scholarly journals Advanced multimodality imaging of an anomalous vessel between the ascending aorta and main pulmonary artery in a dog

2014 ◽  
Vol 16 (1) ◽  
pp. 59-65 ◽  
Author(s):  
Lauren E. Markovic ◽  
Heidi B. Kellihan ◽  
Alejandro Roldán-Alzate ◽  
Randi Drees ◽  
Dale E. Bjorling ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Multimodality Imaging ◽  
Main Pulmonary Artery ◽  
Ascending Aorta

scholarly journals Acquired aortopulmonary fistula: a case report

2020 ◽  
Vol 4 (4) ◽  
pp. 1-5
Author(s):  
Osama Mahmoud ◽  
Hadi Elias ◽  
Arsalan Rafiq ◽  
Amro Alsaid
Keyword(s):  
Heart Failure ◽  
Cardiac Imaging ◽  
Multimodality Imaging ◽  
Main Pulmonary Artery ◽  
Bypass Graft ◽  
Stable Condition ◽  
Transoesophageal Echocardiography ◽  
Ascending Aorta ◽  
Aortic Pseudoaneurysm ◽  
Aortopulmonary Fistula

Abstract Background Aortopulmonary fistula is a rare complication of ascending aorta pathology. Presentation is most commonly dramatic with acute onset chest pain or heart failure secondary to left to right shunting. We describe a patient with acquired aortopulmonary fistula who had an insidious onset of heart failure as his presenting complaint. We also highlight the utility of multimodality cardiac imaging in establishing the diagnosis. Case summary A 79-year-old male patient with a history of coronary artery bypass graft surgery and mechanical aortic valve replacement, 23 years prior, presented with exertional dyspnoea of 7 months duration. An initial workup that included transthoracic and transoesophageal echocardiography as well as coronary and bypass graft angiography failed to diagnose an acquired aortopulmonary fistula complicating an ascending aortic pseudoaneurysm. Upon referral to our institution, the correct diagnosis was suspected on off-axis transthoracic echocardiography. The fistula was subsequently confirmed, and the extent of ascending aorta pathology defined via a multimodality imaging approach that consisted of transoesophageal echocardiography and cardiac computed tomography. The patient underwent successful surgical repair and was discharged in a stable condition. Discussion Acquired aortopulmonary fistula is a rare clinical entity. We describe a patient who had an insidious presentation of heart failure and found to have a large ascending aortic aneurysm that eroded into the main pulmonary artery creating a fistulous communication. The diagnosis was delayed and required a high index of suspicion and multimodality cardiac imaging.

A Comparative Study of the Main Pulmonary Artery and Ascending Aorta Biomechanical Behavior

2011 ◽  
Author(s):  
Bahar Fata ◽  
Elena Galdi ◽  
Michael S. Sacks
Keyword(s):  
Pulmonary Artery ◽  
Mechanical Behavior ◽  
Ductus Arteriosus ◽  
Main Pulmonary Artery ◽  
Blood Flow Rate ◽  
Biomechanical Properties ◽  
Ascending Aorta ◽  
External Diameter ◽  
Blood Flows ◽  
Biomechanical Behavior

During the prenatal period a state of physiologic pulmonary hypertension exists due to the equalization of pressures by the patent ductus arteriosus, resulting in similar wall thickness of the ascending aorta (AA) and main pulmonary artery (MPA). After birth, as the ductus arteriosus closes and pulmonary arterial pressure decreases, attenuation of medial smooth muscle occurs such that the ratio of medial thickness to external diameter decreases from about 25% in fetuses to less than 10% in infants 3 to 6 months of age. After the first year of life, thickness of the MPA is normally less than half that of the adjacent ascending aorta, although the diameters of the two great arteries remain the same relative to one another [1]. During homeostatic conditions, the total pulmonary and systemic blood flows are essentially identical. In spite of their comparable blood flow rate and common embryologic origin, the anatomic characteristics of these two segments of the cardiovascular system differ substantially [2]. Futhremore, both these arteries are affected by many congenital abnormalities and also are subject to hypertension. Knowledge of the normal biomechanical properties of these great arteries is important for surgical treamtment, angioplasty, and tissue engineering. It can also provide insight into the disease processes and is a prerequisite to the study of mechanical behavior during disease conditions. In this study we characterized the biaxial mechanical behavior of both arteries as a function of location, which has not been previously performed in the pulmonary trunk.

scholarly journals Image quality and attenuation values of multidetector CT coronary angiography using high iodine-concentration contrast material: A comparison of the use of iopromide 300 and iopromide 370

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A K M Darwish ◽  
M M Farouk ◽  
H Hafez ◽  
A Adel
Keyword(s):  
Image Quality ◽  
Pulmonary Artery ◽  
Coronary Arteries ◽  
Main Pulmonary Artery ◽  
Iodine Concentration ◽  
Ascending Aorta ◽  
P Value ◽  
Group A ◽  
The Mean ◽  
Attenuation Values

