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Sample records for aortic arch interruption

  1. Truncus arteriosus with aortic arch interruption: cardiovascular magnetic resonance findings in the unrepaired adult

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    Cook Stephen C; Thavendiranathan Paaladinesh; Arruda Janine; Verhaert David; Raman Subha V

    2010-01-01

    Abstract Truncus arteriosus (TA) is a rare congenital condition defined as a single arterial vessel arising from the heart that gives origin to the systemic, pulmonary and coronary circulations. We discuss the unique case of a 28 year-old female patient with unrepaired TA and interruption of the aortic arch who underwent cardiovascular magnetic resonance (CMR).

  2. [Interruption of the aortic arch with no patent ductus arteriosus: is survival possible?].

    Science.gov (United States)

    Boukhris, M; Hakim, K; Ouarda, F; M'saad, H; Boussaada, R

    2014-03-01

    Interruption of the aortic arch is a rare congenital disease. It is defined by the complete interruption between the ascending and descending aorta. A patent ductus arteriosus is necessary to maintain flow from the pulmonary to the descending aorta. Its closure leads to a cardiovascular collapse and this malformation is therefore duct-dependent. However, in rare cases, survival remains possible even after ductus arteriosus closure. We report such a case. PMID:24457106

  3. Interrupted aortic arch diagnosed by ECG-gated multi-slice computed tomography angiography: a case report

    Institute of Scientific and Technical Information of China (English)

    ZHOU Yang-yang; HAN Ping; FENG Gan-sheng; LIANG Bo

    2005-01-01

    @@ Interrupted aortic arch (IAA) is a rare congenital cardiovascular disease with major intracardiac defects and always with multisystem non-cardiac malformations. It occurs in 1: 10,000 births, and about 1% of the patients with congenital heart defects.

  4. Persistent Fifth Aortic Arch with Coarctation

    Science.gov (United States)

    Kim, Sue Hyun; Choi, Eun-Suk; Cho, Sungkyu; Kim, Woong-Han

    2016-01-01

    Persistent fifth aortic arch (PFAA) is a rare congenital anomaly of the aortic arch frequently associated with other cardiovascular anomalies, such as tetralogy of Fallot and aortic arch coarctation or interruption. We report the case of a neonate with PFAA with coarctation who successfully underwent surgical repair. PMID:26889445

  5. 4-D MRI flow analysis in the course of interrupted aortic arch reveals complex morphology and quantifies amount of collateral blood flow

    Energy Technology Data Exchange (ETDEWEB)

    Hirtler, Daniel [University Hospital Freiburg, Department of Pediatric Cardiology and Congenital Heart Disease, Freiburg (Germany); Geiger, Julia; Jung, Bernd [University Hospital Freiburg, Department of Radiology, Medical Physics, Freiburg (Germany); Markl, Michael [Northwestern University, Departments of Radiology and Biomedical Engineering, Chicago, IL (United States); Arnold, Raoul [University Hospital Heidelberg, Department of Pediatric Cardiology and Congenital Heart Disease, Heidelberg (Germany)

    2013-08-15

    We present findings in a 17-year-old with interrupted aortic arch, in whom standard imaging techniques missed functional and morphological problems. Flow-sensitive four-dimensional magnetic resonance (4-D MR) enabled assessment of the complex anatomy and blood-flow characteristics in the entire aorta and direct quantification of blood flow in collateral vessels. Our findings highlight the entire morphological and functional problem of interrupted aortic arch and illustrate the potential of flow-sensitive 4-D MR for surgical planning in congenital heart disease. (orig.)

  6. Aortic arch malformations

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    Kellenberger, Christian J. [University Children' s Hospital, Department of Diagnostic Imaging, Zuerich (Switzerland)

    2010-06-15

    Although anomalies of the aortic arch and its branches are relatively uncommon malformations, they are often associated with congenital heart disease. Isolated lesions may be clinically significant when the airways are compromised by a vascular ring. In this article, the development and imaging appearance of the aortic arch system and its various malformations are reviewed. (orig.)

  7. Diagnostic Value of Prospective Electrocardiogram-triggered Dual-source Computed Tomography Angiography for Infants and Children with Interrupted Aortic Arch

    Institute of Scientific and Technical Information of China (English)

    Hai-Ou Li; Xi-Ming Wang; Pei Nie; Xiao-Peng Ji; Zhao-Ping Cheng; Jiu-Hong Chen; Zhuo-Dong Xu

    2015-01-01

    Background:Accurate assessment of intra-as well as extra-cardiac malformations and radiation dosage concerns are especially crucial to infants and children with interrupted aortic arch (IAA).The purpose of this study is to investigate the value of prospective electrocardiogram (ECG)-triggered dual-source computed tomography (DSCT) angiography with low-dosage techniques in the diagnosis of IAA.Methods:Thirteen patients with suspected IAA underwent prospective ECG-triggered DSCT scan and transthoracic echocardiography (TTE).Surgery was performed on all the patients.A five-point scale was used to assess image quality.The diagnostic accuracy ofDSCT angiography and TTE was compared with the surgical findings as the reference standard.A nonparametric Chi-square test was used for comparative analysis.P<0.05 was considered as a significant difference.The mean effective radiation dose (ED) was calculated.Results:Diagnostic DSCT images were obtained for all the patients.Thirteen IAA cases with 60 separate cardiovascular anomalies were confirmed by surgical findings.The diagnostic accuracy of TTE and DSCT for total cardiovascular malformations was 93.7% and 97.9% (P>0.05),and that for extra-cardiac vascular malformations was 92.3% and 99.0% (P < 0.05),respectively.The mean score of image quality was 3.77 ± 0.83.The mean ED was 0.30 ± 0.04 mSv (range from 0.23 mSv to 0.39 mSv).Conclusions:In infants and children with IAA,prospective ECG-triggered DSCT with low radiation exposure and high diagnostic efficiency has higher accuracy compared to TTE in detection of extra-cardiac vascular anomalies.

  8. Surgical treatment of interrupted aortic arch associated with ventricular septal defect and patent ductus arteriosus in patients over one year of age

    Institute of Scientific and Technical Information of China (English)

    Li Zhiqiang; Li Bin; Fan Xiangming; Su Junwu; Zhang Jing; He Yan; Liu Yinglong

    2014-01-01

    Background Interrupted aortic arch (IAA) is a rare congenital anomaly affecting 1.5% of infants with congenital heart disease.Neonatal repair of IAA is required to avoid irreversible pulmonary vascular lesion.However,in China,patients with IAA associated with ventricular septal defect (VSD) and patent ductus arteriosus (PDA) over one year of age are common.So we investigated the outcome of surgical treatment of IAA with VSD and PDA in patients over one year of age.Methods From January 2009 to December 2012,19 patients with IAA have undergone complete single-stage repair.The patients' mean age was 4.4 years,ranging 1 to 15 years; and their mean weight was 12.8 kg,ranging 4.2 to 36.0 kg.Fifteen IAA were type A,four were type B.Preoperative cardiac catheterization data were available from all patients.Mean pulmonary arterial pressure (mPAP) and pulmonary vascular resistance (PVR) were measured.The measurements of postoperative pulmonary artery pressure were taken in the operating room at the end of the case.All patients underwent echocardiographic examinations before discharged from the hospital.In addition,cardiac catheterization and echocardiographic examinations were performed during follow-up.Selective brain perfusion through the innominate artery during aortic arch reconstruction was used in all patients.Mean follow-up was (1.6±0.8) years.Results There were two hospital deaths (2/19,11%).One patient died of pulmonary hypertension crisis,and another died of postoperative low cardiac output.Five cases had other main postoperative complications but no postoperative neurologic complications.Seventeen survivors were followed up,and there were no late deaths or reoperation.Mean cross-clamp duration was (85±22) minutes and selective brain perfusion duration was (34±11) minutes.Two patients required delayed sternal closure at two days postoperatively.Intensive care unit and hospital stays were (9±8) days and (47±24) days,respectively.Pressure gradients across

  9. Congenital aortic arch anomalies: diagnosis using contrast enhanced magnetic resonance angiography

    Institute of Scientific and Technical Information of China (English)

    ZHU Ming; ZHONG Yu-min; LI Yu-hua; SUN Ai-min; JIN Biao

    2005-01-01

    @@ Congenital aortic arch anomalies occur most commonly in children. The disease can be classified into three types: ① obstructive congenital abnormalities, including coarctation of aorta (CoA) and interruption of aortic arch (IAA); ② non-obstructive congenital abnormalities, including double aortic arch and others; ③ congenital shunt abnormalities, including different types of patent ductus arteriosus (PDA). Management of patients with congenital aortic arch anomalies relies on imaging. Routine imaging modalities, such as conventional X-ray plain film and transthoracic echocardiography (TTE), have been recently complemented by magnetic resonance imaging (MRI).

  10. Hydatid cyst involving the aortic arch.

    Science.gov (United States)

    Apaydin, Anil Z; Oguz, Emrah; Zoghi, Mehdi

    2007-03-01

    We report a very rare case of primary mediastinal hydatid cyst which invaded the ascending aorta and the aortic arch which initially presented as a cranial mass. Aortic wall is a very unusual site for the hydatid cysts. To the best of our knowledge, this is the first reported case of hydatid cyst located within the aortic arch lumen. Patient underwent ascending aortic and hemiarch replacement under hypothermic circulatory arrest and removal of the cyst. Patient had an uneventful recovery and has been on follow-up. Although the literature data are very limited, we believe that the aortic procedure of choice should be graft interpositon rather than patch repair. PMID:17215134

  11. Congenital anomalies of aortic arch: CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Moon, Yung; Kim, Yang Min; Kim, Tae Hoon; Kim, Mi Young [Sejong General hospial, Seoul (Korea, Republic of); Lee, Jae Young [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of); Kim, Hyung Seok [Cheju Medical Center, Cheju (Korea, Republic of)

    2001-01-01

    Aortic arch anomalies result from the failure of an embryonic vascular structure to persists and regress in the usual manner during formation of the aortic arch. The anomalous aortic arch may encircle and compress the trachea and esophagus as a form of a vascular ring. The diagnosis of aortic arch anomaly and the recognition of airway compression are important because they are conditions which complicate the natural and surgical course of related diseases. CT can demonstrate the nature of anatomic structures such as thr treachea and esophagus not revealed by angiogrphy, simultaneosuly disclosing the relationship of stenotic airways and offending mediastinal vessels. Volumetric data acquisition by means of spiral CT enables three dimensional reconstruction, which can provide easy global understanding for the complex anatomy and spatial relationship of airway and cardiovascular structures. Three dimensional imaging is very useful for the physician and surgeon who are not accustomed to mentally reconstructing axial images, and can facilitate surgical planning.

  12. Bovine aortic arch: A novel association with thoracic aortic dilation

    International Nuclear Information System (INIS)

    Aim: To investigate whether there is a link between bovine arch and thoracic aortic aneurysm. Materials and methods: Computed tomography (CT) and magnetic resonance imaging (MRI) images of the thorax of 191 patients with dilated thoracic aortas and 391 consecutive, unselected patients as controls were retrospectively reviewed. Bovine arch was considered present if either a shared origin of the left common carotid and innominate arteries or an origin of the left common carotid from the innominate artery was identified. A chi-square test was used to evaluate the significance of differences between subgroups. Results: A trend towards increased prevalence of bovine arch was seen in patients with dilated aortas (26.2%) compared to controls (20.5%, p = 0.12). The association was statistically significant in patients over 70 years old (31.9%, p = 0.019) and when dilation involved the aortic arch (47.6%, p = 0.003). Conclusions: An association between bovine arch and aortic dilation is seen in older patients, and when dilation involves the aortic arch. Bovine arch should be considered a potential risk factor for thoracic aortic aneurysm.

  13. Techniques for aortic arch endovascular repair.

    Science.gov (United States)

    kHONGKU, Kiattisak; Dias, Nuno; Sonesson, Bjorn; Resch, Timothy

    2016-06-01

    This article reviews endovascular strategies for aortic arch repair. Open repair remains the gold standard particularly for good risk patients. Endovascular treatment potentially offers a less invasive repair. Principles, technical considerations, devices and outcomes of each technique are discussed and summarized. Hybrid repair combines less invasive revascularization options, instead of arch replacement while extending stent-graft into the arch. Outcomes vary with regard to extent of repair and aortic arch pathologies treated. Results of arch chimney and other parallel graft techniques perhaps make it a less preferable choice for elective cases. However, they are very appealing options for urgent or bailout situations. Fenestrated stent-grafting is subjected to many technical challenges in aortic arch due to difficulties in stent-graft orientation and fenestration positioning. In situ fenestration techniques emerge to avoid these problems, but durability of stent-grafts after fenestration and ischemic consequences of temporary carotid arteries coverage raises some concern total arch repair using this technique. Arch branched graft is a new technology. Early outcomes did not meet the expectation; however the results have been improving after its learning curve period. Refining stent-graft technologies and implantation techniques positively impact outcomes of endovascular approaches. PMID:26940011

  14. Aorta-pulmonary septal defect and aortic origin of the right pulmonary artery with interruption of the aortic arch: a clinical analysis of 5 cases%主-肺动脉间隔缺损及右肺动脉起源于升主动脉合并主动脉弓离断(附5例报告)

    Institute of Scientific and Technical Information of China (English)

    张刚成; 韩霞; 李艳萍; 陶凉

    2011-01-01

    Objective Reviewing the experience in the diagnosis and treatment of cases with aorta-pulmonary septal defect and aortic origin of right pulmonary artery complicated with interruption of the aortic arch. Methods Reviewed clinical data from medical records for5 patients (4 boys and 1 girl, age from 1 to 18 years on admission) who had been treated in Wuhan Asia Heart Hospital between 2005 and 2009. Results All cases had type A interruption of the aortic arch ( according to Celoria and Patron's Classification) , type Ⅱ aorta-pulmonary septal defect( according to Mori Classification) and aortic origin of right pulmonary artery complicated with interruption of the aortic arch. Large patent ductus arteries were observed in all cases,and no cardiac abnormality such as ventricular septal defect was found. All patients received echocardiography and spiral CT examination, and 3 of them over 10 years of age received cardiac catheterization and angiography for the evaluation of the pulmonary artery pressure. Two patients, at the age of 14 and 18 years, had severe pulmonary hypertension and declined to receive the operation. One of the 2 cases had hemoptysis and was given prostacyclin ( Iloprost solution for inhalation, a drug for pulmonary artery hypertention ) for reducing the pulmonary pressure. The patient now has an improved cardiac fu0ction without recurrent hemoptysis. One 14-year-old case gave up the operation because of the financial problem and failed to communicate with us after discharge. Radical surgery was performed in the remaining three cases, one had serious infection in the lung and died 11 days after the operation, in one case ( 2 years old) pulmonary artery hypertension has been persisted even though drug therapy was given for a long time and was found at a poor cardiac function 18 months after the operation. One patient recovered well under routine drug therapy and has been followed-up. Conclusion Aorta-pulmonary septal defect and aortic origin of right

  15. 停循环和局部脑灌在主动脉弓中断手术中的应用%The usefulness of deep hypothermic circulatory arrest and regional cerebral perfusion in interrupted aortic arch

    Institute of Scientific and Technical Information of China (English)

    郭铮; 王伟; 张蔚; 沈佳; 唐嘉忠; 朱德明

    2013-01-01

    Objective To evaluate the effects of deep hypothermic circulatory arrest (DHCA) and regional cerebral perfusion (RCP) in interrupted aortic arch (IAA) corrective surgery.Methods Thirty-one infants younger than 3-month-old with IAA were undergone corrective surgery with DHCA or RCP.The bypass time,aortic clamp time,DHCA or RCP time,hematocrit,ventilation time,ICU stay time and post-operative complications were recorded and compared between two groups.Results The bypass time,aortic clamp time were longer in RCP group,and the RCP time was longer than DHCA time.One postoperative death and two neurological complications took place in DHCA group,while no mortality and neurological complications in RCP group.There were no significant differences in mortality and morbidity between two groups.Conclusion Because complicated surgery is undergone in IAA corrective procedure,RCP technique is safer to protect the brain function.%目的 比较深低温停循环(DHCA)与局部低流量脑灌(RCP)在小儿主动脉弓中断(IAA)纠治手术中的应用效果.方法 总结31例3个月以下的IAA合并室间隔缺损、房间隔缺损的婴儿手术病例,分为DHCA和RCP两组不同的体外循环方式,对术中转流时间,阻断时间,红细胞比容,停循环或脑灌时间,呼吸机插管时间,ICU滞留时间,术后低心排出量,肾功能衰竭,肺部炎症,出凝血障碍,多器官功能障碍,神经系统并发症,院内死亡率等情况进行分析.结果 RCP组手术的体外循环时间,阻断时间及脑灌时间显著长于DHCA组.DHCA组患儿死亡1例,神经系统并发症2例,RCP组无死亡和神经系统并发症,但两组无统计学差异.结论 IAA手术需要较长时间在主动脉上进行操作,采用RCP技术可以更好的保护神经系统功能,减少并发症.

  16. 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.

  17. Isolated right aortic arch: Antenatal evaluation

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    Ali Babacan

    2015-06-01

    Full Text Available Aortic arch abnormalities are the least frequently prenatally diagnosed congenital cardiac abnormalities. Right aortic arch (RAA identified in prenatal period is associated frequently with other cardiac/non-cardiac malformations, notably tracheal or esophageal compression and microdeletions 22q11. Intrauterine and postnatal survey of the fetus depends on these anomalies and their effects. Aortic arc variations, particularly RAA, can be diagnosed accurately by fetal echocardiography. Elaborated fetal cardiac and extracardiac evaluation should be undertaken in all cases of RAA by using Doppler ultrasound. Also cytogenetic testing for 22q11 microdeletions should be considered carefully. Nonetheless, it should be kept in mind that isolated RAA has a good prognosis, and in the majority of the patients, it is an asymptomatic vascular variant with a relatively low risk for chromosomal anomaly. In this paper with this case, we aim to evaluate the prenatal findings, associated conditions and prognosis of prenatally detected RAA anomalies in the light of literatures. J Clin Exp Invest 2015; 6 (2: 192-195

  18. Aortic arch vessel anomalies associated with persistent trigeminal artery.

    Science.gov (United States)

    Lotfi, Mehrzad; Nabavizadeh, Seyed Ali; Foroughi, Amin Abolhasani

    2012-01-01

    Developmental anomalies of the aortic arch vessels and persistent trigeminal artery that is the most common of the four anomalous carotid-basilar anastomoses are repeatedly reported in the literature as separate entities. Herein we report a previously undescribed variant including the coexistence of persistent trigeminal artery, truncus bicaroticus and direct origin of left vertebral artery from aortic arch. PMID:22542381

  19. Right aortic arch with isolation of the left innominate artery in a case of double chamber right ventricle and ventricular septal defect

    Directory of Open Access Journals (Sweden)

    Chirantan Mangukia

    2014-01-01

    Full Text Available Herein, we report an unusual case of right aortic arch with isolation of the left innominate artery in a case of double chamber right ventricle with ventricular septal defect. The blood supply to the innominate artery was by a collateral arising from the descending aorta. The embryological development of this anomaly can be explained by the hypothetical double aortic arch model proposed by Edwards with interruption of the arch at two levels.

  20. Right aortic arch with isolation of the left innominate artery in a case of double chamber right ventricle and ventricular septal defect.

    Science.gov (United States)

    Mangukia, Chirantan; Sethi, Sonali; Agarwal, Saket; Mishra, Smita; Satsangi, Deepak Kumar

    2014-05-01

    Herein, we report an unusual case of right aortic arch with isolation of the left innominate artery in a case of double chamber right ventricle with ventricular septal defect. The blood supply to the innominate artery was by a collateral arising from the descending aorta. The embryological development of this anomaly can be explained by the hypothetical double aortic arch model proposed by Edwards with interruption of the arch at two levels. PMID:24987265

  1. Right aortic arch with isolation of the left innominate artery in a case of double chamber right ventricle and ventricular septal defect

    International Nuclear Information System (INIS)

    Herein, we report an unusual case of right aortic arch with isolation of the left innominate artery in a case of double chamber right ventricle with ventricular septal defect. The blood supply to the innominate artery was by a collateral arising from the descending aorta. The embryological development of this anomaly can be explained by the hypothetical double aortic arch model proposed by Edwards with interruption of the arch at two levels

  2. Giant aortic arch aneurysm complicating Kawasaki′s disease

    OpenAIRE

    Kaouthar Hakim; Rafik Boussada; Lilia Chaker; Fatma Ouarda

    2014-01-01

    Kawasaki disease (KD) is a common acute vasculitis in pediatric population that usually involves small- and middle-sized arteries, commonly coronary arteries. Although the incidence and natural course of coronary aneurysms after KD are well documented in studies, related reports on peripheral arterial and aortic aneurysms are scarce. We report the occurrence of a giant aortic aneurysm involving the horizontal part of aortic arch in a 28-month-old boy diagnosed with KD. This complication was m...

  3. Computed tomography of the venous structure along the aortic arch

    International Nuclear Information System (INIS)

    Computed tomography has proved useful in detecting enlarged aortic arch lymph nodes. Along the aortic arch are there veins which simulate lymph nodes. They include left superior intercostal vein, persistent left superior vena cava and vertical vein. Of 526 mediastinal computed tomograms, 23 (4.4%) showed one or more para-aortic nodular shadows. These shadows were classified into three types according to the shape and number. The left superior intercostal vein appeared as a curvilinear or rounded shadow. Two or more nodular shadows are most likely to be lymph nodes. A single nodular shadow represents either lymph node or vein. (author)

  4. A Review of Diseases of Aortic Arch: Diagnosis by CTA

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    S. Sabouri

    2007-05-01

    Full Text Available The noninvasive revolution in cardiovascular imaging has altered the diagnostic algorithm for all types of acquired and congenital cardiovascular disease. CT techniques are commonly used in the diagnosis of aortic arch and its major branch vessels as well as thoracic and abdominal aortic diseases. CT angiogra-phy combines with CT scans obtained detailed in-formation on precise morphology and extent of dis-ease. Studies were performed on an MDCT unit (4row GE light speed. In infants and small children, the seda-tion rate for CT was lower than that used for patients of similar age undergoing cardiac MR imaging. Seda-tion times ranged between 5 and 10 min, in the pedi-atric population, MDCT was performed with a 1- to 2.5-mm slice thickness in adults, MDCT was per-formed with a 2.5-mm slice thickness with 50% re-construction overlap, pitch 0.75-1.CT angiographic studies were performed with nonionic contrast mate-rial with iodine concentrations of 300 mg/mL admin-istered at a dose of 2-3 mL/kg. Contrast material was injected by power injection, followed by normal sa-line, an automated bolus-tracking technique was used at an injection rate of 2-4 mL/sec. the bolus-tracking device was placed on the ascending aorta. For pa-tients with thoracic outlet syndrome, CT angiogram was performed with neutral position of arm and ab-duction of the arm. Radiologist studied the CT image data in an axial cine paging mode as well as multiplanar reformations. To plan effective management of Aorta disease, CTA is displayed using a combination of 3D images, such as those obtained by multiplanar reformation (MPR, curved planar reformation (CPR, maximum intensity projection (MIP and volume rendering (VR. Case reports include coarctation of aorta, vascular ring, right sided aorta, interrupted aortic arch, abber-ant vessels, paitent ductus arteriosus, subclavian steel syndrome, aneurysm, dissection, thoracic outlet syn-drome, arthritis and atherosclerotic stenosis.

  5. Bare Metal Stenting for Endovascular Exclusion of Aortic Arch Thrombi

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    Mahnken, Andreas H., E-mail: mahnken@med.uni-marburg.de [University Hospital Giessen and Marburg, Philipps University of Marburg, Department of Diagnostic Radiology (Germany); Hoffman, Andras; Autschbach, Ruediger; Damberg, Anneke L. M., E-mail: anneke.damberg@rwth-aachen.de [University Hospital RWTH Aachen, Department of Thoracic, Cardiac and Vascular Surgery (Germany)

    2013-08-01

    BackgroundAortic thrombi in the ascending aorta or aortic arch are rare but are associated with a relevant risk of major stroke or distal embolization. Although stent grafting is commonly used as a treatment option in the descending aorta, only a few case reports discuss stenting of the aortic arch for the treatment of a thrombus. The use of bare metal stents in this setting has not yet been described.MethodsWe report two cases of ascending and aortic arch thrombus that were treated by covering the thrombus with an uncovered stent. Both procedures were performed under local anesthesia via a femoral approach. A femoral cutdown was used in one case, and a total percutaneous insertion was possible in the second case.ResultsBoth procedures were successfully performed without any periprocedural complications. Postoperative recovery was uneventful. In both cases, no late complications or recurrent embolization occurred at midterm follow-up, and control CT angiography at 1 respectively 10 months revealed no stent migration, freely perfused supra-aortic branches, and no thrombus recurrence.ConclusionTreating symptomatic thrombi in the ascending aorta or aortic arch with a bare metal stent is feasible. This technique could constitute a minimally invasive alternative to a surgical intervention or complex endovascular therapy with fenestrated or branched stent grafts.

  6. Computed tomography angiography of hybrid thoracic endovascular aortic repair of the aortic arch.

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    Akhtar, Nila J; Oderich, Gustavo S; Vrtiska, Terri J; Williamson, Eric E; Araoz, Philip A

    2013-05-01

    Endovascular repair of the aorta has traditionally been limited to the abdominal aorta and, more recently, the descending thoracic aorta. However, recently hybrid repairs (a combination of open surgical and endovascular repair) have made endovascular repair of the aortic arch possible. Hybrid repair of the aortic arch typically involves an open surgical debranching procedure that allows for revascularization of the aortic arch vessels and subsequent endovascular stent placement. These approaches avoid the deep hypothermic circulatory arrest required for full, open surgical repair of the aortic arch. In hybrid repairs, the stent landing zone determines which branch vessels will be covered and therefore need revascularization. This article will review the preprocedure assessment with computed tomography angiography, techniques for revascularization and postprocedure complications. PMID:23621141

  7. A Review of Diseases of Aortic Arch: Diagnosis by CTA

    OpenAIRE

    S. Sabouri

    2007-01-01

    The noninvasive revolution in cardiovascular imaging has altered the diagnostic algorithm for all types of acquired and congenital cardiovascular disease. CT techniques are commonly used in the diagnosis of aortic arch and its major branch vessels as well as thoracic and abdominal aortic diseases. CT angiogra-phy combines with CT scans obtained detailed in-formation on precise morphology and extent of dis-ease. Studies were performed on an MDCT unit (4row GE light speed). In infants and small...

  8. Double aortic arches, esophageal atresia and tracheal compression

    OpenAIRE

    Majid Yameen; Warade Monali; Aziz Zarina; Karthik G

    2009-01-01

    We report a case of double aortic arch in a 12-month-old male infant well delineated on 64 slice computed tomography scan. It formed a complete vascular ring around the trachea compressing it. The symptoms resolved after surgical division of the ring.

  9. Branched and fenestrated options to treat aortic arch aneurysms.

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    Maurel, Blandine; Mastracci, Tara M; Spear, Rafaelle; Hertault, Adrien; Azzaoui, Richard; Sobocinski, Jonathan; Haulon, Stephan

    2016-10-01

    Conventional surgical repair of aortic arch aneurysms using cardiopulmonary bypass and hypothermic circulatory arrest remains the gold standard, however it is associated with a substantial mortality and morbidity rate, especially in the elderly. Hybrid techniques avoid aortic cross-clamping and circulatory arrest, but are of limited use and are only applicable to selected patients. The development of new devices to treat aortic arch aneurysms endovascularly has the potential to offer a treatment modality to patients unfit for an open repair. We present the challenges specific to endovascular arch repair based on our experience and the literature available from the first experience in 1999 to the third generation graft currently commonly used. Following an initial learning curve associated with the use of the third generation arch branch device, along with careful patient selection and operator experience, early results are promising. Technical success was achieved in all cases, there was no early mortality and strokes were noted in 11%. As with branched and fenestrated technology for thoracoabdominal aneurysm repair, the use of total endovascular repair for arch pathology will require an evolution in endovascular practice and device design. However, at present, the early use of the latest generation device offers a novel approach to patients who previously had no surgical options. PMID:27332680

  10. Perinatal outcomes and anomalies associated with fetal right aortic arch

    Directory of Open Access Journals (Sweden)

    Ahmet Gül

    2012-09-01

    Full Text Available Objective: To evaluate the prenatal findings, associated anomalies, and prognosis of right aortic arch (RAA anomalies. Material and Methods: All cases referred for detailed ultrasonography and fetal echocardiography between October 2006 and July 2009 were systematically examined for aortic arch anomalies and associated cardiac and extracardiac anomalies. Prenatal findings of all cases with aortic arch anomalies and intracardiac and extracardiac findings were prospectively registered in an electronic database that included fetal echocardiography. Outcomes of the cases were collected postnatally from the patients’ obstetricians, neonatal unit archieves, and pediatric cardiologists. Results: We detected 12 cases of RAA (0.37%; n=12/3200. Mean gestational age at diagnosis was 24 weeks (range, 21–33 weeks. Of the 12 cases of RAA, five (41.7% had a major cardiac defect, including tetralogy of Fallot (n= 3, atrioventricular septal defect (n=1, and ventricular septal defect (n=1. An extracardiac anomaly was observed in three cases (25%. The fetal karyotype was trisomy 21 in one case with increased nuchal translucency (6.6 mm. Microdeletion 22q11 analyses performed in three cases were normal. The postnatal courses of the cases with isolated RAA were uneventful. Two cases associated with major cardiac and extracardiac anomalies were lost in the early neonatal period. The case of trisomy 21 was terminated. The other four cases of RAA with an associated cardiac anomaly are currently in follow up. Conclusion: Aortic arch anomalies, particularly RAA, can be diagnosed by fetal echocardiography. The prognosis for isolated RAA is relatively good compared with that for RAA with associated anomalies.

  11. Interrupção do arco aórtico tipo B em uma paciente com síndrome de olho de gato Interrupción del arco aórtico tipo B en una paciente con síndrome del ojo de gato Interrupted aortic arch type B in A patient with cat eye syndrome

    Directory of Open Access Journals (Sweden)

    Sintia Iole Nogueira Belangero

    2009-05-01

    Full Text Available Relatamos um caso de paciente com Síndrome do Olho de Gato (Cat Eye Syndrome-CES e interrupção do arco aórtico tipo B, um achado típico na síndrome da deleção 22q11.2. A análise cromossômica e a técnica de hibridização fluorescente in situ (FISH mostraram um cromossomo marcador isodicêntrico supranumerário com bi-satélite derivado do cromossomo 22. O segmento de 22pter a 22q11.2 no cromossomo supranumerário encontrado em nosso paciente não estava em sobreposição com a região deletada em pacientes com a síndrome da deleção 22q11.2. Entretanto, o achado de interrupção do arco aórtico tipo B não é usual na CES, mas é um defeito cardíaco freqüente na síndrome da deleção 22q11.Informamos un caso de paciente con Síndrome de Ojo de Gato (Cat Eye Syndrome-CES e Interrupción del Arco Aórtico tipo B, un hallazgo típico en el síndrome de la deleción 22q11.2. El análisis cromosómico y la técnica de hibridación in situ fluorescente (FISH mostraron un cromosoma marcador isodicéntrico supernumerario bisatelitado derivado del cromosoma 22. El segmento de 22pter a 22q11.2 en el cromosoma supernumerario encontrado en nuestro paciente no estaba en sobreposición con la región deletada en pacientes con el síndrome de la deleción 22q11.2. Con todo, el hallazgo de interrupción del arco aórtico tipo B no es usual en el CES, sino que es un defecto cardíaco frecuente en el síndrome de deleción 22q11.We report a patient with cat eye syndrome and interrupted aortic arch type B, a typical finding in the 22q11.2 deletion syndrome. Chromosomal analysis and fluorescent in situ hybridization (FISH showed a supernumerary bisatellited isodicentric marker chromosome derived from chromosome 22. The segment from 22pter to 22q11.2 in the supernumerary chromosome found in our patient does not overlap with the region deleted in patients with the 22q11.2 deletion syndrome. However, the finding of an interrupted aortic arch type B is

  12. Echocardiographic and radiographic imaging of aortic root and arotic arch aneurysm in the horse

    International Nuclear Information System (INIS)

    Aneurysm of the aortic root and the aortic arch were demonstrated in two warm-blooded geldings( 6 and 7 years old) by diagnostic ultrasound and radiology. In case one a severe dilatation of the aortic root and in case two an abnormal position of the endopericardial part of the aortic root was detected with diagnostic ultrasound. In the second case radiology revealed an enlargement of the dilated aortic aneurysm. ln the first case an aneurysm verum spontaneum is probable

  13. Right aortic arch: a report of two cases

    International Nuclear Information System (INIS)

    A right aortic arch (RAA) is a rare congenital abnormality not always clinically manifested. The most common symptoms include dysphagia, dyspnoea on exertion, stridor, and bronchitis, resulting from a vascular ring around the trachea or esophagus. Asymptomatic cases may be viewed in adulthood. The report presents two cases of RAA found coincidentally in adult patients diagnosed using conventional chest X- ray and computed tomography (CT). Case 1 presents an abnormal course of the aortic arch, first manifested as dyspnoea in adulthood. Case 2 presents RAA with the right subclavian artery as a separate branch associated with an abnormal course of the left subclavian artery. Asymptomatic esophageal compression was also found. The abnormality was accompanied by numerous atherosclerotic lesions in peripheral vessels. Abnormal blood flow conditions might have contributed to a faster progression of atherosclerosis. RAA may remain asymptomatic for the entire life. Symptoms are caused by compression of the surrounding structures or impaired blood flow. RAA may be associated with malformations of its branches. (author)

  14. Closed injury of the aortic arch and subsequent formation of a false aneurysm.

    Science.gov (United States)

    Janevski, B

    1983-01-01

    The case history of a 25-year-old man who sustained a blunt trauma to the chest in a car accident and developed a false aneurysm of the aortic isthmus is reported. The injury of the aortic arch was not initially recognized. The diagnosis was established on the chest X-rays and arteriograms obtained 1 year after the trauma. The clinical and radiological signs of closed injuries of the aortic arch are reviewed. PMID:6617430

  15. Markedly hypoplastic circumflex retroesophageal right aortic arch: MR imaging and surgical implications

    International Nuclear Information System (INIS)

    Circumflex retroesophageal right aortic arch with a markedly hypoplastic retroesophageal segment is a rare anomaly of the aortic arch. Adequate surgical management relies on precise diagnosis, which might not be feasible with echocardiography. To demonstrate the utility of MR imaging in establishing the diagnosis and to describe potential pitfalls in making the diagnosis. Three patients with a circumflex retroesophageal right aortic arch with a markedly hypoplastic retroesophageal segment were retrospectively evaluated. All patients underwent evaluation by echocardiography and MR imaging. The MR imaging consisted of 3-D MR angiography in two patients and fast gradient recalled echo with cardiac-triggered segmented acquisition in one patient. Surgical confirmation was obtained on all three patients. The arch anatomy was accurately depicted in all three patients by MR imaging and in none of the patients by echocardiography. MR imaging is extremely useful in establishing the diagnosis of markedly hypoplastic retroesophageal circumflex right aortic arch and thus helps in surgical planning. (orig.)

  16. The position of the trachea in infants and children with right aortic arch

    International Nuclear Information System (INIS)

    In infants, the site of the aortic is frequently inferred from the position of the intrathoracic trachea. We retrospectively reviewed the plain frontal chest radiographs of 72 patients with cyanotic congenital heart disease and right aortic arch documented by cardiac catheterization. In infants, the position of the trachea was variable: 47% had the trachea on the right, 33% had the trachea midline and in 7% the trachea was on the left. As the child grows, the aortic arch progressively indents the trachea, and the descending aorta is better visualized. Since the position of the trachea in infants with right aortic arch is variable, one must be cautious in inferring the site of the aortic arch by the position of the trachea. (orig.)

  17. Bacteroides fragilis aortic arch pseudoaneurysm: case report with review

    Directory of Open Access Journals (Sweden)

    Yang Yu-Jen

    2008-05-01

    Full Text Available Abstract We present a case of 58-year-old woman with underlying diabetes mellitus, hepatitis C virus-related liver cirrhosis, and total hysterectomy for uterine myoma 11 moths ago, who was diagnosed ruptured aortic arch mycotic pseudoaneurysm after a certain period of survey for her unknown fever cause. After emergent surgery with prosthetic graft interposition, all her blood cultures and tissue cultures revealed pathogen with Bacteroides fragilis. Although mycotic aneurysms have been well described in literatures, an aneurysm infected solely with Bacteroides fragilis is unusual, with only eight similar cases in the literature. Here we reported the only female case with her specific clinical and management course and summarized all reported cases of mycotic aneurysm caused by Bacteroides fragilis to clarify their conditions and treatments, alert the difficulty in diagnosis, and importance of highly suspicious.

  18. Cine magnetic resonance imaging study of blood flow and wall motion of the aortic arch

    International Nuclear Information System (INIS)

    The aortic arch has 3D distortions in the transverse arch in the axial view, and we previously reported that this distortion is a risk factor in the pathogenesis of arch aneurysms. In this study, we evaluated blood flow and movement of the aortic arch. In 10 healthy young volunteers, ECG-gated cine magnetic resonance imaging was carried out in the axial plane of the transverse arch, the coronal plane of the ascending arch, and the long axial plane along the entire arch. Left anterolateral movements around the midpoint of the transverse arch in the systolic phase were observed in all of the men (6.3±1.59 mm) and women (4.8±0.73 mm). A jet flow was detected in the systolic phase along the right side of the aortic wall. At the top of the plane, this jet flow turned to the left in a clockwise rotation in the anterior view. In the long axial plane, a turbulent flow in the systolic phase was observed distal to the left subclavian arterial orifice in 6 of the 7 cases. In conclusion, this turbulent flow and left anterolateral wall motion of the transverse arch are due to anatomical three-dimensional distortion of the transverse arch. We propose that these phenomena may be important risk factors in the pathogenesis of arch aneurysms. (author)

  19. Prenatal diagnosis of tetralogy of Fallot with a double aortic arch.

    Science.gov (United States)

    Cheng, Andrew L; Pruetz, Jay D; Kung, Grace C

    2016-06-01

    In this study, we present a case of prenatally diagnosed tetralogy of Fallot with a double aortic arch, correlating images from fetal echocardiography, transthoracic echocardiography, and cardiac MRI. PMID:26983561

  20. Imaging a boa constrictor--the incomplete double aortic arch syndrome.

    Science.gov (United States)

    Narayan, Rajeev L; Kanwar, Anubhav; Jacobi, Adam; Sanz, Javier

    2012-11-01

    Incomplete double aortic arch is a rare anomaly resulting from atresia rather than complete involution in the distal left arch resulting in a non-patent fibrous cord between the left arch and descending thoracic aorta. This anatomic anomaly may cause symptomatic vascular rings, leading to stridor, wheezing, or dysphagia, requiring surgical transection of the fibrous cord. Herein, we describe an asymptomatic 59 year-old man presenting for contrast-enhanced CT angiography to assess cardiac anatomy prior to radiofrequency ablation, who was incidentally found to have an incomplete double aortic arch with hypoplasia of the left arch segment and an aortic diverticulum. Recognition of this abnormality by imaging is important to inform both corrective surgery in symptomatic patients, as well as assist in the planning of percutaneous coronary and vascular interventions. PMID:22542042

  1. Blunt Traumatic Aortic Injury of Right Aortic Arch in a Patient with an Aberrant Left Subclavian Artery

    Science.gov (United States)

    Yeo, Daryl Li-Tian; Haider, Sajjad; Zhen, Claire Alexandra Chew

    2015-01-01

    Right-sided aortic arch (RAA) is a rare congenital developmental variant present in about 0.1 percent of the population. This anatomical anomaly is commonly associated with congenital heart disease and complications from compression of mediastinal structures. However, it is unknown if patients are at a higher risk of blunt thoracic aortic injury (BTAI). We report a case of a 20-year-old man admitted to the hospital after being hit by an automobile. Computed tomographic scan revealed an RAA with an aberrant left subclavian artery originating from a Kommerell’s diverticulum. A pseudo-aneurysm was also seen along the aortic arch. A diagnosis of blunt traumatic aortic injury was made. The patient was successfully treated with a 26mm Vascutek hybrid stentgraft using the frozen elephant trunk technique. A literature review of the pathophysiology of BTAI was performed to investigate if patients with right-sided aortic arch are at a higher risk of suffering from BTAI. Results from the review suggest that although theoretically there may be a higher risk of BTAI in RAA patients, the rarity of this condition has prevented large studies to be conducted. Previously reported cases of BTAI in RAA have highlighted the possibility that the aortic isthmus may be anatomically weak and therefore prone to injury. We have explored this possibility by reviewing current literature of the embryological origins of the aortic arch and descending aorta. PMID:25745378

  2. 11 cm Haughton D left cervical aortic arch aneurysm

    OpenAIRE

    Kaul, Pankaj

    2013-01-01

    A 56 year old Caucasian man presented with sudden loss of consciousness while driving and was found to have an 11 cm Haughton D type left cervical aortic arch aneurysm with normal brachiocephalic branching and normal descending thoracic laterality but with considerable tortuosity and redundancy of aortic arch. The aneurysm arose between the left common carotid artery and the left subclavian artery. It compressed and stretched the left common carotid artery, compressed the pulmonary trunk and ...

  3. Early Results of Chimney Technique for Type B Aortic Dissections Extending to the Aortic Arch

    International Nuclear Information System (INIS)

    ObjectiveTo summarize our early experience gained from the chimney technique for type B aortic dissection (TBAD) extending to the aortic arch and to evaluate the aortic remodeling in the follow-up period.MethodsFrom September 2011 to July 2014, 27 consecutive TBAD patients without adequate proximal landing zones were retrograde analyzed. Chimney stent-grafts were deployed parallel to the main endografts to reserve flow to branch vessels while extending the landing zones. In the follow-up period, aortic remodeling was observed with computed tomography angiography.ResultsThe technical success rate was 100 %, and endografts were deployed in zone 0 (n = 3, 11.1 %), zone 1 (n = 18, 66.7 %), and zone 2 (n = 6, 22.2 %). Immediately, proximal endoleaks were detected in 5 patients (18.5 %). During a mean follow-up period of 17.6 months, computed tomography angiography showed all the aortic stent-grafts and chimney grafts to be patent. Favorable remodeling was observed at the level of maximum descending aorta and left subclavian artery with expansion of true lumen (from 18.4 ± 4.8 to 25 ± 0.86 mm, p < 0.001 and 27.1 ± 0.62 to 28.5 ± 0.37 mm, p < 0.001) and depressurization of false lumen (from 23.7 ± 2.7 to 8.7 ± 3.8 mm, p < 0.001, from 5.3 ± 1.2 to 2.1 ± 2.1 mm, p < 0.001). While at the level of maximum abdominal aorta, suboptimal remodeling of the total aorta (from 24.1 ± 0.4 to 23.6 ± 1.5 mm, p = 0.06) and true lumen (from 13.8 ± 0.6 to 14.5 ± 0.4 mm, p = 0.08) was observed.ConclusionBased on our limited experience, the chimney technique with thoracic endovascular repair is demonstrated to be promising for TBAD extending to the arch with favorable aortic remodeling

  4. Early Results of Chimney Technique for Type B Aortic Dissections Extending to the Aortic Arch

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Chen [Affiliated Hospital of Nantong University, Department of General Surgery (China); Tang, Hanfei; Qiao, Tong; Liu, Changjian; Zhou, Min, E-mail: 813477618@qq.com [The Affiliated Hospital of Nanjing University Medical School, Department of Vascular Surgery, Nanjing Drum Tower Hospital (China)

    2016-01-15

    ObjectiveTo summarize our early experience gained from the chimney technique for type B aortic dissection (TBAD) extending to the aortic arch and to evaluate the aortic remodeling in the follow-up period.MethodsFrom September 2011 to July 2014, 27 consecutive TBAD patients without adequate proximal landing zones were retrograde analyzed. Chimney stent-grafts were deployed parallel to the main endografts to reserve flow to branch vessels while extending the landing zones. In the follow-up period, aortic remodeling was observed with computed tomography angiography.ResultsThe technical success rate was 100 %, and endografts were deployed in zone 0 (n = 3, 11.1 %), zone 1 (n = 18, 66.7 %), and zone 2 (n = 6, 22.2 %). Immediately, proximal endoleaks were detected in 5 patients (18.5 %). During a mean follow-up period of 17.6 months, computed tomography angiography showed all the aortic stent-grafts and chimney grafts to be patent. Favorable remodeling was observed at the level of maximum descending aorta and left subclavian artery with expansion of true lumen (from 18.4 ± 4.8 to 25 ± 0.86 mm, p < 0.001 and 27.1 ± 0.62 to 28.5 ± 0.37 mm, p < 0.001) and depressurization of false lumen (from 23.7 ± 2.7 to 8.7 ± 3.8 mm, p < 0.001, from 5.3 ± 1.2 to 2.1 ± 2.1 mm, p < 0.001). While at the level of maximum abdominal aorta, suboptimal remodeling of the total aorta (from 24.1 ± 0.4 to 23.6 ± 1.5 mm, p = 0.06) and true lumen (from 13.8 ± 0.6 to 14.5 ± 0.4 mm, p = 0.08) was observed.ConclusionBased on our limited experience, the chimney technique with thoracic endovascular repair is demonstrated to be promising for TBAD extending to the arch with favorable aortic remodeling.

  5. Abnormal aortic arch morphology in Turner syndrome patients is a risk factor for hypertension.

    Science.gov (United States)

    De Groote, Katya; Devos, Daniël; Van Herck, Koen; Demulier, Laurent; Buysse, Wesley; De Schepper, Jean; De Wolf, Daniël

    2015-09-01

    Hypertension in Turner syndrome (TS) is a multifactorial, highly prevalent and significant problem that warrants timely diagnosis and rigorous treatment. The objective of this study was to investigate the association between abnormal aortic arch morphology and hypertension in adult TS patients. This was a single centre retrospective study in 74 adult TS patients (age 29.41 ± 8.91 years) who underwent a routine cardiac MRI. Patients were assigned to the hypertensive group (N = 31) if blood pressure exceeded 140/90 mmHg and/or if they were treated with antihypertensive medication. Aortic arch morphology was evaluated on MRI images and initially assigned as normal (N = 54) or abnormal (N = 20), based on the curve of the transverse arch and the distance between the left common carotid-left subclavian artery. We additionally used a new more objective method to describe aortic arch abnormality in TS by determination of the relative position of the highest point of the transverse arch (AoHP). Logistic regression analysis showed that hypertension is significantly and independently associated with age, BMI and abnormal arch morphology, with a larger effect size for the new AoHP method than for the classical method. TS patients with hypertension and abnormal arch morphology more often had dilatation of the ascending aorta. There is a significant association between abnormal arch morphology and hypertension in TS patients, independent of age and BMI, and not related to other structural heart disease. We suggest that aortic arch morphology should be included in the risk stratification for hypertension in TS and propose a new quantitative method to express aortic arch morphology. PMID:24935217

  6. Successful repair of a syphilitic aortic arch aneurysm accompanied by serious cerebral infarction.

    Science.gov (United States)

    Sato, Katsutoshi; Chiba, Kiyoshi; Koizumi, Nobusato; Ogino, Hitoshi

    2014-01-01

    We present a 52-year-old male with a syphilitic aortic arch aneurysm accompanied by relevant extensive cerebral infarction. He was admitted to a local hospital for sudden loss of consciousness, where he was diagnosed with serious cerebral infarction. During his treatment, a multilocular aortic arch aneurysm involving the arch vessels was found incidentally. He was transferred to our hospital for surgical treatment. A preoperative routine laboratory test for syphilis was highly positive, which suggested that the aneurysm was likely caused by syphilis and the cerebral infarction was also induced by the involvement of syphilitic aortitis or arteritis. After 2 weeks of antibiotic therapy for syphilis, total arch replacement was performed successfully using meticulous brain protection with antegrade selective cerebral perfusion and deep hypothermia. He recovered without any further cerebral deficits. The pathological examination of the surgical specimen showed some characteristic changes of syphilitic aortitis. PMID:24492165

  7. Tracheal compression due to an elongated aortic arch in patients with congenital heart disease: evaluation using multidetector-row CT

    Energy Technology Data Exchange (ETDEWEB)

    Watanabe, Noriko; Hayabuchi, Yasunobu; Inoue, Miki; Sakata, Miho; Nabo, Manal Mohamed Helmy; Nakagawa, Ryuji; Saijo, Takahiko; Kagami, Shoji [University of Tokushima, Department of Pediatrics, Tokushima (Japan)

    2009-10-15

    The airway can become obstructed as a result of compression by an elongated aortic arch. In this study we evaluated tracheal compression using multidetector-row CT in patients with congenital heart disease and an elongated aortic arch. The trachea was measured at the level of the aortic arch in 205 children and young adults and then the severity of tracheal compression was determined by measuring the tracheal diameter ratio (short axis diameter/long axis diameter). Patients were divided as follows: group I (normal aortic arch; n=166), group II (transversely running aortic arch; n=22), and group III (elongated aortic arch; n=17). From the viewpoint of the relationship of the great arteries, group II had D-malposition, and group III had L-malposition. Age, height, weight and body surface area were significantly correlated with the short and long axis diameter in group I. There was a negative correlation between tracheal diameter ratio and the physical size parameters. The tracheal diameter ratio in group III was 0.50{+-}0.13, which was significantly lower than in groups I and II (P<0.01 and 0.05, respectively). Even apparently asymptomatic patients with an elongated aortic arch can have tracheal compression. An elongated aortic arch may be a useful predictor of tracheal compression. (orig.)

  8. Shared and discrepant susceptibility for carotid artery and aortic arch calcification: A genetic association study.

    Science.gov (United States)

    Zhang, Yumeng; Wang, Li; Zhang, Zhizhong; Zhang, Zongjun; Zhou, Shuyu; Cao, Liping; Cai, Biyang; Liu, Keting; Bai, Wen; Xie, Xia; Fan, Wenping; Liu, Xinfeng; Lu, Guangming; Xu, Gelin

    2015-08-01

    Genome-wide association studies (GWASs) have identified several risk loci for coronary artery calcification. Four single-nucleotide polymorphisms (SNPs, rs1537370, rs1333049, rs2026458 and rs9349379) were associated with coronary artery calcification with P values less than 5 × 10(-8) in GWASs. It is unclear if these associations exist in other vascular beds. Thus, we evaluated the impacts of these four SNPs on carotid artery and aortic arch calcification in this study. Computed tomography was applied to quantify the calcification of carotid artery and aortic arch. 860 patients with stroke completed calcification quantification and genotype testing were included in data analysis. Each SNP was evaluated for the association with carotid artery calcification, and with aortic arch calcification using generalized linear model. Among the four tested SNPs, rs2026458 was associated with calcification in both carotid artery (β = 0.31, 95% confidence interval [CI] 0.10-0.52, P = 0.003) and aortic arch (β = 0.32, 95% CI 0.10-0.54, P = 0.004), while rs1333049 was only associated with carotid artery calcification (β = 0.28, 95% CI 0.06-0.50, P = 0.011). In gender-stratified analyses, rs2026458 had significant impacts on carotid artery (P = 0.003) and aortic arch calcification (P = 0.008) in male, but not in female patients; while rs1537370 was significantly associated with carotid artery calcification in female (P = 0.013), but not in male patients. In conclusion, SNPs associated with coronary artery calcification may also increase the risk of calcification in other arteries such as carotid artery and aortic arch. PMID:26071660

  9. Inflammatory aortic arch syndrome: contrast-enhanced, three-dimensional MR - angiography in stenotic lesions

    International Nuclear Information System (INIS)

    Purpose: To determine the value of contrast-enhanced, three-dimensional MR angiography for the evaluation of stenotic and occlusive vascular lesions in inflammatory aortic arch syndrome. Materials and Methods: 14 patients with inflammatory aortic arch syndrome (giant cell arteritis: n = 8, Takayasu arteritis: n = 4, ankylosing spondylitis: n = 1 sarcoidosis: n = 1) underwent MR angiography of the aortic arch and the supra-aortic vessels (n = 15,2 patients were examined twice) and of the abdominal aorta (n = 2). MRA was performed using a 3D-FLASH sequence (TR/TE 4.6/1.8 ms, flip angle 30 ) on a 1.5T system. MRA imaging was compared with the findings of DSA, which served as gold standard. Results: In a total of 467 examined vascular territories, DSA revealed 50 stenoses and 35 occlusions. All lesions were detected by MRA. In 23 segments, the degree of stenosis was overestimated by MRA. Sensitivity and specificity of MRA were 100% and 94,3%, positive and negative predictive values were 73.6 and 100%, and the accuracy was 95,1%. Conclusions: Despite a tendency to overestimate stenoses, contrast-enhanced three-dimensional MR angiography is a valid, non-invasive technique in the assessment of inflammatory aortic arch syndrome. (orig.)

  10. Invasive aspergillosis in the aortic arch with infectious Aspergillus lesions in pulmonary bullae

    Directory of Open Access Journals (Sweden)

    Isao Watanabe

    2015-03-01

    Full Text Available A patient with pulmonary bullae died of massive hemoptysis. At autopsy a hole was observed in the aortic wall. A microscopic examination indicated small Aspergillus lesions in pulmonary bullae and extensive necrotic lesions with Aspergillus hyphae in the media of the thoracic aorta. These findings led to a diagnosis of invasive aspergillosis in the aortic arch. This is a rare case in which Aspergillus invaded the aorta in a patient without hematologic neoplasms or neutropenia.

  11. Right-sided aortic arch with anomalous origin of the left subclavian artery: Case report

    Directory of Open Access Journals (Sweden)

    Vučurević Goran

    2011-01-01

    Full Text Available Introduction. A right-sided aortic arch is a rare congenital defect of the aorta with incidence of 0.05% to 0.1% reported in published series. Usually it is associated with congenital heart anomalies and esophageal and tracheal compression symptoms. We present a case of a right-sided aortic arch of anomalous left subclavian artery origin, accidentally revealed during multislice CT (MSCT supraaortic branches angiography. Case Outline. A 53-year-old female patient was examined at the Outpatients’ Unit of the Vascular Surgery University Clinic for vertigo, occasional dizziness and difficulty with swallowing. Physical examination revealed a murmur of the left supraclavicular space, with 15 mmHg lower rate of arterial tension on the left arm. Ultrasound of carotid arteries revealed 60% stenosis of the left subclavian artery and bilateral internal carotid artery elongation. MSCT angiography revealed a right-sided aortic arch with aberrant separation of the left subclavian artery that was narrowed 50%, while internal carotid arteries were marginally elongated. There was no need for surgical treatment or percutaneous interventions, so that conservative treatment was indicated. Conclusion. A right-sided aortic arch is a very rare anomaly of the location and branching of the aorta. Multislice CT angiography is of great importance in the diagnostics of this rare disease.

  12. Double aortic arch as a source of airway obstruction in a child

    Directory of Open Access Journals (Sweden)

    Sambhunath Das

    2015-01-01

    Full Text Available Double aortic arch (DAA is a congenital vascular anomaly. The diagnosis was difficult till the child was symptomatic, and other causes were ruled out. We present the interesting images of a child of respiratory distress because of tracheal compression from DAA.

  13. [Antegrade unilateral perfusion of the brain through the brachiocephalic trunk in operations on the aortic arch].

    Science.gov (United States)

    Kozlov, B N; Panfilov, D S; Kuznetsov, M S; Ponomarenko, I V; Nasrashvili, G G; Shipulin, V M

    2016-01-01

    Presented herein is a technique of unilateral antegrade perfusion of the brain in operations on the aortic arch. The method makes it possible to perform both systemic artificial circulation and adequate physiological perfusion of the brain, promoting minimization of the number of neurological complications. PMID:27100557

  14. Double aortic arch with double aneuploidy-rare anomaly in combined Down and Klinefelter syndrome

    NARCIS (Netherlands)

    M.F. Gerretsen; W. Peelen; L.A.J. Rammeloo; D.R. Koolbergen; J. Hruda

    2009-01-01

    A 14-month-old boy with double aneuploidy and a double aortic arch suffered from frequently recurrent severe feeding and respiratory problems. Chromosomal analysis showed a 48,XXY + 21 karyotype: a double aneuploidy of Down syndrome (DS) and Klinefelter syndrome (KS). Only four cases of double aneup

  15. Pitfalls of digital angiography in the diagnosis of right aortic arch

    International Nuclear Information System (INIS)

    The authors describe the difficulties using intravenous digital subtraction angiography, in diagnosing on a left anterior oblique view a right aortic arch with aberrant left subclavian artery and left descending aorta. The proximal topography of the left common carotid artery ostium is a useful sign in the diagnosis of this kind of abnormality. (orig.)

  16. Prenatal diagnosis of the rare association of common arterial trunk and double aortic arch

    OpenAIRE

    Rock, Andrea; Eltayeb, Osama; Camarda, Joseph; Gotteiner, Nina

    2016-01-01

    Key Clinical Message Common arterial trunk with associated double aortic arch is a very rare constellation of congenital heart disease. Prenatal diagnosis allows for surgical repair prior to development of respiratory morbidity, which is otherwise described in all cases with this association.

  17. Aortic Arch Vessel Anomalies Associated with Persistent Trigeminal Artery: (Report of a Case

    Directory of Open Access Journals (Sweden)

    M. Lotfi

    2008-01-01

    Full Text Available Introduction: Developmental anomalies of the aortic arch vessels are well described entities. Persistent trigeminal artery (PTA is the most common type of the four anomalous carotid-basilar anastomoses, and is due to abnormal persistence of what are normal transient communications between the embryonic forebrain and hindbrain arterial systems. Herein we report a previously undescribed variant consisting of coexistence of the PTA, truncus bicaroticus, and di-rect origin of left vertebral artery from aortic arch. "nCase Presentation: A 46 year-old man was admitted in the Namazi hospital with severe nausea, vomiting, severe headache, and decreased level of conscious-ness. Computed tomography scan revealed intraven-tricular hemorrhage with no evidence of subarach-noid hemorrhage. The patient was referred for four-vessel cerebral arteriography to evaluate the entire cerebral vascular anatomy. Arch aortography demon-strated the right subclavian artery as the first branch of the arch. The left vertebral artery arose directly from the arch as the second branch. The third branch consisted of a common trunk giving rise to the right and left common carotid arteries (Truncus Bicaroti-cus. The left subclavian artery arose as the final branch of the aortic arch. Selective angiography con-firmed that left vertebral artery did not arise from the left subclavian artery. Left vertebral artery angiogra-phy revealed a persistent trigeminal artery, with fill-ing of left internal carotid artery and its branches. No aneurysm or any other vascular abnormality was de-tected in this patient. The patient was subsequently managed by evacuation of IVH and ventriculostomy."nDiscussion: The usual configuration of three branches from the aortic arch is found in 60-80% of popula-tion. The left vertebral artery normally originate along the superior portion of the left subclavian ar-tery. However, this artery is subject to a number of variations; among all; the most common

  18. Pattern-based approach to fetal congenital cardiovascular anomalies using the transverse aortic arch view on prenatal cardiac MRI

    Energy Technology Data Exchange (ETDEWEB)

    Dong, Su-Zhen; Zhu, Ming [Shanghai Jiaotong University School of Medicine, Department of Radiology, Shanghai Children' s Medical Center, Shanghai (China)

    2015-05-01

    Fetal echocardiography is the imaging modality of choice for prenatal diagnosis of congenital cardiovascular anomalies. However, echocardiography has limitations. Fetal cardiac magnetic resonance imaging (MRI) has the potential to complement US in detecting congenital cardiovascular anomalies. This article draws on our experience; it describes the transverse aortic arch view on fetal cardiac MRI and important clues on an abnormal transverse view at the level of the aortic arch to the diagnosis of fetal congenital cardiovascular anomalies. (orig.)

