scholarly journals Improved method for the catheterization of the right ventricle in a rat model of pulmonary artery hypertension

2020 ◽  
Vol 30 (4) ◽  
pp. 535-537
Author(s):  
Marcello Tontodonati ◽  
Debbie Ridley ◽  
René Remie ◽  
Peter Clements
Keyword(s):  
Right Ventricle ◽  
Jugular Vein ◽  
Disease Model ◽  
Pulmonary Artery Hypertension ◽  
Animal Disease ◽  
Improved Method ◽  
Novel Approach ◽  
Catheter Tip ◽  
The Right

Abstract Ventricle catheterization in the rat is widely practiced in cardiopulmonary research. The catheters deployed are either fluid filled or solid tip pressure or pressure–volume catheters. The access to the right ventricle is through the right jugular vein, most commonly without direct visualization such as fluoroscopy. Advancement of the catheter tip is aided by visualizing the pressure signals of the monitoring/recording systems used. This approach may present challenges due to various reasons, including the stiffness of new catheters, their dimensions or anatomical changes associated with the animal disease model. In this article, we present a novel approach, which has been optimized, successfully validated surgically and adopted in current projects. It has been shown to improve both the overall quality of the signals recorded and the time to access the right ventricle, thus reducing the overall time of surgery. The method presented in this article is safe, easy to reproduce and does not require additional skills compared to a more ‘standard’ approach.

scholarly journals Epigenetic Regulation of Pulmonary Arterial Hypertension-Induced Vascular and Right Ventricular Remodeling: New Opportunities?

2020 ◽  
Vol 21 (23) ◽  
pp. 8901
Author(s):  
Jordy M. M. Kocken ◽  
Paula A. da Costa Martins
Keyword(s):  
Pulmonary Artery ◽  
Right Ventricle ◽  
Ventricular Remodeling ◽  
Pulmonary Artery Hypertension ◽  
Pulmonary Arterial ◽  
And Migration ◽  
Ventricle Hypertrophy ◽  
The Right ◽  
Disease Exposure

Pulmonary artery hypertension (PAH) is a rare chronic disease with high impact on patients’ quality of life and currently no available cure. PAH is characterized by constant remodeling of the pulmonary artery by increased proliferation and migration of pulmonary arterial smooth muscle cells (PASMCs), fibroblasts (FBs) and endothelial cells (ECs). This remodeling eventually leads to increased pressure in the right ventricle (RV) and subsequent right ventricle hypertrophy (RVH) which, when left untreated, progresses into right ventricle failure (RVF). PAH can not only originate from heritable mutations, but also develop as a consequence of congenital heart disease, exposure to drugs or toxins, HIV, connective tissue disease or be idiopathic. While much attention was drawn into investigating and developing therapies related to the most well understood signaling pathways in PAH, in the last decade, a shift towards understanding the epigenetic mechanisms driving the disease occurred. In this review, we reflect on the different epigenetic regulatory factors that are associated with the pathology of RV remodeling, and on their relevance towards a better understanding of the disease and subsequently, the development of new and more efficient therapeutic strategies.

Scimittar Syndrome; Right time to operate? and mid-term results.

2021 ◽  
Author(s):  
Kenan Abdurrahman Kara ◽  
Ergi̇n Arslanoğlu ◽  
Fatih Tomrukçu ◽  
Abdullah Arif Yılmaz ◽  
Fatih Yiğit ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Pulmonary Arterial Pressure ◽  
Pulmonary Artery Hypertension ◽  
Scimitar Syndrome ◽  
Pulmonary Arterial ◽  
The Right ◽  
Vein Stenosis ◽  
Mid Term Results

Objectives: Scimitar syndrome is a combination of rare congenital cardiopulmonary anomalies that can occur in 3% to 6% of patients with a partial abnormal venous connection. The presence of accompanying cardiac anomalies in these patients and in cases such as severe hypoplasia of the right lung or accompanying pulmonary artery hypertension necessitate early surgery in early infancy. Patients and Methods: 9 patients with scimitar syndrome operated on in our pediatric cardiac surgery clinic from 2012 to 2020 were retrospectively examined in our study. The ages of the patients ranged from 1 to 47 years, with a mean of 18.11±14.44. 1 patient died and mortality was 11.11%. Of the patients, 4 were male (44.44%) and 5 were female (55.56%). Patients' pulmonary arterial pressure ranged from 0.15 to 94 mmHg, with a mean of 39.22 ±22.49. Results: Close to 25% scimitar vein stenosis or scimitar vein drainage occlusion has been reported in the postoperative period, mostly in the newborn group in the literature. 2 patients had non-critical stenosis during the 3rd year follow-up despite the absence of stenosis orocclusion during the first 2 years of follow-up of 9 patients we followed. Their surgical follow-up is still ongoing since they are asymptomatic. Conclusion: As a result, the course of the disease depends on the follow-up of the patient, the timing of the surgery, and the quality of the anastomosis. The follow-up and treatment of these patients will be more accurate in advanced centers experienced in scimitar surgery.

