Showing papers on "Aortic arch published in 1973"

Characteristics of Single Aortic and Right Subclavian Baroreceptor Fiber Activity in Rabbits with Chronic Renal Hypertension

Abstract: Experimental renal hypertension was induced in rabbits by wrapping polyethylene around one kidney and removing the other. The impulse activity in single baroreceptor fibers of the aortic nerves to the aortic arch and the right subclavian areas was studied 7-19 weeks postoperatively during nonpulsatile perfusion of an isolated aortic arch preparation. The results were compared with those obtained in normal rabbits. Curves relating the impulse frequency to the aortic arch pressure were constructed. In rabbits with hypertension, the threshold pressure of the aortic baroreceptor fibers was increased from a normal value of 52.5 ± 5.5 to 106.5 ± 5.8 mm Hg, and the point of inflection was increased from 112.4 ± 6.2 to 163.4 ± 5.1 mm Hg. The sensitivity of the baroreceptors to changes in pressure was reduced from 1.19 ± 0.14 to 0.64 ± 0.06 impulses/sec mm Hg-1. Similar results were obtained for the right subclavian area. Hysteresis, as indicated by the separation of the curves produced by first increasing and then reducing the aortic pressure, was more evident in rabbits with hypertension than in normal rabbits. The changes in baroreceptor activity in rabbits with hypertension were associated with alterations in the mechanical properties of the arterial walls, which were demonstrated by the pressure-volume curves. Also, there were demonstrable histological lesions of the arterial walls and the receptors in rabbits with hypertension.

Absence of Anatomic Origin from Heart of Pulmonary Arterial Supply

Abstract: Among certain patients with cardiovascular malformations, a common phenomenon is a ventricular septal defect and absence of anatomic origin of the pulmonary arterial supply from the heart. In this situation, true pulmonary arteries may be present or absent. In the latter case, the pulmonary arterial supply comes through bronchial arteries. When true pulmonary arteries are present, the left and right pulmonary arteries either may be in continuity at their origins (confluence) or they may arise from separate sites (nonconfluence). When confluence is present, the two pulmonary arteries may arise either from an atretic pulmonary trunk or from certain forms of persistent truncus arteriosus. Pulmonary atresia may be localized to the proximal end of the pulmonary trunk or diffuse in this vessel. When nonconfluence is present, each pulmonary artery arises separately from one of three possible sources as follows: (1) a form of persistent truncus arteriosus, (2) through ducti arteriosi from the aortic arch system, ...

Right aortic arch with mirror-image branching causing vascular ring. A new classification of the right aortic arch patterns.

Abstract: Three patients with right aortic arch and mirror-image branching of the major arteries are presented. In contrast to those reported in the literature, none had associated cardiac defects and all of them had severe symptoms resulting from vascular ring, which required surgical treatment. A new classification of the right aortic arch patterns, based on the site of interruption of the left arch,has been proposed.

Complete Interruption of the Aortic Arch in Adults

Abstract: Three cases of complete interruption of the aortic arch (CIAA) are presented. Two patients were adults manifesting systemic arterial collaterals without a patent ductus arteriosus. The authors conclude that a patent ductus is a deterrent to long-term survival when associated with CIAA.

Angiographic approach to the difficult aortic arch: a new technique for transfemoral cerebral angiography in the aged

Abstract: A new catheter technique for selective study of the branches of the difficult aortic arch has been used in 213 patients. Designed for the femoral approach, it is also applicable to either axillary approach.Ninety-seven per cent of attempted selective catheterizations were successful. The complication rate was minimal, reflecting the relatively short procedure time and economy of manipulation.

Aortic Dissection Involving an Aberrant Right Subclavian Artery Studied by Aortography

Abstract: Summary A case is reported of an aberrant right subclavian artery detected at aortography following its involvement in a dissecting aneurysm commencing in the adjacent aortic arch, an example of a small group unrecognized until complicated by acquired disease. The clinical features are discussed briefly and the absence of tracheo-oesophageal compression at any stage emphasized. Implication of the brachiocephalic branches is noted to be uncommon in such a distally originating aortic dissection. The aorto-graphic findings are described in detail; particular reference is made to a double radio-lucent line in the anomalous vessel related to marked circumferential involvement and to the value of an additional projection in elucidating this and other features.

