The Experts below are selected from a list of 285 Experts worldwide ranked by ideXlab platform
Hiroshi Kamma - One of the best experts on this subject based on the ideXlab platform.
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Persistent fifth Aortic Arch associated with type a Aortic Arch interruption
The Japanese Journal of Thoracic and Cardiovascular Surgery, 2001Co-Authors: Naotaka Atsumi, Naoya Moriki, Hitoshi Horigome, Toshio Mitsui, Yuzuru Sakakibara, Hiroshi KammaAbstract:A male infant, having a persistent fifth Aortic Arch and interruption of the aorta distal to the left subclavian artery, underwent successful surgical treatment. A histological study of the excised segment of the aorta showed that the ductal tissue extended to the junction between the fifth Arch and the descending aorta with consequent narrowing in the corresponding region. The ductal tissue, however, did not contribute to occlusion in the fourth Aortic Arch. The morphogenesis of this combination of Aortic Arch anomalies was also discussed.
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persistent fifth Aortic Arch associated with type a Aortic Arch interruption histological study and morphogenesis
The Japanese Journal of Thoracic and Cardiovascular Surgery, 2001Co-Authors: Naotaka Atsumi, Naoya Moriki, Hitoshi Horigome, Toshio Mitsui, Yuzuru Sakakibara, Hiroshi KammaAbstract:A male infant, having a persistent fifth Aortic Arch and interruption of the aorta distal to the left subclavian artery, underwent successful surgical treatment. A histological study of the excised segment of the aorta showed that the ductal tissue extended to the junction between the fifth Arch and the descending aorta with consequent narrowing in the corresponding region. The ductal tissue, however, did not contribute to occlusion in the fourth Aortic Arch. The morphogenesis of this combination of Aortic Arch anomalies was also discussed.
Giacomo Pongiglione - One of the best experts on this subject based on the ideXlab platform.
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Aortic Arch interruption
2020Co-Authors: Giacomo PongiglioneAbstract:Key-words Definition/Classification Differential diagnosis Etiology Clinical description Diagnostic methods Incidence Management References Abstract Aortic Arch interruption (AAI) is a rare disease with estimated incidence of 0.003 per 1000 live-births, it is characterized by complete lack of anatomical continuity between the transverse Aortic Arch and the descending thoracic aorta. AAI should be distinguished anatomically from atresia of the Aortic Arch where continuity between these segments is achieved by an imperforate fibrous strand of various lengths. This condition is usually not familial but there is a well-known association between AAI and the DiGeorge syndrome with del-22q11. Patients with AAI present heart obstructive lesions, with acute cardiovascular collapse or heart failure after spontaneous closure of the ductus arteriosus in the first days of life. Considerable data indicate that AAI reflects intracardiac malformations producing reduced blood flow to the ascending aorta during the fetal life. Although echocardiography can offer an excellent visualization of the majority of Aortic Arch anomalies, angiocardiography remains the gold standard in the diagnosis of this disease. Management is mainly surgical; it depends on the degree of subAortic obstruction. Aortic Arch interruption (AAI) is a rare disease characterized by complete lack of anatomical continuity between the transverse Aortic Arch and the descending thoracic aorta. The classification of interruption of the Aortic Arch is based on the site of interruption: distal to the left subclavian artery (type A); between the left common carotid artery and the left subclavian artery (type B) and between the innominate artery and the left common carotid artery (type C). Patients with interruption and a right-sided Aortic Arch as well as patients with an aberrant subclavian artery are not taken into consideration by this classification.
