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1.
Stem Cell Res ; 42: 101690, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31901832

RESUMO

The human induced pluripotent stem cell line NCCDFWi001-A was derived from peripheral blood mononuclear cells (PBMC) of a 26-year-old female Marfan syndrome patient carrying two compound heterozygous variants FBN1c.2613A > C, (p.Leu871Phe) and c.684_736 + 4del. The established patient-derived iPSC showed expression of pluripotent stem cell markers and had the ability to differentiate into all of the three germ layers and possessed a normal karyotype.

2.
Orphanet J Rare Dis ; 15(1): 6, 2020 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-31915033

RESUMO

BACKGROUND: Loeys-Dietz syndrome (LDS) is a rare connective tissue disorder for which 6 genes in the TGF-ß pathway have been identified as causative. With the widespread use of genetic testing, the range of known clinical and genetic profiles has broadened, but these features have not been fully elucidated thus far. METHODS AND RESULTS: Using gene panel sequencing or whole exome sequencing, we identified 54 unique rare variants in LDS genes in 57 patients with thoracic aneurysms/dissections, including 27 pathogenic mutations (P + LP) and 27 variants of unknown significance (VUSLP + VUS). Genotype-phenotype correlation analysis revealed that carriers with P/LP/ VUSLP variants in TGFBR1/TGFBR2/SMAD3 genes had significantly more severe cardiovascular features (cardiovascular death/dissection) than carriers with VUSs in these 3 genes at an early age and had less favorable event-free survival. Additionally, carriers with VUS in combination with other risk factors, such as hypertension, might be prone to developing an aortic dissection, as indicated by the fact that 5/8 (62.5%) patients with VUSs in our cohort developed aortic dissections in the presence of hypertension, compared with 25.0% (3/12) in the absence of hypertension (p = 0.047). CONCLUSIONS: To date, this was the largest cohort of LDS patients ever reported in China, and the present study expanded the known mutation and phenotypic spectra of LDS, which might help refine our knowledge of LDS.

3.
Interact Cardiovasc Thorac Surg ; 30(2): 280-286, 2020 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-31665309

RESUMO

OBJECTIVES: Our study aims to assess the technical quality and the learning curve of the preclosure technique for a vascular surgeon using Proglide using cumulative sum analysis (CUSUM analysis). METHODS: This study was designed retrospectively and enrolled 81 consecutive patients with 88 access sites who underwent endovascular aortic repair or thoracic endovascular aortic repair with the preclosure technique using Proglide between July 2017 and February 2018. The patients were divided into 2 groups chronologically: (A) the first 40 cases and (B) the latter 41 cases. Logistic regression analysis was used to assess the impact of technical risk factors on the success of the preclosure technique, and the χ2 test and 1-way ANOVA were applied to analyse the distribution of individual characteristics and risk factors between the 2 groups. CUSUM analysis was adapted to analyse the learning curve and to monitor the technical quality, with a predetermined target failure rate of 5%, an alternative failure rate of 20% and calculated 80% 'alert', 95% 'alarm' and 80% 'reassurance' lines. RESULTS: Primary technical success was obtained in 81 (92.05%) access sites. There were no significant correlations between primary technical success and risk factors, including, common femoral artery diameter (P = 0.88), common femoral artery depth from the skin (P =0.94), the level of common femoral artery calcification (P =0.86) and size of sheath (P =0.96). Moreover, the distribution of related risk factors was not significantly different between groups A and B. CUSUM analysis showed that the cumulative failure rate never crossed the 80% 'alert' and 95% 'alarm' lines. Additionally, the failure rate began to approach the 80% 'reassurance' line after ∼22 cases and crossed the 80% 'reassurance' line after 36 cases. CONCLUSIONS: The technique of totally percutaneous access using Proglide is safe and effective for an experienced vascular surgeon, even if the operator has no previous experience with any preclosure techniques. CUSUM analysis showed that 36 cases are necessary to achieve the target failure rate of 5%.

