• 【套管形状对主动脉壁和血流湍流的影响: 模拟胸主动脉体外循环过程中的水动力研究。】 复制标题 收藏 收藏
    DOI:10.1111/j.1525-1594.2007.00481.x 复制DOI
    作者列表:Minakawa M,Fukuda I,Yamazaki J,Fukui K,Yanaoka H,Inamura T
    BACKGROUND & AIMS: :This study was designed to analyze flow pattern, velocity, and strain on the aortic wall of a glass aortic model during extracorporeal circulation, and to elucidate the characteristics of flow pattern in four aortic cannulas. Different patterns of large vortices and helical flow were made by each cannula. The high-velocity flow (0.6 m/s) was observed in end-hole cannula, causing high strain rate tensor (0.3~0.4 without unit) on the aortic arch. In dispersion cannula, a decreased strain rate tensor (less than 0.1) was found on the outer curvature of the aortic arch. In Soft-flow cannula (3M Cardiovascular, Ann Arbor, MI, USA), further decreased flow velocity (0.2 m/s) and strain (less than 0.2) were observed. In Select 3D cannula (Medtronic, Inc., Minneapolis, MN, USA), a high strain (0.4~0.5) was observed along the inner curvature of the aortic arch. In conclusion, end-hole cannula should not be used in atherosclerotic aorta. Particular attention should be paid both for selection of cannulas and cannulation site based on this result.
    背景与目标: : 本研究旨在分析体外循环过程中玻璃主动脉模型主动脉壁的血流模式,速度和应变,并阐明四个主动脉插管的血流模式特征。每个套管产生不同的大涡旋和螺旋流模式。在端孔套管中观察到高速流 (0.6 m/s),在主动脉弓上引起高应变率张量 (无单元0.3〜0.4)。在分散套管中,在主动脉弓的外曲率上发现了降低的应变率张量 (小于0.1)。在软流套管 (3m心血管,安阿伯,MI,美国) 中,观察到流速进一步降低 (0.2 M/s) 和应变 (小于0.2)。在选定的3D套管 (Medtronic,inc.,Minneapolis,MN,USA) 中,沿主动脉弓的内曲率观察到高应变 (0.4 ~ 0.5)。总之,端孔套管不应用于动脉粥样硬化的主动脉。根据此结果,应特别注意选择插管和插管部位。
  • 【深度学习预测人胸主动脉血流动力学的可行性研究。】 复制标题 收藏 收藏
    DOI:10.1016/j.jbiomech.2019.109544 复制DOI
    作者列表:Liang L,Mao W,Sun W
    BACKGROUND & AIMS: :Numerical analysis methods including finite element analysis (FEA), computational fluid dynamics (CFD), and fluid-structure interaction (FSI) analysis have been used to study the biomechanics of human tissues and organs, as well as tissue-medical device interactions, and treatment strategies. However, for patient-specific computational analysis, complex procedures are usually required to set-up the models, and long computing time is needed to perform the simulation, preventing fast feedback to clinicians in time-sensitive clinical applications. In this study, by using machine learning techniques, we developed deep neural networks (DNNs) to directly estimate the steady-state distributions of pressure and flow velocity inside the thoracic aorta. After training on hemodynamic data from CFD simulations, the DNNs take as input a shape of the aorta and directly output the hemodynamic distributions in one second. The trained DNNs are capable of predicting the velocity magnitude field with an average error of 1.9608% and the pressure field with an average error of 1.4269%. This study demonstrates the feasibility and great potential of using DNNs as a fast and accurate surrogate model for hemodynamic analysis of large blood vessels.
