Presentation is loading. Please wait.

Presentation is loading. Please wait.

Leon M. Ptaszek, MD, PhD, Kibeom Kim, BA, Amy E. Spooner, MD, Thomas E

Published byBernard Fox Modified over 5 years ago

Similar presentations

Presentation on theme: "Leon M. Ptaszek, MD, PhD, Kibeom Kim, BA, Amy E. Spooner, MD, Thomas E"— Presentation transcript:

1 Marfan Syndrome Is Associated With Recurrent Dissection of the Dissected Aorta 
Leon M. Ptaszek, MD, PhD, Kibeom Kim, BA, Amy E. Spooner, MD, Thomas E. MacGillivray, MD, Richard P. Cambria, MD, Mark E. Lindsay, MD, PhD, Eric M. Isselbacher, MD  The Annals of Thoracic Surgery  Volume 99, Issue 5, Pages (May 2015) DOI: /j.athoracsur Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 Computed tomography angiography images of the evolving aortic dissection anatomy in the patient from case 1. (A) At age 36, a single dissection flap separating the true (T) and false (F) lumens in a descending aorta that is only mildly dilated. (B) At age 46, an image taken when the patient presented with recurrent symptoms, which now demonstrates 2 dissection flaps that separate the true lumen (T), original false lumen (F1), and second false lumen (F2). (C) At age 47, a similar flap configuration is present but the F2 lumen has expanded, resulting in a large thoracoabdominal aneurysm. (D) One year after surgical repair, an intimal flap persists in the aortic arch. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 Computed tomography angiography in a surface-shaded display (left anterior oblique projection) in the patient from case 1, performed at age 47 years. Evident is the ascending thoracic aortic interposition graft from prior repair of the initial type A aortic dissection. The original false lumen (F1) and second false lumen (F2) are visualized spiraling around the true lumen (T). The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

4 Fig 3 Axial images and planar reformats (A), (B), (D), and (E) in the left-anterior oblique projection (C) and (F) of computed tomography angiographies from the patient in case 2. (A), (B), and (C) After the first dissection a single dissection flap in the ascending aorta, arch, and descending aorta separate the true (T) and false (F) lumens. (D), (E), and (F) Corresponding images from when the patient presented 5 years later with a recurrent dissection demonstrating the appearance of a second false lumen (F2) and the original false lumen (F1). The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

5 Fig 4 (A) and (C) Planar reformats in the coronal projection and axial images (B) and (D) of computed tomography angiographies from the patient in case 3. (A) and (B) When the patient presented with the initial aortic dissection, a single dissection flap was observed extending from the ascending aorta to the proximal abdominal aorta. (C) and (D) A subsequent scan after the recurrent dissection that demonstrates a triple barrel aortic lumen in the proximal and distal descending thoracic aorta. Note the interposition ascending thoracic graft in (D). The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

6 Fig 5 (A), (B), (D), and (E) Axial images and (C) and (F) planar reformats in the left-anterior oblique projection of computed tomography angiographies from the patient in case 4. (A), (B), and (C) After repair of the ascending thoracic aorta after the first dissection, demonstrating a single dissection flap in the arch and descending aorta separate the true (T) and false (F) lumens. (D), (E), and (F) Corresponding images from when the patient presented with a recurrent dissection demonstrating the appearance of a second false lumen (F2) with shrinking of the original false lumen (F1). The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

7 Fig 6 Sagittal view of the computed tomography angiographies from the patient in case 5. The aortic root (R) is visible adjacent to the artifact associated with the prosthetic valve. Compression of the true lumen (T) and the original false lumen (F1) by the second false lumen (F2) is visible. A dissection flap within F1 is visible in the distal segment. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

8 Fig 7 Graphical representation of aneurysm measurements before and after the double dissection event. All patients experienced an increase in aortic diameter with an average of 1.6 ± 0.3 cm. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Download ppt "Leon M. Ptaszek, MD, PhD, Kibeom Kim, BA, Amy E. Spooner, MD, Thomas E"

Similar presentations

Bradley G. Leshnower, MD, Ravi K. Veeraswamy, MD, Yazan M

Bradley G. Leshnower, MD, Ravi K. Veeraswamy, MD, Yazan M
Bloodless Surgery of Acute Type A Aortic Dissection in a Jehovah’s Witness Patient  Miralem Pasic, MD, PhD, Wolfgang Ruisz, MD, Andreas Koster, MD, PhD,

Bloodless Surgery of Acute Type A Aortic Dissection in a Jehovah’s Witness Patient  Miralem Pasic, MD, PhD, Wolfgang Ruisz, MD, Andreas Koster, MD, PhD,
Ruoyu Zhang, MD, Theo Kofidis, MD, Stefan Baus, MD, Uwe Klima, MD, PhD 

Ruoyu Zhang, MD, Theo Kofidis, MD, Stefan Baus, MD, Uwe Klima, MD, PhD 
Open Distal Fenestration of Chronic Dissection Facilitates Endovascular Elephant Trunk Completion: Late Outcomes  Muhammad Aftab, MD, Jay J. Idrees, MD,

