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Sample records for cava heart pulmonary

  1. Peculiarities of Blood Flow Changes in Venae Cavae during Experimental Pulmonary Embolism.

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    Evlakhov, V I; Poyassov, I Z; Shaidakov, E V

    2016-10-01

    The model of acute pulmonary embolism in rabbits demonstrated reduced pulmonary blood flow, cardiac output, left atrial pressure, and blood flow in venae cavae against the background of elevated left pulmonary artery pressure and increased pulmonary vascular resistance. Simultaneously, the blood flow in the superior vena cava decreased to a lesser extent than that in the inferior vena cava, which was a characteristic feature of the model of pulmonary pathology. In contrast, when histamine was infused into the left jugular vein to equally elevate pressure in pulmonary artery as in the above model, the blood flow in the superior vena cava decreased to a greater extent than that in inferior vena cava. During stenosis of inferior vena cava that decreased the cardiac output to the level observed during modeled pulmonary embolism, the blood flows in both venae cavae dropped equally.

  2. Persistent left cranial vena cava draining into the left atrium associated with pulmonary stenosis in a French bulldog.

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    Zani, Alessandro; Becchetti, Elisa; Leonardi, Paola; Sinatra, Alessandro

    2014-06-01

    A 5-month-old female French bulldog was evaluated for the presence of a heart murmur. Through clinical and echocardiographic evaluations, a severe Type A pulmonary stenosis was diagnosed. Angiography during right ventricular catheterization for valvuloplasty revealed drainage from a persistent left cranial vena cava (PLCVC) into the left atrium; this was confirmed later by contrast echocardiography. This report is the first to describe this anatomical variant of a PLCVC in a dog.

  3. Successful Venous Angioplasty of Superior Vena Cava Syndrome after Heart Transplantation

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    Thomas Strecker

    2014-01-01

    Full Text Available Introduction. For patients with terminal heart failure, heart transplantation (HTX has become an established therapy. Before transplantation there are many repeated measurements with a pulmonary artery catheter (PAC via the superior vena cava (SVC necessary. After transplantation, endomyocardial biopsy (EMB is recommended for routine surveillance of heart transplant rejection again through the SVC. Case Presentation. In this report, we present a HTX patient who developed a SVC syndrome as a possible complication of all these procedures via the SVC. This 35-year-old Caucasian male could be successfully treated by balloon dilatation/angioplasty. Conclusion. The SVC syndrome can lead to pressure increase in the venous system such as edema in the head and the upper part of the body and further serious complications like cerebral bleeding and ischemia, or respiratory problems. Balloon angioplasty and stent implantation are valid methods to treat stenoses of the SVC successfully.

  4. Agenesia de cava superior associada a bloqueio atrioventricular de 3º grau Agenesis of the right superior vena cava associated with total heart block

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    Gustavo J. Ventura Couto

    2008-03-01

    Full Text Available A persistência de veia cava superior esquerda com ausência da veia cava superior é uma anomalia rara, principalmente quando associada a bloqueio atrioventricular de 3º grau. Relatamos o caso de uma paciente, na qual durante implante de marca-passo definitivo, para a correção de bloqueio atrioventricular total, foi detectada presença de veia cava superior esquerda com suspeição de ausência de veia cava superior, o que levou ao emprego de técnica diferenciada para fixação do eletrodo ventricular. Para confirmação da provável agenesia, foram realizados diversos exames complementares de imagem, demonstrando-se a dificuldade no diagnóstico da síndrome aqui descrita.The superior left vena cava with the absent superior vena cava is a rare abnormality, especially when associated with total heart block. We report a case of a patient in which the presence of superior left vena cava and the absence of the superior vena cava was detected during the implantation of a pacemaker for the correction of a total heart block, which led us to use a different technique for the fixation of the ventricular electrode. To confirm the supposed absence, several image exams were made showing the difficulty on the diagnosis of the described syndrome.

  5. Concomitant pulmonary arteriovenous and inferior vena cava malformations. A case report

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    Hawass, N.D.; Kolawole, T.M.; Badawi, M.G.

    1988-05-01

    A case of pulmonary arterio-venous malformation (AVM) presenting with dyspnoea diagnosed by computer tomography (CT) and pulmonary angiography is reported. Venous anomalies in the form of agenesis of the iliac veins and the inferior vena cava (IVC), were discovered through femoral venograms performed after technical difficulties were encountered at pulmonary angiography performed via the femoral route. These venous anomalies co-existed with normal but dilated azygos and hemiazygos systems, and with the azygos appearing as a right hilar mass lesion which showed the 'candy cane sign' on the lateral view on venography. A dilated varix at the confluence of the right renal vein and the IVC collaterals was also noted. This association of a pulmonary AVM and IVC agenesis has not been previously reported in the literature. The embryogenesis of the inferior vena cava and the azygos system is presented in an attempt to explain the rare association of these anomalies. The various techniques of diagnosing the disease entities, expecially by CT, are discussed. The rare co-existence of pulmonary AVM and the absence of the IVC is emphasized.

  6. Mediastinal and pulmonary entomophthoromycosis with superior vena cava syndrome: case report Entomoftoromicose mediastinal e pulmonar com síndrome de veia cava superior: registro de caso

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    João Carlos Coelho Filiio

    1989-12-01

    Full Text Available The first case of mediastinal and pulmonary entomophthoromycosis with supe rior vena cava syndrome is reported. The patient presented with a history of edema of the face, neck and upper limbs as well as collateral circulation in the anterior wall of the chest. Histological examination of tissue from mediastinum revealed a granulomatous reaction with microabscesses surrounded by eosinophilic amorphous material and with broad hyphae in the center. Culture was not performed because a preliminary diagnosis of nonHodgkin's malignant lymphoma was made. Surgical correction of the obstructed area was performed and the patient was sucessfully treated with potassium iodide. The authors propose that mediastinal entomoph thoromycosis must be considered in the differential diagnosis of diseases causing superior vena cava syndrome in tropical and sub-tropical regions. This case enlarges the spectrum of clinical manifestations of the zigomycosis caused by Entomoph-thoraceae.O primeiro caso de entomoftoromicose mediastinal e pulmonar com síndorme de veia cava superior, é descrito. A paciente apresentou-se com historia de edema facial, cervical e de membros superiores, bem como circulação colateral na parede anterior do tórax. O estudo histopatológico do tecido do mediastino, próximo à veia cava, revelou reação granulomatosa com microabscesses, circundados por material amorfo, eosinofílico e com hifas largas no centro. Cultura não foi realizada porque o diagnóstico clínico foi de doença de Hodgkin ou de um linfoma não-Hodgkin. Correção cirúrgica da área obstruída foi realizada e a paciente tratada com iodeto de potássio, nas doses preconizadas, obtendo-se sucesso. Os autores propõem que a entomoftoro-micose mediastinal deva ser considerada no diagnóstico diferencial de doença causando síndrome de veia cava superior em regiões tropicais e subtropicais. Este caso aumenta o espectrum de manifestações clínicas das zigomicoses causadas

  7. Superior vena cava syndrome associated with right-to left shunt through systemic-to-pulmonary venous collaterals

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    Juan, Yu Hsiang; Saboo, Sachin S.; Anand, Vishal; Chatzizisis, Yiannis S.; Steigner, Michael L. [Brigham and Women' s Hospital, Harvard Medical School, Boston (United States); Lin, Yu Ching [Chang Gung Memorial Hospital, Keelung and Chang Gung University, Keelung (China)

    2014-04-15

    Superior vena cava (SVC) obstruction is associated with the gradual development of venous collaterals. We present a rare form of systemic-to-pulmonary subpleural collateral pathway that developed in the bridging subpleural pulmonary veins in a 54-year-old woman with complete SVC obstruction. This uncommon collateral pathway represents a rare form of acquired right-to-left shunt due to previous pleural adhesions with an increased risk of stroke due to right-to-left venous shunting, which requires lifelong anticoagulation.

  8. Non-congenital heart disease associated pediatric pulmonary arterial hypertension

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    Ivy, D D; Feinstein, J. A.; Humpl, T; Rosenzweig, E. B.

    2009-01-01

    Recognition of causes of pulmonary hypertension other than congenital heart disease is increasing in children. Diagnosis and treatment of any underlying cause of pulmonary hypertension is crucial for optimal management of pulmonary hypertension. This article discusses the available knowledge regarding several disorders associated with pulmonary hypertension in children: idiopathic pulmonary arterial hypertension (IPAH), pulmonary capillary hemangiomatosis, pulmonary veno-occlusive disease, he...

  9. An unusual clinical presentation resembling superior vena cava syndrome post heart surgery

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    Pellegrini Ronald

    2005-10-01

    Full Text Available Abstract Background An unusual sequence of post operative events heralded by hemodynamic deterioration followed by dyspnea and rapidly progressive dilatation of superficial neck and facial veins, resembling a superior vena cava syndrome, two days post surgical resection of filamentous aortic valve masses, closure of a patent foramen ovale, and performance of a modified Maze procedure for atrial fibrillation in a patient that presented with transient neurologic findings is presented. Case Presentation Although both clinical findings and hemodynamic derangements completely resolved following tricuspid valve repair aimed to correct the new onset severe tricuspid regurgitation noted post operatively; a clear mechanism was not readily obvious and diagnostic testing data somewhat conflictive. We present a careful retrospective examination of all clinical data and review possible clinical entities that could have been implicated in this particular case and recognize that transesophageal echocardiographic findings were most useful in identifying the best course of action. Conclusion After reviewing all clinical data and despite the inconclusive nature of test results; the retrospective examination of transesophageal echocardiographic findings proved to be most useful in identifying the best course of action. We postulate that in our case, resolution of the suspected pulmonary embolism with anticoagulation and reestablishment of a normal right ventricular geometry with tricuspid valve repair worked in unison in restoring normal hemodynamics and resolving both dyspnea and venous dilatation.

  10. Fontan's circulation with dextrocardia, recent pulmonary embolism, and inferior vena cava filter: Anesthetic challenges for urgent hysterectomy.

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    Singh, Preet Mohinder; Borle, Anuradha; Ramachandran, Rashmi; Trikha, Anjan; Goudra, Basavana Gouda

    2016-01-01

    Fontan's circulation is a unique challenge for the anesthesiologist. Venous pressure is the only source of blood flow for the pulmonary circulation. Patients with such circulation are extremely sensitive to progression of cyanosis (decreased pulmonary blood flow) or circulatory failure. Any major venous compression can compromise the pulmonary blood flow worsening cyanosis; simultaneously, an increased afterload can precipitate circulatory failure. We present a rare patient of surgically corrected Ivemark syndrome with Fontan's physiology with dextrocardia who developed a large uterine fibroid compressing inferior vena cava (IVC). As a result of compression, not only the pulmonary circulation was compromised but she also developed stasis-induced venous thrombosis in the lower limbs that lead to pulmonary embolism (PE) (increased afterload). In addition to oral anticoagulation an IVC filter was inserted to prevent ongoing recurrent PE. Further, to prevent both circulatory compromise and deep venous thrombosis an urgent myomectomy/hysterectomy was planned. In the present case, we discuss the issues involved in the anesthetic management of such patients and highlight the lacunae in the present guidelines for managing perioperative anticoagulation these situations.

  11. Fontan′s circulation with dextrocardia, recent pulmonary embolism, and inferior vena cava filter: Anesthetic challenges for urgent hysterectomy

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    Preet Mohinder Singh

    2016-01-01

    Full Text Available Fontan′s circulation is a unique challenge for the anesthesiologist. Venous pressure is the only source of blood flow for the pulmonary circulation. Patients with such circulation are extremely sensitive to progression of cyanosis (decreased pulmonary blood flow or circulatory failure. Any major venous compression can compromise the pulmonary blood flow worsening cyanosis; simultaneously, an increased afterload can precipitate circulatory failure. We present a rare patient of surgically corrected Ivemark syndrome with Fontan′s physiology with dextrocardia who developed a large uterine fibroid compressing inferior vena cava (IVC. As a result of compression, not only the pulmonary circulation was compromised but she also developed stasis-induced venous thrombosis in the lower limbs that lead to pulmonary embolism (PE (increased afterload. In addition to oral anticoagulation an IVC filter was inserted to prevent ongoing recurrent PE. Further, to prevent both circulatory compromise and deep venous thrombosis an urgent myomectomy/hysterectomy was planned. In the present case, we discuss the issues involved in the anesthetic management of such patients and highlight the lacunae in the present guidelines for managing perioperative anticoagulation these situations.

  12. [Pulmonary hypertension in pediatric heart surgery].

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    Falcone, N

    2001-12-01

    Congenital heart disease can increase or decrease pulmonary blood flow, pulmonary vascular resistance (PVR) or pulmonary artery pressure (PAP). PAP is the product of PVR and pulmonary minute volume (Qp), such that pulmonary hypertension (PHT) may develop as a result of an increase in either PVR or Qp or both. Given that the pulmonary vascular bed is a low pressure system with high flow, any increase in resistance would generate PHT. The normal value of PVR is 2 Woods units (mm Hg/l/min). Increased PAP is due to hypoxic lesions of the endothelium, which release proteolytic enzymes that alter the balance of metabolites of arachidonic acid, regulators of pulmonary vasomotor tone. Hypoxia and acidosis cause intense pulmonary vasoconstriction (hypoxic vasoconstrictor reflex). An increase of PVR is due to a combination of vasoconstrictive processes and remodeling, with hypertrophy of the pulmonary artery. Structural lesions are related to hypertrophy of the endothelium, the transformation of fibroblasts to myocytes and the decrease of the alveolar/arteriolar ratio with the formation of new vessels.PHT may be primary or secondary to another disease. Primary PHT is a rare genetic disease. The most common secondary forms of PHT in pediatrics are due to persistence of neonatal anatomy (neonatal PHT), to heart diseases with left-right shunt (CIV, DAP, etc.), to diseases of the pulmonary parenchyma (interstitial viral infection, mucoviscidosis), and complications of heart surgery. All congenital heart diseases can lead to PHT if not treated promptly. Clinical signs of PHT are highly non-specific: dyspnea, fatigue, syncopes, exercise intolerance, precordialgia, cyanosis and edema. The best approaches to diagnosis and prognosis are echocardiography and cardiac catheterization with vasodilators. Anesthetics that do not alter PVR should be used in such patients, who are sensitive to changes in pulmonary ventilation, to changes in cardiac output and to anesthetics. The treatment of

  13. Retrievable Guenther Tulip Vena Cava Filter in the prevention of pulmonary embolism in patients with acute deep venous thrombosis in perinatal period

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    Koecher, Martin [Department of Radiology, University Hospital, I.P. Pavlova 6, 775 20 Olomouc (Czech Republic)], E-mail: martin.kocher@seznam.cz; Krcova, Vera [Department of Hematooncology, University Hospital, I.P. Pavlova 6, 775 20 Olomouc (Czech Republic); Cerna, Marie [Department of Radiology, University Hospital, I.P. Pavlova 6, 775 20 Olomouc (Czech Republic); Prochazka, Martin [Department of Obstetrics and Gynaecology, University Hospital, I.P. Pavlova 6, 775 20 Olomouc (Czech Republic)

    2009-04-15

    Objectives: To evaluate the feasibility and efficacy of the retrievable Guenther Tulip Vena Cava Filter in the prevention of pulmonary embolism in patients with acute deep vein thrombosis in the perinatal period and to discuss the technical demands associated with the filter's implantation and retrieval. Methods: Between 1996 until 2007, eight women (mean age 27.4 years, range 20-42 years) with acute deep iliofemoral venous thrombosis in the perinatal period of pregnancy and increased risk of pulmonary embolism during delivery were indicated for retrievable Guenther Tulip Vena Cava Filter implantation. All filters were inserted and removed under local anesthesia from the jugular approach. Results: The Guenther Tulip Vena Cava Filter was implanted suprarenally in all patients on the day of caesarean delivery. In follow-up cavograms performed just before planned filter removal, no embolus was seen in the filter in any patient. In all patients the filter was retrieved without complications on the 12th day after implantation. Conclusions: Retrievable Guenther Tulip Vena Cava Filters can be inserted and removed in patients during the perinatal period without major complications.

  14. Vena cava filter; Vena-cava-Filter

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    Helmberger, T. [Klinikum Bogenhausen, Institut fuer Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Muenchen (Germany)

    2007-05-15

    Fulminant pulmonary embolism is one of the major causes of death in the Western World. In most cases, deep leg and pelvic venous thrombosis are the cause. If an anticoagulant/thrombotic therapy is no longer possible or ineffective, a vena cava filter implant may be indicated if an embolism is threatening. Implantation of the filter is a simple and safe intervention. Nevertheless, it is necessary to take into consideration that the data base for determining the indications for this treatment are very limited. Currently, a reduction in the risk of thromboembolism with the use of filters of about 30%, of recurrences of almost 5% and fatal pulmonary embolism of 1% has been reported, with a risk of up to 20% of filter induced vena cava thrombosis. (orig.) [German] Die fulminante Lungenembolie zaehlt zu den Haupttodesursachen in der westlichen Welt. In der Mehrzahl der Faelle sind tiefe Bein- und Beckenvenenthrombosen ursaechlich verantwortlich. Ist eine antikoagulative/-thrombotische Therapie nicht (mehr) moeglich oder unwirksam, kann bei drohender Emboliegefahr die Vena-cava-Filterimplantation indiziert sein. Die Filterimplantation ist eine einfache und sehr sichere Intervention. Dennoch muss bei der Indikationsstellung beruecksichtigt werden, dass die Datenlage zur Wirksamkeit sehr limitiert ist. So wird aktuell ueber eine Reduktion des Thrombembolierisikos um 30% bei Embolierezidiven von knapp 5% und fatalen Lungenembolien von 1% unter Filterprophylaxe berichtet, bei einem Risiko von bis zu 20% fuer die filterinduzierte Vena-cava-Thrombose. (orig.)

  15. Topographic anatomy of the fetal inferior vena cava, coronary sinus, and pulmonary veins: Variations in Chiari's network.

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    Naito, Michiko; Yu, Hee Chul; Kim, Ji Hyun; Rodríguez-Vázquez, José Francisco; Murakami, Gen; Cho, Baik Hwan

    2015-07-01

    To understand anomalies in Chiari's network better, we assessed the topographical anatomy of the fetal inferior vena cava (IVC), coronary sinus, and atria. We examined sagittal serial paraffin sections of 15 human fetuses of crown-rump length 24-36 mm, corresponding to a gestational age of 8 weeks. Although their outflow tract morphologies were similar, these 15 specimens could be classified into two groups. In eight specimens, the left common cardinal vein reached the body wall, whereas in the other seven the vein was obliterated near the left pulmonary vein. Irrespective of the group in which the specimen was included, the anteroposterior arrangement of the coronary sinus, the sinus septum (septum), and the right sinus valve (right valve) could be classified into three types: the right valve-septum-coronary sinus arrangement in seven specimens; the right valve-coronary sinus-septum arrangement in five; and the coronary sinus-right valve-septum arrangement in three. Depending on differences in topographical anatomy, the sinus septum separated the coronary sinus opening from either the right or the left atrium. Likewise, the coronary sinus opening was either adjacent to or distant from the IVC terminal. Rather than the counter-side position of the right valve being at the IVC terminal, the left sinus valve protruded leftward, forming an incomplete interatrial septum. Fetal variations seemed to be closely connected with individual variations and a high frequency of Chiari's network anomalies in adults.

  16. Follow-Up of 6 Patients with Permanent ; Vena Cava Filters in the Prevention of Pulmonary Embolism

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    M. Vahedian

    2011-10-01

    Full Text Available Introduction & Objective: Venous thromboembolic disease is a significant cause of morbidity and mortality in the United States. Deep venous thrombosis (DVT and pulmonary embolism (PE are a spectrum of a single disease entity. In most clinical situations, anticoagulation is the preferred form of therapy .IVC filter placement when using anticoagulation therapy is contraindicated or proves ineffective. The placement of an IVC filter is considered standard preventive treatment for PE. The aim of this study was follow up of patients with permanent vena cava filters in the prevention of pulmonary embolism after six months. Materials & Methods: In this cross sectional study 6 patients with IVC filter were followed up after 6 months. They were examined about having emboli, reccurent DVT, edema, varicosis, bleeding, misplacement, and fracture of filter. Data were analyzed with SPSSV17. Results: 6 patients having a mean age of 58.6 years were evaluated. There was no difference in sex . The reason of admission in all cases was DVT. Doppler sonography was done for all the patients. In 66.66% anticoagulation therapy was done before surgery. The filter was placed percutaneously in all cases. After 6 months in 5 cases there were no signs of DVT, PE, edema, and varicosis. In addition one patient died because of respiratory arrest due to encephalopathy. No complications were seen during admission period. Conclusion: Although IVC filter increases the risk of recurrent DVT in the long term ,it remarkablely decreases the risk of PE.IVC filter is a useful and effective treatment in patients with contraindication of using anticoagulation therapy especially in patients with cancer. (Sci J Hamadan Univ Med Sci 2011;18(2:29-32

  17. Prognostic importance of pulmonary hypertension in patients with heart failure

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    Kjaergaard, Jesper; Akkan, Dilek; Iversen, Kasper Karmark;

    2007-01-01

    Pulmonary hypertension is a well-known complication in heart failure, but its prognostic importance is less well established. This study assessed the risk associated with pulmonary hypertension in patients with heart failure with preserved or reduced left ventricular (LV) ejection fractions...

  18. Left ventricular heart failure and pulmonary hypertension†

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    Rosenkranz, Stephan; Gibbs, J. Simon R.; Wachter, Rolf; De Marco, Teresa; Vonk-Noordegraaf, Anton; Vachiéry, Jean-Luc

    2016-01-01

    In patients with left ventricular heart failure (HF), the development of pulmonary hypertension (PH) and right ventricular (RV) dysfunction are frequent and have important impact on disease progression, morbidity, and mortality, and therefore warrant clinical attention. Pulmonary hypertension related to left heart disease (LHD) by far represents the most common form of PH, accounting for 65–80% of cases. The proper distinction between pulmonary arterial hypertension and PH-LHD may be challenging, yet it has direct therapeutic consequences. Despite recent advances in the pathophysiological understanding and clinical assessment, and adjustments in the haemodynamic definitions and classification of PH-LHD, the haemodynamic interrelations in combined post- and pre-capillary PH are complex, definitions and prognostic significance of haemodynamic variables characterizing the degree of pre-capillary PH in LHD remain suboptimal, and there are currently no evidence-based recommendations for the management of PH-LHD. Here, we highlight the prevalence and significance of PH and RV dysfunction in patients with both HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF), and provide insights into the complex pathophysiology of cardiopulmonary interaction in LHD, which may lead to the evolution from a ‘left ventricular phenotype’ to a ‘right ventricular phenotype’ across the natural history of HF. Furthermore, we propose to better define the individual phenotype of PH by integrating the clinical context, non-invasive assessment, and invasive haemodynamic variables in a structured diagnostic work-up. Finally, we challenge current definitions and diagnostic short falls, and discuss gaps in evidence, therapeutic options and the necessity for future developments in this context. PMID:26508169

  19. Pulmonary artery rupture in a patient receiving an orthotopic heart transplant after total artificial heart explant.

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    Nomoto, Koichi; Weiner, Menachem M; Evans, Adam

    2014-02-01

    Our case illustrates a patient who suffered a pulmonary artery rupture despite previous total artificial heart implantation and replacement with orthotopic heart transplant. Pulmonary artery rupture during or following cardiac surgery has been reported to occur due to both pulmonary artery catheter use and surgical technique. Our case is the first to demonstrate the occurrence of this complication in the total artificial heart patient population.

  20. Veia cava superior esquerda anômala com ausência de veia cava superior direita: achados de imagem Persistent left superior vena cava with absent right superior vena cava: image findings

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    Cyrillo Rodrigues de Araújo Júnior

    2003-10-01

    coronary sinus. We report the case of a patient with a persistent left superior vena cava and absence of right superior vena cava identified by chance during a chest radiograph and computed tomography examination for investigation of chronic pulmonary obstructive disease. The patient had no congenital heart disease and the blood from the right side was drained by the persistent left superior vena cava into the right atrium through the coronary sinus.

  1. Pseudodisplacements of superior vena cava catheter in the persistent left superior vena cava

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    Jantsch, H.; Draxler, V.; Muhar, U.; Schlemmer, M.; Waneck, R.

    1983-01-01

    Pseudodisplacement of a left sided superior vena cava catheter in a persistent superior vena cava may be expected in adults in 0,37% and in a group of children with congenital heart disease in 2,5%. Embryology, anatomy and clinical implications is discussed on the basis of our own cases. The vena cava superior sinistra persitents is depending on a sufficient calibre a suitable vessel for a superior cava catheter.

  2. Right Heart Thrombi Accompained with Pulmonary Embolism

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    Mustafa Çörtük

    2015-10-01

    Full Text Available Aim: Right sided heart thrombus (RSHT is rarely seen. It is generally detected during transthoracic echocardiographic (TTE examination or multislice thoracic computed tomographic scanning for pulmonary embolism (PE. Although RSHT and PE secondary to this situation is rare, mortality during the course of process is very high. We aim to aproach right cardiac trombus and determine the results of treatment. Method: In this study 25 patients hospital records were investigated retrospectively. The data obtained consisted of diagnostic methods, presence of shock state, treatments applied and results were assessed. Results: Th present study revealed that the 32% of patients had been admitted to hospital in shock state, hospital mortality rate was 24%, and this mortality rate was not affected by different treatment choices. Conclusion: The exact incidence of RSHT is unknown. It is reported that the probability of seeing a case suffering from RSHT during echocardiographic examination performed to diagnose the PE is 9%. RSHT may cause PE anytime and requires urgent treatment. In our study, we determined that the hospital mortaliy did not change with the type of given treatment and overall mortality was determined as 24%. There are no sufficient studies searching large series on RSHT in literature. Therefore, there is no agreement on treatment tecniques.

  3. Crux vena cava filter.

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    Murphy, Erin H; Johnson, Eric D; Kopchok, George E; Fogarty, Thomas J; Arko, Frank R

    2009-09-01

    Inferior vena cava filters are widely accepted for pulmonary embolic prophylaxis in high-risk patients with contraindications to anticoagulation. While long-term complications have been associated with permanent filters, retrievable filters are now available and have resulted in the rapid expansion of this technology. Nonetheless, complications are still reported with optional filters. Furthermore, device tilting and thrombus load may prevent retrieval in up to 30% of patients, thereby eliminating the benefits of this technology. The Crux vena cava filter is a novel, self-centering, low-profile filter that is designed for ease of delivery, retrievability and improved efficacy while limiting fatigue-related device complications. This device has been proven safe and user-friendly in an ovine model and has recently been implanted in human subjects.

  4. Pulmonary and tricuspid valvuloplasty in carcinoid heart disease.

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    Karimi, Ashkan; Pourafshar, Negiin; Fudge, James C

    2016-12-28

    A 26-year-old female with carcinoid heart disease consisting of severe pulmonary and tricuspid valve stenosis was admitted with line associated sepsis. She recovered from sepsis with antibiotics and aggressive fluid resuscitation but became grossly volume overloaded with evidence of tense ascites and lower extremity edema. She developed worsening renal and hepatic function due to congestive nephropathy and hepatopathy, which did not respond to intravenous diuretics, and she was deemed too sick for surgical pulmonary and tricuspid valve replacement. Pulmonary and tricuspid valvuloplasty was performed as a rescue measure to alleviate her congestive symptoms and improve her candidacy for valve replacement. © 2016 Wiley Periodicals, Inc.

  5. [Body composition and heart rate variability in patients with chronic obstructive pulmonary disease pulmonary rehabilitation candidates].

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    Curilem Gatica, Cristian; Almagià Flores, Atilio; Yuing Farías, Tuillang; Rodríguez Rodríguez, Fernando

    2014-07-01

    Body composition is a non-invasive method, which gives us information about the distribution of tissues in the body structure, it is also an indicator of the risk of mortality in patients with chronic obstructive pulmonary disease. The heart rate variability is a technique that gives us information of autonomic physiological condition, being recognized as an indicator which is decreased in a number of diseases. The purpose of this study was to assess body composition and heart rate variability. The methodology used is that of Debora Kerr (1988) endorsed by the International Society for advances in Cineantropometría for body composition and heart rate variability of the guidelines described by the American Heart Association (1996). Roscraff equipment, caliper Slimguide and watch Polar RS 800CX was used. , BMI 26.7 ± 3.9 kg / m²; Muscle Mass 26.1 ± 6.3 kg ; Bone Mass 1.3 kg ± 8.1 76 ± 9.9 years Age : 14 candidates for pulmonary rehabilitation patients were evaluated , Adipose mass 16.4 ± 3.6 kg ; FEV1 54 ± 14%. Increased waist circumference and waist hip ratio was associated with a lower overall heart rate variability. The bone component was positively related to the variability of heart rate and patients with higher forced expiratory volume in one second had lower high frequency component in heart rate variability. In these patients, the heart rate variability is reduced globally and is associated with cardiovascular risk parameters.

  6. Inferior vena cava filter misplacement in the right atrium and migration to the right ventricle followed by successful removal using the endovascular technique: A case report and review of the literature

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    Yasushi Wakabayashi

    2015-07-01

    Full Text Available Inferior vena cava filters are effective for preventing the passage of thrombi into the pulmonary arteries in patients with pulmonary embolism and deep vein thrombosis. These filters are indicated in patients with contraindications to anticoagulant therapy or in patients with recurrent acute pulmonary embolism despite the administration of anticoagulant therapy. However, the occurrence of filter-related complications, such as filter migration to the heart, has been increasing. Herein, we report a case of OptEase inferior vena cava filter misplacement in the right atrium. Although the filter migrated to the right ventricle, it was successfully removed and repositioned in the inferior vena cava using endovascular techniques. Unfortunately, moderate tricuspid regurgitation developed, due to the damage to the tricuspid valve that was caused by the procedure. We have also reviewed the relevant literature and discussed the possible strategies for managing cases of filter migration to the heart and preventing filter misplacement.

  7. Pulmonary edema

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    Lung congestion; Lung water; Pulmonary congestion; Heart failure - pulmonary edema ... Pulmonary edema is often caused by congestive heart failure . When the heart is not able to pump efficiently, ...

  8. STRUCTURE OF PULMONARY HYPERTENSION IN PATIENTS AWAITING HEART TRANSPLANTATION

    Directory of Open Access Journals (Sweden)

    A. A. Piontek

    2009-01-01

    Full Text Available The selection of recipients for the orthotopic heart transplantation is of great importance. In 2006–2009 we examined 25 tests on reversibility of pulmonary hypertension, i.e. in 14 patients with dilated cardiomyopathy (DCM (11 males and 3 females aged 41,1 ± 9,3 and in 11 patients with coronary artery disease (CAD (all males aged 50 ± 4.9. Initial pulmonary vascular resistance (PVR was 3,61 ± 1,02 and 3,59 ± 0,98 respectively. Alprostadil was infused to all the patients. Pulmonary hypertension was irreversible in 4 (28,5% DCM patients and in 2 (18% CAD patients. Initial PVR in those patients was 6,27 ± 3,2 and 5,7 ± 2,4 respectively. The average alprostadil dose necessary for the reverse of pulmonary hypertension was 0,054 ± 0,027 μg/kg/min in DCM patients, and 0,047 ± 0,022 μg/kg/min in CAD patients. Thus, the application of alprostadil for the pharmacological correction of pulmonary vascular resistance is most effective in patients with moderate pulmonary hypertension according to Rich classification. 

  9. Pulmonary thromboembolism and right heart thromboemboli--an experience with tenecteplase.

    Science.gov (United States)

    Sharma, Anil; Udgire, Prashant P; Khan, Shanavas; Goyal, B K; Gautam, Shalima

    2012-10-01

    The presence of right heart thromboemboli complicating pulmonary thromboemboli carries with it an increased mortality rate compared to pulmonary thromboemboli alone, but little is known about the optimal management of this difficult clinical situation. We report a case of bilateral pulmonary thromboembolism with right heart thrombi treated successfully with thrombolysis with tenecteplase.

  10. Chronic obstructive pulmonary disease in patients admitted with heart failure

    DEFF Research Database (Denmark)

    Iversen, K K; Kjaergaard, J; Akkan, D;

    2008-01-01

    OBJECTIVE: Chronic obstructive pulmonary disease (COPD) is an important differential diagnosis in patients with heart failure (HF). The primary aims were to determine the prevalence of COPD and to test the accuracy of self-reported COPD in patients admitted with HF. Secondary aims were to study...... a possible relationship between right and left ventricular function and pulmonary function. DESIGN: Prospective substudy. SETTING: Systematic screening at 11 centres. SUBJECTS: Consecutive patients (n = 532) admitted with HF requiring medical treatment with diuretics and an episode with symptoms...... corresponding to New York Heart Association class III-IV within a month prior to admission. INTERVENTIONS: Forced expiratory volume in 1 s (FEV(1)) and forced vital capacity (FVC) were measured by spirometry and ventricular function by echocardiography. The diagnosis of COPD and HF were made according...

  11. Pulmonary Kaposi's sarcoma after heart transplantation: a case report

    Directory of Open Access Journals (Sweden)

    Kristiansen Glen

    2010-07-01

    Full Text Available Abstract Introduction Kaposi's sarcomas have been associated with different conditions of immunosuppression and are also known to be a typical complication of solid organ transplantations. Case presentation We report the case of a 65-year-old Turkish man with a history of heart transplantation 10 months ago who presented for clarification of his dyspnea. The patient had a known history of chronic obstructive pulmonary disease and a smoking history of 40 pack years. Radiologically, three progressively growing intra-pulmonary nodules were detected. The histology was diagnostic for a Kaposi's sarcoma. Visceral and especially primary intra-pulmonary Kaposi's sarcomas are very rare and have been described to have a rather unfavorable prognosis. Conclusions Even with a history suggestive for conventional lung cancer, Kaposi's sarcomas should be considered in patients after transplantation of solid organs. It should be noted that in a minority of cases this tumor exists in the absence of the typical cutaneous lesions.

  12. Evaluation of Pulmonary Perfusion Scan in Heart Disease

    Energy Technology Data Exchange (ETDEWEB)

    Lee, J. T.; Kim, C. K.; Park, C. Y.; Choi, B. S. [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1973-09-15

    Pulmonary perfusion scan with radioactive {sup 113m}In-iron hydroxide particle was performed in the 25 cases of heart disease which had been diagnosed by cardiac catheterization prior to surgery from July, 1972 to July, 1973 at the Department of Radiology and Nuclear Medicine, Yonsei Medical College. It consists of 7 mitral stenosis, 2 mitral insufficiency, 1 aortic insufficiency, 3 atrial septal defect, 5 ventricular septal defect, 2 patent ductus arteriosus, 1 transposition of great vessel and 4 Tetralogy of Fallot. Findings of pulmonary perfusion scan in relation to hemodynamic data of cardiac catheterization were examined. 1) Out of 10 cases of acquired valvular heart disease, In 6 cases of stenosis and 1 case of aortic insufficiency, radioactivity was increased at both upper lung. This finding is noted when pulmonary wedge or venous pressure was elevated above 22 mmHg and arterial systolic pressure above 33 mmHg. 2) Out of 15 cases of congenital heart disease. In almost all cases of artial septal defect and ventricular septal defect except 2 cases, radioactivity was even at both entire lung. In 2 cases of patent ductras arteriosus, radioactivity was decreased especially at the left lung. It is observed that in acyanotic congenital heart disease, radioactivity of lung is not related with pulmonary arterial pressure. In 3 cases of Tetralogy of Fallot, radioactivity was even at both entire lung and in 2 of them, extrapulmonary radioactivity of liver or kidney which depends on size of defect and volume of right to left shunt reversible, was noted.

  13. Pulmonary hemosiderosis due to mitral valvular heart disease

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Eung Yeop; Kim, Tae Sung; Han, Joung Ho; Lee, Kyung Soo [Sungkyunkwan Univ. College of Medicine, Seoul (Korea, Republic of)

    1999-01-01

    We report a case of biopsy-proven secondary hemosiderosis of the lung in a 58-year-old patient with mitral valvular heart disease. Both chest radiography and high-resolution CT demonstrated patchy areas of ground-glass opacity ; the former indicated that it was in both lungs, while the latter showed inter-and intralobular septal thickening. These findings were reversible when pulmonary venous hypertension was corrected.

  14. Pulmonary Hypertension and Right Heart Dysfunction in Chronic Lung Disease

    Directory of Open Access Journals (Sweden)

    Amirmasoud Zangiabadi

    2014-01-01

    Full Text Available Group 3 pulmonary hypertension (PH is a common complication of chronic lung disease (CLD, including chronic obstructive pulmonary disease (COPD, interstitial lung disease, and sleep-disordered breathing. Development of PH is associated with poor prognosis and may progress to right heart failure, however, in the majority of the patients with CLD, PH is mild to moderate and only a small number of patients develop severe PH. The pathophysiology of PH in CLD is multifactorial and includes hypoxic pulmonary vasoconstriction, pulmonary vascular remodeling, small vessel destruction, and fibrosis. The effects of PH on the right ventricle (RV range between early RV remodeling, hypertrophy, dilatation, and eventual failure with associated increased mortality. The golden standard for diagnosis of PH is right heart catheterization, however, evidence of PH can be appreciated on clinical examination, serology, radiological imaging, and Doppler echocardiography. Treatment of PH in CLD focuses on management of the underlying lung disorder and hypoxia. There is, however, limited evidence to suggest that PH-specific vasodilators such as phosphodiesterase-type 5 inhibitors, endothelin receptor antagonists, and prostanoids may have a role in the treatment of patients with CLD and moderate-to-severe PH.

  15. [Acute heart failure: acute cardiogenic pulmonary edema and cardiogenic shock].

    Science.gov (United States)

    Sánchez Marteles, Marta; Urrutia, Agustín

    2014-03-01

    Acute cardiogenic pulmonary edema and cardiogenic shock are two of the main forms of presentation of acute heart failure. Both entities are serious, with high mortality, and require early diagnosis and prompt and aggressive management. Acute pulmonary edema is due to the passage of fluid through the alveolarcapillary membrane and is usually the result of an acute cardiac episode. Correct evaluation and clinical identification of the process is essential in the management of acute pulmonary edema. The initial aim of treatment is to ensure hemodynamic stability and to correct hypoxemia. Other measures that can be used are vasodilators such as nitroglycerin, loop diuretics and, in specific instances, opioids. Cardiogenic shock is characterized by sustained hypoperfusion, pulmonary wedge pressure > 18 mmHg and a cardiac index 30 mmHg) and absent or reduced diuresis (< 0.5 ml/kg/h). The most common cause is left ventricular failure due to acute myocardial infarction. Treatment consists of general measures to reverse acidosis and hypoxemia, as well as the use of vasopressors and inotropic drugs. Early coronary revascularization has been demonstrated to improve survival in shock associated with ischaemic heart disease.

  16. [PULMONARY COMPLICATIONS IN CHILDREN, OPERATED ON FOR INBORN HEART FAILURES IN THE ARTIFICIAL BLOOD CIRCULATION ENVIRONMENT].

    Science.gov (United States)

    Moshkivska, L V; Nastenko, E A; Golovenko, O S; Lazoryshynets, V V

    2015-11-01

    The risk factors of pulmonary complications occurrence were analyzed in children, operated on for inborn heart failures in atrificial blood circulation environment. Pulmonary complications rate and the risk factors of their occurrence were analyzed.

  17. Pulmonary vasodilation in acute and chronic heart failure: empiricism and evidence.

    Science.gov (United States)

    Guglin, Maya

    2011-09-01

    Pulmonary hypertension in heart failure is associated with exercise intolerance and adverse outcomes. With the availability of multiple drugs that cause pulmonary vasodilation and decrease pulmonary arterial pressure, pulmonary hypertension becomes an attractive therapeutic target. Out of several classes of medications, oral phosphodiesterase inhibitors emerge as the most promising in terms of symptomatic improvement, hemodynamic benefits, reverse cardiac remodeling, and functional capacity. Future trials will show whether the use of these drugs translates to decreased morbidity and mortality in heart failure.

