Animal Model of Aortic Valve Calcification: Their Methodology Helps Us Understand Aortic Valve Calcification

Aortic valve calcification disease (CAVD) is the most prevalent degenerative valve disease in humans, leading to significant morbidity and mortality. Despite its common occurrence, our understanding of the underlying mechanisms remains incomplete, and available treatment options are limited and risky. A more comprehensive understanding of the biology of CAVD is essential to identify new therapeutic strategies. Animal models have played a crucial role in advancing our knowledge of CAVD and exploring potential treatments. However, these models have inherent limitations as they cannot fully replicate the complex physiological mechanisms of human CAVD. In this review, we examine various CAVD models ranging from pigs to mice, highlighting the unique characteristics of each model to enhance our understanding of CAVD. While these models offer valuable insights, they also have limitations and shortcomings. We propose that the guide wire model shows promise for future CAVD research, and streamlining the methodology could enhance our understanding and expand the research scope in this field.

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

BackgroundThe 冠的动脉钙(CAC ) 和大动脉的拱门石灰化(AoAC ) 个别地与心血管的疾病和结果被联系。这研究调查了与经历了胸X光检查的 2018 个稳定的咽峡炎病人全部的 angina.MethodsA 在病人为心血管的诊断和结果与 CAC 相结合的 AoAC 的预兆的价值，心脏的多察觉者计算了断层摄影术被跟随在上面四年估计不利事件，它作为心脏的死亡被分类，击，心肌的梗塞，或重复 revascularization 。胸 X 光检查上的 AoAC 的程度从 0 ～ 3 .ResultsDuring 在规模上被分级后续的四年， 620 个病人被冠的 stenting 对待并且 153 (7%) 不利事件发生了。AoAC 的一个更高的等级与一个更高的 CAC 分数被联系。考克斯回归证明 CAC 分数，然而并非 AoAC，与不利事件被联系。在有 CAC 的病人获得 &#x0003c；400， AoAC 显示出添加剂在检测重要冠的动脉疾病(CAD ) 的预兆的价值。一如果 AoAC 在有类似的 CAC score.ConclusionsAs AoAC 的病人是在场的，不利事件的风险的渐渐的增加被注意强烈不管年龄或性与 CAC 分数被相关， CAD 的小心的评估将在常规胸 X 光上与 AoAC 在病人被要求。

Effects of Atorvastatin on Warfarin-induced Aortic Medial Calcification and Systolic Blood Pressure in Rats

The effect of atorvastatin on warfarin-induced aortic medial calcification and systolic blood pressure （SBP） of rats induced by warfarin was studied. Thirty healthy and adult rats were randomly divided into Warfarin group （n=10）, Atorvastatin group （n=10） and normal control group （n=10）. Caudal arterial pressure of rats was measured once a week, and 4 weeks later, aorta was obtained. Elastic fiber, collagen fiber and calcium accumulation in tunica media of cells were measured by Von Kossa staining. The results showed that warfarin treatment led to elevation of systolic blood pressure and aortic medial calcification. The chronic treatment also increased collagen, but decreased elastin in the aorta. However, the atorvastatin treatment had adverse effects. It was concluded that treatment with atorvastatin presented evidence of blood pressure lowing and calcification reducing. These data demonstrate that atorvastatin protected aortic media from warfarin-induced calcification and elevation of systolic blood pressure.

Role of Wnt/β-catenin Signaling Pathway in the Mechanism of Calcification of Aortic Valve

Aortic valve calcification is a common disease in the elderly, but its cellular and molecular mechanisms are not clear. In order to verify the hypothesis that Wnt/β-catenin signaling pathway is involved in the process of calcification of aortic valve, porcine aortic valve interstitial cells（VICs） were isolated, cultured and stimulated with oxidized low density lipoprotein（ox-LDL） for 48 h to induce the differentiation of VICs into osteoblast-like cells. The key proteins and genes of Wnt/β-catenin signaling pathway, such as glycogen synthase kinase 3β（GSK-3β） and β-catenin, were detected by using Western blotting and real-time polymerase chain reaction（PCR）. The results showed that the VICs managed to differentiate into osteoblast-like cells after the stimulation with ox-LDL and the levels of proteins and genes of GSK-3β and β-catenin were increased significantly in VICs after stimulation for 48 h（P0.05）. It is suggested that Wnt/β-catenin signaling pathway may play a key role in the differentiation of VICs into osteoblast-like cells and make great contribution to aortic valve calcification.

