Evidence of aortic dissection and Marfan syndrome in a mummy from the Capuchin Catacombs of Palermo, Sicily.

The authors report on the assessment of an anthropogenic mummy of a young man from the Capuchin Catacombs of Palermo, Sicily, tentatively dated from the mid- to late 19th century AD. The mummy was investigated by full-body CT examination. CT images clearly showed aortic dissection classified as Stanford-A. Due to the relation of aortic dissection to inherited connective tissue diseases in young people, such as Marfan syndrome, conspicuous and pathological findings possibly indicating the presence of underlying Marfan syndrome were assessed. Several systemic features were scored that supported the presence of underlying Marfan syndrome in this mummy. These findings were: pectus carinatum and chest asymmetry, dural ectasia, protrusio acetabuli, dolichocephaly, down-slanting palpebral fissures, malar hypoplasia and (probable) reduced elbow extension. Aortic dissection, a cardinal feature of Marfan syndrome, turned out to be the diagnostic key for the paleoradiological diagnosis of this disease. The demonstrated CT findings contribute to the spectrum of cardiovascular diseases and inherited connective tissue disease in the fields of paleopathology and paleoradiology.

Desarrollo histórico de los bypass extra-anatómicos / Historic development of the extra-corporeal bypass

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Battle of the Bulge: Aortic Aneurysm Management From Early Modernity to the Present.

For centuries, physicians have recognized aortic aneurysms as an acute threat to life. Therapeutic approaches to the disease began in the 18th century when leading physicians, such as René Laennec and Antonio Valsalva, applied research on circulation and blood coagulation to devise whole-body fasting and bleeding regimens to prevent rupture. After John Hunter's success in ligating arteries to treat peripheral aneurysms, surgeons attempted analogous operations on the aorta, but even the renowned Sir Astley Cooper and William Halsted met with disastrous results. Other clinicians tried various methods of creating intraluminal clots, including the application of such new technologies as electricity and plastic. Vessel repair techniques, pioneered by Alexis Carrel and others in the 20th century, eventually provided a reliably effective treatment. In the past few decades, minimally invasive methods that approach aneurysms endovascularly through small groin incisions have been adopted. A successful 2005 congressional campaign to fund screening for aortic aneurysms brought the disease to national attention and symbolizes current confidence in curing it. Drawing on various published and unpublished sources, this paper elucidates the development of specific treatments for aortic aneurysms over time and more broadly addresses how medicine and surgery apply the knowledge and technology available in particular eras to treat a specific, identifiable, and lethal disease. Examining the evolution of these therapeutic efforts unveils broader trends in the history of medicine. This allows aortic aneurysms to serve as a case study for exploring shifting philosophies in medical history.

A Case of Sudden Death in Decameron IV.6: Aortic Dissection or Atrial Myxoma?

Giovanni Boccaccio's Decameron contains a novella that details the sudden death of a young man called Gabriotto, including a portrayal of the discomfort that the protagonist experienced and a rudimentary autopsy performed by local physicians. The intriguing description of symptoms and pathologies has made it possible to read a 7-century-old case through the modern clinical lens. Thanks to the medical and philological analysis of the text-despite the vast difference between modern and medieval medicine-2 hypothetical diagnoses have emerged: either an aortic dissection or an atrial myxoma.

Hallmarks in the Therapeutic Approach of Aortic Aneurysms: The Main Contributors.

Abstract: Deriving from the Greek word for "widening", aneurysms have been a well known entity since antiquity. In the 2nd century AD, Antyllos, the Greek born surgeon who practiced in Rome, described a method for aneurysms' surgical removal that remained a standard procedure till the 19th century. In 18th century John Hunter proposed a limb saving operation method for treating peripheral aneurysms paving thus the way for the modern surgery of aneurysms and Rudolph Matas, carried out the first aneurysmorrhaphy. During the 20th century two eminent surgeons laid the foundations of vascular surgery: Charles Dubost, who utilized the first homograft for aneurysm repair and Michael DeBakey, who performed the first radical treatment of a thoracic aneurysm.

El aneurisma de aorta abdominal / The abdominal aortic aneurysm

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The value of anecdote.

Anecdote is defined as "a usually short narrative of an interesting, amusing, or biographical incident" and are not often deemed scientifically valuable (www.merriam-webster.com). Anecdotes can be analyzed, however, and those observations can become the initiation of important and groundbreaking work. In this article, we describe aecdotes of several cases which by themselves had seemingly little value. The value was added later, when these concepts were extrapolated to important projects, which expanded into series of experiences, which were reproducible and able to be analyzed and judged as valuable devices and/or methods. The authors recognize that some of the images are old and not of great quality but the information provided is as complete as possible and reliable.

Giovanni Battista Morgagni in the murals of Diego Rivera at the National Institute of Cardiology of Mexico City.

The Italian physician Giovanni Battista Morgagni was the founder of the clinico-anatomical method. His masterpiece De sedibus, et causis morborum per anatomen indagatis represented a major breakthrough in the history of medicine. In the murals of Diego Rivera at the National Institute of Cardiology, Morgagni appears at the center of the fresco. With his left index finger points to the chest of a dying patient with a bulging pulsating aortic aneurysm below the left clavicle, and with his right hand, that holds a scalpel, shows the aneurysm found at the autopsy table. With this striking image the clinico-anatomical method is succinctly depicted. Professor Ignacio Chávez, the founder of the National Institute of Cardiology, gave the artist the elements to draw Morgagni, but the disposition and the importance of Morgagni in the fresco were due to the talent of Rivera.

Diego Rivera's fresco and the case taken from Morgagni's De sedibus.

The fresco by Diego Rivera (1886 to 1957) on the history of cardiology was displayed at the "Instituto Nacional de Cardiología" of Mexico City at the time of inauguration on April 14, 1944. Some of the most important masters of the Padua Medical School were depicted, namely Vesalius, Harvey, and Morgagni. There is a vivid description of the anatomoclinical method introduced by Giovanni Battista Morgagni (1682 to 1771), when he was professor of Theoretical Medicine first and then of Anatomy at the University of Padua (1711 to 1771). By reading Morgagni's De sedibus, we found the case of aortic syphilitic aneurysm that corresponds perfectly with the one represented in Diego Rivera's mural. In the Museum of Pathological Anatomy of the Padua University, an anatomical specimen that displays the same lesion is preserved, and we have performed a computed tomography scan to analyze the state of the heart and aneurysm, thus finding diffuse calcific deposits of aorta and pericardium. In conclusion, in Diego Rivera's fresco the clinicopathologic method of Morgagni is well represented and the case of syphilitic aneurysm, reported by Morgagni in his De sedibus, depicted.