Regulation of the aortic valve opening

Slides:

Advertisements

Similar presentations

Resection of ascending aortic aneurysm without use of an interposition aortic graft John S. Ikonomidis, MD, PhD, FRCS(C), Abe DeAnda, MD, D.Craig Miller,

Advertisements

Effects of oxygen, positive end-expiratory pressure, and carbon dioxide on oxygen delivery in an animal model of the univentricular heart Christopher.

Effects of myocardial ischemia on the release of cardiac troponin I in isolated rat hearts Sidney Chocron, MDa, Kifah Alwan, MDa, Gerard Toubin, MDb,

Aortic valve replacement in low-flow, low-gradient aortic stenosis: Left ventricular ejection fraction matters Victor Dayan, MD, PhD, Philippe Pibarot,

Effects of oxygen, positive end-expiratory pressure, and carbon dioxide on oxygen delivery in an animal model of the univentricular heart Christopher.

Retrograde brain perfusion beyond the venous valves

Linear end-systolic pressure-volume relationship during pulsatile left ventricular bypass represents native heart function Osamu Kawaguchi, MD, John.

N. Ad, MDa, E. Birk, MDb, J. Barak, MDa, S. Diamant, MDc, E

Working heart model of heterotopic heart-lung transplantation in rats

False-positive diagnosis of ascending aorta dissection by single-plane transesophageal echocardiography Eugenio Neri, MDa, Dominique Maiza, MDa, Gwenael.

Protamine-induced hypotension in heart operations: Application of the concept of ventricular-arterial coupling Masahiro Oe, MD, Toshihide Asou, MD, Shigeki.

Cine computed tomography for evaluation of tumors invasive to the thoracic aorta: Seven clinical experiences Toshiya Ohtsuka, MDa, Manabu Minami, MDb,

Hani K. Najm, MD, Christopher A

Richard J. Kaplon, MDa, Mehmet C. Oz, MDa, Pawel A

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

Heart reduction surgery: An analysis of the impact on cardiac function

The pumping and left ventricular unloading capabilities of the ventricular synchronous skeletal-muscle ventricle L.A. Geddes, ME, PhD, FACCa, W. Janas,

S. Westaby, FRCSa, T. Katsumata, MDa, R. Evans, MDa, D. Pigott, MDa, D

Implantation of a left ventricular assist device, back-to-front, in an adolescent with a failing mustard procedure Lars Wiklund, MD, PhD, Sveneric Svensson,

Improved myocardial protection in minimally invasive aortic valve surgery with the assistance of port-access technology Shubjeet Kaur, MDa, Jorge Balaguer,

Aortoplasty for aortic regurgitation with ventricular septal defect

Yukinori Moriyam, Riichiro Tod, Koichi Hisatom, Akira Tair

Mitral Regurgitation in Ventricular Premature Contractions

Michael Argenziano, MDa, David A

Tomoaki Murakami, MD, PhD, Atsuhito Takeda, MD, PhD

A computerized control system for cardiopulmonary bypass

Mano J. Thubrikar, PhD, Francis Robicsek, MD, Brett L. Fowler, BS

Effects of failure of the right side of the heart and increased pulmonary resistance on mechanical circulatory support with use of the miniaturized HIA-VAD.

Effect of acutely increased left ventricular afterload on work output from the right ventricle in conscious dogs Mohanraj K. Karunanithi, BE, MBiomedE,

Management of patients with intramural hematoma involving the ascending aorta Yoshimasa Moizumi, MDa, Tsunehiro Komatsu, MDa, Naotaka Motoyoshi, MDa,

Oxygen consumption after cardiopulmonary bypass surgery in children: Determinants and implications Jia Li, MDa, Ingram Schulze-Neick, MDa, Christopher.

In acute lung injury, inhaled nitric oxide improves ventilation-perfusion matching, pulmonary vascular mechanics, and transpulmonary vascular efficiency

Inhaled nitric oxide, right ventricular efficiency, and pulmonary vascular mechanics: Selective vasodilation of small pulmonary vessels during hypoxic.

Richard J. Novick, MDa, Ruud A. W

Improved left ventricular unloading and circulatory support with synchronized pulsatile left ventricular assistance compared with continuous-flow left.

Editorial: The core of leadership

Development of an Implantable Ventricular Assist System

Viscoelasticity of dynamically fixed bioprosthetic valves. II

Support Your Specialty

Mohanraj K. Karunanithi, BE, MBiomedE, Michael P

Extended aortic replacement for acute type a dissection with the tear in the descending aorta Terushisa Kazui, MD, Yukihiko Tamiya, MD, Toshiaki Tanaka,

Modified Ultrafiltration Improves Left Ventricular Systolic Function In Infants After Cardiopulmonary Bypass Michael J. Davies, FRCSa, Khan Nguyen, MDa,

Cerebral hyperthermia during cardiopulmonary bypass in adults

Giancarlo Piano, MD, Bruce L. Gewertz, MD Journal of Vascular Surgery

Real-time recording of annuloplasty suture dehiscence reveals a potential mechanism for dehiscence cascade Eric L. Pierce, BS, Javier Gentile, MD, Andrew.

