Repair of Acute Ascending Aorta-Arch Dissection with Continuous Body Perfusion: A Case Report

2005 ◽  
Vol 6 (1) ◽  
pp. 43 ◽  
Author(s):  
Dimitri Novitzky ◽  
Edward G. Izzo ◽  
Mark J. Alkire ◽  
John C. Brock
Keyword(s):  
Organ Failure ◽  
Aortic Arch ◽  
Ascending Aorta ◽  
The Body ◽  
Entire Body ◽  
Arterial Blood ◽  
Continuous Body ◽  
Aortic Anastomosis ◽  
Femoral Line ◽  
The Right

An approach for the replacement of the distal ascending aorta-proximal arch and acute dissection is described. During the operation, the patient's entire body was continuously perfused, the aortic arch was excluded from the arterial circulation, and the aorta was not clamped at any time. To achieve continuous body perfusion, we independently cannulated the right axillary and the left femoral arteries. The right atrium was cannulated for systemic venous return, and the right radial artery was used for arterial blood pressure monitoring. The myocardium was protected with retrograde cardioplegia, and the body was protected with moderate hypothermia. Vascular clamps were placed to the proximal innominate, left carotid, and left subclavian arteries without discontinuing perfusion of the right axillary artery. A temporary clamp was applied to the femoral line, the aorta was transected, and a large Foley catheter was inserted through the true aortic lumen. The Foley bulb was positioned in the proximal descending thoracic aorta and distended with saline until the aortic blood return ceased. The femoral line clamp was removed from the cannula, and the entire body was perfused during the completion of the distal aortic anastomosis. At the completion of the anastomosis, the Foley bulb was slightly deflated. Once the inserted graft was filled with blood, a large vascular clamp was applied to the graft, and the previously placed clamps were removed from the arch branches. The femoral line was removed, and the body was perfused and rewarmed via the axillary cannulation. Following completion of the proximal graft-aortic anastomosis, the heart was reperfused, and all cannulas were removed in the usual fashion. Rapid recovery characterized the patient's initial postoperative course; however, multiple organ failure secondary to pump-induced inflammatory response followed. Aggressive medical management resulted in complete patient recovery. No neurologic deficits were observed, and the patient regained full cognitive function. This report describes a simple approach to facilitate repair of the aortic arch and minimize postoperative organ failure.

CARDIORENAL EFFECTS OF LARGE INFUSIONS OF DEXTRAN IN DOGS

1954 ◽  
Vol 32 (1) ◽  
pp. 559-566 ◽  
Author(s):  
C. W. Gowdey ◽  
I. E. Young
Keyword(s):  
Cardiac Output ◽  
Peripheral Resistance ◽  
The Body ◽  
Arterial Blood ◽  
High Output Heart Failure ◽  
Mean Pressure ◽  
Anesthetized Dogs ◽  
The Right ◽  
Dextran Solution ◽  
High Output

The production of hypervolemic dilution anemia in intact, anesthetized dogs by the continuous intravenous infusion of 6% dextran solution caused large increases in the cardiac output and urine flow. No consistent changes were observed in pulse rate or arterial blood pressure. The right auricular mean pressure usually increased early in the infusion, but later there was no consistent relation between right auricular pressure and cardiac output. The total peripheral resistance, glomerular filtration rate, and renal blood flow decreased. With infusion volumes exceeding 10% of the body weight, acute high-output heart failure occurred. The observed hemodilution was consistently greater than that expected from the volume of the infusion, because the dextran solution was, presumably, hypertonic.