  18. Changing demographics of pulmonary arterial hypertension in congenital heart disease

    Directory of Open Access Journals (Sweden)

    B.J.M. Mulder

    2010-12-01

    Full Text Available Pulmonary arterial hypertension (PAH is a serious complication of congenital heart disease (CHD. Without early surgical repair, around one-third of paediatric CHD patients develop significant PAH. Recent data from the Netherlands suggest that >4% of adult CHD patients have PAH, with higher rates in those with septal defects. A spectrum of cardiac defects is associated with PAH-CHD, although most cases develop as a consequence of large systemic-to-pulmonary shunts. Eisenmenger's syndrome, characterised by reversed pulmonary-to-systemic (right-to-left shunt, represents the most advanced form of PAH-CHD and affects as many as 50% of those with PAH and left-to-right shunts. It is associated with the poorest outcome among patients with PAH-CHD. 40 yrs ago, ∼50% of children with CHD requiring intervention died within the first year, and <15% survived to adulthood. Subsequent advances in paediatric cardiology have seen most patients with CHD survive to adulthood, with resulting shifts in the demographics of CHD and PAH-CHD. The number of adults presenting with CHD is increasing and, although mortality is decreasing, morbidity is increasing as older patients are at increased risk of arrhythmia, heart failure, valve regurgitation and PAH. Data show that probability of PAH increases with age in patients with cardiac defects.

  19. Pulmonary arterial hypertension associated with congenital heart disease

    Directory of Open Access Journals (Sweden)

    Michele D'Alto

    2012-12-01

    Full Text Available Pulmonary arterial hypertension (PAH is a common complication of congenital heart disease (CHD, with most cases occurring in patients with congenital cardiac shunts. In patients with an uncorrected left-to-right shunt, increased pulmonary pressure leads to vascular remodelling and dysfunction, resulting in a progressive rise in pulmonary vascular resistance and increased pressures in the right heart. Eventually, reversal of the shunt may arise, with the development of Eisenmenger's syndrome, the most advanced form of PAH-CHD. The prevalence of PAH-CHD has fallen in developed countries over recent years and the number of patients surviving into adulthood has increased markedly. Today, the majority of PAH-CHD patients seen in clinical practice are adults, and many of these individuals have complex disease or received a late diagnosis of their defect. While there have been advances in the management and therapy in recent years, PAH-CHD is a heterogeneous condition and some subgroups, such as those with Down's syndrome, present particular challenges. This article gives an overview of the demographics, pathophysiology and treatment of PAH-CHD and focuses on individuals with Down's syndrome as an important and challenging patient group.

  20. Pulmonary endoderm, second heart field and the morphogenesis of distal outflow tract in mouse embryonic heart

    Institute of Scientific and Technical Information of China (English)

    SHI Liang; JING Ya; LI Huichao; WANG Yunxiu; WU Shanshan; CAI Yujin; CUI Huilin; YANG Yanping

    2015-01-01

    Objective:The second heart field ( SHF) , foregut endoderm and sonic hedgehog ( SHH) signa-ling pathway are associate with normal morphogenesis and septation of outflow tract ( OFT) . However, the morpho-logical relationships of the development of foregut endoderm and expression of SHH signaling pathway members with the development of surrounding SHF and OFT are seldom described. In this study, serial sections of mouse embryos from ED9 to ED13 ( midgestation) were stained with a series of marker antibodies for specifically highlighting SHF ( Isl-1 ) , endoderm ( Foxa2 ) , basement membrane ( Laminin ) , myocardium ( MHC ) and smooth muscle (α-SMA) respectively, or SHH receptors antibodies including patched1 (Ptc1), patched2 (Ptc2) and smoothened, to observe the spatiotemporal relationship between them and their contributions to OFT morphogenesis. Results: Our results demonstrated that the development of an Isl-1 positive field in the splanchnic mesoderm ventral to foregut, a subset of SHF, was closely coupled with pulmonary endoderm or tracheal groove, the Isl-1 positive cells sur-rounding pulmonary endoderm were distributed in a special cone-shaped pattern and contributed to the formation of the lateral walls of the intrapericardial aorta and pulmonary trunk and the transient aortic-pulmonary septum, and Ptc1 and Ptc2 were exclusively expressed in pulmonary endoderm during this Isl-l positive field development, suggesting special roles played in inducing the Isl-l positive field formation by pulmonary endoderm. Conclusions: Pulmonary endoderm plays a role in the development and specification of SHF in midgestation, and that pulmonary endoderm-associated Isl-l positive field is involved in patterning the morphogenesis and septation of the intrapericardial arterial trunks.

  1. Pulmonary endoderm, second heart field and the morphogenesis of distal outflow tract in mouse embryonic heart.

    Science.gov (United States)

    Liang, Shi; Li, Hui-Chao; Wang, Yun-Xiu; Wu, Shan-Shan; Cai, Yu-Jin; Cui, Hui-Lin; Yang, Yan-Ping; Ya, Jing

    2014-05-01

    The second heart field (SHF), foregut endoderm and sonic hedgehog (SHH) signaling pathway are all reported to associate with normal morphogenesis and septation of outflow tract (OFT). However, the morphological relationships of the development of foregut endoderm and expression of SHH signaling pathway members with the development of surrounding SHF and OFT are seldom described. In this study, serial sections of mouse embryos from ED9 to ED13 (midgestation) were stained with a series of marker antibodies for specifically highlighting SHF (Isl-1), endoderm (Foxa2), basement membrane (Laminin), myocardium (MHC) and smooth muscle (α-SMA) respectively, or SHH receptors antibodies including patched1 (Ptc1), patched2 (Ptc2) and smoothened, to observe the spatiotemporal relationship between them and their contributions to OFT morphogenesis. Our results demonstrated that the development of an Isl-1 positive field in the splanchnic mesoderm ventral to foregut, a subset of SHF, is closely coupled with pulmonary endoderm or tracheal groove, the Isl-1 positive cells surrounding pulmonary endoderm are distributed in a special cone-shaped pattern and take part in the formation of the lateral walls of the intrapericardial aorta and pulmonary trunk and the transient aortic-pulmonary septum, and Ptc1 and Ptc2 are exclusively expressed in pulmonary endoderm during this Isl-l positive field development, suggesting special roles played in inducing the Isl-l positive field formation by pulmonary endoderm. It is indicated that pulmonary endoderm plays a role in the development and specification of SHF in midgestation, and that pulmonary endoderm-associated Isl-l positive field is involved in patterning the morphogenesis and septation of the intrapericardial arterial trunks.

  2. Imaging the heart in pulmonary hypertension: an update

    Directory of Open Access Journals (Sweden)

    Ekkehard Grünig

    2015-12-01

    Full Text Available Noninvasive imaging of the heart plays an important role in the diagnosis and management of pulmonary hypertension (PH, and several well-established techniques are available for assessing performance of the right ventricle, the key determinant of patient survival. While right heart catheterisation is mandatory for establishing a diagnosis of PH, echocardiography is the most important screening tool for early detection of PH. Cardiac magnetic resonance imaging (CMRI is also a reliable and practical tool that can be used as part of the diagnostic work-up. Echocardiography can measure a range of haemodynamic and anatomical variables (e.g. pericardial effusion and pulmonary artery pressure, whereas CMRI provides complementary information to echocardiography via high-resolution, three-dimensional imaging. Together with echocardiography and CMRI, techniques such as high-resolution computed tomography and positron emission tomography may also be valuable for screening, monitoring and follow-up assessments of patients with PH, but their clinical relevance has yet to be established. Technological advances have produced new variants of echocardiography, CMRI and positron emission tomography, and these permit closer examination of myocardial architecture, motion and deformation. Integrating these new tools into clinical practice in the future may lead to more precise noninvasive determination of diagnosis, risk and prognosis for PH.

  3. Pulmonary Hypertension After Heart Transplantation in Patients Bridged with the Total Artificial Heart.

    Science.gov (United States)

    Shah, Rachit; Patel, Dhavalkumar B; Mankad, Anit K; Rennyson, Stephen L; Tang, Daniel G; Quader, Mohammed A; Smallfield, Melissa C; Kasirajan, Vigneshwar; Shah, Keyur B

    2016-01-01

    Pulmonary hypertension (PH) among heart transplant recipients is associated with an increased risk of mortality. Pulmonary hemodynamics improves after left ventricular assist device (LVAD) implantation; however, the impact of PH before total artificial heart (TAH) implantation on posttransplant hemodynamics and survival is unknown. This is a single center retrospective study aimed to evaluate the impact of TAH implantation on posttransplant hemodynamics and mortality in two groups stratified according to severity of PH: high (≥3 Woods units [WU]) and low (heart catheterization performed at baseline (before TAH) and posttransplant at 1 and 12 months. Patients in the high PVR group (n = 12) experienced improvement in PVR (baseline = 4.31 ± 0.7; 1-month = 1.69 ± 0.7, p heart transplantation (HT), but remained elevated. There was no significant difference in survival between the two groups at 12 months follow-up. Patients with high PVR who are bridged to transplant with TAH had improvement in PVR at 12 months after transplant, and the degree of PVR did not impact posttransplant survival.

  4. Deciphering the genetic and modular connections between coronary heart disease, idiopathic pulmonary arterial hypertension and pulmonary heart disease.

    Science.gov (United States)

    Yuan, Ye; Zhang, Yingying; Zhang, Xiaoxu; Yu, Yanan; Li, Bing; Wang, Pengqian; Li, Haixia; Zhao, Yijun; Shen, Chunti; Wang, Zhong

    2016-07-01

    Coronary heart disease (CHD), idiopathic pulmonary arterial hypertension (IPAH) and pulmonary heart disease (PHD) are circulatory system diseases that may simultaneously emerge in a patient and they are often treated together in clinical practice. However, the molecular mechanisms connecting these three diseases remain unclear. In order to determine the multidimensional characteristic correlations between these three diseases based on genomic networks to aid in medical decision-making, genes from the Online Mendelian Inheritance in Man database were obtained, and applied network construction and modularized analysis were conducted. Functional enrichment analysis was conducted to explore the associations between overlapping genes, modules and pathways. A total of 29 overlapping genes and 3 common modules were identifed for the 3 diseases. Glycosphingolipid biosynthesis and the arachidonic acid metabolism are common pathways, and the biosynthetic process is suggested to be the major function involved in the three diseases. The current study reported, to the best of our knowledge for the first time, the role of glycosphingolipid biosynthesis in IPAH and PHD. The present study provided an improved understanding of the pathological mechanisms underlying CHD, IPAH and PHD. The overlapping genes, modules and pathways suggest novel areas for further research, and drug targets. The observations of the current study additionally suggest that drug indications can be broadened because of the presence of common targets.

  5. Total laparoscopic retrieval of inferior vena cava filter

    Directory of Open Access Journals (Sweden)

    Ehsan Benrashid

    2015-08-01

    Full Text Available While there is some local variability in the use of inferior vena cava filters and there has been some evolution in the indications for filter placement over time, inferior vena cava filters remain a standard option for pulmonary embolism prophylaxis. Indications are clear in certain subpopulations of patients, particularly those with deep venous thrombosis and absolute contraindications to anticoagulation. There are, however, a variety of reported inferior vena cava filter complications in the short and long term, making retrieval of the filter desirable in most cases. Here, we present the case of a morbidly obese patient complaining of chronic abdominal pain after inferior vena cava filter placement and malposition of the filter with extensive protrusion outside the inferior vena cava. She underwent successful laparoscopic retrieval of her malpositioned inferior vena cava filters after failure of a conventional endovascular approach.

  6. Use of the Frog Heart Preparation to Teach Students about the Spontaneous Mechanical Activity of the Vena Cava

    Science.gov (United States)

    Hill, Brent J. F.; Goodman, Ian; Moran, William M.

    2011-01-01

    Most undergraduate physiology texts describe veins simply as reservoirs for blood and conduits for return of blood to the heart. This article describes a laboratory exercise that can be performed by students to demonstrate that veins are much more than reservoirs and conduits for blood flow: they possess a dynamic rhythmic contraction. In this…

  7. Drenagem anômala de veia pulmonar inferior direita em veia cava inferior associada a apêndice hepático intracardíaco Anomalous drainage of the right inferior pulmonary vein into the inferior vena cava associated to intrathoracic hepatic appendix

    Directory of Open Access Journals (Sweden)

    Carlos R Moraes

    1988-08-01

    Full Text Available Descreve-se o caso de uma paciente de 61 anos de idade, com drenagem anômala de veia pulmonar inferior direita em veia cava inferior, associada a apêndice hepático intratorácico, herniado através de fenda no diafragma. A correção cirúrgica foi realizada por anastomose direta da veia anômala com o átrio esquerdo, pela redução do apêndice hepático para a cavidade abdominal e, finalmente, pelo fechamento do defeito diafragmático. O pós-operatório decorreu sem qualquer complicação. Os autores chamam a atenção para a raridade do caso.The authors present a case of a 61-year-old woman with anomalous drainage of the right inferior pulmonary vein into the inferior vena cava associated to an intrathoracic hepatic appendix herniated through a diaphragmatic defect. Surgical correction was obtained by direct anastomosis of the anomalous vein to the left atrium, reduction of the hepatic appendix to the abdominal cavity and closure of the diphragmatic defect. The postoperative course was unevenftul. The rarity of this condition is stressed.

  8. Postpartum Acute Pulmonary Oedema with Sub clinical Rheumatic Heart Disease

    OpenAIRE

    2015-01-01

    Acute dyspnea with pulmonary oedema in postpartum is uncommon but life-threatening event. Contributing factors for pulmonary oedema include, administration of tocolytics, underlying cardiac disease, iatrogenic fluid overload and preeclampsia acounting 0.08% of pregnancies. Pulmonary embolism, amniotic fluid embolism, pneumonia, aspiration and pulmonary oedema are some of the potentially devastating conditions that should be considered by the attending physician.

  9. Pulmonary artery dissection in a patient with Eisenmenger syndrome treated with heart and lung transplantation

    DEFF Research Database (Denmark)

    Tønder, Niels; Køber, Lars; Hassager, Christian

    2004-01-01

    We report the case of a patient with known Eisenmenger syndrome due to congenital ventricular septal defect, who developed pulmonary artery dissection. The patient was successfully treated with heart and lung transplantation.......We report the case of a patient with known Eisenmenger syndrome due to congenital ventricular septal defect, who developed pulmonary artery dissection. The patient was successfully treated with heart and lung transplantation....

  10. Catheter-Induced Thrombosis of the Superior Vena Cava

    Directory of Open Access Journals (Sweden)

    Elio Venturini

    2012-01-01

    Full Text Available There has been an increase in the use of central venous catheters (CVCs in clinical practice. One of the most dangerous complications associated with their use is symptomatic or asymptomatic thrombosis (T, sometimes associated with superior vena cava (SVC syndrome, resulting from impaired venous drainage. The right heart clots can induce an increased risk of mortality due the potential pulmonary embolism (PE. We report a case of asymptomatic 83-year-old woman in whom the thrombosis was detected after an echocardiogram. Echocardiography demonstrated a cardiac mass, and the T was confirmed by (magnetic resonance imaging MRI. The clinical scenario, a high index of suspicion and routine use of echocardiogram in patients with CVC, can lead to a correct diagnosis, preventing dangerous complications.

  11. Prevalence of cerebral and pulmonary thrombosis in patients with cyanotic congenital heart disease

    DEFF Research Database (Denmark)

    Jensen, A S; Idorn, L; Thomsen, C;

    2015-01-01

    BACKGROUND: Patients with cyanotic congenital heart disease (CCHD) have a high prevalence of thrombosis, the most frequently described locations being the cerebral and pulmonary vessels. The reported prevalence of both cerebral infarction and pulmonary thrombosis has been highly variable. The aim...

  12. Serial pulmonary function tests to diagnose COPD in chronic heart failure

    NARCIS (Netherlands)

    Minasian, A.G.; Elshout, F.J.J. van den; Dekhuijzen, P.N.R.; Vos, P.J.E.; Willems, F.F.; Bergh, P.J.P.C. van den; Heijdra, Y.F.

    2014-01-01

    BACKGROUND: It is unknown whether serial pulmonary function tests are necessary for the correct diagnosis of chronic obstructive pulmonary disease (COPD) in patients with stable non-congested chronic heart failure (CHF). The aim of this study was to determine the prevalence of COPD in outpatients wi

  13. Clinical and morphologic features of acute, subacute and chronic cor pulmonale (pulmonary heart disease).

    Science.gov (United States)

    Roberts, William Clifford; Shafii, Alexis E; Grayburn, Paul A; Ko, Jong Mi; Weissenborn, Matthew R; Rosenblatt, Randall L; Guileyardo, Joseph M

    2015-03-01

    Described are certain clinical and morphologic features of one patient with acute, another with subacute, and one with chronic cor pulmonale. All 3 had evidence of severe pulmonary hypertension. The patient with acute cor pulmonale 4 days after coronary bypass for unstable angina pectoris suddenly developed severe breathlessness with cyanosis and had fatal cardiac arrest and necropsy disclosed massive pulmonary embolism. The patient with subacute cor pulmonale had severe right-sided heart failure for 5 weeks and necropsy disclosed microscopic-sized neoplastic pulmonary emboli from a gastric carcinoma without parenchymal pulmonary metastases. The patient with chronic cor pulmonale had evidence of right-sided heart failure for years, the result of primary or idiopathic pulmonary hypertension almost certainly present from birth because the pattern of elastic fibers in the pulmonary trunk was that seen in newborns where the pressure in the pulmonary trunk and ascending aorta are similar. The patient with chronic cor pulmonale had plexiform pulmonary lesions indicative of irreversible pulmonary hypertension. Neither the acute nor the subacute patient had chronic pulmonary vascular changes. All 3 patients had dilated right ventricular cavities and non-dilated left ventricular cavities and only the patient with chronic cor pulmonale had right ventricular hypertrophy.

  14. Isolated supra-cardiac partial anomalous pulmonary venous connection causing right heart failure

    Directory of Open Access Journals (Sweden)

    Robert Sogomonian

    2016-04-01

    Full Text Available Right heart failure (RHF has been overlooked as left heart failure has predominated. One of the many causes of RHF is partial anomalous pulmonary venous connection (PAPVC, an extremely rare entity in nature. Physicians should consider the unusual causes of RHF after ruling out the common causes.

  15. A case of heart failure due to alcoholic cardiomyopathy combined with acute pulmonary embolism.

    Science.gov (United States)

    Xiao, Feng; Yuan, Wei; Li, Xiaorong; Wang, Gannan; Jiang, Ting; Wang, Weiwei; Zhang, Jinsong; Li, Ping; Qi, Lianwen; Chen, Yan

    2014-09-01

    It has not been reported that cases of alcoholic cardiomyopathy (ACM) combined with acute pulmonary embolism (PE). We hereby present a case of a 48-year-old male with ACM with significant enlargement of the heart and heart failure is described. Then, the patient was seized with acute PE which was confirmed by specific examination and his symptoms.

  16. Pioglitazone-induced congestive heart failure and pulmonary edema in a patient with preserved ejection fraction

    Directory of Open Access Journals (Sweden)

    Vaneet Jearath

    2016-01-01

    Full Text Available Pioglitazone-induced heart failure is known in patients with underlying heart disease, but is not well documented in patients with normal left ventricular function. Pioglitazone has been very popular as it is an insulin sensitizer and insulin resistance is prevalent among Indians. Fluid retention exacerbates pre-existing heart failure or precipitates heart failure in a patient with underlying left ventricular dysfunction. However, pathogenesis of heart failure in a patient with normal left ventricular function is not known. Probably it is due to dose-related effect on pulmonary endothelial permeability, rather than alterations in left ventricular mass or ejection fraction. We report a patient who developed congestive heart failure and pulmonary edema with normal left ventricular function within 1 year of starting pioglitazone therapy. We have to be careful in monitoring all possible side effects during followup when patients are on pioglitazone therapy.

  17. Pioglitazone-induced congestive heart failure and pulmonary edema in a patient with preserved ejection fraction

    Science.gov (United States)

    Jearath, Vaneet; Vashisht, Rajan; Rustagi, Vipul; Raina, Sujeet; Sharma, Rajesh

    2016-01-01

    Pioglitazone-induced heart failure is known in patients with underlying heart disease, but is not well documented in patients with normal left ventricular function. Pioglitazone has been very popular as it is an insulin sensitizer and insulin resistance is prevalent among Indians. Fluid retention exacerbates pre-existing heart failure or precipitates heart failure in a patient with underlying left ventricular dysfunction. However, pathogenesis of heart failure in a patient with normal left ventricular function is not known. Probably it is due to dose-related effect on pulmonary endothelial permeability, rather than alterations in left ventricular mass or ejection fraction. We report a patient who developed congestive heart failure and pulmonary edema with normal left ventricular function within 1 year of starting pioglitazone therapy. We have to be careful in monitoring all possible side effects during followup when patients are on pioglitazone therapy. PMID:27127397

  18. Pioglitazone-induced congestive heart failure and pulmonary edema in a patient with preserved ejection fraction.

    Science.gov (United States)

    Jearath, Vaneet; Vashisht, Rajan; Rustagi, Vipul; Raina, Sujeet; Sharma, Rajesh

    2016-01-01

    Pioglitazone-induced heart failure is known in patients with underlying heart disease, but is not well documented in patients with normal left ventricular function. Pioglitazone has been very popular as it is an insulin sensitizer and insulin resistance is prevalent among Indians. Fluid retention exacerbates pre-existing heart failure or precipitates heart failure in a patient with underlying left ventricular dysfunction. However, pathogenesis of heart failure in a patient with normal left ventricular function is not known. Probably it is due to dose-related effect on pulmonary endothelial permeability, rather than alterations in left ventricular mass or ejection fraction. We report a patient who developed congestive heart failure and pulmonary edema with normal left ventricular function within 1 year of starting pioglitazone therapy. We have to be careful in monitoring all possible side effects during followup when patients are on pioglitazone therapy.

  19. Pulmonary embolism in pregnancy: comparison of pulmonary CT angiography and lung scintigraphy.

    LENUS (Irish Health Repository)

    Ridge, Carole A

    2012-02-01

    OBJECTIVE: The purpose of this study was to retrospectively compare the diagnostic adequacy of lung scintigraphy with that of pulmonary CT angiography (CTA) in the care of pregnant patients with suspected pulmonary embolism. MATERIALS AND METHODS: Patient characteristics, radiology report content, additional imaging performed, final diagnosis, and diagnostic adequacy were recorded for pregnant patients consecutively referred for lung scintigraphy or pulmonary CTA according to physician preference. Measurements of pulmonary arterial enhancement were performed on all pulmonary CTA images of pregnant patients. Lung scintigraphy and pulmonary CTA studies deemed inadequate for diagnosis at the time of image acquisition were further assessed, and the cause of diagnostic inadequacy was determined. The relative contribution of the inferior vena cava to the right side of the heart was measured on nondiagnostic CTA images and compared with that on CTA images of age-matched nonpregnant women, who were the controls. RESULTS: Twenty-eight pulmonary CTA examinations were performed on 25 pregnant patients, and 25 lung scintigraphic studies were performed on 25 pregnant patients. Lung scintigraphy was more frequently adequate for diagnosis than was pulmonary CTA (4% vs 35.7%) (p = 0.0058). Pulmonary CTA had a higher diagnostic inadequacy rate among pregnant than nonpregnant women (35.7% vs 2.1%) (p < 0.001). Transient interruption of contrast material by unopacified blood from the inferior vena cava was identified in eight of 10 nondiagnostic pulmonary CTA studies. CONCLUSION: We found that lung scintigraphy was more reliable than pulmonary CTA in pregnant patients. Transient interruption of contrast material by unopacified blood from the inferior vena cava is a common finding at pulmonary CTA of pregnant patients.

  20. Estimation of pulmonary hypertension in lung and valvular heart diseases by perfusion lung scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Fujii, Tadashige [Shinshu Univ., Matsumoto, Nagano (Japan). School of Allied Medical Sciences; Tanaka, Masao; Yazaki, Yoshikazu; Kitabayashi, Hirosi; Koizumi, Tomonori; Kubo, Keisi; Sekiguchi, Morie; Yano, Kesato

    1999-06-01

    To estimate pulmonary hypertension, we measured postural differences in pulmonary blood flow for the lateral decubitus positions on perfusion lung scintigrams with Tc-99 m macro-aggregated albumin, applying the method devised by Tanaka et al (Eur J Nucl Med 17: 320-326, 1990). Utilizing a scintillation camera coupled to a minicomputer system, changes in the distribution of pulmonary blood flow caused by gravitational effects, namely, changes in the total count ratios for the right lung versus the left lung in the right and left lateral decubitus positions (R/L), were obtained for 44 patients with lung disease, 95 patients with valvular heart disease, and 23 normal subjects. Mean standard deviation in the R/L ratios was 3.09{+-}1.28 for the normal subjects, 1.97{+-}0.89 for the patients with lung disease, and 1.59{+-}0.59 for the patients with valvular heart disease. The R/L ratios correlated with mean pulmonary arterial pressure and cardio-thoracic ratios in the lung disease and valvular heart disease groups, with pulmonary arteriolar resistance in the former, and with pulmonary capillary wedge pressure in the latter. Defining pulmonary hypertension (>20 mmHg) as an R/L ratio of less than 1.81, which is the mean-1 standard deviation for normal subjects, the sensitivity and the specificity of the R/L ratio for the diagnosis of pulmonary hypertension were 62.9% and 76.2%, respectively, for the lung disease patients, and 80.3% and 61.8%, respectively, for the valvular heart disease patients. This method seems to be useful for the pathophysiologic evaluation of pulmonary perfusion in cases of lung disease and valvular heart disease. (author)

  1. Combined Double Sleeve Lobectomy and Superior Vena Cava Resection for Non-small Cell Lung Cancer with Persistent Left Superior Vena Cava

    Directory of Open Access Journals (Sweden)

    Daxing ZHU

    2015-11-01

    Full Text Available A 65-year-old man with right central type of lung squamous carcinoma was admitted to our department. Bronchoscopy displayed complete obstruction of right upper lobe bronchus and infiltration of the bronchus intermedius with tumor. Chest contrast computed tomography revealed the tumor invaded right pulmonary artery, superior vena cava, and the persistant left superior vena cava flowed into the coronary sinus. The tumor was successfully removed by means of bronchial and pulmonary artery sleeve resection of the right upper and middle lobes combined with resection and reconstruction of superior vena cava (SVC utilizing ringed polytetrafluoroethylene graft. To the best of our knowledge, this was the first report of complete resection of locally advanced lung cancer involving superior vena cava, right pulmonary artery trunk and main bronchus with persistant left superior vena cava.

  2. Combined Double Sleeve Lobectomy and Superior Vena Cava Resection for Non-small Cell Lung Cancer with Persistent Left Superior Vena Cava

    Institute of Scientific and Technical Information of China (English)

    Daxing ZHU; Xiaoming QIU; Qinghua ZHOU

    2015-01-01

    A 65-year-old man with right central type of lung squamous carcinoma was admitted to our department. Bronchoscopy displayed complete obstruction of right upper lobe bronchus and inifltration of the bronchus intermedius with tumor. Chest contrast computed tomography revealed the tumor invaded right pulmonary artery, superior vena cava, and the persistant letf superior vena cava lfowed into the coronary sinus. hTe tumor was successfully removed by means of bronchial and pulmonary artery sleeve resection of the right upper and middle lobes combined with resection and reconstruction of superior vena cava (SVC) utilizing ringed polytetralfuoroethylene gratf. To the best of our knowledge, this was the ifrst report of complete resection of locally advanced lung cancer involving superior vena cava, right pulmonary artery trunk and main bronchus with persistant letf superior vena cava.

  3. Pulmonary artery catheter insertion in a patient of dextrocardia with anomalous venous connections

    Directory of Open Access Journals (Sweden)

    Tripathi Mukesh

    2004-08-01

    Full Text Available In a young adult patient having situs solitus with dextrocardia the attempted pulmonary artery catheter placement for emergency mitral valve replacement required an unduly long length (50cm of catheter insertion to get into right ventricle and then into pulmonary artery. Although catheter coiling was suspected initially, chest x-ray taken after successfully placement revealed an uncommon congenital anomalous venous connection i.e. right internal jugular opening into left sided superior vena cava then into inferior vena cava after running all along the left border of the heart. With the result, it required to pass 50cm of PA catheter to get into right ventricle in our patient. This emphasizes the need to look for abnormal venous connections during echocardiography and x-ray screening in congenital heart disease. Fluoroscopy is recommended when an unusual length of pulmonary artery catheter insertion is required to enter the pulmonary artery.

  4. [Heart rhythm disturbances in patients with chronic obstructive pulmonary disease in aggregate with coronary heart disease].

    Science.gov (United States)

    Shoĭkhet, Ia N; Klester, E B; Golovin, V A

    2008-01-01

    The purpose of the research was to study kinds, frequencies and features of heart rhythm disturbances (HRD) in patients with chronic obstructive pulmonary disease (COPD) subject to degree of severity, including presence of coronary heart disease (CHD). 1189 of patients with registered HRD were examined. 315 of them had COPD (group 1), 531--combination of COPD and CHD (group 2), 343 were CHD patients (group 3). The extent of examinations included electrocardiogram (ECG), Halter monitoring (HM), bicycle ergometry (BEM), external respiration function estimation. Supraventricular HRD were registered statistically more frequently in group 1: according to ECG data in rest - in 37.2% patients, by BEM results--in 18.8%, by HM--in 50%. Combined (supraventricular and ventricular) HRD were registered most frequently in group 2: 41.2 24.4, and 45.5% respectively. Ventricular HRD dominated in group 3: 47.6, 29.3 and 48.6% respectively. The results of the study indicate that supraventricular HRDprevaile in patients with COPD, combined HRD - in patients with COPD and CHD. Ventricular HRD, which most informatively reflect changes in intracardiac geometry and left ventricle hemodynamics, dominate in CHD patients. The optimization of therapy correction consists in early diagnostics of HRD subject to features of cardiorespiratory system functional state.

  5. Perioperative pharmacological management of pulmonary hypertensive crisis during congenital heart surgery.

    Science.gov (United States)

    Brunner, Nathan; de Jesus Perez, Vinicio A; Richter, Alice; Haddad, François; Denault, André; Rojas, Vanessa; Yuan, Ke; Orcholski, Mark; Liao, Xiaobo

    2014-03-01

    Pulmonary hypertensive crisis is an important cause of morbidity and mortality in patients with pulmonary arterial hypertension secondary to congenital heart disease (PAH-CHD) who require cardiac surgery. At present, prevention and management of perioperative pulmonary hypertensive crisis is aimed at optimizing cardiopulmonary interactions by targeting prostacyclin, endothelin, and nitric oxide signaling pathways within the pulmonary circulation with various pharmacological agents. This review is aimed at familiarizing the practitioner with the current pharmacological treatment for dealing with perioperative pulmonary hypertensive crisis in PAH-CHD patients. Given the life-threatening complications associated with pulmonary hypertensive crisis, proper perioperative planning can help anticipate cardiopulmonary complications and optimize surgical outcomes in this patient population.

  6. CT pulmonary angiography findings that predict 30-day mortality in patients with acute pulmonary embolism

    Energy Technology Data Exchange (ETDEWEB)

    Bach, Andreas Gunter, E-mail: mail@andreas-bach.de [Department of Radiology, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle (Germany); Nansalmaa, Baasai; Kranz, Johanna [Department of Radiology, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle (Germany); Taute, Bettina-Maria [Department of Internal Medicine, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle (Germany); Wienke, Andreas [Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University Halle-Wittenberg, Magdeburger-Str. 8, 06112 Halle (Germany); Schramm, Dominik; Surov, Alexey [Department of Radiology, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle (Germany)

    2015-02-15

    Highlights: • In patients with acute pulmonary embolism contrast reflux in inferior vena cava is significantly stronger in non-survivors (odds ratio 3.29; p < 0.001). • This finding is independent from the following comorbidities: heart insufficiency and pulmonary hypertension. • Measurement of contrast reflux is a new and robust radiologic method for predicting 30-day mortality in patients with acute pulmonary embolism. • Measurement of contrast reflux is a better predictor of 30-day mortality after acute pulmonary embolism than any other existing radiologic predictor. This includes thrombus distribution, and morphometric measurements of right ventricular dysfunction. - Abstract: Purpose: Standard computed tomography pulmonary angiography (CTPA) can be used to diagnose acute pulmonary embolism. In addition, multiple findings at CTPA have been proposed as potential tools for risk stratification. Therefore, the aim of the present study is to examine the prognostic value of (I) thrombus distribution, (II) morphometric parameters of right ventricular dysfunction, and (III) contrast reflux in inferior vena cava on 30-day mortality. Material and methods: In a retrospective, single-center study from 06/2005 to 01/2010 365 consecutive patients were included. Inclusion criteria were: presence of acute pulmonary embolism, and availability of 30-day follow-up. A review of patient charts and images was performed. Results: There were no significant differences between the group of 326 survivors and 39 non-survivors in (I) thrombus distribution, and (II) morphometric measurements of right ventricular dysfunction. However, (III) contrast reflux in inferior vena cava was significantly stronger in non-survivors (odds ratio 3.29; p < 0.001). Results were independent from comorbidities like heart insufficiency and pulmonary hypertension. Conclusion: Measurement of contrast reflux is a new and robust method for predicting 30-day mortality in patients with acute pulmonary

  7. Postpartum Acute Pulmonary Oedema with Sub clinical Rheumatic Heart Disease.

    Science.gov (United States)

    R, Padmaja; Gande, Sri Krishna Padma Challa Rao

    2015-02-01

    Acute dyspnea with pulmonary oedema in postpartum is uncommon but life-threatening event. Contributing factors for pulmonary oedema include, administration of tocolytics, underlying cardiac disease, iatrogenic fluid overload and preeclampsia acounting 0.08% of pregnancies. Pulmonary embolism, amniotic fluid embolism, pneumonia, aspiration and pulmonary oedema are some of the potentially devastating conditions that should be considered by the attending physician. Here, we report a case of postpartum acute pulmonary oedema referred to causality after an emergency caesarean section in a private hospital. No matter what the underlying pathology, prompt administration and appropriate resuscitation is always the first priority. Only after the patient has been stabilized attention must be turned to diagnosis and specific treatment. A diagnosis of severe Mitral Stenosis, probably of rheumatic origin was made after stabilizing the patient.

  8. CT及MRI诊断子宫平滑肌瘤病累及下腔静脉及右心腔%CT and MRI in diagnosis of uterine leiomyomatosis involving the inferior vena cava and the right heart

    Institute of Scientific and Technical Information of China (English)

    王永梅; 李宇; 张兆琪

    2011-01-01

    目的 观察子宫平滑肌瘤病累及下腔静脉及右侧心腔的CT及MRI影像学表现.方法 收集8例病理诊断为子宫平滑肌瘤病累及下腔静脉及右侧心腔患者,回顾性分析术前CT及MRI表现.结果子宫平滑肌瘤病累及下腔静脉及右侧心腔CT及MRI影像学特点:病灶大部分游离于静脉或心腔内,中等不均匀强化,病变与子宫静脉平滑肌瘤原发灶或复发灶相延续;累及右心腔时可见似"拐杖头"或"蛇头"状改变.子宫平滑肌瘤病的特异性表现为子宫或宫旁血管增粗、纡曲成团.结论 CT及MRI不仅可显示子宫平滑肌瘤病累及下腔静脉及右心受累范围,同时可以检出盆腔原发或复发病变,对指导治疗及评价预后有重要意义.%Objective To observe CT and MRI manifestations of uterine leiomyomatosis involving the inferior vena cava and the right cardiac cavity. Methods Eight patients with pathologically diagnosed uterine leiomyomatosis involving the inferior vena cava and right heart chamber were enrolled, and their preoperative CT and MRI data were analyzed retrospectively. Results CT and MRI images showed that the majority of the lesion floated in the vein or heart cavity and connected with the primary or recurrence lesions with moderate heterogeneous enhancement. When the right heart was involved, it looked like "walking stick head" or "snakeheads". Dilated and tortuous blood vessels could be found around the primary or recurrent uterine leiomyomatosis, which was the specific feature of uterine leiomyomatosis. Conclusion CT and MRI can not only observe the range of uterine leiomyomatosis involving the inferior vena cava and the right cardiac cavity, but also detect the primary or recurrent pelvic diseases, therefore are important to the treatment and prognostic evaluation.

  9. Right superior vena cava draining into the left atrium

    Energy Technology Data Exchange (ETDEWEB)

    Calcagni, Giulio; Sidi, Daniel; Bonnet, Damien [University Rene Descartes-Paris 5, Department of Paediatric Cardiology, Hopital Necker-Enfants Malades, Paris (France); Batisse, Alain [Institut de Puericulture et de Perinatalogie, Paris (France); Vouhe, Pascal [University Rene Descartes-Paris 5, Department of Paediatric Cardiac Surgery, Hopital Necker-Enfants Malades, Paris (France); Ou, Phalla [University Rene Descartes-Paris 5, Department of Paediatric Cardiology, Hopital Necker-Enfants Malades, Paris (France); University Rene Descartes-Paris 5, Department of Pediatric Radiology, Hopital Necker-Enfants Malades, Paris (France)

    2008-08-15

    The right superior vena cava draining into the left atrium is a rare malformation causing cyanosis and clubbing in patients in whom no other signs of congenital heart defect are present. Diagnosis may be difficult as cyanosis may be mild and the anomaly is not always easily detectable by echocardiography. For this reason we report a 13-month-old male in whom we confirmed the clinical and echocardiographic suspicion of anomalous drainage of the right superior vena cava using multidetector CT. This allowed successful surgical reconnection of the right superior vena cava to the right atrium. (orig.)

  10. The role of the second heart field in pulmonary vein development : new insights in the origin of clinical abnormalities

    NARCIS (Netherlands)

    Douglas, Yvonne Louise

    2010-01-01

    In this thesis we describe normal and abnormal pulmonary vein development in human and mouse hearts, and focus on the histo(patho)logy of the pulmonary venous and left atrial dorsal wall, in order to elucidate the role of the posterior heart field in the formation and differentiation of the pulmonar

  11. Resting heart rate is a risk factor for mortality in chronic obstructive pulmonary disease, but not for exacerbations or pneumonia

    NARCIS (Netherlands)

    Warnier, Miriam J.; Rutten, Frans H.; De Boer, Anthonius; Hoes, Arno W.; De Bruin, Marie L.