Cerebro-Vascular Disease

Abstract: Publisher Summary This chapter reviews cerebro-vascular disease. Cerebro-vascular disease entails a study of the relatively accessible extra-cranial vessels from the aortic arch to the base of the skull. The aortic arch shows anatomical variation in 5% of the individuals. The more common abnormalities are double innominate arteries or individual origins for each carotid and subclavian artery. Both, cerebral atheroma and ageing influence the degree to which, collateral can hypertrophy and these factors dictate the difficulty in providing an accurate prognosis in the individual case of arterial stenosis of the extra-cranial vessels. Sudden occlusion of an artery, such as that produced by cardiac embolus or aortic dissection, is followed by stasis and coagulation of the blood in the distal segment, as far as the first collateral. In carotid artery disease, the smooth atheroma is most commonly encountered, but ulcers and acute localized dissections also occur. With aneurysmal disease, both the artery elongates and expands, and while mural thrombus is less common in innominate and carotid aneurysms than in the abdominal aorta, the elongation may cause kinking of the artery with temporary cerebral ischaemia.

The plain chest radiograph in d-transposition of the great arteries in the first month of life.

Abstract: The initial plain chest radiograph of 60 infants with transposition of the great arteries and all less than 29 days old are reviewed. The previously described appearances of an oval heart, a narrow pedicle and increased pulmonary markings were only seen in 6 infants (10%). In 10 infants the appearances were normal (16%), and corresponded to the appearances seen in normal infants whose radiographs were used as controls. The relationship of the aortic arch as seen in the angiograms is related to the width of the pedicle as seen in the plain radiographs. The pattern of origin of the aortic arch vessels was observed, and a common brachiocephalic trunk or innominate artery displaced to the left was seen in 10 of the 41 infants with suitable angiograms. The radiographic appearances are also related to the presence of heart failure and to the mixing site or sites, associated pulmonary stenosis or coarctation of the aorta.

Vascular Disease in the Tropics

Abstract: Publisher Summary This chapter discusses vascular disease in the tropics. Arterial and venous disease in the tropics has a pattern somewhat different from that seen in the Europe. The pattern of venous disease is marked by the relative rarity of varicose veins and of deep vein thrombosis, relative to the European incidence. In India, two major chronic arterial diseases predominate—juvenile obliterative arteritis (JOA) and thrombo-angiitis obliterans (TAO). Characteristically, three clinico-pathological types of JOA are recognized: type I is Aortic arch; type II is Segmental thoracic / abdominal aorta and type III is combined. The correlation of the extent of disease seen on contrast angiography with the degree of clinical disability is best in type I and least in type II. Type I JOA presents as a syndrome of brachio-cephalic ischaemia with headache, throbbing, failing vision, upper limb claudication, and raises a wide differential diagnosis. Type II JOA presents as a syndrome of a typical long segment coarctation of the thoracic and / or abdominal aorta, with cardiorespiratory symptoms, headache and lower limb ischaemia. Type III JOA presents a combination of symptoms and signs of type I and II disease. Usually, one of the arch vessels, either the innominate or the left subclavian, is affected. TAO disease is a combination of acute and chronic inflammation of the walls of arteries and veins and occasionally also of the nerves. It is a bilateral disease of the small vessels of the toes, later spreading upward. The distinctive features of TAO are—(a) the diffusely cellular thrombus, (b) the unaffected internal elastic lamina, (c) the well preserved media with moderate cellular infiltration, (d) the diffusely fibroblastic adventitia with focal infiltration, and (e) similar changes in the adjacent veins.

