Acute Aortic Dissection in the Third Trimester of Pregnancy as an Initial Presentation of Marfan Syndrome DOI Creative Commons

Manuel Santos,

Alexandre Valentim Lourenço,

Maria Pulido Valente

и другие.

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.

Язык: Английский

2024 EACTS/EACTAIC/EBCP Guidelines on cardiopulmonary bypass in adult cardiac surgery DOI Creative Commons
Alexander Wahba, Gudrun Kunst, Filip De Somer

и другие.

British Journal of Anaesthesia, Год журнала: 2025, Номер unknown

Опубликована: Фев. 1, 2025

Язык: Английский

Процитировано

3

2024 EACTS/EACTAIC/EBCP Guidelines on cardiopulmonary bypass in adult cardiac surgery DOI Creative Commons
Alexander Wahba, Gudrun Kunst, Filip De Somer

и другие.

European Journal of Cardio-Thoracic Surgery, Год журнала: 2025, Номер 67(2)

Опубликована: Фев. 1, 2025

Язык: Английский

Процитировано

1

Modeling thoracic aortic genetic variants in the zebrafish: useful for predicting clinical pathogenicity? DOI Creative Commons
Andrew Prendergast, Mary B. Sheppard, Jakub K. Famulski

и другие.

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.

Язык: Английский

Процитировано

1

Understanding Thoracic Aortic Disease in Women DOI
Bana Samman, Mimi Deng, Jennifer Chung

и другие.

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.

Язык: Английский

Процитировано

1

The Ascyrus Medical Dissection Stent: A One-Fits-All Strategy for the Treatment of Acute Type A Aortic Dissection? DOI Open Access
Leonard Pitts, Michael C. Moon, Maximilian Luehr

и другие.

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.

Язык: Английский

Процитировано

5

Photon-Counting Detector CT: Advances and Clinical Applications in Cardiovascular Imaging DOI
Muhammad Taha Hagar, Christopher L. Schlett,

Tim Oechsner

и другие.

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.

Язык: Английский

Процитировано

4

Trends and Updates in the Management and Outcomes of Acute Uncomplicated Type B Aortic Dissection DOI Creative Commons
Jasper F. de Kort, Nesar A. Hasami,

Michiel Been Bsc

и другие.

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.

Язык: Английский

Процитировано

0

Thoracic Aorta Measurements Using Intraoperative Transesophageal Echocardiography - Validation via Cardiac Magnetic Resonance DOI
Lisa Q. Rong, Sang Hoon Chun,

Pablo Villar‐Calle

и другие.

Journal of Cardiothoracic and Vascular Anesthesia, Год журнала: 2025, Номер unknown

Опубликована: Фев. 1, 2025

Язык: Английский

Процитировано

0

Aortic Dissections—Postoperative Care and Considerations DOI
Sandi Lam,

Laura Villegas-Bravo,

L A Lester

и другие.

Cardiology Clinics, Год журнала: 2025, Номер 43(2), С. 317 - 322

Опубликована: Март 19, 2025

Язык: Английский

Процитировано

0

Management of Acute Type A Aortic Dissection DOI
Jessica S. Clothier, Serge Kobsa

Cardiology Clinics, Год журнала: 2025, Номер 43(2), С. 261 - 277

Опубликована: Апрель 22, 2025

Язык: Английский

Процитировано

0