A modified clamp for repair of aortic aneurysm and aortic dissection.
Explore the source record for details and available documents.
Adolescent↗
SEARCH · PubMed Health
Results for “Aortic Aneurysm”
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Aortic aneurysm in Marfan's syndrome: changes in the ultrastructure and composition of collagen.
Aneurysmal aortic tissue and the mitral valve of a patient with Marfan's syndrome were examined. Biochemical analysis of the tissue showed a qualitative and quantitative defect in alpha 2 chain production of Type I collagen. On polyacrylamide gel electrophoresis of the aortic extract, two separate bands in the alpha 2 region and an increase of the alpha 1 to alpha 2 ratio were found. Examination by electron microscopy revealed elastic fibre degeneration, helical collagen fibres, and metabolically active modified smooth muscle cells. The formation of helical collagen fibres is attributed to a defect in the development of chains and cross-links of collagen precursors produced by the hypertrophic smooth muscle cells. Elastic fibre disintegration is believed to be due to a lack of support by Type I collagen fibres, which have decreased tensile strength. A scheme for the pathogenesis of aortic aneurysm and other connective tissue abnormalities in Marfan's syndrome is proposed as follows. Type I collagen fibres have decreased tensile strength because of a defect in the alpha 2 chain biosynthesis and decreased cross-linking. Over many years the wall of the ascending aorta is subjected to cyclic stresses and it dilates. Elastic fibres disintegrate. The attempt at repair by metabolically activated modified smooth muscle cells is abortive, and rupture is likely to occur.
Adult↗
Surgical treatment of ascending aortic aneurysms associated with aortic valve insufficiency.
From 1965 to 1978, 111 patients underwent combined operation for ascending aortic aneurysms and aortic valve insufficiency. Fifteen patients had direct coronary implantation (Group 1). In 25 patients operated on between 1972 and 1977, the aortic root was retained (Group 2). An additional 71 patients operated on between 1965 and 1972 were included (Group 3): 40 who had synthetic graft replacement and retention of the aortic root and 31 who had aortoplasty and associated aortic valve repair. In 8 patients in Group 3, recurrent aneurysms were detected an average of 6.5 years after operation. The mortality rate for repaiajor complication after incomplete resection of the aortic root. Total exclusion of the aneurysm should be considered.
Adolescent↗
Integrative cross-tissue transcriptome-wide association and metabolomic analysis reveals novel genetic risk loci for aortic aneurysm.
BACKGROUND: Aortic aneurysm (AA) is a life-threatening cardiovascular condition with a strong genetic component, however, its molecular mechanisms remain poorly understood. Although genome-wide association studies (GWAS) have identified numerous risk loci, most prior studies have investigated genetic and metabolic factors separately, leaving the causal pathways from genetic variants to disease largely unexplored. METHODS: We established an integrative framework combining cross-tissue transcriptome-wide association studies (TWAS) with metabolomic mediation analysis. First, we integrated GWAS data from FinnGen R12 with multi-tissue expression quantitative trait loci (eQTL) data from Genotype-Tissue Expression Project (GTEx) V8, then performed cross-tissue TWAS using the Unified Test for MOlecular SignaTures (UTMOST) and single-tissue validation with the Functional Summary-based Imputation (FUSION) to prioritize susceptibility genes. Second, we applied Mendelian randomization (MR), colocalization, and Fine-mapping Of CaUsal gene Sets (FOCUS) to assess causality and identify high-confidence genes. Third, we performed metabolite mediation analysis to uncover metabolic pathways linking genetic variants to disease risk. Finally, we validated key findings in mouse models of thoracic aortic aneurysm (TAA) and abdominal aortic aneurysm (AAA) using Quantitative Real-Time Reverse Transcription Polymerase Chain Reaction (RT-qPCR) and Western blotting. RESULTS: We identified multiple novel susceptibility genes for AA and its subtypes. Key genes included ADH family members (ADH1A, ADH1B, ADH4, ADH6) and ZNF827, which showed cross-subtype associations with strong colocalization evidence in vascular tissues. Metabolite mediation analysis revealed significant pathways involving N-acetylphenylalanine and methionine sulfoxide. Functional enrichment revealed distinct biological mechanisms: AA and AAA were primarily associated with metabolic pathways, whereas TAA-related genes were enriched in developmental and contractile processes. PheWAS indicated no significant off-target associations. Critically, experimental validation in mouse models confirmed significant upregulation of ZNF827 in TAA and ADH6 in AAA at both mRNA and protein levels, corroborating the genetic predictions. CONCLUSION: This integrated cross-omics analysis identifies novel genetic loci and, crucially, uncovers specific nutrient-related metabolic pathways that mediate genetic risk. These findings provide a mechanistic basis for future nutritional and metabolic intervention studies in AA and its subtypes.
