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Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
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Aortic Regurgitation I: Introduction01:15

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IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
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Aortic Regurgitation II: Clinical Features and Diagnostic Tests01:22

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Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
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Aneurysm I: Introduction01:30

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An aortic aneurysm is a localized outpouching or dilation at a weak point in the artery wall. It may involve different parts of the aorta, such as the abdominal aorta, aortic arch, or thoracic aorta.Etiological factorsSeveral disorders are associated with aortic aneurysms.Congenital causes, such as primary connective tissue disorders like Marfan syndrome, impact the integrity and strength of connective tissues, notably affecting the aorta. Marfan syndrome is a genetic disorder that specifically...
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Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
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The autonomic nervous system (ANS) is an intricate network of nerves that controls functions such as the regulation of heart rate, digestion, and blood pressure regulation. When this system malfunctions, it can lead to various disorders that affect multiple bodily functions. One common feature of many autonomic disorders is the involvement of smooth blood vessels, which play a crucial role in regulating blood flow throughout the body.
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Updated: Nov 19, 2025

Novel and Innovative Hybrid Technique for Type A Aortic Dissection
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Nutcracker syndrome due to chronic aortic dissection.

Yuki Ichihara1, Takashi Azuma1, Satoshi Saito1

  • 1Department of Cardiovascular Surgery, Tokyo Women's Medical University, Tokyo, Japan.

Journal of Cardiac Surgery
|February 2, 2021
PubMed
Summary
This summary is machine-generated.

Nutcracker syndrome (NCS), left renal vein compression, can cause hematuria in patients with aortic dissection. Surgical intervention resolved symptoms in a Marfan syndrome patient, highlighting NCS as a key differential diagnosis.

Keywords:
aortic dissectiongraft replacement of the thoracoabdominal aortahematurianutcracker syndrome

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Area of Science:

  • Vascular Surgery
  • Nephrology
  • Cardiology

Background:

  • Nutcracker syndrome (NCS) involves compression of the left renal vein (LRV) between the abdominal aorta and superior mesenteric artery (SMA).
  • Marfan syndrome is a genetic disorder affecting connective tissue, predisposing individuals to aortic abnormalities like dissection.

Observation:

  • A patient with Marfan syndrome and type B aortic dissection presented with sudden gross hematuria.
  • Computed tomography imaging confirmed LRV compression between the SMA and the dilated, dissecting aorta.

Findings:

  • Surgical intervention successfully released the compressed LRV.
  • Post-operative resolution of gross hematuria was observed promptly.

Implications:

  • NCS should be considered in the differential diagnosis of unexplained hematuria, particularly in patients with chronic aortic dissection.
  • This case underscores the importance of recognizing vascular compression syndromes in complex aortic pathologies.