    背景与目标: : 包括有限元分析 (FEA),计算流体动力学 (CFD) 和流体-结构相互作用 (FSI) 分析在内的数值分析方法已用于研究人体组织和器官以及组织-医疗设备的生物力学相互作用和治疗策略。但是,对于特定于患者的计算分析,通常需要复杂的程序来建立模型,并且需要较长的计算时间来执行模拟,从而阻止了对时间敏感的临床应用中的临床医生的快速反馈。在这项研究中,通过使用机器学习技术,我们开发了深度神经网络 (dnn) 来直接估计胸主动脉内部压力和流速的稳态分布。在对来自CFD模拟的血液动力学数据进行训练之后,dnn将主动脉的形状作为输入,并在一秒钟内直接输出血液动力学分布。训练的dnn能够预测平均误差为1.9608% 的速度幅度场和平均误差为1.4269% 的压力场。这项研究证明了使用DNNs作为大血管血流动力学分析的快速准确替代模型的可行性和巨大潜力。
  • 【复苏性血管内球囊闭塞主动脉期间静脉系统的血流: 使用相衬磁共振成像进行无创评估。】 复制标题 收藏 收藏
    DOI:10.1097/TA.0000000000002557 复制DOI
    作者列表:Izawa Y,Hishikawa S,Matsumura Y,Nakamura H,Sugimoto H,Mato T
    BACKGROUND & AIMS: BACKGROUND:Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a viable resuscitation approach for a subdiaphragmatic injury that can regulate arterial blood flow. On the other hand, the evaluation of venous or portal venous blood flow during REBOA remains insufficient because invasive cannulation or exposure of the vessel may affect the blood flow, and Doppler echography is highly operator-dependent. However, phase contrast magnetic resonance imaging has enabled accurate evaluation and noninvasive measurement. This study aimed to investigate the change of venous and portal venous blood flow during REBOA in a porcine model. METHODS:Seven pigs were anesthetized, and a REBOA catheter was placed. The blood flows of the inferior vena cava (IVC), hepatic vein (HV), portal vein (PV), and superior vena cava (SVC) were measured using phase contrast magnetic resonance imaging, in both the balloon deflated (no-REBOA) and fully balloon inflated (REBOA) states. Mean arterial pressure (MAP), central venous pressure, cardiac index, and systemic vascular resistance index were measured. RESULTS:The blood flows of the suprahepatic, infrahepatic, and distal IVC, HV, and PV in the no-REBOA state were 1.40 ± 0.36 L·min, 0.94 ± 0.16 L·min, 0.50 ± 0.19 L·min, 0.060 ± 0.018 L·min, and 0.32 ± 0.091 L·min, respectively. The blood flow of each section in the REBOA condition was significantly decreased at 0.41 ± 0.078 (33% of baseline), 0.15 ± 0.13 (15%), 0.043 ± 0.034 (9%), 0.029 ± 0.017 (37%), and 0.070 ± 0.034 L·min (21%), respectively. The blood flow of the SVC increased significantly in the REBOA condition (1.4 ± 0.63 L·min vs. 0.53 ± 0.14 L·min [257%]). Mean arterial pressure, central venous pressure, cardiac index, and systemic vascular resistance index were significantly increased after REBOA inflation. CONCLUSION:Resuscitative endovascular balloon occlusion of the aorta decreased blood flows of the IVC, HV, and PV and increased blood flow of the SVC. This result could be explained by the collateral flow from the lower body to the SVC. A better understanding of the effect of REBOA on the venous and portal venous systems may help control liver injury.
    背景与目标:
  • 【运动神经元轴突与背主动脉的平行生长取决于斑马鱼中的Vegfc/Vegfr3信号传导。】 复制标题 收藏 收藏
    DOI:10.1242/dev.091702 复制DOI
    作者列表:Kwon HB,Fukuhara S,Asakawa K,Ando K,Kashiwada T,Kawakami K,Hibi M,Kwon YG,Kim KW,Alitalo K,Mochizuki N
    BACKGROUND & AIMS: :Blood vessels and neurons grow often side by side. However, the molecular and cellular mechanisms underlying their parallel development remain unclear. Here, we report that a subpopulation of secondary motoneurons extends axons ventrally outside of the neural tubes and rostrocaudally as a fascicle beneath the dorsal aorta (DA) in zebrafish. We tried to clarify the mechanism by which these motoneuron axons grow beneath the DA and found that Vegfc in the DA and Vegfr3 in the motoneurons were essential for the axon growth. Forced expression of either Vegfc in arteries or Vegfr3 in motoneurons resulted in enhanced axon growth of motoneurons over the DA. Both vegfr3 morphants and vegfc morphants lost the alignment of motoneuron axons with DA. In addition, forced expression of two mutant forms of Vegfr3 in motoneurons, potentially trapping endogenous Vegfc, resulted in failure of growth of motoneuron axons beneath the DA. Finally, a vegfr3 mutant fish lacked the motoneuron axons beneath the DA. Collectively, Vegfc from the preformed DA guides the axon growth of secondary motoneurons.