scholarly journals Repair of double-chambered right ventricle using right ventricular outflow chamber ventriculotomy via left intercostal thoracotomy under beating heart in two dogs

2014 ◽  
Vol 4 (1) ◽  
Author(s):  
Keiichi Sato ◽  
Isamu Kanemoto ◽  
Kippei Mihara ◽  
Koudai Kawase ◽  
Takuya Mori ◽  
...  
Keyword(s):  
Right Ventricle ◽  
Right Ventricular ◽  
Continuous Wave ◽  
Clinical Signs ◽  
Major Complication ◽  
Beating Heart ◽  
Moderate Hypothermia ◽  
Continuous Wave Doppler ◽  
Novel Approach ◽  
The Right

Double-chambered right ventricle was diagnosed in two dogs, one of them a pup and the other full grown. Both dogs underwent surgery using the novel approach of right ventricular outflow chamber ventriculotomy via left intercostal thoracotomy with moderate hypothermia and moderate pump flow cardiopulmonary bypass under beating heart. No major complication occurred during and after the operation. On continuous wave Doppler echocardiography, the pressure gradient across the stenosis in the right ventricle decreased from 130 mmHg pre-operatively to 40 mmHg post-operatively at 1 year 5 months in the adult dog, and from 209 mmHg pre-operatively to 47 mmHg post-operatively at 1 year in the pup. Both dogs are active without clinical signs.

Acute laryngeal paralysis induced by the migration of a totally implantable venous access device’s catheter tip

2004 ◽  
Vol 118 (3) ◽  
pp. 237-239 ◽  
Author(s):  
S. Hervé ◽  
C. Conessa ◽  
J. Desrame ◽  
O. Chollet ◽  
S. Talfer ◽  
...  
Keyword(s):  
Vessel Wall ◽  
Chemotherapeutic Agent ◽  
Jugular Vein ◽  
Venous Access ◽  
Nerve Paralysis ◽  
Laryngeal Paralysis ◽  
Catheter Tip ◽  
The Right ◽  
Venous Access Device ◽  
Carotid Space

The authors report a case of acute vagus nerve paralysis that appeared during a course of chemotherapy. The drugs had been administered through a totally implantable venous access device (TIVAD), whose catheter tip had migrated into the right internal jugular vein (IJV) and was surrounded by a complete venous thrombosis. The supposed aetiology of this paralysis was a leakage of the cytotoxic drug (5-fluorouracil) from the vessel wall into the surrounding carotid space, because of the stagnation of the chemotherapeutic agent above the thrombosis. Four months after cessation of chemotherapy, the laryngeal paralysis was still evident.

scholarly journals Feasibility of oxygen sensitive cardiac magnetic resonance of the right ventricle in pulmonary artery hypertension

2019 ◽  
Vol 9 (5) ◽  
pp. 502-512
Author(s):  
Karthigesh Sree Raman ◽  
Michael Stokes ◽  
Angela Walls ◽  
Rebecca Perry ◽  
Peter M. Steele ◽  
...  
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Pulmonary Artery ◽  
Right Ventricle ◽  
Pulmonary Artery Hypertension ◽  
Oxygen Sensitive ◽  
The Right

THE IMPACT OF IATROGENIC EMBOLISATION AND ENDOVASCULAR REMOVAL OF A FRACTURED CENTRAL VEIN CATHETER ON THE HEALTH RELATED QUALITY OF LIFE (HRQOL)

2019 ◽  
Vol 17 (1) ◽  
pp. 1-7
Author(s):  
Tomasz Muszyński ◽  
Karina Polak ◽  
Marek Tomala ◽  
Paweł Iwaszczuk ◽  
Tomasz Kwiatkowski ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Right Ventricle ◽  
Central Vein ◽  
Health Related Quality ◽  
Vein Catheter ◽  
Related Quality ◽  
Health Related ◽  
Central Vein Catheter ◽  
The Right

