MISCELLANEOUS AORTIC DISEASE
Large peripheral arterial emboli may obstruct the abdominal aortic bifurcation, resulting in so-called saddle emboli. These usually originate from the left heart but rarely may originate from the aorta itself in the area of an atherosclerotic lesion. Other rarer causes are “paradoxical emboli” (from the right heart or venous.vsystem in patients with right-to-left shunts), atrial myxomas, or infective endocarditis (very large emboli can occur in acute endocarditis and fungal endocarditis). Obstruction at the aortic bifurcation is characterized by the sudden onset of severe pain in both legs, peripheral neurological abnormalities, and evidence of decreased perfusion bilaterally. It must be differentiated from acute atherosclerotic aortic thrombosis and dissecting aneurysm. The diagnosis is confirmed by angiography. Surgical removal of the clot with subsequent anticoagulation and/or treatment of the underlying etiology is necessary.
Infected aortic aneurysms are rare. The most common congenital aortic anomaly is coarctation of the aorta (see Chapter 4). Congenital aortic aneurysms of the sinus of Valsalva may rupture into the right atrium or ventricle, producing a continuous murmur. Sinus of Valsalva aneurysms can occasionally produce coronary occlusion, conduction disturbances, or valvular malfunction.
- THROMBOANGIITIS OBLITERANS
- HEART DISEASE AND PREGNANCY
- PERIPHERAL VENOUS DISEASE
- MISCELLANEOUS AORTIC DISEASE
- THE AIRWAY STRUCTURE
- RAYNAUD'S PHENOMENON
- GENERAL PRINCIPLES OF CARDIAC SURGERY
- PERFUSION
- GAS TRANSFER
- ARTERIAL TRAUMA
- VENTILATION
- ENVIRONMENTAL DAMAGE OF THE EXTREMITIES
- PERIPHERAL ANEURYSMS AMD FISTULAE
- ARTERIOSCLEROSIS OBLITERANS
- GENERAL SURGERY IN THE PATIENT WITH HEART DISEASE
- NONRESPIRATORY FUNCTIONS OF THE LUNG
- THE BLOOD VESSELS STRUCTURE
- NONPULMONARY FACTORS
- PULMONARY GAS EXCHANGE