    背景与目标: : 血管和神经元经常并排生长。然而,它们平行发展的分子和细胞机制仍不清楚。在这里,我们报告了次级运动神经元的亚群在斑马鱼的背主动脉 (DA) 下方的束中向神经管的腹侧和尾部延伸轴突。我们试图阐明这些运动神经元轴突在DA下生长的机制,并发现DA中的Vegfc和运动神经元中的Vegfr3对于轴突生长至关重要。动脉中Vegfc或运动神经元中Vegfr3的强制表达导致DA上运动神经元的轴突生长增强。vegfr3形变和vegfc形变都失去了运动神经元轴突与DA的排列。此外,在运动神经元中强迫表达两种突变形式的Vegfr3,可能捕获内源性Vegfc,导致DA下方的运动神经元轴突生长失败。最后,vegfr3突变鱼在DA下方缺少运动神经元轴突。总的来说,来自预先形成的DA的Vegfc引导次级运动神经元的轴突生长。
  • 【手术矫正主动脉缩窄可治愈顽固性耳鸣和感音神经性耳聋。】 复制标题 收藏 收藏
    DOI:10.1016/j.icvts.2004.02.019 复制DOI
    作者列表:Rathinam S,Pettigrew AM,Pollock JC
    BACKGROUND & AIMS: :Tinnitus is a challenging condition to manage with no effective treatment. We report a case of lifelong tinnitus present in a patient who was cured with the surgical repair of his coarctation of aorta. The patient was a fit 37-year-old with coarctation of aorta, senserineural deafness and intractable tinnitus. He underwent a thoracotomy and tube by-pass of his coarctation of aorta. A complete relief of his tinnitus and improvement in his hearing was noted postoperatively and confirmed on audiograms. This is the first reported case of tinnitus due to coarctation of aorta relieved by surgical correction of the coarctation.
    背景与目标: : 耳鸣是一种具有挑战性的疾病,没有有效的治疗方法。我们报告了一例因手术修复主动脉缩窄而治愈的患者终身耳鸣。该患者为37岁,患有主动脉缩窄,神经性耳聋和顽固性耳鸣。他接受了开胸手术,并对主动脉缩窄进行了管旁路。术后发现他的耳鸣完全缓解,听力得到改善,并在听力图上得到证实。这是首例因主动脉缩窄而通过手术矫正缩窄而缓解的耳鸣病例。
  • 【改良经食管超声心动图检查解剖胸主动脉; 一种新的诊断方法。】 复制标题 收藏 收藏
    DOI:10.1186/s12947-016-0071-6 复制DOI
    作者列表:Jansen Klomp WW,Peelen LM,Brandon Bravo Bruinsma GJ,Van't Hof AW,Grandjean JG,Nierich AP
    BACKGROUND & AIMS: BACKGROUND:Transesophageal echocardiography (TEE) is a key diagnostic modality in patients with acute aortic dissection, yet its sensitivity is limited by a "blind-spot" caused by air in the trachea. After placement of a fluid-filled balloon in the trachea visualization of the thoracic aorta becomes possible. This method, modified TEE, has been shown to be an accurate test for the diagnosis of upper aortic atherosclerosis. In this study we discuss how we use modified TEE for the diagnosis and management of patients with (suspected) acute aortic dissection. NOVEL DIAGNOSTIC APPROACH OF THE DISSECTED AORTA:Modified TEE provides the possibility to obtain a complete echocardiographic overview of the thoracic aorta and its branching vessels with anatomical and functional information. It is a bedside test, and can thus be applied in hemodynamic instable patients who cannot undergo computed tomography. Visualization of the aortic arch allows differentiation between Stanford type A and B dissections and visualization of the proximal cerebral vessels enables a timely identification of impaired cerebral perfusion. During surgery modified TEE can be applied to identify the true lumen for cannulation, and to assure that the true lumen is perfused. Also, the innominate- and carotid arteries can be assessed for structural integrity and adequate perfusion during multiple phases of the surgical repair. CONCLUSIONS:Modified TEE can reveal the "blind-spot" of conventional TEE. In patients with (suspected) aortic dissection it is thus possible to obtain a complete echocardiographic overview of the thoracic aorta and its branches. This is of specific merit in hemodynamically unstable patients who cannot undergo CT. Modified TEE can guide also guide the surgical management and monitor perfusion of the cerebral arteries.