    2014-01-01

    Background: Although it is known that patients with chronic obstructive pulmonary disease (COPD) generally do have an increased heart rate, the effects on both mortality and non-fatal pulmonary complications are unclear. We assessed whether heart rate is associated with all-cause mortality, and non-

  12. Right ventricular Hemodynamic Alteration after Pulmonary Valve Replacement in Children with Congenital Heart Disease

    Directory of Open Access Journals (Sweden)

    Hamid Bigdelian

    2015-03-01

    Full Text Available Introduction:  In patients who underwent surgery to repair Tetralogy of Fallot, right ventricular dilation from pulmonary regurgitation may be result in right ventricular failure, arrhythmias and cardiac arrest. Hence, pulmonary valve replacement may be necessary to reduce right ventricular volume overload. The aim of present study was to assess the effects of pulmonary valve replacement on right ventricular function after repair of Tetralogy of Fallot.   Materials and  Method:  This retrospective study was carried out between July 2011 and October 2013 on 21 consecutive patients in Chamran Heart Center (Esfahan. The study included 13 male (61.9% and 8 female (38.1%. Cardiac magnetic resonance was performed before, 6 and 12 months after pulmonary valve replacement in all patients (Babak Imaging Center, Tehran with the 1.5 Tesla system. The main reason for surgery at Tetralogy of Fallot repaired time was Tetralogy of Fallot + Pulmonary insufficiency (17 cases and Tetralogy of Fallot + Pulmonary atresia (4 cases. Right ventricular function was assessed before and after pulmonary valve replacement with Two-dimensional echocardiography and ttest was used to evaluate follow-up data.   Results:  Right ventricular end-diastolic volume, right ventricular end- systolic volume significantly decreased (P value ˂ 0.05.Right ventricular ejection fraction had a significant increase (P value ˂ 0.05. Right ventricular mass substantially shrank after pulmonary valve replacement. Moreover, pulmonary regurgitation noticeably decreased in patients. The other hemodynamic parameter such as left ventricular ejection fraction improved but was not significant (P value= 0.79. Conclusion:  Pulmonary valve replacement can successfully restores the impaired hemodynamic function of right ventricle which is caused by direct consequence of volume unloading in patient. Pulmonary valve surgery in children with Tetralogy of Fallot who have moderate to severe pulmonary

  13. Whole heart cine MR imaging of pulmonary veins in patients with congenital heart disease. Comparison with Spin Echo MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Mitsui, Hideaki [Yamagata City Hospital Saiseikan (Japan); Saito, Haruo; Ishibashi, Tadashi; Takahashi, Shoki; Zuguchi, Masayuki; Yamada, Shogo

    2002-01-01

    We evaluated the accuracy of Whole Heart Cine (WHC) magnetic resonance (MR) imaging in the depiction of pulmonary veins (PVs) in patients with congenital heart disease (CHD) compared to that of spin echo (SE) MR imaging. Among our 35 patients, 4 patients had anomalous PV return. Detectability of four PVs on each MR examination images were evaluated. MR imaging is an effective modality for the clarification of PVs, and WHC MR imaging is more useful in delineating PV anomalies than SE MR imaging. (author)

  14. An orally active TRPV4 channel blocker prevents and resolves pulmonary edema induced by heart failure.

    Science.gov (United States)

    Thorneloe, Kevin S; Cheung, Mui; Bao, Weike; Alsaid, Hasan; Lenhard, Stephen; Jian, Ming-Yuan; Costell, Melissa; Maniscalco-Hauk, Kristeen; Krawiec, John A; Olzinski, Alan; Gordon, Earl; Lozinskaya, Irina; Elefante, Lou; Qin, Pu; Matasic, Daniel S; James, Chris; Tunstead, James; Donovan, Brian; Kallal, Lorena; Waszkiewicz, Anna; Vaidya, Kalindi; Davenport, Elizabeth A; Larkin, Jonathan; Burgert, Mark; Casillas, Linda N; Marquis, Robert W; Ye, Guosen; Eidam, Hilary S; Goodman, Krista B; Toomey, John R; Roethke, Theresa J; Jucker, Beat M; Schnackenberg, Christine G; Townsley, Mary I; Lepore, John J; Willette, Robert N

    2012-11-01

    Pulmonary edema resulting from high pulmonary venous pressure (PVP) is a major cause of morbidity and mortality in heart failure (HF) patients, but current treatment options demonstrate substantial limitations. Recent evidence from rodent lungs suggests that PVP-induced edema is driven by activation of pulmonary capillary endothelial transient receptor potential vanilloid 4 (TRPV4) channels. To examine the therapeutic potential of this mechanism, we evaluated TRPV4 expression in human congestive HF lungs and developed small-molecule TRPV4 channel blockers for testing in animal models of HF. TRPV4 immunolabeling of human lung sections demonstrated expression of TRPV4 in the pulmonary vasculature that was enhanced in sections from HF patients compared to controls. GSK2193874 was identified as a selective, orally active TRPV4 blocker that inhibits Ca(2+) influx through recombinant TRPV4 channels and native endothelial TRPV4 currents. In isolated rodent and canine lungs, TRPV4 blockade prevented the increased vascular permeability and resultant pulmonary edema associated with elevated PVP. Furthermore, in both acute and chronic HF models, GSK2193874 pretreatment inhibited the formation of pulmonary edema and enhanced arterial oxygenation. Finally, GSK2193874 treatment resolved pulmonary edema already established by myocardial infarction in mice. These findings identify a crucial role for TRPV4 in the formation of HF-induced pulmonary edema and suggest that TRPV4 blockade is a potential therapeutic strategy for HF patients.

  15. Clinical classification in pediatric pulmonary arterial hypertension associated with congenital heart disease

    NARCIS (Netherlands)

    Zijlstra, Willemijn M H; Douwes, Johannes M; Ploegstra, Mark-Jan; Krishnan, Usha; Roofthooft, Marcel; Hillege, Hans L; Ivy, D Dunbar; Rosenzweig, Erika B; Berger, Rolf M F

    2016-01-01

    Congenital heart disease (CHD) is a frequent cause of pediatric pulmonary arterial hypertension (PAH), with diverse etiology and outcome. We aimed to describe phenotypic heterogeneity in pediatric PAH associated with CHD (PAH-CHD), assess the applicability of the Nice CHD classification, and explore

  16. Pulmonary heart valve replacement using stabilized acellular xenogeneic scaffolds; effects of seeding with autologous stem cells

    Directory of Open Access Journals (Sweden)

    Harpa Marius Mihai

    2015-12-01

    Full Text Available Background: We hypothesized that an ideal heart valve replacement would be acellular valve root scaffolds seeded with autologous stem cells. To test this hypothesis, we prepared porcine acellular pulmonary valves, seeded them with autologous adipose derived stem cells (ADSCs and implanted them in sheep and compared them to acellular valves.

  17. Pulmonary arterial hypertension in congenital heart disease : An epidemiologic perspective from a Dutch registry

    NARCIS (Netherlands)

    Duffels, M. G. J.; Engelfriet, P. M.; Berger, R. M. F.; van Loon, R. L. E.; Hoendermis, E.; Vriend, J. W. J.; Bresser, P.; Mulder, B. J. M.; van der Velde, Enno T.

    2007-01-01

    Background: Pulmonary arterial hypertension (PAH) associated with congenital heart disease is usually the result of a large systemic-topulmonary shunt, and often leads to right ventricular failure and early death. The purpose of this study was to determine the prevalence of PAH among adult patients

  18. Contemporary prevalence of pulmonary arterial hypertension in adult congenital heart disease following the updated clinical classification

    NARCIS (Netherlands)

    Riel, A.C. van; Schuuring, M.J.; Hessen, I.D. van; Zwinderman, A.H.; Cozijnsen, L.; Reichert, C.L.; Hoorntje, J.C.A.; Wagenaar, L.J.; Post, M.C.; Dijk, A.P.J. van; Hoendermis, E.S.; Mulder, B.J.; Bouma, B.J.

    2014-01-01

    BACKGROUND: The aging congenital heart disease (CHD) population is prone to develop a variety of sequelae, including pulmonary arterial hypertension (PAH). Previous prevalence estimates are limited in applicability due to the use of tertiary centers, or database encoding only. We aimed to investigat

  19. Secondary Pulmonary Hypertension and Right-Sided Heart Failure at Presentation in Grave’s Disease

    Directory of Open Access Journals (Sweden)

    Swapnil Panjabrao Ganeshpure

    2012-01-01

    Full Text Available A young female presented with evidence of right-sided heart failure and was subsequently found to have significant pulmonary artery hypertension (PAH. Because of her normal left ventricular function and pulmonary capillary wedge pressure, the most probable site of etiology seemed to be the pulmonary vasculature. All the common possible secondary causes of PAH were ruled out, but during the investigations, she was found to have elevated thyroid function tests compatible with the diagnosis of Grave’s disease. The treatment of Grave’s disease, initially by medications and subsequently by radioiodine therapy, was associated with a significant reduction in the pulmonary artery systolic pressure. The purpose of this case report is to highlight one of the unusual and underdiagnosed presentations of Grave’s disease.

  20. Pulmonary arterial wall distensibility assessed by intravascular ultrasound in children with congenital heart disease : an indicator for pulmonary vascular disease?

    NARCIS (Netherlands)

    Berger, Rolf M F; Cromme-Dijkhuis, Adri H; Hop, Wim C J; Kruit, Marco N; Hess, John; Berger, Rudolphus

    2002-01-01

    BACKGROUND: Both pulmonary hypertension and pulmonary overflow are associated with functional and structural changes of the pulmonary arterial wall. Current techniques to evaluate the pulmonary vasculature neglect the pulsatile nature of pulmonary flow. STUDY OBJECTIVES: To determine whether the dyn

  1. Importance of chronic obstructive pulmonary disease for prognosis and diagnosis of congestive heart failure in patients with acute myocardial infarction

    DEFF Research Database (Denmark)

    Kjøller, Erik; Køber, Lars; Iversen, Kasper

    2004-01-01

    AIMS: To evaluate the importance of chronic obstructive pulmonary disease for prognosis and diagnosis of congestive heart failure in patients with acute myocardial infarction. METHOD AND RESULTS: Prospective registration of 6669 consecutive patients admitted with infarction and screened...... in patients with acute myocardial infarction without congestive heart failure, but is also a confounding factor for the diagnosis of congestive heart failure....

  2. The Effects and Mechanism of Atorvastatin on Pulmonary Hypertension Due to Left Heart Disease.

    Directory of Open Access Journals (Sweden)

    Qing Wang

    Full Text Available Pulmonary hypertension due to left heart disease (PH-LHD is one of the most common forms of PH, termed group 2 PH. Atorvastatin exerts beneficial effects on the structural remodeling of the lung in ischemic heart failure. However, few studies have investigated the effects of atorvastatin on PH due to left heart failure induced by overload.Group 2 PH was induced in animals by aortic banding. Rats (n = 20 were randomly divided into four groups: a control group (C, an aortic banding group (AOB63, an atorvastatin prevention group (AOB63/ATOR63 and an atorvastatin reversal group (AOB63/ATOR50-63. Atorvastatin was administered for 63 days after banding to the rats in the AOB63/ATOR63 group and from days 50 to 63 to the rats in the AOB63/ATOR50-63 group.Compared with the controls, significant increases in the mean pulmonary arterial pressure, pulmonary arteriolar medial thickening, biventricular cardiac hypertrophy, wet and dry weights of the right middle lung, percentage of PCNA-positive vascular smooth muscle cells, inflammatory infiltration and expression of RhoA and Rho-kinase II were observed in the AOB63 group, and these changes concomitant with significant decreases in the percentage of TUNEL-positive vascular smooth muscle cells. Treatment of the rats in the AOB63/ATOR63 group with atorvastatin at a dose of 10 mg/kg/day significantly decreased the mean pulmonary arterial pressure, right ventricular hypertrophy, pulmonary arteriolar medial thickness, inflammatory infiltration, percentage of PCNA-positive cells and pulmonary expression of RhoA and Rho-kinase II and significantly augmented the percentage of TUNEL-positive cells compared with the AOB63 group. However, only a trend of improvement in pulmonary vascular remodeling was detected in the AOB63/ATOR50-63 group.Atorvastatin prevents pulmonary vascular remodeling in the PH-LHD model by down-regulating the expression of RhoA/Rho kinase, by inhibiting the proliferation and increasing the

  3. Usefulness of the second heart sound for predicting pulmonary hypertension in patients with interstitial lung disease

    Directory of Open Access Journals (Sweden)

    Sandra de Barros Cobra

    Full Text Available CONTEXT AND OBJECTIVE: P2 hyperphonesis is considered to be a valuable finding in semiological diagnoses of pulmonary hypertension (PH. The aim here was to evaluate the accuracy of the pulmonary component of second heart sounds for predicting PH in patients with interstitial lung disease. DESIGN AND SETTING: Cross-sectional study at the University of Brasilia and Hospital de Base do Distrito Federal. METHODS: Heart sounds were acquired using an electronic stethoscope and were analyzed using phonocardiography. Clinical signs suggestive of PH, such as second heart sound (S2 in pulmonary area louder than in aortic area; P2 > A2 in pulmonary area and P2 present in mitral area, were compared with Doppler echocardiographic parameters suggestive of PH. Sensitivity (S, specificity (Sp and positive (LR+ and negative (LR- likelihood ratios were evaluated. RESULTS: There was no significant correlation between S2 or P2 amplitude and PASP (pulmonary artery systolic pressure (P = 0.185 and 0.115; P= 0.13 and 0.34, respectively. Higher S2 in pulmonary area than in aortic area, compared with all the criteria suggestive of PH, showed S = 60%, Sp= 22%; LR+ = 0.7; LR- = 1.7; while P2> A2 showed S= 57%, Sp = 39%; LR+ = 0.9; LR- = 1.1; and P2 in mitral area showed: S= 68%, Sp = 41%; LR+ = 1.1; LR- = 0.7. All these signals together showed: S= 50%, Sp = 56%. CONCLUSIONS: The semiological signs indicative of PH presented low sensitivity and specificity levels for clinically diagnosing this comorbidity.

  4. Interactions between heart rate variability and pulmonary gas exchange efficiency in humans.

    Science.gov (United States)

    Sin, Peter Y W; Webber, Matthew R; Galletly, Duncan C; Ainslie, Philip N; Brown, Stephen J; Willie, Chris K; Sasse, Alexander; Larsen, Peter D; Tzeng, Yu-Chieh

    2010-07-01

    The respiratory component of heart rate variability (respiratory sinus arrhythmia, RSA) has been associated with improved pulmonary gas exchange efficiency in humans via the apparent clustering and scattering of heart beats in time with the inspiratory and expiratory phases of alveolar ventilation, respectively. However, since human RSA causes only marginal redistribution of heart beats to inspiration, we tested the hypothesis that any association between RSA amplitude and pulmonary gas exchange efficiency may be indirect. In 11 patients with fixed-rate cardiac pacemakers and 10 healthy control subjects, we recorded R-R intervals, respiratory flow, end-tidal gas tension and the ventilatory equivalents for carbon dioxide and oxygen during 'fast' (0.25 Hz) and 'slow' paced breathing (0.10 Hz). Mean heart rate, mean arterial blood pressure, mean arterial pressure fluctuations, tidal volume, end-tidal CO(2), and were similar between pacemaker and control groups in both the fast and slow breathing conditions. Although pacemaker patients had no RSA and slow breathing was associated with a 2.5-fold RSA amplitude increase in control subjects (39 +/- 21 versus 97 +/- 45 ms, P exchange efficiency during variable-frequency paced breathing observed in prior human work is not contingent on RSA being present. Therefore, whether RSA serves an intrinsic physiological function in optimizing pulmonary gas exchange efficiency in humans requires further experimental validation.

  5. Free Floating Right Heart Thrombus Associated with Acute Pulmonary Embolism: An Unsettled Therapeutic Difficulty

    Directory of Open Access Journals (Sweden)

    Clovis Nkoke

    2015-01-01

    Full Text Available Free floating right heart thrombus is a rare phenomenon in the context of acute pulmonary embolism and it is associated with a poor outcome. The increased use of echocardiography has led to an increased detection of right heart thrombi. However, optimal management of free floating right heart thrombus remains controversial with no clear consensus. We present the case of a 74-year-old woman who presented to the emergency department with acute onset dyspnea on minimal exertion which had developed over a period of 1 day. A computed tomography of the chest demonstrated massive bilateral proximal pulmonary embolism. A bedside transthoracic echocardiography performed showed a moderately dilated, poorly functioning right ventricle with visible highly mobile serpiginous thrombus moving to and fro across the tricuspid valve. Thrombolytic therapy was immediately initiated with tenecteplase which resulted in excellent results. Although there is no clear consensus for the management of right heart thrombus associated with pulmonary embolism, thrombolysis is readily available and can be effective in carefully selected patients.

  6. Fatal postoperative systemic pulmonary hypertension in benfluorex-induced valvular heart disease surgery

    Science.gov (United States)

    Baufreton, Christophe; Bruneval, Patrick; Rousselet, Marie-Christine; Ennezat, Pierre-Vladimir; Fouquet, Olivier; Giraud, Raphael; Banfi, Carlo

    2017-01-01

    Abstract Rationale: Drug-induced valvular heart disease (DI-VHD) remains an under-recognized entity. Patient concerns: This report describes a heart valve replacement which was complicated by intractable systemic pulmonary arterial hypertension in a 61-year-old female with severe restrictive mitral and aortic disease. The diagnosis of valvular disease was preceded by a history of unexplained respiratory distress. The patient had been exposed to benfluorex for 6.5 years. Diagnoses: The diagnostic procedure documented specific drug-induced valvular fibrosis. Interventions: Surgical mitral and aortic valve replacement was performed. Outcomes: Heart valve replacement was postoperatively complicated by unanticipated disproportionate pulmonary hypertension. This issue was fatal despite intensive care including prolonged extracorporeal life support. Lessons: Benfluorex is a fenfluramine derivative which has been marketed between 1976 and 2009. Although norfenfluramine is the common active and toxic metabolite of all fenfluramine derivatives, the valvular and pulmonary arterial toxicity of benfluorex was much less known than that of fenfluramine and dexfenfluramine. The vast majority of benfluorex-induced valvular heart disease remains misdiagnosed as hypothetical rheumatic fever due to similarities between both etiologies. Better recognition of DI-VHD is likely to improve patient outcome. PMID:28079786

  7. Free Floating Right Heart Thrombus Associated with Acute Pulmonary Embolism: An Unsettled Therapeutic Difficulty

    Science.gov (United States)

    Nkoke, Clovis; Faucher, Olivier; Camus, Lise; Flork, Laurence

    2015-01-01

    Free floating right heart thrombus is a rare phenomenon in the context of acute pulmonary embolism and it is associated with a poor outcome. The increased use of echocardiography has led to an increased detection of right heart thrombi. However, optimal management of free floating right heart thrombus remains controversial with no clear consensus. We present the case of a 74-year-old woman who presented to the emergency department with acute onset dyspnea on minimal exertion which had developed over a period of 1 day. A computed tomography of the chest demonstrated massive bilateral proximal pulmonary embolism. A bedside transthoracic echocardiography performed showed a moderately dilated, poorly functioning right ventricle with visible highly mobile serpiginous thrombus moving to and fro across the tricuspid valve. Thrombolytic therapy was immediately initiated with tenecteplase which resulted in excellent results. Although there is no clear consensus for the management of right heart thrombus associated with pulmonary embolism, thrombolysis is readily available and can be effective in carefully selected patients. PMID:26078887

  8. Novel Model of Pulmonary Artery Banding Leading to Right Heart Failure in Rats

    OpenAIRE

    Masataka Hirata; Daiki Ousaka; Sadahiko Arai; Michihiro Okuyama; Suguru Tarui; Junko Kobayashi; Shingo Kasahara; Shunji Sano

    2015-01-01

    Background. Congenital heart diseases often involve chronic pressure overload of the right ventricle (RV) which is a major cause of RV dysfunction. Pulmonary artery (PA) banding has been used to produce animal models of RV dysfunction. We have devised a new and easier method of constricting the PA and compared it directly with the partial ligation method. Methods. Eight-week-old male Sprague-Dawley rats (240–260 g) were divided into three groups: sham operation, partial pulmonary artery ligat...

  9. Reversal of echocardiographic right-sided heart pathology in a dog with severe pulmonary hypertension: a case report

    Directory of Open Access Journals (Sweden)

    McMahon P

    2015-06-01

    Full Text Available Peggy McMahon,1 Carley Saelinger 2  1Emergency and Critical Care Department, 2Cardiology Department, Animal Specialty and Emergency Center, Los Angeles, CA, USA Abstract: Pathologic right-sided heart changes are a common echocardiographic finding in patients with pulmonary hypertension (PH. Canines with PH may have right heart pathology documented via echocardiographic color Doppler interrogation including tricuspid valve regurgitation, pulmonic valve insufficiency, elevated pulmonary arterial systolic pressure, elevated pulmonary arterial diastolic pressure, and alterations in ejection profiles. Two-dimensional echocardiographic findings may include right ventricular hypertrophy, interventricular septal flattening, paradoxical interventricular septal motion, pulmonary artery dilation, and potentially abnormal left heart dimensions. In veterinary medicine, much confidence is given to the measurement of pulmonary arterial systolic pressure estimated from tricuspid valve regurgitation to grade the severity of PH and monitor its improvement with little emphasis placed on the integration of two-dimensional echocardiographic right and left heart pathology in conjunction with Doppler findings. To the authors’ knowledge, marked improvement and/or resolution of echocardiographic-documented right heart pathology have not been previously reported in the veterinary literature. This case report documents profound echocardiographic improvement of right-sided heart disease in a dog with severe PH. Keywords: canine, pulmonary hypertension, tricuspid valve regurgitation, right heart hypertrophy, sildenafil  

  10. Stress failure of pulmonary capillaries: role in lung and heart disease

    Science.gov (United States)

    West, J. B.; Mathieu-Costello, O.

    1992-01-01

    Pulmonary capillaries have extremely thin walls to allow rapid exchange of respiratory gases across them. Recently it has been shown that the wall stresses become very large when the capillary pressure is raised, and in anaesthetised rabbits, ultrastructural damage to the walls is seen at pressures of 40 mm Hg and above. The changes include breaks in the capillary endothelial layer, alveolar epithelial layer, and sometimes all layers of the wall. The strength of the thin part of the capillary wall can be attributed to the type IV collagen in the extracellular matrix. Stress failure of pulmonary capillaries results in a high-permeability form of oedema, or even frank haemorrhage, and is apparently the mechanism of neurogenic pulmonary oedema and high-altitude pulmonary oedema. It also explains the exercise-induced pulmonary haemorrhage that occurs in all racehorses. Several features of mitral stenosis are consistent with stress failure. Overinflation of the lung also leads to stress failure, a common cause of increased capillary permeability in the intensive care environment. Stress failure also occurs if the type IV collagen of the capillary wall is weakened by autoantibodies as in Goodpasture's syndrome. Neutrophil elastase degrades type IV collagen and this may be the starting point of the breakdown of alveolar walls that is characteristic of emphysema. Stress failure of pulmonary capillaries is a hitherto overlooked and potentially important factor in lung and heart disease.

  11. 'End-stage' heart failure therapy: potential lessons from congenital heart disease: from pulmonary artery banding and interatrial communication to parallel circulation.

    Science.gov (United States)

    Schranz, Dietmar; Akintuerk, Hakan; Voelkel, Norbert F

    2017-02-15

    The final therapy of 'end-stage heart failure' is orthotopic heart, lung or heart-lung transplantation. However, these options are not available for many patients worldwide. Therefore, novel therapeutical strategies are needed. Based on pathophysiological insights regarding (1) the long-term impact of an obstructive pulmonary outflow tract in neonates with congenitally corrected transposition of the great arteries, (2) the importance of a restrictive versus a non-restrictive atrial septum in neonates born with a borderline left ventricle and (3) the significance of both, a patent foramen ovale and/or open ductus arteriosus for survival of newborns with persistent pulmonary hypertension, the current review introduces some therapeutical strategies that may be applicable to selected patients with heart failure. These strategies include (1) reversible pulmonary artery banding in left ventricular-dilated cardiomyopathy with preserved right ventricular function, (2) the creation of restrictive interatrial communication to treat diastolic (systolic) heart failure, (3) atrioseptostomy or reverse Potts shunt in pulmonary arterial hypertension and (4) return to a fetal, parallel circulation by combining atrioseptostomy and reversed Potts shunt with or without placement of a bilateral pulmonary artery banding. While still being experimental, it is hoped that the procedures presented in the current overview will inspire future novel therapeutic strategies that may be applicable to selected patients with heart failure.

  12. Prognostic Value of Pulmonary Vascular Resistance by Magnetic Resonance in Systolic Heart Failure

    Energy Technology Data Exchange (ETDEWEB)

    Fabregat-Andrés, Óscar, E-mail: osfabregat@gmail.com [Departamento de Cardiologia - Hospital General Universitario de Valencia, Valencia (Spain); Fundación para la Investigación - Hospital General Universitario de Valencia, Valencia (Spain); Estornell-Erill, Jordi [Unidad de Imagen Cardiaca - ERESA - Hospital General Universitario de Valencia, Valencia (Spain); Ridocci-Soriano, Francisco [Departamento de Cardiologia - Hospital General Universitario de Valencia, Valencia (Spain); Departamento de Medicina. Universitat de Valencia, Valencia (Spain); Pérez-Boscá, José Leandro [Departamento de Cardiologia - Hospital General Universitario de Valencia, Valencia (Spain); García-González, Pilar [Unidad de Imagen Cardiaca - ERESA - Hospital General Universitario de Valencia, Valencia (Spain); Payá-Serrano, Rafael [Departamento de Cardiologia - Hospital General Universitario de Valencia, Valencia (Spain); Departamento de Medicina. Universitat de Valencia, Valencia (Spain); Morell, Salvador [Departamento de Cardiologia - Hospital General Universitario de Valencia, Valencia (Spain); Cortijo, Julio [Fundación para la Investigación - Hospital General Universitario de Valencia, Valencia (Spain); Departamento de Farmacologia. Universitat de Valencia, Valencia (Spain)

    2016-03-15

    Pulmonary hypertension is associated with poor prognosis in heart failure. However, non-invasive diagnosis is still challenging in clinical practice. We sought to assess the prognostic utility of non-invasive estimation of pulmonary vascular resistances (PVR) by cardiovascular magnetic resonance to predict adverse cardiovascular outcomes in heart failure with reduced ejection fraction (HFrEF). Prospective registry of patients with left ventricular ejection fraction (LVEF) < 40% and recently admitted for decompensated heart failure during three years. PVRwere calculated based on right ventricular ejection fraction and average velocity of the pulmonary artery estimated during cardiac magnetic resonance. Readmission for heart failure and all-cause mortality were considered as adverse events at follow-up. 105 patients (average LVEF 26.0 ±7.7%, ischemic etiology 43%) were included. Patients with adverse events at long-term follow-up had higher values of PVR (6.93 ± 1.9 vs. 4.6 ± 1.7estimated Wood Units (eWu), p < 0.001). In multivariate Cox regression analysis, PVR ≥ 5 eWu(cutoff value according to ROC curve) was independently associated with increased risk of adverse events at 9 months follow-up (HR2.98; 95% CI 1.12-7.88; p < 0.03). In patients with HFrEF, the presence of PVR ≥ 5.0 Wu is associated with significantly worse clinical outcome at follow-up. Non-invasive estimation of PVR by cardiac magnetic resonance might be useful for risk stratification in HFrEF, irrespective of etiology, presence of late gadolinium enhancement or LVEF.

  13. [Pulmonary artery wedge pressure and heart rate measurement during pharmacological stress induction for left cardial function diagnosis in horses with and without heart disease].

    Science.gov (United States)

    Gehlen, H; Groner, U; Rohn, K; Stadler, P

    2006-07-01

    In 18 horses, the pulmonary artery wedge pressure and the heart rate were measured during pharmacological stress load. 12 horses were healthy (4 trained, 8 untrained) and 6 horses had a heart disease (3 trained, 3 untrained). Pharmacological stress induction was carried out with the sympathomimetic drug dobutamine at a dosage rate of 7.5 microg/kg/min over 10 minutes of infusion. At the fourth minute, the parasympatholytic drug atropine was administered (5 microg/kg bw), and the heart rate and the pulmonary artery wedge pressure were continuously measured over 26 minutes. During sole dobutamine infusion, a significant decrease in heart rate and a significant increase in pulmonary artery wedge pressure were observed. After the application of atropine in the fourth minute, a significant increase in heart rate (from 35.7 +/- 6 up to 106 +/- 38/ min) and in pulmonary artery wedge pressure (from 15.7 +/- 3 up to 24 +/- 8.6 mmHg) were visible in the group of healthy horses. The horses with heart diseases had a significantly higher increase in both parameters (heart rate and pulmonary artery wedge pressure) with a significantly positive correlation (r = 0.7). The heart rate increased in the horses with heart diseases from 35.2 +/- 2,8 beats/min up to 132 +/- 45.7 beats/min and the pulmonary artery wedge pressure increased from 17.3 +/- 3,2 mmHg up to 32.7 +/- 13 mmHg. The cardiac status (healthy or heart disease) as well as the training level of the horses (untrained or trained) had a significant influence on the heart rate and the pulmonary artery wedge pressure. The untrained horses (healthy and heart disease) showed significantly higher values over a longer period of time than did the trained horses with the same cardiac status. Additionally the influence of pharmacological stress induction on echocardiographic parameters was investigated. The left atrial size (p = 0.015) and left ventricular diameter were significanly different in the systole (p = 0.008) and in the

  14. Perspectives on novel therapeutic strategies for right heart failure in pulmonary arterial hypertension: lessons from the left heart

    Directory of Open Access Journals (Sweden)

    M. L. Handoko

    2010-03-01

    Full Text Available Right heart function is the main determinant of prognosis in pulmonary arterial hypertension (PAH. At present, no treatments are currently available that directly target the right ventricle, as we will demonstrate in this article. Meta-analysis of clinical trials in PAH revealed that current PAH medication seems to have limited cardiac-specific effects when analysed by the pump-function graph. Driven by the hypothesis that "left" and right heart failure might share important underlying pathophysiological mechanisms, we evaluated the clinical potential of left heart failure (LHF therapies for PAH, based on currently available literature. As in LHF, the sympathetic nervous system and the renin–angiotension–aldosterone system are highly activated in PAH. From LHF we know that intervening in this process, e.g. by angiotensin-converting enzyme inhibition or β-blockade, is beneficial in the long run. Therefore, these medications could be also beneficial in PAH. Furthermore, the incidence of sudden cardiac death in PAH could be reduced by implantable cardioverter-defibrillators. Finally, pilot studies have demonstrated that interventricular dyssynchrony, present at end-stage PAH, responded favourably to cardiac resynchronisation therapy as well. In conclusion, therapies for LHF might be relevant for PAH. However, before they can be implemented in PAH management, safety and efficacy should be evaluated first in well-designed clinical trials.

  15. Non-invasive estimation of pulmonary vascular resistance in patients of pulmonary hypertension in congenital heart disease with unobstructed pulmonary flow

    Directory of Open Access Journals (Sweden)

    Arindam Pande

    2014-01-01

    Full Text Available Context: Pulmonary vascular resistance (PVR is a critical and essential parameter during the assessment and selection of modality of treatment in patients with congenital heart disease accompanied by pulmonary arterial hypertension. Aim: The present study was planned to evaluate non-invasive echocardiographic parameters to assess pulmonary vascular resistance. Settings and Design: This prospective observational study included 44 patients admitted in the cardiology and pediatric cardiology ward of our institution for diagnostic or pre-operative catheter based evaluation of pulmonary arterial pressure and PVR. Materials and Methods: Detailed echocardiographic evaluation was carried out including tricuspid regurgitation velocity (TRV and velocity time integral of the right-ventricular outflow tract (VTI RVOT . These parameters were correlated with catheter-based measurements of PVR. Results: The TRV/VTI RVOT ratio correlated well with PVR measured at catheterization (PVRcath (r = 0.896, 95% confidence interval [CI] 0.816 to 0.9423, P < 0.001. Using the Bland-Altman analysis, PVR measurements derived from Doppler data showed satisfactory limits of agreement with catheterization estimated PVR. For a PVR of 6 Wood units (WU, a TRV/VTI RVOT value of 0.14 provided a sensitivity of 96.67% and a specificity of 92.86% (area under the curve 0.963, 95% confidence interval 0.858 to 0.997 and for PVR of 8 WU a TRV/VTI RVOT value of 0.17 provided a sensitivity of 79.17% and a specificity of 95% (area under the curve 0. 0.923, 95% confidence interval 0.801 to 0.982. Conclusions: Doppler-derived ratio of TRV/VTI RVOT is a simple, non-invasive index, which can be used to estimate PVR.

  16. Efficacy of pimobendan on survival and reoccurrence of pulmonary edema in canine congestive heart failure.

    Science.gov (United States)

    Mizuno, Masashi; Yamano, Shigeki; Chimura, Shuichi; Hirakawa, Atsushi; Takusagawa, Yoshimi; Sawada, Tamotsu; Maetani, Shigeki; Takahashi, Arane; Mizuno, Takeshi; Harada, Kayoko; Shinoda, Asako; Uchida, Shuhei; Takeuchi, Junichiro; Mizukoshi, Takahiro; Endo, Masaaki; Uechi, Masami

    2017-01-20

    The aim of this study was to evaluate the efficacy of pimobendan with conventional therapies on survival and reocurrence of pulmonary edema in dogs with congestive heart failure (CHF) caused by myxomatous mitral valve disease (MMVD). Records of 197 client-owned dogs from 14 veterinary hospitals were included in this study. Dogs were administered conventional treatments with or without pimobendan. Sixty-four dogs received a standard dose of pimobendan (0.20-0.48 mg/kg every 12 hr (q12hr)), 49 dogs received a low dose of pimobendan (0.05-0.19 mg/kg q12hr), and 84 dogs received conventional therapy alone. Dogs in the standard-dose and low-dose pimobendan groups had significantly longer median survival times than dogs in the conventional group (334, 277 and 136 days, respectively; P<0.001). The reoccurrence rate of pulmonary edema in the standard-dose group was significantly lower than in the low-dose and conventional groups (43%, 59% and 62%, respectively; P<0.05). Combination of pimobendan with a conventional treatment regimen significantly prolonged survival time after an initial episode of pulmonary edema in dogs with CHF caused by MMVD. There was no difference in survival between dogs administered standard and low doses of pimobendan, but pimobendan did prevent the reoccurrence of pulmonary edema in a dose-dependent manner.

  17. Simultaneous transcatheter closure of intralobar pulmonary sequestration and patent ductus arteriosus in a patient with infantile Scimitar syndrome.

    Science.gov (United States)

    Aslan, Eyüp; Tanıdır, İbrahim Cansaran; Saygı, Murat; Onan, Sertaç Hanedan; Güzeltaş, Alper

    2015-03-01

    Scimitar syndrome is a rare disease associated with a right lung sequestration vascularised by arteries arising from the abdominal aorta and abnormal venous drainage into the inferior vena cava. The infantile form is generally presented with severe heart failure, pulmonary hypertension and respiratory distress. It may be associated with various intracardiac defects, including atrial septal defects, ventricular septal defects, patent ductus arteriosus or more complicated structural congenital heart defects. Here, we present a 2-month-old girl with Scimitar syndrome whose pulmonary arterial pressure decreased after transcatheter patent ductus arteriosus closure and embolization of the anomalous systemic arterial supply.

  18. Acute Pulmonary Thromboembolism Presenting As Complete Heart Block - A Rare Presentation

    Directory of Open Access Journals (Sweden)

    Vikash Goyal

    2015-08-01

    Full Text Available Acute pulmonary thromboembolism (PTE is a life threatening condition which requires early diagnosis and management. Electrocardiogram (ECG is helpful for suspecting the disease. The various ECG changes are sinus tachycardia, P pulmonale, Right bundle branch block (RBBB -incomplete or complete, axis shift, S1Q3T3, T wave inversion, and ST-segment depression in leads V1-4, aVF, and Lead III, supra ventricular tachycardia, low voltage QRS complex in limb leads. In addition, sinus bradycardia and complete heart block (CHB can be seen. CHB has been reported as an exceptionally rare manifestation of acute PTE. Here, we are reporting a case of 66 year old male presented with CHB with acute pulmonary thromboembolism, who reverted to sinus rhythm after thrombolysis.

  19. Right heart function during simulated altitude in patients with pulmonary arterial hypertension

    Science.gov (United States)

    Seccombe, Leigh M; Chow, Vincent; Zhao, Wei; Lau, Edmund M T; Rogers, Peter G; Ng, Austin C C; Veitch, Elizabeth M; Peters, Matthew J; Kritharides, Leonard

    2017-01-01

    Objective Patients with pulmonary arterial hypertension (PAH) are often recommended supplemental oxygen for altitude travel due to the possible deleterious effects of hypoxia on pulmonary haemodynamics and right heart function. This includes commercial aircraft travel; however, the direct effects and potential risks are unknown. Methods Doppler echocardiography and gas exchange measures were investigated in group 1 patients with PAH and healthy patients at rest breathing room air and while breathing 15.1% oxygen, at rest for 20 min and during mild exertion. Results The 14 patients with PAH studied were clinically stable on PAH-specific therapy, with functional class II (n=11) and III (n=3) symptoms when tested. Measures of right ventricular size and function were significantly different in the PAH group at baseline as compared to 7 healthy patients (p<0.04). There was no evidence of progressive right ventricular deterioration during hypoxia at rest or under exertion. Pulmonary arterial systolic pressure (PASP) increased in both groups during hypoxia (p<0.01). PASP in hypoxia correlated strongly with baseline PASP (p<0.01). Pressure of arterial oxygen correlated with PASP in hypoxia (p<0.03) but not at baseline, with three patients with PAH experiencing significant desaturation. The duration and extent of hypoxia in this study was tolerated well despite a mild increase in symptoms of breathlessness (p<0.01). Conclusions Non-invasive measures of right heart function in group 1 patients with PAH on vasodilator treatment demonstrated a predictable rise in PASP during short-term simulated hypoxia that was not associated with a deterioration in right heart function. PMID:28123765

  20. Haemodynamic characterisation and heart catheterisation complications in children with pulmonary hypertension : Insights from the Global TOPP Registry (tracking outcomes and practice in paediatric pulmonary hypertension)

    NARCIS (Netherlands)

    Beghetti, M.; Schulze-Neick, I.; Berger, R. M. F.; Ivy, D. D.; Bonnet, D.; Weintraub, R. G.; Saji, T.; Yung, D.; Mallory, G. B.; Geiger, R.; Berger, J. T.; Barst, R. J.; Humpl, T.; Mattos, S.; Jing, Z. C.; Han, Z. Y.; Sondergaard, L.; Jensen, T.; Levy, M.; Mebus, S.; Apitz, Ch.; Szatmari, A.; Ablonczy, L.; Milanesi, O.; Favero, V.; Pulido, T.; De La Garza, P.; Douwes, J. M.; Brun, H.; Moll, L.; Michalak, K.; Kawalec, W.; Zuk, M.; Boillat, M. Fasnacht; Olgunturk, R.; Kula, S. Serdar; Alehan, D.; Day, R. W.; Austin, E.; Moore, D. J.; Atz, A. M.; Feinstein, J. A.

    2016-01-01

    Background: The TOPP Registry has been designed to provide epidemiologic, diagnostic, clinical, and outcome data on children with pulmonary hypertension (PH) confirmed by heart catheterisation (HC). This study aims to identify important characteristics of the haemodynamic profile at diagnosis and HC

  1. EFFECT OF BRONCHODILATORS ON HEART RATE VARIABILITY IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

    Directory of Open Access Journals (Sweden)

    H. H. Shugushev

    2015-12-01

    Full Text Available Aim. To study effect of long-acting theophylline (Theotard, KRKA and combination of salmeterol and fluticasone (Seretide, GlaxoSmithKline on heart rhythm variability (HRV and number of arrhythmic episodes in patients with chronic obstructive pulmonary disease (COPD.Material and methods. 144 patients with COPD and 35 patients of control group were examined. The analysis of HRV and Holter monitoring were made f on 2th and 14th days.Results. Treatment with both drugs led to increase in power of low- and high frequencies and their ratio (LF/HF, decrease in rate of supraventricular and ventricular arrhythmias. Theophylline therapy raised in a number of single and pair supraventricular extrasystoles. Treatment with combination of salmeterol and fluticasone did not change a number of extrasystoles.Conclusion. Combination of salmeterol and fluticasone is more preferable as a broncholytic therapy for patients with COPD and heart rhythm disorders.

  2. Combination of balanced ultrafiltration with modified ultrafiltration attenu-ates pulmonary injury in patients undergoing open heart surgery

    Institute of Scientific and Technical Information of China (English)

    黄惠民; 姚廷俊; 王伟; 朱德明; 张蔚; 陈虹; 付维定

    2003-01-01

    Objective To explore the effects of ultrafiltration technique in preventing and relieving pulmonary injury in children undergoing open heart surgery and cardiopulmonary bypass (CPB).Methods Thirty cases with congenital heart defects were divided into a control group and an experimental group. In the control group, conventional cardiopulmonary bypass was used without ultrafiltration; while in the experimental group, cardiopulmonary bypass with balanced ultrafiltration and modified ultrafiltration were used. Pulmonary static compliance (Cstat), airway resistance (Raw), alveolar-arterial oxygen difference (A-a DO2), hematocrit (HCT), serum albumin (Alb), interleukin-6 (IL-6), endothelia-1 (ET-1) and thromboxane (TXB2) were measured. Results The pulmonary function was improved, HCT and serum albumin concentrations were increased, and some harmful medium-size solutes were decreased in the experimental groups compared with the control group.Conclusions Combination of balanced ultrafiltration with modified ultrafiltration can effectively concentrate blood, exclude harmful inflammatory mediators, and attenuate lung edema and inflammatory responsive pulmonary injury.

