Acute Disease ; Aorta ; Aortic Diseases/therapy* ; Humans ; Syndrome

Humans ; Cardiovascular Diseases/therapy* ; Consensus ; Intra-Aortic Balloon Pumping ; Extracorporeal Membrane Oxygenation ; China ; Shock, Cardiogenic

PURPOSE: To evaluate the effectiveness of treatment of aortic aneurysm with endoluminal stent-grafts usingGianturco stent and poly-tetra-fluoro ethylene (PTFE). MATERIALS AND METHODS: In ten patients with aorticaneurysm, eleven procedures were performed using tubular (n=7) or bifurcated (n=4) Gianturco Z-stents covered withPTFE to treat aortic disease (six atherosclerotic aortic aneurysms, four pseudoaneurysms of abdominal aorta inthree patients with Behcet's disease, and one penetrating atherosclerotic ulcer). Spiral CT angiography was usedfor follow-up from 14 days to 31 months (mean, 12 months). The effectiveness of stent-grafts was evaluated duringfollow-up. RESULTS: In all cases, implantation of stent-grafts was technically successful ; in five, perigraftleakage was detected on completion of aortography. On initial post-procedural CT images obtained 4 - 24 days afterinsertion of the stent-graft, complete thrombosis of the aneurysm was seen in seven cases and perigraft leakage infour. Two of the four cases in which leakage was seen on initial CT improved spontaneously during follow-up.Procedure-related thromboembolism occurred in one case, which was managed by thrombolytic therapy without residualsequelae. During follow-up CT, the size of aortic aneurysms of atherosclerotic disease did not change. Thepseudoaneurysms of Behcet's disease decreased and eventually completely disappeared, with only residual periaorticsoft tissue. CONCLUSION: For the treatment of aortie diseases, stent grafting using a Gianturco stent and PTFE isclinically feasible, safe, and effective.
Aneurysm ; Aneurysm, False ; Angiography ; Aorta, Abdominal ; Aortic Aneurysm ; Aortic Diseases ; Aortography ; Blood Vessel Prosthesis ; Follow-Up Studies ; Humans ; Polytetrafluoroethylene ; Stents* ; Thromboembolism ; Thrombolytic Therapy ; Thrombosis ; Tomography, Spiral Computed

Aortoenteric fistula (AEF) developed after treatment for an abdominal aortic aneurysm (AAA) is a rare but usually fatal complication. We report a rare case of AEF bleeding after endovascular stent grafting for AAA which was managed angiographically. An 81-year-old man presented with hematochezia and acute abdominal pain for 1 day ago. Four years ago, an aortic stent was implanted in the infrarenal aorta for AAA. Endoscopies were performed to evaluate the hematochezia. Evidence of gastrointestinal bleeding was observed, but a clear bleeding point was not detected on upper endoscopy and colonoscopy. Contrast-enhanced computed tomography performed subsequently showed that the bleeding point was located in the fourth portion of the duodenum as an AEF caused by an inflammatory process in the stent-graft. Intra-arterial angiography showed a massive contrast leakage into the bowel via a small fistula from around the aortic stent graft site. Embolization was successfully performed by injecting a mixture of glue and lipiodol into the AEF tract. The patient was discharged with no evidence of gastrointestinal bleeding after the embolization.
Aged, 80 and over ; Angiography ; Aortic Aneurysm, Abdominal/*therapy ; Aortic Diseases/*etiology/radiography/therapy ; Embolization, Therapeutic ; Endoscopy, Gastrointestinal ; Fistula/*etiology/radiography/therapy ; Gastrointestinal Hemorrhage/therapy ; Humans ; Male ; Stents/*adverse effects ; Tomography, X-Ray Computed

The effect of atorvastatin on warfarin-induced aortic medial calcification and systolic blood pressure (SBP) of rats induced by warfarin was studied. Thirty healthy and adult rats were randomly divided into Warfarin group (n=10), Atorvastatin group (n=10) and normal control group (n=10). Caudal arterial pressure of rats was measured once a week, and 4 weeks later, aorta was obtained. Elastic fiber, collagen fiber and calcium accumulation in tunica media of cells were measured by Von Kossa staining. The results showed that warfarin treatment led to elevation of systolic blood pressure and aortic medial calcification. The chronic treatment also increased collagen, but decreased elastin in the aorta. However, the atorvastatin treatment had adverse effects. It was concluded that treatment with atorvastatin presented evidence of blood pressure lowing and calcification reducing. These data demonstrate that atorvastatin protected aortic media from warfarin-induced calcification and elevation of systolic blood pressure.
Aortic Diseases/chemically induced ; Aortic Diseases/drug therapy ; Aortic Diseases/*pathology ; Blood Pressure/*drug effects ; Calcinosis/chemically induced ; Calcinosis/*drug therapy ; Calcinosis/pathology ; Heptanoic Acids/*pharmacology ; Heptanoic Acids/therapeutic use ; Hypertension/chemically induced ; Hypertension/*drug therapy ; Pyrroles/*pharmacology ; Pyrroles/therapeutic use ; Random Allocation ; Rats, Wistar ; Warfarin

No abstract available.
Acute Disease ; Aged, 80 and over ; Aorta, Abdominal ; Aortic Diseases/*etiology/radiography/therapy ; Female ; Humans ; Percutaneous Coronary Intervention/*adverse effects ; Stents ; Suction ; Thrombosis/*etiology/radiography/therapy