    背景与目标:
  • 【升主动脉置换后主动脉瓣和毡条倒置引起的溶血性贫血。】 复制标题 收藏 收藏
    DOI:10.1186/s13019-016-0520-1 复制DOI
    作者列表:Sakaguchi M,Takano T
    BACKGROUND & AIMS: BACKGROUNDS:Hemolysis related to a kinked prosthetic graft or inner felt strip is a very rare complication after aortic surgery. We describe herein a case of hemolytic anemia that developed due to aortic flap of the dissection and inversion of an inner felt strip that was applied at the proximal anastomosis of a replaced ascending aorta 10 years previously. CASE PRESENTATION:A 74-year-old woman presented with consistent hemolytic anemia 10 years after replacement of the ascending aorta to treat Stanford type A acute aortic dissection. The cause of hemolysis was attributed to mechanical injury of red blood cells at a site of stenosis caused by aortic flap of the dissection and inversion of the felt strip used for the proximal anastomosis. Repeated resection of the strip and graft replacement of the ascending aorta resolved this problem. CONCLUSIONS:We considered that blood flow disrupted by a jet of blood at the site of the proximal inner felt strip was the cause of severe hemolysis, we describe rare hemolytic anemia at the site of aortic flap and inverted felt strip after replacement of the ascending aorta.
    背景与目标:
  • 【PCI术后心脏损伤综合征,升主动脉周围血肿和脑梗死: 一例病例报告。】 复制标题 收藏 收藏
    DOI:10.1186/s12872-020-01608-9 复制DOI
    作者列表:Wang Y,Li W,Yuan C,Wang H
    BACKGROUND & AIMS: BACKGROUND:Postcardiac injury syndrome (PCIS) is an inflammatory response syndrome characterized by pericardial effusion with or without pleural effusion; however, serious PCIS with peripheral hematoma of the ascending aorta and acute cerebral infarction after percutaneous coronary intervention (PCI) have not been reported. CASE PRESENTATION:This article reports a very rare case of a 40-year-old patient who developed acute pericardial and pleural effusions (both bloody), acute respiratory distress, peripheral hematoma of the ascending aorta, and acute cerebral infarction after PCI. The patient's ECG showed bow-back downward ST elevation in leads I, II, III, and V4-V6. A blood test showed significant increases in eukaryotic-cell count, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). Echocardiography and pulmonary artery computed tomography angiography (CTA) showed a large amount of pericardial effusion and pleural effusion. CTA of the thoracic and abdominal aorta showed a peripheral hematoma of the ascending aorta. A cranial computed tomography (CT) showed cerebral infarction anterior to the anterior horn of the right ventricle. After tracheal intubation, ventilator breathing support, pericardial and pleural drainage, and adrenocortical steroid (prednisone) treatment, he gradually recovered and was discharged 20 days later. CONCLUSION:We report the management of a case of serious PCIS with peripheral hematoma of the ascending aorta and acute cerebral infarction after PCI. Early diagnosis, early differential diagnosis, and early use of steroid therapy are the key in treating PCIS.
    背景与目标:
  • 【[闭合性创伤继发的腹主动脉损伤]。】 复制标题 收藏 收藏
    DOI:10.1016/s0210-5691(07)74794-0 复制DOI
    作者列表:Frizza JI,Fainstein D,Lasdica S,Ontivero M,Mele JI,Vilariño E
    BACKGROUND & AIMS: :Traumatic injury of the abdominal aorta with total interruption of blood flow is uncommon. When there is total obstruction of the artery, the clinical picture is dramatic. The most frequent mechanism is compression due to the safety belt during a car accident. The patients have absent femoral and distal pulses, associated to neuropathy in the lower limbs. We present a case of abdominal aorta injury secondary to closed trauma and review the causes, presentation forms and management of the injury.
