 17 were males. Plasmatic AVP (mean±SD; pg/mL was within the normal range at T0 (1.4±0.7; baseline, increasing significantly at T1 (62.6±62.9; POBJETIVOS: Avaliar os níveis plasmáticos de vasopressina (AVP em pacientes submetidos à correção convencional de aneurisma de aorta abdominal (AAA. MÉTODOS: A AVP plasmática foi mensurada por radioimunoensaio em 22 pacientes não-consecutivos submetidos à correção eletiva de AAA infrarrenal sob anestesia geral + epidural nos seguintes momentos: pré-operatório (T0; 2h (T1 e 6h (T2 após a cirurgia; e nas manhãs do primeiro (T3, segundo (T4 e terceiro (T5 dia pós-operatório (PO. Variáveis clínicas e laboratoriais de interesse também foram anotadas. RESULTADOS: A média de idade dos pacientes foi de 68±10 anos, sendo 17 homens. A AVP plasmática (média±DP; pg/ mL estava dentro de limites normais no T0 (1,4±0,7; basal, aumentando no T1 (62,6±62,9; P<0,001 e no T2 (31,5±49,7; P<0,001, e retornando aos valores basais no T5 (2,1±3,8; P=NS. Correlações positivas e significativas foram encontradas entre a AVP e glicemia, lactato sérico e leucócitos sanguíneos, mas não com a pressão arterial sistêmica ou com a osmolaridade plasmática no PO. CONCLUSÕES: Na cirurgia de reparação de AAA, considerando que nenhuma correlação foi encontrada

  20. Valva aórtica bicúspide: fundamentos teóricos e clínicos para substituição simultânea da aorta ascendente

    OpenAIRE

    Sá,Mauro Paes Leme De; Bastos,Eduardo Sergio; Murad,Henrique

    2009-01-01

    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...

  1. Aneurisma degenerativo da artéria carótida interna associado a disfagia Degenerative carotid aneurysm presented with disphagia

    OpenAIRE

    Luís Silvestre; Ruy Fernandes e Fernandes; José L. Giménez; Artur Costa e Silva; Luísa Biscoito; Sérgio Cardoso; Luís Mendes Pedro

    2010-01-01

    Os aneurismas do segmento extracraniano da carótida interna são lesões raras, de etiologia diversa e relativamente aos quais o conhecimento actual tem resultado da publicação de pequenas séries e casos clínicos isolados. Apresenta-se o caso de uma doente com um aneurisma degenerativo da carótida interna que foi submetida a tratamento cirúrgico e discute-se o quadro clínico e a estratégia terapêutica adoptadaAtherosclerotic extracranial internal carotid aneurysms are a rare entity and have div...

  2. Aneurisma da artéria cerebelar ântero-inferior: relato de caso Aneurysm of the anterior inferior cerebellar artery: case report

    Directory of Open Access Journals (Sweden)

    Juan Oscar Alarcón Adorno

    2002-12-01

    Full Text Available Os aneurismas intracranianos do sistema vértebro-basilar representam cerca de 5 a 10% de todos os aneurismas cerebrais. Os aneurismas da artéria cerebelar ântero-inferior (AICA são considerados raros, podendo causar síndrome do ângulo ponto cerebelar, com ou sem hemorragia subaracnóidea. Desde 1948, foram descritos poucos casos na literatura. Apresentamos o caso de uma paciente, de 33 anos, na qual, após investigação de quadro de hemorragia subaracnóidea, diagnosticou-se aneurisma sacular da AICA esquerda. Foi submetida a clipagem do aneurisma, com ótimo resultado pós operatório.The intracranial aneurysms of the posterior circulation have been reported between 5 and 10% of all cerebral aneurysms and the aneurysms of the anterior inferior cerebellar artery (AICA are considered rare, can cause cerebello pontine angle (CPA syndrome with or without subarachnoid hemorrhage. Since 1948 few cases were described in the literature. We report on a 33 year-old female patient with subarachnoid hemorrhage due to sacular aneurysm of the left AICA. She was submitted to clipage of the aneurysm without complications.

  3. Existen ventajas en el abordaje extraperitoneal para el tratamiento del aneurisma de aorta abdominal? Are there advantages in the extraperitoneal approach for the treatment of abdominal aortic aneurysm?

    Directory of Open Access Journals (Sweden)

    Heinz Hiller

    2010-02-01

    Full Text Available Existen controversias acerca de las posibles ventajas del abordaje transperitoneal vs. extraperitoneal en la cirugía de aneurisma de aorta abdominal; con este último, algunos estudios reportan menor morbilidad y complicaciones operatorias. Este estudio describe los resultados que se obtuvieron con los dos abordajes en un solo centro de referencia. Es un estudio retrospectivo, descriptivo, de doce años, en un grupo de 299 pacientes con diagnóstico de aneurisma de aorta abdominal que fueron intervenidos de manera electiva y distribuidos en dos grupos según el abordaje (transperitoneal = grupo 1, extraperitoneal = grupo 2. En total se operaron 93 pacientes en el grupo 1 y 206 pacientes en el 2. En ambos predominaron pacientes del sexo masculino. La edad media fue de 68 años. Las frecuencias de co-morbilidades fueron similares en los dos grupos. Se registró una tendencia a menor número de reoperaciones en el grupo 2 (12,9% vs. 5,8%, De otra parte, se observó una tendencia de mayores complicaciones post-operatorias en el grupo 1 con una frecuencia de 30,1% vs. 12,6% en el grupo 2; sin embargo, el tipo de complicaciones fue similar. Los resultados mostraron una estancia hospitalaria media de 13,3 días (DE ± 10,4 vs. 7,19 días (DE ± 4,20 p= 0,00001, estancia post-operatoria media de 9,16 días (DE ± 8,1 vs. 5,62 días (DE ± 3,46 p= 0,001 y estancia en la unidad de cuidados intensivos media de 2,76 días (DE ± 4,19 vs. 1,56 días (DE ± 1,86 p= 0,00001 en los grupos 1 y 2 respectivamente. La mortalidad inmediata total fue de 3,3%. La frecuencia de mortalidad para los grupos fue de 6,5% (n= 6 vs. 1,9% (n= 4 respectivamente. En nuestra experiencia el abordaje por la vía extraperitoneal presenta una tendencia favorable para los pacientes en cuanto a la estancia hospitalaria, la estancia en la unidad de cuidados intensivos, la frecuencia de complicaciones post-operatorias y la frecuencia de re-intervenciones en el post-operatorio inmediato

  4. Aneurismas de la aorta toracoabdominal: guías de indicación quirúrgica y manejo intra y postoperatorio

    Directory of Open Access Journals (Sweden)

    Juan Francisco Nistal Herrera

    2007-10-01

    El presente documento contiene información resumida y actualizada acerca de las características clínicas y anatómicas de los aneurismas toracoabdominales, su historia natural, indicaciones quirúrgicas y manejo pre, intra y postoperatorio, prestando atención especial a aquellos aspectos relacionados con el desarrollo de complicaciones postoperatorias.

  5. Aneurisma da artéria carótida interna extracraniana: relato de caso Aneurysm of the extracranial internal carotid artery: a case report

    Directory of Open Access Journals (Sweden)

    Marcio Ricardo Taveira Garcia

    2004-08-01

    Full Text Available Os aneurismas verdadeiros da artéria carótida interna extracraniana são raros, ao contrário dos supraclinóideos, somando menos de 4% dos aneurismas periféricos. Eles se apresentam clinicamente como massas palpáveis cervicais, junto à margem inferior do ângulo da mandíbula, causando rouquidão, disfagia e dor por compressão nervosa. Há freqüente associação desta doença com outros aneurismas periféricos devido à sua etiologia principal (aterosclerose. Os aneurismas periféricos são comumente identificados à ultra-sonografia Doppler, quando na vigência de janela acústica adequada. Nesta situação, os aneurismas podem ser avaliados tanto morfológica como hemodinamicamente. Sua identificação e estudo são importantes para prevenir graves complicações, como tromboses, infartos maciços ou embólicos da área correspondente no sistema nervoso central, ruptura e dissecção, além de auxiliar na indicação da melhor conduta terapêutica.Unlike supraclinoid aneurysms, true aneurysms of the extracranial internal carotid artery are extremely rare (less than 4% of the peripheral aneurysms. The commonest presentation is a pulsatile neck swelling below the angle of the jaw associated with hoarseness, dysphagia and pain (neural compression. Concomitance with other peripherical aneurysms is frequent and caused by atherosclerosis. The morphological and hemodynamic features are very well evaluated by Doppler ultrasound, when the acoustic window is satisfactory. Identification and evaluation of these aneurysms are very important to prevent thrombosis, rupture, dissections, massive strokes and embolic brain infarcts, besides helping in the decision of the best treatment.

  6. 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

    Directory of Open Access Journals (Sweden)

    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.

  7. Tratamiento endovascular de las patologías de aorta -Estado del arte-: Parte 1 - Aneurismas de aorta abdominal Endovascular treatment of aortic pathologies -State of the art-: Part 1 - Aneurysms of abdominal aorta

    Directory of Open Access Journals (Sweden)

    Carlos E Uribe

    2007-12-01

    Full Text Available En la actualidad, el tratamiento endovascular de las patologías de aorta es una alternativa a la cirugía abierta. Éste ha demostrado ser seguro ya que arroja resultados iguales o superiores que el grupo quirúrgico. En este artículo se presenta el estado actual del tratamiento con endoprótesis de las patologías de aorta, así como las indicaciones, las contraindicaciones y el futuro del tratamiento con este tipo de dispositivos.Endovascular treatment of aortic pathologies is actually an alternative to open surgery. It has proven to be safe, showing similar or better results to those achieved by surgery. In this article, treatment of aortic pathologies by means of endoprosthesis is presented, as well as its indications, contraindications and future treatment with this kind of devices.

  8. Tratamento endoluminal de aneurismas anastomóticos na aorta abdominal: relato de dois casos Endovascular treatment of abdominal aortic anastomotic aneurysms: report of two cases

    Directory of Open Access Journals (Sweden)

    Ricardo Aun

    2006-03-01

    Full Text Available Os aneurismas anastomóticos que envolvem a anastomose proximal de reconstruções do território aorto-ilíaco são graves, e as operações convencionais para sua correção são complexas e passíveis de graves complicações. Apresentamos dois casos de aneurismas de anastomoses proximais de enxerto aorto-bifemoral que ocorreram após 15 e 18 anos, respectivamente, de evolução dos enxertos e que foram corrigidos pela técnica endoluminal. Ambos os pacientes evoluíram bem e foram submetidos a controle pela tomografia computadorizada com 12 e 6 meses de evolução, respectivamente, com exclusão do aneurisma.Proximal anastomosis aneurysm is a rare and severe complication in aortofemoral bypass surgery. Surgical treatment is complex and has a high morbidity and mortality rate. We report two cases of proximal anastomosis aneurysm in late follow up of aortobifemoral bypass surgery, which occurred 15 and 18 years, respectively, after the bypasses and were repaired by the endovascular technique. Both patients progressed well and were submitted to 6- and 12-month follow-up CT scans showing aneurysm exclusion.

  9. 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

    Directory of Open Access Journals (Sweden)

    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

  10. Aneurisma degenerativo da artéria carótida interna associado a disfagia Degenerative carotid aneurysm presented with disphagia

    Directory of Open Access Journals (Sweden)

    Luís Silvestre

    2010-12-01

    Full Text Available Os aneurismas do segmento extracraniano da carótida interna são lesões raras, de etiologia diversa e relativamente aos quais o conhecimento actual tem resultado da publicação de pequenas séries e casos clínicos isolados. Apresenta-se o caso de uma doente com um aneurisma degenerativo da carótida interna que foi submetida a tratamento cirúrgico e discute-se o quadro clínico e a estratégia terapêutica adoptadaAtherosclerotic extracranial internal carotid aneurysms are a rare entity and have diverse etiologies. Comprehensive information about these lesions is difficult to obtain and has resulted from the publication of small series and isolated clinical reports. The authors report the case of an atherosclerotic carotid aneurysm submitted to surgical treatment and discuss the clinical presentation and surgical strategy.

  11. Dissecção espontânea da aorta abdominal infrarrenal Spontaneous dissection of the infrarenal aorta

    Directory of Open Access Journals (Sweden)

    Otacílio de Camargo Junior

    2012-09-01

    Full Text Available A rotura da camada íntima que marca o início da dissecção aórtica se origina na maioria dos casos na aorta torácica, sendo rara a dissecção espontânea da aorta abdominal infra-renal. As três principais causas são: iatrogênica, traumática ou espontânea. A dor abdominal e a isquemia de membros são os sintomas mais comuns e um número significativo de pacientes e´ assintomatico. O diagnóstico tem sido feito através de métodos de imagem como ultrassonografia, tomografia computadorizada, ressonância nuclear magnética e angiografia aliados ao alto índice de suspeição. Relatamos os casos de duas pacientes que apresentaram dissecção de aorta abdominal infrarrenal com quadro de dor abdominal súbita, sem sinais de irritação peritoneal com pulsos presentes e simétricos ao exame físico que deram entrada no pronto socorro do Hospital e Maternidade Celso Pierro da PUC Campinas e que foram tratadas pela equipe de Cirurgia Vascular. As duas pacientes no momento do exame apresentavam-se hipertensas e ao ultrassom apresentavam alteração da conformidade da aorta abdominal que foram tratada s cirurgicamente. Uma paciente foi tratada cirurgicamente submetida a endarterectomia da placa dissecada da aorta abdominal infrarrenal de 2,2 cm de diâmetro e 2,0 cm de extensão. A outra paciente foi submetida a revascularização da aorta abdominal bi-iliaca com prótese de Dacron 16 × 8 mm por apresentar disseccao da aorta abdominal distal. As duas pacientes apresentaram boa evolução pos-operatoria tendo alta hospitalar em bom estado geral.The rupture of the intimal layer marks the beginning of the aortic dissection, which usually happens in the thoracic aorta. The spontaneous dissection of the infrarenal aorta is rare. The main causes are: iatrogenic, traumatic and spontaneous. Abdominal pain and limb ischemia are the commonest symptoms, and some patients are asymptomatics. The diagnosis is made by ultrasound, computed tomography

  12. Aneurisma venoso no pé: relato de casos e revisão da literatura Venous aneurysm of the foot: case reports and review of the literature

    Directory of Open Access Journals (Sweden)

    Octavio Cascaes Dourado

    2006-12-01

    Full Text Available Este relato descreve dois casos de aneurisma venoso no pé, apresentados sob a forma de tumoração indolor e não-pulsátil no dorso do pé e sem história de trauma. O ultra-som Doppler evidenciou formação ovalada, anecóica, em comunicação com a veia e com sinal Doppler venoso, sugestiva de aneurisma venoso. O diagnóstico foi confirmado pelo exame histopatológico, com dilatação aneurismática constituída pelos três componentes da parede da veia. O tratamento consistiu na ligadura e ressecção cirúrgica. Os aneurismas venosos são relativamente raros, havendo relato de sua presença em várias localizações, principalmente nos membros inferiores. Na revisão da literatura, não foram encontrados relatos de aneurismas venosos no pé.We report two cases of venous aneurysms of the foot, presented as a nonpulsatile, painless mass on the back of the foot, with no history of trauma. Doppler ultrasonography showed an anechoic, oval mass communicating with the vein and venous signal suggestive of venous aneurysm. The diagnosis was confirmed by histopathologic analysis, with aneurysmal dilatation involving the three layers of the venous wall. The treatment consisted of ligation and surgical excision. Venous aneurysms are relatively rare, and their presence has been reported in many locations, particularly in the lower limbs. Any venous aneurysms of the foot were found in the review of the literature.

  13. 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

    Directory of Open Access Journals (Sweden)

    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

  14. 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

    Directory of Open Access Journals (Sweden)

    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

  15. Cefaléia sentinela: sinal de alerta da hemorragia subaracnóidea por ruptura de aneurisma intracraniano

    OpenAIRE

    Guescel C. Asano, Amdore

    2006-01-01

    A cefaléia é uma queixa de alta prevalência no mundo. Dentre as várias causas de cefaléia, a hemorragia subaracnóidea por ruptura de aneurisma é uma das mais importantes pela sua elevada taxa de morbidade e mortalidade. Cerca de um terço dos pacientes com hemorragia subaracnóidea por ruptura de aneurisma apresenta um episódio de cefaléia, não usual, de início súbito e forte intensidade, precedendo horas, dias, semanas e meses a hemorragia subaracnóidea, que corresponde a um san...

  16. Aneurisma de artéria femoral superficial roto: relato de caso e revisão de literatura Ruptured superficial femoral artery aneurysm: case report and literature review

    Directory of Open Access Journals (Sweden)

    Alexandre Faraco de Oliveira

    2009-09-01

    Full Text Available O aneurisma de artéria femoral superficial é um evento raro que costuma manifestar-se em pacientes com idade avançada, frequentemente associado a outros aneurismas, periféricos ou de aorta abdominal. O caso relatado refere-se a um paciente cujo aneurisma de artéria femoral superficial se apresentou roto e associado a um aneurisma de aorta abdominal. Foi submetido à revascularização cirúrgica fêmoro-poplítea mediante prótese de politetrafluoretileno, com sucesso. A revisão da literatura demonstra que embora haja uma tendência à manifestação aguda da doença, principalmente como ruptura, os resultados com o tratamento cirúrgico são excelentes.Superficial femoral artery aneurysm is rare and usually occurs in elderly patients, often associated with peripheral or abdominal aortic aneurysms. In the reported case, the patient presented with a ruptured superficial femoral artery aneurysm associated with an abdominal aortic aneurysm. A successful femoropopliteal bypass was performed using a polytetrafluorethylene graft. Literature review shows that, despite the tendency for acute onset of the aneurysm, primarily with a rupture, surgical results are excellent.

  17. Impacto da mortalidade da doença da aorta torácica no estado de São Paulo no período de 1998 a 2007

    Directory of Open Access Journals (Sweden)

    Ricardo Ribeiro Dias

    2013-12-01

    Full Text Available FUNDAMENTO: Ainda não foram analisadas as características epidemiológicas das doenças da aorta torácica (DAT no estado de São Paulo e no Brasil, assim como o seu impacto na sobrevida desses pacientes. OBJETIVOS: Avaliar o impacto da mortalidade das DAT e caracterizá-la epidemiologicamente. MÉTODOS: Análise retrospectiva dos dados do Sistema Único de Saúde para os códigos de DAT do registro de internações, de procedimentos e dos óbitos, a partir do Código Internacional de Doenças (CID-10, registrados na Secretaria de Saúde do Estado de São Paulo durante o período de janeiro de 1998 a dezembro de 2007. RESULTADOS: Foram 9.465 óbitos por DAT, 5.500 homens (58,1% e 3.965 mulheres (41,9%; 6.721 dissecções (71% e 2.744 aneurismas, 86,3% diagnosticados no IML. Foram 6.109 internações, 67,9% do sexo masculino, sendo que 21,2% evoluíram a óbito (69% homens, com proporções semelhantes de dissecção e aneurisma entre os sexos, respectivamente 54% e 46%, porém com mortalidade distinta. Os homens com DAT morrem mais que as mulheres (OR = 1,5. A distribuição etária para óbitos e internações foi semelhante, com predomínio na sexta década. Foram 3.572 operações (58% das internações com mortalidade de 20,3% (os pacientes mantidos em tratamento medicamentoso apresentaram mortalidade de 22,6%; p = 0,047. O número de internações, de cirurgias, de óbitos dos pacientes internados e geral de óbitos por DAT foi progressivamente superior ao aumento populacional no decorrer do tempo. CONCLUSÕES: Atuações específicas na identificação precoce desses pacientes, assim como a viabilização do seu atendimento, devem ser implementadas para reduzir a aparente progressiva mortalidade por DAT imposta à nossa população.

  18. Resultados imediatos e tardios da correção do aneurisma do ventrículo esquerdo Early and late results of surgical correction of left ventricle aneurysms

    Directory of Open Access Journals (Sweden)

    Jarbas J Dinkhuysen

    1993-09-01

    Full Text Available Foram analisados 305 casos operados entre janeiro de 1984 e dezembro de 1991, abrangendo os resultados imediatos e a evolução tardia, de 8 meses a 8,5 anos de pacientes operados de aneurisma do VE. A evolução clínica a longo prazo foi integral, isto é, todos os pacientes que receberam alta hospitalar foram acompanhados. A maioria (88,5% era masculina, com idade entre 33 e 78 anos, sendo que 46% dos pacientes se situavam entre 51 e 60 anos. O sintoma mais freqüente foi dor precordial (73,3%, insuficiência cardíaca (45,9% e arritmias (24,9%. Quanto à classe funcional (NYHA 54% dos pacientes estavam na classe 1,52% na classe II, 12,7% na classe III e 28,7% na classe IV, respectivamente. O estudo hemodinâmico revelou aneurisma e deiscência em todos os casos e com lesão coronária obstrutiva em 1 vaso em 20,9% dos pacientes, 2 vasos em 45,9%, 3 vasos em 25,9% e, finalmente, 4 ou mais vasos em 7,2% dos casos. De acordo com a fração de ejeção das porções contrateis do VE foram divididos em Grupo Bom (Fe = 0,58 34,7% pacientes, Grupo Regular (Fe = 0,35 54,7% pacientes e Grupo Ruim (Fe = 0,22 10,4% pacientes. A técnica cirúrgica empregada foi a de corrigir com auxílio da CEC, o aneurisma, com o coração batendo, de maneira a permitir avaliação funcional das áreas contrateis versus fibrose, reconstruir a anatomia contrátil da melhor forma possível e preservar o miocárdio em condições fisiológicas durante o procedimento. Em casos selecionados, logo após a abertura do aneurisma e remoção dos trombos intracavitários, eram revascularizadas as artérias coronárias interessadas através de pinçamentos intermitentes, da aorta (32ºC, deixando-se a reconstrução da cavidade para o final do procedimento. A aneurismectomia isolada foi o único procedimento em 21,3% dos casos, associados a RM em 77,3% e a outros procedimentos em 1,3%. A mortalidade hospitalar global foi de 6,2% sendo de 2,8% no Grupo Bom, 2,9% no Grupo Regular

  19. Diagnóstico dos aneurismas cerebrais por angiotomografia tridimensional

    Directory of Open Access Journals (Sweden)

    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.

  20. Dissecção espontânea da aorta abdominal infrarrenal

    OpenAIRE

    Camargo Junior,Otacílio de; Chrispim,Antonio Cláudio Guedes; Simões,Claudio Roberto Cabrini; Marcondes,Márcia Fayad; Abreu,Guilherme Camargo Gonçalves de; Meirelles,Guilherme Vieira; Moraes,Kelly Cristina de; Freitas,Marcio Villar de; Araújo,Marivan Pedra; Murta,Gustavo Braga

    2012-01-01

    A rotura da camada íntima que marca o início da dissecção aórtica se origina na maioria dos casos na aorta torácica, sendo rara a dissecção espontânea da aorta abdominal infra-renal. As três principais causas são: iatrogênica, traumática ou espontânea. A dor abdominal e a isquemia de membros são os sintomas mais comuns e um número significativo de pacientes e´ assintomatico. O diagnóstico tem sido feito através de métodos de imagem como ultrassonografia, tomografia computadorizada, ressonânci...

  1. Correção endovascular da aorta ascendente associada a implante de stents coronários

    OpenAIRE

    Saadi, Eduardo Keller; Moura, Leandro de; Zago, Alexandre do Canto; Zago, Alcides José

    2011-01-01

    Endovascular treatment of ascending aorta pseudoanerysms with coronary stents implantation at the same procedure was feasable, although longer followup is necessary.Tratamento endovascular de pseudoaneurismas da aorta ascendente com o implante de stents coronários no mesmo procedimento foi factível, embora seja necessário um maior seguimento.

  2. Reparación de los aneurismas rotos de la aorta abdominal utilizando oclusión intraluminal con balón y circuito de circulación extracorpórea

    Directory of Open Access Journals (Sweden)

    Fernando Calleja

    2009-09-01

    Conclusiones: La oclusión intraaórtica con balón permite control rápido y seguro del cuello del aneurisma. La utilización de la circulación extracorpórea ayuda al restablecimiento rápido de la volemia, de la hemodinámica del paciente y a mantener un campo operatorio sin sangre evitando disecciones innecesarias. Consideramos una notable mejoría de la mortalidad.

  3. Avaliação do posicionamento da aorta em pacientes com escoliose idiopática do adolescente

    Directory of Open Access Journals (Sweden)

    Guilherme Augusto Foizer

    2013-01-01

    Full Text Available OBJETIVO: Avaliar o posicionamento da aorta em pacientes com escoliose. MÉTODOS: Foram realizados exames de imagem em pacientes ambulatoriais com escoliose idiopática do adolescente e em um grupo formado por pacientes hígidos, sendo analisados seis parâmetros: comprimento do corpo vertebral, largura, distância aorta-corpo, diâmetro da aorta, distância aorta-canal e ângulo corpo-aorta. RESULTADOS: As curvas variaram entre T3 e L2 com ângulos de Cobb de 46° e 114°. Pela classificação de Lenke os tipos 1AN e 1BN ocorreram em 20% dos casos, além de 1CN, 3BN, 3C+ com 13,3 % e 1B+, 3C- com 6,7 %. As vértebras próximas ao ápice da curva no grupo escoliose apresentam valores superiores às do grupo controle (em T8 com média de 86,93° no grupo escoliose e média 49,07 no grupo controle (p < 0,0001. CONCLUSÃO: Quanto mais próximo do ápice da deformidade, maior a póstero-lateralização da aorta.

  4. Rotura espontânea de aneurisma da artéria cólica média Spontaneous rupture of aneurysm of the middle colic artery

    Directory of Open Access Journals (Sweden)

    Samuel Moraes Ielo

    2009-12-01

    Full Text Available INTRODUÇÃO: Os aneurismas que envolvem os ramos principais da artéria mesentérica superior são incomuns e entre eles encontra-se uma situação rara: o aneurisma da artéria cólica média. Embora pouco frequente, é um importante grupo de doença vascular, pois boa parte destes é diagnosticada em emergências cirúrgicas. RELATO DO CASO: Descreve-se um caso de aneurisma roto de artéria cólica média em paciente jovem e hígida do sexo feminino, diagnosticado no intra-operatório de laparotomia exploradora frente a um quadro de dor abdominal e diarréia que evoluiu subitamente para abdome agudo e choque. Realizou-se a ligadura desta artéria com controle efetivo da hemorragia, sem comprometimento identificável macroscopicamente de irrigação ou viabilidade do cólon transverso ou demais segmentos colônicos. Apesar do sucesso do tratamento cirúrgico, a paciente evolui para óbito no 12º. dia pós-operatório por complicações hemorrágicas do sistema nervoso central. CONCLUSÃO: A provável causa do aneurisma da artéria cólica média envolve a mediólise segmentar idiopática na qual se observa processo degenerativo da camada média.BACKGROUND: Aneurysms of the superior mesenteric artery branches are uncommon, even among them colic artery aneurysms are rare. These aneurysms are usually asymptomatic, but rupture, thrombosis and distal embolization have been reported like complications. CASE REPORT: A case of a 45-year-old female patient with spontaneous rupture of an aneurysm of middle colic artery, which was diagnosed at exploratory laparotomy, is presented. The patient suddenly developed severe abdominal pain and shock. The aneurysm was completely resected at surgery. Therefore the bleeding could be successfully managed with surgery, but the patient died with post-operative complications. CONCLUSION: In this case, the aneurysm of middle colic artery was probably resulting from idiopatic segmental mediolysis.

  5. 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

    Directory of Open Access Journals (Sweden)

    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

  6. Úlceras penetrantes aórticas múltiples y aneurisma torácico descendente

    Directory of Open Access Journals (Sweden)

    María Bueno

    2006-01-01

    Full Text Available Las úlceras penetrantes de aorta (UPA están causadas por ruptura de una placa aterosclerótica. Asociadas a hematoma intramural, son equivalentes a una disección. Evolucionan a disección, ruptura y aneurismas. Varón de 78 años con antecedentes de hipertensión y neoplasia de colon intervenida con enfermedad residual. En la TC de control aparece imagen de aneurisma de aorta torácica descendente. La RM muestra UPA y aneurisma (Fig. 1. Se realizó tratamiento endovascular por vía femoral y anestesia general, monitorizando la presión del líquido cefalorraquídeo. Se excluyeron el aneurisma y las úlceras (Fig. 2. Fue dado de alta en 48 h.

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

    Directory of Open Access Journals (Sweden)

    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

  8. Origem anômala da artéria pulmonar direita em aorta ascendente (hemitruncus Anomalous origin of right pulmonary artery from ascending aorta (hemitruncus

    Directory of Open Access Journals (Sweden)

    Ivan Romero Rivera

    1998-05-01

    Full Text Available A origem da artéria pulmonar direita em aorta ascendente é uma anomalia congênita rara, com poucos casos descritos na literatura. Descrevemos dois casos desta malformação, um associado à interrupção de arco aórtico tipo B. Em ambos, o diagnóstico foi realizado mediante ecocardiografia bidimensional, com confirmação angiográfica em um. A origem da artéria pulmonar direita era próxima à valva aórtica, anomalia patogeneticamente diferente da origem perto da artéria inominada.The origin of the right pulmonary artery from the ascending aorta is a rare congenital anomaly, with very few reports in the literature. We describe two cases of this rare malformation, one of them, associated with interruption of the aortic arch (type B. In both cases, the diagnosis was made by two-dimensional echocardiography, with angiographic confirmation in one of them. The origin of the right pulmonary artery was close to the aortic valve, anomaly pathogenetically distinct from the type that arises close to the innominate artery.

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

    Directory of Open Access Journals (Sweden)

    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

  10. Spontaneous thrombosis of internal carotid artery: a natural history of giant carotid cavernous aneurysms Trombose espontânea da artéria carótida interna: a história natural dos aneurismas gigantes intracavernosos

    Directory of Open Access Journals (Sweden)

    Lucas Perez de Vasconcellos

    2009-06-01

    Full Text Available OBJECTIVE: To describe five cases of giant carotid cavernous aneurysms which evolved with spontaneous thrombosis of internal carotid artery (STICA, with emphasis at epidemiology, clinical presentation, natural history, related factors and neurological outcome. METHOD: There were 711 consecutives patients with 802 aneurysms with and without surgical treatment during a period of 19 years. We selected 35 patients with 40 carotid cavernous aneurysms (5% of which 20 (50% were giant aneurysms. Among those cases, 5 patients evolved with STICA (25%. Symptoms and findings at presentation were recorded and compared with those at outcome. RESULTS: Clinical presentation was commonly related to atherosclerotic factors such as elevated blood pressure (80%, diabetes mellitus (40% and dislipidemy (40%. All patients presented with hemicranial headache, ophthalmparesy and retro bulbar pain, and after STICA all presented improvement of symptoms. After STICA, 4 patients had regression of deficit, 2 partial and 2 complete. Four patients had sensorial trigeminal neuropathy in V1 and V2 territories, also showing improvement of symptoms after STICA. CONCLUSION: STICA is a common outcome in giant carotid cavernous aneurysms, and is related with significant improvement of symptoms; however, it may be catastrophic for those patients without efficient collateral circulation.OBJETIVO: Relatar cinco casos de aneurismas gigantes intracavernosos que evoluíram com trombose espontânea da artéria carótida interna (TEACI, estudando-se: prevalência, apresentação clínica, história natural, fatores associados e prognóstico neurológico. MÉTODO: Análise de 711 pacientes consecutivos com diagnóstico de 802 aneurismas cerebrais submetidos a tratamento clínico ou cirúrgico num período de 19 anos. Foram identificados 40 aneurismas intracavernosos, sendo que 20 desses eram gigantes. Dentre esses, 5 pacientes com aneurismas gigantes intracavernosos que evoluíram com TEACI

  11. 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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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

  13. Tratamiento quirúrgico de un aneurisma micótico en paciente con riñón en herradura por vía retroperitoneal

    Directory of Open Access Journals (Sweden)

    Ricardo Muñoz-García

    2013-01-01

    Full Text Available Presentamos el caso de un paciente de 73 años diagnosticado de un aneurisma de aorta abdominal micótico que presenta un riñón en herradura. El paciente fue intervenido por vía retroperitoneal, realizándose resección del aneurisma, con postoperatorio irregular, pero finalmente siendo dado de alta sin incidencias y asintomático.

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

    Directory of Open Access Journals (Sweden)

    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.

  15. 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

    Directory of Open Access Journals (Sweden)

    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

  16. Tubo valvulado ápico-aórtico na calcificação da valva aórtica e aorta ascendente Apico-aortic valved conduct for surgical treatment of aortic valve and ascending aorta calcification

    Directory of Open Access Journals (Sweden)

    Luís Alberto Dallan

    1993-03-01

    Full Text Available É descrito método para correção cirúrgica da estenose aórtica adquirida, conseqüente a calcificação da valva aórtica e da aorta ascendente. Foi empregado tubo de Dacron preparado especialmente para o caso, valvulado com prótese biológica número 21, interposto entre o ápice do ventrículo esquerdo e a aorta torácica descendente. Esse conduto permitiu ao fluxo sangüíneo proveniente do ventrículo esquerdo (VE ultrapassar a obstrução de sua via de saída, sendo ajetado diretamente na aorta descendente. O gradiente pressórico através da valva aórtica reduziu-se de 75 mmHg para 35 mm Hg e o gradiente registrado entre o VE e o conduto valvulado foi de 13 mmHg. A paciente teve boa evolução hospitalar, permanecendo assintomática decorridos quatro meses da operação.A method of surgical correction for patients with acquired aortic stenosis involving calcification of the aortic valve and the ascending aorta has been described. A prosthesis to a 21 mm biological valved conduit, interposed between the left ventricular apex and descending thoracic aorta, permits the left ventricle to bypass the obstruction and eject directly into the aorta. The pressure gradient across the aortic valve was decreased from 75 to 31 mmHg, with a 13 mmHg gradient between the left ventricle and the valved conduit. The patients remains assymptomatic four mounths after the operation, without fatigue or shortness of breath.

  17. Resultados a médio prazo do tratamento cirúrgico da dissecção aguda de aorta tipo A com o emprego da prótese intraluminal Surgical treatment of type a aortic dissection using intraluminal prosthesis medium term follow up

    Directory of Open Access Journals (Sweden)

    Jefferson Francisco de OLIVEIRA

    2001-06-01

    Full Text Available Introdução: O conceito de prótese intraluminal foi introduzido por CARREL, em 1912. Em 1978, DUREAU & ABLASA descreveram os primeiros casos de dissecção aguda de aorta tratados com o emprego da prótese intraluminal. Esta prótese foi utilizada nos anos 80 por vários grupos com bons resultados. Vários relatos de complicações (migração, embolias, estenoses, formação de pseudo-aneurismas fizeram com que os grupos cirúrgicos perdessem o entusiasmo por esta técnica. Objetivo: Avaliar a anastomose empregando a prótese intraluminal sem sutura no tratamento da dissecção aguda de aorta tipo A. Casuística e Métodos: Sessenta e quatro pacientes com diagnóstico de dissecção aguda de aorta do tipo A foram operados em nosso Serviço. Em todos os casos empregamos o anel intraluminal como técnica de sutura. A idade média dos pacientes era de 56,3 anos, sendo 57 (89% do sexo masculino. Todos os pacientes eram portadores de hipertensão arterial sistêmica. Em 26 pacientes utilizamos somente a anastomose intraluminal, com o anel proximal acima dos óstios coronários de modo a ressuspender a valva aórtica e o anel distal posicionado junto à origem do tronco braquiocefálico. O tempo médio de pinçamento da aorta nestes pacientes foi de 9 minutos e o tempo médio de CEC de 26 minutos. Somente em 1 caso houve rotura da ligadura sobre o anel proximal, quando realizamos uma operação radical (Bentall- DeBonno, mantendo o anel distal. Em 23 pacientes utilizamos a ressuspensão da valva aórtica e o preparo da raiz da aorta com duplo retalho de Dacron, empregando o anel intraluminal na anastomose distal. Abordamos o arco aórtico em 8 pacientes. A troca da valva aórtica foi necessária em apenas 6 pacientes. A mortalidade global foi de 10,3%, sendo que nos pacientes onde foi possível o tratamento com o duplo anel não houve nenhum óbito. Na avaliação pós-operatória destes pacientes foi realizado ecocardiograma e aortografia. N

  18. Proposta de correção virtual geométrica da projeção ostial da artéria renal no estudo operatório de aneurismas infrarrenais: resultados iniciais de um estudo piloto

    Directory of Open Access Journals (Sweden)

    Giovani José Dal Poggetto Molinari

    2014-03-01

    Full Text Available Introdução: Para o preparo pré-operatório endovascular dos aneurismas infrarrenais é necessária a mensuração acurada de suas características anatômicas e morfológicas, alcançada com o uso de softwares avançados em manipulação de imagens de tomografias multicanais. Este processo permite também o estudo acurado das relações anatômicas das demais artérias do eixo aorto-ilíaco. Uma visualização perpendicular à origem da artéria renal mais baixa possibilita o uso de toda a extensão do colo para fixação da endoprótese e selamento proximal, o que pode ser previsto durante o estudo da tomografia, impedindo um posicionamento subótimo e a sobreposição das estruturas vasculares no intraoperatório. Expõem-se aqui os resultados iniciais de um projeto piloto, envolvendo manipulação de imagens tomográficas, na correção ortogonal da artéria renal aplicada à orientação radioscópica no intraoperatório. Métodos: Por meio de reconstrução multiplanar de imagens tomográficas em software obtém-se um corte axial em ângulo reto. Conceitos geométricos de triangulação virtual promovem a correção ortogonal em três dimensões da visualização ostial da artéria renal, que pode ser reproduzida intraoperatoriamente, através do reposicionamento do arco cirúrgico. Resultados/Discussão: Embora alguns autores argumentem que a anatomia do vaso observada na tomografia possa mudar durante o intraoperatório, sabe-se que o posicionamento angular das artérias renais não se modifica, mesmo após a inserção dos fios guia rígidos, introdutores e da própria endoprótese. Assim, acreditamos ser possível, por meio de conceitos de geometria espacial e correção ortogonal (por meio da manipulação das imagens em software, predizer o posicionamento ideal do aparelho de radioscopia de maneira a reproduzir o mesmo ângulo de projeção ostial da artéria renal em imagem bidimensional intraoperatória (angiografia, assegurando

  19. Correção de aneurisma do tronco braquiocefálico, 10 anos após traumatismo torácico fechado Correction of an innominate artery aneurysm, 10 years after a blunt chest trauma

    Directory of Open Access Journals (Sweden)

    José Almeida Lopes

    2012-03-01

    Full Text Available Aneurismas do tronco braquiocefálico são extremamente raros. Os autores apresentam o caso clínico de um doente de 22 anos de idade, com antecedente de atropelamento de alta energia há cerca de 10 anos por motociclo, com traumatismo toraco-abdominal anterior, em quem foi acidentalmente descoberto um aneurisma do tronco braquiocefálico com 52mm. Para a exclusão do referido aneurisma o doente foi submetido com sucesso à construção de um bypass aorta ascendente-carotídio-subclávio com prótese bifurcada de Dacron® (14x7mm, com abordagem por esternotomia mediana, cervical e supra-clavicular. É feita uma revisão da literatura, sendo descritas e discutidas as características clínicas, o tratamento cirúrgico e o mecanismo de traumatismo torácico sobre o tronco braquiocefálico.Innominate artery aneurysms are extremely rare. The authors present a case report of a 22-year-old patient, in whom was accidently discovered an innominate artery aneurysm of 52 mm, 10 years after a blunt thoraco-abdominal trauma caused by a high energy running over by a motorcycle. For the exclusion of the aneurysm, the patient was successfully submitted to the construction of an ascending aorta-carotid-subclavian bypass with bifurcated Dacron® graft (14x7mm, by means of a median sternotomy, right cervical and supra-clavicular approaches. Review of the literature, clinical features, surgical treatment and chest trauma mechanisms over the innominate artery are described and discussed.

  20. Reoperação da valva mitral minimamente invasiva sem pinçamento da aorta

    Directory of Open Access Journals (Sweden)

    Rodrigo Milani

    2013-09-01

    Full Text Available INTRODUÇÃO: Reoperações da valva mitral apresentam maior índice de complicações quando comparadas com a primeira cirurgia. Com o domínio das técnicas videoassistidas para as primeiras cirurgias da valva mitral, os casos de reoperações passaram a despertar interesse para esses procedimentos menos invasivos. OBJETIVO: Analisar os resultados e as dificuldades técnicas da retroca valvar mitral minimamente invasiva em 10 pacientes. MÉTODO: A circulação extracorpórea foi instalada por meio de colocação de cânulas femorais e cânula na veia jugular interna direita, conduzida em 28 graus de temperatura em fibrilação ventricular. Realizada toracotomia lateral direita com 5 a 6 cm no terceiro ou quarto espaço intercostal. Pericárdio foi descolado apenas na região do átrio esquerdo no ponto da atriotomia. A aorta não foi pinçada. RESULTADOS: Foram avaliados 10 pacientes com idade média de 56,9±10,5 anos. Quatro encontravam-se em ritmo de fibrilação atrial e 6 em ritmo sinusal. O tempo médio entre a primeira operação e a reoperações foi de 11 ± 3,43 anos. O EuroSCORE médio do grupo foi de 8,3 ± 1,82. O tempo médio de fibrilação ventricular e de circulação extracorpórea foi respectivamente 70,9 ± 17,66 min e 109,4 ± 25,37 min. O tempo médio de internamento foi de 7,6 ± 1,5 dias. Não houve óbitos nessa série. CONCLUSÃO: A reoperação da valva mitral pode ser feita por meio de técnicas menos invasivas com bons resultados imediatos e baixa morbimortalidade. Entretanto, esse tipo de cirurgia requer maior tempo de circulação extracorpórea, especialmente nos casos em que o paciente já tenha uma prótese. A presença de uma mínima insuficiência aórtica também torna esse procedimento tecnicamente mais desafiador.

  1. 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)

  2. Considerações clínicas e cirúrgicas sobre aneurismas intracranianos

    Directory of Open Access Journals (Sweden)

    Mário S. Cademartori

    1969-09-01

    Full Text Available São revistos os principais sintomas apresentados por 83 pacientes com aneurismas intracranianos nas seguintes localizações: 41 no sistema carotídeo, 19 no da artéria silviana, 19 no da artéria cerebral anterior e 4 no da artéria basilar. Como método de tratamento, a cirurgia intracraniana foi realizada em 49 pacientes, dos quais 27 apresentavam aneurisma no sifão carotídeo, 14 na cerebral média e 8 na cerebral anterior. A mortalidade operatoria foi de 37% entre os pacientes com aneurisma do sifão carotídeo, de 28,5% nos do grupo da artéria silviana e de 50% nos do grupo da artéria cerebral anterior. Não houve óbito nos 7 pacientes nos quais foi feita oclusão da carótida. A morbilidade foi de 12% nos casos de aneurismas carotídeos, de 20% nos de aneurismas da cerebral média, de 50% nos de cerebral anterior e de 29% naqueles em que a carótida primitiva foi ligada. Como métodos auxiliares, foi utilizada a hipotermia com circulação extra-corpórea em dois pacientes com aneurismas da artéria comunicante anterior e drenagem espinhal contínua em 19 casos. Controles arteriográficos pós-operatórios, feitos em 16 casos, permitiram verificar a eficácia dos procedimentos utilizados bem como algumas falhas de técnica cirúrgica.

  3. Tratamento endovascular da coarctação da aorta: relato de caso Endovascular treatment of aortic coarctation: a case report

    Directory of Open Access Journals (Sweden)

    Aquiles Tadashi Ywata de Carvalho

    2012-03-01

    Full Text Available A coarctação da aorta é uma malformação cardiovascular congênita de elevada prevalência. É caracterizada por um estreitamento da aorta torácica, geralmente logo abaixo da artéria subclávia esquerda. É mais frequente no sexo masculino na razão de 2 a 3:1. O quadro clínico habitualmente é composto por hipertensão arterial em membros superiores e diminuição de pulsos em membros inferiores. Tradicionalmente, o tratamento proposto é cirúrgico, mas a técnica endovascular vem sendo descrita com bons resultados. Relatamos um caso de um paciente do sexo masculino, 24 anos, quadro clínico de claudicação dos membros inferiores e hipertensão arterial sistêmica difícil de controlar há sete anos, com diagnóstico de coarctação da aorta sem outras malformações associadas. O tratamento endovascular foi realizado através de angioplastia da coarctação e implante de endoprótese vascular.Aortic coarctation is a congenital cardiovascular malformation of high prevalence. Implies a narrowing of the thoracic aorta usually just below the left subclavian artery. It is more common in males in a ratio of 2 to 3:1. The clinical presentation consists of hypertension in the arms and reduction of pulses in the legs. Traditionally, surgical treatment is indicated, but the endovascular techniques have been proposed with good results. We report a case of a 24 years male patient with claudication of the lower limbs and hypertension secondary to aortic coarctation successfully treated with angioplasty and aortic endograft.

  4. Aneurismas dissecantes intracranianos da circulação posterior relato de três casos e revisão da literatura

    Directory of Open Access Journals (Sweden)

    Denise S. Diniz-Carneiro

    1992-09-01

    Full Text Available As dissecções dos vasos cerebrais é causa rara de acidente vascular cerebral (quarta causa. Geralmente são de aparecimento espontâneo ou após trauma simples. É mais comprometido o sistema carotídeo e a evolução costuma ser benigna. As dissecções do sistema vértebro-basilar são menos comuns e a dissecção primária da artéria basilar é rara. As dissecções da circulação posterior têm sido diagnosticadas em proporção crescente, porém, seus mecanismos de lesão, o quadro clínico, os critérios de diagnóstico e o tratamento constituem problema da prática neurológica e a taxa de morbidade e mortalidade ainda é alta. Os autores abordam estes problemas e sugerem medidas que possam ser úteis no manuseio dessa patologia. Descrevem-se três casos de dissecção, dois da artéria vertebral e um da artéria basilar. É feito também levantamento de 80 casos já publicados, comparando-os aos três casos descritos.

  5. Tratamento endovascular de aneurisma da artéria renal por embolização com micromolas preservando o fluxo sangüíneo renal: relato de caso Endovascular treatment of renal artery aneurysm using microcoil embolization and renal blood flow preservation: case report

    Directory of Open Access Journals (Sweden)

    Marco Aurélio Cardozo

    2007-06-01

    Full Text Available O tratamento endovascular da doença aneurismática da artéria renal tem sido, cada vez mais, aceito como uma alternativa à cirurgia convencional, especialmente em casos de aneurismas complexos intra-parenquimatosos ou que comprometam a bifurcação da artéria renal. Os autores relatam a experiência do tratamento endovascular de uma paciente com aneurisma sacular da bifurcação da artéria renal direita, associado à hipertensão renovascular de difícil controle. Foi realizada a cateterização seletiva da artéria renal, com a inserção de micromolas no saco aneurismático. O aneurisma foi completamente ocluído com preservação total do fluxo sanguíneo renal. A evolução clínica foi satisfatória com redução significativa das medicações anti-hipertensivas. A angio-tomografia de controle, após o oitavo mês do procedimento, confirmou o sucesso do tratamento.Endovascular treatment of renal artery aneurysmal disease has been increasingly accepted as an alternative to conventional surgery, especially in cases of renal artery bifurcation or complex intrarenal aneurysms. The authors report a case of endovascular treatment of a saccular aneurysm of the right renal artery bifurcation associated with poorly controlled renovascular hypertension. Selective catheterization of the renal artery was performed and microcoils were inserted into the aneurysmal sac. The aneurysm was completely obliterated with total preservation of renal blood flow. Clinical evolution was satisfactory with significant reduction in anti-hypertensive drugs. Control tomographic angiography, after eight months, confirmed treatment success.

  6. 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

    Directory of Open Access Journals (Sweden)

    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.

