Severe aortic obstruction in Williams-Beuren syndrome

External constriction of the descending aorta elicits immediate inhibition of breathing in dogs under Pentothal-chloralose anesthesia both before and after sino-aortic denervation. Impulses initiated by traction of a ligature on the aorta are conducted into the thoracic part of the cord. There is no indication that this mechanism is activated in experiments involving internal occlusion in the innervated animals. Internal occlusion of the descending aorta elicits inhibition of breathing in dogs under morphine sulfate-chloralose anesthesia having all neural pathways intact. The inhibition is related in large part to reflexes from the sino-aortic zones. In the majority of dogs studied the delayed inhibition of breathing following internal occlusion of the descending aorta was greatly reduced but usually not entirely eliminated by sino-aortic denervation. Therefore, some other respiration-inhibiting mechanism is involved. That the respiratory center may be relatively insensitive to changes in blood flow under the conditions of these experiments is indicated by the fact that in individual cases sudden severe changes in blood pressure in sino-aortic denervated animals were not accompanied by changes in respiration.

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Pulmonary mechanics during induced pulmonary edema in anesthetized dogs

Journal of Applied Physiology ◽

10.1152/jappl.1959.14.2.177 ◽

1959 ◽

Vol 14 (2) ◽

pp. 177-186 ◽

Cited By ~ 108

Author(s):

C. D. Cook ◽

J. Mead ◽

G. L. Schreiner ◽

N. R. Frank ◽

J. M. Craig

Keyword(s):

Pulmonary Edema ◽

Lung Compliance ◽

Tidal Range ◽

Pulmonary Mechanics ◽

Vascular Congestion ◽

Anesthetized Dogs ◽

Trapped Gas ◽

Aortic Obstruction ◽

Gas Volume ◽

Normal Lungs

In order to study the mechanisms underlying the changes in the mechanical properties of the lungs during pulmonary edema, pulmonary vascular congestion was produced in spontaneously breathing, anesthetized dogs by partial aortic obstruction and intravenous infusion. Brief periods of congestion were associated with small changes in the lung compliance compared with the progressive and striking compliance reduction (-78%) noted with more prolonged congestion. Lung volume at end-expiration showed little change if edema fluid and trapped gas as well as the ventilated gas volume were taken into account. When edematous lungs were forcibly inflated beyond the tidal range, it was found that the overall compliance at a distending pressure of 30 cm H2O was not much less (-6%) than that of normal lungs. Furthermore, edematous lungs manifested marked ‘static’ hysteresis during such maneuvers. These findings suggested that surface phenomena were responsible for the mechanical behavior of edematous lungs rather than vascular congestion, per se, or intrinsic tissue changes. This was borne out by experiments on excised lungs which showed that the elastic properties of edematous lungs were not significantly different from normal lungs when surface forces were minimized. Submitted on August 25, 1958

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Ability of noninvasive criteria to predict hemodynamically significant aortic obstruction in adults with coarctation of the aorta

Congenital Heart Disease ◽

10.1111/chd.12424 ◽

2016 ◽

Vol 12 (2) ◽

pp. 174-180 ◽

Cited By ~ 2

Author(s):

Marco Astengo ◽

Caroline Berntsson ◽

Åse A. Johnsson ◽

Peter Eriksson ◽

Mikael Dellborg

Keyword(s):

Coarctation Of The Aorta ◽

Aortic Obstruction

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Left aortic arch with right descending aorta and severe coarctation: an unusual “vascular clamp” with airway compression

Cardiology in the Young ◽

10.1017/s1047951118000665 ◽

2018 ◽

Vol 28 (8) ◽

pp. 1056-1058

Author(s):

Ronak Sheth ◽

Roy Varghese ◽

Kothandam Sivakumar

Keyword(s):

Aortic Arch ◽

Clinical Presentation ◽

Main Bronchus ◽

Left Main Bronchus ◽

Left Main ◽

Descending Aorta ◽

Airway Compression ◽

Rare Congenital Anomaly ◽

Aortic Obstruction ◽

Right Descending Aorta

AbstractLeft aortic arch with right descending aorta is a rare congenital anomaly. We describe the clinical presentation of this unusual anomaly associated with cardiorespiratory compromise from severe aortic obstruction and left main bronchus compression. The anatomical peculiarities, embryological basis, and surgical solutions are presented.

