How is a Thoracic Aortic Aneurysm Repaired? At present, it seems that there is no one-size-fits-all treatment, and therefore, patient selection should be performed on an individual basis according to morphological complexities, comorbidities, and anticipated overall survival and durability of any repair. ARBs are also prescribed to people with Marfans syndrome regardless of their blood pressure. 2016;103:1626-1633. 29. Am J Cardiol. Once the diameter exceeds 6cm, the risk of rupture or dissection is extremely high. Each of these complications mentioned here are of limb as well as life-threatening ones and when doctors diagnose them, they indicate for the requirement of repair or surgery. The aorta is the lifeblood of our body and aneurysms can put pressure on it from all sides. 13. If thoracic aortic aneurysms are severe enough to cause symptoms, you may experience severe chest or back pain, shortness of breath, coughing or wheezing, difficulty swallowing, hoarseness, numbness or weakness in one or both arms, and loss of consciousness or low blood pressure. Feel a pulse in your stomach? Sorry, it took a minute to respond but I haven't been feeling well. Abdominal aortic aneurysms are 4 to 6 times more common in men and people assigned male at birth than women and people assigned female at birth. Blood close from any AAA rarely may break loose as well as lodge within the arteries of the patients legs resulting in the blockage of blood circulation and severe as well as sudden leg pain. Chaikof EL, Dalman RL, Eskandari MK, et al. 5. Open surgical repair of 2286 thoracoabdominal aortic aneurysms. Open surgery to repair an aneurysm can require a recovery time of about a month. 2013;45:154-159. Svensson LG, Rodriguez ER. If left untreated, a rupture can lead to life-threatening bleeding. Doctors also call an aortic root aneurysm a dilated aortic root. Aneurysms anywhere in the body are dangerous because they can rupture and cause massive internal bleeding. I am 6'2, about 245lbs, early 40s. Elefteriades showed that patients with aneurysms > 6 cm have a 14.1% annual risk of rupture, dissection, or death, compared with 6.5% for patients with aneurysms between 5 and 6 cm.16. The force of blood pumping can split the layers of the artery wall, allowing blood to leak in between them. 20. Most aneurysms grow slowly. Family history: About 20 percent of all thoracic aneurysms develop in people with a family history of thoracic aneurysms. Risk factors for aneurysm rupture in patients kept under ultrasound surveillance. I had been seen in a large local hospital and asked the consultant why the op could not be done there- she said, tactfully, "it would be in your best interests to go to the Heart Hosp.". The danger lies with ones less than 4 cm wide, as they have a very low chance of bursting but if one gets bigger then there is increasing possibility for rupture soon afterwards Abdominal Aortic Aneurysm Repair With Stent I had a private appointment with a cardiologist and asked him lots of questions and it put my mind at rest a bit. All Rights Reserved Privacy Policy, Robert J. Hinchliffe, MD, FRCS; Paul Hollering. Emergency surgery can sometimes be done to repair an aneurysm that ruptures, though it must be done fast. Is a descending aortic aneurysm more dangerous than an ascending aortic aneurysm? Adopt a healthy diet rich in fruits and vegetables, and low in cholesterol and saturated fats. not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in Risk of a sudden rupture These are the main factors that make a rupture more likely: The aneurysm is larger than 5.5 cm in diameter. N Engl J Med. If you have aortic aneurysm less than 5.5 cm in diameter then chances of rupture increases by 1-2 % per year. Treatment for an abdominal aneurysm may include surgical repair or removal of the aneurysm, or inserting a . Risk of aneurysm rupture annually depends on its specific size, according to which- Less than diameter of 4cm has a risk of less than 1 among 200 in total Diameter between 4cm and 4.9cm have risk between 1 in total 200 and 1 in total 20 Diameter between 5cm and 5.9cm have risk between 1 in total 30 and 1 in total 7 The procedure can cause bleeding, respiratory complications such as pneumonia or even paralysis if not properly cared for afterword I hope you don't mind telling me where did you have your surgery done? Dake MD, Miller DC, Semba CP, et al. Ann Thorac Surg. A diameter greater than 3.5cm is considered to be an aortic aneurysm. I'm thinking of getting a second opinion soon though. 2017;53:4-52. Expansion rate of descending thoracic aortic aneurysms. Some of our partners may process your data as a part of their legitimate business interest without asking for consent. Loscalzo et al. family history, ( on my mom's . 