scholarly journals Central and Peripheral Cannulation for Cardiopulmonary Bypass in Fetal Sheep: A Comparative Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Yun Teng ◽  
Miao Tian ◽  
Bingxin Huang ◽  
Wentao Wu ◽  
Qiuping Jiang ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Stroke Volume ◽  
Right Ventricular ◽  
Heart Diseases ◽  
Left Ventricular ◽  
Tei Index ◽  
Fetal Sheep ◽  
Liver And Kidney ◽  
Central Cannulation ◽  
Myocardial Enzymes

Objective:In-utero correction is an option for treatment of critical congenital heart diseases (CHDs). Fetal cardiac surgery for CHDs is dependent on the reliable use of fetal cardiopulmonary bypass (CPB), but this technology remains experimental. In this study, we established fetal CPB models with central and peripheral cannulation to explore the differences between the two cannulation strategies.Methods: Ten fetal sheep with 90–110 gestational days were randomized into central cannulation (n = 5) and peripheral cannulation (n = 5) groups. All fetal CPB models were successfully established. At each time point (0, 30, and 60 min after initiation of CPB), echocardiography was performed. Blood samples were also collected for blood gas analysis and tests of myocardial enzymes and liver and kidney function.Results: In the central cannulation group, right ventricular Tei index significantly increased (p = 0.016) over time. Compared with the peripheral cannulation group, the left ventricular Tei index of the central cannulation group was significantly higher (1.96 ± 0.31 vs. 0.45 ± 0.19, respectively; p = 0.028) and the stroke volume was lower (0.46 ± 0.55 vs. 2.13 ± 0.05, respectively; p = 0.008) at 60 min after CPB. Levels of liver and kidney injury markers and of acid-base balance, including alanine aminotransferase (ALT), aspartate aminotransferase/ALT ratio, blood urea nitrogen (BUN), BUN/creatinine ratio, base excess and bicarbonates, were significantly higher for peripheral than for central cannulation. Other important physiologic parameters, including heart rate, blood pressure, myocardial enzymes, umbilical artery beat index and resistance index, left ventricular Tei index, and left and right ventricular stroke volume, were comparable between the two groups.Conclusions: Both central and peripheral cannulations can be used to establish fetal CPB models. Central cannulation causes more adverse impacts for cardiac function, whereas peripheral cannulation is more susceptible to complications related to inadequate organ perfusion.

Right ventricular Tei-index in Hypertrophic Cardiomyopathy. The Influence of Left Ventricular Obstruction

CHEST Journal ◽  
2004 ◽  
Vol 126 (4) ◽  
pp. 794S ◽  
Author(s):  
Ioannis Moyssakis ◽  
Dimitris P. Papadopoulos ◽  
Elias J. Gialafos ◽  
Urania G. Papazachou ◽  
Vassilios Votteas
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Right Ventricular ◽  
Left Ventricular ◽  
Tei Index

A novel echocardiographic parameter for assessment of right ventricular function in acute pulmonary embolism: an experimental study

2019 ◽  
Author(s):  
Decai Zeng ◽  
Ji Wu ◽  
Hui Chen ◽  
Ying Tan ◽  
Xueyu Che ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Right Ventricular ◽  
Acute Pulmonary Embolism ◽  
Autologous Blood ◽  
Left Ventricular ◽  
Control Group ◽  
Tei Index ◽  
Significant Difference ◽  
Acute Pe ◽  
Rv Function

Abstract Background Right ventricular (RV) dysfunction played a decisive role in clinical management and associated with poor prognosis in acute pulmonary embolism (PE). It still remains challenging to estimate RV function accurately for the reason of complex structure and geometry. The present study aimed to determine the value of right ventricular outflow tract systolic excursion (RVOT-SE) in evaluating RV function in an animal model with acute PE. Methods Thirty-three healthy New Zealand rabbits were randomly assigned to massive thrombus group, sub-massive thrombus group and control group, 11 rabbits per group. The acute PE model was established by intravenous infusion of autologous blood clots. After 1h of thrombus injection, transthoracic echocardiography was performed to assess RV function in all rabbits. Results The acute PE model was successfully made in 18 rabbits (massive thrombus group, n = 8; sub-massive thrombus group n = 10). Right/left ventricular end-diastolic diameter (RV/LV) ratio and RV myocardial performance (Tei) index were significantly increased, while RV fractional area change (RVFAC), tricuspid annular plane systolic excursion (TAPSE) and RVOT_SE were reduced in massive thrombus group. The value of RVOT-SE and RVFAC in sub-massive thrombus group decreased significantly compared with control group (P < 0.05). But there was no significant difference in RV/LV, TAPSE and Tei index (P > 0.05). ROC analysis showed that RVOT-SE had high sensitivity (94.4%) and specificity (72.7%) in identifying RV dysfunction in acute PE. The area under the ROC curve (AUC) for combined TAPSE and RVOT-SE was greater than that of TAPSE or RVOT-SE alone (AUC= 0.962, P < 0.01). Conclusion RV function in acute PE is significantly decreased, which is closely related to the size of embolus. RVOT_SE is a simple and highly distinctive parameter in identifying RV dysfunction and tends to be superior to conventional parameters in acute PE. The combination of RVOT-SE and TAPSE can further improve the diagnostic accuracy of acute PE.