  7. Dissecação da aorta - fatores de risco no município de Sorocaba

    Directory of Open Access Journals (Sweden)

    Mahonri Faria Guitti

    2007-07-01

    Full Text Available Objetivo: a dissecação aguda da aorta (DAA representa um evento catastrófico que, a despeito da terapêutica instituída, tem altos índices de mortalidade em qualquer lugar do planeta. O objetivo principal do estudo foi identificar os fatores de risco na população estudada. Método: estudo de observação, analítico, de agregado, do tipo coorte não concorrente, envolvendo 243 pacientes submetidos à necropsia no Serviço de Verificação de Óbito da FCM, do CCMB-PUC/SP, no período de dez anos. Estratificação da população alvo em amostras de estudo sendo o primeiro grupo (G1 formado por portadores de dissecação crônica da aorta e o segundo grupo (G2 por portadores de dissecação aguda da artéria. Análise comparativa para amostras independentes e por análise de contingência. Erro alfa admitido de cinco por cento. Trabalho aprovado pela Comissão de Ética da Instituição. Resultados: evidenciou-se significância estatística para: hipertensão arterial sistêmica (HAS (P=0.0030, aterosclerose prévia (P=0,0058 e uso de drogas tóxicas vaso-ativas (P=0,0058. Conclusões: os fatores de risco identificados na casuística foram: HAS, aterosclerose e uso de drogas tóxicas vaso-ativas. Não houve superioridade das imagens no diagnóstico da DAA quando comparadas à necropsia (P=0,072 e a prevalência da doença na casuística foi de 4,94%.

  8. Tratamento endovascular da síndrome da aorta média causada por arterite de Takayasu: relato de caso Endovascular treatment of the middle aortic syndrome due to Takayasu’s arteritis: case report

    Directory of Open Access Journals (Sweden)

    Felipe Nasser

    2009-12-01

    Full Text Available Síndrome da aorta média (SAM é uma condição clínica caracterizada por estenose segmentar ou difusa da aorta, hipertensão arterial e claudicação de membros inferiores. A principal causa da SAM é a arterite de Takayasu. A estenose segmentar pode estar localizada na aorta suprarrenal, renal ou infrarrenal e com alta propensão de lesões estenóticas concomitantes das artérias renais e viscerais. A gravidade da hipertensão arterial é a principal indicação para o tratmento. A técnica endovascular para o tratamento da síndrome da aorta média tem bons resultados e é a menos invasiva. No presente artigo, é descrito o tratamento com sucesso de uma estenose da aorta toracoabdominal com recanalização da artéria mesentérica superior através de angioplastia em uma mulher de 34 anos portadora de arterite de Takayasu e hipertensão arterial grave.Middle aortic syndrome (MAS is a clinical condition characterized by segmental or diffuse narrowing of the aorta, hypertension, and lower limb claudication. The main cause of MAS is Takayasu’s arteritis. Segmental aortic stenosis may be located at the suprarenal, renal or infrarenal aorta with high tendency to concomitant stenosis in both the renal and visceral arteries. Severity of hypertension is the primary indication for intervention. Endovascular therapy is a minimally invasive treatment for MAS and may provide good results. In the present report, we describe a successful endovascular treatment of stenosis of the thoracoabdominal aorta with recanalization of the superior mesenteric artery using angioplasty in a 34-year-old woman with Takaysu’s arteritis and severe hypertension.

  9. Desempenho cognitivo em pacientes operados de aneurisma cerebral

    Directory of Open Access Journals (Sweden)

    FOBE JEAN-LUC

    1999-01-01

    Full Text Available Vinte e cinco pacientes operados de aneurisma cerebral foram submetidos a avaliação cognitiva pós operatória tardia para linguagem, praxia, orientação, lógica, compreensão, memória, depressão, demência e gnosia visual. Os resultados foram correlacionados com idade, escala de Hunt-Hess à admissão, lado, local e tamanho do aneurisma, sangue à TC (Fisher, vaso-espasmo angiográfico (George. Déficit cognitivo tardio estava ausente em 8 pacientes (32%, era leve em 5 (20%, moderado em 6 (24% e grave em 6 (24%. A função cognitiva isoladamente mais alterada foi a da lógica com acometimento moderado e grave em 7 pacientes (28%, seguida de praxia em 6 (24%, orientação em 5 (20%, linguagem e memória em 4 (16%. A alteração gnósica visual, demência e depressão foram pouco frequentes. A compreensão estava levemente alterada em 3 pacientes. Na faixa etária 25-50 anos ocorreu melhor resultado cognitivo com sequela inexistente ou leve em 9 pacientes (75%. Os aneurismas da artéria comunicante posterior direita apresentaram déficit cognitivo tardio ausente ou leve em 5 pacientes (71,42%, os da artéria cerebral média direita apresentaram resultado equivalente em 2 (66,66%. Os aneurismas de artéria cerebral média esquerda apresentaram o pior resultado com sequela cognitiva moderada e grave em 5 pacientes (71,42%. As sequelas neuropsicológicas tardias apresentaram correlação direta com a idade, Hunt-Hess, sangue à TC, vaso-espasmo angiográfico e localização anatômica do aneurisma.

  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

    Energy Technology Data Exchange (ETDEWEB)

    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. 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

    Directory of Open Access Journals (Sweden)

    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.

  12. Correção cirúrgica do aneurisma roto do seio de Valsalva: relato de dois casos Surgical repair of ruptured sinus of Valsalva aneurysms: report of two cases

    Directory of Open Access Journals (Sweden)

    Lourival BONATELLI FILHO

    1999-10-01

    Full Text Available O objetivo deste estudo é relatar a técnica cirúrgica empregada na correção de aneurisma do seio de Valsalva roto para dentro do ventrículo direito, em 2 pacientes adultos, tendo um deles, concomitantemente, leve coarctação da aorta. No primeiro caso, mulher de 22 anos com dispnéia progressiva, cuja avaliação ecocardiográfica revelou rotura do aneurisma do seio de Valsalva para dentro do ventrículo direito e coarctação da aorta leve, com gradiente de 25 mmHg. O cateterismo cardíaco confirmou o diagnóstico. No segundo caso, homem de 35 anos, com piora de dispnéia há 2 meses. Ecocardiograma e cateterismo cardíaco confirmaram o diagnóstico de aneurisma roto do seio de Valsalva para o ventrículo direito. Ambos foram operados através de esternotomia mediana; circulação extracorpórea convencional e cardioplegia sangüínea fria. No primeiro caso a valva aórtica era bivalvulada, com o aneurisma do seio de Valsalva anterior, relacionado à coronária direita, roto para dentro do VD, medindo 6 mm de diâmetro, foi fechado com sutura direta com fio 5-0. No segundo caso a valva aórtica era trivalvulada e o aneurisma do seio de Valsalva direito que rompeu, também, dentro do VD, media 12 mm de diâmetro e o fechamento foi feito com retalho de pericárdio bovino, suturado com pontos separados de polipropileno 5-0. Ambos os pacientes tiveram evolução pós-operatória sem intercorrências. Alta hospitalar ao final de uma semana. No controle ambulatorial, 120 e 60 dias após, respectivamente, estavam assintomáticos.The purpose of this article is to report the surgical treatment of ruptured sinus of Valsalva aneurysms in two patients. First case was a young woman whose aneurysm originated in the right sinus and entered the right ventricle, besides a mild coarctation of the aorta. Surgical repair was carried out using cardiopulmonary bypass with moderate hypothermia. After aortotomy the ruptured sinus of Valsalva was directly closed

  13. Manejo endovascular de la aorta torácica Endovascular treatment of thoracic aorta

    Directory of Open Access Journals (Sweden)

    Juan G Barrera

    2006-10-01

    Full Text Available En comparación con el tratamiento convencional, la terapia endovascular en aneurisma de aorta torácica, presenta los mejores resultados, por lo que se convierte en el tratamiento de elección para la patología de aorta torácica descendente endovascular, por su baja morbimortalidad perioperatoria. El tratamiento quirúrgico por vía retroperitoneal y/o endovascular para aneurisma de aorta abdominal infrarrenal, resulta ser especialmente seguro en pacientes octogenarios o con alta morbilidad. Esta cohorte institucional presenta resultados perioperatorios y en el seguimiento, similares a los reportados en la literatura mundial.Compared with the conventional treatment, endovascular therapy in thoracic aortic aneurysm shows the best results, being the election treatment for the pathology of the descending thoracic aorta, due to its low peri-operative morbid-mortality. Surgical treatment by retro-peritoneal route and/or endovascular for infra-renal abdominal aortic aneurysm is especially safe in octogenarian patients or in those with a high mortality rate. This institutional cohort show peri-operative and follow-up results similar to those reported in the world literature.

  14. Algumas características morfológicas segmentares da parede da aorta de galo doméstico (Gallus domesticus

    Directory of Open Access Journals (Sweden)

    Josiane Medeiros de Mello

    2003-01-01

    Full Text Available A estrutura segmentar da parede aórtica foi estudada em galo doméstico, em níveis torácico e abdominal, nas dimensões de microscopias óptica e eletrônica de varredura. Secções histológicas selecionadas foram submetidas a estudos histomorfométricos usando métodos de análises de imagens. As variáveis analisadas foram as espessuras das túnicas da parede aórtica em três segmentos investigados, compreendendo as porções ascendente torácica; descendente torácica e abdominal, bem como os diâmetros tubulares, em cada porção, e o número médio de lamelas elásticas na túnica média de cada segmento analisado. A parede aórtica do galo doméstico apresenta estrutura predominantemente elástica nas porções torácicas, cujo número relativo de lamelas elásticas decresce gradualmente para a parte abdominal da aorta, onde células musculares lisas predominam. Os diâmetros aórticos decrescem também gradualmente, e progressivamente, da porção torácica ascendente para a porção torácica descendente, e desta para a porção abdominal da aorta.

  15. Tratamento híbrido com endoprótese não recoberta nas dissecções agudas da aorta tipo A New surgical strategy for acute type A aortic dissection: hybrid procedure

    Directory of Open Access Journals (Sweden)

    Ricardo Ribeiro Dias

    2007-12-01

    Full Text Available O tratamento da dissecção aguda da aorta tipo A de Stanford, com a utilização de um novo dispositivo (stent de aorta não recoberto em associação à interposição de tubo supracoronariano para a substituição da aorta ascendente e hemiarco permitem que o arco aórtico e porção da aorta descendente sejam tratados, sem acrescentar complexidade ao procedimento operatório, nem prolongar o tempo de isquemia cerebral ou sistêmica.The new surgical strategy to treat patients with acute type A aortic dissection, the hybrid procedure with an uncovered aortic stent, allows surgeons to treat the aortic arch and the proximal descending aorta, besides the ascending segment, without extension of cerebral or systemic ischemia.

  16. Tratamento endovascular em paciente portador de coarctação da aorta: relato de caso Endovascular treatment in a patient with aortic coarctation: case report

    Directory of Open Access Journals (Sweden)

    Eugênio Carlos Almeida Tinoco

    2007-03-01

    Full Text Available Coarctação da aorta constitui um estreitamento de origem congênita na porção inicial da aorta torácica. Tem incidência de 6 a 8% em nascidos vivos. A apresentação clínica é variada. O tratamento de escolha é o cirúrgico. Relatamos um caso de paciente do sexo feminino de 31 anos, com queixa de dor constrictiva na região cervical, dispnéia e claudicação intermitente em membros inferiores, sendo diagnosticada coarctação da aorta associada a estenose aórtica grave, que foi tratada com combinação das técnicas implantação de stent endovascular e angioplastia por balão.Aortic coarctation is a congenital stenosis in the initial portion of the thoracic aorta. Its incidence ranges between 6-8% of liveborns. Clinical presentations are diversified. The treatment of choice is surgery. We report the case of a 31-year-old female patient with constrictive pain in the cervical region, dyspnea, and intermittent claudication of the lower limbs. She was diagnosed with aortic coarctation associated with severe aortic stenosis, which was treated using a combination of endovascular stent implantation and balloon angioplasty.

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

    Directory of Open Access Journals (Sweden)

    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

  18. 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

    Directory of Open Access Journals (Sweden)

    Arnolfo de Carvalho Neto

    2001-06-01

    Full Text Available 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 sintomas caracterizados por episódios de crises distônicas. A tomografia computadorizada de crânio, que inicialmente era normal, mostrou dilatação aneurismática dos vasos do polígono de Willis. A revisão de literatura demonstra que os principais achados patológicos em casos similares, são, principalmente, fibrose de camada média com destruição da lâmina interna e hiperplasia da íntima. A etiologia da vasculite não é conhecida, acreditando-se que o vírus da varicela-zoster e o próprio HIV possam estar relacionados à mesma. Conclui-se que, apesar de incomum, tal complicação apresenta grande importância pelo fato dos aneurismas colocarem esses pacientes em grupo de alto risco para acidentes vasculares. A sobrevida relatada na literatura é de menos de 6 meses após o diagnóstico da arteriopatia aneurismática cerebral.Cerebral aneurysmal arteriopathy of the circle of Willis is an uncommon manifestation of acquired human immunodeficiency virus (HIV infection and up to now only 15 cases have been published in the literature. For this reason we add our experience of this rare case, and review the most important aspects related to this entity. The patient is a 6 year old male with perinatal transmitted AIDS, tetraparethic, developed symptoms characterized by episodes of dystonic postures. The computed tomography of the brain showed aneurismal arteriopathy of the circle of Willis. He had a previous normal examination. The review

  19. Modelo experimental estável de aneurisma sacular em artéria carótida de suínos utilizando veia jugular interna

    Directory of Open Access Journals (Sweden)

    Severino Lourenço da Silva Júnior

    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.

  20. Tratamento de aneurisma da artéria renal por embolização e técnica de remodelamento de colo: relato de caso Endovascular treatment of renal artery utilizing embolization and aneurism neck remodeling technique: case report

    Directory of Open Access Journals (Sweden)

    Luis Carlos Mendes de Brito

    2011-06-01

    Full Text Available O tratamento endovascular dos aneurismas de artéria renal tem sido descrito como alternativa à cirurgia convencional. Relatamos o caso de uma paciente com um aneurisma de artéria renal complexo à direita que apresentava hipertensão arterial de difícil controle. O tratamento endovascular foi realizado com a técnica de remodelagem de colo (técnica de Moret, ou técnica de embolização assistida por balão. A paciente obteve normalização da pressão arterial após o procedimento sem recidiva dos sintomas ou necessidade do uso de drogas anti-hipertensivas.Endovascular treatment of renal artery aneurysms has been described as an alternative to conventional surgery. We report the case of a patient with complex renal artery aneurysm on the right kidney who had hard-to-control arterial hypertension. Endovascular treatment was performed with the aneurysm neck remodeling technique (Moret technique, or balloon-assisted coil embolization. The patient achieved blood pressure normalization after the procedure without recurrence of symptoms or need for antihypertensive drugs.

  1. 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

    Directory of Open Access Journals (Sweden)

    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

  2. Utilização de endoprótese auto-expansível (Stent introduzida através da artéria femoral para tratamento de dissecção da aorta descendente

    Directory of Open Access Journals (Sweden)

    Fonseca José Honório Palma da

    1998-01-01

    Full Text Available OBJETIVO: Apresentar a correção de dissecção da aorta descendente, utilizando stent recoberto com dácron® introduzido através da artéria femoral na sala de hemodinâmica. MÉTODOS: Quatro pacientes foram submetidos à sedação, anestesia local de ambas regiões inguinais e a heparinização sistêmica, com cateter contendo o stent introduzido, através da artéria femoral comum, previamente dissecada, até a aorta descendente no seu terço médio. RESULTADOS: A expansão do stent foi realizada no local onde existia a lesão da íntima, diagnosticada por arteriografia e ecocardiograma. A oclusão da falsa luz foi imediata. O tempo do procedimento foi em média de 1h e 30min. A alta hospitalar ocorreu sem complicações. CONCLUSÃO: Este procedimento poderá proporcionar uma melhora substancial nos resultados do tratamento das dissecções da aorta descendente.

  3. Nevralgia paratrigeminal de Raeder como forma de expressão de aneurisma gigante intracavernoso

    Directory of Open Access Journals (Sweden)

    Marcelo Gabriel Vega

    1994-03-01

    Full Text Available Os autores apresentam o caso de uma paciente do sexo feminino de 50 anos de idade com quadro de dor ocular à direita, secundária a aneurisma gigante intracavernoso diagnosticada como nevralgia paratrigeminal de Raeder. A paciente foi tratada cirurgicamente com "trapping" da carótida interna direita associado a revascularização cerebral (temporal superficial - ramo profundo da cerebral média com ótima evolução pós-cirúrgica. Discute-se a identidade da síndrome e os diagnósticos diferenciais baseados em revisão da literatura.

  4. 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

    Directory of Open Access Journals (Sweden)

    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

  5. Lesão pulmonar de reperfusão por oclusão da aorta abdominal: modelo experimental em ratos

    Directory of Open Access Journals (Sweden)

    PINHEIRO BRUNO DO VALLE

    2000-01-01

    Full Text Available Introdução: Procedimentos cirúrgicos com oclusão da aorta têm sido associados a lesão pulmonar de reperfusão. O objetivo deste trabalho foi estudar a presença de edema pulmonar em um modelo de lesão de reperfusão por oclusão da aorta em ratos. Material e métodos: 33 ratos Wistar foram anestesiados com tiopental sódico (20mg/kg, via intraperitoneal, seguindo-se laparotomia por incisão mediana, para isolamento da aorta e cava inferior. A seguir, os animais foram randomizados em três grupos. Grupo isquemia-reperfusão (GIR, n = 5: animais submetidos a 30min de oclusão dos vasos, seguindo-se 120min de reperfusão. Grupo isquemia (GI, n = 5: animais submetidos a 30min de oclusão dos vasos. Grupo controle (GC, n = 5: animais submetidos apenas ao procedimento cirúrgico, sem oclusão dos vasos, acompanhados por 150min. Após o sacrifício, em 15 animais foram realizados estudos histopatológicos dos pulmões. Para caracterização de edema, foi realizada a análise morfométrica por contagem de pontos, determinando-se o índice de edema alveolar. Realizou-se também uma análise semiquantitativa da infiltração de polimorfonucleares nos pulmões. Em 18 animais retirou-se o pulmão direito para a determinação da relação entre os pesos úmido e seco. O índice de edema alveolar e a relação peso úmido/peso seco foram comparados entre os grupos através de ANOVA, com a correção de Bonferroni para comparação entre os grupos dois a dois. Resultados: Os animais do GIR apresentaram maior edema alveolar em relação aos do GI e GC (0,24; 0,18; 0,17; respectivamente, com p < 0,001. Não houve diferenças nas relações peso úmido/peso seco dos três grupos. Houve maior infiltração de células inflamatórias nos pulmões dos ratos submetidos a isquemia-reperfusão. Os autores concluem que a oclusão e desoclusão da aorta infra-renal está associada à lesão pulmonar. Essa lesão não foi induzida pela elevação da press

  6. Modelo experimental de aneurisma sacular de artéria ilíaca comum com pericárdio bovino em suínos Experimental model of saccular aneurysm of the common iliac artery with bovine pericardium in pigs

    Directory of Open Access Journals (Sweden)

    Luís Henrique Gil França

    2005-01-01

    Full Text Available OBJETIVO: Desenvolver um novo modelo experimental de pseudoaneurisma sacular de artéria ilíaca comum com o uso de remendo de pericárdio bovino em suínos. MÉTODO: Foram utilizados dois suínos da raça Landrace, com peso de 30 kg e do sexo feminino. Os animais foram submetidos a anestesia geral e a laparotomia com acesso extraperitoneal da aorta infra-renal e artérias ilíacas. Após heparinização sistêmica e pinçamento, foram efetuadas arteriotomia longitudinal e sutura do pericárdio bovino em formato de bolsa previamente confeccionada. Os animais permaneceram confinados por 3 semanas e então foram submetidos a arteriografia para avaliação da perviedade do aneurisma e, posteriormente, sacrificados. RESULTADO: Os animais sobreviveram ao experimento e apresentaram aneurismas pérvios no momento do sacrifício. Não houve ocorrência de ruptura de aneurismas. CONCLUSÃO: O modelo proposto é viável e tem potencial para ser utilizado no estudo e desenvolvimento de novas próteses endovasculares.OBJECTIVE: To develop an experimental model of saccular pseudoaneurysm of the common iliac artery with bovine pericardium in pigs. METHOD: The animals used were two 30-kg female pigs from the Landrace specimen. The animals were submitted to general anesthesia and laparotomy with extraperitoneal access to infrarenal aorta and the iliac arteries. After systemic heparin and clamping, the iliac artery was opened and the pericardium sutured to the vessel wall. All animals were confined for 3 weeks and were sacrificed after performing an arteriography to verify the patency of the aneurysm. RESULT: All animals survived the procedure and the aneurysms were patent. No rupture was detected. CONCLUSION: This is a feasible pig model of iliac artery aneurysm with potential for further studies to develop new endovascular prostheses.

  7. Circulação coronária dependente do ventrículo direito na atresia pulmonar com septo interventricular íntegro. Ausência da origem das artérias coronárias da aorta Right ventricle-dependent coronary circulation in pulmonary atresia with intact ventricular septum. Absence of origin of the coronary arteries from the aorta

    Directory of Open Access Journals (Sweden)

    Ivan Romero Rivera

    1998-08-01

    Full Text Available São descritos os aspectos clínicos, ecocardiográficos e angiográficos de um neonato de sexo masculino, com cinco dias de vida e diagnóstico de atresia pulmonar com septo interventricular íntegro. Tanto o ecocardiograma como a aortografia mostraram ausência da origem das artérias coronárias da aorta. O ecocardiograma bidimensional e, posteriormente, a ventriculografia direita identificaram as artérias coronárias, originando-se no ventrículo direito. Não houve contrastação retrógrada da aorta ou do tronco pulmonar quando contrastadas as artérias coronárias. Este é o primeiro caso relatado com diagnóstico ecocardiográfico pré angiografia, e é um exemplo da necessidade de se avaliar as artérias coronárias em pacientes com atresia pulmonar e septo ventricular íntegro.This report describes the clinical, echocardiographic and angiographic aspects of a five-day old boy with pulmonary atresia and intact ventricular septum. Both the echocardiogram and the aortography did not show any coronary arteries arising from the aorta. Two-dimensional echocardiography was able to identify the coronary arteries originating from the right ventricle and so did the right ventricular angiogram. No retrograde flow into the aorta or pulmonary trunk was identified after opacification of the coronary arteries. As far as we know this is the first case diagnosed by echocardiography, and is a vivid example of the necessity of identifying the coronary arteries in patients with pulmonary atresia and intact ventricular septum.

  8. Preservação das artérias hipogástricas com endoprótese ramificada no tratamento endovascular de aneurismas aorto-ilíacos The Zenith iliac bifurcation Device (IBD for preservation of the internal iliac arteries during endovascular repair of aortic-iliac aneurysms

    Directory of Open Access Journals (Sweden)

    Emanuel Dias

    2010-12-01

    Full Text Available Introdução: Os doentes com indicação para tratamento endovascular de aneurismas da aorta abdominal (EVAR apresentam frequentemente artérias ilíacas comuns ectasiadas ou aneurismáticas, o que impossibilita a sua utilização como zona de encoragem distal da endoprótese. Em cerca de 15 a 30% dos casos pode existir necessidade de oclusão/embolização de uma ou de ambas as hipogástricas, com extensão da endoprótese para a artéria ilíaca externa. Isto tem sido associado a casos de claudicação glútea, isquémia intestinal, deficits neurológicos, e de disfunção vesical, intestinal e eréctil. O uso de endopróteses com ramo para a artéria hipogástrica apresenta-se como uma recente inovação que permite a preservação desta artéria e evitar estas complicações. Caso clínico: Homem de 63 anos, com antecedentes de cirurgia aórtica com interposição protésica aorto-aórtica em 2008 por aneurisma da aorta abdominal (AAA infra-renal, admitido para tratamento endovascular de aneurisma das artérias ilíaca comum e hipogástrica direitas, com 3,3 cm de maior diâmetro. O doente foi submetido a colocação por via femoral de endoprótese Zenith® ramificada para bifurcação ilíaca com preservação da artéria hipogástrica. Conclusões: A utilização de endopróteses ramificadas para a bifurcação ilíaca durante a correcção endovascular de aneurismas aorto-ilíacos para ser uma forma segura e pouco complexa de garantir a preservação das artérias hipogástricas e minimizar as complicações associadas à sua oclusão.Introduction: A significant portion of patients presenting for endovascular aneurysm repair of the abdominal aorta (EVAR have aneurysmatic or ectasied common iliac arteries, raising distal anchorage issues. In these cases, it may be necessary occlusion / embolization of one or both hipo gastric arteries with extension of the endoprothesis to the external iliac artery. This procedure has been associated to

  9. Complicações pós-operatórias de pacientes com dissecção de aorta ascendente tratados cirurgicamente Postoperative complications of surgically treated ascending aortic dissection

    Directory of Open Access Journals (Sweden)

    Gustavo Ferreira Almeida

    2011-09-01

    Full Text Available OBJETIVOS: A dissecção da aorta ascendente tem prognóstico ruim se não for corrigido cirurgicamente. Mesmo após a cirurgia, o manuseio pós-operatório é temido pelo seu curso complicado. Nosso objetivo foi descrever a incidência de complicações pós-operatórias e mortalidade em 1 e 6 meses de pacientes submetidos a cirurgia de correção de dissecção ou aneurisma da aorta ascendente; secundariamente a comparação foi realizada com pacientes pareados submetidos a revascularização miocárdica de urgência. MÉTODOS: Uma análise retrospectiva de banco de dados preenchido prospectivamente de Fevereiro de 2005 a Junho de 2008 revelou 12 pacientes com dissecção da aorta ascendente e 10 com aneurisma de aorta eletivos, analisando demografia e características per-operatórias. Pacientes com dissecção da aorta ascendente foram comparados a pacientes com revascularização miocárdica de acordo com idade (± 3 anos, gênero, procedimento urgente/eletivo e equipe cirúrgica. O principal desfecho foi morbidade (complicações pós-operatórias e tempo de permanência na unidade de terapia intensiva e no hospital. RESULTADOS: Vinte e dois pacientes foram operados para correção de dissecção da aorta ascendente e aneurisma de aorta eletivos, enquanto 246 pacientes foram submetidos à revascularização miocárdica. Pacientes com dissecção da aorta ascendente e aneurisma de aorta eletivos eram semelhantes, exceto pelo maior tempo de ventilação mecânica e de internação hospitalar. Depois do pareamento entre pacientes de revascularização miocárdica e dissecção da aorta ascendente, resultados significativamente piores foram encontrados para este ultimo grupo: maior incidência de complicações pós-operatórias (91 vs 45%, p=0,03 e maior tempo de permanência hospitalar (34,6 ± 35,8 vs 12,9 ± 8,5 dias, p=0,05. Não houve diferença na mortalidade em 1 mês (8,3% e 6 meses (16,6% entre os grupos. CONCLUSÃO: A correção da

  10. 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

    Directory of Open Access Journals (Sweden)

    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

  11. Descrição anatômica dos ramos arteriais da aorta torácica e abdominal do quati (Nasua nasua (Carnivora, Procyonidae

    Directory of Open Access Journals (Sweden)

    Daniel Arrais Biihrer

    2015-03-01

    Full Text Available http://dx.doi.org/10.5007/2175-7925.2015v28n2p119 O quati (Nasua nasua é uma espécie de ampla distribuição na América do Sul, inclusive no Brasil. O objetivo deste estudo foi observar e descrever a morfologia da ramificação dos principais ramos arteriais das aortas torácica e abdominal do quati, comparando os achados com a literatura existente sobre as demais espécies domésticas e silvestres. Para este estudo foram utilizados dois exemplares machos adultos da espécie, coletados em rodovias do estado de Minas Gerais, mortos por atropelamento. Os espécimes foram fixados em solução formalina e tiveram os ramos aórticos preenchidos com látex para posterior dissecação e estudo. Observou-se que a artéria subclávia esquerda é ramo direto do arco aórtico, não há formação de um tronco bicarotídeo nem de um tronco celíacomesentérico, fatos descritos de forma semelhante nos carnívoros domésticos. Dessa forma, notou-se que as ramificações dos ramos arteriais da aorta do quati, tanto na cavidade torácica quanto abdominal, seguem uma distribuição muito semelhante à observada nos carnívoros domésticos, o que reflete sua proximidade evolutiva dentro da ordem Carnivora. Com isso, esse estudo mostrou-se importante por aprofundar o conhecimento anatômico dessa espécie silvestre, permitindo que aspectos já conhecidos da medicina de cães sejam aplicados ao quati.

  12. Aneurisma del seno de Valsalva derecho

    Directory of Open Access Journals (Sweden)

    Rebeca Manrique

    2010-10-01

    Full Text Available Varón de 60 años con antecedente de hipertensión arterial, diagnosticado incidentalmente de aneurisma del seno de Valsalva derecho de 7 cm con insuficiencia aórtica ligera. Bajo circulación extracorpórea y pinzamiento aórtico se reseca el aneurisma y se reconstruye el defecto con un parche de prótesis Dacron Hemashield Platinum® (Maquet, Rastatt, Alemania, reimplantando el ostium coronario derecho y realizando derivación aortocoronaria a primera marginal con vena safena (hallazgo en cateterismo preoperatorio. La ecocardiografía intraoperatoria objetivó insuficiencia aórtica trivial residual. Como complicación postoperatoria presentó ictus en el territorio de la cerebral media izquierda, con restitutio ad integrum.

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

    Directory of Open Access Journals (Sweden)

    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.

  14. Aneurisma verdadeiro pós-traumático de artéria temporal

    Directory of Open Access Journals (Sweden)

    Ana Julia de Deus Silva

    Full Text Available Resumo Os aneurismas de artéria temporal pós-traumático são eventos raros. Geralmente, são pseudoaneurismas. Como a causa mais frequente são ferimentos contusos, deve-se investigar todo paciente que possuir nodulação pulsátil na região da artéria temporal. O paciente apresentava protuberância pulsátil em região frontal direita há quatro meses, após queda de objeto pontiagudo, e o eco-Doppler evidenciou dilatação aneurismática. Assim, foi indicada sua excisão, que foi realizada com sucesso. O exame anatomopatológico demonstrou aneurisma verdadeiro traumático de artéria temporal superficial. Ocorrem devido ao fato de a artéria temporal superficial se localizar diretamente sobre o periósteo, o que a torna muito superficializada. Os aneurismas verdadeiros pós-traumáticos de artéria temporal são extremamente raros e podem ser confundidos com diversas outras afecções, como lipomas e cistos sebáceos.

  15. Aortic properties and atrial electrophysiology in the young and old football players Propriedades da aorta e electrofisiologia atrial em futebolistas profissionais ativos e aposentados

    Directory of Open Access Journals (Sweden)

    Hakan Hasdemir

    2011-06-01

    Full Text Available OBJECTIVE: The purpose of this study was to investigate the differences between P wave dispersion, aortic elastic properties and transthoracic echocardiographic findings in the young and old football players compared to control groups in order to asses the influence of regular sportive activity on aortic distensibility and its potential effect on atrial electrophysiology. METHODS : We recruited 42 young football players with a training history of many years. The control group was formed by 27 healthy sedentary men. Twenty-three healthy retired football players of a professional football club aged over 50 years were included in the study as old group and 18 subjects over 50 year old who did not perform regular exercise when they were young were included in the control group of old subjects. RESULTS: The heart rate and ejection fraction were decreased in the young football players. There were no significant differences in the aortic elastic parameters and P wave dispersion between young football players and control group. But in old subjects with sustained participation in regular sportive activity, the significant difference of left ventricular dimension, wall thickness and systolic functions detected in the young group disappeared while increase in the left atrial diameter became significant. CONCLUSION: Potential effect of aortic elastic properties which changes with age, on atrial electrophysiology through increasing P wave dispersion was shown.OBJETIVO: Com este estudo pretendeu-se levar a cabo um ensaio clínico que permitisse investigar as diferenças entre a dispersão da onda P (DOP, as propriedades elásticas da aorta e os resultados da ecocardiografia transtorácica em futebolistas profissionais ativos e reformados, face a grupos de controle, de modo a avaliar a influência da atividade desportiva regular na distensibilidade aórtica e o seu potencial efeito na electrofisiologia atrial. MÉTODOS: Para este estudo foram recrutados 42

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

    Directory of Open Access Journals (Sweden)

    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

  17. Influência do pré-condicionamento isquêmico na proteção miocárdica em revascularização do miocárdio com pinçamento intermitente da aorta

    Directory of Open Access Journals (Sweden)

    PÊGO-FERNANDES Paulo M.

    2001-01-01

    Full Text Available Objetivo: Este estudo testa a hipótese de que curtos períodos de isquemia podem aumentar a proteção obtida pelo pinçamento intermitente da aorta. Métodos: No grupo controle (18, a operação foi realizada com hipotermia sistêmica a 32 ºC com pinçamento intermitente da aorta e uso de circulação extracorpórea (CEC. No segundo grupo, denominado de pré-condicionamento (17, foram acrescidos dois pinçamentos de 3 minutos da aorta com intervalo de 2 minutos de reperfusão entre eles, previamente ao pinçamento intermitente da forma convencional. CK-MB, troponina I, adenosina e lactato foram obtidos do seio ocoronário no início da circulação extracorpórea (1, ao final da segunda anastomose (2 e ao final da CEC (3. Resultados: Os níveis de CK-MB e troponina I apresentaram uma leve tendência a aumentar ao final da CEC no grupo controle, enquanto os de adenosina e lactato não apresentaram diferença. Conclusão: Concluímos que o pré-condicionamento isquêmico não promoveu melhora significante na proteç��o miocárdica.

  18. Arteritis de Takayasu y aneurisma gigante en escolar: Reporte de caso Takayasu arteritis and giant aneurysm in a school student: A case report

    Directory of Open Access Journals (Sweden)

    Ernesto Vallejo

    2012-10-01

    Full Text Available La arteritis de Takayasu es una vasculitis de grandes vasos que afecta a la aorta y sus ramas principales, llevando a estenosis y trombosis, así como a la formación de aneurismas. Se reporta una incidencia global de 2,6 casos por millón por año, siendo baja en niños. La terapia de elección son los corticoides, seguidos de inmunosupresores en casos de resistencia. Se reporta el caso clínico de un paciente con arteritis de Takayasu con formación de aneurisma gigante de la aorta.Takayasu's arteritis is a vasculitis of large vessels that affects the aorta and its major branches, leading to stenosis and thrombosis, as well as aneurysm formation. An overall incidence of 2.6 cases per million per year has been reported, being lower in children. Corticosteroids are the therapy of choice, followed by immunosuppressants in cases of resistance. We report the case of a patient with Takayasu's arteritis with formation of giant aneurysm of the aorta.

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

    Directory of Open Access Journals (Sweden)

    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

  20. Fígado: vascularização colateral após isquemia induzida por clampeamento da aorta torácica

    Directory of Open Access Journals (Sweden)

    João César Dias Oliveira

    1999-01-01

    Full Text Available A visibilização e a identificação dos vasos que irrigam os tecidos é facilitada quando são utilizadas substâncias com poder corante e de distensão vascular ou meios radiopacos. Nesta pesquisa, em 22 cães foi realizada toracotomia lateral intercostal esquerda no 8º espaço intercostal e clampeamento da aorta torácica a ± 1 cm cranial ao diafragma. Em 10 animais, foi perfundida solução de gelatina/anilina e, no restante, injetado contraste vascular positivo e acompanhamento radiográfico. Foram identificadas artérias que vascularizavam o diafragma, mas não o fígado quando é efetuado o clampeamento aórtico no tórax.

  1. Morphological and biomechanical study of abdominal aorta of rats submitted to experimental chronic alcoholism Avaliação morfológica e biomecânica da aorta abdominal de ratos submetidos ao alcoolismo crônico experimental

    Directory of Open Access Journals (Sweden)

    Nereide Freire Cerqueira

    2005-06-01

    Full Text Available PURPOSE: To assess the influence of experimental chronic alcoholism in the morphology and biomechanics of the aorta, in a rat model. METHODS: Forty-four Wistar rats were randomly divided into two groups of 22 animals each: in the alcoholism group, the rats received water mixed to increasing concentrations of ethyl alcohol; and control group: the rats received pure water for 180 days. The animals were then killed by an overdose of pentobarbital and the abdominal aortas were excised for histological (hematoxylin-eosin, Masson, Calleja, and Picrosirius red stain, histomorphometrical, and biomechanical analysis. RESULTS: Histology and histomorphometry did not show differences in aorta morphology of both groups. Biomechanical analysis showed a significantly greater yield point elongation in the alcoholic rat group (pOBJETIVO: avaliar a influência do alcoolismo crônico experimental na morfologia e biomecânica da artéria aorta de ratos. MÉTODOS:ratos Wistar foram divididos em dois grupos de 22 animais. Grupo alcoolista: os ratos receberam água com concentração crescente de etanol e ração ad libitum durante 6 meses. Grupo controle: os animais receberam água e ração ad libitum pelo mesmo período. Os animais foram sacrificados com overdose de pentobarbital e as aortas abdominais foram excisadas para realização de histologia (hematoxilina-eosina, tricrômio de Masson, Calleja, Picrosirius red, histomorfometria e avaliação biomecânica (carga máxima, alongamento na carga máxima, limite de proporcionalidade, alongamento no limite de proporcionalidade e coeficiente de rigidez. RESULTADOS: A histologia e a histomorfometria não mostraram diferenças significantes na morfologia da aorta em ambos os grupos. A avaliação biomecânica mostrou aumento do alongamento no limite de proporcionalidade no grupo alcoolista (p<0.05. CONCLUSÃO: o alcoolismo crônico experimental não provocou alterações morfológicas na parede da aorta, mas causou

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

    Directory of Open Access Journals (Sweden)

    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.

  3. Cirugía de preservación valvular aórtica en los aneurismas de la raíz aórtica en el síndrome de Marfan

    Directory of Open Access Journals (Sweden)

    Alberto Forteza

    2010-10-01

    Conclusiones: La técnica de reimplante de la válvula aórtica ofrece unos resultados excelentes a corto y medio plazo. Elimina las complicaciones asociadas a las prótesis valvulares y al tratamiento anticoagulante, por lo que debe considerarse el tratamiento de elección para los aneurismas de la raíz de aorta en pacientes con SM.

  4. Tratamento cirúrgico de um aneurisma primário de veia ilíaca externa

    Directory of Open Access Journals (Sweden)

    Márcio Luís Lucas

    2015-09-01

    Full Text Available ResumoAneurismas primários da veia ilíaca são extremamente raros e podem complicar com trombose, embolia pulmonar ou ruptura. Acredita-se que existam apenas 14 casos descritos na literatura. Neste artigo, descrevemos um caso de um jovem de 25 anos, que apresentava edema e cianose do membro inferior esquerdo. A ecografia vascular revelou uma massa cística em fossa ilíaca esquerda. A angiotomografia confirmou o diagnóstico de um aneurisma da veia ilíaca externa esquerda de 3,8 cm, no maior diâmetro. O paciente foi submetido ao tratamento cirúrgico através da ressecção do aneurisma seguida de venorrafia longitudinal. Teve boa evolução pós-operatória, com um seguimento clínico de 44 meses. Houve uma melhora do edema no membro inferior esquerdo, sem complicações tardias.

  5. Dissecção da aorta após transplante cardíaco ortotópico: relato de 2 casos

    Directory of Open Access Journals (Sweden)

    STOLF Noedir A. G.

    2000-01-01

    Full Text Available No período de março de 1985 a setembro de 1999, 214 pacientes foram submetidos a transplante cardíaco em conseqüência de cardiomiopatia refratária ao tratamento farmacológico. Dois (0,9% pacientes, com idades de 33 e 49 anos, desenvolveram dissecção da aorta torácica como complicação tardia fatal após o transplante cardíaco ortotópico. Na primeira paciente, com cardiomiopatia idiopática, esta complicação ocorreu no 93º mês de evolução, enquanto que no segundo, com cardiomiopatia isquêmica, a ocorrência foi mais precoce, no 11º mês. A hipertensão arterial sistêmica e o tabagismo estiveram presentes como fatores de risco em ambos os casos. As manifestações clínicas da dissecção ocorreram de forma aguda e catastrófica que impossibilitaram qualquer atitude cirúrgica e, possivelmente, maior atenção desta rara complicação possa modificar a sua péssima evolução natural.

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

    Directory of Open Access Journals (Sweden)

    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

    Directory of Open Access Journals (Sweden)

    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. Unruptured intracranial aneurysm presenting with epiletic seizure Epilepsia secundária a aneurisma cerebral não roto

    Directory of Open Access Journals (Sweden)

    José C. Sena

    2003-09-01

    Full Text Available Intracranial aneurysms are frequently present with subarachnoid hemorrhage.Less often they produce suggestive symptoms of cranial nerve dysfunction or intracranial tumor when very large. Their association with epilepsy has rarely been reported; such concurrence may not be a coincidence. When the patient presents with epileptiforme attacks the presence of an intracranial aneurysm is rarely considered. In this paper we report the case of a 45-years-old patient with an unruptured aneurysm of the middle cerebral artery with a 10 years history of epileptic seizure.Aneurismas intracranianos freqüentemente se apresentam com hemorragia subaracnóidea quando rotos, porém quando gigantes sangram com menor freqüência e se comportam como verdadeiros tumores, comprimindo estruturas cerebrais adjacentes, apresentando sintomatologia peculiar. Relatamos o caso de um paciente de 45 anos que apresentava crises convulsivas generalizadas com evolução de 10 anos. A investigação radiológica revelou presença de aneurisma gigante da artéria cerebral média, não roto. É realizada revisão da literatura correlacionando a presença de aneurismas não rotos e epilepsia, pois esta associação é pouco freqüente na literatura.

  9. Tratamento cirúrgico sem circulação extracorpórea de arteriopatia relacionada com arterite de Takayasu envolvendo aorta e vasos da base Surgical treatment without extracorporeal circulation of artery disease related to Takayasu's arteritis involving the aorta and great vessels

    OpenAIRE

    Rodrigo Milani; Paulo Brofman; Tayse Sandri; Alexandre Varela; José Augusto Souza; Luiz Gustavo Emed; Stefan da Silveira; Marcelo Dantas; Maximiliano Guimarães; Rafael Pontarolli; Francisco Maia

    2005-01-01

    Relatamos o caso de duas pacientes portadoras de arterite de Takayasu, encaminhadas ao nosso serviço onde as lesões acometiam a aorta torácica descendente e os vasos da base e, em uma delas, lesão obstrutiva crítica do óstio da coronária esquerda. Ambas as pacientes foram operadas sem circulação extracorpórea, com heparinização plena e auxílio de autotransfusão.We report the cases of 2 female patients with Takayasu's arteritis referred to our service with lesions affecting the descending thor...

  10. Endovascular treatment for intracranial infectious aneurysms Tratamento endovascular de aneurismas infecciosos intracranianos

    Directory of Open Access Journals (Sweden)

    Eduardo Wajnberg

    2008-12-01

    Full Text Available OBJETIVE: To re-enforce an alternative, less aggressive treatment modality in the management of intracranial infectious aneurysms. METHOD: We present a series of five patients with infectious endocarditis and intracranial infectious aneurysms (mycotic aneurysms managed by means of endovascular treatment. RESULTS: Endovascular treatment was executed technically uneventfully in all patients. Three patients had favorable clinical outcome: two were classified as Glasgow Outcome Scale 4/5, and one had total neurological recovery (GOS 5/5. Two patients died (GOS 1/5, one in consequence of the initial intracranial bleeding and the other after cardiac complications from endocarditis and open-heart surgery. CONCLUSION: Endovascular techniques are an expanding option for the treatment of IIAs. It has been especially useful for infectious endocarditis patients with IIA, who will be submitted to cardiac surgery with cardiopulmonary bypass and anticoagulation, with the risk of intracranial bleeding.OBJETIVO: Enfatizar o método endovascular como uma opção de tratamento alternativa e menos agressiva no tratamento de aneurismas infecciosos intracranianos. MÉTODO: Apresentamos uma série de cinco pacientes com endocardite infecciosa e aneurismas infecciosos intra-cranianos (aneurismas micóticos tratados através da via endovascular. RESULTADOS: O tratamento endovascular teve sucesso técnico e sem intercorrências relacionadas ao cateterismo em todos os casos. Três pacientes tiveram desfecho clínico favorável: dois com escala de regeneração de Glasgow 4/5 e um com recuperação neurológica completa (GOS 5/5. Dois pacientes tiveram desfecho desfavorável (GOS 1/5, um devido às conseqüências do sangramento intracraniano inicial e outro devido a complicações cardíacas da endocardite e cirurgia de troca valvar. CONCLUSÃO: As técnicas endovasculares são uma nova opção de tratamento dos aneurismas infecciosos intracranianos. Ela é especialmente

  11. Infecção de prótese vascular em cirurgia da aorta torácica: revisão da experiência e relato de caso tratado por técnica não convencional Vascular prosthesis infection in thoracic aorta surgery: review of the experience and a case report illustrating treatment with an unconventional technique

    Directory of Open Access Journals (Sweden)

    Ronaldo Ducceschi Fontes

    2004-03-01

    Full Text Available Relatamos o caso de uma paciente de 37 anos de idade, que há cinco anos havia sido submetida à operação de Bental-de Bono em nosso serviço e retornou com dor de forte intensidade no toráx, sendo diagnosticada dissecção aguda de aorta do tipo III e tratada clinicamente. Um ano após esse episódio houve expansão dessa dissecção e a paciente foi submetida à cirurgia com interposição de prótese de dacron em aorta descendente. No pós-operatório imediato houve broncopneumonia esquerda e a paciente recebeu alta em boas condições e afebril. Após um mês da alta, retornou com febre e toxemia. Com diagnóstico de empiema pleural, foi submetida à toracotomia exploradora que não confirmou esse diagnóstico, havendo apenas intenso espessamento pleural. Quatro meses após a toracotomia exploradora, foram isolados Klebsiella pneumoniae e Enterobacter sp na hemocultura. A ressonância magnética revelou imagens compatíveis com infecção peri-prótese. Com esse quadro clínico e laboratorial foi indicada a remoção do enxerto e derivação axilo-bifemoral. A operação foi realizada com sucesso, a paciente recebeu alta em boas condições e continua fazendo controle ambulatorial e, atualmente, encontra-se com 57 meses de evolução sem complicações. São discutidos os métodos empregados para o diagnóstico e tratamento da infecção de prótese na cirurgia da aorta torácica.We report the case of a 37-year-old-female patient who had undergone a Bentall procedure at our service and returned with intense chest pain and acute aortic dissection type III, which was diagnosed and clinically treated. One year after this episode, this dissection expanded, and the patient underwent surgery with interposition of a Dacron graft in the descending aorta. In the immediate postoperative period, the patient experienced left bronchopneumonia and was discharged afebrile and in good condition. One month after discharge, she returned with fever and

  12. Coarctation of the Aorta

    Science.gov (United States)

    ... treatment is usually successful, the condition requires careful lifelong follow-up. Coarctation of the aorta care at ... of developing high blood pressure. You will need lifelong follow-up for coarctation of the aorta, and ...

  13. Retinite idiopática, vasculite, aneurismas e neurorretinite (IRVAN: relato de caso

    Directory of Open Access Journals (Sweden)

    Kelly Fernandes de Paula Rodrigues

    2012-04-01

    Full Text Available Relatamos caso de um paciente de 14 anos, sexo masculino, que foi admitido com queixa de embaçamento visual bilateral há dois anos. Ao exame oftalmológico observou-se leve hiperemia e edema de disco óptico bilateral, exsudação retiniana, poucas hemorragias retinianas, múltiplos aneurismas, assim como sinais de vasculite. A angiofluoresceinografia demonstrou isquemia periférica extensa, dilatações e hiperfluorescência das paredes dos vasos, e vazamento tardio do disco óptico nas fases finais do exame em ambos os olhos. Este caso representa uma rara entidade caracterizada por oclusão retiniana vascular periférica, vasculite retiniana, múltiplos aneurismas retinianos e neurorretinite (IRVAN. Avaliação sistêmica e laboratorial não revelaram nenhuma anormalidade. O paciente foi submetido à panfotocoagulação de retina com laser de argônio em ambos os olhos, e iniciado tratamento com prednisona via oral, com manutenção da acuidade visual de 20/25 depois de um ano de acompanhamento. O tratamento com laser deve ser considerado quando houver qualquer evidência angiográfica de má perfusão retiniana, e antes do desenvolvimento de qualquer sinal de neovascularização de retina.