Heart and aorta morphology of the deep-diving hooded seal (Cystophora cristata)

2002 ◽  
Vol 80 (11) ◽  
pp. 2030-2036 ◽  
Author(s):  
Charles M Drabek ◽  
Jennifer M Burns
Keyword(s):  
Right Ventricle ◽  
Large Diameter ◽  
Ascending Aorta ◽  
The Body ◽  
Diving Behavior ◽  
Hooded Seal ◽  
Descending Aorta ◽  
Deep Diving ◽  
Cystophora Cristata ◽  
The Right

An investigation of the heart morphology of 8 male and 15 female hooded seals (Cystophora cristata) revealed that the heart is proportionately large and the aortic bulb is larger than that reported for most seals. Hooded seals of all ages have large hearts (0.64% of the body mass) and the right ventricle is proportionately longer and more muscular than reported for other seals. The bulb of the ascending aorta shows the large-diameter characteristic of seals capable of making long deep dives, and is constricted to a diameter of less than one-third in the descending aorta. In addition, the ascending aorta has a much greater concentration of elastin fibers than does the descending aorta. In combination with the large right ventricle, these features probably serve to increase lung perfusion during the hooded seal's surface recovery, and to maintain a high blood pressure throughout the cardiac cycle during diving bradycardia. That there was no substantive difference in the heart morphology of pups, yearlings, and adults, suggests that these features are important in the development of diving behavior, and agrees with the rapid behavioral and physiological development of hooded seal neonates.

scholarly journals Morphometry of the aortic arch and its branches

2013 ◽  
Vol 19 (3) ◽  
pp. 154-159 ◽  
Author(s):  
A.M. Manole ◽  
D.M. Iliescu ◽  
A. Rusali ◽  
P. Bordei
Keyword(s):  
Carotid Artery ◽  
Aortic Arch ◽  
Subclavian Artery ◽  
Common Carotid Artery ◽  
Left Subclavian Artery ◽  
Ascending Aorta ◽  
Ct Scanner ◽  
Arterial Trunk ◽  
Brachiocephalic Trunk ◽  
The Right

Abstract Our study was conducted by the evaluation of angioCT’s performed on a GE LightSpeed VCT64 Slice CT Scanner. The measurements were performed on the aortic arch at the following levels: at the origin of the aorta, the middle part of the ascending aorta, prior to the origin of the brachiocephalic arterial trunk and after the origin of the left subclavian artery. We measured the caliber of the aortic arch arteries and the data are correlated and reported by gender. The diameter of the ascending aorta was between 27 to 28.9 mm in females and in males from 25.8 to 37.6 mm. The diameter of the aorta within the middle segment of the ascending part was between 28-30.2 mm in females and in males from 26.1 to 34.6. The diameter of the aortic arch prior to the origin of the brachiocephalic arterial trunk was between 26.4 to 29.4 mm in females and in males from 25.8 to 37.5 mm. The diameter of the aortic arch after the origin of the left subclavian artery was in a range of 20.4 to 28.4 mm, which corresponds to the limits found in males while in females the aortic diameter was between 21.3 to 24.1 mm. The brachiocephalic trunk diameters were 8.3 to 15.5 mm in females and in males was 9.1 to 14.5 mm. The right common carotid artery had a diameter of 4-8 mm diameter in males and in females ranged from 4.7 to 5.5 mm. The right subclavian artery showed a caliber of 5.7 to 7.5 mm in females and in males from 5.9 to 10.1. The left common carotid artery diameter was 4.6 to 5.7 mm in females and males the diameter was between 5.2 to 7.4 mm. The left subclavian artery had a diameter of 6-10 mm in females and in males ranged from 7.7 to 12.8 mm. We found that the distance between the ascending part of the aorta and the descending segment ranged from 33.3 to 38.5 mm in females and in males from 40 to 68.6 mm. We measured the distance that exists at the crossing of the aortic arch with the left branch of the pulmonary trunk, finding that in females this distance is 3 to 10.3 mm and in males from 3 to 12.5 mm.

scholarly journals HEALTH MEET - MUSIC

2015 ◽  
Vol 3 (1SE) ◽  
pp. 1-2
Author(s):  
Monisha Veeravani
Keyword(s):  
Music Therapy ◽  
Human Life ◽  
High Stress ◽  
The Body ◽  
Special Importance ◽  
Entire Body ◽  
Sound Waves ◽  
The Right ◽  
The Mind ◽  
The Brain