MAGMA↗
Comprehensive evaluation of differential expression of piRNAs in abdominal aortic aneurysm.
Abdominal aortic aneurysm (AAA) is a prevalent and fatal cardiovascular condition characterized by a high incidence rate and nonspecific clinical manifestations, with no effective preventive or therapeutic measures currently available. Piwi-interacting RNAs (piRNAs) have been identified as significant biomarkers for disease diagnosis due to their essential functions in transposon suppression, maintenance of genomic stability, immune response, and epigenetic modulation. The piRNA is intimately associated with various diseases such as cardiac hypertrophy, tumors, and neurodegeneration, yet its role in AAA is unclear. In this study, we employed gene sequencing to analyze the piRNA expression profiles in AAA vascular tissues and predicted variations in their target genes. Our findings revealed a total of 1368 piRNAs with abnormal expression in the AAA group relative to the control group, including 1240 up-regulated and 128 down-regulated piRNAs (|log2(fold change)| ≥ 1.0), with 82 demonstrating significant differences (P < 0.05). Through bioinformatics analysis, it was determined that the Wnt signaling pathway, calcium signaling, TNF-α and the p53 pathway are crucial mechanisms by which piRNAs contribute to the development of AAA. RT-qPCR confirmed that hsa_piR_011324 was the most significantly up-regulated piRNA in AAA (P < 0.0001), corroborating RNA sequencing results. Further results indicate that hsa_piR_011324 promotes phenotypic transformation of human aortic vascular smooth muscle cells (HAVSMCs), enhances the activity of matrix metalloproteinases (MMPs), increased up-regulation of inflammation-related markers IL-1β and TNF-α, and induces apoptotic processes. In conclusion, the present study emphasizes the important regulatory role of hsa_piR_011324 in AAA, suggesting that it holds promise as a prospective target for diagnostic and therapeutic intervention.
Aortic Aneurysm, Abdominal↗
Left cervical aortic arch associated with aortic aneurysm.
An aortic arch extending into the neck is a rare congenital anaomaly. Left-sided cervical aortic arch was thought to be much less common than right-sided, but they are now almost equal in incidence in the published reports. This paper describes a case of left-sided cervical aortic arch in an adult, with a previously undescribed association, aneurysm of the descending thoracic aorta. Cervical aortic arch must be considered in the differential diagnosis of pulsatile cervical swellings. The embryological development of the aortic arch is discussed. This is still controversial and it is not possible to be sure of the embryological explanation of this congenital anomaly of the aortic arch from a study of the adult anatomy.
Adult↗
[Dissecting aortic aneurysm and myocardial infarction--aortic dissection, association with myocardial infarction, its prognosis, and treatment].
Explore the source record for details and available documents.
Aortic Dissection↗
Dissecting aortic aneurysm associated with congenital bicuspid aortic valve.
Among 119 cases of fatal dissecting aneurysm of the aorta, exclusive of those iatrogenically caused or associated with arachnodactyly or aortic stenosis, there were observed 11 cases of congenital bicuspid aortic valve (9%). The ages ranged from 17 to 69 years, five of the patients being 29 years old or younger. Among the latter, three had coarctation of the aorta and one had Turner's syndrome without coarctation. In one of the older patients, aortic insufficiency was present. Hypertension was either established or inferred from cardiac weight in 73% of the cases. In each case, cystic medial necrosis of the aorta was present. Prolapse of valves other than the aortic was observed in 45% of the cases with bicuspid aortic valve. Compared to an estimated incidence of bicuspid aortic valve of about 1 to 2% in the population, the high incidence among subjects with dissecting aneurysm suggests a causative relationship between bicuspid aortic valve and aortic dissecting aneurysm.
Adolescent↗
Skeletal changes produced by aortic aneurysms.