  19. Pattern-based approach to fetal congenital cardiovascular anomalies using the transverse aortic arch view on prenatal cardiac MRI

    International Nuclear Information System (INIS)

    Fetal echocardiography is the imaging modality of choice for prenatal diagnosis of congenital cardiovascular anomalies. However, echocardiography has limitations. Fetal cardiac magnetic resonance imaging (MRI) has the potential to complement US in detecting congenital cardiovascular anomalies. This article draws on our experience; it describes the transverse aortic arch view on fetal cardiac MRI and important clues on an abnormal transverse view at the level of the aortic arch to the diagnosis of fetal congenital cardiovascular anomalies. (orig.)

  20. Modelling and numerical simulation of the human aortic arch under in vivo conditions.

    Science.gov (United States)

    García-Herrera, Claudio M; Celentano, Diego J

    2013-11-01

    This work presents the modelling and simulation of the mechanical behaviour of the human aortic arch under in vivo conditions with pressure levels within the normal and hypertension physiological range. The cases studied correspond to young and aged arteries without cardiovascular pathologies. First, the tissue of these two groups is characterised via in vitro tensile test measurements that make it possible to derive the material parameters of a hyperelastic isotropic constitutive model. Then, these material parameters are used in the simulation of young and aged aortic arches subjected to in vivo normal and hypertension conditions. Overall, the numerical results were found not only to provide a realistic description of the mechanical behaviour of the vessel but also to be useful data that allow the adequate definition of stress/stretch-based criteria to predict its failure. PMID:23371524

  1. Aortic Arch Atherosclerosis in Ischaemic Stroke of Unknown Origin Affects Prognosis

    OpenAIRE

    Abe, Arata; Harada-Abe, Mina; Ueda, Masayuki; Katano, Takehiro; Nakajima, Masataka; Muraga, Kanako; Suda, Satoshi; Nishiyama, Yasuhiro; Okubo, Seiji; Mishina, Masahiro; Katsura, Ken-ichiro; Katayama, Yasuo

    2014-01-01

    Background Cerebral infarction of unknown origin at admission accounts for half of all cerebral infarction cases in some institutions. However, the factors associated with cerebral infarction prognosis have not been sufficiently examined. Here, we investigated whether aortic arch plaques (AAPs) on transoesophageal echocardiography (TOE) were associated with the prognosis of cerebral infarction of unknown origin at admission. Methods Of 571 patients who were hospitalised between June 2009 and ...

  2. Right-Sided Aortic Arch with Aberrant Left Subclavian Artery from Kommerell's Diverticulum

    Directory of Open Access Journals (Sweden)

    M.Y. Mubarak

    2011-06-01

    Full Text Available A previously healthy 52-year-old man had a chest radiograph for medical check-up and found to have a right-sided aortic arch. Computed tomography of the thorax revealed a right-sided aorticarch with aberrant left subclavian artery originated from Kommerell's diverticulum. Barium swallow examination showed compression of the posterior wall of the esophagus. He was asymptomatic and no surgical intervention was performed.

  3. Carbon Dioxide in the Aortic Arch: Coronary Effects and Implications in a Swine Study

    International Nuclear Information System (INIS)

    Purpose: CO2 angiography is considered dangerous in the aortic arch where bubbles may cause critical cerebral and cardiac ischemia. We investigated CO2distribution, physiologic effects in the heart, methods of detection and treatments. Methods: Eight pigs had CO2and iodinated contrast arch angiograms in supine and both lateral decubitus positions. An electrocardiogram, physiologic data and cardiac ultrasound were obtained. Therapies included precordial thumps and rolls to lateral decubitus positions. Results: Supine high descending aorta CO2 injections floated retrograde up the arch during diastole and preferentially filled the right coronary artery (RCA): mean score 3.5 (of 4), in nominate artery 2.4, left coronary artery 1.2; n = 17; p = 0.0001. Aortic root injections preferentially filled the RCA when the animal was supine, left coronary in the right decubitus position, and showed a diffuse pattern in the left decubitus position. Right decubitus rolls filled both coronaries causing several lethal arrhythmias. Precordialthumps successfully cleared CO2. Ultrasound is a sensitive detector of myocardial CO2. Conclusion: Arch distribution of CO2 primarily involves the RCA. Diagnostic ultrasound detects cardiac CO2 well. Precordial thumps are an effective treatment

  4. [Hybrid surgical intervention in a patient with an aortic arch aneurysm and coronary artery disease].

    Science.gov (United States)

    Charchan, E R; Abugov, S A; Puretsky, M V; Kim, S Yu; Skvortsov, A A; Khachatryan, Z R

    2015-01-01

    Presented herein is a clinical case report regarding the use of hybrid technology in surgical treatment of a patient with an aneurysm of the distal portion of the aortic arch and coronary artery disease. The patient underwent a hybrid operation, i.e. debranching of the aortic arch branches, exoprosthetic repair of the ascending aorta, autovenous prosthetic coronary bypass grafting of the branch of the blunt edge of the anterior interventricular artery, stenting of the ascending portion, arch and descending portion of the aorta (stent graft "Medtronic Valiant"). In doing so, we used a non-standard approach to connecting the artificial circulation unit and to choosing the place for establishing proximal anastomoses of autovenous coronary bypass grafts. The early postoperative period was complicated by the development of respiratory insufficiency requiring continuation artificial pulmonary ventilation. The duration of the hospital stay of the patient amounted to 15 days. The check-up multispiral computed tomography showed normal functioning of the reconstruction zones, the stent graft is expanded, with no leak observed. The conclusion was made that hybrid interventions may be considered as an alternative to the classical surgical treatment associated in patients of older age group with a severe course of the postoperative period and high lethality. PMID:26035581

  5. Calcification at orifices of aortic arch branches is a reliable and significant marker of stenosis at carotid bifurcation and intracranial arteries

    International Nuclear Information System (INIS)

    Purpose: Simple rating scale for calcification in the cervical arteries and the aortic arch on multi-detector computed tomography angiography (MDCTA) was evaluated its reliability and validity. Additionally, we investigated where is the most representative location for evaluating the calcification risk of carotid bifurcation stenosis and atherosclerotic infarction in the overall cervical arteries covering from the aortic arch to the carotid bifurcation. Method: The aortic arch and cervical arteries among 518 patients (292 men, 226 women) were evaluated the extent of calcification using a 4-point grading scale for MDCTA. Reliability, validity and the concomitant risk with vascular stenosis and atherosclerotic infarction were assessed. Results: Calcification was most frequently observed in the aortic arch itself, the orifices from the aortic arch, and the carotid bifurcation. Compared with the bilateral carotid bifurcations, the aortic arch itself had a stronger inter-observer agreement for the calcification score (Fleiss’ kappa coefficients; 0.77), but weaker associations with stenosis and atherosclerotic infarction. Calcification at the orifices of the aortic arch branches had a stronger inter-observer agreement (0.74) and enough associations with carotid bifurcation stenosis and intracranial stenosis. In addition, the extensive calcification at the orifices from the aortic arch was significantly associated with atherosclerotic infarction, similar to the calcification at the bilateral carotid bifurcations. Conclusions: The orifices of the aortic arch branches were the novel representative location of the aortic arch and overall cervical arteries for evaluating the calcification extent. Thus, calcification at the aortic arch should be evaluated with focus on the orifices of 3 main branches

  6. Multi-Detector Row Computed Tomographic Evaluation of a Rare Type of Complete Vascular Ring: Double Aortic Arch with Atretic Left Arch Distal to the Origin of Left Subclavian Artery

    OpenAIRE

    Hung, Ying-Ying; Fu, Yun-Ching; Wei, Hao-Ji; Tsai, I-Chen; Chen, Clayton Chi-Chang

    2013-01-01

    Double aortic arch with an atretic left arch distal to the origin of left subclavian artery was diagnosed with multi-detector row computed tomography (MDCT) in two children with dysphagia. This rare type of complete vascular ring is clinically important because it may be confused with right aortic arch in mirror imaging. Anatomic details of this rare type of complete vascular ring demonstrated on MDCT facilitated appropriate surgical treatment.

  7. Early and midterm outcomes of open stent-graft treatment for distal aortic arch aneurysm

    International Nuclear Information System (INIS)

    The aim of this study was to investigate early and late outcomes for open stent-graft treatment, which was introduced as a less-invasive technique for thoracic aortic aneurysm of the distal arch, and to clarify the validity of and indications for this treatment. We retrospectively investigated 38 patients with thoracic aortic aneurysm of the distal arch who underwent open stent-graft placement at our hospital between June 2000 and September 2006. Five patients died in hospital (hospital mortality 13.2%). Age at the time of surgery and onset of postoperative paraplegia were identified as risk factors. Four patients (10.5%) had postoperative paraplegia, but no significant risk factors were seen. The size of the aneurysm was clearly reduced in 18 of the 25 patients (75.8%), in whom computed tomography was performed after discharge, and late outcomes were good. Mural thrombus thickness on the stent landing zone of <4 mm was a predictor for aneurysm shrinkage. Seven patients died during the late period, and the 5-year survival rate among hospital survivors was 80.1%. Early outcomes for open stent-graft are not necessarily good, and late survival is also not excellent. Open stent-graft thus cannot be regarded as an ideal technique for all patients with distal aortic arch aneurysm. However, after aneurysm shrinkage was confirmed during the early period, late outcomes were good. Absence of thick mural thrombus on the stent landing zone may represent a good indication for open stent-graft surgery. (author)

  8. Unexpected difficulty during transcatheter device closure of atrial septal defect associated with right aortic arch

    International Nuclear Information System (INIS)

    Right aortic arch (RAA) associated with isolated atrial septal defect (ASD) is very rare. We report successful closure of ASD associated with RAA using a 26-mm atrial septal occluder in a 30-year-old male patient. The impingement of right descending aorta in RAA caused malposition of the device in the left atrium. Deployment of the device through the right upper pulmonary vein successfully closed the defect. Follow-up evaluation by computerized tomography scan and echocardiogram showed no pulmonary venous obstruction

  9. Prenatal Diagnosis of Down Syndrome Associated with Right Aortic Arch and Dilated Septum Cavi Pellucidi

    Directory of Open Access Journals (Sweden)

    José Morales-Roselló

    2012-01-01

    Full Text Available A 30-year-old woman with a normal first trimester Down syndrome screening attended our ultrasound unit for a 20-week scan. The most remarkable anomalies were the presence of a right aortic arch along with a dilated cavum septi pellucidi. In addition, the scan showed an atrioventricular canal and bilateral choroid plexus cysts. Fetal karyotype showed the existence of trisomy 21. A novel association between Down syndrome and dilated cavum septi pellucidi is reported and the relationship between DS and vascular rings is discussed.

  10. [Acute penetrating atherosclerotic ulcers in aortic arch: differential diagnosis of chest pain].

    Science.gov (United States)

    Rodrigues, Bruno; Ribeiro, Carla; Santos, Luis Ferreira; Moreira, Davide; Ferreira, Pedro; Pipa, João; Beirão, Ilídio; Santos, Oliveira

    2011-01-01

    Penetrating atherosclerotic ulcers (PAU) represent a pathological phenomenon in which ulceration of atheromatous lesions of the aorta penetrates the internal elastic lamina, reaching the middle muscular layer. These ulcers are more common in the descending thoracic aorta, being rare in the ascending aorta. The differential diagnosis between PAU and other entities of acute aortic syndromes (AAS) becomes difficult. The diagnosis of this disease is made through imaging studies: multidetector computed tomography (MDCT), magnetic resonance (MR) or transesophageal echocardiography (TEE). After diagnosis, the PAU of the ascending aorta should be treated surgically in an emergency context. In this paper the authors report a case of PAU in the aortic arch in a 84 years old patient admitted to the emergency room for chest pain. In this context a review of the natural evolution of this entity is made, with emphasis on diagnostic imaging modalities used for its characterization as well as their treatment options. PMID:23560267

  11. Traumatic Pseudo-Aneurysm and Concurrent Dissection of the Aortic Arch Treated with Endovascular Stenting

    Directory of Open Access Journals (Sweden)

    H. Ghanaati

    2010-12-01

    Full Text Available The pseudo-aneurysms of thoracic aorta are rare and a life-threatening complication of aortic"nsurgery and blunt chest trauma. This article demonstrates a case report of a traumatic aortic"narch dissection and formation of a false aneurysm after blunt chest trauma in Iran. A 23-year-old"nman was referred complaining of chest pain and exertional cough. He had a history of chest and"nabdominal trauma five months ago after a car accident, resulting in acceleration-deceleration"ninjury. The trauma resulted in an extensive injury on the left side of the chest and abdomen"nassociated with multiple rib fractures, hemopneumothorax and splenic rupture. Splenectomy"nand left chest tube drainage was performed. The patient was admitted for 15 days. Finally, he"nrecovered to normal and was discharged in satisfactory condition. However, his chest pain and"ncough restarted and its severity gradually increased. In chest x-ray, a left upper mediastinal mass"nwas detected, which was later confirmed by 64 multi-slice chest CT scan as a false aortic arch"naneurysm and aortic dissection. It seems endovascular stent-graft technique for the treatment of"nthoracic aorta aneurysm may present a good treatment choice with a low risk and less invasive"napproach.

  12. [Hybrid operation for a posttraumatic saccular aneurysm of the aortic arch].

    Science.gov (United States)

    Ignat'ev, I M; Volodiukhin, M Iu; Zanochkin, A V; Terekhin, S V

    2013-01-01

    The article deals with a case report of successful hybrid surgical treatment of a patient presenting with a posttraumatic large false saccular aneurysm of the aortic arch with mediastinal displacement and compression of the left recurrent laryngeal nerve and trachea. The patient was subjected to a hybrid operation, i. e., bypass grafting of the brachiocephalic trunk and the left common carotid artery with a bifurcation prosthesis from the ascending aorta through sternotomy, carotid-vertebral and carotid-subclavian bypass grafting on the left in a combination with endoprosthetic repair of the aortic arch with the stent graft Valiant Thoracic 40 × 224 mm (VAMF 4040c200TE) manufactured by the Medtronic Company. The postoperative period was uneventful followed by rather rapid rehabilitation of the patient. One month after the operation, the clinical state improved considerably. His voice restored virtually completely, and breathlessness disappeared. According to the findings of MSCT angiography, the aneurysmatic cavity is thrombosed, with the stent graft showing no evidence of either dislocation or endoleak. The bifurcation bypass graft is functioning. According to the data of duplex scanning, the anastomoses established on the neck are patent. PMID:23531669

  13. Medical image of the week: atherosclerotic aneurysm of aortic arch and decsecnding 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 ...

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

    Directory of Open Access Journals (Sweden)

    Roberto Chiesa

    2008-06-01

    Full Text Available BACKGROUND: Endovascular approach to the aortic arch is an appealing solution for selected patients. OBJECTIVE: To compare the technical and clinical success recorded in the different anatomical settings of endografting for aortic arch disease. METHODS: Between June 1999 and October 2006, among 178 patients treated at our institution for thoracic aorta disease with a stent-graft, the aortic arch was involved in 64 cases. According to the classification proposed by Ishimaru, aortic zone 0 was involved in 14 cases, zone 1 in 12 cases and zone 2 in 38 cases. A hybrid surgical procedure of supra-aortic debranching and revascularization was performed in 37 cases. RESULTS: Zone 0. Proximal neck length: 44±6 mm. Initial clinical success was 78.6%: two deaths (stroke, one type Ia endoleak. At a mean follow-up of 16.4±11 months the midterm clinical success was 85.7%. Zone 1. Proximal neck length: 28±5 mm. Initial clinical success was 66.7%: 0 deaths, four type Ia endoleaks. At a mean follow-up of 16.9±17.2 months the midterm clinical success was 75.0%. Zone 2. Proximal neck length: 30±5 mm. Initial clinical success was 84.2%: two deaths (one cardiac arrest, one multiorgan embolization, three type Ia endoleaks, one case of open conversion. Two cases of delayed transitory paraparesis/paraplegia were observed. At a mean follow-up of 28.0±17.2 months the midterm clinical success was 89.5%. CONCLUSIONS: This study and a literature review demonstrated that hybrid procedure for aortic arch pathology is feasible in selected patients at high risk for conventional surgery. Our experience is still limited by the relatively small sample size. We propose to reserve zone 1 for patients unfit for sternotomy or in cases with aortic neck length > 30 mm following left common carotid artery debranching. We recommend to perform complete aortic rerouting of the aortic arch in cases with lesser comorbidities and shorter aortic neck.CONTEXTO: O tratamento endovascular

  15. [Total Aortic Arch Replacement by Minimally Invasive Approach in a Patient with Permanent Tracheostomy;Report of a Case].

    Science.gov (United States)

    Adachi, Koichi; Yamaguchi, Atsushi; Yuri, Koichi; Matsumoto, Harunobu; Kimura, Naoyuki; Okamura, Homare; Shiraishi, Manabu; Hori, Daijirou; Adachi, Hideo

    2016-06-01

    Standard full median sternotomy for total aortic arch replacement in patients with tracheostomy has higher risks for mediastinitis and graft infection. To avoid surgical site infection, it is necessary to keep a sufficient distance between the tracheostomy and the site of surgical skin incision. We herein report a case of a 74-year-old man with permanent tracheostomy after total laryngectomy, who underwent total aortic arch replacement for an aneurysm. Antero-lateral thoracotomy in the 2nd intercostal space with lower partial sternotomy( ALPS approach) provided an enough distance between the tracheostomy and the surgical field. It also provided a good view for surgical procedure and enabled the standard setup of cardiopulmonary bypass with ascending aortic cannulation, venous drainage from the right atrium and the left ventricular venting through the upper right pulmonary vein. The operation was completed in 345 minutes and the patient was discharged on the 11th postoperative day without any complications. PMID:27246136

  16. Spontaneous perforation of a syphilitic aneurysm of the aortic arch into the pulmonary artery

    International Nuclear Information System (INIS)

    An aortopulmonary fistula in case of a bag-shaped aneurysm of the aortic arch is demonstrated via angiography. A diagnosis to the effect that the existence of this phenomenon is suspected, can already be arrived at when examining the plain radiography of the thorax. We can say that a sign of an aortopulmonary fistula is represented, in case of an aneurysm of the aorta ascendens and of the arcus aortae, by the existence of a left-right shunt with hypercirculation in the pulmonary circulation, in most cases also signs of right ventricular insufficiency. This is often combined with a typical previous history of sudden dyspnoeas and thoracic pain. The article points out the theoretical possibility of balloon catheter occlusion of the fistula to relieve the acute right ventricular load. (orig.)

  17. Duplo arco aórtico: a quebra do silêncio Double aortic arch: the break of silence

    Directory of Open Access Journals (Sweden)

    Ana Rita Abrão

    2011-03-01

    Full Text Available Anéis vasculares representam 1-2% dos casos das cardiopatias congênitas. Relatamos um caso raro de duplo arco aórtico. Mulher, 60 anos, procurou atendimento na clínica médica apresentando 1 ano de história de disfagia, 6 meses de dispneia e 2 meses de dor torácica esporádica. Raio X de tórax revelou: hiperinsuflação pulmonar difusa, alargamento mediastinal, coração com volume e configurações normais, arco aórtico à direita e alterações degenerativas vertebrais. Tomografia computadorizada do tórax: arco aórtico duplo circundando e comprimindo a traqueia e o esôfago. Arco direito mais calibroso, emergindo dele o tronco braquiocefálico. Do arco esquerdo emergem a artéria carótida comum e a subclávia esquerda. Diagnóstico: anel vascular traqueoesofagiano decorrente do duplo arco aórtico, sendo o arco direito dominante. No presente caso, optou-se por seguimento clínico da paciente, levando-se em conta a intensidade dos sintomas apresentados.Vascular rings represent 1 to 2% of cases of congenital heart disease. We report a rare case of double aortic arch. A 60-year-old woman was admitted to the hospital presenting a one-year history of dysphagia, six months of dyspnea and two months of sporadic chest pain. Radiograph of the chest revealed diffuse pulmonary hyper inflation, widening of the mediastinum, heart of normal size and shape, a right-sized aortic arch, and degenerative changes of the thoracic spine. Computed tomography of the chest showed a double aortic arch encircling and compressing the trachea and the esophagus. The right aortic arch had a larger caliber, with brachiocephalic trunk arising from it. The left common carotid artery and the left subclavian artery arose from the left aortic arch. Diagnosis: tracheoesophageal vascular ring due to double aortic arch, with dominant right arch. In this case, we chose to follow the patient medically, taking into consideration the mildness of the symptoms.

  18. Thoracic type Ia endoleak: direct percutaneous coil embolization of the aortic arch at the blood entry site after TEVAR and double-chimney stent-grafts

    Energy Technology Data Exchange (ETDEWEB)

    Bangard, Christopher; Franke, Mareike; Maintz, David; Chang, De-Hua [University Hospital, University of Cologne, Department of Radiology, Cologne (Germany); Pfister, Roman [University Hospital, University of Cologne, Department of Internal Medicine III, Cologne (Germany); Deppe, Antje-Christin [University Hospital, University of Cologne, Department of Cardiothoracic Surgery, Cologne (Germany); Matoussevitch, Vladimir [University Hospital, University of Cologne, Department of Vascular Surgery, Cologne (Germany)

    2014-06-15

    To introduce a novel percutaneous technique to stop blood entry at the lesser aortic arch curvature by coil embolisation in type Ia endoleak after TEVAR. A 61-year-old Marfan patient presented with type Ia endoleak of the aortic arch and a growing aortic arch pseudoaneurysm after TEVAR. Multiple preceding operations and interventions made an endovascular approach unsuccessful. Direct percutaneous puncture of the aneurysmal sac would have cured the sign, but not the cause of blood entry at the lesser curvature of the aortic arch. Direct CT-guided percutaneous puncture of the blood entry site in the aortic arch with fluoroscopically guided coil embolisation using detachable extra-long coils was successfully performed. Three weeks after the intervention, the patient developed fever because of superinfection of the pseudoaneurysm. The blood cultures and CT-guided mediastinal aspirate were sterile. After intravenous administration of antibiotics, the fever disappeared and the patient recovered. Six-month follow-up showed permanent closure of the endoleak and a shrinking aneurysmal sac. Direct percutaneous puncture of the aortic arch at the blood entry site of a thoracic type Ia endoleak after TEVAR and double-chimney stent-grafts with coil embolisation of the wedge-shaped space between the lesser aortic curvature and the stent-graft is possible. (orig.)

  19. Thoracic type Ia endoleak: direct percutaneous coil embolization of the aortic arch at the blood entry site after TEVAR and double-chimney stent-grafts

    International Nuclear Information System (INIS)

    To introduce a novel percutaneous technique to stop blood entry at the lesser aortic arch curvature by coil embolisation in type Ia endoleak after TEVAR. A 61-year-old Marfan patient presented with type Ia endoleak of the aortic arch and a growing aortic arch pseudoaneurysm after TEVAR. Multiple preceding operations and interventions made an endovascular approach unsuccessful. Direct percutaneous puncture of the aneurysmal sac would have cured the sign, but not the cause of blood entry at the lesser curvature of the aortic arch. Direct CT-guided percutaneous puncture of the blood entry site in the aortic arch with fluoroscopically guided coil embolisation using detachable extra-long coils was successfully performed. Three weeks after the intervention, the patient developed fever because of superinfection of the pseudoaneurysm. The blood cultures and CT-guided mediastinal aspirate were sterile. After intravenous administration of antibiotics, the fever disappeared and the patient recovered. Six-month follow-up showed permanent closure of the endoleak and a shrinking aneurysmal sac. Direct percutaneous puncture of the aortic arch at the blood entry site of a thoracic type Ia endoleak after TEVAR and double-chimney stent-grafts with coil embolisation of the wedge-shaped space between the lesser aortic curvature and the stent-graft is possible. (orig.)

  20. Results of "elephant trunk" total aortic arch replacement using a multi-branched, collared graft prosthesis.

    Science.gov (United States)

    Schneider, Stefan R B; Dell'Aquila, Angelo M; Akil, Ali; Schlarb, Dominik; Panuccio, Guiseppe; Martens, Sven; Rukosujew, Andreas

    2016-03-01

    We report on our experience with a simplified elephant trunk (ET) procedure with a multi-branched prosthesis (Vascutek(®) Siena™ Collared Graft). It consists of a proximal portion (20 cm) with prefabricated side branches, a collar and a distal portion (30 cm). The collar, which can be trimmed into any desired diameter, constitutes the suture portion to the descending aorta. Radiopaque markers in the distal portion indicate the landing zone. Between January 2011 and June 2013, 20 consecutive patients (10 women; mean age, 66 ± 9.3 years) underwent ET procedure, including 6 re-do cases. Underlying aortic diseases were acute dissection (n = 6), chronic dissection (n = 4), aneurysm (n = 8) and PAU (n = 2). Mean preoperative diameter of the descending aorta was 49.1 ± 12.9 mm (range 74.7-29.7 mm). Concomitant procedures included ascending aortic replacement in 16 patients; root replacement in 2; AVR in 2, CABG in 3 and mitral repair in 1 patient. CPB time was 263 ± 94 min; mean duration of ACP was 65 ± 14 min. Two patients died on POD 8 and 78, respectively. Major adverse events included stroke (n = 1), resternotomy for bleeding (n = 2), renal failure requiring temporary dialysis (n = 1) and recurrent nerve paresis (n = 2). After a mean follow-up of 10 ± 8 months, all discharged patients were alive. Seven patients underwent stent-graft implantation of the descending aorta and one patient underwent open descending aortic replacement. The last generation of multi-branched arch prosthesis and especially the Vascutek(®) Siena™ Collared Graft make ET procedure a reasonable treatment option even in patients with acute aortic dissection. PMID:25491933

  1. Correlation of atherosclerotic changes in peripheral arteries with pathological involvement of aortic arch in coronary bypass patients

    Directory of Open Access Journals (Sweden)

    Eshraghi N

    2010-10-01

    Full Text Available "nBackground: A correlation between coronary artery disease (CAD and atherosclerosis of peripheral arteries and the determination of noninvasive indexes for its existence and extent have been sought by many researchers. Some studies report that the intima-media thickness (IMT of peripheral arteries could play this role. This study evaluated the correlation between the IMTs of common carotid and common femoral arteries and the degree of atherosclerosis in aortic arch and to evaluate the severity of CAD in candidates of coronary artery bypass grafting (CABG."n "nMethods: In a cross-sectional analytic-descriptive study, The severity of CAD, the grade of atherosclerosis of the aortic arch, and the IMTs of the common carotid and common femoral arteries were determined."n "nResults: There was a significant weak positive correlation between the IMT of common carotid artery (ρ = 0.193, p = 0.039 and common femoral artery (ρ = 0.206, p = 0.028 with the number of involved carotid vessels; the mean of these two parameters was not significantly different between the three CAD groups. There was not any significant relation between the IMTs of common carotid and common femoral arteries with the severity of atherosclerosis in the aortic arch too. There was not any significant relation between the presences of atherosclerotic plaque in the common carotid or the common femoral arteries with the severity of CAD. The severe atherosclerosis of the aortic arch was significantly higher in patients with three vessel disease."n "nConclusion: According to our results, the IMTs of common carotid and/or common femoral arteries may increase with the severity of CAD; however, these parameters are not a surrogate for predicting the CAD severity.

  2. The branching pattern of the aortic arch in the long-legged buzzard (Buteo rufinus Cretzschmar 1829).

    Science.gov (United States)

    Erdoğan, Serkan; Kılınç, Mehmet

    2014-06-01

    The aim of this study was to investigate the vascular branching morphology of the aortic arch in the long-legged buzzard. For this purpose, two long-legged buzzards were evaluated in this study. The latex injection method was used to investigate the branching of the aortic arch. Two innominate brachiocephalic trunks branched continually from aortic arch caudoventral to the primary bronchi and ventral to the syrinx. The left subclavian artery gave rise to sternoclavicular, thoracic, axillary and intercostal arteries in this region. On the right side, it was observed that the right subclavian artery gave off thoracic, sternoclavicular and intercostal arteries, and the axillary artery was the branch of thoracic artery differently from the left one. Each carotid artery was continued to the middle of the neck and soon disappeared, becoming covered by the muscles of the anterior part of the neck, and entering the canal formed by the inferior spinous processes of the cervical vertebrae, within which it ran hidden, and in close contact with its fellow of the other lateral side, to near the head. This morphological study in the long-legged buzzard will elucidate the vascular organization for regional blood supply, and provide specific anatomical data. PMID:24136451

  3. Pulmonary artery stenosis caused by a large aortic arch pseudoaneurysm detected 10 years after a minor trauma

    Directory of Open Access Journals (Sweden)

    Jalal Zamani

    2016-03-01

    Full Text Available Pseudoaneurysm of aorta is a rare condition usually seen after aortic surgeries or serious accidents. Here we report a 60 years old man without any previous medical condition who presented with non-specific symptoms and underwent different investigations for more than 1 year, until the presence of a continuous murmur raised suspicion toward his cardiovascular system. In echocardiographic and computed tomography (CT angiographic studies a large pseudoaneurysm of aortic arch with compression effect on pulmonary artery was detected. At this stage he remembered having suffered a minor trauma 10 years ago. He finally underwent operation and his aortic wall was repaired successfully with a patch. This case highlights the importance of thorough history taking and physical examination in patients irrespective of symptoms and high index of suspicion to detect this life-threatening condition.

  4. Clinical, radiological and functional follow-up after surgical decompression of double aortic arch

    Energy Technology Data Exchange (ETDEWEB)

    Berge, Maartje ten; Laag, Johan van der; Ent, Cornelis K. van der [Department of Respiratory Diseases, Wilhelmina Children' s Hospital, Utrecht (Netherlands); Beek, Frederik J.A. [Department of Radiology, Wilhelmina Children' s Hospital, Lundlaan 6, 3584 EA Utrecht (Netherlands)

    2002-08-01

    Heading AbstractBackground. Double aortic arch (DAA) is a congenital vascular anomaly that causes tracheal and oesophageal compression. It requires surgical intervention in patients with severe symptoms.Objective. To evaluate the clinical, radiological and functional follow-up after surgical relief of the compression.Materials and methods. Ten children (seven boys) with DAA were operated on at a mean age of 1.3 years (range 0.2-7.5). At a mean age of 10.1 years (range 5-18 years), a follow-up study was performed that included clinical, radiological and functional parameters.Results. Seven children reported only mild respiratory symptoms and some trouble with swallowing. Preoperative fluoroscopy with spot images showed the mean tracheal diameter at the level of stenosis to be 37{+-}23% of the maximal diameter. At the time of follow-up, this was 70{+-}13%. The mean of the oesophageal diameter was 39{+-}20% preoperatively and 47{+-}16% postoperatively. Maximal expiratory flow volume (MEFV) curves of seven children showed typical characteristics of intrathoracic upper airway obstruction. Mean peak expiratory flow was significantly reduced (77{+-}10% of predicted, P<0.0001). Bronchial hyper-reactivity, tested by methacholine challenge, was found in two patients.Conclusions. There was marked relief of clinical symptoms after surgical decompression of DAA in all patients. In spite of this, radiological narrowing of trachea and oesophagus persisted and lung function results were abnormal at long-term follow-up. (orig.)

  5. Aortic Arch Calcification Predicts Patency Loss of Arteriovenous Fistula in End-Stage Renal Disease Patients.

    Science.gov (United States)

    Yap, Yit-Sheung; Ting, Kai-Ting; Chi, Wen-Che; Lin, Cheng-Hao; Liu, Yi-Chun; Chuang, Wan-Long

    2016-01-01

    Aortic arch calcification (AAC) is recognized as an important cardiovascular risk factor in patients with end-stage renal disease (ESRD). The aim of the study was to evaluate the impact of AAC grade on patency rates of arteriovenous fistula (AVF) in this specific population. The data of 286 ESRD patients who had an initial AVF placed were reviewed. The extent of AAC identified on chest radiography was divided into four grades (0-3). The association between AAC grade, other clinical factors, and primary patency of AVF was then analyzed by Cox proportional hazard analysis. The multivariate analysis demonstrated that the presence of AAC grade 2 (hazard ratio (95% confidence interval): 1.80 (1.15-2.84); p = 0.011) and grade 3 (3.03 (1.88-4.91); p surgeon assisted with preoperative vascular mapping, only AAC grade 3 (2.41 (1.45-4.00); p = 0.001), and higher intact-parathyroid hormone (p = 0.025) level were correlated with AVF patency loss. In conclusion, higher AAC grade and intact-parathyroid hormone level predicted primary patency loss of AVF in an ESRD population. PMID:27101807

  6. Clinical, radiological and functional follow-up after surgical decompression of double aortic arch

    International Nuclear Information System (INIS)

    Heading AbstractBackground. Double aortic arch (DAA) is a congenital vascular anomaly that causes tracheal and oesophageal compression. It requires surgical intervention in patients with severe symptoms.Objective. To evaluate the clinical, radiological and functional follow-up after surgical relief of the compression.Materials and methods. Ten children (seven boys) with DAA were operated on at a mean age of 1.3 years (range 0.2-7.5). At a mean age of 10.1 years (range 5-18 years), a follow-up study was performed that included clinical, radiological and functional parameters.Results. Seven children reported only mild respiratory symptoms and some trouble with swallowing. Preoperative fluoroscopy with spot images showed the mean tracheal diameter at the level of stenosis to be 37±23% of the maximal diameter. At the time of follow-up, this was 70±13%. The mean of the oesophageal diameter was 39±20% preoperatively and 47±16% postoperatively. Maximal expiratory flow volume (MEFV) curves of seven children showed typical characteristics of intrathoracic upper airway obstruction. Mean peak expiratory flow was significantly reduced (77±10% of predicted, P<0.0001). Bronchial hyper-reactivity, tested by methacholine challenge, was found in two patients.Conclusions. There was marked relief of clinical symptoms after surgical decompression of DAA in all patients. In spite of this, radiological narrowing of trachea and oesophagus persisted and lung function results were abnormal at long-term follow-up. (orig.)

  7. Hybrid Repair of Complex Thoracic Aortic Arch Pathology: Long-Term Outcomes of Extra-anatomic Bypass Grafting of the Supra-aortic Trunk

    Energy Technology Data Exchange (ETDEWEB)

    Lotfi, S., E-mail: shamim.lotfi@kcl.ac.uk; Clough, R. E.; Ali, T. [Guy' s and St. Thomas' NHS Trust, Vascular Surgery (United Kingdom); Salter, R. [Guy' s and St. Thomas' NHS Trust, Interventional Radiology (United Kingdom); Young, C. P. [Guy' s and St. Thomas' NHS Trust, Cardiac Surgery (United Kingdom); Bell, R.; Modarai, B.; Taylor, P., E-mail: peter.taylor@gstt.nhs.uk [Guy' s and St. Thomas' NHS Trust, Vascular Surgery (United Kingdom)

    2013-02-15

    Hybrid repair constitutes supra-aortic debranching before thoracic endovascular aortic repair (TEVAR). It offers improved short-term outcome compared with open surgery; however, longer-term studies are required to assess patient outcomes and patency of the extra-anatomic bypass grafts. A prospectively maintained database of 380 elective and urgent patients who had undergone TEVAR (1997-2011) was analyzed retrospectively. Fifty-one patients (34 males; 17 females) underwent hybrid repair. Median age was 71 (range, 18-90) years with mean follow-up of 15 (range, 0-61) months. Perioperative complications included death: 10 % (5/51), stroke: 12 % (6/51), paraplegia: 6 % (3/51), endoleak: 16 % (8/51), rupture: 4 % (2/51), upper-limb ischemia: 2 % (1/51), bypass graft occlusion: 4 % (2/51), and cardiopulmonary complications in 14 % (7/51). Three patients (6 %) required emergency intervention for retrograde dissection: (2 aortic root repairs; 2 innominate stents). Early reintervention was performed for type 1 endoleak in two patients (2 proximal cuff extensions). One patient underwent innominate stenting and revision of their bypass for symptomatic restenosis. At 48 months, survival was 73 %. Endoleak was detected in three (6 %) patients (type 1 = 2; type 2 = 1) requiring debranching with proximal stent graft (n = 2) and proximal extension cuff (n = 1). One patient had a fatal rupture of a mycotic aneurysm and two arch aneurysms expanded. No bypass graft occluded after the perioperative period. Hybrid operations to treat aortic arch disease can be performed with results comparable to open surgery. The longer-term outcomes demonstrate low rates of reintervention and high rates of graft patency.

  8. Value of MRI in the diagnosis of fetal aortic arch anomalies%MRI在诊断胎儿主动脉弓畸形中的价值

    Institute of Scientific and Technical Information of China (English)

    李旭; 胡克非; 尹传高; 李庚武; 穆仲平; 李雪蕾; 胡俊; 汪晓波; 陆忠斌

    2015-01-01

    目的:探讨MRI在诊断胎儿主动脉弓畸形中的价值。方法回顾性分析2013年3月至2014年10月产前超声检查提示有发育异常,然后行MRI检查,并经引产尸检和生后随访证实为主动脉弓畸形胎儿10例。重点观察MRI图像中主动脉弓位置及头臂动脉有无畸形,以及肝脏、胃腔在胎儿腹腔中的位置,腹部大血管毗邻关系等,并与产前超声和随访结果进行比较。结果10例胎儿中, MRI表现为右位主动脉弓(简称右弓)伴迷走左锁骨下动脉7例,其中1例还合并颈主动脉弓;右弓伴镜像分支1例,左位主动脉弓(简称左弓)伴迷走右锁骨下动脉1例,双主动脉弓1例。尸检和生后MRI随访与产前胎儿心脏MRI诊断均一致,产前超声诊断主动脉畸形漏诊5例,包括诊断右弓漏诊迷走左锁骨下动脉2例、镜像分支1例,诊断右弓伴迷走左锁骨下动脉漏诊颈主动脉弓1例,诊断左房异构漏诊左弓伴迷走右锁骨下动脉1例。此外,超声将1例双主动脉弓误诊为右弓伴迷走左锁骨下动脉。结论胎儿心脏MRI在诊断胎儿主动脉弓畸形中可作为超声的一种有效的补充检查手段。%Objective To explore the value of MRI in the diagnosis of fetal aortic arch anomalies. Methods We retrospectively collected 10 fetuses with aortic arch anomalies indicated by prenatal ultrasound and underwent MR examination and were subsequently proven by autopsy or post-birth follow-up from 320 pregnant women. We focused on the observations of the location of the aortic arch and brachiocephalic artery anomalies, the locations of the liver and stomach in the abdominal cavity, and the large vessels in abdomen. The above-mentioned finding were compared with prenatal ultrasound and follow-up findings. Results Of 10 cases, right aortic arch with aberrant left subclavian artery was seen in 7 cases, right aortic arch with the mirror branch, left aortic arch with

  9. Identification of aortic arch-specific quantitative trait loci for atherosclerosis by an intercross of DBA/2J and 129S6 apolipoprotein E-deficient mice.

    Directory of Open Access Journals (Sweden)

    Yukako Kayashima

    Full Text Available The genetic background of apolipoprotein E (apoE deficient mice influences atherosclerotic plaque development. We previously reported three quantitative trait loci (QTL, Aath1-Aath3, that affect aortic arch atherosclerosis independently of those in the aortic root in a cross between C57BL6 apoEKO mice (B6-apoE and 129S6 apoEKO mice (129-apoE. To gain further insight into genetic factors that influence atherosclerosis at different vascular locations, we analyzed 335 F2 mice from an intercross between 129-apoE and apoEKO mice on a DBA/2J genetic background (DBA-apoE. The extent of atherosclerosis in the aortic arch was very similar in the two parental strains. Nevertheless, a genome-wide scan identified two significant QTL for plaque size in the aortic arch: Aath4 on Chromosome (Chr 2 at 137 Mb and Aath5 on Chr 10 at 51 Mb. The DBA alleles of Aath4 and Aath5 respectively confer susceptibility and resistance to aortic arch atherosclerosis over 129 alleles. Both QTL are also independent of those affecting plaque size at the aortic root. Genome analysis suggests that athero-susceptibility of Aath4 in DBA may be contributed by multiple genes, including Mertk and Cd93, that play roles in phagocytosis of apoptotic cells and modulate inflammation. A candidate gene for Aath5 is Stab2, the DBA allele of which is associated with 10 times higher plasma hyaluronan than the 129 allele. Overall, our identification of two new QTL that affect atherosclerosis in an aortic arch-specific manner further supports the involvement of distinct pathological processes at different vascular locations.

  10. Association of Ankle-Brachial Index and Aortic Arch Calcification with Overall and Cardiovascular Mortality in Hemodialysis

    Science.gov (United States)

    Chen, Szu-Chia; Lee, Mei-Yueh; Huang, Jiun-Chi; Shih, Ming-Chen Paul; Chang, Jer-Ming; Chen, Hung-Chun

    2016-01-01

    Peripheral artery occlusive disease and vascular calcification are highly prevalent in hemodialysis (HD) patients, however the association of the combination of ankle-brachial index (ABI) and aortic arch calcification (AoAC) with clinical outcomes in patients undergoing HD is unknown. In this study, we investigated whether the combination of ABI and AoAC is independently associated with overall and cardiovascular mortality in HD patients. The median follow-up period was 5.7 years. Calcification of the aortic arch was assessed by chest X-ray. Forty-seven patients died including 24 due to cardiovascular causes during the follow-up period. The study patients were stratified into four groups according to an ABI 4 or ≤4 according to receiver operating characteristic curve. Those with an ABI  4 (vs. ABI ≥ 0.95 and AoAC score ≤ 4) were associated with overall (hazard ratio [HR], 4.913; 95% confidence interval [CI], 1.932 to 12.497; p = 0.001) and cardiovascular (HR, 3.531; 95% CI, 1.070 to 11.652; p = 0.038) mortality in multivariable analysis. The combination of a low ABI and increased AoAC was associated with increased overall and cardiovascular mortality in patients undergoing HD. PMID:27608939

  11. DSA in detection of morphology and branches variation of aortic arch%DSA检测主动脉弓形态及分支变异

    Institute of Scientific and Technical Information of China (English)

    王金龙; 张鸿祺; 朱凤水; 焦力群; 李慎茂; 吉训明; 凌锋

    2014-01-01

    目的 应用DSA技术评估主动脉形态及其分支变异.方法 回顾性分析4272例接受主动脉弓及全脑血管DSA患者的DSA资料,评估主动脉弓形态及分支变异的发生率.结果 4272例患者中主动脉弓形态及分支正常3925例(3925/4272,91.88%),主动脉弓形态及分支变异347例(347/4272,8.12%).变异类型:左颈总动脉(LCCA)与头臂干(BT)共干起自主动脉弓(175/4272,4.10%);左椎动脉(LVA)直接起自于主动脉弓LCCA与LSA之间(97/4272,2.27%);右颈总动脉(RCCA)直接发自主动脉弓伴迷走右锁骨下动脉(RSA) (35/4272,0.82%);RCCA、LCCA、LSA直接起自主动脉弓,迷走RSA起自降主动脉(10/4272,0.23%);RCCA、LSA直接起自主动脉弓,RSA与LCCA共干起自主动脉弓,RVA起自RCCA(4/4272,0.10%);右椎动脉双起源于RSA(4例/4272,0.10%);RVA起自右侧颈内动脉(4/4272,0.10%);弓上自右向左发出RCCA、LCCA、LSA、RSA,迷走RSA,LVA缺如,伴原始三叉动脉(4/4272,0.10%);镜像型右位主动脉弓(13/4272,0.30%);右位主动脉弓,LSA起自弓上Kommecell憩室(1/4272,0.02%).结论 通过DSA评估主动脉弓形态类型及分支的变异情况对介入诊断及治疗和某些胸部手术具有重要指导意义.%Objective To investigate the variation of morphology and branches of the aortic arch with DSA.Methods DSA data of 4272 patients received aortic arch and cerebral DSA were retrospectively analyzed,and the variation prevalence of the aortic arch and associated vessel was assessed.Results Among the patients,3925 (3925/4272,91.88%) was normal.There were 347 patients (347/4272,8.12%) were identified with variation of morphology and branches of the aortic arch,including followed type..Brachiocephalic trunk (BT) and left common carotid artery (LCCA) having a common trunk arising from the aortic arch (175/4272,4.10%).Left vertebral artery (LVA) originated from the aortic arch between LCCA and left subclavian artery (LSA,97/4272,2.27

  12. Interdependencies of aortic arch secondary flow patterns, geometry, and age analysed by 4-dimensional phase contrast magnetic resonance imaging at 3 Tesla

    International Nuclear Information System (INIS)

    It was the aim to analyse the impact of age, aortic arch geometry, and size on secondary flow patterns such as helix and vortex flow derived from flow-sensitive magnetic resonance imaging (4D PC-MRI). 62 subjects (age range = 20-80 years) without circumscribed pathologies of the thoracic aorta (ascending aortic (AAo) diameter: 3.2 ± 0.6 cm [range 2.2-5.1]) were examined by 4D PC-MRI after IRB-approval and written informed consent. Blood flow visualisation based on streamlines and time-resolved 3D particle traces was performed. Aortic diameter, shape (gothic, crook-shaped, cubic), angle, and age were correlated with existence and extent of secondary flow patterns (helicity, vortices); statistical modelling was performed. Helical flow was the typical pattern in standard crook-shaped aortic arches. With altered shapes and increasing age, helicity was less common. AAo diameter and age had the highest correlation (r = 0.69 and 0.68, respectively) with number of detected vortices. None of the other arch geometric or demographic variables (for all, P ≥ 0.177) improved statistical modelling. Substantially different secondary flow patterns can be observed in the normal thoracic aorta. Age and the AAo diameter were the parameters correlating best with presence and amount of vortices. Findings underline the importance of age- and geometry-matched control groups for haemodynamic studies. (orig.)

  13. Interdependencies of aortic arch secondary flow patterns, geometry, and age analysed by 4-dimensional phase contrast magnetic resonance imaging at 3 Tesla

    Energy Technology Data Exchange (ETDEWEB)

    Frydrychowicz, Alex [University Hospital Schleswig-Holstein, Clinic for Radiology and Nuclear Medicine, Luebeck (Germany); Berger, Alexander; Russe, Maximilian F.; Bock, Jelena [University Hospital Freiburg, Department of Radiology, Medical Physics, Freiburg (Germany); Munoz del Rio, Alejandro [University of Wisconsin - Madison, Departments of Radiology and Medical Physics, Madison, WI (United States); Harloff, Andreas [University Hospital Freiburg, Department of Neurology and Clinical Neurophysiology, Freiburg (Germany); Markl, Michael [University Hospital Freiburg, Department of Radiology, Medical Physics, Freiburg (Germany); Northwestern University, Departments of Radiology and Biomedical Engineering, Chicago, IL (United States)

    2012-05-15

    It was the aim to analyse the impact of age, aortic arch geometry, and size on secondary flow patterns such as helix and vortex flow derived from flow-sensitive magnetic resonance imaging (4D PC-MRI). 62 subjects (age range = 20-80 years) without circumscribed pathologies of the thoracic aorta (ascending aortic (AAo) diameter: 3.2 {+-} 0.6 cm [range 2.2-5.1]) were examined by 4D PC-MRI after IRB-approval and written informed consent. Blood flow visualisation based on streamlines and time-resolved 3D particle traces was performed. Aortic diameter, shape (gothic, crook-shaped, cubic), angle, and age were correlated with existence and extent of secondary flow patterns (helicity, vortices); statistical modelling was performed. Helical flow was the typical pattern in standard crook-shaped aortic arches. With altered shapes and increasing age, helicity was less common. AAo diameter and age had the highest correlation (r = 0.69 and 0.68, respectively) with number of detected vortices. None of the other arch geometric or demographic variables (for all, P {>=} 0.177) improved statistical modelling. Substantially different secondary flow patterns can be observed in the normal thoracic aorta. Age and the AAo diameter were the parameters correlating best with presence and amount of vortices. Findings underline the importance of age- and geometry-matched control groups for haemodynamic studies. (orig.)

  14. Giant aortic arch aneurysm complicating Kawasaki disease: an original case report

    OpenAIRE

    Kaouthar, Hakim; Rafik, Boussaada; Jihen, Ayari; Imen, Hamdi; Lilia, Chaker; Fatma, Ouarda; Hela, Msaad

    2013-01-01

    Kawasaki disease (KD) is a common acute vasculitis in pediatric population that usually involves small and middle-sized arteries, commonly coronary arteries. Although the incidence and natural course of coronary aneurysms after KD are well documented, related reports on peripheral arterial and aortic aneurysms are scarce.

  15. 3D Computer Simulations of Pulsatile Human Blood Flows in Vessels and in the Aortic Arch: Investigation of Non-Newtonian Characteristics of Human Blood

    CERN Document Server

    Sultanov, Renat A; Engelbrekt, Brent; Blankenbecler, Richard

    2008-01-01

    Methods of Computational Fluid Dynamics are applied to simulate pulsatile blood flow in human vessels and in the aortic arch. The non-Newtonian behaviour of the human blood is investigated in simple vessels of actual size. A detailed time-dependent mathematical convergence test has been carried out. The realistic pulsatile flow is used in all simulations. Results of computer simulations of the blood flow in vessels of two different geometries are presented. For pressure, strain rate and velocity component distributions we found significant disagreements between our results obtained with realistic non-Newtonian treatment of human blood and widely used method in literature: a simple Newtonian approximation. A significant increase of the strain rate and, as a result, wall sear stress distribution, is found in the region of the aortic arch. We consider this result as theoretical evidence that supports existing clinical observations and those models not using non-Newtonian treatment underestimate the risk of disru...

  16. Endovascular Embolization of Bronchial Artery Originating from the Upper Portion of Aortic Arch in Patients with Massive Hemoptysis

    International Nuclear Information System (INIS)

    PurposeOur experience with endovascular embolization (EVE) of the bronchial artery (BA) originating from the upper portion of the aortic arch (AA) in six patients is described.MethodsAltogether, 818 patients with hemoptysis underwent multidetector row computed tomography angiography (MDCTA) before EVE or AA angiography during EVE. Aberrant BAs originating from the upper portion of the AA were the source of massive hemoptysis in six patients (0.73 %). MDCT angiograms and/or Digital subtraction angiograms were retrospectively reviewed. Selective catheterization and embolization were performed.ResultsThe ostia of the BAs were located on the superior surface of the AA between the brachiocephalic trunk and left common carotid artery in three patients, the junction of the aorta and medial surface of the left subclavian artery in two, and the posterior wall of the upper portion of the AA in one. The six BAs comprised two common trunks, three single right sides, and one single left side. The targeted vessels were successfully catheterized and embolized by a coaxial microcatheter system using polyvinyl alcohol particles. Other pathologic BAs and nonbronchial systemic arteries also were embolized. Bleeding was immediately controlled in all patients with no recurrence of hemoptysis. No procedure-related complications occurred.ConclusionsApplication of EVE of anomalous origin of BAs in patients with hemoptysis is important, as demonstrated in the six reported patients. MDCTA before EVE or AA angiography during EVE is critical to avoid missing a rare aberrant BA originating from the upper portion of the AA

  17. Digital tomosynthesis for aortic arch calcification evaluation: performance comparison with chest radiography with CT as the reference standard

    International Nuclear Information System (INIS)

    Background. Recently developed digital tomosynthesis has shown improved detection of pulmonary lesions with a radiation dose comparable to conventional CR but with a much lower radiation dose than CT. Purpose. To compare the diagnostic performance of digital tomosynthesis (DT) with that of chest radiography (CR) for the detection of aortic arch calcification (AAC). Material and Methods. The study included 100 patients who underwent multidetector computed tomography (MDCT), DT, and CR (DT and CR were obtained within one week of CT examination). We evaluated and compared the diagnostic performances of DT and CR for the detection of AAC with MDCT as the reference standard. The extent (four grades 0-3) of AAC on DT and CR was also compared with CT calcium score. Inter-observer agreement was analyzed by using kappa statistics. Results. On DT, overall accuracy for AAC was superior to that of CR (94% and 71%, respectively, P < 0.01). Inter-observer agreement was good with DT and CR (kappa values = 0.74 and 0.62, respectively) for the presence of AAC, and good with DT and moderate with CR (kappa value = 0.64 and 0.53, respectively) for AAC grading. The overall correlation coefficient on AAC grading between DT and CT (calcium score) was superior to that between CR and CT (0.90 and 0.60, respectively). Conclusion. DT is superior to CR for detection and extent evaluation of AAC

  18. Endovascular Embolization of Bronchial Artery Originating from the Upper Portion of Aortic Arch in Patients with Massive Hemoptysis

    Energy Technology Data Exchange (ETDEWEB)

    Jiang, Sen, E-mail: jasfly77@vip.163.com; Sun, Xi-Wen, E-mail: xwsun@citiz.net; Yu, Dong, E-mail: yudong_mail@126.com; Jie, Bing, E-mail: jbshh@163.com [Tongji University School of Medicine, Department of Radiology, Shanghai Pulmonary Hospital (China)

    2013-05-15

    PurposeOur experience with endovascular embolization (EVE) of the bronchial artery (BA) originating from the upper portion of the aortic arch (AA) in six patients is described.MethodsAltogether, 818 patients with hemoptysis underwent multidetector row computed tomography angiography (MDCTA) before EVE or AA angiography during EVE. Aberrant BAs originating from the upper portion of the AA were the source of massive hemoptysis in six patients (0.73 %). MDCT angiograms and/or Digital subtraction angiograms were retrospectively reviewed. Selective catheterization and embolization were performed.ResultsThe ostia of the BAs were located on the superior surface of the AA between the brachiocephalic trunk and left common carotid artery in three patients, the junction of the aorta and medial surface of the left subclavian artery in two, and the posterior wall of the upper portion of the AA in one. The six BAs comprised two common trunks, three single right sides, and one single left side. The targeted vessels were successfully catheterized and embolized by a coaxial microcatheter system using polyvinyl alcohol particles. Other pathologic BAs and nonbronchial systemic arteries also were embolized. Bleeding was immediately controlled in all patients with no recurrence of hemoptysis. No procedure-related complications occurred.ConclusionsApplication of EVE of anomalous origin of BAs in patients with hemoptysis is important, as demonstrated in the six reported patients. MDCTA before EVE or AA angiography during EVE is critical to avoid missing a rare aberrant BA originating from the upper portion of the AA.

  19. Aortic Arch Calcification Predicts the Renal Function Progression in Patients with Stage 3 to 5 Chronic Kidney Disease

    Directory of Open Access Journals (Sweden)

    Lung-Chih Li

    2015-01-01

    Full Text Available Introduction. The presence of aortic arch calcification (AoAC and cardiomegaly on chest radiography has been demonstrated as important risk factors for cardiovascular mortality in patients with chronic kidney disease (CKD. However, the interrelationship among AoAC, cardiomegaly, and renal function progression remains unclear. The aim of this study is to assess whether AoAC and cardiomegaly are independently associated with the renal function progression in patients with stages 3–5 CKD. Methods. We retrospectively determined AoAC and cardiomegaly by chest X-ray in 237 patients, followed up for at least three years without entering dialysis and classified into 4 groups according to the presence or absence of AoAC and cardiomegaly. The change in renal function was measured by the slope of estimated glomerular filtration rate (eGFR. Results. Of the 237 patients, the rate of eGFR decline was significantly higher in the group with coexistence of AoAC and cardiomegaly than any other groups. Baseline AoAC and proteinuria were independently associated with eGFR decline. AoAC were independently determined by age, eGFR slope, and cardiomegaly. Conclusions. The coexistence of AoAC and cardiomegaly is associated with faster eGFR decline. AoAC is an independent determinant of renal outcomes in patients with CKD stages 3–5.

  20. 自体肺动脉组织一期矫治主动脉弓病变合并心内畸形%One-stage repair of congenital aortic arch disease with other cardiac defects by using autologous pulmonary artery tissue

    Institute of Scientific and Technical Information of China (English)

    薛辉; 吴清玉; 李洪银; 张明奎; 奚吉成; 潘广玉; 徐忠华

    2010-01-01

    Objective To analyze the surgical strategy and result of one-stage repair for congenital aortic arch disease associated with other cardiac anomalies. Methods Between April 1993 and November 2009, 25 consecutive patients aged 26 d to 6. 5 years underwent one-stage repair for congenital aortic arch disease with other cardiac anomalies. Among them, 6 patients had coarctation of aorta, 6 patients had interrupted aortic arch, and 13 cases had hypoplasia of aortic arch. The surgical techniques include excision of the anterior wall of pulmonary artery, resection of patent ductus arteriosus tissue, aortic arch reconstruction with autologous pulmonary artery wall, reconstruction of the pulmonary artery and repair of the associated defects. Results Twenty-four patients survived and recovered uneventfully. One patient died of pulmonary hypertention crisis in hospital. The reconstruction of the aorta and the correction of the intracardiac anomalies were proved by postoperative echocardiography and CT scan. There were no neurological or other complications. The follow-up showed that all patients developed normally and there were no restenosis of the aorta arch. Conclusions With the benefits of growth potential and less tension, autologous pulmonary artery tissue is an optimal choice in aortic arch reconstruction. One-stage repair of congenital aortic arch disease associated with other cardiac anomalies can achieve good results.%目的 探讨自体肺动脉组织一期矫治主动脉弓病变合并心内畸形的手术方法和治疗效果.方法 1993年4月至2009年11月,共25例主动脉弓病变合并心内畸形的患儿接受了一期矫治手术.男性17例,女性8例;年龄26 d~6.5岁,平均11个月;体质量3.0~14.5 kg,平均12.4 kg.其中6例患儿为主动脉弓缩窄,6例为主动脉弓中断,13例为主动脉弓发育不良.手术技术包括切开肺动脉前壁,切除动脉导管,应用部分自体肺动脉壁重建主动脉弓,重建肺动脉,并

  1. The management of stenotic and obstructive lesions of the aortic arch branches.

    Science.gov (United States)

    Shumacker, H B; Isch, J H; Jolly, W W; Fitzgerald, E B

    1977-03-01

    The stenotic internal carotid can be managed in a variety of ways and number of tests can be utilized for assessing the collateral blood flow. Except in unusual situations, carotid thromboendarterectomy with or without a patch graft is generally employed. Although some surgeons use no protective shunt at all, or only upon specific indications, intraluminal shunting is utilized extensively. Our preference is to employ the customary Javid shunt technic except in unusual circumstances that suggest that added safety may be assured by shortening to a matter of seconds the period of interruption of carotid flow. In such cases, we believe the temporary axillary-internal carotid intraluminal shunt is of considerable value. Although mediastinal and thoracic procedures and bypass grafts delivering blood from the ascending aorta are not needed nearly as often as they were formerly, they are essential in certain cases. They yield excellent results and carry small risk. Carotid-subclavian grafts have proved quite valuable in restoring pulsatile flow to the subclavian and carotid systems. Our preference, however, because of technical simplicity, is the carotid-axillary bypass procedure. Subclavian-subclavian and axillary-axillary grafts have been employed successfully. When a carotid-axillary bypass is feasible, we would choose this method instead and reserve the others for unusual anatomic-pathologic situations. PMID:848666

  2. Association of Brachial-Ankle Pulse Wave Velocity and Cardiomegaly With Aortic Arch Calcification in Patients on Hemodialysis.

