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Preprint ARTICLE | doi:10.20944/preprints202308.0343.v1

The Correlation of Aortic Neck Angle and Length in Abdominal Aortic Aneurysm with Severe Neck Angulation for Prediction of Intraoperative Neck Complications and Postoperative Outcomes after Endovascular Aneurysm Repair

Khamin Chinsakchai, Thana Sirivech, Frans L Moll, Sasima Tongsai, Kiattisak Hongku

Subject: Public Health And Healthcare, Health Policy And Services Keywords: abdominal aortic aneurysm; severe neck angulation; aortic neck length; outcomes

Online: 4 August 2023 (03:16:36 CEST)

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Objectives: Endovascular aneurysm repair (EVAR) in hostile neck has been associated with adverse outcomes. We aimed to determine the association of infrarenal aortic neck angle and length and establish an optimal cutoff value to predict intraoperative neck complications and post-operative outcomes. Methods: This was a retrospective review of intact infrarenal abdominal aortic aneurysm (AAA) with severe neck angulation (> 60 degrees) who underwent EVAR from October 2010 to October 2018. Demographic data, aneurysm morphology, and operative details were collected. The ratio of neck angle and length was calculated the optimal cutoff value of the aortic neck angle-length index. Patients were classified into two groups using latent profile analysis. Intraoperative neck complications, adjunct neck procedures, and early and late outcomes were compared. Results: 115 patients were included. Group 1(G1), aortic neck angle-length index ≤ 4.8, had 95 patients and Group 2 (G2), aortic neck angle-length index > 4.8, had 20 patients. Demographic data and aneurysm morphology were not significantly different between groups except for neck length (P < 0.001). G2 had more intra-operative neck complications than G1 (21.1% vs 55%, P = 0.005). Adjunctive neck procedures were more common in G2 (18.9% vs 60%, P < 0.001). Thirty-day mortality rate was not statistically different. G1 patients had a 5-year proximal neck re-intervention free rate comparable to G2 patients (93.7%G1 vs 87.5%G2, P = 0.785). The 5-year overall survival rate was not statistically different (59.9%G1 vs 69.2%G2, P = 0.891). Conclusions: Patients with aortic neck angle-length index > 4.8 are at greater risk of intraoperative neck complications and adjunctive neck procedures than patients with an aortic neck angle-length index ≤ 4.8. The 5-year proximal neck re-intervention free rate and the 5-year survival rate were not statistically different. The aortic neck angle-length index is a reliable predictor of intra-operative neck complications during EVAR in AAA with severe neck angulation.

Preprint ARTICLE | doi:10.20944/preprints202307.1260.v1

Development and Initial Characterisation of a Localised Elastin Degradation Ex Vivo Porcine Aortic Aneurysm Model

Matthew Laffey, Brooke Tornifoglio, Caitríona Lally

Subject: Engineering, Bioengineering Keywords: aortic aneurysm model; elastin; aorta compliance; aortic biomechanics

Online: 19 July 2023 (10:46:54 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202209.0253.v1

Type I interferon receptor subunit 1 deletion attenuates experimental abdominal aortic aneurysm formation

Takahiro Shoji, Jia Guo, Yingbin Ge, Yankui Li, Gang Li, Toru Ikezoe, Wei Wang, Xiaoya Zheng, Sihai Zhao, Naoki Fujimura, Jianhua Huang, Baohui Xu, Ronald L. Dalman

Subject: Medicine And Pharmacology, Pathology And Pathobiology Keywords: Abdominal aortic aneurysm; Type I interferon receptor, Leukocytes; Angiogenesis

Online: 19 September 2022 (02:08:07 CEST)

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Preprint REVIEW | doi:10.20944/preprints201810.0636.v1

Risk Factors for Abdominal Aortic Aneurysm in Population-Based Studies: A Systematic Review and Meta-Analysis

Emma Altobelli, Leonardo Rapacchietta, Valerio F. Profeta, Roberto Fagnano

Subject: Medicine And Pharmacology, Oncology And Oncogenics Keywords: abdominal aortic aneurysm, risk factors, observational studies, meta-analysis

Online: 26 October 2018 (15:28:44 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202410.0070.v1

Prognostic Impact of Pulmonary Diseases in 952 Patients with Thoracic and/or Abdominal Aortic Aneurysm

Yoichi Kobayashi, Takashi Ishiguro, Naho Kagiyama, Makoto Sumi, Noboru Takayanagi

Subject: Medicine And Pharmacology, Cardiac And Cardiovascular Systems Keywords: acute exacerbation; aortic aneurysm; idiopathic pulmonary fibrosis; lung cancer; pulmonary disease

Online: 1 October 2024 (13:25:47 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202409.1119.v1

Early Experience with Inner Branch Stent-Graft System for Endovascular Repair of Thoraco-Abdominal and Pararenal Abdominal Aortic Aneurysm

Simone Cuozzo, Antonio Marzano, Ombretta Martinelli, Andrea Molinari, Jihad Jabbour, Vincenzo Brizzi, Enrico Sbarigia

Subject: Medicine And Pharmacology, Surgery Keywords: Thoraco-Abdominal aortic aneurysm (TAAA); Pararenal abdominal aortic aneurysm (PAAA); Branched stent-graft; E-nside multibranch stent-graft system; inner-branch

Online: 15 September 2024 (07:33:08 CEST)

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Objectives: We aim to evaluate technical and clinical outcomes with E-nside stent-graft for thoraco-abdominal aortic aneurysm (TAAA) and pararenal abdominal aortic aneurysm (PAAA) endovascular treatment at our University Hospital Center. Methods: Retrospective analysis of patients electively treated by inner branched EVAR (iBEVAR) between 05/2021 and 03/2023. Demographics, procedural and clinical data were analyzed. Technical success and clinical outcomes, such as access-site related complications were reported. Perioperative and early mortality rate, freedom from aortic reintervention, Target vessels (TVs) patency and endoleak rate were evaluated during the follow-up. Technical aspects (external iliac artery diameter, iliac tortuosity, extent of aortic coverage) were retrospectively analyzed. Results: Twenty-two patients included (age 75.9±5.5; 72.7% male). Aneurism extent was Craw-ford I=4 (18.2%), III=8 (36.4%), IV=5 (22.7%), V=1 (4.5%) and PAAA=4 (18.2%). Mean aortic di-ameter was 63.5±9.9mm. The technical success 95.5% (assisted primary success 100%). The clini-cal success 86.4%. Perioperative and early freedom from all-cause mortality rate 90.9% and 90%, respectively. No case of inter-stage aortic-related mortality reported, as no permanent/temporary spinal cord ischemia (SCI). Seventy-eight out of 81 patent TVs were incorporated through a bridging stent (96.3%). TV success 95.1%. Mean external iliac artery (EIA) diameter 7.5±1.1mm. Twelve patients (six women, 100%) were considered outside the instructions for use (IFU) due to narrow iliac arteries. One access-site related complication reported. Conclusions: Our experience confirms that E-nside has promising technical and clinical success rates, as low reintervention rate, but requires a great sacrifice of healthy aorta and adequate iliac arteries that still represent a limitation, especially among women. Mid- to long-term studies and prospective registries are mandatory to evaluate long-term efficacy and safety, as a comparison between E-nside and other alternative off-the-shelf solution.

Preprint CASE REPORT | doi:10.20944/preprints202405.0348.v1

Rupture of Mycotic Abdominal Aortic Aneurysm as a Result of Incompletely Treated Multiple Peripheral Mycotic Aneurysms

Lee Chan Jang, Dae Hoon Kim, Kwon Cheol Yoo

Subject: Medicine And Pharmacology, Surgery Keywords: Mycotic aneurysm; abdominal aortic aneurysm; infective endocarditis; abdomen, lower extremity; case report

Online: 7 May 2024 (11:02:06 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202410.2260.v1

D-Dimers and MPO Are No Suitable Biomarkers for Application in Abdominal Aortic Aneurysm (AAA) Surveillance in a Real-World Setting of Vascular Surgery Patients

Hans Siegrist, Anja Spieler, Andreas Sebastian Peters, Karola Hedwig Passek, Dittmar Boeckler, Susanne Dihlmann

Subject: Cardiac And Cardiovascular Systems, Medicine And Pharmacology Keywords: abdominal aortic aneurysm; biomarker; D-dimer; Myeloperoxidase (MPO)

Online: 29 October 2024 (06:23:02 CET)

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Preprint ARTICLE | doi:10.20944/preprints202312.1083.v1

Prevalence of Genetic Variants and Deep Phenotyping of Patients with Thoracic Aortic Aneurysm and Dissection: A Cross-Sectional Single Centre Cohort Study

Adrian Mahlmann, Nesma Elzanaty, Mai Saleh, Marc Irqsusi, Ardawan Rastan, Jennifer Lynne Leip, Christian-Alexander Behrendt, Tamer Ghazy

Subject: Medicine And Pharmacology, Cardiac And Cardiovascular Systems Keywords: thoracic aortic disease; phenotype; genetic mutation; genetic variant; aneurysm; dissection

Online: 14 December 2023 (12:14:50 CET)

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Preprint REVIEW | doi:10.20944/preprints202410.2312.v1

A Dual Challenge: Coxiella burnetii Infection in the Context of a Familial Thoracic Aortic Aneurysm -Case Report and Literature Review

Alina-Ramona Cozlac, Caius Glad Streian, Marciana-Ionela Boca, Simina Crișan, Mihai-Andrei Lazar, Mirela-Daniela Virtosu, Adina Ionac, Raluca Elisabeta Staicu, Daniela - Carmen Dugaci, Adela Chirita-Emandi, Ana Lascu, Dan Gaita, Constantin - Tudor Luca

Subject: Cardiac And Cardiovascular Systems, Medicine And Pharmacology Keywords: thoracic aortic aneurysms; ACTA2 gene variant; Coxiella burnetii; infective endocarditis; chronic Q fever

Online: 29 October 2024 (12:56:50 CET)

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Preprint ARTICLE | doi:10.20944/preprints202401.2126.v1

Percutaneous Retrograde Trans-gluteal Embolization Of Type 2 Endoleak Causing Iliac Aneurysm Enlargement After Endovascular Re-pair: Case Report And Literature Review

Andrea Esposito, Rocco Pasqua, Danilo Menna, Antonio Nicola Giordano, Giulio Illuminati, Vito D’Andrea

Subject: Medicine And Pharmacology, Surgery Keywords: Endoleak; Internal iliac artery; Endovascular aortic repair; Endovascular technique; Superior gluteal artery; Embolization.