  3. Resting heart rate is a risk factor for mortality in chronic obstructive pulmonary disease, but not for exacerbations or pneumonia

    DEFF Research Database (Denmark)

    Warnier, Miriam J; Rutten, Frans H; de Boer, Anthonius

    2014-01-01

    BACKGROUND: Although it is known that patients with chronic obstructive pulmonary disease (COPD) generally do have an increased heart rate, the effects on both mortality and non-fatal pulmonary complications are unclear. We assessed whether heart rate is associated with all-cause mortality, and non...... and information on complications (exacerbation of COPD or pneumonia) by scrutinizing patient files of general practitioners. Multivariable cox regression analysis was performed. RESULTS: During the follow-up 132 (33%) patients died. The overall mortality rate was 50/1000 py (42-59). The major causes of death were...... did not result in an increased risk of exacerbations or pneumonia. This may indicate that the increased mortality risk of COPD is related to non-pulmonary causes. Future randomized controlled trials are needed to investigate whether heart-rate lowering agents are worthwhile for COPD patients....

  4. 犬急性肺动脉高压模型上腔静脉多普勒血流速度频谱变化规律研究%Study of superior vena cava Doppler flow velocity spectrum in the canine model of acute pulmonary hypertension

    Institute of Scientific and Technical Information of China (English)

    孙丹丹; 段云友; 陈洪茂; 袁丽君; 梁宁南; 尚福军; 侯娜

    2011-01-01

    Objective To explore the relationship between the pulmonary artery pressure and the changes of spectrum of superior vena cava( SVC )blood flow in the canine model of acute thromboembolic pulmonary hypertension ( ATEPH ). Methods A canine model of ATEPH was developed by infusing thrombus into the femoral vein. The pulmonary arterial pressure was simultaneously measured via the right heart catheter. The maximum systolic peak flow velocity( S ), diastolic peak flow velocityC D ), atrial reverse peak flow velocityC AR ), and ventricular reverse peak flow velocity( VR )of the SVC were measured by Doppler echocardiography in the right supraclavicular fossa view. Paired samples f-test was used to compare the parameters before and after ATEPH. Simple linear regression was used to analyze the relations of the Doppler spectral indexes with the PASP. Results The models were successfully established in 24 dogs with the peak value of pulmonary arterial systolic pressure ( PASP ) greater than 30 mm Hg. Compared with the pre-embolization: S significantly decreased in the moderate and severe pulmonary hypertension group [( 15. 37 ± 8.08 ),( 14.72 ±7.42 ),( 19.92 ±7.27 )cm/s,f =2. 055,2.265,aU P <0.05 ],AR was significantly higher in the moderate and severe hypertension group[ ( 14. 08 ± 5.30),(21.84±6.56),(l0.05±2.8l)cm/s,f = -3.155, -8. 892,all P <0.05 ], VR was significantly higher in the severe pulmonary hypertension group[ ( 13. 03 ± 6.67),(8.87±2. 88)cm/s,f = -2. 101,P<0. 05 ]. The ratios of AR/S and VR/S increased significantly with the increase of PASP, and was positively correlated with PASP( r = 0.693,0.646, all P < 0. 01 ). Conclusion The ratios of AR/S and VR/S have good correlations with the pulmonary artery systolic pressure, and may provide good indexes for the assessment of pulmonary artery pressure.%目的 探索犬血栓栓塞性肺动脉高压模型上腔静脉血流频谱的变化规律及意义.方法 通过股静脉注入血栓栓子建立犬血栓栓

  5. Clinical results of combined palliative procedures for cyanotic congenital heart defects with intractable hypoplasia of pulmonary arteries

    Institute of Scientific and Technical Information of China (English)

    FAN Xiang-ming; ZHU Yao-bin; SU Jun-wu; ZHANG Jing; LI Zhi-qiang; XU Yao-qiang; LI Xiao-feng

    2013-01-01

    Background Congenital heart defects with intractable hypoplasia of the pulmonary arteries without intercourse or with intercourse stenosis is unsuitable for surgical correction or regular palliative procedures.We reported our experience with combined palliative procedures for congenital heart defects with intractable hypoplasia pulmonary arteries.Methods From 2001 to 2012,a total of 41 patients with cyanotic congenital heart defects and intractable hypoplasia of the pulmonary arteries underwent surgical procedures.From among them,31 patients had pulmonary atresia with ventricular septal defect (VSD) and the other 10 cases had complicated congenital heart defects with pulmonary stenosis.Different kinds of palliative procedures were performed according to the morphology of the right and left pulmonary arteries in every patient.If the pulmonary artery was well developed,a Glenn procedure was performed.A modified Blalock-Taussi9 shunt or modified Waterston shunt was performed if pulmonary arteries were hypoplastic.If the pulmonary arteries were severely hypoplastic,a Melbourne shunt was performed.Systemic pulmonary artery shunts were performed bilaterally in 25 cases.A systemic-pulmonary shunt was performed on one side and a Glenn procedure was performed contralaterally in 16 cases.Major aortopulmonary collateral arteries were unifocalized in six cases,ligated in two cases and interventionally embolized in two cases.There was one early death because of cardiac arrest and the hospital mortality was 2.4%.Results Five patients suffered from postoperative low cardiac output syndrome,three had perfusion of the lungs,and two pulmonary infections.Systemic pulmonary shunts were repeated after the original operation in three cases due to the occlusion of conduits.The mean follow-up time was 25 months.The pre-and the post-operation left pulmonary indices were (8.13±3.68) vs.(14.9±6.21) mm2/m2.The pre-and post-operation right pulmonary indices were (12.7±8.13) vs.(17.7±7

  6. Successful matrix guided tissue regeneration of decellularized pulmonary heart valve allografts in elderly sheep.

    Science.gov (United States)

    Theodoridis, Karolina; Tudorache, Igor; Calistru, Alexandru; Cebotari, Serghei; Meyer, Tanja; Sarikouch, Samir; Bara, Christoph; Brehm, Ralph; Haverich, Axel; Hilfiker, Andres

    2015-06-01

    In vivo repopulation of decellularized allografts with recipient cells leads to a positive remodeling of the graft matrix in juvenile sheep. In light of the increasing number of heart valve replacements among older patients (>65 years), this study focused on the potential for matrix-guided tissue regeneration in elderly sheep. Pulmonary valve replacement was performed in seven-year old sheep using decellularized (DV), decellularized and CCN1-coated (RV), or decellularized and in vitro reendothelialized pulmonary allografts (REV) (n=6, each group). CCN1 coating was applied to support re-endothelialization. In vitro re-endothelialization was conducted with endothelial-like cells derived from peripheral blood. Echocardiograms of all grafts showed adequate graft function after implantation and at explantation 3 or 6 months later. All explants were macroscopically free of thrombi at explantation, and revealed repopulation of the allografts on the adventitial side of valvular walls and proximal in the cusps. Engrafted cells expressed vimentin, sm α-actin, and myosin heavy chain 2, while luminal cell lining was positive for vWF and eNOS. Cellular repopulation of valvular matrix demonstrates the capacity for matrix-guided regeneration even in elderly sheep but is not improved by in vitro endothelialization, confirming the suitability of decellularized matrix for heart valve replacement in older individuals.

  7. Association of chronic mucus hypersecretion with FEV1 decline and chronic obstructive pulmonary disease morbidity. Copenhagen City Heart Study Group

    DEFF Research Database (Denmark)

    Vestbo, J; Prescott, E; Lange, P

    1996-01-01

    The aim of this study was to examine the association between chronic mucus hypersecretion, and FEV1 decline, and subsequent hospitalization from chronic obstructive pulmonary disease (COPD). We used data from The Copenhagen City Heart Study on 5,354 women and 4,081 men 30 to 79 yr of age with ass......The aim of this study was to examine the association between chronic mucus hypersecretion, and FEV1 decline, and subsequent hospitalization from chronic obstructive pulmonary disease (COPD). We used data from The Copenhagen City Heart Study on 5,354 women and 4,081 men 30 to 79 yr of age...

  8. The unequal influences of the left and right vagi on the control of the heart and pulmonary artery in the rattlesnake, Crotalus durissus

    DEFF Research Database (Denmark)

    Taylor, E.W.; Andrade, Denis V.; Abe, Augusto A.

    2009-01-01

    Autonomic control of the cardiovascular system in reptiles includes sympathetic components but heart rate (fH), pulmonary blood flow ( 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...

  9. How the python heart separates pulmonary and systemic blood pressures and blood flows.

    Science.gov (United States)

    Jensen, Bjarke; Nielsen, Jan M; Axelsson, Michael; Pedersen, Michael; Löfman, Carl; Wang, Tobias

    2010-05-01

    The multiple convergent evolution of high systemic blood pressure among terrestrial vertebrates has always been accompanied by lowered pulmonary pressure. In mammals, birds and crocodilians, this cardiac separation of pressures relies on the complete division of the right and left ventricles by a complete ventricular septum. However, the anatomy of the ventricle of most reptiles does not allow for complete anatomical division, but the hearts of pythons and varanid lizards can produce high systemic blood pressure while keeping the pulmonary blood pressure low. It is also known that these two groups of reptiles are characterised by low magnitudes of cardiac shunts. Little, however, is known about the mechanisms that allow for this pressure separation. Here we provide a description of cardiac structures and intracardiac events that have been revealed by ultrasonic measurements and angioscopy. Echocardiography revealed that the atrioventricular valves descend deep into the ventricle during ventricular filling and thereby greatly reduce the communication between the systemic (cavum arteriosum) and pulmonary (cavum pulmonale) ventricular chambers during diastole. Angioscopy and echocardiography showed how the two incomplete septa, the muscular ridge and the bulbuslamelle - ventricular structures common to all squamates - contract against each other in systole and provide functional division of the anatomically subdivided ventricle. Washout shunts are inevitable in the subdivided snake ventricle, but we show that the site of shunting, the cavum venosum, is very small throughout the cardiac cycle. It is concluded that the python ventricle is incapable of the pronounced and variable shunts of other snakes, because of its architecture and valvular mechanics.

  10. Management of patients with pulmonary arterial hypertension due to congenital heart disease: recent advances and future directions.

    Science.gov (United States)

    Blok, Ilja M; van Riel, Annelieke C M J; Mulder, Barbara J M; Bouma, Berto J

    2015-12-01

    Pulmonary arterial hypertension is a serious complication of adult congenital heart disease associated with systemic-to-pulmonary shunts. Although early shunt closure restricts development of pulmonary arterial hypertension, patients remain at risk even after repair. The development of pulmonary arterial hypertension is associated with a markedly increased morbidity and mortality. It is important to identify patients with a poor prognosis using disease specific markers. Echocardiography and biomarkers arise as practical tools to determine the risk of mortality. Although pulmonary arterial hypertension cannot be cured, four classes of disease-targeting therapies are currently available and several promising therapies are being studied. There is a shift in drug studies towards more clinically relevant endpoints such as time to clinical worsening and morbidity and mortality events.

  11. Chest ultrasonography in emergency Cesarean delivery in multi-valvular heart disease with pulmonary edema during spinal anesthesia.

    Science.gov (United States)

    Samanta, Sukhen; Samanta, Sujay; Ghatak, Tanmoy; Grover, V K

    2014-05-01

    Valvular heart disease in a parturient presenting for Cesarean section is challenging. A 25 year old primigravida parturient with severe mitral stenosis, mild mitral regurgitation, mild aortic regurgitation, and mild pulmonary arterial hypertension required Cesarean delivery after developing pulmonary edema. Low-dose spinal with hyperbaric bupivacine 0.5% 1.8 mL plus 25 μg of fentanyl was used for anesthesia. Chest ultrasonography (US) and transthoracic echocardiography (TTE) were used for monitoring purposes. Spinal-induced preload reduction improved the pulmonary edema, as evidenced by chest US. Chest US and TTE helped in fluid management.

  12. Evolving hybrid approaches: the preservation of the 'neglected' pulmonary valve function in patients with congenital heart disease.

    Science.gov (United States)

    Vida, Vladimiro L; Bacha, Emile; Stellin, Giovanni

    2016-07-01

    The involvement of the hemodynamic expertise in the operating room led to the development of new strategies aimed to improve both early and long-term outcome of patients with congenital heart disease. During the last decade, with the aim of preserving the pulmonary valve function, we embarked on a new surgical approach, which combines surgical and interventional techniques, which are performed in the operating room. We believe that the preservation of the pulmonary valve function can be extended to any patients with classic tetralogy of Fallot and other selected patients with congenital pulmonary valve hypoplasia and dysfunction.

  13. Dual energy CT pulmonary blood volume assessment in acute pulmonary embolism - correlation with D-dimer level, right heart strain and clinical outcome

    Energy Technology Data Exchange (ETDEWEB)

    Bauer, Ralf W.; Frellesen, Claudia; Schell, Boris; Lehnert, Thomas; Jacobi, Volkmar; Vogl, Thomas J.; Kerl, J.M. [Clinic of the Goethe University, Department of Diagnostic and Interventional Radiology, Frankfurt (Germany); Renker, Matthias [Clinic of the Goethe University, Department of Diagnostic and Interventional Radiology, Frankfurt (Germany); Medical University of South Carolina, Heart and Vascular Center, Ashley River Tower, Charleston, SC (United States); Ackermann, Hanns [Clinic of the Goethe University, Department of Biostatistics and Mathematical Modelling, Frankfurt (Germany); Schoepf, U.J. [Medical University of South Carolina, Heart and Vascular Center, Ashley River Tower, Charleston, SC (United States)

    2011-09-15

    To investigate the role of perfusion defect (PD) size on dual energy CT pulmonary blood volume assessment as predictor of right heart strain and patient outcome and its correlation with d-dimer levels in acute pulmonary embolism (PE). 53 patients with acute PE who underwent DECT pulmonary angiography were retrospectively analyzed. Pulmonary PD size caused by PE was measured on DE iodine maps and quantified absolutely (VolPD) and relatively to the total lung volume (RelPD). Signs of right heart strain (RHS) on CT were determined. Information on d-dimer levels and readmission for recurrent onset of PE and death was collected. D-dimer level was mildly (r = 0.43-0.47) correlated with PD size. Patients with RHS had significantly higher VolPD (215 vs. 73 ml) and RelPD (9.9 vs. 2.9%) than patients without RHS (p < 0.003). There were 2 deaths and 1 readmission due of PE in 18 patients with >5% RelPD, while no such events were found for patients with <5% RelPD. Pulmonary blood volume on DECT in acute PE correlates with RHS and appears to be a predictor of patient outcome in this pilot study. (orig.)

  14. Role of hybrid operating room in surgery for the right atrial thrombus, pulmonary thrombi, and ventricular septal rupture after myocardial infarction

    Science.gov (United States)

    Singh, Ajmer; Mehta, Yatin; Parakh, Rajiv; Kohli, Vijay; Trehan, Naresh

    2016-01-01

    Free-floating right heart thrombi are uncommon and need emergency treatment in view of their tendency to dislodge and cause pulmonary embolism. We report a successful surgical management of a patient who had large mobile right atrial thrombus, bilateral pulmonary thrombi, coronary artery disease, and postmyocardial infarction ventricular septal rupture (VSR). The patient underwent coronary angiography, inferior vena cava filter placement, removal of thrombi from the right atrium and pulmonary arteries, repair of VSR, and coronary artery bypass graft surgery in a hybrid operating room. PMID:27716704

  15. Reversal of echocardiographic right-sided heart pathology in a dog with severe pulmonary hypertension: a case report

    OpenAIRE

    McMahon P; Saelinger C

    2015-01-01

    Peggy McMahon,1 Carley Saelinger 2  1Emergency and Critical Care Department, 2Cardiology Department, Animal Specialty and Emergency Center, Los Angeles, CA, USA Abstract: Pathologic right-sided heart changes are a common echocardiographic finding in patients with pulmonary hypertension (PH). Canines with PH may have right heart pathology documented via echocardiographic color Doppler interrogation including tricuspid valve regurgitation, pulmonic valve insufficiency, elevat...

  16. Pulmonary hypertension

    Science.gov (United States)

    ... that damage the lungs, such as scleroderma and rheumatoid arthritis Birth defects of the heart Blood clots in the lung ( pulmonary embolism ) Heart failure Heart valve disease HIV infection Low oxygen levels in the blood ...

  17. Genistein, a soy phytoestrogen, reverses severe pulmonary hypertension and prevents right heart failure in rats.

    Science.gov (United States)

    Matori, Humann; Umar, Soban; Nadadur, Rangarajan D; Sharma, Salil; Partow-Navid, Rod; Afkhami, Michelle; Amjedi, Marjan; Eghbali, Mansoureh

    2012-08-01

    Pretreatment with a phytoestrogen genistein has been shown to attenuate the development of pulmonary hypertension (PH). Because PH is not always diagnosed early, we examined whether genistein could also reverse preexisting established PH and prevent associated right heart failure (RHF). PH was induced in male rats by 60 mg/kg of monocrotaline. After 21 days, when PH was well established, rats received daily injection of genistein (1 mg/kg per day) for 10 days or were left untreated to develop RHF by day 30. Effects of genistein on human pulmonary artery smooth muscle cell and endothelial cell proliferation and neonatal rat ventricular myocyte hypertrophy were assessed in vitro. Severe PH was evident 21 days after monocrotaline, as peak systolic right ventricular pressure increased to 66.35±1.03 mm Hg and right ventricular ejection fraction reduced to 41.99±1.27%. PH progressed to RHF by day 30 (right ventricular pressure, 72.41±1.87 mm Hg; RV ejection fraction, 29.25±0.88%), and mortality was ≈75% in RHF rats. Genistein therapy resulted in significant improvement in lung and heart function as right ventricular pressure was significantly reduced to 43.34±4.08 mm Hg and right ventricular ejection fraction was fully restored to 65.67±1.08% similar to control. Genistein reversed PH-induced pulmonary vascular remodeling in vivo and inhibited human pulmonary artery smooth muscle cell proliferation by ≈50% in vitro likely through estrogen receptor-β. Genistein also reversed right ventricular hypertrophy (right ventricular hypertrophy index, 0.35±0.029 versus 0.70±0.080 in RHF), inhibited neonatal rat ventricular myocyte hypertrophy, and restored PH-induced loss of capillaries in the right ventricle. These improvements in cardiopulmonary function and structure resulted in 100% survival by day 30. Genistein restored PH-induced downregulation of estrogen receptor-β expression in the right ventricle and lung. In conclusion, genistein therapy not only rescues

  18. Ivabradine Prevents Heart Rate Acceleration in Patients with Chronic Obstructive Pulmonary Disease and Coronary Heart Disease after Salbutamol Inhalation

    Directory of Open Access Journals (Sweden)

    Uta C. Hoppe

    2012-04-01

    Full Text Available Accelerated sinus rhythm is an important side effect of inhaled salbutamol which is especially harmful in patients with chronic obstructive pulmonary disease (COPD and coronary heart disease (CHD. Cross-over, randomized, open label study design. 20 patients (18 males and two females with COPD stage II–IV and comorbide CHD NYHA class I–III were included. Spirometry with 400 mg salbutamol inhalation was performed at two consecutive days of the study. Patients in group I were prescribed 5 mg ivabradine per os 3 h before salbutamol inhalation solely on the first day of the study and patients of group II received 5 mg ivabradine only on the second day of the study. Salbutamol caused a significant increase of HR by 5.5 bpm (95% CI 0.8; 10.2, p < 0.03. After ivabradine ingestion salbutamol did not change HR significantly by −2.4 bpm (−7.0; 2.3, p = 0.33. The attenuation of HR elevation by ivabradine was significant, p < 0.01. Salbutamol alone increased FEV1 by 6.0% (2.7; 9.3, p < 0.01. This effect was not impaired by ivabradine (FEV1 increase by 7.7% (2.8; 12.6, p < 0.01 versus baseline, p = 0.5 versus no ivabradine. Ivabradine 5 mg per os prevents heart rate acceleration after inhalation of 400 mg salbutamol. Ivabradine has no impact on lung function in patients with moderate-to-very-severe COPD and CHD comorbidity.

  19. Successful resection of osteosarcoma pulmonary metastasis extending into left side of heart under cardiopulmonary bypass: a case report

    Institute of Scientific and Technical Information of China (English)

    柴(王莹); 沈钢

    2002-01-01

    @@ Cancerous thrombi of metastatic tumors rarely extend into the cardiac cavity, but such cases usually contraindicate surgery. Here, we report a patient in whom osteosarcoma pulmonary metastasis extended into the left side of the heart, which had metastasized to the left lung after surgery of the chondroblastoma of the left knee, was successfully excised in bloc under CPB.

  20. Recurrent Pneumonia and a Normal Heart: Late Complication after Repair of Hemianomalous Pulmonary Venous Drainage—A Cautionary Tale

    Directory of Open Access Journals (Sweden)

    Maryanne Caruana

    2010-01-01

    Full Text Available Hemianomalous pulmonary venous drainage with intact atrial septum is a rare congenital anomaly and reports of its surgical repair and the long-term complications related to the correction are only infrequently encountered in the literature. We report the case of a patient with hemianomalous pulmonary venous drainage and intact atrial septum who underwent surgical repair using a pericardial baffle and creation of an “atrial septal defect” aged 15 years. Dyspnoea and recurrent chest infections started 7 months after surgery when he was seen by a respiratory physician without cardiac followup. He presented again aged 28 years with a recurrent pneumonia investigated over 6 weeks and heart pronounced normal from examination and echocardiography. Correct diagnosis was made in Grown Up Congenital Heart (GUCH clinic stimulating review of data and catheterisation with pulmonary artery angiography which confirmed it. We feel that this case highlights the importance of specialist care and followup for GUCH patients.

  1. Pulmonary uptake of thallium-201 in patients with congenital heart disease; Comparison between total anomalous pulmonary venous connection and tetralogy of Fallot

    Energy Technology Data Exchange (ETDEWEB)

    Kohata, Tohru; Ono, Yasuo; Iwatani, Hajime; Fukushima, Hideki; Kamiya, Tetsuro; Yagihara, Toshikatsu; Nishimura, Tsunehiko; Takamiya, Makoto (National Cardiovascular Center, Suita, Osaka (Japan))

    1992-01-01

    To evaluate the pulmonary extravascular space in patients with congenital heart disease, lung uptake of Tl-201 was quantitatively studied. Patients' diseases consisted of total anomalous pulmonary venous connection (TAPVC)--supracardiac (I), paracardiac (II) and infracardiac (III) types--, tetralogy of Fallot (T/F), ventricular septal defect (VSD), and patent ductus arteriosus (PDA). Tl-201 imaging was performed before operation and in the early and late stages after operation. Twenty-five other patients with arrhythemias or a history of Kawasaki disease without perfusion defects served as controls. Lung uptake of Tl-201 was analyzed with a computer using the anterior image of the chest, and the averge count ratio of the right lung (P) to the left ventricular wall (LV) was calculated. P/LV values were compared between the patients before and after operation, and differences in anatomical types in TAPVC were also evaluated. In TAPVC, P/LV values decreased gradually after operation, but were significantly higher than those of controls even in the late stage. In the late stage after operation, type I TAPVC had significantly higher P/LV values than those of type-II. In T/F, the P/LV values were significantly higher after operation, even in the late stage, than before operation. In the VSD or PDA group, the P/LV value returned to normal after operation and was significantly lower than that before operation. In conclusion, TAPVC patients was considered to have a larger pulmonary extravascular space even in the late stage after operation, suggesting a sign of pulmonary congestion due to intrapulmonary vascular damage in utero. In T/F, scanty pulmonary vascular beds before operation were perfused with increased pulmonary blood flow after operation. Therefore, postoperative increases in pulmonary blood flow may be responsible for the increased pulmonary extravascular space. (N.K.).

  2. Colapsibilidade da Veia Cava Inferior e sinais e sintomas de insuficiência cardíaca: novos insights e possíveis associações Inferior Vena Cava collapsibility and heart failure signs and symptoms: new insights about possible links

    Directory of Open Access Journals (Sweden)

    Renato De Vecchis

    2012-06-01

    Full Text Available FUNDAMENTO: Nos pacientes com Insuficiência Cardíaca Crônica (ICC foram propostas medidas ultrassonográficas do Índice de Colapsibilidade da Veia Cava Inferior (ICVCI para obter uma avaliação e classificação minuciosa da congestão hemodinâmica. OBJETIVO: A finalidade deste estudo era correlacionar os achados no exame físico com o ICVCI em pacientes com ICC. MÉTODOS: De acordo com um projeto de coorte retrospectivo, analisamos 54 pacientes com ICC, direita ou biventricular, classe NYHA III. O plano era determinar se alguma faixa de ICVCI basal poderia predizer uma persistência ou agravamento da congestão clínica achada no final do acompanhamento subsequente (isto é, após 1-2 meses do tratamento oral otimizado. Para essa finalidade, os pacientes foram subdivididos em três grupos de acordo com o valor de ICVCI basal: ≤ 15% (13 pts, 16 - 40% (21 pts e > 40% (20 pts. Diversos critérios clínicos de congestão foram comparados por meio dos três grupos e incorporados subsequentemente ao modelo multivariado de Cox. RESULTADOS: Preditores multivariados de alto escore de congestão foram distensão da veia jugular (FC: 13,38 95% IC: 2,13 - 84 p = 0,0059 e estertores (FC: 11 95% C.I : 1,45 - 83,8 p = 0,0213. O ICVCI ≤ 15% esteve sempre associado com um alto escore de congestão na segunda visita; todavia, o ICVCI o ≤ 15% não predisse um alto escore de congestão na segunda visita. CONCLUSÃO: No âmbito da ICC, um baixo ICVCI não predisse, em forma confiável, um elevado escore de congestão. Não obstante, o conjunto com ICVCI ≤ 15% sempre se achou associado com sinais e sintomas de uma ICC descompensada, tanto do lado direito como do esquerdo. (Arq Bras Cardiol. 2012; [online].ahead print, PP.0-0BACKGROUND: In chronic heart failure patients (CHF, ultrasound measurement of inferior vena cava collapsibility index (IVCCI has been proposed to yield careful assessment and grading of the hemodynamic congestion. OBJECTIVE: The

  3. Progress in anti-endothelin therapy in the treatment of pulmonary arterial hypertension and heart failure

    Institute of Scientific and Technical Information of China (English)

    MAYANJA Patrick; MA Gen-shan

    2014-01-01

    Endothelin-1 ( ET-1 ) is not only a potent vasoconstrictor , but causes proliferation of many of the vascular cells involved in vascular remodelling .ETA receptors mediate vasoconstriction and cell proliferation , whereas ETB receptors are important for the clearance of ET-1, endothelial cell survival , the release of nitric oxide and prostacyclin , and the inhibition of endothelin-converting enzyme ( ECE )-1.ET is activated in pulmonary arterial hypertension ( PAH) , heart failure ( HF) and many other cardiovascular diseases .The most efficient way to antagonize the ET-1 system is the use of ET-1 receptor antagonists that can block either ETA-or ETA-and ETB-receptors, or ECE inhibition which blocks the conversion of big ET-1 to ET-1.In this brief review , we will try to summarize the progress of anti-endothelin therapy in the treatment of PAH and HF treatment therapies .

  4. Anomalous pulmonary venous return: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Park, Gyeong Min; Kang, MinJin; Lee, Han Bee; Bae, Kyung Eun; Lee, Jaehe; Kim, Jae Hyung; Jeong, Myeong Ja; Kang, Tae Kyung [Sanggye Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of)

    2013-10-15

    Partial anomalous pulmonary venous return is a type of congenital pulmonary venous anomaly. We present a rare type of partial pulmonary venous return, subaortic vertical vein drains left lung to superior vena cava, accompanying hypoplasia of the ipsilateral lung and pulmonary artery. We also review the previous report and relationship of these structures.

  5. Prevalence and profile of congenital heart disease and pulmonary hypertension in Down syndrome in a pediatric cardiology service

    Directory of Open Access Journals (Sweden)

    Felipe Alves Mourato

    2014-06-01

    Full Text Available OBJECTIVE:To determine the frequence and profile of congenital heart defects in Down syndrome patients referred to a pediatric cardiologic center, considering the age of referral, gender, type of heart disease diagnosed by transthoracic echocardiography and its association with pulmonary hypertension at the initial diagnosis.METHODS:Cross-sectional study with retrospective data collection of 138 patients with Down syndrome from a total of 17,873 records. Descriptive analysis of the data was performed, using Epi-Info version 7.RESULTS: Among the 138 patients with Down syndrome, females prevailed (56.1% and 112 (81.2% were diagnosed with congenital heart disease. The most common lesion was ostium secundum atrial septal defect, present in 51.8%, followed by atrioventricular septal defect, in 46.4%. Ventricular septal defects were present in 27.7%, while tetralogy of Fallot represented 6.3% of the cases. Other cardiac malformations corresponded to 12.5%. Pulmonary hypertension was associated with 37.5% of the heart diseases. Only 35.5% of the patients were referred before six months of age.CONCLUSIONS: The low percentage of referral until six months of age highlights the need for a better tracking of patients with Down syndrome in the context of congenital heart disease, due to the high frequency and progression of pulmonary hypertension.

  6. Echocardiographic Assessment of Pulmonary Artery Systolic Pressure and Outcomes in Ambulatory Heart Failure Patients

    Science.gov (United States)

    Kalogeropoulos, Andreas P.; Siwamogsatham, Sarawut; Hayek, Salim; Li, Song; Deka, Anjan; Marti, Catherine N.; Georgiopoulou, Vasiliki V.; Butler, Javed

    2014-01-01

    Background Pulmonary hypertension (PH) in patients with heart failure (HF) is associated with worse outcomes and is rapidly being recognized as a therapeutic target. To facilitate pragmatic research efforts, data regarding the prognostic importance of noninvasively assessed pulmonary artery systolic pressure (PASP) in stable ambulatory patients with HF are needed. Methods and Results We examined the association between echocardiographic PASP and outcomes in 417 outpatients with HF (age, 54±13 years; 60.7% men; 50.4% whites; 24.9% with preserved ejection fraction). Median PASP was 36 mm Hg (interquartile range [IQR]: 29, 46). After a median follow‐up of 2.6 years (IQR: 1.7, 3.9) there were 72 major events (57 deaths; 9 urgent heart transplants; and 6 ventricular assist device implantations) and 431 hospitalizations for HF. In models adjusting for clinical risk factors and therapy, a 10‐mm Hg higher PASP was associated with 37% higher risk (95% CI: 18, 59; P<0.001) for major events, and 11% higher risk (95% CI: 1, 23; P=0.039) for major events or HF hospitalization. The threshold that maximized the likelihood ratio for both endpoints was 48 mm Hg; those with PASP ≥48 mm Hg (N=84; 20.1%) had an adjusted hazard ratio of 3.33 (95% CI: 1.96, 5.65; P<0.001) for major events and 1.47 (95% CI: 1.02, 2.11; P=0.037) for major events or HF hospitalization. Reduced right ventricular systolic function had independent prognostic utility over PASP for adverse outcomes. Right atrial pressure and transtricuspid gradient both contributed to risk. Conclusions Elevated PASP, determined by echocardiography, identifies ambulatory patients with HF at increased risk for adverse events. PMID:24492947

  7. Endothelial dysfunction and atherosclerosis in children with irreversible pulmonary hypertension due to congenital heart disease

    Directory of Open Access Journals (Sweden)

    Murat Çiftel

    2012-01-01

    Full Text Available Objective: To assess endothelial dysfunction and the risk for coronary atherosclerosis in children with irreversible pulmonary hypertension due to congenital heart disease (CHD. Methods: The study included 18 cyanotic patients (the mean age was 12.28 ± 3.26 years who developed irreversible pulmonary hypertension due to cyanotic and acyanotic CHDs, and 18 control patients (the mean age was 11.78 ± 3.00 years. Study groups were compared for flow-mediated dilatation (FMD, carotid intima media thickness (CIMT and atherosclerotic risk factors. Results: Compared to the control group, the mean FMD was significantly reduced in the cyanotic group (5.26 ± 2.42% and 9.48 ± 2.60%, respectively; P-value < 0.001. No significant difference was observed between the groups in CIMT (0.41 ± 0.08 mm and 0.39 ± 0.06 mm, respectively; P-value = 0.299. The levels of total cholesterol, low-density lipoprotein-cholesterol and very low-density lipoprotein-cholesterol were statistically significantly lower compared tothe control group (P-value = 0.001, 0.006 and 0.014, respectively, whereas no statistically significant difference was found in the levels of high-density lipoprotein-cholesterol and triglycerides (P-value = 0.113 and 0.975, respectively. Conclusions: Systemic endothelial dysfunction in children with irreversible pulmonary hypertension due to CHD was noted but there was no increased risk for atherosclerosis.

  8. Altered lymphatics in an ovine model of congenital heart disease with increased pulmonary blood flow.

    Science.gov (United States)

    Datar, Sanjeev A; Johnson, Eric G; Oishi, Peter E; Johengen, Michael; Tang, Eric; Aramburo, Angela; Barton, Jubilee; Kuo, Hsuan-Chang; Bennett, Stephen; Xoinis, Konstantine; Reel, Bhupinder; Kalkan, Gokhan; Sajti, Eniko; Osorio, Oscar; Raff, Gary W; Matthay, Michael A; Fineman, Jeffrey R

    2012-03-15

    Abnormalities of the lymphatic circulation are well recognized in patients with congenital heart defects. However, it is not known how the associated abnormal blood flow patterns, such as increased pulmonary blood flow (PBF), might affect pulmonary lymphatic function and structure. Using well-established ovine models of acute and chronic increases in PBF, we cannulated the efferent lymphatic duct of the caudal mediastinal node and collected and analyzed lymph effluent from the lungs of lambs with acutely increased PBF (n = 6), chronically increased PBF (n = 6), and age-matched normal lambs (n = 8). When normalized to PBF, we found that lymph flow was unchanged following acute increases in PBF but decreased following chronic increases in PBF. The lymph:plasma protein ratio decreased with both acute and chronic increases in PBF. Lymph bioavailable nitric oxide increased following acute increases in PBF but decreased following chronic increases in PBF. In addition, we found perturbations in the transit kinetics of contrast material through the pleural lymphatics of lambs with chronic increases in PBF. Finally, there were structural changes in the pulmonary lymphatic system in lambs with chronic increases in PBF: lymphatics from these lambs were larger and more dilated, and there were alterations in the expression of vascular endothelial growth factor-C, lymphatic vessel endothelial hyaluronan receptor-1, and Angiopoietin-2, proteins known to be important for lymphatic growth, development, and remodeling. Taken together these data suggest that chronic increases in PBF lead to both functional and structural aberrations of lung lymphatics. These findings have important therapeutic implications that warrant further study.

  9. Pulmonary hypertension in adults with congenital heart disease and Eisenmenger syndrome: current advanced management strategies.

    Science.gov (United States)

    D'Alto, Michele; Diller, Gerhard-Paul

    2014-09-01

    The presence of pulmonary arterial hypertension (PAH) increases morbidity and reduces survival in patients with congenital heart disease (CHD). PAH-CHD is a heterogeneous condition, depending on the type of the underlying defect and previous repair strategies. There is growing evidence of the benefits of PAH-specific therapy in the PAH-CHD population, but despite recent advances mortality rates remain relatively high. In the last years, an increasing focus has been placed on patients with PAH-CHD and net left-to-right shunt. Currently, there are limited data to guide the management of these patients and uncertainty on the cut-off values for eventual defect closure. Pregnancy conveys significant risks in PAH-CHD patients: appropriate counselling and care, including psychological support and a multidisciplinary team, should be part of the routine management of women with PAH-CHD of reproductive age. Some subgroups, such as patients with Down's syndrome, Fontan circulation and 'segmental' pulmonary hypertension, present particular challenges in terms of management and therapy. The current review focuses on contemporary treatment strategies in PAH-CHD patients with particular emphasis on challenging patient groups and conditions.

  10. Pulmonary hypertension in children with congenital heart disease (PAH-CHD, PPHVD-CHD). Expert consensus statement on the diagnosis and treatment of paediatric pulmonary hypertension. The European Paediatric Pulmonary Vascular Disease Network, endorsed by ISHLT and DGPK.

    Science.gov (United States)

    Kozlik-Feldmann, Rainer; Hansmann, Georg; Bonnet, Damien; Schranz, Dietmar; Apitz, Christian; Michel-Behnke, Ina

    2016-05-01

    Pulmonary arterial hypertension associated with congenital heart disease (PAH-CHD) is a complex disease that presents with a broad spectrum of morphological and haemodynamic findings of varying severity. Recently, the aspect of paediatric pulmonary hypertensive vascular disease (PPHVD) has been introduced to expand the understanding of the full spectrum of pulmonary hypertension and increased pulmonary vascular resistance. Evaluation and treatment of PAH-CHD/PPHVD-CHD can be divided into in different topics. First, defining criteria for operability and initiation of advanced therapies preoperatively and postoperatively is an unresolved issue. Second, management of Eisenmenger syndrome is still an important question, with recent evidence on the severity of the disease and a more rapidly progressive course than previously described. Third, the Fontan circulation with no subpulmonary ventricle requires a distinct discussion, definition and classification since even a mild rise in pulmonary vascular resistance may lead to the so-called failing Fontan situation. Patients with CHD and single-ventricle physiology (Fontan/total cavopulmonary anastomosis) require a particularly stepwise and individualised approach. This consensus statement is on the current evidence for the most accurate evaluation and treatment of increased pulmonary artery pressure and resistance, as well as ventricular dysfunction, in children with congenital heart defects, and provides according practical recommendations. To optimise preoperative and postoperative management in patients with PAH-CHD, diagnostic and treatment algorithms are provided.

  11. Acute hemodynamic effects of inhaled sodium nitrite in pulmonary hypertension associated with heart failure with preserved ejection fraction

    Science.gov (United States)

    Simon, Marc A.; Vanderpool, Rebecca R.; Nouraie, Mehdi; Bachman, Timothy N.; White, Pamela M.; Sugahara, Masataka; Gorcsan, John; Parsley, Ed L.; Gladwin, Mark T.

    2016-01-01

    BACKGROUND. Pulmonary hypertension (PH) is associated with poor outcomes, yet specific treatments only exist for a small subset of patients. The most common form of PH is that associated with left heart disease (Group 2), for which there is no approved therapy. Nitrite has shown efficacy in preclinical animal models of Group 1 and 2 PH, as well as in patients with left heart failure with preserved ejection fraction (HFpEF). We evaluated the safety and efficacy of a potentially novel inhaled formulation of nitrite in PH-HFpEF patients as compared with Group 1 and 3 PH. METHODS. Cardiopulmonary hemodynamics were recorded after acute administration of inhaled nitrite at 2 doses, 45 and 90 mg. Safety endpoints included change in systemic blood pressure and methemoglobin levels. Responses were also compared with those administered inhaled nitric oxide. RESULTS. Thirty-six patients were enrolled (10 PH-HFpEF, 20 Group 1 pulmonary arterial hypertension patients on background PH-specific therapy, and 6 Group 3 PH). Drug administration was well tolerated. Nitrite inhalation significantly lowered pulmonary, right atrial, and pulmonary capillary wedge pressures, most pronounced in patients with PH-HFpEF. There was a modest decrease in cardiac output and systemic blood pressure. Pulmonary vascular resistance decreased only in Group 3 PH patients. There was substantial increase in pulmonary artery compliance, most pronounced in patients with PH-HFpEF. CONCLUSIONS. Inhaled nitrite is safe in PH patients and may be efficacious in PH-HFpEF and Group 3 PH primarily via improvements in left and right ventricular filling pressures and pulmonary artery compliance. The lack of change in pulmonary vascular resistance likely may limit efficacy for Group 1 patients. TRIAL REGISTRATION. ClinicalTrials.gov NCT01431313 FUNDING. This work was supported in part by the NIH grants P01HL103455 (to MAS and MTG), R01HL098032 (to MTG), and R01HL096973 (to MTG), and Mast Therapeutics, Inc. PMID

  12. 肺心病患者脑循环动力学的研究%Study of cerebrovascular activity in patients with pulmonary heart disease

    Institute of Scientific and Technical Information of China (English)

    李金双; 左剑; 荆春明; 韩云辉

    2002-01-01

    Objective To investigate cerebrovascular activity (CVA) change of pulmonary heart disease patients.Methods To measure CAV of acute stage and compare with CAV of remission stage and control group with CAV tester.Results Average cerebral blood flow velocity,maximal blood velocity,minimal blood velocity and minimal blood flow of pulmonary heart disease patients decrease apparently (P0.05).Conclusion CVA of pulmonary heart disease patients is disorder in different degree,and this disorder aggravate as aggravating of state of disease.