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Staged surgical approach to neonates with aortic obstruction and single-ventricle physiology

The Annals of Thoracic Surgery ◽

10.1016/s0003-4975(99)00792-4 ◽

1999 ◽

Vol 68 (3) ◽

pp. 962-967 ◽

Cited By ~ 23

Author(s):

Jonah N.K Odim ◽

Hillel Laks ◽

Davis C Drinkwater ◽

Barbara L George ◽

James Yun ◽

...

Keyword(s):

Surgical Approach ◽

Single Ventricle ◽

Single Ventricle Physiology ◽

Aortic Obstruction

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Ascending aortic obstruction with hypoplastic innominate artery

International Journal of Cardiology ◽

10.1016/j.ijcard.2015.07.031 ◽

2015 ◽

Vol 199 ◽

pp. 356-357

Author(s):

Fang Fang ◽

Min Bao ◽

Hui Zhang ◽

Tao Wu ◽

Yi Luo ◽

...

Keyword(s):

Innominate Artery ◽

Aortic Obstruction

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Systemic hypertension and aortic obstruction in children

European Journal of Pediatrics ◽

10.1007/bf00442104 ◽

1981 ◽

Vol 135 (3) ◽

pp. 281-289 ◽

Cited By ~ 11

Author(s):

S. Shrivastava ◽

M. Rajani ◽

P. Chopra ◽

A. N. Malaviya ◽

R. Tandon

Keyword(s):

Systemic Hypertension ◽

Aortic Obstruction

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Iatrogenic ascending aortic obstruction in the neonate: Significance of pressure gradients across the aorta

Saudi Journal of Anaesthesia ◽

10.4103/1658-354x.152898 ◽

2015 ◽

Vol 9 (2) ◽

pp. 225

Author(s):

MadanMohan Maddali

Keyword(s):

Pressure Gradients ◽

Aortic Obstruction

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The efficacy and safety of the Amplatzer ductal occluder in young children and infants

Cardiology in the Young ◽

10.1017/s1047951105000570 ◽

2005 ◽

Vol 15 (3) ◽

pp. 279-285 ◽

Cited By ~ 34

Author(s):

Jameel Al-Ata ◽

Amin M. Arfi ◽

Arif Hussain ◽

Amjad A. Kouatli ◽

M. Omar Jalal

Keyword(s):

Young Children ◽

Pulmonary Arteries ◽

Major Complication ◽

High Rate ◽

Excessive Bleeding ◽

Descending Aorta ◽

Complete Occlusion ◽

Transcatheter Occlusion ◽

Occluder Device ◽

Aortic Obstruction

Background: We have used the Amplatzer ductal occluder for transcatheter closure of large persistently patent arterial ducts, and used our experience to assess the safety and efficacy of the device in young children and infants. Methods and patients: We used the Amplatzer ductal occluder prospectively in 43 patients with large patent arterial ducts, reviewing our experience to identify any problems or complications. Results: The procedure proved successful in 42 of the patients. We achieved complete occlusion of the duct in 33 (78.5 per cent) of the patients on the day of insertion. In 6 additional patients, complete occlusion occurred 1 week to 6 months after the procedure. Trivial leaks persisted in 2 patients, while one had a significant residual leak. Problems were encountered in 7 patients. The procedure failed in one, a device was wasted in 2, pulled through in 3, while we experienced kinking of the long Mullins sheath, being unable to retrieve the device, in one patient. Minor complications occurred in 6 patients, finding flow at a peak velocity of 2.2 metres per second in the descending aorta in 2 patients, and at 2.5 metres per second in 2 further patients, and flow at 2.5 metres per second in the pulmonary arteries of two patients. One patient experienced a major complication due to excessive bleeding. Out of the 14 patients suffering adverse events, 13 weighed less than 10 kilograms. This rate of problems and complication in these patients weighing less than 10 kilograms was significantly higher than in the patients weighing more than 10 kilograms. Conclusion: Transcatheter occlusion of moderate to large patent arterial ducts with the Amplatzer ductal occluder device is safe and effective, with a high rate of complete occlusion. Problems and minor complications may be encountered in children weighing less than 10 kilograms. If the device is to be deployed completely in the ductal ampulla, and to avoid descending aortic obstruction, the size of the retention flanges of the occluder should not exceed the largest diameter of the patent arterial duct.

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