A 63-year-old male patient with a type B aortic dissection after the use of tadalafil, a phosphodiesterase type 5 inhibitor, is presented. The possible role of a novel predisposing factor-sexual activity combined with tadalafil-is reviewed. This report and three other cases add a new dimension to the known predisposing factors ...

Aortic aneurysms are a common clinical condition that can cause death due to aortic dissection or rupture. The association between aortic aneurysm pathogenesis and altered TGF-β signaling has been the subject of numerous investigations. Recently, a TGF-β-responsive microRNA (miR), miR-29, has been identified to play a role in cellular phenotypic ...

Pulmonary arterial hypertension (PAH) is a severe and progressive disease that usually culminates in right heart failure and death if left untreated. Although there have been substantial improvements in our understanding and significant advances in the management of this disease, there is a grim prognosis for patients in the advanced ...

In this review, we discuss the mechanisms behind the binding of low-density lipoproteins (LDL) to the arterial wall and how this interaction might be targeted to prevent atherosclerosis. An increasing body of evidence shows that accumulation of LDL in the vessel wall is a critical step in the development of ...

OBJECTIVESNeointimal hyperplasia and superimposed atherosclerosis are central to late vein graft failure following coronary artery bypass grafting. Recent studies on post-injury arterial vessels have suggested a role of osteopontin (OPN) in the process of vascular remodelling. This study was designed to assess the in vivo performance of OPN following vein ...

A 50-year-old man underwent shoulder surgery in the beach chair position. His mean arterial blood pressure at arm level was approximately 65 mm Hg. Postoperatively, there was delayed awakening and a right hemiparesis. Radiologic evaluation revealed a congenital asymmetry of the circle of Willis that resulted in limited collateral flow ...

The pulmonary vasculature is innervated by specific subsets of sympathetic, parasympathetic, and sensory nerve fibers. In contrast to most other organs, innervation density is highest at large-caliber vessels and decreases toward the periphery, and reactivity to vasoactive compounds also changes along the course. In some species, such as the experimentally ...

The present study was to determine the role of the type I isoform of cGMP-dependent protein kinase (PKG I) and its downstream effector myosin phosphatase target subunit 1 (MYPT1) in the responses of different sized coronary arteries to nitrovasodilators. Relaxations of isolated porcine coronary arteries were determined by isometric tension ...

Understanding of the function of endothelin-1 in the pathophysiology of endothelial disease, in particular pulmonary arterial hypertension (PAH), has paved the way for the development of endothelin-receptor antagonists (ERAs) and explains the leading role they now play in the treatment armamentarium for this disease. Three active ERA drugs (bosentan, sitaxentan, ...

OBJECTIVE:To provide a comprehensive review of the pharmacology, pharmacokinetics, pharmacodynamics, clinical trial data, adverse effects, and drug interactions of apixaban.DATA SOURCES:An English-language literature search was performed with MEDLINE/PubMed from January 2007 to August 2011 using the search terms apixaban, factor Xa inhibitors, FXa inhibitors, BMS-562247-01, venous thromboembolism, deep vein thrombosis, ...

The mitral valve is a living structure comprised of specific structural components which contain a heterogeneous population of cells. The cells include an amalgam of interstitial cells within the valve and a continuous covering of endothelial cells, each of which play a role in responding to the mechanical forces that ...

The role of and indications for interventions for renal artery stenosis have long been a hot topic of debate. Despite numerous reports and studies over the years, there remain many unanswered questions. Among them are: Who should be intervened upon? What should be the objectives of intervention? What is the ...

To evaluate the role of neuronal nitric oxides synthase (nNOS) in collateral artery growth (arteriogenesis), we analyzed the expression pattern of nNOS at distinct time points on RNA and protein levels in a rabbit and a murine model of peripheral arteriogenesis. In the rabbit model, Northern blot analyses revealed a ...

Placental trophoblasts (TBs) invade and remodel uterine vessels with an arterial bias. This process, which involves vascular mimicry, re-routes maternal blood to the placenta, but fails in pre-eclampsia. We investigated Notch family members in both contexts, as they play important roles in arterial differentiation/function. Immunoanalyses of tissue sections showed step-wise ...

For about 50 years, angiography represented the only imaging method for studying carotid arteries in order to detect the presence of pathological stenosis due to atherosclerotic plaque. Recently, thanks to the use of non-invasive methods, physicians are able to study and quantify the presence of carotid atherosclerosis in vivo. These ...

Because both endothelin-1 (ET-1) and angiotensin II (AngII) are independent mediators of arterial remodeling, we sought to determine the role of ET receptor inhibition in AngII-accelerated atherosclerosis and aortic aneurysm formation. We administered saline or AngII and/or bosentan, an endothelin receptor antagonist (ERA) for 7, 14, or 28 days to ...

