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  • 1
    Online Resource
    Online Resource
    Aortic Dissection and Related Syndromes (2007)
    Boston, MA : Springer US | [Berlin : Springer
    Details Availability
    Keywords: Medicine ; Cardiology ; Medicine & Public Health ; Aortic Aneurysm therapy ; Aneurysm, Dissecting diagnosis ; Aneurysm, Dissecting therapy ; Aortic Aneurysm diagnosis ; Aorta ; Dissektion
    Description / Table of Contents: Aortic dissection affects approximately two in ten thousand individuals and can be fatal. This state-of the-art publication is a result of the combined efforts of participants from the International Registry of Aortic Dissection (IRAD). The book has been divided into sections. Each chapter provides a succinct overview of the current clinical literature and incorporates illustrations for further explanation.
    Type of Medium: Online Resource
    Pages: Online-Ressource (XI, 364 p, digital)
    ISBN: 9780387360010
    Series Statement: Developments in Cardiovascular Medicine 260
    URL: https://doi.org/10.1007/978-0-387-36001-0
    URL: http://dx.doi.org/10.1007/978-0-387-36001-0
    URL: http://www.springerlink.com/content/np32g2
    URL: http://nbn-resolving.de/urn:nbn:de:1111-200708028241
    URL: https://search.ebscohost.com/login.aspx?direct=true&scope=site&db=nlebk&db=nlabk&AN=196694
    URL: https://swbplus.bsz-bw.de/bsz322109256cov.jpg
    URL: https://swbplus.bsz-bw.de/bsz262196883vor.htm
    URL: https://swbplus.bsz-bw.de/bsz262196883inh.htm
    URL: http://www.gbv.de/dms/bowker/toc/9780387360003.pdf
    DOI: 10.1007/978-0-387-36001-0
    RVK:
    YI 8100
    Language: English
    Note: Includes bibliographical references and index , Front Matter; Epidemiology of Thoracic Aortic Aneurysms, Aortic Dissection, Intramural Hematoma, and Penetrating Atherosclerotic Ulcers; Pathophysiology of Acute Aortic Syndromes; Aortic Dissection: Clinical Presentation; Role of Echocardiography in the Diagnosis of Aortic Dissection; CT Evaluation of Aortic Dissection; Role of MRI in the Diagnosis of Aortic Dissection; Medical Therapy and Acute Surveillance; Endovascular Therapy in Aortic Pathology; Cardiovascular Surgery in the Initial Treatment of Aortic Dissection and Acute Aortic Syndromes; Long-Term Medical Therapy in Aortic Dissection , Acute Aortic Syndromes: Surveillance with ImagingOperation for Acute Aortic Dissection in the Octogenarian Patient; Genetic Disorders Associated with Aortic Dissection; Aortic Intramural Hematoma: Diagnosis, Treatment, and Evolution; Evaluation and Management of Traumatic Aortic Lesions; Future Directions of Aortic Dissection; Vascular Surgical Options; Prevention of Aortic Dissection; Back Matter
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  • 2
    Electronic Resource
    Electronic Resource
    Stenting Versus Surgery of the Thoracic Aorta (2000)
    Oxford, UK : Blackwell Publishing Ltd
    Journal of interventional cardiology 13 (2000), S. 0 
    Details
    ISSN: 1540-8183
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Aneurysms and dissections of the aorta represent a potentially life-threating situation. Surgical resection and interposition of vascular prostheses (Gortex or Dacron) has long been considered the only treatment option. Although there have been great strides during the past decades in the management of patients with thoracic aortic aneurysms and dissections by new surgical techniques, postoperative morbidity and mortality remain high. The afflicted population is usually of older age and present with a variety of comorbidities and significant impact on postsurgical outcome. Postoperative complications, such as paraplegia and renal insufficiency, contribute to prolonged hospital stays and higher medical costs. Conversely, interventional stent-graft placement may be a promising nonsurgical strategy for the treatment of thoracic aortic aneurysms and dissections. The endovascular stent-graft prostheses is based on the concept of a metal grid covered with vessel graft material. The initiation of the natural healing process by exclusion of an aneurysm or sealing of the proximal entry in dissection induces remodeling of the aortic wall and consolidation of the false lumen. Although the initial results of stent-graft treatment of thoracic aortic aneurysms and dissections are promising, the concept of nonsurgical reconstruction must be subjected to a randomized long-term study.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1540-8183.2000.tb00329.x
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  • 3
    Electronic Resource
    Electronic Resource
    Emergency Stent-Graft Placement in Thoracic Aortic Dissection and Evolving Rupture (2003)
    135 Bedford Road, PO Box 418 , Armonk , NY 10504-0418 USA . : Blackwell Science Inc
    Journal of cardiac surgery 18 (2003), S. 0 
    Details
    ISSN: 1540-8191