  13. Deep breathing heart rate variability is associated with respiratory muscle weakness in patients with chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Michel Silva Reis

    2010-01-01

    Full Text Available BACKGROUND: A synchronism exists between the respiratory and cardiac cycles. However, the influence of the inspiratory muscle weakness in chronic obstructive pulmonary disease (COPD on cardiac autonomic control is unknown. The purpose of the present investigation was to evaluate the influence of respiratory muscle strength on autonomic control in these patients. METHODS: Ten chronic obstructive pulmonary disease patients (69±9 years; FEV1/FVC 59±12% and FEV1 41±11% predicted and nine age-matched healthy volunteers (64±5 years participated in this study. Heart-rate variability (HRV was obtained at rest and during respiratory sinusal arrhythmia maneuver (RSA-M by electrocardiograph. RESULTS: Chronic obstructive pulmonary disease patients demonstrated impaired cardiac autonomic modulation at rest and during RSA-M when compared with healthy subjects (p<0.05. Moreover, significant and positive correlations between maximal inspiratory pressure (MIP and the inspiratory-expiratory difference (ΔIE (r = 0.60, p<0.01 were found. CONCLUSION: Patients with chronic obstructive pulmonary disease presented impaired sympathetic-vagal balance at rest. In addition, cardiac autonomic control of heart rate was associated with inspiratory muscle weakness in chronic obstructive pulmonary disease. Based on this evidence, future research applications of respiratory muscle training may bring to light a potentially valuable target for rehabilitation.

  14. [Maze procedure in a case of dextrocardia with atrial septal defect and persistent left superior vena cava].

    Science.gov (United States)

    Muraoka, Arata; Kawada, Masaaki; Misawa, Yoshio

    2014-08-01

    A 52-year-old man was diagnosed with dextrocardia at the age of 1 year and was asymptomatic until 1 year before admission. He was transferred to our hospital for management of atrial fibrillation. A transthoracic echocardiogram showed dextrocardia with atrial septal defect;moderate tricuspid valve regurgitation; and a large, persistent left superior vena cava. A cardiac catheterization study revealed that pulmonary flow/systemic flow (Qp/Qs) was 3.6 and that pulmonary vascular resistance was 2.5 Wood U·m². Intracardiac repair with tricuspid annuloplasty and a maze procedure was scheduled. When establishing cardiopulmonary bypass, venous drainage was initially obtained from the inferior vena cava and the left superior vena cava, and the small superior vena cava was then directly cannulated after opening the right atrium. The patient's postoperative course was uneventful, and serial electrocardiograms have demonstrated maintenance of normal sinus rhythm for 3.5 years after the operation.

  15. Handbook of pulmonary emergencies

    Energy Technology Data Exchange (ETDEWEB)

    Spaquolo, S.V.; Medinger, A

    1986-01-01

    This book presents information on the following topics: clinical assessment of the patient with pulmonary disease; interpretation of arterial blood gases in the emergency patient; life-threatening pneumonia; extrapulmonic ventilatory failure; acute inhalation lung disease; pulmonary edema; near drowning; chest trauma; upper airway emergencies; chronic lung disease with acute respiratory decompensation; acute respiratory failure in the patient with chronic airflow obstruction; asthma; hemoptysis; embolic pulmonary disease; superior vena cava syndrome; catastrophic pleural disease; ventilatory assistance and its complications; and ventilator emergencies.

  16. Removal of a Guenther Tulip retrievable inferior vena cava filter after 147 days in a pediatric patient

    Energy Technology Data Exchange (ETDEWEB)

    Mody, Rekha N.; Stokes, LeAnn S.; Bream, Peter R.; Spottswood, Stephanie E. [Vanderbilt University Medical Center, Department of Radiology, Nashville, TN (United States)

    2006-05-15

    A Guenther Tulip retrievable inferior vena cava filter was placed in a 9-year-old boy with T-cell ALL who had both iliofemoral deep vein thrombosis (DVT) and acute intracranial hemorrhage. The filter was removed 147 days after placement, when the patient was no longer at increased risk for DVT or pulmonary embolus. Removal of the filter did not compromise flow through the vena cava. (orig.)

  17. Hemodynamic parameters obtained by transthoracic echocardiography and right heart catheterization: a comparative study in patients with pulmonary hypertension

    Institute of Scientific and Technical Information of China (English)

    TIAN Zhuang; ZENG Xiao-feng; LIU Yong-tai; FANG Quan; NI Chao; CHEN Tai-bo; FANG Li-gang; GAO Peng; JIANG Xiu-chun; LI Meng-tao

    2011-01-01

    Background Hemodynamic evaluation is crucial for the management of patients with pulmonary hypertention. Clinicians often prefer a rapid and non-invasive method. This study aimed to examine the feasibility of transthoracic echocardiography for the measurements of hemodynamic parameters in patients with pulmonary hypertension.Methods A prospective single-center study was conducted among 42 patients with pulmonary hypertension caused by different diseases. Transthoracic echocardiography and right-heart catheterization were performed within 24 hours. Pulmonary artery systolic, diastolic and mean pressure (PASP, PADP and PAMP), cardiac output (CO), and pulmonary capillary wedge pressure (PCWP) were measured by both methods. A linear correlation and a Bland-Altman analysis were performed to compare the two groups of hemodynamic parameters.Results A good correlation was found between invasive and non-invasive measurements for PASP (r=0.96), PADP (r=0.85), PAMP (r=0.88), CO (r=0.82), and PCWP (r=0.81). Further agreement analysis done by the Bland-Altman method showed that bias and a 95% confidence interval for PASP, PADP, and CO were clinically acceptable while great discrepancies existed for PAMP and PCWP.Conclusions The non-invasive measurements by PASP, PADP, and CO in patients with pulmonary hypertension correlate well with the invasive determinations. Transthoracic echocardiography (TTE) was inappropriate for estimating PCWP and PAMP.

  18. In situ expression of Bcl-2 in pulmonary artery endothelial cells associates with pulmonary arterial hypertension relative to heart failure with preserved ejection fraction

    Science.gov (United States)

    Benza, Raymond L.; Williams, Gretchen; Wu, Changgong; Shields, Kelly J.; Raina, Amresh; Murali, Srinivas

    2016-01-01

    Abstract We have previously reported that pulmonary artery endothelial cells (PAECs) can be harvested from the tips of discarded Swan-Ganz catheters after right heart catheterization (RHC). In this study, we tested the hypothesis that the existence of an antiapoptotic phenotype in PAECs obtained during RHC is a distinctive feature of pulmonary arterial hypertension (PAH; World Health Organization group 1) and might be used to differentiate PAH from other etiologies of pulmonary hypertension. Specifically, we developed a flow cytometry-based measure of Bcl-2 activity, referred to as the normalized endothelial Bcl-2 index (NEBI). We report that higher NEBI values are associated with PAH to the exclusion of heart failure with preserved ejection fraction (HFpEF) and that this simple diagnostic measurement is capable of differentiating PAH from HFpEF without presenting addition risk to the patient. If validated in a larger, multicenter study, the NEBI has the potential to assist physicians in the selection of appropriate therapeutic interventions in the common and dangerous scenario wherein patients present a clinical and hemodynamic phenotype that makes it difficult to confidently differentiate between PAH and HFpEF. PMID:28090298

  19. Computerized lung sound analysis following clinical improvement of pulmonary edema due to congestive heart failure exacerbations

    Institute of Scientific and Technical Information of China (English)

    WANG Zhen; XIONG Ying-xia

    2010-01-01

    Background Although acute congestive heart failure (CHF) patients typically present with abnormal auscultatory findings on lung examination, lung sounds are not normally subjected to rigorous analysis. The goals of this study were to use a computerized analytic acoustic tool to evaluate lung sound patterns in CHF patients during acute exacerbation and after clinical improvement and to compare CHF profiles with those of normal individuals.Methods Lung sounds throughout the respiratory cycle was captured using a computerized acoustic-based imaging technique. Thirty-two consecutive CHF patients were imaged at the time of presentation to the emergency department and after clinical improvement. Digital images were created, geographical area of the images and lung sound patterns were quantitatively analyzed.Results The geographical areas of the vibration energy image of acute CHF patients without and with radiographically evident pulmonary edema were (67.9±4.7) and (60.3±3.5) kilo-pixels, respectively (P <0.05). In CHF patients without and with radiographically evident pulmonary edema (REPE), after clinical improvement the geographical area of vibration energy image of lung sound increased to (74.5±4.4) and (73.9±3.9) kilo-pixels (P <0.05), respectively. Vibration energy decreased in CHF patients with REPE following clinical improvement by an average of (85±19)% (P <0.01). Conclusions With clinical improvement of acute CHF exacerbations, there was more homogenous distribution of lung vibration energy, as demonstrated by the increased geographical area of the vibration energy image. Lung sound analysis may be useful to track in acute CHF exacerbations.

  20. Platelet abnormalities in adults with severe pulmonary arterial hypertension related to congenital heart defects (Eisenmenger syndrome).

    Science.gov (United States)

    Remková, Anna; Šimková, Iveta; Valkovičová, Tatiana; Kaldarárová, Monika

    2016-12-01

    Patients with severe pulmonary arterial hypertension suffer from life-threatening thrombotic and bleeding complications. The aim of this study was to compare selected platelet, endothelial, and coagulation parameters in healthy volunteers and patients with severe pulmonary arterial hypertension because of congenital heart defects. The study included healthy volunteers (n = 50) and patients with cyanotic congenital heart defects classified as Eisenmenger syndrome (n = 41). We investigated platelet count, mean platelet volume, and platelet aggregation - spontaneous and induced by various concentrations of five agonists. Von Willebrand factor (vWF), fibrinogen, factor VIII and XII, plasminogen activator inhibitor, antithrombin, D-dimer, and antiphospholipid antibodies were also investigated. We found a decreased platelet count [190 (147-225) vs. 248 (205-295) 10 l, P < 0.0001], higher mean platelet volume [10.9 (10.1-12.0) vs. 10.2 (9.4-10.4) fl, P < 0.0001], and significantly decreased platelet aggregation (induced by five agonists, in various concentrations) in patients with Eisenmenger syndrome compared with controls. These changes were accompanied by an increase of plasma vWF antigen [141.6 (108.9-179.1) vs. 117.4 (9.2-140.7) IU/dl, P = 0.022] and serum anti-β2-glycoprotein [2.07 (0.71-3.41) vs. 0.47 (0.18-0.99) U/ml, P < 0.0001]. Eisenmenger syndrome is accompanied by platelet abnormalities. Thrombocytopenia with increased platelet size is probably due to a higher platelet turnover associated with platelet activation. Impaired platelet aggregation can reflect specific platelet behaviour in patients with Eisenmenger syndrome. These changes can be related both to bleeding and to thrombotic events. A higher vWF antigen may be a consequence of endothelial damage in Eisenmenger syndrome, but the cause for an increase of anti-β2-glycoprotein is unknown.

  1. Heart rate variability is related to disease severity in children and young adults with pulmonary hypertension

    Directory of Open Access Journals (Sweden)

    Heiner eLatus

    2015-07-01

    Full Text Available BACKGROUND: Pulmonary hypertension (PH is frequently associated with an increase in sympathetic tone. This may adversely affect cardiac autonomic control. Knowledge about the clinical impact of autonomic dysfunction in patients with PH is limited. We aimed to assess whether parameters of heart rate variability (HRV are related to disease severity in children with PH.METHODS: Parameters of HRV [SDNN = standard deviation of normal-to-normal intervals, and SDANN = standard deviation of mean values for normal-to-normal intervals over 5 min] were determined from Holter electrocardiograms of 17 patients with PH without active intracardial shunt (10 female, mean age 12.8 ±8.7 years. Patients were allocated to 2 groups according to their disease severity: patients with moderate PH (ratio of pulmonary to systemic arterial pressure (PAP/SAP ratio 0.75 (n=6. An additional group of 5 adolescents with Eisenmenger syndrome (PAP/SAP ratio 1.13±0.36 was included.RESULTS: Children with severe PH had significantly lower values of HRV [SDNN (73.8 ±21.1 ms vs. 164.9 ±38.1 ms, SDANN (62.2 ±19.0 ms vs. 139.5 ±33.3 ms] compared to patients with moderate PH (p=0.0001 for all. SDNN inversely correlated with ratio of PAP/SAP of PH patients without shunt (r=-0.82; p=0.0002. Eisenmenger patients showed no significant difference of HRV [SDNN 157.6 ±43.2 ms, SDANN 141.2 ±45.3 ms] compared to patients with moderate PH without shunt (p >0.05 for all.CONCLUSIONS: According to our results, children with severe PH may have alterations in HRV. Since HRV appears to be related to disease severity, it may therefore serve as an additional diagnostic marker of PH. Remarkably, although Eisenmenger patients have suprasystemic pulmonary arterial pressures, they seem to have preserved HRV, which might reflect a more favourable autonomic adaptation.

  2. Bilateral inferior vena cava filter insertion in a patient with duplication of the infrarenal vena cava.

    LENUS (Irish Health Repository)

    Leong, S

    2010-06-19

    BACKGROUND: Inferior vena cava (IVC) filter insertion is a commonly performed procedure for indications such as recurrent pulmonary emboli or contraindication to anticoagulation. Symptomatic duplication of the IVC is exceedingly rare with only a handful of cases being described in the literature. AIM: We report an unusual case of a patient with symptomatic duplication of the IVC. RESULT: A 53-year-old woman presented at our hospital for resection of a cerebral metastasis from a non-small cell lung cancer following a recent diagnosis of bilateral lower limb deep venous thrombosis. This required perioperative reversal of anticoagulation and IVC filter insertion. Conventional venography performed during filter insertion documented the existence of a duplicated IVC. CONCLUSION: We present a case of a symptomatic duplication of the IVC requiring filter insertion. We review the developmental anatomy of the IVC along with the diagnostic findings and management strategies available.

  3. CLINICAL APPLICATION OF 99mTc MAA PULMONARY SCINTISCAN IN DEEP VEIN THROMBOSIS AND RHEUMATIC HEART DISEASE

    Institute of Scientific and Technical Information of China (English)

    陈万春; 曾昭瑞; 金立仁; 包玉倩

    1992-01-01

    We studied 21 cases of pulmonary thromboembolism (PTE) in 67 consecutive cases of deep vein thrombosis (DVT) of the lower limbs and 4 cases in 9 selective cases of rheumatic heart disease (RHD). The incidence of PTE in DVT could be inferred as being 31.3%. PTE were diagnosed by 99mTc MAA lung scintiscans. In the DVT cases, lung scintiscan were done right after venography of the legs. Six cases underwent pulmonary angiography, ⅠDSA. As PTE in the DVT cases were all subclinical, only oligemia andvascular "pruning" were noted. Injection of urokinase into the pulmonary artery concerned through a catheter after which intravenous infusion was continued for 10-14 days, only 3 PTE resolved, probably representing early cases.

  4. Pulmonary artery sling: Case report

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Gil Hyun; Lee, Sun Wha; Cha, Sung Ho [Kyunghee University College of Medicine, Seoul (Korea, Republic of)

    1993-09-15

    Aberrant left-sided pulmonary artery(pulmonary artery sling) is an uncommon anomaly,which may cause significant respiratory abnormality. We report a case of pulmonary artery sling which is combined with persistent left superior vena cava and dextrocardia. This case were identified by esophagogram and CT and confirmed by MRI and angiography. We consider that MRI is a valuable new method for the diagnosis of aberrant left-sided pulmonary artery.

  5. Effects of sodium tanshinone II A sulfonate on hemodynamics and cardiac function in patients with senile pulmonary heart disease

    Institute of Scientific and Technical Information of China (English)

    Yin-Hong Liu; Yong Zhang; Yang Zhang; Tao Xue; Cai-Ping Tang; Xiao-Ming Wang

    2016-01-01

    Objective:To investigate the effects of sodium tanshinone II A sulfonate on hemodynamics and cardiac function in patients with senile pulmonary heart disease.Methods:A total of 110 cases that had been diagnosed with senile pulmonary heart disease in our hospital during January 2013 to July 2015 were selected as research objects. In accordance with the random number table, they were randomly divided into observation group and control group, with 55 cases each. Conventional therapy was given to the control group, while observation group received extra sodium tanshinone II A sulfonate administration on a conventional therapy basis. Hemodynamic indexes and cardiac function were compared between the two groups.Results:After treatment, whole blood viscosity, fibrinogen and plasma viscosity were significantly decreased in observation group compared with before treatment (P<0.05), which were also significantly lower compared with control group (P<0.05); the post-treatment levels of PASP, PEP/RVET and VA/VE notably declined in both groups compared with before treatment (P<0.05), and all these post-treatment indexes in observation group were even lower compared with control group (P<0.05).Conclusions:Using sodium tanshinone II A sulfonate to treat senile pulmonary heart disease can actively and effectively improve hemodynamics and cardiac function, which is worthy of clinical promotion.

  6. Comparative imaging of differential pulmonary blood flow in patients with congenital heart disease: magnetic resonance imaging versus lung perfusion scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Roman, Kevin S. [Hospital for Sick Children, Department of Cardiology, Toronto, ON (Canada); Kellenberger, Christian J.; Farooq, Saqba; MacGowan, Christopher K.; Gilday, David L.; Yoo, Shi-Joon [Hospital for Sick Children, Diagnostic Imaging and Radiology, Toronto, ON (Canada)

    2005-03-01

    Lung perfusion scintigraphy is considered the gold standard to assess differential pulmonary blood flow while magnetic resonance (MR) has been shown to be an accurate alternative in some studies. The purpose of the study was to assess the accuracy of phase contrast magnetic resonance (PC-MR) in measuring pulmonary blood flow ratio compared with lung perfusion scintigraphy in patients with complex pulmonary artery anatomy or pulmonary hypertension and to document reasons for discrepant results. We identified 25 cases of congenital heart disease between January 2000 and 2003, in whom both techniques of assessing pulmonary blood flow were performed within a 6-month period without an interim surgical or transcatheter intervention. The study group included cases with branch pulmonary artery stenosis, intracardiac shunts, single ventricle circulation, pulmonary venous anomalies and conotruncal defects. The mean age at study was 5.7 years (range 0.33-12) with a mean weight of 20.3 kg (range 6.5-53.6). The two methods were compared using a Bland-Altman analysis, and the Pearson correlation coefficient was calculated using the lung scan as the gold standard. Discrepant results were examined by reviewing the source images to elucidate reasons for error by MR. Bland-Altman analysis comparing right pulmonary artery (RPA) blood flow percentage, as measured by each modality, showed a mean difference of 1.43{+-}9.8 (95% limits of agreement: -17.8, 20.6) with a correlation coefficient of r=0.84, P<0.0001. In six (24%) cases a large difference (>10%) was found with a mean difference between techniques of 17.9%. The reasons for discrepant results included MR artifacts, dephasing owing to turbulent flow, site of data acquisition and lobar lung collapse. When using PC-MR to assess pulmonary blood flow ratio, important technical errors occur in a significant proportion of patients who have abnormal pulmonary artery anatomy or pulmonary hypertension. If these technical errors are

  7. Combined heart rate variability and pulse oximetry biofeedback for chronic obstructive pulmonary disease: preliminary findings.

    Science.gov (United States)

    Giardino, Nicholas D; Chan, Leighton; Borson, Soo

    2004-06-01

    The purpose of this study was to examine the feasibility of an intervention that included heart rate variability (HRV) biofeedback and walking with pulse oximetry feedback to improve functioning and quality of life for patients with chronic obstructive pulmonary disease (COPD). Twenty patients with COPD participated in 5 weekly sessions of HRV biofeedback and 4 weekly sessions of walking practice with oximetry feedback, with instructions for daily home practice. Primary outcomes measures were the distance walked in 6 min (6MWD) and overall quality of life, as measured by the St. George's Respiratory Questionnaire (SGRQ). Secondary outcomes included measures of self-efficacy, self-reported disability, anxiety, depression, dyspnea before and after the 6MWD, and HRV at the frequency of respiration during spontaneous and paced breathing. After 10 weeks of training, participants showed statistically and clinically significant improvements in 6MWD and quality of life. Significant changes were also seen in self-efficacy, disability, dyspnea before and after the 6MWD, and HRV amplitude during spontaneous breathing. We conclude that our intervention is feasible for patients with COPD and that further research using a randomized controlled design is warranted.

  8. Gene expression of ANP, BNP and ET-1 in the heart of rats during pulmonary embolism.

    Directory of Open Access Journals (Sweden)

    Henrik Gutte

    Full Text Available AIMS: Atrial natriuretic petide (ANP, brain natriuretic peptide (BNP and endothelin-1 (ET-1 may reflect the severity of right ventricular dysfunction (RVD in patients with pulmonary embolism (PE. The exact nature and source of BNP, ANP and ET-1 expression and secretion following PE has not previously been studied. METHODS AND RESULTS: Polystyrene microparticles were injected to induce PE in rats. Gene expression of BNP, ANP and ET-1 were determined in the 4 cardiac chambers by quantitative real time polymerase chain reaction (QPCR. Plasma levels of ANP, BNP, ET-1 and cardiac troponin I (TNI were measured in plasma. PE dose-dependently increased gene expression of ANP and BNP in the right ventricle (RV and increased gene expression of ANP in the right atrium (RA. In contrast PE dose-dependently decreased BNP gene expression in both the left ventricle (LV and the left atrium (LA. Plasma levels of BNP, TNI and ET-1 levels dose-dependently increased with the degree of PE. CONCLUSION: We found a close correlation between PE degree and gene-expression of ANP, and BNP in the cardiac chambers with a selective increase in the right chambers of the heart. The present data supports the idea of natriuretic peptides as valuable biomarkers of RVD in PE.

  9. Abnormal heart rate recovery and chronotropic incompetence on exercise in chronic obstructive pulmonary disease.

    Science.gov (United States)

    Gupta, Mansi; Bansal, Vishal; Chhabra, Sunil K

    2013-08-01

    Chronotropic incompetence (CI; failure to reach the targeted heart rate (HR) on exercise) and a delayed HR recovery (HRR; ≤12 beats decline within the first minute after cessation) reflect autonomic dysfunction (AD) and predict adverse cardiac prognosis. As chronic obstructive pulmonary disease (COPD) is known to be associated with AD, we hypothesized that these patients may manifest these responses on exercise. The prevalence and predictors of these responses in COPD and their association with its severity have not been evaluated. Normoxemic, stable male patients with COPD (n = 39) and 11 healthy controls underwent lung function testing and incremental leg ergometry. HR responses were monitored during exercise and recovery to compute the HRR and CI. Of all the patients, 33 (84.6%) had at least one of the two exercise responses as abnormal, with the majority (23, 58.9%) having both an abnormal HRR and CI. The frequency of abnormal responses increased with increasing Global Initiative for Chronic Obstructive Lung Disease stage and body mass index, airflow obstruction, dyspnoea and exercise capacity index. After adjusting for smoking history and post-bronchodilator forced expiratory volume in 1 second, only a reduced diffusion capacity for carbon monoxide predicted abnormal HRR, though weakly. We concluded that abnormal HRR and CI are common in patients with COPD. These responses are observed with increasing frequency as the severity of disease increases.

  10. Chronic obstructive pulmonary disease and heart failure: research and clinical practice in primary care

    Directory of Open Access Journals (Sweden)

    Francesco Chiumeo

    2015-12-01

    Full Text Available The treatment of chronic obstructive pulmonary disease (COPD and comorbidities, increasing with age, is the challenge that nowadays health care systems are facing to better care treat these patients. For this reason a clinical trial was conducted in the province of Trento by a group of 30 volunteer general practitioners members of SNAMID (Scientific Society for Continuing Medical Education of General Practitioners. The objectives were to identify: i prevalence of COPD in patients (65-98 years in the province of Trento; ii presence and incidence of heart failure (HF in COPD patients; iii early detection of other chronic diseases; and iv improving electronic medical records (EMR as an innovation way of professional care management. From May 2011 to October 2013, 17 doctors completed the two-year work using the EMR. The studied patients were men and women (65-98 years, suffering from COPD; the considered data included: anthropometric information, smoking status, International Classification of Diseases (ICD-9 diagnosis of COPD, HF and chronic diseases, specific blood and instrumental tests. The extracted results were then linked with data of sentinel therapies, collected by the EMR. The database obtained identified patients with COPD or HF not previously recognized with ICD-9 diagnosis. The study identified the sentinel drugs chosen for COPD and HF, excluding other drugs not selective for the study or confusing for a proper statistical evaluation.

  11. Usefulness of the Sum of Pulmonary Capillary Wedge Pressure and Right Atrial Pressure as a Congestion Index that Prognosticates Heart Failure Survival (from the Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness Trial).

    Science.gov (United States)

    Ma, Tony S; Paniagua, David; Denktas, Ali E; Jneid, Hani; Kar, Biswajit; Chan, Wenyaw; Bozkurt, Biykem

    2016-09-15

    In the Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness (ESCAPE) trial, use of a pulmonary artery catheter did not significantly affect advanced heart failure outcomes. However, the success of achieving the targeted hemodynamic goals of pulmonary capillary wedge pressure (PCWP) of 15 mm Hg and right atrial pressure (RAP) of 8 mm Hg and the association of these goals with clinical outcomes were not addressed. Furthermore, goals with 2 independent variables, PCWP and RAP, left room for uncertainties. We assessed the ability of a single hemodynamic target to achieve a threshold sum of PCWP and RAP as a predictor of all-cause mortality, death-or-transplantation (DT), or death-or-rehospitalization (DR) at 6 months in the pulmonary artery catheter-guided treatment arm of ESCAPE (n = 206). Patients with a posttreatment PCWP + RAP of <30 mm Hg had characteristics similar to those of the population who achieved the ESCAPE hemodynamic goals. This group had 8.7% mortality, 13.0% DT, and 58.7% DR at 6 months. The contrasting cohort with PCWP + RAP of ≥30 mm Hg had 45.3% mortality, 54.7% DT, and 84.9% DR at 6 months, with greater relative risk (RR) of death (RR 5.76), DT (RR 4.92), and DR (RR 1.80) and higher prevalence of jugular venous pulsation, edema, hepatomegaly, and ascites at admission and discharge. In conclusion, PCWP + RAP of 30 mm Hg posttreatment, obtained early in the index hospitalization, may represent as a simple congestion index that has prognostic value for heart failure survival and readmission rates at 6 months and as a warning signal for more aggressive intervention, thus warranting further validation.

  12. Role of Adrenomedullin in Congenital Heart Disease Associated with Pulmonary Hypertension

    Institute of Scientific and Technical Information of China (English)

    卢慧玲; 陈绍军; 王宏伟; 程佩萱

    2003-01-01

    The changes of adrenomedullin (ADM), endothelin-1 (ET-1) and nitric oxide (NO) lev-els before and after operation in congenital heart disease (CHD) associated with pulmonary hyper-tension (PH) were observed in order to investigate their role in CHD with PH and their clinical sig-nificance. The CHD patients were divided into 3 groups according to pulmonary artery systolicpressure (PASP): Non-PH group: PASP≤30 mmHg (n = 11); mild-PH group: PASP 3t - 49mmHg (n= 10); moderate or severe-PH group: PASP≥50 mmHg (n=- 12). The control groupconsisted of 15 health children. Plasma ADM, ET-1 and NO levels were determined by radioimmu-noassay and colorimetry methods. The correlation between ADM and ET-1, NO, PASP was ana-lyzed. The changes in plasma ADM, ET-1 and plasma NO on the 7th day after operation among thegroups were compared. The results showed that plasma ADM levels in non-PH group were signifi-cantly higher than that in control group (P<0.05), but there was no significant difference in ET-1and NO levels between the two groups (P>0.05). ADM and ET-1 levels in mild-PH group weresignificantly elevated as compared with those in non-PH group (both P<0. 05), but NO levelswere decreased (P<0. 05). ADM and ET-1 levels in moderate or severe-PH groups were increasedas compared with those in mild-PH group (both P<0.01), but NO level significantly declined (P<0.05). On the 7th day after operation, plasma ADM and ET-1 levels in PH group were signifi-cantly decreased (P<0.05, P<0.01) as compared with those before operation, but there was nosignificant difference in NO levels (P>0.05). But NO levels in non-PH group were significantlyincreased (P<0.05). Plasma ADM levels in CHD were positively correlated with PASP and ET-1(r=0.77, P<0.01; r=0.82, P<0.01), negatively correlated with NO (r=-0.56, P<0.05).It was concluded that during the progression of PH in the cases of CHD, plasma ADM, ET-1 andNO might play an important role in the development of PH. The

  13. CD28/B7 Deficiency Attenuates Systolic Overload-Induced Congestive Heart Failure, Myocardial and Pulmonary Inflammation, and Activated T Cell Accumulation in the Heart and Lungs.

    Science.gov (United States)

    Wang, Huan; Kwak, Dongmin; Fassett, John; Hou, Lei; Xu, Xin; Burbach, Brandon J; Thenappan, Thenappan; Xu, Yawei; Ge, Jun-Bo; Shimizu, Yoji; Bache, Robert J; Chen, Yingjie

    2016-09-01

    The inflammatory response regulates congestive heart failure (CHF) development. T cell activation plays an important role in tissue inflammation. We postulate that CD28 or B7 deficiency inhibits T cell activation and attenuates CHF development by reducing systemic, cardiac, and pulmonary inflammation. We demonstrated that chronic pressure overload-induced end-stage CHF in mice is characterized by profound accumulation of activated effector T cells (CD3(+)CD44(high) cells) in the lungs and a mild but significant increase of these cells in the heart. In knockout mice lacking either CD28 or B7, there was a dramatic reduction in the accumulation of activated effector T cells in both hearts and lungs of mice under control conditions and after transverse aortic constriction. CD28 or B7 knockout significantly attenuated transverse aortic constriction-induced CHF development, as indicated by less increase of heart and lung weight and less reduction of left ventricle contractility. CD28 or B7 knockout also significantly reduced transverse aortic constriction-induced CD45(+) leukocyte, T cell, and macrophage infiltration in hearts and lungs, lowered proinflammatory cytokine expression (such as tumor necrosis factor-α and interleukin-1β) in lungs. Furthermore, CD28/B7 blockade by CTLA4-Ig treatment (250 μg/mouse every 3 days) attenuated transverse aortic constriction-induced T cell activation, left ventricle hypertrophy, and left ventricle dysfunction. Our data indicate that CD28/B7 deficiency inhibits activated effector T cell accumulation, reduces myocardial and pulmonary inflammation, and attenuates the development of CHF. Our findings suggest that strategies targeting T cell activation may be useful in treating CHF.

  14. Modeling Flow Past a Tilted Vena Cava Filter

    Energy Technology Data Exchange (ETDEWEB)

    Singer, M A; Wang, S L

    2009-06-29

    Inferior vena cava filters are medical devices used to prevent pulmonary embolism (PE) from deep vein thrombosis. In particular, retrievable filters are well-suited for patients who are unresponsive to anticoagulation therapy and whose risk of PE decreased with time. The goal of this work is to use computational fluid dynamics to evaluate the flow past an unoccluded and partially occluded Celect inferior vena cava filter. In particular, the hemodynamic response to thrombus volume and filter tilt is examined, and the results are compared with flow conditions that are known to be thrombogenic. A computer model of the filter inside a model vena cava is constructed using high resolution digital photographs and methods of computer aided design. The models are parameterized using the Overture software framework, and a collection of overlapping grids is constructed to discretize the flow domain. The incompressible Navier-Stokes equations are solved, and the characteristics of the flow (i.e., velocity contours and wall shear stresses) are computed. The volume of stagnant and recirculating flow increases with thrombus volume. In addition, as the filter increases tilt, the cava wall adjacent to the tilted filter is subjected to low velocity flow that gives rise to regions of low wall shear stress. The results demonstrate the ease of IVC filter modeling with the Overture software framework. Flow conditions caused by the tilted Celect filter may elevate the risk of intrafilter thrombosis and facilitate vascular remodeling. This latter condition also increases the risk of penetration and potential incorporation of the hook of the filter into the vena caval wall, thereby complicating filter retrieval. Consequently, severe tilt at the time of filter deployment may warrant early clinical intervention.

  15. In vivo evaluation of a new vena cava filter

    Directory of Open Access Journals (Sweden)

    Gilberto do Nascimento Galego

    2016-01-01

    Full Text Available Abstract Background Pulmonary embolism is an important cause of cardiovascular death. Inferior vena cava filters have been shown to be effective for prevention of this condition. Objectives To determine the safety, performance and efficacy of a new inferior vena cava filter in an ovine model. Methods BKone1 filters are self-centering with over-the-wire deployment, have three filtering regions and are made from nickel-titanium alloy. Eight of these filters were implanted in 8 sheep. The sheep were divided into 4 groups of two animals (A and B and the number of clots injected differed by group. Two clots were injected in group 2, four in group 3, eight in group 4 and zero clots in group 1. A animals underwent euthanasia soon after the procedure and B animals were observed for 30 days and then euthanized after a control cavography. All inferior vena cavas were processed for histological examination. Clots were prepared in a metal mold, sectioned and then radiopaque markers were inserted. Clot capture was analyzed by identifying the radiopaque marker on fluoroscopy. Results No clot migration was observed during follow-up. Control cavographies showed patent inferior vena cavas. Pathological examination indicated little inflammatory tissue response. All clots were captured in the condition with 2 clots, only one clot was missed in the group injected with 4 clots and in the condition of 8 clots, they were partly captured. Conclusions The filters were deployed safely. There was a reduction in efficacy as the number of blood clots increased.

  16. Heart Transplantation in a 14-Year-Old Boy in the Presence of Severe Out-of-Proportion Pulmonary Hypertension due to Restrictive Left Heart Disease: A Case Report

    Directory of Open Access Journals (Sweden)

    Martin Schwienbacher

    2013-01-01

    Full Text Available A 14-year-old boy after balloon valvuloplasty of severe aortic valve stenosis in the neonatal period was referred for heart-lung transplantation because of high grade pulmonary hypertension and left heart dysfunction due to endocardial fibroelastosis with severe mitral insufficiency. After heart catheterization, hemodynamic parameters were invasively monitored: a course of levosimendan and initiation of diuretics led to a decrease of pulmonary capillary wedge pressure (from maximum 35 to 24 mmHg. Instead of an expected decrease, mean pulmonary artery pressures (mPAP increased up to 80 mmHg with increasing transpulmonary pressure gradient (TPG up to 55 mmHg. Oral bosentan and intravenous epoprostenol then led to a ~50% decrease of mPAP (TPG between 16 and 22 mmHg. The boy was listed solely for heart transplantation which was successfully accomplished 1 month later.

  17. Pulmonary Hypertension Secondary to Partial Anomalous Pulmonary Venous Return in an Elderly

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    Stefan Koester

    2016-01-01

    Full Text Available Background. Partial anomalous pulmonary venous return (PAPVR is an uncommon congenital abnormality, which may present in the adult population. It is often associated with sinus venosus defect (SVD. The diagnosis and therapy for this condition may be challenging. Case Presentation. We describe a case of an elderly woman who presented with NYHA Class IV dyspnea and was suspected to have symptomatic pulmonary hypertension. She was later found to have anomalous right upper pulmonary vein return to the superior vena cava and associated SVD with bidirectional shunting. Therapeutic options were discussed and medical management alone with aggressive diuresis and sildenafil was adopted. Follow-up visits revealed success in the planned medical therapy. Conclusions. PAPVR is a rare congenital condition that may present during late adulthood. The initial predominant left-to-right shunting associated with this anomaly may go undetected for years with the gradual development of pulmonary hypertension and right heart failure due to right heart volume overload. Awareness of the condition is important, as therapy is time-sensitive with early detection potentially leading to surgical therapy as a viable option.

  18. Assessment of Pulmonary Artery Stiffness of Repaired Congenital Heart Disease Patients

    Science.gov (United States)

    Lee, Namheon; Banerjee, Rajit; Taylor, Michael; Hor, Kan

    2012-10-01

    Surgical correction or palliation of congenital heart disease (CHD) often requires augmenting the main pulmonary artery (MPA) with non-native material or placing a cylindrical graft. The degree to which this intervention affects PA compliance is largely unknown. In this study, the MPA stiffness characteristics were assessed by its compliance, distensibility, and pressure-strain modulus. Coregistered velocity encoded phase-contrast MRI and cardiac catheterization data were available for a cohort of repaired CHD patients (n=8) and controls (n=3). All patients were repaired with either an RV-PA conduit or a RV outflow tract patch. We measured the MPA area change by MRI and MPA pressure during the cath. The measurements were taken through or just distal to the conduit. The MPA compliance and distensibility for the patients were significantly lower than the controls: compliance (9.8±10.8 vs 28.3±7.7mm^2/mmHg, p<0.05), distensibility (2.2±1.5 vs 6.6±2.1%Area change/mmHg, p=0.05). The patients had a significantly higher pressure-strain modulus (152.3±116.4mmHg, p<0.05) than the controls (35.8±10.6mmHg). The abnormally elevated PA stiffness due to the rigidity of the conduit or patch material may cause a compliance mismatch resulting in high stress levels contributing to the observed progressive PA dilatation. This may be a factor in the progressive RV dilatation seen in this cohort of repaired CHD patients.

  19. Pulmonary arterial hypertension associated with bronchopulmonary dysplasia and congenital heart disease in preterm infants. A case report of a preterm infant with recurrent pulmonary hypertension after corrective cardiac surgery and review of the literature.

    Science.gov (United States)

    Muneuchi, Jun; Kuraoka, Ayako; Watanabe, Mamie; Ochiai, Yoshie; Joo, Kunitaka

    2015-01-01

    In preterm infants with congenital heart disease, concomitant bronchopulmonary dysplasia (BPD) is associated with relatively poor clinical outcomes because of the increased pulmonary vascular resistance and adverse effects of inflammation on the damaged lungs, even after surgery. We present herein a 1-year-old female who developed recurrent pulmonary arterial hypertension 6 months after closure of a ventricular septal defect. She was born at 26 weeks of gestation (birth weight, 470 g), and developed BPD requiring oxygen supplementation. Her systemic-to-pulmonary blood flow ratio was 2.1 preoperatively and 1.0 postoperatively, pulmonary arterial pressure was 61/15 (mean 39) mmHg preoperatively and 41/17 (mean 24) mmHg postoperatively, and pulmonary vascular resistance was 4.2 mmHg/L·minute·m(2) preoperatively and 3.6 mmHg/L·minute·m(2) postoperatively. At 1 year of age, echocardiography showed an increase in her estimated right ventricular pressure, indicating worsening pulmonary hypertension. After 3 years of treatment with oxygen supplementation, prostacyclin, and bosentan, her pulmonary arterial pressure improved to the normal range. The pathophysiology of pulmonary arterial hypertension is heterogeneous in preterm infants with congenital heart disease and concomitant BPD. Careful management of these patients is warranted even after corrective cardiac surgery.

  20. Pulmonary Arterial Hypertension

    Science.gov (United States)

    Pulmonary Arterial Hypertension What Is Pulmonary Hypertension? To understand pulmonary hypertension (PH) it helps to understand how blood ows throughout your body. While the heart is one organ, it ...