Inelastic vascular prosthesis for proximal aorta increases pulsatile arterial load and causes left ventricular hypertrophy in dogs Shigeki Morita, MDa,

F. Fontan, MDa, F. Madonna, MDa, D. C. Naftel, PhDb, J. W

Leora B. Balsam, MD, Abe DeAnda, MD

Frederick L. Grover, MDa, b, David J

Patient recovery after intermittent disc escape and spontaneous recession of a mechanical heart valve Francis Robicsek, MD, PhD, Joseph W. Cook, MD

Extravascular doppler measurement of cardiac output in infants and children after operations for congenital heart disease Laurance L. Lequier, MDa, Steven.

Increase in size of the pulmonary autograft after the ross operation in children: Growth or dilation? Laszlo Solymar, MD, PhD, Göran Südow, MD, Daniel.

Ara K. Pridjian, MD, Edward L. Bove, MD, Flavian M. Lupinetti, MD

AORTIC VALVE–PRESERVING PROCEDURE FOR ENLARGEMENT OF THE LEFT VENTRICULAR OUTFLOW TRACT AND MITRAL ANULUS Richard A. Jonas, MD, John F. Keane, MD, James.

Elspeth M. Brown, MRCP, Anthony P. Salmon, FRCP, Robert K. Lamb, FRCS

Assessment of aortic invasion by pulmonary carcinoma with the use of intra-aortic endovascular sonography: A case report Kotaro Yasui, MDa, Susumu Kanazawa,

Physiologic left ventricular reconstruction: Shape, function, and time recaptured Gerald D. Buckberg, MD The Journal of Thoracic and Cardiovascular Surgery

Concomitant replacement of the ascending aorta is free—for some

Postbypass effects of delayed rewarming on cerebral blood flow velocities in infants after total circulatory arrest Rosendo A. Rodriguez, MD, PhDa (by.

Reoperation for aneurysmal disease of the ascending aorta in patients with concomitant aortic valve incompetence Matthias Karck, MDa, Joachim Cremer,

The Journal of Thoracic and Cardiovascular Surgery

Discussion The Journal of Thoracic and Cardiovascular Surgery

Effects of acute left ventricular unloading on right ventricular function in normal and chronic right ventricular pressure-overloaded lambs Boudewijn.

Erosion of inlet cannula of left ventricular assist device manifested as innocuous bleeding in stable patient: Lessons learned in prevention of catastrophic.

Thomas J. Kirby, MDa (by invitation), Michael J

Evaluating the best approach to treatment of aortic stenosis: The jury is still out Glen B. Taksler, PhD The Journal of Thoracic and Cardiovascular Surgery

The Rastelli Operation

Minimally invasive direct coronary artery bypass, percutaneous transluminal coronary angioplasty, and stent placement for left main stenosis William.

Echo-free perfused spaces: A current postoperative finding after homograft replacement of the aortic valve T. Carrel, MD, M. Pasic, MD, E. Oechslin,

Bicuspid Aortic Valves and Dilatation of the Ascending Aorta: Reply

Presentation transcript:

Regulation of the aortic valve opening Masafumi Higashidate, MDa, Kouichi Tamiya, MDb, Toshiyuki Beppu, MSb, Yasuharu Imai, MDa The Journal of Thoracic and Cardiovascular Surgery Volume 110, Issue 2, Pages 496-503 (August 1995) DOI: 10.1016/S0022-5223(95)70246-6 Copyright © 1995 Mosby, Inc. Terms and Conditions

Fig. 1 Left panel, Relations between hemodynamic data and AVOA. O, Onset of ascending aortic pressure elevation; C, dicrotic notch; LVP, left ventricular pressure; S1, peak point of AVOA; S2, inflection point of the decreasing curve of AVOA; AoF, aortic blood flow; F1, peak of forward flow; F2, peak of back flow. t1-t2, initial slow opening; t2-t3, rapid opening; t3-t4, time delay between maximum AVOA and peak aortic flow; t3-t5, initial slow closing; t5-t6, late rapid closing; t6-t7, complete closing. Right panel, An original record showing the relation between left ventricular pressure, AoP, AVOA, and aortic blood flow. Before aortic pressure elevation and aortic flow started, AVOA was already increased. Note that AVOA has already begun to rise before the onset of AoP elevation and aortic flow. The Journal of Thoracic and Cardiovascular Surgery 1995 110, 496-503DOI: (10.1016/S0022-5223(95)70246-6) Copyright © 1995 Mosby, Inc. Terms and Conditions

