Showing papers on "Aortic arch published in 1974"
TL;DR: An analysis was made of 78 pathologic specimens in which a right aortic arch was present, of which the tetralogy of Fallot was the most common andCongenital heart disease was observed in each of the cases of right arch without retroesophageal aorti segment.
Abstract: An analysis was made of 78 pathologic specimens in which a right aortic arch was present. In four, the right arch was part of a double aortic arch. In 74 cases the right aortic arch was the only ar...
247 citations
TL;DR: It is shown that 131 I-albumin crosses the normal aortic endothelium, and that the uptake shows both regional and focal differences, which are interpreted as indicating focal spontaneous areas of increased endothelial permeability, possibly the result of focal hemodynamic injury.
167 citations
TL;DR: It is concluded that the presence of fibr inogen or fibrin in early atheromatous lesions may reflect the demonstrated permeability of normal aortic endothelium to circulating fibrInogen.
130 citations
TL;DR: A patient with marked atherosclerotic stenosis in the left subclavian artery and a previous anastomosis of the left internal mammary artery to the anterior descending branch of theleft coronary artery is reported.
119 citations
TL;DR: In this paper, aortic arch angiography is the most suitable radiological technique in the diagnosis of brain death, and the angiographic findings in patients with brain death are described.
Abstract: The angiographic findings in patients with brain death are described. The authors believe that aortic arch angiography is the most suitable radiological technique in the diagnosis of brain death.
59 citations
TL;DR: Single doses of epinephrine administered to 83 groups of chick embryos at 2-h intervals, produced a spectrum of aortic arch anomalies; those involving the right 4th arch (arcus aortae) were consistently associated with ventricular septal defects.
Abstract: Single doses of epinephrine (5 μg) administered to 83 groups of chick embryos (24–190 h) at 2-h intervals, produced a spectrum of aortic arch anomalies. The epinephrine was placed on the surface, of the extra embryonic membrane over the developing embryo in ovo, at a time when aortic arch morphogenesis is occurring. The peak incidence of anomalies (94%) occurred after treatment during day 5 of incubation (108–112 h). The anomalies involved the 3rd, 4th, and 6th pairs of aortic arches; those involving the right 4th arch (arcus aortae) were consistently associated with ventricular septal defects.
58 citations
TL;DR: Three new cases of intrathoracic vagus nerve sheath tumour are presented and it is suggested that the tumours tend to occur on the bulkiest part of the nerve which is in the upper thorax and where there is room for growth which is below the thoracic inlet.
Abstract: Strickland, B. and Wolverson, M. K. (1974).Thorax, 29, 215-222. Intrathoracic vagus nerve tumours. Three new cases of intrathoracic vagus nerve sheath tumour are presented. Two were neurofibromas associated with generalized neurofibromatosis, the third a neurilemmoma. All three presented as tumours of the superior middle mediastinum on the left in close association with the aortic arch. Previously reported cases are reviewed with special reference to the anatomical position and mode of clinical presentation. The tumours most often occur on the proximal part of the nerve close to the aortic arch and more often on the left than the right. They usually present as an incidental finding on a chest radiograph. To explain this anatomical localization it is suggested that the tumours tend to occur on the bulkiest part of the nerve which is in the upper thorax and where there is room for growth which is below the thoracic inlet. Proximal vagal tumours are more easily seen on a chest radiograph than those occurring distally and are therefore more likely to be detected. Symptoms occur only with proximal lesions.
45 citations
TL;DR: A nondestructive technique to continuously monitor diameter and blood flow at the same point along the descending thoracic aorta has been developed and helped to avoid measurement artifacts such as the inclusion of other arteries, veins, or moving structures.
Abstract: The authors are with the Applied Physiology Branch. Environmental Science Division. U.S. Air Force School of Aerospace Medicine, Brooks AFB, Tex. 78235. A nondestructive technique to continuously monitor diameter and blood flow at the same point along the descending thoracic aorta has been developed. A probe was passed down the esophagus to a level 1 to 2 cm distal to the aortic arch. On its distal end were Doppler-shift velocity-detecting and pulse-echo position- sensing crystals. The pulse-echo system was used not only to measure the diameter of the aorta, but also to aim all of the probe crystals directly across the axis of the aorta. Information supplied by this system aided in the identification of the aorta and helped to avoid measurement artifacts such as the inclusion of other arteries, veins, or moving structures.
37 citations
TL;DR: The change in the sensitivity of the baroreceptors was more closely related to the time interval after the calciferol treatment than it was to the mean arterial blood pressure, and the pressure-volume curves show that it was alsorelated to the decreased distensibility of the aortic arch region.