Open Distal Fenestration of Chronic Dissection Facilitates Endovascular Elephant Trunk Completion: Late Outcomes  Muhammad Aftab, MD, Jay J. Idrees, MD,
Rana O. Afifi, MD, Harith H. Mushtaq, MD, Harleen K

Rana O. Afifi, MD, Harith H. Mushtaq, MD, Harleen K
Yuanjia Zhu, BS, Eric E. Roselli, MD, Jay J. Idrees, MD, Charles M

Yuanjia Zhu, BS, Eric E. Roselli, MD, Jay J. Idrees, MD, Charles M
Jacques Kpodonu, MD, Venkatesh G. Ramaiah, MD, Edward B. Diethrich, MD 

Jacques Kpodonu, MD, Venkatesh G. Ramaiah, MD, Edward B. Diethrich, MD 
Serkan Burç Deşer, MD, Mustafa Kemal Demirağ, MD 

Serkan Burç Deşer, MD, Mustafa Kemal Demirağ, MD 
Randall R. De Martino, MD, MS, Jill Johnstone, MD, Elizabeth A

Randall R. De Martino, MD, MS, Jill Johnstone, MD, Elizabeth A
Reverse extra-anatomic aortic arch debranching procedure allowing thoracic endovascular aortic repair of a chronic ascending aortic aneurysm  Ludovic.

Reverse extra-anatomic aortic arch debranching procedure allowing thoracic endovascular aortic repair of a chronic ascending aortic aneurysm  Ludovic.
Anika L. Mirick, BA, Himanshu J. Patel, MD, G

Anika L. Mirick, BA, Himanshu J. Patel, MD, G
Giant Aortic Thrombus in the Ascending Aorta and Perforation of Bowel Associated With Cocaine Use  Shi Sum Poon, MBChB, Omar Nawaytou, MD, Alfred Hing,

Giant Aortic Thrombus in the Ascending Aorta and Perforation of Bowel Associated With Cocaine Use  Shi Sum Poon, MBChB, Omar Nawaytou, MD, Alfred Hing,
Risk of Spinal Cord Injury After Operations of Recurrent Aneurysms of the Descending Aorta  Jorge Flores, MD, Norihiko Shiiya, MD, PhD, Takashi Kunihara,

Risk of Spinal Cord Injury After Operations of Recurrent Aneurysms of the Descending Aorta  Jorge Flores, MD, Norihiko Shiiya, MD, PhD, Takashi Kunihara,
Open Surgical Repair of 2286 Thoracoabdominal Aortic Aneurysms

Open Surgical Repair of 2286 Thoracoabdominal Aortic Aneurysms
Long-Term Effectiveness of Total Arch Replacement for Type A Aortic Dissection  Yoshie Ochiai, MD, Yutaka Imoto, MD, Masato Sakamoto, MD, Yasutaka Ueno,

Long-Term Effectiveness of Total Arch Replacement for Type A Aortic Dissection  Yoshie Ochiai, MD, Yutaka Imoto, MD, Masato Sakamoto, MD, Yasutaka Ueno,
Virtual Vascular Endoscopy for Acute Aortic Dissection

Virtual Vascular Endoscopy for Acute Aortic Dissection
Management of Type A Aortic Dissection and a Large Pheochromocytoma: A Surgical Dilemma  Frank W. Bowen, MD, Jessie Civan, BS, Anton Orlin, BS, Thomas.

Management of Type A Aortic Dissection and a Large Pheochromocytoma: A Surgical Dilemma  Frank W. Bowen, MD, Jessie Civan, BS, Anton Orlin, BS, Thomas.
Clinical Analysis of Acute Type A Intramural Hematoma: Comparison Between Two Different Pathophysiological Types  Kunihide Nakamura, MD, PhD, Toshio Onitsuka,

Clinical Analysis of Acute Type A Intramural Hematoma: Comparison Between Two Different Pathophysiological Types  Kunihide Nakamura, MD, PhD, Toshio Onitsuka,
Heart Failure Due to Severe Supravalvular Aortic Stenosis in Painless Type A Aortic Dissection  Hiroaki Sakamoto, MD, PhD, Yasunori Watanabe, MD, PhD,

Heart Failure Due to Severe Supravalvular Aortic Stenosis in Painless Type A Aortic Dissection  Hiroaki Sakamoto, MD, PhD, Yasunori Watanabe, MD, PhD,
Stented Elephant Trunk Technique for Retrograde Type A Aortic Dissection After Endovascular Stent Graft Repair  Bin Li, MD, Xu-Dong Pan, MD, Wei-Guo Ma,

Stented Elephant Trunk Technique for Retrograde Type A Aortic Dissection After Endovascular Stent Graft Repair  Bin Li, MD, Xu-Dong Pan, MD, Wei-Guo Ma,

Similar presentations

Ads by Google