5.
Hum Genomics ; 12(1): 46, 2018 10 04.
Artigo em Inglês | MEDLINE | ID: mdl-30286810

RESUMO

BACKGROUND: Marfan syndrome (MFS) is an autosomal dominant connective tissue disorder caused by mutations in the FBN1 gene. Approximately 90% of classic MFS patients have a FBN1 mutation that can be identified by single-gene sequencing or gene-panel sequencing targeting FBN1. However, a small proportion of MFS patients carry a large genomic deletion in FBN1, which cannot be detected by routine sequencing. Here, we performed an MLPA (multiplex ligation-dependent probe amplification) test to detect large deletions and/or duplications in FBN1 and TGFBR2 in 115 unrelated Chinese patients with suspected MFS or early-onset aneurysm/dissection. RESULTS: Five novel large deletions encompassing a single exon or multiple exons in the FBN1 gene were characterized in five unrelated patients, of which four were proven by Sanger sequencing, and the breakpoints were identified. Three of them met the revised Ghent criteria when genetic results were not available, and the other two patients were highly suspected and diagnosed with MFS until the FBN1 deletions were identified. CONCLUSIONS: Our finding expands the mutation spectrum of large FBN1 deletions and emphasizes the importance of screening for large FBN1 deletions in clinical genetic testing, especially for those with classic Marfan phenotype.


Assuntos
Fibrilina-1/genética , Testes Genéticos , Síndrome de Marfan/genética , Deleção de Sequência/genética , Adulto , Análise Mutacional de DNA , Éxons/genética , Feminino , Humanos , Masculino , Síndrome de Marfan/patologia , Pessoa de Meia-Idade , Mutação/genética
6.
Mol Cells ; 41(3): 198-206, 2018 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-29487278

RESUMO

Aortic dissection (AD) is a catastrophic disease with high mortality and morbidity, characterized with fragmentation of elastin and loss of smooth muscle cells. Although AD has been largely attributable to polymorphisms defect in the elastin-coding gene, tropoelastin (TE), other undermined factors also appear to play roles in AD onset. Here, we investigated the effects of post-transcriptional control of TE by microRNAs (miRNAs) on elastin levels in aortic smooth muscle cells (ASMC). We found that miR-144-3p is a miRNA that targets TE mRNA in both human and mouse. Bioinformatics analyses and dual luciferase reporter assay showed that miR-144-3p inhibited protein translation of TE, through binding to the 3'-UTR of the TE mRNA. Interestingly, higher miR-144-3p levels and lower TE were detected in the ASMC obtained from AD patients, compared to those from non-AD controls. In a mouse model for human AD, infusion of adeno-associated viruses (serotype 6) carrying antisense for miR-144-3p (as-miR-144-3p) under CAG promoter significantly reduced the incidence and severity of AD, seemingly through enhancement of TE levels in ASMC. Thus, our data suggest an essential role of miR-144-3p on the pathogenesis of AD.


Assuntos
Aneurisma Dissecante/prevenção & controle , Miócitos de Músculo Liso/metabolismo , Tropoelastina/farmacologia , Aneurisma Dissecante/patologia , Animais , Modelos Animais de Doenças , Feminino , Humanos , Camundongos , Miócitos de Músculo Liso/efeitos dos fármacos , Tropoelastina/farmacocinética
7.
Oncotarget ; 8(53): 91628-91635, 2017 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-29207672

RESUMO

Thoracic endovascular repair (TEVAR) is an effective treatment for type B aortic dissection (TBAD). Here, we evaluated the early-midterm effectiveness and safety of TEVAR for treating TBAD patients after renal transplantation. Six patients with TBAD treated with TEVAR after renal transplantation were recruited between February 2012 and December 2016. They were then followed up with clinical examinations and computed tomography angiography (CTA). TEVAR was successfully performed in all patients (100%), and the primary tear sites were well covered by stents with or without coverage of the left subclavian artery. No severe complications occurred in any patient during perioperative period. The one-year survival rate was 100%, one patient died of renal graft failure and heart failure four years after TEVAR; the remaining five patients (83.3%) survived and exhibited no severe complications. Our findings show that TEVAR provides satisfactory short-midterm results for TBAD patients after renal transplantation. Moreover, our experience shows that it need relative longer proximal landing zone to prevent the endoleak and recurrence. However, regular hematodialysis, long-term immunosuppressive therapy, and blood pressure control remain crucial factors to prolong survival. Long-term follow-up studies are needed to evaluate the long-term prognosis in these patients.

