scholarly journals Effect of coarctation of aorta anatomy and balloon profile on the outcome of balloon angioplasty in infantile coarctation

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hamid Amoozgar ◽  
Narjes Nouri ◽  
Sajad Shabanpourhaghighi ◽  
Neda Bagherian ◽  
Nima Mehdizadegan ◽  
...  
Keyword(s):  
High Pressure ◽  
Pressure Gradient ◽  
Balloon Angioplasty ◽  
Coarctation Of The Aorta ◽  
Cardiovascular Disorder ◽  
Low Pressure ◽  
Coarctation Of Aorta ◽  
Pressure Group ◽  
Mean Pressure ◽  
Neonates And Infants

Abstract Objective Coarctation of the Aorta (CoA) is a relatively common cardiovascular disorder. The present study aimed to evaluate the effect of COA anatomy and high versus low-pressure balloons on the outcome of balloon angioplasty among neonates and infants. Methods In this retrospective study, the neonates and infants undergoing balloon angioplasty at Namazi hospital were enrolled. After balloon angioplasty, immediate data results were promptly recorded.Moreover, midterm echocardiographic information was collected via electronic cardiac records of pediatric wards and clinical and echocardiographic data at least 12 months after balloon angioplasty. Finally, data were analyzed using SPSS-20. Results In this study, 42 infants were included. The median age at the time of balloon angioplasty was 1.55 (range 0.1–12) months and 66.7% of the patients were male. The mean pressure gradient of coarctation was 38.49 ± 24.97 mmHg, which decreased to 7.61 ± 8.00 mmHg (P < 0.001). A high-pressure balloon was used in 27, and a low-pressure balloon was used in 15 patients. COA's pressure gradient changed 30.89 ± 18.06 in the high-pressure group and 24.53 ± 20.79 in the low-pressure balloon group (P = 0.282). In the high-pressure balloon group, 14.81% and in the low-pressure group, 33.33% had recoarctation and need second balloon angioplasty (p < 0.021). The infant with discrete coarctation had a higher decrease in gradient and lower recoarctation. Conclusion Recoarctation rate was lower in the high-pressure balloon. The infant with discrete COA had a better response to the balloon with more decrease in gradient and lower recoarctation rate. Therefore, the stenotic segment anatomy needs to be considered in the selection of treatment methods.

Pressure and Winds

2000 ◽  
Author(s):  
C. David Whiteman
Keyword(s):  
High Pressure ◽  
Pressure Gradient ◽  
Pressure Difference ◽  
Low Pressure ◽  
Pressure Center ◽  
Vertical Column ◽  
Wind Speeds ◽  
Weather Observations ◽  
Stormy Weather ◽  
Rotation Of The Earth

Atmospheric pressure at a given point in the atmosphere is the weight of a vertical column of air above that level. Differences in pressure from one location to another cause both horizontal motions (winds) and vertical motions (convection and subsidence) in the atmosphere. Vertical motions, whether associated with high and low pressure centers or with other meteorological processes, are the most important motions for producing weather because they determine whether clouds and precipitation form or dissipate. The location of high and low pressure centers is a key feature on weather maps, providing information about wind direction, wind speed, cloud cover, and precipitation. Pressure-driven winds carry air from areas where pressure is high to areas where pressure is low. However, the winds do not blow directly from a high pressure center to a low pressure center. Because of the effects of the rotation of the earth and friction, winds blow clockwise out of a high pressure center and counterclockwise into a low pressure center in the Northern Hemisphere. These wind directions are reversed in the Southern Hemisphere. The strength of the wind is proportional to the pressure difference between the two regions. When the pressure difference or pressure gradient is strong, wind speeds are high; when the pressure gradient is weak, wind speeds are low. As air flows out of a high pressure center, air from higher in the atmosphere sinks to replace it. This subsidence produces warming and the dissipation of clouds and precipitation. As air converges in a low pressure center, it rises and cools. If the air is sufficiently moist, cooling can cause the moisture to condense and form clouds. Further lifting of the air can produce precipitation. Thus, rising pressure readings at a given location indicate the approach of a high pressure center and fair weather, whereas falling pressure readings indicate the approach of a low pressure center and stormy weather. The vertical motions caused by the divergence of air out of a high pressure center or the convergence of air into a low pressure center are generally weak, with air rising or sinking at a rate of several cm per second, and they cannot be measured by routine weather observations.