  14. Resultados do tratamento cirúrgico da coarctação de aorta em adultos Outcomes of aortic coarctation surgical treatment in adults

    Directory of Open Access Journals (Sweden)

    Marcelo Biscegli Jatene

    2009-09-01

    Full Text Available OBJETIVO: Reportar a experiência no tratamento cirúrgico da coarctação da aorta (CoAo em pacientes adultos, avaliando os resultados imediatos e a médio prazo. MÉTODOS: Entre janeiro de 1987 e março de 2000, 50 pacientes consecutivos adultos foram submetidos a tratamento cirúrgico da coarctação de aorta, por toracotomia lateral esquerda. Destes, 42 (84% eram hipertensos, com pressão arterial sistólica média de 170,6 mmHg (125-220 mmHg. O gradiente médio no local da coarctação era de 51,4 mmHg (18-123 mmHg. A abordagem de doenças cardiovasculares associadas não foi realizada no mesmo tempo cirúrgico, com exceção de dois casos de persistência do canal arterial (PCA. Ressecção da CoAo e anastomose término-terminal foi realizada em 20 (40% pacientes, ampliação da área de CoAo com retalho de pericárdio bovino em 22 (44% e interposição de um tubo sintético em oito (16%. RESULTADOS: A morbidade operatória foi baixa, ocorrendo apenas uma reoperação por sangramento; a ocorrência mais frequente nas primeiras horas de pós-operatório foi hipertensão, observada em 98% dos pacientes, controlada com medicamentos endovenosos. Não houve óbito hospitalar. O gradiente residual médio foi de 18,7 mmHg (8-33 mmHg. O tempo médio de internação hospitalar foi de 9,5 dias (5-30 dias. O tempo médio de seguimento foi de 46,8 meses (1145 meses em 45 (91,8% pacientes; destes, 41 (91,1% encontravam-se normotensos, sendo que 75,6% sem medicamentos. Em 93,3% dos pacientes, não ocorreram sintomas de qualquer natureza. Quatro pacientes foram reoperados neste período (um para implante de marca-passo definitivo, dois para troca valvar, e outro por endocardite, ocorrendo um óbito tardio por endocardite e sepse. CONCLUSÃO: O tratamento cirúrgico da CoAo, mesmo em pacientes adultos, impõe-se como método terapêutico eficaz, nesta série, independentemente da técnica cirúrgica utilizada, com baixa morbidade e mortalidade, e

  15. Aneurisma de arteria coronaria Coronary artery aneurysm

    Directory of Open Access Journals (Sweden)

    Carlos A Carvajal

    2005-08-01

    Full Text Available La dilatación aneurismática, 1,5 veces el diámetro del vaso mayor normal que compromete un segmento de arteria coronaria, es una patología de rara presentación (incidencia 1,5% a 5%. Su etiología es arteriosclerótica y su principal importancia clínica es la posibilidad de producir infartos por trombosis o espasmo y ruptura. No se conoce su evolución y pronóstico y en la literatura no hay material suficiente para realizar recomendaciones sobre el tratamiento. Se reporta un caso de aneurisma del tronco principal y se revisa la literatura con el objetivo de actualizar la información al respecto.Coronary artery aneurysm is defined as the dilation of a segment of the coronary artery that reaches 1.5 times its normal size. It is an infrequent pathology with an incidence varying between 1.5% and 5%. Its main cause is atherosclerosis and from a clinical point of view its importance resides in the possibility of producing infarcts through thrombosis or spasm, and in its rupture. The natural history and prognosis remain obscure and there is not enough evidence respect to its evolution and prognosis as to give the right guidelines for its treatment. We report the case of a patient with left main coronary artery aneurysm and make an update literature review on this subject.

  16. Endovascular treatment of cerebral aneurysms: a retrospective study of 163 embolized aneurysms Tratamento endovascular de aneurismas cerebrais: estudo de 163 aneurismas embolizados

    Directory of Open Access Journals (Sweden)

    João Renato Figueiredo Souza

    2007-06-01

    Full Text Available OBJECTIVE: To present the results of cerebral aneurysms treated by endovascular technique. METHOD: Retrospective analysis of patient files of Hospital Geral de Fortaleza, Brazil. RESULTS: We report the results of 163 cerebral aneurysms treated by endovascular techniques from January 2002 to October 2005. Patients with ruptured aneurysms (87.2%, according to Hunt-Hess scale were: 33.7% HH I, 28.4% HH II, 24.1% HH III, 13.8% HH IV. The Fisher scale grade IV was the most common (39.7%. Remodeling, coil embolization, arterial occlusion and histoacryl embolization were the techniques employed. Effective occlusion was achieved in 87.7%, partial occlusion in 5.3% and non-effective occlusion in 7.0% of the patients. Glasgow outcome scale results were: 76.3% GOS 5, 5.0% GOS 4, 5.8% GOS 3, 1.4% GOS 2 and 11.5% GOS 1. CONCLUSION: Endovascular treatment seems to be feasible within Brazilian public health system, with results as good as those obtained in larger international centers.OBJETIVO: Apresentar os resultados de aneurismas tratados pela técnica endovascular. MÉTODO: Análise retrospectiva de prontuários do Hospital Geral de Fortaleza, Brasil. RESULTADOS: Apresentamos os resultados de 163 aneurismas cerebrais tratados por técnicas endovasculares de Janeiro de 2002 a Outubro de 2005. Os pacientes com aneurismas rotos (87,2% eram, segundo a escala de Hunt-Hess: 33,7% HH1; 28.4% HH II, 24.1% HH III, 13.8% HH IV. O Grau IV da escala de Fisher foi o mais comum (39,7%. Empregaram-se as técnicas de remodeling, espiras metálicas, oclusão arterial e embolização com histoacryl. Foi obtida oclusão efetiva em 87,7%, oclusão parcial em 5,3% e oclusão não-efetiva em 7,0% dos casos. De acordo com a Glasgow outcome scale, os resultados foram: 76,3% GOS 5, 5,0% GOS 4, 5,8% GOS 3, 1,4% GOS 2 e 11,5% GOS 1. CONCLUSÃO: A aplicação de técnica endovasculares mostra-se viável na rede pública brasileira, com resultados comparáveis aos de grandes centros

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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

  19. Abordagem supraclavicular da artéria subclávia direita para estabelecimento de circulação extracorpórea nas doenças da aorta

    Directory of Open Access Journals (Sweden)

    FABRI Hélio Antônio

    2002-01-01

    Full Text Available OBJETIVO: Estabelecer a circulação extracorpórea através de canulação da artéria subclávia direita por meio de incisão supraclavicular. MÉTODO: Foram estudados, no período de outubro de 2001 a março de 2002, quatro pacientes com diagnóstico de dissecção aguda de aorta tipo A de Stanford, sendo realizada em todos os casos canulação da artéria subclávia direita por via supraclavicular e realização de perfusão cerebral anterógrada durante o período de parada circulatória total. RESULTADOS: A artéria subclávia direita foi canulada diretamente e não houve nenhuma complicação neurovascular relacionada ao procedimento. A circulação extracorpórea foi mantida com fluxo adequado durante toda a operação. Houve 1 óbito hospitalar, não relacionado ao procedimento. DISCUSSÃO: Um dos passos mais importantes na melhora dos resultados operatórios é a perfusão sistêmica anterógrada, realizada através do sistema arterial e a subclávia para isso permite a perfusão da luz verdadeira. A abordagem supraclavicular nos proporciona um campo operatório adequado e facilidade para a realização da perfusão cerebral anterógrada que também é importante neste arsenal para uma redução da mortalidade operatória. CONCLUSÃO: A incisão supraclavicular nos proporciona um acesso factível com boa exposição da artéria subclávia direita em uma região em que ela apresenta um bom calibre e com poucas estruturas adjacentes que poderiam ser lesadas. Além disso, possibilita a canulação de forma direta e com boa posição da cânula arterial.

  20. 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

    Directory of Open Access Journals (Sweden)

    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

  1. 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

    Directory of Open Access Journals (Sweden)

    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

  2. Medida da diferença artério-venosa de oxigênio na monitorização de pacientes com hemorragia subaracnóidea por aneurisma cerebral Measurement of arteriovenous oxygen difference in the monitoring of patients with subarachnoid haemorrhage due to cerebral aneurysm

    Directory of Open Access Journals (Sweden)

    Ronaldo Sérgio Santana Pereira

    1997-01-01

    Full Text Available A diferença artério-venosa de oxigênio (DAVO2, pelo fato de estar relacionada com o metabolismo cerebral, reflete alterações que ocorrem em determinadas situações patológicas, entre elas as causadas pela hemorragia subaracnóidea espontânea (HSAE. Com a finalidade de avaliar a relação entre alterações na DAVO2 com o quadro clínico e a evolução de pacientes com HSAE, devido à ruptura de aneurisma cerebral, este método foi utilizado em 30 pacientes portadores desta patologia, admitidos na Unidade de Neurocirurgia do HBDF. A HSAE foi confirmada por CT de crânio em 17 pacientes e por punção lombar em 13. Dezoito pacientes foram admitidos com Hunt & Hess (H&H I ou II, sete com H&H III e cinco com H&H IV ou V. A medida da DAVO2 baseou-se na equação de Fick e os resultados clínicos foram avaliados pela escala de seqüelas de Glasgow. Dezenove pacientes apresentaram DAVO2 normais (inicialmente e durante a evolução, sendo que três faleceram; cinco tiveram valores de DAVO2 sempre baixos e três faleceram; os restantes seis pacientes tiveram valores da DAVO2 sempre elevados e dois faleceram. Os pacientes com DAVO2 normais tiveram melhor evolução clínica e índice de mortalidade menor, quando comparados com os pacientes com valores anormais da DAVO2 (pThe arterious venous oxygen difference (AVDO2 due to the close relationship with cerebral metabolic rate of oxygen and cerebral blood flow shows metabolic alterations that occur in some pathological situations in the brain including subarachnoid haemorrhage. The AVDO2 was calculated by the Fick equation and the results evaluated by the Glasgow outcome scale. Measurements of arteriojugular oxygen difference were carried out in 30 patients with subarachnoid haemorrhage due to rupture of intracranial aneurysms, as an attempt to monitor the relationship between changes in AVDO2, clinical picture, and evolution of the patients. The subarachnoid haemorrhage was diagnosed by CT scan in

  3. Aorta and iliac artery

    International Nuclear Information System (INIS)

    Yao, J.S.T.; Neiman, H.L.

    1985-01-01

    The aorta and iliac artery constitute the major blood supply to the limbs, and the atherosclerotic process ranks as the most common disorder in this region. Clinical presentation ranges from acute to chronic. Atherosclerotic disease of the aorta associated with femoropopliteal disease is not uncommon. For simplicity, the aorta and iliac artery are considered as a unit, though isolated lesions of the aorta occur. The primary indication for arteriography is in patients who are candidates for reconstructive surgery or for percutaneous balloon dilatation. While diagnosis by clinical examination or noninvasive tests is not difficult, arteriography remains the essential diagnostic technique, especially when patients become candidates for therapy. Visualization of the aortoiliac system may be accomplished by translumbar aortography, catheter arteriography, or by intravenous digital subtraction angiography

  4. Tratamento cirúrgico da coarctação da aorta: experiência de três décadas Surgical treatment of the aortic coarctation: three-decade experience

    Directory of Open Access Journals (Sweden)

    Alline de Souza Alves Oliveira

    2007-09-01

    Full Text Available OBJETIVO: Revisar os resultados imediatos de 30 anos da cirurgia de coarctação da aorta (CoAo, no período entre 1974 e 2004. Foram incluídos todos pacientes operados de CoAo, isolada ou associada a outros defeitos congênitos. MÉTODO: Foram pesquisados os seguintes dados: idade no momento da cirurgia, sexo, lesões associadas, tipo de técnica cirúrgica utilizada, resultado cirúrgico imediato, com ênfase à presença de hipertensão arterial sistêmica. RESULTADOS: Foram operados 104 pacientes, dos quais 75 (72% eram pacientes pediátricos e 29 (28%, adultos. No grupo pediátrico, 23 (22% foram considerados neonatos, 17 (16%, lactentes, 35 (34%, crianças. Os defeitos associados estiveram presentes em 66 (63,5% pacientes, sendo 54 (51,9% no grupo pediátrico e 12 (11,3% no grupo dos adultos. Foram observados sete (6,7% óbitos no pós-operatório imediato (POI. Dentre as diversas técnicas cirúrgicas utilizadas a aortoplastia foi usada em 80 pacientes (76,9%; anastomose término-terminal em 15 (14,4%; técnica de Teles em sete (6,7%; Waldhausen em um (1%, e não foi possível identificar a técnica em um (1% paciente. CONCLUSÕES: Apesar das limitações do presente estudo, pode-se observar que os resultados foram bons, sendo a correção cirúrgica realizada de maneira segura e com baixa mortalidade. O seguimento a médio e longo prazo foi prejudicado pelas deficiências estruturais conhecidas em nosso meio.OBJECTIVE:To make a 30-year review of the immediate results of coarctation of the aorta (CoAo operation, between 1974 and 2004. All the patients underwent CoAo whether in isolation or associated with other congenital defects. METHODS: The following data was investigated: age at the time of surgery, gender, associated lesions, type of surgical technique, and immediate surgical outcome, particularly focusing the presence of systemic arterial hypertension. RESULTS: One hundred and four patients underwent CoAo. Of the 104 enrolled

  5. Aortic root reconstruction through valve-sparing operation: critical analysis of 11 years of follow-up Análise crítica da reconstrução da raiz da aorta com a preservação da valva aórtica: 11 anos de seguimento

    Directory of Open Access Journals (Sweden)

    Ricardo Ribeiro Dias

    2010-03-01

    Full Text Available INTRODUCTION: The composite mechanical valve conduit replacement is the standardized operation for aneurysms of the aortic root. The objective of this study is to evaluate the long-term surgical results of aortic valve-preserving procedures to the root reconstruction. METHODS: From 1996 to 2008, 54 consecutive patients underwent two different techniques of valve-sparing aortic root operation (40 Yacoub operations and 14 David operations. Mean age was 48 ± 14 years (range 17 to 74. 36 patients (66.7% were male and 16 (29.6% experienced Marfan's syndrome. The mean Euroscore was 4 ± 1.25. The mean follow up time was 4.1 years (from 49 days to 10.9 years. Clinical and echocardiographic parameters were analysed. T-Student paired test, the McNemar Non Parametric test and the Kaplan-Meyer Outcome Curves have been used. RESULTS: The hospital mortality was 5.6% and the average hospitalization time was 9±4 days. One non related late death (2% was reported. The actuarial survival and freedom from reoperation were respectively 94.4% and 96% within 11 years of follow-up. There were benefits in reduction of functional class (P=0.002; 78% CF I, in reduction of aortic regurgitation (PINTRODUÇÃO: A utilização do tubo valvulado é a operação clássica para a reconstrução da raiz da aorta. O objetivo deste trabalho é avaliar a reconstrução da aorta ascendente com a preservação da valva aórtica. MÉTODOS: Entre 1996 e 2008, 54 pacientes consecutivos (66,7% do sexo masculino, com idade média de 48 ± 14 anos, foram submetidos à reconstrução da aorta ascendente e preservação da valva aórtica (40 remodelamentos e 14 reimplantes. O Euroscore médio foi de 4 ± 1,25 e 29,6% eram portadores de síndrome de Marfan. O tempo médio de seguimento foi de 4,1 anos (49 dias até 10,9 anos. Foram avaliados por parâmetros clínicos e ecocardiográficos. Para a análise dos dados foram utilizados os testes t de Student pareado, o não-paramétrico de Mc

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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

  8. Experiencia en el manejo endovascular para el tratamiento de la aorta torácica Experience in endovascular management for thoracic aorta treatment

    Directory of Open Access Journals (Sweden)

    Juan G Barrera

    2007-12-01

    Full Text Available Antecedentes: el tratamiento endovascular ofrece la posibilidad de cubrir el origen de la disección y evitar que progrese hasta aneurisma de la aorta, y con ello demuestra una reducción en la mortalidad hasta del 16%. Objetivo: evaluar los resultados quirúrgicos en términos de morbi-mortalidad de los pacientes sometidos a manejo endovascular de las lesiones de la aorta torácica en la Fundación Cardiovascular de Colombia desde 2003 hasta 2005. Diseño-método: estudio longitudinal tipo descriptivo retrospectivo, en el que se evaluaron las historias clínicas de todos los pacientes sometidos a manejo endovascular de patología toracoabdominal; en éste sólo se incluyeron los pacientes con procedimientos de la aorta torácica, desde 2003 hasta 2005. El análisis de los datos se realizó en Stata/SE 8,0. Resultados: se realizaron procedimientos de aorta torácica en 16 pacientes. El 75% de los pacientes eran hombres con edad promedio de 55,9 ± 12,6 años. El 87,5% (14 pacientes presentaban disección aórtica tipo A o B; un paciente transección traumática de la aorta y un paciente aneurisma de aorta torácica descendente. Las disecciones agudas se presentaron en 78,6% (11 pacientes y las crónicas en 21,4% (3 pacientes. El promedio de endoprótesis usadas fue de 2,8 ± 1. La estancia en la unidad de cuidados intensivos fue de 3 ± 2,7 días. El 81,3% de los pacientes no presentaron complicaciones mayores. La mortalidad fue del 18,7% (3 pacientes. A todos se les realizó control post-operatorio con tomografía axial computarizada, con evolución satisfactoria. Conclusión: de acuerdo con los reportes de la literatura con mayor casuística, se considera que el manejo endovascular para el tratamiento de la disección, aneurisma o trauma aórtico es un procedimiento confiable que disminuye la morbi-mortalidad.Antecedents: endovascular treatment has the possibility of covering the dissection origin and to avoid its progression to aortic

  9. Coarctation of the aorta

    International Nuclear Information System (INIS)

    Gogova, T.; Janev, I.

    2015-01-01

    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

  10. 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

    Directory of Open Access Journals (Sweden)

    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

  11. Prothetischer Ersatz der thorakalen Aorta

    Science.gov (United States)

    Voss, Bernhard; Bauernschmitt, Robert; Brockmann, Gernot; Lange, Rüdiger

    Die Aorta ist das Stammgefäß des arteriellen Körperkreislaufs, von dem aus alle Organe mit Blut versorgt werden. Die Aorta entspringt der linken Herzkammer, beginnend mit dem aufsteigenden Teil (Aorta ascendens). Der Anfangsteil der Aorta ascendens ist natürlicherweise etwas erweitert und wird als Aortenbulbus oder nach seinem Erstbeschreiber als Sinus valsalvae bezeichnet. An dessen Basis liegt die Aortenklappe, die einen Rückfluss von Blut in den linken Ventrikel verhindert. Etwa 1 cm oberhalb der Aortenklappe entspringen die Herzkranzgefäße, die den Herzmuskel mit Blut versorgen. Die Aorta ascendens endet mit Beginn des Aortenbogens, aus dem die 3 Kopfhalsgefäße (Truncus bracheocephalicus, linke Arteria carotis und linke Arteria subclavia) abgehen. Nach Abgang der linken Arteria subclavia zieht die Aorta nach unten. Dieser Abschnitt wird als "Aorta descendens“ bezeichnet, wobei der thorakale Anteil bis zum Zwerchfelldurchtritt reicht.

  12. Formas clínicas de los aneurismas arteriales intracraneanos

    Directory of Open Access Journals (Sweden)

    Alejandro H. Schroeder

    1952-06-01

    Full Text Available Los autores exponen las modalidades clínicas que presentan los aneurismas arteriales intracraneanos, baseando su clasificación en experiencia propia que es de 30 casos, y exponen 9 casos típicos que describen clínica y arteriográficamente, relatando el método quirúrgico utilizado. El diagnóstico del aneurisma arterial y la localización del mismo se hace siempre de manera precisa por la arteriografía, método que tiene un mínimo de riezgo (los autores han hecho 400 arteriografías sin accidente grave. Los autores consideran la clasificación propucsta como previa que, a medida que se amplie la experiencia, habrá que modificar o completar. La clasificación empleada es la que va a continuación: 1 formas de hemorragias meningeas; 2 formas con parálisis de los músculos oculares extrínsecos; 3 formas pseudo-tumorales; 4 formas pseudo-encefa-líticas; 5 formas con epilepsia clinicamente esencial.

  13. Aneurisma de la vena de Galeno Galen's vein aneurysm

    Directory of Open Access Journals (Sweden)

    Sergio Piloña Ruiz

    2010-09-01

    Full Text Available La malformación arteriovenosa de la vena de Galeno es una enfermedad congénita poco frecuente que se produce a partir de un defecto en la fusión de las venas cerebrales internas y que, debido a la baja resistencia, produce un cuadro de falla cardíaca de alto gasto. Las manifestaciones clínicas son muy variables y dependen de la edad de presentación. El pronóstico depende del tamaño del aneurisma. Se presenta el caso de un recién nacido del sexo masculino, con diagnóstico prenatal de aneurisma de la vena de Galeno y, desde el nacimiento, graves signos de insuficiencia cardíaca congestiva de difícil tratamiento. Se realiza una revisión sobre el tema.Arteriovenous malformation of Galen's vein is an uncommon congenital disease present from a defect in internal cerebral veins fusion and that due to the low resistance, produces a high output heart failure. Clinical manifestations are very variables depending on age of presentation. Prognosis depends on the size of aneurysm. This is the case of a male newborn diagnosed prenatally with Galen's vein aneurysm and from his birth severe signs of congestive heart failure of difficult treatment. A literature review on this subject is made.

  14. 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

    Directory of Open Access Journals (Sweden)

    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

  15. Tratamiento de aorta abdominal e ilíacas con técnica endovascular: Experiencia quirúrgica Treatment of abdominal aorta and iliac arteries with endovascular technique

    Directory of Open Access Journals (Sweden)

    Juan G Barrera

    2007-08-01

    Full Text Available Antecedentes: desde 1991 la técnica endovascular se ha aplicado con éxito en el manejo de los aneurismas de aorta infrarrenal, y se ha perfeccionado de manera tal que rápidamente se ha convertido en una alternativa para pacientes de alto riesgo para la cirugía convencional. Objetivo: describir los resultados institucionales en el manejo de las patologías de aorta abdominal e ilíacas mediante técnica endovascular desde 2003 a 2005. Diseño-Método: estudio descriptivo, longitudinal, retrospectivo, en el que se analizaron las historias clínicas de los pacientes sometidos a procedimiento endovascular de aorta abdominal e ilíacas. El análisis se realizó en Stata 8,0 S/E. Resultados: a 9 pacientes se les realizó exclusivamente manejo de lesiones en aorta abdominal e ilíacas. Todos los pacientes del estudio fueron hombres con edad media de 68,9 + 8,1 años. Los diagnósticos fueron aneurisma de aorta infrarrenal en 6 pacientes y aneurismas anastomóticos en los 3 restantes. Se evidenció requerimiento de endoprótesis en promedio de 1,9 + 0,8. Se realizó puente femoro-femoral como procedimiento simultáneo en 4 de los 9 pacientes. El 77,8% de los pacientes no tuvo complicaciones. La mortalidad por el procedimiento alcanzó el 22% (2 pacientes, si bien cabe anotar que las complicaciones se presentaron sólo en esos dos pacientes. Conclusiones: la exclusión de aneurismas de aorta y de ilíacas con endoprótesis modulares, se está implementando ampliamente como una opción válida de tratamiento, con resultados excelentes que evitan los riesgos de la intervención convencional y la morbilidad asociada.Antecedents: since 1991 endovascular technique has been successfully used in the management of infra-renal aortic aneurysms and it has been improved in such a way that it has quickly turned into an alternative for patients considered having high risk for conventional surgery. Objective: describe the institutional results in the management of

  16. Aneurisma gigante del apéndice auricular izquierdo

    OpenAIRE

    Moreno-Martínez,Francisco L; González Alfonso,Osvaldo; Lagomasino Hidalgo,Álvaro L; González Díaz,Alejandro; Oliva Céspedes,Carlos; López Bernal,Omaida J

    2006-01-01

    Los aneurismas de la aurícula izquierda son raros y pueden ser congénitos o adquiridos. Los que interesan la pared libre o el apéndice auricular son entidades más raras aún, hasta 2002 sólo existían 49 casos reportados en la aurícula izquierda y 8 en la derecha. La manifestación clínica más frecuente es la aparición de arritmias auriculares incesantes o recurrentes y pueden presentarse embolias sistémicas que pueden dar al traste con la vida del paciente. Presentamos el caso de una paciente a...

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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

  19. 67. Rotura crónica contenida de aneurisma de aorta abdominal: Un diagnóstico infrecuente

    Directory of Open Access Journals (Sweden)

    M.T. González López

    2012-04-01

    Conclusión: La detección de una rotura crónica contenida de AAA obliga a un tratamiento urgente-preferente, ya que supone un riesgo vital evidente, permitiendo en estos casos, dada la estabilidad del paciente, planear la estrategia quirúrgica y valorar un tratamiento endovascular frente al quirúrgico.

  20. Falso Aneurisma Femoral Iatrogénico: Ainda uma indicação para a Cirurgia Convencional? Iatrogenic femoral pseudoaneurysm: still an indication for conventional surgery?

    Directory of Open Access Journals (Sweden)

    Nelson Oliveira

    2011-12-01

    Full Text Available Introdução: Os Falsos Aneurismas (FA são uma das complicações mais frequentemente associadas à punção femoral diagnóstica e de intervenção cardíaca. A sua abordagem terapêutica tem evoluído no sentido da preponderância das técnicas não invasivas sendo a Cirurgia Convencional cada vez menos frequentemente praticada. Objectivos: Os autores propõem a propósito de um caso clínico, e através de uma revisão da literatura discutir a abordagem terapêutica dos FA e as indicações da Cirurgia Convencional. Caso clínico: Doente de sessenta e um anos, sexo masculino, com antecedentes de hipertensão arterial, doença coronária com enfarte agudo do miocárdio prévio, miocardiopatia dilatada, fibrilhação auricular paroxística sendo portador de cardiodesfibrilhador. Foi submetido a cateterismo cardíaco por via femoral direita para ablação do Feixe de His, tendo sido referenciado ao Serviço de Angiologia e Cirurgia Vascular por desenvolvimento progressivo de massa pulsátil dolorosa acompanhada de hipostesia da face anterior da coxa. A Angiodinografia confirmou a presença de falso aneurisma da artéria femoral profunda direita com 3cm de maior diâmetro e a presença de uma fístula entre a artéria e a veia femorais superficiais direitas. Por abordagem cirúrgica aberta, foi realizada a exclusão do falso aneurisma e rafia da artéria e veia femorais superficiais. Conclusão: A abordagem de primeira linha dos falsos aneurismas iatrogénicos pós cateterismo cardíaco é não invasiva mas a Cirurgia Convencional detém ainda um lugar primordial para um grupo restrito de doentes.Introduction: Pseudoaneurysms (PAN are one of the most common complications of cardiac catheterization. Treatment has evolved towards a less invasive approach, reducing the number of Open repairs. Objectives: The authors propose to discuss the contemporary management of PAN and the remaining indications for Conventional Surgical Repair based upon a case

  1. Ultrasonography of abdominal aorta and its branches in dogs

    OpenAIRE

    Kamikawa, Lilian; Bombonato, Pedro Primo

    2007-01-01

    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 diâme...

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

    Directory of Open Access Journals (Sweden)

    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

  3. 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?

    Directory of Open Access Journals (Sweden)

    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

  4. Tracheal replacement by autogenous aorta

    Directory of Open Access Journals (Sweden)

    Anoosh Farhad

    2009-06-01

    Full Text Available Abstract Background Tracheal defects may occur after trauma or prolonged intubation. Resection of tracheal tumors also poses a major challenge for substitution. In an effort to solve this problem, different techniques have been tried with little success. We report on a new animal model which showed acceptable results with fewer complications. Methods We replaced 5 cm of cervical trachea in 10 dogs with harvested infra-renal aorta and repaired the aortic defect with Dacron graft. Results Necropsy of the grafted aorta and anastomotic site revealed well healed anastomosis in all animals together with ciliated columnar epithelium coverage of grafted aorta and neovascularization of aortic wall. Conclusion Aortic graft is preferable to other substitutes because of less antigenicity, less vascularity, and no mucous secretions or peristalsis

  5. Tracheal replacement by autogenous aorta.

    Science.gov (United States)

    Anoosh, Farhad; Hodjati, Hossain; Dehghani, Seifollah; Tanideh, Nader; Kumar, Perikala V

    2009-06-09

    Tracheal defects may occur after trauma or prolonged intubation. Resection of tracheal tumors also poses a major challenge for substitution. In an effort to solve this problem, different techniques have been tried with little success. We report on a new animal model which showed acceptable results with fewer complications. We replaced 5 cm of cervical trachea in 10 dogs with harvested infra-renal aorta and repaired the aortic defect with Dacron graft. Necropsy of the grafted aorta and anastomotic site revealed well healed anastomosis in all animals together with ciliated columnar epithelium coverage of grafted aorta and neovascularization of aortic wall. Aortic graft is preferable to other substitutes because of less antigenicity, less vascularity, and no mucous secretions or peristalsis.

  6. Cisto tímico como diagnóstico diferencial de doença aguda da aorta torácica Thymic cyst as a differencial diagnosis of acute thoracic aortic disease

    Directory of Open Access Journals (Sweden)

    Marcos Gradim Tiveron

    2008-12-01

    Full Text Available Paciente encaminhada de outro serviço com história de dor torácica aguda de forte intensidade com diagnóstico de hematoma intramural na aorta ascendente para correção cirúrgica. Após investigação diagnóstica, identificou-se tumoração cística no mediastino anterior, que envolvia toda a aorta ascendente e que produzia restrição ao enchimento diastólico do ventrículo direito. A análise histológica do tumor ressecado revelou o diagnóstico de cisto tímico. Objetivo deste relato é descrever tumoração mediastinal de baixa prevalência, que pode produzir imagem radiológica com características de hematoma intramural e resultar em conduta terapêutica equivocada.Patient was referred to our Service with acute thoracic pain and diagnosis of intramural hematoma of the ascending aorta for surgical correction. The diagnostic investigation showed a cystic tumor involving the ascending aorta causing restriction of the right ventricular inflow. After resection, the histologic analysis disclosed the diagnosis of thymic cyst. The aim of this study is to describe a rare mediastinal tumor that may simulate a radiologic feature with characteristics of intramural hematoma and may result in a wrong therapeutic approach.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  9. Aneurisma de artéria poplítea com rotura e formação de pseudo-aneurisma Popliteal artery aneurysm with rupture and pseudoaneurysm formation

    Directory of Open Access Journals (Sweden)

    Heraldo Antônio Barbato

    2006-06-01

    Full Text Available Paciente relatava história aguda de dor e edema em membro inferior direito há 5 dias, e a semiologia caracterizava pulsos poplíteos amplos e perfusão distal satisfatória. Exames laboratoriais mostraram insuficiência renal, e o exame de ultra-som duplex evidenciou um aneurisma de artéria poplítea à direita roto, com formação de pseudo-aneurisma e um aneurisma de artéria poplítea à esquerda. O paciente foi submetido à exploração cirúrgica por via de acesso posterior, sendo evidenciado pseudo-aneurisma secundário a aneurisma de artéria poplítea roto e realizada endoaneurismorrafia com interposição de veia. A evolução pós-operatória foi boa. A ruptura de um aneurisma de artéria poplítea é uma complicação rara, e apenas um relato de formação espontânea de pseudo-aneurisma foi encontrado na literatura.The patient presented with a 5-day history of acute pain and swelling in the right lower limb. On physical examination, wide popliteal pulses and satisfactory distal perfusion were observed. The laboratory work-up showed renal failure and the duplex ultrasound examination was suggestive of a ruptured right popliteal artery aneurysm with pseudoaneurysm formation and a left popliteal artery aneurysm. The patient underwent urgent surgery through a posterior popliteal approach. A ruptured aneurysm with pseudoaneurysm formation was found and repaired by endoaneurysmorrhaphy with interposition of a short saphenous vein segment. The postoperative period was unremarkable. Rupture of a popliteal artery aneurysm is a rare complication: a single report of spontaneous popliteal pseudoaneurysm was found in the literature.

  10. 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

    Directory of Open Access Journals (Sweden)

    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

  11. Aneurisma subanular mitral: correção cirúrgica Submitral left ventricular aneurysm: surgical correction

    Directory of Open Access Journals (Sweden)

    Paulo M Pêgo-Fernandes

    1993-06-01

    Full Text Available O aneurisma subanular mitral é doença pouco conhecida em nosso país. Foi descrita, inicialmente, e é vista com maior freqüência na população negra das regiões sul e oeste da África. Parece relacionar-se a uma fraqueza da parede ventricular na área de implantação da cúspide posterior da valva mitral, levando à insuficiência dessa valva. É relatado o caso de homem de 20 anos, branco, com queixa de dispnéia e taquicardia. Foi internado devido a evolução para classe funcional IV. Após compensação clínica, apresentava, ainda, sopro sistólico (+++/++++ em área mitral. A radiografia de tórax mostrou aumento da área cardíaca (+++/++++ às custas de átrio e ventrículo esquerdo. O ecocardiograma, além do aumento dessas câmaras, revelou dilatação aneurismática na região posterior do ventrículo esquerdo, justa-valvar em relação à valva mitral, com sinais de incompetência severa, assim como a cineangiocardiografia. Submetido a cirurgia em 20/10/86, quando foi realizada ressecção do aneurisma, utilizando-se placas de pericárdio bovino para reconstrução. Foi feita, também, troca de valva mitral por válvula biológica. O paciente evoluiu bem, tendo recebido alta hospitalar no oitavo dia de pós-operatório. Atualmente, é assintomático, o ecocardiograma de controle revelou correção cirúrgica satisfatória.Submitral left ventricular aneurysm is a poorly known entity in our country; it has been described mainly in the southern and western African black populations. It appears to be related to a ventricular wall weakness in the area of implantation of the posterior mitral valve leaflet. A 20-year-old white man was admitted with complaints of dyspnea and palpitation. On admission he was in NYH A class IV. After medical treatment the cardiac area was very enlarged and there was a systolic murmur +++/++++. The twodimensional echocardiography as well as the angiocardiography revealed annular submitral left

  12. A insuficiência da valva aórtica na dissecção crônica da aorta proximal: troca ou reconstrução valvar? Aortic valve insufficiency in chronic aortic dissection: valve replacement or reconstruction?

    Directory of Open Access Journals (Sweden)

    Ricardo Beyruti

    1993-06-01

    Full Text Available Com o objetivo de avaliar os resultados clínicos e ecocardiográficos tardios obtidos com a correção da insuficiência aórtica decorrente da dissecção crônica da aorta proximal, foram estudados 48 pacientes consecutivos operados entre janeiro de 1980 e dezembro de 1989, separados em 2 grupos de 24 pacientes cada. Grupo A - pacientes nos quais a valva aórtica foi preservada pela "resuspensão comissural"; Grupo B - pacientes nos quais a valva aórtica foi substituída. Na avaliação ecocardiográfica pré-operatória, os pacientes do Grupo B apresentavam grau de insuficiência aórtica, diâmetros ventriculares (sistólico e diastólico e da aorta ascendente significativamente maiores do que os do Grupo A (p=0,03, sendo comparáveis nos demais parâmetros. A mortalidade hospitalar foi 12,5% no Grupo A e de 4,17% no Grupo B e a sobrevida aos 7 anos, respectivamente, 75,75% ± 9,82% e 82,72% ± 7,87% (NS. A avaliação clínica mostrou que, no pós-operatório, houve melhora significativa (pFrom January 1980 to December 1989, 48 consecutive patients with chronic aortic dissection and aortic valve insufficiency underwent operation. They were analyzed in 2 groups (24 patients each to evaluate the late clinical and echocardiography outcome of those in whom the aortic valve was preserved (Group A compared with those having valve replacement (Group B. The overall preoperative characteristics of the two groups were similar except for the age (Group A 47.9 ± 10.8 versus Group B 40.2 ± 9.5 years, p=0.03. In the preoperative echocardiographic evaluation, Group B patients had significantly higher aortic root and left ventricle systolic and diastolic diameters (p<0.03, and aortic insufficiency grade (p=0.02. The hospital mortality was 12.5% in Group A and 4.2% in Group B and the seven years actuarial survival rate was respectively 75.7% ± 9.8% and 82.7% ± 7.9%. Postoperatively there was, in both groups, a significant improvement in all clinical

  13. The clip-wrap technique in the treatment of intracranial unclippable aneurysms Técnica de "clip-wrap" no tratamento de aneurismas rotos não clipáveis

    Directory of Open Access Journals (Sweden)

    Eberval Gadelha Figueiredo

    2010-02-01

    Full Text Available Fusiform and dolichoectatic aneurysms are challenging lesions to treat with direct clipping. Treatment of these aneurysms often requires alternative surgical strategies, including extracranial-intracranial bypass, wrapping, or clip-wrap techniques. Nonetheless, these alternatives methods of treatment have been underused and frequently overlooked. OBJECTIVE: To report a series of nine cases of otherwise untreatable aneurysms managed using the clip-wrap technique and discuss its surgical nuances. METHOD: In the last four years, 9 cases of ruptured aneurysms treated by the clip-wrap techniques were identified in the Division of Neurological Surgery, University of São Paulo, School of Medicine. RESULTS: The aneurysms were located at middle cerebral artery (2, anterior choroidal artery (1, anterior communicating artery (1, carotid ophthalmic (3, posterior cerebral artery (1 and posterior-inferior cerebellar artery (1. Three were dolichoectatic, 4 were unsuitable to complete surgical clipping because parent or efferent vessels arises from the aneurysm sac (1 MCA, 1 AcomA, 1 CO, 1 PICA aneurysms and two, although ruptured aneurysms, were too small (Aneurismas fusiformes são lesões de difícil tratamento e frequentemente necessitam de técnicas alternativas de tratamento, incluindo anastomose extra-intracranial ou técnicas de "clip-wrap". Contudo o uso destas técnicas é frequentemente esquecido e negligenciado. OBJETIVO: Descrever retrospectivamente casuística de nove casos de aneurismas não clipáveis tratados com a técnicas de "clip-wrap" e discutir as nuances cirúrgicas. RESULTADOS: Revisão dos últimos quatro anos da casuística da Divisão de Clínica Neurocirúrgica do HCFMUSP mostrou que 384 casos eram de aneurismas rotos. Destes, 9 eram de aneurismas não clipáveis tratados com a técnica de "clip-wrap". Destes, 2 aneurismas eram de artéria cerebral media, 1 de artéria coroidéia anterior, 1 de artéria comunicante anterior, 3 de

  14. 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

    Directory of Open Access Journals (Sweden)

    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

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

    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.

  16. Factores de riesgo para la recanalización de los aneurismas cerebrales tratados con coils desprendibles

    Directory of Open Access Journals (Sweden)

    Carlos Mario Jiménez Yepes

    2008-11-01

    Full Text Available INTRODUCCIÓN: la efectividad de la embolización con coils de los aneurismas cerebrales se apoya en última instancia en su capacidad para lograr la exclusión del flujo sanguíneo del interior del aneurisma, que a su vez es el mecanismo por medio del cual se previene el resangrado. Los buenos resultados a corto y mediano plazo de la terapia endovascular con coils para la oclusión de aneurismas cerebrales no están discusión, siempre y cuando sean medidos en términos de complicaciones y prevención del resangrado, e incluso son mejores que con cirugía abierta, como lo han demostrado estudios tanto retrospectivos como prospectivos El problema aparece cuando se evalúa la persistencia de la oclusión de los aneurismas a largo plazo. A pesar de las ventajas de la terapia endovascular con coils, los aneurismas embolizados con este método en ocasiones se recanalizan y se requieren intervenciones adicionales, hecho que se constituye en la principal desventaja de esta modalidad de tratamiento. Este fenómeno, llamado recanalización, se ha reportado hasta en, aproximadamente, un tercio de los pacientes. Se han reportado frecuencias de recanalización del 28% en el primer año, 20% entre el primer y segundo años y 14% entre el segundo y tercer años, mostrando un patrón de recanalización que declina progresivamente hasta el tercer año, después del cual ya prácticamente no se presenta. Cognard y colaboradores (Radiology 1999,212;384-356 encontraron una frecuencia de recanalización del 14% en los aneurismas totalmente ocluidos y del 30% en los parcialmente ocluidos, con una frecuencia continua de recurrencia del 5% a los 3 meses, 9% a los 18 meses y 8% a los 38 meses luego de la embolización. En la serie reportada por Hayakawa (J Neurosurgery 2000, 193;561- 568 49% de los aneurismas tratados por medio de coils se hicieron recurrentes debido a recanalización de la luz meses o años después del tratamiento inicial. Como se puede ver a partir

  17. 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

    Directory of Open Access Journals (Sweden)

    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.

  18. Carótida comum como via de estabelecimento da circulação extracorpórea para perfusão sistêmica e cerebral seletiva na correção das doenças da aorta Carotid artery inflow and anterograde cerebral perfusion in operations to correct aortic disease

    Directory of Open Access Journals (Sweden)

    Luiz Henrique Pamplona Corte Real de Carvalho

    2006-09-01

    Full Text Available OBJETIVO: Analisar os resultados da utilização da artéria carótida comum direita no estabelecimento da circulação extracorpórea (CEC para perfusão sistêmica (PS, bem como na utilização como via anterógrada para proteção cerebral (PC, nos pacientes submetidos à correção das doenças que envolveram a aorta ascendente (AA. MÉTODO: Foram operados 23 pacientes portadores de várias afecções da AA, nos quais a abordagem foi possível por meio do estabelecimento da CEC pela anastomose de um tubo de PTFE (politetrafluoretileno à artéria carótida comum direita e manutenção de fluxo cerebral anterógrado durante a confecção da anastomose distal. O tempo médio de CEC foi de 195 minutos (152 a 253 minutos, a temperatura média sistêmica foi de 24ºC (18ºC a 25ºC, hipofluxo cerebral anterógrado, com média de 29 minutos (27 a 51 minutos e o tempo de internação média foi de 18 dias (8 a 30 dias. RESULTADOS: Todos os pacientes despertaram nas primeiras 48 horas sem dano neurológico. Por ocasião da pré-alta, foram submetidos ao teste MINI MENTAL STATE EXAMINATION (MMSE, que demonstrou não haver desordens cognitivas com dano neurológico. Ocorreram dois casos de infecção pulmonar, dois pacientes necessitaram de diálise e ocorreram dois óbitos relacionados à gravidade dos casos. Não houve óbito per-operatório. CONCLUSÃO: Este é um método prático, rápido, seguro, eficaz e reprodutível, tanto no estabelecimento da CEC como da proteção cerebral anterógrada, reduzindo o risco de isquemia cerebral, alterando a história natural da evolução pós-operatória destas correções.OBJECTIVE: To evaluate the use of the right common carotid artery to establish cardiopulmonary bypass (CPB and the use of anterograde cerebral perfusion as cerebral protection in patients scheduled for ascending aortic repair surgery. METHOD: Twenty-three patients were submitted to aortic repair because of different aortic diseases. In all

  19. Aneurisma congénito de la orejuela izquierda. Caso clínico

    Directory of Open Access Journals (Sweden)

    Johanna T. Otero

    2008-04-01

    Full Text Available El aneurisma auricular congénito es una enfermedad muy rara y su localización más frecuente es la orejuela de la aurícula izquierda con 51 casos comunicados en la literatura. La mayoría son asintomáticos, por lo que su diagnóstico es por hallazgo en técnicas de imagen. Presentamos el caso de un lactante de 4 meses, de género masculino, portador de un síndrome de Treacher-Collins o disostosis mandibulofacial y síndrome bronquial obstructivo cuyo estudio de técnicas de imagen diagnostica un aneurisma de la orejuela izquierda.Se realiza resección quirúrgica del aneurisma bajo circulación extracorpórea sin incidentes. En el seguimiento a 12 meses el paciente se encuentra asintomático y sin videncia ecocardiográfica de recurrencia.

  20. 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

    Directory of Open Access Journals (Sweden)

    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

  1. Papel de la ecocardiografía transesofágica perioperatoria en la patología de la aorta

    Directory of Open Access Journals (Sweden)

    Paula Carmona

    2014-01-01

    Full Text Available La ecocardiografía transesofágica constituye una herramienta diagnóstica esencial en la patología de la aorta, permitiendo un diagnóstico y la instauración de un tratamiento médico o quirúrgico precoz, así como la monitorización durante la cirugía. La ecocardiografía permite un diagnóstico rápido, preciso y aplicable a pacientes inestables hemodinámicamente y con dificultades para ser trasladados para otras pruebas de imagen. El interés en la formación y el reconocimiento de las imágenes ecocardiográficas por parte del cirujano cardiovascular es cada vez mayor. En este artículo revisaremos la identificación de las distintas entidades patológicas aórticas mediante la ecocardiografía transesofágica (disección aórtica aguda, hematoma intramural, úlcera penetrante, aneurismas aórticos, aneurismas de seno de Valsalva, ateroesclerosis aórtica y traumatismos aórticos.

  2. 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

  3. Aneurismas de la arteria pulmonar. Reporte de un caso y revisión de la literatura

    Directory of Open Access Journals (Sweden)

    Rosalba Vivas, MD

    2011-07-01

    Se presenta el caso de una paciente de siete años, quien fue referida para evaluación por endocarditis infecciosa de la válvula tricúspide debida a Staphylococcus aureus. Desarrolló aneurismas bilaterales en ramas lobulares de la arteria pulmonar secundarios a la infección valvular. El aneurisma del lado derecho era de gran tamaño y con alto riesgo de ruptura, razón de peso para que se le efectuara embolización con coils. El procedimiento fue exitoso y no se documentaron complicaciones. La lesión del lado izquierdo se trató de forma expectante teniendo en cuenta que era de menor tamaño. En la actualidad la paciente está en seguimiento ambulatorio con el fin de vigilar la evolución del aneurisma del lado izquierdo.

  4. Fístula aortobroncopulmonar em pós-operatório tardio de coarctação da aorta Fístula aortobroncopulmonar en postoperatorio tardío de coartación de aorta Aortobronchopulmonary fistula in the postoperative period of aortic coarctation

    Directory of Open Access Journals (Sweden)

    Antônio Fernando Coelho Júnior

    2009-04-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Em pacientes com hemoptise e história de cirurgia aórtica, a possibilidade de fístula aortobroncopulmonar deve sempre ser considerada. O objetivo deste estudo foi relatar um caso raro de hemoptise por fístula aortobroncopulmonar em pós-operatório tardio de cirurgia aórtica. RELATO DE CASO: Mulher, 34 anos, correção cirúrgica de coarctação de aorta na infância, apresentando hemoptise maciça. Ecocardiograma evidenciou pseudoaneurisma. Foi realizada a cirurgia e implantado tubo de dacron no segmento aórtico envolvido com sucesso. CONCLUSÕES: Fístula aortobroncopulmonar deve ser lembrada em pacientes com cirurgia aórtica prévia, principalmente pela elevada morbimortalidade se não diagnosticada e tratada precocemente.JUSTIFICATIVA: En pacientes con hemoptisis e historia de cirugía aórtica, la posibilidad de fístula aortobroncopulmonar siempre debe tenerse en cuenta. OBJETIVOS: Relatar un caso raro de hemoptisis por fístula aortobroncopulmonar en postoperatorio tardío de cirugía aórtica. INFORME DE CASO: Mujer, 34 años, corrección quirúrgica de coartación de la aorta en la infancia, presentando hemoptisis masiva. Ecocardiograma mostró evidencias de seudoaneurisma. Se realizó la cirugía, implantándose con éxito un tubo de dacron en el segmento aórtico involucrado. CONCLUSIONES: La fístula aortobroncopulmonar debe ser considerada en pacientes con cirugía aórtica previa, principalmente por la elevada morbimortalidad cuando no es diagnosticada y tratada precozmente.BACKGROUND AND OBJECTIVES: In patients with hemoptysis and a history of aortic surgery, the possibility of aortobronchopulmonary fistula must always be considered. The objective of this study was to report a rare case of hemoptysis due to aortobronchopulmonary fistula in the late postoperative period of aortic surgery. CASE REPORT: Female patient, 34 years, surgical correction of aortic coarctation, presenting massive hemoptysis

  5. Inositol uptake in rat aorta

    International Nuclear Information System (INIS)

    Rapoport, R.M.; Van Gorp, C.; Chang, Ki-Churl

    1990-01-01

    3 H-inositol uptake into deendothelialized aorta was linear for at least 2 h and was composed of both a saturable, Na + -dependent, and a nonsaturable, Na + -independent component. The Na + -dependent component of inositol uptake had a K m of 50 μM and a V max of 289 pmol/mg prot/h. Exposure to LiCl, ouabain, or Ca 2+ - free Krebs-Ringer bicarbonate solution inhibited uptake. Metabolic poisoning with dinitrophenol, as well as incubation with phloretin, an inhibitor of carrier-mediated hexose transport, also inhibited uptake. Exposure to norepinephrine decreased inositol uptake, while phorbol myristate acetate was without effect. Isobutylmethylxanthine significantly increased inositol uptake, while the increased uptake due to dibutyryl cyclic AMP and forskolin were not statistically significant. Sodium nitroprusside, and activator of guanylate cyclase, and 8-bromo cyclic GMP, were without effect on uptake, as was methylene blue, an inhibitor of guanylate cyclase. Inositol uptake into the aorta was increased when the endothelium was allowed to remain intact, although this effect was likely due to uptake in both the endothelial and smooth muscle cells

  6. 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

    Directory of Open Access Journals (Sweden)

    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

  7. Acute spontaneous isolated dissection of abdominal aorta

    Directory of Open Access Journals (Sweden)

    Ali Akbar beigi

    2009-09-01

    Full Text Available

    • Aortic dissection occurs when the layers of the aorta separate as a result of extra luminal cavity of blood through an intimal tear. Dissection limited to the abdominal aorta is rare. Unfortunately, the appropriate management of dissecting aneurysm of abdominal aorta is not documented yet. A 43 years old man was admitted to Al-zahra hospital in Isfahan with sudden onset of periumbilical abdominal pain. CT scan confirmed infrarenal dissection of abdominal aorta. Performing laparotomy, aorta was repaired using bifurcate collagen-coated Dacron graft. Surgical intervention with synthetic graft is recommended in patients with dissecting aortic aneurysm of infrarenal segments where the extent of dissection is limited and accessible.
    • Keywords: Aneurysm, Aortic dissection, Aortic aneurysm abdominal surgery.