8.
Sci Rep ; 6: 33002, 2016 09 09.
Artigo em Inglês | MEDLINE | ID: mdl-27611364

RESUMO

Inherited aortopathy, which is characterized by a high risk of fatal aortic aneurysms/dissections, can occur secondarily to several syndromes. To identify genetic mutations and help make a precise diagnosis, we designed a gene panel containing 15 genes responsible for inherited aortopathy and tested 248 probands with aortic disease or Marfan syndrome. The results showed that 92 individuals (37.1%) tested positive for a (likely) pathogenic mutation, most of which were FBN1 mutations. We found that patients with a FBN1 truncating or splicing mutation were more prone to developing severe aortic disease or valvular disease. To date, this is the largest reported cohort of Chinese patients with aortic disease who have undergone genetic testing. Therefore, it can serve as a considerable dataset of next generation sequencing data analysis of Chinese population with inherited aortopathy. Additionally, according to the accumulated data, we optimized the analysis pipeline by adding quality control steps and lowering the false positive rate.


Assuntos
Doenças da Aorta/epidemiologia , Doenças da Aorta/genética , Predisposição Genética para Doença , Adolescente , Adulto , Grupo com Ancestrais do Continente Asiático , Criança , Pré-Escolar , Feminino , Testes Genéticos , Humanos , Masculino , Pessoa de Meia-Idade , Mutação , Polimorfismo Genético , Adulto Jovem
9.
Clin Chim Acta ; 459: 30-35, 2016 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-27234404

RESUMO

Marfan syndrome (MFS) is an autosomal dominant connective tissue disorder typically involving the ocular, skeletal and cardiovascular systems, and aortic aneurysms/dissection mainly contributes to its mortality. Here, we performed genetic testing of the FBN1 gene in 39 Chinese probands with Marfan/Marfan-like syndrome and their related family members by Sanger sequencing. In total, 29 pathogenic/likely pathogenic FBN1 mutations, including 17 novel ones, were identified. In addition, most MFS patients with aortic disease (62%) had a truncating or splicing mutation. These results expand the FBN1 mutation spectrum and enrich our knowledge of genotype-phenotype correlations. Genetic testing for MFS and its related aortic diseases is increasingly important for early intervention and treatment.


Assuntos
Fibrilina-1/genética , Testes Genéticos , Síndrome de Marfan/genética , Mutação , China , Feminino , Fibrilina-1/sangue , Humanos , Masculino , Síndrome de Marfan/sangue , Síndrome de Marfan/diagnóstico , Pessoa de Meia-Idade
10.
Clin Chim Acta ; 456: 144-148, 2016 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-26877057

RESUMO

Inherited aortopathy, characterized with a high risk of fetal aortic aneurysms/dissections, could occur secondary to several syndromes. To identify genetic mutations and help to give a precise diagnosis, we performed a gene panel testing, involving 15 genes related to inherited aortopathy. Here we reported 10 patients, combining with the genetic testing results, were diagnosed or suspected with Loeys-Dietz syndrome, which would be the largest group of Loeys-Dietz syndrome ever reported in China till now. 10 likely pathogenic mutations or rare variants of uncertain significance were found. These results expanded the mutation spectrum of Loeys-Dietz syndrome and might be implicated in its wide phenotypic spectrum.


Assuntos
Testes Genéticos , Síndrome de Loeys-Dietz/diagnóstico , Síndrome de Loeys-Dietz/genética , Adulto , Aneurisma Aórtico/complicações , Criança , Pré-Escolar , Feminino , Humanos , Síndrome de Loeys-Dietz/complicações , Masculino , Pessoa de Meia-Idade , Mutação
11.
Zhonghua Xin Xue Guan Bing Za Zhi ; 41(7): 598-601, 2013 Jul.
Artigo em Chinês | MEDLINE | ID: mdl-24284190