OBJECTIVES: To assess the clinical features, pathologic findings, postoperative results and the effects of immunosuppressive therapy in patients with Beh et's disease (BD). METHODS: We reviewed the postoperative course of the 9 BD patients who underwent a total of 17 aortic valve replacement procedures with prosthetic valves. RESULTS: Histological examination of the aortic valve commonly revealed diffuse myxoid degeneration (75 percent). Of 17 valve replacement surgeries, 13 surgeries resulted in complications, such as detachment of the prosthetic valve with perivalvular leakage and dehiscence of the sternotomy wound, within an average of 5 months (range from 1 month to 14 months). The rate of prosthetic valve detachment was 76 percent (13 of 17 surgeries). Four of the 9 patients (44 percent) who underwent aortic valve replacement procedures died of heart failure or infection associated with the detachment of the prosthetic valve, and perivalvular leakage within an average of 9 months. Aortic insufficiency associated with dehiscence of the prosthetic valve developed in 11 of 12 surgical cases (92 percent) with a mechanical valve and 2 of 5 surgical cases (40 percent) with tissue valves. Thirteen of 15 surgeries (87 percent) which were not given postoperative immunosuppressive therapy developed complications, while none of 2 surgeries that used postoperative immunosuppressive therapy with prednisolone (1 mg/kg/day) and azathioprine (100 mg/day) had these complications. CONCLUSION: The rates of prosthetic valve detachment in BD involving aortic valve were higher than those of other diseases. Aortic valve involvement was also one of the poor prognostic factors in BD. Intensive postoperative immunosuppressive therapy and surgical methods may be important factors for postoperative results.
Adult ; Aortic Valve/pathology ; Aortic Valve Insufficiency/*etiology/pathology ; Behcet Syndrome/*complications/drug therapy/pathology ; Female ; Heart Valve Diseases/*complications/pathology/surgery ; Heart Valve Prosthesis Implantation/*mortality ; Human ; Immunosuppression ; Male ; Postoperative Complications ; Prosthesis Failure ; Survival Analysis

A 68-year-old woman with known severe aortic stenosis was admitted to the hospital because of hematochezia and dizziness. She had received several blood transfusions over the preceding 3 years and undergone right hemicolectomy 2 years ago for severe lower gastrointestinal bleeding. Postoperative histology revealed angiodysplasia involving the ascending colon. After the hemicolectomy, she continued to have hematochezia and anemia and required additional blood transfusions for anemia. During this admission, platelet count, activated partial-thromboplastin time, von Willebrand factor antigen, and von Willebrand factor ristocetin cofactor were normal. She had a severe deficiency of high-molecular-weight multimers of von Willebrand factor. Colonoscopy showed angiodysplasia in the transverse colon at this time. Successful coagulation of the bleeding angiodysplasia was achieved by argon plasma coagulator. No additional bleeding was observed thereafter. We report a case of Heyde's syndrome with abnormal von Willebrand factor in a patient who presented with intestinal angiodysplasia and aortic stenosis.
Aged ; Anemia/etiology/therapy ; Angiodysplasia/*complications ; Aortic Valve Stenosis/*complications ; Colonic Diseases/*complications ; English Abstract ; Female ; Gastrointestinal Hemorrhage/*etiology ; Humans ; Syndrome ; von Willebrand Disease/*complications/diagnosis

OBJECTIVETo explore the infrequent complications and treatment after endoluminal stent graft implantation for aortic diseases.

METHODSReview of the characters and complications for five cases of aortic diseases by stent graft implantation.

RESULTSThe complications of 4 cases have been relieved by operation or re-stent implantation, 1 case was died.

CONCLUSIONThe complications are difficult to forecast for stent graft placement in aortic diseases, the surgeon should be well practiced in surgical and interventional technique, so as to treat the complications in time.

Aged ; Aortic Diseases ; surgery ; Blood Vessel Prosthesis Implantation ; adverse effects ; methods ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications ; etiology ; therapy ; Retrospective Studies ; Stents

OBJECTIVE: The aims of this study were to compare opening and closing angles of normally functioning mechanical aortic valves measured on dual-source computed tomography (CT) with the manufacturers' values and to compare CT-measured opening angles according to valve function. MATERIALS AND METHODS: A total of 140 patients with 10 different types of mechanical aortic valves, who underwent dual-source cardiac CT, were included. Opening and closing angles were measured on CT images. Agreement between angles in normally functioning valves and the manufacturer values was assessed using the interclass coefficient and the Bland-Altman method. CT-measured opening angles were compared between normal functioning valves and suspected dysfunctioning valves. RESULTS: The CT-measured opening angles of normally functioning valves and manufacturers' values showed excellent agreement for seven valve types (intraclass coefficient [ICC], 0.977; 95% confidence interval [CI], 0.962-0.987). The mean differences in opening angles between the CT measurements and the manufacturers' values were 1.2degrees in seven types of valves, 11.0degrees in On-X valves, and 15.5degrees in ATS valves. The manufacturers' closing angles and those measured by CT showed excellent agreement for all valve types (ICC, 0.953; 95% CI, 0.920-0.972). Among valves with suspected dysfunction, those with limitation of motion (LOM) and an increased pressure gradient (PG) had smaller opening angles than those with LOM only (p < 0.05). CONCLUSION: Dual-source cardiac CT accurately measures opening and closing angles in most types of mechanical aortic valves, compared with the manufacturers' values. Opening angles on CT differ according to the type of valve dysfunction and a decreased opening angle may suggest an elevated PG.
Adult ; Aortic Valve/*radiography ; Female ; Heart Valve Diseases/therapy ; *Heart Valve Prosthesis ; Heart Valve Prosthesis Implantation/*instrumentation ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Tomography, X-Ray Computed/methods