{"424131":{"#nid":"424131","#data":{"type":"event","title":"Biomedical Engineering Seminar","body":[{"value":"\u003Cp\u003E\u003Cstrong\u003E\u201cThoracic Aortic Aneurysm: Reading the Enemy\u2019s Playbook\u201d\u003Cbr \/\u003E\u003C\/strong\u003E\u003C\/p\u003E\u003Cp\u003E\u003Cstrong\u003E\u003Cstrong\u003EJohn A. Elefteriades, M.D.\u003C\/strong\u003E\u003Cstrong\u003E\u003Cbr \/\u003E \u003C\/strong\u003E\u003C\/strong\u003E\u003Cstrong\u003EWilliam W.L. Glenn Professor of Cardiothoracic Surgery and Chief of Cardiothoracic Surgery\u003Cstrong\u003E\u003Cbr \/\u003E Yale University and Yale New-Haven Hospital\u003C\/strong\u003E\u003C\/strong\u003E\u003C\/p\u003E\u003Cp\u003E\u003Cstrong\u003E\u0026nbsp; \u003C\/strong\u003E\u003Cbr \/\u003EThe vast database of the Yale Center for Thoracic Aortic Disease\u2014which includes information on 3000 patients with thoracic aortic aneurysm or dissection, with 9000 catalogued images and 9000 patient-years of follow-up\u2014has, over the last decade, permitted multiple glimpses into the \u201cplaybook\u201d of this virulent disease. Understanding the precise behavioral features of thoracic aortic aneurysm and dissection permits us more effectively to combat this disease. In this monograph, we will first review certain fundamentals\u2014in terms of anatomy, nomenclature, imaging, diagnosis, medical, surgical, and stent treatment. After reviewing these fundamentals, we will proceed with a detailed exploration of lessons learned by peering into the operational playbook of thoracic aortic aneurysm and dissection. Among the glimpses afforded in the behavioral playbook of this disease are the following:\u003Cbr \/\u003E \u003Cbr \/\u003E 1. Thoracic aortic aneurysm, while lethal, is indolent. Mortality usually does not occur until after years of growth.\u003Cbr \/\u003E \u003Cbr \/\u003E 2. The aneurysmal ascending thoracic aorta grows slowly: about 0.1 cm per year (the descending aorta grows somewhat faster).\u003Cbr \/\u003E \u003Cbr \/\u003E 3. Over a patient\u2019s lifetime, \u201chinge points\u201d at which the likelihood of rupture or dissection skyrockets are seen at 5.5 cm for the ascending and 6.5 cm for the descending aorta. Intervening at 5 cm diameter for the ascending and 6 cm for the descending prevents most adverse events.\u003Cbr \/\u003E \u003Cbr \/\u003E 4. Symptomatic aneurysms require resection regardless of size.\u003Cbr \/\u003E \u003Cbr \/\u003E 5. The yearly rate of rupture, dissection, or death is 14.1% for a patient with a thoracic aorta of 6 cm diameter.\u003Cbr \/\u003E \u003Cbr \/\u003E 6. The mechanical properties of the aorta deteriorate markedly at 6 cm diameter (distensibility falls, and wall stress rises)\u2014a finding that \u201cdovetails\u201d perfectly with observations of the clinical behavior of the thoracic aorta.\u003Cbr \/\u003E \u003Cbr \/\u003E 7. Thoracic aortic aneurysm and dissection are largely inherited diseases, with a predominantly autosomal-dominant pattern. The specific genetics are being elucidated at the molecular level.\u003Cbr \/\u003E \u003Cbr \/\u003E 8. Matrix metalloproteinase over activity participates in the destructive processes that degrade an aorta in individuals genetically preprogrammed to develop aneurysms.\u003Cbr \/\u003E \u003Cbr \/\u003E 9. Most dissections are brought on via presumed momentary hypertensive crises by severe exercise or emotion.\u003Cbr \/\u003E \u003Cbr \/\u003E \u003Cbr \/\u003E We look forward to a future in which the aneurysm diathesis can be determined by a genetic test (RNA or DNA based), in which matrix metalloproteinases can be specifically antagonized by medications, in which exercise and emotion can be modulated in susceptible patients, and in which mechanical properties of the aorta (in addition to simple dimension) can be assessed.\u003C\/p\u003E\u003Cp\u003E\u0026nbsp;\u003C\/p\u003E","summary":null,"format":"limited_html"}],"field_subtitle":"","field_summary":[{"value":"\u003Cp\u003EBiomedical Engineering Seminar - \u0022Thoracic Aortic Aneurysm: Reading the Enemy\u2019s Playbook\u0022 - John A. Elefteriades, M.D., Yale University.\u003C\/p\u003E","format":"limited_html"}],"field_summary_sentence":[{"value":"\u0022Thoracic Aortic Aneurysm: Reading the Enemy\u2019s Playbook\u0022  -  John A. Elefteriades, M.D. - Yale University"}],"uid":"27159","created_gmt":"2015-07-14 08:11:30","changed_gmt":"2017-04-13 21:19:06","author":"Vickie Okrzesik","boilerplate_text":"","field_publication":"","field_article_url":"","field_event_time":{"event_time_start":"2015-08-11T12:00:00-04:00","event_time_end":"2015-08-11T13:00:00-04:00","event_time_end_last":"2015-08-11T13:00:00-04:00","gmt_time_start":"2015-08-11 16:00:00","gmt_time_end":"2015-08-11 17:00:00","gmt_time_end_last":"2015-08-11 17:00:00","rrule":null,"timezone":"America\/New_York"},"extras":[],"related_links":[{"url":"https:\/\/www.bme.gatech.edu\/bme\/faculty\/Wei-Sun","title":"Faculty Host Profile"}],"groups":[{"id":"1254","name":"Wallace H. Coulter Dept. of Biomedical Engineering"}],"categories":[],"keywords":[{"id":"1613","name":"Biomedical Engieering"},{"id":"134071","name":"Thoracic Aortic Disease"}],"core_research_areas":[],"news_room_topics":[],"event_categories":[{"id":"1795","name":"Seminar\/Lecture\/Colloquium"}],"invited_audience":[{"id":"78751","name":"Undergraduate students"},{"id":"78761","name":"Faculty\/Staff"},{"id":"78771","name":"Public"},{"id":"174045","name":"Graduate students"}],"affiliations":[],"classification":[],"areas_of_expertise":[],"news_and_recent_appearances":[],"phone":[],"contact":[{"value":"\u003Cp\u003EFaculty Host: \u003Ca href=\u0022mailto:wei.sun@bme.gatech.edu\u0022\u003EWei Sun, Ph.D.\u003C\/a\u003E\u003C\/p\u003E","format":"limited_html"}],"email":[],"slides":[],"orientation":[],"userdata":""}}}