Acta Médica Portuguesa,
Год журнала:
2025,
Номер
unknown
Опубликована: Март 26, 2025
Aortic
dissection
is
rare
and
more
common
in
men.
In
women,
it
frequent
during
pregnancy,
especially
the
third
trimester.
We
present
case
of
a
30-year-old
pregnant
woman
diagnosed
with
type
B
aortic
at
29
weeks
gestation.
Following
diagnosis,
fetal
maturation
was
initiated,
patient
transferred
to
tertiary
care
center.
Due
uncontrolled
hypertension
persistent
pain,
after
evaluating
maternal
risk-benefit,
cesarean
section
performed
six
days.
During
postoperative
period,
multi-drug
regimen
required
for
blood
pressure
control,
but
recovered
discharged.
Genetic
testing,
prompted
by
family
history
sudden
death
(brother)
(father),
identified
mutation
FBN1
gene,
confirming
Marfan
syndrome.
This
highlights
importance
comprehensive
history,
challenges
need
multidisciplinary
approach
these
cases.
Frontiers in Cardiovascular Medicine,
Год журнала:
2025,
Номер
12
Опубликована: Фев. 19, 2025
Thoracic
aortic
aneurysm
and
dissection
(TAAD)
significantly
impact
cardiovascular
morbidity
mortality.
A
large
subset
of
TAAD
cases,
particularly
those
with
an
earlier
onset,
is
linked
to
heritable
genetic
defects.
Despite
progress
in
characterizing
genes
associated
both
syndromic
non-syndromic
TAAD,
the
causative
gene
remains
unknown
most
cases.
Another
important
bottleneck
correct
timely
diagnosis
proportion
variants
significance
(VUS)
that
are
routinely
encountered
upon
medical
testing.
Reliable
functional
modeling
data
required
accurately
identify
new
causal
determine
pathogenicity
VUS.
To
address
this
gap,
our
collaborative
effort-comprising
teams
from
Yale
University,
University
Kentucky,
Ghent
University-explores
a
novel
approach:
zebrafish.
Leveraging
unique
advantages
animal
model
promises
allow
for
accelerated
variant
assessment,
ultimately
enhancing
patient
care.
In
review,
we
critically
explore
currently
available
zebrafish-based
approaches
can
be
used
testing
related
offer
outlook
on
implementation
these
strategies
clinical
applications.
Circulation Research,
Год журнала:
2025,
Номер
136(6), С. 606 - 617
Опубликована: Март 13, 2025
Multifaceted
disparities
exist
between
men
and
women
with
thoracic
aortic
aneurysm
dissection.
Despite
a
higher
prevalence
of
dissection
among
men,
experience
disproportionately
accelerated
aneurysmal
expansion,
greater
risks
rupture
or
dissection,
acute
syndromes
that
occur
at
relatively
smaller
diameters.
In
the
context
type
A
they
also
more
complications,
increased
out-of-hospital
mortality,
delays
in
presentation
diagnosis,
worse
postoperative
survival.
These
gaps
are
largely
driven
by
sex
differences
vascular
aging
remodeling,
which
include
arterial
stiffening
associated
hormonal
changes
during
menopause.
Furthermore,
risk
pregnancy
disease
necessitates
multidisciplinary
approach
to
peripartum
counseling
surveillance.
significant
recent
improvements
early
outcomes,
other
persist,
emphasizing
need
for
sex-specific
research,
patient
counseling,
routine
monitoring,
surgical
thresholds
bridge
gap
outcomes
care
sexes.
Elucidating
underlying
mechanisms
its
difference
women,
as
well
moving
toward
personalized
management
protocols,
will
give
rise
improved
treatment
aortopathy.
Journal of Clinical Medicine,
Год журнала:
2024,
Номер
13(9), С. 2593 - 2593
Опубликована: Апрель 28, 2024
The
treatment
of
DeBakey
type
I
aortic
dissection
remains
a
major
challenge
in
the
field
surgery.
To
upgrade
standard
care
hemiarch
replacement,
novel
device
called
an
“Ascyrus
Medical
Dissection
Stent”
(AMDS)
is
now
available.
This
hybrid
composed
proximal
polytetrafluoroethylene
cuff
and
distal
non-covered
nitinol
stent
inserted
into
arch
descending
thoracic
aorta
during
hypothermic
circulatory
arrest
addition
to
replacement.