  8. Aneurisma y fístula arterio-venosa renal: manejo quirúrgico laparoscópico asistido por robot

    OpenAIRE

    CASTILLO C,OCTAVIO A; CUENTAS J,MARIANO; VIDANGOS V,RUBÉN; GUTIÉRREZ,RODRIGO; PALAVECINO R,PATRICIO

    2013-01-01

    Introducción: Los aneurismas de la arteria renal constituyen una patología infrecuente, y plantean dificultades en la decisión terapéutica. Objetivo: Presentar un caso de un aneurisma complejo intrarenal, asociado a una fístula arterio-venosa de alto flujo, el cual fue resuelto con asistencia robótica. Caso clínico: Paciente de 51 años, con historia prolongada de hipertensión arterial, al cual, en estudio radiológico de rutina, se le diagnostica 3 aneurismas intrarenales derechos, asociado a ...

  9. Sellado de aneurisma coronario con stent cubierto de PTFE (stent graft)

    OpenAIRE

    Portero Pérez,Ma Pilar; Ortas Nadal,Ma Rosario; Ruiz Arroyo,José Ramón; Escota Villanueva,Javier; Peleato Peleato,Antonio

    2008-01-01

    Los aneurismas coronarios son muy raros, su frecuencia oscila entre el 1 y el 2%, siendo la aterosclerosis la enfermedad más asociada, aunque se han descrito los de origen congénito, los asociados a la enfermedad de Kawasaki, a enfermedades del tejido conectivo, a enfermedades infecciosas y a traumatismos torácicos. También se observan los relacionados con la implantación del stent, con la braquiterapia intracoronaria y con los "stents" recubiertos de fármacos. Su evolución no es muy bien con...

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

    Directory of Open Access Journals (Sweden)

    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.

  11. Resultados del tratamiento quirúrgico en aneurismas intracraneales múltiples de la circulación anterior

    Directory of Open Access Journals (Sweden)

    Armando Alemán Rivera

    2001-09-01

    Full Text Available Se realiza un análisis de 10 pacientes con aneurismas múltiples de la porción anterior del polígono de Willis, los cuales representan el 10 % de todos los pacientes con aneurismas operados en el Servicio de Neurocirugía del Hospital Universitario «Arnaldo Milián Castro» de Santa Clara, Villa Clara. En 2 pacientes, los sacos aneurismáticos se localizaban bilateralmente. En un enfermo, la operación fue unilateral, mientras que en el otro, donde los aneurismas se localizaban en ambas arterias cerebrales medias, segmento M2 (aneurismas en espejo, el abordaje se realizó en 2 tiempos quirúrgicos. Todos los sacos aneurismáticos se presillaron y se reportó una mortalidad del 10 %An analysis of 10 patients with multiple aneurysms of the anterior portion of the circle of Willis that accounted for 10 % of all patients with aneurysms operated on at the Neurosurgery Service of "Arnaldo Milián Castro" Teaching Hospital of Santa Clara, Villa Clara, was made. The aneurysmatic sacs were bilaterally located in 2 patients. In one patient, the operation was unilateral, whereas in the other one, in whom the aneurysms were located in both middle cerebral arteries, M2 segment (mirror aneurysms, the operation was performed in 2 surgical times. All the aneurysmatic sacs were stapled and a 10 % mortality was re

  12. Endoprótese revestida de jugular preservada de bovino: estudo comparativo da resposta tecidual em aorta torácica descendente e veia cava inferior de suínos

    Directory of Open Access Journals (Sweden)

    Celso Luiz Muhlethaler Chouin

    Full Text Available OBJETIVO: Avaliar e comparar a resposta tecidual de uma endoprótese biosintetica implantada na aorta torácica descendente e veia cava inferior de suínos. MÉTODO: Foi implantada uma endoprótese auto-expansível composta de aço inoxidável, revestida por veia jugular de bovino, processada pelo método L-hydro, com auxilio de uma bainha de liberação Taheri-Leonhardt (Flórida, EUA na aorta torácica descendente, e a veia cava infra-renal de 10 suínos. Sessenta dias após, as endopróteses foram retiradas e analisadas sob o ponto de vista macro e microscópicos. Foram observados: perviedade, grau de incorporação a parede do vaso, tipo de reação inflamatória, e local de maior resposta, tanto em relação a camada do vaso quanto ao local de contato com o anel de aço RESULTADOS: Todas as endopróteses encontravam-se pérvias, e incorporadas à parede. No setor venoso, seis apresentaram traves fibrosas em sua luz, e quatro apresentaram fibrose perivascular. No setor arterial somente uma prótese apresentou discreta estenose, sem fibrose perivascular. A reação inflamatória crônica tipo corpo estranho ocorreu em 100% das peças, a camada média foi a mais acometida no setor venoso, enquanto a íntima foi mais constante na artéria, o grau de incorporação foi mais firme na veia em comparação a artéria. A reação tecidual mostrou maior tendência nas áreas em intimo contato com o anel de aço (intra-anelar, mais intensa na artéria do que na veia. CONCLUSÃO: A prótese apresentou baixa trombogenicidade em ambos os sistemas, houve maior reação tecidual e baixa biocompatibilidade no setor venoso.

  13. 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

  14. Detecção de calcificação de aorta abdominal por densitometria

    Directory of Open Access Journals (Sweden)

    Osvaldo Sampaio Netto

    2013-02-01

    Full Text Available OBJETIVO: Analisar a acurácia da detecção de calcificação da aorta abdominal por meio de densitometria em comparação com a radiografia lateral de coluna. MATERIAIS E MÉTODOS: Casuística de 80 indivíduos, sendo 50 com diagnóstico de calcificação de aorta abdominal e 30 sem calcificação. Densitometria realizada uma única vez em cada participante, com o paciente em decúbito lateral direito. RESULTADOS: Em relação à idade e ao índice de massa corporal tivemos grupos semelhantes, com idade média de 74,56 ± 10,55 anos e 68,40 ± 10,80 anos e índice de massa corporal de 28,94 ± 6,06 kg/m² e 26,84 ± 4,11 kg/m² nos grupos com calcificação de aorta abdominal e sem calcificação de aorta abdominal, respectivamente. A comparação estatística da densitometria com a radiografia mostra que são semelhantes na detecção da calcificação de aorta abdominal, com valores de 100% na especificidade e valor preditivo positivo; sensibilidade de 94%, valor preditivo negativo de 90,9% e acurácia de 96,3%. Equivalência qualitativa no diagnóstico foi demonstrada pelo índice de correlação de kappa de 0,922. CONCLUSÃO: Os resultados da radiografia e da densitometria são estatisticamente equivalentes, o que permite sugerir a investigação de calcificação de aorta abdominal pela densitometria para a detecção de calcificação da aorta abdominal.

  15. Follow-up of the aneurysmal sac after exclusion and bypass of popliteal artery aneurysms Evolução do saco aneurismático após a exclusão cirúrgica dos aneurismas de artéria poplítea

    Directory of Open Access Journals (Sweden)

    Tais Bugs Wakassa

    2006-04-01

    Full Text Available Popliteal artery aneurysms are frequent and may lead to thromboembolic events and limb loss. PURPOSE: To evaluate clinical and ultrasonographic follow-up of patients who underwent exclusion of a popliteal artery aneurysm using the technique proposed by Edwards. METHODS: Data of all patients who underwent surgery to repair a popliteal artery aneurysm at Hospital das Clinicas, the São Paulo University Medical School between 1996 and 2004 were reviewed. Inclusion criteria were repair with aneurysm exclusion and bypass using the technique proposed by Edwards, as well as the existence of preoperative and postoperative measurements of the aneurysmal sac. RESULTS: Data of 16 patients who underwent 20 procedures for popliteal artery aneurysm exclusion and bypass were available to analysis. The preoperative diameter of the popliteal artery aneurysms ranged from 1.3 cm to 6.1 cm (mean = 3.1 cm. Patients underwent duplex ultrasound scanning 1 month to 7 years after surgical repair. Follow-up of the 20 cases revealed that 10 aneurysms exhibited decreased mean transverse diameters, ranging from 0.2 to 2.3 cm, while 7 had increased in diameter, ranging 0.3 to 3.3 cm, and 3 remained unchanged. Flow was observed only in 5 outo f the 20 procedures, 3 of which (60% had increased diameters. CONCLUSION: Although exclusion is a widely accepted procedure for the repair of popliteal artery aneurysms, data in the literature and the results of this study, which did not include cases of rupture or compression, suggest that strict follow-up of patients who undergo aneurysm exclusion is necessary.Os aneurismas da artéria poplítea são freqüentes e estão associados a eventos trombo-embólicos que podem acarretar isquemia grave com risco de perda da extremidade inferior acometida. OBJETIVO: Avaliar a evolução clínica dos pacientes e ultra-sonográfica dos aneurismas de artéria poplítea excluídos pela técnica de Edwards. MÉTODO: Análise retrospectiva dos

  16. Extended replacement of the thoracic aorta.

    Science.gov (United States)

    Hino, Yutaka; Okada, Kenji; Oka, Takanori; Inoue, Takeshi; Tanaka, Akiko; Omura, Atsushi; Kano, Hiroya; Okita, Yutaka

    2013-01-01

    We present our experience of total aortic arch replacement. Twenty-nine patients (21 males and 8 females; mean age 63.3 ± 13.3 years) with extended thoracic aortic aneurysms underwent graft replacement. The pathology of the diseased aorta was non-dissecting aneurysm in 11 patients, including one aortitis and aortic dissection in 18 patients (acute type A: one, chronic type A: 11, chronic type B: six). Five patients had Marfan syndrome. In their previous operation, two patients had undergone the Bentall procedure, three had endovascular stenting, one had aortic root replacement with valve sparing and 12 had hemi-arch replacement for acute type A dissection. Approaches to the aneurysm were as follows: posterolateral thoracotomy with rib-cross incision in 16, posterolateral thoracotomy extended to the retroperitoneal abdominal aorta in seven, mid-sternotomy and left pleurotomy in three, anterolateral thoracotomy with partial lower sternotomy in two and clam-shell incision in one patient. Extension of aortic replacement was performed from the aortic root to the descending aorta in 4, from the ascending aorta to the descending aorta in 17 and from the ascending to the abdominal aorta in eight patients. Arterial inflow for cardiopulmonary bypass consisted of the femoral artery in 15 patients, ascending aorta and femoral artery in seven, descending or abdominal aorta in five and ascending aorta in two. Venous drainage site was the femoral vein in 10, pulmonary artery in eight, right atrium in five, femoral artery with right atrium/pulmonary artery in four and pulmonary artery with right atrium in two patients. The operative mortality, 30-day mortality and hospital mortality was one (cardiac arrest due to aneurysm rupture), one (rupture of infected aneurysm) and one (brain contusion), respectively. Late mortality occurred in three patients due to pneumonia, ruptured residual aneurysm and intracranial bleeding. Actuarial survival at 5 years after the operations was 80.6

  17. 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.

  18. Primeiro escore de risco inflamatório das endopróteses de aorta First inflammatory risk score for aortic endoprostheses

    Directory of Open Access Journals (Sweden)

    Edmo Atique Gabriel

    2008-12-01

    Full Text Available OBJETIVO: Propor um escore de risco inflamatório para tratamento endovascular dos aneurismas da aorta. MÉTODOS: Vinte e cinco pacientes foram seguidos do período pré-operatório até 3º mês de pós-operatório (1 hora, 6 horas, 24 horas, 48 horas, 7 dias, 1 mês, 2 meses e 3 meses. Variáveis inflamatórias avaliadas foram proteína C reativa, velocidade de hemossedimentação, interleucinas (IL-6, IL8, fator de necrose tumoral alfa, L-selectina, molécula de adesão intercelular (ICAM-1, transfusão de hemáceas, volume de cristalóide, volume de contraste, material da prótese, número de próteses, contagem total de leucócitos e linfócitos. O teste de Spearman apontou as variáveis candidatas ao maior risco inflamatório, segundo P OBJECTIVE: To purpose an inflammatory risk score for aortic aneurysm endovascular treatment. METHODS: Twenty-five patients were followed-up from preoperative period to third month postoperatively (1-hour, 6-hour, 24-hour, 48-hour, 7-day, 1-month, 2- month and 3month. Inflammatory variables were C-reactive protein, hemosedimentation velocity, interleukins (IL-6, IL-8, tumor necrosis factor-Alpha, L-selectin, intercellular adhesion molecule (ICAM-1, red blood cells transfusion, volume of crystalloid, volume of contrast, type of endoprosthesis, number of endoprostheses, total count of leukocytes and lymphocytes. Spearman test defined the variables considered as candidates to higher inflammatory risk based on P < 20%. Logistic regression defined the variables considered as selected for final score based on P < 10%. ROC curve analysis revealed the cut-off values for variables selected by logistic regression. RESULTS: Variables defined by Spearman test were: volume of crystalloid (P=0.04, type of endoprosthesis (P=0.04, volume of contrast (P=0.02, preoperative IL-8 (P = 0.10, 1 - month ICAM-1 (P=0.03 and 1-month L-selectin (P=0.06. Logistic regression revealed that volume of crystalloid and preoperative IL-8

  19. Propagation of a small disturbance in Aorta

    International Nuclear Information System (INIS)

    Gaur, M.; Prakash, R.

    1988-01-01

    The object of the present communication is to provide a mathematical model for the propagation of a small disturbance in the aorta. A differential equation governing the growth and decay of the small disturbance has been obtained. It is observed that the compressive pulses may grow into a shock wave. A mathematical model which is based on geometrical and mechanical properties of aorta admits disturbances in the propagating pulses which are not observed in human beings under normal physiological conditions. It is also observed that friction effects are to resist the tendency of shock formation in the model. The application of the results to the human arterial system shows that strong disturbances or shock waves are not expected under normal physiological conditions, while, in the case of a pathologically increased pressure rise at the root of aorta, shocklike transition may develop in the periphery. Some special cases of interest have also been discussed

  20. Digital subtraction angiography of the thoracic aorta

    International Nuclear Information System (INIS)

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

    1984-01-01

    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

  1. 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.

  2. Pseudoprominent aorta: Radiographic findings and CT correlation

    International Nuclear Information System (INIS)

    Brown, K.T.; Shepard, J.A.O.; Stewart, W.J.

    1985-01-01

    The presence of a persistent left-sided superior vena cava (LSVC) in the absence of a right-sided superior vena cava (RSVC) may be suspected on a posteroanterior (PA) chest radiograph because of a prominent-appearing ascending aorta, which results from the absence of the RSVC. In the absence of an RSVC, the right upper lobe abuts and outlines the course of the ascending aorta, allowing better demonstration of its profile. This report describes a patient with this finding on a PA chest radiograph. Computed tomographic correlation is presented

  3. Pseudoprominent aorta: Radiographic findings and CT correlation

    Energy Technology Data Exchange (ETDEWEB)

    Brown, K.T.; Shepard, J.A.O.; Stewart, W.J.

    1985-05-01

    The presence of a persistent left-sided superior vena cava (LSVC) in the absence of a right-sided superior vena cava (RSVC) may be suspected on a posteroanterior (PA) chest radiograph because of a prominent-appearing ascending aorta, which results from the absence of the RSVC. In the absence of an RSVC, the right upper lobe abuts and outlines the course of the ascending aorta, allowing better demonstration of its profile. This report describes a patient with this finding on a PA chest radiograph. Computed tomographic correlation is presented.

  4. 295. Cirugía Híbrida de Aneurisma Toracoabdominal Con Derivación Extraanatómica de Arterias Viscerales Desde Aorta Ascendente

    Directory of Open Access Journals (Sweden)

    M. García Vieites

    2012-04-01

    El paciente presentó un postoperatorio complicado por síndrome de respuesta inflamatoria sistémica, shock distributivo, fracaso renal agudo que requirió hemodiálisis convencional, siendo alta a los 4 meses. Cinco meses tras el alta, el paciente está en seguimiento en consultas externas, hallándose asintomático desde el punto de vista cardiovascular. Las pruebas de imagen de alta resolución de control muestran correcta exclusión aneurismática sin evidenciarse endofugas.

  5. Remisión de aneurisma luego de exéresis de MAV con aparición de síndrome del acento extranjero

    Science.gov (United States)

    Sosa, Fidel; Bustamante, Jorge; Rodríguez, Facundo; Argañaraz, Romina; Rubino, Pablo; Lambre, Jorge

    2017-01-01

    Resumen Introducción: Los aneurismas asociados a malformaciones arteriovenosas (MAV) son lesiones vasculares que suelen encontrarse hasta en el 15% de los casos, incrementando el riesgo global de hemorragia. La conducta frente a los aneurismas asociados es dicotómica en la literatura, mientras existen reportes de la desaparición de los mismos luego de la exéresis de la MAV, otros artículos enfatizan su tratamiento precoz. El síndrome del acento extranjero es un raro trastorno neurológico en el que el paciente habla su lengua materna como lo haría una persona extranjera y suena con “acento” extranjero a oídos de los oyentes nativos. Objetivo: Presentar un paciente que desarrolla el síndrome del acento extranjero posterior a la exéresis de una MAV y la evolución de un aneurisma asociado. Presentación de caso: Paciente pediátrico que luego de la exéresis de una MAV fronto-opercular posterior izquierda remite por completo un aneurisma de hiperflujo asociado, presentando en el postquirúrgico el síndrome del acento extranjero. Conclusión: Queda reportado el caso de este raro síndrome y la resolución espontánea de un aneurisma proximal luego de la exéresis de una MAV. PMID:28480115

  6. Modeling Blood Flow in the Aorta.

    Science.gov (United States)

    McConnell, Colin J.; Carmichael, Jonathan B.; DeMont, M. Edwin

    1997-01-01

    Presents an exercise to demonstrate two fundamental concepts of fluid mechanics: the Reynolds number and the Principle of Continuity. The exercise demonstrates flow in a major blood vessel, such as the aorta, with and without a stenosis. Students observe the transition from laminar to turbulent flow as well as downstream persistence of turbulence.…

  7. 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

    Directory of Open Access Journals (Sweden)

    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.

  8. Hepatic artery aneurysm: incidental diagnosis with abdominal ultrasonography and treatment by coil embolization Aneurisma de artéria hepática: diagnóstico incidental com ultrassonografia do abdome e tratamento por embolização com molas

    Directory of Open Access Journals (Sweden)

    Luis Jesuino de Oliveira Andrade

    2012-09-01

    Full Text Available Hepatic artery aneurysm (HAA was first reported at autopsy in 1809, represents one fifth of visceral aneurysms and the mortality from spontaneous rupture is high in most of cases. We are reporting a case of an asymptomatic 48-year-old woman with an extrahepatic HAA, diagnosed initially and incidentally with abdominal ultrasonography, confirmed by a three-dimensional contrast-enhanced magnetic resonance imaging and angiography. Endovascular treatment was considered feasible and was successfully treated with coil embolization.Aneurisma da artéria hepática (AAH foi relatado pela primeira vez através de autópsia em 1809, representa um quinto dos aneurismas viscerais, e a mortalidade por ruptura espontânea é alta na maioria dos casos. Relatamos o caso de uma mulher de 48 anos de idade com um AAH extra-hepático assintomático, diagnosticado inicialmente, e incidentalmente, com ultrassonografia abdominal e confirmado através de angiorressonância tridimensional e angiografia contrastada. O tratamento endovascular foi considerado viável, sendo tratada com sucesso através de embolização com molas.

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

    OpenAIRE

    Julio Oscar Cabrera Rego; Osmín Castañeda; Juan Valiente Mustelier; Vladimir Mendoza Rodríguez; Leonardo López Ferrero; Roberto LLerena Rojas

    2011-01-01

    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.La...

  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. Device occlusion of pseudoaneurysm of ascending aorta

    Directory of Open Access Journals (Sweden)

    Mridul Agarwal

    2011-01-01

    Full Text Available Pseudoaneurysm of ascending aorta is an infrequent but well-recognized and potentially fatal complication after cardiac surgeries. The complication can develop early, delayed or late, and the presentation is also varied. We are presenting here two cases of pseudoaneurysm of ascending aorta following cardiac surgery that were successfully managed by the transcatheter method. The first one occurred following coronary artery bypass surgery and the second one occurred following double-valve replacement surgery. The aortic openings of these aneurysms were occluded with 12 mm and 10 mm atrial septal occluders, respectively, with a good outcome. An immediate postprocedure angiogram showed no residual flow into the sac. Six months of follow-up of both cases also showed excellent results.

  12. COAGULACIÓN INTRAVASCULAR DISEMINADA SECUNDARIA A ANEURISMA AÓRTICO DIAGNOSTICADA TRAS EXTRACCIÓN DENTAL

    OpenAIRE

    Cuevas-Ruiz MV; De la Nogal B; Cuevas-Ruiz B

    2006-01-01

    RESUMEN:Las manifestaciones de la coagulación intravascular diseminada (CID) están determinadas por la causa subyacente; sin embargo, en los casos de CID compensada el diagnóstico se basa en las pruebas de laboratorio.Presentamos el caso de un varón de 81 años al que se diagnostico de una coagulación intravascular diseminada secundaria a un aneurisma gigante de ambas ilíacas tras una extracción dentaria. SUMMARYThe clinical presentation of disseminated intravascular coagulopathy (DIC) is dete...

  13. Tratamiento endovascular de 473 aneurismas intracraneanos: resultados angiográficos y clínicos. Experiencia colombiana, 1996-2008

    Directory of Open Access Journals (Sweden)

    Sergio Alberto Vargas

    2010-12-01

    Conclusión. El tratamiento endovascular de los aneurismas intracraneanos se asoció con una baja morbimortalidad y una gran factibilidad técnica. Los resultados fueron similares a diversas series publicadas en la literatura mundial, respaldando la reproducibilidad del método en nuestro medio.

  14. Aneurismas múltiplos de pontes aorto-coronárias de veia safena com ruptura fatal Multiple aneurysms of aortocoronary saphenous vein grafts with fatal rupture

    Directory of Open Access Journals (Sweden)

    Fábio R. Távora

    2007-05-01

    Full Text Available Aneurismas de pontes aorto-coronárias de veia safena são eventos raros, usualmente assintomáticos e detectados de forma incidental. Rupturas espontâneas de pontes de safena são raras, havendo poucos dados radiológicos disponíveis na literatura. Relatamos o caso de um senhor de 39 anos internado com hematêmese dez anos depois de ter sido submetido a cirurgia de revascularização miocárdica. Imagens tomográficas mostraram três aneurismas nas pontes de safena, mas o exame não detectou ruptura. O paciente veio a falecer e a necropsia revelou que a causa do óbito havia sido ruptura de aneurisma de pontes de safena. Esse caso ilustra a necessidade de tratamento agressivo de aneurismas sintomáticos de pontes coronarianas.Aortocoronary saphenous vein graft (SVG aneurysms are rare, and are usually asymptomatic and detected incidentally. Spontaneous rupture of SVG is rare and imaging data are few. We report on a 39-year old man who was admitted to the hospital with hematemesis 10 years after aortocoronary bypass surgery. CT images revealed 3 aortocoronary SVG aneurysms, but failed to detect any rupture. His subsequent death due to rupture of SVG aneurysm was documented at autopsy, illustrating the need for aggressive treatment of symptomatic coronary graft aneurysms.

  15. Coil embolization of an anastomotic leak after ascending aorta replacement

    DEFF Research Database (Denmark)

    Nørgaard, Anders; Andersen, Lars Ib; Haahr, P.E.

    2008-01-01

    in the presence of previous surgical repair of the thoracic aorta. The endovascular procedure, however, is almost only possible in the descending thoracic aorta, although advances have also been made in the aortic arch as well as in the ascending aorta with branched stent grafts. We report a case of a surgically...... treated aneurysm in the ascending thoracic aorta complicated with an anastomotic leak. If a short prosthesis (6 cm) had been available, the anastomotic leak would have been treated with endovascular repair. In lack of this prosthesis, we were forced to treat the patient with a method not generally...

  16. AORTA: Adding Organizational Reasoning to Agents

    DEFF Research Database (Denmark)

    Jensen, Andreas Schmidt; Dignum, Virginia

    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. 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....

  17. Controversias en el manejo actual de la coartación de la aorta

    Directory of Open Access Journals (Sweden)

    Edgardo Vanegas

    2013-09-01

    Full Text Available La coartación de la aorta fue descrita clásicamente como una simple estrechez del istmo aórtico que podría ser "curada" por medio de cirugía. En la actualidad se sabe que es la manifestación clínica de una vasculopatía arterial más amplia, en donde la afección del arco aórtico puede ser variable. La corrección quirúrgica ha demostrado ser un tratamiento efectivo para el manejo de la coartación aórtica nativa y permanece como el de elección en neonatos. De otra parte, la angioplastia con balón es el tratamiento de elección en niños con recoartación, cuyos resultados en la reducción aguda del gradiente aórtico posterior al manejo de la coartación nativa, son similares a los obtenidos con cirugía. La implantación de prótesis endovasculares (stents ha mostrado excelentes resultados a corto plazo tanto en niños mayores como en adultos con coartación nativa. En pacientes con coartación recurrente considerados de alto riesgo quirúrgico, la angioplastia con balón y la implantación de stent ofrecen una estrategia de manejo menos invasiva e igual de efectiva. Se prefiere el uso de stents sobre la angioplastia con balón en adultos y niños mayores con coartación recurrente, ya que el riesgo de recoartación y formación de aneurismas parece ser menor. No se cuenta con suficiente información acerca de los desenlaces a largo plazo posteriores al tratamiento percutáneo de la coartación aórtica. Este artículo revisa las controversias existentes en cuanto al manejo actual de esta condición.

  18. Controversias en el manejo actual de la coartación de la aorta

    Directory of Open Access Journals (Sweden)

    Edgardo Vanegas, MD

    2013-09-01

    Full Text Available La coartación de la aorta fue descrita clásicamente como una simple estrechez del istmo aórtico que podría ser “curada” por medio de cirugía. En la actualidad se sabe que es la manifestación clínica de una vasculopatía arterial más amplia, en donde la afección del arco aórtico puede ser variable. La corrección quirúrgica ha demostrado ser un tratamiento efectivo para el manejo de la coartación aórtica nativa y permanece como el de elección en neonatos. De otra parte, la angioplastia con balón es el tratamiento de elección en niños con recoartación, cuyos resultados en la reducción aguda del gradiente aórtico posterior al manejo de la coartación nativa, son similares a los obtenidos con cirugía. La implantación de prótesis endovasculares (stents ha mostrado excelentes resultados a corto plazo tanto en niños mayores como en adultos con coartación nativa. En pacientes con coartación recurrente considerados de alto riesgo quirúrgico, la angioplastia con balón y la implantación de stent ofrecen una estrategia de manejo menos invasiva e igual de efectiva. Se prefiere el uso de stents sobre la angioplastia con balón en adultos y niños mayores con coartación recurrente, ya que el riesgo de recoartación y formación de aneurismas parece ser menor. No se cuenta con suficiente información acerca de los desenlaces a largo plazo posteriores al tratamiento percutáneo de la coartación aórtica. Este artículo revisa las controversias existentes en cuanto al manejo actual de esta condición.

  19. MR imaging of the toracic aorta

    International Nuclear Information System (INIS)

    Garbagnati, F.; Castoldi, M.C.; Bianchini, E.

    1988-01-01

    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

  20. Dynamic Morphology of the Aorta. Pre- and postoperative imaging

    NARCIS (Netherlands)

    van 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

  1. Chronic posttraumatic pseudoaneurysm of the thoracic aorta 55 ...

    African Journals Online (AJOL)

    Chronic posttraumatic pseudoaneurysm of the thoracic aorta 55 Years after a blunt trauma - A case report with review of literature. M H Milad, A M Gamal, M M Rab. Abstract. Injuries of thoracic aorta due to blunt trauma carry very high mortality rates and studies estimated that less than 2% of people who sustain it remain ...

  2. Structural Features in Tunica Media of the Aorta in Lamb

    Directory of Open Access Journals (Sweden)

    Dalma CSIBI

    2017-05-01

    Full Text Available In blood vessels situated just after the heart, an irregular blood flow occurs due to some specific structural elements of the tunica media. The current paper describes the histological aspects of some post-cardiac arterial sections in lamb. The tissue samples were collected from five 30 days old male lambs (Țurcană breed. Histological specimens from different regions of the aorta were harvested (i.e., the ascending aorta, aortic arch, thoracic and abdominal regions of the descending aorta. From the specified regions, small pieces (cca. 0.5 cm were fixed in neutral 10% buffered formalin. The tissues were subsequently embedded in paraffin wax, sectioned at 5 μm, and stained with Goldner’s trichrome and Verhoeff methods. Tissue analysis was performed using an Olympus system for image acquisition and analysis. Histological appearance of the assessed segments of the aorta in lamb is unusual. Major changes occur in tunica media of the aorta. In the ascending aorta, aortic arch and thoracic regions of the aorta, the histological outline is somewhat the same. The internal region of the media possesses the typical lamellar arrangement. Concerning the outer part of tunica media, the smooth muscle has a tendency to form bundles of various sizes. The muscle islands are not present in the media of abdominal region of the aorta, which exhibits the classic pattern of elastic arteries.

  3. Association Between Thoracic Aorta Calcium and Thoracic Aorta Geometry in a Cohort of Asymptomatic Participants at Increased Cardiovascular Risk.

    Science.gov (United States)

    Craiem, Damian; Alsac, Jean-Marc; Casciaro, Mariano E; El Batti, Salma; Mousseaux, Elie; Sirieix, Marie-Emmanuelle; Simon, Alain

    2016-09-01

    Thoracic aorta calcium detection is known to improve cardiovascular risk prediction for cardiac and noncardiac events beyond traditional risk factors. We investigated the influence of thoracic aorta morphometry on the presence and extent of aortic calcifications. Nonenhanced computed tomography heart scans were performed in 970 asymptomatic participants at increased cardiovascular risk. An automated algorithm estimated the geometry of the entire thoracic aorta and quantified the aortic calcium Agatston score. A nonparametric model was used to analyze the percentiles of calcium score by age. Logistic regression models were calculated to identify anatomical associations with calcium levels. Calcifications were concentrated in the aortic arch and descending portions. Higher amounts of calcium were associated with an enlarged, unfolded, less tapered and more tortuous aorta. The size of the ascending aorta was not correlated with aortic calcium score, whereas enlargement of the descending aorta had the strongest association: the risk of having a global calcium score > 90th percentile was 3.62 times higher (confidence interval, 2.30-5.91; P < .001) for each 2.5-mm increase in descending aorta diameter. Vessel taper, tortuosity, unfolding and aortic arch and descending volumes were also correlated with higher amounts of calcium. Thoracic aorta calcium was predominantly found at the arch and descending aorta and was positively associated with the size of the descending aorta and the aortic arch, but not with the size of the ascending aorta. These findings suggest that aortic dilatation may have different mechanisms and may consequently require different preventive strategies according to the considered segments. Copyright © 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  4. 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.

  5. 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....

  6. Can Severe Kyphoscoliosis Lead to Aorta Rupture?

    Science.gov (United States)

    Kotopoulos, Constantinos; Karakasi, Maria Valeria; Kapetanakis, Stylianos; Pavlidis, Pavlos

    2016-09-01

    Neurofibromatosis type 1 is a polysystemic disease presenting with a multifaceted clinical picture. Clinical manifestations may present in the skin, as well as in the skeletal and cardiovascular system. The present study aims to describe and examine the case of a 46-year-old woman, who suffered from neurofibromatosis type 1 and died abruptly in the emergency room. The forensic examination attributed her death to traumatic rupture of the thoracic aorta resulting from an acute angulation that her vertebral column formed in the thoracic region (severe kyphosis). Outspread cutaneous neurofibromas, severe scoliosis, and osteoporosis (brittle bones) were observed during the autopsy. No atherosclerotic lesions were detected in the aortic lumen. To the authors' knowledge, no similar case has been reported throughout relevant literature.

  7. Correção endovascular de dissecção de aorta ascendente Endovascular repair of ascending aortic dissection

    Directory of Open Access Journals (Sweden)

    José Carlos Dorsa Vieira Pontes

    2013-03-01

    Full Text Available Paciente de 84 anos com dissecção de aorta torácica tipo A de Stanford comprometendo todo o arco aórtico e aorta descendente. Proposto e aceito o tratamento endovascular em função da gravidade do quadro clínico. Procedeu-se à dissecção das artérias femorais comum bilateralmente. A aortografia confirmou a exclusão da falsa luz e a patência dos óstios coronarianos.Woman, 84 years-old, with Stanford type A thoracic aortic dissection committing aortic arch and descending aorta. Proposed and accepted endovascular treatment according to the severity of the clinical picture. Common femoral artery dissection bilaterally was done. Aortography confirmed the exclusion of the false lumen and patency of the coronary ostia.

  8. Aneurismas de la arteria pulmonar. Reporte de un caso y revisión de la literatura Aneurysm of the pulmonary artery. A case report and literature review

    Directory of Open Access Journals (Sweden)

    Rosalba Vivas

    2011-07-01

    Full Text Available Los aneurismas de la arteria pulmonar son poco frecuentes en niños. Entre sus principales causas se encuentran procesos infecciosos como la endocarditis, que favorece el desarrollo de aneurismas micóticos, en especial en pacientes con defectos cardíacos congénitos y en aquellos con adicción a drogas de uso endovenoso (sobre todo en adultos, y lleva al desarrollo de aneurismas micóticos. Las opciones de tratamiento dependen de las características de la lesión y de la condición clínica del paciente. Se presenta el caso de una paciente de siete años, quien fue referida para evaluación por endocarditis infecciosa de la válvula tricúspide debida a Staphylococcus aureus. Desarrolló aneurismas bilaterales en ramas lobulares de la arteria pulmonar secundarios a la infección valvular. El aneurisma del lado derecho era de gran tamaño y con alto riesgo de ruptura, razón de peso para que se le efectuara embolización con coils. El procedimiento fue exitoso y no se documentaron complicaciones. La lesión del lado izquierdo se trató de forma expectante teniendo en cuenta que era de menor tamaño. En la actualidad la paciente está en seguimiento ambulatorio con el fin de vigilar la evolución del aneurisma del lado izquierdo.Pulmonary artery aneurysms are infrequent in children. Among its main causes are infectious processes such as endocarditis which favors the development of mycotic aneurysms especially in patients with congenital heart defects and in those with endovenous drug addiction (mainly in adults that develop mycotic aneurysms. Treatment options depend on the characteristics of the lesion and the clinical condition of the patient. We present the case of a seven year old female patient who was referred for evaluation of infectious endocarditis of the tricuspid valve due to Staphylococcus aureus. She developed bilateral aneurysms in lobular branches of the pulmonary artery secondary to the valve infection. The right aneurysm was

  9. THE INFLUENCE OF AUTOLYSIS ON THE PROTEIN-PEPTIDE PROFILE OF Bos taurus AND Sus scrofa HEART AND AORTA TISSUES

    Directory of Open Access Journals (Sweden)

    I. M. Chernukha

    2016-01-01

    Full Text Available The article presents the results of autolytic processes impact on the protein-peptide profile of Bos taurus and Sus scrofa cardiac muscle and aorta. The results of tissue-specific protein identification are also presented as well as the effect of autolysis. Apolipoprotein A-1 involved in the formation of high-density lipoproteins, peroxiredoxin-1 involved in the suppression of oxidative stress, galectin-1 induced apoptosis of T-lymphocytes, as well as number of heat shock proteins with molecular weight less than 30 kDa were identified in Sus scrofa aorta tissue. It was discovered that functional proteins with molecular weight less than 30 kDa are retained during the freezing process, but destroyed under the action of autolytic enzymes. This work was supported by the Russian Science Foundation (project No. 16–16–10073.

  10. The Effect of Chlorpyrifos on Isolated Thoracic Aorta in Rats

    Directory of Open Access Journals (Sweden)

    Ebru Yıldırım

    2013-01-01

    Full Text Available This study investigated the effect of chlorpyrifos on thoracic aorta and on the level of NO in plasma and aorta. The effect of chlorpyrifos on thoracic aorta in organ bath was determined in 10 rats. Another 45 rats were assigned to 3 groups with 15 rats each: control group 1 received distilled water, control group 2 was given corn oil, and the last group was given 13.5 mg/kg chlorpyrifos dissolved in corn oil every other day for 8 weeks orally. Chlorpyrifos (10−10 M–10−5 M showed no effect on isolated thoracic aorta. Plasma AChE activity was decreased, while LDH, ALT, GGT, and AST activities were increased in chlorpyrifos group compared to control groups. Plasma NO level was increased in chlorpyrifos group compared to control groups. iNOS expression was present in all groups in the cytoplasm of the endothelia and in the smooth muscle cells of aorta. According to semiquantitative histomorphological analysis, iNOS immunopositive reactions were seen in the decreasing order in chlorpyrifos, control 2, and control 1 groups. eNOS immunopositive reactions were observed in the endothelial cell cytoplasm, rarely in the subintimal layer, and the smooth muscle cells of aorta. There were no differences among the groups in terms of eNOS immunostaining. In conclusion, chlorpyrifos induced NO production in aorta following an increase in NOS expression.

  11. Turner Syndrome in Girls Presenting with Coarctation of the Aorta.

    Science.gov (United States)

    Eckhauser, Aaron; South, Sarah T; Meyers, Lindsay; Bleyl, Steven B; Botto, Lorenzo D

    2015-11-01

    To evaluate the frequency of Turner syndrome in a population-based, statewide cohort of girls with coarctation of the aorta. The Utah Birth Defects Network was used to ascertain a cohort of girls between 1997 and 2011 with coarctation of the aorta. Livebirths with isolated coarctation of the aorta or transverse arch hypoplasia were included and patients with complex congenital heart disease not usually seen in Turner syndrome were excluded. Of 244 girls with coarctation of the aorta, 77 patients were excluded, leaving a cohort of 167 girls; 86 patients (51%) had chromosomal studies and 21 (12.6%) were diagnosed with Turner syndrome. All patients were diagnosed within the first 4 months of life and 5 (24%) were diagnosed prenatally. Fifteen patients (71%) had Turner syndrome-related findings in addition to coarctation of the aorta. Girls with mosaicism were less likely to have Turner syndrome-associated findings (3/6 mosaic girls compared with 12/17 girls with non-mosaic 45,X). Twelve girls (57%) diagnosed with Turner syndrome also had a bicommissural aortic valve. At least 12.6% of girls born with coarctation of the aorta have karyotype-confirmed Turner syndrome. Such a high frequency, combined with the clinical benefits of an early diagnosis, supports genetic screening for Turner syndrome in girls presenting with coarctation of the aorta. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Resultados del tratamiento quirúrgico de los aneurismas del complejo cerebral anterior-arteria comunicante anterior

    Directory of Open Access Journals (Sweden)

    Armando Alemán Rivera

    2001-06-01

    Full Text Available Se realiza un estudio de 30 pacientes con aneurismas localizados en el complejo de la arteria cerebral anterior-arteria comunicante anterior (ACoA, operados en el Servicio de Neurocirugía del Hospital Universitario "Arnaldo Milián Castro", durante un período de 7 años. Se analizan variables tales como edad, sexo, estado neurológico preoperatorio, momento quirúrgico, complicaciones y estado al egreso. La mortalidad general fue del 10 %The authors carried out a study in 30 patients with aneurysms located in the anterior communicating artery-anterior cerebral complex (ACA-ACC, that were operated on at the Neurosurgery Service of "Arnaldo Milián Castro" Teaching Hospital, during a period of 7 years. Variables such as age, sex, preoperative neurologic state, surgical moment, complications and status on discharge were analyzed. General mortality was 10 %

  13. Evaluation of diseases of the aorta with ultrafast CT

    International Nuclear Information System (INIS)

    Eldredge, W.J.; Flicker, S.; Altin, R.S.; Naidech, H.J.

    1987-01-01

    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

  14. Tratamento endovascular de aneurisma de tronco braquiocefálico em paciente com síndrome de Ehlers-Danlos tipo IV

    OpenAIRE

    Belczak,Sergio Quilici; Klajner,Rafael Kogan; Ogawa,Lara Cote; Lucato,Laís Leite; Zeque,Bruna Stecca; Macedo,Felipe Basso de; Silva,Ingredy Tavares da; Atihe,Luís Felipe

    2016-01-01

    Resumo A síndrome de Ehlers-Danlos é uma doença genética que acarreta alteração na síntese de colágeno, causando extrema fragilidade do tecido conjuntivo. Tal fragilidade predispõe a uma série de doenças vasculares, como dissecções, aneurismas e pseudoaneurismas. Os autores relatam o histórico de um indivíduo de 19 anos com aneurisma de tronco braquiocefálico que foi submetido ao tratamento endovascular com implante de stents revestidos. O caso evoluiu com complicação do sítio de punção, que ...

  15. Rotura de un aneurisma de arteria esplénica. A propósito de un caso y revisión de la literatura

    Directory of Open Access Journals (Sweden)

    Rafael Perelló

    2008-04-01

    Full Text Available La prevalencia de aneurismas esplénicos en la población general es del 0,8%, siendo más alta en mujeres que en hombres. El embarazo, la fibrodisplasia arterial y la hipertensión portal, con o sin esplenomegalia asociada, son factores de riesgo conocidos asociados al desarrollo de aneurismas esplénicos. Se presenta el caso clínico de una paciente nulípara de 24 años, sin factores de riesgo vasculares y con antecedentes de paludismo, que acudió al servicio de urgencias de nuestro centro por presentar dolor abdominal tras un vuelo en avión de larga distancia. La exploración física y las pruebas complementarias realizadas mostraron un shock hipovolémico por hemoperitoneo. A pesar del tratamiento de apoyo, la paciente falleció antes de su entrada en quirófano. La necropsia mostró la rotura de un aneurisma sacular de la arteria esplénica como causa de muerte. Se discute la posibilidad de que un barotrauma pueda haber sido la causa de rotura aneurismática.

  16. Unexpected limited chronic dissection of the ascending aorta

    Directory of Open Access Journals (Sweden)

    Asta Angiolino

    2008-07-01

    Full Text Available Abstract We report a rare case of a limited chronic dissection of the ascending aorta that was accidentally discovered at operation performed for severe aortic stenosis and moderate to severe dilatation of the ascending aorta. Preoperative investigations such as transoesophageal echocardiography and cardiac catheterization missed the diagnosis of dissection. Intraoperative findings included a 3.5 cm eccentric bulge of the ascending aorta and a 5 mm circular shaped intimal tear comunicating with a limited hematoma or small dissection of the media layer. (The rarety of the report is that the chronic dissection is limited to a small area (approximatively 3.5 × 2.5 cm of the ascending aorta.

  17. Cirugía abierta de los aneurismas de cayado aórtico

    Directory of Open Access Journals (Sweden)

    Salvador Torregrosa

    2009-09-01

    Full Text Available La técnica quirúrgica óptima para el tratamiento de la enfermedad aneurismática extensa de la aorta torácica no está claramente establecida. Las opciones incluyen un procedimiento en estadios, por esternotomía media, habitualmente incorporando una trompa de elefante, en el primero, seguido por toracotomía izquierda para completar el procedimiento. Una segunda opción es un procedimiento en un estadio realizado mediante ester-notomía media exclusivamente, o bien, esternotomía media extendida mediante incisión a través de un espacio intercostal, o bien, toracotomía anterior bilateral (incisión clamshell.

  18. Tratamento endovascular com stent coberto de aneurisma carotídeo associado a arterite rádica Endovascular treatment with a covert-stent of radiation-associated carotid aneurysm

    Directory of Open Access Journals (Sweden)

    Emanuel Dias

    2011-03-01

    Full Text Available Introdução: O uso de radioterapia no tratamento de neoplasias pode causar inflamação e fibrose nas artérias adjacentes e levar a estenose com significado clínico ou, raramente, à formação de aneurismas. A arterite carotídea associada à radioterapia tem surgido como critério anatómico de alto risco para a endarterectomia carotídea (CEA, sendo a arterioplastia e stenting carotídeo (CAS encarado como uma alternativa terapêutica atrativa, apesar da falta de dados acerca dos resultados a longo prazo nesta indicação. Caso clínico: Homem de 70 anos, com antecedentes de neoplasia da laringe em 1998, sujeito a laringectomia radical e a radioterapia adjuvante. Admitido electivamente para tratamento de estenose da artéria carótida primitiva (ACC direita superior a 70%, medida em velocimetria de Eco-doppler, e de pequeno aneurisma do bulbo carotídeo ipsilateral. Apresentava história de acidente isquémico transitório 3 meses antes. O doente foi sujeito a colocação de stent coberto Viabahn® por via percutânea femoral direita na presença de dispositivo de protecção cerebral FilterWire EZ™, cobrindo as artérias carótidas comum e interna direitas no intuito de tratar a estenose da ACC e a dilatação aneurismática do bulbo carotídeo. O seguimento aos 6 meses não mostrou intercorrências. Conclusão: A utilização de um stent coberto para tratamento deste caso de arterite carotídea associada à radiação mostrou-se uma opção simples, eficaz e sem o risco das complicações associadas à cirurgia convencional.Introduction: Clinically significant arterial stenosis and aneurysm may result from inflamation and fibrosis induced by radiotherapy directed to an adjacent tumour. Carotid artery arterioplasty and stenting (CAS have revealed as valid alternatives to carotid endarteriectomy (CEA in patients with high risk such as patients with carotid arteritis secondary to radiotherapy. However, long-term follow-up are sparse

  19. Obstructive pneumonia: an indication for surgery in mega aorta syndrome.

    Science.gov (United States)

    Kalkat, Maninder S; Bonser, Robert S

    2003-04-01

    A 76-year-old woman with annuloaortic ectasia, aortic regurgitation, and aneurysmal dilatation extending from the root to mid descending aorta presented with symptoms of bronchial compression and obstructive pneumonitis. Despite vigorous antibiotic treatment and physiotherapy, the pneumonitis persisted with clinical and radiologic deterioration. An emergency operation was performed to relieve bronchial compression. The operation comprised homograft aortic root replacement with prosthetic replacement of the arch and descending aorta. Postoperatively the pneumonia rapidly resolved.

  20. Surgical treatment of penetrating atherosclerotic ulcer of the descending aorta

    Directory of Open Access Journals (Sweden)

    Kovačević Pavle

    2013-01-01

    Full Text Available Introduction. The term “penetrating atherosclerotic ulcer” (PAU of the aorta describes the condition in which ulceration of an aortic atherosclerotic lesion penetrates the internal elastic lamina into media. PAU is a high-risk lesion due to its deleterious effects on the integrity of aortic wall, with potentially fatal outcome. Case report. A patient with intensive, sharp chest pain irradiating to the back but with no signs of myocardial ischemia on an electrocardiogram was referred to our hospital. Transthoracic echocardiography showed no pathological changes of the ascending aorta. However, multislice computed tomography (CT showed an aortic ulcer with varying degree of the subadventitial hemorrhage in the region of the thoracic aorta at the level of Th 8-9. Due to imminent rupture of the penetrating aortic ulcer, the patient was promptly prepared for surgery. A 15 cm long subadventitial hematoma was found intraoperatively in the right posterolateral aspect of the descending aorta, 5 cm above the diaphragm and 7 cm below the origin of the left subclavial artery. The affected segment of the aorta was resected, followed by an inlay aortic reconstruction with a Dacron tube graft of 24 mm. Control CT revealed satisfactory reconstruction of the descending aorta. Conclusion. PAU is a rare, but potentially fatal disease. Open surgery in patients with PAU is an effective treatment strategy, although endovascular treatment options are emerging.

