scholarly journals Hemodynamic response to positive end-expiratory pressure following right atrium-pulmonary artery bypass (Fontan procedure)

1984 ◽  
Vol 87 (6) ◽  
pp. 856-861 ◽  
Author(s):  
Donald B. Williams ◽  
Paul D. Kiernan ◽  
Michael P. Metke ◽  
H. Michael Marsh ◽  
Gordon K. Danielson
Keyword(s):  
Pulmonary Artery ◽  
Right Atrium ◽  
Artery Bypass ◽  
Fontan Procedure ◽  
Hemodynamic Response ◽  
Positive End Expiratory Pressure

The Hemodynamic Response to Dopamine and Nitroprusside Following Right Atrium–Pulmonary Artery Bypass (Fontan Procedure)

1982 ◽  
Vol 34 (1) ◽  
pp. 51-57 ◽  
Author(s):  
Donald B. Williams ◽  
Paul D. Kiernan ◽  
Hartzeil V. Schaff ◽  
H. Michael Marsh ◽  
Gordon K. Danielson
Keyword(s):  
Pulmonary Artery ◽  
Right Atrium ◽  
Artery Bypass ◽  
Fontan Procedure ◽  
Hemodynamic Response

Hemodynamics Characteristics of a Four-Way Right-Atrium Bypass Connector With an Optimized Central Diverter

2018 ◽  
Author(s):  
Elizabeth Mack ◽  
Jakin Jagani ◽  
Alexandrina Untaroiu
Keyword(s):  
Pulmonary Artery ◽  
Inferior Vena Cava ◽  
Stagnation Point ◽  
Superior Vena Cava ◽  
Right Atrium ◽  
Power Loss ◽  
Inferior Vena ◽  
Superior Vena ◽  
Fontan Procedure ◽  
Vena Cava

The most common surgical procedure used to treat right ventricular heart failure is the Fontan procedure, which connects the superior vena cava and the inferior vena cava directly to the left and right pulmonary arteries bypassing the right atrium. Many studies have been performed to improve the Fontan procedure. Research has been done on a four-way connector that can both passively and actively improve flow characteristics of the junction between the Superior Vena Cava (SVC), Inferior Vena Cava (IVC), Left Pulmonary Artery (LPA) and Right Pulmonary Artery (RPA), using an optimized connector and dual propeller system. However, the configuration of these devices do not specify propeller motor placement and has a stagnation point in the center of the connector. This study focuses on creating a housing for the motor in the center of the connector to reduce the stagnation area and further stabilize the propellers. To do this, we created a program in ANSYS that utilizes the design-of-experiment (DOE) function to minimize power-loss and stagnation points in the connector for a given geometry. First, a CFD model is created to simulate the blood flow inside the connector with different housing geometries. The shape and size of the housing are used as parameters for the DOE process. In this study, an enhanced central composite design technique is used to discretize the design space. The objective functions in the DOE are red blood cell residence time and power loss. It was confirmed that the addition of the housing did decrease the size of the stagnation point. In fact, the housing added in stabilizing the flow through the connector by creating a more defined flow path. Because the flowrates from the IVC and SVC are not the same, the best configuration for the housing was found to be asymmetric along the axis of the pulmonary artery. While this is a continuation of previous studies, the creation of an optimized housing for the motors for the propellers makes implementation of the propeller idea more viable in a real life situation. The added stability of the propellers provided by the housing can also decrease the risk of propeller failure due to rotordynamic instability.

The Technique of the Fontan Procedure with Posterior Right Atrium—Pulmonary Artery Connection

1985 ◽  
Vol 39 (4) ◽  
pp. 371-375 ◽  
Author(s):  
J. Ernesto Molina ◽  
Yang Wang ◽  
Russell Lucas ◽  
James Moller
Keyword(s):  
Pulmonary Artery ◽  
Right Atrium ◽  
Fontan Procedure

scholarly journals Anomalous Origin of the Left Anterior Descending Coronary Artery in an Adult

2021 ◽  
Vol 10 (01) ◽  
pp. e9-e10
Author(s):  
Keisuke Shibagaki ◽  
Chikara Shiiku ◽  
Hiroyuki Kamiya ◽  
Yoichi Kikuchi
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Coronary Artery ◽  
Pulmonary Artery ◽  
Congenital Heart ◽  
Left Coronary Artery ◽  
Internal Thoracic Artery ◽  
Artery Bypass ◽  
Anomalous Origin ◽  
Bypass Grafting