scholarly journals Balloon Angioplasty for Native Aortic Coarctation in 3- to 12-Month-Old Infants

2020 ◽  
Vol 13 (11) ◽  
Author(s):  
Juan Pablo Sandoval ◽  
Sok-Leng Kang ◽  
Kyong-Jin Lee ◽  
Lee Benson ◽  
Kentaro Asoh ◽  
...  
Keyword(s):  
Pressure Gradient ◽  
Balloon Angioplasty ◽  
Systolic Pressure ◽  
Coarctation Of The Aorta ◽  
Aortic Aneurysms ◽  
Older Children ◽  
Cross Sectional ◽  
Cross Sectional Imaging ◽  
Systolic Pressure Gradient ◽  
Lost To Follow Up

Background: Balloon angioplasty for native coarctation of the aorta (CoA) is successful in children and adults but in neonates results in frequent restenosis. The efficacy of balloon angioplasty for native CoA during infancy beyond the neonatal period was examined in infants aged 3 to 12 months of age. Methods: A retrospective review of 68 infants who underwent balloon angioplasty for native CoA. 95% CI are in parentheses. Results: Procedural age was (mean±SD) 6±3.4 months and weight was 7±1.8 kg. Balloon angioplasty produced a large decrease in both the noninvasive arm-to-leg blood pressure gradient (41.2±18.7 to 5.6±9.6 mm Hg) and the invasive peak systolic pressure gradient (34±12 to 11±9 mm Hg). Balloon angioplasty increased the CoA diameter from 2.7±1 mm to 4.6±1.2 mm. One patient was lost to follow-up. A catheter reintervention was required in 11.8% and surgery in 10.3%. The hazard of reintervention was highest early. Median freedom from reintervention was 89% (95% CI, 80%–96%) at 1 year, 83% (95% CI, 73%–92%) at 5 years, and 81% (95% CI, 69%–90%) at 10 years. Femoral artery thrombosis was documented in 6 (9%) infants without any long-term consequence. One patient developed a small aortic aneurysm late and has not required treatment. A robust estimate of the frequency of aortic aneurysms remains to be determined as the majority of subjects have not had cross-sectional imaging. Conclusions: Balloon angioplasty of native CoA is effective and safe in infants aged 3 to 12 months with outcomes comparable to those in older children and adults. Catheter reinterventions can avoid the need for surgery in most patients.

Comparison of Nutritional Status in Elderly Patients with Low-pressure Gradient and High-pressure Gradient Severe Aortic Stenosis

2017 ◽  
Vol 23 (10) ◽  
pp. S53
Author(s):  
Nobuhiko Haruki ◽  
Yoshiharu Kinugasa ◽  
Koichi Matsubara ◽  
Kiyotaka Yanagihara ◽  
Masayuki Hirai ◽  
...  
Keyword(s):  
High Pressure ◽  
Aortic Stenosis ◽  
Nutritional Status ◽  
Elderly Patients ◽  
Pressure Gradient ◽  
Severe Aortic Stenosis ◽  
Low Pressure

scholarly journals Comparing the 12-month patency of low- versus high-pressure dilation in failing arteriovenous fistulae: A prospective multicenter trial (YOROI study)

2018 ◽  
Vol 19 (5) ◽  
pp. 477-483 ◽  
Author(s):  
Koki Wakamoto ◽  
Shigehiro Doi ◽  
Ayumu Nakashima ◽  
Toru Kawai ◽  
Yasufumi Kyuden ◽  
...  
Keyword(s):  
High Pressure ◽  
Patency Rate ◽  
Hazard Model ◽  
Low Pressure ◽  
Hazard Ratio ◽  
Cox Proportional Hazard Model ◽  
Proportional Hazard ◽  
Pressure Group ◽  
Proportional Hazard Model ◽  
Cox Proportional Hazard