Online: 30 January 2024 (15:19:20 CET)

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Preprint ARTICLE | doi:10.20944/preprints202309.0346.v1

Predictors of 30-Day Postoperative Outcome after Elective Endovascular Abdominal Aortic Aneurysm Repair; a Tertiary Referral Center Experience

Maria P Ntalouka, Petroula Nana, Alexandros Brotis, Athanasios Chatzis, Maria Mermiri, Konstantinos Stamoulis, Metaxia Bareka, Athanasios Giannoukas, Miltiadis Matsagkas, Eleni Arnaoutoglou

Subject: Medicine And Pharmacology, Anesthesiology And Pain Medicine Keywords: abdominal aortic aneurysm; endovascular procedure; prognosis; complications, postoperative; acute kidney injury; biomarkers; myocardial infarction; arrhythmia; cerebrovascular accident

Online: 6 September 2023 (08:52:24 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202409.0796.v1

Evolution of the Aorta Post-SAVR in Bicuspid Aortic Valves: A Single Center Experience

Shadi Hamameh, Raffaele Giordano, Vincenzo Speranza, Concetta Calanni, Emanuele Pilato, Luigi Di Tommaso

Subject: Medicine And Pharmacology, Cardiac And Cardiovascular Systems Keywords: Bicuspid; Aortic Valve; Aortopathy; Aortic dilation; Aortic stenosis; Aortic Regurgitation; SAVR; AVR

Online: 10 September 2024 (14:18:21 CEST)

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Preprint REVIEW | doi:10.20944/preprints202407.1230.v1

Sutureless Aortic Prosthesis Valves versus Transcatheter Aortic Valve Implantation in Intermediate Risk Patients with Severe Aortic Stenosis: A Literature Review

Laura Asta, Adriana Sbrigata, Calogera Pisano

Subject: Medicine And Pharmacology, Cardiac And Cardiovascular Systems Keywords: aortic stenosis; transcatheter aortic valve implantation; sutureless aortic prosthesis

Online: 16 July 2024 (10:46:28 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202307.1588.v1

Aortic Valve Dysfunction and Aortopathy According to the Presence or Absence of Raphe in Patients with Bicuspid Aortic Valve Disease

Yu Zhang, BO Hwa Choi, Hyun Keun Chee, Jun Seok Kim, Sung Min Ko

Subject: Medicine And Pharmacology, Cardiac And Cardiovascular Systems Keywords: bicuspid aortic valve; computed tomography; aortic regurgitation; aortic stenosis; aortopathy

Online: 24 July 2023 (10:47:53 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202401.2134.v1

Role of Matrix Metalloproteinases in Thoracic Aortic disease: Are they indicators for the pathogenesis of dissections?

Marc Irqsusi, Lan Anh Dong, Fiora Rodepeter, Rabia Ramzan, Ildar Talipov, Tamer Ghazy, Madeline Günther, Sebastian Vogt, Ardawan Julian Rastan

Subject: Medicine And Pharmacology, Cardiac And Cardiovascular Systems Keywords: Matrixmetalloprotease; Aortic Aneurysm; Aortic Dissection; Pathogenesis

Online: 30 January 2024 (15:07:23 CET)

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Pathogenesis of aortic aneurysm and dissection continues to be under discussion. Extracellular matrix (ECM) remodeling processes in the aortic wall are hypothesized to be involved in the development of the disorders. Therefore, in a histological study, we investigated the expression of metalloproteases 1 and 9 (MMP1 and MMP9) and their inhibitors (TIMP 1 and TIMP 2) in cardiac surgery patients. In parallel, we studied the aortic roots by echocardiography. Clinical reports of 111 patients (30 women and 81 men) who suffered from aortic aneurysms and an aortic dissection were evaluated and studied by transesophageal echocardiography. Seven patients, who had coronary heart disease served as „healthy controls“ All patients were surgically operated in the period from 2007 to 2015. A tissue sample of the aortic biopsies was collected from each patient during surgery. Immunohistochemical staining was performed for MMP1, MMP9 and TIMP1, TIMP2 as well. Vascularization was monitored by an CD 31 antibody. In direct comparison, the expressions are not homogeneous. We found smallest changes in the intima area at all. An increase in MMP 1 and MMP 9 expression was detected in both media and adventitia in case of dissections. TIMP 1 and TIMP 2 distribution increases from the lumen of the vessel outward in the wall layers of the aorta. In case of arteriosclerotic changes, intima had a capillarization, but not in the media. Opposite pattern was found in the dissected aortas. Whereas the intima appears empty, vascularization was found in the media and adventitia layers, as well. There are differences in the vascularization between between the aneurysm and dissection and the different layers as well, respectively. A different remodeling process of the ECM in comparison of the vascular layers must be hypothesized. Reading the patterns of staining and with regard to the known inhibitory effect of MMP9 on ECM remodeling, but especially TIMP 2 on neoangiogenesis, a disturbed nutrition and a dysfunctional vasa vasorum remodeling must be assumed as cause of dissection.

Preprint REVIEW | doi:10.20944/preprints202305.1241.v1

A Systematic Review and Meta-Analysis of Aortic Morphological Changes after Thoracic Endovascular Aortic Repair for Blunt Thoracic Aortic Injury

Paolo Righini, Dor Avishay, Daniela Mazzaccaro, Marina Galliagani, Giovannii Nano

Subject: Medicine And Pharmacology, Surgery Keywords: Blunt thoracic aortic injury; Thoracic endovascular aortic repair; Thoracic aortic sizing; Systematic review; aortic diameters; Endovascular aortic repair; Thoracic aorta imaging

Online: 17 May 2023 (10:55:23 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202305.1269.v1

Immediate and Medium-Term Results of Aortic Valve Replacement With Biological Prosthesis in Elderly Patients: One Center’s Experience

Bakytbek Kadyraliev, Vyacheslav Belov, Andrey Marchenko, Vagram Arutunyan, Soslan Engioev, Konstantin Zhigalov, Orhan Musaev, Nurslu Kdralieva, Alex G. Kuchumov

Subject: Medicine And Pharmacology, Cardiac And Cardiovascular Systems Keywords: aortic valve; bioprosthesis; surgical aortic valve replacement (SAVR)

Online: 18 May 2023 (05:06:17 CEST)

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Preprint REVIEW | doi:10.20944/preprints202304.0649.v1

Evidence of Global Warming: A Meta-Analysis of Temperature Management in Aortic Arch Surgery

Florian Huber, Bruno Schachner, Jessica Zofia Gottsberger, Peter Benedikt, Andreas Florian Zierer

Subject: Medicine And Pharmacology, Cardiac And Cardiovascular Systems Keywords: hypothermia; hypothermic circulatory arrest,; aortic surgery; aortic aneurysm

Online: 20 April 2023 (10:25:07 CEST)

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Preprint BRIEF REPORT | doi:10.20944/preprints202205.0324.v1

Fludrocortisone Induces Aortic Pathologies in Mice

Dien Ye, Congqing Wu, Hui Chen, Ching L. Liang, Deborah A. Howatt, Michael K. Franklin, Jessica J. Moorleghen, Samuel C. Tyagi, Estrellita Uijl, A.H. Jan Danser, Hisashi Sawada, Alan Daugherty, Hong S. Lu

Subject: Biology And Life Sciences, Animal Science, Veterinary Science And Zoology Keywords: aortic aneurysms; aortic dissection; fludrocortisone; angiotensin; hypercholesterolemia; mouse

Online: 24 May 2022 (06:05:35 CEST)

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Background and Objective: In an experiment designed to explore the mechanisms of fludrocortisone-induced high blood pressure, we serendipitously observed aortic aneurysms in mice infused with fludrocortisone. The purpose of this study was to investigate whether fludrocortisone induces aortic pathologies in both normocholesterolemic and hypercholesterolemic mice. Methods and Results: Male adult C57BL/6J mice were infused with either vehicle (85% polyethylene glycol 400 (PEG-400) and 15% dimethyl sulfoxide (DMSO); N=5) or fludrocortisone (12 mg/kg/day dissolved in 85% PEG-400 and 15% DMSO; N=15) for 28 days. Fludrocortisone-infused mice had higher systolic blood pressure, compared to mice infused with vehicle. Fludrocortisone induced aortic pathologies in 4 of 15 mice with 3 having pathologies in the ascending and aortic arch regions and 1 having pathology in both the ascending and descending thoracic aorta. No pathologies were noted in abdominal aortas. Subsequently, we infused either vehicle (N=5/group) or fludrocortisone (N=15/group) into male ApoE -/- mice fed a normal laboratory diet or LDL receptor -/- mice fed either normal or Western diet. Fludrocortisone increased systolic blood pressure, irrespective of mouse strain or diet. In ApoE -/- mice infused with fludrocortisone, 2 of 15 mice had ascending aortic pathologies, but no mice had abdominal aortic pathologies. In LDL receptor -/- mice fed normal diet, 5 had ascending/arch pathologies, 1 had pathologies in the ascending, arch, and suprarenal aortic regions. In LDL receptor -/- mice fed Western diet, 2 died of aortic rupture in either the descending thoracic or abdominal region, and 2 of the 13 survived mice had ascending/arch aortic pathologies. Aortic pathologies included hemorrhage, wall thickening or thinning, or dilation. Given the low incidence, only ascending aortic diameter in LDLR -/- mice fed Western diet reached statistical significance, compared to their vehicle. Conclusion: Fludrocortisone induces aortic pathologies independent of hypercholesterolemia. The findings in mouse studies have the potential to provide caution to people who are taking or have taken fludrocortisone that could have an increased risk of aortic pathologies.

