Acute Aortic Disease.. - Index of

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Legal Considerations in Acute Aortic Diseases 345 10. Weigel CJ. Medicolegal aspects of trauma. In: Mattox KL, Moore EE, Feliciano DV, eds. Trauma. Connecticut: Appleton & Lange. Norwalk, 1988:53–60. 11. Elefteriades JA. Beating a sudden killer. Sci Am 2005; 293(2):64–71. 12. Von Kodolitsch Y, Schwartz AG, Nienaber CA. Clinical prediction of acute aortic dissection. Arch Intern Med 2000; 160:2977–2982. 13. Savino G, Herzog C, Costello P, Schoept UJ. 64 slice cardiovascular CT in the emergency department: concepts and first experiences. Radiol Med 2006; 111:481–496. 14. Hagan PG, Nienaber CA, Isselbacher EM, et al. The international registry of acute aortic dissection (IRAD): new insights into an old disease. JAMA 2000; 283:897–903. 15. Erbel R, Alfonso F, Biileau C, et al. Diagnosis and management of aortic dissection. Eur Heart J 2001; 22:1642–1681. 16. Ohlmann P, Faure A, Morel O, et al. Diagnostic and prognostic value of circulationg D-Dimers in patients with acute aortic dissection. Crit Care Med 2006; 34:1358–1364. 17. Spittell PC, Spittell JA, Joyce JW, et al. Clinical features and differential diagnosis of aortic dissection: experience with 236 cases (1980 through 1990). Mayo Clin Proc 1993; 68:642–651. 18. Von Kodolitsch Y, Nienaber CA, Dieckmann C, et al. Chest radiography for the diagnosis of acute aortic syndrome. Am J Med 2004; 116:73–77. 19. Fradet G, Jamieson WRE, Janusz MT, Ling H, Miyagishima RT, Munro AI. Aortic dissection: current expectations and treatment: experience with 258 patients over 25 years. Can J Surg 1990; 33:465–469. 20. Immer FF. Is there a place for D-dimers in acute type A aortic dissection? Heart 2006; 92:727–728. 21. Hazui H, Fukumoto H, Negoro N, et al. Simple and useful tests for discriminating between acute aortic dissection of the ascending aorta and acute myocardial infarction in the emergency setting. Circ J 2005; 69:677–682. 22. Eggebrecht H, Naber CK, Bruch C, et al. Value of plasma fibrin D-Dimers for detection of acute aortic dissection. J Am Coll Cardiol 2004; 44:804–809. 23. Weber T, Hogler S, Berent R, Lassnig E, Kvas E, Eber B. D-dimer in acute aortic dissection. Chest 2003; 123:1375–1378. 24. Akutsu K, Sato N, Yamamoto T, et al. A rapid bedside D-Dimer assay (Cardiac D-Dimer) for screening of clinically suspected acute aortic dissection. Circ J 2005; 69:397–403. 25. Suzuki T, Katoh H, Watanabe M, et al. Novel biochemical diagnostic method for aortic dissection. Results of a prospective study using an immunoassay of smooth muscle myosin heavy chain. Circulation 1996; 93:1244–1249. 26. Scholl FG, Coady MA, Davies R, et al. Interval or permanent nonoperative management of acute type A aortic dissection. Arch Surg 1999; 13:402–405. 27. Elefteriades JA. What operation for acute type A dissection? J Thorac Cardiovasc Surg 2002; 123(2):201–203. 28. Coady MA, Rizzo JA, Hammond GL, et al. What is the appropriate size criterion for resection of thoracic aortic aneurysms? J Thorac Cardiovasc Surg 1997; 113:476–491. 29. Coady MA, Davies RR, Roberts M, et al. Familial patterns of thoracic aortic aneurysms. Arch Surg 1999; 134:361–367. 30. Hasham SN, Lewin MR, Tran VT, et al. Nonsyndromic genetic predisposition to aortic dissection: a newly recognized, diagnosable, and preventable occurrence in families. Ann Emerg Med 2004; 43:79–82. 31. Albornoz G, Coady MA, Roberts M, et al. Familial thoracic aortic aneurysms and dissections—incidence, modes of inheritance, and phenotypic patterns. Ann Thorac Surg 2006; 82:1400–1405. 32. Thinkexist.com quotation website (accessed 8/05/06).
