J Elefteriades

..We applied tissue microarray analysis to determine MMP profiles in a large group of surgically resected thoracic aneurysms and dissections...

..This work adds to our fundamental understanding of the biology of aortic aneurysms and promises to permit future application of engineering measurements to supplement aneurysm size in clinical decision making in aneurysmal disease...

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..The etiology, clinical impact, natural history and best therapy of unilateral diaphragm paralysis (UDP) are incompletely understood. This condition is not amenable to pacing, which requires an intact phrenic nerve...

..This article discusses technical issues that are common to all durable LVAD devices, with special emphasis on strategy and technical considerations aimed at avoiding surgical pitfalls...

..Leiomyosarcomas arising from the adrenal vein are rare malignancies associated with delayed diagnosis and poor prognosis. The most common vascular site of origin is the inferior vena cava...

..Physicians are vulnerable to highly litigated thoracic aortic diseases. On the basis of a review of litigated cases, we aim to determine legally protective strategies for physicians and methods to improve treatment...

..The historical literature and recent studies are critically reviewed. It concludes that this therapy's usefulness lies in its ability to blunt the severity of the pressure spikes that accompany acute exertion or emotion...

..Promising young athletes are dying from this phenomenon. For this reason, the author suggests routine echocardiographic examination of young athletes...

..Although these genetic breakthroughs are exciting and important, this article espouses the CON point of view that routine genetic testing is not practical or clinically essential at the present time...

..Recent evidence shows that dissections are preceded by a specific severe exertional or emotional event. 11) "Silver lining" of aortic disease. Proximal aortic root disease seems to protect against arteriosclerosis...

..This work explores the behavior of thoracic aneurysms, the state-of-the-art in treatment, and a rational approach to the treatment decision is proposed...

..This case emphasizes that size criteria pertain to asymptomatic patients, and symptomatic patients with aneurysm require resection regardless of size...

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..This consideration represents a "back to the future" paradigm shift reminiscent of the earliest recommendations before surgical therapy was feasible or safe...

..The experiments in the present study explore the feasibility of the converse operation: adding an isolated donor right heart to an entire preserved heart...

..Careful review of diaphragmatic pacing candidates with respect to associated medical conditions, social support, and motivation is essential for appropriate patient selection and successful long-term results...

..Were it possible to retain the recipient's right heart, excising only the left ventricle, this could have important advantages, especially in severe pulmonary hypertension. This report describes such a technique...

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..This article discusses available data regarding the use of stent therapy for degenerative aneurysms...

..In this article, the author discusses the practice of straight DHCA in his institute and the advantage of this technique over other brain preservation techniques...

..Compulsory screening for aortic disease in patients presenting with chest pain can increase the prospects of correct diagnosis and subsequent treatment of the disease...

..The anticipated malperfusion events are actually rare (2 of 79 with femoral artery cannulation, or 2.5%)...

..For individuals with known aortic dilatation, we recommend a program that limits their lifting to 50% of body weight in the bench press or equivalent level of perceived exertion for other specific strength exercises...

..Screening of first-order relatives of probands with TAA is essential. Familial TAAs tend to grow at a higher rate, exemplifying a more aggressive clinical entity...

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..0 cm for the ascending and 6.0 cm for the descending aorta. Symptomatic aneurysms must be resected regardless of size. Family members should be evaluated...

..Although others have investigated the need for concomitant repair, the natural history of aortic disease has not been addressed...

..We believe that these two techniques can be safe and effective alternatives to medical management and aortic replacement surgery in properly selected patients...

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..Potential causes for this discrepancy are discussed, among which the "pressure recovery phenomenon" is considered the most important...

..This analysis strongly supports careful radiologic follow-up and elective, preemptive surgical intervention for the otherwise lethal condition of large thoracic aortic aneurysm...

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..During ARR, coronary button misalignment may produce myocardial ischemia, ventricular arrhythmias, and pump failure leading to death if unrecognized. Here we review our experience with coronary insufficiency after ARR...

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..We sought to investigate possible H. pylori infection in 54 human specimens of 42 aortic aneurysms and 12 penetrating ulcers. No evidence of H. pylori was found in these specimens...

..Patients in this report underwent surgery solely with DHCA...

..Hyperplastic cellular remodeling of the media in ascending thoracic aortic aneurysms may be an initial adaptive response to minimize increased wall stress resulting from vascular dilatation...

..The advent of high-pressure sealants has been of benefit in helping to alleviate these perioperative challenges...

..Although type A aortic dissections represent a surgical emergency, some patients present late after the onset of symptoms. Optimal management of this cohort has not been defined...

..We examined the capability of a novel therapeutic complement inhibitor to prevent pathological complement activation and tissue injury in patients undergoing CPB...

..Race, age, and gender did not significantly affect the prevalence of concurrent ICA. In conclusion, patients with a TAA are at increased risk of having an ICA. We suggest that patients with a TAA be screened for an ICA...

..The purpose of this study was to detect the presence of these enzymes in aortic valvular tissue in healthy and diseased aortic valves with or without the presence of synchronous ascending aortic pathology...

..In conclusion, severe physical and emotional stress may precipitate AAD, presumably on the basis of a transient, severe hypertensive reaction...

..02). In the latter, despite statistical significance, the association was not substantial or clinically important. CONCLUSIONS: Among patients referred for cardiac valve surgery, age does not appear to limit the QOL benefits of surgery...

..The improvement in MR likely results from improved left ventricular function and size consequent upon revascularization...

..Timely intervention for bicuspid-related aortic valve disease or aneurysm can preserve both duration of life and quality of life in affected individuals...

..Resection of mobile aortic arch atheromas is likely to become increasingly important in the future as transesophageal echocardiography leads to their more common identification as a cause of cerebral ischemic events...

..With improvements in echocardiographic imaging, the diagnosis of QAV is likely to be made more reliably in the future and should prompt close clinical follow-up given the frequent association of this lesion with valvular insufficiency...

..Thus, decisions about whether to choose a tissue valve or mechanical valve implant should depend upon other factors such as rates of complications and differences in the life span of the implants...

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..Th1, but not Th2, immune responses have a positive correlation with both outward vascular remodeling and intimal expansion of ascending thoracic aortic aneurysms...

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..The technique is performed off bypass except for apical coring and apical connection. Novacor outflow is to the descending aorta. This approach has been found safe, quick, and effective...

..This evidence adds impetus for further pursuing of right ventricle-sparing heart transplantation to decrease the incidence of death from right heart failure in recipients with severe antecedent pulmonary hypertension...

..Genetic-based therapies (eg, development of drugs on the basis of discovered molecular proteomics) will likely become possible to prevent susceptible patients from forming aneurysms over the long term...

..Further studies are necessary to validate this finding...

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..We investigate the current safety level of these operations--for the purposes of enabling risk/benefit decisions for surgery and also to serve as a benchmark for comparison with emerging endovascular approaches...

..Our goal was to identify a distinct gene expression signature in peripheral blood that may identify individuals at risk for TAA...