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aortic arch calcification on chest X-ray combined with coronary calcium score show additional benefit for diagnosis and outcome in patients with angina

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Journal of Geriatric Cardiology 2016年第3期13卷 218-225页

作者： Jong Shin Woo Weon Kim Se Hwan Kwon Hyo Chul Youn Hyun Soo Kim Jin Bae Kim Soo Joong Kim Woo-Shik Kim Kwon Sam Kim Cardiovascular Division Department of Internal Medicine Kyung Hee University Hospital Kyung Hee University Seoul South Korea Department of Radiology Kyung Hee University Hospital Kyung Hee University Seoul South Korea Department of Thoracic and Cardiovascular Surgery Kyung Hee University Hospital Kyung Hee University Seoul South Korea

Background The coronary artery calcium （CAC） and aortic arch calcification （AoAC） are individually associated with cardiovascular disease and outcome. This study investigated the predictive value of AoAC combined with CAC for cardiovascular diagnosis and outcome in patients with angina. Methods A total of 2018 stable angina patients who underwent chest X-ray and cardiac multi-detector computed tomography were followed up for four years to assess adverse events, which were categorized as cardiac death, stroke, myocardial infarction, or repeated revascularization. The extent of AoAC on chest X-ray was graded on a scale from 0 to 3. Results During the four years of fol- low-up, 620 patients were treated by coronary stenting and 153 （7%） adverse events occurred. A higher grade of AoAC was associated with a higher CAC score. Cox regression showed that the CAC score, but not AoAC, were associated with adverse events. In patients with CAC score 〈 400, AoAC showed an additive predictive value in detecting significant coronary artery disease （CAD）. A gradual increases in the risk of adverse events were noted if AoAC was present in patients with similar CAC score. Conclusions As AoAC is strongly correlated with the CAC score regardless of age or gender, careful evaluation of CAD would be required in patients with AoAC on conventional chest X-rays.

关键词： aortic arch Atherosclerosis Calcification Coronary artery disease

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Three-dimensional lattice Boltzmann method for simulating blood flow in aortic arch

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Chinese Physics B 2008年第3期17卷 1041-1049页

作者：康秀英吉驭嫔刘大禾金永娟 Applied Optics Beijing Area Major Laboratory Department of PhysicsBeijing Normal University Institute of Hematology Chinese Academy of Medical Sciences

The three-dimensional （3D） lattice Boltzmann models, 3DQ15, 3DQ19 and 3DQ27, under different wall boundary conditions and lattice resolutions have been investigated by simulating Poiseuille flow in a circular cylinder for a wide range of Reynolds numbers. The 3DQ19 model with improved Fillippova and Hanel （FH） curved boundary condition represents a good compromise between computational efficiency and reliability. Blood flow in an aortic arch is then simulated as a typical haemodynamic application. Axial and secondary fluid velocity and effective wall shear stress profiles in a 180° bend are obtained, and the results also demonstrate that the lattice Boltzmann method is suitable for simulating the flow in 3D large-curved vessels.

关键词： lattice Boltzmann method aortic arch secondary flow wall shear stress

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Diagnosis of Congenital aortic arch Anomalies in Chinese Children by Multi-Detector Computed Tomography Angiography

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2013年第3期33卷 447-451页

作者：陈鑫屈艳娟彭志远鲁锦国马小静 Department of Radiology Wuhan Asia Heart Hospital Department of Radiology Zhongnan Hospital of Wuhan University

Summary： The purpose of this study was to evaluate the value of multi-detector computed tomography （MDCT） angiography for the diagnosis of congenital aortic arch anomalies and present the radiological images of congenital aortic arch anomalies in Chinese children. MDCT angiography and transthoracic echocardiography （TTE） were applied for the diagnosis of congenital aortic arch anomalies in 362 Chi- nese children between May 2006 and December 2011 （age ranges from 5 days to 12 years; mean age, 3.3 years）. Surgery and/or catheter angiography （CA） were conducted in all patients to confirm the final diagnosis. In the 362 Chinese children with congenital heart anomalies, congenital aortic arch anomalies were definitely diagnosed in 198 children and 164 children ruled out by operation and/or （CA）. Among the 198 children with anomalies, coarctation of aorta （CoA）, interruption of aortic arch （IAA）, fight aor- tic arch, aberrant right subclavian artery and double aortic arch were diagnosed in 134, 32, 20, 10 and 2 children respectively, and there were 6 cases with uncommon congenital aortic arch anomalies： 2 had double aortic arch including 1 with five branches of the aortic arch, 2 had isolation of the right sub- clavian artery with two patent ductus arteriosus （PDA）, 1 had an isolation of the common carotid artery with a PDA, and 1 had double PDA with a single ventricle and pulmonary artery atresia. Among the 32 children with IAA, 28 were of type A, and 4 were of type B. The diagnostic sensitivity, specificity and accuracy of MDCT angiography for congenital aortic arch anomaiies were 100% （198/198）, 98% （161/164） and 99% （359/362）, respectively. The diagnostic sensitivity, specificity and accuracy of TTE were 92% （182/198）, 81% （133/164） and 87% （315/362）, respectively. In conclusion, MDCT angiogra- phy is a reliable, noninvasive imaging technique for the diagnosis of congenital aortic arch anomalies in children. Sometimes, even more information can be obtained from this

