Systemic hypertension induced by aortic cross-clamping: Detrimental effects of direct smooth muscle relaxation compared with ganglionic blockade Mohammed.

Slides:

Advertisements

Similar presentations

Endothelial cell seeding reduces thrombogenicity of Dacron grafts in humans Per Örtenwall, MD, PhD *, Hans Wadenvik, MD, PhD **, Jack Kutti, MD, PhD **,

Advertisements

The role of arteriovenous shunts in the pathogenesis of varicose veins Howard C. Baron, M.D., Sebastiano Cassaro, M.D. Journal of Vascular Surgery Volume.

The effect of inguinal lymphatic manipulation on regional lymph flow patterns Jeffrey R. Rubin, MD, Lisa B. Eberlin, MD Journal of Vascular Surgery Volume.

A review of 100 consecutive reconstructions of the distal vertebral artery for embolic and hemodynamic disease Ramon Berguer, MD, PhD, Mark D. Morasch,

Clinical evaluation of recombinant human platelet – derived growth factor for the treatment of lower extremity diabetic ulcers David L. Steed, MD, the.

Aortic injury occurring after minor trauma in ankylosing spondylitis

Heparin-coated catheters and heparin-induced thrombocytopenia

Prevention of paraplegia during thoracic aortic cross-clamping: Importance of patent internal mammary arteries Joseph S. Giglia, MD, Gerald B. Zelenock,

Elastin, collagen, and some mechanical aspects of arterial aneurysms

Mitogen-activated protein kinase activation: An alternate signaling pathway for sustained vascular smooth muscle contraction Aaron M. Epstein, MD, Douglas.

Richard T. Purdy, M. D. , Frederick C. Beyer, M. D. , William D

Abdominal aortic pseudoaneurysm after blunt trauma

A new valvulotome for in situ bypass grafts

Aortic injury occurring after minor trauma in ankylosing spondylitis

Computed electroencephalographic topographic brain mapping

Walter J. Scott, M.D., Bruce L. Gewertz, M.D.

Silent myocardial ischemia in patients undergoing peripheral vascular surgery: Incidence and association with perioperative cardiac morbidity and mortality

Arjen M. Rijken, MD, Rudi M.J.M. Butzelaar, MD

Malcolm O. Perry, MD, Richard Kempczinski, MD

Transaortic endarterectomy of renal visceral artery lesions in association with infrarenal aortic surgery Robert A. Mason, MD, George B. Newton, MD,

Recurrent thoracic outlet syndrome

Protecting the brain and spinal cord

Bruce L. Gewertz, M. D. , Paul C. Kremser, M. D. , Christopher K

Heparin-coated catheters and heparin-induced thrombocytopenia

Milton M. Slocum, MD, John G. Adams, MD, Rosemary Teel, MT, Donald P

Minimal physiologic temperature variations during renal ischemia alter functional and morphologic outcome Timothy J. Pelkey, BS, Richard S. Frank, MD,

Effects of thoracic aortic occlusion and cerebrospinal fluid drainage on regional spinal cord blood flow in dogs: Correlation with neurologic outcome

Abdominal aortic aneurysm: A general defect in the vasculature with focal manifestations in the abdominal aorta? Björn Sonesson, MD, PhD, Flemming Hansen,

Effects of heparin, desmopressin, and isovolemic hemodilution with dextran on thrombus formation in synthetic vessel grafts inserted into the vena cava.

George H. Meier, MD, Bauer Sumpio, MD, PhD, Henry R

Yehuda G. Wolf, MD, Lars M. Rasmussen, MD, Yoav Sherman, MD, Warner P

Laser-induced fluorescence detection of atherosclerotic plaque with hematoporphyrin derivative used as an exogenous probe Louis G. Prevosti, M.D., James.

Thomas F. Lindsay, MDCM, FRCS(C), Paul M

S.Amjad Hussain, MD, FRCSC, Ahmet Bayar, MD

Physiology of carotid endarterectomy with ocular pneumoplethysmography

Impaired vasodilation of peripheral arteries in response to acetylcholine in human beings with abdominal aortic aneurysm Kimihiro Komori, MD, PhD, Kyoutaro.

Renal transplant perfusion during aortoiliac aneurysmectomy

Lower extremity ischemia in adults younger than forty years of age: A community-wide survey of premature atherosclerotic arterial disease Pavel J. Levy,

Recreational weight lifting and aortic dissection: Case report

Calvin B. Ernst, MD Journal of Vascular Surgery

Ruptured abdominal aortic aneurysm: A population-based study

Mesenteric venous thrombosis

Ramesh Lokanathan, MD, FRCS(C), David C. Taylor, MD, FRCS(C)

Cardiovascular surgery—The rocket and its stars: Presidential address

The role of a defined protocol for cardiac risk assessment in decreasing perioperative myocardial infarction in vascular surgery T.J. Bunt, MD Journal.

