Flow reversal and thromboexclusion constitute a valuable alternative for aortic surgeons to have within their technical armamentarium for the treatment of aortic aneurysmal disease. Although not usually a preferred treatment for general aortic pathologies, this technique can be considered as a treatment option in select situations, such as mycotic aneurysm, a hostile surgical field, and a poor condition of the patient. Here, we present a case of extra-anatomic bypass and thromboexclusion for recurrent aortic aneurysm after previous extra-anatomic bypass and thromboexclusion surgery.
Aneurysm, Infected ; Aortic Aneurysm ; Humans ; Pathology ; Surgeons

Humans ; Aortic Aneurysm, Abdominal ; Aorta, Abdominal/pathology* ; Immunity, Innate

Thoracic aortic aneurysm (TAA) is the most common pathology of the thoracic aorta. The incidence of TAA is increasing and the true incidence of TAA is likely to be higher than currently reported because of its inherently silent nature. TAAs are an increasingly recognized condition that is diagnosed incidentally on imaging studies performed to evaluate unrelated conditions because most patients with TAA have no symptoms. TAAs normally grow in an indolent manner, but can become rapidly lethal once dissection or rupture occurs. Indeed, aortic aneurysms (both abdominal and thoracic) represent the 15th leading cause of death in individuals older than 55 years, and the 19th leading cause of death in individuals of all ages in the United States. The etiologies underlying TAAs are diverse. Therefore, the evaluation and management of TAAs are complex. The present review summarizes the knowledge of the pathophysiology, natural history and diagnostic modalities, as well as current treatment strategies of TAA on the basis of current literature.
Aorta, Thoracic ; Aortic Aneurysm ; Aortic Aneurysm, Thoracic* ; Cause of Death ; Diagnosis* ; Humans ; Incidence ; Natural History ; Pathology ; Prognosis ; Rupture ; United States

A case of leaking abdominal aortic pseudoaneurysm following treatment of bilateral renal stones by extracopored shock wave lithotripsy(ESWL) is presented. Screening of the abdominal aortic pathology is recommended for a patient who needs ESWL for treatment of renal stones. Ultrasonography may be the diagnostic procedure of choice for pre- and post-ESWL evaluation of abdominal aortic pathology.
Aneurysm, False* ; Aortic Aneurysm, Abdominal* ; Humans ; Lithotripsy* ; Mass Screening ; Pathology ; Shock* ; Ultrasonography

With the development of radiologic intervention, the treatments of aortic dissection are getting more and more diversified. In recent years, Debakey Ill and Debakey I aortic dissection has been usually treated with endovascular graft exclusion, or combined surgical and endovascular treatment. It is therefore more important to evaluate the aorta and its complications after interventional treatments. Because multidetector-row computed tomography (MDCT) has advantages, such as short examination time, high spatial resolution, and simple operation, this modality has become a first choice of non-invasive methods for the follow-up of aortic diseases after the intervention. Now the MDCT presentations and their anatomic-pathologic features of aortic dissection after endovascular graft exclusion or combined surgical and endovascular treatment are reviewed in this article.
Aneurysm, Dissecting ; surgery ; Aortic Aneurysm ; pathology ; Blood Vessel Prosthesis Implantation ; Humans ; Multidetector Computed Tomography ; Stents

Adult ; Aneurysm, Dissecting ; complications ; pathology ; Anterior Wall Myocardial Infarction ; etiology ; Aortic Aneurysm, Thoracic ; complications ; Humans ; Male

Endovascular aneurysm repair (EVAR) was initially introduced as a less invasive alternative to conventional open repair. EVAR was subsequently adopted as a treatment option for abdominal aortic aneurysm. In Korea, open repair is more widely available than EVAR, although EVAR can be performed in several hospitals. Due to the rapidly aging population in Korea, there has been a shift from private healthcare to government-regulated universal coverage and EVAR may be a more feasible option for cardiovascular interventionalists in these days. The improvement of EVAR was rapidly attained by many pioneers for the last two decades. Although issues such as indications and durability of EVAR remain to be elucidated, its application can be extended further of milder invasiveness-related effects on comorbidities and less discomfort to patients. Aortic stent-grafting has been performed for various aortoiliac pathologies over the last 13 years at our cardiovascular center.1-3) This article presents a comprehensive review on EVAR by focusing on the clinical trials, indications, complications, and expertise in decision making for EVAR.
Aging ; Aneurysm ; Aorta, Abdominal ; Aortic Aneurysm ; Aortic Aneurysm, Abdominal* ; Comorbidity ; Decision Making ; Delivery of Health Care ; Humans ; Korea ; Pathology ; Stents ; Universal Coverage

