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Tan Tze-Woei - - 2009
The routine use of intraoperative electroencephalography (EEG) monitoring with selective shunt placement during carotid endarterectomy (CEA) has been shown to be safe and effective. We attempt to identify the anatomic and clinical factors associated with significant EEG changes requiring shunt placement during CEA. Between January 2005 and June 2007, 242 ...
Sastry S - - 2009
PURPOSE: As paradoxical embolism is associated with stroke in young adults, migraine, and decompression sickness, the detection of venous-to-arterial circulation shunt (v-aCS), such as patent foramen ovale (PFO), is increasingly important. We compared a rigorous transcranial Doppler (TCD) protocol with transesophageal echocardiography (TEE) to develop criteria for PFO. METHODS: Standardized ...
Cura Marco - - 2009
Spontaneous mesocaval shunt (SMCS) is an uncommon cause of refractory encephalopathy after transjugular intrahepatic portosystemic shunt (TIPS) creation. We report a patient who presented with refractory hepatic encephalopathy (HE) post-TIPS creation for variceal bleeding in whom a SMCS was found. Percutaneous transhepatic occlusion of the SMCS reduced the portal vein ...
Mulaudzi T V - - 2009
To determine the mean carotid artery stump pressure (SP) at which patients develop neurological changes while undergoing awake carotid artery endarterectomy (CEA) under cervical block anaesthesia (CBA). A prospective analysis was carried out of patients undergoing awake CEA under CBA between February 2004 and April 2007. All patients had mean ...
Li Xiaohui - - 2009
The mechanisms responsible for the structural remodeling of pulmonary vasculature induced by increased pulmonary blood flow are not fully understood. This study explores the effect of endogenous hydrogen sulfide (H2S), a novel gasotransmitter, on collagen remodeling of the pulmonary artery in rats with high pulmonary blood flow. Thirty-two Sprague-Dawley rats ...
Evans William N - - 2009
Creating eponyms for surgical procedures or medical discoveries can be a simple objective process of attaching names of innovators. Some eponyms, however, have a controversial history. Undertaking the first systemic-to-pulmonary arterial shunt required the combined efforts of Helen Taussig, Vivien Thomas, and Alfred Blalock. In this review, I attempt to ...
Xu Yao-qiang - - 2009
BACKGROUND: The present study was aimed to compare the effects of bilateral and unilateral bidirectional superior cavopulmonary shunt (b-BDG and u-BDG) on pulmonary artery growth and clinical outcomes. METHODS: The 51 subjects enrolled in this study were divided into two groups: those receiving b-BDG (n = 21) and those receiving ...
Matthews Iren L - - 2009
OBJECTIVES: To assess the relationship that shunt size, blood gases, and radiologic findings has on respiratory function in infants with univentricular heart physiology. SETTING: Cardiac catheter laboratory at Rikshospitalet University Hospital, Norway. PATIENTS: Fifteen infants with univentricular heart physiology admitted for cardiac catheterization. MEASUREMENTS: Lung function was measured by a ...
Vodoz Jean-Frédéric - - 2009
BACKGROUND: Hypoxemia is common in pulmonary hypertension (PH) and may be partly related to ventilation/perfusion mismatch, low diffusion capacity, low cardiac output, and/or right-to-left (RL) shunting. METHODS: To determine whether true RL shunting causing hypoxemia is caused by intracardiac shunting, as classically considered, a retrospective single center study was conducted ...
Figueiredo André A - - 2009
THIS CASE STUDY DESCRIBES THE ASSOCIATION BETWEEN TWO RARE ENTITIES: pulmonary alveolar proteinosis (PAP) and embryonic rhabdomyosarcoma of the prostate in a 54 year old male presenting with pulmonary symptoms and obstructive urinary symptoms. The prostate tumour was treated with a radical cystectomy and adjuvant chemotherapy and radiotherapy. The patient ...
Weng Yi-Ming - - 2009
Cyanosis is a bluish skin due to deoxygenated hemoglobin or methomoglobin in the arterial blood.Central cyanosis mostly results from cardiovascular or pulmonary shunts. Tet spell is an episodic central cyanosis due to total occlusion of right ventricle outflow in a patient with a congenital heart disease, such as Tetralogy of ...
Bergsland Jacob - - 2009
BACKGROUND: The purpose of this study was to evaluate the role of intracoronary shunt during off-pump coronary artery bypass surgery. METHODS: Fifty-six patients undergoing off-pump coronary artery bypass using the left internal mammary artery to bypass the left anterior descending coronary artery were randomly assigned to have the bypass performed ...