  1. Endovascular treatment of superior vena cava syndrome

    DEFF Research Database (Denmark)

    Duvnjak, Stevo; Andersen, Poul Erik

    2011-01-01

    Abstract AIM: The aim of this study was to report our experience with palliative stent treatment of superior vena cava syndrome. METHODS: Between January 2008 and December 2009, 30 patients (mean age 60.7 years) were treated with stents because of stenosed superior vena cava. All patients present...

  2. Progress in the study of the pulmonary embolism in congestive heart failure%心力衰竭并发肺动脉栓塞研究进展

    Institute of Scientific and Technical Information of China (English)

    陈远刚

    2014-01-01

    Many clinical manifestations of congestive heart failure are similar to that of pulmonary embolism. Pulmonary embolism is a common complication of heart failure. The prognosis will be worse when a heart failure patient was complicated with pulmonary embolism. Here we briefly review the progress in the study of the pulmonary embolism in congestive heart failure from the aspects of etiopathogenisis,risk factor,clinical manifestation,diagnosis and prognosis,precaution and treatment. We hope that it may provide some informa-tion and study strategies for the diagnosis and precaution of the pulmonary embolism in congestive heart failure.%充血性心力衰竭(CHF)在许多临床表现上与肺动脉栓塞相似,而前者易并发后者,两者一旦合并存在,即提示患者预后更为恶劣。该文从发病原因、危险因素、临床表现、诊断与预后、预防及治疗等方面复习近年心力衰竭并发肺动脉栓塞研究进展,以期能在诊断及预防CHF并发肺动脉栓塞等方面提供相关的信息和思路。

  3. 体肺分流术在治疗肺血减少型先天性心脏病中的应用评价%Applied value of pulmonary - systemic circulation shunt for pulmonary hypoplasia congenital heart disease

    Institute of Scientific and Technical Information of China (English)

    卫向阳; 孙英民; 张军; 郭小峰; 常超

    2011-01-01

    Objective To assess the efficacy of pulmonary - systemic circulation shunt in pulmonary hypoplasia congenital heart disease. Methods Twenty patients with pulmonary hypoplasia congenital heart disease were treated by pulmonary- systemic circulation shunt,including 12 cases by Waterston and 8 cases by Centre shunt in our department from April 2005 to February 2009. Results In this series 1 case died from heart failure 16 h after operation and 1 case suffered from heart failure 6 months after operation. The rest survived well. Conclusion Pulmonary- systemic circulation shunt may reduce hypoxemia,improve cardiac performance and promote the development of pulmonary vessel in patients with pulmonary hypoplasia congenital heart disease. Moreover,it would provide conditions for radical total operation.%目的 分析体肺分流术在肺血减少型先天性心脏病治疗中的应用效果.方法 对2005年4月至2009年2月我院20例肺血减少型心脏病患者行体肺分流手术,其中Waterston术(升主动脉吻合至右肺动脉)12例,中心分流术8例.结果 围术期死亡1例,术后半年心功能衰竭1例,余病例无远期死亡.结论 对肺动脉发育不良的患者,体肺分流术可减轻患者的缺氧症状,改善患者的心功能,促进肺血管的发育,并为进一步的手术创造条件.

  4. Adult patients with pulmonary arterial hypertension due to congenital heart disease: a review on advanced medical treatment with bosentan

    Directory of Open Access Journals (Sweden)

    Mark J Schuuring

    2010-08-01

    Full Text Available Mark J Schuuring1,2, Jeroen C Vis1,2, Marielle G Duffels1, Berto J Bouma1, Barbara JM Mulder1,21Department of Cardiology, Academic Medical Centre, Amsterdam, The Netherlands; 2Interuniversity Cardiology Institute of The Netherlands, Utrecht, The NetherlandsAbstract: Pulmonary arterial hypertension (PAH is a progressive disease with poor survival outcome. PAH is classified by the 2009 updated clinical classification of pulmonary hypertension and a major subgroup is PAH due to congenital heart disease (CHD with systemic-to-pulmonary shunt. CHD-PAH is a result of systemic-to-pulmonary shunting and chronic increased flow that ultimately results in adaptations of pulmonary vasculature and endothelial dysfunction. The advanced stage is called Eisenmenger syndrome which forms a small percentage (1% of all CHD patients. Therapies targeted on PAH symptoms are called primary therapy for PAH, but most CHD-PAH patients progress to advanced therapy which is directed at the PAH itself. In CHD-PAH, advanced therapies are extensively investigated for all three major pathways: endothelin-1 receptor antagonists such as bosentan, prostanoids such as epoprostenol and phosphodiesterase 5 inhibitors such as sildenafil. Endpoints in most trials were catheterization hemodynamics, World Health Organization functional class, six-minute walking distance and patient-focused outcomes, based on quality of life questionnaires and Borg dyspnea index. The BREATHE-5 and EARLY study were two important randomized controlled trials showing efficacy of bosentan at short follow-up. Moreover in patients with Eisenmenger syndrome, one recent survival retrospective study with majority of patients on bosentan showed strong survival benefit over conservative therapy. A diversity of prospective cohort and retrospective studies were performed but all with limited data, due to small numbers and heterogeneity of underlying CHD diagnoses. Further larger studies are needed to determine optimal

  5. INVESTIGATION OF CENTRAL HEMODYNAMICS VIA RIGHT HEART AND PULMONARY ARTERY CATHETERIZATION IN PATIENTS WITH SYSTEMIC CONNECTIVE TISSUE DISEASES

    Directory of Open Access Journals (Sweden)

    E. V. Nikolaeva

    2015-01-01

    Full Text Available Pulmonary arterial hypertension (PAH associated with systemic connective tissue diseases (SCTD is a poor prognostic manifestation of the latter that result in death if untreated. The invasive determination of hemodynamic parameters is prominent in diagnosing the disease and determining its treatment policy and prognosis.Objective: to analyze the results of catheterization in PAH-SCTD patients admitted to the V.A. Nasonova Research Institute of Rheumatology.Subjects and methods. The investigation included 59 patients admitted to the V.A. Nasonova Research Institute of Rheumatology from September 2009 to September 2014. PAH was diagnosed in accordance with the conventional guidelines. All the patients underwent right heart and pulmonary artery (PA catheterization at the diagnosis and over time during treatment.Results and discussion. All the patients included in the trial met the pre-capillary pulmonary hypertension (PH criteria: mean pulmonary artery pressure (MPAP ≥25 mm Hg; and PA wedge pressure (PAWP <15 mm Hg. The exclusion of other causes of PH (pulmonary fibrosis, left heart disease, and thromboembolism, as well as a high transpulmonary pressure gradient >15 mm Hg and pulmonary vascular resistance (PVR >3 Wood units could diagnose PAH in all our patients. There was a statistically highly significant association between pathological hemodynamic changes and functional class (FC. FC was found to be most closely correlated with right atrial pressure (RAP, cardiac output (CO, PVR, and cardiac index (CI. Among the most common manifestations of heart failure, only the presence of peripheral edemas was associated with worse hemodynamic parameters in PAH. It should be noted that out of two biomarkers (N-terminal pro-brain natriuretic peptide and uric acid, the former is largely related to the magnitude of changes in hemodynamic factors. The critical values of hemodynamic parameters were due to extreme edema – anasarca (RAP >17 mm Hg

  6. PULMONARY ARTERIAL DISEASE ASSOCIATED WITH RIGHT-SIDED CARDIAC HYPERTROPHY AND CONGESTIVE HEART FAILURE IN ZOO MAMMALS HOUSED AT 2,100 M ABOVE SEA LEVEL.

    Science.gov (United States)

    Juan-Sallés, Carles; Martínez, Liliana Sofía; Rosas-Rosas, Arely G; Parás, Alberto; Martínez, Osvaldo; Hernández, Alejandra; Garner, Michael M

    2015-12-01

    Subacute and chronic mountain sickness of humans and the related brisket disease of cattle are characterized by right-sided congestive heart failure in individuals living at high altitudes as a result of sustained hypoxic pulmonary hypertension. Adaptations to high altitude and disease resistance vary among species, breeds, and individuals. The authors conducted a retrospective survey of right-sided cardiac hypertrophy associated with pulmonary arterial hypertrophy or arteriosclerosis in zoo mammals housed at Africam Safari (Puebla, México), which is located at 2,100 m above sea level. Seventeen animals with detailed pathology records matched the study criterion. Included were 10 maras (Dolichotis patagonum), 2 cotton-top tamarins (Saguinus oedipus oedipus), 2 capybaras (Hydrochaeris hydrochaeris), and 1 case each of Bennet's wallaby (Macropus rufogriseus), nilgai antelope (Boselaphus tragocamelus), and scimitar-horned oryx (Oryx dammah). All had right-sided cardiac hypertrophy and a variety of arterial lesions restricted to the pulmonary circulation and causing arterial thickening with narrowing of the arterial lumen. Arterial lesions most often consisted of medial hypertrophy or hyperplasia of small and medium-sized pulmonary arteries. All maras also had single or multiple elevated plaques in the pulmonary arterial trunk consisting of fibrosis, accompanied by chondroid metaplasia in some cases. Both antelopes were juvenile and died with right-sided congestive heart failure associated with severe pulmonary arterial lesions. To the authors' knowledge, this is the first description of cardiac and pulmonary arterial disease in zoo mammals housed at high altitudes.

  7. Pulmonary artery and right ventricle assessment in pulmonary hypertension. Correlation between functional parameters of ECG-gated CT and right-side heart catheterization

    Energy Technology Data Exchange (ETDEWEB)

    Abel, Elodie; Jankowski, Adrien [Clinique univ. de radiologie et imagerie medicale, CHU Grenoble (France); Pison, Christophe [Clinique univ. de pneumologie, CHU Grenoble (France); Bosson, Jean Luc [Dept. of Statistics, CIC, CHU Grenoble (France); Bouvaist, Helene [Clinique univ. de cardiologie, CHU Grenoble (France); Ferretti, Gilbert R. [Clinique univ. de radiologie et imagerie medicale, CHU Grenoble (France); Univ. J. Fourier, Grenoble (France); INSERM U 823, Inst. A. Bonniot, la Tronche (France)], e-mail: gferretti@chu-grenoble.fr

    2012-09-15

    Background: Right ventricular function predicts outcome in patients with pulmonary hypertension (PH). Therefore accurate assessment of right ventricular function is essential to graduate severity, assess follow-up, and response to therapy. Purpose: To evaluate whether PH severity could be assessed using electrocardiography-gated CT (ECG-gated CT) functional parameters. A further objective was to evaluate cardiac output (CO) using two ECG-gated CT methods: the reference Simpson technique and the fully automatic technique generated by commercially available cardiac software. Material and Methods: Our institutional review board approved this study; patient consent was not required. Twenty-seven patients who had undergone ECG-gated CT and right heart catheterization (RHC) were included. Two independent observers measured pulmonary artery (PA) diameter, PA distensibility, aorta diameter, right ventricular cardiac output (CT-RVCO) and right ventricular ejection fraction (CT-RVEF) with automatic and Simpson techniques on ECG-gated CT. RHC-CO and mean pulmonary arterial pressure (mPAP) were measured on RHC. Relationship between ECG-gated CT and RHC measurements was tested with linear regression analysis. Results: Inter-observer agreement was good for all measurements (r > 0.7) except for CT-RVCO calculated with Simpson's technique (r = 0.63). Pulmonary artery (PA) distensibility was significantly correlated to mPAP (r = -0.426, P = 0.027). CT-RVEF was correlated with mPAP only when issued from Simpson technique (r = -0.417, P = 0.034). CT-RVEF was not significantly correlated to RHC-CO (P > 0.2). CT-RVCO measured with Simpson technique (r = 0.487, P = 0.010) and automatic segmentation (r = 0.549, P 0.005) correlated equally with RHC-CO. Conclusion: CT-RVEF and CT-RVCO measured on ECG-gated CT are significantly correlated, respectively, to mPAP and RHC-CO in this population with severe reduction of the right ventricular ejection fraction and could be useful for

  8. A RARE CASE OF EXTENSIVE THROMBOSIS OF INFERIOR VENA CAVA, PORTAL VEIN, SPLENIC VEIN AND SUPERIOR MESENTRIC VEIN

    Directory of Open Access Journals (Sweden)

    Giridhar

    2015-03-01

    Full Text Available While the most common presentation of venous thromboembolic disease is deep vein thrombosis (DVT or pulmonary thromboembolism, rarer manifestations are thrombosis of jugular vein, cerebral sinus and inferior vena cava. Here we are presenting a rare case of inferior vena caval thrombosis with multiple thrombus in portal vein, splenic vein and superior mesenteric vein

  9. Superior vena cava syndrome in a patient with previous cardiac surgery: what else should we suspect?

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    Dolou Paraskevi

    2010-06-01

    Full Text Available Abstract Background Although mediastinal tumors compressing or invading the superior vena cava represent the major causes of the superior vena cava syndrome, benign processes may also be involved in the pathogenesis of this medical emergency. One of the rarest benign causes is a pseudoaneurysm developing in patients previously having heart surgery. Case report We present the case of a large pseudoaneurysm of the ascending aorta, five years after primary surgery, with a significant compression of the right mediastinal venous system causing superior vena cava syndrome, detected at chest CT angiography. Perioperative findings showed two rush out points both coming from the distal aortic suture line which was performed five years ago. The patient underwent reoperation under circulatory arrest facilitating safe exploration and repair of the distal anastomotic leaks Conclusion Enhanced chest CT should be always undertaken in all patients with superior vena cava syndrome, especially in those previously having cardiac or aortic surgery to correctly evaluate the presence of a pseudoaneurysm. Mass effect to the superior vena cava makes necessary an open surgical treatment of the pseudoaneurysm so as to concurrently resolve the right mediastinal venous system's compression. Surgery should be performed in terms of safe approach to avoid exsanguination and cerebral malperfusion.

  10. 慢性肺源性心脏病患者24小时心率变异性的研究%The study of heart rate variability in patients w ith chronic pulmonary heart disease

    Institute of Scientific and Technical Information of China (English)

    何九龙; 王永东; 等

    2001-01-01

    目的:研究男性慢性肺源性心脏病患者的心率变异 性。方法:46例健康男性,34例男性慢性肺源性心脏病患者,行24 h动态心电图记录,作时域和频域分析。结果:慢性肺源性心脏病病人的高频(HF)、低频(LF)、NN50计数占 总R-R间期的百分比(pNN50)、每5 min正常R-R间期标准差的平均值(SDANN)均下降,其中严 重的慢性肺源性心脏病患者下降更为显著。结论:男性慢性肺源性心脏病患者存在植物神经功能紊乱,病情严 重程度也与植物神经功能相关。%Objective:To study variability of heart rate in pat ients with chronic pulmonary heart disease.Method:Twenty-four hour Holter monitoring were perf ormed in 46 male healthy volunteers and 34 cases of chronic pulmonary heart dis ease who were divided into groups according to the severity of their heart failure.Results:The HF,LF,pNN50 and SDANN were decreased in the chronic pulmonary heart disease cases in comparing to the normal group.T hese values were the lowest in the severe chronic pulmonary heart disease g roup.Conclusion:The autonomic nervous function of the chronic pulmonary heart diseasemale sufferers differs from that of normal people .It is possible that the changes of autonomic nervous function of chronic pulmonary heart disease sufferers are related to the severity of chronic pulmonary heart d isease.

  11. Abordagem da valva do tronco pulmonar por desvio direito e uso de cânula bicaval: estudo experimental Approach of the pulmonary valve using right heart bypass and bicaval cannula: experimental study

    Directory of Open Access Journals (Sweden)

    Ana Maria RochaPinto e Silva

    2007-12-01

    Full Text Available OBJETIVO: O objetivo deste estudo foi reproduzir a cirurgia de abordagem da valva do tronco pulmonar por desvio direito, avaliando-se uma nova cânula venosa bicaval com balonetes insufláveis para uso por miniacesso. MÉTODOS: Utilizaram-se 15 suínos da raça Large-White, sendo cinco para a padronização técnica das vias de acesso e monitorização hemodinâmica, nove submetidos ao experimento por meio de esternotomia, e um animal excluído da amostra, operado por mínimo acesso ao tórax. O desvio direito foi estabelecido pela drenagem bicaval, sendo a cânula introduzida pela veia jugular interna direita e locada nas veias cavas cranial e caudal. Os parâmetros medidos foram: Pressão Arterial Média (PAM; Freqüência Cardíaca (FC; Saturação O2 (SAT O2; Capnografia (PetCO2 e Temperatura (T. A análise estatística foi feita comparando-se os valores antes e durante o desvio direito. RESULTADOS: No momento pré-desvio direito, obtiveramse os seguintes valores médios: PAM = 90,8 mmHg, FC = 101,6 bat/min, SAT O2 = 93,8%, PetCO2 = 28,4 mmHg, T = 36,1ºC. Durante o desvio direito, obtiveram-se os seguintes valores médios: PAM = 88,1 mmHg, FC = 98,0 bat/min, SAT O2 = 93,1%, PetCO2 = 25,3 mmHg e T = 36,9ºC. Comparandose as médias obtidas entre os dois momentos, verificou-se não haver diferenças significantes para a PAM, FC e SAT O2 e diferenças significantes para a PetCO2 e a T. CONCLUSÃO: A cânula bicaval com balonetes promoveu drenagem eficaz de ambas as veias cavas, permitindo a manutenção dos parâmetros hemodinâmicos durante o desvio direito, sendo possível realizar a abordagem da valva pulmonar.OBJECTIVE: To reproduce the surgery for correction of pulmonary valve anomalies using right heart bypass and a new bicaval cuffed venous cannula for minimal access surgery. METHODS: Fifteen Large-White pigs were used for this study. The standard technique model was established with the first five pigs, the experiment was done with

  12. Palliative Senning in the Treatment of Congenital Heart Disease with Severe Pulmonary Hypertension

    Directory of Open Access Journals (Sweden)

    Juliano Gomes da Penha

    2015-01-01

    Full Text Available Background:Transposition of the great arteries (TGA is the most common cyanotic cardiopathy, with an incidence ranging between 0.2 and 0.4 per 1000 live births. Many patients not treated in the first few months of life may progress with severe pulmonary vascular disease. Treatment of these patients may include palliative surgery to redirect the flow at the atrial level.Objective:Report our institutional experience with the palliative Senning procedure in children diagnosed with TGA and double outlet right ventricle with severe pulmonary vascular disease, and to evaluate the early and late clinical progression of the palliative Senning procedure.Methods:Retrospective study based on the evaluation of medical records in the period of 1991 to 2014. Only patients without an indication for definitive surgical treatment of the cardiopathy due to elevated pulmonary pressure were included.Results:After one year of follow-up there was a mean increase in arterial oxygen saturation from 62.1% to 92.5% and a mean decrease in hematocrit from 49.4% to 36.3%. Lung histological analysis was feasible in 16 patients. In 8 patients, pulmonary biopsy grades 3 and 4 were evidenced.Conclusion:The palliative Senning procedure improved arterial oxygen saturation, reduced polycythemia, and provided a better quality of life for patients with TGA with ventricular septal defect, severe pulmonary hypertension, and poor prognosis.

  13. Design Optimization of Vena Cava Filters: An application to dual filtration devices

    Energy Technology Data Exchange (ETDEWEB)

    Singer, M A; Wang, S L; Diachin, D P

    2009-12-03

    Pulmonary embolism (PE) is a significant medical problem that results in over 300,000 fatalities per year. A common preventative treatment for PE is the insertion of a metallic filter into the inferior vena cava that traps thrombi before they reach the lungs. The goal of this work is to use methods of mathematical modeling and design optimization to determine the configuration of trapped thrombi that minimizes the hemodynamic disruption. The resulting configuration has implications for constructing an optimally designed vena cava filter. Computational fluid dynamics is coupled with a nonlinear optimization algorithm to determine the optimal configuration of trapped model thrombus in the inferior vena cava. The location and shape of the thrombus are parameterized, and an objective function, based on wall shear stresses, determines the worthiness of a given configuration. The methods are fully automated and demonstrate the capabilities of a design optimization framework that is broadly applicable. Changes to thrombus location and shape alter the velocity contours and wall shear stress profiles significantly. For vena cava filters that trap two thrombi simultaneously, the undesirable flow dynamics past one thrombus can be mitigated by leveraging the flow past the other thrombus. Streamlining the shape of thrombus trapped along the cava wall reduces the disruption to the flow, but increases the area exposed to abnormal wall shear stress. Computer-based design optimization is a useful tool for developing vena cava filters. Characterizing and parameterizing the design requirements and constraints is essential for constructing devices that address clinical complications. In addition, formulating a well-defined objective function that quantifies clinical risks and benefits is needed for designing devices that are clinically viable.

  14. Leiomyosarcoma of the superior vena cava.

    Science.gov (United States)

    de Chaumont, Arthus; Pierret, Charles; de Kerangal, Xavier; Le Moulec, Sylvestre; Laborde, François

    2014-08-01

    Leiomyosarcoma of the superior vena cava is a very rare tumor and only a few cases have been reported, with various techniques of vascular reconstruction. We describe a new case of leiomyosarcoma of the superior vena cava in a 61-year-old woman with extension to the brachiocephalic arterial trunk. Resection and vascular reconstruction were performed using, respectively, polytetrafluoroethylene and polyethylene terephtalate vascular grafts.

  15. Pulmonary valve stenosis

    Science.gov (United States)

    ... valvuloplasty - pulmonary Images Heart valves References Carabello BA. Valvular heart disease. In: Goldman L, Schafer AI, eds. Goldman's Cecil ... Saunders; 2016:chap 69. Otto CM, Bownow RO. Valvular heart disease. In: Mann DL, Zipes DP, Libby P, Bonow ...

  16. Advanced Techniques for Removal of Retrievable Inferior Vena Cava Filters

    Energy Technology Data Exchange (ETDEWEB)

    Iliescu, Bogdan; Haskal, Ziv J., E-mail: ziv2@mac.com [University of Maryland School of Medicine, Division of Vascular and Interventional Radiology (United States)

    2012-08-15

    Inferior vena cava (IVC) filters have proven valuable for the prevention of primary or recurrent pulmonary embolism in selected patients with or at high risk for venous thromboembolic disease. Their use has become commonplace, and the numbers implanted increase annually. During the last 3 years, in the United States, the percentage of annually placed optional filters, i.e., filters than can remain as permanent filters or potentially be retrieved, has consistently exceeded that of permanent filters. In parallel, the complications of long- or short-term filtration have become increasingly evident to physicians, regulatory agencies, and the public. Most filter removals are uneventful, with a high degree of success. When routine filter-retrieval techniques prove unsuccessful, progressively more advanced tools and skill sets must be used to enhance filter-retrieval success. These techniques should be used with caution to avoid damage to the filter or cava during IVC retrieval. This review describes the complex techniques for filter retrieval, including use of additional snares, guidewires, angioplasty balloons, and mechanical and thermal approaches as well as illustrates their specific application.

  17. Scimitar syndrome with pulmonary arteriovenous fistulas.

    Science.gov (United States)

    Le Rochais, J P; Icard, P; Davani, S; Abouz, D; Evrard, C

    1999-10-01

    Right abnormal pulmonary venous return into the inferior vena cava associated with abnormal fissure, dextrocardia, and systemic arterial supply of a variable degree, are the characteristics of the scimitar syndrome. We report on a patient in whom this rare syndrome was associated with pulmonary arteriovenous fistulas within the involved lung.

  18. Effects of Aerobic Exercise Training and Irbesartan on Blood Pressure and Heart Rate Variability in Patients with Chronic Obstructive Pulmonary Disease

    Directory of Open Access Journals (Sweden)

    Karine Marquis

    2008-01-01

    Full Text Available BACKGROUND AND OBJECTIVES: The present pilot study was undertaken to evaluate the efficacy of an aerobic exercise training (AET program alone or combined with an antihypertensive agent (irbesartan to reduce blood pressure (BP and enhance heart rate variability (HRV in chronic obstructive pulmonary disease patients.

  19. Importance of combined left atrial size and estimated pulmonary pressure for clinical outcome in patients presenting with heart failure with preserved ejection fraction

    DEFF Research Database (Denmark)

    Donal, Erwan; Lund, Lars H; Oger, Emmanuel

    2017-01-01

    Aims: Heart failure with preserved ejection fraction (HFpEF) is a complex syndrome with various phenotypes and outcomes. The prognostic relevance of echocardiography and the E/e' ratio has previously been reported. We sought to study in addition, the value of estimated pulmonary pressure and left...

  20. Systolic and diastolic dysfunction of the right heart ventricle in patients with chronic obstructive pulmonary disease in extremely cold climate.

    Science.gov (United States)

    Sivtseva, Anna Innokentievna; Strutynsky, Andrew Vladislavovich; Krivoshapkin, Vadim Grigorievich; Sivtseva, Elena Nikolaevna; Ivanova, Marianna Adolfovna; Timofeev, Leonid Fedorovich

    2014-11-30

    The paper describes echocardiographic values of systolic and diastolic dysfunction the right heart ventricle in 229 patients with chronic obstructive pulmonary disease. In our patients the values AvPAP (?25 mmHg while resting), FDDrv and FSDrv (>26 and 20 mm respectively), the thickness of front wall the RV (>5 mm), the dimension of AD (>35 mm), as well as the reduction the vestibular-distal shortening of RV (<23%), maximum blood velocity and the blood evacuation time from reflect indirectly the progressive reduction the contractive capacity RV myocardium and the occurrence of systolic dysfunction. In patients with severe de-compensation a restrictive type diastolic function is more characteristic - acceleration of early diastolic filling and blood velocity decrease during the auricular systole.

  1. Readmission patterns in patients with chronic obstructive pulmonary disease, chronic heart failure and diabetes mellitus: an administrative dataset analysis.

    Science.gov (United States)

    Brand, C; Sundararajan, V; Jones, C; Hutchinson, A; Campbell, D

    2005-05-01

    Comprehensive disease management programmes for chronic disease aim to improve patient outcomes and reduce health-care utilization. Readmission rates are often used as an outcome measure of effectiveness. This study aimed to document readmission rates, and risk for early and late readmission, for patients discharged from the Royal Melbourne Hospital with a disease diagnosis of chronic heart failure (CHF), chronic obstructive pulmonary disease (COPD) or diabetes mellitus compared to those with other general medical conditions. Eighty five (8.6%) of patients were readmitted within 28 days and 183 (20.8%) were readmitted between 29 and 180 days. No risk factors for early readmission were identified. Patients with a primary disease diagnosis of CHF and COPD are at increased risk of late readmissions (29-180 days).

  2. Clinical significance of changes of heart rate variability in patients with pulmonary heart disease%肺心病患者心率变异性改变的临床意义

    Institute of Scientific and Technical Information of China (English)

    代云红; 薛梅; 李继鹏

    2011-01-01

    目的 分析慢性肺源性心脏病患者的心率变异性改变的临床意义.方法 经动态心电图、血气分析检查,选取肺心病缓解期、急性期与正常受试者各42例,采用时域法分析其HRV的改变.结果 肺心病组HRV均较对照组降低,且重症肺心病随血氧分压下降、二氧化碳分压升高,各参数下降更明显.结论 肺心病患者HRV的改变在预测其心电变化指导临床治疗提供了重要的指标.%Objective To analyze the clinical significance of the changes of chronic pulmonary heart rate variability. Methods The measures of electrocardiogram, blood gas analysis and HRV changes were compared among the patients at stable and acute stage of pulmonary heart disease ( n = 42) and with normal subjects ( n = 42), by using. In comparison pulmonary heart disease group showed more decrease in HRV chayes and severe decline in pulmonary heart disease with in blood oxygen pressure, and more increase in carbon dioxide partial pressure. Conclusion The changes in HRV in patients with pulmonary heart disease in predicting changes in the ECG provides important clinical indicator for its treatment.

  3. Pulmonary Edema

    OpenAIRE

    Tanser, Paul H.

    1981-01-01

    The physician who deals with pulmonary edema from a pathophysiologic basis will seldom make a diagnostic or therapeutic error. Recent additions to preload and afterload therapy have greatly helped in the emergency and ambulatory treatment of pulmonary edema due to left heart failure. Careful follow-up and patient self-monitoring are the most effective means of reducing hospitalization of chronic heart failure patients.

  4. Correlation of 64 row MDCT, echocardiography and cardiac catheterization angiography in assessment of pulmonary arterial anatomy in children with cyanotic congenital heart disease

    Energy Technology Data Exchange (ETDEWEB)

    Chandrashekhar, Guruprasadh, E-mail: cguruprasadh@gmail.com [Departments of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh 160012 (India); Sodhi, Kushaljit Singh, E-mail: sodhiks@gmail.com [Departments of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh 160012 (India); Saxena, Akshay Kumar, E-mail: fatakshay@yahoo.com [Departments of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh 160012 (India); Rohit, Manoj Kumar, E-mail: rohitmanoj@gmail.com [Department of Pediatric Cardiology, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh 160012 (India); Khandelwal, Niranjan, E-mail: khandelwaln@hotmail.com [Departments of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh 160012 (India)

    2012-12-15

    Objective: To study the correlation of low-dose 64-row multi-detector computed tomography (MDCT) with echocardiography and cardiac catheterization angiography (CCA) in the assessment of pulmonary arterial anatomy in children with cyanotic congenital heart disease (CCHD). Materials and methods: This prospective study included 105 children (74 males, 31 females) with CCHD, in the age group of 2 months to 20 years, who underwent 64-row MDCT examination (low-dose CT protocol), echocardiography and CCA for the assessment of pulmonary arteries, including visualization, presence of confluence, stenosis and collaterals. Statistical analysis was performed using the non-parametric statistical analysis test to evaluate the concordance or discordance between echocardiography, MDCT and CCA. Results: 64-row MDCT detected significantly more main and branch pulmonary arteries, patent pulmonary confluences, and more cases of pulmonary artery stenosis. CCA detected more major aorto-pulmonary collaterals than MDCT, whereas echocardiography failed to identify these major aorto-pulmonary collaterals. The effective CT radiation dose to patients less than 2 years of age was in the range of 0.7–2.5 mSv, where as the dose in patients more than 2 years of age ranged from that of 2.1 to 4.2 mSv, which is much less than the radiation dose reported in cardiac catheterization angiography. Conclusion: In cases where cardiac MRI cannot be performed, or is not sufficiently informative, low-dose 64-row MDCT correlates well with CCA and can provide adequate information about pulmonary arterial anatomy in children with cyanotic congenital heart disease, and can replace invasive cardiac catheterization angiography with markedly reduced radiation dosage to the patient.

  5. A MAN WITH A HYDATID CYST IN THE HEART

    Directory of Open Access Journals (Sweden)

    S.M MIRMOHAMMAD SADEGHI

    2001-03-01

    Full Text Available Infection with echinococcus has a world-wide distribution. This parasite affection almost all body organs (such as brain, lungs, spleen, billiary tract, liver, thyroid, parotid, tongue, bone, prostate, bladder, tonsile, pulmonary arteries and inferior vena cava. The other important body organ which also is infected by this parasite is the heart. The patient is a 32 year old man without any symptoms who referred for the evaluation of incidental cardiac murmur on physical examination. All findings in ECG and Chest X ray were normal. Echocardiography showed a large moblie cystic mass in left ventricular outflow tract. Because of the dangerous site of the cyst and probability of rupture and anaphylaxis, he was operated emergently and the cyst was removed successfully. He was discharged from the hospital without any residual LV dysfunction, heart block and cardiac problems.

  6. A MAN WITH A HYDATID CYST IN THE HEART

    Directory of Open Access Journals (Sweden)

    S.M MIRMOHAMMAD SADEGHI

    2001-06-01

    Full Text Available Infection with echinococcus has a world-wide distribution. This parasite affection almost all body organs (such as brain, lungs, spleen, billiary tract, liver, thyroid, parotid, tongue, bone, prostate, bladder, tonsile, pulmonary arteries and inferior vena cava. The other important body organ which also is infected by this parasite is the heart. The patient is a 32 year old man without any symptoms who referred for the evaluation of incidental cardiac murmur on physical examination. All findings in ECG and Chest X ray were normal. Echocardiography showed a large moblie cystic mass in left ventricular outflow tract. Because of the dangerous site of the cyst and probability of rupture and anaphylaxis, he was operated emergently and the cyst was removed successfully. He was discharged from the hospital without any residual LV dysfunction, heart block and cardiac problems.

  7. Assessment of left heart and pulmonary circulation flow dynamics by a new pulsed mock circulatory system

    Science.gov (United States)

    Tanné, David; Bertrand, Eric; Kadem, Lyes; Pibarot, Philippe; Rieu, Régis

    2010-05-01

    We developed a new mock circulatory system that is able to accurately simulate the human blood circulation from the pulmonary valve to the peripheral systemic capillaries. Two independent hydraulic activations are used to activate an anatomical-shaped left atrial and a left ventricular silicon molds. Using a lumped model, we deduced the optimal voltage signals to control the pumps. We used harmonic analysis to validate the experimental pulmonary and systemic circulation models. Because realistic volumes are generated for the cavities and the resulting pressures were also coherent, the left atrium and left ventricle pressure-volume loops were concordant with those obtained in vivo. Finally we explored left atrium flow pattern using 2C-3D+T PIV measurements. This gave a first overview of the complex 3D flow dynamics inside realistic left atrium geometry.

  8. Arrhythmogenic substrate in hearts of rats with monocrotaline-induced pulmonary hypertension and right ventricular hypertrophy

    OpenAIRE

    Benoist, David; Stones, Rachel; Drinkhill, Mark; Bernus, Olivier; White, Ed

    2011-01-01

    Mechanisms associated with right ventricular (RV) hypertension and arrhythmias are less understood than those in the left ventricle (LV). The aim of our study was to investigate whether and by what mechanisms a proarrhythmic substrate exists in a rat model of RV hypertension and hypertrophy. Rats were injected with monocrotaline (MCT; 60 mg/kg) to induce pulmonary artery hypertension or with saline (CON). Myocardial levels of mRNA for genes expressing ion channels were measured by real-time R...

  9. Palliative Senning in the Treatment of Congenital Heart Disease with Severe Pulmonary Hypertension

    OpenAIRE

    Juliano Gomes da Penha; Leina Zorzanelli; Antonio Augusto Barbosa-Lopes; Edimar Atik; Leonardo Augusto Miana; Carla Tanamati; Luiz Fernando Caneo; Nana Miura; Vera Demarchi Aiello; Marcelo Biscegli Jatene

    2015-01-01

    Background:Transposition of the great arteries (TGA) is the most common cyanotic cardiopathy, with an incidence ranging between 0.2 and 0.4 per 1000 live births. Many patients not treated in the first few months of life may progress with severe pulmonary vascular disease. Treatment of these patients may include palliative surgery to redirect the flow at the atrial level.Objective:Report our institutional experience with the palliative Senning procedure in children diagnosed with TGA and doubl...

  10. Correlation between endothelia cells activation and imbalance of cytokines in pulmonary hypertension of congenital heart disease

    Institute of Scientific and Technical Information of China (English)

    师桃; 吕毅; 耿希刚; 李兆志

    2007-01-01

    Objective To explore the correlation between endothelia cells activation and cytokines (ET-1, NO) levels in patients with pulmonary hypertension (PH), and to discuss their roles in the development of PH. Methods Twenty patients with simple ventricular septal defect (VSD) were chosen as controls, and 30 patients with PH were studied. Plasma levels of ET-1 and NO were measured by radioimmunoassay or colorimetric method. Before cardiopulmonary bypass was established, the specimens from right lung were fixed wi...

  11. Vena cava filters in cancer patients: experience with 50 patients Filtros de veia cava inferior em pacientes com câncer: experiência em 50 casos

    Directory of Open Access Journals (Sweden)

    Antonio Eduardo Zerati

    2005-10-01

    Full Text Available OBJECTIVE: To study the immediate and late results obtained from the implantation of vena cava filters in cancer patients with deep vein thrombosis concomitant with neoplasia. METHODS: This was a retrospective evaluation of 50 patients with an association of cancer and deep venous thrombosis who underwent interruption of the inferior vena cava and the insertion of permanent vena cava filters. The indications for the procedure, filter implantation technique, early and late complications related to the operation, and the clinical evolution were evaluated. RESULTS: The most frequent indication for filter implantation was the contraindication for full anticoagulant treatment (80%. The femoral vein was the preferred access route (86% of the patients. There were no complications related to the surgical procedure. During the follow-up, the following complications were observed: 1 episode of nonfatal pulmonary thromboembolism, 2 cases of occlusion of the inferior vena cava, and 1 case of thrombus retained in the device. Twenty patients (40% died due to progression of the neoplasm. CONCLUSIONS: Interruption of the inferior cava vein using an endoluminal filter is a procedure with a low rate of complications. It is a safe and efficient measure for preventing pulmonary embolism in cancer patients who have deep vein thrombosis of the lower limbs.OBJETIVO: Estudar os resultados imediatos e tardios obtidos com a implantação de filtros de veia cava inferior em pacientes com trombose venosa profunda concomitante a neoplasia. MÉTODOS: Avaliamos retrospectivamente 50 pacientes com câncer e trombose venosa profunda associada submetidos a interrupção de veia cava inferior com filtros intraluminais definitivos. Foram estudados aspectos referentes à indicação do procedimento, à técnica de implante dos dispositivos, complicações precoces e tardias relacionadas à operação e à evolução dos pacientes. RESULTADOS: A indicação mais freqüente para o

  12. Medical image of the week: persistent left superior vena cava

    Directory of Open Access Journals (Sweden)

    Hammode E

    2014-10-01

    Full Text Available No abstract available. Article truncated after 150 words. A 19 year old man with acute lymphocytic leukemia was admitted to the ICU with septic shock. Due to areas of cellulitis on the right side of the chest and neck and femoral venous thrombi, a left subclavian central access was attempted. The chest x-ray obtained after line placement is shown below (Figure 1. Blood gas done from the line was consistent with venous blood and venous tranduction was seen. A CT of the chest (Figure 2 confirmed the diagnosis of persistent left superior vena cava (PLSVC. A persistent left superior vena cava is the most common congenital thoracic venous anomaly, seen in 0.3-0.5% of the population (1. Incidence is increased in patients with congenital heart disease to 5%. In most patients a right sided SVC is also present; hence the term SVC duplication has also been used. Embryologically a PLSVC is formed when the left anterior cardinal vein is ...

  13. Effect of heparin in combined with magnesium sulfate on the blood gas and blood viscosity in patients with pulmonary heart failure

    Institute of Scientific and Technical Information of China (English)

    Rui Deng; Hong-Wei Liang; Jun-Hong Liao; Jun-Hua Chen; Hai-Yan Liu

    2016-01-01

    Objective:To observe the effect of heparin in combined with magnesium sulfate on the blood gas indicators and blood viscosity in patients with pulmonary heart disease merged with respiratory failure.Methods: A total of 80 patients with pulmonary heart disease merged with respiratory failure who were admitted in our hospital were included in the study and randomized into the observation group (n=40) and the control group (n=40). The patients in the control group were given routine symptomatic treatments of pulmonary heart disease. On the above basis, the patients in the observation group were given intravenous drip of heparin and magnesium sulfate. The patients in the two groups were treated for 2 weeks. The blood gas indicators, blood viscosity indicators, PAPs, SBP, and DBP in the two groups were compared. The clinical efficacy in the two groups was evaluated.Results:After 2-week treatment, PaO2 and PaCO2 in the two groups were improved, pH value was not significantly changed, PaO2 in the observation group was significantly higher than that in the control group, while PaCO2 was significantly lower than that in the control group. The hemorheology indicators after treatment in the two groups were significantly reduced when compared with before treatment, among which the comparison of WBV, PV, Hct, and EAI between the two groups was statistically significant, and PAPs after treatment in the observation group was significantly reduced when compared with the control group. SBP and DBP after treatment in the two groups were not significantly changed.Conclusions: Heparin in combined with magnesium sulfate in the treatment of pulmonary heart disease merged with respiratory failure can improve the blood gas indicators and blood viscosity indicators, and reduce SBP of pulmonary artery, with a higher efficacy; therefore, it deserves to be widely recommended in the clinic.

