Microsphere reference flow samples during systemic flow adjustment

1987 ◽  
Vol 252 (4) ◽  
pp. H851-H856
Author(s):  
G. A. Geffin ◽  
D. D. O'Keefe ◽  
A. G. Denenberg ◽  
W. M. Daggett
Keyword(s):  
Blood Flow ◽  
Percentage Error ◽  
Regional Myocardial Blood Flow ◽  
Right Heart ◽  
Flow Measurements ◽  
Flow Adjustment ◽  
Reference Flow ◽  
The Right ◽  
Right Heart Bypass ◽  
Heart Bypass

Regional myocardial blood flow measurements in the right heart bypass preparation can be particularly valuable, since this preparation provides control of the main hemodynamic determinants of coronary blood flow. We examined the validity of aortic reference flow samples in relation to coronary samples during continuous systemic flow adjustment for aortic pressure control in six dogs on right heart bypass, anesthetized with chloralose and urethan. Microsphere concentrations were compared in paired reference flow samples drawn from the aortic arch and from a coronary artery for 119 left atrial microsphere injections. During left subclavian artery infusion and during femoral artery infusion at rates above 2,000 ml/min, there were high percentage errors in microsphere concentration between paired samples, consistent with aortic sample dilution by systemically infused blood. In 52 injections during withdrawal or femoral infusion below 2,000 ml/min, at cardiac outputs of 390-4,800 ml/min, the percentage error was 0.001 +/- 1.18% (SE); the absolute value of this error was below 20% in 96%, and below 10% in 77% of these injections. Linear regression related these coronary to aortic microsphere concentrations by the equation Y = 1.005X - 1.64, r = 0.997, Sy.x = 13.2 (5.9%). (Sy.x represents the standard deviation from regression.) These data indicate that valid aortic reference flow samples can be obtained within specific hemodynamic conditions during systemic flow adjustment in the right heart bypass preparation.

A Tribute to the Pioneers of Right Heart Bypass: An Historical Review

2020 ◽  
Vol 11 (2) ◽  
pp. 198-203
Author(s):  
Giovanni Stellin
Keyword(s):  
Clinical Practice ◽  
Energy Loss ◽  
Historical Review ◽  
Canine Model ◽  
Right Heart ◽  
Cavopulmonary Anastomosis ◽  
The Right ◽  
Right Heart Bypass ◽  
Initial Concept ◽  
Heart Bypass

Cavopulmonary anastomosis was first described by Carlon, Mondini, De Marchi in a canine model in 1951 and later, in the clinical practice, by Glenn in 1958. Total right heart bypass was first introduced by Fontan and Kreutzer in 1971, in each instance as treatment for tricuspid atresia. Several modifications of such a procedure followed the initial concept of the right atrium as a pumping chamber, including modifications aimed to minimize energy loss at the anastomotic level and arrhythmias. Tribute is given to our pioneers who developed such an operation aimed to treat any child with functionally univentricular hearts.

scholarly journals The Role of Electrode Size on the Incidence of Spreading Depression and on Cortical Cerebral Blood Flow as Measured by H2 Clearance

1992 ◽  
Vol 12 (2) ◽  
pp. 230-237 ◽  
Author(s):  
Marleen J. Verhaegen ◽  
Michael M. Todd ◽  
David S. Warner ◽  
Bruce James ◽  
Julie B. Weeks
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Gray Matter ◽  
Spreading Depression ◽  
Insertion Depth ◽  
Flow Measurements ◽  
Electrode Size ◽  
Cortical Gray Matter ◽  
The Right

Cerebral blood flow was measured by the H2 clearance method 30 and 60 min after the implantation of 300, 250, 125, or 50 μm diameter platinum–iridium electrodes 2 mm deep into the right parietal cortex of normothermic, normocarbic halothane-anesthetized rats. Another group of animals had 50 μm electrodes inserted 1 mm. In all animals, the presence or absence of a wave of spreading depression (SD) was noted at the time of implantation, with recordings made with glass micropipettes. H2 flow values were compared with those measured in gray matter from the same anatomical region (but from different rats), using [3H]nicotine. The incidence of SD ranged from 60% following insertion of 300 μm electrodes to 0% with 50 μm electrodes. H2 clearance flows also varied with electrode size, from 77 ± 21 ml 100 g−1 min−1 (mean ± standard deviation) with 300 μm electrodes to 110 ± 31 and 111 ± 16 ml 100 g−1 min−1 with 125 and 50 μm electrodes, respectively (insertion depth of 2 mm). A CBF value of 155 ± 60 ml 100 g−1 min−1 was obtained with 50 μm electrodes inserted only 1 mm. Cortical gray matter blood flow measured with [3H]nicotine was 154 ± 35 ml 100 g−1 min−1. When the role of SD in subsequent flow measurements was examined, there was a gradual increase in CBF between 30 and 60 min after electrode insertion in those animals with SD, while no such change was seen in rats without SD. These results indicate that the choice of electrode size and implantation depth influences the measurement of CBF by H2 clearance. CBF values equivalent to those obtained with isotopic techniques can be acutely obtained with small (50 μm diameter) electrodes inserted 1 mm into the cortex. While the occurrence of SD does influence CBF in the period immediately after implantation, a relationship between electrode size and measured flow is present that is independent of SD.

