The Supra-aortic Area

1988 ◽  
pp. 117-150 ◽  
Author(s):  
E. Robert Heitzman
Keyword(s):  
2015 ◽  
Vol 66 (3) ◽  
pp. 231-237 ◽  
Author(s):  
Kate Hanneman ◽  
Paaladinesh Thavendiranathan ◽  
Elsie T. Nguyen ◽  
Hadas Moshonov ◽  
Rachel Wald ◽  
...  

Purpose To evaluate the value of cardiac magnetic resonance imaging (MRI)–based measurements of inferior vena cava (IVC) cross-sectional area in the diagnosis of pericardial constriction. Methods Patients who had undergone cardiac MRI for evaluation of clinically suspected pericardial constriction were identified retrospectively. The diagnosis of pericardial constriction was established by clinical history, echocardiography, cardiac catheterization, intraoperative findings, and/or histopathology. Cross-sectional areas of the suprahepatic IVC and descending aorta were measured on a single axial steady-state free-precession (SSFP) image at the level of the esophageal hiatus in end-systole. Logistic regression and receiver-operating curve (ROC) analyses were performed. Results Thirty-six patients were included; 50% (n = 18) had pericardial constriction. Mean age was 53.9 ± 15.3 years, and 72% (n = 26) were male. IVC area, ratio of IVC to aortic area, pericardial thickness, and presence of respirophasic septal shift were all significantly different between patients with constriction and those without ( P < .001 for all). IVC to aortic area ratio had the highest odds ratio for the prediction of constriction (1070, 95% confidence interval [8.0-143051], P = .005). ROC analysis illustrated that IVC to aortic area ratio discriminated between those with and without constriction with an area under the curve of 0.96 (95% confidence interval [0.91-1.00]). Conclusions In patients referred for cardiac MRI assessment of suspected pericardial constriction, measurement of suprahepatic IVC cross-sectional area may be useful in confirming the diagnosis of constriction when used in combination with other imaging findings, including pericardial thickness and respirophasic septal shift.


Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
David E Timaran ◽  
Eric B Rosero ◽  
Adriana J Higuera ◽  
Ron Peshock ◽  
R James Valentine ◽  
...  

Objective: Abdominal aortic aneurysms are defined as a 50% or greater increase in infrarenal aortic diameter (IAD). However, normal IAD has not been defined for all ethnic groups as minorities have been underrepresented in most studies. The aim of the study was to assess ethnic differences in IAD and infrarenal aortic area (AoA) adjusting for the effects of age, gender and body size in the general population. Methods: Participants (2,515) in a population based study underwent high-resolution magnetic resonance imaging (MRI) of the abdominal aorta. Analyses of variance and multiple regression analyses were used to assess the relationship between race/ethnicity, age, gender and body size and IAD and aortic area. Subjects with AAA detected by MRI (defined as IAD ≥ 3.0 cm) were excluded from the analysis. Results: Decreasing age, female sex, Hispanic ethnicity, and lower height were independent predictors of reduced IAD by multivariate linear regression (all P < 0.001). Of these, female sex and Hispanic ethnicity were the factors more strongly associated with aortic size. Female sex was associated with 0.27 cm reduction in IAD and Hispanic ethnicity with 0.39 cm reduction in IAD. Similarly, decreasing age, female sex, Hispanic ethnicity, and lower height were independent predictors of reduced AoA. Female sex was associated with a 51 cm 2 reduction in AoA and Hispanic ethnicity with 11.1 cm 2 reduction in AoA. Although Hispanics had higher BMI than blacks and whites ( P =.01), and lower height values than blacks and whites (P<.0001), IADs and AoAs were consistently lower among Hispanics. Conclusions: Ethnic differences exist in infrarenal aortic diameter. Despite larger body size, Hispanics have significantly lower IAD than blacks and whites in the general population. The reduced aortic size in Hispanics suggests that the thresholds for abdominal aortic aneurysm diagnosis, rupture and repair may be lower and need to be established.


2018 ◽  
Vol 54 (4) ◽  
pp. 696-701 ◽  
Author(s):  
Metesh Nalin Acharya ◽  
Pouya Youssefi ◽  
Gopal Soppa ◽  
Oswaldo Valencia ◽  
Justin Nowell ◽  
...  

