Possible extracardiac predictors of aortic dissection in Marfan syndrome.

Background: According to previous studies, aortic diameter alone seems to be insufficient to predict the event of aortic dissection in Marfan syndrome (MFS). Determining the optimal schedule for preventive aortic root replacement (ARR) aortic growth rate is of importance, as well as family history, however, none of them appear to be decisive. Thus, the aim of this study was to search for potential predictors of aortic dissection in MFS.

The role of transforming growth factor-beta in Marfan syndrome.

The starting point, in Marfan syndrome (MFS) appears to be the mutation of fibrillin-1 gene whose deconstructed protein product cannot bind transforming growth factor beta (TGF-b), leading to an increased TGF-b tissue level. The aim of this review is to review the already known features of the cellular signal transduction downstream to TGF-b and its impact on the tissue homeostasis of microfibrils, and elastic fibers. We also investigate current data on the extracellular regulation of TGF-b level including mechanotransduction and the feedback cycles of integrin-dependent and independent activation of the latent TGF-b complex.

Management of ascending aortic aneurysm and valvular incompetence with external remodeling.

Aneurysmatic dilatation of the sinotubular junction may result in aortic valvular incompetence even if the leaflets remain structurally intact. Traditionally, such situations are managed by open techniques of both the ascending aorta and the aortic valve. We present a case of aortic regurgitation, due to a 50-mm diameter ascending aortic aneurysm, which was corrected by sinotubular remodeling and wall-reinforcement without the usage of cardio-pulmonary bypass.

Evidence of nitric oxide produced by the internal mammary artery graft in venous drainage of the recipient coronary artery.

Background: The endothelium of the internal mammary artery produces nitric oxide in greater quantity than other vessels employed in revascularization of the ischemic myocardium. The aim of this study was to measure the concentration of stable metabolite (nitrite) of the endothelium-derived nitric oxide in the venous drainage (anterior interventricular vein) of the recipient coronary artery, which was the left anterior descending branch. The sampling was carried out before and after anastomosis completion.

[Analysis of the stable metabolite of endothelium-derived nitric oxide of internal mammary artery bypass grafts at the venous drainage system of the recipient coronary artery. Morphologic implications and consequences].

Introduction: The internal mammary artery's endothelium continuously produces nitric oxide in a large quantity resulting in local and downstream vasodilatation, inhibition of platelet aggregation and in the tunica media prevents smooth muscle cell proliferation.

Objective: The aim of this study was to measure the concentration of the internal mammary artery bypass graft's endothelium derived nitric oxide's stable metabolite, (nitrite) at the venous drainage site (great cardiac vein) of the recipient coronary artery (left anterior descending), and to prove that the change of the biochemical milieu provides morphological stability (vasodilation and lack of atherosclerosis) in the recipient coronary artery based on recoronarographies.

Method: Authors investigated the levels of endothelium derived nitric oxide in intraoperative settings of 50 off pump, partly heparinized coronary bypass surgery cases sampling from the internal mammary free cut end flow (81.