Endovascular repair of thoracic aortic dissection associated with right-sided aortic arch：report of four cases

Aortic dissection involving a right-sided aortic arch（RAA）is extremely rare with an incidence in adults of 0.04%to 0.1%^（[1]）.Thoracic aortic dissection associated with RAA is even a more uncommon and life-threatening condition.For complicated aortic dissection,conventional open surgical repair is considered a standard therapy^（[2]）.However,

MDCT of right aortic arch with aberrant left subclavian artery associated with kommerell diverticulum and calcified ligamentum arteriosum

We present a case of the right aortic arch with kommerell diverticulum (KD) and aberrant left subclavian artery in a symptomatic 50-year-old patient with a calcification in the presumed attachment site of the ligamentum arteriosum (LA) to the KD. In another 30-year-old male patient, the entire course of a calcified LA was demonstrated using multidetector row computed tomography.

Left recurrent laryngeal nerve palsy following aortic arch stenting: A case report

BACKGROUND Aortic arch stenting is continuously emerging as a safe and effective option to alleviate aortic arch stenosis and arterial hypertension.CASE SUMMARY We present a 15-year-old girl with aortic arch hypoplasia who had undergone implantation of an uncovered 22 mm Cheatham-Platinum stent due to severe(native)aortic arch stenosis.On follow-up seven months later,she presented a significant re-stenosis of the aortic arch.A second stent(LD Max 26 mm)was implanted and both stents were dilated up to 16 mm.After an initially unremarkable post-interventional course,the patient presented with hoarseness five days after the intervention.MRI and CT scans ruled out an intracranial pathology,as well as thoracic hematoma,arterial dissection,and aneurysm around the intervention site.Laryngoscopy confirmed left vocal fold paresis attributable to an injury to the left recurrent laryngeal nerve(LRLN)during aortic arch stenting,as the nerve loops around the aortic arch in close proximity to the area of the implanted stents.Following a non-invasive therapeutic approach entailing regular speech therapy,the patient recovered and demonstrated no residual clinical symptoms of LRLN palsy after six months.CONCLUSION Left recurrent laryngeal nerve palsy is a rare complication of aortic arch stenting not previously reported.

Cervical aortic arch with aneurysm formation and an anomalous right subclavian artery and left vertebral artery:A case report

BACKGROUND A cervical aortic arch(CAA)refers to a high-riding aortic arch(AA)that often extends above the level of the clavicle.This condition is very rare,with an incidence of less than 1/10000.CASE SUMMARY A 29-year-old woman was admitted to the otolaryngology department of our hospital for repeated bilateral purulent nasal discharge for the prior 3 mo.The patient was diagnosed with chronic sinusitis and chronic rhinitis at admission.A preoperative noncontrast chest computed tomography scan showed a high-riding,tortuous AA extending to the mid-upper level of the first thoracic vertebra with local cystic dilatation.A further computed tomography angiography examination showed that the brachiocephalic trunk,left common carotid artery,left vertebral artery(LVA)(slender),and left subclavian artery sequentially branched off of the aorta from the proximal end to the distal end of the AA.The proximal end of the right subclavian artery(RSCA)was tortuous and dilated.The AA showed tumorlike local expansion,with a maximum diameter of approximately 4 cm.After consultation with the department of cardiac macrovascular surgery,the patient was diagnosed with left CAA with aneurysm formation and an anomalous RSCA and LVA and was transferred to that department.The patient underwent AA aneurysm resection and artificial blood vessel replacement under general anesthesia and cardiopulmonary bypass.No abnormality was found during the 2-mo follow-up after discharge.CONCLUSION A CAA is a rare congenital anomaly of vascular development.The present unique case of CAA with aneurysm formation and an anomalous RSCA and LVA enriches existing CAA data.

The Characterization of Aortic Valve Calcification at Different Stage of Disease

Cardiac valve calcification is a common disease,especially among the elderly.Calcification can affect valve function and cause heart failure and sudden death(Adler et al.,2002).Aortic valve calcification is alsorelated to arteriosclerosis and coronary heart disease(Rashedi et al.,2015).However,the origin of valve calcification is still unclear.This study characterized the

Difference and similarity between type A interrupted aortic arch and aortic coarctation in adults:Two case reports