The three major types of aortic aneurysms--arteriosclerotic, syphilitic, and dissecting are disussed in relation to the skeletal changes they produce. The favored location, age, and sex predilection are described for each type. Four documented cases from the Hamann-Todd osteological collection are presented with a description of the associated skeletal changes. All four cases appear to be the result of syphilitic infection. These documented cases provide forensic and physical anthropologists with a means of diagnosing aortic aneurysms in modern, historic, and prehistoric human skeletal remains.
Adult↗
ACTA scanning in the diagnosis of abdominal aortic aneurysms.
The presently available diagnostic methods for abdominal aortic aneurysms are reviewed. The application of ACTA scanning for this diagnosis in 35 patients is described. In all cases the presence of an aortic aneurysm was confirmed, even when calcification of its wall was absent. Contrast enhancement demonstrated that aortic lumen not otherwise visualized. In some instances the iliac arteries were clearly seen and more readily so when calcified. Estimates of aneurysm size were compared with measurements taken at surgery with a relatively close correlation. This technique seems to be useful in the differential diagnosis with tortuous abdominal aorta or as a screening procedure. Patients with minimal ectasia of the aorta can be followed by scanning. The planned addition of shorter scanning times and sagital scans with allow the fast evaluation of the longitudinal dimension of the abdominal aortic aneurysm, which is difficult to obtain with the present technique.
Aged↗
Cryptic mycotic abdominal aortic aneurysms: diagnosis and management.
The incidence of cryptic mycotic abdominal aortic aneurysms has relatively increased since antibiotic therapy has become available. The causative organism is the salmonella group in about 50 per cent of cases. This diagnosis should be strongly entertained in patients with fever of unknown origin, vague abdominal pain, and progressive appearance of a pulsatile abdominal mass. Aortography may be helpful in establishing the diagnosis. Some postoperative graft infections may be due to unrecognized cryptic mycotic infection of the aorta and not from external contamination, as previously supposed. Construction of an axillofemoral bypass graft through clean tissue is advised for the successful treatment of the grossly infected infrarenal aortic aneurysm. Three surviving patients with cryptic mycotic abdominal aortic aneurysms are added to the sixteen surviving patients already reported in the literature.
Aged↗
Editor's Choice - Aquaporin-4: A Predictor and Therapeutic Target for Permanent Paraplegia after Endovascular Thoraco-abdominal Aortic Aneurysm Repair.
OBJECTIVE: Endovascular thoraco-abdominal aortic aneurysm (TAAA) repair can impair spinal cord perfusion, leading to paraplegia. The mechanisms driving this devastating complication are poorly understood. This study aimed to interrogate the cerebrospinal fluid (CSF) proteome in patients after TAAA repair to identify biomarkers that herald permanent paraplegia. It also aimed to investigate a potential therapeutic target identified by proteomics using an in vivo model of ischaemic spinal cord injury (iSCI). METHODS: CSF was collected for proteomic analysis from patients before and following TAAA repair. A differentially expressed protein identified in human paraplegic subjects was subsequently interrogated in a rodent model of iSCI. The protein composition of CSF was analysed using tandem mass tag proteomics. Neurological examinations were carried out by a blinded neurologist and T2 weighted magnetic resonance imaging (MRI) was used to measure spinal cord volume and oedema. A rodent model of iSCI was used to investigate a clinically relevant therapeutic target informed by proteomic findings. RESULTS: CSF analysis was taken from 37 patients, all of whom had aneurysm repair using a custom branched and or fenestrated device (median age 73.5 years, range 67 - 78 years; 27 men, ten women; Crawford classification: six type I, 11 type II, 15 type III, three type IV, and two type V). Five patients remained permanently paraplegic and seven recovered from transient paraplegia. The CSF of patients who remained paraplegic contained approximately fourfold more aquaporin-4 (AQP4) (41.8 ± 19.2 ng/mL, n = 5) than those who recovered from paraplegia (10.8 ± 1.3 ng/mL, n = 7; p = .005) or did not develop paraplegia (10.8 ± 1.2 ng/mL, n = 25; p = .004). Permanently paraplegic patients had CSF AQP4 levels > 15 ng/mL and this was associated with greater cord oedema on T2 weighted MRI (1.77 ± 0.19 vs. 1.03 ± 0.36; p = .032). In a rodent model of iSCI, AQP4 inhibition preserved spinal neurons and glia in the dorsal horn and intermediate zones of white matter (p = .004) and protected against ischaemia induced paraplegia (p < .001). CONCLUSION: The AQP4 level in the CSF of a patient represents a prognostic marker of permanent paraplegia after TAAA repair and highlights a novel therapeutic target. These findings represent a conceptual advance in the management of iSCI.