Preprint CASE REPORT | doi:10.20944/preprints202409.0648.v1

A Case Report of Undiagnosed Bicuspid Aortic Valve: A Global Health Challenge

Binay Kumar Panjiyar, Nikita Changlani, Akshita Kaushal, Saroj Kumar Jha, Sanam Wasim Khan, Poshitha Kondadasula, Thrinatha Movva

Subject: Medicine And Pharmacology, Cardiac And Cardiovascular Systems Keywords: aortic aneurysm; aortic valve replacement; aortopathy; bicuspid aortic valve; bioprosthetic valve; surveillance

Online: 9 September 2024 (10:00:43 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202306.2155.v1

Selection for Transcatheter versus Surgical Aortic Valve Replacement and Long-term Survival: 10-year Results of the AUTHEARTVISIT Study

Johann Auer, Pavla Krotka, Berthold Reichard, Denise Traxler, Ralph Wendt, Michael Mildner, Hendrik Jan Ankersmit, Alexandra Graf

Subject: Medicine And Pharmacology, Cardiac And Cardiovascular Systems Keywords: Aortic valve replacement; surgical aortic valve replacement; TAVR; transcatheter aortic valve replacement; bioprosthesis; sB-AVR

Online: 30 June 2023 (08:14:13 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202303.0390.v1

Prospective Evaluation of the Weekend Effect on Mortality Outcomes in Aortic Dissection

Cosmin Banceu, Marius Harpa, Klara Brinzaniuc, Nicolae Neagu, Dan Alexandru Szabo, Diana Banceu, Marvin Oprean, Hussam Al Husseim, Daiana Cristutiu, Alexandru Antoniu Stan, Marius Neamtu Halic, Horatiu Suciu

Subject: Medicine And Pharmacology, Cardiac And Cardiovascular Systems Keywords: aortic dissection outcome; weekend effect; aortic dissection risk factor

Online: 22 March 2023 (03:29:20 CET)

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Preprint ARTICLE | doi:10.20944/preprints202408.0633.v1

Hemodynamic Changes in Supra Aortic Trunks after Transcatheter Aortic Valve Implantation at Duplex Ultrasound Examination

Rocco Pasqua, Giampaolo Luzi, Gianluca Paternoster, Danilo Menna, Elena Orlando, Vincenzo Fioretti, Priscilla Nardi, Giulio Illuminati, Vito D’andrea, Eugenio Stabile, Andrea Esposito

Subject: Medicine And Pharmacology, Cardiac And Cardiovascular Systems Keywords: Aortic Stenosis; Internal Carotid Artery Stenosis, Aortic Valve Repair; Surgical Aortic Valve Repair; TAVI; Duplex ultrasound

Online: 9 August 2024 (10:09:19 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202408.0258.v1

Perioperative and Long Term Outcomes of Acute Stanford Type A Aortic Dissection Repair in Octogenarians

Hannah Masraf, Manoraj Navaratnarajah, Laura Viola, Davorin Sef, Pietro G. Malvindi, Szabolcs Miskolczi, Theodore Velisaaris, Suvitesh Luthra

Subject: Medicine And Pharmacology, Cardiac And Cardiovascular Systems Keywords: acute aortic dissection; octogenarians; type A aortic dissection; perioperative outcomes

Online: 5 August 2024 (08:26:17 CEST)

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Preprint REVIEW | doi:10.20944/preprints202304.1112.v1

Balloon Dilatation in the Management of Congenital Obstructive Lesions of the Heart: Review of Author’s Experiences and Observations – Part II

P. Syamasundar Rao

Subject: Medicine And Pharmacology, Cardiac And Cardiovascular Systems Keywords: pulmonary stenosis; aortic stenosis; aortic coarctation; balloon valvuloplasty; balloon angioplasty; infundibular stenosis; right ventricular filling; aortic remodeling

Online: 28 April 2023 (04:48:14 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202305.2019.v1

Prognostic Impact of Guidelines-oriented Age Cut-off in Intermediate-to-low Risk Patients Undergoing Transcatheter Aortic Valve Implantation in a Large Real-world Multicenter Registry

Stefano Benenati, Francesco Gallo, Won-keun Kim, Arif A Khokhar, Tobias Zeus, Stefan Toggweiler, Roberto Galea, Federico De Marco, Antonio Mangieri, Damiano Regazzoli, Bernhard Reimers, Luis Nombela-Franco, Marco Barbanti, Ander Regueiro, Tommaso Piva, Josep Rodes-Cabau, Italo Porto, Antonio Colombo, Francesco Giannini, Alessandro Sticchi

Subject: Medicine And Pharmacology, Cardiac And Cardiovascular Systems Keywords: aortic stenosis; transcatheter aortic valve replacement; age; surgical risk; low-intermediate risk

Online: 29 May 2023 (14:36:38 CEST)

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Working Paper REVIEW

The Polymer-Based Technology in the Endovascular Treatment of Abdominal Aortic Aneurysms

Gianmarco de Donato, Edoardo Pasqui, Claudia Panzano, Brenda Brancaccio, Gaia Grottola, Giuseppe Galzerano, Domenico Benevento, Giancarlo Palasciano

Subject: Medicine And Pharmacology, Surgery Keywords: Endovascular Aneurysm Repair; EVAR; Aortic Aneurysm; PEG; polymer; Vascular Surgery; aortic endograft.

Online: 24 February 2021 (10:00:44 CET)

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Preprint ARTICLE | doi:10.20944/preprints202404.0899.v1

Totally Endoscopic Replacement of the Ascending Aorta and the Aortic Root including the Aortic Valve via Right Mini-Thoracotomy: A Multicenter Study

Marwan Hamiko, Saad Salamate, Maedeh Ayay Nassari, Andre Spaeth, Sami Sirat, Mirko Doss, Mohamed Amer, Miriam Silaschi, Ali El-Sayed Ahmad, Farhad Bakhtiary

Subject: Medicine And Pharmacology, Cardiac And Cardiovascular Systems Keywords: right minithoracotomy; endoscopic surgery; minimally invasive aortic replacement; minimally invasive aortic root replacement

Online: 15 April 2024 (09:00:07 CEST)

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Background: Recently, minimally invasive access via right-anterolateral mini-thoracotomy (RAMT) has been gaining popularity in cardiac surgery. This approach is also an option for sur-geons performing aortic surgery. Aim of the study is to present our surgical method highlighting the total endoscopic minimally invasive approach via RAMT for replacement of the ascending aorta (AAR) with or without involvement of the aortic root and the aortic valve. Methods: Clini-cal data of 44 patients from three participating institutions with AAR with or without involving the aortic valve or aortic root via RAMT between April 2017 and February 2024 were retrospec-tively analyzed. According to surgical procedure patients were divided in group A with only AAR and group B with concomitant valve or root replacement. Operative time, length of ventila-tion, perioperative outcome, length of intensive care unit (ICU) as well as postoperative hospital stay, and mid- and long-term results were retrospectively analyzed. Results: Mean age was 61.4 ± 10.7 years old with a frequency of male gender (63.6%). Mean cardiopulmonary bypass (CBP) time and aortic cross-clamping time was 94.9 ± 32.5 min. and 63.8 ± 25.9 min., respectively. CPB and aortic clamp time were significantly lower in group A. In the first 24 hours the mean drain-age volume was 790.3 ± 423.6 ml. Re-thoracotomy due to bleeding was zero. Sternotomy could be avoided in all patients. Patients stayed 35.9 ± 23.5 hrs at ICU and were discharged 7.8 ± 3.0 days following surgery from hospital. Mean ventilation time was 5.8 ± 7.6 hrs. All patients survived and 30-day mortality was 0.0%. At a median follow-up time of 18.2 months, all patients were alive. The results were similar in both groups. Conclusions: The full endoscopic RAMT approach with 3D visualization is a safe and feasible technique which can be transferred in the field of aor-tic surgery without compromising surgical quality, postoperative outcomes, or patient safety when performed by an experienced team in a high-volume center.

Preprint REVIEW | doi:10.20944/preprints202407.0416.v2

Racial and Ethnic Disparities in the Presentation and Outcome of Patients with Thoracic Aortic Aneurysms

Nora Bacour, Rutger T Theijse, R Klautz, Nimrat Grewal

Subject: Medicine And Pharmacology, Cardiac And Cardiovascular Systems Keywords: thoracic aortic aneurysms; race; ethnicity

Online: 19 July 2024 (10:16:55 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202406.0396.v2

Prolonged Copper Supplementation Modified Minerals in the Kidney, Liver and Blood, and Potentiated Oxidative Stress and Vasodilation of Isolated Aortic Rings in Young Wistar Rats

Klaudia Kitala–Tańska, Anetta Hanć, Jerzy Juśkiewicz, Michał Majewski

Subject: Medicine And Pharmacology, Medicine And Pharmacology Keywords: 1400 W; aortic rings; copper; COX; iNOS; NS-398; SC-560; trace elements; vascular studies ;

Online: 11 October 2024 (17:06:03 CEST)

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Background: Previous studies have highlighted that copper supplementation at 200% of the recommended daily dietary allowance modified vascular contraction and relaxation through increased reactive oxygen species (ROS) and prostaglandin formation, which modified the antioxidant status of middle-aged Wistar rats. Methods: In this study, young (1 month old) male Wistar rats (n/group = 10) received a diet supplemented with 6.45 mg copper/kg (100% of daily recommendation—Group A) for 8 weeks. The experimental group received 12.9 mg copper/kg of diet (200% of the daily recommendation—Group B). Results: Experimental supplementation with 200% copper modified the copper concentration in the blood (1.21-fold, p = 0.04), liver (1.15-fold, p = 0.032), and kidneys (1.23-fold, p = 0.045), potentiated the ROS formation in the aortic rings, and enhanced the sensitivity of the aortic rings to the vasodilator acetylcholine. We observed an increased participation of nitric oxide (NO) derived from inducible NO synthase (iNOS) in vascular contraction and a decreased net effect of vasodilator prostanoids derived from cyclooxygenase-2 in vascular relaxation. In rat kidneys, the concentrations of potassium (1.08-fold, p = 0.001) and iron (1.13-fold, p = 0.046) were higher, while, calcium (0.88-fold, p = 0.001) and chromium (0.77-fold, p = 0.005) concentrations were lower. In the rat liver, magnesium (1.06-fold, p = 0.012) was higher. No differences were observed in the concentrations of sodium, zinc, manganese, selenium, cobalt, molybdenum, and vanadium. The antioxidant activity of water- and lipid-soluble compounds; total antioxidant status in the blood; and superoxide dismutase, catalase, and malondialdehyde levels in the heart did not change. Conclusions: In young rats, prolonged supplementation with 200% copper had a lesser effect than anticipated on oxidative stress and vascular reactivity. Detailed data on the status of trace elements and their interactions in patients of different age groups are strongly required for effective nutritional and therapeutic intervention.

Preprint REVIEW | doi:10.20944/preprints202305.0868.v1

Minimal Access Aortic Valve Surgery

Bilal H Kirmani, Enoch Akowuah

Subject: Medicine And Pharmacology, Cardiac And Cardiovascular Systems Keywords: minimally invasive; aortic valve; surgery

Online: 11 May 2023 (14:00:03 CEST)

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Preprint REVIEW | doi:10.20944/preprints202308.0217.v1

Bridging Molecular and Clinical Sciences to Achieve the Best Treatment of Enterococcus faecalis Endocarditis

Francesco Nappi, Sanjeet Singh Avtaar Singh, Vikram Jitendra, Antonio Fiore

Subject: Medicine And Pharmacology, Cardiac And Cardiovascular Systems Keywords: Infective Endocarditis, Enterococcus faecalis, Enterococcus faecalis pili, Biofilm, Transcatheter Aortic Valve implantation, Aortic Allograft.

