Although multiplane transesophageal echocardiography has become an accepted diagnostic technique, there is a paucity of literature directly comparing the diagnostic yield of multiplane and biplane transesophageal examinations. This study was designed to compare the ability of multiplane and biplane transesophageal echocardiographic techniques to visualize intracardiac structures. Complete multiplane and biplane ...

A female severe macaw (Ara severa) that was at least 11 years old was evaluated for sudden onset of exercise intolerance and dyspnea. Radiography revealed a large heart silhouette, an increase in prominence of the brachiocephalic arteries, and a diffuse increase in opacity of the lungs. Lateral nonselective angiography revealed ...

The purpose of this study was to determine the extent of aluminum (Al) accumulation in the human aorta and cerebral arteries. The Al contents in the aortae and in the cerebral arteries from 23 human subjects was determined by inductively coupled plasma atomic emission spectrophotometry (ICP-AES). The subjects' age range ...

OBJECTIVES: This study sought to determine the role of transesophageal echocardiography (TEE) and epiaortic ultrasound in the detection of atherosclerosis of the ascending aorta in patients undergoing cardiac surgery. BACKGROUND: Atherosclerosis of the ascending aorta is a major risk factor for perioperative stroke and systemic embolism in patients undergoing cardiac ...

Spontaneous echocardiographic contrast (SEC) is an occasional finding observed in the atria in patients undergoing transesophageal echocardiographic studies, but has rarely been described in the descending thoracic aorta in the absence of an aortic dissection. The pathophysiology of SEC in the cardiac and vascular structures appears to be related to ...

For surgical treatment of aorto-iliac occlusive diseases the prosthetic grafts are used for aorto-femoral bypass in which the end to side anastomoses are done on anterior aspect of aorta. But this approach is leading to some disadvantages caused by gravity or pressure imposed by abdominal viscera and resulting to kinking ...

Two autopsy cases with pericardial tamponade and spontaneous rupture of non-aneurysmal ascending aorta are described. In case 1, no apparent predisposing factor was clinically noticed in a 74 year old male patient, but postmortem examination revealed laceration of the ascending aorta associated with aortic valvular deformity and slight dilatation of ...

Spinal tuberculous osteomyelitis eroding into the aorta is an extremely rare entity. The case of an 80-year-old man with a large proximal anastomotic pseudoaneurysm above an aortobiiliac prosthesis involving the suprarenal aorta is reported. A periaortic and perigraft fluid collection was found to be contiguous with an osteolytic process of ...

Having proposed a new classification on angiographic findings of patients with Takayasu arteritis, we evaluated the angiographic findings of 80 Japanese patients and 102 Indian patients according to this classification. Japanese patients showed a higher frequency of involvement of the ascending aorta, aortic arch and its branches than did the ...

In this study, mechanical characteristics of descending thoracic aorta were evaluated after preservation at +4 degrees C in EuroCollins solution or after programmed cryopreservation with 15% dimethylsulfoxide and compared to control segments. Arterial allografts were procured from multiple organ harvesting over a period of 2 years. All the segments were ...

The relative contents (RCs) of mineral elements in aortae and cerebral arteries from 23 subjects, with ages ranging between 45 and 99 yr, were analyzed by inductively coupled plasma atomic emission spectrometry. The RCs of calcium, phosphorus, and magnesium in the aortae increased markedly after the age of 70. While ...

STUDY OBJECTIVES AND DESIGN: Arterial vasoconstriction is thought to play a role in the etiology of cocaine-induced cardiovascular complications, but little is known about the immediate effects of cocaine on the thoracic aorta and coronary arteries. To examine these effects, we used transesophageal echocardiography to examine the thoracic aorta and ...

Marked arteriosclerosis localized to the descending thoracic and abdominal aorta was observed in a 19-year-old girl with interruption of the aorta (type A) and a ventricular septal defect. She died from rupture of saccular aneurysm of the pulmonary trunk. The descending thoracic and abdominal aorta showed marked thrombogenic, lamellar thickening ...

Late aneurysms are common after repair of coarctation of the aorta by prosthetic patch aortoplasty but are rare after subclavian flap aortoplasty. We present the case of a 14-year-old boy who underwent a grafting procedure for a descending thoracic aortic aneurysm after subclavian flap aortoplasty for coarctation of the aorta ...

BACKGROUND: Study of the long-term results from 1 to 24 years after coarctation of the aorta repair in 891 patients showed that in 48 (5.4%, Mean age, 30.9 +/- 1.1 years) aneurysms had developed at the site of repair. Aneurysms arose in 43 (89.6%) of the patients in whom repair ...

The transverse thoracosternotomy provides excellent exposure for repair of lesions involving the entire thoracic aorta. This approach has been made more feasible by other recent technical advances, such as retrograde perfusion of the brain during circulatory arrest, allowing single-stage replacement of the ascending and descending aorta and aortic arch. The ...

