The surgical treatment of diseases of thoracic aorta has had much better success rate in recent years compaired to the past. Aortic aneurysms or dissections that extend along the entire thoracic aorta are usually approached in two or three stages. Recently we successfully performed one-stage aortic replacement from the aortic root to the abdominal aorta in chronic DeBakey type I dissection. A 25 year-old man who had dyspnea on exertion (NYHA Fc II) and a Marfanoid feature was operated under the diagnosis of chronic type I dissection with severe aortic regurgitation. At operation, a huge ascending aorta with two intimal tearings was seen and the blood supply of intercostal arteries and right renal artery was done from the false lumen. Modified Bentall operation with total aortic replacement was done successfully, and the patient is being followed-up without major complications.
Adult ; Aorta* ; Aorta, Abdominal ; Aorta, Thoracic ; Aortic Aneurysm ; Aortic Valve Insufficiency ; Arteries ; Diagnosis ; Dyspnea ; Humans ; Renal Artery

Marfan syndrome is an inherited autosomal dominant disorder of the connective tissues, and the afflicted patients present with abnormalities of the skeletal, ocular, and cardiovascular system. The progressive dilatation of the proximal aorta leading to dissection and rupture is the typical feature and this can be a lethal complication of this disease. The incidence of Marfan syndrome is estimated to be 1 in 10,000 in most racial and ethnic groups. We experienced two cases of aortic aneurysm in Marfan syndrome. The first case was 32-year-old woman. She was admitted because of sudden onset of a painful abdominal mass for 2 days. Aortic aneurysm was diagnosed by CT and an echocardiogram showed severe mitral regurgitation (area ratio: 13/15). She underwent successful abdominal aortic aneurysm (AAA) repair and was discharged on postoperative 14th day; she was then prepared for open cardiac surgery for mitral valve replacement. The second case was 19- year-old woman. She was admitted with a known abdominal aortic aneurysm that she'd had for 1.5 years. She also underwent abdominal aortic aneurysm (AAA) repair that was technically successful, but she died on postoperative 10th day due to sudden cardiac arrest.
Adult ; Aorta ; Aortic Aneurysm ; Aortic Aneurysm, Abdominal* ; Cardiovascular System ; Connective Tissue ; Death, Sudden, Cardiac ; Dilatation ; Ethnic Groups ; Female ; Humans ; Incidence ; Marfan Syndrome* ; Mitral Valve ; Mitral Valve Insufficiency ; Rupture ; Thoracic Surgery

The enzyme complex 3beta-hydroxysteroid dehydrogenase (3beta-HSD) is involed in the biosynthesis of all classes of active steroids. It has been known that the enzymatic activity of 3beta-HSD is present not only in the classical steroido-genic tissues, but also in many peripheral tissues. This study was performed to investigated of 3beta-HSD immunore-activity in the rat cardiovascular tissues such as the ventricle, atrium, aortic arch, and abdominal aorta. Immunoblot analyses and immunohistochemical studies were performed using polyclonal antibodies raised against purified human placental 3beta-HSD. We identified 43 and 37KDa bands in the ventricle and atrum, whereas only 37KDa band was observed in the aortic arch and abdominal aorta. Immunostaining for 3beta-HSD was detected in the ventricular and atrial cardiocytes. The intensity of staining was much higher in the atrial cardiocytes than in the ventricular cardiocytes. Immunostaining was also found in the smooth muscles of aortic arch and abdominal aorta.
Animals ; Antibodies ; Aorta, Abdominal ; Aorta, Thoracic ; Cardiovascular System* ; Humans ; Muscle, Smooth ; Oxidoreductases ; Rats* ; Steroids