Online: 3 August 2023 (02:42:38 CEST)

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Preprint REVIEW | doi:10.20944/preprints202204.0304.v1

Biomechanics of Transcatheter Aortic Valve Implant

Francesco Nappi, Sanjeet Singh Avtaar Singh, Pierluigi Nappi, Antonio Fiore

Subject: Medicine And Pharmacology, Cardiac And Cardiovascular Systems Keywords: Transcatheter aortic valve implantation; Surgical aortic valve replacement; Structural valve degeneration; Transcatheter heart valves

Online: 29 April 2022 (13:10:19 CEST)

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Preprint REVIEW | doi:10.20944/preprints202405.1401.v1

Antithrombotic Therapy in Patients Undergoing Transcatheter Aortic Valve Implantation

Francesco Pallante, Francesco Costa, Victoria Garcia Ruiz, Giampiero Vizzari, Pietro Iannello, Lucio Teresi, Gabriele Carciotto, Stefania Lo Giudice, Giustina Iuvara, Giulia Laterra, Ander Regueiro, Gennaro Giustino, Juan Horacio Alonso Briales, Jose Maria Hernandez, Marco Barbanti, Antonio Micari, Francesco Patanè

Subject: Medicine And Pharmacology, Cardiac And Cardiovascular Systems Keywords: Antithrombotic therapy; Aortic valve stenosis; Transcatheter Aortic Valve Implantation (TAVI); Transcatheter Aortic Valve Replacement (TAVR); bleeding risk; thrombotic risk; tailored therapy; risk scores.

Online: 21 May 2024 (14:02:21 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202309.0449.v1

Lactate-Based Difference as a Determinant of Outcomes Following Surgery for Type A Acute Aortic Dissection: A LASSO Regression Multicenter Study

Francesco Nappi, Almothana Alzamil, Antonio Salsano, Sanjeet Singh Avtaar Singh, Ivancarmine Gambardella, Francesco Santini, Antonio Fiore, Giacomo Perocchio, Pierre Demondion, Patrick Mesnildrey, Thibaut Schoell, Nicolas Bonnet, Pascal Leprince

Subject: Medicine And Pharmacology, Cardiac And Cardiovascular Systems Keywords: Type A acute aortic dissection; arterial lactate; aortic root replacement; aortic arch repair; valve-sparing aorta replacement; ascending aorta replacement; total arch replacement procedure

Online: 7 September 2023 (03:32:28 CEST)

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Abstract: Type A acute aortic dissection is a serious condition within the acute aortic syndromes that demands immediate treatment. Despite advancements in diagnostic and referral pathways, the survival rate post-surgery currently sits at almost 20%. Our objective was to pinpoint clinical indicators for mortality and morbidity, particularly raised arterial lactate as a key factor for negative outcomes. Methods: All patients referred to the three cardiovascular centres between January 2005 and December 2022 were included in the study. The inclusion criteria required the presence of a lesion involving the ascending aorta, symptoms within 7 days of surgery, and referral for primary surgical repair of TAAAD based on recommendations, with consideration for other concomitant major cardiac surgical procedures needed during TAAAD and retrograde extension of TAAAD. We conducted an analysis of both continuous and categorical variables and utilized predictive mean matching to fill in missing numeric features. For missing binary variables, we used logistic regression to impute values. We specifically targeted early postoperative mortality and employed LASSO regression to minimize potential collinearity of over-fitting variables and variables measured from the same patient. Results: 633 patients were recruited for the study, out of which 449 patients had complete preoperative arterial lactate data. The average age of the patients was 64 years, and 304 patients were male (67.6%). The crude early postoperative mortality rate was 24.5% (110 out of 449 patients). The mortality rate did not show any significant difference when comparing conservative and extensive surgeries. However, malperfusion had a significant impact on mortality [48/131 (36.6%) vs 62/318 (19.5%), p<0.001]. Preoperative arterial lactates were significantly elevated in patients with malperfusion. The optimal prognostic threshold of arterial lactate for predicting early postoperative mortality in our cohort was ≥ 2.6 mmol/L. Conclusion: The arterial lactate concentration in patients referred for TAAAD is an independent factor for both operative mortality and postoperative complications. In addition to mortality, patients with an upper arterial lactate cut-off of ≥2.6 mmol/L face significant risks of VA ECMO and the need for dialysis within the first 48 hours after surgery. To improve recognition and facilitate rapid transfer and surgical treatment protocol, more diligent efforts are required in the management of malperfusion in TAAAD.

Preprint ARTICLE | doi:10.20944/preprints202401.2043.v1

Long‐Term Outcomes of Aortic Stenosis Patients with Different Flow/Gradient Patterns Undergoing Transcatheter Aortic Valve Implantation

George Oikonomou, Anastasios Apostolos, Maria Drakopoulou, Chrysavgi Simopoulou, Maria Karmpalioti, Pantelis Toskas, Konstantinos Stathogiannis, Maria Xanthopoulou, Nikolaos Ktenopoulos, George Latsios, Andreas Synetos, Konstantinos Tsioufis, Konstantinos Toutouzas

Subject: Biology And Life Sciences, Life Sciences Keywords: flow; gradient; aortic stenosis; transcatheter aortic valve implantation; mortality; long term; left ventricular ejection fraction

Online: 29 January 2024 (14:32:32 CET)

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Background Few data exist on comparative long-term outcomes of severe aortic stenosis (AS) patients with different flow-gradient patterns undergoing transcatheter aortic valve implantation (TAVI). This study sought to evaluate the impact of pre-TAVI flow-gradient pattern on long-term clinical outcomes after TAVI and assess changes in left ventricular ejection fraction (LVEF) of different subtypes of AS patients following TAVI. Methods Consecutive patients with severe AS undergoing TAVI in our institution were screened and prospectively enrolled. Patients were divided in four subgroups according to pre-TAVI flow/gradient pattern: (i) low flow - low gradient (LF-LG): stroke volume indexed (SVi) ≤ 35ml/m2 and mean gradient (MG) < 40mmHg), (ii) normal flow - low gradient (NF-LG): SVi > 35ml/m2 and MG < 40mmHg, (iii) low flow - high gradient (LF-HG) : SVi ≤ 35ml/m2 and MG ≥ 40mmHg and (iv) normal flow - high gradient (NF-HG): SVi > 35 ml/m2 and MG ≥ 40mmHg. Transthoracic echocardiography was repeated at 1-year follow-up. Clinical follow-up was obtained at 12 months, and yearly thereafter until 5-year follow up was complete for all patients. Results A total of 272 patients with complete echocardiographic and clinical follow-up were included in our analysis. Their mean age was 80±7 years and the majority of patients (N=138, 50.2%) were women. 62 patients (22.8% of the study population) were distributed in LF-LG group, 98 patients (36%) were LF-HG patients, 95 patients (34.9%) were NF-HG, while 17 patients (6.3%) were NF-LG. There was a greater prevalence of comorbidities among LF-LG AS patients. One-year all-cause mortality differed significantly between the four subgroups of AS patients (log rank p: 0.022) and was more prevalent among LF-LG patients (25.8%) compared to LF-HG (11.3%), NF-HG (6.3%) and NF-LG patients (18.8%). At 5-year follow-up, global mortality remained persistently higher among LF-LG patients (64.5%) compared to LF-HG (47.9%), NF-HG (42.9%) and NF-LG patients (58.8%) (log rank p: 0.029). At multivariable Cox hazard regression analysis, baseline SVi (HR: 0.951, 95% C.I.; 0.918 – 0.984), the presence of at least moderate tricuspid regurgitation at baseline (HR: 3.091, 95% C.I: 1.645 - 5.809) and at least moderate paravalvular leak (PVL) post-TAVI (HR: 1.456 , 95% C.I.: 1.106 - 1.792 ) were significant independent predictors of late global mortality. LF-LG patients and LF-HG patients exhibited a significant increase in LVEF at 1-year follow-up. A lower LVEF (p<0.001) and a lower Svi (p<0.001) at baseline were associated with LVEF improvement at 1 year. Conclusions Patients with LF-LG AS have acceptable 1-year outcomes with significant improvement in LVEF at 1-year follow-up, but exhibit an exceedingly high 5-year mortality following TAVI. The presence of low transvalvular flow and at least moderate tricuspid regurgitation at baseline and significant paravalvular leak post-TAVI were associated with poorer long-term outcomes in the entire cohort of AS patients. The presence of a low LVEF or a low SVi predicts LVEF improvement at 1-year.

Preprint REVIEW | doi:10.20944/preprints202309.0084.v1

Current Knowledge on the Role of Human Cytomegalovirus Infection, Encoded miRNAs, and Aortic Dissection.

