Intravascular and intracardiac blood temperatures in man

1962 ◽  
Vol 17 (4) ◽  
pp. 706-708 ◽  
Author(s):  
Skoda Afonso ◽  
George G. Rowe ◽  
Cesar A. Castillo ◽  
Charles W. Crumpton

Intracardiac and intravascular blood temperatures were measured in a group of 17 afebrile patients undergoing cardiac catheterization. Using a cardiac catheter with a thermistor mounted at the tip, measurements were made in the following locations: different levels of the inferior vena cava, the superior vena cava, the renal, hepatic, and internal jugular veins, the right atrium, pulmonary artery and pulmonary artery wedge position, coronary sinus and right ventricle, and the left atrium and pulmonary veins (in subjects with atrial septal defects or patent foramen ovale). Data obtained confirm and extend observations made by other investigators. The blood temperature in the pulmonary artery, pulmonary artery wedge, left atrium, and pulmonary vein were found to be very nearly the same. Furthermore, temperature recordings made in different sites of the inferior vena cava, superior vena cava, right atrium, and pulmonary artery show variations phasic with respiration. The mechanism of these thermal variations is discussed. Submitted on February 5, 1962

Author(s):  
Elizabeth Mack ◽  
Jakin Jagani ◽  
Alexandrina Untaroiu

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.


2016 ◽  
Vol 10 ◽  
pp. CMC.S38153
Author(s):  
Mariana S. Parahuleva ◽  
Mehmet Burgazli ◽  
Nedim Soydan ◽  
Wolfgang Franzen ◽  
Norbert Guttler ◽  
...  

We report an interesting case of a man with a persistent left superior vena cava (PLSVC) with left azygos vein who underwent electrophysiological evaluation. Further evaluation revealed congenital dilated azygos vein, while a segment connecting the inferior vena cava (IVC) to the hepatic vein and right atrium was missing. The azygos vein drained into the superior vena cava, and the hepatic veins drained directly into the right atrium. The patient did not have congenital anomalies of the remaining thoracoabdominal vasculature.


1998 ◽  
Vol 15 (8) ◽  
pp. 787-794 ◽  
Author(s):  
M. BASHAR A. SHALA ◽  
IVAN A. D'CRUZ ◽  
CAMEILA JOHNS ◽  
JACKIE KAISER ◽  
REGENIA CLARK

2017 ◽  
Vol 12 (4) ◽  
pp. 143-149 ◽  
Author(s):  
Anil Bhattarai ◽  
Arben Dedja ◽  
Vladimiro L. Vida ◽  
Francesco Cavallin ◽  
Massimo A. Padalino ◽  
...  

Background & Objectives: To evaluate the advantages of the one and a half ventricle repair on maintaining a low pressure in the inferior vena cava district. Also evaluate the competition of flows at the superior vena cava – right pulmonary artery anastomosis site, in order to understand the hemodynamic interaction of a pulsatile flow in combination to a laminar one. Materials & Methods: Adult rabbits (n=30) in terminal anaesthesia with a follow up of 8 h were used, randomly distributed in three experimental groups: Group 1: animals with an anastomosis between superior vena cava and right pulmonary artery, as a model of one and one half ventricle repair; Group 2: animals with the cavopulmonary anastomosis followed by clamping of the right pulmonary artery proximal to the anastomosis; and Group 3: sham animals. Pressures of superior vena cava and pulmonary arteries were afterwards measured, in a resting condition as well as after induced pharmacological stress test.Results: In Group 1, superior vena cava pressure was significantly higher, while venous pressure in the inferior vena cava – right atrium district was constant or lower in comparison with the other groups. After stress test, the pressure in the superior vena cava and the heart rate both increased further, but the right ventricular, right atrial and pulmonary artery pressures remained similar to the values in a resting condition. This proved that the inferior vena cava return was well-preserved, and no venous hypertension was present in the inferior vena cava district even after stress test (good exercise tolerance).Conclusion: One and one half ventricle repair can be considered a good surgical strategy for maintaining a low pressure in the inferior vena cava district with potential for right ventricle growth, restoring the more physiological circulation in borderline or failing right ventricle conditions. The experiment presented a positive finding in favour of one and one half ventricle repair, as compared to Fontan type procedure.