Intraoperative decisions are often based on interpretation of results from transesophageal echocardiography (TEE). One such area is the intraoperative evaluation of atheromatous disease of the thoracic aorta and subsequent classification or grading. These grading schemes are predictive of stroke after cardiac surgery. Since intraoperative strategies may be modified based on ...

A biochemical analysis of glycosaminoglycans was performed in arteries of a fifteen-year old white male who died of beta thalassemia major. The patient presented the severe clinical complications resulting from hemochromatosis, which was evidenced at autopsy and by histologic examination. The arteries under study comprised the thoracic and abdominal aortas ...

OBJECTIVES: The present report is a critical review on primary repair of aortic coarctation by patch aortoplasty on the basis of over 30 years surgical experience. METHODS: Since 1962, 60 patients (mean age 9.4 +/- 4.8 years, range 2-25 years), affected by aortic coarctation, underwent patch aortoplasty repair. During the ...

A 54-year-old man with coarctation of the thoracic aorta and acute dissection of the ascending aorta ruptured into the pericardium underwent emergency repair of the dissection by means of replacement of the ascending aorta and the aortic valve. Correction of the aortic coarctation was performed 4 months later. The authors ...

BACKGROUND: Descending thoracic aortomyoplasty is a form of skeletal muscle-powered cardiac assistance. Its use in clinical settings has been limited by the ligation of intercostal arteries necessary to complete a circumferential wrap of the aorta with the latissimus dorsi. METHODS: This study assessed the feasibility and the efficacy of aortomyoplasty ...

OBJECTIVE: From June 1987 to September 1995, 53 patients underwent a new technique of coarctation repair. This technique consists of complete mobilization of the left subclavian artery so that it can be pulled down as far as possible. METHOD: After all the necessary clamping, the anterior wall of the aorta ...

The authors present a case of adult aortic coarctation with two associated intercostal aneurysms and poor left ventricular function. The intercostal aneurysms appear, radiographically, as a subclavian aneurysm. The case illustrates, in aortic coarctation, the potential difficulty in defining the anatomy of the associated vascular aneurysms. The authors also demonstrate ...

We report findings in a male infant born with talipes equinovarus and ischemic necrosis of the left lower leg and foot associated with atypical coarctation of the ascending aorta and stenosis and hypoplasia of the proximal innominate artery. We hypothesize that a vasculopathy of unknown etiology occurred in utero that ...

Spontaneous echocardiographic contrast is associated with embolic events when it occurs in the left atrium. Because little is known about spontaneous echocardiographic contrast in the aorta, we investigated this association retrospectively in 343 patients without aortic dissection or aneurysm who had undergone transesophageal echocardiography. Two independent readers concurred on the ...

Acute aortic dissection during balloon angioplasty for coarctation of the aorta or aneurysm formation during follow-up are well-known complications of this procedure. Dissecting aneurysm development during long-term follow-up after balloon angioplasty of a native coarctation has not been previously reported. We report a case in which a huge dissecting aneurysm ...

BACKGROUND: The surgical management for bridging patients with univentricular heart and systemic obstruction to a Fontan procedure remains controversial. METHODS: Twenty-seven of 96 patients with univentricular heart and unobstructed pulmonary blood flow referred for surgical palliation were seen with systemic obstruction. Twenty-six were neonates with coarctation of the aorta in ...

In the course of coronary bypass operations the proximal anastomosis of the saphenous vein to the aorta is commonly done either with the aorta clamped completely or by using a partially occluding clamp. While under usual circumstances, either method is feasible; under other conditions, such as in the presence of ...

Seventy-two-kilodalton type IV collagenase (MMP-2), a potent collagenase and elastase, is present in inflammatory disease states and may be important in the pathogenesis of aortic aneurysms. Alteration in expression of MMP-2 or its inhibitor, the tissue inhibitor of metalloproteinases type two (TIMP-2), could increase extracellular matrix degradation and lead to ...

The presentation of simultaneous severe coarctation of the descending aorta and severe aortic valve disease is uncommon. We describe the management of simultaneous association of aortic coarctation, aortic valve disease, and ischemic cardiomyopathy and describe a one-stage surgical approach for the correction of all pathologies. After performing the aortic valve ...

Atherosclerosis of the ascending aorta may be associated with a higher perioperative stroke risk in cardiac surgery. This study investigated the use of biplane transesophageal echocardiography (TEE) scanning of the entire thoracic aorta to predict the presence of plaque in the ascending aorta. Eighty-one patients (57 male, 24 female; aged ...

Active or passive bypass to support the distal circulation during cross-clamping of the descending thoracic aorta has been reported to decrease the incidence of paraparesis, to reduce left ventricle afterload, and to preserve distal organ perfusion. The aim of this study was to describe and to evaluate a perfusion technique ...

PURPOSE: While localization of atherosclerosis and aneurysms to the infrarenal aorta has been attributed, in part, to hemodynamic factors, anatomic differences between the proximal and the distal aorta may also be important. Our purpose was to determine the changes in content and organization of major structural proteins (elastin and collagen) ...