Francesco Nappi, Sanjeet Singh Avtaar Singh, Almothana Alzamil

Subject: Medicine And Pharmacology, Cardiac And Cardiovascular Systems Keywords: Human Cytomegalovirus; miRNAs; Acute Aortic Syndrome

Online: 5 September 2023 (10:31:09 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202304.0747.v1

Surgical Strategy for Repair of Acute Type A Aortic Dissection: A Multicenter Study

Francesco Nappi, Sanjeet Singh Avtaar Singh, Ivancarmine Gambardella, Alzamil Almothana, Antonio Salsano, Francesco Santini, Fausto Biancari, Thibaut Schoell, Nicolas Bonnet, Thierry Folliguet, Antonio Fiore

Subject: Medicine And Pharmacology, Cardiac And Cardiovascular Systems Keywords: Type A Acute Aortic dissection; ascending aorta replacement; aortic arch repair; total arch replacement procedure; cerebrovascular perfusion

Online: 23 April 2023 (03:37:12 CEST)

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Preprint REVIEW | doi:10.20944/preprints202107.0384.v2

MicroRNAs in Valvular Heart Diseases: Biological Regulators, Prognostic Markers and Therapeutical Targets

Francesco Nappi, Adelaide Iervolino, Sanjeet Singh Avtaar Singh, Massimo Chello

Subject: Medicine And Pharmacology, Cardiac And Cardiovascular Systems Keywords: miRNAs; valvular heart diseases; aortic stenosis; calcification; mitral valve prolapse, aortic valve defect; vectors; delivery systems; nanoparticles

Online: 8 November 2021 (14:25:40 CET)

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Preprint REVIEW | doi:10.20944/preprints202010.0011.v1

A Review on the Pathophysiology and Management of Anterior Spinal Artery Syndrome

Masum Rahman, Sajedur Rahman, Abu Bakar Siddik, Lucas Carlstrom, Juna Musa, Radzi Hamjah, Salman Salehin, Mohmmad Alvi, Mohammad Hossain, Desmond Brown

Subject: Medicine And Pharmacology, Anatomy And Physiology Keywords: Anterior spinal artery syndrome; Spinal cord Infarction; Aortic insufficiency; Aortic surgery; Spinal shock; Quadriplegia; Bowel-bladder incontinence

Online: 1 October 2020 (09:15:58 CEST)

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Preprint CASE REPORT | doi:10.20944/preprints202407.0324.v1

Staged Hybrid Treatment of Acute Type B Complicated Aortic and External Iliac Artery Dissection and Femoral Occlusion After Transcatheter Aortic Valve Implantation

Hernando Thorne-Vélez, Axel Tolstano Gleiser, Isaac Mendoza Morales, Ana Maria Thorne-Velez, Natalia Penaloza Barrios, Manuela Jaramillo Vasquez, William Daza Reatiga

Subject: Medicine And Pharmacology, Surgery Keywords: vascular surgical procedures; aortic dissection; postoperative complications

Online: 3 July 2024 (08:46:02 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202311.0661.v1

Survival and Recurrence of Endocarditis Following Mechanical vs. Biological Aortic Valve Replacement in Patients Aged 40 to 65 Years: Data from the INFECT-REGISTRY

Antonio Salsano, Michele Di Mauro, Laura Labate, Alessandro Della Corte, Federica Lo Presti, Michele De Bonis, Cinzia Trumello, Mauro Rinaldi, Erik Cura Stura, Guglielmo Actis Dato, Giuseppe Punta, Francesco Nicolini, Davide Carino, Carlo De Vincentiis, Andrea Garatti, Giangiuseppe Cappabianca, Andrea M Musazzi, Diego Cugola, Maurizio Merlo, Davide Pacini, Gianluca Folesani, Sandro Sponga, Igor Vendramin, Alberto Pilozzi Casado, Francesco Rosato, Elisa Mikus, Carlo Savini, Francesco Onorati, Giovanni Battista Luciani, Roberto Scrofani, Francesco Epifani, Francesco Musumeci, Antonio Lio, Andrea Colli, Giosuè Falcetta, Salvatore Nicolardi, Salvatore Zaccaria, Enrico Vizzardi, Antonio Pantaleo, Giuseppe Minniti, Emmanuel Villa, Margherita Dalla Tomba, Francesco Pollari, Fabio Barili, Alessandro Parolari, Roberto Lorusso, Francesco Santini

Subject: Medicine And Pharmacology, Cardiac And Cardiovascular Systems Keywords: endocarditis; aortic valve replacement; prosthetic heart valve.

Online: 9 November 2023 (15:01:57 CET)

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Preprint CASE REPORT | doi:10.20944/preprints202309.1060.v1

Rare and Complex Cardiac Anomalies Associated with 22q11.2 Deletion: An Ultrasonographic Visual Trip from Diagnosis until Delivery

Radu Vlădăreanu, Călina Maier, Raluca Tocariu, Marcela Șerban, Elvira Brătilă

Subject: Medicine And Pharmacology, Obstetrics And Gynaecology Keywords: interrupted aortic arch; 22q11.2DS; ultrasound; genetic tests

Online: 18 September 2023 (05:41:23 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202407.1822.v1

Limited vs Extended Resection of Stanford Type a Acute Aortic Dissections

Suvitesh Luthra, Pietro G Malvindi, Miguel M Leiva-Juárez, Davorin Sef, Hannah Masraf, Szabolcs Miskolczi, Theodore Velisaaris

Subject: Medicine And Pharmacology, Cardiac And Cardiovascular Systems Keywords: acute aortic dissection; type A; stanford type A

Online: 24 July 2024 (07:33:49 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202404.1212.v1

A Pig as a Model to Test Cardiovascular Devices

Yanina L. Rusakova, Denis S Grankin, Kseniya S. Yu. Podolskaya, Irina Yu. Jhuravleva

Subject: Medicine And Pharmacology, Cardiac And Cardiovascular Systems Keywords: laboratory mini-pigs; transesophageal echocardiography; angiography; aortic morphometry

Online: 18 April 2024 (10:43:44 CEST)

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Preprint REVIEW | doi:10.20944/preprints202311.0922.v1

Cardiac Amyloidosis and Valvular Heart Disease

Franz Duca, Christina Kronberger, Robin Willixhofer, Philipp Bartko, Jutta Bergler-Klein, Christian Nitsche

Subject: Medicine And Pharmacology, Cardiac And Cardiovascular Systems Keywords: aortic stenosis; mitral regurgitation; tricuspid regurgitation; AL; ATTR

Online: 14 November 2023 (11:29:57 CET)

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Preprint REVIEW | doi:10.20944/preprints202301.0091.v1

Infective Endocarditis after Transcatheter Aortic Valve Replacement: Challenges in the Diagnosis and Management

Johnny Zakhour, Fatima Allaw, Suha Kalash, Saliba Wehbe, Souha S Kanj

Subject: Medicine And Pharmacology, Cardiac And Cardiovascular Systems Keywords: Transcatheter aortic valve replacement; endocarditis; prosthetic valve endocarditis

Online: 5 January 2023 (02:35:38 CET)

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Preprint ARTICLE | doi:10.20944/preprints202210.0314.v1

Evaluation of Different Cannulation Strategies for Aortic Arch Surgery Using a Cardiovascular Numerical Simulator

Beatrice De Lazzari, Massimo Capoccia, Roberto Badagliacca, Claudio De Lazzari

Subject: Medicine And Pharmacology, Surgery Keywords: Aortic surgery; Aortic arch; Three-way cannulation approach; Carotid artery perfusion; Pressure-volume loop; Lumped parameter model; Software simulation; Cardiovascular modelling.; CARDIOSIM

Online: 20 October 2022 (14:19:25 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202408.0466.v2

Histological Findings In Prosthetic Valve Endocarditis – A Retrospective Cohort Study Conducted at "Dr. Carol Davila" Central Military Emergency University Hospital in Bucharest

CORINA IOANA ANTON, SORIN DUȚULESCU, Florica Staniceanu, Cosmin Alexandru Buzilă, Alexia Teodora Ștefan, Ion Ștefan, Adrian Streinu-Cercel

Subject: Public Health And Healthcare, Other Keywords: infective endocarditis; prosthetic valve endocarditis; mitral valve; aortic valve; histopathology

Online: 30 August 2024 (23:40:38 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202401.1197.v1

Total Muscle Area and Visceral Adipose Tissue Measurements for Frailty Assessment in TAVR Patients

Caglayan Demirel, Christoph Fritz Rothenbuehler, Markus Huber, Michelle Schweizer, Inga Todorski, David Alexander Gloor, Stephan Windecker, Jonas Lanz, Stefan Stortecky, Thomas Pilgrim, Gabor Erdoes

Subject: Medicine And Pharmacology, Cardiac And Cardiovascular Systems Keywords: aortic valve stenosis; body composition parameters; CT scan; sarcopenia; frailty

Online: 16 January 2024 (13:56:43 CET)

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Preprint REVIEW | doi:10.20944/preprints202401.0558.v1

Aortic Valve Embryology, Mechanobiology and Second Messenger Pathways: Implications for Clinical Practice

Maximiliaan L Notenboom, Lucas Van Hoof, Art Schuermans, Johanna JM Takkenberg, Filip R Rega, Yannick JHJ Taverne

Subject: Medicine And Pharmacology, Cardiac And Cardiovascular Systems Keywords: Aortic valve; Embryology; Hemodynamics; Second messenger pathways; Clinical decision-making

Online: 8 January 2024 (06:15:43 CET)

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During the Renaissance, Leonardo Da Vinci was the first person to successfully detail the anatomy of the aortic root and its adjacent structures. Ever since, novel insights into morphology, function and their interplay have accumulated resulting in advanced knowledge on complex functional characteristics of the aortic valve (AV) and root. This shifted the vision from the AV as being a static structure towards that of a dynamic interconnected apparatus within the aortic root as a functional unit, exhibiting a complex interplay with adjacent structures via both humoral and mechanical stimuli. This paradigm shift has stimulated surgical treatment strategies of valvular disease that seek to recapitulate healthy AV function, whereby AV disease can no longer be seen as an isolated morphological pathology which needs to be replaced. As prostheses still cannot reproduce the complexity of human nature, treatment of diseased AVs, whether stenotic or insufficient, has tremendously evolved with a similar shift towards treatments options that are more hemodynamically centered such as the Ross procedure and valve-conserving surgery. Native AV and root components allow for an efficient Venturi effect over the valve to allow for optimal opening during the cardiac cycle, while also alleviating the left ventricle. Next to that, several receptors are present on native AV leaflets, enabling messenger pathways based on their interaction with blood and other shear-stress related stimuli. Many of these physiological and hemodynamical processes are under acknowledged but may hold important clues for innovative treatment strategies, or as potential novel targets for therapeutic agents that halt or reverse the process of valve degeneration. A structured overview of these pathways and their implications for cardiothoracic surgeons and cardiologists is lacking. As such, we provide an overview on embryology, hemodynamics, and messenger pathways of the healthy and diseased AV and its implications for clinical practice, by relating this knowledge to current treatment alternatives and clinical decision-making.