1993;17:357-368. A rupture in this part of the body can be life-threatening. Ann Thorac Surg. If you would like to change your settings or withdraw consent at any time, the link to do so is in our privacy policy accessible from our home page.. What should you not do with an aortic aneurysm? The aorta is the largest blood vessel in the body. They are, however, very useful in preventing cardiovascular events.29 Angiotensin II receptor blockers are currently a major source of optimism in the treatment and prevention of TAAs in patients with Marfan syndrome. The relative survival percentage remained steady at about 87%. The aneurysm has grown quickly (more than 0.5 cm in six months or more than 1 cm in one year). Aneurysms are dangerous because they can rupture, causing internal bleeding. If you were born with a bicuspid valve (aortic valve with two flaps), you have a higher risk of an ascending aortic aneurysm. Like most arteries, the aorta is elastic, which allows it to be filled with blood under high pressure. Eagleton M. (2017). Symptomatic aneurysms and aneurysms associated with a rapid growth rate of > 1 cm per year should also be repaired because of an increased risk for rupture. Eur J Vasc Endovasc Surg. 24. The normal ascending aorta is no more than 3.5 cm in diameter. Jovin IS, Duggal M, Ebisu K, et al. By 2000 this number had increased to 31 but due in part from advances made with medicine and surgery over time its now expected that people will live past their 65th birthday! Went to the ER and they found the BAV with ascending aortic aneurysm measuring 4.7. J Thorac Cardiovasc Surg. medium AAA - 4.5cm to 5.4cm across. Get To Know What Possibly Could Be Causing Your Symptoms! An aneurysm is a bulge that forms in the wall of an artery. Because of the increase in hospital admissions for TAAs over the last decade,2 the decision regarding who will benefit from surgical repair became even more important. I am not on any medicines at all. Mayo Clinic Staff. Now all the time I'm on internet searching and looking in to videos with TAA surgeries and Im freaking out The difference though is that you are now 68 yrs and yours TAA might not growing any more, I'm still 53 Let's hope for the best, thanks again. May I ask you what kind of medicines are you taking? . I have stopped worrying about it now because the anxiety was taking over my life and i suddenly realised that but for the test I would never have known anyway. An abdominal aortic aneurysm is when the lower part of the aorta that extends through the abdominal area becomes enlarged. The hemorrhage most likely will lead to death. Patients with AAAs larger than 7.0 cm lived a median of 9 months.A ruptured aneurysm was certified as a cause of death in 36% of the patients with an AAA of 5.5 to 5.9 cm, in 50% of the patients with an AAA of 6 to 7.0 cm, and 55% of the patients with an AAA larger than 7.0 cm. Read More Created for people with ongoing healthcare needs but benefits everyone. Im 53 yr female and I have just been diagnosed with a thoracic ascending aortic aneurysm of 4cm,still in shock as I never expected it, as I'm not a smoker, neither a drinker, doesn't run in the family. Yearly rupture or dissection rates for thoracic aortic aneurysms: simple prediction based on size. When ascending aortic aneurysms meet the size criteria or co . 7 Symptoms Never to Ignore If You Have Heart Failure. Incidence of descending aortic pathology and evaluation of the impact of thoracic endovascular aortic repair: a population-based study in England and Wales from 1999 to 2010. Older age: An ascending aortic aneurysm usually forms in people in their 60s and 70s. Registered in England and Wales. This will help control your blood pressure as well as your cholesterol levels. I have to follow up and check if it will grow etc. Thursday, January 26 2023 - Have a nice day! Patient is a UK registered trade mark. Achneck HE, Rizzo JA, Tranquilli M, Elefteriades JA. I had six month tests for a year and then yearly. The risk of a fatal bleeding event is high if bleeding is not treated promptly. To view the purposes they believe they have legitimate interest for, or to object to this data processing use the vendor list link below. And more than 70% of patient with ruptured aortic aneurysm are not able to reach hospital alive. The Thoracic Aortic Disease Service at Liverpool Heart and Chest Hospital is a busy service that provides comprehensive care for patients with complex cases of the disease. I am a healthy 67 yr old female with a 4.6 cm ascending aortic aneurysm 4.6 cm. It was found 8 yrs ago, at that time 4.6. Management of diseases