1/10. A surgical case of atypical aortic coarctation using cardiopulmonary bypass.We report a 44-year-old woman with atypical aortic coarctation accompanied by cerebral artery disease. She was hospitalized for vertigo. An extra-anatomic bypass between the ascending aorta and abdominal aorta was performed using partial cardiopulmonary bypass under moderate hypothermia to reduce the after load of the left ventricle and maintain cerebral blood flow and cerebral perfusion pressure. The postoperative course was uneventful and there was no postoperative neurological deficiency.- - - - - - - - - - ranking = 1keywords = cerebral (Clic here for more details about this article) |
2/10. Neonatal aortic arch thrombosis as a result of congenital cytomegalovirus infection.Thrombotic disease is rare in neonates. The main risk factors at this age are perinatal asphyxia, maternal diabetes, sepsis, polycythemia, dehydration, a low cardiac output, and in primis the catheterization of central lines. Another important risk factor is inherited thrombophilia. Arterial thrombosis is even more rare than venous thrombosis and less related to most of the risk factors listed above; it occurs more frequently in the iliac, femoral, and cerebral arteries but very rarely in the aorta. Most of the described cases of aortic thrombosis are associated with the catheterization of an umbilical artery and involve the descending tract and the renal arteries; very few relate to the ascending tract and the aortic arch. The possible role of virus-induced primary vascular endothelium damage in the etiopathogenesis of neonatal arterial thrombosis has been previously hypothesized. Herpesviruses, particularly human cytomegalovirus (HCMV), can infect endothelial cells and directly damage intact vascular endothelium, altering its thromboresistant surface as a result of procoagulant activity mediated by specific viral surface phospholipids, necessary for the coagulation enzyme complex assembly that leads to thrombin generation. We describe a case of congenital aortic arch thrombosis. The clinical, laboratory, and virologic pictures; the anatomopathologic findings (fully compatible with viral infection); the detection of HCMV in various tissues (including the aorta); and the absence of other causes of aortic thrombosis make it possible to attribute the case to a severe congenital HCMV infection with multiple organ involvement, after the primary infection of the mother. The hemostatic system disorders and hemodynamic disturbances related to viral cardiac damage explain the clinical features of the case and indicate that congenital HCMV infection should be included among the causes of neonatal aortic thrombosis.- - - - - - - - - - ranking = 0.33333333333333keywords = cerebral (Clic here for more details about this article) |
3/10. A case of an ascending aortic aneurysm due to mesoaortitis complicated with idiopathic thrombocytopenic purpura.An 80-year-old man was referred to our hospital for the surgical treatment of an ascending aortic aneurysm. The diagnosis of idiopathic thombocytonenic purpura was also made by hematological studies which included the examination of the aspirated bone marrow. Preoperative chest computed tomography showed an ascending aortic aneurysm with a maximum diameter of 80 mm. echocardiography demonstrated mild aortic regurgitation. The platelet count increased by intravenous administration of immunoglobulin. A prosthetic graft replacement of the ascending aorta and aortic valve repair were carried out with the aid of cardiopulmonary bypass, selective cerebral perfusion and hypothermic circulatory arrest. No difficulty was encountered in hemostasis and the postoperative course was uneventful. Histological examination of the aneurysmal wall showed chronic mesoaortitis with patchy destruction of musculo-elastic medial tissue and adventitial focal lymphocytic infiltrates that were similar to syphilitic mesoaortitis, although serological treponemal tests were all negative. Perioperative administration of gamma-globulin is useful to minimize the hemorrhagic complication in a patient undergoing cardiovascular surgery with idiopathic thrombocytopenic purpura.- - - - - - - - - - ranking = 0.33333333333333keywords = cerebral (Clic here for more details about this article) |
4/10. Behcet's aortitis and aortic regurgitation: a report of two cases.Behcet's disease is a rare systemic vasculitis that may lead to neurologic complications and rare manifestations of aortitis and aortic regurgitation. We report 2 cases of Behcet's aortitis and aortic regurgitation. The first patient presented with acute stroke. Recognition of acute aortitis on echocardiography led to the diagnosis of vasculitis as the cause of the cerebral event. This case highlights the echocardiographic features of aortic root pathology from acute aortitis to subsequent aortic valve perforation. In both cases, severe aortic regurgitation necessitated aortic valve replacement. Both were complicated by valve dehiscence requiring reoperation, illustrating the postoperative morbidity in this inflammatory condition.- - - - - - - - - - ranking = 0.33333333333333keywords = cerebral (Clic here for more details about this article) |
5/10. Inflammatory aortic arch aneurysm with total occlusion of cervical branches.We surgically replaced the aortic root and the complex arch in a patient with aortitis syndrome with total occlusion of the cervical branches. Cerebral perfusion was being maintained through the reversed flow of the vertebral artery from the bilateral mammary arteries. Though cerebral perfusion was continued through the prosthetic grafts attached to the subclavian arteries during the procedure, bilateral watershed cerebral infarction corresponding to the most distal part of the anterior- and middle cerebral arterial system developed. With regard to the near infrared spectroscopy as a brain monitoring method, we sought to discuss the limitations.- - - - - - - - - - ranking = 1keywords = cerebral (Clic here for more details about this article) |