Preprint ARTICLE | doi:10.20944/preprints202306.2093.v1

The Effects of Exercise Training on Exercise Capacity and Vascular Function after Transcatheter Aortic Valve Implantation

Luka Vitez, Matjaž Bunc, Borut Jug

Subject: Medicine And Pharmacology, Cardiac And Cardiovascular Systems Keywords: transcatheter aortic valve implantation; cardiac rehabilitation; exercise training; vascular function

Online: 29 June 2023 (11:27:06 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202005.0341.v1

Role of Advanced Glycation End Products on Aortic Calcification in Patients with Type 2 Diabetes Mellitus

Pilar Sanchis, Rosmeri Rivera, Regina Fortuny, Carlos Rio, Miguel Mas-Gelabert, Marta Gonzalez-Freire, Felix Grases, Luis Masmiquel

Subject: Biology And Life Sciences, Endocrinology And Metabolism Keywords: AGEs; aortic calcification; type 2 diabetes mellitus; diabetes-related complications

Online: 21 May 2020 (09:46:56 CEST)

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Preprint ARTICLE | doi:10.20944/preprints201812.0199.v1

Fluid-Structure Interaction in Abdominal Aortic Aneurysms: Effect of Haematocrit

Yorgos G. Stergiou, Athanasios G. Kanaris, Aikaterini A. Mouza, Spiros V. Paras

Subject: Medicine And Pharmacology, Oncology And Oncogenics Keywords: Abdominal Aortic Aneurysm; FSI; CFD; haematocrit; pulsatile flow; non-Newtonian

Online: 17 December 2018 (15:50:54 CET)

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Preprint CONCEPT PAPER | doi:10.20944/preprints202401.1564.v1

A Novel Mathematical Approach with a Correlating Computational Framework for Precisifying Aneurysmal Therapeutics

Aadittya Deouskar, Dhawal Agrawal

Subject: Computer Science And Mathematics, Mathematical And Computational Biology Keywords: Abdominal aortic aneurysm; Mathematical Linear Regression; Computational Fluid Dynamics; Dynamical Systems

Online: 22 January 2024 (07:48:14 CET)

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Preprint ARTICLE | doi:10.20944/preprints201809.0357.v1

Exploring the Aortic Root Diameter and left Ventricle Size Among Lithuanian Athletes

Renata Žumbakytė-Šermukšnienė, Agnė Slapšinskaitė, Miglė Baranauskaitė, Julija Borkytė, Rasa Sederevičiūtė, Kristina Berškienė

Subject: Medicine And Pharmacology, Clinical Medicine Keywords: Performance, Sports, Aortic Valve, Sinus of Valsalva, Echocardiography, Sudden cardiac death

Online: 18 September 2018 (14:40:43 CEST)

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Aortic rupture is known as one of the potential causes of sudden cardiac death in athletes. Nevertheless, adaptation strategies for aortic root dilation in athletes vary. The purpose of this study was to investigate aortic root adaptation to physical workload and to determine if aortic root’s and left ventricle sizes are contingent upon the physical workload. Echocardiography was applied to 151 subjects to measure the aortic root at aortic valve annulus (AA) and at sinus of Valsalva (VS). 122 were athletes (41 females and 81 males) and 29 were non-athletes (14 females and 15 males). Of the 41 female athletes, 32 were endurance athletes, and 9 strength athletes. From 81 male athletes, 56 were endurance athletes, and 25 were strength athletes. AA and VS mean values for the body surface area were presented as rAA and rVS. Left ventricle (LV) meaures incuded LV end-diastolic diameter (LVEDD), interventricular septum thickness in diastole (IVSTd), LV posterior wall thickness in diastole (LVPWTd), LV mass (LVM), LV mass index, LV end-diastolic diameter index (LVEDDI). Results indicated that VS was higher in female athletes (28.9±2.36mm) than in non-athletes (27.19±2.87mm, p=0.03). On the other hand, rAA was higher in strength athletes (12.19±1.48mm/m2) than in endurance athletes (11.12±0.99mm/m2, p=0.04). Additionally, rVS and rAA were higher in female strength athletes (17.19±1.78mm/m2, 12.19±1.48mm/m2) than female basketball players (15.49±1.08mm/m2, p=0.03, 10.75±1.06 mm/m2, p=0.02). Statistically significant positive moderate correlations were found between VS and LVEDD, LVM, IVSTd, LVPWTd, rVS and LVEDDI parameters in all athletes. The diameter of Valsalva sinus was greater in female athletes compared to non-athletes. The rAA mean value for body surface area was greater in female athletes practising strength sports as compared to their counterparts who were practising endurance sports. The diameter of the aortic root at sinuses positively correlated with the LV size in all athletes. Trial was registered at ClinicalTrials.gov Identifier: NCT03656861, September 3, 2018 (retrospectively registered).

Preprint ARTICLE | doi:10.20944/preprints202408.0109.v2

Patient-Prosthesis Mismatch and Its Influence on Immediate Postoperative Von Willebrand Factor Levels in Aortic Valve Replacement Surgery

Andrei Emanuel Grigorescu, Andrei Anghel, Horea Feier

Subject: Medicine And Pharmacology, Cardiac And Cardiovascular Systems Keywords: Patient-prosthesis mismatch; Aortic valve replacement; Von Willebrand factor; Prosthetic valve size

Online: 15 August 2024 (12:16:38 CEST)

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Preprint REVIEW | doi:10.20944/preprints202401.0342.v1

Landscape of Constitutional SOX4 Variation in Human Disorders

Mina Grippa, Claudio Graziano

Subject: Medicine And Pharmacology, Other Keywords: SOX4; SOXopathy; intellectual disability; developmental delay; aortic aneurism; semicircular canals; hypomorphic variants

Online: 4 January 2024 (11:10:12 CET)

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Preprint REVIEW | doi:10.20944/preprints202308.0404.v1

Aortic valve stenosis and cancer: problems of management

Gloria Santangelo, Silvia Moscardelli, Lucia Barbieri, Andrea Faggiano, Stefano Carugo, Pompilio Faggiano

Subject: Public Health And Healthcare, Public Health And Health Services Keywords: aortic stenosis, cancer, valve replacement, cardio-oncology, transcatheter valve implantation, radiation therapy

Online: 4 August 2023 (11:44:10 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202201.0326.v1

Association Between Duration of Deep Hypothermic Circulatory Arrest and Surgical Outcome in Patients with Acute Type A Aortic Dissection: A Large Retrospective Cohort Study

Mona Salehi Ravesh, Christine Friedrich, Jan Schoettler, Lars Hummitzsch, Gunnar Elke, Mohamed Salem, Georg Lutter, Thomas Puehler, Jochen Cremer, Assad Haneya

Subject: Medicine And Pharmacology, Cardiac And Cardiovascular Systems Keywords: Deep hypothermic circulatory arrest time; acute type A aortic dissection; surgical outcome

Online: 21 January 2022 (13:12:22 CET)

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Preprint REVIEW | doi:10.20944/preprints202410.0199.v1

Myval Transcatheter Heart Valve: The Future of Transcatheter Valve Replacement and Significance in Current Timeline

Teoman Kilic, Senol Coskun, Didar Mirzaminidov, Irem Yilmaz, Sadan Yavuz, Tayfun Sahin

Subject: Medicine And Pharmacology, Cardiac And Cardiovascular Systems Keywords: Myval; Safety; transcatheter aortic valve implantation; transcatheter heart valve; valve-in-valve implantation

Online: 2 October 2024 (14:49:09 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202408.1526.v1

Clinical Significance of Para-Aortic Node Metastasis for Prognosis in Patients with Pancreaticobiliary Duct Carcinoma Who Underwent Radical Surgical Resections

Atsushi Nanashima, Junichi Arai, Masahide Hiyoshi, Naoya Imamura, Takeomi Hamada, Yuki Tsuchimochi, Takashi Wada, Ikko Shimizu, Takahiro Ochiai, Hiroshi Kawakami, Yuichiro Sato

Subject: Medicine And Pharmacology, Gastroenterology And Hepatology Keywords: biliary duct carcinoma; pancreatic carcinoma; para-aortic lymph node; intraoperative diagnosis; postoperative prognosis

Online: 21 August 2024 (08:44:47 CEST)

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Preprint CASE REPORT | doi:10.20944/preprints202408.1376.v1

The Association of a Single Nucleotide Variants in TNXB to Arterial Aneurysmal Diseases

Peyton Moore, Griffin Bryant, Katherine Smitherman, Mohanakrishnan Sathyamoorthy

Subject: Medicine And Pharmacology, Cardiac And Cardiovascular Systems Keywords: TNXB; aortic aneurysm; carotid aneurysm; cerebral aneurysm; extracellular matrix; genetics; single nucleotide variants

Online: 20 August 2024 (11:02:57 CEST)

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Preprint COMMUNICATION | doi:10.20944/preprints202307.1504.v1

Association of Myocardial Changes and Gene Expression of the NFATC1 and NFATC4 – Calcineurin Signaling Pathway in Children with Bicuspid Aortic Valve

Andrii Kamenshchyk, Margaryta Gonchar, Valentyn Oksenych, Aleksandr Kamyshnyi

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: bicuspid aortic valve; children; NFATC1 gene expression; myocardial changes; posterior wall thickness; aorta

Online: 21 July 2023 (10:45:22 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202306.0310.v1

Aerobic Exercise Training Improves Calcium Handling and Cardiac Function in Rats with Heart Failure Resulting from Aortic Stenosis

Vitor Loureiro Da Silva, Gustavo Augusto Ferreira Mota, Sérgio Luiz Borges De Souza, Dijon Henrique Salomé De Campos, Alexandre Barroso Melo, Danielle Fernandes Vileigas, Priscila Murucci Coelho, Paula Grippa Sant’Ana, Carlos Padovani, Ana Paula Lima-Leopoldo, Silméia Garcia Zanati Bazan, Andre Soares Leopoldo, Antonio Carlos Cicogna

Subject: Biology And Life Sciences, Life Sciences Keywords: exercise training; aortic stenosis; heart failure; isolated papillary muscle; isolated cardiomyocyte; calcium handling.

Online: 5 June 2023 (10:47:28 CEST)

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Aerobic exercise training (AET) has been used in the management of heart disease. AET may, totally or partially, restore the activity and/or expression of proteins that regulate calcium (Ca2+) handling, optimize intracellular Ca2+ flow, and attenuate cardiac functional impairment in failing hearts. However, the literature presents conflicting data regarding the effects of AET on Ca2+ transit and cardiac function in rats with heart failure resulting from aortic stenosis. The objective of this study was to evaluate the effects of AET on calcium handling and cardiac function in rats with heart failure due to aortic stenosis. Wistar rats were distributed into two groups: control (Sham; n= 61) and aortic stenosis (AoS; n= 44). After 18 weeks, the groups were redistributed into: non-exposed to exercise training (Sham, n = 28 and AoS, n = 22) and trained (Sham-ET, n = 33 and AoS-ET, n = 22) for 10 weeks. Treadmill exercise training was performed with a velocity equivalent to the lactate threshold. Echocardiogram, isolated papillary muscle, and isolated cardiomyocyte analyzed cardiac function. During isolated papillary muscle assay and isolated cardimyocyte was evaluated Ca2+. The expression of regulatory proteins of diastolic Ca2+ was analyzed via Western Blot. AET attenuated the diastolic dysfunction and benefited the systolic function. AoS-ET animals presented better response to post-rest contraction, and SERCA2a and L-type Ca2+ channels blocked than the AoS. Furthermore, AET was able to improve aspects of the mechanical function and the responsiveness of the myofilaments to the Ca2+ of the AoS-ET animals. AoS animals presented alteration in the protein expression of the SERCA2a and NCX, and AET restored SERCA2a and NCX levels near normal values. Therefore, AET increased SERCA2a activity, improved the cellular Ca2+ influx mechanism, and increased myofilament responsiveness to Ca2+, attenuating cardiac dysfunction at cellular, tissue, and chamber levels in animals with aortic stenosis and heart failure.