Neema Praveen Kumar - - 2009
Bidirectional superior cavopulmonary shunt (bidirectional Glenn shunt) is generally performed in many congenital cardiac anomalies where complete two ventricle circulations cannot be easily achieved. The advantages of BDG shunt are achieved by partially separating the pulmonary and systemic venous circuits, and include reduced ventricular preload and long-term preservation of myocardium. ...
Chakraborty A - - 2009
A 58 year old policeman presented with a 4 week history of cough, haemoptysis, exertional dyspnoea, ear discomfort and sore throat. He was previously healthy and taking no regular medications. He was a non-smoker and had no risk factors for coronary artery disease. He had recently completed two courses of ...
Bertolotto Michele - - 2009
We report a case of a patient who developed high-flow priapism following a Winter procedure performed for the treatment of low-flow ischemic priapism. During the creation of bilateral cavernosal-glandular shunts, the tip of the left dorsal artery was accidentally lacerated. A fistula developed through the shunt between the torn artery ...
Ma Ka-Fai Johnny - - 2009
A bronchial artery embolization (BAE) is an important therapeutic method used to control acute and chronic hemoptysis. We report a case of multiple micro-infarcts involving both the kidneys and spleen, following a BAE with 500-700 microm crossed-linked tris-acryl microspheres (Embospheres) in a patient with bronchial artery pulmonary vein shunts. The ...
Taylor E W - - 2009
Autonomic control of the cardiovascular system in reptiles includes sympathetic components but heart rate (f(H)), pulmonary blood flow (Q(pul)) and cardiac shunt patterns are primarily controlled by the parasympathetic nervous system. The vagus innervates both the heart and a sphincter on the pulmonary artery. The present study reveals that whereas ...
Sheth Sameer A - - 2009
Ventriculo-atrial (VA) shunts are often used for CSF diversion in situations involving abdominal pathology that preclude the use of ventriculo-peritoneal shunts. Distal (venous) catheters of VA shunts have historically been inserted using a cut-down on the internal jugular vein (IJV). Less invasive placement of atrial catheters may minimize operative times ...
Kajihara Noriyoshi - - 2009
Functionally single ventricle (f-SV) is susceptible to volume overload. Atrioventricular valve regurgitation (AVVR) tends to develop and ventricular function deteriorates due to excessive pulmonary blood flow following modified Blalock-Taussig shunt (mBTS). On the other hand, a small caliber graft has risks of early obstruction and poor growth of pulmonary vascular ...
Mareedu Ravi K - - 2008
Patent foramen ovale with right to left shunt as a cause of hypoxia without Eisenmengers physiology or with only moderately pulmonary artery pressures is an uncommon presentation. Initial diagnosis via transesophageal echocardiography requires detection of a shunt with either color Doppler or agitated saline contrast with or without Valsalva maneuver. ...
Bertolotto Michele - - 2008
PURPOSE: To illustrate the sonographic and Doppler features of the different types of intrahepatic vascular shunts. METHODS: Patients presenting in our department with intrahepatic vascular shunts with healthy livers or with a variety of liver pathologies underwent color Doppler interrogation and spectral analysis. RESULTS: Intrahepatic vascular shunts may involve all ...
Kella Nandlal - - 2008
A female baby of one-and-a-half-year old presented with extrusion of ventriculoperitoneal (VP) shunt through umbilicus. On exploration, the urachal remnant was found perforated by VP shunt and the tube exteriorized through umbilicus. Child was managed successfully with excision of urachal remnant, removal of VP shunt, antibiotic treatment and re-insertion of ...
Edaigbini A S - - 2008
BACKGROUND: Tricuspid Atresia is the 3rd commonest cyanotic congenital Heart disease. It is characterized by lack of communication between the right atrium and right ventricle. The treatment often requires a palliative systemic to pulmonary shunt before definite surgery. The use of a central shunt via a median sternotomy is suggested ...
Mitchell Simon J - - 2009
Inner ear decompression sickness has been strongly associated with the presence of right-to-left shunts. The implied involvement of intravascular bubbles shunted from venous to arterial circulations is inconsistent with the frequent absence of cerebral symptoms in these cases. If arterial bubbles reach the labyrinthine artery, they must also be distributing ...
de Oliveira Jean G - - 2008
OBJECTIVE: To compare the risk of shunt-dependent hydrocephalus after treatment of ruptured intracranial aneurysms by clipping versus coiling. METHODS: We analyzed 596 patients prospectively added to our database from July of 1999 to November of 2005 concerning the risk of shunt dependency after clipping versus coiling. Factors analyzed included age; ...