    Science.gov (United States)

    Shin, Ming-Chen Paul; Lee, Mei-Yueh; Huang, Jiun-Chi; Tsai, Yi-Chun; Chen, Jui-Hsin; Chen, Szu-Chia; Chang, Jer-Ming; Chen, Hung-Chun

    2016-05-01

    Aortic arch calcification (AoAC) is associated with cardiovascular and all-cause mortality in end-stage renal disease population. AoAC can be simply estimated with an AoAC score using plain chest radiography. The objective of this study is to evaluate the association of AoAC with brachial-ankle pulse wave velocity (baPWV) and cardiomegaly in patients who have undergoing hemodialysis (HD).We retrospectively determined AoAC and cardiothoracic ratio (CTR) by chest x-ray in 220 HD patients who underwent the measurement of baPWV. The values of baPWV were measured by an ankle-brachial index-form device. Multiple stepwise logistic regression analysis was used to identify the factors associated with AoAC score >4.Compared patients with AoAC score ≦4, patients with AoAC score >4 had older age, higher prevalence of diabetes and cerebrovascular disease, lower diastolic blood pressure, higher baPWV, higher CTR, higher prevalence of CTR ≧50%, lower total cholesterol, and lower creatinine level. After the multivariate stepwise logistic analysis, old age, cerebrovascular disease, high baPWV (per 100 cm/s, odds ratio [OR] 1.065, 95% confidence interval [CI] 1.003-1.129, P = 0.038), CTR (per 1%, OR 1.116, 95% CI 1.046-1.191, P = 0.001), and low total cholesterol level were independently associated with AoAC score >4.Our study demonstrated AoAC severity was associated with high baPWV and high CTR in patients with HD. Therefore, we suggest that evaluating AoAC on plain chest radiography may be a simple and inexpensive method for detecting arterial stiffness in HD patients. PMID:27175684

  3. Three-dimensional printed prototypes refine the anatomy of post-modified Norwood-1 complex aortic arch obstruction and allow presurgical simulation of the repair.

    Science.gov (United States)

    Kiraly, Laszlo; Tofeig, Magdi; Jha, Neerod Kumar; Talo, Haitham

    2016-02-01

    Three-dimensional (3D) printed prototypes of malformed hearts have been used for education, communication, presurgical planning and simulation. We present a case of a 5-month old infant with complex obstruction at the neoaortic to transverse arch and descending aortic junction following the neonatal modified Norwood-1 procedure for hypoplastic left heart syndrome. Digital 3D models were created from a routine 64-slice CT dataset; then life-size solid and magnified hollow models were printed with a 3D printer. The solid model provided further insights into details of the anatomy, whereas the surgical approach and steps of the operation were simulated on the hollow model. Intraoperative assessment confirmed the anatomical accuracy of the 3D models. The operation was performed in accordance with preoperative simulation: sliding autologous flaps achieved relief of the obstruction without additional patching. Knowledge gained from the models fundamentally contributed to successful outcome and improved patient safety. This case study presents an effective use of 3D models in exploring complex spatial relationship at the aortic arch and in simulation-based planning of the operative procedure. PMID:26590304

  4. Anatomical study of aortic arch branches' variations with MRA and its significance%主动脉弓分支变异的MRA解剖学分析及其临床意义

    Institute of Scientific and Technical Information of China (English)

    李淑华; 狄玉进; 徐金法; 白敏; 陈军; 布春青

    2011-01-01

    目的:应用磁共振血管成像(MRA)分析主动脉弓分支变异的解剖学特征,探讨MRA评价主动脉弓分支变异的临床意义.方法:对1300例在我院磁共振室接受主动脉弓及其以上MRA检查的患者进行回顾性分析,分析不同类型主动脉弓分支变异的发生情况,并讨论主动脉弓分支变异的临床意义.结果:1300例患者中,形态正常者1207例(92.85%).即头臂干(BT)、左颈总动脉(LCCA)、左锁骨下动脉(LSA)从右向左分别发自主动脉弓,存在变异者93例(7.15%).共发现9种不同类型的变异.包括LCCA与BT共干发自主动脉弓43例(3.31%)·左椎动脉(LVA)于LCCA和LSA之间直接发自主动脉弓28例(2.15%).右颈总动脉(RCCA)直接发自主动脉弓伴迷走右锁骨下动脉(RSA)7例(0.54%).LCCA与RCCA共干发自主动脉弓伴迷走RSA 3例(0.23%).LCCA与BT共干,伴LVA直接发自主动脉弓5例(0.38%).LVA与LSA共干发自主动脉弓3例(0.23%).RCCA发自主动脉弓,右椎动脉(RVA)发自RCCA伴迷走RSA 2例(0.15%),LCCA,RCCA,LVA,RSA均发自主动脉弓1例(0.08%).LCCA与BT共干发自主动脉弓,LVA缺如,伴原始三叉动脉1例(0.08%).结论:主动脉弓分支变异种类繁多,MRA能很好的评价主动脉弓分支数量及其形态与开口位置,对临床有重要意义.%Objective : To evaluate the anatomical features of human aortic arch branch variations using magnetic resonance angiography (MRA) and its clinical significance, Methods;1300 patients who received aortic arch MRA were analyzed retrospectively. The aortic arch branch variations were summarized and the clinical significance was researched. Results : In 1300 cases.1207 of them ( 92. 85%) , which was a normal form, the brachiacephalic trunk ( BT) , left common carotid artery (LCCA) and left subclavian artery (LSA) originated separately from the aortic arch and 93 of them (7. 15%) were a variation form. Nine different types were found In 43 cases (3. 31%), BT and LCCA had a common trunk

  5. Computer Simulations of Pulsatile Human Blood Flow Through 3D-Models of the Human Aortic Arch, Vessels of Simple Geometry and a Bifurcated Artery: Investigation of Blood Viscosity and Turbulent Effects

    CERN Document Server

    Sultanov, Renat A

    2008-01-01

    We report computational results of blood flow through a model of the human aortic arch and a vessel of actual diameter and length. On the top of the aortic arch the branching of the %%three arteries are included: the subclavian and jugular. A realistic pulsatile flow is used in all simulations. Calculations for bifurcation type vessels are also carried out and presented. Different mathematical methods for numerical solution of the fluid dynamics equations have been considered. The non-Newtonian behaviour of the human blood is investigated together with turbulence effects. A detailed time-dependent mathematical convergence test has been carried out. The results of computer simulations of the blood flow in vessels of three different geometries are presented: for pressure, strain rate and velocity component distributions we found significant disagreements between our results obtained with realistic non-Newtonian treatment of human blood and the widely used method in the literature: a simple Newtonian approximati...

  6. Impact of methodology and the use of allometric scaling on the echocardiographic assessment of the aortic root and arch: a study by the Research and Audit Sub-Committee of the British Society of Echocardiography.

    Science.gov (United States)

    Oxborough, David; Ghani, Saqib; Harkness, Allan; Lloyd, Guy; Moody, William; Ring, Liam; Sandoval, Julie; Senior, Roxy; Sheikh, Nabeel; Stout, Martin; Utomi, Victor; Willis, James; Zaidi, Abbas; Steeds, Richard

    2014-09-01

    The aim of the study is to establish the impact of 2D echocardiographic methods on absolute values for aortic root dimensions and to describe any allometric relationship to body size. We adopted a nationwide cross-sectional prospective multicentre design using images obtained from studies utilising control groups or where specific normality was being assessed. A total of 248 participants were enrolled with no history of cardiovascular disease, diabetes, hypertension or abnormal findings on echocardiography. Aortic root dimensions were measured at the annulus, the sinus of Valsalva, the sinotubular junction, the proximal ascending aorta and the aortic arch using the inner edge and leading edge methods in both diastole and systole by 2D echocardiography. All dimensions were scaled allometrically to body surface area (BSA), height and pulmonary artery diameter. For all parameters with the exception of the aortic annulus, dimensions were significantly larger in systole (P<0.05). All aortic root and arch measurements were significantly larger when measured using the leading edge method compared with the inner edge method (P<0.05). Allometric scaling provided a b exponent of BSA(0.6) in order to achieve size independence. Similarly, ratio scaling to height in subjects under the age of 40 years also produced size independence. In conclusion, the largest aortic dimensions occur in systole while using the leading edge method. Reproducibility of measurement, however, is better when assessing aortic dimensions in diastole. There is an allometric relationship to BSA and, therefore, allometric scaling in the order of BSA(0.6) provides a size-independent index that is not influenced by the age or gender. PMID:26693286

  7. 国人升主动脉及主动脉弓的CT解剖研究%CT topography of asending aorta and aortic arch in adult Chinese

    Institute of Scientific and Technical Information of China (English)

    张敏宏; 郭伟; 刘小平; 尹太; 贾鑫; 杜昕

    2009-01-01

    Objective To study the anatomical characteristics of ascending aortic and aortic arch in adult Chinese. Methods From Sep 2006 to Sep 2007, we retrospectivly reviewed 388 volunteers undergoing thoracic aorta CTA in our institution. We measured the diameter of ascending aorta, aortic arch, and branch vessels of aortic arch respectively in AW4.2 work station. CHESS statistical software was used to analyze data. Results The aortic diameter above coronary artery (CA) (D1), the level at origin of brachiocephalie trunk (BCT) ( D3 ), the halfway of the AA( D2 ), the level at origin of LCCA( D4 ) , the level at origin of LSA ( D5 ) and the level at distal origin of LSA ( D6 ) respectively are: ( 34 ± 5 ) mm; ( 33 ± 4) mm; ( 34 ± 5 ) mm; ( 30 ± 4) mm; ( 28 ± 3 ) mm; ( 26 ± 3 ) mm. The diameters of two level between the origin of BCT and RSA are ( 13. 1 ± 1.9) mm, ( 12. 8±2. 3) mm, respectively. The diameter of two level at LCCA is ( 8. 7 ± 1.5 )mm and ( 7. 9 ± 1. 0) mm respectively. The diameter of two level between the origin of LSA and L-vertebral arteryis (10.7±1.7) mm,(9.3±1.3) mm, respectively. Conclusion The data of the diameter and length of ascending aort and vasculature arising from the arch abtained by CT topography in Chinese volunteers are very useful for clinical practice.%目的 通过CT血管造影(computed tomographic arteriography,CTA)方式回顾性研究中国人群升主及弓部血管的直径、长度特点;方法选择2006年9月至2007年9月接受胸主动脉CT血管造影的患者388例,使用GE公司AW4.2工作站测量升主、弓部、弓上分支的直径及长度数据,运用统计学软件进行分析.结果 冠脉开口以上至左锁骨下动脉以远的主动脉直径D1-D6分别为(34±5)mm;(34±5)mm;(33±4)mm;(30±4)mm;(28±3)mm;(26±3)mm.头臂干两处直径d1,d2分别为(13±2)mm;(13±2)mm.左颈总动脉两处直径d3,d4分别为(8.7±1.5)mm;(7.9±1.0)mm.左锁骨下动脉两处直径d5,d6分别为(10.7±1.7)mm;(9.3±1.3)mm

  8. Management strategies for thoracic stent-graft repair of distal aortic arch lesions: is intentional subclavian artery occlusion a safe procedure?

    International Nuclear Information System (INIS)

    The aim of this retrospective analysis was to assess the clinical consequences after intentional left subclavian artery (LSA) occlusion. Thirty-seven patients, 27 type B dissection and 10 thoracic aneurysm, with short proximal neck (less than 2 cm) underwent endovascular treatment with intentional exclusion of LSA origin. No immediate complications occurred. Mean arterial pressure gradient, between right and left arms, ranged from 15 to 45 mmHg. After a mean follow-up of 43.70±24.01 months, mild left arm symptoms secondary to flow reduction occurred in eight cases (21.6%) but only one required LSA transposition, after 8 months, for visual impairment. Type II endoleaks from excluded LSA occurred in 10 cases (27.0%): in seven patients, leaks were treated with coils and/or glue embolization; in one case, leak sealed spontaneously; one patient died before leak embolization could occur; one patient refused any further treatment. Intentional exclusion of the LSA may be justified when a longer proximal landing zone in the aortic arch is required. (orig.)

  9. Management strategies for thoracic stent-graft repair of distal aortic arch lesions: is intentional subclavian artery occlusion a safe procedure?

    Energy Technology Data Exchange (ETDEWEB)

    Fanelli, Fabrizio; Salvatori, Filippo Maria; Pucci, Armando; Lucatelli, Pierleone; Rossi, Plinio; Passariello, Roberto [University of Rome La Sapienza, Department of Radiological Sciences, Rome (Italy); Dake, Michael D. [Stanford University School of Medicine, Department of Cardiothoracic Surgery Radiology, Stanford, CA (United States); Mazzesi, Giuseppe [University of Rome La Sapienza, Institute of Heart and Great Vessels, Rome (Italy)

    2009-10-15

    The aim of this retrospective analysis was to assess the clinical consequences after intentional left subclavian artery (LSA) occlusion. Thirty-seven patients, 27 type B dissection and 10 thoracic aneurysm, with short proximal neck (less than 2 cm) underwent endovascular treatment with intentional exclusion of LSA origin. No immediate complications occurred. Mean arterial pressure gradient, between right and left arms, ranged from 15 to 45 mmHg. After a mean follow-up of 43.70{+-}24.01 months, mild left arm symptoms secondary to flow reduction occurred in eight cases (21.6%) but only one required LSA transposition, after 8 months, for visual impairment. Type II endoleaks from excluded LSA occurred in 10 cases (27.0%): in seven patients, leaks were treated with coils and/or glue embolization; in one case, leak sealed spontaneously; one patient died before leak embolization could occur; one patient refused any further treatment. Intentional exclusion of the LSA may be justified when a longer proximal landing zone in the aortic arch is required. (orig.)

  10. “烟囱”技术在治疗累及主动脉弓分支动脉的Stanford B型主动脉夹层中的应用%Endovascular aortic repair plus chimney technique in the treatment of Stanford type B aortic dissection involving aortic arch

    Institute of Scientific and Technical Information of China (English)

    舒畅; 王暾; 黎明; 李鑫; 李全明; 方坤

    2012-01-01

    Objective To evaluate the efficacy of endovascular aortic repair plus chimney technique in the treatment of Stanford type B aortic dissection involving aortic arch.Methods From June 2009 to March 2012,32 patients of aortic arch dissection with primary entry tear next to the orifices of supra-aortic arteries were treated with chimney technique.Chimney technique was used to reconstruct left subclavian artery (n =2) and left common carotid artery (n =28).Double chimney technique was use to reconstruct innominate artery and left common carotid artery simultaneously in 2 patients.Results Four patients received emergency operation.All patients survived and were followed up for 14.3 ± 7.4 months.No type Ⅰ endoleak occurred.Among 4 patients with Type Ⅱ endoleak,3 received PDA occluding implantation in left subclavian artery and 1 patient in puerperium with Marian syndrome and pregnancy-induced hypertension syndrome recovered by conservative treatment.No severe neurological complications and left subclavian artery ischemia occurred.The locations of aortic and chimney stent-grafts were stable without any migration.All stent-grafts remained patent.Conclusion Endovascular aortic repair plus chimney technique is a safe and effective treatment for Stanford type B aortic dissection involving aortic arch.%目的 探讨“烟囱”技术在累及主动脉弓部分支动脉的Stanford B型夹层的治疗作用.方法 对2009年6月至2012年3月中南大学湘雅二医院血管外科采用“烟囱”技术治疗的第一破口邻近主动脉弓部分支动脉起始端的32例Stanford B型主动脉夹层患者进行回顾性研究.“烟囱”技术重建左锁骨下动脉2例,重建左颈总动脉28例,采用“双烟囱”技术同时重建无名动脉和左颈总动脉2例.结果 急诊手术4例.手术成功率100%,无Ⅰ型内漏发生.4例发生左锁骨下动脉Ⅱ型内漏,3例采用PDA封堵器封堵内漏,1例合并Marfan综合征和妊高症,予以保守治疗,11

  11. Inflammatory aortic arch syndrome: contrast-enhanced, three-dimensional MR - angiography in stenotic lesions; Entzuendliches Aortenbogensyndrom: Stenosediagnostik mittels kontrastmittelverstaerkter 3D-MR-Angiographie im Vergleich mit der DSA

    Energy Technology Data Exchange (ETDEWEB)

    Both, M.; Mueller-Huelsbeck, S.; Biederer, J.; Heller, M.; Reuter, M. [Universitaetsklinikum Schleswig-Holstein, Kiel (Germany). Klinik fuer Diagnostische Radiologie; Reinhold-Keller, E.; Gross, W.L. [Rheumaklinik Bad Bramstedt GmbH (Germany)

    2004-01-01

    Purpose: To determine the value of contrast-enhanced, three-dimensional MR angiography for the evaluation of stenotic and occlusive vascular lesions in inflammatory aortic arch syndrome. Materials and Methods: 14 patients with inflammatory aortic arch syndrome (giant cell arteritis: n = 8, Takayasu arteritis: n = 4, ankylosing spondylitis: n = 1 sarcoidosis: n = 1) underwent MR angiography of the aortic arch and the supra-aortic vessels (n = 15,2 patients were examined twice) and of the abdominal aorta (n = 2). MRA was performed using a 3D-FLASH sequence (TR/TE 4.6/1.8 ms, flip angle 30 ) on a 1.5T system. MRA imaging was compared with the findings of DSA, which served as gold standard. Results: In a total of 467 examined vascular territories, DSA revealed 50 stenoses and 35 occlusions. All lesions were detected by MRA. In 23 segments, the degree of stenosis was overestimated by MRA. Sensitivity and specificity of MRA were 100% and 94,3%, positive and negative predictive values were 73.6 and 100%, and the accuracy was 95,1%. Conclusions: Despite a tendency to overestimate stenoses, contrast-enhanced three-dimensional MR angiography is a valid, non-invasive technique in the assessment of inflammatory aortic arch syndrome. (orig.) [German] Ziel: Bestimmung der Aussagekraft der kontrastmittelverstaerkten 3D-Magnetresonanzangiographie bei der Bewertung stenosierender und okkludierender Gefaessveraenderungen im Rahmen des entzuendlichen Aortenbogensyndroms. Material und Methoden: Bei 14 Patienten mit entzuendlichem Aortenbogensyndrom (Arteriitis temporalis: n = 8, Takayasu-Arteriitis: n = 4, Morbus Bechterew: n = 1, Sarkoidose: n = 1) erfolgte eine MRA des Aortenbogens und der supraaortalen Aeste (n = 15, darunter zwei Doppeluntersuchungen) sowie der Aorta abdominalis (n = 2). Zur Anwendung kam eine kontrastmittelverstaerkte 3D-FLASH-Sequenz (TR/TE 0,4/1,8 ms, Flipwinkel 30 ) an einem 1,5 Tesla-System. Die Befunde der MRA wurden mit der DSA als Referenzmethode

  12. 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

  13. Iopentol (Imagopaque trademark 300 and 350) compared with iohexol (Omnipaque trademark 300 and 350) in cerebral and aortic arch angiography. A clinical trial assessing adverse events and diagnostic information

    International Nuclear Information System (INIS)

    The safety of the non-ionic contrast medium iopentol (ImagopaqueR, Nycomed Imaging AS, Oslo, Norway) when used in cerebral angiography and aortic arch angiography, was the focus of this investigation. Overall quality of visualization and changes in heart rate and blood pressure were, however, also assessed. In total, 39 patients were injected with iopentol and 41 patients with the comparative contrast medium, iohexol (OmnipaqueR, Nycomed Imaging AS, Oslo, Norway). Two patients (5%) in each group reported contrast-related adverse events other than a sensation of heat, while three patients in the iopentol group and four in the iohexol group reported procedure-related adverse events. A sensation of heat was reported by 21 patients (54%) in the iopentol group, and by 20 patients (49%) in the iohexol group. There were no clinically relevant changes in heart rate or blood pressure. The diagnostic information obtained was of sufficient or excellent quality for all patients. Statistical analyses did not indicate any significant difference between the two contrast media. Iopentol was well suited for cerebral and aortic arch angiography, comparable to iohexol regarding safety and efficacy. (orig.)

  14. Aortic stenting.

    Science.gov (United States)

    Droc, Ionel; Calinescu, Francisca Blanca; Droc, Gabriela; Blaj, Catalin; Dammrau, Rolf

    2015-01-01

    The approach to aortic pathology is nowadays more and more endovascular at both thoracic and abdominal levels. Thoracic stenting has gained worldwide acceptance as first intention to treat pathologies of the descending thoracic aorta. Indications have been extended to aortic arch aneurysms and also to diseases of the ascending aorta. The current devices in use for thoracic endovascular repair (TEVAR) are Medtronic Valiant, Gore TAG, Cook Tx2 and Jotec. The choice of the endograft depends on the thoracic aortic pathology and the anatomical suitability. The technological evolution of the abdominal aortic endografts was very rapid, arriving now at the fourth generation. We report the results of 55 elective cases of endovascular abdominal aortic repair (EVAR) performed in two vascular surgical centers in Romania and Germany. The prostheses used were 16 E-vita Abdominal XT, 12 Excluder, eight Talent, seven PowerLink, three Endurant and nine custom-made, fenestrated or branched from Jotec. The mean follow-up was 18 months with CT-scan, duplex ultrasound and contrast-enhanced ultrasound. The mortality was 2%. EVAR tends to become the gold standard for abdominal aortic aneurysm repair. Technological development of the devices with lowest profile introduction systems will permit to extend the anatomical indications to new frontiers. PMID:26200430

  15. Deployment Accuracy of the Conformable GORE® TAG® Thoracic Endoprosthesis in the Treatment of Zones 2 and 3 Aortic Arch Aneurysms Compared with the Previous TAG®

    OpenAIRE

    Ito, Eisaku; Kanaoka, Yuji; Maeda, Koji; Ohta, Hiroki; ISHIDA, ATSUSHI; Ohki, Takao

    2015-01-01

    Purposes: When placing stent grafts, deployment accuracy and birdbeaking due to inadequate conformability and device apposition along the inner curvature of the arch have been encountered. The new Conformable GORE® TAG® Thoracic Endoprosthesis (CTAG) is designed to have enhanced compression resistance and improved conformability in difficult anatomy. The present study compared the deployment accuracy and conformability of the CTAG Device with TAG Device.

  16. Medical image of the week: aortic ring

    Directory of Open Access Journals (Sweden)

    Wong C

    2014-10-01

    Full Text Available No abstract available. Article truncated after 150 words. A 78 year old man presented with altered mental status and was found to have an intraventricular hemorrhage. He was intubated for airway protection. On the post-intubation chest radiograph (Figure 1, the patient was noted to have a widening of the right paratracheal stripe. A CT chest (Figure 2 was obtained to characterize this finding and revealed an aortic ring which encircles the trachea and esophagus. Vascular rings are uncommon congenital abnormalities, accounting for approximately 1% of congenital heart disease. Complete vascular rings can occur with a right aortic arch with a ligamentum arteriosum or with a double aortic arch, such as with our patient (1. This ring can cause airway compression, stridor, esophageal compression, or no symptoms at all. As the embryo develops, the left fourth pharyngeal arch normally persists to become the aortic arch while the right fourth pharyngeal arch regresses. If both fourth pharyngeal arches persist, a ...

  17. Network interruptions

    CERN Multimedia

    2005-01-01

    On Sunday 12 June 2005, a site-wide security software upgrade will be performed on all CERN network equipment. This maintenance operation will cause at least 2 short network interruptions of 2 minutes on each equipment item. There are hundreds of such items across the CERN site (Meyrin, Prévessin and all SPS and LHC pits), and it will thus take the whole day to treat them all. All network users and services will be affected. Central batch computing services will be interrupted during this period, expected to last from 8 a.m. until late evening. Job submission will still be possible but no jobs will actually be run. It is hoped to complete the computer centre upgrades in the morning so that stable access can be restored to lxplus, afs and nice services as soon as possible; this cannot be guaranteed, however. The opportunity will be used to interrupt and perform upgrades on the CERN Document Servers.

  18. [DISORDERS OF LUNG FUNCTION IN THE EARLY POSTOPERATIVE PERIOD IN PATIENTS OPERATED ON THE ASCENDING AORTA WITH THE EXPANSION OF INTERVENTION ON THE AORTIC ARCH].

    Science.gov (United States)

    Bokeria, L A; Nikitin, E S; Mironenko, V A; Rychin, S V; Vyganovskaya, N B; Makrushin, I M; Gordeev, S L

    2015-01-01

    Precapillary artery--arterial (bronchial artery--pulmonay artery) anastomoses, come into play in cases where the locking artery open and alveoli washed arterialized blood. Normally, these anastomoses are closed. Intrapulmonary shunts carry blood supply acinar hinder extraordinary circumstances (chronic pulmonary embolism, surgery, occurring in cardiopulmonary bypass, when the flaw of blood through the Iungs is suspended for the duration of cardiopulmonary bypass). Patients operated on the ascending aorta with the expansion of intervention on the nortic arch during the correction of pathology carry blood supply only the central nervous system. All other organs and systems at this time were protected by mild hypothermia. However, during circulatory arrest, required for correction of pathology acinar damage as a result of hypoxia, probably because there is no blood flow in the pulmonary artery and there is no blood flow in the bronchial arteries. Last, in the ordinary course of artificial circulation, capable due to arterio-arterial pulmonary anastomoses prevent hypoxic damage to acinar, not lead to persistent hypoxemia in the immediate postoperative period in these patients, as a result of violations of lung diffusion capacity. PMID:27019884

  19. [A hybrid approach to surgery for thoracic aortic aneurysm

    DEFF Research Database (Denmark)

    L., de la Motte; Baekgaard, N.; Jensen, L.P.; Just, S.; Olesen, A.; Skott, P.

    2009-01-01

    graft and a newly developed aneurysm of the aortic arch. Using a left lateral thoracotomy to avoid manipulation of the pseudoaneurysm, we adopted a hybrid approach by first debranching the subclavian and carotid arteries from the descending aorta followed by endoluminal grafting of the aortic arch. The...

  20. Occlusive ascending aorta and arch atheroma treated with deep hypothermic circulatory arrest and thromboendarterectomy

    Science.gov (United States)

    O’ Sullivan, Katie E.; Early, Sarah A.; Lawler, Leo; Hurley, John

    2013-01-01

    We describe an uncommon presentation of severely advanced aortic atherosclerosis in a 48-year old man with a history of hypertension and heavy smoking. Initial presentation with upper limb ischaemia led to the diagnosis of an aortic arch atheroma occluding 90% of the aortic lumen, managed with deep hypothermic circulatory arrest and aortic thromboendarterectomy. To our knowledge, this is the first reported case of atherosclerotic plaque resulting in aortic occlusion and requiring emergent operative intervention. PMID:23956265

  1. Occlusive ascending aorta and arch atheroma treated with deep hypothermic circulatory arrest and thromboendarterectomy.

    LENUS (Irish Health Repository)

    O' Sullivan, Katie E

    2013-12-01

    We describe an uncommon presentation of severely advanced aortic atherosclerosis in a 48-year old man with a history of hypertension and heavy smoking. Initial presentation with upper limb ischaemia led to the diagnosis of an aortic arch atheroma occluding 90% of the aortic lumen, managed with deep hypothermic circulatory arrest and aortic thromboendarterectomy. To our knowledge, this is the first reported case of atherosclerotic plaque resulting in aortic occlusion and requiring emergent operative intervention.

  2. Occlusive ascending aorta and arch atheroma treated with deep hypothermic circulatory arrest and thromboendarterectomy.

    Science.gov (United States)

    O' Sullivan, Katie E; Early, Sarah A; Lawler, Leo; Hurley, John

    2013-12-01

    We describe an uncommon presentation of severely advanced aortic atherosclerosis in a 48-year old man with a history of hypertension and heavy smoking. Initial presentation with upper limb ischaemia led to the diagnosis of an aortic arch atheroma occluding 90% of the aortic lumen, managed with deep hypothermic circulatory arrest and aortic thromboendarterectomy. To our knowledge, this is the first reported case of atherosclerotic plaque resulting in aortic occlusion and requiring emergent operative intervention. PMID:23956265

  3. Occlusive ascending aorta and arch atheroma treated with deep hypothermic circulatory arrest and thromboendarterectomy

    OpenAIRE

    O’ Sullivan, Katie E.; Early, Sarah A; Lawler, Leo; Hurley, John

    2013-01-01

    We describe an uncommon presentation of severely advanced aortic atherosclerosis in a 48-year old man with a history of hypertension and heavy smoking. Initial presentation with upper limb ischaemia led to the diagnosis of an aortic arch atheroma occluding 90% of the aortic lumen, managed with deep hypothermic circulatory arrest and aortic thromboendarterectomy. To our knowledge, this is the first reported case of atherosclerotic plaque resulting in aortic occlusion and requiring emergent ope...

  4. Beveled reversed elephant trunk procedure for complex aortic aneurysm.

    Science.gov (United States)

    Fujikawa, Takuya; Yamamoto, Shin; Sekine, Yuji; Oshima, Susumu; Kasai, Reo; Sasaguri, Shiro

    2016-03-01

    The reversed elephant trunk procedure uses an inverted graft for distal aortic replacement before aortic arch replacement in patients with mega aorta, to reduce the risk in the second stage. However, the conventional technique restricts the maximum diameter of the inverted graft to the aortic graft diameter. We employed a beveled reversed elephant trunk procedure to overcome the discrepancy between graft diameters in a 54-year-old woman with a severely twisted ascending aortic graft and enlarging chronic dissection of the aortic arch and descending thoracic aorta. The patient was discharged with a satisfactory repair and no neurologic deficit. PMID:25406402

  5. Treatment of an Aortic Traumatic Double Rupture

    Directory of Open Access Journals (Sweden)

    Attinà Domenico

    2015-03-01

    Full Text Available Traumatic thoracic aortic rupture is a life-threatening condition; aortic isthmus is the most common site of rupture, but in rare cases traumatic injury can localize elsewhere, such as at aortic arch or at the level of the diaphragm. In the past few years, endovascular treatment of traumatic aortic injury became a safe procedure, with lower mortality and complication, if compared with open surgery. We report a case of a 40-year-old-man admitted to emergency department after a violent car crash in which an aortic traumatic double rupture was successfully treated with two endovascular stent-grafts coverage.

  6. Aortic stenosis

    Science.gov (United States)

    ... stenosis; Valvular aortic stenosis; Congenital heart - aortic stenosis; Rheumatic fever - aortic stenosis Images Aortic stenosis Heart valves References Carabello BA. Valvular heart disease. In: Goldman L, Schafer AI, eds. Goldman's Cecil ...

  7. Combined surgical and catheter-based treatment of extensive thoracic aortic aneurysm and aortic valve stenosis

    DEFF Research Database (Denmark)

    De Backer, Ole; Lönn, Lars; Søndergaard, Lars

    2015-01-01

    An extensive thoracic aortic aneurysm (TAA) is a potentially life-threatening condition and remains a technical challenge to surgeons. Over the past decade, repair of aortic arch aneurysms has been accomplished using both hybrid (open and endovascular) and totally endovascular techniques. Thoraci...

  8. Aortic dissection: case series

    Directory of Open Access Journals (Sweden)

    Bhavana Venkata Nagabhushana Rao

    2016-04-01

    Full Text Available Aortic dissection may not be attended by a physician in his lifetime, but he should possess all the clinical acumen to deal with as it is a catastrophic disease. Early and accurate diagnosis will save a life. Here we present three cases we faced in sequence over a period of two months. A case of extensive dissection arch to thoracic aorta, its display in detail. Second case eliciting ambiguity between coronary ischemia and aortic dissection. Management difficulties of such clinician situation are discussed. Third case, the fracture of a renal artery stent leading to severe hypertension, abdominal pain, and aortic dissection. Such case was not described in the literature to our knowledge. [Int J Res Med Sci 2016; 4(4.000: 1268-1271

  9. Debranching Solutions in Endografting for Complex Thoracic Aortic Dissections

    Directory of Open Access Journals (Sweden)

    Onur Selcuk Goksel

    2014-08-01

    Full Text Available Background: Conventional surgical repair of thoracic aortic dissections is a challenge due to mortality and morbidity risks. Objectives: We analyzed our experience in hybrid aortic arch repair for complex dissections of the aortic arch. Methods: Between 2009 and 2013, 18 patients (the mean age of 67 ± 8 years-old underwent hybrid aortic arch repair. The procedural strategy was determined on the individual patient. Results: Thirteen patients had type I repair using trifurcation and another patient with bifurcation graft. Two patients had type II repair with replacement of the ascending aorta. Two patients received extra-anatomic bypass grafting to left carotid artery allowing covering of zone 1. Stent graft deployment rate was 100%. No patients experienced stroke. One patient with total debranching of the aortic arch following an acute dissection of the proximal arch expired 3 months after TEVAR due to heart failure. There were no early to midterm endoleaks. The median follow-up was 20 ± 8 months with patency rate of 100%. Conclusion: Various debranching solutions for different complex scenarios of the aortic arch serve as less invasive procedures than conventional open surgery enabling safe and effective treatment of this highly selected subgroup of patients with complex aortic pathologies.

  10. Debranching Solutions in Endografting for Complex Thoracic Aortic Dissections

    International Nuclear Information System (INIS)

    Conventional surgical repair of thoracic aortic dissections is a challenge due to mortality and morbidity risks. We analyzed our experience in hybrid aortic arch repair for complex dissections of the aortic arch. Between 2009 and 2013, 18 patients (the mean age of 67 ± 8 years-old) underwent hybrid aortic arch repair. The procedural strategy was determined on the individual patient. Thirteen patients had type I repair using trifurcation and another patient with bifurcation graft. Two patients had type II repair with replacement of the ascending aorta. Two patients received extra-anatomic bypass grafting to left carotid artery allowing covering of zone 1. Stent graft deployment rate was 100%. No patients experienced stroke. One patient with total debranching of the aortic arch following an acute dissection of the proximal arch expired 3 months after TEVAR due to heart failure. There were no early to midterm endoleaks. The median follow-up was 20 ± 8 months with patency rate of 100%. Various debranching solutions for different complex scenarios of the aortic arch serve as less invasive procedures than conventional open surgery enabling safe and effective treatment of this highly selected subgroup of patients with complex aortic pathologies

  11. Debranching Solutions in Endografting for Complex Thoracic Aortic Dissections

    Energy Technology Data Exchange (ETDEWEB)

    Goksel, Onur Selcuk, E-mail: onurgokseljet@gmail.com [Istanbul University, Istanbul Medical Faculty, Cardiovascular Surgery, Istanbul (Turkey); Guven, Koray [Istanbul University, Istanbul Medical Faculty, Radiology, Istanbul (Turkey); Karatepe, Celalettin [Mustafa Kemal Medical Faculty, Cardiovascular Surgery, Istanbul (Turkey); Gok, Emre [Istanbul University, Istanbul Medical Faculty, Cardiovascular Surgery, Istanbul (Turkey); Acunas, Bulent [Istanbul University, Istanbul Medical Faculty, Radiology, Istanbul (Turkey); Cinar, Bayer [Medical Park Hospital, Istanbul (Turkey); Alpagut, Ufuk [Istanbul University, Istanbul Medical Faculty, Cardiovascular Surgery, Istanbul (Turkey)

    2014-08-15

    Conventional surgical repair of thoracic aortic dissections is a challenge due to mortality and morbidity risks. We analyzed our experience in hybrid aortic arch repair for complex dissections of the aortic arch. Between 2009 and 2013, 18 patients (the mean age of 67 ± 8 years-old) underwent hybrid aortic arch repair. The procedural strategy was determined on the individual patient. Thirteen patients had type I repair using trifurcation and another patient with bifurcation graft. Two patients had type II repair with replacement of the ascending aorta. Two patients received extra-anatomic bypass grafting to left carotid artery allowing covering of zone 1. Stent graft deployment rate was 100%. No patients experienced stroke. One patient with total debranching of the aortic arch following an acute dissection of the proximal arch expired 3 months after TEVAR due to heart failure. There were no early to midterm endoleaks. The median follow-up was 20 ± 8 months with patency rate of 100%. Various debranching solutions for different complex scenarios of the aortic arch serve as less invasive procedures than conventional open surgery enabling safe and effective treatment of this highly selected subgroup of patients with complex aortic pathologies.

  12. Current interruption transients calculation

    CERN Document Server

    Peelo, David F

    2014-01-01

    Provides an original, detailed and practical description of current interruption transients, origins, and the circuits involved, and how they can be calculated Current Interruption Transients Calculationis a comprehensive resource for the understanding, calculation and analysis of the transient recovery voltages (TRVs) and related re-ignition or re-striking transients associated with fault current interruption and the switching of inductive and capacitive load currents in circuits. This book provides an original, detailed and practical description of current interruption transients, origins,

  13. Aortic insufficiency

    Science.gov (United States)

    ... Heart valve - aortic regurgitation; Valvular disease - aortic regurgitation; AI - aortic insufficiency ... BA. Valvular heart disease. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: ...

  14. Hybrid treatment of penetrating aortic ulcer

    Energy Technology Data Exchange (ETDEWEB)

    Lara, Juan Antonio Herrero; Martins-Romeo, Daniela de Araujo; Escudero, Carlos Caparros; Falcon, Maria del Carmen Prieto; Batista, Vinicius Bianchi, E-mail: jaherrero5@hotmail.com [Unidade de Gestao Clinica (UGC) de Diagnostico por Imagem - Hosppital Universitario Virgen Macarena, Sevilha (Spain); Vazquez, Rosa Maria Lepe [Unit of Radiodiagnosis - Hospital Nuestra Senora de la Merced, Osuna, Sevilha (Spain)

    2015-05-15

    Penetrating atherosclerotic aortic ulcer is a rare entity with poor prognosis in the setting of acute aortic syndrome. In the literature, cases like the present one, located in the aortic arch, starting with chest pain and evolving with dysphonia, are even rarer. The present report emphasizes the role played by computed tomography in the diagnosis of penetrating atherosclerotic ulcer as well as in the differentiation of this condition from other acute aortic syndromes. Additionally, the authors describe a new therapeutic approach represented by a hybrid endovascular surgical procedure for treatment of the disease. (author)

  15. Interrupt Handlers in Java

    DEFF Research Database (Denmark)

    Korsholm, Stephan; Schoeberl, Martin; Ravn, Anders Peter

    2008-01-01

    An important part of implementing device drivers is to control the interrupt facilities of the hardware platform and to program interrupt handlers. Current methods for handling interrupts in Java use a server thread waiting for the VM to signal an interrupt occurrence. It means that the interrupt...... is handled at a later time, which has some disadvantages. We present constructs that allow interrupts to be handled directly and not at a later point decided by a scheduler. A desirable feature of our approach is that we do not require a native middleware layer but can handle interrupts entirely with Java...... code. We have implemented our approach using an interpreter and a Java processor, and give an example demonstrating its use....

  16. Aneurysms: thoracic aortic aneurysms.

    Science.gov (United States)

    Chun, Kevin C; Lee, Eugene S

    2015-04-01

    Thoracic aortic aneurysms (TAAs) have many possible etiologies, including congenital heart defects (eg, bicuspid aortic valves, coarctation of the aorta), inherited connective tissue disorders (eg, Marfan, Ehlers-Danlos, Loeys-Dietz syndromes), and degenerative conditions (eg, medial necrosis, atherosclerosis of the aortic wall). Symptoms of rupture include a severe tearing pain in the chest, back, or neck, sometimes associated with cardiovascular collapse. Before rupture, TAAs may exert pressure on other thoracic structures, leading to a variety of symptoms. However, most TAAs are asymptomatic and are found incidentally during imaging for other conditions. Diagnosis is confirmed with computed tomography scan or echocardiography. Asymptomatic TAAs should be monitored with imaging at specified intervals and patients referred for repair if the TAAs are enlarging rapidly (greater than 0.5 cm in diameter over 6 months for heritable etiologies; greater than 0.5 cm over 1 year for degenerative etiologies) or reach a critical aortic diameter threshold for elective surgery (5.5 cm for TAAs due to degenerative etiologies, 5.0 cm when associated with inherited syndromes). Open surgery is used most often to treat asymptomatic TAAs in the ascending aorta and aortic arch. Asymptomatic TAAs in the descending aorta often are treated medically with aggressive blood pressure control, though recent data suggest that endovascular procedures may result in better long-term survival rates. PMID:25860136

  17. Interruptions: Derrida and Hospitality

    OpenAIRE

    Mark W. Westmoreland

    2008-01-01

    Come in. Welcome. Be my guest and I will be yours. Shall we ask, in accordance with the Derridean question, "Is not hospitality an interruption of the self?" What is the relationship between the interruption and the moment one enters the host's home? Derrida calls us toward a new understanding of hospitality - as an interruption. This paper will illuminate the history of hospitality in the West as well as trace Derrida's discussions of hospitality throughout many of works. The overall goal of...

  18. Association of Aortic Calcification on Plain Chest Radiography with Obstructive Coronary Artery Disease

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Yeong Han; Chang, Jeong Ho [Dept. of Diagnostic Radiology, Daegu Catholic University Hospital, Daegu (Korea, Republic of); Park, Jong Sam [Dept. of Radiologic Tecnology, Daegu Health College, Daegu (Korea, Republic of)

    2009-03-15

    This study was conducted to determine an association between aortic calcification viewed on plain chest radiography and obstructive coronary artery disease. Retrospective review of all chest radiography obtained from consecutive patients undergoing coronary angiography. Chest PA images were reviewed by technical radiologist and radiologist. Considering the presence of aortic arch calcification, images were compared with the results of coronary angiography. In addition, the size of aortic arch calcification were divided into two groups - the smaller and the larger than 10 mm. Among the total 846 patients, the number of the patients with obstructive coronary artery disease is total 417 (88.3%) in males and 312 (83.4%) in females. Considering the presence of aortic arch calcification, the positive predictive value of relation between aortic arch calcification and obstructive coronary artery disease was 91.4% and the relative risk of the group with aortic arch calcification to the opposite group was 1.10. According to the size of aortic arch calcification and obstructive coronary artery disease, the positive predictive value was 91.9% and the relative risk between two groups was 1.04. This study shows that aortic calcification was closely associated with obstructive coronary artery disease. If the aortic calcification is notified on plain chest radiography, we strongly recommend to consult with doctor.

  19. Association of Aortic Calcification on Plain Chest Radiography with Obstructive Coronary Artery Disease

    International Nuclear Information System (INIS)

    This study was conducted to determine an association between aortic calcification viewed on plain chest radiography and obstructive coronary artery disease. Retrospective review of all chest radiography obtained from consecutive patients undergoing coronary angiography. Chest PA images were reviewed by technical radiologist and radiologist. Considering the presence of aortic arch calcification, images were compared with the results of coronary angiography. In addition, the size of aortic arch calcification were divided into two groups - the smaller and the larger than 10 mm. Among the total 846 patients, the number of the patients with obstructive coronary artery disease is total 417 (88.3%) in males and 312 (83.4%) in females. Considering the presence of aortic arch calcification, the positive predictive value of relation between aortic arch calcification and obstructive coronary artery disease was 91.4% and the relative risk of the group with aortic arch calcification to the opposite group was 1.10. According to the size of aortic arch calcification and obstructive coronary artery disease, the positive predictive value was 91.9% and the relative risk between two groups was 1.04. This study shows that aortic calcification was closely associated with obstructive coronary artery disease. If the aortic calcification is notified on plain chest radiography, we strongly recommend to consult with doctor.

  20. Impact on calcification of aortic arch by lifestyle-related,physiologic and biochemical factors%主动脉弓钙化影响因素的调查与分析

    Institute of Scientific and Technical Information of China (English)

    周海林; Thomas GN; 江朝强; 林大庆; 郑家强; 刘斌; 张维森; 徐琳; 靳雅丽; 朱彤

    2009-01-01

    Objective To explore the impact of lifestyle-related,physiological and biochemical factors on aortic arch calcification(AAC).Methods 20 430 subjects aged 50 to 85 years were included in this study from the first and second recruitment phase of the Guangzhou Biobank Cohort Study.All the subjects received face-to-face interviews to collect detailed information on their socio-demographic background,occupational exposures,living environment,lifestyle,family and personal disease histories,and received a physical examination and tests including 12-lead ECG,chest radiograph,and pulmonary function testing.Each subject was screened for a range of fasting biochemical parameters.Radiographs were reviewed by two senior radiologists.300 radiographs were independently read by the two radiologists to assess agreement using Kappa coefficient.Logistic regression was used to assess the association between life style,physiological and biocheroical factors and AAC.Resuits (1)The rate of agreement on diagnosis for the two radiologists was 85% and Kappa coefficient was 0.68(P<0.01) which showed a moderate agreementbetween the two radiologists.(2) Except hypertension,the subjects were significantly difierent on their lifestyle,physiological and biochemical factors in both men and women(P<0.05).(3)AAC was significantly associated with older age,smoking status,LDL-C,and hypertension(P<0.01)in both genders.Ors(95%CI)indicated the following results:age was 1.11(1.10-1.12) in men and 1.12 (1.12-1.13)in women;smoking as 1.31(1.17-1.47)in men and 1.31(1.09-1.57)in women;LDL-Cas 1.16(1.06-1.27) in men and 1.38(1.22-1.56) in women,hypertension as 1.33(1.18-1.50) in men and 1.27(1.18-1.38) in women.However,diabetes was found to be associated with an increased risk of AAC in women[OR(95%CI)]1.38(1.22-1.56).Conclusion Age,smoking,hypertension and Low-density lipoprotcin level were risk factors to beth genders,on AAC,while diabetes increased the risk of AAC,in women.%目的 探讨生活习惯及生

  1. Modificação técnica para correção de coarctação aórtica com hipoplasia do arco aórtico Technical modification for correction of aortic coarctation using hypoplastic arch

    Directory of Open Access Journals (Sweden)

    José Alberto Caliani

    2008-09-01

    2005 and July 2006, nine newborn patients with aortic coarctation and significant aortic hypoplasia were selected, and underwent a new surgical approach in order to correct this aortic defect. The definition of aortic arch hypoplasia according to Moulaert's criteria is an aortic arch with a diameter that is less than 50% of the diameter of the ascending aorta. In this study, only patients with proximal and distal aortic hypoplasia were selected. Many techniques were previously used, but significant residual gradients were observed, as well as the incovenience of definitive occlusion of the left subclavian artery. The aim of this study is to describe a new surgical technique that includes left posterolateral thoracotomy, wide mobilization of descending aorta with occlusion of the first two intercostal branches, transection of the left subclavian artery at its base, wide resection of the hypoplastic area and the surronding regions of the ductus arteriosus; end-to-end anastomosis between the aortic arch and descending aorta, with 7-0 PDS thread and reimplantation of the subclavian artery into the left carotid artery with side-to-end anastomosis. RESULTS: There were no perioperative or late deaths. The mean residual gradient was 5 mmHg. Up to now, there were no cases of recoarctation or medullary neurological lesions. CONCLUSION: Despite the small number of cases and the short follow-up, this technique modification may be an excellent option for the treatment of this complex situation.

  2. Dental arch asymmetry

    OpenAIRE

    Al-Zubair, Nabil Muhsen

    2014-01-01

    Objective: This study was conducted to assess the dental arch asymmetry in a Yemeni sample aged (18-25) years. Materials and Methods: The investigation involved clinical examination of 1479 adults; only 253 (129 females, 124 males) out of the total sample were selected to fulfill the criteria for the study sample. Study models were constructed and evaluated to measure mandibular arch dimensions. Three linear distances were utilized on each side on the dental arch: Incisal-canine distance, can...

  3. Aortic Aneurysm: A Rare Cause of Ortner's Syndrome

    International Nuclear Information System (INIS)

    A young man presented with hoarseness of voice and was found to have left vocal cord paralysis and a large opacity on chest X-ray in the left upper zone. CT angiography showed a giant aneurysm of the aortic arch involving the left subclavian artery. Using a dual perfusion system, with the femoral bypass circuit taking care of the spinal protection and the aortic bypass circuit providing the cerebral protection, the aneurysm was excised and a 16 mm Dacron graft was anastomosed to the aortic arch and the left subclavian artery was anastomosed to the interposition graft. He had a smooth postoperative course and his hoarseness subsided in next 6 months. (author)

  4. [Surgical aspects of acute aortic dissection].

    Science.gov (United States)

    Laas, J; Heinemann, M; Jurmann, M; Borst, H G

    1992-12-01

    This paper highlights some of the surgical aspects of acute aortic dissections such as: emergency diagnosis, indications for surgery, reconstructive operative techniques, malperfusion phenomena and necessity for follow-up. Aortic dissection is caused by an intimal tear, called the "entry", and subsequent splitting of the media by the stream of blood. Two lumina are thus created, which may communicate through "re-entries". As this creates severe weakness of the aortic wall, rupture and/or dilatation are the imminent dangers of acute aortic dissection. Acute aortic dissection type A, by definition involving the ascending aorta (Figures 1 and 2), is an absolute indication for emergency surgical treatment, because its natural history shows an extremely poor outcome (Figure 3). Due to impending (intrapericardial) aortic rupture, it may be necessary to limit diagnostic procedures to a minimum. Transesophageal echocardiography is the method of choice for establishing a quick, precise and reliable diagnosis (Figure 4). In stable patients, computed tomography gives additional information about aortic diameters or sites of extrapericardial perforation. Digital subtraction angiography (DSA) shows perfusion of the lumina and dependent organs. The surgical strategy in acute aortic dissection type A aims at replacement of the ascending aorta. Reconstructive techniques have to be considered, especially in aortic valve regurgitation without annuloectasia (Figures 5 and 6). In recent times, the use of GRF tissue glue has reduced the need for teflon felt. Involvement of the aortic arch should be treated aggressively up to the point of total arch replacement in deep hypothermic circulatory arrest as part of the primary procedure (Figure 7). Malperfusion phenomena of aortic branches remain risk-factors.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1483624

  5. Glossary to ARCH (GARCH)

    DEFF Research Database (Denmark)

    Bollerslev, Tim

    The literature on modeling and forecasting time-varying volatility is ripe with acronyms and abbreviations used to describe the many different parametric models that have been put forth since the original linear ARCH model introduced in the seminal Nobel Prize winning paper by Engle (1982).  The...... figure especially prominently in the ARCH literature....

  6. Interruptions: Derrida and Hospitality

    Directory of Open Access Journals (Sweden)

    Mark W. Westmoreland

    2008-06-01

    Full Text Available Come in. Welcome. Be my guest and I will be yours. Shall we ask, in accordance with the Derridean question, "Is not hospitality an interruption of the self?" What is the relationship between the interruption and the moment one enters the host's home? Derrida calls us toward a new understanding of hospitality - as an interruption. This paper will illuminate the history of hospitality in the West as well as trace Derrida's discussions of hospitality throughout many of works. The overall goal of this project is to provide readers of Derrida with a sort of reference guide for his discussions on and deconstructive approach to hospitality.

  7. Guilt by association: a paradigm for detection of silent aortic disease

    OpenAIRE

    Ziganshin, Bulat A.; Elefteriades, John A.

    2016-01-01

    Detection of clinically silent thoracic aortic aneurysm (TAA) is challenging due to the lack of symptoms (until aortic rupture or dissection occurs). A large proportion of TAA are identified incidentally while imaging a patient for other reasons. However, recently several clinical “associates” of TAA have been described that can aid in identification of silent TAA. These “associates” include intracranial aneurysm, aortic arch anomalies, abdominal aortic aneurysm (AAA), simple renal cysts (SRC...

  8. Interruptions disrupt reading comprehension.

    Science.gov (United States)

    Foroughi, Cyrus K; Werner, Nicole E; Barragán, Daniela; Boehm-Davis, Deborah A

    2015-06-01

    Previous research suggests that being interrupted while reading a text does not disrupt the later recognition or recall of information from that text. This research is used as support for Ericsson and Kintsch's (1995) long-term working memory (LT-WM) theory, which posits that disruptions while reading (e.g., interruptions) do not impair subsequent text comprehension. However, to fully comprehend a text, individuals may need to do more than recognize or recall information that has been presented in the text at a later time. Reading comprehension often requires individuals to connect and synthesize information across a text (e.g., successfully identifying complex topics such as themes and tones) and not just make a familiarity-based decision (i.e., recognition). The goal for this study was to determine whether interruptions while reading disrupt reading comprehension when the questions assessing comprehension require participants to connect and synthesize information across the passage. In Experiment 1, interruptions disrupted reading comprehension. In Experiment 2, interruptions disrupted reading comprehension but not recognition of information from the text. In Experiment 3, the addition of a 15-s time-out prior to the interruption successfully removed these negative effects. These data suggest that the time it takes to process the information needed to successfully comprehend text when reading is greater than that required for recognition. Any interference (e.g., an interruption) that occurs during the comprehension process may disrupt reading comprehension. This evidence supports the need for transient activation of information in working memory for successful text comprehension and does not support LT-WM theory. PMID:25867225

  9. 小儿主动脉弓手术中深低温停循环和局部脑灌注的应用效果%Applied research of deep hypothermic circulatory arrest and regional cerebral perfusion in pediatric aortic arch surgery

    Institute of Scientific and Technical Information of China (English)

    郭铮; 郑景浩; 王伟; 付惟定; 朱德明

    2014-01-01

    目的 观察并比较深低温停循环(DHCA)和局部脑灌注(RCP)在小儿主动脉弓手术中的应用效果.方法 70例小于3个月的主动脉缩窄和主动脉弓中断合并房间隔缺损、室间隔缺损的手术患儿根据体外循环方法不同分成DHCA组和RCP组.DHCA组35例,男23例,女12例;年龄(1.33±0.80)个月;体质量(4.3±2.9)kg.RCP组35例,男20例,女15例;年龄(1.35±0.90)个月;体质量(4.4±3.2) kg.分析两组体外循环时间、主动脉阻断时间、停循环或脑灌注时间,呼吸机辅助时间、监护室停留时间,术后肾功能不全、低心排血量综合征、肺部炎症、神经系统并发症和院内死亡等情况.结果 神经系统并发症发病率,DHCA组显著高于RCP组(P<0.05).体外循环时间,RCP组显著的长于DHCA组(P<0.05).RCP时间显著长于DHCA时间(P<0.01).在主动脉阻断时间、呼吸机插管时间、监护室停留时间和术后肾功能不全、低心排血量综合征、肺部炎症及院内死亡比例等两组间差异无统计学意义.结论 RCP是一种有效的脑保护技术,同DHCA相比,能更好的对大脑进行持续的脑血流灌注,适用于复杂耗时的小儿主动脉弓手术,在神经系统保护方面较DHCA有着更好的效果.%Objective To observe and evaluate the effects of the deep hypothermic circulatory arrest(DHCA) and regional cerebral perfusion(RCP) in pediatric aortic arch surgery.Methods According to different methods of CPB,70 infants less than 3-month-old with CoA or IAA were undergone corrective surgery with DHCA or RCP.The bypass time,aortic clamp time,DHCA or RCP time,ventilation time,ICU stay time and post-operative complications were recorded and compared between two groups.Results The incidence of neurological complications was significantly higher in DHCA group.The CPB time was significantly longer in the RCP group,and the RCP time was significantly longer than DHCA time.Blocking time,ventilator intubation time

  10. Unreliability of aortic size index to predict risk of aortic dissection in a patient with Turner syndrome

    Science.gov (United States)

    Nijs, Jan; Gelsomino, Sandro; Lucà, Fabiana; Parise, Orlando; Maessen, Jos G; Meir, Mark La

    2014-01-01

    Aortic size index (ASI) has been proposed as a reliable criterion to predict risk for aortic dissection in Turner syndrome with significant thresholds of 20-25 mm/m2. We report a case of aortic arch dissection in a patient with Turner syndrome who, from the ASI thresholds proposed, was deemed to be at low risk of aortic dissection or rupture and was not eligible for prophylactic surgery. This case report strongly supports careful monitoring and surgical evaluation even when the ASI is < 20 mm/m2 if other significant risk factors are present. PMID:24944765

  11. Miscarriage: A Dream Interrupted

    Science.gov (United States)

    Trepal, Heather C.; Semivan, Suzanne Gibson; Caley-Bruce, Mary

    2005-01-01

    Pregnancy is a developmental task that requires women to become accustomed to inherent and sometimes profound biological, somatic, and psychological changes. When pregnancy is interrupted by miscarriage, it may become a pivotal crisis point in the development of a woman's maternal identity as well as an issue in family development. This manuscript…

  12. Sound, memory and interruption

    DEFF Research Database (Denmark)

    Pinder, David

    2016-01-01

    This chapter considers how art can interrupt the times and spaces of urban development so they might be imagined, experienced and understood differently. It focuses on the construction of the M11 Link Road through north-east London during the 1990s that demolished hundreds of homes and displaced ...

  13. How to Perfuse: Concepts of Cerebral Protection during Arch Replacement

    Directory of Open Access Journals (Sweden)

    Andreas Habertheuer

    2015-01-01

    Full Text Available Arch surgery remains undoubtedly among the most technically and strategically challenging endeavors in cardiovascular surgery. Surgical interventions of thoracic aneurysms involving the aortic arch require complete circulatory arrest in deep hypothermia (DHCA or elaborate cerebral perfusion strategies with varying degrees of hypothermia to achieve satisfactory protection of the brain from ischemic insults, that is, unilateral/bilateral antegrade cerebral perfusion (ACP and retrograde cerebral perfusion (RCP. Despite sophisticated and increasingly individualized surgical approaches for complex aortic pathologies, there remains a lack of consensus regarding the optimal method of cerebral protection and circulatory management during the time of arch exclusion. Many recent studies argue in favor of ACP with various degrees of hypothermic arrest during arch reconstruction and its advantages have been widely demonstrated. In fact ACP with more moderate degrees of hypothermia represents a paradigm shift in the cardiac surgery community and is widely adopted as an emergent strategy; however, many centers continue to report good results using other perfusion strategies. Amidst this important discussion we review currently available surgical strategies of cerebral protection management and compare the results of recent European multicenter and single-center data.

  14. Clarifying the anatomy of the fifth arch artery

    Directory of Open Access Journals (Sweden)

    Saurabh Kumar Gupta

    2016-01-01

    Full Text Available The artery allegedly forming in the fifth pharyngeal arch has increasingly been implicated as responsible for various vascular malformations in patients with congenitally malformed hearts. Observations from studies on developing embryos, however, have failed to provide support to substantiate several of these inferences such that the very existence of the fifth arch artery remains debatable. To the best of our knowledge, in only a solitary human embryo has a vascular channel been found that truly resembled the artery of the fifth arch. Despite the meager evidence to support its existence, the fifth arch artery has been invoked to explain the morphogenesis of double-barreled aorta, some unusual forms of aortopulmonary communications, and abnormalities of the brachiocephalic arteries. In most of these instances, the interpretations have proved fallible when examined in the light of existing knowledge of cardiac development. In our opinion, there are more plausible alternative explanations for the majority of these descriptions. Double-barreled aorta is more likely to result from retention of the recently identified dorsal collateral channels while abnormalities of brachiocephalic arteries are better explained on the basis of extensive remodeling of aortic arches during fetal development. Some examples of aortopulmonary communications, nonetheless, may well represent persistence of the developing artery of the fifth pharyngeal arch. We here present one such case - a patient with tetralogy of Fallot and pulmonary atresia, in whom the fifth arch artery provided a necessary communication between the ascending aorta and the pulmonary arteries. In this light, we discuss the features we consider to be essential before attaching the tag of "fifth arch artery" to a candidate vascular channel.