Congenital Hemihypertrophy with Abnormalities of The Aortic Arch, and of the Skeletal, Cutaneous and Ocular Systems

Abstract: Summary The authors record a case of congenital hemihypertrophy in a woman of 24 years. Diagnosis is usually made earlier in infancy or childhood. The principal features of this curious malformation are described. Associated malformations are common. In the present case, a particular malformation is stressed, namely an abnormality of the aortic arch with a right-sided aorta and low implantation of the left subclavian artery which arose from an aortic diverticulum. Another interesting point is the presence of anomalies of the extremities, brachydactyly, and syndactyly. Cutaneous and ocular anomalies are more common and the condition appears to be related to phacomatosis. The different theories of the pathogenesis of the condition are discussed.

Abdominal aortography from the axillary approach.

Abstract: A simple method of performing abdominal aortography from the left axillary approach is described, which is successful in most older patients with elongated, tortuous aortic arches.No additional equipment is necessary.A satisfactory alternative method is available on the occasional patient in whom the guidewire cannot be advanced distally over the aortic arch.

Temporary and permanent bypass prostheses in the treatment of aortic coarctation.

Abstract: Dacron tubes were successfully used as grafts for the bypassing of aortic coarctation in 4 patients because of extensive arteriosclerotic changes of the aorta near the coarctation. The use of prostheses less than 12 mm in diameter is not recommended. Intra-operative blood flow recordings indicated that the bypass flow should be more than 2 I /min. In 2 patients with poorly developed collaterals, temporary shunts were applied in order to protect the spinal cord and the kidneys. The use of silicone rubber tubes from the aortic arch or subclavian artery to the descending aorta is recommended. Systemic heparinization is not necessary.

Improved cardiac assistance with an aortic arch balloon.

Abstract: The haemodynamic effects of intra-aortic counterpulsation with normally used cylindrical and newly designed aortic arch balloons on the coronary blood flow and the performance of the normal dog heart were compared. Both balloon types resulted in a decrease of left ventricular systolic and end-diastolic pressure, systolic arterial and end-diastolic arterial pressure. The amplitude of diastolic augmentation was significantly larger with the aortic arch balloon. The carotid artery flow increased significantly more with the aortic arch balloon (36%) than with the cylindrical balloon. Pulsation in the aortic arch effected a significant decrease in left ventricular impedance (33%), which was inversely correlated with a marked increment of the stroke volume (36%). In addition, mean coronary blood flow increased during aortic arch balloon pulsation (37%). From these data, it is concluded that optimal intra-aortic balloon pulsation should be performed with large balloons close to the aortic valve. The newly designed aortic arch balloon fulfils this condition.

The occurrence of two vascular rings in the same infant.

Abstract: Summary A fatal case of an infant with a combination of two vascular rings is described. One ring consisted of a right-sided aortic arch, aberrant left subclavian artery and persistent ductus arteriosus, the other of an anomalous left pulmonary artery branched off from the right pulmonary artery. The importance of a properly performed roentgen examination of the oesophagus is stressed.

Intrathoracic neurofibroma of

Abstract: The chest radiograph showed an abnormal shadow, convex to the left in the mediastinum, extending from the level of the aortic arch to the ninth thoracic vertebra. A further small shadow was seen behind the heart just above the diaphragm. In the lateral view the major shadow was seen to overlap and extend anterior to the descending aorta. The smaller one was behind the heart (Figs I, 2). An aortogram revealed a mass arising posteriorly and intimately related to the arch and the upper part of the descending aorta, but there was no evidence of aortic abnormality, nor was any vascular supply demonstrated from the tumour to the aorta. An exploratory thoracotomy was undertaken. A long cord-like tumour overlaid the arch of the aorta and descended in front of it. It extended upwards into the posterior triangle of the neck and its lower end passed through the oesophageal hiatus into the abdomen. This occupied the course of the vagus nerve. The phrenic nerve also showed a nodular thickening. The tumour was dissected in both directions and the accessible portion of it was excised. Postoperative recovery was uneventful. The specimen was an irregular cylindrical cord of tissue 20 cm long and 0.7 cm minimum diameter, with a smooth glistening surface and fusiform swellings throughout its length; the largest measured IO x 5 cm and 4 x 2.5 cm (Fig. 3). The cut surface of these swellings was homogeneous and opalescent. Microscopy showed loose spindle-celled tumour tissue of variable cellularity with long wavy cytoplasmic processes, between which there were multiple