Abstract: Calciferol (vitamin D 2 ) (50,000-100,000 IU) and calcium lactate (1 g) were added to the normal diet of 22 rabbits for 7-11 days. When mean arterial blood pressure had risen from a control value of 87.2 ± 3.7 mm Hg to an experimental value of 137.8 ± 5.7 mm Hg (11-145 weeks), the aortic arch of 9 of these rabbits was isolated and perfused with Krebs-Henseleit solution. The impulse activity in 75 aortic baroreceptor fibers from the left aortic nerve was studied during nonpulsatile perfusion at different pressures and was compared with the impulse activity in 29 fibers from 17 normal rabbits. The threshold pressures and the pressure at the point of inflection of the curves were lower in these fibers than they were with fibers from normal rabbits. The gradient of the curves relating baroreceptor impulse frequency to aortic pressure was depressed from a normal mean value of 1.19 impulses/sec mm Hg -1 to 0.61 impulses/sec mm Hg -1 ( P r =-0.95) than it was to the mean arterial blood pressure ( r = -0.76). The pressure-volume curves show that it was also related to the decreased distensibility of the aortic arch region. Histologically, the aortic arch region had extensive medial sclerosis with calcification.
29 citations
TL;DR: An ultrasonic Doppler transducer suitable for intra-esophageal use in humans has been constructed, tested, and its function as a flow monitoring device assessed on a series of 15 unselected anaesthetized human subjects undergoing surgery.
Abstract: An ultrasonic Doppler transducer suitable for intra-esophageal use in humans has been constructed, tested, and its function as a flow monitoring device assessed on a series of 15 unselected anaesthetized human subjects undergoing surgery. Doppler flow signals from the descending thoracic aorta have been obtained in all cases. Once correctly positioned, the probe can give continuous qualitative monitoring of pulsatile aortic blood flow velocity for extended periods. It is possible to observe flow waves in the descending thoracic aorta from the aortic arch distally for about 20 cm and observe the change from disturbed to laminar flow patterns over this length.
25 citations
TL;DR: A review of over 950 open-heart operations done at St. Mary's Long Beach Hospital from July 1, 1969 through Sept 15, 1973, showed five instances of acute aortic dissection occurring during cardiopulmonary bypass.
Abstract: A review of over 950 open-heart operations done at St. Mary's Long Beach Hospital from July 1, 1969 through Sept 15, 1973, showed five instances of acute aortic dissection occurring during cardiopulmonary bypass. Three of these patients were successfully resuscitated and were long-term survivors. Routine femoral artery cannulation was carried out in 836 patients. All five dissections occurred in this group. None occurred in the 114 aortic arch cannulations, but three of these patients developed severe bleeding problems at the cannulation site, of which two died. Prompt diagnosis of the acute aortic dissection and immediate treatment were crucial to these patients' survival; vigorous postoperative antihypertensive medical management was likewise an important factor. The occurrence of intraoperative acute aortic dissection is not necessarily fatal if rapidly recognized and properly handled.
TL;DR: From the four cases described, it is evident that not all of the features of the complex need be present in a given case and, when present, some lesions are not of functional significance.
Abstract: A developmental complex is described characterized by (1) supravalvular stenosis of the aorta and pulmonary trunk, (2) dysplasia of valves and (3) stenosis of ostia of coronary arteries and branches of the aortic arch. From the four cases described, it is evident that not all of the features of the complex need be present in a given case and, when present, some lesions are not of functional significance. The variations underly the potential for differences in the hemodynamic states of affected subjects.
TL;DR: There is some evidence that cerebral ischemic symptoms may arise as early as the fourth decade and the relative lack of symptoms in infants and children when compared to adults reflects in part more collateral development and the absence of associated occlusive disease of the cerebral vessels in children.
Abstract: Five cases of congenital subclavian steal demonstrated by angiography are reported.The anatomy, hemodynamics, clinical findings and angiographic features are reviewed.Ischemic symptoms are infrequently present in infants and children and most cases are discovered incidentally during evaluation of congenital heart disease and/or coarctation of the aorta. The relative lack of symptoms in infants and children when compared to adults reflects in part more collateral development and the absence of associated occlusive disease of the cerebral vessels in children. While the natural history of this disorder is not known, there is some evidence that cerebral ischemic symptoms may arise as early as the fourth decade.Subclavian steal associated with a right aortic arch usually occurs on the left side and is caused by hypoplasia, atresia or isolation of the proximal portion of the left subclavian artery. Subclavian steal associated with a left aortic arch is usually caused by coarctation of interruption of the aortic...