    背景与目标: : 完全中断血流的腹主动脉外伤并不常见。当动脉完全阻塞时,临床表现是戏剧性的。最常见的机制是在车祸中由于安全带的压缩。患者的股骨和远端脉搏缺失,与下肢神经病变有关。我们介绍了一例继发于闭合性创伤的腹主动脉损伤,并回顾了损伤的原因,表现形式和处理方法。
  • 【川崎病后,主动脉的生物物理特性发生了变化。】 复制标题 收藏 收藏
    DOI:10.1016/j.echo.2013.08.022 复制DOI
    作者列表:Vaujois L,Dallaire F,Maurice RL,Fournier A,Houde C,Thérien J,Cartwright D,Dahdah N
    BACKGROUND & AIMS: BACKGROUND:The long-term sequelae of Kawasaki disease (KD) are based on the coronary complications. Because KD causes generalized vasculitis, with documented aneurysms in the femoral, iliac, renal, axillary, and brachial arteries, the aim of this study was to assess the biophysical properties of the aorta (BPA) after KD. The BPA are biometric measurements representing vascular structural and dynamic changes in response to cardiac work. METHODS:Anthropometric and echocardiographic measurements of the aorta in a series of patients with KD were compared with those of healthy subjects. The BPA were calculated noninvasively by extrapolating previously validated equations that were conceived for invasive measurements. Because BPA vary with body habitus, control subjects were used to normalize BPA parameters for height to compute BPA Z-score equations. RESULTS:Between June 2007 and February 2010, BPA were recorded in 57 patients with KD >1 year after the onset of the disease, 45 without and 12 with coronary artery sequelae. The mean intervals between the acute onset of KD and enrollment were 10.0 ± 5.0 and 5.8 ± 4.5 years for patients with and without coronary artery sequelae, respectively (P = .008). Patients with KD with coronary artery sequelae had significantly altered Z scores of aortic diameter modulation, Peterson's elastic modulus, and β stiffness index (P = .001-.016). Patients with KD without coronary artery sequelae also exhibited altered elasticity, stiffness, and pulse-wave velocity (P = .001-.026). CONCLUSIONS:Altered BPA after KD are detectible despite apparent resolution of acute vasculitis. Future directions toward determining multilevel and multilayer vascular impact, including vascular autonomous homeostasis, require thorough investigation.
    背景与目标:
  • 【中度扩张管状升主动脉的自然史: 确定最佳成像间隔的意义。】 复制标题 收藏 收藏
    DOI:10.1093/ejcts/ezx024 复制DOI
    作者列表:Park KH,Chung S,Kim DJ,Kim JS,Lim C
    BACKGROUND & AIMS: OBJECTIVES:For a moderately dilated ascending aorta (diameter 35-54 mm), current guidelines recommend continuous annual or semi-annual examinations with computed tomography or magnetic resonance imaging. However, few data have shown the yield and benefit of such a protocol. This study aimed to investigate the fate of a moderately dilated ascending aorta and thereby determine the adequate imaging interval. METHODS:In our institutional database, we identified adult patients having an ascending aortic diameter ≥40 mm in contrast-enhanced computed tomography and follow-up imaging(s) after ≥1 year. Of the 509 patients (mean age 67.2 ± 10.4 years) enrolled in the study, the maximal diameter of the ascending aorta was compared between the first and last images. Also, their medical records were reviewed to investigate the associated illness and clinical events. RESULTS:The mean growth rate of the patients with a 40-44 mm ( n  = 321), 45-49 mm ( n  = 142) and ≥50 mm ( n  = 46) ascending aorta was 0.3 ± 0.5, 0.3 ± 0.5 and 0.7 ± 0.9 mm/year, respectively. During the mean interval of 4.3 ± 2.4 years, significant progression (diameter increase by ≥5 mm) occurred in 3.4, 5.6 and 21.7%, respectively. The 3- to 5-year rates of freedom from significant progression were 99.1%-96.5% (40-44 mm) and 97.8%-96.4% (45-49 mm). In multivariate analysis, initial ascending aortic diameter ≥45 mm and aortic valve regurgitation were significantly associated with significant progression. Acute type A aortic dissection occurred in 5 patients (1%), before the maximal diameter of the ascending aorta reached 55 mm or significant progression was observed. CONCLUSIONS:For a moderately dilated ascending aorta not exceeding 45 mm in maximal diameter and stable in the first annual follow-up image, a 3- to 4-year interval would be reasonable before subsequent imaging. More frequent imaging may be warranted in patients with aortic valve insufficiency or with an aortic diameter ≥45 mm.