scholarly journals Biventricular Pulsus Alternans

2009 ◽  
Vol 2009 ◽  
pp. 1-3 ◽  
Author(s):  
Param Vidwan ◽  
George A. Stouffer
Keyword(s):  
Myocardial Infarction ◽  
Stroke Volume ◽  
Right Ventricular ◽  
Cardiac Catheterization ◽  
Systolic Pressure ◽  
Anterior Wall ◽  
Left Ventricular ◽  
Pulsus Alternans ◽  
Anterior Wall Myocardial Infarction

Pulsus alternans is a rare hemodynamic condition characterized by beat-to-beat variability in systolic pressure. It is attributed to variations in stroke volume with alternate cardiac cycles and is typically seen in patients with advanced myopathic conditions. Left ventricular pulsus alternans is rare, and right ventricular pulsus alternans is even less common. There are only a few reports of biventricular pulsus alternans. We report the case of a 62-year-old female with a recent anterior wall myocardial infarction who had biventricular pulsus alternans at the time of cardiac catheterization.

scholarly journals Early detection of left ventricular failure in right ventricular congenital heart diseases

2019 ◽  
Vol 11 (4) ◽  
pp. e388
Author(s):  
Angèle Boët ◽  
Julien Guihaire ◽  
Emmanuel Le Bret ◽  
Sébastien Hascoet ◽  
Gilles Jourdain ◽  
...  
Keyword(s):  
Early Detection ◽  
Right Ventricular ◽  
Congenital Heart ◽  
Heart Diseases ◽  
Left Ventricular ◽  
Left Ventricular Failure ◽  
Congenital Heart Diseases ◽  
Ventricular Failure

scholarly journals Left ventricular stroke volume in the fetal sheep is limited by extracardiac constraint and arterial pressure

2001 ◽  
Vol 535 (1) ◽  
pp. 231-239 ◽  
Author(s):  
Daniel A. Grant ◽  
Jean‐Claude Fauchère ◽  
Kellie J. Eede ◽  
John. V. Tyberg ◽  
Adrian M. Walker
Keyword(s):  
Arterial Pressure ◽  
Stroke Volume ◽  
Left Ventricular ◽  
Left Ventricular Stroke Volume ◽  
Fetal Sheep ◽  
Ventricular Stroke Volume

Nitecapone Reduces Cardiac Neutrophil Accumulation in Clinical Open Heart Surgery 

1999 ◽  
Vol 91 (2) ◽  
pp. 355-361 ◽  
Author(s):  
Eero J. Pesonen ◽  
Antti E. Vento ◽  
Juhani O. Ramo ◽  
Juha Vuorte ◽  
Sten-Erik Jansson ◽  
...  
Keyword(s):  
Hydrogen Peroxide ◽  
Cardiopulmonary Bypass ◽  
Stroke Volume ◽  
Left Ventricular ◽  
Neutrophil Activation ◽  
Myeloperoxidase Activity ◽  
Left Ventricular Stroke Volume ◽  
Neutrophil Accumulation ◽  
Hydrogen Peroxide Production ◽  
Ventricular Stroke Volume

Background To study the effect of nitecapone, a novel antioxidant, on cardiac neutrophil activation during cardiopulmonary bypass in patients. Methods In a double-blind, placebo controlled trial, 30 male patients undergoing coronary artery bypass grafting were randomly assigned to control (crystalloid cardioplegia, n = 15) and nitecapone groups (cardioplegia supplemented with nitecapone, n = 15). Leukocyte differential counts, neutrophil and monocyte CD11b and L-selectin expressions and neutrophil hydrogen peroxide production were measured in blood samples parallelly obtained from the coronary sinus and aorta before cardiopulmonary bypass and at 1, 5, and 10 min after aortic declamping. Myocardial myeloperoxidase activity was analyzed in biopsies taken at 1, 5, and 10 min after declamping. Results Transcoronary neutrophil difference (i.e., aorta--sinus coronarius) at 1 min after aortic declamping was significantly lower in nitecapone-treated patients (0.41 [-0.42-0.98] x 10(9) cells/l) than in controls (0.68 [-0.28-2.47] x 10(9) cells/l; P = 0.032). At 5 min after aortic declamping, significant transcoronary reduction of neutrophil hydrogen peroxide production and CD11b expression were observed in controls but not in nitecapone patients. At 24 h postoperatively, left ventricular stroke volume was better in nitecapone-treated patients (94 [51-118] ml) than controls (66 [40-104] ml; P= 0.018). Data are median [range]. Conclusion Nitecapone added to cardioplegia solution reduces cardiac neutrophil accumulation and transcoronary neutrophil activation during clinical cardiopulmonary bypass. Reflected by better left ventricular stroke volume, nitecapone treatment may be an additional way of reducing the deleterious effects of neutrophil activation during cardiopulmonary bypass.