Atherosclerosis in symptomatic peripheral arterial disease affects wide portions of numerous arteries in lower extremities. The resulting active inflammation in a considerable amount of arterial tissue facilitates systemic detection via measurement of inflammation-related variables. We reasoned that the combined assessment of defense against oxidative stress, in the form of paraoxonase-1 ...

Abstract Context.-Idiopathic pulmonary fibrosis is a uniformly lethal disease with limited biomarkers and no proven therapeutic intervention short of lung transplantation. Pulmonary fibrosis at one time was thought to be a result of inflammation in the lung. Although some forms of pulmonary fibrosis may result from inflammation, idiopathic pulmonary fibrosis ...

The role of acetylcholine in determining the tone of blood vessels.

Aims We have previously characterized a cGMP-dependent Ca(2+)-activated Cl(-) current in vascular smooth muscle cells (SMCs) and have shown its dependence on bestrophin-3 expression. We hypothesized the importance of this current for synchronization of SMCs in the vascular wall. In the present study we aimed to test this hypothesis by ...

Congenital pulmonary vein stenosis (PVS) is a very rare cardiac malformation and commonly associated with cardiac or extracardiac abnormalities. It is usually found during the newborn period and survival to maturity is very rare due to either of progressive pulmonary hypertension or associated cardiac anomalies. In this case report, an ...

Aberrant origin of a pulmonary artery from the ascending aorta is an uncommon congenital vascular malformation with poor survival without surgery. In this case report, we describe the unusual late diagnosis of this congenital malformation in an otherwise asymptomatic young man presenting with mild hemoptysis. We review the natural and ...

Unilateral pulmonary vein atresia is a rare congenital heart disease. Its symptoms begin to manifest in childhood and may be similar to those of other left-side heart obstructions. The diagnosis of this disorder is difficult and usually requires several imaging methods. This report presents the case of a 7-year-old girl ...

Although real time three-dimensional transthoracic echocardiography (RD-3DTTE) has been used in children with complex congenital heart diseases, the benefit of RD-3DTTE as a vision of the pulmonary veins still requires further evaluation. We present here, a 3-year-old girl with a stenosis of the left upper pulmonary vein (LUPV). Excellent images ...

The management of adult congenital heart disease is challenging and poses specific problems. We report a patient with ventricular septal defect and pulmonary stenosis who underwent successful repair and coronary artery bypass grafting at the age of 76 years.

A 28-year-old Cambodian man with a history of congenital heart disease presented with a 6-month history of increasing fatigue, night sweats, and weight loss. His surgical history included two Blalock-Taussig shunts, ventricular septal defect closure, and placement of a pulmonary valve conduit via a Rastelli procedure. Echocardiographic and cardiac computed ...

Cardiovascular disease in patients with congenital hypopituitarism is not rare; however, there is a lack of reports referring to cardiac interventions in such patients. We present a 76-year-old man with complete pituitary hormone deficiency, who presented with recurrent events of unstable angina. He had a significant stenosis of the left ...

Congenital diaphragmatic hernia (CDH) is a congenital anomaly consisting of a posterolateral defect in the diaphragm also known as a Bochdalek hernia. It occurs in 1 in 2000 to 3000 newborns and is associated with a variable degree of pulmonary hypoplasia (PH) and persistent pulmonary hypertension (PPH). Despite remarkable advances ...

We report the case of a 5-year-old girl with persistent chest X-ray abnormalities following an episode of pneumonia who has a complex congenital pulmonary malformation comprising of a congenital pulmonary airway malformation, an intralobar sequestration and two bronchogenic cysts, all present within the same lobe. The observation suggests a common ...

In this report, we describe a very rare case of a congenital subaortic left ventricular aneurysm in an 80-year-old patient. Cardiac computed tomography imaging is a reliable and noninvasive tool for diagnosis and follow-up of subaortic aneurysms.

Isolated absent pulmonary valve syndrome is a very rare entity. We report the case of a four-year-old boy who had congenital absent pulmonary valve with a thin and aneurysmal right ventricular infundibulum. The histological picture was suggestive of Uhl's anomaly. This association of partial right ventricular Uhl's anomaly with absent ...

We report the case of a 21-year-old man who presented with a hilar mass and whose condition was diagnosed as a congenital anomalous communication between the bronchial and pulmonary artery. We review his lung vascular embryology and anatomy that led to this rare systemic to pulmonary arterial shunt, describe other ...

Tetralogy of Fallot (TOF) represents the most common form of cyanotic congenital heart disease, accounting for 6.8% of all congenital heart disease. As surgical techniques and medical management of patients with TOF have improved, most affected patients are reaching adulthood. Though surgical outcomes are favorable (<2% early mortality rate), adults ...