2018 ◽  
Vol 41 (12) ◽  
pp. 867-871 ◽  
Author(s):  
Konomi Togo ◽  
Yoshiaki Takewa ◽  
Nobumasa Katagiri ◽  
Yutaka Fujii ◽  
Akihiro C Yamashita ◽  
...  

Introduction: Recently, the use of veno-venous extracorporeal membrane oxygenation for adult patients with severe acute respiratory failure has increased. We previously investigated the optimal return cannula position; however, the optimal drainage cannula position has not yet been fully clarified. The aim of this study was to investigate the optimal drainage cannula position. Methods: Veno-venous extracorporeal membrane oxygenation was performed in four adult goats (mean body weight 59.6 ± 0.6 kg). The position of the drainage cannula was varied among the right atrium, the upper inferior vena cava, and the lower inferior vena cava, whereas the position of the return cannula was fixed in the superior vena cava. The recirculation fraction and arterial oxygen saturation and pressure (SaO2, PaO2) were measured in all drainage cannula positions. Results: In the lower inferior vena cava drainage cannula position, the recirculation fraction was the lowest. In the lower inferior vena cava, upper inferior vena cava, and right atrium drainage cannula positions at 3 L/min, SaO2 and PaO2 after 20 min were 92.9% ± 4.9% and 75.1 ± 26.0 mm Hg, 99.5% ± 0.5% and 113.8 ± 20.9 mm Hg, and 93.8% ± 6.2% and 91.9 ± 17.7 mm Hg, respectively. Conclusion: With respect to blood oxygenation, the optimal position for the drainage cannula was the upper inferior vena cava. These findings suggested that blood from the superior vena cava, inferior vena cava, and hepatic vein was most efficiently drained in the upper inferior vena cava cannula position.


1993 ◽  
Vol 6 (6) ◽  
pp. 349-352 ◽  
Author(s):  
Toshimasa Takayama ◽  
Saburo Hirai ◽  
Teruo Ishihara ◽  
Kazuyoshi Yamaguchi ◽  
Junya Fukuda ◽  
...  

2020 ◽  
Vol 55 (1) ◽  
pp. 69-72
Author(s):  
Tobias Zander ◽  
Vanesa Di Caro ◽  
Manuel Maynar ◽  
Martin Rabellino

Venous stent placement of symptomatic occlusion of the superior and inferior vena cava is considered the treatment of choice in malignant disease because this technique can restore patency and achieve a relief of symptoms. However, tumor thrombus extension into the right atrium harbors the potential risk of stent migration and perforation. One strategy to avoid this potential life-threatening complication could be the placement of a bridging stent from the superior vena cava-to-inferior vena cava. This case reports describes the superior vena cava-to-inferior vena cava bridging stent technique in 2 patients with malignant occlusion of the superior and inferior vena cava. Special considerations such as technical details of the devices and potential complications are discussed.


2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Masatoshi Narikawa ◽  
Masayoshi Kiyokuni ◽  
Junya Hosoda ◽  
Toshiyuki Ishikawa

Abstract Background Transseptal puncture and pulmonary vein isolation (PVI) in patients with atrial fibrillation (AF) are generally performed via the inferior vena cava (IVC). However, in cases where the IVC is inaccessible, a specific strategy may be needed. Case summary An 86-year-old woman with paroxysmal AF and an IVC filter in situ was referred to our hospital for ablation therapy. An IVC filter for pulmonary embolism and deep venous thrombosis had been implanted 15 years prior, therefore we selected a transoesophageal echocardiography (TOE)-guided transseptal puncture using a superior vena cava (SVC) approach. After the single transseptal puncture, we performed fast anatomical mapping, voltage mapping by multipolar mapping catheter, and then PVI by contact force-guided radiofrequency catheter using a steerable sheath. Following the ablation, bidirectional conduction block between the four pulmonary veins and the left atrium was confirmed by both radiofrequency and mapping catheter. No complications occurred and no recurrence of AF was documented in the 12 months after the procedure. Discussion When performing a transseptal puncture during AF ablation, an SVC approach, via access through the right internal jugular vein, enables the sheath to directly approach the left atrium without angulation and improves operability of the ablation catheter. Combining the use of general anaesthesia, TOE, a steerable sheath, and contact force-guided ablation may contribute to achieving minimally invasive PVI with a single transseptal puncture via an SVC approach.


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