Aleksic Marko - - 2008
In carotid surgery, it could be useful to know which patient will tolerate carotid cross-clamping in order to minimize the risks of perioperative strokes. In this clinical study, an artificial neuronal network (ANN) was applied and compared with conventional statistical methods to assess the value of various parameters to predict ...
Sharaf Mahmoud - - 2008
Significant hypoxemia can result from right-to-left intracardiac shunting through a patent foramen ovale, an atrial septal defect or a ventricular septal defect. Pulmonary embolus, congenital heart disease and pericardial tamponade are well-recognized causes of right-to-left shunting. However, right-to-left shunting can also follow pericardiocentesis. A case of profound hypoxemia caused by ...
Ramakrishnan S - - 2008
We describe an unusual route and uncommon device use for the percutaneous closure of a modified Blalock-Taussig (BT) shunt. A 4-year-old male had presented with severe upper body swelling after a bidirectional Glenn shunt done one month earlier. The BT shunt which was clipped during the surgery was found to ...
Matsuhisa Hironori - - 2009
A two-month-old male infant with tetralogy of Fallot underwent a right-sided modified Blalock-Taussig shunt using a 4 mm expanded polytetrafluoroethylene graft through a right thoracotomy. Five months later, the patient developed otitis media, followed by repeated relapses of pneumonia and fever of unknown origin. Multidetector-row computed tomography and angiography, performed ...
Ones Tunc - - 2008
A case of pulmonary arteriovenous malformation (PAVM) in a 32-year-old woman who underwent successful left upper lobectomy is presented. A whole-body technetium-99m-labeled macro-aggregated albumin scan was used to demonstrate intrapulmonary right-to-left shunt, and shunt fraction was calculated as 39%. The patient underwent a follow-up scan after the operation; shunt fraction ...
Rigatelli Gianluca - - 2008
BACKGROUND: The contribution of different right atrium anatomical-functional characteristics to the risk of paradoxical stroke has not been extensively investigated, probably in part because of the limits of standard echocardiography. OBJECTIVE: We sought to assess, using intracardiac echocardiography (ICE), the right atrium anatomical-functional characteristics and their role in the pathophysiology ...
Bove Edward L - - 2008
OBJECTIVE: Stage one reconstruction (Norwood operation) for hypoplastic left heart syndrome can be performed with either a modified Blalock-Taussig shunt or a right ventricle-pulmonary artery shunt. Both methods have certain inherent characteristics. It is postulated that mathematic modeling could help elucidate these differences. METHODS: Three-dimensional computer models of the Blalock-Taussig ...
Ivert Torbjörn - - 2008
Congenital malformations causing mild cyanosis can be overlooked. A large intrapulmonary right pulmonary artery to left atrium connection was the unusual etiology of arterial oxygen desaturation and erythrocytosis in an asymptomatic 30-year-old patient. The shunt was not possible to detect at echocardiography. It was closed via a median sternotomy without ...
Elhammady Mohamed Samy A - - 2008
Ventriculoatrial (VA) shunts remain the most used alternative to ventriculoperitoneal shunts in infants with hydrocephalus. The authors report a case of an acute VA shunt malfunction as a result of distal catheter displacement in an 18-month-old girl with partial anomalous pulmonary venous return. The child presented with respiratory compromise, and ...
Padalino Massimo A - - 2008
BACKGROUND: The modification of placing the shunt from the right ventricle to the pulmonary arteries, also known as Sano procedure, has allegedly improved results over the short term in surgical palliation of hypoplastic left heart syndrome with the Norwood procedure. With this in mind, we reviewed autopsied specimens from neonates ...
Erez Eldad - - 2008
BACKGROUND: Establishing stable and adequate flow of blood to the lungs using a systemic-to-pulmonary arterial shunt in infants with low birth weight may involve significant morbidity and mortality. We reviewed our experience with this procedure in patients weighing less than 3 kilograms. METHODS: Between June, 2002, and June, 2007, we ...
Shim Jae-Kwang - - 2008
Although numerous studies have validated the efficacy of intracoronary shunt on reducing left ventricular dysfunction during off-pump coronary artery bypass surgery (OPCAB), there is lack of evidence supporting its role on right ventricular (RV) function during right coronary artery (RCA) revascularization. Therefore, we studied the effect of intracoronary shunt during ...