RESUMO

OBJECTIVE: To analyze the clinical features, precaution and management of complete heart block (CHB) after transaortic extended septal myectomy operation (extended Morrow procedure) in patients with hypertrophic obstructive cardiomyopathy (HOCM). METHODS: From October 1996 to December 2011, 10[6 men; mean age (45.4 ± 15.8) years, range 13-60 years] out of 160 consecutive HOCM patients underwent extended Morrow procedure developed CHB postoperatively. Their clinical data were retrospectively analyzed. Baseline transthoracic echocardiography showed that the left ventricular outflow tract (LVOT) gradients was from 68 to 149 (105.1 ± 25.9) mm Hg (1 mm Hg = 0.133 kPa), ECG showed right bundle branch block in 5 patients and atrial fibrillation, atrial premature beats or ST-T segment changes in other 5 patients. Besides extended Morrow procedure, concomitant surgical procedures included mitral valve replacement (MVR) in 2 (2/10) and MVR plus coronary artery bypass grafting in another 2 (2/10) patients. Follow-up data were obtained by subsequent clinic visits in outpatient department and telephone interviews. RESULTS: The in-hospital mortality was 20% (these two patients died of low cardiac output syndrome and multiple organs failure). Four patients underwent MVR simultaneously survived the operation. Postoperative echocardiography demonstrated a reduced LVOT gradient[(13.6 ± 9.7) mm Hg, P < 0.001]. Permanent pacemakers were implanted in all 8 survived patients at 6 days to 7 months after operation. No other severe complications were observed. During follow-up [from 4 to 72 (19.4 ± 22.1) months], there was no death, 1 patient readmitted to our center at 71 months post operation to change the pacemaker because of low voltage of previously implanted pacemaker. Physical capacity and quality of life improved significantly post operation in these 8 patients. The NYHA functional class remained at I-II post operation and during follow up. CONCLUSIONS: CHB is a severe complication after extended Morrow procedure for patients with HOCM and timely permanent pacemaker implantation is mandatory for patients with post procedure CHB.


Assuntos
Bloqueio Atrioventricular/etiologia , Cardiomiopatia Hipertrófica/cirurgia , Complicações Pós-Operatórias , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
12.
Zhonghua Yi Xue Za Zhi ; 93(2): 110-3, 2013 Jan 08.
Artigo em Chinês | MEDLINE | ID: mdl-23648346

RESUMO

OBJECTIVE: To assess the clinical outcomes of transaortic extended septal myectomy on early and midterm survival of patients with hypertrophic obstructive cardiomyopathy (HOCM). METHODS: From October 2009 to April 2012, 118 consecutive patients underwent extended Morrow's procedure for HOCM. There were 69 males and 49 females with an average age of (46 ± 13) years. Their clinical data were analyzed retrospectively. Preoperative transthoracic, intraoperative transoesophageal and postoperative transthoracic echocardiography was performed to assess septal thickness, left ventricular outflow tract (LVOT) gradient, mitral valve function and systolic anterior motion (SAM) of anterior mitral valve leaflet, etc. Concomitant surgical procedures were performed if other cardiac diseases required surgical interventions. Follow-up study was carried out during subsequent clinic visits at outpatient department and through telephone interviews with patients and their relatives. RESULTS: The septal thickness was (25 ± 7) mm. SAM was detected in all. The in-hospital mortality was 0.8% (1/118) since one patient died of multiple organs failure one week later. Postoperative echocardiography demonstrated marked reduction in LVOT gradient (92 ± 22 vs 13 ± 10 mm Hg (1 mm Hg = 0.133 kPa), P = 0.000), New York Heart Association (NYHA) class (2.9 ± 0.6 vs 1.2 ± 0.4, P = 0.000) and significant improvement in mitral regurgitation. Concomitant surgical procedures were performed in 45 cases (38.1%, all for preexisting conditions). Complications included complete atrioventricular block (n = 3), first degree atrioventricular block (n = 6), complete left bundle branch block (n = 51), intraventricular conduction delay or left anterior division block (n = 26), transient renal dysfunction (n = 2) and intra-aortic-balloon-pumping (n = 2). No other severe complication was observed. During a follow-up period of 1 - 27 (7 ± 6) months, there was no readmission or death. All patients reported significant increase in physical ability and obvious decrease in limiting symptoms. At the latest follow-up, the NYHA functional class maintained grade I-II in all. And mitral regurgitation remained absent or mild. CONCLUSION: Surgical procedure for HOCM patients is both safe and efficacious. It provides an excellent relief of LVOT obstruction.


Assuntos
Procedimentos Cirúrgicos Cardíacos , Cardiomiopatia Hipertrófica/cirurgia , Obstrução do Fluxo Ventricular Externo/cirurgia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento
13.
Eur J Cardiothorac Surg ; 43(3): 534-40, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-22761504