BACKGROUND Aortic coarctation(CoA)is usually confused with interrupted aortic arch(IAA),especially adult type A interrupted aortic arch,due to their similar anatomical location.Although the main difference between them is whether arterial lumen exhibits continuity or not,the clinical manifestations are similar and connection exists between them.Adult type A IAA is considered as an extreme form of CoA,which is complete discontinuity of aortic function and lumen caused by degenerative arterial coarctation.This paper reports two cases(interrupted aortic arch and severe aortic coarctation)to analyze the difference and similarity between them.CASE SUMMARY The two cases of patients presented with hypertension for many years.Computed tomography angiography showed that the aortic arch and descending aorta were discontinuous or significantly narrowed with extensive collateral flow.The IAA patient refused surgical treatment and blood pressure could be controlled with drugs.While the CoA patient underwent stent implantation because of uncontrollable hypertension,the blood flow recovered smoothly and the blood pressures at both ends of the stenosis returned to normal after surgery.CONCLUSION Adult type A IAA and CoA have difference and similarity,and type A IAA is associated with CoA to a certain extent.The treatment method should be chosen based on the patient's clinical symptoms rather than the severity of the lesion.

Minimally Invasive Surgical Technique in Double Aortic Arch with Distal Atretic Left-Side in Infant:From a Single-Surgeon Clinical Experience

Background:Double aortic arch(DAA)with distal left-sided aortic arch atresia(LAAA)can form complete vascular ring by ligamentum connection.We aimed to introduce an uncommon DAA-LAAA diagnosis and treatment by the minimally invasive surgical technique(MIST).Methods:We retrospectively reviewed 7 cases of DAA-LAAA that were treated from January 2017 to July 2021.All infant patients underwent surgical repair by minimally invasive surgical technique.Mean follow-up was 14.43 months(range,5–21 months).Results:There were seven patients with DAA-LAAA,including six males and one female.Median age was 19.29 months(range,9.0–29.0 months).Median weight was 11.30 kg(range,9.6–13.0 kg).Three patients were found severe tracheal compression by cardiac computed tomography angiography(cCTA).Six patients with isolated DAA-LAAA were performed operations through left subaxillary minithoracotomy,and one patient with ventricular septal defect(VSD)was performed operation concurrently under the cardiopulmonary bypass(CPB)through right subaxillary minithoracotomy.All patients had symptom improvement in the postoperative period and discharged successfully.Follow-up data showed good results in short-term.Conclusions:We introduce a new surgical pathway for DAA-LAAA treatment with good symptomatic relief in short-term.MIST is a safe,feasible and economical approach for infant patients.

Isolated interrupted aortic arch in an adult:A case report

BACKGROUND Interrupted aortic arch(IAA)is a rare congenital heart disease defined by an interruption of the lumen and anatomical continuity between the ascending and descending major arteries.It is usually found within a few hours or days of birth.Without surgery,the chances of survival are low.If IAA patients have an effective collateral circulation established,they can survive into adulthood.However,IAA in adults is extremely rare,with few reported cases.CASE SUMMARY A 27-year-old woman presented with a 6-year history of progressively worsening shortness of breath and chest tightness on exertion.She had cyanotic lips and clubbing of the fingers.A transthoracic echocardiogram revealed an enlarged heart and dilation of the main pulmonary artery.There was an abnormal 9 mm passage between the descending aorta and pulmonary artery.The ventricular septal outflow tract had a 14 mm defect.Doppler ultrasound suggested a patent ductus arteriosus and computed tomographic angiography showed the absence of the aortic arch.The diagnoses were ventricular septal defect,patent ductus arteriosus,and definite interruption of the aortic arch.Although surgical correction was recommended,the patient declined due to the surgical risks and was treated with medications to reduce pulmonary artery pressure and treat heart failure.Her condition has been stable for 12 mo of follow-up.CONCLUSION Although rare,IAA should be considered in adults with refractory hypertension or unexplained congestive heart failure.

Relationship between sKL, BSP and HD abdominal aortic calcification and prognosis