Abstract Background Iodine concentration is one of the main determinants of arterial enhancement in CTA, and current low-osmolar and iso-osmolar nonionic CM for intravascular administration still come in a handful of molecules, but a relatively wide range of different iodine concentrations. This gives the opportunity to optimize CTA protocols as a function of several factors such as patient characteristics, CT technology, and CM features in an attempt to maximize the diagnostic yield of CTA examinations while considering patient safety and avoiding unnecessary extra costs. Objective To compare image quality and attenuation values of multidetector CT coronary angiography (MDCT) between iopromide 300 and iopromide 370 and to evaluate whether the higher iodine contrast material has better image quality or not. Material and Methods Patients were prospectively enrolled and were randomized into two groups (group A, 30 patients received iopromide 300, iodine flux 1.2g I/s; group B, 30 patients received iomeprol 370, iodine flux 1.48g I/s). CT attenuation values were measured in the proximal end coronary arteries,ascending aorta and main pulmonary artery. The image quality of 15 coronary artery segments was graded by cardiologist in consensus with the use of a four-point scale (1 excellent enhancement to 4 poor enhancement). Non-parametric statistical approaches were used to compare the two groups. Results No statistically significant differences were found between the mean attenuation values (302 HU for iopromide 300 and 326 HU for iopromide 370, P = 0.175) in the coronary arteries in the two groups. The mean attenuation value of the proximal ascending aorta (AA)and main pulmonary artery (MPA) was found to be 345+/-63 HU and 241+/- 89 in group A respectively, whereas the mean attenuation value in proximal ascending aorta and main pulmonary artery in group B was found to be 348+/-74 and 238+/- 50 respectively. No significant difference was found between iopromide 300 and iopromide 370 in terms of contrast enhancement at the level of great arteries, P value AA = 0.826 and P value for MPA = 0.884. 92.9% of coronary arterial segments got score (range 1–2) in group A whereas 93.6 of coronary arterial segments got score (range 1-2) in group with no statistically significant difference P value = 0.755. Conclusion With the current CT technology iopromide 300 is not inferior to iopromide 370 in terms of coronary artery attenuation values and image quality. Iopromide 300 provides similar enhancement of coronary arteries and excellent image quality as compared with iopromide 370 using identical amount of total iodine with fewer cost and less estimated adverse effects owing to low iodine concentration of iopromide 300.

scholarly journals Successful sparing approach between the ascending aorta and the main pulmonary artery to the giant coronary aneurysm of the left main coronary artery

2020 ◽  
Vol 13 (4) ◽  
pp. e234203
Author(s):  
Ken Nakamura ◽  
Kouan Orii ◽  
Takayuki Abe ◽  
Hirofumi Haida
Keyword(s):  
Coronary Artery ◽  
Pulmonary Artery ◽  
Left Main Coronary Artery ◽  
Main Pulmonary Artery ◽  
Coronary Aneurysm ◽  
Ascending Aorta ◽  
Left Main ◽  
Giant Coronary Aneurysm

Coronary aneurysm located just above the left main coronary artery (LMT) is rare and difficult to treat. How the aneurysm is accessed is very important as it determines the result of the surgery. A 70-year-old man with a large coronary aneurysm (40 mm in diameter) in the LMT underwent surgery to prevent its rupture; however, there was severe adhesion. Initially, dissection of the ascending aorta or the pulmonary artery seemed necessary to access the aneurysm; however, the process was possible with limited dissection between the ascending aorta and the pulmonary artery, and we succeeded in firmly closing the LMT site of entry.

Anomalous origin of the left main pulmonary artery from the ascending aorta associated with Digeorge syndrome

1995 ◽  
Vol 75 (17) ◽  
pp. 1294-1295 ◽  
Author(s):  
Hidemi Dodo ◽  
Juan C. Alejos ◽  
Joseph K. Perloff ◽  
Hillel Laks ◽  
Davis C. Drinkwater ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Digeorge Syndrome ◽  
Main Pulmonary Artery ◽  
Ascending Aorta ◽  
Anomalous Origin ◽  
Left Main

scholarly journals Estimated in Vivo Postnatal Surface Growth Patterns of the Ovine Main Pulmonary Artery and Ascending Aorta

2013 ◽  
Vol 135 (7) ◽  
Author(s):  
Bahar Fata ◽  
Danielle Gottlieb ◽  
John E. Mayer ◽  
Michael S. Sacks
Keyword(s):  
Pulmonary Artery ◽  
Adult Stage ◽  
Main Pulmonary Artery ◽  
Postnatal Growth ◽  
Ascending Aorta ◽  
Growth Patterns ◽  
Surface Growth ◽  
Effective Surface ◽  
Cross Sectional ◽  
Postnatal Maturation

