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Triedman J K - - 1993
OBJECTIVES: The purpose of this study was to evaluate the prevalence of and risk factors for aortopulmonary collateral vessels in patients who have undergone a bidirectional Glenn or Fontan procedure, or both. BACKGROUND: Aortopulmonary collateral vessels are frequently observed angiographically in patients after a bidirectional Glenn or Fontan procedure. These ...
Maeda T - - 1993
A 57-year-old woman presented with hepatic encephalopathy, cirrhosis, and a dual-channel portosystemic venous shunt (PSVS). The shunt was treated successfully by embolization with steel coils via retrograde systemic venous access. Encephalopathy resolved. This new approach is considered safer than the previously reported percutaneous transhepatic route or the mesenteric venous route, ...
van Gelder H M - - 1993
Placement of an encircling Silastic band around Blalock-Taussig shunts facilitates identification and ligation of the shunt at the time of corrective operation. This technique of "shunt banding" is particularly useful for left-sided shunts, both native and modified. We have noted no complications, specifically shunt constriction. Placement of the band adds ...
Wu C C - - 1993
To define the prevalence rate of left-to-right interatrial shunt through patent foramen ovale in adults with symptomatic left-sided cardiac lesions, 56 patients were examined with transthoracic and transesophageal echocardiography and cardiac catheterization. By transesophageal echocardiography, 15 patients (group A) were found to have left-to-right interatrial shunt through patent foramen ovale, ...
el-Fiky M M - - 1993
Respiratory dysfunction is a well recognized complication of cardiopulmonary bypass. The size of the pulmonary shunt fraction is the best indicator of respiratory dysfunction but its measurement conventionally requires use of a pulmonary artery catheter to measure mixed venous oxygen content. We compared pulmonary shunt fraction, based on a non-invasive ...
Greenspan J S - - 1993
The creation of left to right cardiac shunts in neonates is frequently complicated by pulmonary morbidity in the immediate postoperative course. To elucidate the pattern, severity, and cause of lung dysfunction, pulmonary function testing was performed preoperatively and 1, 3, and 7 days postoperatively on 7 neonates undergoing Blalock-Taussig shunting. ...
Kluger Y - - 1993
A case of patent foramen ovale with right-to-left intracardiac shunt after blunt chest injury is presented. The association of pulmonary contusion, pulmonary hypertension, and patent foramen ovale in a previously healthy subject is discussed. In such a case reduction of the afterload on the right ventricle is the suggested modality ...
Papagiannis J - - 1993
A patient with polysplenia syndrome, dextrocardia, left atrial isomerism, normal great vessel relationships, and no intracardiac shunts developed progressive cyanosis and clubbing. Pulmonary arteriovenous malformations (PAVMs) were diagnosed by angiography and confirmed by lung biopsy. Superior mesenteric arteriogram revealed hypoplasia of the intrahepatic portal vein branches and a portosystemic shunt. ...
Davies R P - - 1993
A percutaneous transjugular intrahepatic portocaval shunt (TIPS) was successfully performed using Wallstents in a 53-year-old man with neoplastic disease causing portal hypertension and life-threatening variceal hemorrhage. Shortly afterwards, recurrent hemorrhage was investigated by shunt venography which showed that extrinsic narrowing of the hepatic vein and hepatic vena cava was causing ...
Numaguchi Y - - 1993
PURPOSE: To describe six patients who underwent ventriculoperitoneal (V-P) shunting for hydrocephalus and developed scalloping deformity of the dorsal surface of the corpus callosum, and to evaluate the cause and frequency of this phenomenon. MATERIALS AND METHODS: MR images of 35 patients whose hydrocephalus was successfully corrected by V-P shunting ...
Matsunaga N - - 1993
Coronary-to-pulmonary artery shunts via the bronchial artery (CA-BA-PA shunts) were observed in 16 of 2,922 consecutive patients who underwent selective coronary cineangiography. Underlying diseases included Takayasu arteritis (n = 8), chronic pulmonary inflammatory diseases (n = 4), pulmonary thromboembolism (n = 2), pulmonary artery tumor (n = 1), and tetralogy ...
Ahrens T - - 1993
The assessment of pulmonary function, from a clinical perspective, can be performed accurately only if the clinician understands the concept ventilation/perfusion ratios of the lung. The major categories of ventilation/perfusion ratios are intrapulmonary shunting and physiologic deadspace. Virtually all pulmonary assessments and interventions are aimed to address Qs/Qt or Vd/Vt. ...