Aorta is the largest artery in the human body. Its starting point is the aortic orifice of the aortic valve and it terminates at the level of the fourth lumbar vertebra. The main function of the aorta is to transport oxygenated blood to supply all the organs and cells. With advancing age, the structure and hence the function show progressive changes. Various changes in the aortic morphology include the luminal diameter of aorta, whole length of the aorta, thickness, the microstructural components also change, and these include collagen, elastin and smooth muscle cells. In addition, the dimensions of all segments of the aorta increase with age in both sexes. Since age is a major risk factor for degenerative change and diseases affecting the aorta, understanding the detailed anatomy of the aorta may provide essential information concerning the age-associated process of the aorta. Knowledge of the morphological changes in the aorta is also important for future clinical therapies pertaining to aortic disease. Additionally, the information regarding the structural changes with age may be applied for age determination. This review describes the overview of the anatomy of the aorta, age related changes in the morphology of the aorta and aortic diseases.
Aorta ; Aorta, Abdominal ; Aorta, Thoracic ; Aortic Diseases ; Aortic Valve ; Arteries ; Collagen ; Elastin ; Human Body ; Humans ; Myocytes, Smooth Muscle ; Oxygen ; Phenobarbital ; Risk Factors ; Spine

PURPOSE: To assess the utility of spin-echo magnetic resonance(MR) imaging in the evaluation of thoracic and abdominal aortic aneurysm. MATERIALS AND METHODS: The spin-echo MR images of 27 aortic aneurysms in 22 patients were analyzed and correlated with angiography and/or operative findings retrospectively. Evaluations included location, type, and maximum diameter of the aneuyusm, mural thrombus, major branch involvement, and relationship with adjacent organ. RESULTS: The location of aneurysms was ascending thoracic aorta in seven cases, ascending thoracic aorta and aortic arch in one, descending thoracic aorta in six, thoracoabdominal aorta in three, and abdominal aorta in eight. Nineteen were fusiform, and eight were saccular. The mean of maximum diameters of the aneurysms was 7.9cm (4-10cm) on MR and 7.3cm (3-10cm) on angiography. Mural thrombus were noted in 13 cases on MR imaging and seven cases on angiograhpy. Angiography also underestimated the amount of mural thrombus. Eight cases involved major aortic branches. Although MR imaging and angiography were equal in the assessment of major abdominal aortic branches, MR imaging could not clearly demonstrate arch vessels, especially left subclavian artery, in aortic arch aneurysms. Among seven ascending thoracic aneurysms, six had aortic regurgitation. MR imaging showed left ventricular enlargement in all six cases. There was pericardial effusion in four cases which were noted only on MR imaging. MR imaging demonstrated hydronephrosis and renal atrophy in two cases of abdominal aortic aneurysms respectively. CONCLUSION: In the assessment of size of the aneurysm, mural thrombus, and relation with adjacent organs, MR imaging was better than angiography. MR and anglographic findings were equal in the assessment of the location and type of the aneurysm. Angiography was better than MR imaging in the assessment of major branch involvement, especially left subclavian artery.
Aneurysm ; Angiography ; Aorta ; Aorta, Abdominal ; Aorta, Thoracic ; Aortic Aneurysm ; Aortic Aneurysm, Abdominal* ; Aortic Valve Insufficiency ; Atrophy ; Humans ; Hydronephrosis ; Magnetic Resonance Imaging ; Pericardial Effusion ; Retrospective Studies ; Subclavian Artery ; Thrombosis

Marfan syndrome is an inheritable connective tissue with protean clinical manifestations involving the ocular, skeletal and cardiovascular system. It is well estabalished that a clinical hall marker and the major cause of morbidity in Marfan syndrome is aortic root dilatation and associated aortic dissection which begins just above the coronary ostia in ascending aorta. We report a rare case of Marfan syndrome with aortic dissection which began just below left subclavian artery in descending aorta. A 20-years old woman was admitted to Soonchunhyang hospital because of sudden onset of back pain. On phsical examination, she had characteristic Marfanoid feature. Chest X-ray and Echocardiography showed cardiomegaly and severe dilatation of ascending aorta. Chest CT and aortography showed severe aneurysm of ascending aorta and aortic dissection of descending aorta with intimal flap. she was treated with medical treatment because of poor general condition.
Aneurysm ; Aorta ; Aorta, Abdominal* ; Aorta, Thoracic ; Aortic Aneurysm* ; Aortography ; Back Pain ; Cardiomegaly ; Cardiovascular System ; Connective Tissue ; Dilatation ; Echocardiography ; Female ; Humans ; Marfan Syndrome* ; Subclavian Artery ; Thorax ; Tomography, X-Ray Computed ; Young Adult