    背景与目标:
  • 【内源性卵巢激素调节 β-肾上腺素受体介导的大鼠主动脉舒张。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Conde MV,Marín J,Fernandez-Criado C,Balfagón G
    BACKGROUND & AIMS: :The aim of this study was to assess the influence of the endogenous status of ovarian hormones on the relaxation induced by the beta-adrenoceptor agonists isoprenaline (isoproterenol) and dobutamine in thoracic aorta segments, precontracted with noradrenaline, from age-matched (13-week-old) virgin (oestrus) and ovariectomized (OVX) prepubertal female Wistar rats. Isoprenaline-induced relaxation was decreased in intact aortic segments from OVX rats compared with that in segments from oestrus rats. Relaxation was significantly reduced by endothelium removal, 1 micromol/l propranolol or 100 micromol/l N(G)-nitro-L-arginine methyl ester (L-NAME). The beta(1)-adrenoceptor agonist dobutamine induced less relaxation in intact arteries from oestrus rats than did isoprenaline, and dobutamine-induced relaxation was markedly less in intact segments from OVX compared with oestrus rats. This dobutamine-induced relaxation was abolished by endothelium removal, and reduced by 1 micromol/l propranolol, 100 micromol/l L-NAME or 1 micromol/l yohimbine. Cholera toxin (an activator of the stimulatory G-protein G(s)) caused relaxation in intact arteries from oestrus rats; this relaxation was decreased by both deprivation of ovarian hormones and endothelium removal. Forskolin (a direct activator of the catalytic subunit of adenylate cyclase) and sodium nitroprusside (a nitric oxide donor and cGMP-dependent vasodilator agonist) induced similar endothelium-independent relaxation in arteries from both oestrus and OVX rats. These results suggest that the relaxation elicited by endothelial beta-adrenoceptor activation in the rat thoracic aorta is impaired by deprivation of female ovarian hormones; this impairment is caused, at least in part, by decreases in both the endothelial release of NO and G(s) function.
    背景与目标: : 这项研究的目的是评估卵巢激素的内源性状态对 β-肾上腺素受体激动剂异丙肾上腺素 (异丙肾上腺素) 和多巴酚丁胺在胸主动脉段中诱导的松弛的影响,来自年龄匹配的 (13周大) 处女 (发情期) 和去卵巢 (OVX) 青春期前雌性Wistar大鼠。与发情大鼠相比,OVX大鼠完整主动脉段异丙肾上腺素诱导的松弛减少。通过内皮去除,1微mol/l普萘洛尔或100微mol/l N(G)-硝基-L-精氨酸甲酯 (l-name) 显着降低松弛。与异丙肾上腺素相比,β (1)-肾上腺素受体激动剂多巴酚丁胺在发情期大鼠的完整动脉中引起的松弛较少,而多巴酚丁胺在OVX的完整节段中引起的松弛明显较少。这种多巴酚丁胺诱导的松弛通过内皮去除消除,并被1微摩尔/升普萘洛尔、100微摩尔/升l-name或1微摩尔/升育亨宾还原。霍乱毒素 (刺激性g蛋白G(s) 的激活剂) 引起发情大鼠完整动脉的松弛; 卵巢激素的剥夺和内皮的去除均降低了这种松弛。Forskolin (腺苷酸环化酶催化亚基的直接激活剂) 和硝普钠 (一氧化氮供体和cGMP依赖性血管扩张激动剂) 在发情和OVX大鼠的动脉中诱导了类似的非内皮依赖性舒张。这些结果表明,剥夺女性卵巢激素会损害大鼠胸主动脉中内皮 β-肾上腺素受体激活引起的松弛; 这种损害至少部分是由NO和G(s) 功能的内皮释放减少引起的。
  • 【通过主动脉放置在左心室中的套管灌注的离体工作大鼠心脏中的壁应力引起的节律障碍。】 复制标题 收藏 收藏
    DOI:10.1016/s1056-8719(99)00036-2 复制DOI
    作者列表:Igić R,Po W,Teplitz L
    BACKGROUND & AIMS: :The purpose of the present study was to determine if our recently introduced novel working rat heart preparation could be used to study wall stress-induced dysrhythmias. A double cannula, which consisted of an outer cannula that, was inserted in the aorta and an inner cannula that was advanced into the left ventricle was used. The perfusion flowed through the inner cannula into the left ventricle and was ejected from there into the aorta. Afterload was changed suddenly from 60 to 160 Hg of pressure by turning a valve so that the fluid was diverted to a column set at a different height. A sudden increase of aortic pressure that lasted for 10 sec caused cardiac ectopic beats. Wall stress-induced dysrhythmias were more sustained during perfusion with low potassium and low magnesium Krebs-Henseleit solution. Bradykinin (1 microg) or epinephrine (10 microg) was injected as a bolus via an in-line injection port placed at the inner cannula. Bradykinin significantly reduced the incidence of ectopic beats and epinephrine increased the incidence of nonsustained runs of VT. This "working" heart preparation is a convenient tool to study wall stress-induced dysrhythmias.