Longo J M - - 1993
To assess the potential role of ultrasound (US) in evaluating transjugularly inserted intrahepatic portosystemic shunts, the authors performed sonographic, including duplex and color Doppler, studies in 23 patients. Imaging was performed before, during the first week after, and 2-3 months after shunt placement. The prostheses were readily visualized and shunt ...
Partington B P - - 1993
A congenital intrahepatic portosystemic shunt was successfully closed in a 3-month-old Golden Retriever by use of a transvenous coil embolization procedure. The pup's patent ductus venosus was occluded by placing 8 Dacron fiber-covered, stainless steel, spring embolization coils into the shunt vessel through a catheter placed through the jugular vein. ...
Lai L P - - 1993
A residual atrial septal defect with bidirectional shunt was detected by transesophageal echocardiography in a 28-year-old man 3 years after percutaneous transluminal mitral commissurotomy (PTMC) with the antegrade transseptal technique. He had had severe mitral stenosis, pulmonary hypertension, and tricuspid regurgitation before the procedure. The result of PTMC was suboptimal, ...
Gold J P - - 1993
In spite of recent advances in neonatal open repair for complex cyanotic heart disease, some patients require palliation with a systemic-to-pulmonary artery shunt. We report a 5-year experience (1985-1990) with 112 Blalock-Taussig shunts. Forty-six of the 92 patients had some variant of tetralogy of Fallot, with a wide spectrum of ...
Sleigh G - - 1993
The authors present the case of a nine-year-old patient with spina bifida and hydrocephalus treated with a ventriculo-atrial shunt who developed fatal pulmonary hypertension 5 1/2 years after his last valve revision; he had been well and active up to one month before his death. Details of the dramatic cardiovascular ...
Waggoner A D - - 1993
Intravenous injections of agitated saline (contrast) are used to identify right-to-left atrial shunt during transesophageal echocardiography (TEE). Color flow imaging (CFI) with TEE can be used to detect left-to-right atrial shunt but its application to detect right-to-left shunt is not known. We performed CFI and contrast during TEE in 72 ...
Schmitz-Rode T - - 1993
A new basket, developed for percutaneous removal of wall-adherent thrombi, was tested in model thrombosed hemodialysis shunts and clinically in two polytetrafluoroethylene grafts and one Brescia-Cimino shunt after recanalization by aspiration thrombectomy. The residual wall-adherent thrombus was removed by one or two passes with the mesh basket. The occlusion material ...
Trowitzsch E - - 1992
Increased resistance in the pulmonary vessels in children with ventriculo-atrial shunts is a rare and often unrecognized permanent complication. We report 2 children in whom this diagnosis was detected by two-dimensional echocardiography. The first patient received a ventriculo-atrial shunt at age 9 days for congenital internal hydrocephalus. At 17 months ...
Strome S - - 1992
A new rat model was developed to reexamine the potential for laryngeal transplantation. The final anatomic derivation evolved from two earlier developmental phases. The first model had only a single arterial anastomosis; the second had an end-to-end arterial anastomosis with an end-to-end arteriovenous shunt. The final product employed an end-to-side ...
Halsey J H JH - - 1992
BACKGROUND AND PURPOSE: Controversy continues about the pathogenesis of perioperative stroke in carotid endarterectomy and the use of shunting. The purpose of this study was to determine, using transcranial Doppler ultrasonography, the severity of ischemia during clamping of the carotid artery as a basis for analysis of complications in patients ...
Verdant A - - 1992
Over the past 16 years, 267 consecutive patients underwent surgery for a descending thoracic aortic aneurysm. To provide optimal protection of surrounding organs during aortic occlusion, a 9-mm Gott shunt was used for distal perfusion in all cases. The shunt was placed preferentially between the ascending aorta and the descending ...
Haasnoot K - - 1992
The use of ventriculo-atrial shunts for CSF diversion in developing hydrocephalus has become rare because of the risk of chronic thrombo-embolism and subsequent pulmonary hypertension associated with an unfavourable prognosis. However, there remains a group of patients in whom ventriculo-atrial shunts have been inserted in the past. In this group, ...
Marmon L M - - 1992
A 8.6-kg, 10-month-old boy with idiopathic cavernous transformation of the portal vein developed variceal hemorrhage refractory to nonoperative management. A distal splenorenal shunt was performed while the bleeding was controlled with balloon tamponade. Hemorrhage was successfully controlled with no recurrent bleeding and the shunt remains patent at 1 year of ...