Composite sequential bypasses to the ankle and beyond for limb salvage

Research and research funding in vascular surgery

J.Dennis Baker, MD Journal of Vascular Surgery

Gary W. Barone, MD, Axel W. Joob, MD, Terry L. Flanagan, MPH, Carey E

Journal of Vascular Surgery Volume 12, Issue 6, Pages (December 1990)

Nitroglycerin to control blood pressure during endovascular stent-grafting of descending thoracic aortic aneurysms Emanuel O. Bernard, MD, Edith R. Schmid,

Discussion The Journal of Thoracic and Cardiovascular Surgery

Incidence and results of arterial complications among 16,350 patients undergoing cardiac catheterization Sateesh C. Babu, MD a, George O. Piccorelli,

Seizures following subclavian-carotid bypass

Hemodynamic basis of stasis ulceration—A hypothesis

Carotid biaxillary bypass: A new operation

Concomitant renal endarterectomy and aortic reconstruction

Acute aortic occlusion – Factors that influence outcome

Monitoring vascular surgical performance

D. Emerick Szilagyi, MD—An appreciation

Presidential address: The second-generation vascular surgeon

George D. Lilly 1906–1988 Journal of Vascular Surgery

James A. DeWeese, MD Journal of Vascular Surgery

Estrogen improves endothelial function

Innominate artery trauma: A thirty-year experience

Popliteal entrapment syndrome: A report of tibial nerve entrapment

Supraclavicular reoperation for neurogenic thoracic outlet syndrome

Endovascular repair of two abdominal aortic aneurysms

Renal vasoconstriction and transient declamp hypotension after infrarenal aortic occlusion: Role of plasma purine degradation products Richard S. Frank,

Cornelius A. Sullivan, MD, Michael J. Rohrer, MD, Bruce S. Cutler, MD

Presentation transcript:

Systemic hypertension induced by aortic cross-clamping: Detrimental effects of direct smooth muscle relaxation compared with ganglionic blockade Mohammed M. Moursi, MD, Matthew A. Facktor, BMA, Gerald B. Zelenock, MD, Louis G. D'Alecy, DMD, PhD Journal of Vascular Surgery Volume 19, Issue 4, Pages 707-716 (April 1994) DOI: 10.1016/S0741-5214(94)70045-1 Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 Time course and sampling protocol. Large box represents 90-minute infrarenal aortic cross-clamp time. Rx box represents 30 minutes intraoperative drug (nitroprusside or trimethaphan camsylate) therapy. Hemodynamic variables were recorded continuously. Arrows correspond to sampling times (−10, 30, 60, 90, 120 minutes; end of each period) when data and blood were taken for analysis. Journal of Vascular Surgery 1994 19, 707-716DOI: (10.1016/S0741-5214(94)70045-1) Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 Time course of suprarenal MAP (A) and CO (B) before, during, and after application of infrarenal aortic cross-clamp. Trimethaphan camsylate treatment was more effective antihypertensive medication than nitroprusside. Ninety-minute cross-clamp time and 30 minutes of intraoperative drug therapy are indicated as solid horizontal bars. Both groups (n = 10) are pooled for preclamp and period A periods and are represented by circle. Lower panel (B) shows dramatic and significant CO increase in NP group. TC group experienced no significant CO changes. Sample sizes are indicated parenthetically. Journal of Vascular Surgery 1994 19, 707-716DOI: (10.1016/S0741-5214(94)70045-1) Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 Time course of suprarenal MAP (A) and CO (B) before, during, and after application of infrarenal aortic cross-clamp. Trimethaphan camsylate treatment was more effective antihypertensive medication than nitroprusside. Ninety-minute cross-clamp time and 30 minutes of intraoperative drug therapy are indicated as solid horizontal bars. Both groups (n = 10) are pooled for preclamp and period A periods and are represented by circle. Lower panel (B) shows dramatic and significant CO increase in NP group. TC group experienced no significant CO changes. Sample sizes are indicated parenthetically. Journal of Vascular Surgery 1994 19, 707-716DOI: (10.1016/S0741-5214(94)70045-1) Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 Time course of HR (A) and SV (B) in both TC and NP groups. Both groups exhibited increase in HR during drug administration. When drug infusion stopped, HR decreased in NP group but remained elevated in TC group. Lower panel (B) shows SV decrease in TC group after drug administration and relative constancy of SV in NP group. Sample sizes are indicated parenthetically. Journal of Vascular Surgery 1994 19, 707-716DOI: (10.1016/S0741-5214(94)70045-1) Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 Time course of HR (A) and SV (B) in both TC and NP groups. Both groups exhibited increase in HR during drug administration. When drug infusion stopped, HR decreased in NP group but remained elevated in TC group. Lower panel (B) shows SV decrease in TC group after drug administration and relative constancy of SV in NP group. Sample sizes are indicated parenthetically. Journal of Vascular Surgery 1994 19, 707-716DOI: (10.1016/S0741-5214(94)70045-1) Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 Time course of TPR (A) and CMW (B) in both TC and NP groups. After initial increase after clamp application, TPR is significantly reduced in NP group but unchanged in TC group. In lower panel (B) CMW increases with clamp application. NP group had significantly increased CMW whereas TC group had reduced values to baseline levels. Sample sizes are indicated parenthetically. Journal of Vascular Surgery 1994 19, 707-716DOI: (10.1016/S0741-5214(94)70045-1) Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 Time course of TPR (A) and CMW (B) in both TC and NP groups. After initial increase after clamp application, TPR is significantly reduced in NP group but unchanged in TC group. In lower panel (B) CMW increases with clamp application. NP group had significantly increased CMW whereas TC group had reduced values to baseline levels. Sample sizes are indicated parenthetically. Journal of Vascular Surgery 1994 19, 707-716DOI: (10.1016/S0741-5214(94)70045-1) Copyright © 1994 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions