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Diagnosis and Treatment of Aortic Diseases : Developments in Cardiovascular Medicine - C. A. Nienaber

Diagnosis and Treatment of Aortic Diseases

Developments in Cardiovascular Medicine

By: C. A. Nienaber (Editor), Rossella Fattori (Editor)

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Published: 31st March 1999
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The definite treatment ofaortic disorders goes back to the resection ofisthmic coarctation by Clarence Crafoord in 1944. It took another third of a century until all portionsofthe aortabecameaccessible to highly standardized surgery. This progress, delayed as it was in relation to most other cardiovascular in­ terventions, depended on the availability of safe protective methods for the heart and central nervous system, of reliable vascular grafts and atraumatic instruments, novel suture material and tissue adhesives. The development ofadvanced surgical techniques went hand in hand with, and depended upon, the emergence of proper diagnostic tools, starting with aortography andultimately culminating inCT-scanning, transesophageal echo­ cardiography and magnetic resonance imaging. These tools now allow for the rational planning and conductofany aortic intervention which may be surgical or, more recently, catheter-guided. Nienaber's and Fattori's new book aptly is addressing both the diagnos­ tic procedure as well as the treatment of aortic disease. The authors are well known experts in the fields of advanced diagnostics of aortic pathology, both spearheading a remarkably innovative group of aortic interventionalists as well. On account of their expertise, their chapters are able to answer any question rising in conjunction with these subjects.

`References are both comprehensive and unusually current. This is an excellent volume to find information about aortic pathology, particularly of the thoracic aorta. It also has a good discussion of modern diagnostic techniques ... will be of most value to cardiologists, interventionalists, and pathologists rather than surgeons.' Journal of Vascular Surgery (March 2000)

List of Contributorsp. xi
Forewordp. 1
Prefacep. 3
Aortic Dissectionp. 5
Introductionp. 5
Definitionp. 6
Etiology and pathogenesisp. 6
Classificationp. 11
Clinical presentationp. 11
Diagnosisp. 15
Magnetic resonance imagingp. 18
Echocardiographyp. 24
Computed tomographyp. 27
The optimal diagnostic approachp. 27
Coronary angiography in aortic dissectionp. 32
Management of acute aortic dissectionp. 32
Medical treatmentp. 33
Treatment of cardiac tamponadep. 34
Management of malperfusionp. 35
Chronic medical treatmentp. 36
Surgical treatment of aortic dissectionp. 38
Technical aspects of surgeryp. 43
Repair of the aortic archp. 44
Follow-up strategyp. 45
Referencesp. 48
Aortic Aneurysmp. 57
Etiologyp. 58
Atherosclerosisp. 58
Ulcerp. 59
Cystic medial degenerationp. 59
Traumap. 60
Infectious aortitisp. 61
Noninfectious aortitisp. 61
Congenital aneurysmp. 62
Pathophysiologyp. 63
Diagnostic approachp. 65
Clinical presentation and physical examinationp. 65
Imaging modalitiesp. 66
Ultrasoundp. 67
Angiographyp. 70
Computed tomographyp. 71
Magnetic resonance imagingp. 75
Current diagnostic approachp. 79
Pathologyp. 81
Intraoperative and necropsy findingsp. 81
Referencesp. 83
Surgical Treatment of Aortic Aneurysmsp. 87
Introductionp. 87
Pathogenesis and natural historyp. 88
Diagnosisp. 90
Indications for surgeryp. 92
Surgical techniquesp. 93
Ascending thoracic aortic aneurysmp. 93
Composite valve graftp. 97
Aortic arch aneurysmp. 101
"Elephant trunk" adjunctive procedures for thoracic aortic aneurysmsp. 103
Descending thoracic aortic aneurysmp. 104
Abdominal aortic aneurysmp. 107
Resultsp. 107
Ascending aortic aneurysmp. 107
Arch aneurysmp. 108
Descending thoracic aortic aneurysmp. 109
Abdominal aortic aneurysmp. 110
Endovascular stent-grafting of descending thoracic aortic aneurysmp. 111
Endovascular stent-grafting of abdominal aortic aneurysmp. 115
Summaryp. 118
Referencesp. 120
Inherited Disorders of the Aortap. 129
Introductionp. 129
Single gene disordersp. 130
Marfan syndromep. 130
Marfan-like connective tissue disorderp. 142
Ehlers Danlos syndromep. 143
Familial thoracic aortic aneurysms and dissections (Erdheim's cystic medial necrosis)p. 145
Supraventricular aortic stenosisp. 147
Arterial tortuosity syndromep. 148
Polycystic kidney diseasep. 149
Genetic basis to common aortic diseasesp. 149
Abdominal aortic aneurysmsp. 149
Thoracic aortic aneurysms and dissectionsp. 150
Acknowledgmentsp. 151
Referencesp. 152
Aortic Traumap. 161
Demography and mechanismp. 161
Pathologyp. 163
Clinical presentationp. 164
Natural historyp. 166
Infrequent locations of traumatic aortic lesionp. 168
Diagnosisp. 169
Chest radiographyp. 169
Computed tomographyp. 172
Echocardiographyp. 176
Aortographyp. 179
Magnetic resonancep. 181
Optimal diagnostic approachp. 184
Surgeryp. 186
Chronic posttraumatic aneurysmp. 194
Acknowledgmentsp. 194
Referencesp. 195
Aortitisp. 201
Introductionp. 201
Etiology and historical perspective to Takayasu's aortitisp. 201
Pathophysiologyp. 202
Classificationp. 203
Diagnostic proceduresp. 204
Clinical/laboratory assessmentp. 205
Clinical manifestationsp. 205
Physical examinationp. 205
Laboratory findingsp. 206
Physiological testingp. 206
Imagingp. 207
Pathologyp. 212
Treatment/managementp. 214
Medical treatmentp. 214
Surgical treatmentp. 214
Outcomep. 215
Other aortic inflammatory diseasesp. 216
Giant cell arteriitisp. 216
Behcet's diseasep. 217
Buerger diseasep. 218
Kawasaki diseasep. 218
Cogan's syndromep. 218
Ankylosing spondylitisp. 219
Reiter's syndromep. 219
HLA B-27 positive aortic diseasep. 219
Infectious aortic diseasep. 220
Miscellaneous diseasesp. 221
Conclusionp. 221
Referencesp. 222
Etiology and Pathology of the Aortic Arch Malformationsp. 225
Development of the aortic arch systemp. 225
Obstructive anomalies of the aortic archp. 227
Aortic coarctation and tubular hypoplasiap. 227
Aortic arch interruptionp. 240
Other anomalies of the aortic archp. 247
Aberrant subclavian arteryp. 248
Right aortic archp. 250
Vascular ringsp. 253
Double aortic archp. 254
Cervical aortap. 257
Minor anomalies of brachiocephalic arteriesp. 257
Supravalvular aortic stenosisp. 257
Dysplasia of the great arteries ["Maccheroni syndrome"]p. 260
Bicuspid aortic valve and aortic dissectionp. 262
Anatomo-pathologic experience at the University of Paduap. 263
Referencesp. 269
Indexp. 277
Table of Contents provided by Syndetics. All Rights Reserved.

ISBN: 9780792355175
ISBN-10: 0792355172
Series: Developments in Cardiovascular Medicine
Audience: Professional
Format: Hardcover
Language: English
Number Of Pages: 284
Published: 31st March 1999
Publisher: Springer
Country of Publication: NL
Dimensions (cm): 23.5 x 15.5  x 1.91
Weight (kg): 1.32