TL;DR: This report describes the first case of cervical aortic arch in which the anomaly was diagnosed clinically and the patient operated upon successfully, and a description of noninvasive techniques for differential diagnosis is presented.
TL;DR: Aortic baroreceptor fibers that were studied in the anesthetized cat and dog after cervical aortic and carotid sinus nerves had been sectioned found that they coursed centrally in the cervical vagus.
Abstract: The baroreceptor fibers which arise from the aortic arch course centrally within the vagus nerve in the dog, and they usually follow this path in the cat. Near the origin of the superior laryngeal nerve, a separate branch of the cervical vagus (the cervical aortic nerve) arises. Previously, it was thought that this nerve contained all the important baroreceptor afferents. Aortic baroreceptor fibers that are not within the cervical aortic nerve were studied in the anesthetized cat and dog after cervical aortic and carotid sinus nerves had been sectioned. Some experiments were acute, but most were conducted 13-60 days after nerve section (to allow transected nerves to degenerate). After degeneration, baroreceptor activity was found in the peripheral aortic nerves in most animals. The sensory terminals of the surviving baroreceptor fibers were on the aortic arch on the left side and at the root of the right subclavian artery on the right side. In one of four chronic cats, four of eight chronic dogs after degeneration, and one of three animals in acute experiments a depressor response (8-70 mm Hg in chronic and 10 mm Hg in acute experiments) followed stimulation of the peripheral aortic nerve. The surviving aortic baroreceptor fibers coursed centrally in the cervical vagus.
TL;DR: A review of 195 cases of d-TGA disclosed the incidence of right aortic arch to be 8 per cent, but in cases associated with VSD and PS the incidence was higher and fifty per cent of the cases with right arch had other severe cardiac malformation.
TL;DR: A progressive increase in the size of this aneurysm was associated with symptoms and anatomic findings consistent with the subclavian “steal” syndrome, and it gradually enlarged, eventually rupturing with exsanguination.
Abstract: An aneurysm in the anomalous left subclavian artery developed in an elderly woman with a right aortic arch and an aberrant left subclavian artery (left ligamentum arteriosum connected to the left common carotid artery). The aneurysm gradually enlarged, eventually rupturing with exsanguination. A progressive increase in the size of this aneurysm was associated with symptoms and anatomic findings consistent with the subclavian “steal” syndrome.
TL;DR: A new simplified technique for prosthetic replacement of the aortic arch is described: with the aid of cardiopulmonary bypass, a permanent bypass graft was inserted from the aortsa to the brachiocephalic and left carotid arteries.
TL;DR: Light, fluorescence and electron microscope studies of chicken and chick embryo aorta reveal the occurrence of cell masses without the characteristics of smooth muscle cells situated within the media, in the transitional region between the aortic arch and the descending thoracicAorta.
Abstract: Light, fluorescence and electron microscope studies of chicken and chick embryo aorta reveal the occurrence of cell masses without the characteristics of smooth muscle cells situated within the media, in the transitional region between the aortic arch and the descending thoracic aorta. The cell masses consist of two cell types: one type (G cells) contains large numbers of cytoplasmic granules (900–2200 A in diameter); the other cell type consists of Schwann cell-axon complexes. G cells are innervated by monoaminergic nerve fibres considered to be efferent ones. Some G cells are in contact with endothelial cells or medial smooth muscle cells. G cells appear in the aortic wall at 9 days in ovo; they do not regress in old chickens.
TL;DR: Hypothermia with cardiopulmonary bypass is the approach of choice with aneurysms of the aortic arch because it affords the best protection for the central nervous system and myocardium.
TL;DR: The first case of right aortic arch with mirror-image type branching and coarctation of the aorta is presented and the patient has Turner's syndrome.
TL;DR: Post-mortem examination of 130 subjects demonstrated a relatively high incidence of ulcerated atherosclerotic lesions of the aortic arch and proximal great vessels, the most commonly affected location was the origin of the brachiocephalic artery.
Abstract: Post-mortem examination of 130 subjects demonstrated a relatively high incidence of ulcerated atherosclerotic lesions of the aortic arch and proximal great vessels. The most commonly affected location was the origin of the brachiocephalic artery. Two patients are described in whom retinal embolism probably originated from this source. Ulceration of the brachio cephalic artery and other proximal great vessels may be an important source of ocular and neurological disability, as well as constituting a hazard for arteriographic catheters negotiating these arteries, such as occurs during arch aortography and selective catheterization of the brachiocephalic artery.
TL;DR: A family had tetralogy of Fallot and right aortic arch in three successive generations and the inheritance pattern of the cardiac lesion does not appear to follow classical mendelian genetics.