Brown J A - - 1992
Scanning electron microscopy of corroded resin casts of the renal vasculature of Scyliorhinus caniculus has revealed a novel vascular pathway arising from the afferent arteriole and bypassing the glomerulus. This glomerulus bypass shunt occurred in 36% of the glomerular casts examined. The shunt ran to join a peritubular network of ...
Zemel G - - 1992
A transjugular intrahepatic portosystemic shunt (TIPS) can be created percutaneously with the Palmaz balloon-expandable stent. This article describes a transjugular-only approach with a 16-gauge needle. A functional and efficacious shunt can be achieved in most cases with stent diameters of 8-10 mm. Occasionally, a 12-mm-diameter shunt is necessary for effective ...
Gin K G - - 1992
A 74-year-old man who had dyspnea and cyanosis demonstrated venous thrombosis and multiple lung ventilation-perfusion mismatches suggesting pulmonary emboli. Transthoracic echocardiography demonstrated a right atrial mass and a microbubble contrast study did not reveal right-to-left shunt. Transesophageal echocardiography revealed an embolus entrapped in the foramen ovale projecting into the left ...
Longo J M - - 1992
Percutaneous placement of portosystemic shunts requires access to the portal system from a transjugular approach. Color Doppler sonography was used to direct the transjugular puncture in intrahepatic portosystemic shunt procedures in four patients. In each case, the technique allowed quick, safe transjugular puncture of the portal vein and close real-time ...
Turtas S - - 1992
A very rare complication of ventriculoperitoneal shunt is presented. The tip of the distal catheter extruded through a skin fistula in the right subclavian region. After the replacement of a new catheter in the peritoneal cavity, inflammation of the overlying scar occurred. Then, a ventriculoatrial shunt was carried out. The ...
McDowell H A HA - - 1992
Intraoperative transcranial Doppler monitoring of cerebral ischemia during carotid clamping under general anesthesia was done in 238 carotid artery operations, mostly endarterectomy. Depending on the severity of reduction of middle cerebral artery mean velocity, patients were classified as no, mild, or severe ischemia at clamping. With a carotid shunt, velocity ...
Nagino M - - 1992
We report an unusual case of a large inferior mesenteric-caval shunt in a 25-year-old man without cirrhosis with hypoproteinemia and hypochromic anemia. In this large shunt the direct communication was between the inferior mesenteric vein and the internal iliac vein. Hemodynamic change as a result of the shunt was thought ...
Movsowitz C - - 1992
A patent foramen ovale (PFO) is an embryological remnant found in 27% of adults. It is a potential right-to-left intracardiac shunt. Shunting may be the result of reversal in the interatrial pressure gradient or abnormal streaming of blood in the right atrium. The pathologic consequences of right-to-left shunting include hypoxemia ...
Redo S F - - 1992
Long-term ventricular cerebrospinal fluid shunting can prove difficult in the neonatal population, particularly in those neonates who have had previous abdominal and vascular procedures. This article presents a technique of providing vascular access for ventriculoatrial shunting via the azygos vein for patients with limited vascular access and in whom ventriculoperitoneal ...
Reed J G - - 1992
Safe angioplasty of a portacaval shunt requires particular knowledge of the tissue characteristics of an anastomosis and the behavior of a balloon during inflation. The nature and true diameter of a portacaval shunt anastomosis are more difficult to evaluate than those of a peripheral arterial lesion, and complications are potentially ...
Okita Y - - 1992
Acute pulmonary edema developed in 2 patients after a Blalock-Taussig shunt procedure. Both patients had a univentricular heart complex with pulmonary stenosis. One patient underwent a modified Blalock-Taussig shunt using a polytetrafluoroethylene tube and the other underwent a classic Blalock-Taussig anastomosis. Acute pulmonary edema after the Blalock-Taussig shunt is rare, ...
Kelbaek H - - 1992
Non-invasive determination of left-to-right shunts at the atrial level was performed by a new procedure using first-pass radionuclide measurement of cardiac output of the right and left ventricle. In 23 patients with coronary artery disease without shunt the mean difference between the cardiac outputs of the right and left ventricle ...