scholarly journals Clinical Experience of Right Heart Bypass Using Heparin-coated Tube and Roller Pump System.

1992 ◽  
Vol 21 (5) ◽  
pp. 510-514
Author(s):  
Hajime OHZEKI ◽  
Satosi NAKAZAWA ◽  
Akira SAITO ◽  
Hisanaga MORO ◽  
Hirofumi OKAZAKI ◽  
...  
Keyword(s):  
Clinical Experience ◽  
Right Heart ◽  
Pump System ◽  
Roller Pump ◽  
Right Heart Bypass ◽  
Heart Bypass

scholarly journals The study of systemic hemodynamic disorders of patients with varicose and post-thrombotic diseases

2020 ◽  
Vol 19 (2) ◽  
pp. 32-37
Author(s):  
I. N. Shanaev
Keyword(s):  
Blood Flow ◽  
Right Ventricle ◽  
Right Atrium ◽  
Ultrasound Examination ◽  
Anterior Wall ◽  
Right Heart ◽  
Normal Limits ◽  
Flow Through ◽  
The Right ◽  
Restrictive Type

Aim. Study of heart function in the patients with CVD. Materials and methods. 46 patients with varicosity (VD) and 34 patients with post-thrombotic disease (PTD) were examined; the control group was represented by 15 healthy volunteers. The diagnosis was established using the CEAP basic classification. The study did not include patients with a diagnosed arterial hypertension, diabetes mellitus, chronic lung disease, significant hemodynamic heart defects, coronary heart disease. Ultrasound examination of the heart and veins of the lower extremities was performed on a Saote My Lab Alpha, Acuson Sequoia 512 apparatus. In addition to the standard protocol of heart ultrasound examination, the parameters of the right heart were calculated: sizes of the right ventricle (RV), right atrium, thickness of the anterior wall of the pancreas; to assess the ejection fraction (EF) of the pancreas the mobility of the lateral edge of the tricuspid ring was calculated, and the pressure on the tricuspid valve (TV) was measured. Diastolic ventricular function was studied by spectrograms of tricuspid and mitral blood flow. Results. Most of the indicators of cardiac activity in patients with VD were within normal limits, but a tendency to increase increasing of the right heart size was noted. In addition, the thickness of the interventricular septum and the right ventricle (RV) anterior wall was found to increase from 0.8 to 1.1 cm and from 0.3 to 0.5 cm, respectively, according clinical classes from C2 to C6 (CEAP). Eject fraction (EF) of both the RV and the left ventricle (LV) were also within normal limits, but with a tendency to decrease (67.8 % – C2, to 62 % – C6). The growth of the clinical class is followed by the increasing of percentage of non-restrictive blood flow through the tricuspid valve (TV). The restrictive type of blood flow in patients with VD had not been identified. Patients with PTD also showed a tendency to increase the right heart. However, whereas the size of the RV, as a rule, did not exceed 3.0 cm, the size of the right atrium was slightly higher than normal one in the clinical class C4 and C5.6. All the patients had EF of LV within normal limits, but it slightly decreased by the growth of class. Only patient classes C3 and C4 had EF of RV within the normal range. The 18 % of patient class C5.6 had EF lower than normal with value 48%. Diastolic dysfunction (DD) of the RV was detected in 73.3% of patients with class C3 and 100% with classes C4 and C5.6. Moreover, a restrictive type of blood flow through TV appeared from class C4 and the percentage increased up to 27.2% (class C5,6). Conclusions. DD of the RV was the main hemodynamic disorder.

