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Saliba E.,Montreal Heart Institute | Saliba E.,Chum Center Hospitalier Of Luniversite Of Montreal | Sia Y.,Montreal Heart Institute | Sia Y.,Chum Center Hospitalier Of Luniversite Of Montreal
IJC Heart and Vasculature

Background: Thoracic ascending aorta aneurysms (TAA) are an important cause of mortality in adults but are a relatively less studied subject compared to abdominal aortic aneurysms (AAA). The purpose of this review is to explain the main aspects (etiology, pathophysiology, diagnosis) of this disease and to summarize the most recent developments in its management. Methodology: Literature was obtained through online health related search engines (PubMed, MEDLINE) by including the following keywords: ascending aorta aneurysm, thoracic aneurysms, Marfan syndrome, bicuspid aortic valve, familial thoracic syndrome, aortic dissection, aorta imaging and aortic aneurysm guidelines. We included articles dating from 1980 to 2014. Findings: Literature revealed how lethal this disease can be and how simple steps such as follow-up and prophylactic surgery can significantly reduce morbidity and mortality. This review also allowed us to realize the many developments that have been made in recent years in the understanding of pathologic mechanisms of this disease. Conclusion: TAA is a silent disease that needs to be recognized early in its course and followed closely in order to recommend appropriate preventive and prophylactic therapy in a timely manner. © 2015 The Authors. Source

Hassanaly S.I.,Chum Center Hospitalier Of Luniversite Of Montreal | Talajic J.C.,Chum Center Hospitalier Of Luniversite Of Montreal | Harissi-Dagher M.,Chum Center Hospitalier Of Luniversite Of Montreal
American Journal of Ophthalmology

Purpose To describe outcomes after Boston Type 1 Keratoprosthesis (KPro) surgery in aniridic eyes. Design Retrospective, interventional case series. Methods setting: University-based tertiary care institution. patient population: Twenty-six aniridic eyes of 19 patients who underwent KPro implantation by a single experienced surgeon (M.H.-D.) between October 27, 2008 and January 16, 2012. main outcome measures: Preoperative and postoperative best-corrected visual acuity (BCVA), intraoperative and postoperative complications, and keratoprosthesis retention. Results Mean age was 56 years (range, 28-72); 10 patients were male. Seven patients had bilateral procedures. No intraoperative complications were encountered. Preoperatively, BCVA was 20/300 or worse in all eyes. After a mean follow-up time of 28.7 ± 13.5 months (range 4-50), the most recent BCVA was 20/200 or better in 14 eyes. Visual potential was limited by preexisting terminal glaucoma (n = 2), phthisis after retinal detachment (n = 4), and suprachoroidal hemorrhage (n = 2). Other postoperative complications included retroprosthetic membrane formation (n = 15), infectious keratitis (n = 1), extrusion (n = 2), and corneal melt (n = 4). Uncomplicated vitritis was reported in 6 eyes. No endophthalmitis occurred in this series. Most eyes have glaucoma and are on medical treatment. The overall retention rate of the initial prosthesis was 77%. Conclusions The prognosis in aniridic patients after KPro is variable. Meticulous follow-up and a subspecialty team approach are of utmost importance. © 2014 by Elsevier Inc. All rights reserved. Source

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