AbstractAn anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital heart disease. Among the variants, an anomalous origin of the left anterior descending coronary artery from the pulmonary artery (ALADPA) is extremely rare. Here, we report a case of ALADPA in an adult that was treated with coronary artery bypass grafting using the left internal thoracic artery.

scholarly journals P686 Right atrial, right ventricular and pulmonary cement embolism: a rare complication of percutaneous vertebroplasty

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
S Akhunova ◽  
R Khayrullin ◽  
N Stekolshchikova ◽  
M Samigullin ◽  
V Padiryakov
Keyword(s):  
Pulmonary Artery ◽  
Right Ventricle ◽  
Right Atrium ◽  
Percutaneous Vertebroplasty ◽  
Rare Complication ◽  
Clinical Manifestations ◽  
Stable Condition ◽  
Right Atrial ◽  
Cement Embolism ◽  
The Right

Abstract A 68-year-old man was admitted to the hospital with complaints of pain in the lumbar spine. He had L5 disc herniation, Spinal stenosis of the L5 root canal - S1 on the right in the past medical history. Percutaneous vertebroplasty at the level of L3 and Th8 vertebral bodies was performed six months ago due to painful vertebral hemangioma. The man is suffering from arterial hypertension, receives antihypertensive therapy. During routine transthoracic echocardiography, a hyperechoic structure with a size of 9.5 x 0.9 cm was found in the right atrium and right ventricle. Chest computed tomography with contrast enhancement revealed signs of bone cement in the right atrium and right ventricle, in the right upper lobe artery, in the branches of the upper lobe artery, in the paravertebral venous plexuses. Considering the duration of the disease, the stable condition, the absence of clinical manifestations and disorders of intracardiac hemodynamics, it was decided to refrain from surgical treatment. Antiplatelet therapy and dynamic observation were recommended. Conclusion Percutaneous vertebroplasty is a modern minimally invasive surgical procedure for the treatment of degenerative-dystrophic diseases of the spine. However, the cement can penetrate into the paravertebral veins and migrate to the right chambers of the heart and the pulmonary artery. This clinical case demonstrates asymptomatic cement embolism of the right chambers of the heart and pulmonary artery after percutaneous vertebroplasty, detected incidentally during routine echocardiography. Abstract P686 Figure.

Abstract 14268: Responses to Exercise During Right Heart Catheterisation in Pulmonary Hypertension

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Stephanie Wiltshire ◽  
Katherine Kearney ◽  
Karen Brown ◽  
Carolyn Corrigan ◽  
Annette Pidoux ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Statistical Significance ◽  
Peripheral Resistance ◽  
Hemodynamic Response ◽  
Stroke Work ◽  
Hemodynamic Changes ◽  
Right Heart ◽  
Heart Catheterisation ◽  
Right Heart Catheterisation ◽  
Response To Exercise

Background: Hemodynamic changes during exercise at right heart catheterisation (RHC) may be a diagnostic and prognostic tool in pulmonary arterial hypertension (PAH). Method and Results: We retrospectively assessed the hemodynamic response to exercise during RHC of 138 patients with PAH secondary to idiopathic PAH (IPAH), connective tissue disease (CTD) or congenital heart disease (CHD). RHCs were performed at a single centre between 2007 and 2018. A submaximal comfort-based protocol on a reclined bicycle or straight leg raise test (SLRT) was employed. IPAH demonstrated the highest mean pulmonary artery pressure (mPAP) at rest, rising 47% with exercise, but a 66% rise in CO allowed pulmonary vascular resistance (PVR) to fall. Those with CTD demonstrated a 56% rise in mPAP, 70% rise in CO and PVR remained unchanged. In CHD, there was a 46% rise in mPAP, 49% rise in CO and a rise in PVR. Notably, there was a rise in pulmonary artery wedge pressure (PAWP) in all groups, most marked in those with IPAH. Total peripheral resistance (TPR), pulmonary artery compliance (PAC) and pulmonary artery elastance (Ea) changes were variable. TPR marginally decreased in IPAH patients, remained unchanged in those with CTD and increased in CHD. PAC decreased in all groups, with the lowest values observed in those with IPAH. Ea increased in all groups but was most notably higher in those with IPAH. Right ventricular stroke work index (RVSWI) increased in all patients, the lowest values before and after exercise were observed in the CTD cohort. Mean pulmonary artery pulsatility index (PaPi) increased in all groups, although was subtle and didn’t meet statistical significance for those with CTD and CHD. Conclusions: The hemodynamic response to exercise in patients with PAH differs between aetiologies. A rise in PAWP occurred in all groups, with ventricular interdependence a possible explanation. Whether there is a relationship between exercise hemodynamic changes and prognosis remains undetermined.

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