Paraplegia↗
Hiccups: an unusual manifestation of an abdominal aortic aneurysm.
A patient with hiccups was found to have an abdominal aortic aneurysm that subsequently ruptured. We believe that a leaking abdominal aortic aneurysm led to an ileus-induced distention of the splenic flexure of the colon with consequent diaphragmatic irritation and phrenic nerve stimulation. This led to persistent hiccups as a result of repetitive stimulation of the reflex arc mediating hiccups. Persistent hiccups require investigation for an underlying organic etiology, and a leaking abdominal aortic aneurysm should be included in the differential diagnosis.
Aged↗
Leg ischemia following surgery for abdominal aortic aneurysm.
Resection of an abdominal aortic aneurysm was associated with intraoperative or postoperative leg ischemia in seven of 100 consecutive survivors of this procedure. Distal embolization of thrombus and debris is the apparent cause in the majority of cases (six). One case of stenosis at a graft-to-vessel anastomosis was identified. Early (intraoperative) thromboembolectomy averted tissue loss in four cases. The role of concurrent lumbar sympathectomy in ameliorating ischemic tissue loss is evaluated. Postaneurysmectomy leg ischemia may accompany other serious complications, particularly hypotension and renal failure.
Aorta, Abdominal↗
The surgical pathology of thoracic aortic aneurysms.
In 63 resected thoracic aortic aneurysms, the commonest histological finding (45 cases, 71.4%) was cystic medionecrosis. These cases formed two groups, 29 with widespread fragmentation and loss of elastic tissue (elastopathy) and 16 cases without elastopathy who were older and included most of the 18 cases of dissecting aneurysms. Thirteen patients had the Marfan syndrome, 10 showing cystic medionecrosis with elastopathy, indistinguishable from the cases with no Marfan stigmata although partial 'dissections' were mainly found in the Marfan patients, Histological appearances ranged from normal to complete loss of media. Cystic changes in muscle fibres apparently preceded elastic fragmentation. Fourteen cases (22%) had aortitis: 4 were syphilitic and 3 of other known aetiology. In 7 patients the aetiology of the inflammatory process was unknown and appearances included granulomatous infarct-like lesions and necrotizing aortitis or changes indistinguishable histologically from syphilis.
Adult↗
Mycotic aortic aneurysm in premature infants.
Three cases of aortic aneurysm adjacent to the tip of the umbilical artery catheter are described. The clinical presentation, radiographic findings, and proposed pathogenesis are discussed. Mycotic aneurysms in childhood are infrequent but serious threats to life, requiring early recognition and prompt therapy. The appearance of a progressively enlarging middle or posterior mediastinal mass in a child with a history of septicemia should suggest a mycotic aneurysm.
Aneurysm, Infected↗
Abdominal aortic aneurysm with rupture into inferior vena cava associated with horseshoe kidney.
The first patient with an abdominal aortic aneurysm with rupture into the inferior vena cava associated with a horseshoe kidney is reported. Rupture of an aortic aneurysm into the inferior vena cava with formation of an aortocaval fistula has been reported in 100 patients. Aortic aneurysm in combination with horseshoe kidneys has been described in 34 patients. The diagnosis was made by an abdominal aortogram. The patient's preoperative condition was characterized by circulatory and renal failure subsequent to the development of a large aortocaval fistula. Operative repair was performed by dividing and rotating the kidney, dividing a renal polar artery, incising the aneurysm, and over-sewing the fistula from within. The patient's postoperative course was complicated by renal failure and sepsis and he died two months later. It is essential to preserve renal function in patients with this combination of anomalies.
Aorta, Abdominal↗
Surgical classification of abdominal aortic aneurysms.
A new surgical classification of abdominal aortic aneurysms is proposed. The classification is based upon the clinical features immediately prior to surgery and the findings during operation. Group I consists of elective cases without symptoms, group II elective cases with symptoms, group III suspected rupture, group IV rupture without clinical shock and group V rupture with clinical shock. The mortality in a material of 129 cases was 0 in group I and progressed to 74% in group V. The mortality distribution was confirmed by a collective review of the literature. The proposed classification sheds light upon the natural history of the disease, prognosis and indication for operation.
Aged↗