Music gives people a deeper understanding on the level of sensation and motivates them to become better and this element can change the world when it is wider than our own. It is music that connects the beginning to the end and becomes the literature of our heart. Fills the soul with affection, takes the mind from deep darkness to eternal heights. Music has the status of a® God, so purity has special importance in this genre. Music is the way to cultivate the mind through the seven pure and five vocal cords. Therefore, it can be said that music is necessary to keep the body and mind healthy, cheerful. This keeps the body, mind and brain healthy, and concentrates. Stress is also removed from music. It has been proved by various scientific experiments that both music practice and yoga practice develop strength in human life and many diseases can be treated. Music therapy i.e. music therapy nowadays plays an important role in relieving many health problems. Is playing If you live under high stress or are suffering from insomnia problem, then you can take help of this therapy. Each sound produces specific waves. These sound waves directly affect our brain. Everything in existence is affected by these waves. If a music is composed with the right words and the appropriate ragas, it will work on our brain in the same way that the software works inside a computer. Since our entire body is under the control of the brain, we can get the right result by having the expected effect on the brain through remedial music. संगीत लोगों को संवेदना के स्तर पर एक गहरी समझ देकर उन्हें बेहतर बनने की दिशा में प्रेरित करता है और यही तत्व जब निज से व्यापक होता है तो दुनिया भी बदल सकती है. ये संगीत ही है जो आदि को अंत से जोडकर हमारे हृदय का साहित्य बन जाता है। आत्मा को स्नेह से भर देता है मन को गहन अन्धकार से लेकर अनन्त ऊंचाइयों तक ले जाता है । संगीत क® ईश्वर का दर्जा प्राप्त है, इसीलिए इस विधा में शुध्दता का विशेष महत्व है। सात षुघ्द अ©र पांच क®मल स्वर®ं के माध्यम से मन क® साधने का उपाय है संगीत। अतः कहा जा सकता है कि शरीर तथा मन क® स्वस्थ््ा, प्रफुल्लित रखने के लिए संगीत आवश््यक है। इससे शरीर, मन, मस्तिष्क स्वस्थ््ा रहता है, एकाग्र रहता है। संगीत से तनाव भी दूर ह®ता है। विभिन्न वैज्ञानिक प्रयोगों द्वारा यह सिद्ध हो चुका है कि संगीत साधना व योग साधना दोनों से मनुष्य के जीवन में शक्ति का विकास होता है और अनेक बीमारियों का उपचार किया जा सकता है म्यूजिक थेरेपी यानी संगीत चिकित्सा आजकल अनेक स्वास्थ्य समस्याओं से राहत दिलाने में अहम भूमिका निभा रही है। आप अगर ज्यादा तनाव में रहते हैं या अनिद्रा की समस्या से पीडित हैं तो इस चिकित्सा की सहायता ले सकते हैं । हर ध्वनि से विशिष्ट तरंगें पैदा होती हैं। ये ध्वनि तरंगें सीधे हमारे मस्तिष्क को प्रभावित करती हैं। इन्हीं तरंगों से अस्तित्व में मौजूद हर चीज प्रभावित होती है। अगर कोई संगीत सही शब्दों और उपयुक्त रागों के साथ तैयार किया जाए तो वह हमारे मस्तिष्क पर उसी तरह काम करेगा जैसे किसी ’कम्प्यूटर’ के अंदर ’साफ्टवेयर’ काम करता है। चूंकि हमारा पूरा शरीर मस्तिष्क के नियंत्रण में होता है, इसलिए हम मस्तिष्क पर उपचारी संगीत के माध्यम से अपेक्षित प्रभाव डालकर सही परिणाम प्राप्त कर सकते हैं।

scholarly journals New Cutting Method to Aid Performance of Graft-to-Graft Aortic Anastomosis

2015 ◽  
Vol 42 (4) ◽  
pp. 348-349 ◽  
Author(s):  
Kerim Cagli ◽  
Gokhan Lafci ◽  
Adnan Yalcinkaya ◽  
Adem Ilkay Diken
Keyword(s):  
Aortic Arch ◽  
Ascending Aorta ◽  
Graft Replacement ◽  
Cutting Method ◽  
Replacement Surgery ◽  
Accurate Performance ◽  
Aortic Anastomosis

In graft-replacement surgery of the ascending aorta and aortic arch, 2 separate grafts are frequently needed in order to construct a more physiologically configured aorta. We describe a new cutting method for accurate performance of graft-to-graft anastomosis.

