A Novel Hypothetical Method to increase the Dimensions of the Coronary Arteries when Required

Mitral Stenosis ◽

Ductus Arteriosus ◽

Experimental Studies ◽

Left Ventricular ◽

Fistula Formation ◽

Surgical Closure ◽

Venous Fistula ◽

Background: The purpose was to develop a novel hypothetical method to increase the size of coronary arteries.Methods: During long-term observation an increase in coronary size has been seen in three unexpected scenarios. Changes in coronary artery sizes were observed in patients with mitral stenosis (n=69) by angiogram prior to percutaneous balloon mitral valvuloplasty or valve replacement surgery for severe mitral stenosis. The coronaries of patients with patent ductus arteriosus who underwent surgical closure in the past (n=14) were examined by echocardiogram. Patients with renal failure on long-term dialysis through peripheral arterio-venous fistula without left ventricular hypertrophy (n=17) were studied by echocardiography. Normal age, weight and sex matched coronary sizes served as controls in the study. All these observations were made over a period of 12 years.Results: The sizes of coronaries in patients with mitral stenosis, patients who underwent closure for patent ductus arteriosus, and in patients on hemodialysis through arteriovenous fistulas were higher than normal controls (p<0.05, for all). A hypothetical model to increase the coronary sizes could be developed based on the analysis of the differential equations of Poiseuille’s. A method is proposed of creating a peripheral arterio-venous fistula, which could be closed later electively by a percutaneous method/surgery. The closure time needs to be determined by experimental studies. The other methods could be a continuous exercise program or by the use of beta-blockers.Conclusion: A novel hypothetical method of peripheral arteriovenous fistula formation is decsribed which could potentially increase the size of the coronaries, which could be closed later.

A Novel Hypothetical Method to increase the Dimensions of the Coronary Arteries When Required

10.20944/preprints201908.0300.v1 ◽

2019 ◽

Author(s):

Mark Christopher Arokiaraj

Keyword(s):

Coronary Arteries ◽

Mitral Stenosis ◽

Ductus Arteriosus ◽

Left Ventricular ◽

Fistula Formation ◽

Surgical Closure ◽

Venous Fistula ◽

Background: The purpose was to develop a novel hypothetical method to increase the size of coronary arteries. Methods: In the long-term observation the coronary sizes were dilated in three unexpected scenarios. The coronary artery sizes were observed in patients with mitral stenosis (n=59) by angiogram prior to percutaneous balloon mitral valvuloplasty or valve replacement surgery for severe mitral stenosis. The coronaries of patients with patent ductus arteriosus who underwent surgical closure in the past (n=12) were examined by echocardiogram. Patients with renal failure on long-term dialysis through peripheral arterio-venous fistula without left ventricular hypertrophy (n=17) were studied by echocardiography. Normal age, weight and sex matched coronary sizes served as controls in the study. All these observations were made over a period of 11.5 years. Results: The sizes of coronaries in patients with mitral stenosis, patients who underwent closure for patent ductus arteriosus, and in patients on hemodialysis through arteriovenous fistulas were higher than normal controls (p<0.05, for all). A hypothetical model to increase the coronary sizes could be developed based on the analysis of the differential equations of Poiseuille’s. The proposed method is creating a peripheral arterio-venous fistula, which could be closed later electively by a percutaneous method/surgery. The closure time needs to be determined by experimental studies. The other methods could be a continuous exercise program or usage of beta-blockers. Conclusion: A novel hypothetical method of peripheral arteriovenous fistula formation could potentially increase the size of the coronaries, and this could be closed later.

Long-term morbidities associated with vocal cord paralysis after surgical closure of a patent ductus arteriosus in extremely low birth weight infants

Journal of Perinatology ◽

10.1038/jp.2009.124 ◽

2009 ◽

Vol 30 (6) ◽

pp. 408-413 ◽

Cited By ~ 65

Author(s):

J R Benjamin ◽

P B Smith ◽

C M Cotten ◽

J Jaggers ◽

R F Goldstein ◽

...

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Vocal Cord Paralysis ◽

Ductus Arteriosus ◽

Extremely Low Birth Weight ◽

Low Birth Weight Infants ◽

Surgical Closure ◽

Patent Ductus Arteriosus Before and After Surgery

Paediatrica Indonesiana ◽

10.14238/pi29.3-4.1989.39-51 ◽

1989 ◽

Vol 29 (3-4) ◽

pp. 39-51

Author(s):

Bambang Madiyono ◽

Ismet N. Oesman ◽

Sudigdo Sastroasmoro ◽

Sukman Tulus Putra ◽

Eva Jeumpa Soelaiman ◽

...

