Role of imaging modalities in the choice of treatment strategy for mega aorta syndrome

Saushkin V.V.; Panfilov D.S.; Vrublevsky A.V.; Sazonova S.I.; Kozlov B.N.

doi:https://doi.org/10.17116/hirurgia202202167

Saushkin V.V.

Tomsk National Research Medical Center

Panfilov D.S.

Tomsk National Research Medical Center

ORCID: 0000-0003-2201-350X

Vrublevsky A.V.

Tomsk National Research Medical Center

Sazonova S.I.

Tomsk National Research Medical Center

ORCID: 0000-0003-2799-3260

Kozlov B.N.

Cardiology Research Institute of the Tomsk National Research Medical Center of the Russian Academy of Sciences

ORCID: 0000-0002-0217-7737

Role of imaging modalities in the choice of treatment strategy for mega aorta syndrome

Authors:

Saushkin V.V., Panfilov D.S., Vrublevsky A.V., Sazonova S.I., Kozlov B.N.

More about the authors

Journal: Pirogov Russian Journal of Surgery. 2022;(2): 67‑74

DOI: 10.17116/hirurgia202202167

Read: 1766 times

Download PDF (RU)

Contact the author

Table of contents

To cite this article:

Saushkin VV, Panfilov DS, Vrublevsky AV, Sazonova SI, Kozlov BN. Role of imaging modalities in the choice of treatment strategy for mega aorta syndrome. Pirogov Russian Journal of Surgery. 2022;(2):67‑74. (In Russ.)
https://doi.org/10.17116/hirurgia202202167

Подписка 2026 Хирургия. Журнал им. Н.И. Пирогова (Pirogov Russian Journal of Surgery)

Использование инфографики авторами научных работ

Close metadata

Recommended articles:

Markers of severe fibrosis in chronic pancreatitis and long-term postoperative outcomes in patients with chronic pancreatitis. Pirogov Russian Journal of Surgery. 2026;(2):43-50

Primary-chronic osteomyelitis and fibrous dysplasia of the mandible in children. Differential diagnosis and treatment. Stomatology. 2025;(4):41-48

Silicone lymphadenopathy is a rare complication of breast implant rupture. Plastic Surgery and Aesthetic Medicine. 2025;(3):30-37

Redo frozen elephant trunk procedures after surgical treatment of acute aortic dissection type I. Russian Journal of Cardiology and Cardiovascular Surgery. 2025;(5):503-510

Surgical treatment of ascending aortic aneurysm with proximal stent graft-induced new entry after previous thoracic endovascular aortic repair. Russian Journal of Cardiology and Cardiovascular Surgery. 2025;(6):719-722

Selection of patients for aortic valve replacement via right anterior minithoracotomy based on different CT criteria. Russian Journal of Cardiology and Cardiovascular Surgery. 2026;(1):38-45

Explantation of cava filter migrated to the right cardiac chambers. Russian Journal of Cardiology and Cardiovascular Surgery. 2026;(1):108-111

Assessment of the relative position of the elements of the temporomandibular joint in the analysis of computed tomograms. Stomatology. 2026;(1):58-67

Lung cancer screening as a part of the preventive medical examination of certain groups of the adult population. Methodological recommendations. Russian Journal of Preventive Medicine. 2026;(1-2):9-37

Electroneuromyography with bipolar stimulation probe for intercostal nerve cryoablation after thoracoabdominal aortic aneurysm and mega aorta repair. Russian Journal of Cardiology and Cardiovascular Surgery. 2026;(2):14-21

Abstract:

The authors report a 76-year-old female with mega-aorta syndrome that was asymptomatic for a long time. The first symptoms appeared after ascending aorta enlargement up to 81 mm and compression of superior vena cava. The patient underwent frozen elephant trunk procedure. The authors demonstrate the possibilities of assessing the aortic strain by ECG-synchronized CT angiography and 2D transesophageal ultrasound with speckle tracking. Potential role of these methods in determining the type of aortic reconstruction is discussed.

Keywords:

mega aorta syndrome

circular strain

computed tomography

transesophageal echocardiography

thoracic aorta

thoracic aorta replacement

frozen elephant trunk

Authors:

Saushkin V.V.

Tomsk National Research Medical Center

Panfilov D.S.

Tomsk National Research Medical Center

ORCID: 0000-0003-2201-350X

Vrublevsky A.V.

Tomsk National Research Medical Center

Sazonova S.I.