Quantitation of anterior descending vs. circumflex venous drainage in the canine great cardiac vein and coronary sinus

1978 ◽  
Vol 234 (2) ◽  
pp. H163-H166 ◽  
Author(s):  
H. K. Nakazawa ◽  
D. L. Roberts ◽  
F. J. Klocke
Keyword(s):  
Indocyanine Green ◽  
Coronary Sinus ◽  
Venous Drainage ◽  
Right Heart ◽  
Great Cardiac Vein ◽  
Indocyanine Green Dye ◽  
Right Heart Bypass ◽  
Heart Bypass

The fractions of left anterior descending (LAD) and circumflex (LC) inflow drainage into the canine great cardiac vein (GCV) and coronary sinus (CS) have been quantitated by use of a right heart bypass preparation in which GCV outflow was isolated from the remainder of CS outflow. Following direct LAD injection of indocyanine green dye (ICG), 63 +/- 8% (SD) of the total amount of dye recovered appeared in GCV outflow and the remainder in CS outflow. CS recovery of ICG was decreased appreciably by ligation of epicardial venous connections between the LAD and LC beds, but was not affected by selective reductions of LAD or LC inflow. Only 3 +/- 3% of ICG injected into the LC was recovered in GVC outflow under basal conditions, and these low values were not affected measurably by selective reductions of LAD or LC inflow. CS drainage of LAD inflow could be augmented by selective increments of GCV pressure exceeding 7-10 mmHg. Increments of LC drainage in GCV outflow required CS pressures that exceeded GCV pressures by greater than 10 mmHg.

Comparison between regional myocardial blood flow measurements and results of exercise tests

1977 ◽  
Vol 3 (4) ◽  
pp. 359-366 ◽  
Author(s):  
Barbara H. Roberts ◽  
Peter F. Cohn ◽  
B. Leonard Holman ◽  
Douglass F. Adams ◽  
Jackie R. See
Keyword(s):  
Blood Flow ◽  
Myocardial Blood Flow ◽  
Regional Myocardial Blood Flow ◽  
Exercise Tests ◽  
Flow Measurements ◽  
Blood Flow Measurements ◽  
Regional Myocardial Blood

scholarly journals Repair of an Isolated Right Partial Anomalous Pulmonary Venous Connection by Rerouting Blood Flow Through an Interatrial Septum Flap in a 68-Year-Old-Woman: A Case Report

2020 ◽  
Author(s):  
Atsushi Morishtia ◽  
Ikuo Hagino ◽  
Hideyuki Tomioka ◽  
Seiichiro Katahira ◽  
Takeshi Hoshino ◽  
...  
Keyword(s):  
Blood Flow ◽  
Pulmonary Artery ◽  
Right Atrium ◽  
Septal Defect ◽  
Surgical Repair ◽  
Interatrial Septum ◽  
Pulmonary Artery Hypertension ◽  
Right Heart ◽  
The Right ◽  
Anomalous Pulmonary Venous Connection

Abstract Background: Partial anomalous pulmonary venous connection draining into the right atrium with an intact atrial septum is a very rare clinical entity in the adult population. Partial anomalous pulmonary venous connection must be suspected as a differential diagnosis when the cause of right heart enlargement and pulmonary artery hypertension is unknown.Case presentation: This study describes the surgical case of an isolated right partial anomalous pulmonary venous connection to the right atrium in a 68-year-old woman, who underwent tricuspid ring annuloplasty and right-sided maze procedure simultaneously. She had complaints of gradually progressing dyspnea on exertion. However, a diagnosis could not be established despite consultations at multiple hospitals for over a year. Right heart catheterization revealed severe pulmonary artery hypertension with a mean pulmonary artery pressure of 46 mmHg, step-up phenomenon of oxygen saturation at the mid-level of the right atrium with a pulmonary-to-systemic blood flow ratio of 2.4, and a pulmonary vascular resistance of 3.1 Wood Units. In addition, it was mandatory to comprehensively utilize valuable imaging modalities, such as transthoracic echocardiography, transesophageal echocardiography, and multidetector computed tomography angiography for the accurate diagnosis and efficient surgical planning of this partial anomalous pulmonary venous connection. As medical treatment with pulmonary artery vasodilator therapy did not improve her symptoms, she underwent surgical repair. An atrial septal defect was created surgically with a curvilinear tongue-shaped cut. The right anomalous pulmonary veins were rerouted through the surgically created atrial septal defect into the left atrium with a baffle comprised of the interatrial septum flap, kept in continuity with the anterior margin and sutured while mobilizing the enlarged right atrium. The patient had an uneventful postoperative course and remains asymptomatic. Conclusions: The described surgical technique could be considered an effective alternative for patients undergoing surgical repair for a partial anomalous pulmonary venous connection isolated to the right atrium. The indication for surgery must be judged on a case-by-case basis in these patients with prevalent systemic-to-pulmonary shunting.

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