Iatrogenic embolisation of the right ventricle of the heart by a fragment of one of the most basic ICU devices, which has fractured and detached the central vein catheter, is rarely described in subject literature. Removing such an element from the heart is highly risky and requires the use of very modern techniques and equipment. The Atrieve Vascular Snare™ was employed in the described patient. Therefore, it is necessary to present this process and its effectiveness through an evaluation of the health related quality of life (HRQoL) associated with the perception of health status by those patients. This is a requirement in modern medicine. The main aim of this paper was to evaluate the HRQoL after this embolisation. A 67-year-old patient was referred to the Vascular Surgery Department with Endovascular Interventions Ward, John Paul II Hospital in Kraków, after the defragmenting of the central vein catheter and replacement to the right ventricle of the heart. An endovascular approach through the right common femoral vein (RCFV) under local anesthesia of the groin was chosen as the preferred method for removing the broken catheter fragment. The right ventricle of the heart was reached using a 18-30mm Atrieve Vascular Snare™. A structure consisting of three loops facilitated the quick grasp and removal of the catheter fragment at the first attempt through the RCFV. Despite the short time needed for the procedure, the patient experienced periprocedural ventricular fibrillation (VF) with the necessity of defibrillation. After one successful defibrillation attempt, sinus rhythm was restored. The post-operative course showed no complications whatsoever, and the patient was sent to the General Surgery Ward in order for a new Hickman catheter to be implemented and further parenteral nutrition treatment to be carried out. The endovascular technique with the use of Atrieve Vascular Snare™ is an effective method which was used in the case of our patient under local anesthesia. It provides for the fast, safe and convenient removal of a disrupted and dislocated catheter fragment. It allows one to improve the patient’s HRQoL not only in the short term, but also in the longitudinal (6 months after surgery) follow up.

scholarly journals Removal of Unusual Foreign Metal Object (Nail) from the Right Ventricle of Human Heart: A Case Report

2021 ◽  
Vol 24 (3) ◽  
pp. E560-E563
Author(s):  
Mingliang Zuo ◽  
Qiuyi Chen ◽  
Bo Xiang ◽  
Tao Yu ◽  
Lixue Yin
Keyword(s):  
Right Ventricle ◽  
Rare Case ◽  
Human Heart ◽  
Foreign Bodies ◽  
Jugular Vein ◽  
Comet Tail ◽  
Metal Object ◽  
Surgical Extraction ◽  
Life Threatening ◽  
The Right

Migration of foreign bodies (FB) with the blood flow to the heart is a rare, but very alarming condition as it may lead to life-threatening complications and death. Objects that are larger than 5 mm in diameter and/or irregular in shape are recommended for removal from extra- and intracardiac areas to prevent incurable embolization. Surgical extraction of intracardiac objects is a serious surgical challenge associated with difficulties to operate, during the continuous movement of the heart, and identify the exact FB location. Early diagnosis and timely removal of FBs are crucial treatment factors for this rare case resolution. We report a case of accidental migration of a metal FB object (nail) about 1.0*0.3 cm from the right neck area jugular vein to the right ventricle apex in the heart. The FB localization was accurately detected using Bi-plane transesophageal echocardiography (TEE) with a special comet-tail artifact. TEE provided valuable information before surgery, and the nail was successfully removed through open-heart surgical procedures and cardiopulmonary bypass (CPB). Postoperative tests indicated no complications.

Anatomy Revisited: Hemodialysis Catheter Malposition into the Chest

2018 ◽  
Vol 47 (1-3) ◽  
pp. 58-61
Author(s):  
Pan Xie ◽  
Kanfu Peng ◽  
Keqin Zhang ◽  
Hongwen Zhao ◽  
Yuxiu Sheng ◽  
...  
Keyword(s):  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Chronic Hemodialysis ◽  
Catheter Position ◽  
Cross Sectional ◽  
Hemodialysis Catheter ◽  
Catheter Tip ◽  
And Migration ◽  
Wall Perforation ◽  
The Right

In most situations, central catheters are implanted in the right jugular vein as initial access for hemodialysis. However, after repeated punctures, the proximal vessels become stenosed and thrombosed and misplacement is likely to occur. Correct catheter position in the vein can be easily ascertained with X-ray or cross-sectional CT imaging. In this report, we describe the case of a 77-year-old patient on chronic hemodialysis via catheter due to arteriovenous fistula dysfunction. We placed a cuffed-tunneled hemodialysis catheter in the left internal jugular vein. Malpositioning of the catheter led to perforation of the great veins and migration of the catheter tip into the chest. It is important to be aware of the risk of potential incorrect positioning of dialysis catheters. Due to the stenosis and fragility of the vessel wall, perforation may occur. In cases of doubt, correct placement of large-bore catheters via the internal jugular vein should be verified by means of appropriate imaging before hemodialysis is performed.