RESUMO

OBJECTIVES: The aim was to assess the early and mid-term clinical effects of transaortic extended septal myectomy (TAESM) on obstructive hypertrophic cardiomyopathy (HCM) in China. METHODS: Ninety-three consecutive patients [57 men; mean age 45.8 ± 13.4 (11-74) years] with obstructive HCM underwent TAESM in Fuwai hospital. Their clinical data were analysed retrospectively. All the patients had drug-refractory symptoms and left ventricular outflow tract (LVOT) obstruction with a resting or physically provoked gradient of ≥50 mmHg. Preoperative transthoracic, intra-operative transoesophageal and postoperative transthoracic echocardiography was performed to assess LVOT gradients, septal thickness, LVOT diameter, mitral valve function, etc. Systolic anterior motion (SAM) of the anterior mitral valve leaflet had been detected in all preoperatively. RESULTS: All the surgical procedures of the 93 patients were technically successful. The average length of postoperative stay was 7.8 ± 3.7 days. The 30-day and in-hospital mortality was 0%. Initial postoperative transoesophageal echocardiography (TEE) demonstrated marked reduction in LVOT gradient (91.76 ± 25.08 to 14.34 ± 13.44 mmHg, P < 0.0005) and significant improvement in mitral regurgitation (MR; P < 0.0005). Concomitant surgical procedures were carried out in 37 (39.8%). Complete atrioventricular block occurred in 3, complete left bundle branch block in 44, intraventricular conduction delay in 18, complete right bundle branch block in 2, transient renal dysfunction in 2 and transient intra-aortic-balloon-pumping was needed in 2. No other complications were observed during hospital stay. During a follow-up of 10.72 ± 11.02 (1-24) months, there were no readmissions or deaths, and all patients subjectively reported an obvious decrease in limiting symptoms and a significant increase in physical ability. At the latest follow-up, the New York Heart Association functional class decreased from 3.09 ± 0.60 (2-4) preoperatively to 1.12 ± 0.32 (1-2) (P < 0.0005); the LVOT gradient remained low at 14.78 ± 14.01 mmHg; MR remained absent (51) or at mild-(41)-to-moderate-(1) levels and SAM resolved completely in 98.9% (92 of 93) patients. CONCLUSIONS: TAESM provides excellent relief from LVOT obstruction in HCM patients, with a conspicuous clinical and echocardiographic outcome at early and mid-term follow-up. For obstructive HCM and cardiac comorbidities, concomitant cardiac procedures with TAESM can be performed with low risk and satisfactory results.


Assuntos
Procedimentos Cirúrgicos Cardíacos/métodos , Cardiomiopatia Hipertrófica/cirurgia , Septos Cardíacos/cirurgia , Adolescente , Adulto , Idoso , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Criança , China , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Estatísticas não Paramétricas
14.
J Vasc Interv Radiol ; 23(4): 453-60, 460.e1, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22464711

RESUMO

PURPOSE: To report the immediate and follow-up outcome of thoracic endovascular aortic repair (TEVAR) in highly selected patients with retrograde type A aortic dissection (RAAD) and an entry tear in the descending aorta. MATERIALS AND METHODS: TEVAR was performed in 17 patients with RAAD and an entry tear in the descending aorta. None of the patients had severe aortic regurgitation, cardiac tamponade, coronary artery involvement, or brain ischemia. The false lumen in the ascending aorta was patent in nine patients. Two patients had acute malperfusion of the branched artery. Computed tomography (CT) was performed 14 days, 3 months, and 6 months after the intervention and annually thereafter. RESULTS: All procedures were technically successful, with complete coverage of the entry tear and complete thrombosis of the false lumen in the ascending aorta. All patients survived through the follow-up period (25.7 months ± 17.2). TEVAR resulted in thrombosis of the false lumen, reabsorption of the false lumen thrombus, and enlargement of the true lumen. The mean maximal diameter of the ascending aorta and the false lumen in the ascending aorta significantly decreased after TEVAR. At the distal edge of the stent graft, the mean diameter of the descending aorta and the false lumen markedly decreased after TEVAR. Complete thrombosis of the false lumen was observed at the distal edge of the stent graft in 16 (94.1%) patients and at the diaphragmatic level in 9 (52.9%) patients. CONCLUSIONS: TEVAR for RAAD with an entry tear in the descending aorta is a safe and effective technique in highly selected patients.