  1. PIV and MRV Measurements in Human Thoracic Aorta Phantoms

    Science.gov (United States)

    Iyengar, Ananth; Elkins, Christopher; Draney, Mary; Medina, Francisco; Wicker, Ryan

    2004-11-01

    Aortic dissection is a non-traumatic injury to the aorta in which a flap is created inside the aorta by the separation of the inner lining of the vessel wall from its outer layers. It is hypothesized that dissections start as tears in vessels' inner lining and propagate as blood impinges through the tear into the separated part of the vessel wall. No two dissections are alike, but many share common characteristics, one of which is that tear sites occur in similar places in the aorta. In an effort to understand the origins of these tear sites and the propagation of dissections, we are studying blood flow in human aortas. To begin, we are using rigid aorta phantoms based on anatomies of healthy adults extracted from computed tomography (CT) and magnetic resonance imaging (MRI) medical scans. Clear polyurethane phantoms are created by casting around water-soluble positive molds manufactured using rapid prototyping. We study steady flows with Reynolds numbers comparable to those present in the aorta during the systolic pulse and physiologically pulsatile flows. The entire three-dimensional flow is measured using magnetic resonance velocimetry (MRV), a technique based on MRI principles capable of measuring three-component mean velocities. MRV results are compared to the instantaneous and average two-component velocity fields measured in a few 2D planes with particle image velocimetry (PIV). The PIV results provide validation for the MRV and insight into the instantaneous flow structures that may possibly lead to aortic dissection through fluid structure wall interaction.

  2. Direct emergence of the dorsospinal artery from the aorta and spinal cord blood supply. Case reports and literature review

    International Nuclear Information System (INIS)

    Siclari, Francesca; Fasel, Jean H.D.; Gailloud, Philippe

    2006-01-01

    Direct emergence of a dorsospinal artery from the aorta is a rare anatomic variant, of which a total of seven cases have been reported. This report offers an additional angiographic observation and reviews the literature. Two observations of common intercostal trunks documented during spinal angiography are described. In the first observation, the common intercostal trunk provided complete blood supply to two adjacent vertebral levels (T11 and T12). In other words, the trunk included an intercostal branch and a dorsospinal branch for each level. In the second observation, the common intercostal trunk provided an intercostal branch for each level (T9 and T10), but only one dorsospinal branch (T10). An isolated dorsospinal artery (DA) originated separately from the aorta at the T9 level, and provided a significant contribution to the anterior spinal axis. The two reported cases illustrate the concept of ''complete'' versus ''incomplete'' common intercostal trunks. In instances where an incomplete trunk is documented, a separate DA originating directly from the aorta must be looked for. A review of the literature indicates a tendency for isolated DAs to participate in the blood supply to the spinal cord. (orig.)

  3. Cerebral aneurysmal dilatation in an infant with perinatally acquired HIV infection and HSV encephalitis Aneurisma cerebral sintomático precoce em lactente com infecção congênita por HIV e encefalite herpética

    Directory of Open Access Journals (Sweden)

    Magda Lahorgue Nunes

    2001-03-01

    Full Text Available Although most children with human immunodeficiency virus (HIV infection have neurological dysfunction, in childhood the incidence of symptomatic cerebrovascular disease is low. Cerebral aneurysmal arteriopathy in childhood AIDS has been reported in the past and considered to have a relatively long latency following the primary infection. We report a 1 month-old infant with congenitally acquired HIV infection, and herpes encephalitis; she presented a sudden cardiorespiratory arrest followed by coma and was found to have a giant saccular aneurysm of the left basilar artery. Literature review showed that cerebral aneurysmal artheriopathy is an unusual manifestation in newborns and infants and this case is possibly the youngest patient reported with aneurysma, herpes encephalitis and AIDS. The role of HIV and herpes simplex infections in the pathogenesis of this lesion is discussed.A maioria das crianças com síndrome da imunodeficiência adquirida (SIDA apresenta complicações neurológicas, mas a incidência de doença cerebrovascular sintomática nesta faixa etária é baixa. Existem relatos prévios de arteriopatia aneurismática em crianças com SIDA, mas a latência entre a infecção primária e o desenvolvimento dos sintomas geralmente é longa. Relatamos lactente com infecção congênita por HIV, que apresentou encefalite herpética e apresentou subitamente parada cardiorespiratória, seguida de coma. A investigação através de neuroimagem demonstrou aneurisma sacular gigante da artéria basilar. A revisão da literatura demonstra ser a arteriopatia aneurismática uma entidade rara no perído neonatal e em lactentes, sendo possivelmente este o caso mais jovem até o presente relatado com doença cerebrovascular aneurismática associada a herpes e SIDA. A relação da associação entre SIDA e infecção por herpes vírus na gênese da doença cerebrovascular é discutida.

  4. Effects of Continuous and Accumulated Exercise on Endothelial Function in Rat Aorta.

    Science.gov (United States)

    Martinez, Juliana Edwiges; Taipeiro, Elane de Fátima; Chies, Agnaldo Bruno

    2017-04-01

    The practice of exercise in short bouts repeated throughout the day may be an alternative strategy to lift people out of physical inactivity. to evaluate if accumulated exercise, as occurs in continuous exercise training, improve endothelial function in rat aorta. Wistar male rats were divided into three groups: continuous exercise (CEx, 1 hour on the treadmill) or accumulated exercise (AEx, 4 bouts of 15 minutes / day) for 5 days/week for 8 weeks, or sedentary (SED). During the training period, body weight gain and increase in exercise performance were recorded. On sacrifice day, aorta was dissected into rings (3-5 mm) and mounted on the organ bath. Fitness was significantly greater in CEx and AEx rats as compared with SED animals. In addition, compared with the SED group, CEx animals had a lower body mass gain, and the aorta obtained from these animals had reduced contractile response to norepinephrine and greater acetylcholine-induced relaxation. These results were not observed in ACEx animals. Both CEx and AEx improved fitness, but only CEx led to reduced body weight gain and improved endothelial function. A prática de exercícios em sessões curtas que se repetem ao longo do dia pode ser uma alternativa para tirar as pessoas da inatividade física. Verificar se o exercício acumulado, tal como ocorre com o treinamento com exercício contínuo, melhora a função endotelial na aorta de ratos. Ratos Wistar machos foram divididos em 3 grupos: treinamento com exercício contínuo (ExC; 1 hora em esteira) ou com exercício acumulado (ExA; 4 sessões de 15 minutos ao longo do dia) por 5 dias/semana, durante 8 semanas, ou grupo sedentário (SED). Durante o treinamento, foram registrados o ganho de peso corporal e desempenho na esteira. No dia do sacrifício, anéis (3-5 mm) da aorta foram obtidos e montados em banho de órgãos. Animais ExC e ExA mostraram aptidão física significativamente maior em comparação com os SED. Paralelamente, em comparação com SED

  5. Aneurisma do seio de Valsalva: análise de sete casos Aneurysm of the sinus of Valsalva: analysis of seven cases

    Directory of Open Access Journals (Sweden)

    Ricardo M Mustafá

    1991-04-01

    Full Text Available Os autores apresentam a experiência acumulada de janeiro de 1984 a julho de 1990, no Instituto de Moléstias Cardiovasculares (IMC, de sete casos de aneurisma do seio de Valsalva (ASV, tratados cirurgicamente com uso de retalho de pericárdio bovino (PB, ou troca valvar nos casos indicados. Cinco casos eram de origem congênita e dois estavam associados a doença reumática. Dos congênitos, quatro estavam rotos, sendo dois para o átrio direito e dois para o ventrículo direito; em um caso não havia rotura e se projetava para o ventrículo esquerdo. Dos dois casos associados a doença reumática, um estava roto para o ventrículo direito e o outro apresentava protrusão do saco aneurismático para o ventrículo esquerdo e eversão da válvula aórtica correspondente. Foi usado retalho de PB para dar sustentação à sutura nos casos de ASV congênitos; destes, um evoluiu com deiscência da sutura aos sete meses e aos seis anos, sendo reoperado nas duas ocasiões. Nos casos associados a doença reumática, foi realizada a substituição valvar com prótese biológica PB IMC; dos dois pacientes, um foi a óbito, em decorrência de acidente vascular cerebral, no 15º dia de pós-operatório. Conclui-se que, quando não há alterações secundárias nas válvulas (ex.: calcificação, endocardite, etc, a restauração é possível e desejada, com boa evolução quando se usa retralho de pericárdio bovino.The authors present their experience on seven cases of Valsalva-sinus aneurysm (VSA at the Instituto de Moléstias Cardiovasculares (IMC, from January 1984 to July 1990, treated surgically using bovine pericardium patch (PB-IMC or valve replacement when indicated. Five cases were congenital and two were related to rheumatic disease. In two of the congenital cases the aneurysms were leaking into the right atrium, two were leaking into the right ventricle. And the remaining one was not leaking but was projected into the left ventricle. One of the

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

    International Nuclear Information System (INIS)

    Daitoku, Kazuyuki; Fukui, Kozo; Ichinoseki, Ikkoh; Munakata, Mamoru; Takahashi, Shoichi; Fukuda Ikuo

    2004-01-01

    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)

  7. Aorta Ascending Aneurysm Analysis Using CFD Models towards Possible Anomalies

    Directory of Open Access Journals (Sweden)

    Mariana Simão

    2017-06-01

    Full Text Available Computational fluid dynamics (CFD can be seen as complementary tool alongside the visualization capabilities of cardiovascular magnetic resonance (CMR and computed tomography (CT imaging for decision-making. In this research CT images of three cases (i.e., a healthy heart pilot project and two patients with complex aortic disease are used to validate and analyse the corresponding computational results. Three 3D domains of the thoracic aorta were tested under hemodynamic conditions. Under normal conditions, the flow inside the thoracic aorta is more streamlined. In the presence of ascending aortic aneurysm, large areas of blue separation zones (i.e., low velocities are identified, as well as an internal geometry deformation of the aortic wall, respectively. This flow separation is characterized by the reversal of flow and sudden drop of the wall shear stress (WSS in the aorta. Moreover, the aortic aneurysm simulations adversely affect the flow by increasing the pressure drop and flow inefficiency, due to the anatomical configuration of the ascending aorta. Altered hemodynamics led to a vortex formation and locally reversed the flow that eventually induced a low flow velocity and oscillating WSS in the thoracic aorta. Significant changes in the hemodynamic characteristics affect the normal blood circulation with strong turbulence occurrence, damaging the aortic wall, leading ultimately to the need of surgical intervention to avoid fatal events.

  8. Aneurisma de tronco de coronaria izquierda y síndrome antifosfolípido: sobrevida a 12 años. Informe de un caso y revisión de la literatura

    OpenAIRE

    Paz Soldán-Patiño,Claudia Patricia; Rojas-Velasco,Gustavo; Arias-Mendoza,María Alexandra; Enríquez-Gómez,Edmundo; Meave-González,Aloha; Álvarez-Sangabriel,Amada; Amigo,Mary Carmen; Vargas-Barrón,Jesús; Martínez-Sánchez,Carlos Rodolfo

    2012-01-01

    Los aneurismas coronarios son una patología poco frecuente, con una incidencia anual del 1% a 2%. Su origen puede ser atereosclerótico, congénito o deberse a otras causas menos habituales. Su manifestación inicial puede ser el infarto de miocardio y la muerte súbita, como consecuencia de su rotura o por la existencia de trombos intracoronarios. Los aneurismas coronarios de gran tamaño, no ateroscleróticos y localizados en el tronco común de la arteria coronaria izquierda son excepcionales. El...

  9. The AORTA Architecture: Integrating Organizational Reasoning in Jason

    DEFF Research Database (Denmark)

    Jensen, Andreas Schmidt; Dignum, Virginia; Villadsen, Jørgen

    2014-01-01

    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 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 agents...... the agents can coordinate their organizational tasks using AORTA....

  10. Aneurisma de la vena de Galeno como causa de falla cardíaca Galen's vein aneurysm as cause of heart failure

    Directory of Open Access Journals (Sweden)

    Claudia Echeverría

    2005-04-01

    Full Text Available Se presenta el caso de un recién nacido que ingresa a cuidado intensivo con un cuadro de falla cardiaca de difícil manejo con ductus arterioso de gran tamaño, a quien se le realizó cierre quirúrgico del mismo y pese a ello persistía con clínica de falla cardiaca que no mejoraba con tratamiento médico. Se hizo un hallazgo incidental de un aneurisma de la vena de Galeno de gran tamaño. El aneurisma de la vena de Galeno es una patología congénita poco frecuente que se origina de un defecto en la fusión de las venas cerebrales internas, debido a la baja resistencia produce un cuadro de falla cardiaca de alto gasto. Los defectos de gran tamaño pueden contener entre 50% a 60% del gasto cardiaco. Se debe sospechar aneurisma en todo recién nacido o lactante menor con cuadro de falla cardíaca y dilatación de cavidades derechas sin evidencia de anomalía cardíaca estructural.We present the case of a newborn admitted to the intensive care unit with a heart failure of difficult medical management. A large ductus arteriosus was found. It was surgically corrected, but the heart failure persisted and did not improve with medical treatment. Incidentally, a big Galen's vein aneurysm was found. Galen's vein aneurysm is a rare congenital pathology, originated by a fusion defect of the internal cerebral veins. Due to its low resistance, it produces a picture of high-output heart failure. Large defects may contain 50% to 60% of cardiac output. An aneurysm may be suspected in each newborn or infant with clinical picture of heart failure and right cardiac chamber dilation without any evidence of structural cardiac anomaly.

  11. Disección de aorta: Aspectos básicos y manejo endovascular Aortic dissection: Basic aspects and endovascular management

    Directory of Open Access Journals (Sweden)

    Nicolás I Jaramillo

    2005-08-01

    Full Text Available El tratamiento de la patología aórtica torácica se complica por la asociación con una alta mortalidad en la reparación quirúrgica, y al mismo tiempo fragilidad y gran comorbilidad en los adultos de edad avanzada. En la búsqueda por reducir la incidencia de resultados negativos, en la década pasada se introdujo la técnica de intervención por la vía de la mínima invasión, con la colocación de dispositivos del tipo stent vía endovascular. La técnica, originalmente descrita por Parodi e inicialmente diseñada para uso en la corrección de aneurismas de aorta abdominal, ha sido adoptada para el uso en la patología aórtica torácica. El mejoramiento en el entendimiento de la fisiopatología y la historia natural de la enfermedad de la aorta torácica y el análisis de los resultados, han facilitado la toma de decisiones en cuanto al tratamiento en términos del tiempo de la intervención apropiada. El tratamiento de la disección de la aorta torácica con el uso de stent endovascular, es uno de los más recientes avances en el tratamiento y hoy recibe una atención especial, al punto que es una alternativa menos invasiva; incluso la tecnología está apenas en sus primeras etapas y en los últimos años se han mejorado significativamente el diseño y el sistema de liberación de estos dispositivos endovasculares conocidos como stent-grafts. Estas prótesis se utilizan de forma creciente en el tratamiento de aneurismas, disecciones, rupturas traumáticas, úlceras penetradas gigantes y hematomas intramurales de la aorta torácica descendente, con buenos resultados tanto tempranos como a mediano plazo. La poca frecuencia, la alta complejidad y la severidad de la patología, y al mismo tiempo el alto riesgo teórico de las complicaciones que se pueden generar, deben mantener cauto al operador, especialmente cuando esta técnica se aplica en pacientes jóvenes. De manera conceptual la solución por la vía endoluminal en las fases agudas

  12. Es el reimplante valvular mejor que el bentall biológico modificado para tratar aneurismas de la raíz asociados a insuficiencia?

    OpenAIRE

    Obando López, Carlos Eduardo; Bresciani, Renato; Camacho, Jaime; Carreño Jaimes, Marisol; Gutiérrez, Héctor; Sandoval, Néstor; Umaña Mallarino, Juan Pablo

    2010-01-01

    Es el reimplante valvular mejor que el Bentall Biológico Modificado para tratar aneurismas de la raíz asociados a insuficiencia? Obando CE; Gutiérrez HF; Santamaría G, Bresciani R; Camacho J; Sandoval N; Umaña J. Departamento de Cirugía Cardiovascular, Fundación Cardio Infantil, Bogotá, Colombia. Objetivo: comparar resultados funcionales, morbilidad y sobrevida a corto y mediano plazo, tras la realización de Bentall modificado con prótesis Freestyle vs reimplante valvular de Tirone David, en ...

  13. The Largest Reported Dissecting Aneurysm of Ascending Aorta ...

    African Journals Online (AJOL)

    He presented with dyspnea, chest pain and amazing symptom of superior vena cava syndrome. The patient underwent open heart surgery with resection of ascending aorta aneurysm with classic Bentall operation. The post-operative period was associated with uneventful course and the patient was discharged with good ...

  14. Ischemic colitis complicating reconstruction of the abdominal aorta

    DEFF Research Database (Denmark)

    Schroeder, T V; Christoffersen, J K; Andersen, J

    1985-01-01

    A review of 23 patients with ischemic colitis after surgical treatment of the abdominal aorta disclosed a pathogenetic heterogeneous finding. Ligation of the inferior mesenteric artery, abolished collateral blood supply or nonocclusive low flow state, or both, was a common feature. An incidence...

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

    DEFF Research Database (Denmark)

    Larsen, Kirsten Vendelbo; Nedergaard, Ove A.

    1999-01-01

    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...

  16. Dr Murray's case of ligation of the abdominal aorta - Somerset ...

    African Journals Online (AJOL)

    1991-04-06

    Apr 6, 1991 ... judgment. ,"A tedious and rather difficult part of the operation suc- ceeded; viz. the making a division in the aortic plexus of nerves, and in the membranous sheath covering the aorta, to get betwixt the vessel and the spine, which I effected partly by the steel end of an elevator cranii, but chiefly by my nails, ...

  17. 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.

  18. 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.

  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. The risks of aorta impingement from pedicle screw may increase due to aorta movement during posterior instrumentation in Lenke 5C curve: a computed tomography study.

    Science.gov (United States)

    Chen, Ling; Xu, Leilei; Qiu, Yong; Qiao, Jun; Wang, Fei; Liu, Zhen; Shi, Benglong; Qian, Bang-ping; Zhu, Zezhang

    2015-07-01

    To investigate the aorta movement following correction surgery for patients with thoracolumbar/lumbar scoliosis and to determine the subsequent risk of the aorta impingement for pedicle screw (PS) misplacement. Thirty-six AIS patients with a main thoracolumbar or lumbar curve were included in this study. According to the direction of the main curve, the patients were divided into Group R and Group L, with Group R comprising 16 patients with a right-sided curve and Group L comprising 20 patients with a left-sided curve. All patients underwent CT scans of the lower thoracic and lumbar spine before and after surgery. To identify the relative positions of the aorta to vertebral body, several parameters were measured from the CT images of the middle transverse planes of vertebrae from T11 to L4, including aorta-vertebra angle (α), vertebral rotation angle (β), left safety distance (LSD) and right safety distance (RSD). The risk of the aorta impingement from T11 to L4 was calculated. An intragroup comparison regarding the position of the aorta relative to the vertebral body before and after correction surgery was performed accordingly. After surgery, the aorta moved toward the vertebral body among all levels in both groups. Compared with that in Group L, the aorta in Group R was significantly closer to the entry point at all levels, especially at T11. Before surgery, the aorta in Group R was at a high risk of impingement from left PS placement regardless of the diameters of the simulated screws. While in Group L, the risk of aorta impingement was mainly caused by the right placement of 45 mm PS. After surgery, both groups had an increased risk of aorta impingement from PS insertion, especially at T11. The risk of aorta impingement from PS placement was significantly higher in Group R than in Group L. The risk of aorta impingement increased as the aorta shifted leftward after correction surgery, especially in right-sided Lenke 5C curve. Thus, preoperative risk

  1. Ascending Aorta Stenting After Off-Pump Aortic Wrapping in Stanford A Retrograde Aortic Dissection.

    Science.gov (United States)

    Verscheure, Dorian; Ramadan, Ramzi; Azmoun, Alexandre; Guihaire, Julien; Angel, Claude; Brenot, Philippe; Deleuze, Philippe

    2017-08-01

    We report 4 cases of off-pump ascending aorta wrapping combined with ascending aorta stenting in retrograde Stanford A acute aortic dissection (SAAD). Since 2008, 18 patients have undergone wrapping of the ascending aorta at our institution. Four patients had a persistent circulating false lumen in the ascending aorta after wrapping, with a threat to the aortic root. We chose an endovascular approach with ascending aorta stenting. Follow-up computed tomography showed a reapplication of the intimal flap in the reinforced aorta. Ascending aorta stenting after aortic wrapping for retrograde SAAD is a safe and efficient technique to prevent proximal progression of the dissection. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

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

    International Nuclear Information System (INIS)

    Rao, A.R.

    1976-01-01

    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- 14 C)-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)

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

    International Nuclear Information System (INIS)

    Michailov, M.C.; Prechter, I.; Greimel, H.; Welscher, U.E.

    1983-01-01

    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.) [de

  4. Mechanics, Mechanobiology, and Modeling of Human Abdominal Aorta and Aneurysms

    Science.gov (United States)

    Humphrey, J.D.; Holzapfel, G.A.

    2011-01-01

    Biomechanical factors play fundamental roles in the natural history of abdominal aortic aneurysms (AAAs) and their responses to treatment. Advances during the past two decades have increased our understanding of the mechanics and biology of the human abdominal aorta and AAAs, yet there remains a pressing need for considerable new data and resulting patient-specific computational models that can better describe the current status of a lesion and better predict the evolution of lesion geometry, composition, and material properties and thereby improve interventional planning. In this paper, we briefly review data on the structure and function of the human abdominal aorta and aneurysmal wall, past models of the mechanics, and recent growth and remodeling models. We conclude by identifying open problems that we hope will motivate studies to improve our computational modeling and thus general understanding of AAAs. PMID:22189249

  5. 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

  6. Descending thoracic aorta dissection associated with esophageal carcinoma

    Directory of Open Access Journals (Sweden)

    Kaushik Saha

    2013-01-01

    Full Text Available The association of aortic dissection with a malignancy is a rare finding and previous reports are usually those of primary aortic sarcomas. A 45-year-old male presented to us with chest pain and dysphagia for 1 month with a background history of obstructive airway disease and uncontrolled hypertension. In this report we present a case of typical descending aorta dissection with associated esophageal carcinoma.

  7. Intrapericardial bronchogenic cyst adherent to ascending aorta in young patient

    Directory of Open Access Journals (Sweden)

    Reddy Atipo-Galloye

    2014-06-01

    Full Text Available Bronchogenic cysts arise from an abnormal budding of the ventral diverticulum of the foregut or the thracheobronchial tree during embryogenesis. An intrapericardial location is an extremely rare finding. Symptoms are related to cardiac structure compression, but in most case they remain asymptomatic. We present a case of intrapericardial bronchogenic cyst in a young patient, resected entirely with repair of right lateral proximal ascending aorta with PTFE graft.

  8. Hemodynamic Modeling of Surgically Repaired Coarctation of the Aorta.

    Science.gov (United States)

    Olivieri, Laura J; de Zélicourt, Diane A; Haggerty, Christopher M; Ratnayaka, Kanishka; Cross, Russell R; Yoganathan, Ajit P

    2011-12-01

    PURPOSE: Late morbidity of surgically repaired coarctation of the aorta includes early cardiovascular and cerebrovascular disease, shortened life expectancy, abnormal vasomodulator response, hypertension and exercise-induced hypertension in the absence of recurrent coarctation. Observational studies have linked patterns of arch remodeling (Gothic, Crenel, and Romanesque) to late morbidity, with Gothic arches having the highest incidence. We evaluated flow in native and surgically repaired aortic arches to correlate respective hemodynamic indices with incidence of late morbidity. METHODS: Three dimensional reconstructions of each remodeled arch were created from an anatomic stack of magnetic resonance (MR) images. A structured mesh core with a boundary layer was generated. Computational fluid dynamic (CFD) analysis was performed assuming peak flow conditions with a uniform velocity profile and unsteady turbulent flow. Wall shear stress (WSS), pressure and velocity data were extracted. RESULTS: The region of maximum WSS was located in the mid-transverse arch for the Crenel, Romanesque and Native arches. Peak WSS was located in the isthmus of the Gothic model. Variations in descending aorta flow patterns were also observed among the models. CONCLUSION: The location of peak WSS is a primary difference among the models tested, and may have clinical relevance. Specifically, the Gothic arch had a unique location of peak WSS with flow disorganization in the descending aorta. Our results suggest that varied patterns and locations of WSS resulting from abnormal arch remodeling may exhibit a primary effect on clinical vascular dysfunction.

  9. CT and MR imaging of the thoracic aorta

    Directory of Open Access Journals (Sweden)

    Di Cesare Ernesto

    2016-01-01

    Full Text Available At present time, both CT and MRI are valuable techniques in the study of the thoracic aorta. Nowadays, CT represents the most widely employed technique for the study of the thoracic aorta. The new generation CTs show sensitivities up to 100% and specificities of 98-99%. Sixteen and wider row detectors provide isotropic pixels, mandatory for the ineludible longitudinal reconstruction. The main limits are related to the X-ray dose expoure and the use of iodinated contrast media. MRI has great potential in the study of the thoracic aorta. Nevertheless, if compared to CT, acquisition times remain longer and movement artifact susceptibility higher. The main MRI disadvantages are claustrophobia, presence of ferromagnetic implants, pacemakers, longer acquisition times with respect to CT, inability to use contrast media in cases of renal insufficiency, lower spatial resolution and less availability than CT. CT is preferred in the acute aortic disease. Nevertheless, since it requires iodinated contrast media and X-ray exposure, it may be adequately replaced by MRI in the follow up of aortic diseases. The main limitation of MRI, however, is related to the scarce visibility of stents and calcifications.

  10. 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

  11. Raeder's syndrome after embolization of a giant intracavernous carotid artery aneurysm: pathophysiological considerations Síndrome de Raeder após embolização de aneurisma gigante de artéria carótida intracavernosa: considerações fisiopatológicas

    Directory of Open Access Journals (Sweden)

    Claudio Esteves Tatsui

    2005-09-01

    Full Text Available We present the case of a 47 years old woman submitted to an endovascular trapping of a left cavernous internal carotid artery aneurysm, in which the distal balloon was inflated, as usually done, within the cavernous segment of the internal carotid artery, different from the proximal one which was inflated inside the carotid canal due to technical problems. Consequently, a clinical picture of Raeder's paratrigeminal neuralgia took place. This is the first case report in the literature with theses characteristics. A review of the anatomic pathways and further considerations about the possible pathophysiological mechanisms involved are presented.Apresentamos o caso de uma mulher de 47 anos submetida a obliteração endovascular de um aneurisma gigante de carótida interna cavernosa à esquerda, no qual o balão distal foi inflado, tal como usual, dentro do segmento cavernoso da artéria carótida interna, diferente do proximal, o qual foi inflado dentro do canal carotídeo devido a problemas técnicos. Conseqüentemente, um quadro clínico de neuralgia paratrigeminal de Raeder se instalou. Este é o primeiro relato na literatura com estas características. Uma revisão das vias anatômicas e maiores considerações a respeito de possíveis mecanismos fisiopatológicos envolvidos são apresentados.

  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. Proteção cerebral no tratamento cirúrgico dos aneurismas do arco aórtico: estudo experimental em cães Cerebral protection to be used during aortic arch aneurysms resection

    Directory of Open Access Journals (Sweden)

    Henrique Murad

    1993-09-01

    Full Text Available Os autores realizaram estudo experimental comparativo entre dois métodos de proteção cerebral utilizados na abordagem cirúrgica dos aneurismas do arco aórtico, avaliando a sua eficácia. Os métodos comparados foram a hipotermia sistêmica profunda isolada (menor que 20ºC com pinçamento arterial braquiocefálico e a hipotermia sistêmica profunda associada à perfusão carotídea seletiva. Dois grupos de 15 cães cada foram submetidos, respectivamente, a hipotermia sistêmica profunda com pinçamento arterial braquiocefálico (GRUPO I e a hipotermia sistêmica profunda associada a perfusão seletiva da carótida direita (GRUPO II. Foram colhidas amostras seriadas de sangue para análise das alterações metabólicas de pH e PaCO2 que ocorreram no retorno venoso cerebral, aferidas na veia jugular interna, bem como as alterações histopatológicas encontradas com 45 min, 90 min e 135 min de cada procedimento. Os resultados demonstraram que, apesar de ambos os métodos de proteção cerebral serem eficazes por um período de 45 minutos, o método utilizado no GRUPO II mostrou ser superior em períodos de até 90 minutos. Em períodos de 135 minutos os métodos tiveram resultados semelhantes, não oferecendo proteção cerebral adequada.The authors proposition is to make an experimental study of two methods of cerebral protection to be used during aortic arch aneurysm resection. The methods to be evaluated were profound systemic hypothermia (under 20oC with great vessels occlusion and profound systemic hypothermia with selective right carotid artery perfusion. Two groups of 15 dogs each were submitted either to profound systemic hypothermia with great vessels occlusion (GROUP I or to profound systemic hypothermia with selective right carotid artery perfusion (GROUP II. Serial jugular vein samples for pH and PaC02 were analyzed to evaluate ischemic cerebral metabolic derangements. Hystopathological studies were also made at 45, 90 and 135

  14. 296. Aneurisma de Seno de Valsalva no Coronariano Fistulizado a Aurícula Derecha Acompañado de Comunicación Auricular Tipo Ostium Secundum

    Directory of Open Access Journals (Sweden)

    M. García Vieites

    2012-04-01

    Los aneurismas del seno de Valsalva tienen una prevalencia estimada de 0,14%, siendo más comunes en la población masculina. Su localización más frecuente es el seno coronario derecho (70–90%, seguido de seno no coronariano (10–20%, y raramente de seno coronariano izquierdo. Aunque frecuentemente se presentan con defectos congénitos, su asociación con comunicación interauricular es baja. Evolucionan hacia la dilatación progresiva que puede llevar a rotura hacia pericardio o bien fistulizar a cavidades cardíacas. Un diagnóstico e intervención quirúrgica precoz son fundamentales, con una tasa de mortalidad posquirúrgica baja a corto y largo plazo.

  15. 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 ...

  16. Demonstration of ascending aorta in hypoplastic left heart syndrome with aortic atresia by balloon occlusion aortography

    International Nuclear Information System (INIS)

    Lo, R.N.S.; Leung, M.P.; Lau, K.C.

    1987-01-01

    Balloon occlusion angiography in the descending aorta produced clear retrograde visualization of the hypoplastic ascending aorta and related structures in eighteen neonates with aortic atresia. Transient bradycardia was the only complication observed. It is technically simpler than retrograde cannulation of the aorta via an arteriotomy and should be the method of choice when cardiac catheterization is required in patients with the hypoplastic left heart syndrome. (orig.)

  17. Treatment of traumatic rupture of the thoracic aorta

    Directory of Open Access Journals (Sweden)

    Davidović Lazar

    2008-01-01

    Full Text Available INTRODUCTION Interest for traumatic thoracic aorta rupture stems from the fact that its number continually increases, and it can be rapidly lethal. OBJECTIVE The aim of this study is to present early and long term results as well as experiences of our team in surgical treatment of traumatic thoracic aorta rupture. METHOD Our retrospective study includes 12 patients with traumatic thoracic aorta rupture treated between 1985 and 2007. There were 10 male and two female patients of average age 30.75 years (18-74. RESULTS In six cases, primary diagnosis was established during the first seven days days after trauma, while in 6 more than one month later. In 11 cases, classical open surgical procedure was performed, while endovascular treatment was used in one patient. Three (25% patients died, while two (16.6% had paraplegia. Nine patients (75% were treated without complications, and are in good condition after a mean follow-up period of 9.7 years (from one month to 22 years. CONCLUSION Surgical treatment requires spinal cord protection to prevent paraplegia, using cardiopulmonary by-pass (three of our cases or external heparin-bonded shunts (five of our cases. Cardiopulmonary by-pass is followed with lower incidence of paraplegia, however it is not such a good solution for patients with polytrauma because of hemorrhage. The endovascular repair is a safe and feasible procedure in the acute phase, especially because of traumatic shock and polytrauma which contributes to higher mortality rate after open surgery. On the other hand, in chronic postrauamatic aortic rupture, open surgical treatment is connected with a lower mortality rate and good long-term results. There have been no published data about long-term results of endovascular treatment in the chronic phase.

  18. Characterization of fracture toughness exhaustion in pig aorta.

    Science.gov (United States)

    Chu, Boby; Gaillard, Emmanuel; Mongrain, Rosaire; Reiter, Steven; Tardif, Jean-Claude

    2013-01-01

    Spontaneous rupture of the aorta (SRA) without aneurysm, dissection, inflammation or infection of the aortic wall can be of two types: traumatic and non-traumatic. SRA is most of the time a fatal event. Consequently, it is important to understand the conditions which lead to the aortic rupture, and, in the case of non-traumatic SRA, to predict the temporal likelihood of rupture. The present work incorporates the temporal aspect by examining the effects of fatigue on aortic wall properties, and adopts an energy approach, based on fracture toughness, to evaluate the aorta's resistance to rupture. Fracture toughness characterization is a destructive testing process and as a consequence cannot be implemented as a clinical tool. However, using concepts in damage mechanics, in theory, it should be possible to indirectly assess fracture toughness from other mechanical properties, such as aortic wall stiffness. Tissue samples from non-aneurysmal porcine aortas were fatigued and were subjected to both biaxial and guillotine tests to assess wall stiffness variations and fracture toughness exhaustion, respectively. The experiments reveal that aortic wall stiffness variations and fracture toughness exhaustion decreased as a function of loading cycles and can be modeled with exponential functions. After one million loading cycles, the stiffness ratio between the non-fatigued sample and the fatigued sample, dropped to about 0.85, while the fracture toughness ratio counterpart fell to about 0.80. Consequently, the changes in both stiffness and fracture toughness as a function of applied fatigue cycles can be measured in aortic tissues. Moreover, these results suggest the possibility to use fracture toughness exhaustion curves as a fatigue criterion. Copyright © 2012 Elsevier Ltd. All rights reserved.

  19. Computational modeling of blood flow in the aorta--insights into eccentric dilatation of the ascending aorta after surgery for coarctation.

    Science.gov (United States)

    Szopos, Marcela; Poussineau, Nicole; Maday, Yvon; Canniffe, Carla; Celermajer, David S; Bonnet, Damien; Ou, Phalla

    2014-10-01

    To assess whether combining a computational modeling technique with data from patient magnetic resonance imaging studies can detect different fluid dynamics and vascular biomechanical properties of the ascending and horizontal aorta in patients with angulated "gothic" arch geometry compared with those with normal "Romanesque" arch geometry after aortic coarctation repair. Advanced computational fluid dynamics techniques (coupled Navier-Stokes and elastodynamics equations) were used to predict the fluid-wall interactions in large arteries. We modeled the fluid dynamics and shear stress in the ascending and horizontal aorta in cases of "gothic" arch and normal "Romanesque" aortic arch geometry. A total of 30 patients after aortic coarctation repair prospectively underwent 3-dimensional magnetic resonance imaging angiography of the thoracic aorta. Measurements of the ascending and horizontal aorta were assessed using multiplanar reformatting images. Our computational model demonstrated that wall shear stress is greater in those with an angulated "gothic" aortic arch than in those with a "Romanesque" arch. In particular, wall shear stress affected the anterior and posterior segments of the ascending aorta and the inferior and superior segments of the horizontal aorta (vs the left and right segments). In vivo, a "gothic" arch was associated with dilatation of the ascending and horizontal aorta, which was eccentric rather than concentric (Pgothic" aortic arch after repair of coarctation. This suggests that patients with an angulated "gothic" aortic arch might warrant increased surveillance for aortic complications. Copyright © 2014 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  20. Left Ventricular Myxoma Occluding the Suprarenal Abdominal Aorta in an Infant.

    Science.gov (United States)

    Kawabata, Takuya; Kasahara, Shingo; Ohtsuki, Shin-ichi; Kuroko, Yosuke; Kotani, Yasuhiro; Fujii, Yasuhiro; Yoshizumi, Ko; Arai, Sadahiko; Sano, Shunji

    2015-07-01

    Myxoma is the most common primary cardiac tumor in adults; however, it is extremely rare in infants. Acute occlusion of the abdominal aorta by a cardiac myxoma is also rare. We report the case of an infant with acute occlusion of the suprarenal abdominal aorta by a left ventricular myxoma. The patient underwent successful catheter embolectomy of the abdominal aorta and surgical resection of the cardiac myxoma. This is a very rare case report of the combination of infantile left ventricular myxoma and acute occlusion of the abdominal aorta. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  1. [Resistant arterial hypertension and coarctation of the aorta].

    Science.gov (United States)

    Martínez-Quintana, Efrén; Rossique-Delmas, Pilar; Rodríguez-González, Fayna

    2014-01-01

    Coarctation of the aorta accounts for around 5 percent of all congenital heart defects. Many of these patients develop arterial hypertension, and occasionally resistant arterial hypertension, despite adequate correction. This may lead to potentially fatal complications such as heart failure, aortic dissection, cerebrovascular events, or myocardial infarction. Therefore, a correct diagnosis must be made and an appropriate treatment started to reduce arterial hypertension, arteriosclerotic vascular disease, as well as the increased risk of cardiovascular morbidity and mortality. Copyright © 2014 Sociedad Española de Arteriosclerosis. Published by Elsevier España. All rights reserved.

  2. Spiral CT angiography of the abdominal aorta and its branches

    Energy Technology Data Exchange (ETDEWEB)

    Costello, P. [Dept. of Radiology, Deaconess Hospital and Harvard Medical School, Boston, MA (United States); Gaa, J. [Dept. of Radiology, Deaconess Hospital and Harvard Medical School, Boston, MA (United States)

    1993-08-01

    Spiral CT angiography (CTA) was performed on 19 patients for the pre-operative assessment of abdominal aortic aneurysms and in 3 post-operative renal artery bypass patients. Spiral CTA performed during intravenous contrast infusion provided a volume of data that was reconstructed at thin increments. Images were edited and reformatted either as surface rendered three-dimensional or maximum intensity projection (MIP) displays. Final images were viewed in a cine-loop presentation of quality comparable to conventional angiograms. The entire aorta can be examined from the coeliac axis to mid-pelvis with only 107 ml of 60% contrast. (orig.)

  3. Penetrating ulcer of descending thoracic aorta: radiological findings and the report of five cases; Ulcera penetrante de aorta toracica descendente. Hallazgos radiologicos. Presentacion de cinco casos

    Energy Technology Data Exchange (ETDEWEB)

    Anton, C.; Corchon, C.; Alvarez, B.; Logrono, I. [Hospital de Navarra (Spain)

    1999-07-01

    Penetrating ulcer of the aorta is characterized by the ulceration of atheromatous plaque with perforation of the internal elastic lamina, which favors the formation of a hematoma within the tunica media of the aorta. It presents with acute chest pain and may mimic ischemic heart disease or other aortic lesions such as dissection or aneurysm rupture. It is an uncommon but severe disease, the diagnosis of which is based mainly on radiological evidence. We describe the radiological findings observed in five patients with penetrating ulcer of the aorta studies by difference imaging techniques. (Author) 14 refs.

  4. Anestesia para cesariana em gestante com hipoplasia de aorta distal: relato de caso Anestesia para cesárea en embarazada con hipoplasia de aorta distal: relato de caso Anesthesia for cesarean section on a pregnant woman with hypoplasia of the distal aorta: case report

    Directory of Open Access Journals (Sweden)

    Leonardo de Andrade Reis

    2008-02-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Anomalias vasculares maternas, potencialmente graves para o feto, podem colocar em risco a perfusão uterina, suscitando cuidados ainda maiores por parte da equipe anestésica. O objetivo deste relato foi mostrar a conduta anestésica para operação cesariana em uma gestante com hipoplasia de aorta distal, logo abaixo da emergência das artérias renais, com estenose da artéria renal e ausência de artérias ilíacas. RELATO DO CASO: Paciente de 30 anos, 54 kg, na segunda gestação com uma cesariana anterior sem intercorrências. Durante a realização de ecografia gestacional na 12ª semana observou-se interrupção da aorta logo abaixo da saída das artérias renais. A paciente foi encaminhada para a realização de cineangiocoronariografia que mostrou hipoplasia da aorta distal abaixo das artérias renais, com ausência das artérias ilíacas. Durante a investigação clínica a paciente mostrou-se assintomática, com exceção de hipertensão arterial e claudicação aos grandes esforços. A paciente foi submetida à anestesia peridural contínua, com titulação da dose anestésica necessária à realização da cesariana. Inicialmente foram injetados 50 mg de bupivacaína a 0,5% sem vasoconstritor e 10 µg de sufentanil. Quinze minutos após, a anestesia foi complementada com mais 25 mg de bupivacaína a 0,5%, o que foi suficiente para atingir adequado nível de bloqueio. A cesariana transcorreu sem intercorrências e a criança nasceu em boas condições clínicas. CONCLUSÕES: O uso de anestesia peridural contínua com doses fracionadas demonstrou ser uma técnica anestésica segura para a realização desse procedimento por reduzir os riscos de hipotensão arterial materna inerente ao bloqueio espinal e também por minimizar a transferência placentária de fármacos, que ocorrem quando do emprego da anestesia geral. A titulação de fármacos através do cateter peridural possibilitou atingir nível anest

  5. Ebstein's anomaly with coarctation of the aorta. An unusual association

    Directory of Open Access Journals (Sweden)

    Ebaid Munir

    1999-01-01

    Full Text Available Ebstein's anomaly with coarctation of the aorta is an extremely unusual condition. In this report, the clinical and surgical features of 3 male patients, aged 7 months, 4 years and 14 years, are discussed. All patients were in situs solitus. The first 2 patients had atrioventricular and ventriculoarterial discordance and progressed to heart failure in the neonatal period. The third had atrioventricular and ventriculoarterial concordance, as well as Wolf-Parkinson-White syndrome, with frequent episodes of paroxysmal tachycardia. The 3 patients underwent surgery for correction of the coarctation of the aorta. The patient with atrioventricular and ventriculoarterial concordance underwent tricuspid valvuloplasty using a DeVega-like technique. In addition, ablation of 2 anomalous pathways (Kent bundle, which were detected by the electrophysiologic study, was also subsequently performed. The 3 patients showed a good postoperative outcome for 2 years, although, in those with discordance, the surgical procedure did not influence the dysplasia of the tricuspid valve, because this valve showed light to moderate dysfunction.

  6. Elastin aging and lipid oxidation products in human aorta

    Directory of Open Access Journals (Sweden)

    Kamelija Zarkovic

    2015-04-01

    Full Text Available Vascular aging is associated with structural and functional modifications of the arteries, and by an increase in arterial wall thickening in the intima and the media, mainly resulting from structural modifications of the extracellular matrix (ECM components. Among the factors known to accumulate with aging, advanced lipid peroxidation end products (ALEs are a hallmark of oxidative stress-associated diseases such as atherosclerosis. Aldehydes generated from the peroxidation of polyunsaturated fatty acids (PUFA, (4-hydroxynonenal, malondialdehyde, acrolein, form adducts on cellular proteins, leading to a progressive protein dysfunction with consequences in the pathophysiology of vascular aging. The contribution of these aldehydes to ECM modification is not known. This study was carried out to investigate whether aldehyde-adducts are detected in the intima and media in human aorta, whether their level is increased in vascular aging, and whether elastin fibers are a target of aldehyde-adduct formation. Immunohistological and confocal immunofluorescence studies indicate that 4-HNE-histidine-adducts accumulate in an age-related manner in the intima, media and adventitia layers of human aortas, and are mainly expressed in smooth muscle cells. In contrast, even if the structure of elastin fiber is strongly altered in the aged vessels, our results show that elastin is not or very poorly modified by 4-HNE. These data indicate a complex role for lipid peroxidation and in particular for 4-HNE in elastin homeostasis, in the vascular wall remodeling during aging and atherosclerosis development.

  7. Branches of the abdominal aorta in Aotus azarae infulatus

    Directory of Open Access Journals (Sweden)

    Bianca Mendonça Faria

    2016-05-01

    The genus Aotus is found in South America and is known for its nocturnal habit. The morphology of the genus is poorly understood even though it is used in biomedical research. The objective of this study was to identify the collateral branches of the abdominal aorta of two females and one male Aotus azarae infulatus (commonly known as the night monkey. The vessels were observed and stained with Neoprene latex and radiopaque contrast. The animals were fixed in an aqueous solution of 10% formaldehyde via intramuscular and intracavitary routes, dissected and radiographed. It was observed that the celiac artery was divided into three subjacent branches, the gastric, hepatic and splenic arteries. The left and right renal arteries originated from a common trunk in two animals (animals 1 and 2, while the adrenal artery in one of the animals was derived from the celiac trunk and renal artery (animal 2. In one animal the mesenteric artery flow gave rise to individual cranial rectal, sigmoid and left colic arteries (animal 3. In the three animals the abdominal aorta bifurcated in the final portion of the abdomen, with the external and internal iliac artery on each side, and then the median sacral artery. These anatomical variations need to be identified and reported because these animals are frequently used in clinical and surgical, veterinary practices.

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

    Science.gov (United States)

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

    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. PMID:26635924

  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. Heterogeneity of smooth muscle cells in tunica media of aorta in ...

    African Journals Online (AJOL)

    ... of the tunica media of goat aorta are phenotypically heterogeneous and run in multiple directions. These characteristics probably confer mechanical strength and functional plasticity to the aortic wall. Designers of aortic substitutes should bear this in mind. Keywords: Vascular, Smooth Muscle Cells, Heterogeneity, Aorta ...

  11. 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.).

  12. Improved protein extraction and protein identification from archival formalin-fixed paraffin-embedded human aortas.

    Science.gov (United States)

    Fu, Zongming; Yan, Kun; Rosenberg, Avraham; Jin, Zhicheng; Crain, Barbara; Athas, Grace; Heide, Richard S Vander; Howard, Timothy; Everett, Allen D; Herrington, David; Van Eyk, Jennifer E

    2013-04-01

    Evaluate combination of heat and elevated pressure to enhance protein extraction and quality of formalin-fixed (FF), and FF paraffin-embedded (FFPE) aorta for proteomics. Proteins were extracted from fresh frozen aorta at room temperature (RT). FF and FFPE aortas (3 months and 15 years) were extracted at RT, heat alone, or a combination of heat and high pressure. Protein yields were compared, and digested peptides from the extracts were analyzed with MS. Combined heat and elevated pressure increased protein yield from human FF or FFPE aorta compared to matched tissues with heat alone (1.5-fold) or at RT (8.3-fold), resulting in more proteins identified and with more sequence coverage. The length of storage did adversely affect the quality of proteins from FF tissue. For long-term storage, aorta was preserved better with FFPE than FF alone. Periostin and MGF-E8 were demonstrated suitable for MRM assays from FFPE aorta. Combination of heat and high pressure is an effective method to extract proteins from FFPE aorta for downstream proteomics. This method opens the possibility for use of archival and often rare FFPE aortas and possibly other tissues available to proteomics for biomarker discovery and quantification. © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  13. Intima-media thickness of the descending aorta in patients with bicuspid aortic valve

    Directory of Open Access Journals (Sweden)

    Johan Petrini

    2016-06-01

    Conclusions: Intima-media thickness of the descending aorta is not affected by aortic valve morphology (BAV/TAV; age is the main determinant of AoIMT. Genetic markers (SNPs known to influence IMT in the carotid artery seem to correlate to IMT in the descending aorta only in patients with TAV.

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

    International Nuclear Information System (INIS)

    Sommerhoff, B.A.; Sechtem, U.P.; Schiller, N.B.; Higgins, C.B.