  15. A modified total arch replacement combined with a stented elephant trunk implantation for acute type A dissection under deep hypothermic circulatory arrest and selective antegrade cerebral perfusion

    OpenAIRE

    Yang, Su-Min; Xu, Ping; Cheng-xiang LI; Huang, Qiang; Gao, Hong-Bo; Li, Zhen-Fu; Chang, Qing

    2014-01-01

    Objectives Since the optimal management of patients with acute aortic dissection is unclear, this study analyzed total arch replacement combined with stented elephant trunk implantation in the treatment of acute type A aortic dissection. Methods Between February 2008 and February 2013, 86 consecutive patients admitted to our hospital for acute type A dissection underwent total arch replacement combined with stented elephant trunk implantation under deep hypothermic circulatory arrest. The Ben...

  16. A rare cause of recurrent aortic dissection.

    Science.gov (United States)

    Agrawal, Yashwant; Gupta, Vishal

    2016-07-01

    We report the case of a 19-year-old man with a history of Loeys-Dietz syndrome (LDS), which was diagnosed when he had a Stanford type A aortic dissection. He also had multiple aneurysms including ones in the innominate, right common carotid, and right internal mammary arteries. He had had multiple procedures including Bentall's procedure, repeat sternotomy with complete arch and valve replacement, and coil embolization of internal mammary artery aneurysm in the past. His LDS was characterized by gene mutation for transforming growth factor-β receptor 1. He presented to our facility with sudden onset of back pain, radiating to the right shoulder and chest. He was diagnosed with Stanford type B aortic dissection and underwent thoracic aorta endovascular repair for his aortic dissection. This case represents the broad spectrum of pathology associated with LDS where even with regular surveillance and aggressive medical management the patient developed Stanford B aortic dissection. PMID:27358537

  17. A rare cause of recurrent aortic dissection

    Directory of Open Access Journals (Sweden)

    Yashwant Agrawal

    2016-07-01

    Full Text Available We report the case of a 19-year-old man with a history of Loeys–Dietz syndrome (LDS, which was diagnosed when he had a Stanford type A aortic dissection. He also had multiple aneurysms including ones in the innominate, right common carotid, and right internal mammary arteries. He had had multiple procedures including Bentall’s procedure, repeat sternotomy with complete arch and valve replacement, and coil embolization of internal mammary artery aneurysm in the past. His LDS was characterized by gene mutation for transforming growth factor-β receptor 1. He presented to our facility with sudden onset of back pain, radiating to the right shoulder and chest. He was diagnosed with Stanford type B aortic dissection and underwent thoracic aorta endovascular repair for his aortic dissection. This case represents the broad spectrum of pathology associated with LDS where even with regular surveillance and aggressive medical management the patient developed Stanford B aortic dissection.

  18. Outcomes of single-stage total arch replacement via clamshell incision

    Directory of Open Access Journals (Sweden)

    Ishizaka Toru

    2011-09-01

    Full Text Available Abstract Background Treatment of complex aortic pathologies involving the transverse arch with extensive involvement of the descending aorta remains a surgical challenge. Since clamshell incision provides superior exposure of the entire thoracic aorta, we evaluated the use of this technique for single-stage total arch replacement by arch vessel reconstruction. Methods The arch-first technique combined with clamshell incision was used in 38 cases of aneurysm and aortic disease in 2008 and 2009. Extensive total arch replacement was used with clamshell incision for reconstruction of arch vessels under deep hypothermic circulatory arrest. Results Overall 30-day mortality was 13%. The mean operating time was approximately 8 hours. Deep hypothermia resulted in mean CPB time exceeding 4.5 hours and mean duration of circulatory arrest was 25 minutes. The overall postoperative temporary and permanent neurologic dysfunction rates were 3% and 3% for elective and 3% and 0% for emergency surgery, respectively. All patients except the five who died in hospital were discharged without nursing care after an average post-operative hospital stay of 35 days. Conclusions The arch-first technique, combined with clamshell incision, provides expeditious replacement of the thoracic aorta with an acceptable duration of hypothermic circulatory arrest and minimizes the risk of retrograde atheroembolism by using antegrade perfusion.

  19. Reoperation on aortic disease in patients with previous aortic valve surgery

    Institute of Scientific and Technical Information of China (English)

    SUN Xiao-gang; ZHANG Liang; YU Cun-tao; QIAN Xiang-yang; CHANG Qian

    2013-01-01

    Background Aortic valve replacement (AVR) is a safe and effective method in the treatment of aortic valve diseases.This study aimed to increase the understanding on re-treatment of aortic diseases after aortic valve surgery through a retrospective analysis of 47 related cases.Methods Forty-seven patients (38 males and 9 females) with previous aortic valve surgery have received reoperation on aorta from January 2003 to June 2012,and the mean interval time of re-intervention to aortic disease was 6 years ((6.0± 3.8) years).The secondary aortic surgery included aortic root replacement (14 cases),ascending aorta replacement (10 cases),aortic root/ascending aorta plus total arch replacement with stented elephant trunk implantation (21 cases),and total thoracoabdominal aorta replacement (2 cases).All these patients have received outpatient re-exams or follow-up by phone calls.Results After the initial aortic valve replacement,patients suffered from aortic dissection (25 cases,53%),ascending aortic aneurysm (12 cases,26%) or aortic root aneurysm (10 cases,21%).Diameter in ascending aorta increased (5.2±7.1) mm per year and aortic sinus (3.3±3.1) mm per year.The annual growth value of diameter in ascending aorta was higher in patients with rheumatic heart disease than that in Marfan syndrome (P<0.05).All 47 patients have received reoperation on aorta.One patient died in operating room because aortic dissection seriously involved right coronary artery.Seven patients had renal insufficiency after operation; neurological complications occurred in 14 patients including 7 patients with stroke and the others with transient brain dysfunction.All patients were followed up,the mean survival time was (97.25±17.63) months,95% confidence interval was 55.24-73.33 months.Eight cases were died during follow-up and five-year survival rate was 83%.Conclusion To reduce the aortic adverse events after first aortic valve surgery,it is necessary to actively treat and strictly

  20. Evolution of Endovascular Treatment for Complex Thoracic Aortic Disease

    OpenAIRE

    Roselli, Eric E.

    2008-01-01

    In a relatively short period of time, transcatheter and endovascular approaches to treat thoracic aortic and structural heart disease have exploded onto the scene. New device frontiers already being forged in the experimental stages include expanded indications and variations of fenestrated and branch stentgrafting to treat thoracoabdominal and arch disease, endovascular ascending and aortic root repair, and all of the cardiac valves. A fundamental concept to optimize durability of endovascul...

  1. Guilt by association: a paradigm for detection of silent aortic disease.

    Science.gov (United States)

    Ziganshin, Bulat A; Elefteriades, John A

    2016-05-01

    Detection of clinically silent thoracic aortic aneurysm (TAA) is challenging due to the lack of symptoms (until aortic rupture or dissection occurs). A large proportion of TAA are identified incidentally while imaging a patient for other reasons. However, recently several clinical "associates" of TAA have been described that can aid in identification of silent TAA. These "associates" include intracranial aneurysm, aortic arch anomalies, abdominal aortic aneurysm (AAA), simple renal cysts (SRC), bicuspid aortic valve, temporal arteritis, a positive family history of aneurysm disease, and a positive thumb-palm sign. In this article we examine these associates of TAA and the data supporting their involvement with asymptomatic TAA. PMID:27386404

  2. Aortic reconstruction with bovine pericardial grafts

    Directory of Open Access Journals (Sweden)

    Silveira Lindemberg Mota

    2003-01-01

    Full Text Available INTRODUCTION: Glutaraldehyde-treated crimped bovine pericardial grafts are currently used in aortic graft surgery. These conduits have become good options for these operations, available in different sizes and shapes and at a low cost. OBJECTIVE:To evaluate the results obtained with bovine pericardial grafts for aortic reconstruction, specially concerning late complications. METHOD: Between January 1995 and January 2002, 57 patients underwent different types of aortic reconstruction operations using bovine pericardial grafts. A total of 29 (50.8% were operated on an urgent basis (mostly acute Stanford A dissection and 28 electively. Thoracotomy was performed in three patients for descending aortic replacement (two patients and aortoplasty with a patch in one. All remaining 54 underwent sternotomy, cardiopulmonary bypass and aortic resection. Deep hypothermia and total circulatory arrest was used in acute dissections and arch operations. RESULTS: Hospital mortality was 17.5%. Follow-up was 24.09 months (18.5 to 29.8 months confidence interval and complication-free actuarial survival curve was 92.3% (standard deviation ± 10.6. Two patients lately developed thoracoabdominal aneurysms following previous DeBakey II dissection and one died from endocarditis. One "patch" aortoplasty patient developed local descending aortic pseudoaneurysm 42 months after surgery. All other patients are asymptomatic and currently clinically evaluated with echocardiography and CT scans, showing no complications. CONCLUSION: Use of bovine pericardial grafts in aortic reconstruction surgery is adequate and safe, with few complications related to the conduits.

  3. Multivariate Rotated ARCH models

    OpenAIRE

    Shephard, Neil; Sheppard, Kevin; Noureldin, Diaa

    2012-01-01

    This paper introduces a new class of multivariate volatility models which is easy to estimate using covariance targeting, even with rich dynamics. We call them rotated ARCH (RARCH) models. The basic structure is to rotate the returns and then to fit them using a BEKK-type parameterization of the time-varying covariance whose long-run covariance is the identity matrix. The extension to DCC-type parameterizations is given, introducing the rotated conditional correlation (RCC) model. Inference f...

  4. The ARCHES Project

    Science.gov (United States)

    Motch, C.; Arches Consortium

    2015-09-01

    The Astronomical Resource Cross-matching for High Energy Studies (ARCHES) project is a FP7-Space funded programme started in 2013 and involving the Observatoire Astronomique de Strasbourg including the CDS (France), the Leibniz- Institut für Astrophysik Potsdam (Germany), the University of Leicester (UK), the Universidad de Cantabria (IFCA, Spain) and the Instituto Nacional de Tecnica Aeroespacial (Spain). ARCHES will provide the international astronomical community with well-characterised multi-wavelength data in the form of spectral energy distributions (SEDs) for large samples of objects extracted from the 3XMM X-ray catalogue of serendipitous sources. The project develops new tools implementing fully probabilistic simultaneous cross-correlation of several catalogues and a multi-wavelength finder for clusters of galaxies. SEDs are based on an enhanced version of the 3XMM catalogue and on a careful selection of the most relevant multi-wavelength archival catalogues. In order to ensure the largest audience, SEDs will be distributed to the international community through CDS services and through the Virtual Observatory. These enhanced resources are tested in the framework of several science cases. More information may be found at http://www.arches-fp7.eu/

  5. New temporary internal introducer shunt for brain perfusion during total endovascular arch replacement with in situ fenestration technique.

    Science.gov (United States)

    Sonesson, Björn; Resch, Tim; Dias, Nuno; Malina, Martin

    2012-10-01

    Complete endovascular arch replacement by in situ fenestration technique requires maintenance of cerebral perfusion during the fenestration procedure by an extracorporeal femoral-carotid bypass. The bypass has the disadvantages of being invasive, requiring a pump, and shunting blood extracorporeally. This report describes bench testing and an in vivo experimental animal setup with an endovascular, temporary introducer shunt. This technique represents an adjunctive step toward a complete endovascular repair for the aortic arch. PMID:22857810

  6. The ARCHES project

    CERN Document Server

    Motch, C; Genova, F; Esteban, F Jiménez-; López, M; Michel, L; Mingo, B; Mints, A; Gómez-Morán, A Nebot; Pineau, F -X; Rosen, S; Sanchez, E; Schwope, A; Solano, E; Watson, M

    2016-01-01

    ARCHES (Astronomical Resource Cross-matching for High Energy Studies) is a FP7-Space funded project whose aim is to provide the international astronomical community with well-characterised multi-wavelength data in the form of spectral energy distributions (SEDs) for large samples of objects extracted from the 3XMM DR5 X-ray catalogue of serendipitous sources. The project has developed new tools implementing fully probabilistic simultaneous cross-correlation of several catalogues for unresolved sources and a multi-wavelength finder for clusters of galaxies for extended sources. These enhanced resources have been tested in the framework of several science cases.

  7. Pericarditis as initial manifestation of proximal aortic dissection in young patients.

    Science.gov (United States)

    Bains, Suchdeep Raj; Kedia, Anita; Roldan, Carlos A

    2008-03-01

    Pericarditis was the primary manifestation of aortic dissection in these 2 young men. Both patients had no phenotypic characteristics of Marfan or Ehlers-Danlos syndrome. These patients had pleuritic chest pain and characteristic electrocardiographic changes consistent with pericarditis. However, timely performed transthoracic echocardiograms revealed proximal aortic dissection with hemopericardium noted at surgery in both cases. Although the sensitivity of transthoracic echocardiogram for proximal aortic dissection is approximately 60%, certain findings can alert the physician to the possibility of aortic dissection. Therefore, in young patients with suspected pericarditis, a timely performed transthoracic echocardiogram should include a careful evaluation of the ascending aorta and arch to rule out this lethal diagnosis. PMID:18358965

  8. Global interrupt and barrier networks

    Science.gov (United States)

    Blumrich, Matthias A.; Chen, Dong; Coteus, Paul W.; Gara, Alan G.; Giampapa, Mark E; Heidelberger, Philip; Kopcsay, Gerard V.; Steinmacher-Burow, Burkhard D.; Takken, Todd E.

    2008-10-28

    A system and method for generating global asynchronous signals in a computing structure. Particularly, a global interrupt and barrier network is implemented that implements logic for generating global interrupt and barrier signals for controlling global asynchronous operations performed by processing elements at selected processing nodes of a computing structure in accordance with a processing algorithm; and includes the physical interconnecting of the processing nodes for communicating the global interrupt and barrier signals to the elements via low-latency paths. The global asynchronous signals respectively initiate interrupt and barrier operations at the processing nodes at times selected for optimizing performance of the processing algorithms. In one embodiment, the global interrupt and barrier network is implemented in a scalable, massively parallel supercomputing device structure comprising a plurality of processing nodes interconnected by multiple independent networks, with each node including one or more processing elements for performing computation or communication activity as required when performing parallel algorithm operations. One multiple independent network includes a global tree network for enabling high-speed global tree communications among global tree network nodes or sub-trees thereof. The global interrupt and barrier network may operate in parallel with the global tree network for providing global asynchronous sideband signals.

  9. Simple Way of Recording Dental Arch Forms

    OpenAIRE

    Gupta, Shreya; Ratre, Ram Kishore; Jain, Sandhya; Chandki, Rita

    2015-01-01

    Like finger prints each individual has a unique dental arch form design. Recording patient’s dental arch form may be required in various fields in dentistry be it longitudinal studies for evaluating growth, forensic dentistry and most importantly in orthodontic practice for fabricating arch wires for individual patients. An easy and practical method to obtain individual arch form for each patient is explained.

  10. Equivalent Imperfections In Arched Structures

    Directory of Open Access Journals (Sweden)

    Dallemule Marian

    2015-09-01

    Full Text Available There are currently three design methods to verify the in-plane buckling of an arched structure: substitute member method, the method of equivalent imperfection with recommendations for arched bridges, and the equivalent unique global and local initial imperfection method (EUGLI, which uses the critical elastic buckling mode as an imperfection. The latter method is included in the EN 1993-1-1 cl. 5.3.2 (11 since 2002; however, to this day it is neither utilized in the design practice nor is it incorporated in ordinary structural analysis software. The main purpose of this article is to show the application of the proposed methods in a step-by-step manner to the numerical example considered and to compare these design methods for various arched structures. Verification of the in-plane buckling of an arch is explained in detail.

  11. Aortic valve bypass

    DEFF Research Database (Denmark)

    Lund, Jens T; Jensen, Maiken Brit; Arendrup, Henrik; Ihlemann, Nikolaj

    2013-01-01

    In aortic valve bypass (AVB) a valve-containing conduit is connecting the apex of the left ventricle to the descending aorta. Candidates are patients with symptomatic aortic valve stenosis rejected for conventional aortic valve replacement (AVR) or transcatheter aortic valve implantation (TAVI...

  12. Presentation of an uncommon form of aortic dissection and rupture in Marifoan syndrome

    International Nuclear Information System (INIS)

    In Marfan syndrome, aneurysmatic enlargement of ascending aorta and dissection starting at the root are the most common cardiovascular complications. We present an infrequent case of a 15-year-old patient with a typical case of Marfan syndrome. CT disclosed an aorta and aortic arch of normal size with dissection originating distally with respect to the point where left subclavian artery arises. The disecction extended to descending aorta and to iliac and femoral arteries. Aortic rupture occurred in the arch, with massive hemothorax. The CT findings were confirmed at necropsy. 9 refs

  13. Customer interruption cost and results

    Energy Technology Data Exchange (ETDEWEB)

    Eua-Arporn, B.; Bisarnbutra, S. [Chulalongkorn Univ., Bangkok (Thailand)

    1997-12-31

    Results of a comprehensive study on short-term direct impacts and consumer interruption costs, incurred as a result of power supply interruption, were discussed. The emphasis was on questionnaire development, general responses and the average customer damage function of some selected sectors. The customer damage function was established for each category of customers (agriculture, industry, mining, wholesale, retail merchandising, residential, etc) as well as for different locations. Results showed that the average customer damage function depended mostly on customer category. Size and location were not significant factors. 5 refs., 7 tabs.

  14. Minimally Invasive Aortic Valve Replacement

    Medline Plus

    Full Text Available ... the primary reason that we end up offering patients aortic valve surgery in our community. Aortic stenosis ... a picture of the aortic valve from a patient who had a very diseased aortic valve. And ...

  15. Renal embolism as a primary manifestation of Streptococcus dysgalactiae subspecies equisimilis endocarditis in a patient with chronic aortic dissection.

    Science.gov (United States)

    Ishimaru, Naoto; Kinami, Saori; Ohnishi, Hisashi; Takagi, Asuka; Kawamoto, Megumi; Doukuni, Ryota; Umezawa, Kanoko; Oozone, Sachiko; Yoshimura, Sho; Sakamoto, Susumu

    2015-06-01

    We report a case of renal embolism as an initial manifestation of Streptococcus dysgalactiae subspecies equisimilis (SDSE) endocarditis in a patient with chronic aortic dissection. A 37-year-old man who underwent total aortic arch replacement owing to aortic dissection, presented with a 3-h history of fever, chills, and acute right-sided flank pain. The endocarditis affected the native aortic valve and was complicated by a renal embolism. Blood culture results were positive for SDSE. Intravenous penicillin resulted in satisfactory clinical and echocardiographic recovery. PMID:26110298

  16. Experimental behavior of FRP strengthened masonry arches

    OpenAIRE

    Oliveira, Daniel V.; Basílio, Ismael; Lourenço, Paulo B.

    2010-01-01

    This paper deals with the experimental behavior of solid clay brick masonry arches strengthened with glass fiber reinforced polymer composites. Twelve half-scaled segmental masonry arches subjected to a load applied at the quarter span were tested under displacement control up to failure. The arches were built using handmade low strength bricks and a commercial lime-based mortar, trying to mimic ancient structures. Besides reference unreinforced arches, five different strengthening arrangemen...

  17. Aortic Aneurysm Repair

    Medline Plus

    Full Text Available ... to become you to our live webcast. Today we’re going to repair an abdominal aortic aneurysm ... and together as a team of multidisciplinary physicians, we’re going to repair an abdominal aortic aneurysm ...

  18. Aortic Aneurysm Statistics

    Science.gov (United States)

    ... connective tissue disorders, such as Marfan syndrome and Ehlers-Danlos syndrome, get thoracic aortic aneurysms. Signs and symptoms of thoracic aortic aneurysm can include Sharp, sudden pain in the chest or upper back. Shortness of ...

  19. Aortic growth rates in chronic aortic dissection

    International Nuclear Information System (INIS)

    Aim: To determine and compare rates of descending aortic enlargement and complications in chronic aortic dissection with and without a proximal aortic graft. Methods and materials: Fifty-two patients with dissection involving the descending aorta and who had undergone at least two computed tomography (CT) examinations at our institution between November, 1993 and February, 2004 were identified, including 24 non-operated patients (four type A, 20 type B) and 28 operated patients (type A). CT examinations per patient ranged from two to 10, and follow-up ranged from 1-123 months (mean 49 months, median 38.5 months). On each CT image, the aortic short axis (SA), false lumen (FL), and true lumen (TL) diameters were measured at the longitudinal midpoint of the dissection and at the point of maximum aortic diameter. Complications were tabulated, including aortic rupture and aortic enlargement requiring surgery. Results: For non-operated patients, the midpoint and maximum point SA, TL, and FL diameters increased significantly over time. For operated patients, the midpoint and maximum point SA and FL diameters increased significantly over time. In both groups, aortic enlargement was predominantly due to FL expansion. Diameter increases in non-operated patients were significantly larger than those in operated patients. The rate of change in aortic diameter was constant, regardless of aortic size. Four non-operated and six operated patients developed aortic complications. Conclusions: In patients with a dissection involving the descending thoracic aorta, the FL increased in diameter over time, at a constant rate, and to a greater degree in non-operated patients (mostly type B) compared with operated patients (all type A)

  20. Interruptions during hospital nurses’ medication administration rounds

    Directory of Open Access Journals (Sweden)

    Marian Smeulers

    2013-05-01

    Full Text Available Medication administration errors are common, costly and the cause of adverse events in clinical practice. Interruptions during medication administration rounds are thought to be a prominent causative factor of these medication errors. In this observational study, data were collected on the number and duration of several different sources of verbal and non-verbal interruptions using unobtrusive structured observations on 32 medication administration rounds. Interruptions occurred very often (6.9 times per nurse each hour, differed in frequency among the medication administration rounds and were from a variety of sources. The most frequent interruptions were caused by nursing colleagues (43% and non-verbal interruptions from the ward environment (25%, such as noises from pagers, conversations in the vicinity of the nurse, the work of cleaners, or stock management by pharmacy staff. The longest durations of interruptions were from nursing colleagues’ verbal interrup- interruptions. When comparing the medication rounds, more and longer interruptions were observed during the morning rounds than those at noon. A comparison between surgical and non-surgical units showed that interruptions occurred more often and lasted longer in non-surgical units than those in surgical units. But the observed differences were not statistically significant. In conclusion, interruptions during medication administration rounds are frequent and originated from different human and environmental sources. Interventions should target not only interruptions by colleagues, but should also consider ways to reduce self-initiated interruptions and those arising from the immediate ward environment.

  1. Comparison of Commercially Available Arch Wires with Normal Dental Arch in a Group of Iranian Population

    OpenAIRE

    Zohreh Hedayati; Farnaz Fakhri; Vahid Moshkel Gosha

    2015-01-01

    Statement of the Problem The stability of orthodontic treatment depends on preserving the patient’s pretreatment arch form and arch size during and after treatment. Purpose This investigation was aimed to study the size and shape of Iranian mandibular dental arch and evaluate the correlation of their average dental arch with commercially available preformed rectangular nickel-titanium arch wires. Materials and Method In this study, 148 subjects were selected among students of Shiraz Universit...

  2. Medical image of the week: acute aortic dissection

    Directory of Open Access Journals (Sweden)

    Desai H

    2015-06-01

    Full Text Available No abstract available. Article truncated after 150 words. An 85-year-old gentleman with the past medical history significant for hypertension, smoking, and coronary artery disease presented to the emergency department (ED with complains of sudden onset of chest pain. His pain was described as squeezing and radiating to the back, associated with nausea and vomiting. His chest pain improved with nitroglycerin in ED. Chest x-ray showed a tortuous aortic knob and widened mediastinum. He underwent a CT angiogram, which showed, Stanford Type B aortic dissection, from distal aortic arch to renal arteries (Figure 1. He was managed in the hospital conservatively with tight blood pressure control given the type of dissection and no surgical intervention was done. He was uneventfully discharged with follow up arranged with vascular surgery. Aortic dissection is classified by Stanford Criteria as Type A which involves the ascending aorta and arch and Type B when it involves the descending aorta. Type A dissection is a ...

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

    International Nuclear Information System (INIS)

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

  4. Surgical repair for giant ascending aortic aneurysm to superior vena cava fistula with positive syphilitic test.

    Science.gov (United States)

    Sekine, Yuji; Yamamoto, Shin; Fujikawa, Takuya; Oshima, Susumu; Ono, Makoto; Sasaguri, Shiro

    2015-10-01

    Syphilitic aortitis is usually associated with thoracic aortic saccular aneurysm, aortic regurgitation and coronary ostial stenosis. However, syphilitic aneurysms have rarely been reported today. Here, we report a patient with ascending aortic aneurysm with aorta-superior vena cava (SVC) fistula with positive syphilitic test. A 52-year-old man was admitted to our institution with a giant ascending aortic aneurysm complicated with SVC syndrome. Computed tomography revealed a giant ascending aneurysm 79 mm in diameter. The result of serodiagnostic tests for syphilis had not been judged yet preoperatively. Total arch replacement concomitant with elephant trunk was performed. Intraoperatively, we detected the ascending aorta to SVC fistula. Postoperatively, we suspected the syphilitic aneurysm strongly, because preoperative serodiagnostic test was concluded to be positive. However, histological examination did not show typical syphilitic features. The patient remains asymptomatic 1 year later. Although extremely rarely today, syphilitic aneurysm should be still considered in the differential diagnosis of ascending aortic aneurysm. PMID:24000069

  5. Contributing Mechanisms of Aortic Atheroma in Ischemic Cerebrovascular Disease.

    Science.gov (United States)

    Kong, Qi; Ma, Xin

    2015-12-01

    In recent years, the correlation between aortic atheroma (AA) and the occurrence and recurrence of ischemic cerebrovascular disease (ICVD) has attracted much attention, but the contributory mechanisms remain controversial. This review analyzes related research on the roles of AA in ICVD, and demonstrates the correlation between the formation and development of AA and abnormal metabolism, inflammation, hemodynamic changes, and other contributory factors. The presence of complex aortic plaque (CAP) in the ascending aorta and aortic arch increases the risk of cerebral embolism and degree of injury, while the association between CAP in the descending aorta and cerebral embolism remains ambiguous. AA also functions as an indicator of atherosclerosis burden as well as hypercoagulability, which may further increase the risk of ICVD. Further study on the relationship of AA to ICVD will improve diagnosis and treatment in clinical practice. PMID:26522269

  6. Comparison of Commercially Available Arch Wires with Normal Dental Arch in a Group of Iranian Population

    Directory of Open Access Journals (Sweden)

    Zohreh Hedayati

    2015-06-01

    Full Text Available Statement of the Problem: The stability of orthodontic treatment depends on preserving the patient’s pretreatment arch form and arch size during and after treatment. Purpose: This investigation was aimed to study the size and shape of Iranian mandibular dental arch and evaluate the correlation of their average dental arch with commercially available preformed rectangular nickel-titanium arch wires. Materials and Method: In this study, 148 subjects were selected among students of Shiraz University of Medical Sciences. The inclusion criteria were having Angle class I in molar and canine relationships, and normal growth pattern. Intercanine and intermolar widths were measured after scanning their mandibular dental casts. Three main arch form templates; square, ovoid and tapered (Orthoform TM; 3M, Unitek, CA, USA and 12 commercially available preformed mandibular nickel-titanium arch wires were scanned. Intercanine and intermolar widths of arch wires were compared with dental arch widths of the study samples. Arch width, arch form and the most appropriate arch wire were determined for each cast. Student’s t-test was used to compare arch widths and arch depths of male and female sub-jects. Coefficient of variance was used to determine the variability of indices in the study samples. Results: Most preformed arch wires were wider than the average width of the nor-mal Iranian dental arch. The most frequent arch form in Iranian population was tapered. Inter molar width was the only statistically significant variable between males and females. Conclusion: Variation in available preformed arch wires does not entirely cover the range of diversity of the normal dental arch of our population. Narrow arc

  7. Including aortic valve morphology in computational fluid dynamics simulations: initial findings and application to aortic coarctation.

    Science.gov (United States)

    Wendell, David C; Samyn, Margaret M; Cava, Joseph R; Ellwein, Laura M; Krolikowski, Mary M; Gandy, Kimberly L; Pelech, Andrew N; Shadden, Shawn C; LaDisa, John F

    2013-06-01

    Computational fluid dynamics (CFD) simulations quantifying thoracic aortic flow patterns have not included disturbances from the aortic valve (AoV). 80% of patients with aortic coarctation (CoA) have a bicuspid aortic valve (BAV) which may cause adverse flow patterns contributing to morbidity. Our objectives were to develop a method to account for the AoV in CFD simulations, and quantify its impact on local hemodynamics. The method developed facilitates segmentation of the AoV, spatiotemporal interpolation of segments, and anatomic positioning of segments at the CFD model inlet. The AoV was included in CFD model examples of a normal (tricuspid AoV) and a post-surgical CoA patient (BAV). Velocity, turbulent kinetic energy (TKE), time-averaged wall shear stress (TAWSS), and oscillatory shear index (OSI) results were compared to equivalent simulations using a plug inlet profile. The plug inlet greatly underestimated TKE for both examples. TAWSS differences extended throughout the thoracic aorta for the CoA BAV, but were limited to the arch for the normal example. OSI differences existed mainly in the ascending aorta for both cases. The impact of AoV can now be included with CFD simulations to identify regions of deleterious hemodynamics thereby advancing simulations of the thoracic aorta one step closer to reality. PMID:22917990

  8. Aortic Valve Sparing in Different Aortic Valve and Aortic Root Conditions.

    Science.gov (United States)

    David, Tirone E

    2016-08-01

    The development of aortic valve-sparing operations (reimplantation of the aortic valve and remodeling of the aortic root) expanded the surgical armamentarium for treating patients with aortic root dilation caused by a variety of disorders. Young adults with aortic root aneurysms associated with genetic syndromes are ideal candidates for reimplantation of the aortic valve, and the long-term results have been excellent. Incompetent bicuspid aortic valves with dilated aortic annuli are also satisfactorily treated with the same type of operation. Older patients with ascending aortic aneurysm and aortic insufficiency secondary to dilated sinotubular junction and a normal aortic annulus can be treated with remodeling of the aortic root or with reimplantation of the aortic valve. The first procedure is simpler, and both procedures are likely equally effective. As with any heart valve-preserving procedure, patient selection and surgical expertise are keys to successful and durable repairs. PMID:27491910

  9. Unicuspid aortic valve disease: a magnetic resonance imaging study

    Energy Technology Data Exchange (ETDEWEB)

    Debl, K.; Buchner, S.; Heinicke, N.; Riegger, G.; Luchner, A. [Klinik und Poliklinik fuer Innere Medizin II, Universitaetsklinikum Regensburg (Germany); Djavidani, B.; Poschenrieder, F.; Feuerbach, S. [Inst. fuer Roentgendiagnostik, Universitaetsklinikum Regensburg (Germany); Schmid, C.; Kobuch, R. [Klinik und Poliklinik fuer Herz-, Thorax- und herznahe Gefaesschirurgie, Universitaetsklinikum Regensburg (Germany)

    2008-11-15

    Purpose: congenitally malformed aortic valves are a common finding in adults with aortic valve disease. Most of these patients have bicuspid aortic valve disease. Unicuspid aortic valve disease (UAV) is rare. The aim of our study was to describe valve morphology and the dimensions of the proximal aorta in a cohort of 12 patients with UAV in comparison to tricuspid aortic valve disease (TAV) using magnetic resonance imaging (MRI). Materials and methods/results: MRI studies were performed on a 1.5 T scanner in a total of 288 consecutive patients with aortic valve disease. 12 aortic valves were retrospectively classified as UAV. Annulus areas and dimensions of the thoracic aorta were retrospectively compared to a cohort of 103 patients with TAV. In UAV, valve morphology was unicuspid unicommissural with a posterior commissure in all patients. Mean annulus areas and mean diameters of the ascending aorta were significantly greater in UAV compared to TAV (12.6 {+-} 4.7 cm{sup 2} vs. 8.7 {+-} 2.3 cm{sup 2}, p < 0.01 and 4.6 {+-} 0.7 cm vs. 3.6 {+-} 0.5 cm, p < 0.0001, respectively), while no differences were observed in the mean diameters of the aortic arch (2.3 {+-} 0.6 cm vs. 2.3 {+-} 0.4 cm, p = 0.69). The diameters of the descending aorta were slightly smaller in UAV compared to TAV (2.2 {+-} 0.5 cm vs. 2.6 {+-} 0.3 cm, p < 0.05). (orig.)

  10. Unicuspid aortic valve disease: a magnetic resonance imaging study

    International Nuclear Information System (INIS)

    Purpose: congenitally malformed aortic valves are a common finding in adults with aortic valve disease. Most of these patients have bicuspid aortic valve disease. Unicuspid aortic valve disease (UAV) is rare. The aim of our study was to describe valve morphology and the dimensions of the proximal aorta in a cohort of 12 patients with UAV in comparison to tricuspid aortic valve disease (TAV) using magnetic resonance imaging (MRI). Materials and methods/results: MRI studies were performed on a 1.5 T scanner in a total of 288 consecutive patients with aortic valve disease. 12 aortic valves were retrospectively classified as UAV. Annulus areas and dimensions of the thoracic aorta were retrospectively compared to a cohort of 103 patients with TAV. In UAV, valve morphology was unicuspid unicommissural with a posterior commissure in all patients. Mean annulus areas and mean diameters of the ascending aorta were significantly greater in UAV compared to TAV (12.6 ± 4.7 cm2 vs. 8.7 ± 2.3 cm2, p < 0.01 and 4.6 ± 0.7 cm vs. 3.6 ± 0.5 cm, p < 0.0001, respectively), while no differences were observed in the mean diameters of the aortic arch (2.3 ± 0.6 cm vs. 2.3 ± 0.4 cm, p = 0.69). The diameters of the descending aorta were slightly smaller in UAV compared to TAV (2.2 ± 0.5 cm vs. 2.6 ± 0.3 cm, p < 0.05). (orig.)

  11. Endovascular treatment of thoracic aortic diseases

    Directory of Open Access Journals (Sweden)

    Davidović Lazar

    2013-01-01

    Full Text Available Bacground/Aim. Endovascular treatment of thoracic aortic diseases is an adequate alternative to open surgery. This method was firstly performed in Serbia in 2004, while routine usage started in 2007. Aim of this study was to analyse initial experience in endovacular treatment of thoracic aortic diseses of three main vascular hospitals in Belgrade - Clinic for Vascular and Endovascular Surgery of the Clinical Center of Serbia, Clinic for Vascular Surgery of the Military Medical Academy, and Clinic for Vascular Surgery of the Institute for Cardiovascular Diseases “Dedinje”. Methods. Between March 2004. and November 2010. 41 patients were treated in these three hospitals due to different diseases of the thoracic aorta. A total of 21 patients had degenerative atherosclerotic aneurysm, 6 patients had penetrating aortic ulcer, 6 had posttraumatic aneurysm, 4 patients had ruptured thoracic aortic aneurysm, 1 had false anastomotic aneurysm after open repair, and 3 patients had dissected thoracic aneurysm of the thoracoabdominal aorta. In 15 cases the endovascular procedure was performed as a part of the hybrid procedure, after carotidsubclavian bypass in 4 patients and subclavian artery transposition in 1 patient due to the short aneurysmatic neck; in 2 patients iliac conduit was used due to hypoplastic or stenotic iliac artery; in 5 patients previous reconstruction of abdominal aorta was performed; in 1 patient complete debranching of the aortic arch, and in 2 patients visceral abdominal debranching were performed. Results. The intrahospital mortality rate (30 days was 7.26% (3 patients with ruptured thoracic aneurysms died. Endoleak type II in the first control exam was revealed in 3 patients (7. 26%. The patients were followed up in a period of 1-72 months, on average 29 months. The most devastating complication during a followup period was aortoesofageal fistula in 1 patient a year after the treatment of posttraumatic aneurysm. Conversion was

  12. Minimally Invasive Aortic Valve Replacement

    Medline Plus

    Full Text Available ... to help prevent aortic stenosis? There's no prophylactic methods that anybody can take to prevent aortic stenosis ... to progression and aortic sclerosis is not a reason to need an operation or aggressive management at ...

  13. Minimally Invasive Aortic Valve Replacement

    Medline Plus

    Full Text Available ... opens freely when the heart contracts. On the right, we see a picture of the aortic valve ... the aortic valve because the probe is sitting right behind the aortic valve. Lots of patients on ...

  14. Minimally Invasive Aortic Valve Replacement

    Medline Plus

    Full Text Available ... surgery in our community. Aortic stenosis is a process by which the aortic valve, which is the ... and does not open easily or appropriately. This process starts out as a disease we call aortic ...

  15. Image quality and diagnostic accuracy of unenhanced SSFP MR angiography compared with conventional contrast-enhanced MR angiography for the assessment of thoracic aortic diseases

    Energy Technology Data Exchange (ETDEWEB)

    Krishnam, Mayil S. [University of California, Cardiovascular and Thoracic Imaging, UCI Medical Center, Irvine, CA (United States); Tomasian, Anderanik; Malik, Sachin; Ruehm, Stefan G. [University of California at Los Angeles, Department of Radiological Sciences, Ronald Reagan Medical Center, Los Angeles, CA (United States); Desphande, Vibhas; Laub, Gerhard [Siemens Medical Solutions, Los Angeles, CA (United States)

    2010-06-15

    The purpose of this study was to determine the image quality and diagnostic accuracy of three-dimensional (3D) unenhanced steady state free precession (SSFP) magnetic resonance angiography (MRA) for the evaluation of thoracic aortic diseases. Fifty consecutive patients with known or suspected thoracic aortic disease underwent free-breathing ECG-gated unenhanced SSFP MRA with non-selective radiofrequency excitation and contrast-enhanced (CE) MRA of the thorax at 1.5 T. Two readers independently evaluated the two datasets for image quality in the aortic root, ascending aorta, aortic arch, descending aorta, and origins of supra-aortic arteries, and for abnormal findings. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were determined for both datasets. Sensitivity, specificity, and diagnostic accuracy of unenhanced SSFP MRA for the diagnosis of aortic abnormalities were determined. Abnormal aortic findings, including aneurysm (n = 47), coarctation (n = 14), dissection (n = 12), aortic graft (n = 6), intramural hematoma (n = 11), mural thrombus in the aortic arch (n = 1), and penetrating aortic ulcer (n = 9), were confidently detected on both datasets. Sensitivity, specificity, and diagnostic accuracy of SSFP MRA for the detection of aortic disease were 100% with CE-MRA serving as a reference standard. Image quality of the aortic root was significantly higher on SSFP MRA (P < 0.001) with no significant difference for other aortic segments (P > 0.05). SNR and CNR values were higher for all segments on SSFP MRA (P < 0.01). Our results suggest that free-breathing navigator-gated 3D SSFP MRA with non-selective radiofrequency excitation is a promising technique that provides high image quality and diagnostic accuracy for the assessment of thoracic aortic disease without the need for intravenous contrast material. (orig.)

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

    Science.gov (United States)

    Roberts, C S; Roberts, W C

    1990-11-01

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

  17. Evaluation of the fit of preformed nickel titanium arch wires on normal occlusion dental arches

    Directory of Open Access Journals (Sweden)

    Rakhn G. Al-Barakati

    2016-01-01

    Conclusions: Using an archwire form with the best fit to the dental arch should produce minimal changes in the dental arch form when NiTi wires are used and require less customization when stainless-steel wires are used.

  18. Abdominal Aortic Aneurysms: Treatments

    Science.gov (United States)

    ... access catheters Vertebroplasty Women and vascular disease Women's health Social Media Facebook Twitter ... Abdominal Aortic Aneurysms Interventional Radiologists Treat Abdominal Aneurysms Nonsurgically Interventional radiologists are vascular ...

  19. Calcification of the aortic wall in hypercalcemic rabbits.

    Science.gov (United States)

    Rokita, E; Cichocki, T; Divoux, S; Gonsior, B; Höfert, M; Jarczyk, L; Strzałkowski, A

    1992-10-01

    The mineralization process was investigated in the aortic wall of hypercalcemic rabbits. The elevated calcium level in serum was induced by intramuscular injection of vitamin D3. The animals were killed at different times of the experiment (max. 246 d). The freeze-dried tissue homogenates were used for elemental composition studies by means of proton induced X-ray emission (PIXE) and atomic absorption spectroscopy. The structural information was obtained from infrared (IR) and X-ray diffraction (XRD) spectra. Moreover, the ascending part of the aortic arch was separated and used for micro-PIXE (PIXE in combination with proton microprobe) and histochemical examinations. It was found that hypercalcemia (blood serum Ca content elevated by about 20%) induced calcification of the aortic wall. The mineral phase within the aortic wall consisted of Ca-P salts. The Ca/P ratio continuously increased during the experiment and approached 2 after 246 d of the vitamin D3 treatment. The IR and XRD studies made possible the identification of the complex phase composition of the samples. The hydroxyapatite crystals were detected after 196 days, however, in earlier phases of the experiment, amorphous calcium phosphate, dicalcium phosphate dihydrate and octacalcium phosphate were also observed. On the basis of the data obtained, the mechanism of the precipitation and growth of inorganic deposits in the tunica media of the aortic wall was discussed. PMID:1333314

  20. Percutaneous closure of patent ductus arteriosus in interrupted inferior caval vein through femoral vein approach

    International Nuclear Information System (INIS)

    Percutaneous closure of the patent arterial duct in patients with interrupted inferior caval vein poses a technical challenge. A 12-year-old girl with a patent ductus arteriosus (PDA) and interrupted inferior caval vein is described in this report. The diagnosis of interrupted inferior caval vein and azygos continuation was made in the catheterization laboratory. A catheter was advanced and snared in the descending aorta. An exchange wire was advanced through the catheter and snared in the descending aorta. Then, an Amplatzer TorqVue 2 delivery sheath was advanced over the wire from the venous side and again snared in the descending aorta. An Amplatzer duct occluder (ADO) size 8/6 was advanced through the sheath while still holding the sheath with a snare. The device was opened. The sheath was then unsnared once the aortic disc was completely out. The sheath and the device were pulled back into the duct and the device was successfully implanted. The device was then released and it attained a stable position. An aortic angiogram was performed which showed complete occlusion

  1. Impact of Endografting on the Thoracic Aortic Anatomy: Comparative Analysis of the Aortic Geometry before and after the Endograft Implantation

    Energy Technology Data Exchange (ETDEWEB)

    Midulla, Marco, E-mail: marco.midulla@chru-lille.fr [University Hospital of Lille, Cardiovascular and Interventional Radiology (France); Moreno, Ramiro, E-mail: ramoroa@gmail.com [Rangueil University Hospital, Department of Radiology (France); Negre-Salvayre, Anne, E-mail: anne.negre-salvayre@inserm.fr [INSERM, UMR 1048, I2MC (France); Nicoud, Franc, E-mail: franck.nicoud@univ-montp2.fr [CNRS, UMR 5149 I3M, CC 051, University Montpellier II (France); Pruvo, Jean Pierre, E-mail: jean-pierre.pruvo@chru-lille.fr [University Hospital of Lille, Cardiovascular and Interventional Radiology (France); Haulon, Stephan, E-mail: stephan.haulon@chru-lille.fr [University Hospital of Lille, Department of Vascular Surgery (France); Rousseau, Hervé, E-mail: rousseau.h@chu-toulouse.fr [Rangueil University Hospital, Department of Radiology (France)

    2013-03-13

    PurposeAlthough the widespread acceptance of thoracic endovascular aortic repair (TEVAR) as a first-line treatment option for a multitude of thoracic aortic diseases, little is known about the consequences of the device implantation on the native aortic anatomy. We propose a comparative analysis of the pre- and postoperative geometry on a clinical series of patients and discuss the potential clinical implicationsMethodsCT pre- and postoperative acquisitions of 30 consecutive patients treated by TEVAR for different pathologies (20 thoracic aortic aneurysms, 6 false aneurysms, 3 penetrating ulcers, 1 traumatic rupture) were used to model the vascular geometry. Pre- and postoperative geometries were compared for each patient by pairing and matching the 3D models. An implantation site was identified, and focal differences were detected and described.ResultsSegmentation of the data sets was successfully performed for all 30 subjects. Geometry differences between the pre- and postoperative meshes were depicted in 23 patients (76 %). Modifications at the upper implantation site were detected in 14 patients (47 %), and among them, the implantation site involved the arch (Z0–3) in 11 (78 %).ConclusionModeling the vascular geometry on the basis of imaging data offers an effective tool to perform patient-specific analysis of the vascular geometry before and after the treatment. Future studies will evaluate the consequences of these changes on the aortic function.

  2. Impact of Endografting on the Thoracic Aortic Anatomy: Comparative Analysis of the Aortic Geometry before and after the Endograft Implantation

    International Nuclear Information System (INIS)

    PurposeAlthough the widespread acceptance of thoracic endovascular aortic repair (TEVAR) as a first-line treatment option for a multitude of thoracic aortic diseases, little is known about the consequences of the device implantation on the native aortic anatomy. We propose a comparative analysis of the pre- and postoperative geometry on a clinical series of patients and discuss the potential clinical implicationsMethodsCT pre- and postoperative acquisitions of 30 consecutive patients treated by TEVAR for different pathologies (20 thoracic aortic aneurysms, 6 false aneurysms, 3 penetrating ulcers, 1 traumatic rupture) were used to model the vascular geometry. Pre- and postoperative geometries were compared for each patient by pairing and matching the 3D models. An implantation site was identified, and focal differences were detected and described.ResultsSegmentation of the data sets was successfully performed for all 30 subjects. Geometry differences between the pre- and postoperative meshes were depicted in 23 patients (76 %). Modifications at the upper implantation site were detected in 14 patients (47 %), and among them, the implantation site involved the arch (Z0–3) in 11 (78 %).ConclusionModeling the vascular geometry on the basis of imaging data offers an effective tool to perform patient-specific analysis of the vascular geometry before and after the treatment. Future studies will evaluate the consequences of these changes on the aortic function

  3. Thoracic endovascular aortic repair for complicated chronic type B aortic dissection in a patient on hemodialysis with recurrent ischemic colitis.

    Science.gov (United States)

    Miyazaki, Yuko; Furuyama, Tadashi; Matsubara, Yutaka; Yoshiya, Keiji; Yoshiga, Ryosuke; Inoue, Kentaro; Matsuda, Daisuke; Aoyagi, Yukihiko; Kato, Masaaki; Matsumoto, Takuya; Maehara, Yoshihiko

    2016-12-01

    We present a successful case of thoracic endovascular aortic repair (TEVAR) for chronic Stanford type B aortic dissection (B-AD) with recurrent ischemic colitis. The patient was a 56-year-old woman with abdominal pain as the main complaint who had two operations previously: the total arch replacement 8 years ago and the Bentall 7 years ago for acute Stanford type A aortic dissection. Her abdominal pain worsened as her blood pressure became low during her hemodialysis treatment. An enhanced computed tomography scan was performed on the patient and showed chronic B-AD that occurred from the distal anastomotic part of the total arch graft to the bilateral common iliac arteries. The celiac artery and superior mesenteric artery (SMA) arose from the true lumen, and these were compressed by the expanded false lumen. Her complicated chronic B-AD was treated with the Zenith Dissection Endovascular System, and its procedure was performed as her proximal entry tear was covered by a proximal tapered Zenith TX2 stent graft, supplemented by a noncovered aortic stent extending across both renal arteries, the SMA, and the celiac artery. Seven days after this operation, enhanced computed tomography showed that the patient's true lumen was expanded and her blood flow to the true lumen and SMA was improved. On the other hand, her false lumen tended to be thrombosed. Consequently, she was discharged 10 days after the operation without any postoperative complications as she had no abdominal complaints even though she underwent hemodialysis three times per week after the operation. We believe that TEVAR supplemented by a noncovered aortic stent is an effective treatment, even for highly chronic B-AD in dialysis patients. PMID:27090121

  4. Imaging in aortic dissection

    International Nuclear Information System (INIS)

    Aortic dissection (AD) is a catastrophic aortic disease. Imaging techniques play an invaluable role in the diagnostic evaluation and management of patients with AD. Major signs of AD with different imaging modalities are described in this article with a pertinent discussion on guidelines for the optimized approach of imaging study (13 refs.)

  5. Aortic Aneurysm Repair

    Medline Plus

    Full Text Available Aortic Aneurysm Repair May 7, 2009 Good afternoon. Welcome to the Baptist Cardiac and Vascular Institute here in Miami. My name ... our live webcast. Today we’re going to repair an abdominal aortic aneurysm using a technology called ...

  6. Maxillary and mandibular anterior crown width/height ratio and its relation to various arch perimeters, arch length, and arch width groups

    Science.gov (United States)

    Shahid, Fazal; Alam, Mohammad Khursheed; Khamis, Mohd Fadhli

    2015-01-01

    Objective: To investigate the maxillary and mandibular anterior crown width/height ratio and its relation to various arch perimeters, arch length, and arch width (intercanine, interpremolar, and intermolar) groups. Materials and Methods: The calculated sample size was 128 subjects. The crown width/height, arch length, arch perimeter, and arch width of the maxilla and mandible were obtained via digital calliper (Mitutoyo, Japan). A total of 4325 variables were measured. The sex differences in the crown width and height were evaluated. Analysis of variance was applied to evaluate the differences between arch length, arch perimeter, and arch width groups. Results: Males had significantly larger mean values for crown width and height than females (P ≤ 0.05) for maxillary and mandibular arches, both. There were no significant differences observed for the crown width/height ratio in various arch length, arch perimeter, and arch width (intercanine, interpremolar, and intermolar) groups (P ≤ 0.05) in maxilla and mandible, both. Conclusions: Our results indicate sexual disparities in the crown width and height. Crown width and height has no significant relation to various arch length, arch perimeter, and arch width groups of maxilla and mandible. Thus, it may be helpful for orthodontic and prosthodontic case investigations and comprehensive management. PMID:26929686

  7. Surgical Management of Aorto-Esophageal Fistula as a Late Complication after Graft Replacement for Acute Aortic Dissection.

    Science.gov (United States)

    Lee, Jae-Hong; Na, Bubse; Hwang, Yoohwa; Kim, Yong Han; Park, In Kyu; Kim, Kyung-Hwan

    2016-02-01

    A 49-year-old male presented with chills and a fever. Five years previously, he underwent ascending aorta and aortic arch replacement using the elephant trunk technique for DeBakey type 1 aortic dissection. The preoperative evaluation found an esophago-paraprosthetic fistula between the prosthetic graft and the esophagus. Multiple-stage surgery was performed with appropriate antibiotic and antifungal management. First, we performed esophageal exclusion and drainage of the perigraft abscess. Second, we removed the previous graft, debrided the abscess, and performed an in situ re-replacement of the ascending aorta, aortic arch, and proximal descending thoracic aorta, with separate replacement of the innominate artery, left common carotid artery, and extra-anatomical bypass of the left subclavian artery. Finally, staged esophageal reconstruction was performed via transthoracic anastomosis. The patient's postoperative course was unremarkable and the patient has done well without dietary problems or recurrent infections over one and a half years of follow-up. PMID:26889449

  8. Nonlinear Dynamics of Electrostatically Actuated MEMS Arches

    KAUST Repository

    Al Hennawi, Qais M.

    2015-05-01

    In this thesis, we present theoretical and experimental investigation into the nonlinear statics and dynamics of clamped-clamped in-plane MEMS arches when excited by an electrostatic force. Theoretically, we first solve the equation of motion using a multi- mode Galarkin Reduced Order Model (ROM). We investigate the static response of the arch experimentally where we show several jumps due to the snap-through instability. Experimentally, a case study of in-plane silicon micromachined arch is studied and its mechanical behavior is measured using optical techniques. We develop an algorithm to extract various parameters that are needed to model the arch, such as the induced axial force, the modulus of elasticity, and the initially induced initial rise. After that, we excite the arch by a DC electrostatic force superimposed to an AC harmonic load. A softening spring behavior is observed when the excitation is close to the first resonance frequency due to the quadratic nonlinearity coming from the arch geometry and the electrostatic force. Also, a hardening spring behavior is observed when the excitation is close to the third (second symmetric) resonance frequency due to the cubic nonlinearity coming from mid-plane stretching. Then, we excite the arch by an electric load of two AC frequency components, where we report a combination resonance of the summed type. Agreement is reported among the theoretical and experimental work.

  9. Checklist interruption and resumption: A linguistic study

    Science.gov (United States)

    Linde, Charlotte; Goguen, Joseph

    1987-01-01

    This study forms part of a project investigating the relationships among the formal structure of aviation procedures, the ways in which the crew members are taught to execute them, and the ways in which thet are actually performed in flight. Specifically, this report examines the interactions between the performance of checklists and interruptions, considering both interruptions by radio communications and by other crew members. The data consists of 14 crews' performance of a full mission simulation of a higher ratio of checklist speech acts to all speech acts within the span of the performance of the checklist. Further, it is not number of interruptions but length of interruptions which is associated with crew performance quality. Use of explicit holds is also associated with crew performance.

  10. Basic interrupt and command structures and applications

    International Nuclear Information System (INIS)

    Interrupt and command structures of a real-time system are described through specific examples. References to applications of a real-time system and programing development references are supplied. (auth)

  11. Aortic Aneurysm Repair

    Medline Plus

    Full Text Available ... Rua, and together as a team of multidisciplinary physicians, we’re going to repair an abdominal aortic ... takes a special type of training. Both the doctors in the room are board certified and highly ...

  12. Aortic Aneurysm Repair

    Medline Plus

    Full Text Available ... the age of 65. It’s most common in males. There is an increasing number, due to the ... The risk factors for abdominal aortic aneurysms are males over 60, hardening of the arteries, which is ...

  13. Aortic Aneurysm Repair

    Medline Plus

    Full Text Available ... wall will actually thin out. And the big risk here is that if this gets too big ... to the aging baby boomers. Next slide. The risk factors for abdominal aortic aneurysms are males over ...

  14. Aortic Aneurysm Repair

    Medline Plus

    Full Text Available ... this procedure. So let’s go back now and learn a little bit about abdominal aortic aneurysms. Great. ... And one of the things that I’m learning from this movie as we looking at these ...

  15. Aortic Aneurysm Repair

    Medline Plus

    Full Text Available ... atherosclerosis, high blood pressure, smokers, or a family history of abdominal aortic aneurysms. Today’s patient is a ... screened. In fact, patients who have a family history of aneurysm, men who are smoking over the ...

  16. Aortic Aneurysm Repair

    Medline Plus

    Full Text Available ... to the aging baby boomers. Next slide. The risk factors for abdominal aortic aneurysms are males over 60, ... doing a good examination and also accessing for risk factors. So we have a very integrated team here, ...

  17. Aortic Aneurysm Repair

    Medline Plus

    Full Text Available ... as atherosclerosis, high blood pressure, smokers, or a family history of abdominal aortic aneurysms. Today’s patient is ... be screened. In fact, patients who have a family history of aneurysm, men who are smoking over ...

  18. Aortic Aneurysm Repair

    Medline Plus

    Full Text Available ... this is to prevent rupture and to prevent death from rupture. This area just underneath the renal ... Okay. Abdominal aortic aneurysms cause approximately 15,000 deaths in the United States each year. It affects ...

  19. Aortic valve replacement

    DEFF Research Database (Denmark)

    Kapetanakis, Emmanouil I; Athanasiou, Thanos; Mestres, Carlos A;

    2008-01-01

    BACKGROUND AND AIMS OF THE STUDY: Prompted by anecdotal evidence and observations by surgeons, an investigation was undertaken into the potential differences in implanted aortic valve prosthesis sizes, during aortic valve replacement (AVR) procedures, between northern and southern European countr...... southern European countries. Imbalances in the prevalence of rheumatic heart disease, health resource availability and variations in surgical practice throughout Europe might be possible etiological causes....

  20. Novel endovascular procedures and new developments in aortic surgery.

    Science.gov (United States)

    Cheng, S W K

    2016-09-01

    Endovascular repair has evolved to become a viable mainstream treatment for aortic pathology in both acute and elective settings. As technology advanced, traditional anatomical barriers were progressively tackled using new devices and novel procedures, and there are now multiple options available to the vascular surgeon. In the abdominal aorta, advances in endovascular aneurysm repair have been in the treatment of hostile aortic necks using new sealing concepts and ancillary procedures, and in branch preservation using fenestrations and snorkels. Access challenges have been met with a percutaneous approach and low-profile devices, and standard protocols have improved mortality for ruptured aneurysms. In the thoracic aorta, more invasive hybrid procedures have given way gradually to branched endografts. Particular challenges to the anaesthetist include blood pressure control and the prevention of stroke and paraplegia. Current focus in the thoracic aorta is in treating aortic arch pathology and in optimal management of acute and chronic dissections. This review describes the latest trends in the endovascular treatment of aortic diseases and examines the current evidence for different modalities of management. PMID:27566806

  1. Wall shear stress indicators in abnormal aortic geometries

    Science.gov (United States)

    Prahl Wittberg, Lisa; van Wyk, Stevin; Fuchs, Laszlo; Gutmark, Ephraim; Gutmark-Little, Iris

    2015-11-01

    Cardiovascular disease, such as atherosclerosis, occurs at specific locations in the arterial tree. Characterizing flow and forces at these locations is crucial to understanding the genesis of disease. Measures such as time average wall shear stress, oscillatory shear index, relative residence time and temporal wall shear stress gradients have been shown to identify plaque prone regions. The present paper examines these indices in three aortic geometries obtained from patients whose aortas are deformed due to a genetic pathology and compared to one normal geometry. This patient group is known to be prone to aortic dissection and our study aims to identify early indicators that will enable timely intervention. Data obtained from cardiac magnetic resonance imaging is used to reconstruct the aortic arch. The local unsteady flow characteristics are calculated, fully resolving the flow field throughout the entire cardiac cycle. The Quemada model is applied to account for the non-Newtonian properties of blood, an empirical model valid for different red blood cell loading. The impact of the deformed aortic geometries is analyzed to identify flow patterns that could lead to arterial disease at certain locations.

  2. On inner constraints in plane circular arches

    Energy Technology Data Exchange (ETDEWEB)

    Ruta, G.C. [Universita di Roma ' ' La Sapienza' ' , Dipartimento di Ingegneria Strutturale e Geotecnica, via Eudossiana 18, I-00184 Roma (Italy)

    2004-12-01

    A one-dimensional model of plane circular arches with rigid sections is introduced. Suitable strain measures are defined as deviations from rigid displacements. If the arch is thin, constitutive arguments make the shearing strain negligible. Hence, the shearing indeformability will be assumed as inner constraint. By means of a formal power series expansion of the exact measures of deformation it is shown that the shearing indeformability implies some constraints on the axial strain. In particular, the first-order axial strain must vanish in the case of infinitesimal displacements. The same procedure is applied to pure flexible arches, in order to compare the two sets of results. It is shown that the hypothesis of finite pure flexibility is not compatible with small deformations of the arch. An example is provided to evaluate the effects of the two constraints at the first non-linear step of the perturbation expansions. (orig.)

  3. Determinant factors of Yemeni maxillary arch dimensions

    Directory of Open Access Journals (Sweden)

    Nabil Muhsen Al-Zubair

    2015-01-01

    Conclusion: Measurements of palatal depth and relationships of the canines to one another and to other teeth thus had the widest ranges, implying that these dimensions are the strongest determinants of maxillary arch size.

  4. Are Aortic Stent Grafts Safe in Pregnancy?

    OpenAIRE

    Nader Khandanpour; Mehta, Tapan A.; Adiseshiah, M; Meyer, Felicity J.

