Trapdoor endarterectomy for coral reef plaque of the paravisceral aorta in the modern era
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PROVIDER: S-EPMC10884470 | biostudies-literature | 2023 Nov
REPOSITORIES: biostudies-literature
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Project description:Modern reef-building corals sustain a wide range of ecosystem services because of their ability to build calcium carbonate reef systems. The influence of environmental variables on coral calcification rates has been extensively studied, but our understanding of their relative importance is limited by the absence of in situ observations and the ability to decouple the interactions between different properties. We show that temperature is the primary driver of coral colony (Porites astreoides and Diploria labyrinthiformis) and reef-scale calcification rates over a 2-year monitoring period from the Bermuda coral reef. On the basis of multimodel climate simulations (Coupled Model Intercomparison Project Phase 5) and assuming sufficient coral nutrition, our results suggest that P. astreoides and D. labyrinthiformis coral calcification rates in Bermuda could increase throughout the 21st century as a result of gradual warming predicted under a minimum CO2 emissions pathway [representative concentration pathway (RCP) 2.6] with positive 21st-century calcification rates potentially maintained under a reduced CO2 emissions pathway (RCP 4.5). These results highlight the potential benefits of rapid reductions in global anthropogenic CO2 emissions for 21st-century Bermuda coral reefs and the ecosystem services they provide.
| S-EPMC5677334 | biostudies-literature
Project description:BackgroundCoral reef aorta (CRA) is a rare condition characterized by atherosclerosis and overt calcification of the aorta leading to severe luminal stenosis of the vessel. Most patients present with hypertension and intermittent claudication at the time of diagnosis. Risk factors associated with this condition are essentially the same as those associated with atherosclerosis. However, no unique condition seems to predispose an individual to develop CRA.Case summaryWe describe the case of a patient known for rheumatoid arthritis (RA) treated with long-term systemic corticosteroids who presented with a shock of unknown aetiology and left ventricular ejection fraction of 10%. Conventional and computed tomography angiography showed a CRA with subtotal lesion of the aortic arch that led to cardiogenic shock.DiscussionEven though the exact aetiology of her condition will remain uncertain, RA and extended use of corticosteroids likely played a role in the development of this severe form of CRA.
| S-EPMC6439383 | biostudies-literature
Project description:A patient with coral reef aorta at the level of the renal and visceral arteries was treated endovascularly. We used intravascular lithotripsy for improving stent expansion and intravascular ultrasound as an intraoperative diagnostic tool. The renal artery periscope technique maintained renal perfusion after placement of the aortic endograft.
| S-EPMC11442343 | biostudies-literature
Project description:BackgroundThe coral reef aorta (CRA) is a rare disease of extreme calcification in the juxtarenal aorta. These heavily calcified exophytic plaques grow into the lumen and can cause significant stenoses, leading to visceral ischaemia, renovascular hypertension, and claudication. Surgery or percutaneous intervention with stenting carries a high risk of complications and mortality.Case summaryA 67-year-old female had presented with severe hypertension and exercise limiting claudication for 18 months. On evaluation, she was found to have severe bilateral renal artery stenoses with juxtarenal CRA causing subtotal occlusion. Both renal arteries were stented. For CRA, we used intravascular lithotripsy (IVL) assisted plain balloon angioplasty to minimize possibilities of major dissection and perforation and avoided chimney stent-grafts required to protect visceral and renal arteries. We used a double-balloon technique using a 6 × 60 mm IVL Shockwave M5 catheter and a 9 × 30 mm simple peripheral balloon catheter, inflated simultaneously at the site of CRA as parallel, hugging balloons to have an effective delivery of IVL. Shockwaves were given in juxta/infrarenal aorta to have satisfactory dilatation without any complication. The gradient across aortic narrowing reduced from 80 to 4 mmHg. She had an uneventful recovery and has remained asymptomatic at 6-month follow-up.DiscussionWhen CRA is juxtarenal with no safe landing zones for stent-grafts, IVL may be a safe, less complex and effective alternative to the use of juxtarenal aortic stent-graft with multiple chimney or snorkel stent-grafts. This is the first report of a novel use of IVL to treat CRA.
| S-EPMC8188876 | biostudies-literature
Project description:Coral reef aorta (CRA) is characterized by heavily calcified obstructive lesions in the aorta. Thoracic endovascular aortic repair (TEVAR) is an established, less invasive procedure for aortic diseases; however, aortic occlusive diseases are commonly treated with conventional open surgery, and there are no reports of TEVAR in patients with a saccular aneurysm in CRA. We present a 72-year-old frail woman with a descending thoracic saccular aneurysm in CRA; therefore, we performed TEVAR. Although we had difficulty in advancing the stent graft system because it was caught in the severely calcified aorta, we finally succeeded in excluding the aneurysm.