关键词： congenital anomalies multi-detector computed tomography angiography aortic arch

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A canine model of aortic arch aneurysm created with autologous pericardium

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Journal of Interventional Medicine 2022年第3期5卷 133-137页

作者： Weixiao Li Jun Li Qiang li Mingzhe Cui Rutao Xu Shuiting Zhai Cheshire Nick Tianxiao Li Jiangbo Chen Wenli Zhao Department of Vascular and Endovascular Surgery Zhengzhou University People's HospitalHenan Provincial Peoples HospitalZhenghouChina Operation Department Zhengzhou University People's HospitalHenan Provincial People's HospitalZhenghouChina Department of Medical Imaging Zhengzhou University People's HospitalHenan Provincial People's HospitalZhenghouChina Department of Vascular Surgery Royal Brompton and Harefield HospitalLondonUK Department of Cerebrovascular Disease Zhengzhou University People's HospitalHenan Provincial People's HospitalZhenghouChina

Background:To establish a canine model of aortic arch aneurysm that is suitable for research on new devices and techniques applied to the aortic *** and methods:Fifteen mongrel dogs underwent *** autologous pericardial patch was sewn on the aortotomy site in the anterior wall of the aortic *** animals were followed up for 3 months *** tomography angiography was used to visualize and measure the aneurysm *** and eosin staining was used to observe the histological characteristics of the aneurysm *** in aneurysm diameter over time were analyzed using analysis of ***:One dog died of hemorrhage during *** dogs survived the surgical *** of them died on the first postoperative day because of ruptures at the suturing *** diameter of the aneurysm model was twice as large as that of the aortic *** was no significant change in the maximum diameter of the aneurysm model during the follow-up ***:We established a controllable and stable aortic arch aneurysm model created with an autologous pericardium *** aneurysm model can be used to research endoleaks after thoracic endovascular aortic repair and new endovascular techniques can be applied to the aortic arch.

关键词： aortic aneurysm Pericardium patch Ascending aorta aortic arch Animal model

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DOUBLE SUPERIOR VENAE CAVAE ASSOCIATED WITH ABERRANT SUBCLAVIAN ARTERY——THE ATAVISTIC AND TRANSITIONAL NATURE OF “PROXIMAL LOSS” aortic arch

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Science China Mathematics 1981年第1期 133-140页

作者：万选才 Chinese Academy of Medical Sciences Institute of Basic Medical Research

A case of double superior venae cavae （Bvc） associated with bilateral azygos veins （Bas）,aberrant subclavian artery （Sa） and other rare variations is recorded in a two-year-old Chinesegirl with an unknown cause of death. A review of the literature since 1844 indicates that therehas been no reported case of a right Sa associated with Bvc+Baz. The primitive arrangementof the thoracic large vessels in this case (Bvc+Baz and CHtype of aortic branches) substan-tiates the atavistic nature of Sa. The proximal loss pattern (PL) of the aortic arch with itsassociated Bvc+Baz was a primitive transitional link between the vascular arrangement ofthe Mesozoic reptilian and that of mammals or avians. According to this concept, there shouldbe an occurrence of the PLvariation （i.e. Sa） in all the mammals and avians and an occur-rence of the 1-, 2- or 6-branch type of PLin human beings or in other animals.

关键词： THE ATAVISTIC AND TRANSITIONAL NATURE OF aortic arch DOUBLE SUPERIOR VENAE CAVAE ASSOCIATED WITH ABERRANT SUBCLAVIAN ARTERY PROXIMAL LOSS

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Simultaneous Endovascular Approach for aortic arch Aneurysm Associated with aortic Valve Stenosis. What Have We Learned?