Purpose: This study was performed to investigate the effect of the balloon dilation pressure on the 12-month patency rate in patients with failed arteriovenous fistulas undergoing hemodialysis. Materials and methods: In this multicenter, prospective, randomized trial, the 4-mm-diameter YOROI balloon was used for dilation of stenotic lesions. The balloons were inflated to a pressure of 8 atm (low-pressure group) or 30 atm to achieve complete expansion (high-pressure group). The 12-month patency rate after balloon angioplasty was analyzed by the Kaplan–Meier method and log-rank test and/or a Cox proportional hazard model. We also investigated the dilation pressure required to achieve complete expansion in the high-pressure group. Results: In total, 71 patients were enrolled and allocated to either the low-pressure group (n = 34) or the high-pressure group (n = 37). The 12-month patency rates showed no significant difference between the low- and high-pressure groups (47% and 49%, respectively; p = 0.87). In the low-pressure group, the patency rate was not different between patients with complete dilation and residual stenosis (44% and 50%, respectively; p = 0.87). The Cox proportional hazard model revealed that the 12-month patency rate was associated with the stenosis diameter (hazard ratio 0.36; p = 0.001) and the presence of diabetes (hazard ratio 0.33; p = 0.018). Finally, the pressure required to achieve complete dilation was ≤20 atm in 76% of patients and ≤30 atm in 97% of patients. One patient required a dilation pressure of >30 atm. Conclusion: The patency rate does not differ between low-pressure dilation and high-pressure dilation.

scholarly journals Balloon Angioplasty for Native Coarctation of the Aorta in Neonates and Infants With Congestive Heart Failure

2009 ◽  
Vol 50 (4) ◽  
pp. 152-157 ◽  
Author(s):  
Chi-Di Liang ◽  
Wen-Jen Su ◽  
Hung-Tao Chung ◽  
Mao-Sheng Hwang ◽  
Chien-Fu Huang ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Balloon Angioplasty ◽  
Coarctation Of The Aorta ◽  
Neonates And Infants

Increased pressure during retrograde cerebral perfusion provides better preservation of the Na+, K+-ATPase activity

Perfusion ◽  
2006 ◽  
Vol 21 (6) ◽  
pp. 319-324 ◽  
Author(s):  
Luojia Yang ◽  
Zhijun Li ◽  
Yanmin Yang ◽  
Raymound Zhu ◽  
Randy Summers ◽  
...  
Keyword(s):  
High Pressure ◽  
Atpase Activity ◽  
Cerebral Perfusion ◽  
Circulatory Arrest ◽  
Low Pressure ◽  
Control Group ◽  
Pressure Group ◽  
Retrograde Cerebral Perfusion ◽  
Significant Impairment ◽  
The Brain

This study was carried out to determine if increased perfusion pressure during retrograde cerebral perfusion (RCP) provides better preservation of the brain Na+, K+-ATPase activity. Twenty pigs were subjected to anesthesia alone (control group, n =5), hypothermic circulatory arrest (HCA) (HCA group, n =5), HCA+RCP at perfusion pressures of 24-29 mmHg (Low-pressure group, n= 5), or HCA+RCP at perfusion pressures of 34-40 mmHg (High-pressure group, n =5). The brain was harvested for the measurement of tissue Na+, K+-ATPase activity. Relative to the control pigs (67.29∓2.1%), significant impairment of Na+, K+-ATPase activity was observed in all three experimental groups (29.89∓7.4% in HCA group, 33.59∓2.9% in the Low-pressure group, and 52.09∓1.8% in the High-pressure group, p <0.01). The best preservation of the enzyme, particularly in the cortex and cerebellum regions, was observed in the High-pressure group (p <0.01). In conclusion, HCA causes severe impairment of Na+, K+-ATPase activity, and increasing perfusion pressures from 24 +29 to 34 +40 mmHg during RCP significantly improves preservation of Na+, K+-ATPase activity, and the improvement of the protection varies in different regions of the brain.