    2015-01-01

    Aortic stent grafts are increasingly used to treat aortic aneurysms and also other aortic pathologies. The safety of aortic stent grafts in pregnancy has never been studied or reported. We report on two cases of aortic stent grafts in pregnant women and discuss the effect of pregnancy on these aortic stent grafts.

  5. Subglottic granuloma after aortic replacement: resection via flexible bronchoscopy after an emergency tracheostomy

    OpenAIRE

    Nose, Naohiro; So, Tetsuya; Sekimura, Atsushi; Miyata, Takeaki; Yoshimatsu, Takashi

    2014-01-01

    A subglottic granuloma is one of the late-phase complications that can occur after intubation. It can cause a life-threatening airway obstruction; therefore, a rapid diagnosis and appropriate treatment plan is necessary. A 62-year-old male had undergone an emergency total arch replacement for acute aortic dissection. Postoperative ventilation support had been performed until the 15th postoperative day (POD). He was discharged from the hospital on POD 30. On POD 50, he was brought to our hospi...

  6. Aortic regurgitation after transcatheter aortic valve replacement.

    Science.gov (United States)

    Werner, Nikos; Sinning, Jan-Malte

    2014-01-01

    Paravalvular aortic regurgitation (AR) negatively affects prognosis following transcatheter aortic valve replacement (TAVR). As transcatheter heart valves (THV) are anchored using a certain degree of oversizing at the level of the aortic annulus, incomplete stent frame expansion because of heavily annular calcifications, suboptimal placement of the prosthesis, and/or annulus-prosthesis size-mismatch can contribute to paravalvular AR with subsequent increased mortality risk. Echocardiography is essential to differentiate between transvalvular and paravalvular AR and to further elucidate the etiology of AR during the procedure. However, because echocardiographic quantification of AR in TAVR patients remains challenging, especially in the implantation situation, a multimodal approach to the evaluation of AR with use of hemodynamic measurements and imaging modalities is useful to precisely quantify the severity of AR immediately after valve deployment. "Next-generation" THVs are already on the market and first results show that paravalvular AR related to design modifications (eg, paravalvular space-fillers, full repositionability) are rarely seen in these valve types.  PMID:24632758

  7. Minimally Invasive Aortic Valve Replacement

    Medline Plus

    Full Text Available ... aortic stenosis, are there any activities that I should avoid doing? That's a great question, Jim. Generally ... do not have symptoms but have aortic stenosis should be considered for surgery. Age, in and of ...

  8. Minimally Invasive Aortic Valve Replacement

    Medline Plus

    Full Text Available ... who have symptomatic aortic stenosis of a severe nature. It's even been liberalized in some patient populations ... the heart. The aortic valve, because of its nature being in back of the heart, is not ...

  9. Minimally Invasive Aortic Valve Replacement

    Medline Plus

    Full Text Available ... up offering patients aortic valve surgery in our community. Aortic stenosis is a process by which the ... basic valve types that we use in our practice, those being tissue valves and mechanical valves. Tissue ...

  10. Minimally Invasive Aortic Valve Replacement

    Medline Plus

    Full Text Available ... North Carolina. My name is John Streitman and I'm a cardiothoracic surgeon here at the Heart ... the corrective surgery of aortic valve replacement. If I have aortic stenosis, are there any activities that ...

  11. Minimally Invasive Aortic Valve Replacement

    Medline Plus

    Full Text Available ... of that slide, that demonstrates that patients with New York Heart Association class heart failure 1 and ... right down the aortic valve and that's the new aortic valve that Dr. Streitman's placed. And you ...

  12. Minimally Invasive Aortic Valve Replacement

    Medline Plus

    Full Text Available ... to help prevent aortic stenosis? There's no prophylactic methods that anybody can take to prevent aortic stenosis ... it will be archived on the ORlive Web site and ORlive.com and, of course, a link ...

  13. Minimally Invasive Aortic Valve Replacement

    Medline Plus

    Full Text Available ... conditions or other significant medical problems, the American College of Cardiology recommends aortic valve replacement for basically ... more likely we see aortic stenosis. Again, patient education is part of the evaluation and management of ...

  14. Minimally Invasive Aortic Valve Replacement

    Medline Plus

    Full Text Available ... see aortic stenosis in patients younger, in their 40s and 50s, if they have congenitally bicuspid, or ... a year and, you know, probably 30 to 40 minimally invasive aortic valve replacements a year. So ...

  15. Minimally Invasive Aortic Valve Replacement

    Medline Plus

    Full Text Available ... Hospital in Pinehurst, North Carolina. During the program, it's easy for you to learn about the procedure. ... the aortic valve, and proceeds to aortic stenosis. It's really not felt to be due to wear ...

  16. Combined Interventional and Surgical Treatment for Acute Aortic Type A Dissection

    International Nuclear Information System (INIS)

    Surgical repair and endovascular stent-graft placement are both therapies for thoracic aortic dissection. A combination of these two approaches may be effective in patients with type A dissection. In this study, we evaluated the prognosis of this combined technique. From December 2003 to December 2006, 15 patients with type A dissection were admitted to our institute; clinical data were retrospectively reviewed. Follow-up was performed at discharge and approximately 12 months after operation. Endovascular stent-graft placement by interventional radiology and surgical repair for reconstruction of aortic arch was performed in all patients. Total arch replacement for distal arch aneurysm was carried out under deep hypothermia with circulatory arrest; antegrade-selected cerebral perfusion was used for brain protection. Four patients concomitantly received a coronary artery bypass graft. Hospital mortality rate was 6.7%; the patient died of cerebral infarction. Neurological complications developed in two patients. Multi-detector-row computed tomography scans performed before discharge revealed complete thrombosis of the false lumen in six patients and partial thrombosis in eight patients. At the follow-up examination, complete thrombosis was found in another three patients, aortic rupture, endoleaks, or migration of the stent-graft was not observed and injuries of peripheral organs or anastomotic endoleaks did not occur. For patients with aortic type A dissection, combining intervention and surgical procedures is feasible, and complete or at least partial thrombosis of the false lumen in the descending aorta can be achieved. This combined approach simplified the surgical procedures and shortened the circulatory arrest time, minimizing the necessity for further aortic operation.

  17. Consistency of aortic distensibility and pulse wave velocity estimates with respect to the Bramwell-Hill theoretical model: a cardiovascular magnetic resonance study

    Directory of Open Access Journals (Sweden)

    De Cesare Alain

    2011-01-01

    Full Text Available Abstract Background Arterial stiffness is considered as an independent predictor of cardiovascular mortality, and is increasingly used in clinical practice. This study aimed at evaluating the consistency of the automated estimation of regional and local aortic stiffness indices from cardiovascular magnetic resonance (CMR data. Results Forty-six healthy subjects underwent carotid-femoral pulse wave velocity measurements (CF_PWV by applanation tonometry and CMR with steady-state free-precession and phase contrast acquisitions at the level of the aortic arch. These data were used for the automated evaluation of the aortic arch pulse wave velocity (Arch_PWV, and the ascending aorta distensibility (AA_Distc, AA_Distb, which were estimated from ascending aorta strain (AA_Strain combined with either carotid or brachial pulse pressure. The local ascending aorta pulse wave velocity AA_PWVc and AA_PWVb were estimated respectively from these carotid and brachial derived distensibility indices according to the Bramwell-Hill theoretical model, and were compared with the Arch_PWV. In addition, a reproducibility analysis of AA_PWV measurement and its comparison with the standard CF_PWV was performed. Characterization according to the Bramwell-Hill equation resulted in good correlations between Arch_PWV and both local distensibility indices AA_Distc (r = 0.71, p AA_Distb (r = 0.60, p Arch_PWV and both theoretical local indices AA_PWVc (r = 0.78, p AA_PWVb (r = 0.78, p Arch_PWV was well related to CF_PWV (r = 0.69, p Conclusions The present work confirmed the consistency and robustness of the regional index Arch_PWV and the local indices AA_Distc and AA_Distb according to the theoretical model, as well as to the well established measurement of CF_PWV, demonstrating the relevance of the regional and local CMR indices.

  18. Motion characterization of aortic wall and intimal flap by ECG-gated CT in patients with chronic B-dissection

    Energy Technology Data Exchange (ETDEWEB)

    Ganten, Maria-Katharina [Department of Radiology, Deutsches Krebsforschungszentrum, Im Neuenheimer Feld 280, 69120 Heidelberg (Germany); Department of Diagnostic Radiology, Ruprecht-Karls-University of Heidelberg (Germany)], E-mail: m.ganten@dkfz-heidelberg.de; Weber, Tim F.; Tengg-Kobligk, Hendrik von [Department of Radiology, Deutsches Krebsforschungszentrum, Im Neuenheimer Feld 280, 69120 Heidelberg (Germany); Boeckler, Dittmar [Department of Vascular and Endovascular Surgery, Ruprecht-Karls-University of Heidelberg (Germany); Stiller, Wolfram [Department of Medical Physics in Radiology, Deutsches Krebsforschungszentrum, Im Neuenheimer Feld 280, 69120 Heidelberg (Germany); Geisbuesch, Philipp [Department of Vascular and Endovascular Surgery, Ruprecht-Karls-University of Heidelberg (Germany); Kauffmann, Guenter W. [Department of Diagnostic Radiology, Ruprecht-Karls-University of Heidelberg (Germany); Delorme, Stefan [Department of Radiology, Deutsches Krebsforschungszentrum, Im Neuenheimer Feld 280, 69120 Heidelberg (Germany); Bock, Michael [Department of Medical Physics in Radiology, Deutsches Krebsforschungszentrum, Im Neuenheimer Feld 280, 69120 Heidelberg (Germany); Kauczor, Hans-Ulrich [Department of Radiology, Deutsches Krebsforschungszentrum, Im Neuenheimer Feld 280, 69120 Heidelberg (Germany)

    2009-10-15

    Rationale and objectives: To evaluate whether dynamic computed tomography (CT)-imaging can provide functional vessel information in patients with chronic aortic dissection type Stanford-B (ADB). Materials and methods: In 32 patients, ECG-gated CT-angiography images were obtained. Cross-sectional area change and wall distensibility were investigated by semiautomatic vessel area segmentation at the end of aortic arch. Significance of distensibility differences was tested with regard to the aortic diameter, and the oscillation of the intimal flap was analyzed. Results: The aorta could be segmented successfully in all patients. These were separated into three subgroups: (A) 6 patients with an aortic diameter <4 cm and without a visible intimal flap, (B) 9 patients with an aortic diameter <4 cm, and (C) 17 individuals with an aortic diameter {>=}4 cm; (B) and (C) having a visible intimal flap. Differences in distensibility between the subgroups were not significant. Overall mean distensibility was D{sub tot} = (1.3 {+-} 0.6) x 10{sup -5} Pa{sup -1}. Analysis of intimal flap oscillation showed a pulsatile short axis diameter decrease of the true lumen of up to 29%. Conclusion: Dynamic, ECG-gated CT-angiography can demonstrate pulsatile changes in aortic area and a highly variable motion of the intimal flap. Aortic distensibility appears independent of diameter or presence of a intimal flap. Follow-up studies may show correlation with possible complications.

  19. Contemporary Management of Type B Aortic Dissection in the Endovascular Era.

    Science.gov (United States)

    Bannazadeh, Mohsen; Tadros, Rami O; McKinsey, James; Chander, Rajiv; Marin, Michael L; Faries, Peter L

    2016-04-01

    Aortic dissection (AD) is one of the most common catastrophic pathologies affecting the aorta. Anatomic classification is based on the origin of entry tear and its extension. Type A dissections originate in the ascending aorta, whereas the entry tear in Type B dissections starts distal to the left subclavian artery. The patients with aortic dissection who manifest complications such as rupture, malperfusion, aneurysmal degeneration, and intractable pain are classified as complicated AD. Risk factors for developing aortic dissection include age, male gender, and aortic wall structural abnormalities. The most common presenting symptom of acute aortic dissection is pain. Malperfusion occurs as a result of end-organ ischemia due to involvement of aortic branches from the dissecting process. This can happen in various locations causing mesenteric ischemia (mesenteric vessels), stroke (aortic arch vessels), renal failure (renal arteries), spinal ischemia, and limb ischemia (iliac or subclavian arteries). Aneurysmal degeneration is the most common complication of patients with chronic Type B dissection who are managed with medical therapy. Management of Type B aortic dissection (TBAD) remains controversial. Many groups recommend conservative therapy for newly diagnosed TBAD and reserve surgical management for patients who develop complications such as rupture, malperfusion, aneurysmal dilatation, and refractory pain. The mainstay of medical therapy includes antihypertensive medication to reduced ΔP/ ΔT by lowering blood pressure and heart rate. With the continued success of thoracic endovascular aortic repair (TEVAR), this procedure has been extended to treat TBAD in selected patients. The outcomes of TEVAR are promising, with early mortality rates from 10% to 20%. With promising results from these series, some groups recommend early TEVAR in uncomplicated TBAD to prevent future adverse events. The goals of endovascular treatment of TBAD are to cover the entry tear

  20. IRF6 Sequencing in Interrupted Clefting.

    Science.gov (United States)

    Cuddapah, Sanmati R; Kominek, Selma; Grant, John H; Robin, Nathaniel H

    2016-05-01

    In a retrospective review of patients seen at the University of Alabama at Birmingham Cleft and Craniofacial Center, four patients with rare interrupted clefting were identified who had undergone genetic testing. Each of these patients had a typical cleft lip, with intact hard palate and cleft of the soft palate. Given this picture of mixed clefting, IRF6 sequencing was done and was negative for mutations in all four patients. As genetic testing for single-gene mutations and exome sequencing become clinically available, it may be possible to identify novel mutations responsible for this previously unreported type of interrupted clefting. PMID:26090788

  1. Arch Index: An Easier Approach for Arch Height (A Regression Analysis

    Directory of Open Access Journals (Sweden)

    Hironmoy Roy

    2012-04-01

    Full Text Available Background: Arch-height estimation though practiced usually in supine posture; is neither correct nor scientific as referred in literature, which favour for standing x-rays or arch-index as yardstick. In fact the standing x-rays can be excused for being troublesome in busy OPD, but an ink-footprint on simple graph-sheet can be documented, as it is easier, cheaper and requires almost no machineries and expertisation. Objective: So this study aimed to redefine the inter-relationship of the radiological standing arch-heights with the arch-index for correlation and regression so that from the later we can derive the radiographical standing arch-height values indirectly, avoiding the actual maneuver. Methods: The study involved 103 adult subjects attending at a tertiary care hospital of North Bengal. From the standing x-rays of foot, the standing navicular, talar heights were measured, and ‘normalised’ with the foot length. In parallel foot-prints also been obtained for arch-index. Finally variables analysed by SPSS software. Result: The arch-index showed significant negative correlations and simple linear regressions with standing navicular height, standing talar height as well as standing normalised navicular and talar heights analysed in both sexes separately with supporting mathematical equations. Conclusion: To measure the standing arch-height in a busy OPD, it is wise to have the foot-print first. Arch-index once get known, can be put in the equations as derived here, to predict the preferred standing arch-heights in either sex.

  2. CT diagnosis of aortic disorders, 1

    International Nuclear Information System (INIS)

    A total of 176 persons (95 male and 81 female) exclusive of those with disease of the heart or great vessels or diabetes mellitus were examined by CT for the diameter, tortousity and calcification of the wall of the aorta. The results are summarized as follows: 1. The diameter of the aorta at any of its levels studied was found to be larger in males than in females and tended to increase with advancing age. In males, the diameter of the ascending aorta increased significantly between the 40 s and 50 s age groups, while in females it showed a significant increase during a period from the 50 s to 60 s. Moreover, it should be noted that this age-related increase in diameter was more marked in its more proximal portions. 2. The upper limits of normal values of aortic calibers were 40 mm at the ascending aorta, 30 mm at the descending aorta and 30 mm and 25 mm, respectively, at those levels of the abdominal aorta just above and below the origin of the renal artery. 3. The ascending aorta tended to displace rightwards with aging while the descending aorta went somewhat leftwards. The abdominal aorta showed no consistent tendency in this respect. 4. The calcification of aortic walls was noted in none of the subjects less than 40 years of age. However, its incidence increased with advancing age (11.5 % in the 40 s, 20.6 % in the 50 s, 60.0 % in the 60 s, 81.8 % in the 70 s and 87.5 % in the 80 s) and was higher in males than in females. of all portions of the aorta studied, the aortic arch had the highest incidence of calcification, followed by the abdominal aorta, descending aorta and ascending aorta. These results indicate that CT proved to be more effective and non-invasive than conventional angiographical study in delineating the caliber and tortuosity of the aorta as well as the calcification of its walls, thus providing a useful means of diagnosing aortic diseases. (author)

  3. Dental Arch Dimension of Malay Ethnic Group

    Directory of Open Access Journals (Sweden)

    H. A. Mohammad

    2011-01-01

    Full Text Available Problem statement: Many previous studies tried to define and put specific measurements for dental arches dimension in different ethnics groups. However, these studies may be specific to an ethnic group and cannot always be applied to other ethnic types. The aim of this study: is to obtain specific dental arch dimensions for Malaysian Malay ethnic groups and compare between both genders. Approach: Involved clinical examination, collection and analysis of 60 dental cast of Malaysian Malay subjects from pure ethnic group (30 males and 30 females, 20-24 years old. All dental landmarks were located and determined and subsequently measurements had been done according to specific points have been selected. Statistical analysis were done using t-test. Results: Dental arch dimension were established in normal occlusion for Malaysian Malay ethnic group in this study. No significant difference was observed in arch dimensions between male and female of Malaysian Malay. Conclusion: These measurement should be considered during treatment, especially in prosthodontics and orthodontics where arch dimension can be modified appreciably.

  4. The murine angiotensin II-induced abdominal aortic aneurysm model: rupture risk and inflammatory progression patterns

    Directory of Open Access Journals (Sweden)

    Richard Y Cao

    2010-07-01

    Full Text Available An abdominal aortic aneurysm (AAA is an enlargement of the greatest artery in the body defined as an increase in diameter of 1.5-fold. AAAs are common in the elderly population and thousands die each year from their complications. The most commonly used mouse model to study the pathogenesis of AAA is the angiotensin II (Ang II infusion method delivered via osmotic mini-pump for 28 days. Here, we studied the site-specificity and onset of aortic rupture, characterized three-dimensional (3D images and flow patterns in developing AAAs by ultrasound imaging, and examined macrophage infiltration in the Ang II model using 65 apolipoprotein E deficient mice. Aortic rupture occurred in 16 mice (25 % and was nearly as prevalent at the aortic arch (44 % as it was in the suprarenal region (56 % and was most common within the first seven days after Ang II infusion (12 of 16; 75 %. Longitudinal ultrasound screening was found to correlate nicely with histological analysis and AAA volume renderings showed a significant relationship with AAA severity index. Aortic dissection preceded altered flow patterns and macrophage infiltration was a prominent characteristic of developing AAAs. Targeting the inflammatory component of AAA disease with novel therapeutics will hopefully lead to new strategies to attenuate aneurysm growth and aortic rupture.

  5. How I do it: transapical cannulation for acute type-A aortic dissection

    Directory of Open Access Journals (Sweden)

    Alexiou Christos

    2008-01-01

    Full Text Available Abstract Aortic dissection is the most frequently diagnosed lethal disease of the aorta. Half of all patients with acute type-A aortic dissection die within 48 hours of presentation. There is still debate as to the optimal site of arterial cannulation for establishing cardiopulmonary bypass in patients with type-A aortic dissection. Femoral artery cannulation with retrograde perfusion is the most common method but because of the risk of malperfusion of vital organs and atheroembolism related to it different sites such as the axillary artery, the innominate artery and the aortic arch are used. Cannulation of these sites is not without risks of atheroembolism, neurovascular complications and can be time consuming. Another yet to be popularised option is the transapical aortic cannulation (TAC described in this article. TAC consists of the insertion of the arterial cannula through the apex of the left ventricle and the aortic valve to lie in the sinus of Valsalva. Trans-oesophageal guidance is necessary to ensure correct placement of the cannula. TAC is an excellent method of establishing cardiopulmonary bypass as it is quick, provides a more physiological method of delivering antegrade arterial flow and is the only method to assure perfusion of the true lumen.

  6. Overview of current surgical strategies for aortic disease in patients with Marfan syndrome.

    Science.gov (United States)

    Miyahara, Shunsuke; Okita, Yutaka

    2016-09-01

    Marfan syndrome is a heritable, systemic disorder of the connective tissue with a high penetrance, named after Dr. Antoine Marfan. The most clinically important manifestations of this syndrome are cardiovascular pathologies which cause life-threatening events, such as acute aortic dissections, aortic rupture and regurgitation of the aortic valve or other artrioventricular valves leading to heart failure. These events play important roles in the life expectancy of patients with this disorder, especially prior to the development of effective surgical approaches for proximal ascending aortic disease. To prevent such catastrophic aortic events, a lower threshold has been recommended for prophylactic interventions on the aortic root. After prophylactic root replacement, disease in the aorta beyond the root and distal to the arch remains a cause for concern. Multiple surgeries are required throughout a patient's lifetime that can be problematic due to distal lesions complicated by dissection. Many controversies in surgical strategies remain, such as endovascular repair, to manage such complex cases. This review examines the trends in surgical strategies for the treatment of cardiovascular disease in patients with Marfan syndrome, and current perspectives in this field. PMID:26586198

  7. Iatrogenic neonatal type B aortic dissection: comprehensive MRI-based diagnosis and follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Geiger, Julia; Markl, M. [University Hospital Freiburg, Department of Diagnostic Radiology and Medical Physics, Freiburg (Germany); Stiller, B.; Arnold, R. [University Hospital Freiburg, Department of Congenital Heart Disease and Pediatric Cardiology, Freiburg (Germany); Schlensak, C. [University Hospital Freiburg, Department of Cardiovascular Surgery, Freiburg (Germany)

    2011-10-15

    Neonatal aortic dissection is rare and most frequently iatrogenic. Decision making and appropriate imaging are highly challenging for pediatric cardiologists and radiologists. We present MRI and echocardiographic findings in the follow-up at 6 months of age of a boy with a conservatively treated iatrogenic neonatal aortic dissection (type B). To evaluate the morphology of the aortic arch and descending aorta, we carried out multidirectional time-resolved three-dimensional flow-analysis and contrast-enhanced MR angiography (CE-MRA). The MRI and Doppler echocardiographic results were closely comparable. Three-dimensional visualization helped assess details of blood flow acceleration and alteration caused by the dissection, and played a key role in our deciding not to treat surgically. (orig.)

  8. MDCT assessment of tracheomalacia in symptomatic infants with mediastinal aortic vascular anomalies: preliminary technical experience

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Edward Y. [Children' s Hospital Boston and Harvard Medical School, Departments of Radiology and Medicine, Pulmonary Division, Boston, MA (United States); Mason, Keira P. [Children' s Hospital Boston and Harvard Medical School, Department of Anesthesiology, Boston, MA (United States); Zurakowski, David [Children' s Hospital Boston and Harvard Medical School, Department of Orthopedic Surgery, Boston, MA (United States); Waltz, David A. [Children' s Hospital Boston and Harvard Medical School, Department of Medicine, Division of Respiratory Diseases, Boston, MA (United States); Ralph, Amy; Riaz, Farhana [Children' s Hospital Boston and Harvard Medical School, Department of Radiology, Boston, MA (United States); Boiselle, Phillip M. [Harvard Medical School, Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA (United States)

    2008-01-15

    Mediastinal aortic vascular anomalies are relatively common causes of extrinsic central airway narrowing in infants with respiratory symptoms. Surgical correction of mediastinal aortic vascular anomalies alone might not adequately treat airway symptoms if extrinsic narrowing is accompanied by intrinsic tracheomalacia (TM), a condition that escapes detection on routine end-inspiratory imaging. Paired inspiratory-expiratory multidetector CT (MDCT) has the potential to facilitate early diagnosis and timely management of TM in symptomatic infants with mediastinal aortic vascular anomalies. To assess the technical feasibility of paired inspiratory-expiratory MDCT for evaluating TM among symptomatic infants with mediastinal aortic vascular anomalies. The study group consisted of five consecutive symptomatic infants (four male, one female; mean age 4.1 months, age range 2 weeks to 6 months) with mediastinal aortic vascular anomalies who were referred for paired inspiratory-expiratory MDCT during a 22-month period. CT angiography was concurrently performed during the end-inspiration phase of the study. Two pediatric radiologists in consensus reviewed all CT images in a randomized and blinded fashion. The end-inspiration and end-expiration CT images were reviewed for the presence and severity of tracheal narrowing. TM was defined as {>=}50% reduction in tracheal cross-sectional luminal area between end-inspiration and end-expiration. The presence of TM was compared to the bronchoscopy results when available (n = 4). Paired inspiratory-expiratory MDCT was technically successful in all five patients. Mediastinal aortic vascular anomalies included a right aortic arch with an aberrant left subclavian artery (n = 2), innominate artery compression (n = 2), and a left aortic arch with an aberrant right subclavian artery (n = 1). Three (60%) of the five patients demonstrated focal TM at the level of mediastinal aortic vascular anomalies. The CT results were concordant with the

  9. Isolated sleep paralysis elicited by sleep interruption.

    Science.gov (United States)

    Takeuchi, T; Miyasita, A; Sasaki, Y; Inugami, M; Fukuda, K

    1992-06-01

    We elicited isolated sleep paralysis (ISP) from normal subjects by a nocturnal sleep interruption schedule. On four experimental nights, 16 subjects had their sleep interrupted for 60 minutes by forced awakening at the time when 40 minutes of nonrapid eye movement (NREM) sleep had elapsed from the termination of rapid eye movement (REM) sleep in the first or third sleep cycle. This schedule produced a sleep onset REM period (SOREMP) after the interruption at a high rate of 71.9%. We succeeded in eliciting six episodes of ISP in the sleep interruptions performed (9.4%). All episodes of ISP except one occurred from SOREMP, indicating a close correlation between ISP and SOREMP. We recorded verbal reports about ISP experiences and recorded the polysomnogram (PSG) during ISP. All of the subjects with ISP experienced inability to move and were simultaneously aware of lying in the laboratory. All but one reported auditory/visual hallucinations and unpleasant emotions. PSG recordings during ISP were characterized by a REM/W stage dissociated state, i.e. abundant alpha electroencephalographs and persistence of muscle atonia shown by the tonic electromyogram. Judging from the PSG recordings, ISP differs from other dissociated states such as lucid dreaming, nocturnal panic attacks and REM sleep behavior disorders. We compare some of the sleep variables between ISP and non-ISP nights. We also discuss the similarities and differences between ISP and sleep paralysis in narcolepsy. PMID:1621022

  10. Determination of entry site for acute type A aortic dissection by initial enhanced CT-scan

    Energy Technology Data Exchange (ETDEWEB)

    Mase, Takenori; Narumiya, Chihiro; Aoyama, Takahiko; Nagata, Yoshihisa [Aichi Medical Univ., Nagakute (Japan). School of Medicine

    2002-01-01

    Acute type A aortic dissection presents a surgical emergency because conservative therapy is not effective in the majority of instances. Enhanced CT-scan of the chest is commonly available and is considered to be an optimal diagnostic method for this disease. The operative strategy is to resect the primary tear to close the entry site of the aortic dissection and replace it with a tubular Dacron graft. Therefore, the existence of the entry site is important in determining the operative procedure. Based on the numerical value of the enhanced CT-scan inspection, the present study seeks to preoperatively identify the location of the presumed entry site in aortic dissection. From May 1996 to June 1999, 21 consecutive patients (Marfan's syndrome excluded) with acute type A aortic dissection underwent surgical treatment. Nineteen patients were preoperatively examined by enhanced CT-scan: 11 men and 8 women, with a mean age of 61 years. CT-scan slices used for early diagnosis were of the ascending aorta, aortic arch, descending aorta, and thoracoabdominal aorta. The largest diameters of the whole and true lumen were measured from cross-sectional aortic images with a personal computer, and the areas of the whole and true lumen were obtained by the manual tracing method. The true ratio was calculated for the largest diameter and area of the whole lumen. The nineteen patients were divided into two groups according to the location of the entry site based on the operating views. Seven patients with the entry site in the ascending aorta were classified as group A, and twelve patients with the entry site further in the aortic arch and descending aorta were classified as group B. Comparisons were performed by non-parametric analysis. Moreover, a discriminant analysis was applied to evaluate the classification between the two groups. The ratio of the largest diameter of the true lumen in group A at the level of the ascending and descending aorta was significantly greater than

  11. Determination of entry site for acute type A aortic dissection by initial enhanced CT-scan

    International Nuclear Information System (INIS)

    Acute type A aortic dissection presents a surgical emergency because conservative therapy is not effective in the majority of instances. Enhanced CT-scan of the chest is commonly available and is considered to be an optimal diagnostic method for this disease. The operative strategy is to resect the primary tear to close the entry site of the aortic dissection and replace it with a tubular Dacron graft. Therefore, the existence of the entry site is important in determining the operative procedure. Based on the numerical value of the enhanced CT-scan inspection, the present study seeks to preoperatively identify the location of the presumed entry site in aortic dissection. From May 1996 to June 1999, 21 consecutive patients (Marfan's syndrome excluded) with acute type A aortic dissection underwent surgical treatment. Nineteen patients were preoperatively examined by enhanced CT-scan: 11 men and 8 women, with a mean age of 61 years. CT-scan slices used for early diagnosis were of the ascending aorta, aortic arch, descending aorta, and thoracoabdominal aorta. The largest diameters of the whole and true lumen were measured from cross-sectional aortic images with a personal computer, and the areas of the whole and true lumen were obtained by the manual tracing method. The true ratio was calculated for the largest diameter and area of the whole lumen. The nineteen patients were divided into two groups according to the location of the entry site based on the operating views. Seven patients with the entry site in the ascending aorta were classified as group A, and twelve patients with the entry site further in the aortic arch and descending aorta were classified as group B. Comparisons were performed by non-parametric analysis. Moreover, a discriminant analysis was applied to evaluate the classification between the two groups. The ratio of the largest diameter of the true lumen in group A at the level of the ascending and descending aorta was significantly greater than that

  12. Aortic Aneurysm Repair

    Medline Plus

    Full Text Available ... to repair an abdominal aortic aneurysm using a technology called an “endograft,” which is sometimes called the “ ... separate area, and it’s because of this small technology that allows you to do this. Exactly. So ...

  13. Aortic Aneurysm Repair

    Medline Plus

    Full Text Available ... the arteries, which is known as atherosclerosis, high blood pressure, smokers, or a family history of abdominal aortic ... imaging. We can integrate ultrasound imaging, the patient’s blood pressure, and so it’s a little bit like being ...

  14. Aortic Aneurysm Repair

    Medline Plus

    Full Text Available ... an abdominal aortic aneurysm. Normally this procedure takes us about 45 minutes to an hour of doctor work time, which is, I think, a fairly quick procedure to replace a major life-threatening problem in the patient’s abdomen. So you can see ...

  15. Structural behavior and design criteria for bridge strengthening by tied arch. Comparison with network arch bridges

    OpenAIRE

    Valenzuela, Matías A.; Casas Rius, Joan Ramon

    2013-01-01

    This study focuses on a new strengthening method of continuous bridges with several spans that present extensive damage in their foundation/piers due to scour and erosion. The method consists on the construction of a new upper steel arch with a network hanger's arrangement over the original deck with the aim to hang the existing deck to the new arch. The deck is acting as a tie in the new structural configuration. This allows to remove the damaged foundations/piers, deriving on an arch bridge...

  16. Kilmacduagh Cathedral, south exterior wall, door, jamb, arch and hood

    OpenAIRE

    O'Donovan, Danielle

    2002-01-01

    South door jamb, arch and hood moulding. Jamb and arch moulding from intrados comprises: hollow chamfer, quadrant, hollow chamfer, right-angled rebate, hollow chamfer. The hood, from extrados comprises: frontal fillet, hollow chamfer, right-angled rebate, hollow chamfer.

  17. Aortic valve annuloplasty: new single suture technique.

    Science.gov (United States)

    Schöllhorn, Joachim; Rylski, Bartosz; Beyersdorf, Friedhelm

    2014-06-01

    Reconstruction strategies for aortic valve insufficiency in the presence of aortic annulus dilatation are usually surgically challenging. We demonstrate a simple, modified Taylor technique of downsizing and stabilization of the aortic annulus using a single internal base suture. Since April 2011, 22 consecutive patients have undergone safe aortic valve annuloplasty. No reoperations for aortic valve insufficiency and no deaths occurred. PMID:24882316

  18. Structure and distribution of arches in shaken hard sphere deposits

    OpenAIRE

    Pugnaloni, Luis A.; Barker, G. C.

    2003-01-01

    We investigate the structure and distribution of arches formed by spherical, hard particles shaken in an external field after they come to rest. Arches (or bridges) are formed during a computer-simulated, non-sequential deposition of the spheres after each shaking cycle. We identify these arches by means of a connectivity criterion and study their structural characteristics and spatial distribution. We find that neither the size distribution nor the shape of the arches is strongly affected by...

  19. Assembly and lifting of Pearl-Chain arches

    DEFF Research Database (Denmark)

    Halding, Philip Skov; Hertz, Kristian Dahl; Viebæk, N.E.;

    2015-01-01

    buildings and bridges. The assembly and lifting of two Pearl-Chain arches, with a span of 13 m and rise of 1 m, is considered in this paper. Precast “Super-Light Deck” elements were used for the arches, which had a thickness of 22 cm. Both arches were successfully lifted, rotated in mid-air, and placed...

  20. Congenital defects of atlantal arch. A report of eight cases

    International Nuclear Information System (INIS)

    Atlantal arch defects are rare. The purpose of this paper is to investigate the incidence and clinical implications of these, using Cervical CT with traumatic patients. A retrospective review of 1,534 cervical spine computed tomography (CT) scans was performed to identify patients with atlantal arch defects. Posterior arch defects of the atlas were grouped in accordance with the classification of Currarino et al. Posterior arch defects were found in 7 (7/1534, 0.44%) and anterior arch defects were found in 2 (2/1534, 0.13%) of the 1,534 patients. The type A posterior arch defect was found in 5 patients and the type B posterior arch defect was found in 2 patients. No type C, D, or E defects were observed. One patient with a type B posterior arch defect had an anterior atlantal-arch midline cleft. Associated cervical spine anomaly was not observed in our cases. None of the reviewed patients had neurological deficits because of atlantal arch defects. Most congenital anomalies of the atlantal arch are found incidentally during investigation of neck mass, neck pain, radiculopathy, and after trauma. Almost cases of atlantal arch defects are not need to operate. But it is important to note some cases require surgical treatment. (author)

  1. Precast Pearl-Chain concrete arch bridges

    DEFF Research Database (Denmark)

    Halding, Philip Skov; Hertz, Kristian Dahl; Schmidt, Jacob Wittrup

    2015-01-01

    the technology was used. We also study other important components and details in the Pearl-Chain Bridge concept and review the effects of different types of loads. A theoretical case study of a circular 30 m span Pearl-Chain Bridge is presented showing the influence of a number of parameters: The......A Pearl-Chain Bridge is a closed-spandrel arch bridge consisting of a number of straight pre-fabricated so called Super-Light Deck elements put together in an arch shape by post-tensioning cables. Several Pearl-Chain arches can be positioned adjacent to each other by a crane to achieve a bridge of...... number of post-tensioning cables, the rise to span ratio, the height of the filling, and the height of the Super-Light Decks. We find that Pearl-Chain Bridges can be adjusted to resist specific moment loads by changing the normal force in the arch cross section by altering the above parameters. It is...

  2. Arch Coal focuses on its future

    International Nuclear Information System (INIS)

    Arch Coal, Inc (ACI) has emerged as the second largest US coal producer, with nearly 5000 employees producing 110 million tons of coal per year. The article discusses the company's philosophy, as stated by Steve Leer, President and CEO, and reports interviews with six other senior executives talking about policy on finances, sales, marketing, business development and operations. 8 photos

  3. First direct aortic retrievable transcatheter aortic valve implantation in humans.

    Science.gov (United States)

    Chandrasekhar, Jaya; Glover, Chris; Labinaz, Marino; Ruel, Marc

    2014-11-01

    We describe 2 cases in which transcatheter aortic valve implantation was performed with a Portico prosthesis (St Jude Medical, St Paul, MN) through a direct aortic approach. In 1 of the cases, prosthesis retrieval was needed during the procedure and was essential to the successful outcome. This is the first report, to our knowledge, of direct aortic Portico prosthesis implantation, and it highlights the significance of the retrievable nature of this device. PMID:25442452

  4. Static Checking of Interrupt-driven Software

    DEFF Research Database (Denmark)

    Brylow, Dennis; Damgaard, Niels; Palsberg, Jens

    2001-01-01

    Resource-constrained devices are becoming ubiquitous. Examples include cell phones, palm pilots, and digital thermostats. It can be difficult to fit required functionality into such a device without sacrificing the simplicity and clarity of the software. Increasingly complex embedded systems...... require extensive brute-force testing, making development and maintenance costly. This is particularly true for system components that are written in assembly language. Static checking has the potential of alleviating these problems, but until now there has been little tool support for programming at the...... assembly level. In this paper we present the design and implementation of a static checker for interrupt-driven Z86-based software with hard real-time requirements. For six commercial microcontrollers, our checker has produced upper bounds on interrupt latencies and stack sizes, as well as verified...

  5. Anaphylactoid Reactions to Tolmetin After Interrupted Dosage

    OpenAIRE

    Bretza, Joseph A.; Novey, Harold S.

    1985-01-01

    Seven patients had anaphylactoid reactions after ingesting tolmetin sodium. In each case the reaction followed readministration of the drug after an interrupted period of at least three days and within 90 minutes of taking a single 400-mg capsule. None of the patients had had prior anaphylaxis and none were judged atopic. Skin tests to an extract of the drug (0.02 mg) were uniformly negative, whereas a higher concentration produced a nonspecific irritant reaction. In vitro tests in one patien...

  6. Method of interrupting asphalt solidifying operation

    International Nuclear Information System (INIS)

    Purpose: To shorten the time required for interrupting operation, by specifying methods of supplying and interrupting liquid wastes, water and asphalts. Method: Electrical power supply for a heat medium heater is disconnected simultaneously with the start for the stopping operation. The temperature for the heat medium is detected by a heat medium thermometer, the flow rate of a waste liquid supply pump is reduced by way of a rotation controller for the liquid waste supply pump and the amount of liquid wastes supplied is gradually decreased along with the reduction in the temperature for the heat medium. Then, when the temperature for the heat medium lowered to about 190 - 2100C, supply of the liquid wastes is interrupted and cleaning water is supplied to a liquid wastes supply tank while closing the liquid wastes supply tank main valve and opening a cleaning water valve to thereby clean the radioactive substances. Then, after stopping the supply of the cleaning water, asphalt is continued to be supplied for several minutes, the radioactive substances deposited in an evaporator and an agitation blade are sufficiently washed out. Then, after stopping the asphalt tank, operations for the driving device and the heat medium pump are stopped. This enables cooling for the heat medium in a short time using no exclusive heat medium cooler, as well as clean the radioactive substances. (Horiuchi, T.)

  7. Thoracic aortic aneurysm and dissection.

    Science.gov (United States)

    Goldfinger, Judith Z; Halperin, Jonathan L; Marin, Michael L; Stewart, Allan S; Eagle, Kim A; Fuster, Valentin

    2014-10-21

    Aortic dissection is the most devastating complication of thoracic aortic disease. In the more than 250 years since thoracic aortic dissection was first described, much has been learned about diseases of the thoracic aorta. In this review, we describe normal thoracic aortic size; risk factors for dissection, including genetic and inflammatory conditions; the underpinnings of genetic diseases associated with aneurysm and dissection, including Marfan syndrome and the role of transforming growth factor beta signaling; data on the role for medical therapies in aneurysmal disease, including beta-blockers, angiotensin receptor blockers, and angiotensin-converting enzyme inhibitors; prophylactic surgery for aneurysm; surgical techniques for the aortic root; and surgical and endovascular management of aneurysm and dissection for different aortic segments. PMID:25323262

  8. Abdominal aortic aneurysm surgery

    DEFF Research Database (Denmark)

    Gefke, K; Schroeder, T V; Thisted, B; Olsen, P S; Perko, M J; Agerskov, Kim; Røder, O; Lorentzen, Jørgen Ewald

    1994-01-01

    The goal of this study was to identify patients who need longer care in the ICU (more than 48 hours) following abdominal aortic aneurysm (AAA) surgery and to evaluate the influence of perioperative complications on short- and long-term survival and quality of life. AAA surgery was performed in 55......, 78% stated that their quality of life had improved or was unchanged after surgery and had resumed working. These data justify a therapeutically aggressive approach, including ICU therapy following AAA surgery, despite failure of one or more organ systems.......The goal of this study was to identify patients who need longer care in the ICU (more than 48 hours) following abdominal aortic aneurysm (AAA) surgery and to evaluate the influence of perioperative complications on short- and long-term survival and quality of life. AAA surgery was performed in 553...

  9. 30 CFR 18.48 - Circuit-interrupting devices.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Circuit-interrupting devices. 18.48 Section 18... Design Requirements § 18.48 Circuit-interrupting devices. (a) Each machine shall be equipped with a circuit-interrupting device by means of which all power conductors can be deenergized at the machine....

  10. Acute aortic dissection in a young healthy athlete with androgenic anabolic steroid use: A case report

    Directory of Open Access Journals (Sweden)

    Barman M, Djamel B, Mathews J

    2014-07-01

    Full Text Available Background: Acute aortic dissection can occur at the time of intense physical exertion in strength-trained athletes like weight lifters, bodybuilders, throwers, and wrestlers. Rapid rise in blood pressure and history of hypertension are the most common causes of aortic dissection in athletes. It is a very tragic event because of its high mortality rate of about 32% in young patients. We report a case of aortic dissection in a young weightlifter with a history of anabolic steroid usage with an extensive intimal tear of the aorta at Sino tubular junction and arch. All athletes must be assessed for predisposing factors for aortic dissection, and all patients should be encouraged to undergo appropriate diagnostic studies, like echocardiography and blood pressure monitoring while weightlifting to recognize possible predisposing factors for aortic dissection. Athletes who do have a problem should be encouraged to avoid or limit their exercise or activity by their cardiologist. It is vital that this disastrous event be prevented in young people. In conclusion, although a rare occurrence, AD should be considered in symptomatic patients with any family history of early cardiac deaths, a history suggestive of a connective tissue disorder (that is, multiple joint surgeries or who practice weightlifting.

  11. Acute aortic intramural hematoma

    Energy Technology Data Exchange (ETDEWEB)

    Bae, Oh Keun; Choi, Yo Won; Kim, Kwon Hyung; Jeon, Seok Chol; Park, Choong Kee; Seo, Heung Suk; Hahm, Chang Kok [Hanyang Univ. College of Medicine, Seoul (Korea, Republic of)

    1997-02-01

    To evaluate the radiologic findings of acute intramural hematoma of the aorta, and the clinical follow up thereof. Among 34 cases confirmed clinically and radiologically as aortic dissection, and analysis was carried out based on 15 cases in which intramural hematoma without false lumen was demonstrated, on initial CT, 12 cases of in which follow up CT was used and five cases involving an aortogram. Elements such as the shape of the thickened aortic wall, ulcer-like intimal defects, and intimal calcification were examined. Changes in these elements were also examined on follow-up CT. DeBackey types 1 and 3 accounted for one and 14 cases, respectively. Initial precontrast CT demonstrated continuous, crescentic high attenuation areas along the wall of the descending aorta. In postcontrast scans, the crescentic areas were of relatively lower-attenuation and appeared along the aorta wall. Displaced intimal calcifications were seen in nine of fifteen patients. There was no intimal flap on all five aortogram, while aortic wall thickening and atherosclerotic change were demonstrated in four cases and in one case, respectively. Focal ulcers were seen in three cases. Ulcer-like intimal defects were demonstrated in a total of eleven cases (eight on CT, two on aortogram, and one on both). In ten of the twelve cases seen on follow up CT, the thickness of the intramural hematoma was seen to be reduced. Among the 15 cases, the operation was performed in two cases, and the remaining 13 received conservative treatment. In ten cases observed for more than twelve months, a recurrence of symptoms did not occur. Eccentric aortic wall thickening in patients who complain of acute chest pain is the result of acute aortic dissection with intramural hematoma, or a penetrating atherosclerotic ulcer of the aorta. The later may be differentiated from the former by the presence of on ulcer-like intimal defect. When both diseases are limited to the descending aorta, conservative treatment may

  12. Acute aortic intramural hematoma

    International Nuclear Information System (INIS)

    To evaluate the radiologic findings of acute intramural hematoma of the aorta, and the clinical follow up thereof. Among 34 cases confirmed clinically and radiologically as aortic dissection, and analysis was carried out based on 15 cases in which intramural hematoma without false lumen was demonstrated, on initial CT, 12 cases of in which follow up CT was used and five cases involving an aortogram. Elements such as the shape of the thickened aortic wall, ulcer-like intimal defects, and intimal calcification were examined. Changes in these elements were also examined on follow-up CT. DeBackey types 1 and 3 accounted for one and 14 cases, respectively. Initial precontrast CT demonstrated continuous, crescentic high attenuation areas along the wall of the descending aorta. In postcontrast scans, the crescentic areas were of relatively lower-attenuation and appeared along the aorta wall. Displaced intimal calcifications were seen in nine of fifteen patients. There was no intimal flap on all five aortogram, while aortic wall thickening and atherosclerotic change were demonstrated in four cases and in one case, respectively. Focal ulcers were seen in three cases. Ulcer-like intimal defects were demonstrated in a total of eleven cases (eight on CT, two on aortogram, and one on both). In ten of the twelve cases seen on follow up CT, the thickness of the intramural hematoma was seen to be reduced. Among the 15 cases, the operation was performed in two cases, and the remaining 13 received conservative treatment. In ten cases observed for more than twelve months, a recurrence of symptoms did not occur. Eccentric aortic wall thickening in patients who complain of acute chest pain is the result of acute aortic dissection with intramural hematoma, or a penetrating atherosclerotic ulcer of the aorta. The later may be differentiated from the former by the presence of on ulcer-like intimal defect. When both diseases are limited to the descending aorta, conservative treatment may

  13. Bicuspid aortic valve and aortic coarctation are linked to deletion of the X chromosome short arm in Turner syndrome

    Science.gov (United States)

    Bondy, Carolyn; Bakalov, Vladimir K; Cheng, Clara; Olivieri, Laura; Rosing, Douglas R; Arai, Andrew E

    2013-01-01

    Background Congenital heart disease (CHD) is a cardinal feature of X chromosome monosomy, or Turner syndrome (TS). Haploinsufficiency for gene(s) located on Xp have been implicated in the short stature characteristic of the syndrome, but the chromosomal region related to the CHD phenotype has not been established. Design We used cardiac MRI to diagnose cardiovascular abnormalities in four non-mosaic karyotype groups based on 50-metaphase analyses: 45,X (n=152); 46,X,del(Xp) (n=15); 46,X,del(Xq) (n=4); and 46,X,i(Xq) (n=14) from peripheral blood cells. Results Bicuspid aortic valves (BAV) were found in 52/152 (34%) 45,X study subjects and aortic coarctation (COA) in 19/152 (12.5%). Isolated anomalous pulmonary veins (APV) were detected in 15/152 (10%) for the 45,X study group, and this defect was not correlated with the presence of BAV or COA. BAVs were present in 28.6% of subjects with Xp deletions and COA in 6.7%. APV were not found in subjects with Xp deletions. The most distal break associated with the BAV/COA trait was at cytologic band Xp11.4 and ChrX:41,500 000. One of 14 subjects (7%) with the 46,X,i(Xq) karyotype had a BAV and no cases of COA or APV were found in this group. No cardiovascular defects were found among four patients with Xq deletions. Conclusions The high prevalence of BAV and COA in subjects missing only the X chromosome short arm indicates that haploinsufficiency for Xp genes contributes to abnormal aortic valve and aortic arch development in TS. PMID:23825392

  14. [Thoracic Endovascular Aortic Repair Following Axillo-femoral Bypass in a Patient with Stanford B Acute Aortic Dissection Accompanied by Abdominal Visceral Ischemia;Report of a Case].

    Science.gov (United States)

    Nishimoto, Takayuki; Bonkohara, Yukihiro; Azuma, Takashi; Iijima, Masaki; Higashidate, Masafumi

    2016-09-01

    A 60-year-old woman was transfer-red to the emergency department of our medical center with worsening chest and back pain. Computed tomography revealed Stanford type B aortic dissection. There was a false lumen from the distal arch to the abdominal aorta just above the celiac artery. Although she was at 1st treated conservatively, she abruptly developed acute renal failure and lower limb ischemia because of an enlarged false lumen, and emergency axillo-femoral bypass surgery was performed with an 8 mm tube graft. However, renal failure gradually worsened, which necessitated continuous hemodiafiltration was performed. Thoracic endovascular aortic repair was then performed, and her renal function recovered. PMID:27586321

  15. Biotechnologie des archées

    OpenAIRE

    Querellou, Joel

    2010-01-01

    La majorité des enzymes utilisées dans l’industrie provient des bactéries et des levures. Mais les conditions extrêmes dans lesquelles se développent de nombreuses espèces d’archées font que leurs constituants cellulaires possèdent des propriétés et une stabilité propices à leur utilisation en biotechnologie.

  16. CT and MR imaging of post-aortic left brachiocephalic vein

    International Nuclear Information System (INIS)

    The usefulness of CT and MR imaging (MRI) for the diagnosis of post-aortic left brachiocephalic vein (PALBV) is discussed. The subjects of the present study consisted of five patients with PALBV, two males and three females, aged for months to sixty years. Chest CT and MRI were performed as a follow-up study of other intrathoracic lesions in two cases, and for further examination of congenital heart diseases in two infant cases. The other patient underwent both CT and MRI to evaluate sporadic chest pain. Therefore, all PALBV were found incidentally. PALBV passes below the aortic arch in front of the trachea, draining the superior vena cava behind the ascending aorta. The finding was particularly well documented on consecutive coronal sections on MRI. In patients with intrathoracic malignant or specific inflammatory lesion, differentiation between PALBV and lymphadenopathy is necessary for treatment. From our experience, marked enhancement on CT and no signal intensity on MRI in PALBV could differentiate this anomaly from mediastinal lymphadenopathy. In two infantile cases with congenital cardiovascular anomalies such as tetralogy of Fallot, right aortic arch and pulmonary arterial stenosis, MRI was found to be superior to CT in demonstrating these anomalies. (author)

  17. CT and MR imaging of post-aortic left brachiocephalic vein

    Energy Technology Data Exchange (ETDEWEB)

    Amano, Yasuo; Takagi, Ryo; Hayashi, Hiromitsu; Kumazaki, Tatsuo (Nippon Medical School, Tokyo (Japan))

    1993-10-01

    The usefulness of CT and MR imaging (MRI) for the diagnosis of post-aortic left brachiocephalic vein (PALBV) is discussed. The subjects of the present study consisted of five patients with PALBV, two males and three females, aged for months to sixty years. Chest CT and MRI were performed as a follow-up study of other intrathoracic lesions in two cases, and for further examination of congenital heart diseases in two infant cases. The other patient underwent both CT and MRI to evaluate sporadic chest pain. Therefore, all PALBV were found incidentally. PALBV passes below the aortic arch in front of the trachea, draining the superior vena cava behind the ascending aorta. The finding was particularly well documented on consecutive coronal sections on MRI. In patients with intrathoracic malignant or specific inflammatory lesion, differentiation between PALBV and lymphadenopathy is necessary for treatment. From our experience, marked enhancement on CT and no signal intensity on MRI in PALBV could differentiate this anomaly from mediastinal lymphadenopathy. In two infantile cases with congenital cardiovascular anomalies such as tetralogy of Fallot, right aortic arch and pulmonary arterial stenosis, MRI was found to be superior to CT in demonstrating these anomalies. (author).

  18. Variations among the primary maxillary dental arch forms using a polynominal equation model.

    Science.gov (United States)

    Tsai, Hung-Huey

    2003-01-01

    This study identifies arch symmetry and describes arch form variations in normal primary maxillary dental casts. Sixty-two percent of casts had asymmetrical arches, and 38% had symmetrical arches. Six types of arch form were identified according to the ratio of arch width to length. There were more long types than short types. The rounded and short types tended to have a more-symmetrical arch than did the long type. PMID:12739689

  19. Tobacco smoking and aortic aneurysm

    DEFF Research Database (Denmark)

    Sode, Birgitte F; Nordestgaard, Børge G; Grønbæk, Morten;

    2012-01-01

    from the Copenhagen City Heart Study followed for up to 34years and in 56,211 individuals from the Copenhagen General Population Study followed for up to 7years. RESULTS: During follow-up, 335 and 169 individuals developed aortic aneurysm outcomes in the Copenhagen City Heart Study and Copenhagen...... General Population Study, respectively. According to the magnitude of the hazard ratios, tobacco consumption was the most important risk factor for hospitalization and death from aortic aneurysm, followed by male sex and hypertension in both cohorts. The population attributable risk of aortic aneurysm...... outcomes due to tobacco consumption was 64% and 47% in the Copenhagen City Heart Study and Copenhagen General Population Study, respectively, and ranked highest among population attributable risks of aortic aneurysm in both cohorts. The absolute 10-year risk for hospitalization or death from aortic...

  20. Interrupting the Interruption: Neoliberalism and the Challenges of an Antiracist School

    Science.gov (United States)

    Meshulam, Assaf; Apple, Michael W.

    2014-01-01

    The article examines a US public elementary bilingual, multicultural school that attempts to interrupt the reproduction of existing relations of dominance and subordination across a variety of differences. The school's experiences illuminate the complex reality of schools as a site of struggle and compromise between at times contradictory…

  1. Arch Index: An Easier Approach for Arch Height (A Regression Analysis)

    OpenAIRE

    Hironmoy Roy; Kalyan Bhattacharya; Samar Deb; Kuntala Ray

    2012-01-01

    Background: Arch-height estimation though practiced usually in supine posture; is neither correct nor scientific as referred in literature, which favour for standing x-rays or arch-index as yardstick. In fact the standing x-rays can be excused for being troublesome in busy OPD, but an ink-footprint on simple graph-sheet can be documented, as it is easier, cheaper and requires almost no machineries and expertisation. Objective: So this study aimed to redefine the inter-relationship of the radi...

  2. Evaluation of the fit of preformed nickel titanium arch wires on normal occlusion dental arches

    OpenAIRE

    Al-Barakati, Rakhn G.; Nasser D. Alqahtani; Abdulaziz AlMadi; Sahar F. Albarakati; ALKofide, Eman A.

    2016-01-01

    Aim: To determine the fits of preformed nickel titanium (NiTi) archwires on dental arches with normal occlusion. Methods: Forty sets of upper and lower plaster models were obtained from men and women with Class I occlusions. Preformed 0.016″ × 0.022″ NiTi archwires from Rocky Mountain Orthodontics (RMO), 3 M Unitek, Ormco, and Dentaurum were evaluated in terms of their fits on dental arches from male, female, and combined cases. Data were analyzed by using fourth- and sixth-order polynomia...

  3. In-plane elastic stability of fixed parabolic shallow arches

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    The nonlinear behavior of fixed parabolic shallow arches subjected to a vertical uniform load is inves- tigated to evaluate the in-plane buckling load. The virtual work principle method is used to establish the non-linear equilibrium and buckling equations. Analytical solutions for the non-linear in-plane sym- metric snap-through and antisymmetric bifurcation buckling loads are obtained. Based on the least square method, an approximation for the symmetric buckling load of fixed parabolic arch is proposed to simplify the solution process. And the relation between modified slenderness and buckling modes are discussed. Comparisons with the results of finite element analysis demonstrate that the solutions are accurate. A cable-arch structure is presented to improve the in-plane stability of parabolic arches. The comparison of buckling loads between cable-arch systems and arches only show that the effect of cables becomes more evident with the increase of arch’s modified slenderness.

  4. Imaging features of double aortic arch shown by multidetector computed tomography angiography

    International Nuclear Information System (INIS)

    We present a three-dimensional reconstructed image of vascular ring in a 2.5-month-old patient, which was obtained using multidetector computed tomography (MDCT). MDCT angiography made an accurate diagnosis of this life-threatening, but correctable, anomaly in an infant with a stridor, repeated respiratory infections and episodes of apnea

  5. Recurrent respiratory infections caused by a double aortic arch: The diagnostic role of spirometry

    OpenAIRE

    Calabrese, Cecilia; Corcione, Nadia; Di Spirito, Valentina; Guarino, Carmine; Rossi, Giovanni; Domenico Gargiulo, Gaetano; Vatrella, Alessandro

    2013-01-01

    A young woman with a clinical history characterized by recurrent respiratory infections, occurring since early infancy, was referred to our hospital. When the patient was a young girl, she underwent sweat chloride test, serum analysis of immunoglobulins, and evaluation of blood lymphocyte subsets; all these diagnostic tests were normal, as well as chest X ray aside from pneumonia episodes. Skin prick tests were positive for several different allergens, and a diagnosis of allergic rhinitis was...

  6. Anatomic variations of the branches of the aortic arch in a Peruvian population

    Directory of Open Access Journals (Sweden)

    Julio Arturo Huapaya

    2015-07-01

    Full Text Available INTRODUCCIÓN Reportes previos en dos países de América del Sur encontraron una variante anatómica que no había sido reportada en el resto del mundo, lo que podría dar indicios acerca de una diferencia racial. OBJETIVO Describir las variaciones en la distribución anatómica de las ramas del arco aórtico en una población peruana. MÉTODOS Estudio retrospectivo de una serie de casos de personas en quienes se realizó una angiografía por tomografía de la aorta torácica. Se analizaron los informes que registraron la descripción de las variaciones de las ramas del arco aórtico, basados en los ocho tipos descritos por la literatura científica. RESULTADOS Se analizaron 361 informes. Se encontró que 282 pacientes (78,12% tuvieron la configuración clásica (tipo I, arco aórtico que da origen al tronco braquiocefálico, a la carótida común izquierda y a la subclavia izquierda, seguido por el tipo II (arteria carótida común izquierda como rama del tronco braquiocefálico con 41 pacientes (11,36%, y el tipo IX (un ostium común para el tronco braquiocefálico y la carótida común izquierda con 25 pacientes (6,93%. Este último y otros dos tipos resultaron ser nuevas variantes del arco aórtico. CONCLUSIÓN En esta serie de casos peruana, los tipos de arco aórtico I, II y IX fueron los más frecuentes. Adicionalmente, se encontraron otros dos tipos nuevos que no habían sido descritos en la literatura previamente. Es necesario profundizar la investigación sobre estas variantes para evaluar el factor racial en Sudamérica y una posible relación con eventos clínicos o quirúrgicos.

  7. Anatomic variations of the branches of the aortic arch in a Peruvian population

    OpenAIRE

    Julio Arturo Huapaya; Kristhy Chávez-Trujillo; Miguel Trelles; Roy Dueñas Carbajal; Renato Ferrandiz Espadin

    2015-01-01

    INTRODUCCIÓN Reportes previos en dos países de América del Sur encontraron una variante anatómica que no había sido reportada en el resto del mundo, lo que podría dar indicios acerca de una diferencia racial. OBJETIVO Describir las variaciones en la distribución anatómica de las ramas del arco aórtico en una población peruana. MÉTODOS Estudio retrospectivo de una serie de casos de personas en quienes se realizó una angiografía por tomografía de la aorta torácica. Se analizar...