Husain A K - - 1992
Polyvinylchloride (PVC) disposable endotracheal suction catheters were successfully used as temporary intravascular shunts in 5 patients of popliteal artery trauma. These simple shunts should be used routinely in such conditions to immediately re-establish blood supply to the ischaemic limb particularly in patients of polytrauma where systemic anticoagulation is contraindicated. This ...
Horiguchi Y - - 1992
BACKGROUND: Shunt vessels were imaged and shunt flow was analysed by cross sectional and Doppler echocardiography in 12 patients who had had 14 shunt procedures (nine left Blalock-Taussig shunts, three right Blalock-Taussig shunts, one modified Waterston shunt, and one central shunt). METHODS: The shunt vessels were classified by echocardiography as ...
Liu P - - 1992
Blalock-Taussig shunts (subclavian to pulmonary anastomoses) have remained the most effective palliation in cyanotic heart disease. Late complications are rare but can be devastating. The case of a 26-year-old female with tetralogy and an original Blalock shunt constructed at age four years is reported. Despite subsequent primary repair of the ...
Marber M S - - 1992
Two patients with systemic embolism were studied with transoesophageal contrast echocardiography which demonstrated its probable paradoxical nature. In both cases paradoxical embolism was associated with pulmonary embolism. Precordial contrast echocardiography demonstrated a right-to-left shunt in one patient but was unable to demonstrate a shunt in the second. Transoesophageal echocardiography suggested ...
Okuda K - - 1992
In this article, various angiographic techniques that may be useful in the assessment of portal hemodynamics are described with illustrative angiograms, providing examples of celiac arteriography; arterial venography; transsplenic, umbilical, operative, and transhepatic portography; hepatic venography; and other techniques. When they are combined with other imaging modalities, the information gained ...
Mendoza C U - - 1992
Inhalation anesthesia with halothane, inhibiting hypoxic pulmonary vasoconstriction, causes an increase in intrapulmonary shunt development as well as an increase of alveolar-arterial oxygen tension difference. In contrast, total intravenous anesthesia with propofol, as with other intravenous anesthetics, should not alter pulmonary gas exchange. The present study was carried out using ...
Willison C D - - 1992
Due to the limited absorptive capacity of the pleural cavity, infants and young children are not generally ideal candidates for ventriculopleural shunts. We report using chest cavities as alternate for temporary diversion of CSF in a young child. Venous access to the cervical region could not be utilized because of ...
Hust M H - - 1992
An unusual floating mass was detected in the right atrium of a 71-year-old man with liver cirrhosis and intractable ascites using two-dimensional echocardiography. The mass was caused by the venous tip of a Denver peritoneovenous shunt. Shunt patency could be assessed easily by compression of the pump body; this maneuver ...
Eichmann A - - 1992
A case of postoperative hyperemia of the glans penis following revascularization surgery for erectile impotence is described. This new surgical concept (Hauri) combines arterial revascularization with an arteriovenous shunt. The so-called 'postoperative hyperemia of the glans penis' is observed in 10-20% of the cases after arterialization of the dorsal penile ...
Matsunaga N - - 1992
Coronary artery-cardiac chamber shunts (CA-CC shunts) were observed in 101 out of 2267 consecutive patients (4.5%) receiving selective coronary angiography. In these patients, contrast medium injected into the coronary artery escaped directly into the cardiac chamber. CA-CC shunts were angiographically classified into the following two types. Type I: The endocardial ...
Sanger R - - 1991
A case of chylous ascites occurring after elective abdominal aortic aneurysm repair is described. The patient was initially managed conservatively with hyperalimentation and intermittent drainage of the retroperitoneal collection, but, this proved inadequate and a peritoneo-venous shunt was inserted. Although the shunt appeared to work well the patient finally died ...
Chimowitz M I - - 1991
We performed transcranial Doppler ultrasound (TCD) and transesophageal contrast echocardiography simultaneously in four patients. In one patient with a patent foramen ovale and another patient with pulmonary A-V fistulae, we detected micro air bubbles in the right middle cerebral artery three to five cardiac cycles after their appearance in the ...
Kobayashi J - - 1991
The effects of "pulsatile" bidirectional cavopulmonary shunt (BCPS) produced by the flow from the ventricle or Blalock-Taussig (B-T) shunt on ventricular function and pulmonary circulation were evaluated in 10 patients with univentricular heart from 3 to 37 months (mean, 16.6 +/- 9.5 months) after surgery. Age at operation ranged from ...
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