Abstract: A family had tetralogy of Fallot and right aortic arch in three successive generations. While the inheritance pattern of the cardiac lesion does not appear to follow classical mendelian genetics, genetic factors have certainly played a role in the familial aggregation of tetralogy in this family.
TL;DR: Clinical and angiographic data of a patient fulfilling the criteria for the diagnosis of isolated absence or interruption of the aortic arch, without a ductus or any other cardiac defect are described.
Abstract: Interruption of the aortic arch is an infrequent congenital anomaly. In its usual variety it is almost constantly associated with a persistent ductus arteriosus which provides adequate blood flow to the descending aorta. Coincidental cardiac malformations are often present, such as a ventricular septal defect or a bicuspid aortic valve, among many others. Isolated absence or interruption of the aortic arch, without a ductus or any other cardiac defect is an exceptional finding. In our search through the published reports, we were able to trace only three previous reports of this pathology (Pillsbury, Lower, and Shumway, I964; Zetterquist, I967; Morgan et al., 1970), all of them diagnosed in life. We describe here the clinical and angiographic data of a patient fulfilling the criteria for the diagnosis of this rare condition.
TL;DR: A 22-year old man with right aortic arch and congenital subclavian steal syndrome secondary to hypoplastic malformation of the left subclAVian artery proximal to the ostium of the vertebral artery is presented and the graft is patent as demonstrated by postoperative aortography.
TL;DR: Although this condition is rare, it should be kept in mind when surgical treatment of arterial insufficiency of the leg is planned, because malformation of the major arteries to the lower limb may also occasionally be the cause of retarded growth of the legs.
Abstract: Two cases of congenital hypoplasia of the lower limb arteries are presented. The patients were treated surgically with saphenous vein bypass grafting. A short summary of the foetal development of the arteries of the lower limb is given. Although this condition is rare, it should be kept in mind when surgical treatment of arterial insufficiency of the leg is planned.In the aortic arch congenital anomalies are relatively common. In the major arteries of the lower extremity such abnormalities are, however, rare (Rob & Owen, 1958; Mansfield & Howard, 1964). Nevertheless, this condition must be considered as a possible cause of arterial insufficiency. Malformation of the major arteries to the lower limb may also occasionally be the cause of retarded growth of the leg.
TL;DR: A discussion is presented of the surgical approaches for the different vascular injuries of the thorax including different methods of repair of ruptures of the descending thoracic aorta.
Abstract: This report concerns thirty-nine cases of thoracic vascular injury. There were twenty-one cases of great vessel injuries in area I (thoracic inlet and upper thorax) including the ascending aorta (one), innominate artery (six), left common carotid artery (two), aortic arch (one), left subclavian artery (four), right subclavian artery (one), superior vena cava (two), innominate veins (one), and axillary arteries (three). Six were due to blunt trauma and fifteen were due to penetrating trauma including tracheal-innominate artery fistulas. There were seven injuries in area II (pulmonary arteries and veins). In area III there were eleven injuries of the descending thoracic aorta. Nine of these ruptured secondary to blunt trauma, one was a penetrating injury of the heart and aorta, and one was a penetrating aortic injury with a bullet embolus. A discussion is presented of the surgical approaches for the different vascular injuries of the thorax including different methods of repair of ruptures of the descending thoracic aorta.
TL;DR: A female fetus of 63 mm crown-rump length was examined and a small membranous ventricular septal defect, and a single umbilical artery were detected, highlighting the potential counseling value of detailed examination of small fetal specimens.
Abstract: A female fetus of 63 mm crown-rump length was examined. Aplasia of the left radius and thumb, preaxial polydactyly of the left foot, rib and vertebral fusions on the left side, right aortic arch, a small membranous ventricular septal defect, and a single umbilical artery were detected. The potential counseling value of detailed examination of small fetal specimens is stressed.
TL;DR: It is postulated that the adrenergic component of the depressor zone of the aortic arch participates in the peripheral mechanism of the regulatory effects of the sympathetic nervous system on the baroreceptor apparatus.
Abstract: The structural organization of the adrenergic (sympathetic) component of the autonomic innervation of the depressor zone of the cat aortic arch was studied by luminescence microscopy of the catecholamines. A terminal adrenergic plexus, branching extensively in the connective-tissue basis of the depressor area of the aortic arch, was discovered. The participation of vessels supplying blood to the depressor area was established. Adrenergic neurons were found in the territory of the depressor zone of the aortic arch. It is postulated that the adrenergic component of the depressor zone of the aortic arch participates in the peripheral mechanism of the regulatory effects of the sympathetic nervous system on the baroreceptor apparatus.