Abstract:
OBJECTIVES:Left ventricular assist device (LVAD) implantation may alter right ventricular shape and function and lead to tricuspid regurgitation. This in turn has been reported to be a determinant of right ventricular (RV) failure after LVAD implantation, but the effect of mechanical left ventricular (LV) unloading on the tricuspid annulus is unknown. The aim of the study was to provide insight into the effect of LVAD support on tricuspid annular geometry and dynamics that may help to optimize LV unloading with the least deleterious effect on the right-sided geometry. METHODS:In seven open-chest anaesthetized sheep, nine sonomicrometry crystals were implanted on the right ventricle. Additional nine crystals were implanted around the tricuspid annulus, with one crystal at each commissure defining three separate annular regions: anterior, posterior and septal. Left ventricular unloading was achieved by connecting a cannula in the left atrium and the aorta to a continuous-flow pump. The pump was used for 15 min at a full flow of 3.8 ± 0.3 l/min. Epicardial echocardiography was used to assess the degree of tricuspid insufficiency. Haemodynamic, echocardiographic and sonomicrometry data were collected before and during full unloading. Tricuspid annular area, and the regional and total perimeter were calculated from crystal coordinates, while 3D annular geometry was expressed as the orthogonal distance of each annular crystal to the least squares plane of all annular crystals. RESULTS:There was no significant tricuspid regurgitation observed either before or during LV unloading. Right ventricular free wall to septum diameter increased significantly at end-diastole during unloading from 23.6 ± 5.8 to 26.3 ± 6.5 mm (P = 0.009), but the right ventricular volume, tricuspid annular area and total perimeter did not change from baseline. However, the septal part of the annulus significantly decreased its maximal length (38.6 ± 8.1 to 37.9 ± 8.2 mm, P = 0.03). Annular contraction was not altered. The tricuspid annulus had a complex 3D saddle-shaped geometry that was unaffected during experimental conditions. CONCLUSIONS:In healthy sheep hearts, left ventricular unloading increased septal-free wall RV diameter and reduced the length of the septal annulus, without altering the motion or geometry of the tricuspid annulus. Acute left ventricular unloading alone in healthy sheep was not sufficient to significantly perturb tricuspid annular dynamics and result in tricuspid insufficiency.
journal_name
Interact Cardiovasc Thorac Surgjournal_title
Interactive cardiovascular and thoracic surgeryauthors
Malinowski M,Wilton P,Khaghani A,Brown M,Langholz D,Hooker V,Eberhart L,Hooker RL,Timek TAdoi
10.1093/icvts/ivw138subject
Has Abstractpub_date
2016-09-01 00:00:00pages
391-6issue
3eissn
1569-9293issn
1569-9285pii
ivw138journal_volume
23pub_type
杂志文章abstract::Acute aortic dissection frequently causes life-threatening organ ischemia. The optimal therapy for acute type-B aortic dissection is still controversial. Early surgery for acute dissections with organ malperfusion is known to carry a high morbidity and mortality. Endovascular treatment, such as stent placement for bra...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2008.191361
更新日期:2009-02-01 00:00:00
abstract::Mitral annular calcification (MAC) is sometimes associated with Carpentier type 2 mitral valve regurgitation and is a challenge to repair. Complete annular decalcification and mitral valve reconstruction is considered the ideal treatment. This report demonstrates the success of chordal replacement and band annuloplast...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivs249
更新日期:2012-09-01 00:00:00
abstract::Open repair of aortic aneurysm causes spinal cord perfusion pressure to decrease due to the steal phenomenon from the bleeding of intercostal arteries and cross-clamping of the aorta. We attempted to perfuse the intercostal arteries for preoperative detection of the artery of Adamkiewicz using newly developed catheter...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2009.219790
更新日期:2010-06-01 00:00:00
abstract::The ideal timing and optimal management of surgical repair for isolated complete atrioventricular septal defect (CAVSD) still remains controversial. To determine outcomes after the surgical repair of CAVSD, we reviewed 100 consecutive patients who underwent complete repair at our institute between January 1992 and Aug...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2006.134288
更新日期:2007-02-01 00:00:00
abstract::To determine whether coronary artery bypass grafting (CABG) with complete revascularization improves survival in patients with multivessel disease (MVD) over CABG with incomplete revascularization, we performed a meta-analysis of adjusted (but not unadjusted) risk estimates from observational studies. Databases includ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1093/icvts/ivu012
更新日期:2014-05-01 00:00:00