  14. Percutaneous retrieval of a vena cava filter from the right atrium: case report

    Energy Technology Data Exchange (ETDEWEB)

    Rasuli, P. [The Ottawa Hospital and University of Ottawa, Dept. of Radiology, Ottawa, Ontario (Canada); Mehran, R. [The Ottawa Hospital and University of Ottawa, Dept. of Thoracic Surgery, Ottawa, Ontario (Canada); French, G. [The Ottawa Hospital and University of Ottawa, Dept. of Radiology, Ottawa, Ontario (Canada); Turek, M. [The Ottawa Hospital and University of Ottawa, Dept. of Internal Medicine, Ottawa, Ontario (Canada); Lalonde, K.A. [The Ottawa Hospital and University of Ottawa, Dept. of Thoracic Surgery, Ottawa, Ontario (Canada); Cardinal, P. [The Ottawa Hospital and University of Ottawa, Dept. of Internal Medicine, Ottawa, Ontario (Canada)

    2000-07-01

    Migration of vena cava filters can occur spontaneously, but it can also occur as a result of entanglement of the filter with a guidewire, particularly during 'blind' (unguided) insertion of a central venous line. When a filter migrates to the heart, traditional practice has been either to leave the filter in place or to remove it surgically by means of open heart surgery and cardiopulmonary bypass. We found only 6 reports of successful percutaneous retrieval or repositioning of a vena cava filter (Table 1). We describe a new interventional technique for retrieving a filter from the right atrium and a novel endosurgical method for removing a filter from the innominate vein. (author)

  15. Evaluation and Treatment of Congenital Heart Disease and Pulmonary Artery Hypertension%先心病并发肺动脉高压的评估与治疗

    Institute of Scientific and Technical Information of China (English)

    龙雷王; 高纪平; 祝益民

    2013-01-01

    Pulmonary arterial hypertension is the most common complication of congenital heart disease,resulting in congenital heart disease surgery risk increased obviously,the fatality rate was up to 4.9%-29.0%. This paper reviews the congenital heart disease at home and abroad in recent years merger pulmonary hypertension medical progress,in order to for clinical treatment of congenital heart disease in pulmonary hypertension combined to provide the reference.%  肺动脉高压是先天性心脏病最常见的并发症,导致先天性心脏病手术风险明显增高,病死率达4.9%~29.0%.本文综述了近年来国内外先天性心脏病合并肺动脉高压的诊疗进展,以期为临床治疗先天性心脏病合并肺动脉高压提供参考.

  16. A genome-wide association study of pulmonary function measures in the Framingham Heart Study.

    Directory of Open Access Journals (Sweden)

    Jemma B Wilk

    2009-03-01

    Full Text Available The ratio of forced expiratory volume in one second to forced vital capacity (FEV(1/FVC is a measure used to diagnose airflow obstruction and is highly heritable. We performed a genome-wide association study in 7,691 Framingham Heart Study participants to identify single-nucleotide polymorphisms (SNPs associated with the FEV(1/FVC ratio, analyzed as a percent of the predicted value. Identified SNPs were examined in an independent set of 835 Family Heart Study participants enriched for airflow obstruction. Four SNPs in tight linkage disequilibrium on chromosome 4q31 were associated with the percent predicted FEV(1/FVC ratio with p-values of genome-wide significance in the Framingham sample (best p-value = 3.6e-09. One of the four chromosome 4q31 SNPs (rs13147758; p-value 2.3e-08 in Framingham was genotyped in the Family Heart Study and produced evidence of association with the same phenotype, percent predicted FEV(1/FVC (p-value = 2.0e-04. The effect estimates for association in the Framingham and Family Heart studies were in the same direction, with the minor allele (G associated with higher FEV(1/FVC ratio levels. Results from the Family Heart Study demonstrated that the association extended to FEV(1 and dichotomous airflow obstruction phenotypes, particularly among smokers. The SNP rs13147758 was associated with the percent predicted FEV(1/FVC ratio in independent samples from the Framingham and Family Heart Studies producing a combined p-value of 8.3e-11, and this region of chromosome 4 around 145.68 megabases was associated with COPD in three additional populations reported in the accompanying manuscript. The associated SNPs do not lie within a gene transcript but are near the hedgehog-interacting protein (HHIP gene and several expressed sequence tags cloned from fetal lung. Though it is unclear what gene or regulatory effect explains the association, the region warrants further investigation.

  17. Does intravenous sildenafil clinically ameliorate pulmonary hypertension during perioperative management of congenital heart diseases in children? - A prospective randomized study

    Directory of Open Access Journals (Sweden)

    Vipul Krishen Sharma

    2015-01-01

    Full Text Available Background: Pulmonary hypertension (PHT, if present, can be a significant cause of increased morbidity and mortality in children undergoing surgery for congenital heart diseases (CHD. Various techniques and drugs have been used perioperatively to alleviate the effects of PHT. Intravenous (IV sildenafil is one of them and not many studies validate its clinical use. Aims and Objectives: To compare perioperative PaO 2 - FiO 2 ratio peak filling rate (PFR, systolic pulmonary artery pressure (PAP - systolic aortic pressure (AoP ratio, extubation time, and Intensive Care Unit (ICU stay between two groups of children when one of them is administered IV sildenafil perioperatively during surgery for CHDs. Materials and Methods: Patients with ventricular septal defects and proven PHT, <14 years of age, all American Society of Anesthesiologists physical status III, undergoing cardiac surgery, were enrolled into two groups - Group S (IV sildenafil and Group C (control - over a period of 14 months, starting from October 2013. Independent t-test and Mann-Whitney U-test were used to compare the various parameters between two groups. Results: PFR was higher throughout, perioperatively, in Group S. PAP/AoP was 0.3 and 0.4 in Group S and Group C, respectively. In Group S, mean group extubation time was 7 ± 7.34 h, whereas in Group C it was 22.1 ± 10.6. Postoperative ICU stay in Group S and Group C were 42.3 ± 8.8 h and 64.4 ± 15.9 h, respectively. Conclusion: IV sildenafil, when used perioperatively, in children with CHD having PHT undergoing corrective surgery, improves not only PaO 2 - FiO 2 ratio and PAP - AoP ratio but also reduces extubation time and postoperative ICU stay.

  18. Plasma von Willebrand factor as a predictor of survival in pulmonary arterial hypertension associated with congenital heart disease

    Directory of Open Access Journals (Sweden)

    A.A. Lopes

    2011-12-01

    Full Text Available Biomarkers have been identified for pulmonary arterial hypertension, but are less well defined for specific etiologies such as congenital heart disease-associated pulmonary arterial hypertension (CHDPAH. We measured plasma levels of eight microvascular dysfunction markers in CHDPAH, and tested for associations with survival. A cohort of 46 inoperable CHDPAH patients (age 15.0 to 60.2 years, median 33.5 years, female:male 29:17 was prospectively followed for 0.7 to 4.0 years (median 3.6 years. Plasma levels of von Willebrand factor antigen (VWF:Ag, tissue plasminogen activator (t-PA and its inhibitor (PAI-1, P-selectin, reactive C-protein, tumor necrosis factor alpha, and interleukin-6 and -10 were measured at baseline, and at 30, 90, and 180 days in all subjects. Levels of six of the eight proteins were significantly increased in patients versus controls (13 to 106% increase, P < 0.003. Interleukin-10 level was 2.06 times normal (P = 0.0003; Th2 cytokine response. Increased levels of four proteins (t-PA, PAI-1, P-selectin, and interleukin-6 correlated with disease severity indices (P < 0.05. Seven patients died during follow-up. An average VWF:Ag (mean of four determinations above the level corresponding to the 95th percentile of controls (139 U/dL was independently associated with a high risk of death (hazard ratio = 6.56, 95%CI = 1.46 to 29.4, P = 0.014. Thus, in CHDPAH, microvascular dysfunction appears to involve Th2 inflammatory response. Of the biomarkers studied, plasma vWF:Ag was independently associated with survival.

  19. A case of coarctation of the aorta associated with the patent ductus arteriosus and the persistent left superior vena cava

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Yoo Keun [Hanyang University College of Medicine, Seoul (Korea, Republic of)

    1974-10-15

    This is a case report of multiple congenital vascular anomalies in which coarctation of the aorta combined with the patent ductus arteriosus and the persistent left superior vena cava. The patient was a 15 year old girl and congenital heart disease was suspected during infancy. However, she heard the disease incurable, so she had been well with herb medicine until admission in our hospital. By physical examination and roentgenological studies including aortography, the diagnosis of the patent ductus arteriosus was detected and the coarctation of the aorta was suspected. The persistent left superior vena cava was found during surgery and it was proved roentgenologically by venography.

  20. Acute pulmonary edema following liposuction due to heart failure and atypical pneumonia.

    Science.gov (United States)

    Wollina, Uwe; Graf, Andreas; Hanisch, Volkmar

    2015-05-01

    Microcannular liposuction in tumescent anesthesia is the most effective treatment for painful lipedema. Tumescent anesthesia is an established and safe procedure in local analgesia when performed according to guidelines. Major adverse effects are rare. In patients with advanced lipedema, however, the commonly presented comorbidities bear additional risks.We report on post-surgical acute pulmonary edema after tumescent liposuction according to guidelines in a 52-year-old female patient with lipedema of the legs. We discuss in detail possible scenarios that might be involved in such emergency. In the present case the most likely was a retarded community acquired atypical pneumonia with aggravation of pre-existent comorbidities.A combined treatment with intravenous b-lactam antibiosis, positive pressure ventilation, and continuous venovenous hemodialysis and filtration resulted in complete remission in a couple of days. In conclusion, tumescent liposuction of advanced lipedema patients should only be performed in well-trained centers with sufficient infrastructure.

  1. Patent ductus arteriosus in an adult cat with pulmonary hypertension and right-sided congestive heart failure: hemodynamic evaluation and clinical outcome following ductal closure.

    Science.gov (United States)

    Novo-Matos, José; Hurter, Karin; Bektas, Rima; Grest, Paula; Glaus, Tony

    2014-09-01

    Right-sided congestive heart failure (CHF) developed secondary to severe pulmonary hypertension (PH) in an 8-year-old cat with a left-to-right shunting patent ductus arteriosus (PDA). Vascular reactivity was tested prior to shunt ligation by treatment with oxygen and sildenafil. This treatment was associated with a significant decrease in pulmonary artery pressure as assessed by echocardiography. Subsequently surgical shunt ligation was planned. During thoracotomy, digital occlusion of the PDA was performed for 10 min with simultaneous catheter measurement of right ventricular pressure, which did not increase. Permanent shunt ligation resulted in a complete and sustained clinical recovery. A lung biopsy sample obtained during thoracotomy demonstrated histopathological arterial changes typical of PH. Cats can develop clinically severe PH and right-sided CHF secondary to a left-to-right PDA even at an advanced age. Assuming there is evidence of pulmonary reactivity, PDA occlusion might be tolerated and can potentially produce long-term clinical benefits.

  2. Fractured inferior vena cava filter strut presenting as a penetrating foreign body in the right ventricle: report of a case.

    Science.gov (United States)

    Kumar, S Prathap; Mahtabifard, Ali; Young, J Nilas

    2008-01-01

    Migration of a fractured strut of an inferior vena cava (IVC) filter to the heart is a rare complication. We report the case of a 40-year-old woman who had this complication eight months after infrarenal IVC filter placement. She presented with chest pain. The broken arm of the IVC filter had migrated to the heart and penetrated the free wall of the right ventricle. It was removed successfully by cardiac surgery without the aid of cardiopulmonary bypass.

  3. Honolulu Heart Program

    Science.gov (United States)

    2016-04-13

    Cardiovascular Diseases; Coronary Disease; Cerebrovascular Accident; Heart Diseases; Heart Failure, Congestive; Myocardial Infarction; Asthma; Emphysema; Lung Diseases, Obstructive; Aortic Aneurysm, Abdominal; Bronchitis; Dementia; Hypertension; Chronic Obstructive Pulmonary Disease; Heart Failure

  4. Mechanisms responsible for pulmonary hypertension

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    @@ Pulmonary hypertension is a pathophysiologic process characterized by progressive elevation of pulmonary vascular resistance and right heart failure, which is a common complication of many diseases. Pulmonary hypertension with no apparent causes (unknown etiology) is termed primary pulmonary hypertension or, more recently, idiopathic pulmonary arterial hypertension (IPAH).

  5. Pulmonary arterial hypertension : an update

    NARCIS (Netherlands)

    Hoendermis, E. S.

    2011-01-01

    Pulmonary arterial hypertension (PAH), defined as group 1 of the World Heart Organisation (WHO) classification of pulmonary hypertension, is an uncommon disorder of the pulmonary vascular system. It is characterised by an increased pulmonary artery pressure, increased pulmonary vascular resistance a

  6. 53. Bilateral ductal stenting for nonconfluent pulmonary arteries in a newborn

    Directory of Open Access Journals (Sweden)

    K. Al Dhahri

    2016-07-01

    Full Text Available Bilateral PDA dependent pulmonary circulation with right and left pulmonary artery discontinuity is very rare. Limited data available for bilateral PDA stenting. Bilateral PDA stenting in nonconfluent pulmonary arteries is challenging procedure but can be considered as an option in the management of complex conditions like this. 12 days old Preterm (36 weeks gestation male baby with birth weight of 2.6 kg developed respiratory distress with severe cyanosis and desaturation upto 50%. Baby was intubated and started on Prostaglandin 0.05 mic/kg/mt. His saturation improved to 80%. Echocardiogram showed complex cyanotic heart disease, Situs ambiguous, dextrocardia, complete unbalanced AV septal defect, pulmonary atresia , nonconfluent small branch pulmonary arteries supplied by the bilateral patent ductus arteriosus (PDA from right aortic arch and all four pulmonary veins form a confluence and drain into superior vena cava(SVC through vertical vein with no obstruction. Baby was taken up for PDA stenting. descending aortogram showed right aortic arch with vertical tortuous duct to right pulmonary artery (RPA and another short duct with acute angle from left subclavian artery to left pulmonary artery (LPA . Both ducti stented with coronary stents. Vertical vein angiogram showed both lungs drain to a confluence and then to SVC via ascending vertical vein with no obstruction. After stenting lung perfusion improved and the baby was stable and maintained 80% saturation on room air. Bilateral PDA dependent pulmonary circulation with right and left pulmonary artery discontinuity is very rare. Our case is unique with Heterotaxy, TAPVC, Dextrocardia and double ducti. Eventhough bilateral ductal stenting is technically challenging it is successful through femoral artery approach.

  7. Implantation of VVI pacemaker in a patient with dextrocardia, persistent left superior vena cava, and sick sinus syndrome

    Science.gov (United States)

    Guo, Gongliang; Yang, Lili; Wu, Jinyi; Sun, Liqun

    2017-01-01

    Abstract Background: Dextrocardia, or right-lying heart, is an uncommon congenital heart disease in which the apex of the heart is located on the right side of chest. Persistent left superior vena cava (PLSVA) is a rare venous anomaly that is often associated with the abnormalities of cardiac transduction system. A case with combination of dextrocardia, persistent left superior vena cava, and sick sinus syndrome has not been reported. Methods: We used different techniques including cardiac color Doppler echocardiography, 24-hour Holter monitoring, and abdominal ultrasound to make a diagnosis and treated the patient by implanting a VVI pacemaker. Results: A 50-year-old woman was admitted with a syncope. Angiography of the right atrium and superior vena cava, echocardiography, electrocardiography, and abdominal ultrasound revealed the presence of the combination of mirror image dextrocardia, PLSVA, and sick sinus syndrome. The complex structural anomalies presented great technical challenges for interventional treatments. After thorough examination and understanding of the structural anatomy and anomalies of the superior and inferior vena cava and cardiac chambers, we successfully treated this patient by implanting a VVI pacemaker. Conclusion: Physicians must be aware of the complexity of the morphological and anatomical structures of dextrocardia accompanying PLSVC. Given that the diagnosis of situs inversus was performed at a relatively advanced age, it is therefore important to make such a correct diagnosis followed by appropriate therapeutic intervention. PMID:28151908

  8. C-reactive protein, lung hyperinflation and heart rate variability in chronic obstructive pulmonary disease --a pilot study.

    Science.gov (United States)

    Corbo, Giuseppe Maria; Inchingolo, Riccardo; Sgueglia, Gregory Angelo; Lanza, Gaetano; Valente, Salvatore

    2013-04-01

    Chronic obstructive pulmonary disease (COPD) is associated to cardiovascular morbidity and mortality, and abnormalities of the autonomic nervous system have been described in subjects with severe disease. We studied heart rate variability (HRV) in COPD patients at rest and during the 6-minute Walk Test (6mWT) and the association with lung function impairment taking into account systemic inflammation. Thirty outpatients with stable COPD underwent lung function measurements, blood gas analysis, ECG Holter and transcutaneous pulse oximetry during 6mWT and then they were classified by BODE index. Also C-reactive protein (CRP) was measured. At rest, we observed a significant reduction of HRV for increasing BODE index. During the 6mWT, HRV tended to decrease in BODE 1 subjects whereas an increase was observed in BODE 2 and BODE 3-4 subjects. Subjects with elevated CRP values had a significant reduction in Standard Deviation of all normal RR intervals at rest (SDNN: p = 0.013), Total Power (TFA: p = 0.04) and Very Low Frequency band (VLF: p = 0.041). At rest, subjects with Inspiratory Capacity-to-Total Lung Capacity ratio (IC/TLC) hyperinflation indices. At rest and during submaximal exercise, COPD patients with moderate and severe disease had an abnormal cardiac autonomic modulation which was related to both systemic inflammation and lung function impairment.

  9. Computed tomography for the detection of free-floating thrombi in the right heart in acute pulmonary embolism

    Energy Technology Data Exchange (ETDEWEB)

    Mansencal, Nicolas [Universite de Versailles-Saint Quentin (UVSQ), Ambroise Pare Hospital, Assistance Publique-Hopitaux de Paris (AP-HP), Centre de Reference des Maladies Cardiaques Hereditaires, Department of Cardiology, Boulogne (France); AP-HP, Hopital Universitaire Ambroise Pare, Service de Cardiologie et des Maladies Vasculaires, Centre de Reference des Maladies Cardiaques Hereditaires, Boulogne (France); Attias, David; Guiader, Julie; Abi Nasr, Imad; Dubourg, Olivier [Universite de Versailles-Saint Quentin (UVSQ), Ambroise Pare Hospital, Assistance Publique-Hopitaux de Paris (AP-HP), Centre de Reference des Maladies Cardiaques Hereditaires, Department of Cardiology, Boulogne (France); Caille, Vincent; Jardin, Francois; Vieillard-Baron, Antoine [Universite de Versailles-Saint Quentin (UVSQ), Ambroise Pare Hospital, Assistance Publique-Hopitaux de Paris (AP-HP), Intensive Care Unit, Boulogne (France); Desperramons, Julien; El Hajjam, Mostafa; Lacombe, Pascal [Universite de Versailles-Saint Quentin (UVSQ), Ambroise Pare Hospital, Assistance Publique-Hopitaux de Paris (AP-HP), Department of Radiology, Boulogne (France)

    2011-02-15

    The aim of this study was to assess the prevalence of free-floating thrombi in the right heart (FFT) and the accuracy of computed tomography (CT) for their detection in pulmonary embolism (PE). We studied 340 consecutive patients presenting with PE. All patients underwent CT and echocardiography. The prevalence of FFT was 3.5% in the global population of PE and 22% in high-risk PE. Dyspnoea, cardiogenic shock, cardiac arrest and tachycardia were more frequently found in patients with FFT (p = 0.04, p < 0.0001, p = 0.0003 and p = 0.01, respectively). Sensitivity and specificity of CT for the detection of FFT were 100% (95% confidence interval: 74%-100%) and 97% (95%-99%), whereas positive and negative predictive values were 57% (34%-78%) and 100% (99%-100%). Among patients with FFT, right ventricular dilation was always detected by CT, whereas no right ventricular dilation was found among patients with a false diagnosis of FFT performed by CT (p < 0.0001). Prevalence of FFT is 3.5% and differs according to the clinical presentation. Detection of FFT by CT is feasible and should lead to echocardiography being promptly performed for the confirmation of FFT. (orig.)

  10. Correlation between endothelia cells activation and imbalance of cytokines in pulmonary hypertension of congenital heart disease

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective To explore the correlation between endothelia cells activation and cytokines (ET-1, NO) levels in patients with pulmonary hypertension (PH), and to discuss their roles in the development of PH. Methods Twenty patients with simple ventricular septal defect (VSD) were chosen as controls, and 30 patients with PH were studied. Plasma levels of ET-1 and NO were measured by radioimmunoassay or colorimetric method. Before cardiopulmonary bypass was established, the specimens from right lung were fixed with formaldehyde solution, embedded with paraffin and stained by SP immunohistochemistry. Intercellular adhesion molecule-1 (ICAM-1) expression was measured through the determination of the light density with computer imaging technology. Results Compared with that of the patients with simple VSD, the light density of ICAM-1 and plasma level of ET-1 increased in patients with PH; but plasma level of NO decreased (P<0.05). Positive correlation was observed between ICAM-1 and ET-1/NO (P<0.05). Conclusion Endothelia cells activation and imbalance of ET-1/NO might play an important role in the development of PH.

  11. Velocity and Vorticity in the Right Heart from 4DMRI Measurements

    Science.gov (United States)

    Hertzberg, Jean; Browning, James; Fenster, Brett

    2016-11-01

    Measurements of blood flow in the human heart were made using time-resolved 3D cardiac magnetic resonance phase contrast flow imaging (4DMRI). This work focuses on blood flow in the right ventricle (RV) and right atrium (RA) in both normal subjects and patients with pulmonary hypertension (PH). Although cardiac output is unchanged early in the disease, details of the flow field differ between normals and PH patients. In particular, vorticity at peak diastole has been found to correlate with PH. The underlying physics of this difference are being explored by a qualitative visual comparison of 3D flow structures in the vena cava, RA, and RV between healthy subjects and pulmonary hypertensive patients.

  12. 老年慢性肺心病伴发冠心病60例临床分析%Clinical Analysis of 60 Cases Chronic Pulmonary Heart Disease in Elderly Combined with Coronary Heart Disease

    Institute of Scientific and Technical Information of China (English)

    田茂琼

    2012-01-01

    目的:探讨慢性肺心病伴冠心病的临床特点,为临床的诊断及治疗提供依据.方法:慢性肺心病合并冠心病患者60例列入研究组,单纯肺心病患者60例列入对照组,收集和分析两组患者的临床资料,分别对两组基本资料、病史、临床表现、心电图检测进行比较.结果:两组患者性别、心律失常、肺性P波无显著差异(P>0.05),研究组有吸烟史、肥胖、夜间阵发性呼吸困难、高血压史、高血脂症史、糖尿病史、心绞痛史、心肌梗死、左束支传导阻滞、心肌梗死表现、持续性缺血、电轴左偏、持续房颤的患者比例明显高于对照组,研究组患者重度右心衰、电轴右偏比例明显低于对照组,数据经统计学比较具有显著差异(P<0.05).结论:对慢性肺心病合并冠心病的确诊,应结合患者的基本情况、临床表现、病史、心电图变化等综合判断.%Objective; To discuss the clinical features of chronic pulmonary heart disease combined with coronary heart disease, in comparing with simple pulmonary heart disease. Method; 60 cases with chronic pulmonary heart disease combined with coronary heart disease were distributed into study group and 60 cases with simple pulmonary heart disease were distributed into control group. Collected the clinical information of two groups and compared the basic information, medical history, clinical manifestations and electrocardiogram. Result; Sex, arrhythmia and pulmonary P wave had no significantly difference of two groups (P>0. 05). The patients rate of smoking history, obesity, paroxysmal nocturnal dyspnea, history of hypertension, hyperlipidemia, history, history of diabetes, history of angina, myocardial infarction, left bundle branch block, myocardial infarction, performance, persistent ischemia, electrical left axis deviation and continuous AF in study group were significantly higher than control group ( P<0. 05). The rate of severe right heart

  13. The predictive value of plasma B-type natriuretic peptide levels on outcome in children with pulmonary hypertension undergoing congenital heart surgery

    Directory of Open Access Journals (Sweden)

    Ayse Baysal

    2014-09-01

    Full Text Available Background and objectives: In children undergoing congenital heart surgery, plasma brain natriuretic peptide levels may have a role in development of low cardiac output syndrome that is defined as a combination of clinical findings and interventions to augment cardiac output in children with pulmonary hypertension. Methods: In a prospective observational study, fifty-one children undergoing congenital heart surgery with preoperative echocardiographic study showing pulmonary hypertension were enrolled. The plasma brain natriuretic peptide levels were collected before operation, 12, 24 and 48 h after operation. The patients enrolled into the study were divided into two groups depending on: (1 Development of LCOS which is defined as a combination of clinical findings or interventions to augment cardiac output postoperatively; (2 Determination of preoperative brain natriuretic peptide cut-off value by receiver operating curve analysis for low cardiac output syndrome. The secondary end points were: (1 duration of mechanical ventilation ≥72 h, (2 intensive care unit stay >7days, and (3 mortality. Results: The differences in preoperative and postoperative brain natriuretic peptide levels of patients with or without low cardiac output syndrome (n = 35, n = 16, respectively showed significant differences in repeated measurement time points (p = 0.0001. The preoperative brain natriuretic peptide cut-off value of 125.5 pg mL−1 was found to have the highest sensitivity of 88.9% and specificity of 96.9% in predicting low cardiac output syndrome in patients with pulmonary hypertension. A good correlation was found between preoperative plasma brain natriuretic peptide level and duration of mechanical ventilation (r = 0.67, p = 0.0001. Conclusions: In patients with pulmonary hypertension undergoing congenital heart surgery, 91% of patients with preoperative plasma brain natriuretic peptide levels above 125.5 pg mL−1 are at risk of developing low cardiac

  14. Efficacy of Lipo PGE1 on severe chronic pulmonary heart disease patients combined with pulmonary hypertension%凯时对重症肺源性心脏病合并肺动脉高压患者的疗效

    Institute of Scientific and Technical Information of China (English)

    史艳; 李雷兵; 孙彩虹

    2012-01-01

    Objective To evaluate the effects of Lipo PGE1 on severe chronic pulmonary heart disease patients combined with pulmonary hypertension.Methods Sixty-eight cases of severe chronic pulmonary heart disease combined with pulmonary hypertension were randomly divided into treatment group (34 cases) and control group(34 cases).Both groups received the conventional antibiotics,oxygen therapy and other treatments,and 10 μg Lipo PGE1 were added to the treatment group every day.Serum CNP,ADM levels and pulmonary artery pressure,arterial oxygen tension (PaO2),partial pressure of arterial blood sputum dioxide (PaCO2) were measured before and after the treatment.Results After treatment,blood CNP,ADM levels and pulmonary artery pressure,PaCO2 was significantly lower than those before treatment,PaO2 was significantly higher than that before treatment.There were significant difference between the treatment group and the control group (P < 0.05).Conclusions Lipo PGE1 can significantly reduce the serum CNP,ADM levels and pulmonary artery pressure of patients of chronic pulmonary heart disease combined with pulmonary hypertension,and improve the cardiac function,pulmonary hypertension and arterial blood gas.%目的 评价凯时(Lipo PGEl)对重症肺源性心脏病合并肺动脉高压患者的疗效.方法 将68例重症肺源性心脏病合并肺动脉高压患者,随机分为实验组和对照组各34例,实验组在常规抗感染、氧疗等治疗的基础上每日加用凯时10 μg静脉微量泵入,对照组仅给予常规治疗.治疗前后检测血C型利钠肽(CNP)、肾上腺髓质素(ADM)水平及肺动脉压、动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2).结果 治疗后血CNP、ADM水平及肺动脉压、PaCO2较治疗前明显降低,PaO2较治疗前明显升高,两组比较差异有统计学意义(P<0.05).结论 凯时治疗重症肺源性心脏病合并肺动脉高压能显著降低血CNP、ADM水平及肺动脉压,改善心功能及肺动脉高压,改善动脉血气.

  15. A computer-based matrix for rapid calculation of pulmonary hemodynamic parameters in congenital heart disease

    Directory of Open Access Journals (Sweden)

    Lopes Antonio

    2009-01-01

    Full Text Available Background : In patients with congenital heart disease undergoing cardiac catheterization for hemodynamic purposes, parameter estimation by the indirect Fick method using a single predicted value of oxygen consumption has been a matter of criticism. Objective : We developed a computer-based routine for rapid estimation of replicate hemodynamic parameters using multiple predicted values of oxygen consumption. Materials and Methods : Using Microsoft ® Excel facilities, we constructed a matrix containing 5 models (equations for prediction of oxygen consumption, and all additional formulas needed to obtain replicate estimates of hemodynamic parameters. Results : By entering data from 65 patients with ventricular septal defects, aged 1 month to 8 years, it was possible to obtain multiple predictions for oxygen consumption, with clear between-age groups ( P < .001 and between-methods ( P < .001 differences. Using these predictions in the individual patient, it was possible to obtain the upper and lower limits of a likely range for any given parameter, which made estimation more realistic. Conclusion : The organized matrix allows for rapid obtainment of replicate parameter estimates, without error due to exhaustive calculations.

  16. An uncommon course of the right superior vena cava in a patient with heterotaxy syndrome.

    Science.gov (United States)

    Chenu, Caroline; Fouilloux, Virginie; Kreitmann, Bernard; Metras, Dominique

    2012-01-01

    We present the case of an infant with congenital heart disease which includes a partial atrioventricular canal defect with the absence of the atrial septum (common atrium) and an extremely uncommon course of the right-sided superior vena cava (SVC) including an intra-atrial segment coursing intramurally along the right posterolateral atrial wall, with an intracardiac orifice situated low within the right side of the atrium, close to the atrial orifice of the right hepatic veins. This feature of the anatomy was discovered intraoperatively at the time of surgical repair. Systemic venous anatomy also included interrupted inferior vena cava (IVC) with azygos continuation to a left-sided SVC draining directly into the left side of the atrium. The successful surgical procedure included tunneling of the left-sided SVC to the right side of the common atrium and atrial septation with a patch.

  17. Experiência preliminar com novo filtro de veia cava: resultados de 15 implantes Preliminary experience with a new vena cava filter: results of 15 implantations

    Directory of Open Access Journals (Sweden)

    Winston B. Yoshida

    2008-09-01

    , 15 vena cava filters were deployed in nine men and six women, who ranged in age from 38 to 79 years (mean, 57.8 years. The approach used was always transjugular. Indications for filter placement were proximal deep venous thrombosis with a contraindication to anticoagulation in 12 patients; hemorrhagic complications with anticoagulation in two patients; and pulmonary embolism, despite adequate anticoagulation in one patient. New vena cava filters were evaluated for releasing, tilting, malpositioning and caval perforation. Follow-up included assessment of access site thrombosis and filter migration, recurrent venous thromboembolism, and caval thrombosis by duplex ultrasound. No patient received anticoagulants in the follow-up. In all patients the filter was successfully released, with no malpositioning, tilting, perforation or access thrombosis. The patients were followed for 3 to 23 months (mean = 11 months. No patient developed recurrent venous thromboembolism. No other patients developed inferior vena cava thrombosis or filter migration. Death occurred in seven patients, all related to baseline illness. This preliminary study suggests good feasibility and safety of the new filter up to the observation period.

  18. Prevention of pulmonary vascular and myocardial remodeling by the combined tyrosine and serine-/threonine kinase inhibitor, sorafenib, in pulmonary hypertension and right heart failure

    Directory of Open Access Journals (Sweden)

    M. Klein

    2008-06-01

    Full Text Available Inhibition of tyrosine kinases can reverse pulmonary hypertension but little is known about the role of serine-/threonine kinases in vascular and myocardial remodeling. We investigated the effects of sorafenib, an inhibitor of the tyrosine kinases VEGFR, PDGFR and c-kit as well as the serine-/threonine kinase Raf-1, in pulmonary hypertension and right ventricular (RV pressure overload. In monocrotaline treated rats, sorafenib (10 mg·kg–1·d–1 p.o. reduced pulmonary arterial pressure, pulmonary artery muscularization and RV hypertrophy, and improved systemic hemodynamics (table 1. Sorafenib prevented phosphorylation of Raf-1 and suppressed activation of downstream signaling pathways (Erk 1/2. After pulmonary banding, sorafenib, but not the PDGFR/c-KIT/ABL-inhibitor imatinib reduced RV mass and RV filling pressure significantly. Congruent with these results, sorafenib only prevented ERK phosphorylation and vasopressin induced hypertrophy of the cardiomyocyte cell line H9c2 dose dependently (IC50 = 300 nM. Combined inhibition of tyrosine and serine-/threonine kinases by sorafenib prevents vascular and cardiac remodeling in pulmonary hypertension, which is partly mediated via inhibition of the Raf kinase pathway.

  19. Safety and Efficacy of the Gunther Tulip Retrievable Vena Cava Filter: Midterm Outcomes

    Energy Technology Data Exchange (ETDEWEB)

    Hoffer, Eric K., E-mail: eric.k.hoffer@hitchcock.org; Mueller, Rebecca J.; Luciano, Marcus R.; Lee, Nicole N.; Michaels, Anne T.; Gemery, John M. [Dartmouth-Hitchcock Medical Center, Department of Radiology, Section of Vascular and Interventional Radiology (United States)

    2013-08-01

    PurposeTo evaluate of the medium-term integrity, efficacy, and complication rate associated with the Gunther Tulip vena cava filter.MethodsA retrospective study was performed of 369 consecutive patients who had infrarenal Gunther Tulip inferior vena cava filters placed over a 5-year period. The mean patient age was 61.8 years, and 59 % were men. Venous thromboembolic disease and a contraindication to or complication of anticoagulation were the indications for filter placement in 86 % of patients; 14 % were placed for prophylaxis in patients with a mean of 2.3 risk factors. Follow-up was obtained by review of medical and radiologic records.ResultsMean clinical follow-up was 780 days. New or recurrent pulmonary embolus occurred in 12 patients (3.3 %). New or recurrent deep-vein thrombosis occurred in 53 patients (14.4 %). There were no symptomatic fractures, migrations, or caval perforations. Imaging follow-up in 287 patients (77.8 %) at a mean of 731 days revealed a single (0.3 %) asymptomatic fracture, migration greater than 2 cm in 36 patients (12.5 %), and no case of embolization. Of 122 patients with CT scans, asymptomatic perforations were identified in 53 patients (43.4 %) at a mean 757 days.ConclusionThe Gunther Tulip filter was safe and effective at 2-year follow-up. Complication rates were similar to those reported for permanent inferior vena cava filters.

  20. Cement embolus trapped in the inferior vena cava filter during percutaneous vertebroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Li, Zhi; Ni, Rui Fang; Zhao, Xin; Yang, Chao; Li, Ming Ming [First Affiliated Hospital of Soochow University, Suzhou (China)

    2013-06-15

    A 58-year-old female patient, diagnosed with adenocarcinoma of the lung, underwent percutaneous vertebroplasty at the L4 vertebral body due to painful spinal metastases. Because of deep venous thrombosis of the left femoral and iliac veins, an inferior vena cava filter had been placed before vertebroplasty. Bone cement migrated into the venous bloodstream and then was being trapped within the previously placed filter. This case illustrates that caval filter could capture the bone cement and prevent it from migrating to the pulmonary circulation.

  1. Can geometric indices of heart rate variability predict improvement in autonomic modulation after resistance training in chronic obstructive pulmonary disease?

    Science.gov (United States)

    Santos, Ana Alice Soares Dos; Ricci-Vitor, Ana Laura; Bragatto, Vanessa Santa Rosa; Santos, Ana Paula Soares Dos; Ramos, Ercy Mara Cipulo; Vanderlei, Luiz Carlos Marques

    2017-03-01

    Chronic obstructive pulmonary disease (COPD) is associated with autonomic dysfunctions that can be evaluated through heart rate variability (HRV). Resistance training promotes improvement in autonomic modulation; however, studies that evaluate this scenario using geometric indices, which include nonlinear evaluation, thus providing more accurate information for physiological interpretation of HRV, are unknown. This study aimed to investigate the influence of resistance training on autonomic modulation, using geometric indices of HRV, and peripheral muscle strength in individuals with COPD. Fourteen volunteers with COPD were submitted to resistance training consisting of 24 sessions lasting 60 min each, with a frequency of three times a week. The intensity was determined as 60% of one maximum repetition and was progressively increased until 80% for the upper and lower limbs. The HRV and dynamometry were performed at two moments, the beginning and the end of the experimental protocol. Significant increases were observed in the RRtri (4·81 ± 1·60 versus 6·55 ± 2·69, P = 0·033), TINN (65·36 ± 35·49 versus 101·07 ± 63·34, P = 0·028), SD1 (7·48 ± 3·17 versus 11·04 ± 6·45, P = 0·038) and SD2 (22·30 ± 8·56 versus 32·92 ± 18·78, P = 0·022) indices after the resistance training. Visual analysis of the Poincare plot demonstrated greater dispersion beat-to-beat and in the long-term interval between consecutive heart beats. Regarding muscle strength, there was a significant increase in the shoulder abduction and knee flexion. In conclusion, geometric indices of HRV can predict improvement in autonomic modulation after resistance training in individuals with COPD; improvement in peripheral muscle strength in patients with COPD was also observed.

  2. Potential biomarkers predicting risk of pulmonary hypertension in congenital heart disease: the role of homocysteine and hydrogen sulfide

    Institute of Scientific and Technical Information of China (English)

    Sun Ling; Sun Shuo; Li Yufen; Pan Wei; Xie Yumei; Wang Shushui; Zhang Zhiwei

    2014-01-01

    Background Pulmonary hypertension (PH) is a common complication of congenital heart disease (CHD).Although risk stratification is vital for prognosis and therapeutic guidance,the need for understanding the role of novel biomarkers cannot be overlooked.The aim of the present study was to investigate the changes of homocysteine and hydrogen sulfide levels and find potential biomarkers for early detection and treatment.Methods Between September 2012 and April 2013,we prospectively collected data on 158 pediatric patients with left to right shunt CHD at our institution.Standard right heart catheterizations were performed in all cases.Seventy-seven cases were associated with PH.The levels of homocysteine and hydrogen sulfide were detected with fluorescence polarization immunoassay and a sensitive silver-sulphur electrode,respectively.Enzyme-linked immunosorbent assay was used to determine the expression of methylenetetrahydrofolate reductase (MTHFR),cystathionine β-synthase (CBS),and cystathionine gamma-lyase (CSE).Radioimmunoassays were used to obtain folic acid and vitamin B12 levels.Results The difference in the levels of homocysteine,folic acid,vitamin B12,hydrogen sulfide,as well as the MTHFR and CSE expression between patients with PH and without PH were statistically significant (all P <0.05).Homocysteine had the best sensitivity and specificity to predict PH (P <0.001).Subgroup analysis showed that the levels of homocysteine and hydrogen sulfide,and the expression of CSE and MTHFR between patients with dynamic and obstructive PH were significantly different (all P <0.05).Based on the ROC curve,homocysteine had the best sensitivity and specificity to predict obstructive PH (P=0.032),while CSE had the most significant sensitivity and specificity to predict the dynamic PH (P=0.008).Conclusions Increased levels of homocysteine and decreased levels of hydrogen sulfide were significantly negatively correlated in PH associated with CHD.The underlying mechanism

  3. Right Heart 4DMRI Flow Visualization in Normal and Hypertensive subjects

    Science.gov (United States)

    Hertzberg, Jean; Browning, James; Fenster, Brett; Schroeder, Joyce

    2015-11-01

    Recent advances in time-resolved 3D cardiac magnetic resonance imaging (4DMRI) have allowed for the 3-dimensional characterization of blood flow in the right ventricle (RV) and right atrium (RA). In this talk, an overview of a large, ongoing, multi-disciplinary investigation of 4D right heart hemodynamics in normal and pathologic patients is given, as well as lessons learned from 4DMRI cardiac research. Time-resolved visualization techniques for understanding and communicating complex right heart flow structures throughout the cardiac cycle are presented. Finally, a qualitative visual comparison of 3D flow structures in the vena cava, RA, and RV between healthy subjects and pulmonary hypertensive patients is presented.