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract  Background: Even with rapid diagnosis and effective medical treatment mortality in type B aortic dissection with evidence of extraaortic leakage of blood remains high. Considering a mortality rate of 29% to 50% associated with emergency surgical repair, the concept of endovascular stent-graft placement may become a life-saving option in impending or evolving rupture by endovascular sealing of the entry tear and subsequent abortion of leakage. Methods: The concept was tested by comparing short-term and 1-year outcomes of 11 patients after emergency endovascular stent-graft placement with historic-matched control patients subjected to conventional therapy. All patients had acute type B dissection complicated by loss of blood into periaortic spaces. Results: Emergency stent-graft placement was successful without periprocedural morbidity, aborted leakage, and ensured reconstruction of the dissected aorta; at a mean follow-up of 15 ± 6 months no death had occurred in the stent-graft group whereas four patients had died with conventional treatment (p 〈 0.05). Conclusion: With appropriate logistics and expertise, type B aortic dissection with leakage and evolving rupture may benefit from nonsurgical reconstruction of the dissected segment by endovascular stent grafts.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1540-8191.2003.02082.x
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  • 4
    Electronic Resource
    Electronic Resource
    The Concept of Interventional Therapy in Acute Aortic Syndrome (2002)
    Oxford, UK : Blackwell Publishing Ltd
    Journal of cardiac surgery 17 (2002), S. 0 
    Details
    ISSN: 1540-8191
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1540-8191.2002.tb01188.x
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  • 5
    Electronic Resource
    Electronic Resource
    Value of Intravascular Ultrasound for Endovascular Stent-Graft Placement in Aortic Dissection and Aneurysm (2003)
    135 Bedford Road, PO Box 418 , Armonk , NY 10504-0418 USA . : Blackwell Science Inc
    Journal of cardiac surgery 18 (2003), S. 0 
    Details
    ISSN: 1540-8191
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract  Background: Endovascular stent-graft placement is a new concept for the treatment of aortic dissection and aneurysm. Intravascular ultrasound (IVUS) with established diagnostic features may be instrumental in guiding endovascular procedures. Methods: We performed IVUS and digital angiography before, during, and after implantation of 47 stent grafts in 40 patients with Stanford type B dissection (26 patients, 28 stent grafts), thoracic aneurysm (9 patients, 11 stent grafts), and abdominal aneurysm (5 patients, 8 stent grafts). Results: IVUS could clearly identify the aortic anatomy and differentiate between true and false lumen in all cases of dissection. In four patients with type B dissection extending from the thoracic to the abdominal aorta the true lumen was exclusively identified by IVUS, and thus, essential for safe execution of the procedure. In another patient stent-graft placement in the aorta was optimized by covering a second entry detected by IVUS, but undetected by angiography. The site of stent implantation, the true and false lumen, as well as entry and reentry were always identified in both thoracic and abdominal aorta. In comparison with angiography, IVUS information led to additional balloon molding due to incomplete stent apposition in seven cases. Conclusions: As an adjunctive imaging modality IVUS is likely to improve stent-graft placement in aortic type B dissection, especially in patients with abdominal extension.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1540-8191.2003.02083.x
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  • 6
    Electronic Resource
    Electronic Resource
    Lack of Impact of Myocardial Ischemia on the Signal-Averaged ECG Assessment by Time-Domain Analysis (2002)
    Oxford, UK : Blackwell Publishing Ltd
    Annals of noninvasive electrocardiology 7 (2002), S. 0 
    Details
    ISSN: 1542-474X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: Late potentials represent an arrhythmogenic substrate in chronically infarcted myocardium. It is hypothesized that acute transient ischemia enhances anisotropic electrical ventricular activation and facilitates reentry mechanisms. Study aim was the prospective assessment of the impact of dipyridamole-induced myocardial ischemia on the signal-averaged ECG.Methods: Dipyridamole stress thallium-201 SPECT imaging was utilized to avoid noise contamination of the signal-averaged ECG from exercise and to document evidence and localization of myocardial ischemia or persistent perfusion defects in 68 patients with suspected coronary artery disease. Before and during dipyridamole-induced vasodilatation serial signal-averaged ECG was performed to evaluate the influence of transient ischemia on the occurrence of late potentials.Results: There was a significant difference between heart rate at rest and heart rate under dipyridamole influence in patients with inducible ischemia (70 ± 13 vs. 87 ± 13; P 〈 0.0001) in contrast to patients without dipyridamole-induced ischemia (74 ± 20 vs. 80 ± 16; n.s.). The number of averaged beats and achieved noise level was comparable between both groups. Thirty-three of 68 patients (49%) revealed dipyridamole-induced ischemia; however, no changes of the SAECG parameters, such as QRS, RMS, LAS at 25–250 and 40–250 Hz bandpass filtering in the leads X, Y, Z and vector magnitude, respectively, were observed as a result of ischemia.Conclusion: These results suggest that transient myocardial ischemia does not affect the signal-averaged ECG. Clinically, the signal-averaged ECG analysis seems not to be helpful in identifying patients with silent ischemia. A.N.E. 2002;7(3):191–197