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International Journal of Clinical Medicine 2015年第2期6卷 81-84页

作者： Joel Lapeze Guy Durand de Gevigney Didier Revel Olivier Jegaden Department of Cardiovascular Surgery Louis Pradel HospitalLyonFrance Department of Cardiology Louis Pradel HospitalLyonFrance Department of Radiology Louis Pradel HospitalLyonFrance Department of Cardiovascular Surgery Cleveland Clinic Abu DhabiAbu DhabiUAE

aortic arch aneurysms are rarely isolated entities, and most frequently associated with either ascending or descending aorta pathologies. Association with aortic valve stenosis is uncommon and traditional surgical treatment is always challenging. Here we report a minimally invasive and endovascular management of these two pathologies in a 89-year-old man with LAD-stented ischemic cardiomyopathy. We describe our initial therapeutic strategy, per procedure difficulties and final management of this challenging case. Finally, we discuss the different therapeutic options for the endovascular treatment of aortic arch aneurysm associated with aortic valve stenosis.

关键词： aortic arch Endovascular Procedure aortic Stenosis Transcatheter aortic Valve Implantation

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aortic arch Atherosclerosis——An Important Potential Source Of Cerebral Embolic Stroke

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中国临床神经科学 2000年第Z1期8卷 55-页

作者： Yi Guo Shao wen Zhang Si Chen Department of neurology: Shenzhen People Hospital Shenzhen 518020 Department of neurology: Shenzhen People Hospital Shenzhen 518020 Department of neurology: Shenzhen People Hospital Shenzhen 518020

　　Background and purpose: Recent years with use of transesophageal echography renew awareness of aortic atherosclerosis. The purpose of this study was to determine the prevalence, clinical significance, and embolic potential of thoracic aortic plaque in patients with cerebral emblism; and further study the correlation aortic plaque with carotid or heart disease. Method: 49 consecutive patients with cerebral embolism was included in this sutdy. We uscd TEE to evaluated potential source of emboli in aortic arch and heart, and duplex in carotid artery. A atherosclerotic lesion of thoracic aorta was defined as normal(O); mild plaque (1); moderate plaque (2); protruding plaque or mobile plaque (3). Result: 31(63%) patients showed evidence of AAA; 7 (14.3%) patients had mild AAA, 9 (18.4%) patients had moderate AAA and 15 (32.7%) patients had severe AAA, In these 15 patients 11 patients neither severe ICAA or embolic heart disease, the AAA may be responsible to the cerebral embolism; 33 patients had internal carotid arterial atherosclerosis(ICAA), 9 patients had embolic heart disease; Age, ICAA had significant correlated with aortic plaque. Conclusion: aortic atherosclerosis is common in cerebral embolism. aortic plaque might be not only responsible for some unexplained embolic event, but also for some of the embolic stroke in the group of patient do have carotid artery or heart disease. Age might be important risk factor for the development of atherosclerotic lesion in the thoracic aorta.

关键词： heart disease cerebral embolism thoracic aorta carotid artery potential source risk factor aortic arch

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Treatment of Stanford type A aortic dissection with triple prefenestration, reduced diameter, and three-dimensional-printing techniques: A case report

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World Journal of Clinical Cases 2021年第1期9卷 183-189页

作者： Ming Zhang Yuan-Hao Tong Chen Liu Xiao-Qiang Li Chang-Jian Liu Zhao Liu Vascular Surgery Nanjing Drum Tower HospitalThe Affiliated Hospital of Nanjing University Medical SchoolNanjing 210008Jiangsu ProvinceChina Vascular Surgery Nanjing Drum Tower HospitalThe Affiliated Hospital of Nanjing University Medical SchoolNanjing 21008Jiangsu ProvinceChina

BACKGROUND A 63-year-old female was diagnosed with acute Stanford type A aortic *** patient had pain in the chest and back for 1 *** computed tomography angiography(CTA)showed Stanford type A aortic dissection(Myla type III aortic arch).The intimal tear was located at the top of the aortic arch and retrograded to the ascending *** SUMMARY Preoperatively,a three-dimensional(3D)-printed model of the aortic arch was made according to CTA ***,under the guidance of the 3D-printed aortic model,a pre-fenestrated stent-graft was customized,and the diameter of the stent-graft was reduced intraoperatively by surgeons.3D printing,triple prefenestration,and reduced diameter techniques were used during the *** CTA examinations were performed at the 3rd mo and 1st year after the surgery;the results showed that the aortic dissection was repaired without endoleak,and all three branches of the aortic arch remained *** Applying the triple pre-fenestration technique for aortic arch lesions was feasible and minimally invasive in our *** technique provides a new avenue for thoracic endovascular aortic repair of Stanford type A aortic dissection.