Gillespie Matthew J - - 2008
Systemic-to-pulmonary artery shunt occlusion is a life-threatening complication in patients with shunt-dependent pulmonary blood flow. In the current era, the definitive diagnosis of shunt obstruction, and interventions to re-establish shunt patency are performed in the catheterization laboratory, rather than the operating room. This review summarizes the various transcatheter techniques used ...
Bakovic Darija - - 2008
INTRODUCTION: Most decompression procedures induce the formation of asymptomatic venous gas bubbles. They can be classified as "silent bubbles," which are asymptomatic compared to paradoxical arterialization of venous gas emboli, which can lead to serious neurologic damage. The penetration of such gas bubbles into the arterial circulation is due to ...
Mumtaz Muhammad A - - 2008
BACKGROUND: We manage patients with pulmonary atresia, ventricular septal defect, major systemic-to-pulmonary collateral arteries, and diminutive central pulmonary arteries with a staged approach. The first procedure is a central end-to-side aortopulmonary shunt (Melbourne shunt) intended to cause growth and development of the central pulmonary arteries. We subsequently measured central pulmonary ...
Ruiz Carlos E - - 2008
OBJECTIVES: This study evaluated the feasibility of percutaneous patent foramen ovale (PFO) closure using a transcatheter suture (Superstitch), leaving no device behind. BACKGROUND: PFO has been implicated in cryptogenic strokes and migraine with auras. Percutaneous PFO closure, being less invasive than surgical closure, is increasingly performed. There are, however, early ...
Shin Dong-Seong - - 2008
Shunt infections are a common complication of ventriculoperitoneal (VP) shunts, but the formation of a brain abscess related to a shunt system is very rare. A 44-year-old woman had a VP shunt inserted for hydrocephalus secondary to a subarachnoid hemorrhage. She suffered an episode of meningitis and sepsis 8 months ...
Ohye Richard G - - 2008
The initial palliative procedure for patients born with hypoplastic left heart syndrome and related single right ventricle anomalies, the Norwood procedure, remains among the highest risk procedures in congenital heart surgery. The classic Norwood procedure provides pulmonary blood flow with a modified Blalock-Taussig shunt. Improved outcomes have been reported in ...
Karimi Mohsen - - 2008
Hypoplastic left heart syndrome is a rare congenital heart defect characterized by underdevelopment of left-sided heart structures, including the aortic arch. The contemporary surgical management of this anomaly includes the Norwood procedure and provision of pulmonary blood flow by either a modified Blalock-Taussig shunt (MBTS) or a right ventricle-to-pulmonary artery ...
Ozanne Augustin - - 2008
We discuss the arterial supply of the cranial nerves from their exit out of the brain stem to their exit from the skull base. Four distinct groups can be differentiated from an embryologic and phylogenetic standpoint. Understanding the arterial supply to the cranial nerves and the potential anastomoses is paramount ...
Nakamura Kenichi - - 2008
Fatal biliary complications and liver abscesses are likely in cases of acute hepatic arterial occlusion after hepatobiliary surgery with bilioenteric anastomosis. A 60-year-old man with hilar hepatic metastasis of gastric cancer underwent curative surgery. While the recurrent nodule was removed with the involved bile duct, vascular structures were preserved. Massive ...
Liboni William - - 2008
Patent foramen ovale (PFO) is a frequent finding in migraine patients. The standard technique for PFO diagnosis is actually trans-oesophageal echocardiography (TEE). It requires the injection of a contrast agent unable to pass the pulmonary filter; hence, it is possible to detect a right-to-left shunt by observing the presence of ...
Manabe Shinji - - 2008
INTRODUCTION: We report the characteristics, diagnosis and treatment of dural arteriovenous fistula (DAVF) of the hypoglossal canal in nine patients with this relatively rare vascular disorder. METHODS: Of 248 patients with intracranial DAVFs managed at our institution, nine patients (3.6%; four men, five women; mean age 62 years) were diagnosed ...
Perkins Linda A - - 2008
Though uncommon, right-to-left shunt through a patent foramen ovale with normal right-side pressure and with a normal interatrial pressure gradient has been reported. The speculated pathophysiology is attributed to directional blood flow streaming from the vena cava to the left atrium. Hypoxemia secondary to right-to-left shunt with normal pulmonary artery ...
Stringer Mark D - - 2008
Congenital portosystemic venous shunts are rare. Their gross anatomy has not been well defined. Four different varieties of congenital portosystemic venous shunts are described in six children seen during a 10-year period, focusing on the anatomy of the shunt as determined by imaging studies and surgery. A detailed review of ...
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