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Fully-automatic, patient-specific 3D Aortic Arch modeling for patient treatment with Aortic Arch anomalies
Journal of Cardiovascular Magnetic Resonance, 2012Co-Authors: Benedetta Leonardi, R Ionasec, D Vitanovski, A Everett, Michael Suehling, Ludmilla Mantione, Giacomo PongiglioneAbstract:Summary: Timing and type of Aortic wall abnormalities (AWC) repair are still being debated. Automatically patient-specific 3D Aortic Arch geometrical model estimation from MRI images can provide a better knowledge of the geometry of the Aortic Arch anomaly and can be useful to evaluate preoperatively the best treatment. Therefore, we have developed a software to automatically compute a patient-specific 3D Aortic Arch geometrical model from CMR data and we have validated it. Background: Timing and type of surgical or transcatheter repair of Aortic wall abnormalities (AWC) in patients with Aortic coarctation (COA) and/or bicuspid Aortic valve (BAV) are presently being debated, as associated morbidity and mortality can still occur. We have developed a system to automatically compute a patient-specific 3D Aortic Arch geometrical model from CMR data, which provides crucial information to understand the geometry of the pathophysiological abnormalities of the Aortic Arch and to evaluate preoperatively the best treatment. (Figure presented) Aim: To validate the accuracy of the computed 3D geometrical model of the Aortic Arch by comparing manual measurements extracted directly from CMR images with the one automatically derived from the geometrical model. Methods: The system performance was evaluated on 32 patients with Aortic Arch anomalies (age: 5-36 years), 17 with COA and 15 with BAV and ascending aorta dilation. For reference, the Aortic Arch min and max diameters were measured manually from unenhanced, free - breathing, T2-prepared, segmented 3D SSFP sequence at Aortic sinus (AS), sino-tubular junction (STJ), ascending aorta (AAO), transverse Arch (TA), and descending aorta (DA). A computer-based, hierArchical model, which includes the Aortic root, the ascending/descending aorta and the Aortic Arch, was estimated automatically from the CMR data using a novel machine learning algorithm (Figure 1). Diameter measurements at corresponding positions were then automatically derived from the computer-based model and compared with manual ones. Results: Statistical results significantly correlated (p < 0.001, r = 0.94) between min and max manual and automatic Aortic measurements: AS (min p < 0.001 r = 0.85; max p < 0.001 r = 0.94), STJ (min p < 0.001 r = 0.88; max p < 0.001 r = 0.90), AAO (min p < 0.001 r = 0.94; max p < 0.001 r = 0.94), TA (min p < 0.001 r = 0.89; max p < 0.001 r = 0.93), DA (min p < 0.001 r = 0.90; max p < 0.001 r = 0.92). Mean measurement error of 1.59±0.6 mm was achieved for the min diameter and 1.44±0.9 mm for the max diameter. The maximal error occurred at the minimum diameter of each segment with the STJ the greatest (min 2.07±2.53) and the DA the least (min 0.8±0.83). Mean processing time for fully automatic Aortic model estimation and measurement extraction was 1.5 s. Conclusions: Aortic parameters taken by our model are reliable, fully reproducible and faster as compared to manual methods. 2) The 3D Aortic model is likely to improve therapeutic decision making in COA and/or BAV.
Yoshiyuki Maekawa - One of the best experts on this subject based on the ideXlab platform.
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Aortic Arch reconstruction for interrupted Aortic Arch using an aberrant right subclavian artery
The Japanese Journal of Thoracic and Cardiovascular Surgery, 2013Co-Authors: Kentaroh Umezu, N. Ohashi, Yoshiyuki Maekawa, Takahiko Sakamoto, Yorikazu HaradaAbstract:An aberrant right subclavian artery can be used in a variety of ways in complex Aortic Arch reconstructions, including reconstruction of an interrupted Aortic Arch. Here, we described the case of a 4-month-old female infant with a type B interrupted Aortic Arch, who underwent Arch reconstruction using an aberrant right subclavian artery.
Naotaka Atsumi - One of the best experts on this subject based on the ideXlab platform.
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Persistent fifth Aortic Arch associated with type a Aortic Arch interruption
The Japanese Journal of Thoracic and Cardiovascular Surgery, 2001Co-Authors: Naotaka Atsumi, Naoya Moriki, Hitoshi Horigome, Toshio Mitsui, Yuzuru Sakakibara, Hiroshi KammaAbstract:A male infant, having a persistent fifth Aortic Arch and interruption of the aorta distal to the left subclavian artery, underwent successful surgical treatment. A histological study of the excised segment of the aorta showed that the ductal tissue extended to the junction between the fifth Arch and the descending aorta with consequent narrowing in the corresponding region. The ductal tissue, however, did not contribute to occlusion in the fourth Aortic Arch. The morphogenesis of this combination of Aortic Arch anomalies was also discussed.