    1986-01-01

    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

  15. Automated quantitative 3D analysis of aorta size, morphology, and mural calcification distributions

    Energy Technology Data Exchange (ETDEWEB)

    Kurugol, Sila, E-mail: sila.kurugol@childrens.harvard.edu; Come, Carolyn E.; Diaz, Alejandro A.; Ross, James C.; Washko, George R.; San Jose Estepar, Raul [Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts 02115 (United States); Kinney, Greg L.; Black-Shinn, Jennifer L.; Hokanson, John E. [Colorado School of Public Health, University of Colorado Denver, Aurora, Colorado 80045 (United States); Budoff, Matthew J. [Los Angeles Biomedical Research Center at Harbor and UCLA Medical Center, Torrance, California 90502 (United States)

    2015-09-15

    Purpose: The purpose of this work is to develop a fully automated pipeline to compute aorta morphology and calcification measures in large cohorts of CT scans that can be used to investigate the potential of these measures as imaging biomarkers of cardiovascular disease. Methods: The first step of the automated pipeline is aorta segmentation. The algorithm the authors propose first detects an initial aorta boundary by exploiting cross-sectional circularity of aorta in axial slices and aortic arch in reformatted oblique slices. This boundary is then refined by a 3D level-set segmentation that evolves the boundary to the location of nearby edges. The authors then detect the aortic calcifications with thresholding and filter out the false positive regions due to nearby high intensity structures based on their anatomical location. The authors extract the centerline and oblique cross sections of the segmented aortas and compute the aorta morphology and calcification measures of the first 2500 subjects from COPDGene study. These measures include volume and number of calcified plaques and measures of vessel morphology such as average cross-sectional area, tortuosity, and arch width. Results: The authors computed the agreement between the algorithm and expert segmentations on 45 CT scans and obtained a closest point mean error of 0.62 ± 0.09 mm and a Dice coefficient of 0.92 ± 0.01. The calcification detection algorithm resulted in an improved true positive detection rate of 0.96 compared to previous work. The measurements of aorta size agreed with the measurements reported in previous work. The initial results showed associations of aorta morphology with calcification and with aging. These results may indicate aorta stiffening and unwrapping with calcification and aging. Conclusions: The authors have developed an objective tool to assess aorta morphology and aortic calcium plaques on CT scans that may be used to provide information about the presence of cardiovascular

  16. Chest radiography in acute traumatic rupture of the thoracic aorta

    Energy Technology Data Exchange (ETDEWEB)

    Heystraten, F.M.; Rosenbusch, G.; Kingma, L.M.; Lacquet, L.K.; Boo, T. de; Lemmens, W.A.

    Of 123 patients who had suffered blunt trauma to the chest traumatic aortic rupture was eventually confirmed in 61 and absent in 62 patients. The chest radiographs of these patients were examined for 15 signs reported in the literature as being associated with traumatic aortic rupture. Although many individual signs were significantly more frequent in the aortic rupture group they were not useful in differentiating between patients with and those without rupture of the aorta. By using discriminant analysis combining 2 or 3 signs, patients were classified as having aortic rupture or not. The best discrimination between the two groups was obtained using the combined signs of a widened paratracheal stripe, and opacified pulmonary window, a widened right paraspinal interface and a displaced nasogastric tube.

  17. Quantitative analysis of calcification of the abdominal aorta by CT

    International Nuclear Information System (INIS)

    Watanabe, Hiromi; Kubota, Kazuo; Ito, Kengo; Ono, Shuichi; Matsuzawa, Taiju

    1983-01-01

    Of the abdominal aorta, the relationship between the calcification index (C.I.) obtained from CT films and the atheromatous surface involved (S.I.) obtained from autopsy specimens was studied. The relations of C.I. to hypertension and hyperlipidemia were also analyzed. The coefficient of correlation between C.I. and S.I. was 0.83 (p< 0.001). Compared with a non-hypertensive group, the hypertensives showed a higher C.I., and such a difference was great in the male patients in their 50s and females in their 60s and 70s. The male patients with hyperlipidemia did not show definite differences in C.I. from the non-hyperlipidemia group, but the female patients in their 60s and 70s showed significantly higher values. (Chiba, N.)

  18. 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 agents......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...... 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...

  19. 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.

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

    DEFF Research Database (Denmark)

    Jensen, Andreas Schmidt

    -aware and autonomous. The reasoning component makes them organization-aware, and their autonomy is intact because the component does not change the existing reasoning mechanisms. As such, it allows the agents to decide whether to adhere to the system’s expectations. The ability to reason about organizations has......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...

  1. Effects of thapsigargin in isolated rat thoracic aorta

    DEFF Research Database (Denmark)

    Mikkelsen, E O; Thastrup, Ole; Christensen, S B

    1988-01-01

    response to Tg was resistent to wash-out in drug-free PSS and was not affected by phentolamine, indomethacin or mepyramine but partly reduced by the calcium-antagonist nitrendipine and eliminated by wash-out in calcium-free PSS. Atropine eliminated the endothelium dependent relaxant effect of carbachol......, but had no effect on the Tg or on the calcium ionophore A 23187 evoked relaxation. Ultraviolet radiation decreased the relaxant effect of Tg and A 23187 without affecting the carbachol induced relaxations. The results showed that vascular endothelium depressed the contractile effect of Tg and that Tg like...... A 23187 had an endothelium dependent relaxant effect on rat aorta different from that of carbachol. The results indicate that Tg in vascular smooth muscle acts by stimulating the transmembranal influx of extracellular calcium....

  2. Arginine restores cholinergic relaxation of hypercholesterolemic rabbit thoracic aorta.

    Science.gov (United States)

    Cooke, J P; Andon, N A; Girerd, X J; Hirsch, A T; Creager, M A

    1991-03-01

    Reduced synthesis of endothelium-derived relaxing factor (EDRF) may explain impaired endothelium-dependent vasodilation in hypercholesterolemia. Accordingly, we designed studies to determine if endothelium-dependent relaxation in hypercholesterolemic rabbits may be restored by supplying L-arginine, the precursor of EDRF. Normal or hypercholesterolemic rabbits received intravenous L-arginine (10 mg/kg/min) or vehicle for 70 minutes. Subsequently, animals were killed, thoracic aortas were harvested, and vascular rings were studied in vitro. Rings were contracted by norepinephrine and relaxed by acetylcholine chloride or sodium nitroprusside. Vasorelaxation was quantified by determining the maximal response (expressed as percent relaxation of the contraction) and the ED50 (dose of drug inducing 50% relaxation; expressed as -log M). In vessels from hypercholesterolemic animals receiving vehicle, there was a fivefold rightward shift in sensitivity to acetylcholine compared with normal animals (p = 0.05, n = 5 in each group). In vessels from hypercholesterolemic animals, L-arginine augmented the maximal response to acetylcholine (83 +/- 16% versus 60 +/- 15%, p = 0.04 versus vehicle) and increased the sensitivity to acetylcholine (ED50 value: 6.7 +/- 0.2 versus 6.2 +/- 0.2, p less than 0.05 versus vehicle). Arginine did not affect maximal and EC50 responses to acetylcholine in vessels from normal animals. Arginine did not potentiate endothelium-independent responses in either group. We conclude that the endothelium-dependent relaxation is normalized in hypercholesterolemic rabbit thoracic aorta by in vivo exposure to L-arginine, the precursor for EDRF.

  3. Tratamento endovascular de pseudoaneurisma de aorta torácica com fístula aorto-brônquica em pós-operatório tardio de cirurgia de correção de coarctação de aorta Endovascular treatment of thoracic aortic pseudoaneurysm with aortobronchial fistula in the late postoperative period of surgical correction of the aortic coarctation

    Directory of Open Access Journals (Sweden)

    Ana Augusta Gayoso Neves

    2011-03-01

    Full Text Available Fístula aorto-brônquica é uma conexão entre a aorta e o brônquio, e mesmo quando imediatamente reconhecida e tratada possui alto risco de letalidade. Pode se desenvolver após cirurgias de aorta, e é geralmente uma consequência de pseudoaneurisma. A hemoptise, massiva ou intermitente, é o principal sintoma apresentado. O tratamento convencional da fístula aorto-brônquica é a cirurgia aberta de aorta torácica, com reconstrução traqueobrônquica. Recentemente, o reparo endovascular tem sido proposto como uma alternativa. Os autores apresentam um relato de tratamento endovascular, realizado com êxito, de pseudoaneurisma de aorta torácica com fístula aorto-brônquica 22 anos após cirurgia para correção de coarctação aórtica.Aortobronchial fistula is an abnormal passage between the aorta and the bronchus, and even when recognized and treated promptly, it carries a high risk of fatality. It can develop after aortic operations, and it is usually the result of a pseudoaneurysm. Massive or intermittent hemoptysis is the main symptom. Conventional treatment of aortobronchial fistula is open surgery of the thoracic aorta with tracheobronchial reconstruction. Recently, endovascular repair has been proposed as an alternative. The authors report a case of successful endovascular treatment of thoracic aortic pseudoaneurysm with aortobronchial fistula, 22 years after surgical correction of the aortic coarctation.

  4. Anterior retroperitoneal rami: until now unnamed direct branches of the abdominal aorta.

    Science.gov (United States)

    Turyna, R; Kachlik, D; Feyreisl, J; Stingl, J; Baca, V

    2014-09-01

    The aim of the study was to gain a thorough knowledge of the topography and distribution of until now officially unnamed minute direct branches from abdominal aorta, stemming from its ventral and lateral aspects, supplying surrounding tissue, and to comprise it to the existing studies. The study was performed in fixed cadaverous material collected from India ink injections of abdominal aorta samples with large surrounding retroperitoneal tissue. The 25 samples were dissected under magnifying binocular glass, followed by graphic reconstruction; statistical analysis, and the study was preceded with detailed review of branches from abdominal aorta. For systematization of the segmental anatomy of the abdominal aorta and infrarenal segment of inferior vena cava, we defined three levels in this area. The retroperitoneal branches were most frequently situated simultaneously within all three predefined levels according to renal and inferior mesenteric arteries origin. There were 18% of retroperitoneal branches within Level 1, 39% within Level 2 and 43% within Level 3. They were branches not only from the abdominal aorta, but also from the testicular/ovarian artery, common iliac artery and in one case from the right accessory renal artery. Paired arrangement was recorded mainly cranially to the origin of inferior mesenteric artery, unpaired branches were more frequently found caudally. In conclusion, due to the terminological disunity of these arteries in the clinical literature and total absence in the anatomical literature, we propose to denominate them as anterior retroperitoneal branches of abdominal aorta (rami retroperitoneales anteriores aortae abdominalis). © 2014 Wiley Periodicals, Inc.

  5. Characterization of atherosclerotic disease in thoracic aorta: A 3D, multicontrast vessel wall imaging study

    Energy Technology Data Exchange (ETDEWEB)

    Zhou, Changwu [Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing (China); Department of Radiology, The Second Clinical Medical College, Yangzhou University, Yangzhou (China); Qiao, Huiyu; He, Le [Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing (China); Yuan, Chun [Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing (China); Department of Radiology, University of Washington, Seattle, WA (United States); Chen, Huijun; Zhang, Qiang; Li, Rui [Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing (China); Wang, Wei; Du, Fang [Department of Radiology, The Second Clinical Medical College, Yangzhou University, Yangzhou (China); Li, Cheng, E-mail: cjr.licheng@vip.163.com [Department of Radiology, Zhongda Hospital, Medical School of Southeast University, Nanjing (China); Zhao, Xihai, E-mail: xihaizhao@tsinghua.edu.cn [Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing (China)

    2016-11-15

    Purpose: To investigate the characteristics of plaque in the thoracic aorta using three dimensional multicontrast magnetic resonance imaging. Materials and methods: Elderly subjects (≥60 years) were recruited in this study. Thoracic aorta was imaged on a 3.0T MR scanner by acquiring multicontrast sequences. The plaque burden was evaluated by measuring lumen area, wall area, wall thickness, and normalized wall index. The presence or absence of plaque and intraplaque hemorrhage (IPH)/mural thrombus (MT) were identified. The characteristics of atherosclerosis among different thoracic aorta segments (AAO: ascending aorta; AOA: aortic arch, and DOA: descending aorta) were determined. Results: Of 66 recruited subjects (mean age 72.3 ± 6.2 years, 30 males), 55 (83.3%) had plaques in the thoracic aorta. The prevalence of plaque in AAO, AOA, and DAO was 5.4%, 72.7%, and 71.2%, respectively. In addition, 21.2% of subjects were found to have lesions with IPH/MT in the thoracic aorta. The prevalence of IPH/MT in segment of AAO, AOA and DAO was 0%, 13.6%, and 12.1%, respectively. The aortic wall showed the highest NWI in DAO (34.1% ± 4.8%), followed by AOA (31.2% ± 5%), and AAO (26.8% ± 3.3%) (p < 0.001). Conclusion: Three dimensional multicontrast MR imaging is capable of characterizing atherosclerotic plaques in the thoracic aorta. The findings of high prevalence of plaques and the presence of high risk plaques in the thoracic aorta suggest early screening for aortic vulnerable lesions in the elderly.

  6. Low Density Lipoprotein and Non-Newtonian Oscillating Flow Biomechanical Parameters for Normal Human Aorta.

    Science.gov (United States)

    Soulis, Johannes V; Fytanidis, Dimitrios K; Lampri, Olga P; Giannoglou, George D

    2016-04-01

    The temporal variation of the hemodynamic mechanical parameters during cardiac pulse wave is considered as an important atherogenic factor. Applying non-Newtonian blood molecular viscosity simulation is crucial for hemodynamic analysis. Understanding low density lipoprotein (LDL) distribution in relation to flow parameters will possibly spot the prone to atherosclerosis aorta regions. The biomechanical parameters tested were averaged wall shear stress (AWSS), oscillatory shear index (OSI) and relative residence time (RRT) in relation to the LDL concentration. Four non-Newtonian molecular viscosity models and the Newtonian one were tested for the normal human aorta under oscillating flow. The analysis was performed via computational fluid dynamic. Tested viscosity blood flow models for the biomechanical parameters yield a consistent aorta pattern. High OSI and low AWSS develop at the concave aorta regions. This is most noticeable in downstream flow region of the left subclavian artery and at concave ascending aorta. Concave aorta regions exhibit high RRT and elevated LDL. For the concave aorta site, the peak LDL value is 35.0% higher than its entrance value. For the convex site, it is 18.0%. High LDL endothelium regions located at the aorta concave site are well predicted with high RRT. We are in favor of using the non-Newtonian power law model for analysis. It satisfactorily approximates the molecular viscosity, WSS, OSI, RRT and LDL distribution. Concave regions are mostly prone to atherosclerosis. The flow biomechanical factor RRT is a relatively useful tool for identifying the localization of the atheromatic plaques of the normal human aorta.

  7. Muerte súbita por disección de aorta torácica secundaria a coartación de aorta Sudden death due to thoracic aorta dissection associated with aortic coarctation

    OpenAIRE

    A. Rico; J. Lucena; M. Blanco; R. Marín; E. Barrero; M. Santos

    2008-01-01

    La disección aórtica es un cuadro catastrófico caracterizado porque la sangre penetra y separa los planos laminares de la media, formando un nuevo conducto lleno de sangre dentro de la pared de la aorta (hematoma disecante intramural), que suele romperse y producir una hemorragia masiva. Presentamos el caso de un joven de 22 años, con antecedentes de hipertensión arterial sin tratamiento, que fallece súbitamente como consecuencia de una rotura-disección de aorta torácica asociado a coartación...

  8. Valve-sparing root and ascending aorta replacement after heart transplantation.

    Science.gov (United States)

    Elhenawy, Abdelsalam M; Feindel, Christopher M; Ross, Heather; Butany, Jagdish; Yau, Terrence M

    2012-12-01

    A 45-year-old female underwent heart transplantation 17 years ago, with a heart from a 15-year-old donor. Recently, she had developed an aneurysm of the donor aortic root and ascending aorta, with severe aortic insufficiency. Two surgical options were considered; retransplantation versus replacement of the aortic root and ascending aorta. A valve-sparing replacement of the aortic root and ascending aortic aneurysm was performed. The donor aorta showed pathologic changes typical of Marfan syndrome. Nineteen months postoperatively, the patient remains in functional class I, with trivial aortic insufficiency. Copyright © 2012 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  9. Klebsiella pneumoniae Pseudoaneurysm of the Ascending Aorta after Coronary Artery Bypass Graft

    Directory of Open Access Journals (Sweden)

    Seyed Khalil Forouzannia

    2010-05-01

    Full Text Available "nMycotic pseudoaneurysm of the ascending aorta is rare in patients undergoing coronary artery bypass graft (CABG and usually caused by staphylococcus aureus. We describe a patient with a mycotic pseudoaneurysm of the ascending aorta at the proximal vein graft anastomosis site after CABG. Culture from the sinus tract of the sternum and from the aneurysm sac was Klebsiella pneumoniae. Surgical technique was patch repair of aorta under hypothermic circulatory arrest. He is asymptomatic at 24 months follow-up.

  10. [Stanford type B aortic dissection associated with coarctation of the aorta].

    Science.gov (United States)

    Senaha, Shigenobu; Uezu, Toru; Shimoji, Mitsuyoshi; Akasaki, Mitsuru

    2015-03-01

    We report a rare case of type B aortic dissection associated with coarctation of the aorta. A 35-year-old man had sudden dyspnea and severe back pain. Computed tomography revealed aortic coarctation at the distal aortic arch, and aortic dissection below the coarctation. The diameter of proximal descending aorta was enlarged to 52 mm. We electively performed excision of aortic coarctation and descending aortic graft replacement. Coarctation of the aorta has a poor prognosis, The risk of aortic rupture due to aortic dissection is very high, and the histological abnormality is also pointed out. Therefore we should perform aggressive surgical treatment.

  11. Surgical outcome of traumatic rupture of the thoracic aorta.

    Science.gov (United States)

    Tatou, E; Steinmetz, E; Jazayeri, S; Benhamiche, B; Brenot, R; David, M

    2000-01-01

    The aim of this study was to point out the results of different techniques of spinal cord protection in surgically-treated patients with traumatic thoracic aorta (TTA). A multicentric study was carried out involving 182 patients with TTA. Four patients died before surgery. Two patients were operated on without any investigation and 2 had no aortic tear at thoracotomy. The remaining 174 patients had aortic isthmus disruption and were included in the study. The mean age was 32.3+/-14.29 years with 126 men (72.4%) and 48 women (27.6%). Road accidents were causal in 163 patients (93.66%); polytraumatism was frequent. A standard chest roentgenogram led to a diagnosis which was confirmed with aortography in 94.8% of cases. Surgical repair of visceral lesions was performed in 52 patients (29.9%) for traumatic spleen, liver, diaphragm, mesentery, and gut. These operations were done before or after aortic operation in 21.3% and 8.6% of cases, respectively. Thirty-three patients (19%) died and 9 (5.2%) had paraplegia. Sixty-nine patients had clamp and sew technique (group 1). Ninety-three patients had different types of extracorporeal circulation (group 2), and 12 patients had Gott shunt (group 3). No difference appeared between the 3 groups according to mortality and paraplegia. But the sex ratio, age, visceral lesions, craniocerebral lesions, the type of aortic repair, and cross-clamp time were discriminative. The univariate analysis point out age, cross-clamp time, hemothorax, and anatomical type of aortic injury as the risk factors of death. This was confirmed by a multivariable test which retained age, cross-clamp time, and hemothorax as risk factors. When not diagnosed in time, TTA is serious and has a bad prognosis. In spite of a high mortality and morbidity, the surgical management has improved. Immediate operation and medullar protection are the stumbling block in this operation. Operation can be delayed in some cases, but one must take care of hemodynamic

  12. Lower limb ischaemia due to occlusion of a persistent sciatic artery aneurysm: a case report Isquemia crítica do membro inferior por trombose de aneurisma de uma artéria ciática persistente: caso clínico

    Directory of Open Access Journals (Sweden)

    José Tiago

    2012-06-01

    Full Text Available Persistent sciatic artery is a rare embryological anomaly. The authors report the clinical case of a 81-year-old man presenting with a right lower limb ischaemia and a pulsatile mass in the buttock. Computed tomographic angiography demonstrated a complete and unilateral persistent sciatic artery, with an aneurysmal degeneration on its, proximal third. During the pre-operative workup, spontaneous aneurismal occlusion occurred, worsening the condition to a critical ischaemia. The patient underwent, successfully, a distal femoro-popliteal bypass. Review of the literature confirms the rarity of this anomaly, which is frequently associated to degenerative changes. Surgical repair is prompt recommended to prevent complications.A persistência da artéria ciática é uma anomalia embriológica rara. Os autores relatam o caso clínico de um homem de 81 anos de idade, que se apresentou com sinais de isquemia do membro inferior direito associado a uma massa pulsátil na região glútea. Foi realizada uma angiografia por TC que mostrou a presença de uma artéria ciática completa e unilateral no membro inferior direito, com degenerescência aneurismática no seu terço proximal. Durante a avaliação pré-operatória, o doente desenvolveu um quadro de isquemia crítica por oclusão espontânea do aneurisma da artéria ciática, pelo que foi submetido com sucesso a um bypass femoro-poplíteo infra-genicular. A revisão da literatura confirma a raridade desta entidade, assim como a tendência da artéria ciática para alterações degenerativas precoces. A correção cirúrgica deve ser expedita para prevenir complicações decorrentes das alterações degenerativas.

  13. Sympatholytic properties of several AT(1)-receptor antagonists in the isolated rabbit thoracic aorta

    NARCIS (Netherlands)

    Nap, Alexander; Balt, Jippe C.; Pfaffendorf, Martin; van Zwieten, Pieter A.

    2002-01-01

    Objective To evaluate the facilitating effect of angiotensin II on sympathetic neurotransmission to quantitatively compare the sympatho-inhibitory potencies of the selective AT(1)-receptor antagonists losartan, irbesartan and telmisartan in the isolated rabbit thoracic aorta. Design To investigate

  14. Magnetic resonance imaging of coarctation of the aorta and postoperative interrupted aortic arch

    Energy Technology Data Exchange (ETDEWEB)

    Kakizawa, Hideyuki; Tanaka, Takashi; Takada, Osamu; Nakayama, Shingo; Ogata, Hiroshi; Zuguchi, Masayuki (Tohoku Univ., Sendai (Japan). School of Medicine)

    1991-03-01

    ECG-gated MRI was performed at 1.5 T on 9 patients with coarctation of the aorta and restensis of the aorta after previous aortoplasty for coarctation of the aorta or interrupted aortic arch. The age of the patients ranged from 7 days to 3.3 years. MRI was more useful in assessing the severity of stenosis than echocardiography. Four patients had balloon dilation angioplasty for restenosis of the aorta. MRI was also useful in deciding the appropriate balloon size for angioplasty, and follow up after treatment. However, MRI could not always visualize the whole lesion in one slice, especially when the course of the aortic arch was not on the same plane. (author).

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

    International Nuclear Information System (INIS)

    Ures, S.

    1984-01-01

    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.) [pt

  16. Resuscitative Endovascular Balloon Occlusion of the Aorta: Pushing Care Forward.

    Science.gov (United States)

    Teeter, William; Romagnoli, Anna; Glaser, Jacob; Fisher, Andrew D; Pasley, Jason; Scheele, Brian; Hoehn, Melanie; Brenner, Megan

    Resuscitative endovascular balloon occlusion of the aorta (REBOA), used to temporize noncompressible and junctional hemorrhage, may be deployable to the forward environment. Our hypothesis was that nonsurgeon physicians and high-level military medical technicians would be able to learn the theory and insertion of REBOA. US Army Special Operations Command medical personnel without prior endovascular experience were included. All participants received didactic instruction of the Basic Endovascular Skills for Trauma Course™ together, with individual evaluation of technical skills. A pretest and a posttest were administered to assess comprehension. Four members of US Army Special Operations Command-two nonsurgeon physicians, one physician assistant, and one Special Operations Combat Medic-were included. REBOA procedural times moving from trial 1 to trial 6 decreased significantly from 186 ± 18.7 seconds to 83 ± 10.3 seconds (ρ < .0001). All participants demonstrated safe REBOA insertion and verbalized the indications for REBOA insertion and removal through all trials. All five procedural tasks were performed correctly by each participant. Comprehension and knowledge between the pretest and posttest improved significantly from 67.6 ± 7.3% to 81.3 ± 8.1% (ρ = .039). This study demonstrates that nonsurgeon and nonphysician providers can learn the steps required for REBOA after arterial access is established. Although insertion is relatively straightforward, the inability to gain arterial access percutaneously is prohibitive in providers without a surgical skillset and should be the focus of further training. 2017.

  17. 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.

  18. Elevation of oxidative stress in the aorta of genetically hypertensive mice.

    Science.gov (United States)

    Uddin, Mukarram; Yang, Hong; Shi, MingJian; Polley-Mandal, Manorama; Guo, ZhongMao

    2003-07-01

    Hypertension is an age-dependent disorder. Oxidative stress has been suggested to play a role in aging and age-dependent disorders. The objective of this study is to examine the oxidant and antioxidant status in the aorta of a mouse model with high blood pressure (BPH). Our results showed that the level of malondialdehyde (MDA) in the aorta of BPH mice was approximately 2.6-fold higher than that of the normal blood pressure (BPN) mice, suggesting an increased in vivo oxidative stress in the arterial wall of BPH mice. In addition, the release of hydrogen peroxide (H2O2) from the aorta of BPH mice was significantly faster than that of BPN mice. To determine if the increased H2O2 release is related to a down-regulation of antioxidant enzymes in the arterial wall, we measured the activities of the major antioxidant enzymes in mouse aortas. We observed that the activities of Cu/Zn-superoxide dismutase (SOD) and glutathione peroxidase-1 in BPH mice were similar to BPN mice. On the other hand, the catalase activity in the aorta of BPH mice was significantly reduced while the activities of Mn-SOD and extracellular (EC)-SOD in the aorta of BPH mice were significantly elevated as compared with BPN mice. These results suggest that increase in SOD activity and decrease in catalase activity might be responsible for the increased release of H2O2 in the arterial wall of BPH mice.

  19. Fluid Dynamics of Coarctation of the Aorta and Effect of Bicuspid Aortic Valve

    Science.gov (United States)

    Keshavarz-Motamed, Zahra; Garcia, Julio; Kadem, Lyes

    2013-01-01

    Up to 80% of patients with coarctation of the aorta (COA) have a bicuspid aortic valve (BAV). Patients with COA and BAV have elevated risks of aortic complications despite successful surgical repair. The development of such complications involves the interplay between the mechanical forces applied on the artery and the biological processes occurring at the cellular level. The focus of this study is on hemodynamic modifications induced in the aorta in the presence of a COA and a BAV. For this purpose, numerical investigations and magnetic resonance imaging measurements were conducted with different configurations: (1) normal: normal aorta and normal aortic valve; (2) isolated COA: aorta with COA (75% reduction by area) and normal aortic valve; (3) complex COA: aorta with the same severity of COA (75% reduction by area) and BAV. The results show that the coexistence of COA and BAV significantly alters blood flow in the aorta with a significant increase in the maximal velocity, secondary flow, pressure loss, time-averaged wall shear stress and oscillatory shear index downstream of the COA. These findings can contribute to a better understanding of why patients with complex COA have adverse outcome even following a successful surgery. PMID:24015239

  20. Hybrid Approach of Aortic Diseases: Zone 1 Delivery and Volumetric Analysis on the Descending Aorta.

    Science.gov (United States)

    Duncan, José Augusto; Dias, Ricardo Ribeiro; Dinato, Fabrício José; Fernandes, Fábio; Ramirez, Félix José Álvares; Mady, Charles; Jatene, Fabio Biscegli

    2017-01-01

    Conventional techniques of surgical correction of arch and descending aortic diseases remains as high-risk procedures. Endovascular treatments of abdominal and descending thoracic aorta have lower surgical risk. Evolution of both techniques - open debranching of the arch and endovascular approach of the descending aorta - may extend a less invasive endovascular treatment for a more extensive disease with necessity of proximal landing zone in the arch. To evaluate descending thoracic aortic remodeling by means of volumetric analysis after hybrid approach of aortic arch debranching and stenting the descending aorta. Retrospective review of seven consecutive patients treated between September 2014 and August 2016 for diseases of proximal descending aorta (aneurysms and dissections) by hybrid approach to deliver the endograft at zone 1. Computed tomography angiography were analyzed using a specific software to calculate descending thoracic aorta volumes pre- and postoperatively. Follow-up was done in 100% of patients with a median time of 321 days (range, 41-625 days). No deaths or permanent neurological complications were observed. There were no endoleaks or stent migrations. Freedom from reintervention was 100% at 300 days and 66% at 600 days. Median volume reduction was of 45.5 cm3, representing a median volume shrinkage by 9.3%. Hybrid approach of arch and descending thoracic aorta diseases is feasible and leads to a favorable aortic remodeling with significant volume reduction.

  1. Hybrid Approach of Aortic Diseases: Zone 1 Delivery and Volumetric Analysis on the Descending Aorta

    Directory of Open Access Journals (Sweden)

    José Augusto Duncan

    Full Text Available Abstract Introduction: Conventional techniques of surgical correction of arch and descending aortic diseases remains as high-risk procedures. Endovascular treatments of abdominal and descending thoracic aorta have lower surgical risk. Evolution of both techniques - open debranching of the arch and endovascular approach of the descending aorta - may extend a less invasive endovascular treatment for a more extensive disease with necessity of proximal landing zone in the arch. Objective: To evaluate descending thoracic aortic remodeling by means of volumetric analysis after hybrid approach of aortic arch debranching and stenting the descending aorta. Methods: Retrospective review of seven consecutive patients treated between September 2014 and August 2016 for diseases of proximal descending aorta (aneurysms and dissections by hybrid approach to deliver the endograft at zone 1. Computed tomography angiography were analyzed using a specific software to calculate descending thoracic aorta volumes pre- and postoperatively. Results: Follow-up was done in 100% of patients with a median time of 321 days (range, 41-625 days. No deaths or permanent neurological complications were observed. There were no endoleaks or stent migrations. Freedom from reintervention was 100% at 300 days and 66% at 600 days. Median volume reduction was of 45.5 cm3, representing a median volume shrinkage by 9.3%. Conclusion: Hybrid approach of arch and descending thoracic aorta diseases is feasible and leads to a favorable aortic remodeling with significant volume reduction.

  2. The value of anterior displacement of the abdominal aorta in diagnosing neuroblastoma in children

    Directory of Open Access Journals (Sweden)

    Jose Luiz de Oliveira Schiavon

    Full Text Available Abstract Objective: To determine the value of anterior displacement of the abdominal aorta, when present at any level or only at the level of the adrenal gland, contralateral to the mass, in diagnosing neuroblastoma on computed tomography or magnetic resonance imaging in children up to 7 years of age. Materials and Methods: Imaging examinations of 66 patients were classified by consensus as for the presence of anterior aorta displacement and were compared with the pathology report. Results: We found anterior abdominal aorta displacement in 26 (39.39% of the 66 patients evaluated. Among those 26 patients, we identified neuroblastoma in 22 (84.62%, nephroblastoma in 3 (11.54%, and Burkitt lymphoma in 1 (3.85%. The positive predictive value was 84.62%, and the specificity was 88.24%. The displacement of the aorta was at the adrenal level, contralateral to the mass, in 14 cases, all of which were attributed to neuroblastoma. Conclusion: When the abdominal aorta is displaced at the level of the adrenal gland, contralateral to the mass, it can be said that the diagnosis is neuroblastoma, whereas abdominal aorta displacement occurring at other abdominal levels has a positive predictive value for neuroblastoma of approximately 85%.

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

    International Nuclear Information System (INIS)

    Seehofnerová, Anna; Kok, Madeleine; Mihl, Casper; Douwes, Dave; Sailer, Anni; Nijssen, Estelle; Haan, Michiel J.W. de; Wildberger, Joachim E.; Das, Marco

    2015-01-01

    Using smaller volumes of contrast media (CM) in CT angiography (CTA) is desirable in terms of cost reduction and prevention of contrast-induced nephropathy (CIN). The purpose was to evaluate the feasibility of low CM volume in CTA of the aorta. 77 patients referred for CTA of the aorta were scanned using a standard MDCT protocol at 100 kV. A bolus of 50 ml CM (Iopromide 300 mg Iodine/ml) at a flow rate of 6 ml/s was applied (Iodine delivery rate IDR = 1.8 g/s; Iodine load 15 g) followed by a saline bolus of 40 ml at the same flow rate. Scan delay was determined by the test bolus method. Subjective image quality was assessed and contrast enhancement was measured at 10 anatomical levels of the aorta. Diagnostic quality images were obtained for all patients, reaching a mean overall contrast enhancement of 324 ± 28 HU. Mean attenuation was 350 ± 60 HU at the thoracic aorta and 315 ± 83 HU at the abdominal aorta. 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

  4. Evaluation of reconstruction parameters of electrical impedance tomography on aorta detection during saline bolus injection

    Directory of Open Access Journals (Sweden)

    Thürk Florian

    2016-09-01

    Full Text Available An accurate detection of anatomical structures in electrical impedance tomography (EIT is still at an early stage. Aorta detection in EIT is of special interest, since it would favor non-invasive assessment of hemodynamic processes in the body. Here, diverse EIT reconstruction parameters of the GREIT algorithm were systematically evaluated to detect the aorta after saline bolus injection in apnea. True aorta position and size were taken from computed tomography (CT. A comparison with CT showed that the smallest error for aorta displacement was attained for noise figure nf = 0.7, weighting radius rw = 0.15, and target size ts = 0.01. The spatial extension of the aorta was most precise for nf = 0.7, rw = 0.25, and ts = 0.07. Detection accuracy (F1-score was highest with nf = 0.6, rw = 0.15, and ts = 0.04. This work provides algorithm-related evidence for potentially accurate aorta detection in EIT after injection of a saline bolus.

  5. The value of anterior displacement of the abdominal aorta in diagnosing neuroblastoma in children

    Energy Technology Data Exchange (ETDEWEB)

    Schiavon, Jose Luiz de Oliveira; Caran, Eliana Maria Monteiro; Lederman, Henrique Manoel, E-mail: schiavon00@gmail.com [Universidade Federal de Sao Paulo (EPM/UNIFESP), Sao Paulo, SP (Brazil). Escola Paulista de Medicina; Odone Filho, Vicente [Universidade de Sao Paulo (FM/USP), Sao Paulo, SP (Brazil). Faculdade de Medicina

    2016-11-15

    Objective: To determine the value of anterior displacement of the abdominal aorta, when present at any level or only at the level of the adrenal gland, contralateral to the mass, in diagnosing neuroblastoma on computed tomography or magnetic resonance imaging in children up to 7 years of age. Materials and Methods: Imaging examinations of 66 patients were classified by consensus as for the presence of anterior aorta displacement and were compared with the pathology report. Results: We found anterior abdominal aorta displacement in 26 (39.39%) of the 66 patients evaluated. Among those 26 patients, we identified neuroblastoma in 22 (84.62%), nephroblastoma in 3 (11.54%), and Burkitt lymphoma in 1 (3.85%). The positive predictive value was 84.62%, and the specificity was 88.24%. The displacement of the aorta was at the adrenal level, contralateral to the mass, in 14 cases, all of which were attributed to neuroblastoma. Conclusion: When the abdominal aorta is displaced at the level of the adrenal gland, contralateral to the mass, it can be said that the diagnosis is neuroblastoma, whereas abdominal aorta displacement occurring at other abdominal levels has a positive predictive value for neuroblastoma of approximately 85%. (author)

  6. 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

  7. Rasmussen aneurysm - a case report in a child and review of the literature; Aneurisma de Rasmussen - relato de um caso em crianca e revisao da literatura

    Energy Technology Data Exchange (ETDEWEB)

    Matos, Adriana Silva; Goyanna, Fabiola; Gomes, Leo; Alexandre, Alexandre Kalil Castanheira; Rocha, Josilton Antonio; Souza, Paulo Engracio Matos de; Machado, Marcos; Santos, Marcelo Benicio dos [Hospital Sao Rafael, Salvador, BA (Brazil). Servico de Bioimagem

    2000-04-01

    The authors report a case of an 11-year-old boy with a Rasmussen aneurysm presenting with dyspnea, fever and hemoptysis. The patient underwent radiological, tomographic and angiographic assessments. The pathogenesis of the aneurysm was related to the erosion of a pulmonary artery branch with replacement of the adventitia and media layers by granulation tissue, due to an adjacent tuberculous cavity. A plain chest x-ray showed bilateral nodular opacities, largest on the right lung, which enhanced simultaneously with the mediastinal vessels on CT. Its vascular nature was confirmed by angiographic studies.(author)

  8. 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.

  9. Ruptura traumática de la aorta descendente torácica Traumatic ruptura of the descending thoracic aorta

    Directory of Open Access Journals (Sweden)

    Gabriel González Sosa

    2013-03-01

    Full Text Available Los traumatismos torácicos graves (TT, ya sean abiertos o cerrados, pueden ocurrir secundarios a lesiones por arma de fuego, arma blanca, accidentes de tránsito, caídas de altura o compresiones torácicas por aplastamientos, entre otros y se han transformado en una causa importante de morbilidad y mortalidad, pero son las lesiones vasculares directamente responsables de un 20 a un 25 % del total de las muertes, causadas por estos traumatismos. La mayoría de los afectados por estas lesiones son personas jóvenes previamente sanas, fundamentalmente del sexo masculino. Se presenta un caso clínico de un paciente de 38 años de edad, con antecedentes de salud previos, que durante una riña, sufrió una herida en la región posterior del hemitórax derecho, por debajo del borde inferior de la escápula, penetrante en la cavidad torácica, ocasionada por un objeto corto punzante de fabricación artesanal, cuyo pedazo quedó dentro de esta cavidad, lo cual provocó una lesión de alrededor de 3 cm de longitud, aproximadamente a nivel de la aorta descendente torácica. El paciente fue intervenido quirúrgicamente de manera urgente, y se logró suturar la lesión vascular con éxito, proceder que casi nunca es posible debido al alto índice de mortalidad de este tipo de lesiones, pues la mayoría de las personas fallecen antes de su llegada a un centro especializado de salud.Severe thoracic traumatisms, either open or close, may occur secondary to injuries caused by firearms, knifes, traffic accidents, falls from height or thoracic compression due to crushing, among others. They have become an important cause of mortality and morbidity but they are vascular injuries directly responsible for 20 to 25 % of the total number of deaths caused by this type of traumatism. Most of the injuries occurred in healthy young people, mainly men. This is the case of a 38 years-old patient with a history of health problems, who in a street fight, suffered an injury

  10. In vivo assessment of blood flow patterns in abdominal aorta of mice with MRI: implications for AAA localization

    Science.gov (United States)

    Long, Robert C.; Consolini, Michelle A.; Suo, Jin; Willett, Nick J.; Fielden, Sam W.; Giddens, Don P.; Taylor, W. Robert; Oshinski, John N.

    2009-01-01

    Abdominal aortic aneurysms (AAA) localize in the infrarenal aorta in humans, while they are found in the suprarenal aorta in mouse models. It has been shown previously that humans experience a reversal of flow during early diastole in the infrarenal aorta during each cardiac cycle. This flow reversal causes oscillatory wall shear stress (OWSS) to be present in the infrarenal aorta of humans. OWSS has been linked to a variety of proatherogenic and proinflammatory factors. The presence of reverse flow in the mouse aorta is unknown. In this study we investigated blood flow in mice, using phase-contrast magnetic resonance (PCMR) imaging. We measured blood flow in the suprarenal and infrarenal abdominal aorta of 18 wild-type C57BL/6J mice and 15 apolipoprotein E (apoE)−/− mice. Although OWSS was not directly evaluated, results indicate that, unlike humans, there is no reversal of flow in the infrarenal aorta of wild-type or apoE−/− mice. Distensibility of the mouse aortic wall in both the suprarenal and infrarenal segments is higher than reported values for the human aorta. We conclude that normal mice do not experience the reverse flow in the infrarenal aorta that is observed in humans. PMID:19684182

  11. Differences in the Thoracic Aorta by Region and Sex in a Murine Model of Marfan Syndrome.

    Science.gov (United States)

    Jiménez-Altayó, Francesc; Siegert, Anna-Maria; Bonorino, Fabio; Meirelles, Thayna; Barberà, Laura; Dantas, Ana P; Vila, Elisabet; Egea, Gustavo

    2017-01-01

    Marfan syndrome (MFS) is a hereditary disorder of the connective tissue that causes life-threatening aortic aneurysm, which initiates at the aortic root and can progress into the ascending portion. However, analysis of ascending aorta reactivity in animal models of MFS has remained elusive. Epidemiologic evidence suggests that although MFS is equally prevalent in men and women, men are at a higher risk of aortic complications than non-pregnant women. Nevertheless, there is no experimental evidence to support this hypothesis. The aim of this study was to explore whether there are regional and sex differences in the thoracic aorta function of mice heterozygous for the fibrillin 1 ( Fbn1 ) allele encoding a missense mutation ( Fbn1 C1039G/+ ), the most common class of mutation in MFS. Ascending and descending thoracic aorta reactivity was evaluated by wire myography. Ascending aorta mRNA and protein levels, and elastic fiber integrity were assessed by qRT-PCR, Western blotting, and Verhoeff-Van Gieson histological staining, respectively. MFS differently altered reactivity in the ascending and descending thoracic aorta by either increasing or decreasing phenylephrine contractions, respectively. When mice were separated by sex, contractions to phenylephrine increased progressively from 3 to 6 months of age in MFS ascending aortas of males, whereas contractions in females were unchanged. Endothelium-dependent relaxation was unaltered in the MFS ascending aorta of either sex; an effect related to augmented endothelium-dependent hyperpolarization-type dilations. In MFS males, the non-selective cyclooxygenase (COX) inhibitor indomethacin prevented the MFS-induced enhancement of phenylephrine contractions linked to increased COX-2 expression. In MFS mice of both sexes, the non-selective nitric oxide synthase inhibitor L-NAME revealed negative feedback of nitric oxide on phenylephrine contractions, which was associated with upregulation of eNOS in females. Finally, MFS

  12. Differences in the Thoracic Aorta by Region and Sex in a Murine Model of Marfan Syndrome

    Directory of Open Access Journals (Sweden)

    Francesc Jiménez-Altayó

    2017-11-01

    Full Text Available Marfan syndrome (MFS is a hereditary disorder of the connective tissue that causes life-threatening aortic aneurysm, which initiates at the aortic root and can progress into the ascending portion. However, analysis of ascending aorta reactivity in animal models of MFS has remained elusive. Epidemiologic evidence suggests that although MFS is equally prevalent in men and women, men are at a higher risk of aortic complications than non-pregnant women. Nevertheless, there is no experimental evidence to support this hypothesis. The aim of this study was to explore whether there are regional and sex differences in the thoracic aorta function of mice heterozygous for the fibrillin 1 (Fbn1 allele encoding a missense mutation (Fbn1C1039G/+, the most common class of mutation in MFS. Ascending and descending thoracic aorta reactivity was evaluated by wire myography. Ascending aorta mRNA and protein levels, and elastic fiber integrity were assessed by qRT-PCR, Western blotting, and Verhoeff-Van Gieson histological staining, respectively. MFS differently altered reactivity in the ascending and descending thoracic aorta by either increasing or decreasing phenylephrine contractions, respectively. When mice were separated by sex, contractions to phenylephrine increased progressively from 3 to 6 months of age in MFS ascending aortas of males, whereas contractions in females were unchanged. Endothelium-dependent relaxation was unaltered in the MFS ascending aorta of either sex; an effect related to augmented endothelium-dependent hyperpolarization-type dilations. In MFS males, the non-selective cyclooxygenase (COX inhibitor indomethacin prevented the MFS-induced enhancement of phenylephrine contractions linked to increased COX-2 expression. In MFS mice of both sexes, the non-selective nitric oxide synthase inhibitor L-NAME revealed negative feedback of nitric oxide on phenylephrine contractions, which was associated with upregulation of eNOS in females. Finally

  13. Differences in the Thoracic Aorta by Region and Sex in a Murine Model of Marfan Syndrome

    Science.gov (United States)

    Jiménez-Altayó, Francesc; Siegert, Anna-Maria; Bonorino, Fabio; Meirelles, Thayna; Barberà, Laura; Dantas, Ana P.; Vila, Elisabet; Egea, Gustavo

    2017-01-01

    Marfan syndrome (MFS) is a hereditary disorder of the connective tissue that causes life-threatening aortic aneurysm, which initiates at the aortic root and can progress into the ascending portion. However, analysis of ascending aorta reactivity in animal models of MFS has remained elusive. Epidemiologic evidence suggests that although MFS is equally prevalent in men and women, men are at a higher risk of aortic complications than non-pregnant women. Nevertheless, there is no experimental evidence to support this hypothesis. The aim of this study was to explore whether there are regional and sex differences in the thoracic aorta function of mice heterozygous for the fibrillin 1 (Fbn1) allele encoding a missense mutation (Fbn1C1039G/+), the most common class of mutation in MFS. Ascending and descending thoracic aorta reactivity was evaluated by wire myography. Ascending aorta mRNA and protein levels, and elastic fiber integrity were assessed by qRT-PCR, Western blotting, and Verhoeff-Van Gieson histological staining, respectively. MFS differently altered reactivity in the ascending and descending thoracic aorta by either increasing or decreasing phenylephrine contractions, respectively. When mice were separated by sex, contractions to phenylephrine increased progressively from 3 to 6 months of age in MFS ascending aortas of males, whereas contractions in females were unchanged. Endothelium-dependent relaxation was unaltered in the MFS ascending aorta of either sex; an effect related to augmented endothelium-dependent hyperpolarization-type dilations. In MFS males, the non-selective cyclooxygenase (COX) inhibitor indomethacin prevented the MFS-induced enhancement of phenylephrine contractions linked to increased COX-2 expression. In MFS mice of both sexes, the non-selective nitric oxide synthase inhibitor L-NAME revealed negative feedback of nitric oxide on phenylephrine contractions, which was associated with upregulation of eNOS in females. Finally, MFS ascending

  14. Anestesia en la coartación de la aorta

    Directory of Open Access Journals (Sweden)

    Lincoln de la Parte Pérez

    2001-12-01

    Full Text Available Se presenta un estudio retrospectivo de 200 pacientes operados de coartación de la aorta, en el Cardiocentro del Hospital Pediátrico Universitario "William Soler", en el período de 1990 a 1995. La ketamina fue el agente más utilizado en la premedicación anestésica de nuestros pacientes (190 pacientes, 95 %. En 150 pacientes se utilizó asociada con la atropina y en 40 se le adicionó además midazolam. En los 10 enfermos restantes se empleó sólo atropina. El fentanyl fue el agente más utilizado en la inducción de la anestesia (123 pacientes, 61,5 % y en el mantenimiento (186 enfermos, 92 % y aportó gran estabilidad hemodinámica. Se empleó vasodilatador en la mayoría de los pacientes (176 pacientes, 88 %, para el control de la presión arterial y dentro de éstos, los más utilizados fueron la nitroglicerina mezclada con regitina en 135 pacientes (67,5 %. Las complicaciones más frecuentes fueron la hipertensión arterial (76 pacientes, 38 % la acidosis metabólica (24 pacientes, 12 % y las arritmias cardíacas (14 pacientes, 7 %.A retrospective study of 200 patients operated on of aortic coarctation at the Cardiology Center of "William Soler" Pediatric Teaching Hospital from 1990 to 1995 was conducted. Ketamine was the most used agent in the anesthetic premedication of our patients (190 patients, 95 %. It was associated with atropine in 150 patients and midazolan was also added in 40 patients. In the other 10 patients atropine was only used. Fentanyl was the most administered agent in the induction of anesthesia (123 patients, 61.5 % and in the maintenance (186 patients, 92 %. It provided a great hemodynamic stability. Vasodilators were used in most of the patients (176 patients, 88 % to control arterial pressure. The most used were nitroglycerin mixed with regitine (135 patients, 67.5 %. The most frequent complications were arterial hypertension (76 patients, 38 %, metabolic acidosis (24 patients, 12 %, and cardiac arrhytmias (14

  15. Tensile characterisation of the aorta across quasi-static to blast loading strain rates

    Science.gov (United States)

    Magnus, Danyal; Proud, William; Haller, Antoine; Jouffroy, Apolline

    2017-06-01

    The dynamic tensile failure mechanisms of the aorta during Traumatic Aortic Injury (TAI) are poorly understood. In automotive incidents, where the aorta may be under strains of the order of 100/s, TAI is the second largest cause of mortality. In these studies, the proximal descending aorta is the most common site where rupture is observed. In particular, the transverse direction is most commonly affected due to the circumferential orientation of elastin, and hence the literature generally concentrates upon axial samples. This project extends these dynamic studies to the blast loading regime where strain-rates are of the order of 1000/s. A campaign of uniaxial tensile experiments are conducted at quasi-static, intermediate (drop-weight) and high (tensile Split-Hopkinson Pressure Bar) strain rates. In each case, murine and porcine aorta models are considered and the extent of damage assessed post-loading using histology. Experimental data will be compared against current viscoelastic models of the aorta under axial stress. Their applicability across strain rates will be discussed. Using a multi-disciplinary approach, the conditions applied to the samples replicate in vivo conditions, employing a blood simulant-filled tubular specimen surrounded by a physiological solution.

