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Classification of Aortic Dissection 27 Figure B (See color insert) Note multiple penetrating aortic ulcers, although only one was suspected radiographically. Furthermore, we find at surgery that the PAU patients, despite radiologic detection of a single penetrating ulcer, often harbor many such ulcers over a wide segment of aorta. In the operating room, these appear “ready to burst” (Fig. B). We feel this factor also argues in favor of an aggressive surgical approach. For ascending IMH and PAU, we have an aggressive posture, like most centers. We operate on these lesions acutely, like for type A dissection. Figure C (See color insert) Note from schematic depictions that typical dissection (1) often impairs branch vessel flow, but this never happens with IMH and PAU (2). Abbreviations: IMH, intramural hematoma; PAU, penetrating aortic ulcer.
28 Nienaber and Ince One good feature regarding IMH and PAU, on which Dr. Nienaber touches briefly, which we wish to emphasize, is the following: IMH and PAU, in sharp contradistinction to typical aortic dissection, never produce branch vessel occlusion (Fig. C). We have not encountered a single violation of this principle; colleagues from around the world have similar impressions. References 1. Coady MA, Rizzo JA, Elefteriades JA. Pathologic variants of thoracic aortic dissections: Penetrating atherosclerotic ulcers and intramural hematomas. Cardiol Clin No Amer 1999; 17:637−657. 2. Tittle SL, Lynch RJ, Cole PE, Singh H, Rizzo JA, Kopf GS, Elefteriades JA. Midterm follow-up of penetrating ulcer and intramural hematoma of the aorta. J Thorac Cardiovasc Surg 2002; 123:1051−1059.
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Acute Aortic Disease
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15. Heart Failure: Basic Science an
Page 6: 52. Clinical, Interventional, and I
Page 9 and 10: Informa Healthcare USA, Inc. 270 Ma
Page 12 and 13: Introduction Informa Healthcare has
Page 14 and 15: Foreword There is no disease more c
Page 16 and 17: Preface Over 100 years ago, the gre
Page 18: Preface xi Some distinguishing feat
Page 21 and 22: xiv Acknowledgments Above all, than
Page 23 and 24: xvi Contents 6. Genetic Basis of Th
Page 26 and 27: Contributors Nili Avidan Division o
Page 28: Contributors xxi Arun Raghupathy Di
Page 31 and 32: 2 Nienaber and Ince Table 1 Risk Co
Page 33 and 34: 4 Nienaber and Ince In addition to
Page 35 and 36: 6 Nienaber and Ince CLASSIFICATION
Page 37 and 38: 8 Nienaber and Ince Lansman’s Cla
Page 39 and 40: 10 Nienaber and Ince Figure 4 Curve
Page 41 and 42: 12 Nienaber and Ince Figure 6 Evolu
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Page 45 and 46: 16 Nienaber and Ince (A) (B) Probab
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Page 49 and 50: 20 Nienaber and Ince of the predila
Page 51 and 52: 22 Nienaber and Ince 34. Pieters FA
Page 53 and 54: 24 Nienaber and Ince 75. Mehta RH,
Page 55: 26 Nienaber and Ince hematoma (IMH)
Page 59 and 60: 30 Isselbacher SYMPTOMS Pain Experi
Page 61 and 62: 32 Isselbacher and wane in severity
Page 63 and 64: 34 Isselbacher The mechanisms are u
Page 65 and 66: 36 Isselbacher deficits are most co
Page 67 and 68: 38 Isselbacher 3. Nallamothu BK, Me
Page 69 and 70: 40 Danias spinal arteries) and the
Page 71 and 72: 42 Danias Figure 2 Anteroposterior
Page 73 and 74: 44 Danias However, due to the dista
Page 75 and 76: 46 Danias TEE is highly sensitive f
Page 77 and 78: 48 Danias faster, with higher resol
Page 79 and 80: 50 Danias Figure 6 Transverse slice
Page 81 and 82: 52 Danias hematoma, CT was reported
Page 83 and 84: 54 Danias Figure 9 Transverse black
Page 85 and 86: 56 Danias Figure 12 Single phase-co
Page 87 and 88: 58 Danias restricted to the absolut
Page 89 and 90: 60 Danias In conclusion, in the rig
Page 91 and 92: 62 Danias DISCUSSION AND COMMENTARY
Page 93 and 94: 64 Danias tomography, among others.
Page 95 and 96: 66 Danias cardiac silhouette. The a
Page 97 and 98: 68 Raghupathy and Eagle the inciden
Page 99 and 100: 70 Raghupathy and Eagle Figure 1 Sp
Page 101 and 102: 72 Raghupathy and Eagle SIGNS A tho
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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 239 concern
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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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294 Brinster et al. wire manipulati
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296 Brinster et al. Thoracoabdomina
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298 Brinster et al. 25. Hagan PG, N
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300 Brinster et al. 60. Elefteriade
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302 Brinster et al. 98. Liu ZG, Sun
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304 Brinster et al. 131. Szeto WY,
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306 Brinster et al. 100% 90% 80% 70
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308 Brinster et al. ● “Long-ter
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310 Hackmann et al. treatment. New
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312 Hackmann et al. tissue than in
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314 Hackmann et al. Table 1 Pharmac
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316 Hackmann et al. Some anti-hyper
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318 Hackmann et al. inhibits NF-κB
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320 Hackmann et al. Patients with C
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322 Hackmann et al. ACKNOWLEDGMENTS
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324 Hackmann et al. 34. Thompson RW
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326 Hackmann et al. 70. LeMaire SA,
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328 Hackmann et al. 105. Marra DE,
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330 Hackmann et al. DISCUSSION AND
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332 Elefteriades Diseases of the th
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334 Elefteriades Table 1 Individual
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336 Elefteriades Table 1 Individual
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338 Elefteriades Failure to Diagnos
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340 Elefteriades of physicians on t
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342 Elefteriades Figure 3 Computed
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344 Elefteriades reviewed over the
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346 Elefteriades DISCUSSION AND COM
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348 Elefteriades Figure 1 (See colo
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350 Elefteriades that are the subje
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SECTION VII: SYNTHESIS 20 The Key L
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The Key Lessons of This Book—In a
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362 Index Aging, aortic aneurysms a
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364 Index Cytokines, aortic aneurys
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366 Index Pathoanatomy classificati
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368 Index [Thoracic aortic aneurysm
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Figure 1.C Note from schematic depi
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Figure 8.1 Dramatic clinical exampl
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Figure 11.2 Proposed schema for the
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Figure 19.1 Future prospects in car
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