Right ventricular systolic pressure load alters myocyte maturation in fetal sheep

2000 ◽  
Vol 279 (4) ◽  
pp. R1157-R1164 ◽  
Author(s):  
A. Barbera ◽  
G. D. Giraud ◽  
M. D. Reller ◽  
J. Maylie ◽  
M. J. Morton ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Systolic Pressure ◽  
Weight Ratio ◽  
Left Ventricular ◽  
Volume Data ◽  
Fetal Sheep ◽  
Ventricular Systolic Pressure ◽  
Hypertrophic Growth ◽  
Maximal Pressure ◽  
Near Term

The effects of right ventricular (RV) systolic pressure (RVSP) load on fetal myocyte size and maturation were studied. Pulmonary artery (PA) pressure was increased by PA occlusion from mean 47.4 ± 5.0 (±SD) to 71 ± 13.6 mmHg ( P < 0.0001) in eight RVSP-loaded near-term fetal sheep for 10 days. The maximal pressure generated by the RV with acute PA occlusion increased after RVSP load: 78 ± 7 to 101 ± 15 mmHg ( P< 0.005). RVSP-load hearts were heavier (44.7 ± 8.4 g) than five nonloaded hearts (31.8 ± 0.2 g; P < 0.03); heart-to-body weight ratio (10.9 ± 1.1 and 6.5 ± 0.9 g/kg, respectively; P < 0.0001). RVSP-RV myocytes were longer (101.3 ± 10.2 μm) than nonloaded RV myocytes (88.2 ± 8.1 μm; P < 0.02) and were more often binucleated (82 ± 13%) than nonloaded myocytes (63 ± 7%; P < 0.02). RVSP-loaded myocytes had less myofibrillar volume than did nonloaded hearts (44.1 ± 4.4% and 56.1 ± 2.6%; P < 0.002). We conclude that RV systolic load 1) leads to RV myocyte enlargement, 2) has minor effects on left ventricular myocyte size, and 3) stimulates maturation (increased RV myocyte binucleation). Myocyte volume data suggest that RV systolic loading stimulates both hyperplastic and hypertrophic growth.

P3360Quantitative assessment of tricuspid regurgitation using right and left ventricular stroke volumes obtained from tomographic equilibrium radionuclide ventriculography

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
D Eyharts ◽  
Y Lavie-Badie ◽  
S Cazalbou ◽  
P Fournier ◽  
E Cariou ◽  
...  
Keyword(s):  
Stroke Volume ◽  
Right Ventricular ◽  
Tricuspid Regurgitation ◽  
Systolic Function ◽  
Radionuclide Ventriculography ◽  
Left Ventricular ◽  
Volumetric Method ◽  
Ventricular Systolic Function ◽  
Right Ventricular Systolic Function ◽  
Function Assessment

Abstract Background Quantitative assessment of valve regurgitation using volumetric method by comparing right and left ventricular stroke volumes is still under investigations. Aims To investigate the accuracy of tomographic equilibrium radionuclide ventriculography (t-ERV) for the quantification of tricuspid regurgitation (TR). Methods and results Sixty-one patients (44 men; mean age 59±12 years) who underwent both t-ERV and transthoracic echocardiography (TTE) studies within 2 weeks for right ventricular systolic function assessment were eligible for inclusion. A sub-group of 22 patients underwent both t-ERV and CMR. Patients with mitral/aortic regurgitation by TTE were excluded of the study. TR regurgitant volume (RVol) was calculated using the proximal isovelocity surface area (PISA) method from TTE and the volumetric method (right ventricular stroke volume minus left ventricular stroke volume) from t-ERV. RVol tended to be higher using the ERV volumetric method as compared to PISA method (43±35 and 35±33 ml, respectively; P<0.0001). There was a significant correlation between RVol as assess by ERV and by TTE (R=0.95, P<0.0001). Intraclass correlation coefficient between TTE and ERV for TR quantification was 0.95 (P<0.0001). Among patients who underwent CMR, the correlation between RVol obtained by TTE and by t-ERV and CMR were R=0.81 and R=0.75, respectively (all P<0.0001), without difference between the two correlations (P=0.263). Linear regression (left) and Bland-Altma Conclusion TR assessment using the t-ERV correlates well with PISA from TTE in patients referred for right ventricular systolic function assessment.

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