Due
its
specific
design,
it
may
result
reduced
risk
for
anastomotic
new
entries,
effective
restoration
branch
vessel
malperfusion
positive
remodeling.
In
this
narrative
review,
we
provide
overview
about
indications
technical
use
AMDS.
Additionally,
summarize
current
available
literature
discuss
potential
pitfalls
application
AMDS
regarding
failure
re-intervention.
RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren,
Год журнала:
2024,
Номер
unknown
Опубликована: Ноя. 20, 2024
Abstract
Since
the
approval
of
first
dual-source
photon-counting
detector
CT
(PCD-CT)
in
fall
2021,
significant
insights
have
been
gained
its
application
for
cardiovascular
imaging.
This
review
aims
to
provide
a
comprehensive
overview
current
state
knowledge
and
growing
body
research
literature,
illustrating
innovative
applications
perspectives
through
case
examples.
We
conducted
structured
literature
review,
identifying
relevant
studies
via
Google
Scholar
PubMed,
using
keywords
“photon-counting
detector”,
“cardiovascular
CT”,
“cardiac
“ultra-high-resolution
CT”.
analyzed
published
since
January
2015.
Additionally,
we
integrated
our
own
clinical
experiences
In
addition
well-known
benefit
increased
temporal
resolution
offered
by
scanners,
PCD-CT
provides
three
key
advantages:
1)
Optimized
geometric
dose
efficiency
with
an
improved
contrast-to-noise
ratio,
2)
intrinsic
spectral
sensitivity,
3)
ability
ultrahigh-resolution
CT.
technology
enables
image
quality
or
radiation
reduction
established
protocols.
Its
use
non-invasive
cardiac
diagnostics
obese
patients,
those
high
plaque
burden,
after
stent
implantation
appears
technically
feasible,
potentially
expanding
scope
The
sensitivity
also
allows
tailored
acquisition,
reducing
metallic
artifacts
contrast
agent
doses
patients
renal
impairment.
Early
experience
support
these
potential
diagnostics,
suggesting
workflow
optimization
patient
management.
However,
challenges
remain,
including
costs,
large
data
volumes,
somewhat
longer
reconstruction
times,
technical
difficulties
combining
ultra-high
resolution.
Prospective
randomized
endpoints
are
lacking
confirm
clear
advantage
over
conventional
scanners.
Future
should
focus
on
endpoint-based
robust
cost-benefit
analyses
evaluate
this
facilitate
evidence-based
integration
practice.
Annals of Vascular Surgery,
Год журнала:
2025,
Номер
unknown
Опубликована: Янв. 1, 2025
Type
B
aortic
dissection
(TBAD)
presents
a
complex
clinical
challenge
requiring
coordinated,
multidisciplinary
care
to
optimize
patient
outcomes.
While
rapid
intervention
is
crucial
for
complicated
TBAD,
the
optimal
management
of
uncomplicated
cases
remains
less
well-defined.
Historically,
TBAD
was
managed
medically,
but
recent
years
have
seen
shift
toward
selective
interventional
approaches.
Updated
American
and
European
guidelines
now
recommend
thoracic
endovascular
repair
(TEVAR)
high-risk,
cases,
characterized
by
factors
including
large
diameter,
entry
tears,
or
persistent
pain.
Observations
from
International
Registry
Acute
Aortic
Dissection
highlight
significant
reduced
mortality
over
time.
The
ADSORB
INSTEAD-XL
trials
suggested
that
pre-emptive
TEVAR
may
benefit
certain
high-risk
patients
promoting
favorable
remodeling.
However,
routine
use
in
all
presently
still
controversial
due
risks
such
as
stroke
spinal
cord
ischemia,
which
emphasize
importance
careful
selection.
Current
evidence
supports
tailored
approach
integrates
imaging
risk
identify
most
likely
TEVAR.
In
addition,
ongoing
randomized
controlled
trials,
IMPROVE-AD,
SUNDAY,
EARNEST,
will
hopefully
provide
critical
data
on
benefits
TBAD.
Moving
forward,
interdisciplinary
collaboration
among
different
medical
engineering
specialties,
refined
stratification
be
essential
advance
management,
enhancing
outcomes
both
cases.
