Document Detail

Ascending aortic aneurysms: asymmetrical differences in aortic cross-sectional wall motion detected by epiaortic echocardiography.
MedLine Citation:
PMID:  20619679     Owner:  NLM     Status:  In-Process    
OBJECTIVE: To evaluate in vivo cross-sectional conformational changes of ascending aortic wall excursion in patients undergoing resection for aortic aneurysm with those undergoing elective coronary artery bypass grafting (CABG) using epi-aortic echocardiography.
DESIGN: A prospective observational investigation.
SETTING: A single tertiary care university hospital.
PARTICIPANTS: Thirty-four patients undergoing elective ascending aorta resection and 23 elective CABG patients.
INTERVENTION: In an open-chest model and with use of an epi-aortic echocardiographic probe, measurements of aortic wall excursion were made on the ascending aortic aneurysms. Control measurements were made on the transitional neck portions of the aneurysmal aortas (internal control) and CABG aortas (external control).
MEASUREMENTS AND MAIN RESULTS: The aortic aneurysm measurements exhibited no difference (2.8%, p < 0.62) between the excursion of the anterior and posterior walls. In contrast, under similar hemodynamic conditions, the anterior wall of the aneurysm neck moved 48.2% (p < 0.0004) more than the posterior wall. Similarly, in the CABG control group, the anterior wall moved 24% (p < 0.027) more than the posterior wall.
CONCLUSION: This in vivo study documented a lack of asymmetric aortic wall motion in ascending aortic aneurysms. In contrast, both the internal and external control groups (aneurysm neck and CABG) demonstrated asymmetric wall motion. The lack of asymmetric wall motion may be an important aspect of aneurysm pathophysiology and key to the development of management strategies for timing of surgical intervention.
Raj K Modak; George J Koullias; Usha S Govindarajulu; Maryann Tranquilli; Paul G Barash; John A Elefteriades
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2010-07-08
Journal Detail:
Title:  Journal of cardiothoracic and vascular anesthesia     Volume:  24     ISSN:  1532-8422     ISO Abbreviation:  J. Cardiothorac. Vasc. Anesth.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9110208     Medline TA:  J Cardiothorac Vasc Anesth     Country:  United States    
Other Details:
Languages:  eng     Pagination:  776-9     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier Inc. All rights reserved.
Department of Anesthesiology, Section of Cardiothoracic Anesthesia, Yale University School of Medicine, New Haven, CT 06520-8051, USA.
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