Delineating the normal postnatal development of the pulmonary artery (PA) and ascending aorta (AA) can inform our understanding of congenital abnormalities, as well as pulmonary and systolic hypertension. We thus conducted the following study to delineate the PA and AA postnatal growth deformation characteristics in an ovine model. MR images were obtained from endoluminal surfaces of 11 animals whose ages ranged from 1.5 months/15.3 kg mass (very young) to 12 months/56.6 kg mass (adult). A bicubic Hermite finite element surface representation was developed for the each artery from each animal. Under the assumption that the relative locations of surface points were retained during growth, the individual animal surface fits were subsequently used to develop a method to estimate the time-evolving local effective surface growth (relative to the youngest measured animal) in the end-diastolic state. Results indicated that the spatial and temporal surface growth deformation patterns of both arteries, especially in the circumferential direction, were heterogeneous, leading to an increase in taper and increase in cross-sectional ellipticity of the PA. The longitudinal PA growth stretch of a large segment on the posterior wall reached 2.57 ± 0.078 (mean ± SD) at the adult stage. In contrast, the longitudinal growth of the AA was smaller and more uniform (1.80 ± 0.047). Interestingly, a region of the medial wall of both arteries where both arteries are in contact showed smaller circumferential growth stretches—specifically 1.12 ± 0.012 in the PA and 1.43 ± 0.071 in the AA at the adult stage. Overall, our results indicated that contact between the PA and AA resulted in increasing spatial heterogeneity in postnatal growth, with the PA demonstrating the greatest changes. Parametric studies using simplified geometric models of curved arteries during growth suggest that heterogeneous effective surface growth deformations must occur to account for the changes in measured arterial shapes during the postnatal growth period. This result suggests that these first results are a reasonable first-approximation to the actual effective growth patterns. Moreover, this study clearly underscores how functional growth of the PA and AA during postnatal maturation involves complex, local adaptations in tissue formation. Moreover, the present results will help to lay the basis for functional replacement by defining critical geometric metrics.

Effect of In Vivo Physical Interaction of the Ascending Aorta and Main Pulmonary Artery on Postnatal Surface Growth Patterns in Ovine

2011 ◽  
Author(s):  
Bahar Fata ◽  
Danielle Gottlieb ◽  
John E. Mayer ◽  
Michael S. Sacks
Keyword(s):  
Pulmonary Artery ◽  
Main Pulmonary Artery ◽  
Postnatal Growth ◽  
Ascending Aorta ◽  
Growth Patterns ◽  
Physical Interaction ◽  
Dimensional Changes ◽  
Cardiovascular Defects ◽  
Valved Conduit

Congenital abnormalities of the main pulmonary artery (MPA) and ascending aorta (AA) often necessitate surgical repair or the use of a valved conduit replacement, requiring multiple re-interventions due to regurgitation or failure of the prosthetic conduit. In recent years there has been a growing interest in the development of a living autologous tissue graft that could address the critical need for growing substitutes in the repair of congenital cardiovascular defects [1]. Regardless of the particulars of the therapeutic approach, the detailed growth characteristics of the native artery is required to establish the baseline dimensional changes post-implantation. During normal embryogenesis the Truncus Arteriosus begins to split and form into the anterior pulmonary artery and the posterior aorta [2]. Due to their common embryologic origin from a single outflow tract, there are disease conditions that originate in one artery and eventually affect both arteries [3]. Therefore, the postnatal growth deformation of both the MPA and AA was computed to quantify the effects of the mechanical association of these two arteries.

The Value of Dual-Source CT in the Diagnosis of Anomalous Origin of Pulmonary Artery

2021 ◽  
Author(s):  
Yusen Feng ◽  
Pengcheng Ma ◽  
Lijuan Wang ◽  
Guifang Sun ◽  
Bin Liu ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Main Pulmonary Artery ◽  
Left Pulmonary Artery ◽  
Ascending Aorta ◽  
Left Main ◽  
Descending Aorta ◽  
Dual Source ◽  
Inner Diameter ◽  
The Right ◽  
Pulmonary Artery Diameter

Abstract Objective: This study is designed to explore the dual-source computed tomography (DSCT) imaging manifestations of the origin of three rare pulmonary artery abnormalities, and to improve the understanding and diagnosis of the disease.Methods: Collected 30 cases of patients diagnosed by DSCT with pulmonary artery abnormal origins, and retrospectively analyzed their imaging data and postoperative pathological data.Results: Among the 30 patients with abnormal pulmonary artery origin, 16 patients were with unilateral pulmonary artery absence (UAPA), 8 patients were with anomalous origin of unilateral pulmonary artery (AOPA), and 6 patients were left pulmonary artery suspension (LPAS). The diagnosis rate of DSCT is significantly higher than that of echocardiography. The results of DSCT imaging showed that the inner diameter of the ascending aorta, the aortic arch and the descending aorta of UAPA patients were significantly larger than those of LPAS patients (P<0.05). Compared with AOPA patients, the left pulmonary artery diameter, the ratio of the left main pulmonary artery diameter to the main pulmonary artery diameter, and ratio of the left main pulmonary artery diameter to the right main pulmonary artery diameter were significantly increased in UAPA patients (P<0.05). There was no significant difference in the ratio of the inner diameter of the ascending aorta to the descending aorta in patients with UAPA, AOPA and LPAS. Compared with UAPA patients, AOPA patients had no significant changes in the inner diameter of the main pulmonary artery, the inner diameter of the right main pulmonary artery, and the ratio of the inner diameter of the right main pulmonary artery to the main pulmonary artery.Conclusion: DSCT can be used to diagnose the origin of pulmonary artery abnormalities and distinguish its types.

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