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persistent fifth Aortic Arch associated with type a Aortic Arch interruption histological study and morphogenesis
The Japanese Journal of Thoracic and Cardiovascular Surgery, 2001Co-Authors: Naotaka Atsumi, Naoya Moriki, Hitoshi Horigome, Toshio Mitsui, Yuzuru Sakakibara, Hiroshi KammaAbstract:A male infant, having a persistent fifth Aortic Arch and interruption of the aorta distal to the left subclavian artery, underwent successful surgical treatment. A histological study of the excised segment of the aorta showed that the ductal tissue extended to the junction between the fifth Arch and the descending aorta with consequent narrowing in the corresponding region. The ductal tissue, however, did not contribute to occlusion in the fourth Aortic Arch. The morphogenesis of this combination of Aortic Arch anomalies was also discussed.
Yutaka Okita - One of the best experts on this subject based on the ideXlab platform.
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Anatomical variations of Aortic Arch vessels in Japanese patients with Aortic Arch disease.
The Japanese Journal of Thoracic and Cardiovascular Surgery, 2018Co-Authors: Yuki Ikeno, Yutaka Koide, Takashi Matsueda, Katsuhiro Yamanaka, Takeshi Inoue, Satoshi Ishihara, Shinichi Nakayama, Hiroshi Tanaka, Koji Sugimoto, Yutaka OkitaAbstract:OBJECTIVES: The present study analyzed the prevalence of variations of the Aortic Arch branching in Japanese population, comparing patients with Aortic Arch disease with healthy controls. METHODS: Between from October 1999 and December 2015, 815 Japanese patients with Aortic Arch disease defined as Aortic Arch aneurysm (diameter ≥ 45 mm) and Aortic dissection (group A) underwent Aortic Arch surgery in our institution. As a control group, 1506 traumatic screened patients were enrolled (group C). RESULTS: Aortic Arch anomaly was diagnosed in 140 patients (17.2%) in the group A and in 222 patients (14.7%) in the group C (p = 0.125). Significant differences were found in the incidence of aberrant subclavian artery (A: 14 patients, 1.7%, vs. C: 8 patients, 0.5%, p = 0.006). Significantly more patients with Aortic Arch aneurysm in the group A had anomalies of the Aortic Arch compared with the group C (p = 0.009), including bovine Aortic Arch (p = 0.049) and aberrant subclavian artery (p
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In situ total Aortic Arch replacement for infected distal Aortic Arch aneurysms with penetrating atherosclerotic ulcer.
The Journal of Thoracic and Cardiovascular Surgery, 2014Co-Authors: Kenji Okada, Katsuhiro Yamanaka, Takeshi Inoue, Toshihito Sakamoto, Masamichi Matsumori, Fumi Kawakami, Yutaka OkitaAbstract:BACKGROUND: We present a series of patients who underwent in situ total Aortic Arch replacement for infected distal Aortic Arch aneurysms. METHODS: Between 2002 and 2013, 9 patients with infected distal Aortic Arch aneurysms underwent total Aortic Arch replacement using antegrade selective cerebral perfusion. There were 4 male and 5 female patients with a mean age of 72.7±9.0 years. All patients had penetrating atherosclerotic ulcer in the distal Aortic Arch, which formed saccular aneurysms. Four patients had preoperative hoarseness. Maximum preoperative white blood cell count was 10,211±4375/μL, and mean serum C-reactive protein concentration was 12.7±7.2 mg/dL. Causative microorganisms were identified by blood culture or Aortic wall culture and were as follows: Candida albicans, Pseudomonas aeruginosa, Edwardsiella tarda, Streptococcus dysgalactiae, Listeria monocytogenes, Staphylococcus aureus (2 cases), and unknown (2 cases). Radical debridement with in situ total Aortic Arch replacement was performed in all patients, followed by the omental flap grafting in 7 patients. All surgery was performed on an urgent or emergency basis. RESULTS: Average cardiopulmonary bypass time and lower body circulatory arrest time were 199.7±50.7 minutes and 66.6±13.8 minutes, respectively. There was no in-hospital mortality, but 1 patient died of asphyxia 5 months after hospital discharge. Freedom from recurrence of infection was 100%. CONCLUSIONS: Surgical treatment with the combination of radical debridement with in situ total Aortic Arch replacement using antegrade selective cerebral perfusion and omental flap grafting was a reliable procedure for the treatment of infected distal Aortic Arch aneurysms.