Keyword(s):

Pulmonary Hypertension ◽

Left Atrial ◽

Ventricular Hypertrophy ◽

Ductus Arteriosus ◽

Left Ventricular ◽

Systolic Murmur ◽

Surgical Closure ◽

Pulmonary Flow ◽

Twenty five patients with patent ductus arteriosus, who had undergone surgical closure were studied retrospectively. Girls were more affected than boys; the sex ratio was 4 : I. Associated cardiac lesions were diagnosed in 3 patients, two with ventricular septal defect and one with congenital mitral stenosis. Congestive heart failure was diagnosed in 5 patients before surgery. Typical continuous murmur was heard in most cases (76%), while in the rest only systolic murmur was detected. Electrocardiographic left atrial enlargement, left ventricular hypertrophy and right ventricular hypertrophy were found in 8%, 48% and 40%, respectively.Cardiomegaly with increased pulmonary vascular markings was found in 60% of cases, while ratio of left atrial to aortic root diameter greater than 1.2 was detected in 60% of patients. The PDA could be directly visualized by echocardiography in 15 cases.Cardiac catheterization was performed in 17 cases, 47% with hyperkinetic pulmonary hypertension, 41% with high pulmonary flow without pulmonary hypertension and 12% with mild increased pulmonary flow. The pulmonary-systemic flow ratio (Qp/Qs) was more correlated to pulmonary vascular markings rather than to cardio-thoracic ratio. Division of the ductus was the procedure of choice, but in 16% of cases ductal ligation was performed because of technical reasons. Postoperative catch-up in both weight and height was observed more clearly in children operated at earlier age. Ejection systolic murmur was still detected in 2 patients, in whom hyperkinetic pulmonary hypertension existed prior to surgery. No cardiomegaly was found in patients followedup I year or more after surgery. The mortality was nil.

Transient left ventricular systolic dysfunction following surgical closure of large patent ductus arteriosus among children and adolescents operated at the cardiac centre, Ethiopia

Journal of Cardiothoracic Surgery ◽

10.1186/1749-8090-8-139 ◽

2013 ◽

Vol 8 (1) ◽

Cited By ~ 8

Author(s):

Birkneh Tilahun ◽

Endale Tefera

Keyword(s):

Children And Adolescents ◽

Left Ventricular Systolic Dysfunction ◽

Systolic Dysfunction ◽

Ductus Arteriosus ◽

Left Ventricular ◽

Ventricular Systolic Dysfunction ◽

Surgical Closure ◽

Cardiac Centre ◽

Left ventricular remodeling and change of systolic function after closure of patent ductus arteriosus in adults: Device and surgical closure

American Heart Journal ◽

10.1016/j.ahj.2007.04.045 ◽

2007 ◽

Vol 154 (3) ◽

pp. 436-440 ◽

Cited By ~ 43

Author(s):

Young-Hoon Jeong ◽

Tae-Jin Yun ◽

Jong-Min Song ◽

Jung-Jun Park ◽

Dong-Man Seo ◽

...

Keyword(s):

Ventricular Remodeling ◽

Systolic Function ◽

Left Ventricular Remodeling ◽

Ductus Arteriosus ◽

Left Ventricular ◽

Surgical Closure ◽

Ligation of left pulmonary artery instead of patent ductus arteriosus

Cardiology in the Young ◽

10.1017/s1047951120002784 ◽

2020 ◽

Vol 30 (12) ◽

pp. 1943-1945

Author(s):

Semih Murat Yucel ◽

Irfan Oguz Sahin

Keyword(s):

Surgical Treatment ◽

Pulmonary Artery ◽

Surgical Complication ◽

Ductus Arteriosus ◽

Left Pulmonary Artery ◽

Artery Ligation ◽

Surgical Closure ◽

Post Operative Period ◽

AbstractDuctus arteriosus is an essential component of fetal circulation. Due to occurring changes in the cardiopulmonary system physiology after birth, ductus arteriosus closes. Patent ductus arteriosus can be closed by medical or invasive (percutaneous or surgical) treatment methods. Percutaneous or surgical closure of patent ductus arteriosus can be performed for the cases that medical closure failed. Surgical treatment is often preferred method for closure of patent ductus arteriosus in the neonatal period. The most common surgical complications are pneumothorax, recurrent laryngeal nerve injury, bleeding, and recanalisation. A very rare surgical complication is left pulmonary artery ligation that has been presented in a few cases in the literature. Echocardiography control should be performed in the early post-operative period, especially in patients with clinical suspicion. If reoperation is required, it should never be delayed. We report a newborn patient whose left pulmonary artery ligated accidentally during patent ductus arteriosus closure surgery and surgical correction of this complication at the early post-operative period.