2013 ◽  
Vol 20 (1) ◽  
pp. 16-24 ◽  
Author(s):  
Li-An Wu ◽  
Chung-I. Chang ◽  
Jou-Kou Wang ◽  
Tiffany Ting-Fang Shih ◽  
Mei-Hwan Wu ◽  
...  
Keyword(s):  

2017 ◽  
Vol 79 (7) ◽  
Author(s):  
I. Nur Fariza ◽  
Sh-Hussain Salleh ◽  
Fuad Noman ◽  
Hadri Hussain

The application of human identification and verification has widely been used for over the past few decades.  Drawbacks of such system however, are inevitable as forgery sophisticatedly developed alongside the technology advancement.  Thus, this study proposed a research on the possibility of using heart sound as biometric. The main aim is to find an optimal auscultation point of heart sounds from either aortic, pulmonic, tricuspid or mitral that will most suitable to be used as the sound pattern for personal identification.  In this study, the heart sound was recorded from 92 participants using a Welch Allyn Meditron electronic stethoscope whereas Meditron Analyzer software was used to capture the signal of heart sounds and ECG simultaneously for duration of 1 minute.  The system is developed by a combination Mel Frequency Cepstrum Coefficients (MFCC) and Hidden Markov Model (HMM).  The highest recognition rate is obtained at aortic area with 98.7% when HMM has 1 state and 32 mixtures, the lowest Equal Error Rate (EER) achieved was 0.9% which is also at aortic area.  In contrast, the best average performance of HMM for every location is obtained at mitral area with 99.1% accuracy and 17.7% accuracy of EER at tricuspid area.


2020 ◽  
Vol 27 (5) ◽  
pp. 785-791
Author(s):  
Lucien Chassin-Trubert ◽  
Thomas Gandet ◽  
Baris Ata Ozdemir ◽  
Youcef Lounes ◽  
Pierre Alric ◽  
...  

Purpose: To analyze the structural variation of the aortic arch and the supra-aortic arteries and establish an average spatial configuration that would be a pattern for a “universal double fenestration” design for physician-modified endovascular grafts (PMEGs) used in total thoracic endovascular aortic repair (TEVAR). Materials and Methods: Aortic arch morphology was retrospectively analyzed by reviewing the preoperative thoracic computed tomography angiography scans in 33 consecutive patients (mean age 68 years; 27 men) treated between January 2017 and March 2019 using double-fenestrated PMEGs for zone 0 TEVAR. Image analysis was completed according to a standardized technique on a vascular workstation with center lumen line reconstruction for all measurements. Variations in branching pattern of the aortic arch were classified into 8 types. Results: The arch trunk configuration was type I in 26 patients (79%), type II in 5 (15%), type III in 1, and type IV in 1. Mean aortic diameters at the level of mid ascending aorta, innominate artery (IA), left common carotid artery (LCCA), and left subclavian artery (LSA) were 35.7±3.7, 34.2±4.5, 33.3±6.7, and 33.7±4.7 mm, respectively. Mean diameters of the trunk were 12.2±1.7, 7.5±1.4, and 8.0±0.8 mm, respectively. Mean longitudinal center to center lengths were 15.9±2.5 mm between the LSA and LCCA and 12.1±3.0 mm between the LCCA and IA. Mean clock positions using the LSA as reference were 12:50 for the IA and 12:05 for the LCCA. In 32 patients (97%) all the supra-aortic branch vessels fit perfectly inside two delimited areas defined by a proximal common square area of 30×30 mm for the IA and LCCA and a second distal 8-mm-diameter circle for the LSA. Conclusion: Variations of the aortic arch anatomy are numerous and common. A general morphological pattern is described that delimits the aortic area where these variations occur. This information can be utilized for the design of an off-the-shelf double-fenestrated stent-graft for zone 0 TEVAR.


Blood ◽  
1999 ◽  
Vol 93 (9) ◽  
pp. 2898-2906 ◽  
Author(s):  
Christiane Ody ◽  
Pierre Vaigot ◽  
Pascale Quéré ◽  
Beat A. Imhof ◽  
Catherine Corbel

The fibrinogen receptor GPIIb-IIIa integrin is known to be expressed on cells of the megakaryocytic lineage, but its presence on hematopoietic progenitors has been a controversial issue. To resolve this ambiguity unequivocally, we performed clonogenic assays and intrathymic cell-transfer experiments in congenic animals. As the ontogeny of the avian hematopoietic system is well documented, we used this experimental model to trace GPIIb-IIIa expression during embryogenesis. Consequently, we now report that the GPIIb-IIIa integrin is expressed as early as embryonic day 3.5 (E3.5) to 4 in intraaortic hematopoietic clusters, the first site of intraembryonic hematopoietic progenitor emergence, and later in E6 paraaortic foci. Myeloid and erythroid progenitors were also detected within the GPIIb-IIIa+ CD45+ population isolated from the E3.5 to 4 aortic area, while in embryonic and adult bone marrow, myeloid, erythroid, and T-cell progenitors were present in the GPIIb-IIIa+ c-kit+ population. Furthermore, we also provide the first evidence, that GPIIb-IIIa+ bone marrow cells can differentiate into T cells. Hence, GPIIb-IIIa can be used as a marker for multilineage hematopoietic progenitors, permitting identification of early intraembryonic sites of hematopoiesis, as well as the isolation of embryonic and adult hematopoietic progenitors.


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