  16. Reduced expression of perlecan in the aorta of secondary hyperparathyroidism model rats with medial calcification.

    Science.gov (United States)

    Shibata, Maki; Shigematsu, Takashi; Hatamura, Ikuji; Saji, Fumie; Mune, Sachiko; Kunimoto, Ken; Hanba, Yoshiyuki; Shiizaki, Kazuhiro; Sakaguchi, Toshifumi; Negi, Shigeo

    2010-01-01

    Vascular calcification is an important complication that worsens the prognosis for dialysis patients, although its detailed molecular mechanisms are still unknown. We produced a rat model for vascular calcification with hyperphosphatasemia and hyperparathyroidism, performing a 5/6 nephrectomy and providing a high-phosphorus, low-calcium diet for eight weeks. We examined mRNA obtained from the calcified aortae using microarray analysis, and searched for alterations in gene expression specifically in the calcified lesions. Medial calcification was demonstrated in the abdominal aorta of 12 out of 42 hyperparathyroidism rats. In the aortae of hyperparathyroid rats with vascular calcification, the genes for heparan sulfate proteoglycans, including perlecan, were found to be down-regulated using microarray analysis and real time PCR. Immunohistochemistry also demonstrated reduced production of perlecan in the aortae of hyperparathyroid rats. Perlecan is a major component of the vascular wall basement membrane and may play a role in protecting vascular smooth muscle cells from inflammatory cells and various toxins. It has also been reported that heparan sulfate chains may inhibit osteogenesis. Our findings indicate that perlecan may protect vascular smooth muscle cells from various factors that promote vascular calcification. It may be that reduced expression of perlecan in the calcified aortae of hyperparathyroid rats is a risk factor for vascular calcification.

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

    International Nuclear Information System (INIS)

    Mart, Christopher R; McNerny, Bryn E

    2013-01-01

    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

  18. Evaluation of personal dosimetry in abdominal aorta endo prosthesis procedures; Avaliacao da dosimetria pessoal em procedimentos de endoproteses de aorta abdominal

    Energy Technology Data Exchange (ETDEWEB)

    Bacchim Neto, Fernando A.; Alves, Allan F.F.; Freitas, Carlos C.M. de; Pina, Diana R. [Universidade Estadual Paulista Julio de Mesquita Filho (FMB/UNESP), Botucatu, SP (Brazil). Faculdade de Medicina

    2016-07-01

    The objective of this paper is to evaluate the currently dosimetry technique employed in the medical staff during interventional radiology procedures. Thermoluminescent dosimeters were positioned in different regions of the primary interventionist during procedures of stent graft in abdominal aortic aneurysms. The equivalent dose rate profile shows a tendency of difference between dose rate found in the chest in relation to the abdomen, hands and feet. Statistically, dose rates found in the hands differ from those found in the chest with p=0.05. These results suggest that only a dosimeter placed on the chest does not describe faithfully the radiation doses to which these professionals are occupationally exposed. (author)

  19. Dietary fat level affecting histochemical radiosensitivity in dorsal aorta in rats

    International Nuclear Information System (INIS)

    Yousri, R.M.; Roushdy, H.M.; EL-Malkh, N.M.; Ashry, M.A.; Soliman, S.M.

    1988-01-01

    The present work has been conducted to investigate the effect of dietary fat status and/or cumulative whole body gamma radiation exposures up to 15 Gy the histochemical pattern of the dorsal aortas of male albino rats. Experimental animals were fed on either fat-rich or fat-free diet and the observations compared with those fed normal fat diet. The histochemical investigations has been confined to the concentration levels of mucopolysaccharide substance and total lipids. The dorsal aorta normal fat group showed higher content of PAS-positive material in the first two layers of the aorta wall in comparison with decreased amount of collagen fibers was shown in fat-rich group

  20. Two-stage multilevel en bloc spondylectomy with resection and replacement of the aorta.

    Science.gov (United States)

    Gösling, Thomas; Pichlmaier, Maximilian A; Länger, Florian; Krettek, Christian; Hüfner, Tobias

    2013-05-01

    We report a case of multilevel spondylectomy in which resection and replacement of the adjacent aorta were done. Although spondylectomy is nowadays an established technique, no report on a combined aortic resection and replacement has been reported so far. The case of a 43-year-old man with a primary chondrosarcoma of the thoracic spine is presented. The local pathology necessitated resection of the aorta. We did a two-stage procedure with resection and replacement of the aorta using a heart-lung machine followed by secondary tumor resection and spinal reconstruction. The procedure was successful. A tumor-free margin was achieved. The patient is free of disease 48 months after surgery. En bloc spondylectomy in combination with aortic resection is feasible and might expand the possibility of producing tumor-free margins in special situations.

  1. Effect of high density lipoproteins on permeability of rabbit aorta to low density lipoproteins

    International Nuclear Information System (INIS)

    Klimov, A.N.; Popov, V.A.; Nagornev, V.A.; Pleskov, V.M.

    1985-01-01

    A study was made on the effect of high density lipoproteins (HDL) on the permeability of rabbit aorta to low density lipoproteins (LDL) after intravenous administration of human HDL and human ( 125 I)LDL to normal and hypercholesterolemic rabbits. Evaluation of radioactivity in plasma and aorta has shown that the administration of a large dose of HDL decreased the aorta permeability rate for ( 125 I)LDL on an average by 19% in normal rabbits, and by 45% in rabbits with moderate hypercholesterolemia. A historadiographic study showed that HDL also decreased the vessel wall permeability to ( 125 I)LDL in normal and particularly in hypercholesterolemic animals. The suggestion was made that HDL at very high molar concentration can hamper LDL transportation through the intact endothelial layer into the intima due to the ability of HDL to compete with LDL in sites of low affinity on the surface of endothelial cells. (author)

  2. 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.

  3. Diagnostic and therapy of acute thoracic aortic diseases; Diagnostik und Therapie akuter Erkrankungen der thorakalen Aorta

    Energy Technology Data Exchange (ETDEWEB)

    Schotten, Sebastian; Pitton, Michael B. [Universitaetsmedizin Mainz Univ. (Germany). Klinik und Poliklinik fuer Diagnostische und Interventionelle Radiologie

    2017-09-15

    Acute diseases of the thoracic aorta represent a relatively rare but life threatening spectrum of pathologies. The non-traumatic diseases are usually summarized by the term ''acute aortic syndrome''. A timely diagnosis and initiation of therapy are cornerstones for the patient outcome. CT has become the standard imaging procedure due do its widespread availability and excellent sensitivity. Furthermore, CT is able to discriminate the variants of acute aortic diseases and to detect the wide spectrum of complications. The volumetric CT dataset is also the basis for planning of interventional procedures. Open surgical repair still represents the standard of care for acute pathologies of the ascending aorta while endovascular therapy, due to minimally invasive character and good outcome, has replaced open surgery in most cases of complicated lesions of the descending aorta.

  4. Endovascular Stent for Coarctation of the Aorta in a Child and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Hsu-Ting Cheng

    2011-08-01

    Full Text Available An 11-year-old, 35-kg boy underwent balloon angioplasty twice, at the ages of 4 years and 10 years, with only limited effect. He was admitted for another cardiac catheterization because of chest pain and breathlessness on exercise. Aortography revealed severe discrete coarctation of the aorta, with the narrowest diameter of 6 mm. The pressures of the ascending aorta and descending aorta were 115/72 mmHg and 93/66 mmHg, respectively. After implantation of a 16-mm-diameter stent, the systolic pressure gradient decreased from 22 mmHg to 0 mmHg. Annual follow-up for 6 years showed normal blood pressure, no exercise intolerance, and no recoarctation.

  5. Presystolic flow in ascending aorta in a case of left ventricular diastolic dysfunction

    Directory of Open Access Journals (Sweden)

    S.R. Mittal

    2015-03-01

    Full Text Available A 65 years old hypertensive presented with effort breathlessness. Echocardiography revealed significant concentric remodeling of left ventricle. (relative wall thickness – 0.86 with significantly impaired relaxation (E/A – 0.54 and Ea/Aa – 0.52. Doppler evaluation of flow in ascending aorta revealed a presystolic flow which coincided with P wave of ECG and A wave of mitral flow. This finding suggests increased stiffness of left ventricle resulting in significant increase in left ventricular pressure during left atrial contraction and presystolic flow in aorta. Our case shows that all cases of grade 1 diastolic dysfunction are not alike. Presystolic flow in ascending aorta suggests greater degree of diastolic dysfunction than what is apparent from conventional criteria.

  6. Coartación de la aorta: una revisión sistemática

    OpenAIRE

    O Ruíz Pérez; LR Méndez Duran

    2015-01-01

    La coartación de la aorta es una patología caracterizada por el estrechamiento de la arteria aorta, con la consecuente obstrucción de su flujo; localizada con mayor frecuencia a nivel de aorta torácica descendente distal al origen de la subclavia izquierda, y en la pared posterior de la arteria. Supone aproximadamente el 5,1% (3-10%) de las cardiopatías congénitas y constituye la octava malformación cardiaca por orden de frecuencia. La presentación clínica de la coartación aórtica es muy vari...

  7. Spectrum analysis of turbulence in the canine ascending aorta measured with a hot-film anemometer.

    Science.gov (United States)

    Yamaguchi, T; Kikkawa, S; Tanishita, K; Sugawara, M

    1988-01-01

    We measured turbulence velocity in the canine ascending aorta using a hot-film anemometer. Blood flow velocity was measured at various points across the ascending aorta approximately 1.5-2 times the diameter downstream from the aortic valve. The turbulence spectrum was calculated and its characteristics were examined in connection with the mean Reynolds number and/or measuring positions. In the higher wave number range the values of the turbulence spectra were higher at larger mean Reynolds number. In the higher wave number range, the values of the turbulence spectra were higher at points closer to the centerline of the aorta, when the mean Reynolds number was relatively large. The patterns of the turbulence spectra at various points outside the boundary layer on the aortic wall were similar.

  8. New device for saphenous vein-to-aorta proximal anastomosis without side-clamping

    Directory of Open Access Journals (Sweden)

    Tappainer Ernesto

    2007-05-01

    Full Text Available Abstract Background Side clamping to perform saphenous vein-to-aorta proximal anastomosis is a well known cause of cerebral embolization during coronary bypass surgery. Automatic and manual devices have been introduced to avoid aortic clamping and facilitate proximal anastomosis but the manual ones only allow the traditional hand-sewing running suture. Nevertheless, they are not easy to use and very expensive to buy. Methods We developed a simple object that helps to perform a manual proximal anastomosis without the need to clamp the side of the aorta. This device is a steel bar which blocks the aortic hole and simultaneously it provides a slit to receive the needle. Through the slit comes out a thin, sharp, straight, but also well directed and predictable jet of blood which could be easily controlled during the suture. Results The function of the object is quite different from other devices. Nothing is deployed in the aorta. The object is only placed on the aorta with the small appendage slipped into the hole. The main advantage of the device is that while manipulation of the aorta is avoided no foreign bodies are incorporated in the suture and – most importantly – the aortic intima is not touched at all. The main drawback of the device is the blood jet coming from the slit so that the blood pressure has to be lowered by vasodilators during the anastomosis. Moreover, the suture has to change direction and the needle has to enter the aortic wall first to slip out through the slit. Conclusion The object was named "Slit Device" and is not a routine instrument. It would be only an alternative to other anastomotic devices with the same surgical indications. In the case of ascending aortic disease and saphenous vein grafting, the Slit Device avoids aortic clamping thereby preventing atheroembolism and also avoiding the need for hypothermic circulatory arrest in patients with unclampable aorta.

  9. 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.

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

    International Nuclear Information System (INIS)

    Tengg-Kobligk, Hendrik von; Gruenberg, K.M.; Giesel, F.L.; Ley-Zaporozhan, J.; Ley, S.; Henninger, V.; Kauczor, H.U.; Radiologische Universitaetsklinik Heidelberg; Boeckler, D.; Krummenauer, F.

    2009-01-01

    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 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 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.)

  11. CFD analysis of multiphase blood flow within aorta and its thoracic branches of patient with coarctation of aorta using multiphase Euler-Euler approach

    International Nuclear Information System (INIS)

    Ostrowski, Z; Melka, B; Adamczyk, W; Rojczyk, M; Nowak, A J; Golda, A

    2016-01-01

    In the research a numerical Computational Fluid Dynamics (CFD) model of the pulsatile blood flow was created and analyzed. A real geometry of aorta and its thoracic branches of 8-year old patient diagnosed with a congenital heart defect - coarctation of aorta was used. The inlet boundary condition were implemented as the User Define Function according to measured values of volumetric blood flow. The blood flow was treated as multiphase: plasma, set as the primary fluid phase, was dominant with volume fraction of 0.585 and morphological elements of blood were treated in Euler-Euler approach as dispersed phases (with 90% Red Blood Cells and White Blood Cells as remaining solid volume fraction). (paper)

  12. Helical CT of traumatic injuries of the thoracic aorta

    International Nuclear Information System (INIS)

    Mengozzi, E.; Burzi, M.; Miceli, M.; Lipparini, M.; Sartoni Galloni, S.

    2000-01-01

    Acute thoracic aortic injuries account for up to 10-20% of fatalities in high-speed deceleration road accidents and have an estimated immediate fatality rate of 80-90%. Untreated survivors to acute trauma (10-20%) have a dismal prognosis: 30% of them die within 6 hours, 40-50% die within 24 hours, and 90% within 4 months. It was investigated the diagnostic accuracy of Helical Computed Tomography (Helical CT) in acute traumatic injuries of the thoracic aorta, and the role of this technique in the diagnostic management of trauma patients with a strong suspicion of aortic rupture. It was compared retrospectively the chest Helical CT findings of 256 trauma patients examined June 1995 through August 1999. Chest Helical CT examinations were performed according to trauma score, to associated traumatic lesions and to plain chest radiographic findings. All the examinations were performed with no intravenous contrast agent administration and the pitch 2 technique. After a previous baseline study, contrast-enhanced scans were acquired with pitch 1 in 87 patients. Helical CT showed aortic lesions in 9 of 256 patients examined. In all the 9 cases it was found a mediastinal hematoma and all of them had positive plain chest radiographic findings of mediastinal enlargement. Moreover, in 6 cases aortic knob blurring was also evident on plain chest film and in 5 cases depressed left mainstem bronchus and trachea deviation rightwards were observed. All aortic lesions were identified on axial scans and located at the isthmus of level. Aortic rupture was always depicted as pseudo diverticulum of the proximal descending tract and intimal flap. It was also found that periaortic hematoma in 6 cases and intramural hematoma in 1 case. There were non false positive results in the series: 7 patients with Helical CT diagnosis of aortic rupture were submitted to conventional aortography that confirmed both type and extension of the lesions as detected by Helical CT, and all findings were

  13. A case of Behcet's disease with aneurysms of common carotid arteries and abdominal aorta

    International Nuclear Information System (INIS)

    Choo, Yeon Myung; Chang, Kee Hyun; Choi, Sung Jae

    1984-01-01

    One case of Behcet's disease with multiple aneurysms in both common carotid arteries and abdominal aorta is presented with brief review of the literatures. A 26-year-old woman had slowly enlarging pulsatile masses in both sides of neck and recurrent ulcerations in oral cavity and genitalia. One day prior to admission, aphasia, right facial nerve palsy and right hemiplegia suddenly developed. Brain CT showed acute infarction in left basal ganglia. Both Carotid Angiography and abdominal Aortography demonstrated multiple aneurysms in both common carotid arteries and abdominal aorta with organizing thrombi and thromboembolism of internal carotid artery

  14. Primary percutaneous coronary intervention in an anomalous single coronary trunk arising anomalously from ascending aorta.

    Science.gov (United States)

    Gupta, Mohit D; Girish, M P; Bansal, Ankit; Chaturvedi, Vivek; Trehan, Vijay; Tyagi, Sanjay

    2016-07-01

    A 45-year-old male patient presented with acute anterior wall myocardial infarction. Angiography revealed a single coronary trunk arising from the ascending aorta above the coronary sinuses and giving rise to right coronary artery, left circumflex artery and critical stenosis in the left anterior descending artery. This report also highlights the feasibility of performing percutaneous coronary intervention (PCI) in this rare anomaly and discusses the important technical considerations to be kept in mind while attempting such a case. This is the first report of such an anomalous origin of a single coronary trunk arising from ascending aorta.

  15. Morphological state of aorta in the fetuses and newborns suffered from chronic intrauterine hypoxia (experimental research

    Directory of Open Access Journals (Sweden)

    O. V. Kaluzhina

    2015-04-01

    Full Text Available The cardiovascular system in newborns with chronic hypoxia is affected in 40–70%. Aim. To investigate morphological state of aorta in the fetuses and newborns suffered from chronic intrauterine hypoxia. Methods and results. Aortic wall was investigated with modern morphological methods in 34 laboratory animals in order to identify the morphological features of the fetuses and newborns’ vessel affected by this pathogenic factor. It was established that chronic hypoxia leads to endothelial trophics deterioration, its flattening, dystrophic processes with following cells desquamation, density reduction of smooth muscle cells, thickening of the intima-media. Conclusion. It shows alterative-sclerotic changes in aorta in cases with chronic hypoxia influence.

  16. Ruptured penetrating ulcer of the ascending aorta with pulmonary artery compression.

    Science.gov (United States)

    Okiwelu, Ngozichukwuka; Finn, Chris; Vanden Driesen, Rohan; Sanders, Lucas; Joshi, Pragnesh

    2016-03-01

    Pulmonary artery involvement has been reported in various degrees of complicated dissection of the ascending aorta. The prognosis remains poor without high-risk surgical intervention, but conservative management can be considered in high-risk cases. We report a case of nonoperative management of an octogenarian who presented with a contained rupture of his proximal ascending aorta, likely from a penetrating atherosclerotic ulcer. It was complicated by extrinsic compression of the pulmonary trunk and transient pulmonary hypertension without features of acute right heart failure. He remained alive at the one-year follow-up. © The Author(s) 2014.

  17. Equine pericardial roll graft replacement of infected pseudoaneurysm of the ascending aorta

    Directory of Open Access Journals (Sweden)

    Kubota Hiroshi

    2012-06-01

    Full Text Available Abstract The standard procedure for treating infected aortic aneurysms is to resect the infected aorta, debridement of the surrounding tissue, in situ graft replacement, and omentopexy. However, the question of which graft material is optimal is still a matter of controversy. We recently treated a patient with an infected ascending aortic aneurysm. Because of previous abdominal surgery, the omentum was unavailable. The ascending aorta was replaced in situ with equine pericardial roll grafts. The patient is alive and well 29 months after the operation.

  18. Surgical treatment of a floating thrombus of the ascending aorta causing repeated arterial embolisms.

    Science.gov (United States)

    Labsaili, Hicham; Bouaggad, Amal; Alami, Aroussi Aziz; Rama, Akhtar; Leprince, Pascal

    2015-07-01

    Floating thrombus of the ascending aorta is a rare and often ignored cause of peripheral embolic events. We report the observation of a patient presenting recurrent peripheral embolic demonstrations: acute ischemia of the right lower limb complicated of a thigh amputation and transient cerebrovascular accident. The assessment by angioscanner highlighted a 40-mm thrombus of the ascending aorta. The thrombus was removed surgically. This diagnosis should not be ignored in the assessment of an embolic pathology with the risk of severe functional after-effects caused by an important diagnostic delay. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Diagnosis of a perforating aneurysm of the aorta as late complication of patch aortoplasty by central venous DSA

    Energy Technology Data Exchange (ETDEWEB)

    Zitzmann, A.; Kreuzer, E.; Huber, R.M.; Kenn, R.W.; Pfeifer, K.J.

    1988-06-01

    11 years after patch aortoplasty due to coarctation of the aorta a 33 year-old-patient experienced two spontaneous haemoptyses. A centralvenous digital subtraction angiography demonstrated a large aneurysm of the proximal descending aorta penetrating the left upper lobe of the lung. The successful emergency surgical treatment consisted of implantation of a dacron-prothesis.

  20. 45Ca2+movements induced by Ca2+chloride in isolated rat aorta under K+-free conditions

    NARCIS (Netherlands)

    Wermelskirchen, D.; Nebel, U.; Wirth, A.; Wilffert, B.

    1991-01-01

    Increasing the extracellular Ca2+concentration induced a dihydropyridine-insensitive contraction in the isolated rat aorta bathed in K+-free solution. To obtained further insight into the mechanisms of this contraction45Ca2+uptake measurements were carried out with isolated rat aorta. Increasing the

  1. CA-45(2+) MOVEMENTS INDUCED BY CA2+ CHLORIDE IN ISOLATED RAT AORTA UNDER K+-FREE CONDITIONS

    NARCIS (Netherlands)

    WERMELSKIRCHEN, D; NEBEL, U; WIRTH, A; WILFFERT, B

    1991-01-01

    Increasing the extracellular Ca2+ concentration induced a dihydropyridine-insensitive contraction in the isolated rat aorta bathed in K+-free solution. To obtain further insight into the mechanism of this contraction Ca-45(2+) uptake measurements were carried out with isolated rat aorta. Increasing

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

    International Nuclear Information System (INIS)

    Pfister, S.L.; Schmitz, J.M.; Willerson, J.T.; Campbell, W.B.

    1986-01-01

    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 37 0 C for 15 min with 14 C-AA (5 x 10 -5 M) 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 14 C-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 PGE 2 . 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

  3. Neurofibromatose associada a arteriopatia de moyamoya e aneurisma fusiforme: relato de caso Neurofibromatosis associated with moyamoya arteriopathy and fusiform aneurysm: a case report

    Directory of Open Access Journals (Sweden)

    JOSÉ IBIAPINA SIQUEIRA NETO

    1998-12-01

    Full Text Available Relato de caso de neurofibromatose tipo I associada a doença oclusiva extensa do sistema carotídeo em sua porção intracraniana e aneurisma fusiforme de circulação posterior. O paciente, de 28 anos de idade e com diagnóstico de doença de von Recklinghausen, passou a apresentar episódios de síncope, crises parciais complexas e declínio cognitivo. Após quadro agudo de cefaléia e sinais de irritação meníngea, com líquor hemorrágico, o paciente foi investigado com, TC de crânio, RNM e angiografia cerebral, sendo detectadas alterações tipo moyamoya e dilatação aneurismática de artéria cerebral posterior. Apresentamos os achados clínicos e radiológicos deste caso com poucos relatos similares na literatura médica, discutimos opções terapêuticas e reiteramos a inclusão de diagnósticos diferenciais raros em indivíduos que apresentem icto com menos de quarenta anos de idade.We report a case of von Recklinghausen's disease associated with multiple intracranial arterial occlusion ("moyamoya-like" and a fusiform aneurysm. A 28 years-old man with type I neurofibromatosis presented with syncope, complex partial seizures and mental deterioration. After an acute headache episode associated with meningeal signs, drowsiness, and hemorrhagic CSF, the patient was evaluated with cranial CT scan, MRI and angiogram that revealed an obstructive arteriopathy compatible with moyamoya disease and a fusiform aneurysm in the posterior circulation. The authors discuss the clinical and radiological findings and the therapeutic decision in this case comparing with the few similar reports in the medical literature. Recognition of an underlying rare genetic disorder may be of considerable importance in young patients presenting with seizures.

  4. 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.

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

    International Nuclear Information System (INIS)

    Pérez Díaz, Matías F.F.; Acosta, Mariano; Mohamed, Fabián H.; Ferramola, Mariana L.; Oliveros, Liliana B.; Gimenez, María S.

    2013-01-01

    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 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 2+ , in aorta. Also, 100 ppm Cd 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 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 2+ in drinking water induces oxidative stress in aorta. • Under casein diet, 100 ppm Cd 2+ increases Nrf2, MT II and NOX2 expressions in aorta. • Under casein diet, 100 ppm Cd 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

  6. Identifying the principal modes of variation in human thoracic aorta morphology.

    Science.gov (United States)

    Casciaro, Mariano E; Craiem, Damian; Chironi, Gilles; Graf, Sebastian; Macron, Laurent; Mousseaux, Elie; Simon, Alain; Armentano, Ricardo L

    2014-07-01

    Diagnosis and management of thoracic aorta (TA) disease demand the assessment of accurate quantitative information of the aortic anatomy. We investigated the principal modes of variation in aortic 3-dimensional geometry paying particular attention to the curvilinear portion. Images were obtained from extended noncontrast multislice computed tomography scans, originally intended for coronary calcium assessment. The ascending, arch, and descending aortas of 500 asymptomatic patients (57 ± 9 y, 81% male) were segmented using a semiautomated algorithm that sequentially inscribed circles inside the vessel cross-section. Axial planes were used for the descending aorta, whereas oblique reconstructions through a toroid path were required for the arch. Vessel centerline coordinates and the corresponding diameter values were obtained. Twelve size and shape geometric parameters were calculated to perform a principal component analysis. Statistics revealed that the geometric variability of the TA was successfully explained using 3 factors that account for ∼80% of total variability. Averaged aortas were reconstructed varying each factor in 5 intervals. Analyzing the parameter loadings for each principal component, the dominant contributors were interpreted as vessel size (46%), arch unfolding (22%), and arch symmetry (12%). Variables such as age, body size, and risk factors did not substantially modify the correlation coefficients, although some particular differences were observed with sex. We conclude that vessel size, arch unfolding, and symmetry form the basis for characterizing the variability of TA morphology. The numerical data provided in this study as supplementary material can be exploited to accurately reconstruct the curvilinear shape of normal TAs.

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

    International Nuclear Information System (INIS)

    Guinea, Gustavo V; Atienza, José M; Rojo, Francisco J; Yiqun, Li; Claes, Els; Elices, Manuel; García-Herrera, Claudio M; Goicolea, José M; García-Montero, Carlos; Burgos, Raúl L; Goicolea, Francisco J

    2010-01-01

    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

  8. Medical image of the week: atherosclerotic aneurysm of aortic arch and descecnding thoracic aorta

    Directory of Open Access Journals (Sweden)

    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 ...

  9. Coarctatio aortae: 40 års opfølgning efter kirurgisk korrektion - sekundaerpublikation

    DEFF Research Database (Denmark)

    Høimyr, Hilde; Pedersen, Thais A L; Christensen, Thomas D

    2009-01-01

    Coarctation of the aorta (CoA) was previously considered cured after surgical repair. Among 229 patients operated for CoA in Aarhus between 1965 and 1985, 14 died at surgery and 35 died during 20-40 years of follow-up, mainly due to cardiovascular disease. The mortality among CoA patients was 4...

  10. Aorta cross-section calculation and 3D visualization from CT or MRT data using VRML

    Science.gov (United States)

    Grabner, Guenther; Modritsch, Robert; Stiegmaier, Wolfgang; Grasser, Simon; Klinger, Thomas

    2005-04-01

    Quantification of vessel diameters of artherosclerotic or congenital stenosis is very important for the diagnosis of vascular diseases. The aorta extraction and cross-section calculation is a software-based application that offers a three-dimensional, platform-independent, colorized visualization of the extracted aorta with augmented reality information of MRT or CT datasets. This project is based on different types of specialized image processing algorithms, dynamical particle filtering and complex mathematical equations. From this three-dimensional model a calculation of minimal cross sections is performed. In user specified distances, the aorta is cut in differently defined directions which are created through vectors with varying length. The extracted aorta and the derived minimal cross-sections are then rendered with the marching cube algorithm and represented together in a three-dimensional virtual reality with a very high degree of immersion. The aim of this study was to develop an imaging software that delivers cardiologists the possibility of (i) furnishing fast vascular diagnosis, (ii) getting precise diameter information, (iii) being able to process exact, local stenosis detection (iv) having permanent data storing and easy access to former datasets, and (v) reliable documentation of results in form of tables and graphical printouts.

  11. COMPORTAMIENTO MECANICO DE LA AORTA ASCENDENTE: CARACTERZACION EXPERIMENTAL Y SIMULACION NUMERICA.

    OpenAIRE

    GARCIA HERRERA, CLAUDIO; GARCIA HERRERA, CLAUDIO

    2008-01-01

    En este trabajo se realiza una caracterización experimental y numérica del comportamiento mecánico de la pared de la aorta humana. Se destaca la importancia (le este tema debido al creciente interés cii coiiocer las propiedades y la respuesta mecánica de 193p.

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

    International Nuclear Information System (INIS)

    Baptista, Rafaela de Fátima Ferreira; Taipeiro, Elane de Fátima; Queiroz, Regina Helena Costa; Chies, Agnaldo Bruno; Cordellini, Sandra

    2014-01-01

    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. Effect of camelina oil on the structure of aortas in rats

    DEFF Research Database (Denmark)

    Pawlowska, Marta; Harrison, Adrian Paul; Piersiak, Tomasz

    2016-01-01

    in tension. Aortic wall elasticity was measured in duplicate. Samples of the aorta were also prepared for histology (total aortic wall thickness, thickness of tunica intima and media, thickness of adventitia) and immunohistochemistry (volume and mean fluorescence intensity of collagens I and III and elastin...

  14. Opioid receptors mediate enhancement of ACh-induced aorta relaxation by chronic intermittent hypobaric hypoxia.

    Science.gov (United States)

    Yuan, Fang; Li, Hong-Wei; Song, Shi-Jun; Teng, Xu; Ma, Hui-Jie; Guo, Zan; Zhang, Yi; Zhou, Zhao-Nian

    2013-06-25

    The present study was designed to investigate the role of opioid receptors in the vasorelaxation effect of chronic intermittent hypobaric hypoxia (CIHH) in thoracic aorta rings and the underlying mechanism in rats. Adult male Sprague-Dawley (SD) rats were randomly divided into 2 groups: CIHH treatment group and control group. The rats in CIHH group were exposed to hypoxia in a hypobaric chamber (simulated 5 000 m altitude) for 28 days, 6 h per day. The rats in control group were kept in the same environment as CIHH rats except no hypoxia exposure. The relaxation of thoracic aorta rings was recorded by organ bath perfusion technique, and expression of opioid receptors was measured by Western blot. Results are shown as follows. (1) The acetylcholine (ACh)-induced endothelium-dependent relaxation of thoracic aorta in CIHH rats was increased obviously in a concentration-dependent manner compared with that in control rats (P ACh-induced relaxation in CIHH rats was abolished by naloxone, a non-specific opioid receptor blocker (P ACh-induced vasorelaxation of thoracic aorta through KATP channel pathways.

  15. Hemolytic anemia caused by aortic flap and inversion of felt strip after ascending aorta replacement.

    Science.gov (United States)

    Sakaguchi, Masayuki; Takano, Tamaki

    2016-08-02

    Hemolysis related to a kinked prosthetic graft or inner felt strip is a very rare complication after aortic surgery. We describe herein a case of hemolytic anemia that developed due to aortic flap of the dissection and inversion of an inner felt strip that was applied at the proximal anastomosis of a replaced ascending aorta 10 years previously. A 74-year-old woman presented with consistent hemolytic anemia 10 years after replacement of the ascending aorta to treat Stanford type A acute aortic dissection. The cause of hemolysis was attributed to mechanical injury of red blood cells at a site of stenosis caused by aortic flap of the dissection and inversion of the felt strip used for the proximal anastomosis. Repeated resection of the strip and graft replacement of the ascending aorta resolved this problem. We considered that blood flow disrupted by a jet of blood at the site of the proximal inner felt strip was the cause of severe hemolysis, we describe rare hemolytic anemia at the site of aortic flap and inverted felt strip after replacement of the ascending aorta.

  16. Beyond the root: dilatation of the distal aorta in Marfan's syndrome

    NARCIS (Netherlands)

    Engelfriet, P. M.; Boersma, E.; Tijssen, J. G. P.; Bouma, B. J.; Mulder, B. J. M.

    2006-01-01

    OBJECTIVE: To investigate dilatory changes of the aorta distal to the root in patients with Marfan's syndrome. METHODS AND RESULTS: Data of 268 patients with Marfan's syndrome who were enrolled in the Euro Heart Survey on adult congenital heart disease were analysed. Data used for this study were

  17. Unexpected death caused by rupture of a dilated aorta in an adult male with aortic coarctation

    DEFF Research Database (Denmark)

    Leth, Peter Mygind; Knudsen, Peter Juel Thiis

    2015-01-01

    arch without dissection combined with aortic coarctation. The patient, a 46-year-old man, was found dead at home. PMCT showed haemopericardium and dilatation of the ascending aorta and the aortic arch. This appearance led to the mistaken interpretation that the images represented a dissecting aneurysm...

  18. 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

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

    Science.gov (United States)

    Baptista, Rafaela de Fátima Ferreira; Taipeiro, Elane de Fátima; Queiroz, Regina Helena Costa; Chies, Agnaldo Bruno; Cordellini, Sandra

    2014-01-01

    Background Stress and ethanol are both, independently, important cardiovascular risk factors. Objective To evaluate the cardiovascular risk of ethanol consumption and stress exposure, isolated and in association, in male adult rats. Methods 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. Results 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. Conclusion 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. PMID:24676223

  20. Analysis of thoracic aorta hemodynamics using 3D particle tracking velocimetry and computational fluid dynamics.

    Science.gov (United States)

    Gallo, Diego; Gülan, Utku; Di Stefano, Antonietta; Ponzini, Raffaele; Lüthi, Beat; Holzner, Markus; Morbiducci, Umberto

    2014-09-22

    Parallel to the massive use of image-based computational hemodynamics to study the complex flow establishing in the human aorta, the need for suitable experimental techniques and ad hoc cases for the validation and benchmarking of numerical codes has grown more and more. Here we present a study where the 3D pulsatile flow in an anatomically realistic phantom of human ascending aorta is investigated both experimentally and computationally. The experimental study uses 3D particle tracking velocimetry (PTV) to characterize the flow field in vitro, while finite volume method is applied to numerically solve the governing equations of motion in the same domain, under the same conditions. Our findings show that there is an excellent agreement between computational and measured flow fields during the forward flow phase, while the agreement is poorer during the reverse flow phase. In conclusion, here we demonstrate that 3D PTV is very suitable for a detailed study of complex unsteady flows as in aorta and for validating computational models of aortic hemodynamics. In a future step, it will be possible to take advantage from the ability of 3D PTV to evaluate velocity fluctuations and, for this reason, to gain further knowledge on the process of transition to turbulence occurring in the thoracic aorta. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. MDCT angiography of thoracic aorta endovascular stent-grafts: pearls and pitfalls.

    Science.gov (United States)

    Hoang, Jenny K; Martinez, Santiago; Hurwitz, Lynne M

    2009-02-01

    The objective of our study was to review expected findings and complications after thoracic endovascular aortic repair on CT angiography (CTA). Luminal and extraluminal changes to the thoracic aorta occur after endovascular stent-grafting. The radiologist can facilitate appropriate management by detecting and differentiating expected CTA findings from complications.

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

    NARCIS (Netherlands)

    C. Orelio; E.A. 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

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

    DEFF Research Database (Denmark)

    Larsen, Kirsten Vendelbo

    2001-01-01

    tetraethylammonium (TEA) and 4-aminopyridine (4-AP), but unaffected by glibenclamid. It is concluded that the acetylcholine-evoked relaxation of rabbit aorta is dependent on: the endothelium; the activation of muscarinic receptors; independent of prostanoids; and mediatedn by NO alone. Th eNO released...

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

    Energy Technology Data Exchange (ETDEWEB)

    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. Comparison of in vitro flows past a mechanical heart valve in anatomical and axisymmetric aorta models

    Science.gov (United States)

    Haya, Laura; Tavoularis, Stavros

    2017-06-01

    Flow characteristics past a bileaflet mechanical heart valve were measured under physiological flow conditions in a straight tube with an axisymmetric expansion, similar to vessels used in previous studies, and in an anatomical model of the aorta. We found that anatomical features, including the three-lobed sinus and the aorta's curvature affected significantly the flow characteristics. The turbulent and viscous stresses were presented and discussed as indicators for potential blood damage and thrombosis. Both types of stresses, averaged over the two axial measurement planes, were significantly lower in the anatomical model than in the axisymmetric one. This difference was attributed to the lower height-to-width ratio and more gradual contraction of the anatomical aortic sinus. The curvature of the aorta caused asymmetries in the velocity and stress distributions during forward flow. Secondary flows resulting from the aorta's curvature are thought to have redistributed the fluid stresses transversely, resulting in a more homogeneous stress distribution in the anatomical aortic root than in the axisymmetric root. The results of this study demonstrate the importance of modelling accurately the aortic geometry in experimental and computational studies of prosthetic devices. Moreover, our findings suggest that grafts used for aortic root replacement should approximate as closely as possible the shape of the natural sinuses.

  6. Polyamine concentration is increased in thoracic ascending aorta of patients with bicuspid aortic valve

    Czech Academy of Sciences Publication Activity Database

    Forte, A.; Grossi, Mario; Bancone, C.; Cipollaro, M.; De Feo, M.; Hellstrand, P.; Persson, L.; Nilsson, B.O.; Della Corte, A.

    Roč. 33, č. 3 ( 2017 ), s. 327-339 ISSN 0910-8327 Institutional support: RVO:68378050 Keywords : Aneurysm * Aortopathy * Bicuspid aortic valve * Ornithine decarboxylase * Polyamines * Thoracic ascending aorta Subject RIV: EB - Genetics ; Molecular Biology Impact factor: 3.434, year: 2016

  7. Blunt traumatic aortic rupture of the proximal ascending aorta repaired by resection and direct anastomosis.

    Science.gov (United States)

    Harmouche, Majid; Slimani, Eric Karim; Heraudeau, Adeline; Verhoye, Jean-Philippe

    2013-10-01

    Traumatic aortic injury represents 15% of motor vehicle related deaths with death occurring at the scene in 85% of the cases. Aortic disruptions usually occur at the isthmus in a transverse fashion with all three of the aortic layers being involved. Herein, we report the case of a 68-year old man with no prior medical history who was struck by a vehicle while riding his bicycle. The ruptured segment of aorta was resected circumferentially and interrupted horizontal mattress pledgeted prolene sutures were used to ensure full thickness aortic integrity of the proximal and distal aortic segments. The aorta was closed with a single-layer technique using 4/0 prolene suture. There were no postoperative complications and patient was discharged on Day 44. The case here discussed demonstrates a rare presentation of blunt aortic injury. The proximal ascending aorta is an unusual site of transection following blunt trauma with few reports in the literature. We were able to repair the aorta with direct suture, thus avoiding the use of artificial material.

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

    NARCIS (Netherlands)

    Stok, Wim J.; Westerhof, Berend E.; Karemaker, John M.

    2006-01-01

    Noninvasive finger blood pressure has become a surrogate for central blood pressure under widely varying circumstances. We tested the validity of finger-aorta transfer functions (TF) to reconstruct aortic pressure in seven cardiac patients before, during, and after incremental bicycle exercise. The

  9. Morphometric Properties of the Thoracic Aorta of Warmblood and Friesian Horses with and without Aortic Rupture

    NARCIS (Netherlands)

    Saey, V; Ploeg, M; Delesalle, C; van Loon, G; Gröne, A; Ducatelle, R; Duchateau, L; Chiers, K

    2016-01-01

    Rupture of the aorta is much more common in Friesians compared with other breeds of horse. Rupture always occurs adjacent to the scar of the ligamentum arteriosum. Previous histological examination of ruptured aortic walls suggested the presence of an underlying connective tissue disorder.

  10. 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.

  11. A importância do diagnóstico por imagem na classificação dos endoleaks como complicação do tratamento endovascular de aneurismas aórticos The value of diagnostic imaging in the classification of endoleaks as a complication of endoluminal grafting of aortic aneurysms

    Directory of Open Access Journals (Sweden)

    Francisco Abaeté das Chagas Neto

    2010-10-01

    Full Text Available OBJETIVO: Relatar uma série de casos de endoleaks, com descrição da classificação vigente. MATERIAIS E MÉTODOS: Realizou-se um estudo retrospectivo dos endoleaks diagnosticados em nossa instituição, entre 2005 e 2009. Foram incluídos 20 casos, utilizados para ilustrar os diferentes tipos de endoleaks. RESULTADOS: Setenta por cento dos pacientes eram do sexo masculino. A idade variou entre 43 e 91 anos, média de 76,3 anos. Treze casos foram observados na aorta abdominal infrarrenal, quatro na aorta torácica, dois nas artérias ilíacas e um no território carotídeo. A ultrassonografia foi o método utilizado para o diagnóstico em 3 casos e a tomografia computadorizada, nos outros 17 casos. Classificação: tipo I, 60%; tipo II, 25%; tipo III, 15%. Não foram observados os demais tipos nesta série. CONCLUSÃO: O diagnóstico precoce e a correta classificação são fundamentais para o manejo adequado dos casos de endoleaks, tornando o conhecimento de seus subtipos conceito fundamental na formação do médico especialista em radiologia e diagnóstico por imagem e para o cirurgião vascular.OBJECTIVE: To describe a series of endoleak cases and their respective classification. MATERIALS AND METHODS: The authors developed a retrospective study of endoleaks diagnosed at their institution in the period between 2005 and 2009. Twenty cases were included to illustrate the different types of endoleaks. RESULTS: Seventy percent of the patients were men, and the ages ranged from 43 to 91 years (mean, 76.3 years. Thirteen cases were observed in the infrarenal abdominal aorta, four in the thoracic aorta, two in the iliac artery, and one in the carotid territory. Ultrasonography was the method utilized for diagnosis in three cases, and computed tomography in the other 17 cases. Classification: 60% type I, 25% type II, 15% type III. Other endoleak types were not observed in the present series. CONCLUSION: Early diagnosis and correct classification

  12. Proteção cerebral no tratamento cirúrgico dos aneurismas do arco aórtico: estudo experimental em cães Cerebral protection during surgical approach to the aortic arch aneurysms resection: experimental study in dogs

    Directory of Open Access Journals (Sweden)

    Gaudêncio Lopes Espinosa

    1994-12-01

    Full Text Available É realizado estudo experimental comparativo entre dois métodos de proteção cerebral na abordagem cirúrgica dos aneurismas do arco aórtico, avaliando a sua eficácia: hipotermia sistêmica profunda isolada (menor que 20ºC com pinçamento arterial braquiocefálico e hipotermia sistêmica profunda associada à perfusão carotídea seletiva. Dois grupos de 15 cães cada foram submetidos, respectivamente, à hipotermia sistêmica profunda com pinçamento arterial braquiocefálico (Grupo I e à hipotermia sistêmica profunda associada à perfusão seletiva da carótida direita (Grupo II. Foram analisadas amostras seriadas das alterações metabólicas de pH e PaCO2 que ocorreram no retorno venoso cerebral aferidas na veia julgular interna, bem como as alterações histopatológicas encontradas com 45 min., 90 min. e 135 min. de cada procedimento. Os resultados demonstram que, apesar de ambos os métodos de proteção cerebral serem eficazes por um período de 45 minutos, o método utilizado no Grupo II mostrou ser superior em períodos de até 90 minutos de isquemia cerebral. Em períodos de 135 minutos os métodos tiveram resultados semelhantes, não oferecendo proteção cerebral adequada.The authors proposition is to make an experimental study of two methods of cerebral protection to be used during aortic arch aneurysm resection. The methods to be evaluated were profound systemic hypothermia (under 20ºC whith great vessels occlusion and profound systemic hypothermia with selective right carotid artery perfusion. Two groups of 15 dogs each were submitted either to profound systemic hypothermia with great vessels occlusion (Group I, or to profound systemic hypothermia with selective right carotid artery perfusion (Group II. Serial jugular vein samples for pH and PaCO2 were analyzed to evaluate ischemic cerebral metabolic derangements. Hystopathological studies were also performed 45, 90 and 135 minutes, through animal sacrifice in each

  13. Methylprednisolone stiffens aortas in lipopolysaccharide-induced chronic inflammation in rats.

    Directory of Open Access Journals (Sweden)

    Ya-Hui Ko

    Full Text Available INTRODUCTION: Glucocorticoids are commonly used as therapeutic agents in many acute and chronic inflammatory and auto-immune diseases. The current study investigated the effects of methylprednisolone (a synthetic glucocorticoid on aortic distensibility and vascular resistance in lipopolysaccharide-induced chronic inflammation in male Wistar rats. METHODS: Chronic inflammation was induced by implanting a subcutaneous slow-release ALZET osmotic pump (1 mg kg(-1 day(-1 lipopolysaccharide for either 2 or 4 weeks. Arterial wave transit time (τ was derived to describe the elastic properties of aortas using the impulse response function of the filtered aortic input impedance spectra. RESULTS: Long-term lipopolysaccharide challenge enhanced the expression of advanced glycation end products (AGEs in the aortas. Lipopolysaccharide also upregulated the inducible form of nitric oxide synthase to produce high levels of nitric oxide (NO, which resulted in vasodilation, as evidenced by the fall in total peripheral resistance (Rp . However, lipopolysaccharide challenge did not influence the elastic properties of aortas, as shown by the unaltered τ. The NO-mediated vascular relaxation may counterbalance the AGEs-induced arterial stiffening so that the aortic distensibility remained unaltered. Treating lipopolysaccharide-challenged rats with methylprednisolone prevented peripheral vasodilation because of its ability to increase Rp . However, methylprednisolone produced an increase in aorta stiffness, as manifested by the significant decline in τ. The diminished aortic distensibility by methylprednisolone paralleled a significant reduction in NO plasma levels, in the absence of any significant changes in AGEs content. CONCLUSION: Methylprednisolone stiffens aortas and elastic arteries in lipopolysaccharide-induced chronic inflammation in rats, for NO activity may be dominant as a counteraction of AGEs.

  14. Evaluation of atherosclerosis in the abdominal aorta by contrast enhanced helical CT

    International Nuclear Information System (INIS)

    Gong, Honghan; Hiraishi, Kumiko; Shimizu, Tadafumi; Adachi, Itaru; Sueyoshi, Kouzou; Narabayashi, Isamu

    1997-01-01

    We retrospectively evaluated helical CT findings of the abdominal aorta in 85 patients (47 men and 38 women) ranging from 21 to 84 years of age (mean±SD : 58.8±13.6) with nonvascular disease. The degree of atherosclerosis of the abdominal aorta was assessed by examining the imaging findings of the curvature, double contour (wall thickening), and calcification of the abdominal aorta. Each of the atherosclerosis findings was classified into one of four degree of severity: no atherosclerosis as 0, minimal atherosclerosis as 1, moderate atherosclerosis as 2, and severe atherosclerosis as 3. Findings of abdominal aortic sclerosis were given a score of 9. The mean score of the men was 2.8±1.8 and that of the women was 1.1±1.2. The mean score of patients below age 39 was 0.3±0.7, that of patients between ages 40 and 59 was 1.4±1.5, and that of patients over age 60 was 2.9±1.6. The results showed that atherosclerosis occurred earlier and more frequently, and was more severe, in the men than in the women. There are many nonsymptomatic patients with arteriosclerosis, and they should be carefully managed. Because of high resolusion and fast scanning, helical CT is useful for evaluating the severity of atherosclerosis. Double contour of the abdominal aorta at the later arterial phase of the contrast enhancement was an important finding, suggesting atherosclerosis of the abdominal aorta. (author)

  15. Wall Stress and Geometry of the Thoracic Aorta in Patients With Aortic Valve Disease.

    Science.gov (United States)

    Doyle, Barry J; Norman, Paul E; Hoskins, Peter R; Newby, David E; Dweck, Marc R

    2018-04-01

    Aortic valve disease increases velocity and changes the way blood enters the aorta. Over time, the biomechanical environment can cause aortic remodelling. We hypothesized that aortic geometry and wall stress would be different in patients with aortic valve disease compared with controls. We examined 40 patients with aortic sclerosis (n = 10) or mild (n = 10), moderate (n = 10), and severe (n = 10) aortic stenosis, and also 10 control individuals. The thoracic aorta of each individual was reconstructed into a three-dimensional model from computed tomography. We measured geometric variables and used finite element analysis to compute aortic wall stress. Statistical analyses were performed to test our hypothesis. Aortic wall stress was significantly associated with tortuosity of the descending aorta (r = 0.35, p = 0.01), arch radius (r = 0.49, p < 0.01), ascending aortic diameter (r = 0.59, p < 0.01), and aortic centerline length (r = 0.39, p < 0.01). Wall stress was highest in patients with severe stenosis (p = 0.02), although elevations in wall stress were also noted in those with mild stenosis (p = 0.02), and aortic sclerosis (p = 0.02) compared with controls. Similar trends were observed when we corrected for difference in blood pressure. Total centerline tortuosity was higher in patients with severe aortic stenosis than in controls (p = 0.04), as was descending aorta tortuosity (p = 0.04). Aortic geometry is associated with aortic wall stress. Patients with aortic valve disease have higher aortic wall stress than controls, and those with severe aortic stenosis have more tortuous aortas. However, increases in geometric measures and wall stress are not stepwise with increasing disease severity. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

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

    International Nuclear Information System (INIS)

    Lucarelli, Claudio Luiz

    1995-01-01

    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)

  17. Calcifications of the thoracic aorta on extended non-contrast-enhanced cardiac CT.

    Directory of Open Access Journals (Sweden)

    Damian Craiem

    Full Text Available BACKGROUND: The presence of calcified atherosclerosis in different vascular beds has been associated with a higher risk of mortality. Thoracic aorta calcium (TAC can be assessed from computed tomography (CT scans, originally aimed at coronary artery calcium (CAC assessment. CAC screening improves cardiovascular risk prediction, beyond standard risk assessment, whereas TAC performance remains controversial. However, the curvilinear portion of the thoracic aorta (TA, that includes the aortic arch, is systematically excluded from TAC analysis. We investigated the prevalence and spatial distribution of TAC all along the TA, to see how those segments that remain invisible in standard TA evaluation were affected. METHODS AND RESULTS: A total of 970 patients (77% men underwent extended non-contrast cardiac CT scans including the aortic arch. An automated algorithm was designed to extract the vessel centerline and to estimate the vessel diameter in perpendicular planes. Then, calcifications were quantified using the Agatston score and associated with the corresponding thoracic aorta segment. The aortic arch and the proximal descending aorta, "invisible" in routine CAC screening, appeared as two vulnerable sites concentrating 60% of almost 11000 calcifications. The aortic arch was the most affected segment per cm length. Using the extended measurement method, TAC prevalence doubled from 31% to 64%, meaning that 52% of patients would escape detection with a standard scan. In a stratified analysis for CAC and/or TAC assessment, 111 subjects (46% women were exclusively identified with the enlarged scan. CONCLUSIONS: Calcium screening in the TA revealed that the aortic arch and the proximal descending aorta, hidden in standard TA evaluations, concentrated most of the calcifications. Middle-aged women were more prone to have calcifications in those hidden portions and became candidates for reclassification.