  8. Transformations of Aortic Arches During Metamorphosis of the Spade-Foot Toad, Pelobates fuscus

    Czech Academy of Sciences Publication Activity Database

    Majorová, H.; Roček, Zbyněk

    2004-01-01

    Roč. 260, č. 3 (2004), s. 309. ISSN 0362-2525. [International Congress of Vertebrate Morphology /7./. 27.07.2004-01.08.2004, Boca Raton] Keywords : Anura * Circulatory System * Metamorphosis Subject RIV: EA - Cell Biology

  9. Unusual Case of Overt Aortic Dissection Mimicking Aortic Intramural Hematoma.

    Science.gov (United States)

    Disha, Kushtrim; Kuntze, Thomas; Girdauskas, Evaldas

    2016-04-01

    We report an interesting case in which overt aortic dissection mimicked two episodes of aortic intramural hematoma (IMH) (Stanford A, DeBakey I). This took place over the course of four days and had a major influence on the surgical treatment strategy. The first episode of IMH regressed completely within 15 hours after it was clinically diagnosed and verified using imaging techniques. The recurrence of IMH was detected three days thereafter, resulting in an urgent surgical intervention. Overt aortic dissection with evidence of an intimal tear was diagnosed intraoperatively. PMID:27066437

  10. Reinforced aortic root reconstruction for acute type A aortic dissection involving the aortic root

    Directory of Open Access Journals (Sweden)

    Han Qing-qi

    2013-06-01

    Full Text Available OBJECTIVE: There are debates regarding the optimal approach for AAAD involving the aortic root. We described a modified reinforced aortic root reconstruction approach for treating AAAD involving the aortic root. METHODS: A total of 161 patients with AAAD involving the aortic root were treated by our modified reinforced aortic root reconstruction approach from January 1998 to December 2008. Key features of our modified approach were placement of an autologous pericardial patch in the false lumen, lining of the sinotubular junction lumen with a polyester vascular ring, and wrapping of the vessel with Teflon strips. Outcome measures included post-operative mortality, survival, complications, and level of aortic regurgitation. RESULTS: A total of 161 patients were included in the study (mean age: 43.3 1 15.5 years. The mean duration of follow-up was 5.1 1 2.96 years (2-12 years. A total of 10 (6.2% and 11 (6.8% patients died during hospitalization and during follow-up, respectively. Thirty-one (19.3% patients experienced postoperative complications. The 1-, 3-, 5-, and 10-year survival rates were 99.3%, 98%, 93.8%, and 75.5%, respectively. There were no instances of recurrent aortic dissection, aortic aneurysm, or pseudoaneurysm during the entire study period. The severity of aortic regurgitation dramatically decreased immediately after surgery (from 28.6% to 0% grade 3-4 and thereafter slightly increased (from 0% to 7.2% at 5 years and 9.1% at 10 years. CONCLUSION: This modified reinforced aortic root reconstruction was feasible, safe and durable/effective, as indicated by its low mortality, low postoperative complications and high survival rate.

  11. The Concept of the Arch Window in the Spiral Switch of the Great Arteries.

    Science.gov (United States)

    Chiu, Ing-Sh; Lee, Meng-Luen; Huang, Shu-Chien; Chang, Chung-I; Chen, Yih-Sharng; Wu, Mei-Hwan; Anderson, Robert H

    2016-08-01

    When the arterial switch operation includes the Lecompte maneuver, the arterial trunks are reconnected in parallel, rather than the spiral fashion observed in the normal heart. Thus, although the ventriculo-arterial connections are hemodynamically corrected, the anatomic arrangement cannot be considered normal. We hypothesized that, if feasible, it would be advantageous to restore a spiral configuration for the arterial trunks. In 58 patients, we reconstructed the arterial trunks such that, postoperatively, the pulmonary channel spirals round the aorta, passing to either the right or the left, and branches posteriorly. We compared the outcomes with those in 95 patients undergoing a standard non-spiraling operation over the same period. Average follow-up was 8.2 ± 4.5 years. The estimated 10-year survival was similar in the cohorts, at 94.7 % for those with spiraling trunks, as compared to 90.4 % for those with parallel outflow tracts. Reoperation-free survival at 10 years was not significantly different (87.6 vs. 90.5 %). Supravalvar pulmonary stenosis, aortic neo-coarctation, or left bronchial stenosis, however, was encountered in one-eighth of those undergoing a standard operation. None of these complications occurred in those patients who, postoperatively, had spiraling outflow tracts (P = 0.002). Reconstruction of spiraling trunks after the arterial switch has, thus far, avoided the complications of supravalvar pulmonary stenosis, neo-aortic kinking, or bronchial stenosis. The spiraling arrangement prevents compression of the pulmonary vessels and bronchial tree by the aorta, since it provides a wide window in the new aortic arch. PMID:27272691

  12. Three-dimensional measurement of foot arch in preschool children

    OpenAIRE

    Chang Hsun-Wen; Lin Chien-Ju; Kuo Li-Chieh; Tsai Ming-June; Chieh Hsiao-Feng; Su Fong-Chin

    2012-01-01

    Abstract Background The prevalence of flexible flatfoot is high among preschool-aged children, but the effects of treatment are inconclusive due to the unclear definitions of normal flatfoot. To date, a universally accepted evaluation method of the foot arch in children has not been completely established. Our aims of this study were to establish a new method to evaluate the foot arch from a three dimensional perspective and to investigate the flexibility of the foot arch among children aged ...

  13. Three-dimensional measurement of foot arch in preschool children

    OpenAIRE

    Chang, Hsun-Wen; Lin, Chien-Ju; Kuo, Li-Chieh; Tsai, Ming-June; Chieh, Hsiao-Feng; Su, Fong-Chin

    2012-01-01

    Background The prevalence of flexible flatfoot is high among preschool-aged children, but the effects of treatment are inconclusive due to the unclear definitions of normal flatfoot. To date, a universally accepted evaluation method of the foot arch in children has not been completely established. Our aims of this study were to establish a new method to evaluate the foot arch from a three dimensional perspective and to investigate the flexibility of the foot arch among children aged from two ...

  14. Normal azygos arch: retrotracheal visualization on frontal chest tomograms.

    Science.gov (United States)

    Austin, J H; Thorsen, M K

    1981-12-01

    Anteroposterior, linear tomograms of 78 adult subjects in the supine position revealed visualization of pleural reflections off the retrotracheal part of the normal azygos arch in 38 (49%). The course of the arch varied by about 3 cm. Five distinct patterns were found, mainly depending on the course of the inferior margin of the arch. The inferior margin varied from relatively superior retrotracheal positions to intermediate positions appearing to intersect the carina, to relatively inferior and right-sided positions posterior to the proximal right main bronchus. Recognition of these normal variations of the azygos arch should serve to differentiate them from abnormalities in this region. PMID:6976093

  15. Normal azygos arch: retrotracheal visualization on frontal chest tomograms

    International Nuclear Information System (INIS)

    Anteroposterior, linear tomograms of 78 adult subjects in the supine position revealed visualization of pleural reflections off the retrotracheal part of the normal azygos arch in 38 (49%). The course of the arch varied by about 3 cm. Five distinct patterns were found, mainly depending on the course of the inferior margin of the arch. The inferior margin varied from relatively superior retrotracheal positions to intermediate positions appearing to intersect the carina, to relatively inferior and right-sided positions posterior to the proximal right main bronchus. Recognition of these normal variations of the azygos arch should serve to differentiate them from abnormalities in this region

  16. Normal azygos arch: retrotracheal visualization on frontal chest tomograms

    Energy Technology Data Exchange (ETDEWEB)

    Austin, J.H.M. (Columbia-Presbyterian Medical Center, New York); Thorsen, M.K.

    1981-12-01

    Anteroposterior, linear tomograms of 78 adult subjects in the supine position revealed visualization of pleural reflections off the retrotracheal part of the normal azygos arch in 38 (49%). The course of the arch varied by about 3 cm. Five distinct patterns were found, mainly depending on the course of the inferior margin of the arch. The inferior margin varied from relatively superior retrotracheal positions to intermediate positions appearing to intersect the carina, to relatively inferior and right-sided positions posterior to the proximal right main bronchus. Recognition of these normal variations of the azygos arch should serve to differentiate them from abnormalities in this region.

  17. Interrupted z-pinch in argon

    International Nuclear Information System (INIS)

    The pinch effect in a low-pressure discharge in air between two cone-shaped copper electrodes was investigated. The paraxial dense part of the z-pinch became interrupted due to the barrel shape of the magnetic and electric fields, and two relatively stable plasma jets, connected with the electrode tips, were formed in the discharge shortly after the breakdown. Later a high-density ellipsoidal structure with a sharp boundary formed. Michelson interferometry and the Schlieren method, respectively, were used in measurements of the plasma density in the discharge channel and in the small inhomogeneity regions. A distinct filamentary structure of the plasma jets was well seen in the Schlieren pictures. The electron temperature was calculated from the intensities of spectral lines and of continuum radiation in the visible region. (J.U.) 1 fig., 3 refs

  18. Understanding receptivity to interruptions in mobile human-computer interaction

    OpenAIRE

    Fischer, Joel

    2011-01-01

    Interruptions have a profound impact on our attentional orientation in everyday life. Recent advances in mobile information technology increase the number of potentially disruptive notifications on mobile devices by an increasing availability of services. Understanding the contextual intricacies that make us receptive to these interruptions is paramount to devising technology that supports interruption management. This thesis makes a number of contributions to the methodology of studying ...

  19. Monitoring of arched sched ground layer

    International Nuclear Information System (INIS)

    Arched Shed was a part of controlled area of NPP A1 site in Jaslovske Bohunice (Slovakia). It had been used for temporary storage of loose radioactive waste (RAW) which has been characterized within the BIDSF project C13, Characterisation of Loose Radioactive Waste'. Stored RAW has been treated and sorted within the project ',Realization of the 2nd stage of Decommissioning Project of NPP A1'. Area of Arched Shed represents approximately 270 m2 (45 m x 6 m). Ground layer of the AS consists mostly of soil with solid elements (stones and gravel). The aim of monitoring was to remove the contaminated soil up to 1 m below ground level. Requirement for detail monitoring of the Arched Shed ground layer resulted from conclusions of the BIDSF project C13 which has proved that massic activity 137Cs of soil was up to few thousands Bq·kg-1 in underground layer. Dominant easy to measure radionuclide in the soil is 137Cs which has been used as a key radionuclide for methodology of in-situ soil monitoring. Following methods has been applied during characterization: dose rate survey, sampling from defined ground layer followed by laboratory gamma spectrometry analysis by the accredited testing laboratory of radiation dosimetry VUJE (S-219) and in-situ scintillation gamma spectrometry by 1.5''x1.5'' LaBr detector. Massic activity of the remaining soil (not excavated) comply the criteria for free release into the environment (Government Regulation of Slovak Republic 345/2006 Coll.). Area was filled up by non-contaminated soil up to the ground level of surroundings. Afterward the area was covered with geotextile and concrete panels and nowadays it is ready for further usage within the NPP A1 decommissioning project as a place for treatment, conditioning and disposal of contaminated soil and concrete. (authors)

  20. A Functional Version of the ARCH Model

    CERN Document Server

    Hormann, Siegfried; Reeder, Ron

    2011-01-01

    Improvements in data acquisition and processing techniques have lead to an almost continuous flow of information for financial data. High resolution tick data are available and can be quite conveniently described by a continuous time process. It is therefore natural to ask for possible extensions of financial time series models to a functional setup. In this paper we propose a functional version of the popular ARCH model. We will establish conditions for the existence of a strictly stationary solution, derive weak dependence and moment conditions, show consistency of the estimators and perform a small empirical study demonstrating how our model matches with real data.

  1. The intelligibility of interrupted speech depends upon its uninterrupted intelligibility.

    Science.gov (United States)

    Ardoint, Marine; Green, Tim; Rosen, Stuart

    2014-10-01

    Recognition of sentences containing periodic, 5-Hz, silent interruptions of differing duty cycles was assessed for three types of processed speech. Processing conditions employed different combinations of spectral resolution and the availability of fundamental frequency (F0) information, chosen to yield similar, below-ceiling performance for uninterrupted speech. Performance declined with decreasing duty cycle similarly for each processing condition, suggesting that, at least for certain forms of speech processing and interruption rates, performance with interrupted speech may reflect that obtained with uninterrupted speech. This highlights the difficulty in interpreting differences in interrupted speech performance across conditions for which uninterrupted performance is at ceiling. PMID:25324110

  2. Combination of traumatic thoracic aortic pseudoaneurysm and myocardial contusion leading to left ventricular aneurysm

    International Nuclear Information System (INIS)

    The combination of thoracic aortic pseudoaneurysm and left ventricular aneurysm resulting from a single traumatic incident is an exceedingly rare occurrence. We present a case of a 10-year-old girl who sustained significant blunt trauma to the chest after being involved in a rollover motor vehicle accident. The child underwent immediate repair of a transected aortic arch. An inferior wall left ventricular aneurysm developed 3 weeks later, and the patient underwent successful repair of the left ventricular aneurysm and a damaged mitral valve. The use of fast multidetector row CT, cardiac MRI, and echocardiography have improved our ability to diagnose these types of injuries and accurately image their anatomic relationships in the acute and perioperative settings. (orig.)

  3. Three-dimensional measurement of foot arch in preschool children

    Directory of Open Access Journals (Sweden)

    Chang Hsun-Wen

    2012-09-01

    Full Text Available Abstract Background The prevalence of flexible flatfoot is high among preschool-aged children, but the effects of treatment are inconclusive due to the unclear definitions of normal flatfoot. To date, a universally accepted evaluation method of the foot arch in children has not been completely established. Our aims of this study were to establish a new method to evaluate the foot arch from a three dimensional perspective and to investigate the flexibility of the foot arch among children aged from two to six. Methods A total of 44 children aged from two to six years of age were put into five age groups in this study. The navicular height was measured with one leg standing, and both feet were scanned separately in both sitting and one leg standing positions to compute the foot arch volume. The arch volume index, which represents the ratio of the difference in volume between sitting and one leg standing positions to the volume when sitting was calculated to demonstrate the flexibility of the foot arch. The differences of measured parameters between each aged group were analyzed by one-way ANOVA. Results The arch volumes when sitting and standing were highly correlated with the navicular height. The navicular height ranged from 15.75 to 27 mm, the arch volume when sitting ranged from 6,223 to 11,630 mm3, and the arch volume when standing from 3,111 to 7,848 mm3 from two to six years of age. The arch volume index showed a declining trend as age increased. Conclusion This study is the first to describe the foot arch with volume perspective in preschool-aged children. The foot arch volume was highly correlated with the navicular height. Research results show both navicular height index and arch volume index gradually increase with age from two to six. At the same time the arch also becomes rigid with age from two to six. These results could be applied for clinical evaluation of the foot arch and post-treatment evaluation.

  4. Aortic root surgery in septuagenarians: impact of different surgical techniques

    Directory of Open Access Journals (Sweden)

    Haverich Axel

    2009-04-01

    Full Text Available Abstract Background To evaluate the impact and safety of different surgical techniques for aortic root replacement (ARR on early and late morbidity and mortality in septuagenarians undergoing ARR. Methods Ninety-five patients (73.8 ± 3.2 years were operated and divided into three groups according to the aortic root procedure; MECH-group (n = 51 patients with a mechanical composite graft, BIO-group (n = 22 patients with a customized biological composite graft, and REIMPL-group (n = 22 patients with a valve sparing aortic root reimplantation (David I. In 42.1% (40/95 of these patients the aortic arch was replaced. Follow-up was completed in 95.2% (79/83 of in-hospital survivors. Results Hospital mortality was 12.6% (12/95 in the entire population (MECH. 15.7% (8/51, BIO 19.7% (4/22, REIMPL 0% (0/22; p = 0.004. Two patients died intraoperatively. The most frequent postoperative complications were prolonged mechanical ventilation ((>48 h in 16.8% (16/93 (MECH. 7% (7/51, BIO 36.4% (8/22, REIMPL 4.5% (1/22; p = 0.013 and rethoracotomy for postoperative bleeding in 12.6% (12/95 (MECH. 12% (6/51, BIO 22.7% (5/22, REIMPL 4.5% (1/22; p = 0.19. Nineteen late deaths (22.9% (19/83 (MECH 34.8% (15/43, BIO 16.7% (3/18, REIMPL 4.5% (1/22; p = 0.012 occurred during a mean follow-up of 41 ± 42 months (MECH 48 ± 48 months, BIO 25 ± 37 months, REIMPL 40 ± 28 months, p = 0.028. Postoperative NYHA class decreased significantly (p = 0.017 and performance status (p = 0.027 increased for the entire group compared to preoperative values. Conclusion Our data indicate that valve sparing aortic root reimplantation is safe and effective in septuagenarians, and is associated with low early and late morbidity and mortality.

  5. Thoracic and abdominal aortic diameters in a general population: MRI-based reference values and association with age and cardiovascular risk factors

    Energy Technology Data Exchange (ETDEWEB)

    Mensel, Birger; Hesselbarth, Lydia; Wenzel, Michael; Kuehn, Jens-Peter; Hegenscheid, Katrin [University Medicine Greifswald, Institute of Diagnostic Radiology and Neuroradiology, Greifswald (Germany); Doerr, Marcus [University Medicine Greifswald, Department of Internal Medicine, Greifswald (Germany); DZHK (German Center for Cardiovascular Research), partner site Greifswald, Greifswald (Germany); Voelzke, Henry [University Medicine Greifswald, Institute for Community Medicine, Greifswald (Germany); DZHK (German Center for Cardiovascular Research), partner site Greifswald, Greifswald (Germany); Lieb, Wolfgang [Christian Albrechts University, Institute of Epidemiology, Kiel (Germany); Lorbeer, Roberto [Ludwig-Maximilians-University Hospital, Institute of Clinical Radiology, Munich (Germany)

    2016-04-15

    To generate reference values for thoracic and abdominal aortic diameters determined by magnetic resonance imaging (MRI) and analyse their association with cardiovascular risk factors in the general population. Data from participants (n = 1759) of the Study of Health in Pomerania were used for analysis in this study. MRI measurement of thoracic and abdominal aortic diameters was performed. Parameters for calculation of reference values according to age and sex analysis were provided. Multivariable linear regression models were used for determination of aortic diameter-related risk factors, including smoking, blood pressure (BP), high-density lipoprotein cholesterol (HDL-C). For the ascending aorta (β = -0.049, p < 0.001), the aortic arch (β = -0.061, p < 0.001) and the subphrenic aorta (β = -0.018, p = 0.004), the body surface area (BSA)-adjusted diameters were lower in men. Multivariable-adjusted models revealed significant increases in BSA-adjusted diameters with age for all six aortic segments (p < 0.001). Consistent results for all segments were observed for the positive associations of diastolic BP (β = 0.001; 0.004) and HDL (β = 0.035; 0.087) with BSA-adjusted aortic diameters and for an inverse association of systolic BP (β = -0.001). Some BSA-adjusted median aortic diameters are smaller in men than in women. All diameters increase with age, diastolic blood pressure and HDL-C and decrease as systolic BP increases. (orig.)

  6. Thoracic and abdominal aortic diameters in a general population: MRI-based reference values and association with age and cardiovascular risk factors

    International Nuclear Information System (INIS)

    To generate reference values for thoracic and abdominal aortic diameters determined by magnetic resonance imaging (MRI) and analyse their association with cardiovascular risk factors in the general population. Data from participants (n = 1759) of the Study of Health in Pomerania were used for analysis in this study. MRI measurement of thoracic and abdominal aortic diameters was performed. Parameters for calculation of reference values according to age and sex analysis were provided. Multivariable linear regression models were used for determination of aortic diameter-related risk factors, including smoking, blood pressure (BP), high-density lipoprotein cholesterol (HDL-C). For the ascending aorta (β = -0.049, p < 0.001), the aortic arch (β = -0.061, p < 0.001) and the subphrenic aorta (β = -0.018, p = 0.004), the body surface area (BSA)-adjusted diameters were lower in men. Multivariable-adjusted models revealed significant increases in BSA-adjusted diameters with age for all six aortic segments (p < 0.001). Consistent results for all segments were observed for the positive associations of diastolic BP (β = 0.001; 0.004) and HDL (β = 0.035; 0.087) with BSA-adjusted aortic diameters and for an inverse association of systolic BP (β = -0.001). Some BSA-adjusted median aortic diameters are smaller in men than in women. All diameters increase with age, diastolic blood pressure and HDL-C and decrease as systolic BP increases. (orig.)

  7. Minimally Invasive Aortic Valve Replacement

    Medline Plus

    Full Text Available ... see we've used the cautery to achieve access to the sternum. On the left hand side ... wound, which allows us to get more ready access to the aorta and the aortic valve. The ...

  8. Minimally Invasive Aortic Valve Replacement

    Medline Plus

    Full Text Available ... to requiring surgery for aortic stenosis, left ventricular hypertrophy is a common manifestation. By that, I mean generally speaking any muscle that works harder in the body gets thicker ...

  9. Minimally Invasive Aortic Valve Replacement

    Medline Plus

    Full Text Available ... symptoms and ultimately surgery may be in the future. The symptoms seen primarily with aortic stenosis at ... echocardiography is? Echocardiography is the use of ultrasound technology. Ultrasound technology is a form of the same ...

  10. Minimally Invasive Aortic Valve Replacement

    Medline Plus

    Full Text Available ... thank you, Jim. This is obviously just a model of the heart just to give some perspective ... aortic repair, he would have had a cardiac evaluation prior to that and they probably would have ...

  11. Minimally Invasive Aortic Valve Replacement

    Medline Plus

    Full Text Available ... for patients who would not tolerate well a traditional open operation or a less invasive operation, as ... physical reserve. So Barbara Bush recently had a traditional aortic valve replacement surgery. What makes a patient ...

  12. Minimally Invasive Aortic Valve Replacement

    Medline Plus

    Full Text Available ... in severe aortic stenosis, as it's probably more stress than the patient's heart should have to undergo. ... There's been a lot of work done by academic cardiac surgeons and cardiologists to try to define ...

  13. Minimally Invasive Aortic Valve Replacement

    Medline Plus

    Full Text Available ... other cardiovascular diseases including heart attack and increased risk of cardiovascular death. John, is there anything you ... with time. This highlights the mortality or the risk of death associated with aortic valve replacement and ...

  14. Minimally Invasive Aortic Valve Replacement

    Medline Plus

    Full Text Available ... aortic stenosis and even tricuspid stenosis from rheumatic causes are much more common. To expand upon that ... out of the bloodstream and is thought to cause less untoward effects to the brain and other ...

  15. Minimally invasive aortic valve replacement

    DEFF Research Database (Denmark)

    Foghsgaard, Signe; Schmidt, Thomas Andersen; Kjaergard, Henrik K

    2009-01-01

    . The 30-day mortality rate for the 98 patients was zero, although 14 of the 98 mini-sternotomies had to be converted to complete sternotomies intraoperatively due to technical problems. Such conversion doubled the operative time over that of the planned full sternotomies. In the group of patients whose......In this descriptive prospective study, we evaluate the outcomes of surgery in 98 patients who were scheduled to undergo minimally invasive aortic valve replacement. These patients were compared with a group of 50 patients who underwent scheduled aortic valve replacement through a full sternotomy...... operations were completed as mini-sternotomies, 4 died later of noncardiac causes. The aortic cross-clamp and perfusion times were significantly different across all groups (P < 0.001), with the intended full-sternotomy group having the shortest times. In conclusion, the mini-aortic valve replacement is an...

  16. Minimally Invasive Aortic Valve Replacement

    Medline Plus

    Full Text Available ... more likely we see aortic stenosis. Again, patient education is part of the evaluation and management of ... for patients who would not tolerate well a traditional open operation or a less invasive operation, as ...

  17. Minimally Invasive Aortic Valve Replacement

    Medline Plus

    Full Text Available ... more likely we see aortic stenosis. Again, patient education is part of the evaluation and management of ... likely than patients who don't have other cardiovascular conditions: coronary artery disease, peripheral vascular disease, et ...

  18. Minimally Invasive Aortic Valve Replacement

    Medline Plus

    Full Text Available ... in severe aortic stenosis, as it's probably more stress than the patient's heart should have to undergo. ... these series, when you critically look at the literature, the operative times can be significantly longer and ...

  19. Minimally Invasive Aortic Valve Replacement

    Medline Plus

    Full Text Available ... to minimize their symptoms, but that doesn't impact the course of the disease itself. When I' ... more likely we see aortic stenosis. Again, patient education is part of the evaluation and management of ...

  20. Minimally Invasive Aortic Valve Replacement

    Medline Plus

    Full Text Available ... starts out as a disease we call aortic sclerosis, which is the beginning of the process of ... path life. Again, it's a progressive disease from sclerosis, or the beginning of thickening of the valve, ...

  1. Minimally Invasive Aortic Valve Replacement

    Medline Plus

    Full Text Available ... thank you, Jim. This is obviously just a model of the heart just to give some perspective ... the aorta at this point. 9 Earlier this month Robin Williams had his aortic valve replaced and ...

  2. Transcatheter Aortic Heart Valve Thrombosis

    DEFF Research Database (Denmark)

    Hansson, Nicolaj C; Grove, Erik L; Andersen, Henning R;

    2016-01-01

    BACKGROUND: There is increasing focus on transcatheter heart valve (THV) thrombosis. However, there are limited data on incidence, clinical implications and predisposing factors of THV thrombosis following transcatheter aortic valve replacement (TAVR). OBJECTIVES: We assessed the incidence...

  3. Minimally Invasive Aortic Valve Replacement

    Medline Plus

    Full Text Available ... somebody for this operation. Again, there's no medical therapy that has been proven to slow or reverse ... to their physician. This may lead to earlier treatment and better outcomes as well. Aortic stenosis, as ...

  4. Minimally Invasive Aortic Valve Replacement

    Medline Plus

    Full Text Available ... more likely we see aortic stenosis. Again, patient education is part of the evaluation and management of ... surgery we, as surgeons, know from our anatomy training during our course of training, we know where ...

  5. Minimally Invasive Aortic Valve Replacement

    Medline Plus

    Full Text Available ... John, is there anything you can do to help prevent aortic stenosis? There's no prophylactic methods that ... very good looks. It's a great tool to help cardiac surgeons. Thanks, Jim. And I would underscore ...

  6. Minimally Invasive Aortic Valve Replacement

    Medline Plus

    Full Text Available ... able to look at the aortic valve very well. In fact, transesophageal echocardiography is the best modality ... use to help evaluate both cardiac function as well as anatomy in patients who need heart surgery. ...

  7. Minimally Invasive Aortic Valve Replacement

    Medline Plus

    Full Text Available ... a series of charts that we have, historical data, to know really what the best size is ... heart and lung circulation, so that we can open the aorta safely and replace this patient's aortic ...

  8. Minimally Invasive Aortic Valve Replacement

    Medline Plus

    Full Text Available ... in severe aortic stenosis, as it's probably more stress than the patient's heart should have to undergo. ... in younger patients who want to return to work and activity more quickly, we feel that this ...

  9. Minimally Invasive Aortic Valve Replacement

    Medline Plus

    Full Text Available ... uncommon to have more problems with their tissue quality and so we do have to be careful ... does not have an aortic aneurysm in the first part of their aorta there, their ascending aorta. ...

  10. Minimally Invasive Aortic Valve Replacement

    Medline Plus

    Full Text Available ... No medications as such have been proven to slow that disease path life. Again, it's a progressive ... no medical therapy that has been proven to slow or reverse the process of aortic stenosis. Clearly, ...

  11. Minimally Invasive Aortic Valve Replacement

    Medline Plus

    Full Text Available ... This process starts out as a disease we call aortic sclerosis, which is the beginning of the ... either tissues from cows or pigs, what we call porcine for pigs and bovine for cows. Essentially, ...

  12. Minimally Invasive Aortic Valve Replacement

    Medline Plus

    Full Text Available ... including heart attack and increased risk of cardiovascular death. John, is there anything you can do to ... aortic stenosis, there's a pretty rapid progression into death if no intervention is taken. We feel that ...

  13. Magnetic resonance angiography in the evaluation of aortic abnormalities in infants and children

    International Nuclear Information System (INIS)

    To assess the usefulness of magnetic resonance angiography (MRA) of aortic abnormalities in infants and children, 65 patients with congenital heart disease underwent 72 X-ray angiography (XRA) and MRA examinations before or after operation. Informed consent was obtained from the parent prior to the studies. MRA was performed at 1.5 T with a 3D fast gradient-echo technique following the administration of intravenous gadolinium, and the results were compared with those of XRA. MRA correctly diagnosed all aortic abnormalities of 27 right aortic arches and/or aberrant vessels, and 20 stenotic or dilated lesions. MRA identified 54 of 62 shunt vessels (87%). The diameter of the shunt vessels detected or not detected on MRA were ≥1.6 mm or ≤1.3 mm, respectively, when measured on XRA. The vessels not detected on MRA were 4 ductus arteriosus and 4 aortopulmanary collateral arteries, the former of which were diagnosed by echocardiography and the latter of which were clinically insignificant. The diameters of the ascending and descending aorta, and the left subclavian artery measured both on MRA and XRA correlated and agreed sufficiently. In conclusion, MRA is an accurate less invasive technique for imaging most aortic abnormalities in infants and children. (author)

  14. HADRIAN’S ARCHES FROM ROMAN PERIOD, JORDAN: A COMPARATIVE STUDY

    OpenAIRE

    Nassar, Mohammad

    2014-01-01

    This article provides a study of Hadrian arches from three main locations: Jordan, Turkey, and Greece. Collectively within these countries, four arches have been found the Hadrian arch at Jerash (Gerasa) in Jordan, the Hadrian arch in Antalya and Ephesus, both in Turkey, and the Hadrian arch in Athens, Greece. The units of our analysis include all the different designs and plans used in constructing these arches. The analyzed design and planning units constitute a database that enables the...

  15. Arch Height: A Regression Analysis of Different Measuring Parameters

    Directory of Open Access Journals (Sweden)

    Hironmoy Roy

    2011-07-01

    Full Text Available Rationale: For measuring the height of the arch of foot either standing navicular height or talar height of the medial longitudinal arch was accepted in earlier days, where as the ‘standing normalised navicular height’ is taken by modern day by authors as a yardstick. But being troublesome and time consuming, we practically not opt for them in busy OPD schedule; rather go for measuring the arch-height in supine posture. Objectives: So this study was aimed to derive the regression between the standing arch-height values with the supine counterparts, so that former can be predicted easily from later. Methodology: It was carried out among 103 adult subjects in the purview of North Bengal Medical College & Hospital. From the x-ray films of their feet in supine and standing posture the navicular and talar heights were determined and the records were analysed. Result: Statistically significant correlation followed by regression analysis could reveal simple linear regression-equations for predicting the standing arch-height values from the supine values; derived separately in both males and females. Conclusion: Thus, from a known supine arch-height value, we can derive the respective standing arch- height, as well as the ‘standing normalised navicular height’ indirectly avoiding the entire troublesome maneuver in regular practice. So the present study recommends this method in clinical fields as because this is more rational and ideal approach to estimate arch height.

  16. Level-ARCH Short Rate Models with Regime Switching

    DEFF Research Database (Denmark)

    Christiansen, Charlotte

    This paper introduces regime switching volatility into level- ARCH models for the short rates of the US, the UK, and Germany. Once regime switching and level effects are included there are no gains from including ARCH effects. It is of secondary importance exactly how the regime switching is spec...

  17. Modelling subset multivariate ARCH model via the AIC principle

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    In this paper we consider the problem of identifying a parsimonious subset multivariate ARCH model based on the AIC principle. The proposed approach can reduce the number of parameters in the final ARCH specification and allows for non-constant correlations between the components. Some simulation results illustrate the viability of the proposed procedure.

  18. Quin Franciscan Friary, west door jamb, arch and hood

    OpenAIRE

    O'Donovan, Danielle

    2005-01-01

    West door jamb, arch and hood moulding. From intrados, moulding comprises: quadrant, hollow chamfer, right-angled rebate, hollow chamfer, quadrant. The hood comprises: hollow, free-standing fillet, hollow, chamfer. This door, with its pointed arch contained within a square moulded label, is very similar in design to that at Bishopsquarter. The moulding is identical.

  19. Dunsoghly Castle Chapel, door jamb, arch and hood

    OpenAIRE

    O'Donovan, Danielle

    2001-01-01

    Door jamb, arch and hood of the detatched castle chapel. Jamb and arch moulding from intrados comprise: hollow chamfer, right-angled rebate, quadrant. The hood, which is placed at some distance from the jamb, comprises from outside in: frontal fillet, hollow chamfer, right-angled rebate, hollow chamfer.

  20. Swallowing threshold parameters of subjects with shortened dental arches.

    NARCIS (Netherlands)

    Kreulen, C.M.; Witter, D.J.; Tekamp, F.A.; Slagter, A.P.; Creugers, N.H.J.

    2012-01-01

    OBJECTIVES: To quantify swallowing threshold parameters of subjects with a moderate shortened dental arch dentition (SDA: missing molar teeth, but premolar teeth in occluding position and uninterrupted anterior regions) compared to subjects with a complete dental arch dentition (CDA). METHODS: Fourt

  1. Seismic multi-arch structures in East China

    Institute of Scientific and Technical Information of China (English)

    YANG; Wencai; CHEN; Zhide

    2006-01-01

    In previous papers (Wencai, 2002, 2003), the author has analyzed the deep seismic reflection profiles along some of the Mesozoic plutons in East China, and has pointed out that the crustal structures around these intrusions usually correlate with a special seismic fabric called the seismic multi-arch structure. This paper will continue to show main characteristics of the seismic multi-arch structures and discuss their relationship with mantle-origin magmatism and the lithospheric thinning process. Calibration of seismic reflectors in Chinese continental drilling sites shows that small-scale arch-like reflectors can be generated by fractured eclogites or other plutons, they do not belong to the multi-arch structure specially discussed in the paper. The multi-arch structure is characterized by several arch-like reflectors distributed in both the upper and lower crust with granitoid plutons or stocks exposed on the surface, which do not have obvious negative Europium anomalies. Based on the distribution pattern of arch reflectors, the multi-arch magmatic structures can be divided into three main types, namely the simple vertical combination type, the spread arch magmatic structure and the arch-bouquet structure. All of them correlate to mantle-origin magmatism, but occur in different places. The spread arch magmatic structures occur within a Mesozoic/Cenozoic rift zone with very thin and hot lithosphere. The vertical combination type of the multi-arch structures occurred near the rift zones where lithosphere was thin and hot. The arch-bouquet magmatic structures occur far from the rift zones where the lithosphere is not hot. The continental rifting acted as the late episode of the lithospheric thinning process seeing that the rift zones usually coincide with the thinnest parts of the lithosphere in East China. In different locations within the lithospheric thinning areas, mantle-origin magmatic activities have different characteristics, which might generate different

  2. Approximator: Predicting Interruptibility in Software Development with Commodity Computers

    DEFF Research Database (Denmark)

    Tell, Paolo; Jalaliniya, Shahram; Andersen, Kristian S. M.;

    2015-01-01

    closer to, or even better than, human judgment. However, existing approaches to assess interruptibility have been designed to rely on external sensors. In this paper, we present Approximator, a system that estimates the interruptibility of a user based exclusively on the sensing ability of commodity...

  3. Panorama de l’archéologie castrale en France

    Directory of Open Access Journals (Sweden)

    Élise Boucharlat

    2010-02-01

    Full Text Available Aux originesOn ne saurait se livrer, en cette année 2009, à quelque réflexion que ce soit sur l’archéologie du château en France sans évoquer le cinquantenaire de la création du Centre de recherches en archéologie médiévale de Caen par le doyen Michel de Boüard. Lui qui a le plus précocement contribué à asseoir la reconnaissance académique de l’archéologie médiévale française était dans le même temps l’archéologue du château de Caen, de Doué-la-Fontaine... Une approche réellement archéologiqu...

  4. Effect of Obesity on Arch Index in Young Adults

    Directory of Open Access Journals (Sweden)

    Sneha Sameer Ganu

    2013-01-01

    Full Text Available Background: Excessive increases in weight bearing forces caused by obesity may negatively affect the lower limbs and feet but minimal research has examined the long-term loading effects of obesity on the musculoskeletal system, particularly in reference to the feet. Objectives: The purpose of the study was to investigate the effect of obesity on medial longitudinal arch of foot in young adults. Method: 60 subjects, 30 obese & 30 non obese were assessed for height & weight using standard technique. Radiographic images under static condition were used for calculating the arch index. Result: The arch index of obese subjects was significantly lower than the non obese subjects & there is a negative correlation between the BMI & the arch index. Conclusion: These results suggests that obesity lowers the medial longitudinal arch of foot.

  5. Left testicular artery arching over the ipsilateral renal vein

    Institute of Scientific and Technical Information of China (English)

    Munekazu Naito; Hayato Terayama; Yoichi Nakamura; Shogo Hayashi; Takayoshi Miyaki; Masahiro Itoh

    2006-01-01

    Aim: To report two cases of the left testicular artery arching over the left renal vein (LRV) before running downward to the testis. Methods: The subjects were obtained from two Japanese cadavers. During the student course of gross-anatomical dissection, the anatomical relationship between the testicular vessels and the renal vein was specifically observed. Results: The arching left testicular artery arose from the aorta below the LRV and made a loop around the LRV, which appeared to be mildly compressed between the arching artery and the psoas major muscle.Conclusion: Clinically, compression of the LRV between the abdominal aorta and the superior mesenteric artery occasionally induces LRV hypertension, resulting in varicocele, orthostatic protenuria and hematuria. Considering that the incidence of a left arching testicular artery is higher than that of a right one, an arching left artery could be an additional cause of LRV hypertension.

  6. Seismic behavior of concrete filled steel tubular arch structures

    Institute of Scientific and Technical Information of China (English)

    Xiong Feng; Sashi K Kunnath; Liu Haowu

    2005-01-01

    Shaking table tests of a 1:10 scale arch model performed to investigate the seismic behavior and resistance of concrete filled steel tubular (CFT) arch structures are described in this paper. The El-Centro record and Shanghai artificial wave were adopted as the input excitation. The entire test process can be divided into three stages depending on the lateral brace configurations, i.e., fully (five) braced, two braces removed, and all braces removed. A total of 46 tests, starting from the elastic state to failure condition, have been conducted. The natural vibration frequencies, responses of acceleration,displacement and strain were measured. From the test results, it is demonstrated that the CFT arch structures are capable of resisting severe ground motions and that CFT arches offer a credible alternative to reinforced concrete arches, especially in regions of high seismic intensity.

  7. Effects of interruption of irradiation on Harwell Red Perspex (PMMA)

    International Nuclear Information System (INIS)

    Harwell Red Perspex PMMA (Polymethylmethacrylate) is a dosimeter very much used in the industrial treatments by Radiations ionizing. The purpose of this work is to test the response of this dosimeter for radiation processes having undergone one or more interruptions. This experimental study based on the development of a factorial experimental design on two levels showed that the response of this dosimeter increases for the interrupted treatments. The value of the estimated amount of response increase is all the more significant as the temperature during the interruption is high. Also it made possible to determine a mathematical model binding the value of the amount posted to the factors of influence: Temperature, target amount, a number of interruptions and duration of each interruption.

  8. The use of interruptible power in west Texas waterflood operations

    International Nuclear Information System (INIS)

    Interruptible power purchased from electric utilities has been used by chemical and process industries for many years, but is not generally used in oil producing operations. Interruptible power represents an established option to reduce electric power costs, which are often the oil producer's single largest operating expense. The recent use of interruptible power in Amoco Production Company's West Texas waterflood operations has significantly reduced operating expenses. Interruptible power rates are offered by many electric utility companies; however, the impact on producing operations is generally not known. This paper addresses the initial areas of concern and offers over two years of case history data showing how interruptible power affects operating costs. production equipment, producing rates and safety/environmental operations

  9. Minimally Invasive Aortic Valve Replacement

    Medline Plus

    Full Text Available ... Winkley nor myself have any financial or professional relationships with the manufacturers or the devices used in ... John, just to interrupt for moment, Charles, Charles V., asks can the mitral valve also be replaced ...

  10. 3C236 Radio Source, Interrupted?

    CERN Document Server

    O'Dea, C P; Baum, S A; Sparks, W B; Martel, A R; Allen, M G; Macchetto, F D; Miley, G K; Dea, Christopher P. O'; Koekemoer, Anton M.; Baum, Stefi A.; Sparks, William B.; Martel, Andre R.; Allen, Mark G.; Macchetto, Ferdinando D.; Miley, George K.

    2001-01-01

    We present new HST STIS/MAMA near-UV images and archival WFPC2 V and R band images which reveal the presence of four star forming regions in an arc along the edge of the dust lane in the giant (4 Mpc) radio galaxy 3C236. Two of the star forming regions are relatively young with ages of order 1E7 yr, while the other two are older with ages of order 1E8 - 1E9 yr which is comparable to the estimated age of the giant radio source. Based on dynamical and spectral aging arguments, we suggest that the fuel supply to the AGN was interrupted for 1E7 yr and has now been restored, resulting in the formation of the inner 2 kpc scale radio source. This time scale is similar to that of the age of the youngest of the star forming regions. We suggest that the transport of gas in the disk is non-steady and that this produces both the multiple episodes of star formation in the disk as well as the multiple epochs of radio source activity. If the inner radio source and the youngest star forming region are related by the same eve...

  11. Interrupted Binary Mass Transfer in Star Clusters

    CERN Document Server

    Leigh, Nathan W C; Toonen, Silvia

    2016-01-01

    Binary mass transfer is at the forefront of some of the most exciting puzzles of modern astrophysics, including Type Ia supernovae, gamma-ray bursts, and the formation of most observed exotic stellar populations. Typically, the evolution is assumed to proceed in isolation, even in dense stellar environments such as star clusters. In this paper, we test the validity of this assumption via the analysis of a large grid of binary evolution models simulated with the SeBa code. For every binary, we calculate analytically the mean time until another single or binary star comes within the mean separation of the mass-transferring binary, and compare this time-scale to the mean time for stable mass transfer to occur. We then derive the probability for each respective binary to experience a direct dynamical interruption. The resulting probability distribution can be integrated to give an estimate for the fraction of binaries undergoing mass transfer that are expected to be disrupted as a function of the host cluster pro...

  12. Interrupted Stellar Encounters in Star Clusters

    CERN Document Server

    Geller, Aaron M

    2015-01-01

    Strong encounters between single stars and binaries play a pivotal role in the evolution of star clusters. Such encounters can also dramatically modify the orbital parameters of binaries, exchange partners in and out of binaries, and are a primary contributor to the rate of physical stellar collisions in star clusters. Often, these encounters are studied under the approximation that they happen quickly enough and within a small enough volume to be considered isolated from the rest of the cluster. In this paper, we study the validity of this assumption through the analysis of a large grid of single - binary and binary - binary scattering experiments. For each encounter we evaluate the encounter duration, and compare this with the expected time until another single or binary star will join the encounter. We find that for lower-mass clusters, similar to typical open clusters in our Galaxy, the percent of encounters that will be "interrupted" by an interloping star or binary may be 20-40% (or higher) in the core,...

  13. Endoluminal treatment of aortic dissection

    Energy Technology Data Exchange (ETDEWEB)

    Chavan, Ajay; Lotz, Joachim; Galanski, Michael [Department of Diagnostic Radiology, Hannover Medical School, Carl Neuberg Strasse 1, 30625, Hannover (Germany); Oelert, Frank; Haverich, Axel; Karck, Matthias [Department of Thoracic and Cardiovascular Surgery, Hannover Medical School, Carl Neuberg Strasse 1, 30625, Hannover (Germany)

    2003-11-01

    Aortic dissection is most often a catastrophic medical emergency which, if untreated, can be potentially fatal. The intention of therapy in patients with aortic dissection is to prevent aortic rupture or aneurysm formation as well as to relieve branch vessel ischaemia. Patients with aortic dissection are often poor candidates for anaesthesia and surgery and the surgical procedure itself is challenging requiring thoracotomy, aortic cross clamping, blood transfusion as well as prolonged hospital stay in some cases. Operative mortality is especially high in patients with critical mesenteric or renal ischaemia. The past decade has experienced the emergence of a number of interventional radiological or minimally invasive techniques which have significantly improved the management of patients with aortic dissection. These include stent grafting for entry site closure to prevent aneurysmatic widening of the false lumen as well as percutaneous techniques such as balloon fenestration of the intimal flap and aortic true lumen stenting to alleviate branch vessel ischaemia. False lumen thrombosis following entry closure with stent grafts has been observed in 86-100% of patients, whereas percutaneous interventions are able to effectively relieve organ ischaemia in approximately 90% of the cases. In the years to come, it is to be expected that these endoluminal techniques will become the method of choice for treating most type-B dissections and will assist in significantly reducing the number of open surgical procedures required for type-A dissections. The intention of this article is to provide an overview of the current status of these endoluminal techniques based on our own experience as well as on a review of the relevant literature. (orig.)

  14. Endoluminal treatment of aortic dissection

    International Nuclear Information System (INIS)

    Aortic dissection is most often a catastrophic medical emergency which, if untreated, can be potentially fatal. The intention of therapy in patients with aortic dissection is to prevent aortic rupture or aneurysm formation as well as to relieve branch vessel ischaemia. Patients with aortic dissection are often poor candidates for anaesthesia and surgery and the surgical procedure itself is challenging requiring thoracotomy, aortic cross clamping, blood transfusion as well as prolonged hospital stay in some cases. Operative mortality is especially high in patients with critical mesenteric or renal ischaemia. The past decade has experienced the emergence of a number of interventional radiological or minimally invasive techniques which have significantly improved the management of patients with aortic dissection. These include stent grafting for entry site closure to prevent aneurysmatic widening of the false lumen as well as percutaneous techniques such as balloon fenestration of the intimal flap and aortic true lumen stenting to alleviate branch vessel ischaemia. False lumen thrombosis following entry closure with stent grafts has been observed in 86-100% of patients, whereas percutaneous interventions are able to effectively relieve organ ischaemia in approximately 90% of the cases. In the years to come, it is to be expected that these endoluminal techniques will become the method of choice for treating most type-B dissections and will assist in significantly reducing the number of open surgical procedures required for type-A dissections. The intention of this article is to provide an overview of the current status of these endoluminal techniques based on our own experience as well as on a review of the relevant literature. (orig.)

  15. Servicing a globally broadcast interrupt signal in a multi-threaded computer

    Science.gov (United States)

    Attinella, John E.; Davis, Kristan D.; Musselman, Roy G.; Satterfield, David L.

    2015-12-29

    Methods, apparatuses, and computer program products for servicing a globally broadcast interrupt signal in a multi-threaded computer comprising a plurality of processor threads. Embodiments include an interrupt controller indicating in a plurality of local interrupt status locations that a globally broadcast interrupt signal has been received by the interrupt controller. Embodiments also include a thread determining that a local interrupt status location corresponding to the thread indicates that the globally broadcast interrupt signal has been received by the interrupt controller. Embodiments also include the thread processing one or more entries in a global interrupt status bit queue based on whether global interrupt status bits associated with the globally broadcast interrupt signal are locked. Each entry in the global interrupt status bit queue corresponds to a queued global interrupt.

  16. Mission archéologique islamique

    Directory of Open Access Journals (Sweden)

    Claire Hardy-Guilbert

    1997-11-01

    Full Text Available La troisième mission exploratoire du programme de recherches archéologiques sur la période islamique au Yémen s'est déroulée du 1 au 22 décembre 1995, en collaboration avec le Dr Ahmad Bataya, et a porté sur la côte méridionale, entre Abyan et Sayhut. Outre une étude approfondie de la ville d'al-Shihr, les prospections ont porté sur les régions d'Abyan, Ahwar et Sayhut. Prospection de la côte : Si Aden-même, le plus grand port yéménite depuis le 10ème siècle, est aujourd'hui trop urba...

  17. Acute aortic valve prolapse in Marfan's syndrome.

    OpenAIRE

    Carr, N J; Cullen, S. A.

    1991-01-01

    A 22 year old man with Marfan's syndrome died suddenly following acute aortic valve prolapse. Although aortic root involvement in Marfan's syndrome is common, we have found no previous description of this particular complication in the literature.

  18. Ministernotomy approach for surgery of the aortic root and ascending aorta.

    Science.gov (United States)

    Perrotta, Sossio; Lentini, Salvatore

    2009-11-01

    Different minimally invasive approaches have been proposed for cardiac surgery. Between those, the ministernotomy finds wide consensus for the treatment of the aortic disease, being both the upper reversed T and the upper J the mostly used type of incisions. The authors review the literature on the use of ministernotomy in the treatment of the ascending aorta and arch pathology. The scientific literature was reviewed by searching Medline, the Cochrane Library and the CINAHL database. A total of 1411 papers were found in Medline, 186 in the Cochrane database and 514 in CINAHL database; 50 papers were used to write the article; of which seven represent the most significant papers on the subject. The authors, journal, date and country of publication, patients group studied, relevant outcomes, and the results of these papers are tabulated. The ministernotomy is gaining consensus among surgeons. The indication to surgery, initially restricted only to selected elective patients, is now extended to more complex surgeries, including both the aortic root and aortic arch, redo-operations and, in minor cases, to emergency patients. Furthermore, the use of ministernotomy in redo aortic surgery with patent left internal mammary artery (LIMA) to left anterior descending (LAD) artery is a promising alternative. However, the use of this technique is still limited to few institutions and there are still a limited number of studies comparing this approach to full sternotomy in a prospective, randomized fashion. Even with those limitations, from the review of the literature, it seems that ministernotomy approach for aortic root and ascending aorta surgery is a feasible alternative, showing some advantages compared to full sternotomy. Those advantages include: reduced postoperative bleeding and pain, lower risk of mediastinitis, better aesthetic results, and faster respiratory function recovery. This is true not only for first time surgery, but also, and especially, for redo cases

  19. Aortic valve replacement through right thoracotomy.

    OpenAIRE

    Rao, P N; A S Kumar

    1993-01-01

    There has never, to our knowledge, been a report of aortic valve replacement via a right thoracotomy. However, we recently used this approach in 2 young women with severe aortic stenosis. Exposure of the aortic valve was excellent, and we encountered neither technical difficulties nor sequelae related to the right thoracotomy. We believe that right thoracotomy provides adequate access for safe aortic valve replacement and yields cosmetically more appealing results than does median sternotomy.

  20. ABDOMINAL AORTIC ANEURYSM (AAA

    Directory of Open Access Journals (Sweden)

    Rajesh G

    2011-11-01

    Full Text Available AAA is defined as a distension of the infrarenal aorta by more than 50% (or 1.5 times compared with a corresponding healthy, aged and gender matched population. AAA afflicts 1 to 6 % of the general population aged more than 60 years and the incidence rises by approximately 0.15% annually. When the definition of a maximum external diameter ≥3 cm is used, the prevalence of AAA is upto 6 times greater in men than in women. AAAs are much more common than thoracic aortic aneurysms. Most common cause of AAA is atherosclerosis (95%. Less common causes include infectious or inflammatory origin or those associated with connective tissue disorders. Process of AAA formation is multifactorial. Other than the general risk factors for atherosclerosis, genetic predispo s iti on, aut o immunity and hemodynamic factors all play roles in its formation. AAA is 1.5 times more frequent in hypert ensive patients. Smokers have 8 times risk for developing AAA. The existence of familial aggre gation of AAA implicates genetic factors in the etiology of AAA. Women with AAA are more likely to have a positive family history of this disorder. Those with a family history of AAA have an increased risk of 30%, and their aneurysms tend to occur at a younger age and carry a greater risk of rupture than do sporadic aneurysms.

  1. Resolution of an Acute Aortic Syndrome with Aortic Valve Insufficiency Post-PCI

    OpenAIRE

    de Barros e Silva, Pedro G.M.; Aquino, Thiago de; Resende, Marcos V.; Richter, Ivo; Barros, Cecilia M.; Andrioli, Vanessa G.; Baruzzi, Antonio C.; Medeiros, Caio C.J.; Furlan, Valter

    2014-01-01

    Patient: Female, 52 Final Diagnosis: Acute aortic syndrome with aortic valve insufficiency post-PCI Symptoms: Chest pain Medication: — Clinical Procedure: Conservative Specialty: Cardiology Objective: Unusual or unexpected effect of treatment Background: Acute aortic syndrome is the modern term that includes aortic dissection, intramural hematoma, and symptomatic aortic ulcer. Iatrogenic coronary artery dissection extending to the aorta during percutaneous coronary intervention is a very rare...

  2. Stroke in Patients With Aortic Stenosis

    DEFF Research Database (Denmark)

    Greve, Anders Møller; Dalsgaard, Morten; Bang, Casper N;

    2014-01-01

    BACKGROUND AND PURPOSE: There are limited data on risk stratification of stroke in aortic stenosis. This study examined predictors of stroke in aortic stenosis, the prognostic implications of stroke, and how aortic valve replacement (AVR) with or without concomitant coronary artery bypass graftin...... associated with mortality. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT00092677....

  3. Pardon the Interruption: Goal Proximity, Perceived Spare Time, and Impatience

    OpenAIRE

    Ji Hoon Jhang; John G. Lynch Jr.

    2015-01-01

    There is no worse time to be interrupted than right now. Being close to attaining a goal to complete a focal task increases the attractiveness of that task compared to an interrupting task (study 1), makes people less willing to take on some otherwise attractive interruption than if they were farther away from completion (studies 2, 3, and 4), and causes them to perceive that in that moment they have little spare time (studies 3 and 4). Consumers immersed in goal pursuit are affected by local...

  4. Arch Height: A Regression Analysis of Different Measuring Parameters

    OpenAIRE

    Hironmoy Roy; Kalyan Bhattacharya; Asit Chandra Roy; Samar Deb; Kuntala Ray

    2011-01-01

    Rationale: For measuring the height of the arch of foot either standing navicular height or talar height of the medial longitudinal arch was accepted in earlier days, where as the ‘standing normalised navicular height’ is taken by modern day by authors as a yardstick. But being troublesome and time consuming, we practically not opt for them in busy OPD schedule; rather go for measuring the arch-height in supine posture. Objectives: So this study was aimed to derive the regression between the...

  5. Thomas Young's theory of the arch: Thermal effects

    OpenAIRE

    Huerta Fernández, Santiago

    2010-01-01

    The engineers of the 18th century were well aware of the movements suffered by arch bridges due to changes of temperature. In 1801 this problem caused concern to the experts reporting on Telford’s design for a 600 feet iron arch. Vicat reported in 1824 “un mouvement périodique” in the arches of the bridge of Souillac and George Rennie published in 1842 the movements observed in Southwark Bridge after its completion in 1818. However the analysis of these perturbations was studied much later, w...

  6. Statistical inference in semiparametric locally stationary ARCH models

    OpenAIRE

    Truquet, Lionel

    2015-01-01

    In this paper, we develop a complete methodology for semiparametric inference in the time-varying ARCH model (tv-ARCH) introduced by Dahlhaus and Rao (2006) and studied by Fryzlewicz et al. (2008). Our first motivation is to detect and estimate non time-varying coefficients in a tv-ARCH process. Using kernel estimation, we construct $\\sqrt{T}-$consistent estimates for non time-varying coefficients and, with a two-step procedure, asymptotically efficient estimates in the semiparametric sense w...

  7. Deformation of contact surfaces in a vacuum interrupter after high-current interruptions

    Science.gov (United States)

    Wang, Haoran; Wang, Zhenxing; Zhou, Zhipeng; Jiang, Yanjun; Wang, Jianhua; Geng, Yingsan; Liu, Zhiyuan

    2016-08-01

    In a high-current interruption, the contact surface in a vacuum interrupter might be severely damaged by constricted vacuum arcs causing a molten area on it. As a result, a protrusion will be initiated by a transient recovery voltage after current zero, enhancing the local electric field and making breakdowns occur easier. The objective of this paper is to simulate the deformation process on the molten area under a high electric field by adopting the finite element method. A time-dependent Electrohydrodynamic model was established, and the liquid-gas interface was tracked by the level-set method. From the results, the liquid metal can be deformed to a Taylor cone if the applied electric field is above a critical value. This value is correlated to the initial geometry of the liquid metal, which increases as the size of the liquid metal decreases. Moreover, the buildup time of a Taylor cone obeys the power law t = k × E-3, where E is the initial electric field and k is a coefficient related to the material property, indicating a temporal self-similar characteristic. In addition, the influence of temperature has little impact on the deformation but has great impact on electron emission. Finally, the possible reason to initiate a delayed breakdown is associated with the deformation. The breakdown does not occur immediately when the voltage is just applied upon the gap but is postponed to several milliseconds later when the tip is formed on the liquid metal.

  8. Endovascular stent graft repair for thoracic aortic aneurysms: the history and the present in Japan.

    Science.gov (United States)

    Kawaguchi, Satoshi; Shimizu, Hideyuki; Yoshitake, Akihiro; Shimazaki, Taro; Iwahashi, Toru; Ogino, Hitoshi; Ishimaru, Shin; Shigematsu, Hiroshi; Yozu, Ryohei

    2013-01-01

    Stent-grafts for endovascular repair of thoracic aortic aneurysms have been commercially available for more than ten years in the West, whereas, in Japan, a manufactured stent-graft was not approved for the use until March 2008. Nevertheless, endovascular thoracic intervention began to be performed in Japan in the early 1990s, with homemade devices used in most cases. Many researchers have continued to develop their homemade devices. We have participated in joint design and assessment efforts with a stent-graft manufacturer, focusing primarily on fenestrated stent-grafts used in repairs at the distal arch, a site especially prone to aneurysm. In March 2008, TAG (W.L. Gore & Associates, Inc., Flagstaff, Arizona, USA) was approved as a stent graft for the thoracic area first in Japan, which was major turning point in treatment for thoracic aortic aneurysms. Subsequently, TALENT (Medtronic, Inc., Minneapolis, Minnesota, USA) was approved in May 2009, and TX2 (COOK MEDICAL Inc., Bloomington, Indiana, USA) in March 2011. Valiant as an improved version of TALENT was approved in November 2011, and TX2 Proform as an improved version of TX2 began to be supplied in October 2012. These stent grafts are excellent devices that showed good results in Western countries, and marked effectiveness can be expected by making the most of the characteristics of each device. A clinical trial in Japan on Najuta (tentative name) (Kawasumi Labo., Inc., Tokyo, Japan) as a line-up of fenestrated stent grafts that can be applied to distal arch aneurysms showing a high incidence, and allow maintenance of blood flow to the arch vessel was initiated. This trial was completed, and Najuta has just been approved in January of 2013 in Japan, and further development is expected. In the U.S., great efforts have recently been made to develop and manufacture excellent stent grafts for thoracic aneurysms, and rapid progress has been achieved. In particular, in the area of the aortic arch, in which we

  9. [MINIMALLY INVASIVE AORTIC VALVE REPLACEMENT].

    Science.gov (United States)

    Tabata, Minoru

    2016-03-01

    Minimally invasive aortic valve replacement (MIAVR) is defined as aortic valve replacement avoiding full sternotomy. Common approaches include a partial sternotomy right thoracotomy, and a parasternal approach. MIAVR has been shown to have advantages over conventional AVR such as shorter length of stay and smaller amount of blood transfusion and better cosmesis. However, it is also known to have disadvantages such as longer cardiopulmonary bypass and aortic cross-clamp times and potential complications related to peripheral cannulation. Appropriate patient selection is very important. Since the procedure is more complex than conventional AVR, more intensive teamwork in the operating room is essential. Additionally, a team approach during postoperative management is critical to maximize the benefits of MIAVR. PMID:27295772

  10. Aortic Impedance in Little Mice

    OpenAIRE

    Reddy, Anilkumar K.; Taffet, George E.; Hartley, Craig J.

