Articles: aortic-rupture-etiology.
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Comparative Study
Volume growth of abdominal aortic aneurysms correlates with baseline volume and increasing finite element analysis-derived rupture risk.
The diagnosis and management of abdominal aortic aneurysms (AAAs) currently relies on the aortic maximal diameter, which grows in an unpredictable manner. Infrarenal aortic volume has recently become clinically feasible to measure, and an estimate of biomechanical rupture risk derived from finite element analysis, the peak wall rupture index (PWRI), has been shown to predict AAA rupture. Our objective was to ascertain how well volume growth correlates with baseline volume and increasing PWRI, compared with the maximal diameter. ⋯ Volume better predicts aneurysm growth rate and correlates stronger with increasing estimated biomechanical rupture risk compared with diameter. Our results support the notion of monitoring all three dimensions of an AAA.
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The management of degenerative aneurysms of the aortic arch requires careful selection of patients, taking into consideration risk of rupture and operative risks, which is more relevant with the emergence of hybrid debranching and branched and fenestrated endovascular options. The natural history of true arch aneurysms has not been previously studied. We aimed to determine the expansion rate of thoracic aortic arch aneurysm and to identify predictors for rupture. ⋯ Aneurysm expansion rate >5.5 mm/y is a significant rupture predictor in addition to size compared with aneurysm morphology and other demographic factors. Aneurysm size >6.5 mm and hyperlipidemia are determining factors of expansion rate. These may have implications in selection of patients for surgery. Better control of hyperlipidemia may alleviate the risk of rupture.
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Interact Cardiovasc Thorac Surg · Apr 2016
Are normal-sized ascending aortas at risk of late aortic events after aortic valve replacement for bicuspid aortic valve disease?
Bicuspid aortic valve (BAV)-associated aortopathy has been proposed to progress after isolated aortic valve replacement (AVR) surgery, which has been traditionally used as an argument against a TAVR procedure in this clinical subset. Still, more than half of BAV patients have a normal-sized proximal aorta at the time of AVR surgery. We aimed to analyse the long-term risk of adverse aortic events after isolated conventional AVR surgery for BAV and normal-sized proximal aorta. ⋯ BAV patients with aortic valve dysfunction and normal-sized ascending aorta are at considerably low risk of late adverse aortic events after isolated AVR.
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Post-mortem computed tomography (PMCT) and post-mortem computed tomography angiography (PMCTA) are rapidly becoming effective and practical methods in forensic medicine. In this article, we introduce a PMCTA approach by cardiac puncture and its application in a specific forensic case. A 50-year-old female sanitation worker was found dead on a road. ⋯ Sternal fracture and rib fractures were detected by PMCT and aortic rupture by PMCTA. The cause of death was hemorrhagic shock due to traumatic aortic rupture. In certain circumstances, the combination of PMCT and PMCTA is helpful for forensic pathologists to determine the cause of death in cases involving traumatic vascular injury.