OBJECTIVE: To explore the cause of death, clinical manifestations and forensic pathological features of death cases caused by aortic dissection. METHODS: Sixty-three cases of aortic dissection were selected from forensic medical center, Sun Yat-sen University from 2001 to 2011 and retrospectively analyzed. RESULTS: The patients were mostly young and middle-aged male, aged from 30 to 49 years old. The DeBakey type II was the most common pathological type and the main cause of death was pericardial tamponade. The most common symptom was abdominal pain. However, the location of aorta dissection did not always correlate with the location of pain. Some cases showed no obvious clinical symptoms. The rupture was usually located in ascending aorta with atherosclerosis and pathological changes of hypertension. CONCLUSION It is significant for diagnosis and evaluation the cause of death of aortic dissection by knowing the clinical symptoms and forensic pathological features.
Adult ; Age Factors ; Aged ; Aortic Dissection/pathology* ; Aorta/pathology* ; Aortic Aneurysm/pathology* ; Aortic Rupture/pathology* ; Cardiac Tamponade/pathology* ; Death, Sudden/pathology* ; Diagnostic Errors ; Female ; Forensic Pathology ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors ; Severity of Illness Index ; Young Adult

Since 2000 Dorros et al. reported the first case of type A aortic dissection (TAAD) treated with an endovascular repair, surgeons explored a novel treatment option for TAAD gradually. The application of endovascular repair for TAAD highlights some points below which should pay attention to because of the special anatomic location and morphological characteristics of ascending aorta: (1) customized treatment strategy based on the characteristics of patients; (2) pre-operation evaluation; (3) selection of the stent and delivery system; (4) selection of the access sites; (5) preservation of the coronary artery flow, aortic valve function and perfusion of the branch vessels; (6) accurate location of stent-graft; (7) mid-term and long-term follow-up. In a word, it's helpful to avoid misunderstanding in treatment and improve the safety of operation by grasping the indication and the technical points and making the customized treatment strategy based on the characteristics of patients.
Aneurysm, Dissecting ; surgery ; Aorta ; pathology ; surgery ; Aortic Aneurysm ; surgery ; Blood Vessel Prosthesis Implantation ; Endovascular Procedures ; Humans ; Stents

BACKGROUND AND OBJECTIVES: The purpose of this study was to assess the results of a newly developed aortic valve repair technique. SUBJECTS AND METHODS: Between December 1997 and April 2005, 75 aortic valvuloplasties were performed using a new technique that addressed the 3 main components of the aortic root; annulus, sinotubular junction and leaflet. An internal synthetic strip and ring were implanted along the fibrous annulus to reduce the annulus and sinotubular junction, and additional leaflets were implanted for leaflet correction. Based on the primary pathology, there were 35, 22 and 18 cases of isolated aortic regurgitation, aortic regurgitation due to ascending aortic aneurysm and aortic regurgitation due to annuloaortic ectasia, respectively. RESULTS: The average age of the subjects was 46.4+/-16 years; there were 51 and 24 males and females, respectively. There was no operative mortality, with a 2-year freedom from reoperation rate of 97%. Follow up echocardiograms showed significant improvements in the grade of aortic regurgitation, from a preoperative mean of 3.1+/-1.2 to 1.08+/-0.7 immediate postoperatively, to 1.15+/-0.6 at the final follow up. CONCLUSION: The results of the current study showed this technique to be effective in the treatment of aortic regurgitation of various causes. Although long-term results are pending, it is our contention that this aortic valve repair technique will be a reliable method in the future.
Aortic Aneurysm ; Aortic Valve Insufficiency ; Aortic Valve* ; Dilatation, Pathologic ; Female ; Follow-Up Studies ; Freedom ; Humans ; Male ; Marfan Syndrome ; Mortality ; Pathology ; Reoperation