346 Elefteriades DISCUSSION AND COMMENTARY Questions for the Authors The potential for molecular genetic diagnosis of the aneurysm diathesis poses many ethical issues. In reference to children, how early in life will we want to have this diagnosis? It is absolutely true that the advancement of genetic diagnosis in medicine, and the corresponding potential and actual molecular therapies, pose profound ethical issues. Many of these issues are eloquently and insightfully examined in a recent book by Gregory Stock (1). In terms of diagnosing the aneurysm diathesis in children, we hope that this will not place an undue emotional burden on the child or his parents. Acute aortic events are extremely uncommon until the teenage years. In the large Yale registry, we have just one pre-teen patient who suffered a Type A dissection (a 10-year-old girl, who died of this disorder). We currently recommend conventional echocardiographic screening in the early to mid-teen years. If the genetic tests advance as we hope, we see no reason not to screen from a blood sample or buccal swab in early childhood. Do you predict that the RNA-signature gene chip will be used in Emergency Rooms for screening, in a fashion similar to the use of d-Dimer for pulmonary embolism? We would be delighted if further in-the-field testing confirmed a sensitivity adequate for use of the RNA-signature gene chip for screening purposes. This remains to be determined. Another use we hopefully envision would involve screening of family members of affected individuals. Ultimately, screening of the general population, as in the use of the PSA for prostate cancer, can be envisioned as well. All of these applications are at this time potential, but as yet unrealized or proven, avenues for diagnosis. Stress is a factor in precipitating acute aortic dissection. Could the molecular confirmation of the aneurysm diathesis in a particular patient contribute to stress and, thus, help to precipitate an aortic dissection? This is certainly possible. A similar potential exists for conventional imaging studies like echo, CT, and MRI scanning. Reference 1. Stock, Gregory. Redesigning Humans: Our Inevitable Genetic Future. Boston/New York: Houton-Miflin, 2002.
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Acute Aortic Disease
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15. Heart Failure: Basic Science an
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52. Clinical, Interventional, and I
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Informa Healthcare USA, Inc. 270 Ma
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Introduction Informa Healthcare has
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Foreword There is no disease more c
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Preface Over 100 years ago, the gre
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Preface xi Some distinguishing feat
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xiv Acknowledgments Above all, than
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xvi Contents 6. Genetic Basis of Th
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Contributors Nili Avidan Division o
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Contributors xxi Arun Raghupathy Di
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2 Nienaber and Ince Table 1 Risk Co
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4 Nienaber and Ince In addition to
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6 Nienaber and Ince CLASSIFICATION
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8 Nienaber and Ince Lansman’s Cla
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10 Nienaber and Ince Figure 4 Curve
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12 Nienaber and Ince Figure 6 Evolu
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14 Nienaber and Ince dissection, su
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16 Nienaber and Ince (A) (B) Probab
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18 Nienaber and Ince Table 5 Risk P
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20 Nienaber and Ince of the predila
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22 Nienaber and Ince 34. Pieters FA
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24 Nienaber and Ince 75. Mehta RH,
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26 Nienaber and Ince hematoma (IMH)
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28 Nienaber and Ince One good featu
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30 Isselbacher SYMPTOMS Pain Experi
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32 Isselbacher and wane in severity
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34 Isselbacher The mechanisms are u
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36 Isselbacher deficits are most co
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38 Isselbacher 3. Nallamothu BK, Me
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40 Danias spinal arteries) and the
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42 Danias Figure 2 Anteroposterior
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44 Danias However, due to the dista
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46 Danias TEE is highly sensitive f
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48 Danias faster, with higher resol
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50 Danias Figure 6 Transverse slice
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52 Danias hematoma, CT was reported
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54 Danias Figure 9 Transverse black
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56 Danias Figure 12 Single phase-co
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58 Danias restricted to the absolut
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60 Danias In conclusion, in the rig
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62 Danias DISCUSSION AND COMMENTARY
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64 Danias tomography, among others.