| S-EPMC9556586 | biostudies-literature
Project description:Coral reef aorta (CRA), a rare disease, is characterized by severe calcification of the juxta-renal and suprarenal aorta that grows into the lumen and leads to severe stenosis. A 70-year-old woman with refractory hypertension and lower limb claudication presented with hypertension and congestive heart failure. Treatment with vasodilators and diuresis led to oliguria and exacerbated kidney function, while her congestion remained. Abdominal computerized tomography showed a bulky, irregular localized supra-renal aortic calcification with stenosis. A peripheral artery ultrasound and angiography showed no occlusive lesions in the distal run-off vessels. Based on her medical history and the unique aspects of the localized calcified lesion, CRA was diagnosed. We suspected that the congestive heart failure, refractory hypertension, and renal failure resulted from the supra-renal aortic stenosis. Because she developed oliguria with diuretics and vasodilators, we performed an open graft replacement with a thoracoabdominal approach. The reddish-brown calcified mass came off easily and was very fragile. The postoperative course was uneventful, and her heart and renal failure were completely resolved. This is the first report showing the fragility of CRA. Considering its fragility, catheter treatment may need to be avoided to prevent distal embolism. <Learning objective: When we encounter a calcified lesion localized at the level of the juxta and supra-renal aorta with extensive growth into the lumen, coral reef aorta (CRA) should be suspected. Considering that CRA lesion can be very fragile in contrast to the usual atherosclerotic lesion, as shown in our case, CRA might possibly increase the risk of distal embolization. Therefore, open graft replacement could be safer than endovascular stent-graft placement.>.
| S-EPMC7588505 | biostudies-literature
Project description:Abstract During the excavation of Mayan tombs, little did the archaeologists know that the fossils they discovered in the tomb stones would fundamentally alter our understanding of the earliest origins of coral reef fishes. Located just 500 kilometers from the point where an asteroid impact reconfigured the world's biological systems 66 million years ago, we find the earliest origins of three typical reef fish groups. Their presence in Mexico just 3 million years after this impact finally reconciles the conflict between the fossil and phylogenetic evidence for the earliest origins of reef fishes. The incorporation of these fossils into a global reconstruction of fish evolutionary history reveals a new picture of the early biogeography of reef fishes, with strong Atlantic links. From locations associated with biological destruction and societal collapse, we see evidence of the origins of one of the world's most diverse and spectacular marine ecosystems: coral reefs.
| S-EPMC9343231 | biostudies-literature
Project description:Identification of fossil corals is often limited due to poor preservation of external skeleton morphology, especially in the genus Acropora which is widespread across the Indo-Pacific. Based on skeleton characteristics from thin section, we here develop a link between the internal skeleton structure and external morphology. Ten characteristics were summarized to distinguish Acropora and five related genera, including the type and differentiation of corallites, the skeleton nature of corallites (septa, columellae, dissepiments, wall), and calcification centers within septa. Acropora is distinctive for its dimorphic corallites: axial and radial. Isopora is similar to Acropora but possess more than a single axial corallites. Montipora and Astreopora (family Acroporidae) have monomorphic corallites and a synapticular ring wall, with clustered calcification center in the former and medial lines in the latter. Pocillopora and Porties are classified by distinctive dissepiments, columellae and septa. These microstructural skeleton characteristics were effective in the genus identification of fossil corals from drilled cores in the South China Sea. Eighteen detailed characteristics (ten of axial corallites, four of radial corallites, and four of coenosteum) were used in the Acropora species classification. The axial corallites size and structure (including corallite diameter, synapticular rings, and septa), the septa of radial corallites, and the arrangement of coenosteum were critical indicators for species identification. This identification guide can help paleoenvironmental and paleoecological analyses and modern coral reef conservation and restoration.
| S-EPMC8019043 | biostudies-literature
Project description:We report the unusual case of a 68-year-old man with coral reef aorta complicated with severe calcified valvular heart disease who has been undergoing dialysis for 21 years. This report highlights the etiology and the unusual manifestations of coral reef aorta in a long-term dialysis patient. (Level of Difficulty: Intermediate.).
| S-EPMC8571789 | biostudies-literature
Project description:Coral Reef Stony Coral Tissue Loss Disease Microbiomes in Coral Tissue and Near-Coral Seawater
| PRJNA672912 | ENA