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1542-474X.2002.tb00162.x
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  • 7
    Electronic Resource
    Electronic Resource
    Interventional Closure with Amplatzer PFO Occluder of Patent Foramen Ovale in Patients with Paradoxical Cerebral Embolism (2005)
    350 Main Street , Malden , MA 02148-5020 , USA , and P.O. Box 1354, Garsington Road , Oxford OX4 2DQ , UK . : Blackwell Science Inc
    Journal of interventional cardiology 18 (2005), S. 0 
    Details
    ISSN: 1540-8183
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Percutaneous transcatheter closure has been proposed as an alternative to surgical closure or long-term anticoagulation in patients with presumed paradoxical embolism and patent foramen ovale (PFO). We report our mid-term results of 55 consecutive symptomatic patients (mean age: 47 years, range: 20–79) who underwent percutaneous transcatheter closure of PFO after at least one event of cerebral ischemia; 16 (29%) patients had at least one transient ischemic attack and 39 (71%) patients at least one embolic stroke. Multiple embolic events had occurred in 6 (11%) patients. Percutaneous transcatheter closure was technically successful in all 55 patients (100%). For the majority of patients, an Amplatzer PFO occluder measuring 25 mm in diameter (n = 49) or an Amplatzer PFO occluder measuring 35 mm in diameter (n = 6) was used. Complete occlusion by color Doppler and transesophageal contrast echocardiography investigation was achieved in 96% at follow-up 3-6 months after implantation; only 2 patients had a trivial residual shunt at follow-up. Mean fluoroscopy time was 6.7 minutes (range: 1.7–47.1), and in-hospital follow-up was uneventful except for 1 patient who developed a cardiac tamponade requiring uneventful and successful needle pericardiocentesis. At a mean follow-up of 19 months (range: 3–32) no recurrent embolic neurological events was observed. Transcatheter closure of PFO with Amplatzer PFO occluder devices is a safe and effective therapy for patients with previous paradoxical embolism and aneurysmatic or nonaneurysmatic PFO. Percutaneous closure is associated with a high success rate, low incidence of hospital complications, and freedom of cerebral ischemia events.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1540-8183.2005.04050.x
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  • 8
    Electronic Resource
    Electronic Resource
    Left ventricular contractile state after surgical correction of tetralogy of Fallot: Risk factors for late left ventricular dysfunction (1990)
    Springer
    Pediatric cardiology 11 (1990), S. 61-68 
    Details
    ISSN: 1432-1971
    Keywords: Cardiac surgery ; Contractile state ; Echocardiography ; Hypoxemia ; Tetralogy of Fallot
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The purpose of this study was to analyze potential “risk-factors” for late left ventricular dysfunction after surgical correction of Fallot's tetralogy (FT). As the ejection-phase indices cannot distinguish abnormalities of contractility from altered loading conditions, the slope values of the end-systolic pressure-length and stress-shortening relationships were analyzed by increasing afterload. Thirty-two patients were studied after surgical correction of FT in infancy. The age at investigation was 19.2±5.6 years, total correction had been performed at the age of 7.7±3.3 years. In 20 patients a one-stage operation was performed, and in 12 patients a two-stage correction. The control group consisted of 30 healthy volunteers, aged 18–30 years. The following potential risk factors for left ventricular dysfunction were evaluated: one-stage vs. two-stage correction, age at total correction, preoperative systemic oxygen saturation, preoperative hematocrit, occurrence of hypoxic spells, preoperative ratio of left-to-right ventricular peak systolic pressure, and preoperative ratio of left-to-right ventricular end-diastolic volume. In most patients the baseline data for end-systolic wall stress lay outside the normal range, indicating abnormal loading conditions. Thus, analysis of load-independent indices of the contractile state seems to be mandatory in these patients. Our data show that the severity of preoperative hypoxemia is an important risk factor for late dysfunction of the left ventricle (p〈0.01). Additionally, the relation of left and right ventricular peak systolic pressures and enddiastolic volumes were related to the contractile state (p〈0.01). No influence of preoperative hypoxic spells, the need for a palliative aortopulmonary shunt, or the age at surgical correction on the postoperative contractile state was demonstrated. The latter may have been due to the fact that none of the patients were operated on within the first 2 years of life.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02239563
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  • 9