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66 Danias cardiac silhouette. The a
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68 Raghupathy and Eagle the inciden
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70 Raghupathy and Eagle Figure 1 Sp
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72 Raghupathy and Eagle SIGNS A tho
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74 Raghupathy and Eagle patients ma
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76 Raghupathy and Eagle Table 5 Dia
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78 Raghupathy and Eagle Table 6 A S
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80 Raghupathy and Eagle Figure 6 (A
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82 Raghupathy and Eagle Figure 9 (A
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84 Raghupathy and Eagle EDITOR’S
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86 Raghupathy and Eagle 30. Erbel R
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88 Raghupathy and Eagle is highly l
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90 Elefteriades and Rizzo required
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92 Elefteriades and Rizzo Table 1 S
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94 Elefteriades and Rizzo 70s, this
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96 Elefteriades and Rizzo Table 3 C
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98 Elefteriades and Rizzo DISCUSSIO
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100 Milewicz et al. KNOWN GENETIC S
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102 Milewicz et al. Table 2 Quick G
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104 Milewicz et al. ascending aorti
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106 Milewicz et al. Turner syndrome
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108 Milewicz et al. dissection in t
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110 Milewicz et al. Figure 5 Haplot
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112 Milewicz et al. A genome wide s
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114 Milewicz et al. Structural anal
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116 Milewicz et al. assembly of a h
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118 Milewicz et al. in the nuclei o
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120 Milewicz et al. 22. Furlong J,
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122 Milewicz et al. DISCUSSION AND
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124 Milewicz et al. Figure A Distri
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126 Elefteriades and Koullias Figur
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128 Elefteriades and Koullias prope
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8 Matrix Metalloproteinases in Aort
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Matrix Metalloproteinases in Aortic
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INTRODUCTION 9 Inflammation and Rem
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Inflammation and Remodeling in the
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10 Weight Lifting and Aortic Dissec
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Weight Lifting and Aortic Dissectio
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11 Timing of Acute Aortic Events: H
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Timing of Acute Aortic Events 171 F
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SECTION IV: TREATMENT OF ACUTE AORT
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Natural History of Thoracic Aortic
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206 Shahriari and Farkas properties
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208 Shahriari and Farkas Figure 2 E
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210 Shahriari and Farkas Less than
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212 Shahriari and Farkas helpful if
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214 Shahriari and Farkas Figure 6 A
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216 Shahriari and Farkas (68). Many
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218 Shahriari and Farkas Figure 9 H
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220 Shahriari and Farkas fistula is
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222 Shahriari and Farkas MEGS is de
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224 Shahriari and Farkas 26. Svenss
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226 Shahriari and Farkas 63. Fehren
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14 Acute Aortic Dissection: Anti-im
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Acute Aortic Dissection 231 lamella
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Acute Aortic Dissection 233 P t is
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Acute Aortic Dissection 235 From th
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Acute Aortic Dissection 237 Figure
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Acute Aortic Dissection 241 Table 2
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Acute Aortic Dissection 243 dissect
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Acute Aortic Dissection 245 22. Bax
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Acute Aortic Dissection 247 62. Lin
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Acute Aortic Dissection 249 DISSCUS
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252 Elefteriades and Griepp ACUTE A
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254 Elefteriades and Griepp Figure
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256 Elefteriades and Griepp sometim
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262 Elefteriades and Griepp to a se
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264 Elefteriades and Griepp Natural
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266 Elefteriades and Griepp CONCLUS
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268 Elefteriades and Griepp DISCUSS
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270 Brinster et al. thoracic aneury
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272 Brinster et al. Figure 1 Retrop
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274 Brinster et al. artery. Z3 land
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276 Brinster et al. or ischemia of
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278 Brinster et al. registry arm (2
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280 Brinster et al. Table 3 Early P
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282 Brinster et al. According to th
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284 Brinster et al. ranged from 1 t
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Table 4 Meta-Analysis of Tevar for
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288 Brinster et al. conventional op
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290 Brinster et al. using no (or lo
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292 Brinster et al. Table 5 Risk Fa
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Page 391 and 392: 362 Index Aging, aortic aneurysms a
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