of the descending thoracic aorta in the endovascular era: a Medicare population study. Save my name, email, and website in this browser for the next time I comment. The journal presents original contributions as well as a complete . recovery returns you to your active life. The only meds were for pain, no meds for life. Key factors to consider when selecting patients for TAA repair. The two trials comparing early open surgical repair to surveillance found this result holds true regardless of patient age or aneurysm size (within the range of 4.0 cm to 5.5 cm diameter). Thoracic Aortic Aneurysm or Thoracic Aneurysm and Aortic Dissection (TAAD): Causes, Signs, Symptoms, Treatment, Home Remedies. J Vasc Surg. You are off to a good start by searching for information on the subject. Endovascular abdominal aortic aneurysm repair: type 2 endoleaks and risk of rupture . The more serious side effects include heart problems due to interruption between your spines blood flow and nerves that control muscles down below; infections at sites where there was open tissue removal during surgery (this includes local wound healing); swelling around areas Vishnu Siva wrote about but didnt go into detail on because they were less relevant than others like kidney function loss which could lead you towards needing dialysis therapy eventually. All Rights Reserved. Unoperated aortic aneurysm: a survey of 170 patients. Preoperative Risk Assessment for Optimal TEVAR Outcomes, By Tristan R. A. These include longer delivery systems and more accurate deployment systems (necessary in tortuous anatomy with very high blood flow and exceptionally large forces and motion). This article on Epainassist.com has been reviewed by a medical professional, as well as checked for facts, to assure the readers the best possible accuracy. This article may contains scientific references. Aortic aneurysms less than 4 centimeters in size have a low chance of bursting, but an aneurysm more than 5.5 centimeters in diameter has an increasing chance of rupturing in the next year.One of the things that makes aortic aneurysms so dangerous is that many times, they go undetected until they burst. 30. If you and your doctor agree that a watch-and-wait approach is best, you may be placed on medications to help lower your blood pressure and cholesterol. Im 53 yr female and I have just been diagnosed with a thoracic ascending aortic aneurysm of 4cm, still in shock as I never expected it, as I'm not a smoker, neither a drinker, doesn't run in the family. Occasionally, there may be abdominal, back, or leg pain. Ann Thorac Surg. and no plaque. Symptomatic aneurysms and aneurysms associated with a rapid growth rate of > 1 cm per year should also be repaired because of an increased risk for rupture. Therefore, guidelines have suggested that repair is appropriate for saccular aneurysms > 2 cm or saccular aneurysms associated with a total aortic diameter > 5 cm.16, The latest ESVS guidelines suggest that based on the size differential between men and women at baseline, the threshold can be reduced to 50 to 55 mm for women. What is a Thoracic Aortic Aneurysm (TAA)? Design: The study was observational with data from patients screened with ultrasound scanning for AAA at five Veterans Affairs Medical Centers for enrollment in the Aneurysm Detection and Management . Don't know what to think? Stay well and hope this helps. Evidences have suggested that expansion of aneurysms takes place at the average rate from 0.3cm to 0.4cm yearly and tends to expand at the fastest rate as compared to any small aneurysm. This article does not provide medical advice. Instead of looking only at the aortic diameter, some data suggest that aortic aneurysm size relative to body surface area is more important than absolute diameter.17 Davies and colleagues used an aortic size index (ASI) of aortic diameter (cm) divided by body surface area (m2). An aortic aneurysm occurs when the aorta's wall is torn open. 2005;41:1-9. In the VALOR trial, the rate of serious morbidity among patients undergoing open surgical repair of the descending aorta was double that of the TEVAR patients (84% vs 41%, respectively). The aneurysm is causing symptoms such as pain in the back, stomach . Aortic pathology determines midterm outcome after endovascular repair of the thoracic aorta: report from the Medtronic Thoracic Endovascular Registry (MOTHER) database. Gopaldas RR, Huh J, Dao TK, et al. 2016;102:817-824. I'll be happy to answer any questions you may have, if it well help.. Have bicuspid valve and thoracic aneurysm also . I know this since a week ago and I'm in deep depression, I feel like nothing can be like yesterday any more since I didn't know