ARCH Replacement in Acute Aortic Dissection Type a in Normothermia

2001 ◽  
Vol 71 (3) ◽  
pp. 282-286
Author(s):  
Ovidiu Stiru ◽  
Roxana Carmen Geana ◽  
Adrian Tulin ◽  
Raluca Gabriela Ioan ◽  
Victor Pavel ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Ct Scan ◽  
Aortic Arch ◽  
Acute Aortic Dissection ◽  
Circulatory Arrest ◽  
Type A ◽  
Ascending Aorta ◽  
Descending Aorta ◽  
The Right ◽  
Aortic Dissection Type A

The purpose of this case presentation is to present a simplified surgical technique when in a patient with acute aortic dissection type A (AAD), aortic arch, and ascending aorta is completely replaced without circulatory arrest. A 67-year old male was presented in our institution with severe chest and back pain at 12 h after the onset of the symptoms. Imaging studies by 3D contrast-enhanced thoracic computed tomography (CT-scan) and transesophageal echocardiography (TEE) revealed ascending aortic dissection towards the aortic arch, which was extending in the proximal descending aorta. We practiced emergency median sternotomy and established cardiopulmonary bypass (CBP) between the right atrium and the right femoral artery with successive cross-clamping of the ascending and descending aorta below the origin of the left subclavian artery (LSA). In normothermic condition without circulatory arrest and with antegrade cerebral perfusion, we replaced the ascending aorta and aortic arch with a four branched Dacron graft. Patient evolution was uneventful, and he was discharged, after fourteen days from the hospital. At a one-year follow-up, 3D CT-scan showed no residual dissection with a well-circulated lumen of the supra-aortic arteries. Using the described surgical approach, CPB was not interrupted, the brain was protected, and hypothermia was no used. This approach made these surgical procedures shorter, and known complications of hypothermia and circulatory arrest are avoided.Acute aortic dissection aortic type A, total arch replacement, normothermia

Catheter-tip flowmeter for coronary arterial flow in closed-chest dogs

1964 ◽  
Vol 19 (6) ◽  
pp. 1199-1201 ◽  
Author(s):  
Heinz P. Pieper
Keyword(s):  
Blood Flow ◽  
Pulsatile Flow ◽  
Left Coronary Artery ◽  
Ascending Aorta ◽  
Arterial Blood Flow ◽  
Performance Tests ◽  
Closed Chest ◽  
Arterial Blood ◽  
Catheter Tip ◽  
The Right

The design of a catheter-tip flowmeter for the measurement of coronary arterial blood flow in closed-chest dogs is presented. The miniaturized flowmeter is attached to the tip of a rigid catheter which is inserted through the right carotid artery. The flowmeter is placed in the ascending aorta where it measures the inflow into the left coronary artery. Performance tests show the reliability of the instrument for the measurement of pulsatile flow. pulsatile flow Submitted on February 3, 1964

scholarly journals OBSERVATIONS ON THE SITES OF REMOVAL OF BACTERIA FROM THE BLOOD IN PATIENTS WITH BACTERIAL ENDOCARDITIS

1945 ◽  
Vol 81 (1) ◽  
pp. 9-23 ◽  
Author(s):  
Paul B. Beeson ◽  
Emmett S. Brannon ◽  
James V. Warren
Keyword(s):  
Femoral Vein ◽  
Venous Blood ◽  
Bacterial Endocarditis ◽  
The Body ◽  
Mixed Venous Blood ◽  
Renal Veins ◽  
Arterial Blood ◽  
Venae Cavae ◽  
Bacterial Content ◽  
The Right