Four patients with suprarenal coarctation of the abdominal aorta were managed from 1978 to 1993 (mean follow-up 8.75 years). Ages at the time of diagnosis were 2 months, 8 months, 4.5 years, and 15 years, respectively. Three children presented with severe hypertension, two of whom were in congestive heart failure, ...

The authors describe an unusual presentation of penetrating atherosclerotic ulcer of the aorta in an 84-year-old man. The ulcer perforated the aorta, and hematoma extended into the soft tissues of the neck, causing upper airway and esophageal obstruction. The results of autopsy proved the findings of prior chest radiography and ...

Anatomic placement of a synthetic graft from the infrarenal aorta to the iliofemoral vessels has been a long recognized technique used to bypass occlusive disease of the distal aorta and iliofemoral arteries. However, in a few select patients with failure or infection of the abdominal graft, or in patients with ...

A 59-year-old woman with dissection of the thoracic aorta and a fusiform aneurysm of the abdominal aorta without evidence of Marfan's syndrome underwent aneurysmorrhaphy with a bifurcated expanded polytetrafluoroethylene graft. Histological specimens of the aneurysmal wall revealed the presence of idiopathic cystic medial necrosis. As typical findings of idiopathic cystic ...

The study was designed to establish the underlying pathology of aortic coarctation in hypoplastic left heart syndrome. Aortic coarctation in patients with hypoplastic left heart syndrome is a significant problem when a Norwood procedure or heart transplantation is performed. Previous reports have claimed that the obstruction was merely a branch-point ...

A 64-year-old woman without manifestations of Marfan syndrome was referred for the close investigation of a pulsatile abdominal mass. Computed tomographic scans and magnetic resonance images revealed aneurysmal dilatation of the entire aorta, including the ascending aorta and extending to the bifurcation of the aorta, as well as tortuousness of ...

BACKGROUND: Aneurysmal dilation of the aorta with subsequent rupture or dissection occurs frequently in patients with Marfan syndrome and is the primary cause of morbidity. These complications are related to the altered composition and disorganized structure of the aortic media. Our goal was to use high-frequency ultrasonic tissue characterization to ...

Three consecutive neonates (aged 7, 14 and 30 days, body-weight 2980 g, 3000 g and 3400 g respectively) with interruption of the aorta (n = 2) and severe coarctation (n = 1) in the presence of left aortic arch and right descending aorta are reported. Associated lesions were an aortopulmonary ...

A fourth case of displacement of one ring of an intraluminal graft is reported. This occurred in a woman who was operated on for acute dissection of the aorta. The displacement happened 8 h after surgery and produced acute obstruction of the ascending aorta. Restoration of the proximal ring of ...

In this article we report the successful treatment of a lower descending thoracic aorta hydatidosis that mimicked a posterior saccular aneurysm; surgical excision was performed and the aorta was repaired with a prosthetic Dacron patch. At a 26-month follow-up, the patient is alive and conducting a normal life. Discussion about ...

The case of a 19-year-old woman with Turner's syndrome, dissecting aneurysm of the ascending aorta, coarctation of the aorta and bicuspid aortic valve stenosis is presented. Balloon angioplasty was performed before surgery to relieve the pressure gradient caused by coarctation of the aorta. Successful surgical treatment was carried out using ...

To evaluate the effectiveness of tailoring aortoplasty used to treat fusiform aneurysms of the ascending aorta, we reviewed the results of operation in 17 patients. Nine patients had tailoring aortoplasty alone, and 8 patients had aortoplasty with Dacron wrap of the ascending aorta. Fourteen of 17 patients were discharged from ...

Aneurysms of the thoracoic aorta may on rare occasions lead to shortness of breath by external compression of the tracheobronchial tree. We report the case of a patient who presented with orthopnea due to extensive compression of the trachea and the major airways by a large aneurysm of the ascending ...

From July 1992 to January 1993, a total of 5 cases of hypoplastic left heart syndrome were diagnosed by echocardiograms and confirmed by available angiographic, surgical or autopsy results. The flow dynamics disclosed by spectrum display in the aortic root and patent ductus arteriosus (PDA), in systole, were: (1) antegrade ...

The authors report a case of atypical coarctation of the thoracic aorta discovered by chance in a 37-year-old man, victim of a car accident. The angiogram revealed a "string-of-beads" contour in the coarctate area while the left subclavian artery presented a severe stenosis at its origin. Vascular checkup examination failed ...

When acute thrombosis of the abdominal aorta occurs in a comatose patient, direct examination of the intraabdominal organs becomes mandatory. Once a laparotomy has been performed, media calcinosis of the infrarenal aorta is a contraindication to its use as an inflow source. We describe a technique for exposing the thoracic ...

Malignant fibrous histiocytoma of the aorta developed in a 70-year-old man 4 years after he had undergone repair of a type B aortic dissection with Dacron graft interposition. The tumor surrounded the graft externally and involved the adventitia of the aorta near the proximal anastomosis. Clinically and radiologically it mimicked ...