A 15-year-old girl gave a recent history of dyspnoea and "funny turns". She had congenital aortic stenosis, previous valvotomies, a mechanical valve replacement, permanent pacemaker, atrial tachyarrhythmias, impaired ventricular function, systemic hypotension, pulmonary hypertension, and anxiety. The diagnosis of diaphragmatic flutter was delayed due to all the differential diagnoses and ...

Crossed pulmonary arteries are rare anomalies of the pulmonary trunk and its branches. In this anomaly, the ostium of the left pulmonary artery originates superiorly and to the right of the right pulmonary artery. This anomaly is usually associated with other congenital cardiac and extracardiac diseases. We report three neonates ...

Congenital coronary artery fistulas (CAFs) are uncommon abnormalities. A connection between the left main stem and main pulmonary artery is extremely rare. Congenital CAFs are frequently associated with another congenital heart disease. Associated anomalies include atrial septal defect, tetralogy of Fallot, patent ductus arteriosus, ventricular septal defect, and pulmonary atresia. ...

Congenital anomalies of the pericardium are extremely rare and often difficult to diagnose. We describe a 66-year-old woman presenting with multivessel coronary artery disease and right heart insufficiency complicated by an extremely left-rotated heart due to a congenital absence of left pericardium. A multidetector row computerized tomographic study was performed ...

We present the case of a young patient with severe congenital musculoskeletal abnormalities. associated with different pathologies, with involvement of the arterial tree on both the systemic and pulmonary circulation, and involvement of the lungs due to thoracic hypoplasia. The presence of such extensive pathology raises the question of the ...

A case of remarkable vertebrobasilar insufficiency due to congenital multiple occlusive cerebro-vascular anomalies is presented. Anomalies are of the anterior and posterior circulation, presumably induced by "segmental vulnerability" and modified by infection of recurrent tonsillitis. Symptoms of repeated faintness and black-out attacks and deterioration of cognitive function compromised the quality ...

Congenital pulmonic stenosis (PS) rarely presents in patients over the age of 55 years. A stable asymptomatic course into late adulthood is the usual history of mild to moderate PS. Balloon valvuloplasty has become the procedure of choice for congenital PS, especially in children and young adults. There are rare ...

Pulmonary arterial hypertension (PAH) is a common problem in adult patients with congenital heart disease. We review available data on aetiology, clinical presentation, prognosis and management of PAH in this setting. In addition, we discuss general management strategies and emerging disease-targeting therapies.

Many congenital heart defects with pulmonary valve pathology are repaired or palliated in childhood. It is anticipated that these patients will need subsequent pulmonary valve replacement due to the pulmonary regurgitation or right ventricular dilation/failure that results from their original operation. Interestingly, some patients with prior congenital heart surgery and ...

Congenital unilateral pulmonary venous atresia is a rare anatomical defect. Patients present with pulmonary symptoms, and diagnosis may be elusive. Pulmonary arterial wedge angiography is the gold standard with which to achieve diagnosis, and surgical intervention is often required for symptomatic patients.

Due to improved outcome after surgery for congenital heart defects, children, adolescents, and grown-ups with congenital heart defects become an increasing population. In order to evaluate operative risk and early outcome after mechanical aortic valve replacement (AVR) in this population, we reviewed patients who underwent previous repair of congenital heart ...

We report a rare case of coexisting pulmonary artery sling, congenital tracheal stenosis, and dextrocardia caused by right lung hypoplasia. Successful treatment of severe postoperative tracheomalacia was achieved by aortopexy, aiming displacement of the aortic arch across orthogonally in front of the trachea due to dextrocardia. The aim of this ...

Congenital hypofibrinogenemia is a rare condition. We believe that cardiac surgery using cardiopulmonary bypass in a patient with congenital hypofibrinogenemia has not been reported before. We discuss the management in a patient with this condition who successfully underwent an aortic valve replacement and coronary artery bypass grafting.

Congenital pulmonary vein stenosis (PVS) presents as an isolated lesion or in association with other congenital heart anomalies. The most extensive forms of the disease are uniformly fatal because neither surgical repair nor transcatheter therapy results in long-term relief of the stenosis. A case is presented involving single-ventricle physiology associated ...

BACKGROUND: The field of congenital heart disease is constantly evolving through better understanding of the disease itself, albeit its history, prevalence, genetics, and follow-up. Concurrently surgical techniques and approaches have been developed, modified, and refined. DATA SOURCES: The impact of interventional pediatric cardiology has been dramatic. The field of catheter-based ...

Adolescent and adults with congenital heart disease (CHD) represent a special group of individuals. They often require regular assessment of their cardiac anatomy and functional hemodynamics. Most children with repaired CHD surviving to adulthood are either corrected or fully repaired and may not require long term follow-up. However, there are ...

We report a mildly symptomatic 12-year-old boy with a very rare congenital anomaly-isolated unilateral pulmonary vein atresia. Diagnosis was made using CT angiography and its role in diagnosis is discussed.