Type A aortic dissection model to improve endovascular research and technologies.

OBJECTIVE Type A aortic dissection is a life-threatening disease requiring immediate surgical treatment. With emerging catheter-based technologies, endovascular stent-graft implantation to treat aneurysms and dissections has become a standardized procedure. However, endovascular treatment of the ascending aorta remains challenging. Thus we designed an ascending aortic dissection model to allow simulation of endovascular treatment. METHODS Five formalin-fixed human aortas were prepared. The ascending aorta was opened semicircularly in the middle portion and the medial layer was separated from the intima. The intimal tube was readapted using running monofilament sutures. The preparations were assessed by 128-slice computed tomography. A bare-metal stent was implanted for thoracic endovascular aortic repair in 4 of the aortic dissection models. RESULTS Separation of the intimal and medial layer of the aorta was considered to be sufficient because computed tomography showed a clear image of the dissection membrane in each aorta. The dissection was located 3.9 ± 1.4 cm proximally from the aortic annulus, with a length of 4.6 ± 0.9 cm. Before stent implantation, the mean distance from the intimal flap to the aortic wall was measured as 0.63 ± 0.163 cm in the ascending aorta. After stent implantation, this distance decreased to 0.26 ± 0.12 cm. CONCLUSION This model of aortic dissection of the ascending human aorta was reproducible with a comparable pathological and morphological appearance. The technique and model can be used to evaluate new stent-graft technologies to treat type A dissection and facilitate training for surgeons.

Cytomegalovirus Immunoglobulin After Thoracic Transplantation: An Overview

Cytomegalovirus (CMV) is a highly complex pathogen which, despite modern prophylactic regimens, continues to affect a high proportion of thoracic organ transplant recipients. The symptomatic manifestations of CMV infection are compounded by adverse indirect effects induced by the multiple immunomodulatory actions of CMV. These include a higher risk of acute rejection, cardiac allograft vasculopathy after heart transplantation, and potentially bronchiolitis obliterans syndrome in lung transplant recipients, with a greater propensity for opportunistic secondary infections. Prophylaxis for CMV using antiviral agents (typically oral valganciclovir or intravenous ganciclovir) is now almost universal, at least in high-risk transplants (D+/R-). Even with extended prophylactic regimens, however, challenges remain. The CMV events can still occur despite antiviral prophylaxis, including late-onset infection or recurrent disease, and patients with ganciclovir-resistant CMV infection or who are intolerant to antiviral therapy require alternative strategies. The CMV immunoglobulin (CMVIG) and antiviral agents have complementary modes of action. High-titer CMVIG preparations provide passive CMV-specific immunity but also exert complex immunomodulatory properties which augment the antiviral effect of antiviral agents and offer the potential to suppress the indirect effects of CMV infection. This supplement discusses the available data concerning the immunological and clinical effects of CMVIG after heart or lung transplantation

Experimental child pedestrian accident reconstruction: thoracic impact. Final report.

Mode of access: Internet.

Computer simulation of human thoracic skeletal response - volume I, theory.

National Highway Traffic Safety Administration, Washington, D.C.

Computer simulation of human thoracic skeletal response - volume II, THORAX programmer's and user's manual. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

Side impact sub-system test development: MVMA thoracic impactor test procedure and evaluation. Final report.

Mode of access: Internet.

Development and evaluation of Hybrid III multi-point thoracic deflection measurement sensors. Final report.

Mode of access: Internet.

Die Krankheiten des Herzens und der Aorta /

Translation of: The diseases of the heart and aorta. Dublin : Hodges and Smith, 1854.

On the origin of the lymphatic system from the veins and the development of the lymph hearts and thoracic duct in the pig /

Offprint: American journal of anatomy. Vol. 1, no. 3 (May 26, 1902).

Heart disease and thoracic aneurysm /

Mode of access: Internet.

A text-book of diseases of the chest: pericardium, heart, aorta, bronchi, lungs, mediastinum and pleura,

Mode of access: Internet.

A manual of the physical diagnosis of thoracic diseases,

Mode of access: Internet.

Thoracic surgery.

Includes bibliographies.

Ein Fall von Aneurysma dissecans der Aorta.

Mode of access: Internet.