    Electronic Resource
    Electronic Resource
    Aortic Diseases – Do We Need MR Techniques? (2000)
    Springer
    Herz 25 (2000), S. 331-341 
    Details
    ISSN: 1615-6692
    Keywords: Key Words Magnetic resonance imaging ; Aortic diseases ; Aortic dissection ; Schlüsselwörter Magnetresonanztomographie ; Aortenerkrankung ; Aortendissektion
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Die gegenwärtig klinisch verfügbaren MR-Magnetresonanzverfahren zur Bildgebung bestehen aus Spin-Echo-Imaging, Gradient-Echo-Imaging, Flow-Mapping und MR-Angiographie nach intravenöser Gabe von Gadolinium. Die Möglichkeiten der MR-Diagnostik erlauben unter Einbeziehung der verschiedenen genannten Protokolle am besten die Darstellung und funktionelle Beschreibung aller klinisch relevanten Aortenerkrankungen. Im vorliegenden Manuskript wird bei verschiedenen klinisch relevanten Aortenerkrankungen die MR-Technik anderen bildgebenden Verfahren gegenübergestellt und diskutiert. Abschließend kommen wir zu der Auffassung, dass die MR-Techniken die umfassendsten und relevantesten Informationen liefern und mit dem Einsatz von MR-Angiographie sogar invasive Verfahren wie Aortographie nach Katheterpunktion ersetzen. Wir halten die verschiedenen MR-Verfahren in ihrer Kombination für die wichtigste nichtinvasive Diagnostik bei sowohl akuten als auch chronischen Aortenerkrankungen.
    Notes: Abstract MR with its various imaging protocols including spin-echo MR-imaging, gradient MR-imaging, flow-mapping and MR angiography is the ideal tool for noninvasive assessment of any kind of aortic diseases. The technique allows to image the aorta both in the thoracic cage and in the abdominal aspects better than any other tomographic image modality. With the capability of angiography after intravenous injection of gadolinium even the information previously only obtained from invasive catheter-based studies is now available within minutes after an intravenous injection. The overview manuscript compares various clinical settings of aortic diseases as assessed by various imaging modalities and highlights the capability of MR-imaging for aortic diseases both in the chronic and the acute clinical setting.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s000590050026
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  • 10
    Electronic Resource
    Electronic Resource
    Comparison of conventional and transesophageal echocardiography with magnetic resonance imaging for anatomical mapping of thoracic aortic dissection (1994)
    Springer
    The international journal of cardiovascular imaging 10 (1994), S. 1-14 
    Details
    ISSN: 1573-0743
    Keywords: aortic dissection ; transesophageal echocardiography ; magnetic resonance imaging ; anatomical mapping of the aorta
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Thirty-five consecutive patients with clinically suspected aortic dissection were subjected to a dual noninvasive imaging protocol using comprehensive echocardiography and ECG-triggered MRI with multi-slice spin echo and cine sequences in random order. The purpose of this dual imaging study was to compare the diagnostic accuracy of two-dimensional and color-coded Doppler echocardiography using the conventional transthoracic (TTE) and the transesophageal approach (TEE) with magnetic resonance imaging (MRI) for the exact morphologic evaluation and anatomical mapping of the thoracic aorta. The results of each diagnostic method were validated independently against the ‘gold standard’ of intraoperative findings (n=17), necropsy (n=4) or contrast angiography (n=22). Compared to conventional transthoracic echocardiography both TEE and MRI were more reliable in detecting aortic dissections (TTE vs TEE: p〈0.02; TTE vs MRI: p〈0.01) and associated epiphenomena. Moreover, the reliability of TTE decreased significantly from proximal to distal segments of the aorta, e.g. from the ascending segment to the arch (p〈0.05) and to the descending aorta (p〈0.005), whereas the sensitivities of both TEE and MRI were excellent irrespective of the site of dissection. With regard to epiphenomena such as thrombus formation and entry location, MRI emerged as the optimal method for detailed morphologic information in all segments of the aorta. No serious side effects were encountered with either method. Thus, in patients with suspected acute or subacute aortic dissections the echocardiographic assessment should include the transesophageal approach for significant improvement of the moderate sensitivity and specificity of TTE. Both TEE and MRI are non-traumatic, safe and diagnostically accurate to identify and classify acute and subacute dissections of the thoracic aorta irrespective of their location. MRI provides superb anatomical mapping of all type A and B dissections and more detailed information on the site of entry and thrombus formation than TEE. These features of TEE and MRI may render retrograde contrast angiography obsolete in the setting of thoracic aortic dissection and may encourage surgical interventions exclusively on the basis of noninvasive imaging.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01151576
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