Tomsk National Research Medical Center

ORCID: 0000-0003-2799-3260

Kozlov B.N.

Cardiology Research Institute of the Tomsk National Research Medical Center of the Russian Academy of Sciences

ORCID: 0000-0002-0217-7737

Received:

02.07.2021

Accepted:

21.09.2021

Close metadata

References:

Bossone E, Eagle K. Epidemiology and management of aortic disease: aortic aneurysms and acute aortic syndromes. Nature Reviews Cardiology. 2020;18(5):331-348. https://doi.org/10.1038/s41569-020-00472-6
Kim T, Martin T, Lee W, et al. Evolution in the management of the total thoracic aorta. J Thorac Cardiovasc Surg. 2009;137(3):627-634. https://doi.org/10.1016/j.jtcvs.2008.11.012
Elefteriades J, Farkas E. Thoracic Aortic Aneurysm. J Am Coll Cardiol. 2010;55(9):841-857. https://doi.org/10.1016/j.jacc.2009.08.084
Kuzmik G, Sang A, Elefteriades J. Natural history of thoracic aortic aneurysms. J Vasc Surg. 2012;56(2):565-571. https://doi.org/10.1016/j.jvs.2012.04.053
Uchida N, Katayama A, Kuraoka M, Sueda T. One-stage total thoracic aortic repair for mega-aorta using frozen elephant trunk technique. Interact Cardiovasc Thorac Surg. 2011;13(4):419-420. https://doi.org/10.1510/icvts.2011.275933
Pasta S, Agnese V, Di Giuseppe M et al. In Vivo Strain Analysis of Dilated Ascending Thoracic Aorta by ECG-Gated CT Angiographic Imaging. Ann Biomed Eng. 2017;45(12):2911-2920. https://doi.org/10.1007/s10439-017-1915-4
Honma H, Ohno T, Fujimoto H, Matsuzaki T, Murata H, Mizuno K. Evaluation of the Elastic Properties of the Thoracic Descending Aorta with Strain-Rate Measurement with Transesophageal Echocardiography: Its Correlation with the Left Ventricular Diastolic Function Assessed with Transthoracic Echocardiography. Journal of Nippon Medical School. 2010;77(3):145-154. https://doi.org/10.1272/jnms.77.145
Zubair M, de Beaufort H, Belvroy V, et al. Impact of Cardiac Cycle on Thoracic Aortic Geometry—Morphometric Analysis of Ecg Gated Computed Tomography. Ann Vasc Surg. 2020;65:174-182. https://doi.org/10.1016/j.avsg.2019.10.072
Morrison T, Choi G, Zarins C, Taylor C. Circumferential and longitudinal cyclic strain of the human thoracic aorta: Age-related changes. J Vasc Surg. 2009;49(4):1029-1036. https://doi.org/10.1016/j.jvs.2008.11.056
Saeyeldin A, Gryaznov A, Zafar M, et al. Interstage mortality in two‐stage elephant trunk surgery. J Card Surg. 2021;36(6):1882-1891. https://doi.org/10.1111/jocs.15441
Belov YuV, Charchyan ER, Breshenkov DG, and other. Surgical treatment of mega aorta syndrome: a single-center experience. Khirurgiya Zhurnal im N.I. Pirogova. 2021;(6-2):15-25. (In Russ.). https://doi.org/10.17116/hirurgia202106215
Panfilov DS, Kozlov BN, Saushkin VV, Shipulin VM. Hybrid treatment of the ascending aortic aneurysm and «shaggy aorta» syndrome. Kardiologiia. 2019;59(S5):65-68. (In Russ.). https://doi.org/10.18087/cardio.2646
Kozlov BN, Panfilov DS, Zavadovsky KV, Saushkin VV, Kuznetsov MS, Nasrashvili GG, Andriyanova AV, Shipulin VM. Hybrid surgery of the aortic arch. The siberian medical journal. 2015;30(2):60-64. (In Russ.).
Rong LQ, Palumbo MC, Rahouma M, et al. Immediate Impact of Prosthetic Graft Replacement of the Ascending Aorta on Circumferential Strain in the Descending Aorta. Eur J Vasc Endovasc Surg. 2019;58(4):521-528. https://doi.org/10.1016/j.ejvs.2019.05.003.
2014 ESC Guidelines on the diagnosis and treatment of aortic diseases. Eur Heart J. 2014;35(41):2873-2926. https://doi.org/10.1093/eurheartj/ehu281