Veno-Right Ventricle Bypass as a Lung Support System during Pulmonary Surgery without Ventilation

1997 ◽  
Vol 20 (10) ◽  
pp. 557-561 ◽  
Author(s):  
K. Horita ◽  
Z.L. Cao ◽  
T. Itoh
Keyword(s):  
Right Ventricle ◽  
Jugular Vein ◽  
Superior Vena ◽  
Femoral Vein ◽  
Ventilatory Support ◽  
Vena Cava ◽  
Venous Drainage ◽  
Pulmonary Surgery ◽  
Native Lung ◽  
The Right

A special lung support technique is required during carina! or tracheal surgery. Veno venous extracorporeal membrane oxygenation (ECMO) has become an accepted techinique for temporary lung support. Therefore, the purpose of our experiments was to evaluate the effect of veno venous ECMO (veno-right ventricle bypass) without ventilatory support. In five mongrel dogs, two venous drainage cannula were inserted into the superior vena cava through the right jugular vein and the inferior vena cava through the right femoral vein. In addition, a venous return cannula was inserted into the right ventricle (RV) through the right jugular vein. The veno-right ventricle (veno-RV) bypass system was composed of a centrifugal pump and membrane oxygenator; pump flow was maintained at 88 ± 14 ml/kg/min. Excellent hemodynamics and good oxygenation were obtained. On the basis of these results, we conclude that veno-RV bypass may be used as lung support during pulmonary surgery even though the native lung is not ventilated during the veno-RV bypass procedure.

scholarly journals P1495 Suddenly haunted by a turbulent heart beat in the right ear. Post-traumatic monolateral pulsatile tinnitus caused by cervical arteriovenous malformation: colour-Doppler ultrasound and angio-CT find

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
V Silvestri ◽  
RITA Mele
Keyword(s):  
Quality Of Life ◽  
Doppler Ultrasound ◽  
Jugular Vein ◽  
Heart Beat ◽  
Pulsatile Tinnitus ◽  
Colour Doppler ◽  
Angio Ct ◽  
Post Traumatic ◽  
The Right

Abstract Funding Acknowledgements No financial disclosure to be added INTRODUCTION Tinnitus, the perceived sensation of sound in absence of corresponding external acoustic stimulus, has a prevalence of 15% among adults [1]; it may impair quality of life in about 1-2% of cases. When pulsatile, objective and synchronous with heart beat, it may be secondary to vascular abnormalities [2]; in some patients a post-traumatic pathogenesis ( head and neck) has been reported, with a prevalence up to 10% . CASE REPORT We report the case of a 28 year old male patient with a history of a right side pulsatile tinnitus occurred three days after head trauma. Described as "hearing heart beat in the right ear as a turbulent sound", it corresponded with an audible bruit and palpable fremitus in latero-cervical region. History was negative for medical or surgical comorbidities as laboratory investigation; color Doppler ultrasound revealed an external carotid artery collateral- internal jugular vein fistula, resulting in a pulsatile turbulent flow, synchronic with heart beat. Angio-CT scan of epiaortic vessels confirmed findings in the context of occipital articulation, near jugular foramen. Patient postponed further investigations for personal reasons. DISCUSSION Vascular post-traumatic lesions may cause post-traumatic pulsatile tinnitus. Symptom onset may be delayed from several days up to twelve weeks after trauma and it can be a sign of life-threatening disorders such as carotid cavernous fistulas, arteriovenous malformations, and carotid dissections [3 ] . Clinical management includes basic diagnostic steps ( history, assessment of tinnitus severity, clinical ear examination, audiological and a neurovascular examination [2] . CT and MR with angiography, following colour-Doppler ultrasound , are used to determine the anatomical cause of vascular pulsatile tinnitus and to study surrounding structures. Angiography may be helpful for diagnosis and treatment planning [4]. CONCLUSIONS Pulsatile tinnitus may occur after head and neck trauma, may affect quality of life and can be caused by live-threatening lesions. Arteriovenous fistulae between carotid artery branches and jugular vein may be treatable anatomical cause of symptoms, and have to be considered in differential diagnosis . Abstract P1495 Figure. Pulsatile tinnitus:Imaging and Pathology

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