    2008-01-01

    The Little dwarf mouse lives 30% longer than its age-matched wild-type (WT) mouse. We determined aortic input impedance in 21 (8 Little, 13 WT) 4 month-old mice. Modulus of impedance was calculated from the Fourier transformed aortic pressure (P) and average luminal flow velocity (Vavg) as ∣Zi∣ = ∣P∣/∣Vavg∣. Characteristic impedance was estimated by averaging the 2nd-10th harmonic of the impedance moduli. We found the impedance modulus ∣Zi∣ to be similar in the 2 groups (WT vs. Little; mean±S...

  11. Aneurysms of the ascending aorta and arch: the role of imaging in diagnosis and surgical management.

    Science.gov (United States)

    Bonnichsen, Crystal R; Sundt, Thoralf M; Anavekar, Nandan S; Foley, Thomas A; Morris, Michael F; Martinez, Matthew W; Williamson, Eric E; Glockner, James F; Araoz, Philip A

    2011-01-01

    Thoracic aortic aneurysms tend to be asymptomatic and were previously often diagnosed only after a complication such as dissection or rupture occurred. Better imaging techniques and an increase in the use of cross-sectional imaging has led to an increase in the diagnosis of aortic aneurysms, which has allowed for elective treatment prior to the development of a complication. The location, size and etiology of an aneurysm all impact the clinical outcomes and these factors are used to determine the appropriate timing of surgical replacement. Surgeons often rely on the information obtained from preoperative imaging to determine when to intervene and what type of procedure will be necessary, making it important for the radiologist to understand these issues in order to provide the necessary information. Postoperative imaging after surgical replacement of the aorta is also important, as there are some common findings that occur in this patient population that can impact how they are treated. The purpose of this article is to review the etiology and associated findings of aneurysms of the ascending aorta and arch, with a focus on how computed tomography angiography and magnetic resonance angiography findings are used to determine the appropriate timing for elective replacement and the type of surgical procedure, as well as the role of follow-up imaging. This will include a review of the most commonly performed types of surgical procedures, to provide an understanding of how the findings of preoperative imaging studies impact what the surgeon does in the operating room, as well as the expected findings of postoperative imaging studies. PMID:21166528

  12. Instant Messaging Usage and Interruptions in the Workplace

    Directory of Open Access Journals (Sweden)

    Hui‐Jung Chang

    2014-12-01

    Full Text Available The goal of the present study is to explore IM interruption by relating it to media choices and purposes of IM use in the workplace. Two major media choice concepts were: media richness and social influence; while four purposes of IM use were: organization work, knowledge work, socializing, and boundary spanning activities. Data (N = 283 were collected via a combination of convenience and snowball sampling of “computer‐using workers” in Taiwan, based on the Standard Occupational Classification system published by the Taiwan government. Results indicated that media choice works better than purpose of IM use to explain IM interruption. Among them, social influence was the best predictor to IM interruption in the workplace. In addition, instant feedback and personalization provided by IM, and IM usage for the purposes of knowledge work and socializing, also relate to IM interruption in the workplace.

  13. Interrupting Anticoagulation in Patients With Nonvalvular Atrial Fibrillation

    OpenAIRE

    Yates, Scott W

    2014-01-01

    No agents are approved to reverse the effects of newer anticoagulants used to reduce the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation. This review focuses on ways to monitor, interrupt, and reverse such anticoagulation.

  14. Arch development with trans-force lingual appliances.

    Science.gov (United States)

    Clark, William J

    2005-01-01

    Trans-Force lingual appliances are designed to correct arch form in patients with contracted dental arches. Interceptive treatment with this new series of pre-activated lingual appliances offers new possibilities for arch development, in combination with fixed appliances. Palatal and lingual appliances insert in horizontal lingual sheaths in molar bands. No activation is required after the appliance is fitted, and this principle is extended to a series of appliances for sagittal and transverse arch development. Both sagittal and transverse appliances have additional components to achieve 3-way expansion where this is indicated. The invisible lingual appliances may be used in correction of all classes of malocclusion at any stage of development, from mixed dentition through permanent dentition, and this approach has wide indications in adult treatment. PMID:15794037

  15. Rathbourney church, south door, jamb, arch and hood moulding

    OpenAIRE

    O'Donovan, Danielle

    2005-01-01

    Door jamb and arch moulding comprises, from intrados: hollow chamfer, hollow chamfer, right-angled rebate, quadrant, quadrant. The hood comprises, from outward in: frontal fillet, frontal fillet, hollow chamfer.

  16. Proximal Interruption of the Pulmonary Artery: A Case Series.

    Science.gov (United States)

    Anand, S H; Jasper, Anitha; Mani, Sunithi Elizabeth; Joseph, Elizabeth; Mathai, John

    2015-12-01

    We present a few cases of Proximal Interruption of the Pulmonary Artery, an uncommon developmental anomaly associated with congenital heart disease. The cases had varied clinical presentations. Chest radiograph showed a hypoplastic lung with an ipsilateral small hilum on the side of the interruption and hyperinflation of the contralateral lung. Contrast CT confirmed the diagnosis, demonstrating non-visualization of the left or right pulmonary artery, and other related findings. PMID:26816968

  17. A Wrist-Worn Thermohaptic Device for Graceful Interruption

    DEFF Research Database (Denmark)

    Bolton, Frank; Jalaliniya, Shahram; Pederson, Thomas

    2015-01-01

    Thermal haptics is a potential system output modality for wearable devices that promises to function at the periphery of human attention. When adequately combined with existing attention-governing mechanisms of the human mind, it could be used for interrupting the human agent at a time when the......-Aware-systems-inspired approach “Egocentric Interaction” aimed at supporting the design of envisioned Wearable Personal Assistants intended to, among other things, help human perception and cognition with the management of interruptions....

  18. Using The Descending Aortic Wall Thickness Measured In Transesophageal Echocardiography As A Risk Marker For Aortic Dissection

    OpenAIRE

    Zaher Fanari; Sumaya Hammami; Muhammad Baraa Hammami; Safa Hammami; Chete Eze-Nliam; Weintraub, William S.

    2015-01-01

    Objective: The aim of this study is to estimate whether aortic wall thickness is increased in patients with Aortic dissection (AD) compared to low risk control group and can be used in addition to aortic diameter as a risk marker of AD. Background: AD occurs due to pathologies that may increase thickness of the aortic wall. Transesophageal echocardiography (TEE) has the ability to visualise both the thoracic aortic wall and lumen. Aortic diameter has been used to predict aortic dissection...

  19. A comparison of four methods of predicting arch length.

    Science.gov (United States)

    Gardner, R B

    1979-04-01

    1. Four arch length prediction equations (Nance, Johnston-Tanaka, Moyers, and Hixon-Oldfather) were compared by examining pretreatment casts, pretreatment intraoral radiographs, and posttreatment casts of forty-one patients of mixed-dentition age. 2. A comparison of correlation coefficients and slopes of the predicted arch length versus the actual arch lengths revealed that the Hixon-Oldfather method conformed closest to the ideal. 3. No combination of the four methods produced a more accurate equation than the single most accurate method. 4. Neither the sex of the patient nor the type of occlusion affected the prediction accuracy of any of the four equations. 5. All methods tend to overpredict the arch length size by 1 to 3 mm., with the exception of the Hixon-Oldfather equation, which underpredicted by approximately 0.5 mm. 6. An analysis of the intrainvestigator error showed a very low standard error of estimate for individual tooth measurements and for the prediction values. 7. A variance analysis showed that most of the variation was due to arch length (85%), a slight amount was due to the prediction method (8%), and 6% of the variation was due to the rater. 8. A low correlation was found between space available versus actual discrepancy and space available versus actual arch length. 9. High correlation coefficients were found for the predicted arch lengths when compared with the actual arch lengths. As expected, the correlation coefficients for the predicted widths of only the canines and premolars compared with the actual widths were not quite as high. PMID:285614

  20. Comparison of arch forms between Turkish and North American

    OpenAIRE

    Ahmet A. Celebi; Hakan Keklik; Enes Tan; Ucar, Faruk I.

    2016-01-01

    ABSTRACT Objective: The aim of this study was to clarify the morphological differences in the mandibular arches of Turkish and North American white subjects. Methods: The sample included 132 Turkish (34 Class I, 58 Class II, and 40 Class III) and 160 North American (60 Class I, 50 Class II, and 50 Class III) subjects. The most facial portion of 13 proximal contact areas was digitized from photocopied images of patients' mandibular dental arches. Clinical bracket points were calculated for ...

  1. Spectrum of Aortic Valve Abnormalities Associated with Aortic Dilation Across Age Groups in Turner Syndrome

    Science.gov (United States)

    Olivieri, Laura J.; Baba, Ridhwan Y.; Arai, Andrew E.; Bandettini, W. Patricia; Rosing, Douglas R.; Bakalov, Vladimir; Sachdev, Vandana; Bondy, Carolyn A.

    2014-01-01

    Background Congenital aortic valve fusion is associated with aortic dilation, aneurysm and rupture in girls and women with Turner syndrome (TS). Our objective was to characterize aortic valve structure in subjects with TS, and determine the prevalence of aortic dilation and valve dysfunction associated with different types of aortic valves. Methods and Results The aortic valve and thoracic aorta were characterized by cardiovascular magnetic resonance imaging in 208 subjects with TS in an IRB-approved natural history study. Echocardiography was used to measure peak velocities across the aortic valve, and the degree of aortic regurgitation. Four distinct valve morphologies were identified: tricuspid aortic valve (TAV) 64%(n=133), partially fused aortic valve (PF) 12%(n=25), bicuspid aortic valve (BAV) 23%(n=47), and unicuspid aortic valve (UAV) 1%(n=3). Age and body surface area (BSA) were similar in the 4 valve morphology groups. There was a significant trend, independent of age, towards larger BSA-indexed ascending aortic diameters (AADi) with increasing valve fusion. AADi were (mean +/− SD) 16.9 +/− 3.3 mm/m2, 18.3 +/− 3.3 mm/m2, and 19.8 +/− 3.9 mm/m2 (p<0.0001) for TAV, PF and BAV+UAV respectively. PF, BAV, and UAV were significantly associated with mild aortic regurgitation and elevated peak velocities across the aortic valve. Conclusions Aortic valve abnormalities in TS occur with a spectrum of severity, and are associated with aortic root dilation across age groups. Partial fusion of the aortic valve, traditionally regarded as an acquired valve problem, had an equal age distribution and was associated with an increased AADi. PMID:24084490

  2. Exact monitoring of aortic diameters in Marfan patients without gadolinium contrast: intraindividual comparison of 2D SSFP imaging with 3D CE-MRA and echocardiography

    Energy Technology Data Exchange (ETDEWEB)

    Veldhoen, Simon [University Medical Center Wuerzburg, Department of Diagnostic and Interventional Radiology, Bavaria (Germany); University Medical Center Hamburg-Eppendorf, Department of Diagnostic and Interventional Radiology, Hamburg (Germany); Behzadi, Cyrus; Derlin, Thorsten; Henes, Frank Oliver; Adam, Gerhard; Bannas, Peter [University Medical Center Hamburg-Eppendorf, Department of Diagnostic and Interventional Radiology, Hamburg (Germany); Rybczinsky, Meike; Kodolitsch, Yskert von; Sheikhzadeh, Sara [University Medical Center Hamburg-Eppendorf, Department of General and Interventional Cardiology, Hamburg (Germany); Bley, Thorsten Alexander [University Medical Center Wuerzburg, Department of Diagnostic and Interventional Radiology, Bavaria (Germany)

    2014-10-15

    To assess whether ECG-gated non-contrast 2D steady-state free precession (SSFP) imaging allows for exact monitoring of aortic diameters in Marfan syndrome (MFS) patients using non-ECG-gated contrast-enhanced 3D magnetic resonance angiography (CE-MRA) and echocardiography for intraindividual comparison. Non-ECG-gated CE-MRA and ECG-gated non-contrast SSFP at 1.5 T were prospectively performed in 50 patients. Two readers measured aortic diameters on para-sagittal images identically aligned with the aortic arch at the sinuses of Valsalva, sinotubular junction, ascending/descending aorta and aortic arch. Image quality was assessed on a three-point scale. Aortic root diameters acquired by echocardiography were used as reference. Intra- and interobserver variances were smaller for SSFP at the sinuses of Valsalva (p = 0.002; p = 0.002) and sinotubular junction (p = 0.014; p = 0.043). Image quality was better in SSFP than in CE-MRA at the sinuses of Valsalva (p < 0.0001), sinotubular junction (p < 0.0001) and ascending aorta (p = 0.02). CE-MRA yielded higher diameters than SSFP at the sinuses of Valsalva (mean bias, 2.5 mm; p < 0.0001), and comparison with echocardiography confirmed a higher bias for CE-MRA (7.2 ± 3.4 mm vs. SSFP, 4.7 ± 2.6 mm). ECG-gated non-contrast 2D SSFP imaging provides superior image quality with higher validity compared to non-ECG-gated contrast-enhanced 3D imaging. Since CE-MRA requires contrast agents with potential adverse effects, non-contrast SSFP imaging is an appropriate alternative for exact and riskless aortic monitoring of MFS patients. (orig.)

  3. Exact monitoring of aortic diameters in Marfan patients without gadolinium contrast: intraindividual comparison of 2D SSFP imaging with 3D CE-MRA and echocardiography

    International Nuclear Information System (INIS)

    To assess whether ECG-gated non-contrast 2D steady-state free precession (SSFP) imaging allows for exact monitoring of aortic diameters in Marfan syndrome (MFS) patients using non-ECG-gated contrast-enhanced 3D magnetic resonance angiography (CE-MRA) and echocardiography for intraindividual comparison. Non-ECG-gated CE-MRA and ECG-gated non-contrast SSFP at 1.5 T were prospectively performed in 50 patients. Two readers measured aortic diameters on para-sagittal images identically aligned with the aortic arch at the sinuses of Valsalva, sinotubular junction, ascending/descending aorta and aortic arch. Image quality was assessed on a three-point scale. Aortic root diameters acquired by echocardiography were used as reference. Intra- and interobserver variances were smaller for SSFP at the sinuses of Valsalva (p = 0.002; p = 0.002) and sinotubular junction (p = 0.014; p = 0.043). Image quality was better in SSFP than in CE-MRA at the sinuses of Valsalva (p < 0.0001), sinotubular junction (p < 0.0001) and ascending aorta (p = 0.02). CE-MRA yielded higher diameters than SSFP at the sinuses of Valsalva (mean bias, 2.5 mm; p < 0.0001), and comparison with echocardiography confirmed a higher bias for CE-MRA (7.2 ± 3.4 mm vs. SSFP, 4.7 ± 2.6 mm). ECG-gated non-contrast 2D SSFP imaging provides superior image quality with higher validity compared to non-ECG-gated contrast-enhanced 3D imaging. Since CE-MRA requires contrast agents with potential adverse effects, non-contrast SSFP imaging is an appropriate alternative for exact and riskless aortic monitoring of MFS patients. (orig.)

  4. Comparison of arch forms between Turkish and North American

    Directory of Open Access Journals (Sweden)

    Ahmet A. Celebi

    2016-04-01

    Full Text Available ABSTRACT Objective: The aim of this study was to clarify the morphological differences in the mandibular arches of Turkish and North American white subjects. Methods: The sample included 132 Turkish (34 Class I, 58 Class II, and 40 Class III and 160 North American (60 Class I, 50 Class II, and 50 Class III subjects. The most facial portion of 13 proximal contact areas was digitized from photocopied images of patients' mandibular dental arches. Clinical bracket points were calculated for each tooth based on mandibular tooth thickness data. Four linear and two proportional measurements were taken. The subjects were grouped according to arch form types (tapered, ovoid and square in order to have frequency distribution compared between ethnic groups in each Angle classification. Results: The Turkish group showed significantly lower molar depth and more significant molar width-depth (W/D ratio in all three Angle classifications. On the other hand, the Turkish group also showed a significantly larger intercanine width in Class III malocclusion and intermolar width in Class II malocclusion. The most frequent arch forms seen were the ovoid arch form in the Turkish group and the tapered form in the white group. Conclusions: Our results demonstrate that when treating Turkish patients, one should expect to use preformed ovoid arch form orthodontic wires in a significant percentage of patients.

  5. Developmental feature of the lumbosacral vertebral arch in childhood

    International Nuclear Information System (INIS)

    We investigated a developmental feature of the lumbosacral vertebral arch in childhood that has rarely been reported previously. Sixty-seven patients underwent functional posterior rhizotomy from September 2000 to June 2006 at National Center for Child Health and Development. Sixty of these patients, who had no deformity in their lumbosacral spine, were included in this study and their Computed Tomography (CT) images were analyzed retrospectively. There were 36 boys and 24 girls, aged from 2-12 years. The rate and mean number of non-union vertebral arches between L1 and S3 were 78.3% (95% CI, 65.8-87.9%) and 1.7 (standard deviation (SD), 1.3). The non-union arch was most frequently found at the S1 level, and was more significantly observed in the younger age group (2-5 years of age). The S4 and S5 arches, which often remained open as the sacral hiatus, were constantly open in childhood. This study demonstrates that the vertebral arches of the lumbosacral spine in normal development are often not fused during childhood. It is important to differentiate normal non-union arches from pathological spina bifida. (author)

  6. Multidetector-row computed tomography of thoracic aortic anomalies in dogs and cats: Patent ductus arteriosus and vascular rings

    Directory of Open Access Journals (Sweden)

    Nolte Ingo

    2011-09-01

    Full Text Available Abstract Background Diagnosis of extracardiac intrathoracic vascular anomalies is of clinical importance, but remains challenging. Traditional imaging modalities, such as radiography, echocardiography, and angiography, are inherently limited by the difficulties of a 2-dimensional approach to a 3-dimensional object. We postulated that accurate characterization of malformations of the aorta would benefit from 3-dimensional assessment. Therefore, multidetector-row computed tomography (MDCT was chosen as a 3-dimensional, new, and noninvasive imaging technique. The purpose of this study was to evaluate patients with 2 common diseases of the intrathoracic aorta, either patent ductus arteriosus or vascular ring anomaly, by contrast-enhanced 64-row computed tomography. Results Electrocardiography (ECG-gated and thoracic nongated MDCT images were reviewed in identified cases of either a patent ductus arteriosus or vascular ring anomaly. Ductal size and morphology were determined in 6 dogs that underwent ECG-gated MDCT. Vascular ring anomalies were characterized in 7 dogs and 3 cats by ECG-gated MDCT or by a nongated thoracic standard protocol. Cardiac ECG-gated MDCT clearly displayed the morphology, length, and caliber of the patent ductus arteriosus in 6 affected dogs. Persistent right aortic arch was identified in 10 animals, 8 of which showed a coexisting aberrant left subclavian artery. A mild dilation of the proximal portion of the aberrant subclavian artery near its origin of the aorta was present in 4 dogs, and a diverticulum analogous to the human Kommerell's diverticulum was present in 2 cats. Conclusions Contrast-enhanced MDCT imaging of thoracic anomalies gives valuable information about the exact aortic arch configuration. Furthermore, MDCT was able to characterize the vascular branching patterns in dogs and cats with a persistent right aortic arch and the morphology and size of the patent ductus arteriosus in affected dogs. This additional

  7. Minimally Invasive Aortic Valve Replacement

    Medline Plus

    Full Text Available ... more likely we see aortic stenosis. Again, patient education is part of the evaluation and management of ... want to embrace less invasive or more progressive technology, you want to make ... with that information and certainly shouldn't be insulted by that. ...

  8. Minimally Invasive Aortic Valve Replacement

    Medline Plus

    Full Text Available ... well. I want to underscore again that exercise testing is really not recommended in patient with classic symptoms in severe aortic stenosis, as it's probably more stress than the patient's heart should have to undergo. Once again, serial evaluations, as with any chronic disease process, are ...

  9. Minimally Invasive Aortic Valve Replacement

    Medline Plus

    Full Text Available ... or in most patients who come to requiring surgery for aortic stenosis, left ventricular hypertrophy is a common manifestation. By that, I mean generally speaking any muscle that works harder in the body gets thicker and bigger over time and that's ...

  10. Minimally Invasive Aortic Valve Replacement

    Medline Plus

    Full Text Available ... county more likely we see aortic stenosis. Again, patient education is part of the evaluation and management of valvular disease prior to surgery is paramount. It's important for a patient to understand really with any chronic condition what ...

  11. Minimally Invasive Aortic Valve Replacement

    Medline Plus

    Full Text Available ... valve in the aortic position will grow over time and proves a nice replacement. However, that's sort of operating on two valves to fix one valvular problem. And for most patients in our practice in their 50s, 60s, et cetera, we tend ...

  12. [Perioperative management of endovascular stent graft placement for abdominal aortic aneurysm].

    Science.gov (United States)

    Yamashita, A; Ishida, K; Aratake, K; Wakamatsu, H; Kawata, R; Kunihiro, M; Sakabe, T

    2000-09-01

    We retrospectively examined the changes in hemodynamics, oxygen index and renal function along with the complications in 25 patients who had undergone endovascular stent graft placement (ESG) surgery for abdominal aortic aneurysm. During stent graft placement, mean arterial pressure decreased to 58 +/- 8 mmHg by increasing the dose of anesthetics and/or using vasodilators. Except for this intended hypotensive period, mean arterial pressure and heart rate were relatively stable and adequately maintained during surgical manipulation. Oxygenation index was well maintained. A patient with a high preoperative creatinine level underwent prophylactic hemodialysis postoperatively. In other patients except one who died in early postoperative period, both BUN and creatinine levels were kept within normal ranges. Four patients died postoperatively and the causes of the death in two patients are related to the surgical procedure; one with multiple emboli possibly due to released atheloma from the aortic wall during procedure, the other with sepsis due to infected stent graft. Although ESG is a well tolerated procedure, embolism is the most serious complication. Careful preoperative evaluation of the ascending arch and descending aortic wall and monitoring with transcranial doppler are necessary. PMID:11025953

  13. Stent-graft implantation for clinically diagnosed syphilitic aortic aneurysm in an HIV-infected patient.

    Science.gov (United States)

    Yasuda, Shota; Imoto, Kiyotaka; Uchida, Keiji; Kawaguchi, Satoshi; Yokoi, Yoshihiko; Shigematsu, Hiroshi; Masuda, Munetaka

    2014-01-01

    We describe our experience with stent-graft placement in a patient with a clinically diagnosed syphilitic aortic aneurysm.The patient was a 43-year-old man with syphilitic and human immunodeficiency virus (HIV) co-infection. Computed tomography (CT) revealed an aortic aneurysm with 89 mm in maximum size which was located at distal aortic arch and was considered syphilis derived saccular aneurysm. The aneurysm was judged at high risk of rupture from its shape. We decided to perform stent-graft implantation. Before surgery, the patient was given antibacterial and anti-HIV agents. Hand-made fenestrated stent graft by Tokyo Medical University was implanted. The graft was placed from the ascending aorta to Th 9 level in the descending aorta. The aneurysm completely disappeared during follow-up, with no flare-up of syphilitic infection up to 2 years after surgery.The number of patients with syphilis and human immunodeficiency virus co-infection is now increasing. Stent-graft implantation may be an effective treatment in such immunocompromised patients. PMID:23774613

  14. MDCT evaluation of acute aortic syndrome (AAS).

    Science.gov (United States)

    Valente, Tullio; Rossi, Giovanni; Lassandro, Francesco; Rea, Gaetano; Marino, Maurizio; Muto, Maurizio; Molino, Antonio; Scaglione, Mariano

    2016-05-01

    Non-traumatic acute thoracic aortic syndromes (AAS) describe a spectrum of life-threatening aortic pathologies with significant implications on diagnosis, therapy and management. There is a common pathway for the various manifestations of AAS that eventually leads to a breakdown of the aortic intima and media. Improvements in biology and health policy and diffusion of technology into the community resulted in an associated decrease in mortality and morbidity related to aortic therapeutic interventions. Hybrid procedures, branched and fenestrated endografts, and percutaneous aortic valves have emerged as potent and viable alternatives to traditional surgeries. In this context, current state-of-the art multidetector CT (MDCT) is actually the gold standard in the emergency setting because of its intrinsic diagnostic value. Management of acute aortic disease has changed with the increasing realization that endovascular therapies may offer distinct advantages in these situations. This article provides a summary of AAS, focusing especially on the MDCT technique, typical and atypical findings and common pitfalls of AAS, as well as recent concepts regarding the subtypes of AAS, consisting of aortic dissection, intramural haematoma, penetrating atherosclerotic ulcer and unstable aortic aneurysm or contained aortic rupture. MDCT findings will be related to pathophysiology, timing and management options to achieve a definite and timely diagnostic and therapeutic definition. In the present article, we review the aetiology, pathophysiology, clinical presentation, outcomes and therapeutic approaches to acute aortic syndromes. PMID:27033344

  15. Transcatheter aortic valve implantation versus surgical aortic valve replacement for severe aortic stenosis: a meta analysis

    Institute of Scientific and Technical Information of China (English)

    WU Yi-cheng; ZHANG Jian-feng; SHEN Wei-feng; ZHAO Qiang

    2013-01-01

    Background Transcatheter aortic valve implantation (TAVI) has emerged as the treatment choice for non-operable patients with severe symptomatic aortic stenosis (AS) and may be a good alternative to surgery for those at very high or prohibitive surgical risk.We performed a meta-analysis to evaluate the comparative benefits of TAVI versus surgical aortic valve replacement (SAVR) in patients with severe AS.Methods A comprehensive literature search of PubMed,Embase,ScienceDirect and Cochrane Central Register of Controlled trials was performed,and randomized trials as well as cohort studies with propensity score analysis were included.Results One randomized trial (n=699) and six retrospective cohort studies (n=781) were selected for meta-analysis.Mortality at 30-day and 1-year follow-up was comparable between TAVI and SAVR.Despite similar incidences of stroke,myocardial infarction,re-operation for bleeding,and renal failure requiring dialysis,TAVI was associated with a lower occurrence rate of new-onset atrial fibrillation (OR 0.51,95% CI 0.33-0.78) and shorter procedural time (mean difference -67.50 minutes,95% CI-87.20 to-47.81 minutes).Post-operative aortic regurgitation and permanent pacemaker implantation were more common in patients after TAVI than in those with SAVR (OR 5.53,95% CI 3.41-8.97; OR 1.71,95% Cl 1.02-2.84,respectively).Conclusion In patients with severe symptomatic AS,TAVI and SAVR did not differ with respect to short-and mid-term survival,but the incidence of permanent pacemaker implantation and post-procedural aortic regurgitation remain relatively high after TAVI.

  16. Indexing aortic valve area by body surface area increases the prevalence of severe aortic stenosis

    DEFF Research Database (Denmark)

    Jander, Nikolaus; Gohlke-Bärwolf, Christa; Bahlmann, Edda;

    2014-01-01

    To account for differences in body size in patients with aortic stenosis, aortic valve area (AVA) is divided by body surface area (BSA) to calculate indexed AVA (AVAindex). Cut-off values for severe stenosis are...

  17. Supravalvular aortic stenosis associated to infectious endocarditis and cerebral vascular disease in a patient with Williams-Beuren Syndrome.

    Science.gov (United States)

    De Rubens Figueroa, Jesús; Marhx, Alfonso; López Terrazas, Javier; Palacios Macedo, Alexis

    2015-01-01

    The Williams-Beuren syndrome is a rare genetic disease characterized by: (a) typical facial features; (b) psychomotor retardation with a specific neurocognitive profile; (c) cardiovascular condition and (d) likely transient hypocalcemia in infancy. The objective of this study was to describe the clinic evolution and diagnosis of patient with this syndrome that was associated with endocarditis caused by Streptococcus parasanguis in the ascending aorta and an aneurism located in the fronto-temporal area, which produced a parenchymal hematoma in the left lobe, and subarachnoid hemorrhage. He was treated with ceftriaxone and dicloxacillin. Then we proceeded to correct the aneurysm and perform vegetation resection in aortic arteries with supravalvular aortic stenosis correction. The evolution after one year has been favorable and is currently without neurologic sequelae. A 5-year-old male patient presented a diagnosis of supravalvular aortic stenosis. After cardiac catheterization was performed, he presented a fever and right side paresis. The echocardiogram showed multiple vegetations in the ascendant aortic arch and the supraortic arteries. The blood cultures reported S. parasanguis. The magnetic resonance showed a subarachnoid hemorrhage with an aneurysm and a hematoma. PMID:25882107

  18. Early outcomes of transcatheter aortic valve replacement in patients with severe aortic stenosis: single center experience

    OpenAIRE

    Bozkurt, Engin; KELEŞ, TELAT; Durmaz, Tahir; Akçay, Murat; Sari, Cenk; Ayhan, Hüseyin; Bayram, Nihal Akar; Aslan, Abdullah Nabi; Baştuğ, Serdal; Bilen, Emine

    2014-01-01

    Introduction Transcatheter aortic valve implantation is a promising alternative to high risk surgical aortic valve replacement. The procedure is mainly indicated in patients with severe symptomatic aortic stenosis who cannot undergo surgery or who are at very high surgical risk. Aim Description early results of our single-center experience with balloon expandable aortic valve implantation. Material and methods Between July 2011 and August 2012, we screened in total 75 consecutive patients wit...

  19. Congenital aortic regurgitation in a child with a tricuspid non-stenotic aortic valve.

    OpenAIRE

    Hashimoto, R; Miyamura, H; Eguchi, S

    1984-01-01

    After follow up for seven years a 10 year old boy with congenital aortic regurgitation was found to have a tricuspid non-stenotic aortic valve at operation. The right coronary cusp was dysplastic, thickened, and contracted; the gap between its free margin and aortic wall was bridged with two fibrous bands; and the left coronary and non-coronary cusps were almost normal. The aortic valve was replaced with a prosthesis (St Jude Medical No 23), and the postoperative course was uneventful.

  20. The Effects of Interruptions on Oncologists' Patient Assessment and Medication Ordering Practices

    Directory of Open Access Journals (Sweden)

    Patricia L. Trbovich

    2013-01-01

    Full Text Available Interruptions are causal factors in medication errors. Although researchers have assessed the nature and frequency of interruptions during medication administration, there has been little focus on understanding their effects during medication ordering. The goal of this research was to examine the nature, frequency, and impact of interruptions on oncologists' ordering practices. Direct observations were conducted at a Canadian cancer treatment facility to (1 document the nature, frequency, and timing of interruptions during medication ordering, and (2 quantify the use of coping mechanisms by oncologists. On average, oncologists were interrupted 17 % of their time, and were frequently interrupted during safety-critical stages of medication ordering. When confronted with interruptions, oncologists engaged/multitasked more often than resorting to deferring/blocking. While some interruptions are necessary forms of communication, efforts must be made to reduce unnecessary interruptions during safety-critical tasks, and to develop interventions that increase oncologists' resiliency to inevitable interruptions.

  1. MARFAN SYNDROME AND QUADRICUSPID AORTIC VALVE

    OpenAIRE

    Sürücü, Hüseyin; ÇİMEN, Sadi

    2013-01-01

    ABSTRACTWhile the major cardiovascular manifestation in Marfan syndrome is a progressive dilatation of the ascending aorta, leading to aortic aneurysm formation and eventually to fatal aortic rupture or dissection, mitral valve prolapse and calcification of the mitral valve annulus, dilatation of the main pulmonary artery may be seen. There was no knowledge about the association of Marfan syndrome and quadricuspid aortic valve. In this case report, we aimed to declare this association between...

  2. Recurrent tamponade and aortic dissection in syphilis.

    Science.gov (United States)

    Stansal, Audrey; Mirault, Tristan; Rossi, Aude; Dupin, Nicolas; Bruneval, Patrick; Bel, Alain; Azarine, Arshid; Minozzi, Catherine; Deman, Anne Laure; Messas, Emmanuel

    2013-11-01

    Syphilitic cardiovascular disease has been described since the 19th century, mainly on autopsy series. Major clinical manifestations are aortic aneurysm, aortic insufficiency, and coronary ostial stenosis. The diagnosis of syphilitic cardiovascular disease is based mainly on positive serologic tests and overt clinical manifestations. We present here a rare and unusual clinical presentation of a tertiary syphilis with recurrent tamponade and type B aortic dissection, whose positive diagnosis was made by polymerase chain reaction on pericardial fluid analysis. PMID:24182507

  3. Treatment options for postdissection aortic aneurysms.

    Science.gov (United States)

    Sobocinski, Jonathan; Patterson, Benjamin O; Clough, Rachel E; Spear, Rafaelle; Martin-Gonzalez, Teresa; Azzaoui, Richard; Hertault, Adrien; Haulon, Stéphan

    2016-04-01

    Aortic dissection is one of the most devastating catastrophes that can affect the aorta. Surgical treatment is proposed only when complications such as rupture or malperfusion occur. No clear consensus has been reached regarding the best therapy to prevent aortic rupture after the acute phase. We have performed a thorough review of the most recent literature on the strategies to treat patients in the chronic phase of aortic dissection. PMID:26771869

  4. Arc Behaviours in Vacuum Interrupters with Axial Magnetic Field Electrodes

    Institute of Scientific and Technical Information of China (English)

    WANG Zhongyi; ZHENG Yuesheng; LIU Zhiyuan; CHENG Shaoyong

    2008-01-01

    To improve the limiting current interruption capability and minimizing vacuum interrupter with axial magnetic field (AMF) electrodes,it is significant to investigate the vacuum arc behaviours between the contacts.AMF distributions of the slot type electrodes were studied by both numerical analysis and experiments. Furthermore,the behaviours of vacuum arcs for different parameters of the slot type AMF electrodes were investigated by using high-speed CCD camera.The influences of gap distance,contact diameter and phase shift time between AMF and arc current on the vacuum arc were investigated.The results provide a reference for research and development of vacuum interrupters with slot type or other types of AMF electrode.

  5. Thinking aloud in the presence of interruptions and time constraints

    DEFF Research Database (Denmark)

    Hertzum, Morten; Holmegaard, Kristin Due

    2013-01-01

    and time constraints, two frequent elements of real-world activities. We find that the presence of auditory, visual, audiovisual, or no interruptions interacts with thinking aloud for task solution rate, task completion time, and participants’ fixation rate. Thinking-aloud participants also spend......Thinking aloud is widely used for usability evaluation and its reactivity is therefore important to the quality of evaluation results. This study investigates whether thinking aloud (i.e., verbalization at levels 1 and 2) affects the behaviour of users who perform tasks that involve interruptions...... longer responding to interruptions than control participants. Conversely, the absence or presence of time constraints does not interact with thinking aloud, suggesting that time pressure is less likely to make thinking aloud reactive than previously assumed. Our results inform practitioners faced with...

  6. Classification of the height and flexibility of the medial longitudinal arch of the foot

    DEFF Research Database (Denmark)

    Nilsson, Mettte Kjaergaard; Friis, Rikke; Michaelsen, Maria Skjoldahl;

    2012-01-01

    BACKGROUND: The risk of developing injuries during standing work may vary between persons with different foot types. High arched and low arched feet, as well as rigid and flexible feet, are considered to have different injury profiles, while those with normal arches may sustain fewer injuries....... CONCLUSIONS: The cut-off values presented in this study can be used to categorize people performing standing work into groups of different foot arch types. The results of this study are important for investigating a possible link between arch height and arch movement and the development of injuries....

  7. Abdominal Aortic Surgery: Anesthetic Implications

    OpenAIRE

    Cunningham, Anthony J.

    1991-01-01

    The objectives of the review are to highlight the clinical characteristics of the patient population; to assess multivariate risk factor analysis and the invasive/non-invasive techniques available for risk factor identification and management in this high-risk surgical population; to assess the major hemodynamic, metabolic, and regional blood flow changes associated with aortic cross-clamping/unclamping procedures and techniques for their modification or attenuation; and to assess the influen...

  8. Transverse Aortic Constriction in Mice

    OpenAIRE

    deAlmeida, Angela C.; van Oort, Ralph J.; Wehrens, Xander H. T.

    2010-01-01

    Transverse aortic constriction (TAC) in the mouse is a commonly used experimental model for pressure overload-induced cardiac hypertrophy and heart failure.1 TAC initially leads to compensated hypertrophy of the heart, which often is associated with a temporary enhancement of cardiac contractility. Over time, however, the response to the chronic hemodynamic overload becomes maladaptive, resulting in cardiac dilatation and heart failure.2 The murine TAC model was first validated by Rockman et ...

  9. De Bakey Ⅰ型主动脉夹层的外科治疗%Surgical Treatment of De Bakey Ⅰ Aortic Dissection

    Institute of Scientific and Technical Information of China (English)

    陶登顺; 王辉山; 姜辉; 张南滨; 宋恒昌; 葛玉光; 杨忠路

    2011-01-01

    Objective To explore the surgical procedures and cerebral protection and improve surgical results by summarizing the experiences of surgical treatment of 68 patients of De Bakey Ⅰ aortic dissection. Methods We retrospectively analyzed the clinical data of 68 patients (including 45 males and 23 females aged 29 to 72 years with an age of 44.5±17.2 years) with De Bakey Ⅰ aortic dissection who were treated in the General Hospital of Shenyang Command between May 2004 and April 2010. Acute aortic dissection (occurring within 2 weeks) was present in 57 patients and chronic aortic dissection in 11. The intimal tear was located in the ascending aorta in 45 patients, in the aortic arch in 12 and in the descending part of the aortic arch in 11. Thirty-five patients underwent emergency operation and 33 underwent selected or limited operation. The operations were performed under hypothermic circulation arrest plus selective antegrade cerebral perfusion or right vena cave retrograde cerebral perfusion to protect the brain. Total arch replacement and stented elephant trunk were performed in 25 patients, Bentall operation with concomitant total arch replacement and stented elephant trunk in 16 patients, pure right semi aortic arch replacement and stented elephant trunk in 15 patients, total aortic arch replacement in 7 patients, right semi aortic arch replacement and stented elephant trunk in 3 patients, and Cabrol operation with concomitant aortic conduit with valve and total arch replacement and stented elephant trunk in 2 patients. Results Five patients (4 with acute aortic dissection and 1 with chronic aortic dissection) died with an operative mortality of 7.4% (5/68). The causes of death were anastomotic bleeding during surgery in 1 patient, postoperative low cardiac output syndrome and malignant arrhythmia in 2, acute renal failure in 1 and cerebral complications in 1. During peri-operative period, psychotic symptoms occurred in 5 patients,pericardial effusion in 2

  10. "Interruptions disrupt reading comprehension": Correction to Foroughi et al. (2015).

    Science.gov (United States)

    2016-07-01

    Reports an error in "Interruptions disrupt reading comprehension" by Cyrus K. Foroughi, Nicole E. Werner, Daniela Barragán and Deborah A. Boehm-Davis (Journal of Experimental Psychology: General, 2015[Jun], Vol 144[3], 704-709). In the article the effect sizes (Cohen's d) were reported using the incorrect formula. The correct formula and effect sizes are provided. (The following abstract of the original article appeared in record 2015-15250-001.) Previous research suggests that being interrupted while reading a text does not disrupt the later recognition or recall of information from that text. This research is used as support for Ericsson and Kintsch's (1995) long-term working memory (LT-WM) theory, which posits that disruptions while reading (e.g., interruptions) do not impair subsequent text comprehension. However, to fully comprehend a text, individuals may need to do more than recognize or recall information that has been presented in the text at a later time. Reading comprehension often requires individuals to connect and synthesize information across a text (e.g., successfully identifying complex topics such as themes and tones) and not just make a familiarity-based decision (i.e., recognition). The goal for this study was to determine whether interruptions while reading disrupt reading comprehension when the questions assessing comprehension require participants to connect and synthesize information across the passage. In Experiment 1, interruptions disrupted reading comprehension. In Experiment 2, interruptions disrupted reading comprehension but not recognition of information from the text. In Experiment 3, the addition of a 15-s time-out prior to the interruption successfully removed these negative effects. These data suggest that the time it takes to process the information needed to successfully comprehend text when reading is greater than that required for recognition. Any interference (e.g., an interruption) that occurs during the comprehension

  11. Evaluation of dental arch width and form changes after orthodontic treatment and retention with a new computerized method.

    Science.gov (United States)

    Taner, Tülin Ugur; Ciger, Semra; El, Hakan; Germeç, Derya; Es, Alphan

    2004-10-01

    The purpose of this study was to evaluate longitudinal arch width and form changes and to define arch form types with a new computerized method. Maxillary and mandibular models of 21 Class II Division 1 patients were examined before treatment (T(0)), after treatment (T(1)), and an average of 3 years after retention (T(2)). Arch width measurements were made directly on scanned images of maxillary and mandibular models. Arch form changes at T(0)-T(1) and T(1)-T(2) were evaluated by superimposing the computer-generated Bezier arch curves with a computer program. Types of dental arch forms were defined by superimposing them with the pentamorphic arch system, which included 5 different types of arch forms: normal, ovoid, tapered, narrow ovoid, and narrow tapered. Maxillary arch widths were increased during orthodontic treatment. Mandibular posterior arch widths were also increased. The expansion of the mandibular arch forms was less than in the maxillary arch forms. Arch width changes were generally stable, except for reduction in maxillary and mandibular interlateral, inter-first premolar, and mandibular intercanine widths. Pretreatment maxillary arch forms were mostly tapered; mandibular arch forms were tapered and narrow tapered. In maxillary arch forms, 76% of the treatment changes were maintained. Mandibular arch form was maintained in 67% of the sample, both during treatment and after retention. In mandibular arches, 71% of orthodontically induced arch form changes were maintained. PMID:15470349

  12. [A treatment chart adapted to the arch form].

    Science.gov (United States)

    Bocquet-Moreau, E; Danguy, Ch; Bertrand, J; Danguy, M

    2005-12-01

    Arch wires used in orthodontic treatment must conform to the shape of the dental arches so that in their final positions teeth will be set in a pathway of neuromuscular equilibrium. However, sometimes distortions of the alveoli deform the shape of the arch. In such cases the treatment charts constructed on the actual alveolo-dental relationship will not reflect desired objectives. We believe that the transverse muco-gingival dimension Andrews called the Wala line responds better to therapeutic requirements. Moreover, molar attachments, key elements of a full-banded appliance, are in harmony with it. So the type of chart that the authors propose for use with the Straight Wire technique, one based on the Wala line, will help orthodontists place teeth at the conclusion of orthodontic treatment in the best possible relationships to patients' specific anatomic configurations. PMID:16471375

  13. Game model of safety monitoring for arch dam deformation

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Arch dam deformation is comprehensively affected by water pressure,temperature,dam’s structural behavior and material properties as well as other factors.Among them the water pressure and temperature are external factors(source factors) that cause dam deformation,and dam’s structural behavior and material properties are the internal factors of deformation(resistance factors).The dam deformation is the result of the mutual game playing between source factors and resistance factors.Therefore,resistance factors of structure and materials that reflect resistance character of arch dam structure are introduced into the traditional model,where structure factor is embodied by the flexibility coefficient of dam body and the maximum dam height,and material property is embodied by the elastic modulus of dam.On the basis of analyzing the correlation between dam deformation and resistance factors,the game model of safety monitoring for arch dam deformation is put forward.

  14. LANGER’S AXILLARY ARCH AND ITS CLINICAL IMPLICATIONS

    Directory of Open Access Journals (Sweden)

    Jyothi K C

    2014-09-01

    Full Text Available Introduction: The axillary arch muscle of Langer is the most common anatomical variant of axillary musculature which is of clinical and surgical importance. It may lead to neurovascular compression syndrome in the cervicoaxillary region and can be misinterpreted while examining axilla and also impairs movements of shoulder joint. Observation: During routine dissection of axilla for undergraduate teaching, an unusual muscular slip in the left axilla was observed .The muscular slip was extending from lattisimus dorsi muscle to undersurface of pectoralis major muscle, arching over axillary vessels and cords of brachial plexus. Conclusion: The axillary arch may cause obstruction to axillary vessels and nerves and may be involved in thoracic outlet syndrome and shoulder instability. The knowledge of this muscular variant could help to minimize intraoperative complications related to surgeries in or nearby axilla such as mastectomy, breast reconstruction and axillary lymphadenectomy or lymph node biopsy.

  15. Optical silencing of C. elegans cells with arch proton pump.

    Directory of Open Access Journals (Sweden)

    Ayako Okazaki

    Full Text Available BACKGROUND: Optogenetic techniques using light-driven ion channels or ion pumps for controlling excitable cells have greatly facilitated the investigation of nervous systems in vivo. A model organism, C. elegans, with its small transparent body and well-characterized neural circuits, is especially suitable for optogenetic analyses. METHODOLOGY/PRINCIPAL FINDINGS: We describe the application of archaerhodopsin-3 (Arch, a recently reported optical neuronal silencer, to C. elegans. Arch::GFP expressed either in all neurons or body wall muscles of the entire body by means of transgenes were localized, at least partially, to the cell membrane without adverse effects, and caused locomotory paralysis of worms when illuminated by green light (550 nm. Pan-neuronal expression of Arch endowed worms with quick and sustained responsiveness to such light. Worms reliably responded to repeated periods of illumination and non-illumination, and remained paralyzed under continuous illumination for 30 seconds. Worms expressing Arch in different subsets of motor neurons exhibited distinct defects in the locomotory behavior under green light: selective silencing of A-type motor neurons affected backward movement while silencing of B-type motor neurons affected forward movement more severely. Our experiments using a heat-shock-mediated induction system also indicate that Arch becomes fully functional only 12 hours after induction and remains functional for more than 24 hour. CONCLUSIONS/SGNIFICANCE: Arch can be used for silencing neurons and muscles, and may be a useful alternative to currently widely used halorhodopsin (NpHR in optogenetic studies of C. elegans.

  16. Planning and Analysis of an Arched Indoor Stadium

    Directory of Open Access Journals (Sweden)

    Alice T V

    2014-04-01

    Full Text Available This paper deals with planning and designing of a multilevel indoor stadium with hanging table tennis court and Olympic standard swimming pool. In order to support the large span the stadium is designed as an arched structure. The materials for the construction are chosen so as to have a minimum carbon di-oxide foot print. Static and earthquake analysis were done by using STAAD.Pro V8i. The paper also does a comparison between arched structure and plane frame structure.

  17. Excitation of Arch and Suspension Bridges by Subwires

    Directory of Open Access Journals (Sweden)

    Noriaki Hiwatashi

    1993-01-01

    Full Text Available A force generation method using a subwire for arch and suspension bridges is proposed. The subwire is connected to the arch or the cable of the bridge through rollers. The uniform force produced by pulling and releasing the pretensioned subwires acts on the bridge as an externalforce. A new device called “the resonance force generator” is also developed to excite the bridges by applying a small force. To verify the proposed concept, a stress ribbon bridge was excited with the resonance force generator.

  18. Excitation of Arch and Suspension Bridges by Subwires

    OpenAIRE

    Noriaki Hiwatashi; Yoji Mizuta; Yutaka Ishihara; Itio Hirai

    1993-01-01

    A force generation method using a subwire for arch and suspension bridges is proposed. The subwire is connected to the arch or the cable of the bridge through rollers. The uniform force produced by pulling and releasing the pretensioned subwires acts on the bridge as an externalforce. A new device called “the resonance force generator” is also developed to excite the bridges by applying a small force. To verify the proposed concept, a stress ribbon bridge was excited with the resonance force ...

  19. Pregnancy after aortic root replacement in Loeys-Dietz syndrome: High risk of aortic dissection.

    Science.gov (United States)

    Braverman, Alan C; Moon, Marc R; Geraghty, Patrick; Willing, Marcia; Bach, Christopher; Kouchoukos, Nicholas T

    2016-08-01

    Loeys-Dietz syndrome due to mutations in TGFBR1 and 2 is associated with early and aggressive aortic aneurysm and branch vessel disease. There are reports of uncomplicated pregnancy in this condition, but there is an increased risk of aortic dissection and uterine rupture. Women with underlying aortic root aneurysm are cautioned about the risk of pregnancy-related aortic dissection. Prophylactic aortic root replacement is recommended in women with aortopathy and aortic root dilatation to lessen the risk of pregnancy. There is limited information in the literature about the outcomes of pregnancy after root replacement in Loeys-Dietz syndrome. We present a case series of three women with Loeys-Dietz syndrome who underwent elective aortic root replacement for aneurysm disease and subsequently became pregnant and underwent Cesarean section delivery. Each of these women were treated with beta blockers throughout pregnancy. Surveillance echocardiograms and noncontrast MRA studies during pregnancy remained stable demonstrating no evidence for aortic enlargement. Despite the normal aortic imaging and careful observation, two of the three women suffered acute aortic dissection in the postpartum period. These cases highlight the high risk of pregnancy following aortic root replacement in Loeys-Dietz syndrome. Women with this disorder are recommended to be counseled accordingly. © 2016 Wiley Periodicals, Inc. PMID:27125181

  20. Infected aortic aneurysm and inflammatory aortic aneurysm. In search of an optimal differential diagnosis

    International Nuclear Information System (INIS)

    Infected aortic aneurysm and inflammatory aortic aneurysm each account for a minor fraction of the total incidence of aortic aneurysm and are associated with periaortic inflammation. Despite the similarity, infected aortic aneurysm generally shows a more rapid change in clinical condition, leading to a fatal outcome; in addition, delayed diagnosis and misuse of corticosteroid or immunosuppressing drugs may lead to uncontrolled growth of microorganisms. Therefore, it is mandatory that detection of aortic aneurysm is followed by accurate differential diagnosis. In general, infected aortic aneurysm appears usually as a saccular form aneurysm with nodularity, irregular configuration; however, the differential diagnosis may not be easy sometimes for the following reasons: symptoms, such as abdominal and/or back pain and fever, and blood test abnormalities, such as elevated C-reactive protein and enhanced erythrocyte sedimentation rate, are common in infected aortic aneurysm, but they are not found infrequently in inflammatory aortic aneurysm; some inflammatory aortic aneurysms are immunoglobulin (Ig) G4-related, but not all of them; the prevalence of IgG4 positivity in infected aortic aneurysm has not been well investigated; enhanced uptake of 18F-fluorodeoxyglucose (FDG) by 18F-FDG-positron emission tomography may not distinguish between inflammation mediated by autoimmunity and that mediated by microorganism infection. Here we discuss the characteristics of these two forms of aortic aneurysm and the points of which we have to be aware before reaching a final diagnosis. (author)

  1. Regional aortic distensibility and its relationship with age and aortic stenosis: a computed tomography study.

    Science.gov (United States)

    Wong, Dennis T L; Narayan, Om; Leong, Darryl P; Bertaso, Angela G; Maia, Murilo G; Ko, Brian S H; Baillie, Timothy; Seneviratne, Sujith K; Worthley, Matthew I; Meredith, Ian T; Cameron, James D

    2015-06-01

    Aortic distensibility (AD) decreases with age and increased aortic stiffness is independently associated with adverse cardiovascular outcomes. The association of severe aortic stenosis (AS) with AD in different aortic regions has not been evaluated. Elderly subjects with severe AS and a cohort of patients without AS of similar age were studied. Proximal aortic cross-sectional-area changes during the cardiac cycle were determined using retrospective-ECG-gating on 128-detector row computed-tomography. Using oscillometric-brachial-blood-pressure measurements, the AD at the ascending-aorta (AA), proximal-descending-aorta (PDA) and distal-descending-aorta (DDA) was determined. Linear mixed effects modelling was used to determine the association of age and aortic stenosis on regional AD. 102 patients were evaluated: 36 AS patients (70-85 years), 24 AS patients (>85 years) and 42 patients without AS (9 patients DDA (1.1 ± 1.2 vs. 1.2 ± 0.8, P = 0.97). In patients without AS, AD decreased with age in all aortic regions (P < 0.001). The AA in patients <50 years were the most distensible compared to other aortic regions. There is regional variation in aortic distensibility with aging. Patients with aortic stenosis demonstrated regional differences in aortic distensibility with lower distensibility demonstrated in the proximal ascending aorta compared to an age-matched cohort. PMID:25855464

  2. When and how to replace the aortic root in type A aortic dissection.

    Science.gov (United States)

    Leshnower, Bradley G; Chen, Edward P

    2016-07-01

    Management of aortic root pathology during repair of acute type A aortic dissection (TAAD) requires a comprehensive evaluation of the patient's anatomy, demographics, comorbidities and physiologic status at the time of emergent operative intervention. Surgical options include conservative repair of the root (CRR) (with or without replacement of the aortic valve), replacement of the native valve and aortic root using a composite valve-conduit and valve sparing root replacement (VSRR). The primary objective of this review is to provide data for surgeons to aid in their decision-making process regarding management of the aortic root during repair of TAAD. No time or language restrictions were imposed and references of the selected studies were checked for additional relevant citations. Multiple retrospective reviews have demonstrated equivalent operative mortality between aortic root repair and replacement during TAAD. There is a higher incidence of aortic root reintervention with aortic root repair compared to aortic root replacement (ARR). Experienced, high-volume aortic centers have demonstrated the safety of VSRR in young, hemodynamically stable patients presenting with TAAD. In conclusion, aortic root repair can safely be performed in the vast majority of patients with TAAD. Despite the increased surgical complexity, ARR does not increase operative mortality and improves the freedom from root reintervention. VSRR can be performed in highly selected populations of patients with TAAD with durable mid-term valve function. PMID:27563551

  3. [Unicuspid Aortic Valve Stenosis Combined with Aortic Coarctation;Report of a Case].

    Science.gov (United States)

    Kubota, Takehiro; Wakasa, Satoru; Shingu, Yasushige; Matsui, Yoshiro

    2016-06-01

    Unicuspid aortic valve in an adult is extremely rare. In addition, 90% of the patients with aortic coarctation are reported to die before the age 50. A 60-year-old woman was admitted to our hospital for further examination of exertional dyspnea which had begun one year before. She had been under medical treatment for hypertension since early thirties, and had been also diagnosed with moderate aortic stenosis at 50 years of age. She was at 1st diagnosed with aortic coarctation combined with bicuspid aortic valve stenosis. The aortic valve was then found unicuspid and was replaced under cardiopulmonary bypass with perfusion to both the ascending aorta and the femoral artery. Repair of aortic coarctation was performed 3 months later through left thoracotomy without extracorporeal circulation due to the rich collateral circulation. She had no postoperative complications, and hypertension as well as ankle-brachial index improved to the normal levels. PMID:27246132

  4. Institutional Narcissism, Arrogant Organization Disorder and Interruptions in Organizational Learning

    Science.gov (United States)

    Godkin, Lynn; Allcorn, Seth

    2009-01-01

    Purpose: This article aims to present an alternative approach to diagnosing behavioral barriers to organizational learning. Design/methodology/approach: The paper juxtaposes interruptions in organizational learning with characteristics of narcissism and arrogant organization disorder. Psychoanalytically informed theory and DSM-IV criteria are…

  5. 14 CFR 91.1417 - CAMP: Mechanical interruption summary report.

    Science.gov (United States)

    2010-01-01

    ... Ownership Operations Program Management § 91.1417 CAMP: Mechanical interruption summary report. Each program manager who maintains program aircraft under a CAMP must mail or deliver, before the end of the 10th day... and engine and aircraft on which it was installed. Propeller featherings for training,...

  6. Children and Career Interruptions: The Family Gap in Denmark

    DEFF Research Database (Denmark)

    Gupta, Nabanita Datta; Smith, Nina

    2002-01-01

    Abstract: The effect of children and career interruptions on the family gap is analysed based on longitudinal data covering the years 1980-1995. The estimated model controls for unobserved time-constant heterogeneity. The results show that when controlling for unobserved heterogeneity, the negative...

  7. Realistically Rendering SoC Traffic Patterns with Interrupt Awareness

    DEFF Research Database (Denmark)

    Angiolini, Frederico; Mahadevan, Sharkar; Madsen, Jan;

    2005-01-01

    generate realistic test traffic. This paper presents a selection of applications using interrupt-based synchronization; a reference methodology to split such applications in execution subflows and to adjust the overall execution stream based upon hardware events; a reactive simulation device capable of...

  8. Percutaneous coronary intervention following repair of type B aortic dissection: a report of 8 cases

    Institute of Scientific and Technical Information of China (English)

    Quanmin Jing; Xiaozeng Wang; Yaling Han; Bo Luan; Geng Wang; Xiaojiang Liu; Hongxu Jin

    2008-01-01

    Objective Patients with aortic dissection have a significant incidence of coronary artery disease.The purpose of this study is to evaluate the safety and feasibility of percutaneous coronary stent in patients who have undergone endovascular stent,and to assess the effect of anti-coagulant and anti-platelet treatment on patients' thrombosis process.Methods From January 2005 to July 2007,8 patients who had undergone endovascular stent-graft during the past 1 to 7 months for type B aortic dissection repair,underwent percutaneous coronary intervention (PCI) because of coexisting coronary artery disease.Anti-coagulant and anti-platelet treatments were administrated after PCI according to the standard protocol.Patients were followed up for a mean period of 23 months.Clinical and false lumen status data were collected during the follow-up.Results PCI were technically successful in all 8 patients and no severe complications such as death,paraplegia,renal failure occurred during hospitalization.Complete false lumen thrombosis was observed in 5 patients and incomplete false lumen thrombosis in the remained 3 patients at the end of follow up.There were no major complications such as death,dissection rupture or aneurysm development occurred during the follow-up period.Conclusion Our data implied that PCI can be safely performed in patients with type B aortic dissection who have undergone endovascular stent-graft,without interrupting the thrombosis process.

  9. Loughrea Carmelite Friary, exterior west wall, door, jamb, arch and hood

    OpenAIRE

    O'Donovan, Danielle

    2003-01-01

    Jamb, arch and hood moulding of west door. Jamb and arch moulding, from intrados, comprises: quadrant, hollow chamfer, quadrant. Hood, from exterior to interior, comprises: broad frontal fillet, hollow chamfer, quadrant, hollow chamfer.

  10. Influence of space of double row piles on soil arching effect

    Directory of Open Access Journals (Sweden)

    Zhao bo

    2015-02-01

    Full Text Available FLAC3d software, based on continuous theory, is used to analysis influence of space of double row piles on soil arching effect. The result shows that different from single row pile, double row piles will produce soil arching effect at front pile and rear pile severally, this phenomenon is called multiple soil arching effect; the residual load of front of front row pile will increase,the soil arch zone and the soil arching effect will decrease with the continuous increase of double row pile spacing.At the same time the soil arching effect of rear pile decreases, while the soil arching effect of front pile increases and finally the soil arching effect between front pile and rear pile will be equal.

  11. The surgical importance of an axillary arch in sentinel node biopsy.

    LENUS (Irish Health Repository)

    Ridgway, P F

    2011-03-01

    When Carl Langer described the aberrant axillary arch in 1846 its relevance in sentinel node biopsy (SNB) surgery could not have been contemplated. The authors define an incidence and elucidate relevance of the arch in SNB of the axilla.