  18. Aneurismas del complejo arteria cerebral anterior / arteria comunicante anterior: Resultados del tratamiento quirúrgico Aneurysms of the anterior cerebral artery-anterior communicating artery complex: Results of the surgical treatment

    Directory of Open Access Journals (Sweden)

    Justo L González González

    2006-03-01

    Full Text Available Los aneurismas del complejo arteria cerebral anterior-arteria comunicante anterior figuran entre los más frecuentes de localización intracraneal y, debido a su variabilidad anatómica y características hemodinámicas, constituyen un reto especial para cualquier esfuerzo terapéutico. Con el objetivo de caracterizarlos y evaluar los resultados del tratamiento quirúrgico de estas lesiones, se estudian los pacientes operados en el Servicio de Neurocirugía del Hospital Clinicoquirúrgico «Hermanos Ameijeiras», entre enero de 1983 y agosto de 1998. Se observó que el 71,1 % de la muestra egresó en excelente estado; el 13,44 %, con secuelas mínimas; el 3,48 %, con secuelas graves y que la mortalidad fue del 11,53 %. Se concluye que estos aneurismas son más frecuentes en el sexo masculino, en la cuarta y quinta décadas de la vida (media de 39,9 años y que el tamaño crítico de ruptura se ubica mayoritariamente entre 6 mm y 11 mm. De igual forma se observó que la edad, el tamaño sacular, el vasoespasmo y la ruptura transoperatoria influyen sobre los resultados y que la influencia de estas dos últimas complicaciones es muy fuerte. El infarto cerebral isquémico fue la causa de muerte más frecuente

  19. Follow-up of aortic dissection: contribution of MR angiography for evaluation of the abdominal aorta and its branches

    International Nuclear Information System (INIS)

    Bogaert, J.; Meyns, B.; Rademakers, F.E.; Bosmans, H.; Verschakelen, J.; Flameng, W.; Marchal, G.; Baert, A.L.

    1997-01-01

    Spin-echo MR is an established method to evaluate thoracic aortic dissections, but is not well suited to study the abdominal aorta. In this study we evaluated whether MR angiography could provide a complete examination of the abdominal aorta. In 28 patients (40 MR studies) with suspected (n = 6) or known (n = 34) aortic dissection, MR studies were performed. Thoracic aorta was evaluated with spin-echo and gradient-recalled-echo MR imaging. Axial two-dimensional time-of-flight MR angiography with thin overlapping slices was used to study the abdominal aorta. Intermediate and high signal intensity on MR angiography was interpreted as patent flow, and low signal was interpreted as thrombus. The presence of an intima flap and the re-entry site could be depicted in all MR studies. Thrombus in the false channel was seen in 8 studies. The origin of the abdominal visceral branches and their relation to the false-true channel could be depicted, except in 4 of 80 renal arteries studied. Extension of the dissection into the coeliac trunk was seen in 2 and in the superior mesenteric artery in 10 studies. Dilatation of the suprarenal abdominal aorta was seen in 20 studies, and of the infrarenal aorta in 9 studies. MR angiography provides valuable information about the abdominal aorta and its branches in patients with aortic dissection. This makes MR imaging appealing as the preferred imaging modality for the diagnosis and follow-up of aortic dissection. (orig.). With 6 figs., 6 tabs

  20. Follow-up of aortic dissection: contribution of MR angiography for evaluation of the abdominal aorta and its branches

    Energy Technology Data Exchange (ETDEWEB)

    Bogaert, J. [Department of Radiology, Catholic University Hospitals, Herestraat 49, B-3000 Leuven (Belgium); Meyns, B. [Department of Cardiac Surgery, Catholic University Hospitals, Herestraat 49, B-3000 Leuven (Belgium); Rademakers, F.E. [Department of Internal Medicine, Division of Cardiology, Catholic University Hospitals, Herestraat 49, B-3000 Leuven (Belgium); Bosmans, H. [Department of Radiology, Catholic University Hospitals, Herestraat 49, B-3000 Leuven (Belgium); Verschakelen, J. [Department of Radiology, Catholic University Hospitals, Herestraat 49, B-3000 Leuven (Belgium); Flameng, W. [Department of Cardiac Surgery, Catholic University Hospitals, Herestraat 49, B-3000 Leuven (Belgium); Marchal, G. [Department of Radiology, Catholic University Hospitals, Herestraat 49, B-3000 Leuven (Belgium); Baert, A.L. [Department of Radiology, Catholic University Hospitals, Herestraat 49, B-3000 Leuven (Belgium)

    1997-06-01

    Spin-echo MR is an established method to evaluate thoracic aortic dissections, but is not well suited to study the abdominal aorta. In this study we evaluated whether MR angiography could provide a complete examination of the abdominal aorta. In 28 patients (40 MR studies) with suspected (n = 6) or known (n = 34) aortic dissection, MR studies were performed. Thoracic aorta was evaluated with spin-echo and gradient-recalled-echo MR imaging. Axial two-dimensional time-of-flight MR angiography with thin overlapping slices was used to study the abdominal aorta. Intermediate and high signal intensity on MR angiography was interpreted as patent flow, and low signal was interpreted as thrombus. The presence of an intima flap and the re-entry site could be depicted in all MR studies. Thrombus in the false channel was seen in 8 studies. The origin of the abdominal visceral branches and their relation to the false-true channel could be depicted, except in 4 of 80 renal arteries studied. Extension of the dissection into the coeliac trunk was seen in 2 and in the superior mesenteric artery in 10 studies. Dilatation of the suprarenal abdominal aorta was seen in 20 studies, and of the infrarenal aorta in 9 studies. MR angiography provides valuable information about the abdominal aorta and its branches in patients with aortic dissection. This makes MR imaging appealing as the preferred imaging modality for the diagnosis and follow-up of aortic dissection. (orig.). With 6 figs., 6 tabs.

  1. Murine abdominal aortic aneurysm model by orthotopic allograft transplantation of elastase-treated abdominal aorta.

    Science.gov (United States)

    Liu, Zhenjie; Wang, Qiwei; Ren, Jun; Assa, Carmel Rebecca; Morgan, Stephanie; Giles, Jasmine; Han, Qi; Liu, Bo

    2015-12-01

    Murine models have proved instrumental in studying various aspects of abdominal aortic aneurysm (AAA), from identification of underlying pathophysiologic changes to the development of novel therapeutic strategies. In the current study, we describe a new model in which an elastase-treated donor aorta is transplanted to a recipient mouse and allowed to progress to aneurysm. We hypothesized that by transplanting an elastase-treated abdominal aorta of one genotype to a recipient mouse of a different genotype, one can differentiate pathophysiologic factors that are intrinsic to the aortic wall from those stemming from circulation and other organs. Elastase-treated aorta was transplanted to the infrarenal abdominal aorta of recipient mice by end-to-side microsurgical anastomosis. Heat-inactivated elastase-treated aorta was used as a control. Syngeneic transplants were performed with use of 12-week-old C57BL/6 littermates. Transplant grafts were harvested from recipient mice on day 7 or day 14 after surgery. The aneurysm outcome was measured by aortic expansion, elastin degradation, proinflammatory cytokine expression, and inflammatory cell infiltration and compared with that produced with the established, conventional elastase infusion model. The surgical technique success rate was 75.6%, and the 14-day survival rate was 51.1%. By day 14 after surgery, all of the elastase-treated transplanted abdominal aortas had dilated and progressed to AAAs, defined as 100% or more increase in the maximal external diameter compared with that measured before elastase perfusion, whereas none of the transplanted aortas pretreated with inactive elastase became aneurysmal (percentage increase in maximum aortic diameter: 159.36% ± 23.27%, transplanted elastase, vs 41.46% ± 9.34%, transplanted inactive elastase). Aneurysm parameters, including elastin degradation and infiltration of macrophages and T lymphocytes, were found to be identical to those observed in the conventional elastase

  2. Análisis del comportamiento mecánico en una sección de la aorta // Mechanical behavior analysis in an aorta section

    Directory of Open Access Journals (Sweden)

    A. González-Martin

    2009-05-01

    Full Text Available La importancia social de las enfermedades arteriales motiva el interés en desarrollar estudios sobreel comportamiento mecánico de las paredes arteriales que aporten información para la prácticamédica, ya que estas enfermedades están fuertemente relacionadas con factores mecánicos comoson los estados de deformación y tensión. El presente trabajo ofrece una metodología para analizarel comportamiento mecánico de una arteria (la aorta. Dicho análisis parte de una geometría realconstruida a partir de imágenes médicas. En la formulación del modelo de elementos finitos seescogió un material con comportamiento no-lineal, con grandes deformaciones, hiperelástico, nohomogéneoy ortótropico. A la hora de analizar los resultados logrados y compararlos con losresultados obtenidos por otros autores no es posible establecer una comparación debido a losdiferentes métodos de ensayo empleados por distintos autores y la dificultad en laexperimentación en arterias humanas, solo es posible establecer zonas criticas en las cuales sepresente algún tipo de enfermedad arterial.Palabras claves: aorta, modelación, elementos finitos (EF, hiperelásticidad.______________________________________________________________________________AbstractThe social importance of the arterial illnesses motivates the interest in developing studies on themechanical behavior of the arterial walls. The medical practice has pointed that these illnesses arestrongly related with mechanical factors, such as states of deformation and tension as other relatedparameters. The present work offers a methodology to analyze the mechanical behavior of anartery (the aorta. This analysis uses a real geometry model that has been built based on medicalimages. In the formulation of the finite elements model the material has been considered with ano-linear behavior, with big deformations, hyperplasic, no-homogeneous and orthotropic. It is notpossible to establish comparisons between the

  3. Model-based segmentation and motion analysis of the thoracic aorta from 4D ECG-gated CTA images.

    Science.gov (United States)

    Biesdorf, Andreas; Wörz, Stefan; Müller, Tobias; Weber, Tim Frederik; Heye, Tobias; Hosch, Waldemar; von Tengg-Kobligk, Hendrik; Rohr, Karl

    2011-01-01

    Pathologies of the thoracic aorta can alter the shape and motion pattern of the aorta throughout the cardiac cycle. For diagnosis and therapy planning, determination of the aortic shape and motion is important. We introduce a new approach for segmentation and motion analysis of the thoracic aorta from 4D ECG-CTA images, which combines spatial and temporal tracking, motion determination by intensity-based matching, and 3D fitting of vessel models. The approach has been successfully applied to 30 clinically relevant 4D CTA image sequences. We have also performed a quantitative evaluation of the segmentation accuracy.

  4. 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.

  5. Traumatic rupture of the thoracic aorta. A review of 49 cases

    Energy Technology Data Exchange (ETDEWEB)

    Stark, P.; Cook, M.; Vincent, A.; Smith, D.C.

    1987-09-01

    We examined retrospectively the chest radiograph of forty-nine patients with angiographically proven aortic ruptures. The plain film findings found most consistently were a wide mediastinum (69.5%), partial obliteration of the descending aorta (67.3%), left apical cap (65.3%), downward displacement of the left main bronchus (65.3%), tracheal deviation to the right (63.2%), obscuration of the aortic arch (55.1%), right paratracheal stripe thickening (53%) and nasogastric tube deviation to the right (50%). We also examined 113 sequential aortograms performed after thoracic trauma over 3 years, to determine the positive rate in our series; 14 studies were positive for a rate of 12.4%. No single case of proved ruptured aorta with a normal chest radiograph was detected.

  6. Fluid structure interaction (FSI) simulation of bileaflet mechanical heart valve in an anatomic aorta geometry

    Science.gov (United States)

    Ge, Liang; Borazjani, Iman; Dasi, Lakshmi; Sotiropoulos, Fotis; Yoganathan, Ajit

    2007-11-01

    FSI simulation of a medical quality BMHV implanted in the aortic position is studied. The valve is implanted in an anatomic non-compliant aorta geometry, which is reconstructed from MRI data acquired from a healthy volunteer. A physiological incoming flow waveform is specified at the inlet with the peak systolic Reynolds number equal to 6000. The flow solver is based on the CURVIB (curvilinear immersed boundary method) of Ge and Sotiropoulos, 2007 (JCP) and the FSI problem is solved with strong coupling partitioned approach. Direct numerical simulation is carried out on a grid system consisting of 10M grid nodes. The impact on hemodynamics by valve implantation is studied by considering different valve implantation angles. The calculated numerical results are analyzed in terms of leaflet kinematics and flow physics, and compared with data from our previous work, where the same valve is implanted in a simplified straight aorta geometry.

  7. 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

    2015-01-01

    in relation to atherosclerosis. Thirteen patients with normal aortic valves were included in to the study. TO implemented on a conventional US scanner (ProFocus 2202 UltraView, BK Medical, Herlev, Denmark) with a linear array transducer (8670, BK Medical, Herlev, Denmark) was used intraoperatively......In the ascending aorta, atherosclerotic plaque formation, which is a risk factor for cerebrovascular events, most often occurs along the inner curvature. Atherosclerosis is a multifactorial disease, but the predilection site for the aortic vessel degradation is probably flow dependent. To better...... understand the aortic flow and especially the complex flow patterns, the ascending aorta was scanned intraoperatively in patients undergoing heart surgery using the angle-independent vector velocity ultrasound method Transverse Oscillation (TO). The primary aim of the study was to analyze systolic backflow...

  8. Ruptured tuberculous false aneurysm of the abdominal aorta: a case report.

    Science.gov (United States)

    Mechchat, Alae; Lekehal, Brahim; Mesnaoui, Abbes; Ammar, Fannid; Bensaid, Younes

    2011-01-01

    Tuberculous false aneurysm of the aorta is rare and has an unpredictable complication of aneurysm rupture. We report a case of a 32-year old woman who was referred to the Department of Vascular Surgery, Avicenne Hospital for severe abdominal pain. Chest x-ray revealed miliary tuberculosis. Contrast enhanced computed tomography (CT) scan showed a false aortic aneurysm involving the juxtarenal aorta. Antituberculous treatment was started because of high presumption of tuberculosis. Five days later, the patient presented with symptoms of aneurysm rupture. She underwent an emergency a surgical resection of the aneurysm with repair of the aortic wall defect by a Dacron Silver patch. The histopathologic examination of the aortic wall showed features of tuberculosis.

  9. 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)

  10. Clinical evaluation of atherosclerosis and mechanical properties of the thoracic aorta

    International Nuclear Information System (INIS)

    Saiki, Atsushi

    1991-01-01

    To evaluate the aortic wall atherosclerosis, X-ray CT and ECG gated radionuclide angiography were performed in 25 subjects. They were classified into 17 normotensive group (N) and 8 hypertensive group (HT). The time-activity curve was generated using radionuclide angiography in the portion of the thoracic aorta. The aortic wall distensibility was expressed as 100ΔV/V 0 / PP, where ΔV was difference between maximum and minimum (V 0 ) counts of the aorta, and PP was pulse pressure. The degree of the aortic wall atherosclerosis was evaluated by X-ray CT. The aortic wall CT-score was calculated from the CT-scores measured whithin the region of interest of the other margin of the aorta and of the background by X-ray CT. There was a significant correlation between aortic wall CT-score and systolic blood pressure (r=0.59, p<0.01) or aortic wall distensibility (r=-0.74, p<0.01)), but no correlation existed between aortic wall CT-score and diastolic blood pressure (r=0.11, p:NS). The aortic wall distensibility was higher and the aortic wall CT-score was lower in N-group than in HT-group, whereas there was no difference of the radius of the aorta between both groups. These results suggest that the aortic wall atherosclerosis advanced progressively in hypertensive patients and systolic blood pressure was a good predictor of the degree of the aortic atherosclerosis. (author)

  11. Coarctation of the Aorta in Infants Under One Year of Age

    African Journals Online (AJOL)

    1974-03-02

    Mar 2, 1974 ... (trisomy 16 - 18). Total. 20. 2. 3. 28. 48. 2. 3. From Table III the residual gradients of 12 out of 13 cases operated on, can be seen. The patient with associated tubular hypoplasia, who had nothing done to the aorta at operation, is excluded. Six (50%) had gradients of 20 mmHg, or more. Only 2 of these had ...

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

    International Nuclear Information System (INIS)

    Ming, Zhu; Qian, Wang

    2009-01-01

    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.)

  13. 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.)

  14. Melatonin effect on hypertension and nitric oxide balance in the heart and aorta

    Czech Academy of Sciences Publication Activity Database

    Pecháňová, Olga; Paulis, L.; Zicha, Josef; Kuneš, Jaroslav; Šimko, F.

    2006-01-01

    Roč. 24, č. S6 (2006), s. 395-395 ISSN 0263-6352. [Scientific Meeting of the International Society of Hypertension /21./. 15.10.2006-19.10.2006, Fukuoka] Grant - others:VEGA(SK) 2/6148/26 Institutional research plan: CEZ:AV0Z50110509 Keywords : melatonin * nitric oxide balance * hypertension * SHR and WKY rat * heart and aorta Subject RIV: FA - Cardiovascular Diseases incl. Cardiotharic Surgery

  15. Clinical Aspects on Chimney Stent Graft Technique in Endovascular Repair of the Aorta.

    OpenAIRE

    BinJabr, Adel

    2015-01-01

    Introduction: Open repair of the aorta carries a high risk for morbidity and mortality especially in the elderly population and in patients unfit for major surgery. Endovascular aortic repair is safe, durable and effective when there is adequate proximal and distal sealing zone for the aortic stent graft. Fenestrated and branched stent grafts have made the repair possible for complex but elective cases that do not have an adequate sealing zone. Urgent complex cases and patients with midaortic...

  16. Spironolactone differently influences remodeling of the left ventricle and aorta in L-NAME-induced hypertension

    Czech Academy of Sciences Publication Activity Database

    Šimko, F.; Matúšková, J.; Ľupták, I.; Pinčíková, T.; Krajčírovičová, K.; Štvrtina, S.; Pomšár, J.; Pelouch, V.; Paulis, L.; Pecháňová, Olga

    2007-01-01

    Roč. 56, Suppl.2 (2007), S25-S32 ISSN 0862-8408 Grant - others:VEGA(SK) 1/3429/06; VEGA(SK) 2/6148/26; -(SK) APVT-51-027404 Institutional research plan: CEZ:AV0Z50110509 Keywords : spironolacton * NO-deficient hypertension * remodeling of LV and aorta Subject RIV: FA - Cardiovascular Diseases incl. Cardiotharic Surgery Impact factor: 1.505, year: 2007

  17. Effect of Levodropropizine on isolated rabbit aorta contracted with phenylephrine and its Relationship with calcium

    OpenAIRE

    cankara, fatma nihan; çiçek, ekrem

    2014-01-01

    Objective: The aim of this study was to investigate the relationship between calcium (Ca+2) channels and levodropropizine, also to compare the potency of diltiazem and levodropropizine on phenylephrine pre-contracted rabbit aortic rings. Mateial-Method: 2-3 mm width rings of thoracic aorta were removed and suspended in 25 ml organ baths containing Krebs-Henseleit solution to reach baseline tension. To investigate contraction inhibiting effect of levodropropizine, Ca+2 free Krebs solution was ...

  18. Levosimendan in a neonate with severe coarctation of aorta and low cardiac output syndrome

    Directory of Open Access Journals (Sweden)

    Yann Olivier Boegli

    2013-01-01

    Full Text Available We report successful use of levosimendan after failed balloon angioplasty in a critically ill neonate with coarctation of aorta (CoA and severe low cardiac output syndrome (LCOS. Treatment with levosimendan improved left heart function, and decreased lactate and brain natriuretic peptide levels. To our knowledge, this is the first report on the safe and successful use of levosimendan in the management of LCOS due to severe CoA in a neonate awaiting surgical repair.

  19. Computer-aided patch planning for treatment of complex coarctation of the aorta

    Science.gov (United States)

    Rietdorf, Urte; Riesenkampff, Eugénie; Kuehne, Titus; Huebler, Michael; Meinzer, Hans-Peter; Wolf, Ivo

    2009-02-01

    Between five and eight percent of all children born with congenitally malformed hearts suffer from coarctations of the aorta. Some severe coarctations can only be treated by surgical repair. Untreated, this defect can cause serious damage to organ development or even lead to death. Patch repair requires open surgery. It can affect patients of any age: newborns with severe coarctation and/or hypoplastic aortic arch as well as older patients with late diagnosis of coarctation of the aorta. Another patient group are patients of varying age with re-coarctation of the aorta or hypoplastic aortic arch after surgical and/or interventional repair. If anatomy is complex and interventional treatment by catheterization, balloon angioplasty or stent placement is not possible, surgery is indicated. The choice of type of surgery depends not only on the given anatomy but also on the experience the surgical team has with each method. One surgical approach is patch repair. A patch of a suitable shape and size is sewed into the aorta to expand the aortic lumen at the site of coarctation. At present, the shape and size of the patch are estimated intra-operatively by the surgeon. We have developed a software application that allows planning of the patch pre-operatively on the basis of magnetic resonance angiographic data. The application determines the diameter of the coarctation and/or hypoplastic segment and constructs a patch proposal by calculating the difference to the normal vessel diameter pre-operatively. Evaluation of MR angiographic datasets from 12 test patients with different kinds of aortic arch stenosis shows a divergence of only (1.5+/-1.2) mm in coarctation diameters between manual segmentations and our approach, with comparable time expenditure. Following this proposal the patch can be prepared and adapted to the patient's anatomy pre-operatively. Ideally, this leads to shorter operation times and a better long-term outcome with a reduced rate of residual stenosis and

  20. Mechanism of vasorelaxation induced by Achillea wilhelmsii in rat isolated thoracic aorta

    Directory of Open Access Journals (Sweden)

    Saeed Niazmand

    2014-01-01

    Full Text Available Background: Achillea wilhelmsii (A. wilhelmsii is used in Iraninan folk medicine for the treatment of hypertension; also, in previous reports, the hypotensive and antihypertensive effects of this plant have been indicated. The aim of the present study is to investigate the vasorelaxant effect of the hydroalcholic extract of A. wilhelmsii and its underlying mechanisms in isolated rat aorta. Materials and Methods: The effect of the hydroalcholic A. wilhelmsii extract was tested on the contractile response of Wistar rat aorta induced by potassium chloride (KCl and phenylephrine (PE using a pressure transducer that is connected to the PowerLab. Results: The cumulative concentrations of A. wilhelmsii (0.5-8 mg/ml induced a vasorelaxation both in endothelium-intact and endothelium-denuded aortas precontracted by high K + (6 Χ 10−2 M or 10−6 M PE. A. wilhelmsii, at a concentration of 4 mg/ml, reduced Ca 2+ -induced contraction (P < 0.001 vs. control after PE or KCl had generated a stable contraction in the Ca 2+ -free solution. Furthermore, after incubation with diltiazem, the vasorelaxant effect of A. wilhelmsii reduced in the endothelium-denuded aortas precontracted by PE or KCl (P < 0.001 vs. control. In contrast, A. wilhelmsii-induced relaxation was not affected by glibenclamide, BaCl 2 , ruthenium red, methylene blue, or heparin. Conclusions: The results showed that A. wilhelmsii had a vasorelaxation effect, which was not endothelium-dependent. The relaxation was mediated by inhibition of extracellular Ca 2+ influx through voltage- and receptor-operated Ca 2+ channels (VDDCs and ROCCs in vascular smooth muscle cells.

  1. Prophylactic temporary abdominal aorta balloon occlusion in women with placenta previa accretism during late gestation.

    Science.gov (United States)

    Qiu, Zhongyuan; Hu, Jifen; Wu, Jianbo; Chen, Lihong

    2017-11-01

    To evaluate the clinical efficacy of prophylactic temporary balloon occlusion of the abdominal aorta in patients with placenta previa accretism during cesarean section. Twenty-three consecutive patients, prenatally confirmed with placenta previa accretism were retrospectively analyzed in our center from August 2012 to October 2014. All 23 subjects underwent cesarean section with prophylactic balloon occlusion of the abdominal aorta. All of the 23 subjects experienced singleton pregnancies leading to the birth of live infants. Of these subjects, the following problems were diagnosed: placenta accrete (n = 10), placenta increte (n = 10), and placenta precrete (n = 3). Mean intraoperative hemorrhage was 1170.0 mL. Fifteen patients received red blood cell transfusion with a mean transfusion volume of 2.3 units. The incidence of hysterectomy was 21.74% (5/23) with blood loss ranging from 2000 to 5000 mL (mean 3360.0 mL). One complication encountered in this retrospective study was lower extremity arterial thrombosis. Eighteen patients were followed-up by telephone to 14 months following discharge, all babies were noted to be healthy. Prophylactic abdominal aorta balloon occlusion (ABO) was relatively safe in the treatment of patients with placenta previa accretism. This approach could represent a key aspect in a multidisciplinary algorithm in reducing hemorrhage in abnormal placentation.

  2. Increased albumin permeation in eyes, aorta, and kidney of hypertensive rats fed galactose

    International Nuclear Information System (INIS)

    Tilton, R.G.; LaRose, L.; Chang, K.; Weigel, C.J.; Williamson, J.R.

    1986-01-01

    These experiments were undertaken to determine whether ingestion of galactose increases albumin permeation in the vasculature of hypertensive rats. 50% dextrin (control) or 50% galactose diets were fed to unilaterally nephrectomized, male Sprague-Dawley rats weighing 200 g. Hypertension (systolic pressure >175 mmHg) was induced by weekly IM injections of 25 mg/kg DOCA and 1% saline drinking water; 3 months later 125 I-albumin permeation was assessed in whole eyes, aorta and kidneys. 125 I-albumin permeation was significantly increased in all 3 tissues of hypertensive rats (n = 9) vs controls (n = 9): aorta (3.30 +/- 0.19 (SD) vs 2.87 +/- 0.14), eye (3.15 +/- 0.14 vs 2.59 +/- 0.11), and kidney (6.58 +/- 0.63 vs 3.85 +/- 0.50). Albumin permeation was increased still further in hypertensive rats fed the galactose diet (n = 8): aorta (3.75 +/- 0.38), eye (3.82 +/- 0.17), and kidney (10.74 +/- 3.13). Hypertension +/- galactose feeding had no effect on albumin permeation in lung, skin, or brain. These findings indicate that: (1) hypertension increases albumin permeation in vessels affected by diabetic vascular diseases, and 2) hypertension-induced increases in albumin permeation are increased still further by galactose ingestion, presumably mediated by imbalances in polyol/insitol metabolism (analogous to those induced by diabetes) independent of hyperglycemia and/or insulinopenia

  3. Congenital diseases of the thoracic aorta. Role of MRI and MRA

    International Nuclear Information System (INIS)

    Russo, Vincenzo; Renzulli, Matteo; Palombara, Cesare la; Fattori, Rossella

    2006-01-01

    Aortic malformations may be associated with other congenital heart abnormalities or may present independently, as incidental findings in asymptomatic patients. For more than 30 years, conventional imaging techniques for detection and assessment of congenital anomalies of the aorta have been chest X-ray, echocardiography and angiography. In recent times, considerable interest in congenital aortic diseases has been shown, due to technical progresses of noninvasive imaging modalities. Among them, magnetic resonance imaging (MRI) almost certainly offers the greatest advantages, especially in young patients in which a radiation exposure must be avoided as much as possible. MRI provides an excellent visualization of vascular structures with a wide field of view, well suited for evaluation of the thoracic aorta malformations. With the implementation of magnetic resonance angiography (MRA) it is also possible to depict any relationship with supra-aortic or mediastinal vessels. Phase contrast technique allows identification of the hemodynamic significance of the aortic alteration. Some technical considerations, which include fast spin-echo, gradient-echo and, especially, MRA techniques with phase-contrast and contrast enhanced methods, are discussed and applied in the evaluation of congenital thoracic aorta diseases. (orig.)

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

    International Nuclear Information System (INIS)

    Valentovic, M.A.; Gairola, C.; Lubawy, W.C.

    1982-01-01

    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

  5. Descending aorta-to-femoral artery bypass: preliminary experience with a thoracoscopic technique.

    Science.gov (United States)

    Kolvenbach, R; Da Silva, L; Schwierz, E; Deling, O

    2000-04-01

    Descending aorta-to-femoral artery bypass is a durable procedure with excellent long-term patency rates. The operation is usually performed using a lateral thoracotomy combined with retroperitoneal tunneling of the graft. Assuming that a smaller incision would reduce the operative trauma, minimally invasive video endoscopic techniques were used to perform a thoracoscopic bypass operation. In all patients, exposure of the descending aorta was obtained using thoracoscopy. This was accomplished with a maximum of four ports. For placing the conventional side-biting aortic clamp, a 3- to 4-cm incision was necessary. Using this incision as an access port, the proximal anastomosis was sutured endoscopically. Retroperitoneal tunneling was performed using laparoscopically guided balloon dissection. Eleven consecutive patients underwent surgery. In two patients, conversion to a standard thoracotomy was necessary because of extensive intrathoracic adhesions. There were no major complications, except for one hematoma. After a mean follow-up of 9.5 months, all bypass grafts were still patent. Patients could be discharged after a mean postprocedural hospital stay of 7.4 days (range, 5-12). Thoracoscopic descending aorta-to-femoral artery bypass is an operation with excellent patency rates; however, it is a novel technique that still requires further technical improvements. Clinical studies are needed to prove the safety and efficacy of this minimally invasive technique.

  6. Pharmacological studies of tentacle extract from the jellyfish Cyanea capillata in isolated rat aorta.

    Science.gov (United States)

    Wang, Beilei; Zhang, Bo; Wang, Qianqian; Zhang, Zhi; Nie, Fei; Liu, Guoyan; Zheng, Jiemin; Xiao, Liang; Zhang, Liming

    2013-08-30

    Our previous studies demonstrated that tentacle extract (TE) from the jellyfish, Cyanea capillata, could cause a dose-dependent increase of systolic blood pressure, which seemed to be the result of direct constriction of vascular smooth muscle (VSM). The aim of this study is to investigate whether TE could induce vasoconstriction in vitro and to explore its potential mechanism. Using isolated aorta rings, a direct contractile response of TE was verified, which showed that TE could induce concentration-dependent contractile responses in both endothelium-intact and -denuded aortas. Interestingly, the amplitude of contraction in the endothelium-denuded aorta was much stronger than that in the endothelium-intact one, implying that TE might also bring a weak functional relaxation in addition to vasoconstriction. Further drug intervention experiments indicated that the functional vasodilation might be mediated by nitric oxide, and that TE-induced vasoconstriction could be attributed to calcium influx via voltage-operated calcium channels (VOCCs) from the extracellular space, as well as sarcoplasmic reticulum (SR) Ca²⁺ release via the inositol 1,4,5-trisphosphate receptor (IP₃R), leading to an increase in [Ca²⁺](c), instead of activation of the PLC/DAG/PKC pathway or the sympathetic nerve system.

  7. Pharmacological Studies of Tentacle Extract from the Jellyfish Cyanea capillata in Isolated Rat Aorta

    Directory of Open Access Journals (Sweden)

    Liming Zhang

    2013-08-01

    Full Text Available Our previous studies demonstrated that tentacle extract (TE from the jellyfish, Cyanea capillata, could cause a dose-dependent increase of systolic blood pressure, which seemed to be the result of direct constriction of vascular smooth muscle (VSM. The aim of this study is to investigate whether TE could induce vasoconstriction in vitro and to explore its potential mechanism. Using isolated aorta rings, a direct contractile response of TE was verified, which showed that TE could induce concentration-dependent contractile responses in both endothelium-intact and -denuded aortas. Interestingly, the amplitude of contraction in the endothelium-denuded aorta was much stronger than that in the endothelium-intact one, implying that TE might also bring a weak functional relaxation in addition to vasoconstriction. Further drug intervention experiments indicated that the functional vasodilation might be mediated by nitric oxide, and that TE-induced vasoconstriction could be attributed to calcium influx via voltage-operated calcium channels (VOCCs from the extracellular space, as well as sarcoplasmic reticulum (SR Ca2+ release via the inositol 1,4,5-trisphosphate receptor (IP3R, leading to an increase in [Ca2+]c, instead of activation of the PLC/DAG/PKC pathway or the sympathetic nerve system.

  8. Thoracic and abdominal aortas stiffen through unique extracellular matrix changes in intrauterine growth restricted fetal sheep.

    Science.gov (United States)

    Dodson, R Blair; Rozance, Paul J; Petrash, Carson C; Hunter, Kendall S; Ferguson, Virginia L

    2014-02-01

    Intrauterine growth restriction (IUGR) is a fetal complication of pregnancy epidemiologically linked to cardiovascular disease in the newborn later in life. However, the mechanism is poorly understood with very little research on the vascular structure and function during development in healthy and IUGR neonates. Previously, we found vascular remodeling and increased stiffness in the carotid and umbilical arteries, but here we examine the remodeling and biomechanics in the larger vessels more proximal to the heart. To study this question, thoracic and abdominal aortas were collected from a sheep model of placental insufficiency IUGR (PI-IUGR) due to exposure to elevated ambient temperatures. Aortas from control (n = 12) and PI-IUGR fetuses (n = 10) were analyzed for functional biomechanics and structural remodeling. PI-IUGR aortas had a significant increase in stiffness (P fetal vascular remodeling in PI-IUGR may set the stage for possible altered growth and development and help to explain the pathophysiology of adult cardiovascular disease in previously IUGR individuals.

  9. 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.

  10. Transcriptional and phenotypic changes in aorta and aortic valve with aging and MnSOD deficiency in mice.

    Science.gov (United States)

    Roos, Carolyn M; Hagler, Michael; Zhang, Bin; Oehler, Elise A; Arghami, Arman; Miller, Jordan D

    2013-11-15

    The purpose of this study was to characterize changes in antioxidant and age-related gene expression in aorta and aortic valve with aging, and test the hypothesis that increased mitochondrial oxidative stress accelerates age-related endothelial and aortic valve dysfunction. Wild-type (MnSOD(+/+)) and manganese SOD heterozygous haploinsufficient (MnSOD(+/-)) mice were studied at 3 and 18 mo of age. In aorta from wild-type mice, antioxidant expression was preserved, although there were age-associated increases in Nox2 expression. Haploinsufficiency of MnSOD did not alter antioxidant expression in aorta, but increased expression of Nox2. When compared with that of aorta, age-associated reductions in antioxidant expression were larger in aortic valves from wild-type and MnSOD haploinsufficient mice, although Nox2 expression was unchanged. Similarly, sirtuin expression was relatively well-preserved in aorta from both genotypes, whereas expression of SIRT1, SIRT2, SIRT3, SIRT4, and SIRT6 were significantly reduced in the aortic valve. Expression of p16(ink4a), a marker of cellular senescence, was profoundly increased in both aorta and aortic valve from MnSOD(+/+) and MnSOD(+/-) mice. Functionally, we observed comparable age-associated reductions in endothelial function in aorta from both MnSOD(+/+) and MnSOD(+/-) mice. Interestingly, inhibition of NAD(P)H oxidase with apocynin or gp91ds-tat improved endothelial function in MnSOD(+/+) mice but significantly impaired endothelial function in MnSOD(+/-) mice at both ages. Aortic valve function was not impaired by aging or MnSOD haploinsufficiency. Changes in antioxidant and sirtuin gene expression with aging differ dramatically between aorta and aortic valve. Furthermore, although MnSOD does not result in overt cardiovascular dysfunction with aging, compensatory transcriptional responses to MnSOD deficiency appear to be tissue specific.

  11. Effects of intraoperative electron irradiation in the dog on cell turnover in intact and surgically-anastomosed aorta and intestine

    International Nuclear Information System (INIS)

    Sindelar, W.F.; Morrow, B.M.; Travis, E.L.; Tepper, J.; Merkel, A.B.; Kranda, K.; Terrill, R.

    1983-01-01

    Adults dogs were subjected to laparotomy and intraoperative electron irradiation after division and reanastomosis of aorta or after construction of a blind loop of small intestine having a transverse suture line and an end-to-side anastomosis. Dogs received intraoperative irradiation of both intact and anastomosed aorta or intestine in doses of 0, 2000, 3000, or 4500 rad. Animals were sacrificed at seven days or three months following treatment. At 24 hours prior to sacrifice, dogs received 5 mCi tritiated thymidine intravenously. Irradiated and non-irradiated segments of aorta and small intestine, including intact and anastomotic regions, were analyzed for tritiated thymidine incorporation and were subjected to autoradiography. Incorporation studies showed diminution in tritiated thymidine uptake by irradiated portions of aorta and small intestine, in both intact and anastomotic regions. Autoradiograms revealed that irradiated areas of intact or anastomotic aorta or intestine had diminished labeling of stromal cells, suggesting a lowered cell proliferative capacity of irradiated tissue compared to non-irradiated portions. Inflammatory cells showed similar labeling indices in irradiated and non-irradiated tissues, both intact and surgically-manipulated, suggesting that irradiation does not significantly affect a subsequent local inflammatory response. Radiation-induced decreases in tritiated thymidine incoporation in irradiated aorta and small intestine were generally more marked at seven days than at three months following irradiation, suggesting that radiation-induced depression of cell turnover rates decreases with time

  12. Early impact of aortic wrapping on patients undergoing aortic valve replacement with mild to moderate ascending aorta dilatation

    Directory of Open Access Journals (Sweden)

    Sosnowski Andrzej

    2010-08-01

    Full Text Available Abstract Background The management of mild to moderate dilatation of the ascending aorta of less than 5 cm is controversial, particularly when concomitant surgical correction of aortic valve is required. We investigate the impact of a simple method of aorta reduction using Dacron graft wrapping during aortic valve replacement on the rest of the aorta. Methods We studied 14 patients who had ascending aorta dilatation of 4-5 cm before undergoing aortic wrapping during their aortic valve replacement and compared with their post-operative imaging within a month. Results The diameters of the ascending aorta wrapped with the Dacron graft were significantly reduced within 4 weeks after surgery from 44.7 ± 2.6 to 33.6 ± 3.9 mm (p Conclusions Reduction of ascending aortic dilatation by wrapping with a Dacron graft in this preliminary study is associated with favourable early reversed aortic remodelling. This supports the hypothesis that correction of mild-moderate dilatation of the ascending aorta with Dacron wrapping at the time of aortic valve surgery may prevent the progression of the dilatation, although the long-term study on a larger population is needed to confirm its benefits.

  13. Modeling of coarctation of aorta in human fetuses using 3D/4D fetal echocardiography and computational fluid dynamics.

    Science.gov (United States)

    Chen, Zhuo; Zhou, Yue; Wang, Jingying; Liu, Xiaowei; Ge, Shuping; He, Yihua

    2017-12-01

    We sought to develop a hemodynamic model of aortic and ductal arches using computational fluid dynamics (CFD) and 3D/4D spatio-temporal image correlation (STIC) fetal echocardiography and to investigate the hemodynamics of coarctation of aorta (CoA) in human fetuses using this approach. We obtained 3D/4D STIC fetal echocardiographic images of the aortic and ductal arches (DA) in five normal fetuses. Based on these images, we simulated the hemodynamics in the two arches using CFD. Subsequently, we reduced the dimensions of aortic isthmus from 100% to 85%, 70%, 55%, 40%, and 25% of the original dimension digitally. Numerical simulation was repeated in each condition, and flow profile, velocity, pressure, and wall shear stress (WSS) were compared with those of the baseline normal aortic and ductal arches. With the progressive narrowing in the aortic isthmus, there were alterations in the flow profile, velocity, pressure, and WSS. The downstream vortexes disappeared, and the double helix profile became single helix. When the aortic isthmus reduced by 55% in dimension, there was an exponential increase in velocity and WSS and decrease in pressure. The aortic and ductal arch geometry and flow lead to the alterations in flow profile, velocity, pressure, and WSS in the aortic isthmus in normal and CoA models, which are conductive of ductal issue migration into these areas. A 55% reduction in the dimension of aortic isthmus is associated with exponential change in velocity, pressure, and WSS, a probable threshold for hemodynamically significant CoA. © 2017, Wiley Periodicals, Inc.

  14. 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

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

    International Nuclear Information System (INIS)

    Entezari, Pegah; Kino, Aya; Honarmand, Amir R.; Galizia, Mauricio S.; Yang, Yan; Collins, Jeremy; Yaghmai, Vahid; Carr, James C.

    2013-01-01

    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

  16. Early Cellular Changes in the Ascending Aorta and Myocardium in a Swine Model of Metabolic Syndrome.

    Directory of Open Access Journals (Sweden)

    Rabya Saraf

    Full Text Available Metabolic syndrome is associated with pathological remodeling of the heart and adjacent vessels. The early biochemical and cellular changes underlying the vascular damage are not fully understood. In this study, we sought to establish the nature, extent, and initial timeline of cytochemical derangements underlying reduced ventriculo-arterial compliance in a swine model of metabolic syndrome.Yorkshire swine (n = 8 per group were fed a normal diet (ND or a high-cholesterol (HCD for 12 weeks. Myocardial function and blood flow was assessed before harvesting the heart. Immuno-blotting and immuno-histochemical staining were used to assess the cellular changes in the myocardium, ascending aorta and left anterior descending artery (LAD.There was significant increase in body mass index, blood glucose and mean arterial pressures (p = 0.002, p = 0.001 and p = 0.024 respectively in HCD group. At the cellular level there was significant increase in anti-apoptotic factors p-Akt (p = 0.007 and p = 0.002 and Bcl-xL (p = 0.05 and p = 0.01 in the HCD aorta and myocardium, respectively. Pro-fibrotic markers TGF-β (p = 0.01, pSmad1/5 (p = 0.03 and MMP-9 (p = 0.005 were significantly increased in the HCD aorta. The levels of pro-apoptotic p38MAPK, Apaf-1 and cleaved Caspase3 were significantly increased in aorta of HCD (p = 0.03, p = 0.04 and p = 0.007 respectively. Similar changes in coronary arteries were not observed in either group. Functionally, the high cholesterol diet resulted in significant increase in ventricular end systolic pressure and-dp/dt (p = 0.05 and p = 0.007 respectively in the HCD group.Preclinical metabolic syndrome initiates pro-apoptosis and pro-fibrosis pathways in the heart and ascending aorta, while sparing coronary arteries at this early stage of dietary modification.

  17. Tratamento cirúrgico do abscesso aórtico com descontinuidade ventrículo esquerdo-aorta em endocardite infecciosa Surgical treatment of aortic abscess in infectious endocarditis

    Directory of Open Access Journals (Sweden)

    Antoninho Sanfins Arnoni

    1987-04-01

    Full Text Available A endocardite infecciosa é uma complicação séria, em pacientes portadores de valvopatias, e, algumas vezes, apresenta dificuldades técnicas para sua correção. Uma dessas situações diz respeito a disfunções de próteses colocadas em posição aórtica, ou de valvas naturais aórticas, em que a endocardite leva à descontinuidade entre o ventrículo esquerdo e a aorta, por comprometimento da continuidade mitroaórtica, ou do septo muscular. No Instituto Dante Pazzanese de Cardiologia, operamos 3 pacientes, nos quais havia abscesso em fundo cego, mas provocando grande separação entre o ventrículo esquerdo e a aorta e nos quais a fixação da prótese não poderia ser feita pelas técnicas habituais, nem pela suspensão do folheto anterior da mitral. Nesses casos, reconstruímos a continuidade entre o ventrículo esquerdo e a aorta, empregando retalho de pericárdio bovino e fixando a prótese, em parte, no anel valvar ainda preservado e, em parte, em um anel criado pelos pontos passados no pericárdio implantado. Um desses pacientes faleceu com 26 dias de pós-operatório, por embolia pulmonar, e com a prótese normal. Os 2 outros receberam alta e estão assintomáticos, com 14 e 4 meses de evolução. O último tem discreto refluxo aórtico, ao ecocardiograma.Infectious endocarditis is a serious complication in patients with valve diseases and sometimes presents technical difficulties for its treatment. One of those situations concerns prosthesis dysfunctions placed in aortic position or of natural aortic valves, in which endocarditis causes partial descontinuity between the left ventricle and the aorta by the lesion of the continuity of the mitral-aortic or of the muscular septum. In the Instituto Dante Pazzanese de Cardiologia we operated three patients with closed abscesses but with a great separation between the left ventricle and the aorta in which the fixation of the prosthesis couldn't be done by the usual technique nor by the

  18. 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

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

    Directory of Open Access Journals (Sweden)

    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.

  20. Mycotic aneurysm of the extracranial internal carotid artery - report of a case and review of the literature; Aneurisma micotico da arteria carotida interna extracraniana - relato de um caso e revisao da literatura

    Energy Technology Data Exchange (ETDEWEB)

    Nascimento, Edilene Cristina do; Silva, Ivone Martins da [Pernambuco Univ., Recife, PE (Brazil). Hospital das Clinicas. Servico de Radiologia; Albuquerque, Silvio Cavalcanti de [Instituto Materno Infantil de Pernambuco, Recife, PE (Brazil). Servico de Radiologia; Abath, Carlos [Angiorad, Recife, PE (Brazil)

    1998-08-01

    The authors report a case of mycotic aneurysm of the extracranial internal carotid artery in a 4-year-old- male child, resulting from tonsillar infection. The authors relate the difficulties to initially suggest the diagnosis, stress the importance of the differential diagnosis particularly in children and describe the findings on conventional films, US colour-Doppler, CT and carotid digital subtraction angiography. (author)

  1. Effects of high-salt diet on the activity of angiotensin-converting enzyme and generation of reactive oxygen species in rat aorta.

    Science.gov (United States)

    Arutyunyan, T V; Korystova, A F; Kublik, L N; Levitman, M Kh; Shaposhnikova, V V; Korystov, Yu N

    2014-04-01

    The dynamics of angiotensin-converting enzyme activity in the aorta and blood plasma and generation of ROS in the aorta were studied in rats subjected to two high-salt diets (0.4% and 1% NaCl solutions). During high-salt diets, activity of angiotensin-converting enzyme in the aorta progressively decreased to the minimal during week 1 and remained lower than control level for 1 month. Both diets were followed by a decrease in ROS concentration in the aorta, and this effect was more pronounced when the dosage of salt increased. ROS level in the aorta varied similarly during both diets, but the amplitude of the response was significantly higher in rats receiving 0.4% salt solution. ROS amount in the aorta during high-salt diets differed from the control level and depended from salt dosage and the duration of administration.