In 6 patients with bacterial endocarditis studies were made of the bacterial content of arterial and venous blood. Paired samples were collected, approximately simultaneously, from two different locations in the circulatory system, and colony counts were determined. As many as 48 specimens were taken for culture during a single period of study. Venous blood was drawn not only from different locations in the extremities, but also from the superior and inferior venae cavae, the right auricle, and the hepatic and renal veins. As would be expected, colony counts were highest in arterial blood. Blood from the antecubital veins gave colony counts only slightly lower than arterial blood. In the femoral veins, on the other hand, there were appreciably fewer organisms. This difference is attributed to the type of tissues drained by the two veins. Colony counts in blood from the superior and inferior venae cavae were also lower than arterial counts, the ratio being comparable to that found in femoral vein blood. In the renal veins colony counts were only slightly below the arterial level indicating that few organisms are removed from the blood during passage through the kidneys. The greatest reduction in bacterial content was found in hepatic vein blood. In 3 of the 6 subjects this reduction amounted to more than 95 per cent, and in all subjects the difference was very considerable. Mixed venous blood in the right auricle of the heart gave colony counts which were usually one-half to two-thirds as high as in corresponding samples of arterial blood. An interesting finding in these studies was a remarkable constancy of the bacterial content of arterial blood, during periods of 1 or 2 hours. Despite the fact that a considerable portion of the bacteria which leave the heart in arterial blood appear to be removed during a single circuit of the body, the number of bacteria in successive samples of arterial blood shows little change. This indicates that in bacterial endocarditis organisms are discharged into the blood from the endocardial vegetations at a comparatively even rate, rather than in a haphazard fashion as a result of the breaking off of infected particles.

2 Hz Electro-Acupuncture at Yinlingquan (SP9) and Ququan (LR8) Acupoints Induces Changes in Blood Flow in the Liver and Spleen

2012 ◽  
Vol 40 (01) ◽  
pp. 75-84 ◽  
Author(s):  
Wen-Cheng Chou ◽  
Hsu-Jan Liu ◽  
Yi-Wen Lin ◽  
Chin-Yi Cheng ◽  
Tsai-Chung Li ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Blood Flow ◽  
The Body ◽  
Arterial Blood ◽  
Flow Perfusion ◽  
Significant Difference ◽  
Specific Organ ◽  
The Mean ◽  
The Right ◽  
Measurement Period

According to the principles of traditional Chinese medicine, channels and collaterals within the body provide pathways through which qi and blood travel, and each channel or collateral is linked with a specific organ. The Yinlingquan (spleen 9, SP9) and Ququan (liver 8, LR8) acupoints represent the sea points of the spleen and liver meridians, respectively, from which qi and blood flow into their specific visceral organs. The purpose of this study was to investigate the changes in blood flow/perfusion in the liver and spleen resulting from the application of 2 Hz electro-acupuncture (EA) to the Yinlingquan (SP9) or Ququan (LR8) acupoints. A total of 18 Spragrue-Dawley rats were randomly divided into three groups of six rats each as follows: sham group receiving sham EA; Yinlingquan (SP9) group receiving 2 Hz EA, applied at bilateral Yinlingquan (SP9) acupoints; and Ququan (LR8) groups receiving 2 Hz EA, applied at bilateral Ququan (LR8) acupoints. The mean blood flow/perfusion of the spleen and liver was recorded using a laser Doppler blood flow monitor prior to EA (representing the baseline), during EA, and post-EA. Each measurement period lasted ten minutes. Nitric oxide levels were also measured from the right femoral arterial blood, following the conclusion of each series of blood flow/perfusion recordings. The results indicate that the sham EA did not increase the mean blood flow/perfusion in the liver or spleen; 2 Hz EA at bilateral Yinlingquan (SP9) acupoints increased the mean blood flow/perfusion in the spleen, but not in the liver. In contrast, 2 Hz EA at bilateral Ququan (LR8) acupoints increased the mean blood flow/perfusion in the liver, but not in the spleen. Nitric oxide levels showed no significant difference between any of the groups at any stage of the measurements. According to the results, we conclude that EA at the Yinlingquan (SP9) and Ququan (LR8) acupoints can increase the blood flow in the spleen and liver, respectively.

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