Over the last thirty years the internal mammary system has become the recipient of choice when performing free tissue transfer breast reconstruction.(1-5) The cranial ends of the internal mammary artery and vein are safely and reliably used for anastomosis following division. Using these cranial vessels maintains their normal antegrade direction ...

A 54-year-old woman was admitted to our hospital with recurrent chest pain for 1 month. She had a history of aortic root replacement with a stentless valve following aortic valve replacements done twice 12 years ago, and coronary artery bypass grafting 6 years ago. The stentless valve was implanted with ...

The branching patterns of the external carotid artery vary among individuals, and consideration of the proximity of nerves is important during catheter insertion in superselective intra-arterial infusion via the superficial temporal artery. We aimed to evaluate the anatomy of the external carotid artery and its surrounding nerves for safe and ...

Idiopathic mediastinal fibrosis (IMF) is an uncommon clinical condition and the manifestations of this disease vary from a relatively benign disorder with minor symptoms to severe pulmonary vascular occlusion leading to mortality, commonly presenting a diagnostic and therapeutic challenge. Here we present the case of a Taiwanese woman with obstruction ...

OBJECTIVES: To compare the data calculated from the three dimensional (3D) reconstruction of a coronary stenosis with the fractional flow reserve (FFR) values measured on the same coronary segment. METHODS: Multiple projections of 22 patients (7 female, 15 male, age: 61±9.73years) were evaluated by the IC30 software of the Axiom ...

Background: The hepatic artery is prone to numerous anatomic variations dictated by certain variables of the organogenesis. Aim : To research study the anatomic variations of the hepatic artery as well as their implications within surgical practice. Methods: Study of a post-mortem series of 33 cases of dissection of the ...

Aorto-ostial left main (LM) percutaneous coronary intervention (PCI) remains a challenge in interventional cardiology, as precise positioning of stents using conventional angiographic landmarks is difficult. Previously described techniques either involve the use of additional complex steps or commercially available special devices that carry extra costs. We describe a novel technique ...

Renal artery duplex ultrasonography (RA-DUS) is commonly used for the evaluation and follow-up of renal artery atherosclerotic disease. In a complete study, renal artery flow is evaluated from the vessel origin to the intraparenchymal branches. The quality of RA-DUS is in part technologist-dependent, but many factors may affect the ability ...

Aneurysms of the hepatic artery are rare, but are associated with significant mortality because of their lack of symptoms at presentation and risk of rupture. We report a case of an enlarging 4-cm hepatic artery aneurysm involving the proximal common hepatic artery to the bifurcation of the right and left ...

The distribution of central benzodiazepine receptors in the human brain has been characterized by single-photon emission computed tomography (SPECT) using I-iomazenil, and it may dynamically change. We present the case of a 52-year-old man with left internal carotid artery occlusion, who underwent extracranial-intracranial arterial bypass surgery and exhibited postoperative improvement ...

A 32-year-old woman was admitted to our institution for further evaluation of aortic stenosis. Diagnosis of severe aortic stenosis was made by transthoracic echocardiography. Transesophageal echocardiography, live three-dimensional echocardiography and cardiovascular MRI allowed precise evaluation of valve morphology. Interestingly, valve morphology was unicuspid unicommissural with a posterior funnel-shaped valve opening. ...

Although sequential portal and arterial revascularization (SPAr) is the most common method of graft reperfusion at liver transplantation (OLT), contemporaneous portal and hepatic artery revascularization (CPAr) has been used to reduce arterial ischemia to the bile ducts. The aim of this study was to prospectively compare SPAr (group 1; n ...

Currently, aortic valve replacement is the mainstay treatment for aortic regurgitation due to commissural detachment. Herein, we report a novel technique of aortic root and commissural repair and its intermediate clinical outcome in patients with significant aortic regurgitation caused by commissural detachment. The detached commissure and aortic root were treated ...

The long-term benefits of a left internal mammary artery bypass graft compared to the left anterior descending artery have been well described. The use of drug-eluting stents has minimized the morbidity of revascularization. Hybrid coronary revascularization is the planned use of minimally invasive surgical techniques for left internal mammary artery-left ...

We describe a new method for aortic anastomosis in the repair of acute aortic dissection. The anastomosis sites are prepared and sutured in an interrupted horizontal mattress manner with telescoping technique. By this kind of method, the interrupted sutures decrease damage to the fragile aortic wall and the antegrade blood ...

BACKGROUND: We are developing a total cavopulmonary support system for failing Fontan physiology using the percutaneous Wang-Zwische double-lumen cannula (DLC). METHODS: We developed a sheep model of failing Fontan physiology through a right thoracotomy in 5 sheep. An extracardiac conduit was anastomosed to the inferior vena cava and superior vena ...

Objectives: The remodeling of the dilatated valve annulus with a prosthetic ring for the repair of valve insufficiency is a well-established concept in mitral valve surgery, and may also be suitable for aortic valve reconstruction. In this study, two models of prosthetic aortic annuloplasty devices were investigated. Methods: Fresh porcine ...