and I was happy. What Are People Looking For In Online Fitness Classes? Brown LC, Powell JT. Nobody used the word aneurysm or even mentioned it to me at the time. Incredibly the aorta pumps around 200,000,000 liters of blood around the body in a lifetime. American Family Physician. Forsythe RO, Newby DE, Robson JM. Coselli JS, Bozinovski J, LeMaire SA. These findings were borne out in the national data sets, which concluded that TEVAR can be performed in older, sicker patients with less perioperative morbidity and shorter length of hospital stay.23,24, The mortality risks from TEVAR are strongly related to timing of intervention and age. Submitted by Joann from Denver, Colorado I understand 5.0 CM + is the time where you should consider surgery. Always speak to your doctor before acting and in cases of emergency seek The treatment for an abdominal aortic aneurysm (AAA) mostly depends on how big it is. and Privacy Policy and steps will be taken to remove posts identified Susan Fishman, APC, CRC is a veteran freelance writer with more than 25 years of experience in health education. 19. When the vessel is significantly widened, it's called an aneurysm. 2011;53:1499-1505. View risks, prognosis, videos and what to expect when considering this procedure. Wow I suppose it's a very big surgery! An aneurysm that is less than 5 cm may be monitored without surgery. Intact form of AAA i.e. When this happens we have whats called dilated or dissected roots either can be life threatening but if there isnt enough time for them to rupture before someone notices then survival may still be possible with treatment However, your doctor may recommend surgical repair of a small aneurysm thats growing more than 0.5 cm per year. Specifically, ask your doctor about your risk of complications from surgical repair compared to your risk of aortic aneurysm rupture if you decide not to undergo surgical repair. How long can u live with an aortic aneurysm? 2007;83:S862-S864; discussion S890-S892. I had a follow up CT scan and then an MRI. 2007;84:1180-1185. Expansion rates and outcomes for the 3.0-cm to the 3.9-cm infrarenal abdominal aortic aneurysm AAAs of 3.0 cm to 3.9 cm expanded slowly, did . No change. Generally, aortic diameter 3 cm constitutes an AAA. The dilatation is continuous and gradual. Shovel snow, chop wood, dig earth or use a sledgehammer or snow blower. Surgery is typically reserved for aortic aneurysms that are 5.5 cm or greater in diameter. In a person with no symptoms, if the AAA is 4.0 to 5.5 cm in diameter, treatment depends on several factors, including: The size of the aneurysm If the aneurysm is expanding If there are symptoms If there are aneurysms in other blood vessels A person's surgical risk An aneurysm is a weak spot in a blood vessel wall. 11. Schermerhorn ML, Giles KA, Hamdan AD, et al. Novel insight into the pathobiology of abdominal aortic aneurysm and potential future treatment concepts. Symptoms of a thoracic aneurysm may include: Pain in the jaw, neck, or upper back. Also according to Dr. Nguyen Duy Tan, Thong Nhat Hospital is one of the specialized centers for this method and has been successful in many cases of aortic aneurysm and dissection with a high . The aorta carries blood from your heart to your abdomen, legs, and pelvis. It may also burst or rupture, spilling blood into the surrounding tissue (called a hemorrhage). An aneurysm that grows and becomes large enough can burst, causing dangerous, often fatal, bleeding inside the body. Circulation. Brain aneurysms are caused by weaknesses in the blood vessel wall that causes the vessel to balloon. Ann Thorac Surg. right-arrow He or she will also consider the location of the aneurysm, any symptoms, your age, and other health conditions to determine the need for any further treatment. Heart. The DOT Guidelines: Allow a 1 year card for asymptomatic AAA over 4 but less than 5cm but only with clearance from cardiovascular surgeon. According to my dr that's possible. Prog Cardiovasc Dis. I am very well and keep fit in case I need it done. Its still not well understood why some people develop an aortic aneurysm while others dont. We'll go over some of the most common reasons for this, from pregnancy to eating a large, The glycemic index (GI) is a value used to measure how much a specific food increases your blood sugar levels. The likelihood increases by up to 4% every 10 years of life. 1995;59:1204-1209. The mortality benefit means lives saved both literally as well, The risks of undergoing major surgery areevealing themselves in the form aortic aneurysms. Conrad MF, Ergul EA, Patel VI, et al. You have more than one aneurysm along the length of the aorta. Learn how we can help 4.6k