abstract::Transesophageal echocardiography (TEE) is the fastest method for diagnosing aortic dissection type A and allows 3D TEE, even in hemodynamically instable patients. 3D TEE may provide additional information on aortic morphology, the involvement of coronary arteries by the dissection and aortic valve function. In this re...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2010.234724
更新日期:2010-07-01 00:00:00
abstract::The Djumbodis system is a metallic stent designed to prevent false lumen dilatation after repair of acute aortic dissection. Although the exact number of Djumbodis stents inserted worldwide could not be ascertained from a review of the literature, available data indicate 9 specific device-related complications from 4 ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivaa178
更新日期:2020-11-01 00:00:00
abstract::Although radiation therapy is widely used to treat breast cancer, high doses of radiation may cause various complications. We report a case of a left ventricular aneurysm complicated with an intractable skin ulcer caused by radiation therapy for breast cancer. The communication between the aneurysm and skin ulcer caus...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivaa014
更新日期:2020-05-01 00:00:00
abstract:OBJECTIVES:The aim of this study was to evaluate abdominal aortic remodelling after the standard compared with the elongated frozen elephant trunk (FET) technique in patients with aortic dissection. METHODS:Twenty-six patients underwent surgery and were randomized into 2 groups. Fifteen patients were treated with the ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章,随机对照试验
doi:10.1093/icvts/ivz026
更新日期:2019-07-01 00:00:00
abstract::American Heart Association recommendations have changed preoperative management of patients with antiplatelet therapy (APT). We assessed safety and outcomes of surgery in patients who were receiving APT. A prospective study of patients operated on while receiving APT was matched with those with no APT (ratio 1:4), usi...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivr005
更新日期:2012-02-01 00:00:00
abstract::A best evidence topic in vascular surgery was written according to a structured protocol. The question addressed was whether carotid artery stenting (CAS) is equivalent or even superior to carotid endarterectomy (CEA) for the treatment of significant carotid artery stenosis. Four hundred and ninety-four papers were id...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2005.117358
更新日期:2005-12-01 00:00:00
abstract::The aim of this retrospective study was to assess the success rates of limb salvage, and the primary and secondary patency rates of reconstructions of critical limb ischemia (CLI) patients undergoing combined infrainguinal reconstruction and intraluminal angioplasty of crural arteries. In 2000-2005, infrainguinal reco...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2009.204867
更新日期:2009-08-01 00:00:00
abstract:OBJECTIVES:The anti-fibrillatory effect of potassium is well recognized from experimental models. There have, however, been very few clinical reports on the use of potassium to convert ventricular fibrillation (VF) after cardioplegic arrest. METHODS:In total, 8465 adult patients undergoing cardiac operations on cardio...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivs455
更新日期:2013-02-01 00:00:00
abstract:OBJECTIVES:Interventional treatment of tricuspid valve disease has so far received little attention due to the anatomical challenges in a thrombogenic surrounding. In the present study, we present an imaging-based, personalized interventional approach to the therapy of tricuspid regurgitation. METHODS:In our porcine m...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivu143
更新日期:2014-09-01 00:00:00
abstract::The aim of this study was to compare our experience between open and video-assisted thoracic surgery (VATS) approaches to the management of thoracic effusions in ventricular assist device (VAD) patients. This was a retrospective review of a prospectively collected database of VAD patients at a single institution. Pati...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivr020
更新日期:2012-01-01 00:00:00
abstract::To investigate the effects on cerebral perfusion by experimental venous congestion of the superior vena cava (SVC) during bicaval cardiopulmonary bypass (CPB) at 34 °C, pigs were subjected to SVC obstruction at levels of 75%, 50%, 25% and 0% of baseline SVC flow at two arterial flow levels (low, LQ, high, HQ). The cer...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2010.238535
更新日期:2010-11-01 00:00:00
abstract::Left ventricular papillary muscle geometry is distorted in dilated non-ischemic hearts, and following anterior infarction caused by a wrap around left anterior descending artery occlusion. Loss of the apex creates a spherical left ventricular (LV) chamber, and subsequent dilation causes secondary mitral insufficiency ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2005.109868
更新日期:2005-10-01 00:00:00
abstract:OBJECTIVES:Transfusions of blood products can be lifesaving, but they are also associated with considerable risks and adverse effects, including immune response and infections. In cardiac surgery, transfusions have also been associated with increased mortality. We prospectively studied the effects of a structured progr...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivu266