Fig. 1 Left panel, Relations between hemodynamic data and AVOA. O, Onset of ascending aortic pressure elevation; C, dicrotic notch; LVP, left ventricular pressure; S1, peak point of AVOA; S2, inflection point of the decreasing curve of AVOA; AoF, aortic blood flow; F1, peak of forward flow; F2, peak of back flow. t1-t2, initial slow opening; t2-t3, rapid opening; t3-t4, time delay between maximum AVOA and peak aortic flow; t3-t5, initial slow closing; t5-t6, late rapid closing; t6-t7, complete closing. Right panel, An original record showing the relation between left ventricular pressure, AoP, AVOA, and aortic blood flow. Before aortic pressure elevation and aortic flow started, AVOA was already increased. Note that AVOA has already begun to rise before the onset of AoP elevation and aortic flow. The Journal of Thoracic and Cardiovascular Surgery 1995 110, 496-503DOI: (10.1016/S0022-5223(95)70246-6) Copyright © 1995 Mosby, Inc. Terms and Conditions

Fig. 2 Relationship of inflection point of the decreasing curve of AVOA (S2) and AoP. AVOA (S2) was measured at the onset of rapid late closing. AoP was also measured with peak systolic pressure. This graph has the positive correlation (r = 0.97) of S2 with AoP, suggesting that S2 is a triangular open point. The Journal of Thoracic and Cardiovascular Surgery 1995 110, 496-503DOI: (10.1016/S0022-5223(95)70246-6) Copyright © 1995 Mosby, Inc. Terms and Conditions

Fig. 3 Upper panel, Effects of rapid blood transfusion on AVOA. LVP, Left ventricular pressure; AoF, aortic blood flow. Maximum AVOA increased with AoF increasing. Lower panel, Relationship between maximum AVOA and AoF at blood transfusion (volume loading). Maximum AVOA increased with increasing of the aortic blood flow; however, the relationship of both is a nonlinear correlation. The Journal of Thoracic and Cardiovascular Surgery 1995 110, 496-503DOI: (10.1016/S0022-5223(95)70246-6) Copyright © 1995 Mosby, Inc. Terms and Conditions

Fig. 3 Upper panel, Effects of rapid blood transfusion on AVOA. LVP, Left ventricular pressure; AoF, aortic blood flow. Maximum AVOA increased with AoF increasing. Lower panel, Relationship between maximum AVOA and AoF at blood transfusion (volume loading). Maximum AVOA increased with increasing of the aortic blood flow; however, the relationship of both is a nonlinear correlation. The Journal of Thoracic and Cardiovascular Surgery 1995 110, 496-503DOI: (10.1016/S0022-5223(95)70246-6) Copyright © 1995 Mosby, Inc. Terms and Conditions

Fig. 4 Left panel, Effects of venous inflow occlusion on AVOA. During a brief inflow occlusion, aortic blood flow (AoF) was decreased, left ventricular pressure (LVP) was decreased, AoP was decreased, and maximum AVOA was decreased. Right panel, Relationship between maximum AVOA and AoF at inflow occlusion--a graph of the AOF and maximum AVOA showed a nonlinear correlation. The Journal of Thoracic and Cardiovascular Surgery 1995 110, 496-503DOI: (10.1016/S0022-5223(95)70246-6) Copyright © 1995 Mosby, Inc. Terms and Conditions

Fig. 4 Left panel, Effects of venous inflow occlusion on AVOA. During a brief inflow occlusion, aortic blood flow (AoF) was decreased, left ventricular pressure (LVP) was decreased, AoP was decreased, and maximum AVOA was decreased. Right panel, Relationship between maximum AVOA and AoF at inflow occlusion--a graph of the AOF and maximum AVOA showed a nonlinear correlation. The Journal of Thoracic and Cardiovascular Surgery 1995 110, 496-503DOI: (10.1016/S0022-5223(95)70246-6) Copyright © 1995 Mosby, Inc. Terms and Conditions

Fig. 5 Effects of constriction of the ascending aorta on phasic changes of (AVOA) area. Although the stroke volume was decreased, maximum AVOA was not decreased. AoP and left ventricular pressure (LVP) were elevated with increase of aortic stenosis. AoF, Aortic blood flow. The Journal of Thoracic and Cardiovascular Surgery 1995 110, 496-503DOI: (10.1016/S0022-5223(95)70246-6) Copyright © 1995 Mosby, Inc. Terms and Conditions