6/10. giant cell arteritis as a cause of death. Report of nine cases.Nine patients who have died of giant cell arteritis (GCA) are described. Two patients died of myocardial infarction caused by GCA in the coronary arteries. Another two patients died of dissecting aneurysm of the aorta where GCA were found in the lesions of the aorta wall. giant cell arteritis causing cerebral stroke was the cause of death in five patients. None of the cases were receiving adequate corticosteroid treatment when symptoms of the ischemic catastrophies started. These cases illustrate that GCA is a generalized arteritis that can involve arteries of vital importance.- - - - - - - - - - ranking = 0.33333333333333keywords = cerebral (Clic here for more details about this article) |
7/10. Multiple cerebral aneurysms associated with aortitis syndrome--case report.A 48-year-old female presented with four aneurysms in the anterior half of the circle of willis associated with aortitis syndrome. All the aneurysms were successfully clipped. In general, intracranial hemodynamic change, due to stenosis or occlusion of carotid arteries, is considered to initiate aneurysm growth in the vertebrobasilar system in this syndrome, but renal hypertension was probably involved in our patient. Careful screening for multiple aneurysms, even in the anterior circulation, should be undertaken in patients with aortitis syndrome who present with an aneurysm.- - - - - - - - - - ranking = 1.3333333333333keywords = cerebral (Clic here for more details about this article) |
8/10. Successful outcome after massive bleeding in a heart transplant recipient with mycotic aortitis. Case report.Sudden mediastinal haemorrhage one month after heart transplantation in an 18-year-old youth was found to originate from a rupture of the ascending aorta associated with mycotic aortitis. Aortic continuity was restored with a Dacron graft. Cultures from the resected vessel wall showed candida albicans. The patient recovered, and 11 months later is well.- - - - - - - - - - ranking = 0.29914341544816keywords = haemorrhage (Clic here for more details about this article) |
9/10. The challenge of calcific aortitis.Coronary bypass and valvular operations have become more prevalent as the nation's elderly population grew 21% within the last decade. Ascending aortic calcification was a manifestation of this aging process. Aortic cannulation appeared impossible. Postoperatively, the stroke rate reached 14%, and the number of unexpected deaths rose sharply. Embolization of calcific and arteriosclerotic debris to cerebral and coronary vessels is believed to be the cause. The sharp, beveled, and narrowed jet-forming tips assaulted the delicate and soft intima of the artery. Nineteen cases of severely calcified aorta with increased predictable risk factors were operated on within the past 5 years. There were 12 coronary bypass grafts, 4 ventricular aneurysmectomies, and 3 valve replacements. Five of these cases were redo operations. The average age for these patients was 73.7 years. With the availability of the cannula introducer, we were able to find a small soft spot inside the arch or ascending aorta and cannulate these patients. We began to cool the patients down immediately and chose one of the three available methods for cardiac arrest. By changing the angle of application and direction of the axis of the clamp, we could cross-clamp the aorta loosely in 11 patients and administer cardioplegia. Intraluminal balloon occlusion of the ascending aorta was used once. The remainder of the cases had fibrillatory arrest. All proximal anastomoses in the coronary patients were done while on cross-clamp, intraluminal balloon occlusion, or brief periods of circulatory arrest. All sutures were passed from inside the aorta to avoid displacing or dissecting calcified plaques.(ABSTRACT TRUNCATED AT 250 WORDS)- - - - - - - - - - ranking = 0.33333333333333keywords = cerebral (Clic here for more details about this article) |
10/10. Intracranial aneurysms associated with aortitis syndrome: case report and review of the literature.OBJECTIVE AND IMPORTANCE: aortitis syndrome is a systemic vasculitis of unknown etiology, affecting mainly the major branches of the aorta and leading to stenosis or occlusion. Intracranial aneurysms are rarely associated with this syndrome. Only 15 cases have been previously reported. CLINICAL PRESENTATION: A 54-year-old woman with a 10-year history of aortitis syndrome demonstrated nonruptured cerebral aneurysms in the left internal carotid and anterior communicating arteries, with decreased flow in the right internal carotid artery and ipsilateral A1 segment. INTERVENTION: The patient underwent clipping of the aneurysms through a left pterional craniotomy and transsylvian approach. CONCLUSION: In our review of 16 reported cases, including the present case (13 with ruptured aneurysms and 3 with nonruptured aneurysms), there were 25 saccular aneurysms, and we noted the following clinical characteristics: 1) patient age was 26 to 64 years, with an average of 50.2 years; 2) aneurysms arose predominantly along the course of collateral flow, especially in the vertebrobasilar system (13 of 25 aneurysms, 52.0%); 3) there was a high incidence of multiplicity (7 of 16 cases, 43.8%). These characteristics suggest that increased hemodynamic stress, produced by stenosis or occlusion of the major branches of the aorta and systemic hypertension, plays an important role in the development of cerebral aneurysms in patients with this syndrome.- - - - - - - - - - ranking = 0.66666666666667keywords = cerebral (Clic here for more details about this article) |
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