Preprint CASE REPORT | doi:10.20944/preprints202102.0167.v1

Combined Aortic Valve Replacement and Coronary Bypass Grafting in Patient With Lipton’s R-III Type of Single Coronary Artery Anomaly

Milica Karadzic Kocica, Hristina Ugrinovic, Dejan Lazovic, Nemanja Karamarkovic, Milos Grujic, Borivoje Lukic, Oliver Radmili, Vladimir Cvetic, Mladen Kocica

Subject: Medicine And Pharmacology, Cardiac And Cardiovascular Systems Keywords: single coronary artery; aortic valve surgery, coronary artery bypass grafting surgery; case report

Online: 8 February 2021 (15:42:53 CET)

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Preprint ARTICLE | doi:10.20944/preprints201812.0338.v1

Incremental Predictive Value of Longitudinal Axis Strain and Late Gadolinium Enhancement Using Standard CMR Imaging in Patients with Aortic Stenosis

Lucia Agoston-Coldea, Kunal Bheecarry, Carmen Cionca, Cristian Petra, Lelia Strimbu, Camelia Ober, Silvia Lupu, Daniela Fodor, Teodora Mocan

Subject: Medicine And Pharmacology, Cardiac And Cardiovascular Systems Keywords: severe aortic stenosis; longitudinal axis strain; late gadolinium enhancement; cardiac magnetic resonance imaging

Online: 28 December 2018 (07:12:57 CET)

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Preprint ARTICLE | doi:10.20944/preprints202307.1290.v2

The Role of Endosongraphy in Cardiology: Clinical Applications

Abdelrahman Elhakim, Kawther Karkour, Philip Sauter, Michael Rode, Mohamed Elhakim, Peter Radke, Mohamed Saad

Subject: Medicine And Pharmacology, Cardiac And Cardiovascular Systems Keywords: Endosonographic ultrasound; transesophageal echocardiography; left atrial appendage thrombus; mitral and aortic valve; left ventricle

Online: 27 September 2023 (14:24:14 CEST)

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Preprint CASE REPORT | doi:10.20944/preprints202202.0251.v1

The First Case of Granulicatella adiacens Identified from a Resected Heart Valve by Next Generation Sequencing (NGS) in Poland

Anna Podgórska, Maria Kordybach-Prokopiuk, Maria Jaworska-Wilczyńska, Piotr Hoffman, Katarzyna Biernacka, Krzysztof Kuśmierski, Robert Kuthan, Tomasz Hryniewiecki, Anna Lutyńska

Subject: Medicine And Pharmacology, Cardiac And Cardiovascular Systems Keywords: Infective endocarditis; Granulicatela adiacens; Nutritionally variant streptococci (NVS); Next-generation sequencing (NGS); Aortic valve

Online: 21 February 2022 (10:45:14 CET)

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Preprint ARTICLE | doi:10.20944/preprints202410.1263.v1

Enhancing Radiologist Efficiency with AI: A Multi-Reader Multi-Case Study on Aortic Dissection Detection and Prioritisation

Martina Cotena PhD, Angela Ayobi, Colin Zuchowski, Jacqueline C. Junn, Brent D. Weinberg, Peter D. Chang, Daniel S. Chow, Jennifer E. Soun, Mar Roca-Sogorb, Yasmina Chaibi, Sarah Quenet

Subject: Computer Science And Mathematics, Artificial Intelligence And Machine Learning Keywords: aortic dissection; automated detection; deep learning; prioritised worklist; emergency radiology; multi-reader multi-case study

Online: 16 October 2024 (11:38:12 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202403.0852.v1

Balloon Valvuloplasty In Congenital Critical Aortic Valve Stenosis – A Rescue Procedure For The Left Ventricle

Jochen Pfeifer, Axel Rentzsch, Martin Poryo, Hashim Abdul-Khaliq

Subject: Medicine And Pharmacology, Pediatrics, Perinatology And Child Health Keywords: critical aortic valve stenosis; transcatheter balloon valvuloplasty; retrieval loop; neonate; cardiogenic shock; left ventricular dysfunction

Online: 14 March 2024 (15:16:30 CET)

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Preprint ARTICLE | doi:10.20944/preprints202211.0003.v2

A New Understanding of Serum Creatinine Levels as a Predictive Factor of Mortality Outcomes in Aortic Disease

Cosmin Banceu, Marius Harpa, Radu Deac, Klara Brinzaniuc, Ioan Tilea, Andreea Varga, Dan Alexandru Szabo, Diana Banceu, Daiana Cristutiu, Alexandra Stoica, Marvin Oprean, Horatiu Suciu

Subject: Medicine And Pharmacology, Cardiac And Cardiovascular Systems Keywords: aortic diseases; serum creatinine; acute kidney injury; cardiac surgery; in-hospital mortality; cross-clamp time

Online: 14 November 2022 (01:12:17 CET)

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Acute kidney injury (AKI) is a complication that can occur after cardiac surgery and requires ongoing research in light of the exponential expansion of technological advancements and knowledge in medicine. In this study, we aim to evaluate the outcomes of treated electives of emergency aortic disease with high serum creatinine levels (SCr). Methods: The cohort includes 183 patients, all of whom have an aortic disease and whose SCr levels were checked upon admission on the first day in the intensive care unit (ICU) and upon discharge from the hospital. We examined the correlation of SCr levels with in-hospital mortality and immediate mortality at least six months after discharge as well as with cross-clamp time and bypass time.Results: A high SCr level upon admission is a significant predictive factor of n-hospital mortality (p = 0.001) but not immediate mortality (p = 0.409). A statistically significant correlation was also observed between elevated SCr level on the first day of ICU and aortic disease (p = 0.041) but not immediate mortality (p = 0.119). We observed a significant correlation between aortic disease and in-hospital mortality (p < 0.001), but no correlation was found between high SCr level on the first day of ICU and immediate mortality (p = 0.119). The cross-clamp time is statistically significant correlated with elevated SCr level (p = 0.013) and in-hospital mortality (p = 0.001) but not immediate mortality (p = 0.847). Furthermore, the bypass time is negatively correlated with a high SCr level on the first day of ICU (p = 0.090), in-hospital mortality (p = 0.410), and immediate mortality (p = 0.625). We also found that aortic disease is not correlated with elevated creatinine levels at ICU discharge (p = 0.152) or long-term mortality (p = 0.106). Conclusions: Although this study only included a small portion of the elaborate aspects of surgical and medical management developed around cardiac patients who received invasive treatment, the conclusions reached are nevertheless clearly relevant, as evidenced by the significantly correlations uncovered. In order to manage AKI after AAS and improve the outcome, the SCr level could be used as a marker for renoprotective strategy. Moving forward, these results serve as a first step in motivating us to expand the range of our research, collect newly relevant data, and use it to benefit patients.

Preprint ARTICLE | doi:10.20944/preprints202206.0230.v1

How the First Year of the COVID-19 Pandemic Impacted Patients’ Care in the Vascular Surgery Divisions of the Southern Regions of the Italian Peninsula

Eugenio Martelli, Giovanni Sotgiu, Laura Saderi, Massimo Federici, Giuseppe Sangiorgi, Matilde Zamboni, Allegra Rosa Martelli, Giancarlo Accarino, Giuseppe Bianco, Francesco Bonanno, Umberto Marcello Bracale, Enrico Cappello, Giovanni Cioffi, Giovanni Colacchio, Adolfo Crinisio, Salvatore De Vivo, Carlo Patrizio Dionisi, Loris Flora, Giovanni Impedovo, Francesco Intrieri, Luca Iorio, Gabriele Maritati, Piero Modugno, Mario Monaco, Giuseppe Natalicchio, Vincenzo Palazzo, Fernando Petrosino, Francesco Pompeo, Raffaele Pulli, Davide Razzano, Maurizio Ruggero Ruggieri, Carlo Ruotolo, Paolo Sangiuolo, Gennaro Vigliotti, Pietro Volpe, Antonella Biello, Pietro Boggia, Michelangelo Boschetti, Enrico Maria Centritto, Flavia Condò, Lucia Cucciolillo, Amodio Salvatore D'Amodio, Mario De Laurentis, Claudio Desantis, Daniela Di Lella, Giovanni Di Nardo, Angelo Disabato, Ilaria Ficarelli, Angelo Gasparre, Antonio Nicola Giordano, Alessandro Luongo, Mafalda Massara, Vincenzo Molinari, Andrea Padricelli, Marco Panagrosso, Anna Petrone, Serena Pisanello, Roberto Prunella, Michele Tedesco, Alberto Maria Settembrini

Subject: Medicine And Pharmacology, Hematology Keywords: COVID-19; carotid stenosis; abdominal aortic aneurysm; chronic limb-threatening ischemia; amputation; deep venous thrombosis

Online: 16 June 2022 (04:40:54 CEST)

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Preprint REVIEW | doi:10.20944/preprints202208.0190.v1

Neurovascular Manifestations of Iron-Deficient Anemia: Narrative Review and Practical Reflections through A Teaching Case

Marialuisa Zedde, Giacomo Portaro, Laura Ferri, Francesco Cavallieri, Manuela Napoli, Claudio Moratti, Fabrizio Piazza, Franco Valzania, Rosario Pascarella

Subject: Medicine And Pharmacology, Neuroscience And Neurology Keywords: iron-deficient anemia; IDA; stroke; cerebral venous thrombosis; brain MRI; aortic thrombosis; pulmonary embolism; embolic pattern

Online: 10 August 2022 (04:31:26 CEST)

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Background: Anemia is one of the most frequent diseases worldwide, affecting a third of the general population. Anemia in general and in particular, iron-deficient anemia (IDA), has been associated to a higher risk of thrombotic manifestations, including ischemic stroke and cerebral venous thrombosis (CVT), as well as systemic extra cerebral arterial and venous thrombosis. Despite these data, anemia is seldom considered as an etiological factor of stroke. Methods: An individual case encompassing all known neurovascular and systemic arterial and venous thrombotic manifestations related to IDA is presented with the focus on clinical reasoning issues in the diagnostic pathways, starting from the neuroradiological signs. The main questions have been identified and addressed in a narrative review of the most relevant data in the literature from a pragmatic and clinical viewpoint. Results and Discussion: The presented case concerns a 46 years old man admitted to the Stroke Unit because of acute is-chemic stroke with multiple thrombi in large intracranial and extracranial vessels, multifocal ischemic lesions in several arterial territories and the concurrent finding of asymptomatic CVT, pulmonary embolism with lung infarction and aortic thrombosis. An extended diagnostic work-up excluded the main etiologies (arterial dissection, cardiac embolism, genetic and acquired prothrombotic disorders, as cancer and antiphospholipid syndrome), except for a severe IDA, such as to require blood transfusions followed by anticoagulant therapy for the several thrombotic manifestations. Neuroimaging and systemic vascular findings have been analyzed and the main issues proposed by the case in the diagnostic pathway have been identified and discussed in a pragmatic clinical road map reviewing the data provided by the literature. Conclusions: IDA is a common but treatable condition that, independently or synergically, may increase the risk of thrombotic events. The diagnostic and therapeutic approach has not yet defined and each case should be individually addressed in a pragmatic clinical road map.