  12. The long-term costs of career interruptions.

    Science.gov (United States)

    Ketsche, Patricia G; Branscomb, Lisette

    2003-01-01

    This article is based on a study that analyzed the long-term salary implications of career choices made by healthcare administrators. The study used a cohort of graduates from a single health administration program; these individuals had comparable levels of human capital at the outset of their careers. We estimated the effect of periods of part-time employment and job interruptions--voluntary and involuntary--on long-term salary progression. We also estimated the impact of other career choices, such as membership in a professional organization or the decision to relocate. After controlling for these choices, we estimated the residual effect of gender on salary. We found that voluntary interruptions had a greater effect on long-term salary growth than did involuntary interruptions of the same length or periods of part-time employment. Individuals evaluating options for balancing career and family constraints should understand the long-term cost of choosing a career interruption rather than part-time employment during periods of heightened responsibilities outside the workplace. Healthcare administrators should also be educated about the positive association between professional memberships and career advancement to make informed decisions about participation in such organizations. Surprisingly, after controlling for all choice variables, gender had no measurable effect on long-term salary growth. Half of those who indicated a voluntary interruption for dependent care reasons preferred part-time or flexible-hour work if it had been available. These results suggest that a pool of healthcare administrators might compete for positions if more part-time opportunities were available. PMID:12592867

  13. Magnetic Resonance Imaging of Thoracic Aortic Dissections

    OpenAIRE

    Sax, Steven L.

    1990-01-01

    Magnetic resonance imaging is an excellent noninvasive method for evaluating thoracic aortic dissections. A variety of magnetic resonance scans of aortic dissections are shown, documenting the ability of magnetic resonance to image the true lumen, the false channel, and the intimal septum. Detail is provided on magnetic resonance imaging techniques and findings. (Texas Heart Institute Journal 1990;17:262-70)

  14. Rock-Arch Instability Characteristics of the Sandstone Plate under Different Loading Conditions

    OpenAIRE

    Shuren Wang; Paul Hagan; Baowen Hu; Kanchana Gamage; Cheng Yan; Dianfu Xu

    2014-01-01

    Under the concentrated loading and the uniform loading, the tests on the brittle fracture and the hinged arching until the rock-arch instability of the sandstone plate were conducted using self-developed loading device, and the sensitivity of influent factors on the rock-arch failure was analyzed by numerical test based on the particle flow code (PFC). The results showed that sandstone plate instability presented four phases: small deformation elastic stage, brittle fracture arching stage, ...

  15. A secondary analysis to determine variations of dental arch measurements with age and gender among Ugandans

    OpenAIRE

    Okori, Hilda; Apolot, Pricilla S.; Mwaka, Erisa; Tumusiime, Gerald; Buwembo, William; Munabi, Ian G.

    2015-01-01

    Background Dental arch dimensions are useful in dental practice and in forensic odontology. Local data is essential because ethnic differences exist in dental arch dimensions. In the Ugandan population no studies had been done on dental arch dimensions. The objective of the current study was to determine the variations in dental arch dimensions with age and gender in a sample of dental casts from the Ugandan population. Method This was a secondary analysis of dental casts previously prepared ...

  16. Visceral hybrid reconstruction of thoracoabdominal aortic aneurysm after open repair of type a aortic dissection by the Bentall procedure with the elephant trunk technique: A case report

    Directory of Open Access Journals (Sweden)

    Marjanović Ivan

    2014-01-01

    Full Text Available Introduction. Reconstruction of chronic type B dissection and thoracoabdominal aortic aneurysm (TAAA remaining after the emergency reconstruction of the ascending thoracic aorta and aortic arch for acute type A dissection represents one of the major surgical challenges. Complications of chronic type B dissection are aneurysmal formation and rupture of an aortic aneurysm with a high mortality rate. We presented a case of visceral hybrid reconstruction of TAAA secondary to chronic dissection type B after the Bentall procedure with the elephant trunk technique due to acute type A aortic dissection in a high-risk patient. Case report. A 62 year-old woman was admitted to our institution for reconstruction of Crawford type I TAAA secondary to chronic dissection. The patient had had an acute type A aortic dissection 3 years before and undergone reconstruction by the Bentall procedure with the elephant trunk technique with valve replacement. On admission the patient had coronary artery disease (myocardial infarction, two times in the past 3 years, congestive heart disease with ejection fraction of 25% and chronic obstructive pulmonary disease. On computed tomography (CT of the aorta TAAA was revealed with a maximum diameter of 93 mm in the descending thoracic aorta secondary to chronic dissection. All the visceral arteries originated from the true lumen with exception of the celiac artery (CA, and the end of chronic dissection was below the origin of the superior mesenteric artery (SMA. The patient was operated on using surgical visceral reconstruction of the SMA, CA and the right renal artery (RRA as the first procedure. Postoperative course was without complications. Endovascular TAAA reconstruction was performed as the second procedure one month later, when the elephant trunk was used as the proximal landing zone for the endograft, and distal landing zone was the level of origin of the RRA. Postoperatively, the patient had no neurological deficit and

  17. Acute aortic dissection in pregnant women.

    Science.gov (United States)

    Yang, Zhaohua; Yang, Shouguo; Wang, Fangshun; Wang, Chunsheng

    2016-05-01

    Acute aortic dissection occurring during pregnancy represents a lethal risk to both the mother and fetus. Management of parturient with acute aortic dissection is complex. We report our experience of two pregnancies with type A acute aortic dissection. One patient is a 31-year-old pregnant woman (33rd gestational week) with a bicuspid aortic valve and the other is a 32-year-old pregnant woman (30th gestational week) with the Marfan syndrome. In both cases, a combined emergency operation consisting of Cesarean section, total hysterectomy prior to corrective surgery for aortic dissection was successfully performed within a relatively short period of time after the onset. Both patients' postoperative recovery was uneventful, and we achieved a favorable maternal and fetal outcome. PMID:25085319

  18. Transcatheter aortic valve replacement in elderly patients

    Institute of Scientific and Technical Information of China (English)

    Dimytri Siqueira; Alexandre Abizaid; Magaly Arrais J.; Eduardo Sousa

    2012-01-01

    Aortic stenosis is the most common native valve disease, affecting up to 5% of the elderly population. Surgical aortic valve replacement reduces symptoms and improves survival, and is the definitive therapy in patients with symptomatic severe aortic stenosis. However, despite the good results of classic surgery, risk is markedly increased in elderly patients with co-morbidities. Transcatheter aortic valve replacement (TAVR) allows implantation of a prosthetic heart valve within the diseased native aortic valve without the need for open heart surgery and cardiopulmonary bypass, offering a new therapeutic option to elderly patients considered at high surgical risk or with contraindications to surgery. To date, several multicenter registries and a randomized trial have confirmed the safety and efficacy of TAVR in those patients. In this chapter, we review the background and clinical applications of TAVR in elderly patients.

  19. Comparison of arch forms between Korean and North American white populations.

    Science.gov (United States)

    Kook, Yoon-Ah; Nojima, Kunihiko; Moon, Hong-Beom; McLaughlin, Richard P; Sinclair, Peter M

    2004-12-01

    The purpose of this study was to evaluate morphologic differences in the mandibular arches of Korean and North American white subjects. The subjects were grouped according to arch form (tapered, ovoid, and square) to compare the frequency distribution of the 3 arch forms between the ethnic groups in each Angle classification. The sample included 160 white (60 Class I, 50 Class II, and 50 Class III) and 368 Korean (114 Class I, 119 Class II, and 135 Class III) subjects. The most facial portion of 13 proximal contact areas was digitized from photocopied images of the mandibular dental arches. Clinical bracket points were calculated for each tooth according to mandibular tooth thickness data, and then 4 linear and 2 proportional measurements were taken. Arch width was statistically significantly smaller in the white group than in the Korean group, but arch depth did not differ. In the Korean group, the most frequent arch form was square, whereas in the white group the tapered arch form predominated. When the subjects were regrouped by arch form, the Korean arches had a tendency to be larger and deeper than the white arches within each of the 3 arch form types. PMID:15592215

  20. Measuring medial longitudinal arch deformation during gait. A reliability study

    DEFF Research Database (Denmark)

    Bencke, Jesper; Christiansen, Ditte; Jensen, Anne Kathrine Bendrup; Okholm, Anne; Sonne-Holm, Stig; Bandholm, Thomas

    2012-01-01

    Clinical evaluation of medial longitudinal arch deformation (MLAD) during walking gait is often estimated from static measures of e.g. navicular drop (ND) measured during quiet standing. The aim of the present study was to test the reliability of a new three-dimensional method of measuring the MLAD...

  1. Visualization of soil arching in flexible piled embankments

    Indian Academy of Sciences (India)

    Tuğba Eskışar

    2015-10-01

    Piled embankments rely on soil arching, but, when geogrid reinforcements are used, membrane action within the reinforcement contributes to load distribution. The arching of soil in unreinforced and reinforced piled embankments is evaluated in this study. A small-scale test apparatus is used to model the settlement up to 5 mm in an embankment with four pile elements. Visual inspection of the soil settlement and soil-reinforcement interaction is important to explain the mechanism of arching. In this study, X-ray Computed Tomography (CT) method was used as a non-destructive technique. The arching of soil between the piles was observed in the case of rigid piles and in the case of flexible piles with grid type of reinforcement. The load carrying capacity increased up to 33% in the case of geogrid reinforcement, and the differential settlement decreased around 35%, proving the efficiency of piled embankments with geogrid reinforcements. It is also shown that, using X-ray CT method and visualization techniques provides a better understanding of soil behavior in a reinforced embankment with the flexible pile foundation system.

  2. Ennis Franciscan Friary, tomb niche under tower, jamb and arch

    OpenAIRE

    O'Donovan, Danielle

    2005-01-01

    Sketch of jamb and arch, moulding comprises from intrados out: hollow chamfer, hollow chamfer, hollow chamfer, right-angled rebate, hollow chamfer, hollow chamfer. One of a number of Flamboyant tombs found on or west of the Shannon. The Ennis example is closest in design to that in the north chancel wall at Athenry Dominican Friary.

  3. Portumna Dominican Friary, west door, jamb, arch and hood

    OpenAIRE

    O'Donovan, Danielle

    2001-01-01

    West door jamb, arch and hood. Moulding from intrados comprises: hollow, fillet, roll-and-fillet, fillet, hollow. The hood, which is placed far from the jamb, comprises from outer to inner face: frontal fillet, hollow, right-angled rebate, hollow.

  4. 3D Stretchable Arch Ribbon Array Fabricated via Grayscale Lithography

    Science.gov (United States)

    Pang, Yu; Shu, Yi; Shavezipur, Mohammad; Wang, Xuefeng; Mohammad, Mohammad Ali; Yang, Yi; Zhao, Haiming; Deng, Ningqin; Maboudian, Roya; Ren, Tian-Ling

    2016-06-01

    Microstructures with flexible and stretchable properties display tremendous potential applications including integrated systems, wearable devices and bio-sensor electronics. Hence, it is essential to develop an effective method for fabricating curvilinear and flexural microstructures. Despite significant advances in 2D stretchable inorganic structures, large scale fabrication of unique 3D microstructures at a low cost remains challenging. Here, we demonstrate that the 3D microstructures can be achieved by grayscale lithography to produce a curved photoresist (PR) template, where the PR acts as sacrificial layer to form wavelike arched structures. Using plasma-enhanced chemical vapor deposition (PECVD) process at low temperature, the curved PR topography can be transferred to the silicon dioxide layer. Subsequently, plasma etching can be used to fabricate the arched stripe arrays. The wavelike silicon dioxide arch microstructure exhibits Young modulus and fracture strength of 52 GPa and 300 MPa, respectively. The model of stress distribution inside the microstructure was also established, which compares well with the experimental results. This approach of fabricating a wavelike arch structure may become a promising route to produce a variety of stretchable sensors, actuators and circuits, thus providing unique opportunities for emerging classes of robust 3D integrated systems.

  5. Arch Venture Partners' investment considerations for CBRNE products and opportunities

    Science.gov (United States)

    Crandell, K.; Lazarus, S.; Gardner, P. J.

    2008-04-01

    ARCH is interested in building leading, highly-valued companies from leading research. Toward that end we value innovations created by the leading researchers in the world, many of which are funded to solve critical scientific challenges including those in the instrumentation and CBRNE area. The most important CBRNE innovations we have seen at ARCH are breakthroughs involving significant unaddressed technology risk and have the potential for broad proprietary intellectual property as a result. The model ARCH has evolved in instrumentation is to look for a breakthrough innovation, with strong intellectual property and continue to strengthen the patent estate through the life of the company. ARCH looks to build companies around leading interdisciplinary scientific and engineering teams, and we favor platform technology that can be applied to multiple market applications both commercial and government. As part of a strategy to build a great company, addressing important CBRNE challenges can help a company strengthen its technical team and its IP estate. This supports a focus on early low volume markets on the way toward addressing a fuller portfolio of applications. Experienced Venture Capitalists can help this process by identifying important executive talent, partners and applications, offering financial syndication strength, and helping shape the company's strategy to maximize the ultimate value realized.

  6. UNILATERAL INCOMPLETE SUPERFICIAL PALMAR ARCH: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Subhankar Chakraborty

    2015-12-01

    Full Text Available The functional importance of hand is revealed by its rich vascularity contributed by superficial and deep palmar arches (SPA and DPA.Superficial palmar arch is located superficial to flexor tendons, and deep palmar arch deep to lumbrical muscles. Variations are found more often in SPA than DPA, later being more or less constant. During routine undergraduate dissection, we observed, unilateral incomplete SPA being formed by superficial palmar branches of ulnar and radial artery in the right hand of a male cadaver. These two arteries remained independent without anastomosis forming incomplete arch (SPA.The superficial branch of ulnar artery entered hand superficial to flexor retinaculum and supplied middle, ring and little finger by three branches. The superficial branch of radial artery via its two branches supplied index finger and thumb. Classical SPA formation was seen on left side. The presence of an incomplete SPA as in this case is a potential danger in RA harvesting for CABG.Variations in SPA play a pivotal role in microvascular surgical procedures of hand, RAinterventions and arterial graft applications.

  7. Transcatheter Aortic Valve Replacement in Bicuspid Aortic Valve Disease

    DEFF Research Database (Denmark)

    Mylotte, Darren; Lefevre, Thierry; Søndergaard, Lars;

    2014-01-01

    .7%; type 1 BAV was 68.3%; and type 2 BAV was 5.0%. Multislice computed tomography (MSCT)-based TAV sizing was used in 63.5% of patients (77.1% balloon-expandable THV vs. 56.0% self-expandable THV, p = 0.02). Procedural mortality was 3.6%, with TAV embolization in 2.2% and conversion to surgery in 2.2%. The......BACKGROUND: Limited information exists describing the results of transcatheter aortic valve (TAV) replacement in patients with bicuspid aortic valve (BAV) disease (TAV-in-BAV). OBJECTIVES: This study sought to evaluate clinical outcomes of a large cohort of patients undergoing TAV-in-BAV. METHODS......: We retrospectively collected baseline characteristics, procedural data, and clinical follow-up findings from 12 centers in Europe and Canada that had performed TAV-in-BAV. RESULTS: A total of 139 patients underwent TAV-in-BAV with the balloon-expandable transcatheter heart valve (THV) (n = 48) or...

  8. Screening for Abdominal Aortic Aneurysm

    OpenAIRE

    Linné, Anneli

    2014-01-01

    Abdominal Aortic Aneurysm (AAA) is a common disease with a prevalence of 1.5-2.0% in 65-year old men in Sweden. The risk of having AAA is increased with smoking, high age, family history of AAA and cardiovascular disease. Women have a lower prevalence (0.5%) and develop AAA later in life. An AAA seldom gives any symptom prior to rupture. Untreated rupture is associated with 100% mortality, while surgically treated rupture is associated with 25-70% mortality. Prophylactic sur...

  9. Bicuspid Aortic Valve Disease and Ascending Aortic Aneurysms: Gaps in Knowledge

    Directory of Open Access Journals (Sweden)

    Katie L. Losenno

    2012-01-01

    Full Text Available The bicuspid aortic valve is the most common congenital cardiac anomaly in developed nations. The abnormal bicuspid morphology of the aortic valve results in valvular dysfunction and subsequent hemodynamic derangements. However, the clinical presentation of bicuspid aortic valve disease remains quite heterogeneous with patients presenting from infancy to late adulthood with variable degrees of valvular stenosis and insufficiency and associated abnormalities including aortic coarctation, hypoplastic left heart structures, and ascending aortic dilatation. Emerging evidence suggests that the heterogeneous presentation of bicuspid aortic valve phenotypes may be a more complex matter related to congenital, genetic, and/or connective tissue abnormalities. Optimal management of patients with BAV disease and associated ascending aortic aneurysms often requires a thoughtful approach, carefully assessing various risk factors of the aortic valve and the aorta and discerning individual indications for ongoing surveillance, medical management, and operative intervention. We review current concepts of anatomic classification, pathophysiology, natural history, and clinical management of bicuspid aortic valve disease with associated ascending aortic aneurysms.

  10. CREATIVITY METHODS IN TEACHING THE ARCH-DESIGN STUDIO

    Directory of Open Access Journals (Sweden)

    EIGBEONAN Andrew B.

    2013-01-01

    Full Text Available The aim of this paper is to search and find methods of fostering creativity or ideas relating to creativity in teaching the arch-design studio. Teaching creativity through its methods will be making the students grounded in designing with creativity ideas and therefore we can have professionals that design and build with satisfaction, safety and complementary. It means we can have real buildings and places that satisfy our clients, the society and in harmony with the environment. Although there are similarities in the curricula of training architects all over the world, but educators go about it in their own convenient and suitable ways and styles. The ideas of creativity have been part of architecture from the onset, but are not deligently applied and also not formally incorporated in the curricula of training. The topic is also very relevant and timely as arch-educators and other stakeholders are of the opinion that something has to be done to improve the ways and methods of training architects, especially the teaching of the arch-design studio with regards to creativity. Through exploration of literature and interviews (physical and telephone call this paper finds methods of stimulating creativity ideas in the teaching of arch-design studio. Some of the methods of motivating creativity found in teaching the arch-design studio are: analogy, metaphors, biomimicry, brainstorming, attribute listing, mental map, TRIZ, restrictions, charrette, browsing, excursions, focus groups, other peoples viewpoints, using crazy ideas, using experts, visualizing a goal, working with dreams and images and giving students design tools such as drawings CAD and model making.

  11. Arch of opportunity : Peace country operators expand, undeterred by vandalism

    Energy Technology Data Exchange (ETDEWEB)

    Jaremko, D.

    2006-01-15

    Activity levels in the Peace River Arch (Para) area of northwest Alberta are continuing despite reports of oilfield vandalism. Devon Energy is continuing its development of the 2 trillion cubic feet of original gas in place in the Dunevegan field and is also planning activities in the Triassic halfway formation in the southwest Arch. At depths between 2500 and 2800 metres, initial gas-flow rates from sour wells range from 2 to 5 million cubic feet per day. Devon is also targeting medium gravity oil in the northwest arch, and light gravity oil in the eastern part of the PRA. EnCana is expected to exit 2005 with production of 350 MMcf of gas equivalent per day from the PRA after having drilled more than 200 wells. A number of juniors are also expressing interest in the area. Galleon Energy has increased its focus in the PRA to 9000 barrels of oil equivalent per day and has separated its strategy into 4 areas: multi-zone drilling; a tight gas resource play; light, sweet crude development; and deep exploration in the arch's southwest corner. Talisman Energy has 4 rigs working in the area and plans to spend $168 million in the Grande Prairie area, with plans to drill 85 wells. Details of the Peace Arch Operators Group were provided, who meet with regulatory bodies like the Alberta Energy and Utilities Board (EUB), Alberta Environment, regional governments and the RCMP. A rash of oilfield sabotage in the late 1990s led to notoriety for the area. In October 2005, more sabotage occurred near a drilling rig. Satellite connected, web-interface cameras were installed by Anadarko, the rig's owner. Most people in the area are in favour of development, since oil and gas activity in the area will lead to economic benefits for the region. 3 figs.

  12. Three-dimensional stiffness of the carpal arch.

    Science.gov (United States)

    Gabra, Joseph N; Li, Zong-Ming

    2016-01-01

    The carpal arch of the wrist is formed by irregularly shaped carpal bones interconnected by numerous ligaments, resulting in complex structural mechanics. The purpose of this study was to determine the three-dimensional stiffness characteristics of the carpal arch using displacement perturbations. It was hypothesized that the carpal arch would exhibit an anisotropic stiffness behavior with principal directions that are oblique to the conventional anatomical axes. Eight (n=8) cadavers were used in this study. For each specimen, the hamate was fixed to a custom stationary apparatus. An instrumented robot arm applied three-dimensional displacement perturbations to the ridge of trapezium and corresponding reaction forces were collected. The displacement-force data were used to determine a three-dimensional stiffness matrix using least squares fitting. Eigendecomposition of the stiffness matrix was used to identify the magnitudes and directions of the principal stiffness components. The carpal arch structure exhibited anisotropic stiffness behaviors with a maximum principal stiffness of 16.4±4.6N/mm that was significantly larger than the other principal components of 3.1±0.9 and 2.6±0.5N/mm (p<0.001). The principal direction of the maximum stiffness was pronated within the cross section of the carpal tunnel which is accounted for by the stiff transverse ligaments that tightly bind distal carpal arch. The minimal principal stiffness is attributed to the less constraining articulation between the trapezium and scaphoid. This study provides advanced characterization of the wrist׳s three-dimensional structural stiffness for improved insight into wrist biomechanics, stability, and function. PMID:26617368

  13. Giant Thoracic Aneurysm Following Valve Replacement for Bicuspid Aortic Valve.

    Science.gov (United States)

    Tran, Cao; Ul Haq, Ehtesham; Nguyen, Ngoc; Omar, Bassam

    2015-01-01

    Bicuspid aortic valve is a common congenital anomaly associated with aortopathy, which can cause aortic root dilatation, necessitating regular screening if the aortic root is > 4.0 cm. Despite the low absolute incidence of aortic complications associated with bicuspid aortic valve in the general population, the consequences of such complications for an individual patient can be devastating. Herein we propose a balanced algorithm that incorporates recommendations from the three major guidelines for follow-up imaging of the aortic root and ascending thoracic aorta in patients with a bicuspid aortic valve, maintaining the current recommendations with regard to surgical thresholds. PMID:26827748

  14. Quadricuspid aortic valve with ruptured sinus of Valsalva.

    Science.gov (United States)

    Akerem Khan, Shamruz Khan; Tamin, Syahidah Syed; Burkhart, Harold M; Araoz, Philip A; Young, Phillip M

    2013-02-01

    We present a case of a 24-year-old woman who was diagnosed with quadricuspid aortic valve with ruptured sinus of Valsalva. Quadricuspid aortic valve is a rare congenital cardiac anomaly. The recognition of quadricuspid aortic valve has clinical significance as it causes aortic valve dysfunction, and is often associated with other congenital cardiac abnormalities. We showed the important role of multimodality imaging in diagnosing a quadricuspid aortic valve associated with ruptured sinus of Valsalva. PMID:22874066

  15. Imaging of thoracic aortic dissection

    International Nuclear Information System (INIS)

    Acute thoracic aortic dissection has a high mortality rate if untreated, so the diagnosis must be rapidly made. Multiple imaging techniques are often used. This retrospective study from 1988 to 1993 assesses the usefulness in diagnosis of chest X-rays, computed tomography (CT) scanning, aortography, magnetic resonance imaging (MRI), trans-thoracic (TTE) and trans-oesophageal (TOE) echocardiography. Forty-two patients with a final clinical diagnosis of dissection were studied. The diagnosis was confirmed in 16 (13 at surgery and three at autopsy). Three died with dissection given as the only cause of death. Chest X-ray abnormalities were seen in all 19 patients with surgery or death from dissection, with a widened mediastinum and/or dilated aorta being present in 17. In the group of 16 patients with surgery or autopsy proof, CT scans found dissections in 9 out of 12 patients studied and correctly classified the type in only five. Aortography was preformed in five, with accurate depiction of dissection and type in all. TTE found dissections in three of eight patients imaged by this method. MRI and TOE were preformed each on two patients, with accurate depiction of dissection and type in each. Because of the relatively low sensitivity of CT scanning in defining aortic dissections Westmead Hospital is currently assessing the use of TOE as the prime imaging modality prior to surgical intervention. 17 refs., 4 tabs., 4 figs

  16. ARCH AS AN ELEMENT OF RELIGIOUS ARCHITECTURE IN CHRISTIAN AND ISLAMIC ARCHITECTURE

    OpenAIRE

    Ibragimov, I. A.

    2011-01-01

    Problem statement. The forms of Christian and Islamic arches are compared in the context of re-ligious essence of Christianity and Islam. The form of arch is considered from two positions. The first position is the character of the form of the arch; the second position is the character of dynamic vector of the arch in visual perception.Results and conclusions. The character of the form of the arch is considered for the first time in the context of orientation of man in religious and notional ...

  17. Correlation between arch form and facial form: A cross sectional study

    Directory of Open Access Journals (Sweden)

    Sanjna Nayar

    2015-01-01

    Full Text Available Arch form is a key determinant in teeth position. Teeth selection and placement must be based on the functional and esthetic needs of the patient. Keeping in mind, the biomechanics involved with the prosthesis. The aim of the study was to evaluate the correlation between arch form and facial form. About 40 individuals in the age group of 20-25 years were involved in the study. The arch form and facial form were analyzed statistically to check for any correlation. It was found that, 63.63% of leptoprosophic individuals had squarish arch form while, 54.6% of mesoprosophic faces had ovoid arch form.

  18. Interrupted thermal desorption of TiH2

    International Nuclear Information System (INIS)

    Structural changes of commercial TiH2 were studied using interrupted temperature desorption spectroscopy and X-ray diffraction techniques to understand the mechanism of its degradation under non-equilibrium conditions. Rapid cooling on different stages of temperature-programmed heating allowed to study the intermediate phase compositions that evolve upon cooling from the high-temperature phase βTi(H). The phase transformation sequence is described as a number of consecutive reactions corresponding to the observed desorption peaks. Phases δTiH2-x, γTiH, and the solid solution αTi(H) were found to be intermediates in the εTiH2 → αTi transformation when the latter is interrupted. Additional evidence for the thermodynamic stability of γTiH is given.

  19. Compensability index for compensation radiotherapy after treatment interruptions

    Directory of Open Access Journals (Sweden)

    Putora Paul

    2012-12-01

    Full Text Available Abstract Background The goal of our work was to develop a simple method to evaluate a compensation treatment after unplanned treatment interruptions with respect to their tumour- and normal tissue effect. Methods We developed a software tool in java programming language based on existing recommendations to compensate for treatment interruptions. In order to express and visualize the deviations from the originally planned tumour and normal tissue effects we defined the compensability index. Results The compensability index represents an evaluation of the suitability of compensatory radiotherapy in a single number based on the number of days used for compensation and the preference of preserving the originally planned tumour effect or not exceeding the originally planned normal tissue effect. An automated tool provides a method for quick evaluation of compensation treatments. Conclusions The compensability index calculation may serve as a decision support system based on existing and established recommendations.

  20. Business interruption exposures in the context of the North Sea

    International Nuclear Information System (INIS)

    Piper Alpha and the Phillips Petroleum loss in Pasadena have highlighted the value of business interruption insurance, as an integral part of the exposures that should be seriously considered for protection by the risk manager of a company actively involved in the production of oil and gas. Lower oil prices which appear to be the most likely scenario over the next few years, make it imperative that exposures to loss are carefully managed. Business interruption insurance has traditionally been one area which the major oil companies have tended to ignore, on the basis that the loss of a single platform would not be expected to have a serious impact on the balance sheet of the parent and the share price. (Author)

  1. Compensability index for compensation radiotherapy after treatment interruptions

    International Nuclear Information System (INIS)

    The goal of our work was to develop a simple method to evaluate a compensation treatment after unplanned treatment interruptions with respect to their tumour- and normal tissue effect. We developed a software tool in java programming language based on existing recommendations to compensate for treatment interruptions. In order to express and visualize the deviations from the originally planned tumour and normal tissue effects we defined the compensability index. The compensability index represents an evaluation of the suitability of compensatory radiotherapy in a single number based on the number of days used for compensation and the preference of preserving the originally planned tumour effect or not exceeding the originally planned normal tissue effect. An automated tool provides a method for quick evaluation of compensation treatments. The compensability index calculation may serve as a decision support system based on existing and established recommendations

  2. Treatment interruptions: Statistics, causes and management in service radiotherapy

    International Nuclear Information System (INIS)

    Despite the clinical maximum administer the prescribed dose at a given time, treatment interruptions are unavoidable in practice. In tumors quickly reproduce no evidence that the prolongation thereof entails loss of tumor control. It has tracked two of these conditions: squamous cell cancer of the head and neck (SCCHN) and lung cancer (NSCLC) over 2011 and 2012 to evaluate both the number of stops treatment as the reason for them and its management. (Author)

  3. Interrupted searches in the BBMCSFilter context for MINLP problems

    Science.gov (United States)

    Fernandes, Florbela P.; Costa, M. Fernanda P.; Fernandes, Edite M. G. P.

    2016-06-01

    The BBMCSFilter method was developed to solve mixed integer nonlinear programming problems. This kind of problems have integer and continuous variables and they appear very frequently in process engineering problems. The objective of this work is to analyze the performance of the method when the coordinate searches are interrupted in the context of the multistart strategy. From the numerical experiments, we observed a reduction on the number of function evaluations and on the CPU time.

  4. The Interrupted Power Law and The Size of Shadow Banking

    OpenAIRE

    Davide Fiaschi; Imre Kondor; Matteo Marsili; Valerio Volpati

    2013-01-01

    Using public data (Forbes Global 2000) we show that the asset sizes for the largest global firms follow a Pareto distribution in an intermediate range, that is ``interrupted'' by a sharp cut-off in its upper tail, where it is totally dominated by financial firms. This flattening of the distribution contrasts with a large body of empirical literature which finds a Pareto distribution for firm sizes both across countries and over time. Pareto distributions are generally traced back to a mechani...

  5. Valvular Aortic Stenosis: A Proteomic Insight

    Directory of Open Access Journals (Sweden)

    Fernando Vivanco

    2010-02-01

    Full Text Available Calcified aortic valve disease is a slowly progressive disorder that ranges from mild valve thickening with no obstruction of blood flow, known as aortic sclerosis, to severe calcification with impaired leaflet motion or aortic stenosis. In the present work we describe a rapid, reproducible and effective method to carry out proteomic analysis of stenotic human valves by conventional 2-DE and 2D-DIGE, minimizing the interference due to high calcium concentrations. Furthermore, the protocol permits the aortic stenosis proteome to be analysed, advancing our knowledge in this area. Summary: Until recently, aortic stenosis (AS was considered a passive process secondary to calcium deposition in the aortic valves. However, it has recently been highlighted that the risk factors associated with the development of calcified AS in the elderly are similar to those of coronary artery disease. Furthermore, degenerative AS shares histological characteristics with atherosclerotic plaques, leading to the suggestion that calcified aortic valve disease is a chronic inflammatory process similar to atherosclerosis. Nevertheless, certain data does not fit with this theory making it necessary to further study this pathology. The aim of this study is to develop an effective protein extraction protocol for aortic stenosis valves such that proteomic analyses can be performed on these structures. In the present work we have defined a rapid, reproducible and effective method to extract proteins and that is compatible with 2-DE, 2D-DIGE and MS techniques. Defining the protein profile of this tissue is an important and challenging task that will help to understand the mechanisms of physiological/pathological processes in aortic stenosis valves.

  6. Dental arch form in three Pacific populations: a comparison with Japanese and Australian aboriginal samples.

    Science.gov (United States)

    Kasai, K; Kanazawa, E; Aboshi, H; Richards, L C; Matsuno, M

    1997-12-01

    The purpose of this study was to provide information about arch shape variations among South Pacific populations. The application of Fourier transforms, Y(phi i) = ao/2 + sigma (aicos phi i + bisin phi i) was used to separate two components of variation; size and shape. Dental arch size can be described by one coefficient (ao), while the shape can be summarized by the first three harmonics (amp1-3) in the Fourier series. The materials used in this study were dental casts of South Pacific populations (Fiji, Western Samoa and Kiribati), Australian Aboriginals and Japanese. Fijians, Western Samoans and Kiribati people have larger upper and lower dental arches than that of Japanese. These populations were separated by the arch size and first Fourier amplitudes which showed the arch depth/width ratio. The Fijian upper and lower dental arches were significantly larger than those found in other populations and was characterized by a wide posterior arch breadth. The Western Samoan and Kiribati arch shape was more similar to the Japanese arch shape than the Fijian. Distribution patterns of arch shape characteristics in these populations showed the same tendencies in the upper and lower arches. PMID:9476433

  7. Hand Sewn single layer serosubmucoasal interrupted vs. continuous intestinal anastomosis

    International Nuclear Information System (INIS)

    : To compare the effectiveness of single layer serosubmucosal (extramucosal) continuous / interrupted intestinal anastomosis. Design: Prospective comparative study. Setting: Department of surgery Nawabshah Medical College Hospital Nawabshah and GMMC Hospital sukkur. Study Period: From January 2007 to January 2012. For period of 6 year. Subject: Total of 174 patients undergoing construction of intestinal anastomoses. Evaluation: For anastomotic leakage. Results: Overall 13 (7.47%) patients developed anastomotic leakage, 3 (1.72%) patients had+sub-clinical and 10 (5.74%) clinical (obviously) anastomoitc leakage. 7 (8.04%) patients and 6 (6.89%) developed anastomotic leakage, in group ''A'' and ''8'' respectively. Conclusion: Anastomotic failure is a reflection of operating skills, decision making of surgeon and postoperative care. There is no significant difference in anastomotic dehiscence between continuous and interrupted single layer serosubmucosal technique if patients selection is proper, however interrupted method is comparatively easy to construct in less accessible site. (author)

  8. Factors associated with treatment interruption for hepatitis C

    Directory of Open Access Journals (Sweden)

    Luciana Oliveira de Rezende Melo

    2014-02-01

    Full Text Available Objective To evaluate risk factors related to Hepatitis C treatment interruption. Methods Retrospective cohort of patients seen at the Hepatology outpatient service at Hospital dos Servidores do Estado do Rio de Janeiro, from 2001 to 2009. The factors investigated were: age, gender, genotype, degree of liver fibrosis, type of treatment, treatment time in weeks, diabetes mellitus, and systemic hypertension. Survival curves and bivariate and multivariate Cox regression models were used in the analyses. Results The risk of treatment interruption is six times greater in patients with more advanced degrees of liver fibrosis (F4 compared to those with less advanced degree (F2 in the period from 0 to 24 weeks of treatment. Genotype was found to be an important factor to explain therapy cessation after 24 weeks of treatment – the risk of stopping treatment was 2.5 times higher in patients with genotype 3 than in those with genotype 1. Conclusion Degree of liver fibrosis and genotype proved to be the main risk factors associated to treatment interruption.

  9. Interruption Phenomenon in Intermediate-Frequency Vacuum Arc

    Science.gov (United States)

    Jiang, Yuan; Wu, Jianwen

    2016-03-01

    In the condition of the 3 mm gap, experiments for 360 Hz intermediate-frequency vacuum arc are carried out in interrupters with the diameters being 41 mm and with the contact materials being CuCr50 and Cu-W-WC alloy respectively. The results indicate that the contacts material is closely related to the breaking capacity of the vacuum interrupters and characteristics of an intermediate-frequency vacuum arc. For contacts with the same diameter, the breaking capacity of CuCr50 is better than that of Cu-W-WC. When the current fails to be interrupted, the arcs overflow the gap and present irregular performances in the first half wave. Consequently a voltage spike appears. More macroscopic metal droplets can be seen in the arc column between CuCr50 contacts because of the lower melting point. It is observed that the droplet emission is much more severe during arc reignition than that in the first half wave. It is much more conspicuous that the high frequency arc voltage noises appear in Cu-W-WC contacts when the vacuum arcs reignite, for higher temperature and stronger electronic emission ability of Cu-W-WC contacts. supported by National Natural Science Foundation of China (No. 51377007), Specialized Research Fund for the Doctoral Program of Higher Education of China (No. 20131102130006), and Fundamental Research Funds for the Central Universities of China

  10. Open surgical repair of abdominal aortic aneurysm: Proximal aortic control by endoaortic balloon - A novel approach

    OpenAIRE

    Balakrishnan Soundaravalli; Palaniappan, M.; Rajani Sundar; Chandrasekar, P.

    2012-01-01

    Patients with infrarenal abdominal aortic aneurysm with unfavorable anatomy for endovascular aneurysm repair have to undergo open surgical repair. Open surgery has its own morbidity in terms of proximal clamping and declamping, bleeding and prolonged hospital stay and mortality. We present two such patients with juxtarenal abdominal aortic aneurysm who underwent open surgical repair. The proximal aortic control during open surgical repair of the aneurysm was achieved by endoaortic balloon occ...

  11. Open surgical repair of abdominal aortic aneurysm: Proximal aortic control by endoaortic balloon - A novel approach

    Directory of Open Access Journals (Sweden)

    Balakrishnan Soundaravalli

    2012-01-01

    Full Text Available Patients with infrarenal abdominal aortic aneurysm with unfavorable anatomy for endovascular aneurysm repair have to undergo open surgical repair. Open surgery has its own morbidity in terms of proximal clamping and declamping, bleeding and prolonged hospital stay and mortality. We present two such patients with juxtarenal abdominal aortic aneurysm who underwent open surgical repair. The proximal aortic control during open surgical repair of the aneurysm was achieved by endoaortic balloon occlusion technique.

  12. First transcatheter aortic valve implantation for severe pure aortic regurgitation in Asia

    OpenAIRE

    Chiam, Paul Toon-Lim; Ewe, See Hooi; Chua, Yeow Leng; Lim, Yean Teng

    2014-01-01

    Transcatheter aortic valve implantation (TAVI) has become the standard of care for inoperable patients with symptomatic severe aortic stenosis (AS), and an alternative to open aortic valve replacement for patients at high surgical risk. TAVI has also been performed in several groups of patients with off-label indications such as severe bicuspid AS, and as a valve-in-valve therapy for a degenerated surgical bioprosthesis. Although TAVI with CoreValve® prosthesis is technically challenging, and...

  13. Anatomics Knowledges of Aortic Root in the Transcatheter Aortic Valve Implantation.

    OpenAIRE

    Marcelo Cerezo; Omar Bertani; Gisela Panciroli; Sebastián Duhalde; Karina Ferreira; Luciano Honaine

    2010-01-01

    The Aortic Valve is a valvular system that bears different high pressure forces. It takes part of a complex structure called Aortic Root. Nowadays, anatomic knowledge has taken a preponderant role, due to the use of the Transcatether Aortic Valve Implant (TAVI). To describe the patient´s characteristics which exclude them of the TAVI for anatomic reasons in cadaveric dissections and transthoracic echocardiograms. A descriptive retrospective analysis of 67 individuals was performed and divided...

  14. Emergency Transcatheter Aortic Valve Implantation for Acute and Early Failure of Sutureless Perceval Aortic Valve.

    Science.gov (United States)

    Durand, Eric; Tron, Christophe; Eltchaninoff, Hélène

    2015-09-01

    We report the case of a 78-year-old woman admitted for cardiogenic shock related to acute and early failure (severe aortic regurgitation) of a Perceval sutureless aortic bioprosthesis (Sorin Group, Saluggia, Italy). Clinical stability was achieved using rescue transfemoral transcatheter aortic valve-in-valve implantation with an Edwards SAPIEN 3 prosthesis (Edwards Lifesciences, Irvine, CA). To our knowledge, we report herein the first case of successful valve-in-valve implantation using a SAPIEN 3 transcatheter heart valve in a sutureless bioprosthetic aortic valve with acute and early deterioration. PMID:26095935

  15. Left ventricular diastolic function in valvular aortic stenosis after aortic valve replacement

    Directory of Open Access Journals (Sweden)

    Ristić-Anđelkov Anđelka

    2002-01-01

    Full Text Available In adults with significant sympthomatic aortic valve stenosis, aortic valve replacement is therapy of choice. Replacement of the diseased aortic valve with a prosthetic valve yields relief of left ventricular outflow obstruction. Myocardial remodeling with regression of mass transpires as the heart adapts to the new level of after load. In patients with moderate left ventricular hypertrophy improvement in diastolic function during the first year after aortic valve replacement is visible, while in patients with extreme myocardial hypertrophic changes it was slower.

  16. Stroke Volume estimation using aortic pressure measurements and aortic cross sectional area: Proof of concept.

    Science.gov (United States)

    Kamoi, S; Pretty, C G; Chiew, Y S; Pironet, A; Davidson, S; Desaive, T; Shaw, G M; Chase, J G

    2015-08-01

    Accurate Stroke Volume (SV) monitoring is essential for patient with cardiovascular dysfunction patients. However, direct SV measurements are not clinically feasible due to the highly invasive nature of measurement devices. Current devices for indirect monitoring of SV are shown to be inaccurate during sudden hemodynamic changes. This paper presents a novel SV estimation using readily available aortic pressure measurements and aortic cross sectional area, using data from a porcine experiment where medical interventions such as fluid replacement, dobutamine infusions, and recruitment maneuvers induced SV changes in a pig with circulatory shock. Measurement of left ventricular volume, proximal aortic pressure, and descending aortic pressure waveforms were made simultaneously during the experiment. From measured data, proximal aortic pressure was separated into reservoir and excess pressures. Beat-to-beat aortic characteristic impedance values were calculated using both aortic pressure measurements and an estimate of the aortic cross sectional area. SV was estimated using the calculated aortic characteristic impedance and excess component of the proximal aorta. The median difference between directly measured SV and estimated SV was -1.4ml with 95% limit of agreement +/- 6.6ml. This method demonstrates that SV can be accurately captured beat-to-beat during sudden changes in hemodynamic state. This novel SV estimation could enable improved cardiac and circulatory treatment in the critical care environment by titrating treatment to the effect on SV. PMID:26736434

  17. The role of aortic wall CT attenuation measurements for the diagnosis of acute aortic syndromes

    International Nuclear Information System (INIS)

    Objectives: To determine if measurements of aortic wall attenuation can improve the CT diagnosis of acute aortic syndromes. Methods: CT reports from a ten year period were searched for acute aortic syndromes (AAS). Studies with both an unenhanced and a contrast enhanced (CTA) series that had resulted in the diagnosis of intramural hematoma (IMH) were reviewed. Diagnoses were confirmed by medical records. The attenuation of aortic wall abnormalities was measured. The observed attenuation threshold was validated using studies from 39 new subjects with a variety of aortic conditions. Results: The term “aortic dissection” was identified in 1206, and IMH in 124 patients’ reports. IMH was confirmed in 31 patients, 21 of whom had both unenhanced and contrast enhanced images. All 21 had pathologic CTA findings, and no CTA with IMH was normal. Attenuation of the aortic wall was greater than 45 HUs on the CTA images in all patients with IMH. When this threshold was applied to the new group, sensitivity for diagnosing AAS was 100% (19/19), and specificity 94% (16/17). Addition of unenhanced images did not improve accuracy. Conclusions: Measurements of aortic wall attenuation in CTA have a high negative predictive value for the diagnosis of acute aortic syndromes

  18. Interruption Management in the Intensive Care Unit: Predicting Resumption Times and Assessing Distributed Support

    Science.gov (United States)

    Grundgeiger, Tobias; Sanderson, Penelope; MacDougall, Hamish G.; Venkatesh, Balasubramanian

    2010-01-01

    Interruptions are frequent in many work domains. Researchers in health care have started to study interruptions extensively, but their studies usually do not use a theoretically guided approach. Conversely, researchers conducting theoretically rich laboratory studies on interruptions have not usually investigated how effectively their findings…

  19. 78 FR 47749 - Certain Ground Fault Circuit Interrupters and Products Containing Same

    Science.gov (United States)

    2013-08-06

    ... COMMISSION Certain Ground Fault Circuit Interrupters and Products Containing Same AGENCY: U.S. International... certain ground fault circuit interrupters and products containing the same by reason of infringement of... general exclusion order barring entry of ground fault circuit interrupters that infringe certain claims...

  20. Heartbeat-related displacement of the thoracic aorta in patients with chronic aortic dissection type B: Quantification by dynamic CTA

    Energy Technology Data Exchange (ETDEWEB)

    Weber, Tim F. [University of Heidelberg, Department of Diagnostic and Interventional Radiology, Im Neuenheimer Feld 110, 69120 Heidelberg (Germany)], E-mail: tim.weber@med.uni-heidelberg.de; Ganten, Maria-Katharina [German Cancer Research Center, Department of Radiology, Im Neuenheimer Feld 280, 69120 Heidelberg (Germany)], E-mail: m.ganten@dkfz.de; Boeckler, Dittmar [University of Heidelberg, Department of Vascular and Endovascular Surgery, Im Neuenheimer Feld 110, 69120 Heidelberg (Germany)], E-mail: dittmar.boeckler@med.uni-heidelberg.de; Geisbuesch, Philipp [University of Heidelberg, Department of Vascular and Endovascular Surgery, Im Neuenheimer Feld 110, 69120 Heidelberg (Germany)], E-mail: philipp.geisbuesch@med.uni-heidelberg.de; Kauczor, Hans-Ulrich [University of Heidelberg, Department of Diagnostic and Interventional Radiology, Im Neuenheimer Feld 110, 69120 Heidelberg (Germany)], E-mail: hu.kauczor@med.uni-heidelberg.de; Tengg-Kobligk, Hendrik von [German Cancer Research Center, Department of Radiology, Im Neuenheimer Feld 280, 69120 Heidelberg (Germany)], E-mail: h.vontengg@dkfz.de

    2009-12-15

    Purpose: The purpose of this study was to characterize the heartbeat-related displacement of the thoracic aorta in patients with chronic aortic dissection type B (CADB). Materials and methods: Electrocardiogram-gated computed tomography angiography was performed during inspiratory breath-hold in 11 patients with CADB: Collimation 16 mm x 1 mm, pitch 0.2, slice thickness 1 mm, reconstruction increment 0.8 mm. Multiplanar reformations were taken for 20 equidistant time instances through both ascending (AAo) and descending aorta (true lumen, DAoT; false lumen, DAoF) and the vertex of the aortic arch (VA). In-plane vessel displacement was determined by region of interest analysis. Results: Mean displacement was 5.2 {+-} 1.7 mm (AAo), 1.6 {+-} 1.0 mm (VA), 0.9 {+-} 0.4 mm (DAoT), and 1.1 {+-} 0.4 mm (DAoF). This indicated a significant reduction of displacement from AAo to VA and DAoT (p < 0.05). The direction of displacement was anterior for AAo and cranial for VA. Conclusion: In CADB, the thoracic aorta undergoes a heartbeat-related displacement that exhibits an unbalanced distribution of magnitude and direction along the thoracic vessel course. Since consecutive traction forces on the aortic wall have to be assumed, these observations may have implications on pathogenesis of and treatment strategies for CADB.

  1. Approche archéo-anthropologique des inhumations militaires

    OpenAIRE

    Rigeade, Catherine

    2009-01-01

    Le fait militaire occupe une place importante au sein des études historiques car il permet d’entrevoir les rapports entre l’armée et la société. Les conflits armés sont très largement abordés en archéologie par l’étude des systèmes défensifs ou par la découverte d’objets de parures ou de pièces d’armes. En revanche, on ne dénombre que peu d’ensembles funéraires mis en place à la suite d’un conflit ou d’évènements guerriers ayant fait l’objet d’une fouille archéologique ou d’une étude anthropo...

  2. Post Flare Giant Arches and Run-Away Reconnection

    Science.gov (United States)

    West, Matthew; Seaton, Daniel B.; Savage, Sabrina; Bryans, Paul

    2016-05-01

    The nature of post-flare giant arches and their relation to regular post flare loops has long been debated, especially in the context of how post-flare giant arches can sustain their growth for such long periods. In this presentation we discuss how magnetic reconnection can be sustained to such great heights, and the role the background corona plays in maintaining this growth. We use observations from 14 October 2014, when the SWAP EUV solar telescope on-board the PROBA2 spacecraft observed an eruption that led to the formation of perhaps the largest post-eruptive loop system seen in the solar corona in solar cycle 24. These loops grew to a height of approximately 400000 km (>0.5 solar-radii). We provide evidence of on-going reconnection, through observations spanning from the chromosphere to the middle corona, and discuss how only certain conditions can maintain prolonged growth.

  3. An unusual case of left aberrant innominate artery with right aortic arch: evaluation with high-resolution CT

    Energy Technology Data Exchange (ETDEWEB)

    Calcagni, Giulio [University Rene Descartes-Paris 5, Department of Pediatric Cardiology, Hopital Necker Enfants Malades, Paris (France); Gesualdo, Francesco; Brunelle, Francis; Ou, Phalla [University Rene Descartes-Paris 5, Department of Pediatric Radiology, Hopital Necker Enfants Malades, Paris Cedex 15 (France)

    2008-01-15

    A left aberrant innominate (brachiocephalic) artery is an angiographically well-known entity that may cause tracheal compression. We report a male newborn who was admitted for further investigation of a prenatally suspected major vessel anomaly. High-resolution CT was used to completely assess the abnormal anatomy and the relationship with the airway, as well as to guide the surgical approach for its correction. (orig.)

  4. The evolution of amphibian metamorphosis: insights based on the transformation of the aortic arches of Pelobates fuscus (Anura)

    Czech Academy of Sciences Publication Activity Database

    Kolesová, H.; Lametschwandtner, A.; Roček, Zbyněk

    2007-01-01

    Roč. 210, č. 4 (2007), s. 379-393. ISSN 0021-8782 Institutional research plan: CEZ:AV0Z30130516 Keywords : Anura * circulatory system * development * evolution * metamorphosis Subject RIV: EG - Zoology Impact factor: 2.547, year: 2007

  5. Congenital pulmonary steal associated with Tetralogy of Fallot, right aortic arch and an isolated left carotid artery

    International Nuclear Information System (INIS)

    In patients with Tetralogy of Fallot, collateral supply to the pulmonary artery from systemic arterial sources is frequently encountered. However, collateral blood flow arising from the cerebral circulation has, to our knowledge, not been reported in this condition. We describe a patient with Tetralogy of Fallot in whom the left pulmonary artery filled directly via retrograde flow from the left carotid artery. Review of the literature in search of a similar case was unrevealing. A theoretical embryologic basis for this anomaly is discussed. (orig.)

  6. Congenital pulmonary steal associated with Tetralogy of Fallot, right aortic arch and an isolated left carotid artery

    Energy Technology Data Exchange (ETDEWEB)

    Tozzi, R.; Kiley, R.; Doyle, E.; Hernanz-Schulman, M.; Genieser, N.; Ambrosino, M.; Pinto, R.

    1989-07-01

    In patients with Tetralogy of Fallot, collateral supply to the pulmonary artery from systemic arterial sources is frequently encountered. However, collateral blood flow arising from the cerebral circulation has, to our knowledge, not been reported in this condition. We describe a patient with Tetralogy of Fallot in whom the left pulmonary artery filled directly via retrograde flow from the left carotid artery. Review of the literature in search of a similar case was unrevealing. A theoretical embryologic basis for this anomaly is discussed. (orig.).

  7. Dissecting aortic aneurysm in maintenance hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Ounissi M

    2009-01-01

    Full Text Available The dissecting aortic aneurysm (DAA is a rare pathology that may result in fatal outcome. We report follow up of three cases of DAA patients undergoing maintenance hemo-dialysis who were managed conservatively.

  8. CT diagnosis of aortic graft infections

    International Nuclear Information System (INIS)

    Two cases of aortic graft infections diagnosed by computed tomography (CT) are presented. CT scans demonstrated a zone of low attenuation in the perigraft area, in one case with a rim enhancement. The diagnoses were verfied by operation. (orig.)

  9. Surveillance intervals for small abdominal aortic aneurysms

    DEFF Research Database (Denmark)

    Bown, Matthew J; Sweeting, Michael J; Brown, Louise C;

    2013-01-01

    Small abdominal aortic aneurysms (AAAs [3.0 cm-5.4 cm in diameter]) are monitored by ultrasound surveillance. The intervals between surveillance scans should be chosen to detect an expanding aneurysm prior to rupture....

  10. Aortic aneurysm secondary to umbilical artery catheterization

    International Nuclear Information System (INIS)

    A 14-month-girl presented with an asymptomatic posterior mediastinal mass. She had a history of prematurity, umbilical artery catheterization, and sepsis. The diagnosis of aortic aneurysm was made by dynamic computed tomography. The aneurysm was successfully resected. (orig.)

  11. Seismic vulnerability of historical arch type bridge structures in Italy

    OpenAIRE

    Qadir Bhatti, Abdul

    2009-01-01

    Italy is located on a earthquake prone area and old bridges were desinged without any seismic provision. In the years (2009), tremors were felt in Italy due to the strong earthquakes at Abruzzo, which highlight the earthquake threat to Italy. This study focuses on seismic vulnerability of arch type masonry bridge structures in Italy, designed primarily for gravity loads, when they are subjected to earthquakes. A case study has been carried out for the vulnerability study for a ...

  12. CREATIVITY METHODS IN TEACHING THE ARCH-DESIGN STUDIO

    OpenAIRE

    EIGBEONAN, Andrew B.

    2013-01-01

    The aim of this paper is to search and find methods of fostering creativity or ideas relating to creativity in teaching the arch-design studio. Teaching creativity through its methods will be making the students grounded in designing with creativity ideas and therefore we can have professionals that design and build with satisfaction, safety and complementary. It means we can have real buildings and places that satisfy our clients, the society and in harmony with the environment. Although the...

  13. Quasi-MLE for quadratic ARCH model with long memory

    OpenAIRE

    Grublytė, Ieva; Surgailis, Donatas; Škarnulis, Andrius

    2015-01-01

    We discuss parametric quasi-maximum likelihood estimation for quadratic ARCH process with long memory introduced in Doukhan et al. (2015) and Grublyt\\.e and \\v{S}karnulis (2015) with conditional variance given by a strictly positive quadratic form of observable stationary sequence. We prove consistency and asymptotic normality of the corresponding QMLE estimates, including the estimate of long memory parameter $0< d < 1/2$. A simulation study of empirical MSE is included.

  14. Behaviour of Frictional Joints in Steel Arch Yielding Supports

    Czech Academy of Sciences Publication Activity Database

    Horyl, P.; Šňupárek, Richard; Maršálek, P.

    2014-01-01

    Roč. 59, č. 3 (2014), s. 723-734. ISSN 0860-7001 R&D Projects: GA MŠk ED2.1.00/03.0082; GA MŠk ED1.1.00/02.0070 Grant ostatní: GA MŠk(CZ) MSM6198910027 Institutional support: RVO:68145535 Keywords : steel arch yielding support * frictional joints * bolt connection * slip support * fem Subject RIV: DH - Mining, incl. Coal Mining Impact factor: 0.608, year: 2013

  15. Strength of arch-shaped members in bending and shear

    OpenAIRE

    Campana, Stefano; Fernández Ruiz, Miguel; Muttoni, Aurelio

    2014-01-01

    Arch-shaped members are widely used for construction of tunnels, bridges, silos and shells. These members are not typically provided with transverse reinforcement and may thus have a brittle behaviour at failure. When subjected to bending or shear, traditional design methods used for straight members are not applicable due to deviation forces developing at the curved chords carrying compression and tension, which is not always accounted in design codes. In this paper, two experimental series ...

  16. MODELING EXCHANGE RATES USING ARCH FAMILY OF MODELS

    Directory of Open Access Journals (Sweden)

    Ştefan Cristian CIUCU

    2016-06-01

    Full Text Available In this study, after a brief literature review, the RON / EURO exchange rate time series over the 03.01.2005 - 05.02.2015 time period is analyzed. After checking the stationarity of the data - ARCH, GARCH, EGARCH and TARCH models will be developed and compared. Next the best model is chosen and the serial correlation and the Jarque-Bera test are further analyzed with various conclusions being drawn.

  17. The Randomized Shortened Dental Arch Study: Tooth Loss

    OpenAIRE

    Walter, M H; Weber, A; Marré, B; Gitt, I.; Gerß, J.; Hannak, W.; Hartmann, S.; Heydecke, G; Huppertz, J.; Jahn, F; Ludwig, A.; Mundt, T.; Kern, M; Klein, V; Pospiech, P.

    2010-01-01

    The evidence concerning the management of shortened dental arch (SDA) cases is sparse. This multi-center study was aimed at generating data on outcomes and survival rates for two common treatments, removable dental prostheses (RDP) for molar replacement or no replacement (SDA). The hypothesis was that the treatments lead to different incidences of tooth loss. We included 215 patients with complete molar loss in one jaw. Molars were either replaced by RDP or not replaced, according to the SDA ...

  18. Modelling autogenous expansion for magnesia concrete in arch dams

    Institute of Scientific and Technical Information of China (English)

    Feng JIN; Guoxin ZHANG; Xiaoqing LUO; Chuhan ZHANG

    2008-01-01

    Magnesia Concrete is a kind of expansive con-crete used in Chinese hydraulic engineering more and more widely. To evaluate the effects of autogenous expan-sion on the stresses of arch dams, a simple model of auto-genous expansion for Magnesia Concrete in dam engineering is presented. This model is based on three assumptions: 1) the total amount of autogenous expan-sion of Magnesia Concrete is related only to the properties of materials and mixing of concrete; 2) the autogenous expansion of Magnesia Concrete is irreversible due to the irreversibility of hydration reaction of Magnesia in the concrete; 3) the autogenous expansion strain rates of Magnesia Concrete bear a relation between temperature and residual Magnesia per unit volume of concrete. The model is verified by some experimental data of autogen-ous expansion of Magnesia Concrete and field-measured data of an arch dam in China. Embedded into finite ele-ment arch dam simulation software, this model is employed to simulate the effects of autogenous expansion of Magnesia Concrete in hydraulic engineering.

  19. Wheel arch aerodynamics of a modern road vehicle

    International Nuclear Information System (INIS)

    A geometrically faithful model of the Aston Martin V12 Vanquish was formed in 3D CAD and used to perform an extensive CFD study into the airflow in and around the wheel arch of the vehicle. Parameters such as spin ratio, ground clearance, vertical and horizontal insertion into the wheel arch and the yaw angles experienced during cornering, were all under investigation. The additional aim of the research was to validate or refute the use of CFD as a tool in this complex area of fluid flow. This research serves to highlight a number of problems and potential solutions in the use of CFD. Meshing problems can be eliminated with increased computational power and suggestions have been made to improve the modeling of rotating boundaries that include radial features such as wheel spokes. Much of the CFD data ties well with previously conducted experimental work, if not numerically then in trend. Without additional physical validation however, it is difficult to ascertain the overall accuracy and usefulness of the remaining results, which have not yet been conducted in physical reality. Despite its limitations, the use of CFD permitted an extensive analysis in a comparatively short length of time and served to highlight potential areas for increased scrutiny. As an example, results from the final yaw angle case drew attention to a potential concern for aerodynamic destabilisation of the vehicle during cornering, generating lift on the front arch of the car that is already lifted due to cornering forces and body roll. (author)

  20. C-arm guided closed reduction of zygomatic arch fracture

    International Nuclear Information System (INIS)

    The zygomatic arch is structurally protruded and is easily fractured. The classic management of zygomatic arch fracture has been mentioned the Keen, Lothrop, Dingman and Alling and threaded K-wire. All of the above methods have advantages and disadvantages. To minimize the disadvantages, we performed threaded K-wire for the first time using C-arm image intensifier. The subjects were 16 patients with Knight North group II (Zygomatic arch fracture). Among them the C-arm was used in 12 patients and the operator used sensitivity general method in 4 patients and confirmed the operation by mobile X-ray equipment. In conclusion, both groups were satisfied surgically and cosmetically. Using the C-arm, actual image at the time operation was clear and satisfied, the surrounding tissue damage was minimized and at was more accurately completed. The operation time was shortened by 30 to 60 minutes proving it to be an efficient method. We suggest though that further studies be needed to evaluate the radiation effect on these patients