    背景与目标: : 本研究的目的是确定我们最近引入的新型工作大鼠心脏制剂是否可用于研究壁应力引起的节律障碍。使用了一个双套管,该套管由插入主动脉的外部套管和进入左心室的内部套管组成。灌注通过内套管流入左心室,并从那里喷射到主动脉。通过转动阀使后负荷从60至160 Hg的压力突然改变,使得流体被转移到设置在不同高度的塔中。持续10秒的主动脉压力突然升高导致心脏异位搏动。在使用低钾和低镁Krebs-Henseleit溶液灌注期间,壁应力引起的心律不齐更加持续。缓激肽 (1 microg) 或肾上腺素 (10 microg) 通过放置在内部套管上的在线注射端口作为推注注射。缓激肽显着降低了异位搏动的发生率,肾上腺素增加了非持续性VT运行的发生率。这种 “有效” 的心脏准备是研究壁应力引起的心律不齐的便捷工具。
  • 【来自未分离,未收获的RIMA的Radial动脉移植物流入: 在CABG手术中避免与主动脉近端吻合的方法。】 复制标题 收藏 收藏
    DOI:10.1016/s1010-7940(00)00585-6 复制DOI
    作者列表:Pehkonen E,Seppänen S,Niemelä K,Majahalme S
    BACKGROUND & AIMS: :Performing the proximal anastomosis of a free arterial graft to the ascending aorta is problematic, especially if the wall of the aorta is calcified or thickened. We describe a method, which makes it possible to avoid this procedure.
    背景与目标: : 对升主动脉进行游离动脉移植物的近端吻合是有问题的,尤其是在主动脉壁钙化或增厚的情况下。我们描述了一种方法,可以避免此过程。
  • 【[肾下主动脉经皮血管成形术9例报告].】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Saliou C,Clerget-Gurnaud JM,Soury P,Sraieb T,Guillemot L,Laurian C
    BACKGROUND & AIMS: :Between June 1996 and September 2000, nine angioplasties of the infra-renal aorta were performed in two Surgical Vascular Centers (Hospital Saint-Joseph, Paris, Polyclinic La Baule), in 6 men and three women age ranged from 36 to 72 years (middle age 48 years and 2 months). Eight of these patients presented important stenoses of the middle infra-renal aorta, or in the aortic bifurcation, one of them presented an occlusion, leading to severe intermittent claudication, and rest pain. After endoluminal kissing balloon angioplasty, five aortic stents (five patients), and six iliac primitive arteries stents (in three patients), extended beyond the aorta, were placed. One isolated angioplasty was also performed. All the procedures were performed in the operative room, with good results, except for one patient requiring emergency aorto-bi-femoral by-pass, because of acute leg ischemia, immediately following the procedure. Follow-up was clinical, with Us-Doppler scan, and angiogram in all cases. After 36 months follow-up (4-52), all patients are asymptomatic, with permeable stents. This technique is well-known since 1980, without excessive morbidity. Aortic angioplasty represents the right technique, with good long-term results, for middle or terminal aorta atheromatous stenosis, according to classical aorto-bi-femoral by-passes. Final result depends on associated iliac arteries stenoses.
    背景与目标: : 在1996年6月和2000年9月之间,在两个外科血管中心 (巴黎圣约瑟夫医院,拉波勒综合诊所) 进行了9次肾下主动脉血管成形术,其中6名男性和3名女性的年龄在36至72岁之间 (中年48岁和2个月)。这些患者中有8例出现肾下主动脉中部或主动脉分叉处的重要狭窄,其中一例出现闭塞,导致严重的间歇性跛行和静息疼痛。腔内接吻球囊血管成形术后,放置了五个主动脉支架 (五个患者) 和六个原始动脉支架 (三个患者),延伸到主动脉之外。还进行了一次孤立的血管成形术。所有程序均在手术室中进行,效果良好,除了一名患者因急性腿部缺血而需要紧急主动脉双股骨旁路外,在手术后立即进行。随访均为临床,所有病例均采用Us多普勒扫描和血管造影。经过36个月的随访 (4-52),所有患者均无症状,均采用可渗透支架。这种技术是众所周知的1980年,没有过度的发病率。根据经典的主动脉-双股骨旁通道,主动脉血管成形术代表了正确的技术,具有良好的长期效果,可治疗中或终末主动脉粥样狭窄。最终结果取决于相关的动脉狭窄。

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