Preprint ARTICLE | doi:10.20944/preprints202004.0107.v1

Using Discrete Multiphysics Modelling to Assess the Effect of Calcification on Hemodynamic and Mechanical Deformation of Aortic Valve

Adamu Musa Mohammed, Mostapha Ariane, Alessio Alexiadis

Subject: Engineering, Control And Systems Engineering Keywords: Discrete Multiphysics Modelling; Smoothed Particle Hydrodynamics; Lattice Spring Model; Particle-base method; Aortic Valve; Calcification; Stenosis

Online: 7 April 2020 (13:33:02 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202408.0452.v1

Propensity-Matched Comparison of Percutaneous Versus Surgical Access for Transfemoral Transcatheter Aortic Valve Replacement (TAVR)

Georgios E. Papadopoulos, Ilias Ninios, Eleftherios Leptopoulos, Konstantinos Papazoglou, Konstantinos Konstantinidis, Sotirios Evangelou, Andreas Ioannidis, Vlasis Ninios

Subject: Medicine And Pharmacology, Cardiac And Cardiovascular Systems Keywords: transcatheter aortic valve replacement; femoral access; surgical cut-down; percutaneous; in-hospital outcomes; hospital length of stay

Online: 8 August 2024 (04:17:35 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202407.0148.v1

Higher incidence of Congenital Aortic Valve Stenosis in higher Magnetic latitudes countries: New Insights and Potential Therapies

Abdullah Abdulrhman Alabdulgader

Subject: Medicine And Pharmacology, Cardiac And Cardiovascular Systems Keywords: Bicuspid Aortic Valve Stenosis(BCAS); Congenital Heart Disease(CHD); endothelial mesenchymal transformation (EndoMT); Magnetic Field; Cardiogenesis; Signaling Pathway

Online: 2 July 2024 (00:17:12 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202409.0010.v1

Magnetic Resonance Imaging of Temporomandibular Joint and Aortic Root Score in Fibrillinopathies

Paloma Moisii, Alexandru Gratian Naum, Andra Mara Ursu, Adrian Vilcu, Irina Mihaela Eşanu, Irina Jari

Subject: Medicine And Pharmacology, Cardiac And Cardiovascular Systems Keywords: Marfan syndrome; MASS phenotype; mitral valve prolapse syndrome; Marfan -like skeleton features; aortic Z score; temporomandibular joint dysfunction; disc displacement

Online: 2 September 2024 (13:26:01 CEST)

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Background and Objectives: Fibrillinopathies have different phenotypic expression: Marfan- like skeleton features, MLSF; mitral valve prolapse syndrome, MVPS; MASS phenotype, M= mitral valve prolapse, MVP, A= aortic root dilation, S= skeletal features, and the second S= (cutaneous) striae; Marfan syndrome, MS. These are inherited connective tissue diseases, provoked by a mutation of the encoding gene for a protein(fibrillin 1, FBN1) which has major importance in the formation of elastic fibers.The study had the following main objectives: the correlation between disc displacement, DD( a major sign for temporomandibular joint dysfunction, TMD) on magnetic resonance imaging, MRI, and aortic Z score(a major sign for aortic root dilation) on echocardiography; the predictive value of DD towards aortic Z score. DD had 2 types of severity: DD with reduction(the mild type, DDwR) , and DD without reduction( the severe type, DDwoR). Materials and Methods: The type of fibrillinopathy was precised by clinical exam( systemic score), ophthalmic exam(for ectopia lentis), and echocardiography(aortic Z score, MVP). Medical treatment consisted in betablockers, BB(for patients with tachycardia), or angiotensin II receptor blockers, ARB. Surgical treatment was addressed to aortic root aneurysm, and severe MR. DD benefited by dental conservatory treatment, or surgical restoration.Results: DD- Z score had a powerful correlation in MASS(Rho= 0.787, p< 0.01), and in MS patients(Rho=0.819, p< 0.01). For the entire sample, both DDwR- Z score, and DDwoR- Z score had a moderate correlation(Rho= 0.469, and respectively 0.669). Muchmore, DD was an important predictor for Z score. DDwoR had a double power of prediction for Z score, comparative with DDwR(B coefficient= 1.661 for DDwR, and 3.281 for DDwoR). Conclusions: TMD had a powerful correlation with aortic root dilation, in MASS, and MS patients from the sample. Likewise, TMD was a major predictor for aortic root dilation, in the entire sample. We can utilize in clinical practice, an extracardiac finding, TMD, obtained by a non-invasive technique, MRI, for cardiac severity stratification of fibrillinopathies.

Preprint ARTICLE | doi:10.20944/preprints202205.0145.v1

The Flashlight-Sign: a Novel B-Flow Based Ultrasound Finding for Detection of Intraluminal, Wall-Adherent, Floating Structures of the Abdominal Aorta and Peripheral Arteries

Christian Lottspeich, Daniel Puhr-Westerheide, Jan Stana, Ulrich Hoffmann, Michael Czihal

Subject: Medicine And Pharmacology, Cardiac And Cardiovascular Systems Keywords: abdominal aorta; arterial embolism; B-Flow sonography; contrast enhanced ultrasound; endovascular aortic repair; flashlight sign; peripheral arteries; wall adherent floating structures

Online: 11 May 2022 (03:44:41 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202305.0354.v1

ECG-Gated CCTA in the Assessment of Post-procedural Complications

Carlo Liguori, Giulia Lassandro, Giovanni Ferrandino, Stefano Giusto Picchi, Stefania Tamburrini, Gabriella Toro, Fabio Tamburro, Salvatore Masala, Mariano Scaglione

Subject: Medicine And Pharmacology, Cardiac And Cardiovascular Systems Keywords: CCTA; cardiac CT; Coronary artery disease; CAD; Coronary Computed Tomography Angiography; Transcatheter aortic valve implantation; TAVI; Pacemaker; PMK; Percutaneous coronary intervention; PCI

Online: 5 May 2023 (10:42:41 CEST)

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Preprint REVIEW | doi:10.20944/preprints202305.0209.v1

Focus on the Most Common Paucisymptomatic Vasculopathic Population, from Diagnosis to Secondary Prevention of Complications

Eugenio Martelli, Iolanda Enea, Matilde Zamboni, Massimo Federici, Umberto M. Bracale, Giuseppe Sangiorgi, Allegra R. Martelli, Teresa Messina, Alberto M. Settembrini

Subject: Medicine And Pharmacology, Cardiac And Cardiovascular Systems Keywords: diagnosis; secondary prevention; complications; abdominal aortic aneurysm; carotid stenosis; lower extremity arterial disease; popliteal artery aneurysm; renal artery stenosis; subclavian artery stenosis

Online: 4 May 2023 (07:21:59 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202103.0745.v1

Machine Learning-Based Pulse Wave Analysis for Early Detection of Abdominal Aortic Aneurysms Using In Silico Pulse Waves

Tianqi Wang, Weiwei Jin, Fuyou Liang, Jordi Alastruey

Subject: Biology And Life Sciences, Biochemistry And Molecular Biology Keywords: abdominal aortic aneurysm; pulse wave analysis; one-dimensional modelling; in silico pulse waves; machine learning; recurrent neural network; long short-term memory

Online: 30 March 2021 (14:05:44 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202405.1155.v1

Inversion of Left Ventricular Axial Shortening: In Silico Proof of Concept for Treatment of HFpEF

Wolfgang A. Goetz, Jiang Yao, Michael Brener, Rishi Puri, Martin Swaans, Simon Schopka, Sigrid Wiesner, Marcus Creutzenberger, Horst Sievert, Ghassan S. Kassab

Subject: Biology And Life Sciences, Anatomy And Physiology Keywords: finite element method; computational simulation; aortic stiffness; atrio-ventricular plane displacement; ventricular strain; ventricular function; left ventricular apex; inverse left ventricular shortening; HFpEF

Online: 17 May 2024 (09:02:23 CEST)

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Preprint ARTICLE | doi:10.20944/preprints202407.0962.v1

Diagnostic Performance of a Deep Learning-Powered Application for Aortic Dissection Triage Prioritization and Classification

Vladimir Laletin, Angela Ayobi, Peter D. Chang, Daniel Chow, Jennifer Soun, Jacqueline C. Junn, Marlene Scudeler, Sarah Quenet, Maxime Tassy, Christophe Avare, Mar Roca-Sogorb, Yasmina Chaibi

Subject: Medicine And Pharmacology, Emergency Medicine Keywords: deep learning; medical and biomedical image processing; aortic dissection; AI-based solution for radiology; machine learning diagnostic performance; medical imaging automated analysis; emergency radiology

Online: 11 July 2024 (12:33:57 CEST)

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Preprint ARTICLE | doi:10.20944/preprints201809.0082.v1

Transcriptomics as Precision Medicine to Classify In Vivo Models of Dietary-Induced Atherosclerosis at Cellular and Molecular Levels

Alexei Evsikov, Caralina Marín de Evsikova

Subject: Medicine And Pharmacology, Cardiac And Cardiovascular Systems Keywords: atherosclerosis; coronary aortic disease; gene set enrichment analysis; heart disease; Apoe mouse; transcriptomics; RNA-seq analysis; pathway enrichment analysis; mouse; precision medicine; New Zealand White rabbit

Online: 5 September 2018 (04:49:40 CEST)

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