Document Detail

Hemodynamic impact of transseptal access to the ascending aorta in a porcine model.
MedLine Citation:
PMID:  23046337     Owner:  NLM     Status:  In-Data-Review    
Purpose : To evaluate the hemodynamic impact of transseptal sheath access to the ascending aorta using increasing sheath diameters. Methods : Transseptal puncture was performed in 6 pigs (62±9 kg) facilitating guidewire passage across the left heart to the descending aorta to establish transseptal through-and-through access into the ascending aorta. Hemodynamic parameters were evaluated during 6- to 16-F sheath deployments and after sheath retraction according to a standardized protocol. Fluorescent microspheres were injected for quantitative assessment of myocardial and cerebral perfusion and left-right shunting volume. Results : Cardiac output, heart rate, and central venous pressure (CVP) were stable throughout the study in all animals. The ratio between pulmonary artery pressure and mean arterial pressure was significantly higher during sheath deployment compared to after retraction (p<0.01), indicating transient mitral valve insufficiency. The ratio between left atrial pressure and CVP was significantly higher with the sheath in place (p<0.01), signaling transient left-right shunting; the hemodynamic alteration disappeared after sheath retraction. Myocardial perfusion (p=0.224), cerebral perfusion (p=0.209), and left-right shunting volume (p=0.111) were not significantly affected by the transseptal access. Conclusion : Transseptal access to the ascending aorta in a porcine model is feasible without persisting hemodynamic impairment or severe influence on myocardial or cerebral perfusion even with up to 16-F sheaths. Potential adverse effects need to be addressed before clinical use of this alternative access to the ascending aorta, aortic arch, and its side branches.
Sabine Wipper; Christina Lohrenz; Klaas Peymann; Detlef Russ; Jan Felix Kersten; Sebastian William Carpenter; Axel Larena-Avellaneda; Christian Detter; Sebastian Debus; Tilo Kölbel
Related Documents :
856737 - A physical model of time-dependent flow in the human air passages.
16485047 - Impact of chronic lisinopril therapy on left atrial volume versus dimension in chronic ...
8311607 - Hemodynamic significance of the coronary vein valves.
6490677 - A mathematical study of semilunar valve vibration.
1967 - Reactions of the arterial blood pressure in changed haemodynamic conditions and under t...
15840897 - Clinical comparison of automatic, noninvasive measurements of blood pressure in the for...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists     Volume:  19     ISSN:  1545-1550     ISO Abbreviation:  J. Endovasc. Ther.     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100896915     Medline TA:  J Endovasc Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  679-88     Citation Subset:  IM    
1 Departments of Vascular Medicine and.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Proximal Type I Endoleak After Previous EVAR With Palmaz Stents Crossing the Renal Arteries: Treatme...
Next Document:  Revisiting Case IV: A reassessment of bias and standard errors of Case IV under range restriction.