Objective: To investigate the relationship between the expression levels of sKL and BSP and the calcification and prognosis of abdominal aorta in patients with HD. Methods: 130 patients with HD admitted to our hospital between January 2015 and June 2017 were selected as the research subjects;all patients were treated with Fresenius hemodialysis machine for intervention treatment;the expression levels of sKL and BSP in the patients' blood were monitored, and 30 mmonths were followed up The extent of calcification of the abdominal aorta and the quality of the prognosis of the patients were evaluated and the relationship between the expression levels of sKL and BSP and the calcification and prognosis of the abdominal aorta were analyzed. Results: The levels of sKL and BSP in the blood of patients with different degrees of abdominal aortic calcification were significantly different, and the differences were statistically significant (P <0.05). Among the patients with mild or no calcification, the levels of sKL and BSP were the highest in the blood and those in the death group were the lowest. The sKL level was significantly lower than the survival group, and the BSP level was significantly higher than the survival group, and the differences were statistically significant (P <0.05);the survival rate of patients with high sKL expression was significantly better than that of patients with low sKL expression, and the survival rate of low BSP expression was significantly better High expression in BSP;high sKL and low BSP are independent protective factors affecting abdominal aortic calcification and prognostic quality in HD patients (P <0.05);combined use of sKL and BSP in predicting the prognostic quality of HD patients is sensitive and specific Both are greater than 90%, and AUC> 0.90. Conclusions:High sKL and low BSP in the blood of HD patients are independent protective factors affecting abdominal aortic calcification and prognostic quality. The combined application of sKL and BSP can effectively predict the prognostic quality value of patients.

Intracranial hemangiopericytoma with right-sided aortic arch: a case report and summary of experience

Hemangiopericytoma is clinically rare and easily confused with meningioma.Right-sided aortic arch is also a rare disease of congenital cardiovascular variability.The intracranial hemangiopericytoma associated with the right-sided aortic arch has not been reported in the literature.We are here to register a case of right aortic arch concurrent with intracranial hemangiopericytoma;the patient was initially thought to be a simple meningioma,but he was eventually diagnosed as a hemangiopericytoma with right aortic arch and multiple intracranial vascular stenosis and malformation.Whether there was a genetic correlation between the two provides a potential research direction for us.Therefore,the diagnosis and treatment of some rare diseases should be a more comprehensive analysis and evaluation.Adequate examination and accurate diagnosis are crucial,which will directly affect the efficacy of surgery and the prognosis of patients.

The clinical study of modified total aortic arch replacement and stent elephant trunk technique treatment for patients with DeBakey Ⅰ thoracic aortic dissection

Objective To summarize the clinical study of modified total aortic arch replacement and stent elephant trunk technique treatment to patients with DeBakey Ⅰ thoracic aortic dissection. Methods From January 2006 to October 2010,101 cases of DeBakeyⅠaortic dissection were treated by modified total arch replacement and stent elephant trunk technique,in which emergencey surgery were performed on 73 cases. There were 76 male and 25

Aorta-pulmonary septal defect and aortic origin of the right pulmonary artery with interruption of the aortic arch:a clinical analysis of 5 cases

Objective Reviewing the experience in diagnosis and treatment of cases with aorta-pulmonary septal defect and aortic origin of right pulmonary artery complicated with interruption of aortic arch. Methods Clinical data from medical records for 5 patients (4 boys and 1 girl,age from 1 to 18 years on admission) who had been treated in Wuhan Asia Heart Hospital between 2005 and 2009

Aortoplasty with pulmonary autograft patch for coarctation of the aorta combined with hypoplastic aortic arch in infant

Objective To discuss the operative techniques and results of coarctation resection plus aortoplasty with pulmonary autograft patch for coarctation of the aorta combined with hypoplastic aortic arch in infant. Methods Between May 2007 and Dec 2009,14 cases including 9 males and 5 females with coarctation of the aorta and hypoplastic aortic arch underwent coarctation resection plus aortoplasty with pulmonary autograft patch in

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

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

Diagnosis of Congenital Aortic Arch Anomalies in Chinese Children by Multi-Detector Computed Tomography Angiography

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

Cardiac-MRI demonstration of the ligamentum arteriosum in a case of right aortic arch with aberrant left subclavian artery

Right-sided aortic arch with aberrant left subclavian artery (RAA/ALSC) is the second most common mediastinal complete vascular ring. Adult presentation of dysphagia lusoria due to a RAA/ALSC is uncommon with fewer than 25 cases reported in the world literature. The left lateral portion of this vascular ring is not a vessel, but an atretic ductus arteriosus, the ligamentum arteriosum, which has been identified in different cases as the major cause of tracheo-esophageal impingement. Surgical division of the ligamentum arteriosum allows the vessels to assume a less constricting pattern decreasing dysphagic symptoms. Clear visualization of the ligamentum arteriosum by diagnostic imaging has not been obtained in previously reported cases. We demonstrated, using magnetic resonance imaging, the location and the complete course of a left-sided ligamentum arteriosum in a patient with adult-onset dysphagia due to a RAA/ALSC with a small Kommerell' s diverticulum, providing, during the same session, a complete assessment of both mediastinal vascular abnormalities and esophageal impingement sites.