The Similarity of Ducted Jets With Low and High Pressure Gradients

2008 ◽  
Author(s):  
Marcos Noboru Arima ◽  
Marcos de Mattos Pimenta ◽  
Guilherme Araujo Lima da Silva
Keyword(s):  
High Pressure ◽  
Pressure Gradient ◽  
Linear Expansion ◽  
Low Pressure ◽  
Momentum Balance ◽  
Pressure Gradients ◽  
Center Line ◽  
Operational Conditions ◽  
Definition Of ◽  
Jet Velocities

The objective of the present work is to study what type of effects the dimensionless jet parameters really consider. To do it, three classical dimensionless jet parameters are redeveloped using an unified methodology. This methodology is based on the integral balances of mass and momentum. The momentum balance terms are classified as inertial or pressure terms and as flux or source terms. This redevelopment enlighten the meaning of the dimensionless jet parameters and allows the definition of a new set of parameters. A scaling methodology is presented to compare the dimensionless jet parameters adequacy in scaling center line jet velocity and jet width at different operational conditions. Two regimes are distinguished: low pressure gradient and high pressure gradient. The scaling for low pressure gradient is based on two criteria: the diffusivity ratio proportionality and the linear expansion rate of the jet. The diffusivity is modelled using the Prandtl’s mixing length model and a dimensional analysis based only on inertial momentum terms. The scaling for high pressure gradient is based on jet velocities and widths scaled simultaneously by pressure and inertial momentum terms. The application of this methodology to jet literature data shows jet similarity for low and high pressure gradients. However, some drawbacks are identified in scaling the jet width at high pressure gradients.

scholarly journals Lumbar Plexus Block Using High-pressure Injection Leads to Contralateral and Epidural Spread

2008 ◽  
Vol 109 (4) ◽  
pp. 683-688 ◽  
Author(s):  
Jeff C. Gadsden ◽  
Danielle M. Lindenmuth ◽  
Admir Hadzic ◽  
Daquan Xu ◽  
Lakshmanasamy Somasundarum ◽  
...  
Keyword(s):  
High Pressure ◽  
Injection Pressure ◽  
Low Pressure ◽  
Neuraxial Anesthesia ◽  
Lumbar Plexus ◽  
Pressure Group ◽  
Sensory Blockade ◽  
High Injection ◽  
Lumbar Plexus Block ◽  
Plexus Block

Background The main advantage of lumbar plexus block over neuraxial anesthesia is unilateral blockade; however, the relatively common occurrence of bilateral spread (up to 27%) makes this advantage unpredictable. The authors hypothesized that high injection pressures during lumbar plexus block carry a higher risk of bilateral or neuraxial anesthesia. Methods Eighty patients undergoing knee arthroscopy (age 18-65 yr; American Society of Anesthesiologists physical status I or II) during a standard, nerve stimulator-guided lumbar plexus block using 35 ml mepivacaine, 1.5%, were scheduled to be studied. Patients were randomly assigned to receive either a low-pressure (&lt; 15 psi) or a high-pressure (&gt; 20 psi) injection, as assessed by an inline injection pressure monitor (BSmart; Concert Medical LLC, Norwell, MA). The block success rate and the presence of bilateral sensory and/or motor blockade were assessed. Results An interim analysis was performed at n = 20 after an unexpectedly high number of patients had neuraxial spread, necessitating early termination of the study. Five of 10 patients (50%) in the high-pressure group had a neuraxial block with a dermatomal sensory level T10 or higher. In contrast, no patient in the low-pressure group (n = 10) had evidence of neuraxial spread. Moreover, 6 patients (60%) in the high-pressure group demonstrated bilateral sensory blockade in the femoral distribution, whereas no patient in the low-pressure group had evidence of a bilateral femoral block. Conclusions Injection of local anesthetic with high injection pressure (&gt; 20 psi) during lumbar plexus block commonly results in unwanted bilateral blockade and is associated with high risk of neuraxial blockade.