Assuntos
Aneurisma Dissecante/diagnóstico por imagem , Aneurisma Dissecante/cirurgia , Aneurisma da Aorta Torácica/diagnóstico por imagem , Aneurisma da Aorta Torácica/cirurgia , Ruptura Aórtica/diagnóstico por imagem , Ruptura Aórtica/cirurgia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia , Resultado do Tratamento
15.
J Endovasc Ther ; 18(4): 477-84, 2011 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-21861733

RESUMO

PURPOSE: To report our early experience with endovascular repair of acute non-A-non-B aortic dissections using chimney grafts to preserve blood flow to a left common carotid artery (LCCA) located in the proximal landing zone. METHODS: From June 2009 to May 2010, 8 patients (7 men; mean age 49 years, range 29-75) with acute non-A-non-B aortic dissection and no adequate proximal sealing zones underwent thoracic endovascular aortic repair (TEVAR). Covered stents were placed parallel to the aortic stent-grafts to restore flow to the LCCAs while extending the proximal fixation zones; the left subclavian arteries were intentionally covered after carefully cerebrovascular assessment. Follow-up examinations included computed tomography (CT) at 2 weeks, 3 months, 6 months, 12 months, and yearly thereafter. RESULTS: All the procedures were completed successfully, with one main aortic stent-graft deployed and one chimney graft implanted in the LCCA. Two retrograde type II endoleaks identified intraoperatively were left untreated but followed closely using CT. There were no instances of puncture site complications, stroke, paralysis, or death during the hospital stay. The 30-day mortality was 0%. During the mean 11.4-month follow-up (range 6-15), there was no mortality, and duplex ultrasound and CT showed patency of all stent-grafts, enlargement of the true lumen, and compression of the false lumen. One type II endoleak disappeared in 2 weeks postoperatively, while the other gradually faded until it was nearly gone at 11 months postoperatively. During follow-up, no renal insufficiency, new late endoleaks, endograft migration, fracture, stent-graft related complications, or deaths were observed. CONCLUSION: In short-term follow-up, TEVAR combined with the chimney technique seems promising for aortic dissections that involve the aortic arch with inadequate proximal sealing zones. More cases and long-term results are needed to evaluate the safety and efficiency of this alternative endovascular technique.


Assuntos
Aneurisma Dissecante/cirurgia , Aneurisma Aórtico/cirurgia , Implante de Prótese Vascular/métodos , Artéria Carótida Primitiva/cirurgia , Procedimentos Endovasculares , Doença Aguda , Adulto , Idoso , Aneurisma Dissecante/diagnóstico por imagem , Aneurisma Dissecante/fisiopatologia , Aneurisma Aórtico/diagnóstico por imagem , Aneurisma Aórtico/fisiopatologia , Aortografia/métodos , Prótese Vascular , Implante de Prótese Vascular/efeitos adversos , Implante de Prótese Vascular/instrumentação , Artéria Carótida Primitiva/diagnóstico por imagem , Artéria Carótida Primitiva/fisiopatologia , China , Procedimentos Endovasculares/efeitos adversos , Procedimentos Endovasculares/instrumentação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Desenho de Prótese , Fluxo Sanguíneo Regional , Estudos Retrospectivos , Stents , Fatores de Tempo , Tomografia Computadorizada por Raios X , Resultado do Tratamento
16.
Artigo em Chinês | MEDLINE | ID: mdl-20939470

RESUMO

OBJECTIVE: To investigate the security and efficiency of endovascular repair for Stanford type B aortic dissection (AD) with severe complications. METHODS: Between January 2003 and December 2009, 60 patients having Stanford type B AD with severe complications were treated, including 39 males and 21 females with an average age of 43.7 years (range, 34-71 years). Severe complications included 27 cases of huge hemothorax, 1 case of paraplegia, 7 cases of acute renal failure, 10 cases of celiac trunk ischemia, 10 cases of superior mesenteric artery ischemia, and 5 cases of severe limb ischemia. Emergency stent-graft deployment were applied in all patients, and 64 stent-grafts were successfully implanted. RESULTS: All patients survived and were followed up 3-86 months. Hemothorax disappeared after 28 days to 3 months of operation in all hemothorax patients; renal function returned normal after 1 to 9 days; limb and visceral ischemia disappeared gradually after 1 to 14 days; and muscular strength of lower limb in the paraplegia patient began to recover after 4 hours of operation. The postoperative CT angiography showed enlarged true lumen and thrombosis in the false lumen. CONCLUSION: Emergency endovascular repair is a safe and effective method to treat Stanford type B AD with severe complications.


Assuntos
Aneurisma Dissecante/complicações , Aneurisma Dissecante/cirurgia , Aneurisma Aórtico/complicações , Aneurisma Aórtico/cirurgia , Implante de Prótese Vascular , Adulto , Idoso , Prótese Vascular , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Stents
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