BACKGROUND AND PURPOSE: Stent-assisted endovascular treatment and flow diversion techniques are increasingly used for the management of wide-neck intracranial aneurysms. We report our initial clinical experience using a new flow diversion technique for the endovascular management of bifurcation aneurysms. MATERIALS AND METHODS: Eight bifurcation aneurysms were treated by placing 2 ...

Objectives: Studies carried out to date suggest that the interrupted suture technique using U-Clips for anastomoses in coronary surgery may be superior to the standard running polypropylene suture. The purpose of this study was to compare safety and effectiveness of a central T-graft anastomosis constructed with the left internal thoracic ...

Radial artery occlusion (RAO) is an infrequent but important consequence of transradial access. It prevents subsequent use of the same radial artery for coronary angiography and intervention. We describe a new "proximal entry" technique in 3 cases of RAO, which allowed successful completion of the procedures. This technique should add ...

BACKGROUND: Endothelial function is best measured with the noninvasive brachial artery flow-mediated dilatation (FMD) method. Peripheral arterial diseases and systemic cardiovascular diseases have FMD-lowering effect. The effects of lower extremity ischemia are associated with muscle inflammation and claudication, which may further lead to arterial stress. Our aim in this study ...

Whether the relief of chronic right atrial (RA) volume load by device closure of an atrial septal defect (ASD) normalizes RA size is unknown. The present study evaluated the prevalence and determinants of incomplete RA reverse remodeling (RAR) after ASD closure in adults. Transthoracic echocardiography was performed in 44 consecutive ...

OBJECTIVES: Arteriovenous fistulae (AVFs) play a key role for people who rely on chronic haemodialysis. Stenosis in the venous outflow of the AVF will cause an alternative route of the subcutaneous blood flow via the deeper venous pathways by means of side branches and the perforating veins (PVs). The purpose ...

The purpose of the present study was to compare the aortic valve area, aortic valve annulus, and aortic root dimensions measured using magnetic resonance imaging (MRI) with catheterization, transthoracic echocardiography (TTE), and transesophageal echocardiography (TEE). An optimal prosthesis-aortic root match is an essential goal when evaluating patients for transcatheter aortic ...

BACKGROUND: The incidence of concomitant carotid artery stenosis and unruptured intracranial aneurysm (UIA) has been reported to be between 3% and 5%. The rupture risk of UIA measuring <7 mm is very low according to International Study of Unruptured Intracranial Aneurysm data. However, there may be a potential risk of ...

INTRODUCTION: Combined aneurysms of aortic and iliac arteries are rare with a prevalence of less than 0.1%. However, these combined aneurysms are associated with a high incidence of thrombosis, distal embolism or rupture. Endovascular repair is a therapeutic option. The procedure often includes embolisation of the internal iliac artery, which ...

Pulmonary arteriovenous malformations (PAVM) are caused by abnormal communications between pulmonary arteries and pulmonary veins. They are most often congenital, and may occur as isolated lesions or part of complex congenital syndromes. We describe a case of PAVM diagnosed in a 16 weeks fetus. To the best of our knowledge ...

BACKGROUND: The purpose of this study was to evaluate the potential of combined use of transthoracic Doppler echocardiographic coronary flow velocity reserve (CFVR) measurements and findings of retrograde coronary flow in the three main coronary arteries for the assessment of borderline (angiographic diameter stenosis, 50%-75%) and high-grade (angiographic diameter stenosis, ...

Spontaneous spinal epidural hematoma (SSEH) is a rare condition, and its etiology remains unclear. Spinal venous wall instability due to intravenous pressure changes and the resultant venous rupture seem to be the underlying pathophysiological mechanisms. Here, the authors report a case of posterior SSEH at the C3-5 level causing mild ...

Pancreaticoduodenal artery (PDA) aneurysms are rare and often found in association with lesions of the celiac axis. We report the case of a 72-year-old morbidly obese male who presented with chronic abdominal pain and a 4.5 cm inferior PDA aneurysm with associated occlusion of the celiac axis. The patient was ...

Numerous techniques have been described to treat intracranial vessel perforation during endovascular interventions. We describe a novel application of Onyx-18 for the treatment of intracranial catheter perforations by sealing the vessel from the outside while retracting the catheter into the arterial lumen.

Monitoring regional cerebral oxygen saturation (rSO(2)) by use of near-infrared spectroscopy (NIRS) is a useful method for detecting cerebral ischemia. Tracheo-innominate artery fistula is a rare but life-threatening complication of tracheostomy. The surgical procedures for management of tracheo-innominate artery fistula include direct or patch closure of the fistula, ligation or ...

INTRODUCTION: Aneurysm of the extracranial internal carotid artery (AEICA) is extremely rare catastrophic pathology associated with cerebral embolism and rupture. There was no report on AEICA associated with bullous lung disease. REPORT: We report a case of AECIA in a 44-year-old female patient combined with asymptomatic pulmonary bulla, and successfully ...

Brachial artery flow-mediated dilation (FMD) is a strong predictor of future cardiovascular disease and is believed to represent a "barometer" of systemic endothelial health. Although a recent study in pigs confirmed a strong correlation between brachial and femoral artery endothelial function, it is unclear to what extent brachial artery FMD ...