views Answered >2 years ago Thank A 50-year-old female asked: Usually, surgical repair is necessary once an aneurysm reaches 5 centimeters (cm) in diameter. National Heart, Lung and Blood Institute. Risk related to the burst or rupture of small aneurysms i.e. Try our Symptom Checker Got any other symptoms? It seems very different in the USA. Patients with endoleaks that sealed and low flow There have been device-specific trials and registries that demonstrated the perioperative safety of this procedure, with 30-day mortality rates of 2.1% in the phase 2 multicenter trial of the TAG thoracic endoprosthesis (Gore & Associates) and 2% in the VALOR trial of the Talent thoracic stent graft system (Medtronic).9,10 Despite the protection that TEVAR confers against aortic rupture, patients treated with TEVAR appear to be at high risk of premature death from all causes (malignancy, cardiovascular, or other nonaortic-related causes) compared with age- and sex-matched populations of nonthoracic aneurysm patients.11. 1. Treatment options An aneurysm that is less than 5 cm may be monitored without surgery.. 2018 Jan;67(1):2-77.e2. Editors choicemanagement of descending thoracic aorta diseases. Statins are medications that can help lower your LDL cholesterol. The Heart Hospital, London, a branch of University College Hospital, is known to be one of the best in Europe. The aorta is the body's largest blood vessel. Abdominal Aortic Aneurysm takes place whenever walls of main blood vessel in humans responsible for carrying the blood away from their heart i.e. National trends and regional variation of open and endovascular repair of thoracic and thoracoabdominal aneurysms in contemporary practice. I did go to the bother of trawling through old medical records and I found an echo which had been done when I was 31 that showed widening of 3.2 cms. Privacy Policy|Advertising Policy|Privacy Preferences Center|Do Not Sell My Personal Information. An abdominal aortic aneurysm is also called AAA or triple A. Ann Thorac Surg. Diameter of 8cm or higher than that have risk between 3 in total 10 and 5 in total 10. Ann Surg. 6. Novel measurement of relative aortic size predicts rupture of thoracic aortic aneurysms. Once stretched, it is hard to return to its original shape. The feedback link Was this Article Helpful on this page can be used to report content that is not accurate, up-to-date or questionable in any manner. If you have no symptoms and a. This process is called a dissection. Push, pull, bear down or lift anything heavier than 30 pounds (or 10 pounds for patients recovering from surgery). Open surgery for thoracic aneurysmal disease is a complex procedure with a high perioperative risk. This helps with managing other health conditions, such as high blood pressure, high blood cholesterol, and heart disease that can damage or weaken the walls of the aorta and increase the chance for rupture or dissection. Egton Medical Information Systems Limited. Weston Vascular Network Sinus of Valsalva aneurysm (SOVA) is an abnormal dilatation of the aortic root located between the aortic valve annulus and the sinotubular junction. In terms of restrictions on activity, we agree with the 2010 multidisciplinary guidelines for managing patients with thoracic aortic disease [Hiratzka et al. But sometimes people have no symptoms at all. More importantly, once it has widened, it will continue to do so. Just had a CT scan and showed I have a 4.4 CM aortic root. However, varying degrees of degeneration can be seen in patients without these disorders, occurring as an idiopathic variant in familial syndromes or as an acquired form. Hello Sonia, thank you so much for the information, I'll keep this in to my list. Next Article By Robert J. Hinchliffe, MD, FRCS, and Paul Hollering, Thoracic aortic aneurysm (TAA) is a potentially life-threatening disorder that without intervention carries a poor prognosis. I was diagnosed with the same condition four years ago when I was 64. The surgeon said it was no big deal for a man my size get some exercise but keep your heart rate to 120bpm (hard to do) And follow up in a year with a Cat scan. I am in the US.. My surgery was in a veterans hospital. I am 50. The bulging aneurysm can put pressure on the nerves or brain tissue. Aortic aneurysms account for 40,000 deaths annually in the United States.12 Maximum aortic diameter is the key parameter used to predict rupture risk and is therefore central in directing clinicians whether to offer surveillance or surgical repair.13 However, despite the increase in patients undergoing operations, natural history data concerning the risk of aneurysm rupture and the evidence base for threshold diameters at