Intracuff Pressures Do Not Predict Laryngopharyngeal Discomfort after Use of the Laryngeal Mask Airway 

1997 ◽  
Vol 87 (1) ◽  
pp. 63-67 ◽  
Author(s):  
Armin Rieger ◽  
Bergit Brunne ◽  
Hans Walter Striebel
Keyword(s):  
High Pressure ◽  
Laryngeal Mask Airway ◽  
Sore Throat ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Low Pressure ◽  
Laryngeal Mask ◽  
Double Blind Study ◽  
Pressure Group ◽  
Significant Difference

Background The laryngeal mask airway (LMA) is a large foreign body that exerts pressure on the pharyngeal mucosa, which may lead to throat discomfort. To determine whether intracuff pressures are associated with such discomfort, a randomized, double-blind study was performed to determine the effect of high versus low intracuff pressures. Methods Seventy healthy women were randomly allocated to two groups with different LMA intracuff pressures: 30 mmHg (low pressure) or 180 mmHg (high pressure). Pressures were controlled with a microprocessor-controlled monitor. Insertion of the LMA was performed by one investigator and facilitated with propofol and verified fiberoptically. Anesthesia was maintained with enflurane and nitrous oxide. The LMAs were removed while the patients were still asleep. Patients assessed their laryngopharyngeal complaints (sore throat, dysphagia, hoarseness) at 8, 24, and 48 h after operation on a 101-point numerical rating scale. Results No significant difference was found in the overall incidence of complaints between both groups (low pressure: 50%; high pressure: 42%). On the day of surgery, dysphagia (38%) was more frequent than sore throat (16%) or hoarseness (6%) (P &lt; 0.05) within the high-pressure group. In the low-pressure group, the incidence of these complaints was not significantly different (33%, 20%, and 23%, respectively). On the following day, dysphagia was still present in 20% of the women in both groups, and other symptoms comprised 10% or less of the reported complaints. Conclusions Differences in LMA intracuff pressures did not influence either the incidence or severity of laryngopharyngeal complaints.

scholarly journals The immediate and late results for balloon angioplasty of native coarctation of aorta in pediatrics age group

2020 ◽  
Vol 16 (2) ◽  
pp. 16-20
Author(s):  
Maitham Qasim Mohammed ◽  
Husam Thaaban Al-Zuhairi ◽  
Ameer Adnan Muhsen ◽  
Sadiq M. Al Hamash
Keyword(s):  
Balloon Angioplasty ◽  
Balloon Dilation ◽  
Coarctation Of The Aorta ◽  
Late Result ◽  
Heart Catheterization ◽  
Coarctation Of Aorta ◽  
Transverse Arch ◽  
Associated Lesions ◽  
Percutaneous Balloon

Background: percutaneous balloon dilation of corotation of aorta is a less invasive and alternative to surgical repair for patients with discrete coaction of aorta and although the used of balloon angioplasty in patients with recurrent postoperative coarctation gained a wide consensus, the use this technique for native coarctation is still controversial in children less one years.  Objective: to evaluate the immediate and late result of balloon dilation of native coarctation of aorta in infant and children. Type of the study: A prospective study.  Subjects & Methods: The study was done on forty-five patients who were referred for cardiac catheterization and balloon angioplasty of native coarctation of the aorta at Ibn-AL-Bitar center for cardiac surgery between January 2015 to May 2016.Left heart catheterization was performed with evaluation of the morphology and pressure gradient across the stenotic segment of aorta. Follow up evaluations were done between 1 week and 18 months after discharge (mean 6 months) with transthoracic echocardiography.   Results: The age of patients range from 1month to 4 years (median age at time of procedure was12.3month).  Associated lesions in 11 patients (24.4%).  Immediate results were reduction in gradient from 42.5± 17.3 to 10.3± 8.2 mm Hg in forty-two patients (93.3%). Late result during follow up period, 29 patients (69%) had maintain gradient less than 20mmHg. Complications were reported in 6 patients (13.3%). there was one procedure related death (2.2%).    Conclusions: Balloon angioplasty for treatment of native coarctation of the aorta is effective with sustained benefit on long-term follow-up in infants and children >6 months. Transverse arch hypoplasia and children <6 months old has major effect on late outcome of recurrent coarctation of aorta.

Sign in / Sign up

Export Citation Format

Share Document