BACKGROUND: Coronary artery targets are essential for referral acceptance to achieve complete coronary revascularization. PATIENTS AND METHODS: A prospective double-blind study was carried out to determine whether the addition of nitroglycerin to cold blood hyperkalemic cardioplegia would optimize the size and number of coronary artery targets during conventional coronary bypass ...

The ultimate treatment goal for intracranial aneurysms is to reconstruct the vessel wall and correct the hemodynamic disturbance. A flow diverter is a stent placed in the parent artery to reduce blood flow in the aneurysm sac to the point of stagnation, gradual thrombosis, and neointimal remodeling to maintain outflow ...

Spontaneous dissection of the coronary arteries is an extremely rare event that occurs usually in middle-aged women and is mostly recognized at postmortem examination in victims of sudden death. It is a rare coronary pathologic finding whose precise incidence, etiology, pathogenesis, treatment, and evolution have not been clearly established. We ...

PURPOSE: This paper evaluates the indications, techniques, results, and complications of intra-arterial thrombolysis with or without a multihole microcatheter in three cases of acute hand ischaemia in comparison with the literature. MATERIALS AND METHODS: Three men (mean age 39 years) with symptoms and signs of acute hand ischaemia (i.e. pain, ...

We describe the case of a woman presenting to the intensive care unit (ICU) with acute respiratory failure requiring mechanical ventilation. The patient had severe pulmonary hypertension secondary to interstitial lung disease with a past history, which included sarcoidosis and tuberculosis. She was dependent on inhaled nitric oxide (iNO) to ...

We sought to determine the significance of incomplete stent frame expansion after transcatheter aortic valve implantation with the Medtronic-CoreValve device. Incomplete coronary stent expansion is a well-described phenomenon. Transcatheter valves are mounted on stents; however, the incidence of incomplete stent expansion after transcatheter aortic valve implantation, its sequelae and predictors ...

In this case report, we present a 45-year-old man who experienced abdominal pain while bench-pressing heavy weights. A computed tomography angiogram showed a dissection of the celiac artery extending into the hepatic and splenic arteries, with thrombus in the false lumen into the common hepatic artery. With resolution of his ...

Our laboratory has developed an adjustable systemic-pulmonary artery (AS) shunt to provide improved control of pulmonary blood flow (PBF) after neonatal palliation of hypoplastic left heart syndrome (HLHS). Six piglets of 6-10 kg underwent left thoracotomy and placement of a 3.5 mm polytetrafluoroethylene (PTFE) shunt from the left subclavian artery ...

Bleeding from the proximal suture line during aortic root replacement using a composite valve graft is a crucial and catastrophic problem. We present a simple flanged Bentall technique using a Valsalva tube graft to eliminate bleeding from the proximal suture line. The method is to wrap the proximal anastomosis completely ...

In earlier work, we suggested that the start of the isovolumic contraction period could be detected in arterial pressure waveforms as the start of a temporary pre-systolic pressure perturbation (AIC(start), start of the Arterially detected Isovolumic Contraction), and proposed the retrograde coronary blood volume flow in combination with a backwards ...

Persistent trigeminal artery is a rare persistent carotid-basilar anastomosis that usually connect the infracavernous segment of the ICA with the basilar artery. Rarely, PTA may feed cerebellar artery. We describe an exceptional case of PTA terminating in postero-inferior cerebellar artery (PICA) hemispheric branch. Angiographic and CTA features are presented and ...

Abstract  Abnormalities in the aorta of patients with tetralogy of Fallot (TOF) can lead to aortic dilatation and aortic regurgitation. We report a six-year-old male with TOF with dysplastic aortic valve, severe aortic regurgitation, and aortic aneurysm involving the aortic root, ascending aorta, and the proximal aortic arch, who underwent ...

Background and purpose:  The presence of collateral middle cerebral artery (MCA) flow via the primary collateral pathway is thought to protect against the progression of cerebral ischaemia. However, there have been few reports on early clinical outcomes according to the presence of collateral MCA flow in acute ischaemic stroke (AIS) ...

Prosthesis embolization represents a severe complication following transcatheter aortic valve implantation (TAVI). We describe a case of ventricular embolization of the Edwards Sapien valve following transapical TAVI. The prosthesis was extracted successfully using the same transapical access. This approach obviated the need for conversion to a median sternotomy to explant ...

PURPOSE: To describe the intraosseous arterial anatomy of the proximal ulna. METHODS: We used 9 fresh-frozen, above-elbow amputations to map the intraosseous arterial supply using the Spalteholtz technique. We treated 3 additional above-elbow amputations similarly, and then dissected them to map the extraosseous arterial supply. We recorded the extraosseous arterial ...

Object The purpose of this paper is to evaluate whether venous indocyanine green (ICG) videoangiography has any potential for predicting the presence of a safe collateral circulation for veins that are at risk for intentional or unintentional damage during surgery. Methods The authors performed venous ICG videoangiography during 153 consecutive ...