更新日期:2014-11-01 00:00:00
abstract::A 53 year-old woman had been followed up since 1996 after receiving bilateral adrenalectomy for the treatment of bilateral adrenal pheochromocytoma in von Hippel-Lindau (VHL) disease. In March 2003, she suffered from cough, dizziness and faint, and was referred to our hospital. The radiographic findings exhibited the ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2004.096784
更新日期:2005-02-01 00:00:00
abstract:OBJECTIVES:Our institution adopted a lateral thoracotomy approach to epicaridal pacemaker implantation with the objective of avoiding epicardial scar tissue and to achieve adequate lead pacing and sensing. We sought to assess the short-term outcomes of this approach. METHODS:A single-centre review was conducted in pae...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivx379
更新日期:2018-05-01 00:00:00
abstract::Although the maze procedure is highly effective for most patients with atrial fibrillation (AF), its standardized application to elderly patients is controversial. Between 2004 and 2007, 143 patients with a mean age of 65 years of age or older underwent the modified Cox-maze procedure concomitant with other cardiac pr...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2010.263491
更新日期:2011-06-01 00:00:00
abstract::Anatomical variations of one or both thymic upper poles located behind the left innominate vein (LIV) are found in some patients; however, minimally invasive dissection of ectopic thymic tissues behind the LIV is technically complex. We describe a case of a dumbbell-shaped thymoma behind the LIV. The patient was succe...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivz165
更新日期:2019-11-01 00:00:00
abstract::The natural history of the LV systolic function (LV-SF) and functional capacity of survivors of heart transplantation (Htx) has not been defined. Some investigators suggest that SF may be different in recipients with different pre-transplant aetiologies: ischaemic or dilated, idiopathic disease. Routine transthoracic ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2007.167924
更新日期:2008-08-01 00:00:00
abstract::Cystic tumor of the atrioventricular nodal region is a rare cardiac primary tumor that can cause heart blockage and sudden death. Antemortem diagnosis and successful excision of the atrioventricular nodal region are extremely rare. A 41-year-old woman who presented with dyspnea and palpitations is reported. Electrocar...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2008.191866
更新日期:2009-05-01 00:00:00
abstract::Spontaneous aneurysm in the axillary artery is extremely rare. The standard treatment for axillary artery aneurysm has been surgical repair, but endovascular management of select aneurysms using stent grafts has become more prevalent with the development of endoluminal technology. We report the case of a 36-year old m...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivu308
更新日期:2015-01-01 00:00:00
abstract:OBJECTIVE:To report a rare case of fatal early acute thrombosis of mechanical mitral prosthesis. METHODS:A 62-year-old lady, who underwent closed mitral valvotomy for rheumatic heart disease 19 years ago, presented with Canadian Cardiovascular Society Class II angina and New York Heart Association Class III dyspnoea. ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2005.125757
更新日期:2006-08-01 00:00:00
abstract::Endovascular stent grafting has emerged as an effective method for the treatment of complicated acute type B aortic dissections. In cases where access to the aorta cannot be established through the ileofemoral trunks, the axillary arteries are used as an alternative route. Often, however, these arteries are too small ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2011.268748
更新日期:2011-08-01 00:00:00
abstract:OBJECTIVES:We aimed to assess the results of various tailored management strategies for adults with coarctation in our centre. METHODS:We reviewed all adults patients treated for aortic caorctation between January 2000 and December 2015 in our institution. The primary end point was a composite of death, perioperative ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivx039
更新日期:2017-09-01 00:00:00
abstract::OBJECTIVES Video-thoracoscopic surgery (VTS) has been accepted as a safe and credible technique since 1990. Lung injury is one of the main perioperative complications. Few data are available about cardiac trauma and VTS-related false aneurysm of the left ventricular (LV) wall has not yet been reported. METHODS A 62-y...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivs119
更新日期:2012-07-01 00:00:00
abstract:OBJECTIVE:Pulmonary lobectomy for lung cancer is a well-established and safe operation. This report serves to highlight an important complication and an underlying essential surgical principle when performing pulmonary resections, to avoid a potentially fatal outcome. METHODS:A case report is presented. We describe an...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1016/S1569-9293(03)00188-9
更新日期:2003-12-01 00:00:00