Marfan syndrome is an inheritable connective tissue with protean clinical manifestations involving the ocular, skeletal and cardiovascular system. It is well estabalished that a clinical hall marker and the major cause of morbidity in Marfan syndrome is aortic root dilatation and associated aortic dissection which begins just above the coronary ostia in ascending aorta. We report a rare case of Marfan syndrome with aortic dissection which began just below left subclavian artery in descending aorta. A 20-years old woman was admitted to Soonchunhyang hospital because of sudden onset of back pain. On phsical examination, she had characteristic Marfanoid feature. Chest X-ray and Echocardiography showed cardiomegaly and severe dilatation of ascending aorta. Chest CT and aortography showed severe aneurysm of ascending aorta and aortic dissection of descending aorta with intimal flap. she was treated with medical treatment because of poor general condition.
Aneurysm ; Aorta ; Aorta, Abdominal* ; Aorta, Thoracic ; Aortic Aneurysm* ; Aortography ; Back Pain ; Cardiomegaly ; Cardiovascular System ; Connective Tissue ; Dilatation ; Echocardiography ; Female ; Humans ; Marfan Syndrome* ; Subclavian Artery ; Thorax ; Tomography, X-Ray Computed ; Young Adult

The Marfan syndrome is a generalized connective tissue disease involving eye, musculoskeletal system, cardiovascular system, and inherited autosomal dominant with various expression type. The cardiovascular complications such as aortic aneurysm, aortic dissection, aortic regurgitation, mitral regurgitation and aortic dissection which usually occurs in previously normal sized aorta are poor prognostic factors. However, the aortic dissection which developed in patient with Marfan syndrome and aortic aneurysm was rare. We experienced one case of dissecting aneurysm in patient diagnosed as previous aortic aneurysm, aortic regurgitation, and Marfan syndrome, receiving successful operation.
Aneurysm, Dissecting ; Aorta ; Aortic Aneurysm* ; Aortic Valve Insufficiency ; Cardiovascular System ; Connective Tissue Diseases ; Humans ; Marfan Syndrome* ; Mitral Valve Insufficiency ; Musculoskeletal System

The risk factors of abdominal aortic aneurysm (AAA) are old age, atherosclerosis, hypertension, smoking and family history of AAA. And the risk factors of aortic dissection are old age, atherosclerosis, hypertension and other aortic diseases such as aortic aneurysm, coarctation of aorta, aortic arteritis and bicuspid aortic valve. Although AAA and aortic dissection shares common risk factors, combination of these two disease are very uncommon. We report a case of 69-year-old female presented with chronic ascending aortic dissection combined with infrarenal AAA with a diameter of 7 cm and a case of 73-year-old-male presented with intramural hematoma of descending thoracic aorta combined with infrarenal AAA with a diameter of 6 cm.
Aged ; Aorta, Thoracic ; Aortic Aneurysm ; Aortic Aneurysm, Abdominal* ; Aortic Coarctation ; Aortic Diseases ; Aortic Valve ; Arteritis ; Atherosclerosis ; Bicuspid ; Female ; Hematoma ; Humans ; Hypertension ; Risk Factors ; Smoke ; Smoking

Aortic aneurysm is one several well-known cardiovascular complications in patients with autosomal dominant polycystic kidney disease (ADPCKD). Commonly affected site of aortic aneurysm and its related dissection in ADPCKD is abdominal aorta. Long standing hypertension, haemodialysis, old age are closely related with discovering of aortic aneurysm and dissection in ADPCKD. However, thoracic aortic aneurysms and its related severe aortic regurgitations (ARs) are rare in younger patients suffering from ADPCKD, especially ones who have normal renal function. Here, we report a case involving a 27-year-old Asian male patient with severe AR due to an ascending aneurysm of the thoracic aorta associated with ADPCKD. The patient had normal renal function without Marfan's habitus. The AR and thoracic aortic aneurysm were corrected surgically.
Adult ; Aneurysm ; Aorta, Abdominal ; Aorta, Thoracic ; Aortic Aneurysm ; Aortic Aneurysm, Thoracic ; Aortic Valve ; Aortic Valve Insufficiency ; Asian Continental Ancestry Group ; Humans ; Hypertension ; Male ; Polycystic Kidney, Autosomal Dominant ; Stress, Psychological