which TAA repair becomes beneficial are limited. One hundred and ninety-two patients with an intact AAA of 5 cm or greater in diameter were seen in 9 years; 59 . The aneurysm is growing quickly, 0.5 cm or more over 6 to 12 months, regardless of its size. 2011;124:2661-2669. Diehm N, Dick F, Schaffner T, et al. Inflammatory type of aneurysm, inflammation and swelling of the aneurysm wall leading to severe abdominal pain. In some cases, they also replace the aortic valve with a synthetic valve. You have more than one aneurysm along the length of the aorta. Treatment. The shortfall in long-term survival of patients with repaired thoracic or abdominal aortic aneurysms: retrospective case-control analysis of hospital episode statistics. J Vasc Surg. Aneurysms expanding in a rapid way for instance of higher than 0.5cm for more than 6 months may involve relatively higher risk related to rupture. What is a dangerous size for an aortic aneurysm? 2005;365:2187-2192. An aneurysm occurs when an artery wall weakens, causing it to bulge or dilate abnormally. A thoracic aortic aneurysm refers to the part of the aorta that runs through the chest. 2013;23:568-581. It happens when the artery wall weakens. This aneurysm is considered large and therefore at high risk for rupture. Survival after open versus endovascular thoracic aortic aneurysm repair in an observational study of the Medicare population. Stanford Healthcare. Complications in frail and elderly patients can be the reason for loss of independence, and thus, quality of life should be an important consideration, especially in patients whose aneurysms were not symptomatic before surgery. In a recent study, Patterson et al aimed to determine the rate of TAA expansion.18 After analyzing CT scans from nearly 1,000 TAA patients, an aortic expansion rate of 2.76 mm per year was reported for all patients. Some ascending aortic aneurysms never rupture or cause any noticeable symptoms. Ascending aortic aneurysms are the second most. The part of the aorta in the chest is called the thoracic aorta. Professor of Vascular Surgery Aortic Aneurysm. Svensson LG, Crawford ES, Hess KR, et al. An aortic aneurysm is a balloon-like bulge in the aorta, the large artery that carries blood from the heart through the chest and torso. And if surgical repair is advised, dont put it off. Well done! I had an echo and maintain yearly and a CT scan every 6mos. Aortic organ disease epidemic, and why do balloons pop? Thirty-five percent (39/110) of family members had BAV/AAT or . 9. Thoracic endovascular Aortic Repair (TEVAR) has become one of those procedures doctors rely on when treating patients suffering from descending aneurysms where they discover late stage cancers early thanks again TAVR They become more common with every decade of age. Disclosures: None. I had surgery 5/20/16 for a TAA repair. I felt fine before the surgery but my energy level is down, I get tired rather quickly. A long section of the aorta is involved. Only 5.3% of those with a diameter of 40 to 44 mm achieved the theoretical threshold size (55 mm) within 2 years. Other TAAs are those that result from aortic dissection or acute aortic syndrome or are associated with anatomic variants such as an aberrant left subclavian artery (Kommerell diverticulum). Posted You may even observe a huge variability in the expansion rate among different patients and for a specific patient in different years. It is not a substitute for professional medical advice, diagnosis or treatment. upmc.com/services/heart-vascular/conditions-treatments/pages/ascending-aortic-arch-aneurysm.aspx, vascular.org/patient-resources/vascular-conditions/thoracic-aortic-aneurysm, mayoclinic.org/diseases-conditions/thoracic-aortic-aneurysm/diagnosis-treatment/treatment/txc-20122075, escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-10/Ascending-aortic-aneurysms-pathophysiology-and-indications-for-surgery, my.clevelandclinic.org/health/articles/thoracic-aortic-aneurysm/symptoms-diagnosis, Debra Sullivan, Ph.D., MSN, R.N., CNE, COI. The archs downward portion, called the descending aorta, is connected to a network of arteries that supplies most of the body with oxygen-rich blood. First question is: is there any possibility that it will never grow? Aortic Aneurysms: The Most Dangerous Type. 2002;74:S1877-S1880. Considering the available trials and registries that have demonstrated the high all-cause mortality in TAA patients, it would appear justified to increase the threshold in high-risk (complex comorbidities) patients or where the procedure is predicted to be technically difficult (ie, off label or outside the instructions for use).
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