关键词： Type A aortic dissection aortic arch Pre-fenestration 3D printing Endovascular repair Case report

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A pilot study of aortic hemodynamics before and after thoracic endovascular repair with a double-branched endograft

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Medicine in Novel Technology and Devices 2019年第4期4卷 7-23页

作者： Yu Zhu Wenbo Zhan Mohamad Hamady Xiao Yun Xu Department of Chemical Engineering Imperial College LondonUK Department of Interventional Radiology St Mary’s HospitalImperial College Healthcare NHS TrustLondonUK

Branched endografts have been developed to treat complex pathology in the aortic arch and ascending *** study aims to evaluate the haemodynamic performance of a double-branched thoracic endograft by detailed comparison of flow patterns and wall shear stress in the aorta and supra-aortic branches before and after stentgraft ***-and post-intervention CT images were acquired from two patients who underwent thoracic endovascular aortic repair(TEVAR)with a double-branched endograft for thoracic aortic *** images were used to reconstruct patient-specific models,which were analysed using computational fluid dynamics employing physiologically realistic boundary *** results showed that there was sufficient blood perfusion through the arch *** presence of inner tunnels caused flow derangement and asymmetric wall shear stress in the ascending aorta,where shear range index was up to 6 times higher than in the preintervention *** shear stress in the aortic arch increased considerably after intervention as a result of accelerated *** maximum flow-induced displacement forces on the branched endografts were around 22 N for both patients,which was below the threshold for device *** from this pilot study demonstrated that aortic flow patterns were significantly altered by the branched endograft which caused increased spatial variation of wall shear stress in the ascending aorta and the *** no obvious adverse hemodynamic features were found immediately after intervention for the cases we analysed,follow-up studies will be needed to assess durability of the device.

关键词： Thoracic endovascular aortic repair(TEVAR) aortic arch Branched endograft Blood flow Computational fluid dynamics

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Congenital vascular rings:a rare cause of respiratory distress in infants and children

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Chinese Medical Journal 2007年第16期120卷 1408-1412页

作者： MA Gui-qin LI Zhong-zhi LI Xiao-feng PENG Yun DU Zhong-dong JIN Lan-zhong WANG Fang-yun WEI Hai-yan ZHENG Lin ZHANG Xin Department of Cardiology Beijing Children＇s Hospital Capital Medical University Beijing 100045 China Department of Radiology Beijing Children＇s Hosptial Capital Medical University Beijing 100045 China

Background Congenital vascular rings may often cause unexplained respiratory symptoms in infants and young children. Their diagnosis and treatment are often delayed. Few studies of vascular rings have been reported in China. The aim of this study was to describe the clinical presentation, diagnosis and surgical management of infants and children with congenital vascular rings. Methods Clinical histories, physical examinations, investigations, image studies and surgical interventions were retrospectively evaluated in 7 children （age range： 2 months- 4 years, mean 7 months） with congenital vascular rings. Chest radiography was performed in all patients. Echocardiography and computed tomography （CT） with 3-dimensional （3D） reconstructions were performed in 6 patients. Esophagography, cardiac catheterization and angiography, and bronchoscopy were performed in 1, 1 and 4 children, respectively. Results Six of the 7 patients had respiratory symptoms, including recurrent cough, stridor and wheeze. Age at onset of symptoms ranged from 1 month to 11 months. Chest X-ray showed nothing important on the vascular rings, besides bronchitis and pneumonia. Contrast-enhanced CT diagnosed vascular rings in 6 patients. Four patients had double aortic arches, two had balanced arches and two were right arch dominant. One patient had a right aortic arch with left ligament and 1 patient had a pulmonary artery sling. Echocardiography failed to diagnose vascular rings in 2 patients. The esophagogram of 1 patient showed esophageal compression. Bronchoscopy of 4 patients showed compression of the distal trachea. Five of the 7 patients underwent surgical division of the vascular rings. Surgical observation confirmed the CT findings in each patient. Conclusions Patients, especially infants or young children, with recurrent respiratory symptoms such as chronic cough, stridor and wheeze, should be examined for the possible presence of congenital vascular rings. Contrast-enhanced CT can clearl

关键词： cardiovascular abnormalities aortic arch infant

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