  4. Neonatal repair of total anomalous pulmonary venous connection and lung agenesis.

    Science.gov (United States)

    Kaku, Yuji; Nagashima, Mitsugi; Matsumura, Goki; Yamazaki, Kenji

    2015-07-01

    Here we report a neonatal case of total anomalous pulmonary venous connection with left lung agenesis. Diagnostic imaging demonstrated that the left pulmonary veins were totally absent and the right pulmonary veins connected with the common pulmonary chamber. Drainage from the common pulmonary venous chamber entered the persistent left suerior vena cava. In addition, it revealed complete absence of the left main bronchus and left lung vessels. The neonate successfully underwent surgical repair 18 days after birth.

  5. Clinical Study of Vena Cava Filter in Preventing from Pulmonary Embolism Induced by Lower Extremity Deep Venous Thrombosis%下肢深静脉血栓形成致肺栓塞发生及其应用腔静脉滤器预防的临床研究

    Institute of Scientific and Technical Information of China (English)

    韩冰; 葛长青; 张宏光; 周晨光; 吉国辉; 杨錚; 张亮

    2012-01-01

    目的 总结因下肢深静脉血栓形成(DVT)导致肺栓塞(PE)发生的概率,探讨应用腔静脉滤器(VCF)植入预防PE发生的情况.方法 回顾性分析我院2005年1月至2012年1月期间收治的1 058例下肢DVT患者的临床资料.结果1 058例DVT患者中发生PE者34例(3.21%),发生死亡者15例(1.42%).其中887例未植入VCF者中发生PE者32例(3.61%),死亡15例(1.69%);171例植入VCF者中发生PE者2例(1.17%),无死亡患者.植入VCF的171例患者中经股静脉植入151例,经颈静脉植入20例;VCF植入后3~4周内回收,尝试回收145例,成功回收139例,其中经颈静脉回收13例,126例经股静脉回收.PE和死亡的发生时间均集中在10 d内,PE发生最长时间为35 d.未植入VCF患者的PE发生率及死亡率均明显高于植入VCF患者(P<0.01).未植入VCF患者的PE发生率及死亡率双下肢均明显高于右下肢及左下肢(P<0.05),右下肢明显高于左下肢(P<0.05).下肢DVT合并下腔静脉血栓者PE发生率及死亡率均明显高于中心型(P<0.05),中心型明显高于周围型(P<0.05),周围型与混合型间差异无统计学意义(P>0.05).随访(39±19)个月(1个月~7年),VCF的累积通畅率为98.7%.植入的滤器无移位、倾斜和扩张不良.结论 VCF植入能有效预防PE,但应严格掌握适应证.%Objective To summarize the probability of pulmonary embolism (PE) induced by lower extremity deep venous thrombosis (DVT) and investigate the role of vena cava filter (VCF) in preventing from PE. Methods The clinical data of 1 058 patients with lower extremity DVT from January 2005 to January 2012 were analyzed retrospectively. Results The PE rate was 3. 21% (34/1 058) and the death rate was 1. 42% (15/1 058) in 1 058 patients with lower extremity DVT. The VCF was implanted in 171 of 1 058 patients. The VCFs of 151 patients were implanted from femoral vein, 20 patients were implanted from jugular vein. The PE rates were 3. 61% (32/887) and

  6. Abnormal shortened diastolic time length at increasing heart rates in patients with abnormal exercise-induced increase in pulmonary artery pressure

    Directory of Open Access Journals (Sweden)

    Bombardini Tonino

    2011-11-01

    Full Text Available Abstract Background The degree of pulmonary hypertension is not independently related to the severity of left ventricular systolic dysfunction but is frequently associated with diastolic filling abnormalities. The aim of this study was to assess diastolic times at increasing heart rates in normal and in patients with and without abnormal exercise-induced increase in pulmonary artery pressure (PASP. Methods. We enrolled 109 patients (78 males, age 62 ± 13 years referred for exercise stress echocardiography and 16 controls. The PASP was derived from the tricuspid Doppler tracing. A cut-off value of PASP ≥ 50 mmHg at peak stress was considered as indicative of abnormal increase in PASP. Diastolic times and the diastolic/systolic time ratio were recorded by a precordial cutaneous force sensor based on a linear accelerometer. Results At baseline, PASP was 30 ± 5 mmHg in patients and 25 ± 4 in controls. At peak stress the PASP was normal in 95 patients (Group 1; 14 patients (Group 2 showed an abnormal increase in PASP (from 35 ± 4 to 62 ± 12 mmHg; P Conclusion The first and second heart sound vibrations non-invasively monitored by a force sensor are useful for continuously assessing diastolic time during exercise. Exercise-induced abnormal PASP was associated with reduced diastolic time at heart rates beyond 100 beats per minute.

  7. Superior Vena Cava Thrombosis in a Case of Lung Adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Santanu Ghosh

    2013-01-01

    Full Text Available Superior vena cava syndrome is a common presentation of bronchogenic carcinoma. The mechanism of obstruction is by compression of superior vena cava by the bronchogenic tumor itself or enlarged mediastinal lymph nodes. However obstruction due to intravascular thrombosis is extremely uncommon. Here, we report a rare case of a 65-year-old male smoker who presented with superior vena cava syndrome and bilateral pleural and pericardial effusion with thrombotic occlusion of the superior vena cava in adenocarcinoma of the lung. He was given chemotherapy with carboplatin and gemcitabine with anticoagulant therapy.

  8. Pulmonary Hypertension Association

    Science.gov (United States)

    ... at www.AHeartCures.org . Help Kickoff November’s Pulmonary Hypertension Awareness Month Want to help raise awareness for ... Heart2CurePH | Help promote Awareness Month Chronic Thromboembolic Pulmonary Hypertension (CTEPH) Awareness Chronic thromboembolic pulmonary hypertension (CTEPH) is ...

  9. Assessment of the physiologic contribution of right atrial function to total right heart function in patients with and without pulmonary arterial hypertension.

    Science.gov (United States)

    Sivak, Joseph A; Raina, Amresh; Forfia, Paul R

    2016-09-01

    Total right heart function requires normal function of both the right ventricle and the right atrium. However, the degree to which right atrial (RA) function and right ventricular (RV) function each contribute to total right heart function has not been quantified. In this study, we aimed to quantify the contribution of RA function to total right heart function in a group of pulmonary arterial hypertension (PAH) patients compared to a cohort of normal controls without cardiovascular disease. The normal cohort comprised 35 subjects with normal clinical echocardiograms, while the PAH cohort included 37 patients, of whom 31 had echocardiograms before and after initiation of PAH-specific therapy. Total right heart function was measured via tricuspid annular plane excursion (TAPSE). TAPSE was broken down into two components, the excursion occurring during RA contraction (TAPSERA) and that occurring before RA contraction (TAPSERV). RA fractional area change (RA-FAC) was also compared between the two groups. In the PAH cohort, more than half of the total TAPSE occurred during atrial systole, compared to less than one-third in the normal cohort (51.0% vs. 32.1%; P right heart function in patients with PAH than in normal subjects.

  10. Pulmonary valve replacement with a mechanical prosthesis. Promising results of 28 procedures in patients with congenital heart disease

    NARCIS (Netherlands)

    Hoendermis, Elke S.; den Hamer, Inez J.; Ebels, Tjark; Waterbolk, T

    2006-01-01

    Objective: Pulmonary valve replacement is performed increasingly late after correction of Tetralogy of Fallot. Most reports deal with pulmonary allografts as the valvar substitute of choice, although late deterioration and reoperation(s) are the rule. Mechanical valves are scarcely reported and if s

  11. Effects of iloprost combined with low dose tadalafil in adult congenital heart disease patients with severe pulmonary arterial hypertension: a single-center,open-label controlled study

    Institute of Scientific and Technical Information of China (English)

    张曹进

    2014-01-01

    Objective To evaluate the therapy efficacy of iloprost combined with low dose tadalafil in adult congenital heart disease(CHD)patients with severe pulmonary arterial hypertension(PAH).Methods Adult CHD patients with severe PAH were included and divided into the sequential combination therapy group[iloprost:10μg/inhalation,6 times per day for 6 months,and then add oral tadalafil(5 mg/d)till 12 months,n=32]and upfront combination therapy group[iloprost:10μg/inhalation,6 times per day combined with oral tadalafil(5 mg)

  12. Compensatory dilatation of the Azygos Venous system Secondary To Superior Vena Cava Occlusion.

    Science.gov (United States)

    Paoletti, Francesco; Pellegrino, Valeria; Antonelli, Melissa; Ripani, Umberto; Mosca, Stefano; Durì, Davide; Galzerano, Antonio

    2009-01-01

    Superior vena cava (SVC) occlusion can be clinically recognized in the acute setting when the stenosing process does not allow the development of collateral venous channels, which guarantee the venous drainage to the right heart. On the contrary, when the obstruction develops progressively, the diagnosis of SVC obstruction may remain undiagnosed. In the present case, the presence of SVC thrombosis was purely coincidental. In fact, the obstruction was first noticed on diagnostic tests performed because of the malfunction of a totally implantable Porth a Cath placed into the superior vena cava (through right subclavian access), five years before, in a patient suffering from non-Hodgkin disease. Venography is the most appropriate diagnostic methodology which reveals the presence of a dilated azygos vein as a compensatory mechanism. Comparison with computed tomography allows to confirm the diagnosis and to identify the possible causes. Dilatation of the azygos vein, secondary to superior vena cava thrombosis, although a rare event, should be taken into consideration in those patients with CVC and who present with frequent episodes of deep venous thrombosis.

  13. Fatal pericardial tamponade after superior vena cava stenting.

    NARCIS (Netherlands)

    Ploegmakers, M.J.M.; Rutten, M.J.C.M.

    2009-01-01

    We discuss a fatal complication of percutaneous superior vena cava (SVC) self-expandable stent placement in a patient with superior vena cava syndrome (SVCS). The SVCS was caused by a malignant mediastinal mass with total occlusion of the SVC. Twenty-four hours after the procedure, the patient died

  14. Treatment of a coronary artery to superior vena cava fistula resulting from early closure of a Possis Perma-Flow graft.

    Science.gov (United States)

    Graham, M M; Kells, C M; Sullivan, J; O'Neill, B J

    1999-06-01

    The Perma-Flow graft used in bypass surgery achieves more complete revascularization when paucity of native conduits exists. We report a coronary artery to superior vena cava fistula as a complication of this graft, leading to severe right heart failure. The fistula was successfully occluded percutaneously, improving the patient's clinical situation.

  15. Complete Heart Block with Diastolic Heart Failure and Pulmonary Edema Secondary to Enlarging Previously Diagnosed Thrombosed Aneurysm of Sinus of Valsalva in a Patient with History of Autosomal Dominant Polycystic Kidney Disease

    Science.gov (United States)

    Eltawansy, Sherif Ali; Thomas, Maria Joana; Daniels, Jeffrey

    2015-01-01

    Autosomal dominant polycystic kidney disease (ADPKD) is associated with vascular aneurysms that can affect any part of the vascular tree, like ascending aorta or coronary arteries. Sinus of Valsalva is known as an anatomical dilation at the root of aorta above the aortic valve and very few cases show aneurysm at that site in patients with ADPKD. Sinus of Valsalva aneurysm (SVA) can present with rupture and acute heart failure and infective endocarditis or could be asymptomatic accidentally discovered during cardiac catheterization. We report a case of a 76-year-old male with a unique constellation of cardiovascular anomalies associated with ADPKD. Patient was previously diagnosed with aneurysms affecting ascending aorta, sinus of Valsalva, and coronary arteries. Several years later, he came with complete heart block which was discovered later to be secondary to enlargement of his previously diagnosed thrombosed SVA. His case was complicated with acute heart failure and pulmonary edema. Conclusion. Patients with ADPKD can present with extrarenal manifestations. In our case, aneurysm at sinus of Valsalva was progressively enlarging and presented with complete heart block. PMID:25861484

  16. Role of echocardiography in diagnosis of pulmonary hypertension

    Directory of Open Access Journals (Sweden)

    Srbinovska Kostovska Elizabeta

    2013-07-01

    Full Text Available Pulmonary hypertension (PH is a progressive process that leads to right ventricular (RV overload, hypertrophy, dilatation and RV failure. In cases with chronic heart failure, this condition is associated with more severe symptoms and worse outcomes.Transthoracic echocardiography can give several parameters which correlate with right heart haemodynamics, and should be performed in a case of suspected PH. Several parameters are important for estimation of the RV function, which can be reason for poor outcome: right atrial and ventricular dimensions and volumes, functional area changes, tricuspid annular plane systolic excursion (TAPSE, myocardial performance index, infe- rior vena cava size and collapsibility, S velocity estimated by Tissue Doppler Imaging, and additional information obtained from the advance echocardiograpic techniques, like strain, strain rate, three-dimensional echocardiography. Estimation of PH based on Doppler echo- cardiography measurements is not suitable for screening of mild, asymptomatic PH. Echocardiography can be recommended as a screening tool for specific diseases, follow up PH, and assessment when right heart catheterization is indicated.

  17. Sildenafil reduces signs of oxidative stress in pulmonary arterial hypertension: Evaluation by fatty acid composition, level of hydroxynonenal and heart rate variability

    Directory of Open Access Journals (Sweden)

    Khrystyna Semen

    2016-04-01

    Full Text Available Pulmonary arterial hypertension (PAH is a rare multifactorial disease with an unfavorable prognosis. Sildenafil therapy can improve functional capacity and pulmonary hemodynamics in PAH patients. Nowadays, it is increasingly recognized that the effects of sildenafil are pleiotropic and may also involve changes of the pro-/antioxidant balance, lipid peroxidation and autonomic control. In present study we aimed to assess the effects of sildenafil on the fatty acids (FAs status, level of hydroxynonenal (HNE and heart rate variability (HRV in PAH patients. Patients with PAH were characterized by an increase in HNE and changes in the FAs composition with elevation of linoleic, oleic, docosahexanoic acids in phospholipids as well as reduced HRV with sympathetic predominance. Sildenafil therapy improved exercise capacity and pulmonary hemodynamics and reduced NT-proBNP level in PAH. Antioxidant and anti-inflammatory effects of sildenafil were noted from the significant lowering of HNE level and reduction of the phopholipid derived oleic, linoleic, docosahexanoic, docosapentanoic FAs. That was also associated with some improvement of HRV on account of the activation of the neurohumoral regulatory component. Incomplete recovery of the functional metabolic disorders in PAH patients may be assumed from the persistent increase in free FAs, reduced HRV with the sympathetic predominance in the spectral structure after treatment comparing to control group. The possibilities to improve PAH treatment efficacy through mild stimulation of free radical reactions and formation of hormetic reaction in the context of improved NO signaling are discussed.

  18. Right Heart Transvalvular Embolus with High Risk Pulmonary Embolism in a Recently Hospitalized Patient: A Case Report of a Therapeutic Challenge

    Directory of Open Access Journals (Sweden)

    Gyanendra Kumar Acharya

    2015-01-01

    Full Text Available Thrombus-in-transit is not uncommon in pulmonary embolism but Right Heart Transvalvular Embolus (RHTVE complicating this is rare. A 54-year-old obese male with recent hospitalization presented with severe dyspnea and collapse. Initial investigations revealed elevated d-dimer and troponin. CTA showed saddle pulmonary embolus and bedside echocardiogram revealed right ventricular (RV pressure overload and dilatation (RV > 41 mm, McConnell’s sign, and mobile echodensity attached to tricuspid valve. Patient was immediately resuscitated and promptly transferred for surgical embolectomy under cardiopulmonary bypass. A long segment of embolus traversing through the tricuspid valve and extensive bilateral pulmonary artery embolus were removed. IVC filter was placed for a persistent right lower extremity DVT. Hypercoagulable work-up was negative. Patient continued to do well after discharge on Coumadin. Open embolectomy offers great promises where there is no consensus in optimal management approach in such patients. Bedside echocardiogram is vital in risk stratification and deciding choice of advanced PE treatment.

  19. Immediate pulmonary dysfunction in ischemic heart disease patients undergoing off-pump versus on-pump CABG

    Directory of Open Access Journals (Sweden)

    Ashraf Helal Abd-Allah

    2016-05-01

    Conclusion: Pulmonary functions deteriorate significantly after coronary artery revascularization with and without CPB, but to a significant greater reduction among those on-pump than among those off-pump surgeries.

  20. 肺心病患者睡眠低氧血症特点及氧疗和无创正压通气的应用价值%Hypoxemia features of sleep of pulmonary heart disease and practical value of oxygen therapy and positive pressure ventilation with no trauma

    Institute of Scientific and Technical Information of China (English)

    翟玮; 周利臣; 黄席珍

    2002-01-01

    1 Subjects and method 12 patients of pure pulmonary heart disease,10 males,2 females,aged form 54~ 70 years old(mean age:60 years old).Among these patients,there were 9 cases with long term smoking history,7 cases with chronic bronchitis and pulmonary emphysema,1 case with remote pulmonary tuberculosis,1 case with chronic bronchiectasis,2 cases with pulmonary interstitial fibrosis,1 case with chronic organized pneumonia.Weighing index(21~ 24)kg/m2.Sleep hypoxencic follow international sleep medical diagnosis criterion and pulmonary heart disease follow diagnosis and treatment standard of COPD made by respiratory China Medical College.

  1. Pulmonary arterial hypertension in pregnancy.

    Science.gov (United States)

    Običan, Sarah G; Cleary, Kirsten L

    2014-08-01

    Pulmonary hypertension is a medical condition characterized by elevated pulmonary arterial pressure and secondary right heart failure. Pulmonary arterial hypertension is a subset of pulmonary hypertension, which is characterized by an underlying disorder of the pulmonary arterial vasculature. Pulmonary hypertension can also occur secondarily to structural cardiac disease, autoimmune disorders, and toxic exposures. Although pregnancies affected by pulmonary hypertension and pulmonary arterial hypertension are rare, the pathophysiology exacerbated by pregnancy confers both high maternal and fetal mortality and morbidity. In light of new treatment modalities and the use of a multidisciplinary approach to care, maternal outcomes may be improving.

  2. Endomyocardial fibrosis as a cause of Budd-Chiari syndrome and fatal pulmonary embolism.

    Science.gov (United States)

    Bestetti, Reinaldo B; Silva, Carolina M P D C; Ardito, Sabrina Q; Theodoropoulos, Tatiana A D; Cury, Patrícia M; Corbucci, Hélio A R

    2010-01-01

    A 24-year-old-man had right-sided heart failure of 3 months' duration. A Doppler echocardiogram revealed atrium and right ventricular enlargement, obliteration of the right ventricular apex, and a mass with an echolucent center measuring 20x21 mm in the right ventricular outlet. He died of pulmonary embolism. At autopsy, a huge organized thrombus obliterating the right ventricular apex passing through the tricuspid valve to the right atrium and then extending to the inferior vena cava up to the suprahepatic veins was seen. Histologically, an intense fibrotic thickening of the endomyocardium extending into the myocardium was observed. Cardiac thrombosis associated with endomyocardial fibrosis should be added to the list of causes of Budd-Chiari syndrome.

  3. Experience of High Quality Nursing for Patients With Pulmonary Heart Failure%肺源性心力衰竭患者的优质护理体会

    Institute of Scientific and Technical Information of China (English)

    陈瑞萍

    2015-01-01

    目的:探究肺源性心力衰竭患者的优质护理,提高护理质量。方法分析我院收治的100例肺源性心力衰竭患者的临床资料,随机分为对照组和治疗组,每组50例。对照组给予常规护理,护理组在常规护理基础上,实施心理护理、饮食指导护理等优质护理,比较两组患者的满意度。结果护理组在护理满意度方面优于对照组,P<0.05,差异具有统计学意义。结论对于肺源性心力衰竭患者进行优质护理,患者的满意度较高,生活质量得到改善。%Objective To explore the pulmonary heart failure patients quality care, improve quality of care. Methods Selected 100 cases of pulmonary heart failure clinical data in our hospital, were randomly divided into the control group and the treatment group, each group had 50 cases. In the control group were treated with routine care, care of patients in the usual care group, based on the implementation of psychological care, nursing, dietary guidance quality care, patient satisfaction between the two groups. Results Patients care in nursing satisfaction group than the control group, P<0.05, had difference statistically signiifcance. Conclusion Pulmonary failure patients quality care, higher patient satisfaction, quality of life improved signiifcantly.

  4. Long-term prognosis of asthma, chronic obstructive pulmonary disease, and asthma-chronic obstructive pulmonary disease overlap in the Copenhagen City Heart study

    DEFF Research Database (Denmark)

    Lange, Peter; Çolak, Yunus; Ingebrigtsen, Truls Sylvan

    2016-01-01

    focus on individuals with asthma-COPD overlap. METHODS: We assigned participants from the Copenhagen City Heart Study into six subgroups: healthy never-smokers, ever-smokers without asthma and COPD, those with asthma with low cumulated smoking exposure and no airflow limitation, those with COPD, those...... mixed-effects model. FINDINGS: We included 8382 participants from the Copenhagen City Heart Study in our study: 2199 never-smokers, 5435 ever-smokers, 158 with asthma, 320 with COPD, 68 with asthma-COPD overlap with early-onset asthma, and 202 with asthma-COPD overlap with late-onset asthma...

  5. Research of B-tyepe natriuretic Peptide, blood gas analysis,and Pulmonary Function in Patients with Chronic Bronchitis,Chronic Obstructive Pulmonary Disease and Pulmonary Heart Disease%慢性支气管炎、COPD及肺心病患者BNP、肺功能和血气变化的研究

    Institute of Scientific and Technical Information of China (English)

    卜凡靖; 张红; 范磊; 刘伟

    2012-01-01

    Objective To explore the change of BNP ( B-type natriuretic peptide ), pulmonary function and blood gas analysis in patients with chronic bronchitis, rhronir obstructive pulmonary disease and pulmonary heart disease. Methods Vein blood was pumped from the patients with chronic bronchitis, chronic obstructive pulmonary disease and pulmonary heart disease, then testing plama BNP and pulmonary function, and artery blood was pumped for bood gas analysis. A contrastive study was performed among two groups and control group. Results From chronic bronchitis to chronic obstructive pulmonary disease and pulmonary heart disease, BNP tended to increase ( P < 0. 05 ). From chronic bronchitis to rhronir obstructive pulmonary disease and pulmonary heart disease, FE V, /FVC, MMEF tended to decrease ( both P < 0. 05 ), PaO, , PH tended to decrease, and PaCO, tended to increase ( allP < 0. 05 ). The BNP levels were negatively related with PaO2,PH(r= -0.69, - 0. 58 ,bothP <0. 01 ), and positively related with PaCO2( r = 0. 55 ,P < 0. 01 ). The BNP levels were negatively correlated with FEV,/FVC, MMEF( r = -0. 71 , -0. 68, bothP <0. 01 ). Conclusion The BNP levels had significant correlation with the blood analysis and pulmonary junction parameter. The BNP level may be an indicator in judging the prognosis of the COPD.%目的 探讨慢性支气管炎(慢支)、COPD、慢性肺源性心脏病(肺心病)患者不同时期BNP(B型钠尿肽)、肺功能、动脉血气的变化.方法 慢支、COPD、肺心病患者均空腹抽静脉血检测BNP;另抽动脉血检测血气;并行肺功能检测.三组间对比,并与正常组对照.结果 由慢支发展到COPD、肺心病时BNP逐渐升高(P<0.05);慢支、COPD及肺心病各组FEV1/FVC、MMEF逐渐降低(P均<0.05),动脉血氧分压(PaO2)、PH值逐渐降低,二氧化碳分压(PaCO2)逐渐增高(P均<0.05).BNP与PaO2、PH呈显著负相关(r=-0.69,-0.58,P均<0.01),而与PaCO2呈正相关(r=0.55,P<0.01).BNP与FEV1/FVC

  6. Cavo-atrial bypass with a polytetrafluoroethylene graft for the treatment of a complete, traumatic transection of the suprahepatic inferior vena cava.

    Science.gov (United States)

    Prevot, Flavien; Berna, Pascal; Badoux, Louise; Regimbeau, Jean-Marc

    2016-09-27

    In the event of injury to the vena cava, the surgeon's goal is to control the bleeding and then repair the vascular damage. Given the wide range of lesions observed, the repair step has not been standardized. There are a few case reports of simple venoplasty or cavocaval bypass with a polytetrafluoroethylene graft. The present report introduces another treatment option for total avulsion of the suprahepatic inferior vena cava when a lack of remnant venous tissue below the heart prevents direct repair: cavo-atrial bypass with a polytetrafluoroethylene graft.

  7. [Effect of peripheral vasodilators on pulmonary respiratory function and the indices of bicycle spiroergometry in heart failure patients].

    Science.gov (United States)

    Ordian, M M; Sobol', Iu S; Kassirskiĭ, S G

    1987-01-01

    The effect of corinfar and isosorbide on respiratory function of the lungs and indices of spirobicycle ergometry was studied in 40 patients with heart failure resulting from various heart diseases. The results have shown that despite difference in the mechanism of action, the use of these drugs at the given doses combined with digoxin is accompanied by a distinct and comparable positive influence on external respiratory function and indices of spirobicycle ergometry in patients with heart failure.

  8. 慢性肺源性心脏病并冠心病80例治疗探讨%Treatment of chronic pulmonary heart disease and coronary heart disease 80 cases

    Institute of Scientific and Technical Information of China (English)

    马雪梅

    2013-01-01

    Objective To explore and examine the clinical and prevention measures of chronic pulmonary heart disease and coronary heart disease in.Methods Totally 80 cases of patients suffering from chronic pulmonary heart disease and coronary heart disease study in patients with acute exacerbation of the application on the basis of carrying out comprehensive treatment of macrolide antibiotics,according to the specific circumstances of the patients' anticoagulant,thrombolytic and invasive or noninvasive mechanical ventilation and other processing of remission in patients followed up at the same time the long-term home oxygen therapy and oral empty platelet aggregation drugs,non-invasive airway of the double -barreled such as positive pressure ventilation for treatment of patients with heart and lung function improved ; lung coronary heart disease associated with elevated blood lipids in patients with oral lipid-lowering drugs and low-fat diet intervention.Results This group of patients after treatment effective in 26 cases (32.5%),effective in 34 (42.5%),ineffective in 20 cases (25%),of which 10 died (12.5%).Conclusions The long-term prevention and followed up for chronic pulmonary heart disease and coronary heart disease are very important and adhere to the long-term home oxygen therapy can also reduce patients'readmission rates.%目的 探讨慢性肺源性心脏病并冠心病在临床上的表现及防治措施.方法 本文选择80例患有慢性肺源性心脏病并冠心病的患者进行研究,对于处在急性发作期的患者,在进行综合治疗的基础上应用大环内酯类抗生素,再根据患者的具体情况进行抗凝、溶栓以及有创或者是无创机械通气等的处理,对缓解期的患者进行随诊,同时进行长期的家庭氧疗及口服抗血小板凝集药物、无创双管气道正压通气等治疗对患者的心肺功能进行改善;对伴随血脂增高的患者应采用口服降脂药及低

  9. [A failed improvement in pulmonary function and exercise capacity with carvedilol in congestive heart failure despite an excellent effect on left ventricular function].

    Science.gov (United States)

    Guazzi, M; Pontone, G; Trevisi, N; Lomanto, M; Matturri, M; Agostoni, P

    1998-02-01

    This study was aimed at investigating in chronic heart failure (CHF) the effects that beta-blockade with carvedilol may have on lung function, and their relationship with left ventricular (LV) performance and peak exercise oxygen uptake (VO2p). CHF causes disturbances in ventilation and pulmonary gas transfer (stress failure of alveolar-capillary membrane) that participate in limiting VO2p. Carvedilol improves LV function and not VO2p. Twenty-one NYHA functional class II-III patients were randomized (2 to 1) to carvedilol (25 mg bid., 14 patients) or placebo (7 patients) for 6 months. Rest forced expiratory volume (FEV1), vital capacity (VC), total lung capacity (TLC), carbon monoxide diffusing capacity (DLCO), its alveolar-capillary membrane component (DM), pulmonary venous and transmitral flows (for monitoring changes in LV end-diastolic pressure, EDP), LV diastolic (EDD) and systolic (ESD) dimensions, stroke volume (SV), ejection fraction (EF), fiber shortening velocity (VCF) were measured at baseline and at 3 and 6 months. VO2p, peak ratio of dead space to tidal volume (VD/VTp), ventilatory equivalent for CO2 production (VE/VCO2), VO2 at anaerobic threshold (VO2at) were also determined. FEV1, VC, TLC, DLCO, DM were impaired in CHF compared to 14 volunteers, and did not vary with treatment. Carvedilol reduced EDP, EDD, ESD, and increased EF, SV, VCF, without affecting VO2p, VO2at, VD/VTp, VE/VCO2, at 3 and 6 months. Placebo was ineffective. In CHF, carvedilol exerts neutral effects on ventilation and pulmonary gas transfer and ameliorates LV function at rest. This proves that antifailure treatment may not be similarly effective on cardiac and pulmonary function; and does not contradict the possibility that persistence of lung impairment may contribute to lack of improvement in exercise performance with carvedilol.

  10. Pulmonary Artery Intimal Sarcoma: A Case Report

    Directory of Open Access Journals (Sweden)

    Joseph P. Kriz

    2016-04-01

    Full Text Available Pulmonary artery intimal sarcomas are rare and lethal malignant tumors that typically affect larger vessels: the aorta, inferior vena cava, and pulmonary arteries. Since symptoms and imaging of pulmonary arterial intimal sarcomas mimic pulmonary thromboembolism, the differential diagnosis of a patient presenting with chest pain, dyspnea, and filling defect within the pulmonary arteries should include intimal sarcoma. Often right ventricular failure is observed due to pulmonary hypertension caused by the obstructive effect of the tumor and concomitant chronic thromboembolism. We report the case of a 72-year-old African-American male with arterial intimal sarcoma of the left and right pulmonary artery with extension through the right artery into the bronchus and right lung.

  11. Efficacy Observation of Dopamine and Phentolamine in the Treatment of Refractory Heart Failure with Pulmonary Heart Disease%多巴胺与酚妥拉明治疗肺心病难治性心衰疗效观察

    Institute of Scientific and Technical Information of China (English)

    杨靖义

    2011-01-01

    Objective: To observe the low-dose dopamine and phentolamine in the treatment of pulmonary heart disease with refractory heart failure in clinical efficacy. Methods:pulmonary heart disease in our hospital 1 10 patients with refractory heart failure, 55 patients were randomly divided into control group, treatment group 55 cases, the basis of treatment are used sodium restriction, water restriction, continuous low flow oxygen, active anti-inflammatory and smooth airway, asthma, cardiac, diuretic, correct water and electrolyte balance; treatment group on the basis of conventional therapy plus low-dose dopamine, phentolamine, compared 2 groups of patients. Results:The treatment group 42 cases, effective in 9 cases, 4 cases, total effective rate 92.7%. Control group, 40 cases markedly effective, 8 cases, 7 cases, total effective rate 87.3%. After treatment,are better than before treatment, the treatment group than the control group (P<0.05), the difference was statistically significant. Conclusion:The conventional treatment of refractory heart failure, pulmonary heart disease based on the combined use of small doses of dopamine, phentolamine can improve symptoms, improve the efficacy, better than the simple use of digitalis preparations to improve heart failure symptoms.%目的:观察小剂量多巴胺及酚妥拉明治疗肺心病难治性心衰的临床疗效.方法:收集我院肺心病难治性心衰患者110例,随机分为对照组55例,治疗组55例,基础治疗均采用限钠,限水,持续低流量吸氧,积极抗感染,畅通气道,平喘,强心,利尿,纠正水电解质平衡;治疗组在常规治疗基础上加用小剂量多巴胺,酚妥拉明,比较2组的疗效.结果:治疗组显效42例,有效9例,无效4例,总有效率92.7%.对照组显效40例,有效8例,无效7例,总有效率87.3%.两组治疗后均优于治疗前,治疗组明显优于对照组(P<0.05),差异有统计学意义.结论:在常规治疗肺心病难治性心衰基础上,联合使

  12. Two congenital coronary abnormalities affecting heart function: anomalous origin of the left coronary artery from the pulmonary artery and congenital left main coronary artery atresia

    Institute of Scientific and Technical Information of China (English)

    Xiao Yanyan; Jin Mei; Han Ling; Ding Wenhong; Zheng Jianyong; Sun Chufan; Lyu Zhenyu

    2014-01-01

    Background The anomalous origin of the left coronary artery (LCA) from the pulmonary artery (ALCAPA) and congenital left main coronary artery atresia (CLMCA-A) are two kinds of very rare coronary heart diseases which affect heart function profoundly.This study aimed to retrospectively illustrate the clinical features and therapy experience of ALCAPA and CLMCA-A patients.Methods From April 1984 to July 2012,in Beijing Anzhen Hospital,23 patients were diagnosed with ALCAPA and 4 patients with CLMCA-A.We summarized the clinical data of the 27 cases and retrospectively analyzed the clinical manifestation,diagnosis,and treatments of these two kinds of congenital coronary abnormalities.Results The 23 patients (13 males and 10 females,aged ranging from 2.5 months to 65 years) identified with ALCAPA were classified into infantile type (age of onset younger than 12 months,16 cases) and adult type (age of onset older than 12 months,7 cases).Four patients were diagnosed with CLMCA-A (three males and one female,aged ranging from 3 months to 2 years).The main clinical manifestations of infantile-type ALCAPA and CLMCA-A include repeated respiratory tract infection,heart failure,dyspnea,feeding intolerance,diaphoresis,and failure to thrive.And these two congenital coronary abnormalities might be misdiagnosed as endocardial fibroelastosis,dilated cardiomyopathy,and acute myocardial infarction.As for the adult-type ALCAPA,cardiac murmurs and discomfort of the precordial area are the most common presentations and might be misdiagnosed as coronary heart disease,myocarditis,or patent ductus arteriosus.In ECG examination:Infantile-type ALCAPA and CLMCA-A showed abnormal Q waves with T wave inversion in leads I,avL,and V4-V6,especially in lead avL.However,ECG of adult-type ALCAPA lacked distinct features.In chest radiography:pulmonary congestion and cardiomegaly were the most common findings in infantile-type ALCAPA and CLMCA-A,while pulmonary artery segment dilation was more common in

  13. Tomographic anatomy of the vena cava and renal veins: features relevant to vena cava filter placement

    Directory of Open Access Journals (Sweden)

    Thiago Melo do Espírito Santo

    2015-03-01

    Full Text Available BACKGROUND: There is a growing demand for invasive procedures involving the inferior vena cava, in particular for placement of vena cava filters. It is not always easy to identify the more distal renal vein with cavography, for safe release of filters. OBJECTIVES: To determine parameters for the relationships between the renal veins and the infrarenal vena cava and their corresponding vertebral bodies, their relationships with biotype and the occurrence of anatomic variations, the relationships between vertebral bodies and the bifurcation of the common iliac veins and the distance from this bifurcation to the outflow of the more distal renal vein, with reference to placement of vena cava filters. METHODS: A total of 150 abdominal computed tomography scans conducted from October to November 2011 were analyzed and classified according to the biotype exhibited (using Charpy's angle. Scans were performed at MEDIMAGEM and analyzed at the Integrated Vascular Surgery Service, both part of Hospital da Beneficência Portuguesa in São Paulo, Brazil. RESULTS: In 127 of the 150 scans analyzed (84.66%, the more distal renal vein emerged between the first lumbar intervertebral space (L1-L2 and the body of L2, irrespective of patient biotype. Just 23 patients (15.33% exhibited a more distal renal vein with outflow below the body of L2, i.e. in the projection of the space between L2 and L3. CONCLUSIONS: The radiological correlation between the confluence of the more distal renal vein and vertebral bodies exhibits little variation, irrespective of the biotype of the patient.

  14. Suprarenal symplastic leiomyoma of the inferior vena cava.

    Science.gov (United States)

    Kepenekci, Ilknur; Demirkan, Arda; Sözener, Ulas; Cakmak, Atil; Demirer, Seher; Alaçayir, Iskender; Ekinci, Cemil

    2009-01-01

    We report on a case of a leiomyoma in the inferior vena cava that appeared in the image to be located in the adrenal gland. En bloc excision of the tumor with the right adrenal gland and the involved segment of the vena cava was carried out. Histopathological work-up of the tumor revealed smooth muscle fibers and marked nuclear pleomorphism consistent with symplastic leiomyoma. This case report presents a distinct histological variant of the rarely seen primary smooth muscle tumor of the inferior vena cava.

  15. Superior vena cava syndrome in hemodialysis patient

    Directory of Open Access Journals (Sweden)

    Azeb Molhem

    2011-01-01

    Full Text Available Obstruction of blood flow in the superior vena cava (SVC results in symptoms and signs of SVC syndrome. SVC obstruction can be caused either by invasion or external compression of the SVC by contagious pathologic processes involving the right lung, lymph nodes, and other mediastinal structures, or by thrombosis of blood within the SVC. Occasionally, both mechanisms co-exist. We hereby report a case of a 28-year-old male, Saudi patient who was diagnosed with end-stage renal disease and was maintained on regular hemodiaysis via right jugular vein dual lumen catheter for ten months. Three years later, the patient presented with signs and symptoms suggestive of SVC obstruction that was successfully managed with SVC stenting.

  16. Peripheral primitive neuroectodermal tumor of the kidney presenting with pulmonary tumor embolism: A case report

    Institute of Scientific and Technical Information of China (English)

    Sathya; Chinnaa; Chandan; J; Das; Sanjay; Sharma; Prabhjot; Singh; Amlesh; Seth; Suvendu; Purkait; Sandeep; R; Mathur

    2014-01-01

    Peripheral primitive neuroectodermal tumor(PNET) of the kidney is a rare, aggressive tumor known for its recurrence and metastatic potential. Despite the frequency of venous extension to the renal veins and inferior vena cava, pulmonary tumor embolism at the initial presentation is not common. We report a case of 22-year-old female with PNET of the kidney who presented with tumor embolism in the inferior vena cava(IVC) and bilateral pulmonary artery. The patient underwent surgical resection and histopathological analysis confirmed the presence of tumor within the IVC and pulmonary arteries. The patient received adjuvant chemotherapy and is currently doing well on follow-up.

  17. Diagnose problems of pulmonary heart disease complicated with hypertension,coronary heart disease%肺心病伴发高血压冠心病的诊断问题

    Institute of Scientific and Technical Information of China (English)

    李增玉

    2016-01-01

    Objective TO investiGate tHe cLinicaL diaGnOsis Of puLmOnary HypertensiOn,Heart disease WitH cOrOnary Heart disease. Methods FrOm May 2013 tO May 2014,tHe 50 seLected puLmOnary Heart disease cOmpLicated WitH cOrO-nary Heart disease and HypertensiOn Were treated as tHe ObservatiOn GrOup,50 cases Of puLmOnary Heart disease Were tHe cOntrOL GrOup,tHe cLinicaL data Were cOmparativeLy revieWed,incLudinG eLectrOcardiOGram testinG,cLinicaL manifestatiOns. Results Obesity rate,tHe rate Of smOKinG HistOry,parOXysmaL nOcturnaL dyspnea in tHe ObservatiOn GrOup Were siGnificant-Ly HiGHer,tHe severe riGHt Heart faiLure rate Was LOWer tHan tHOse in tHe cOntrOL GrOup,tHe differences Were siGnificant( P﹤0. 05). THere Was nO siGnificant difference in tHe number Of patients WitH arrHytHmias(P﹥0. 05),but tHe rates Of myOcar-diaL infarctiOn,HypertensiOn,diabetes,anGina,HistOry Of HyperLipidemia in tHe ObservatiOn GrOup Were siGnificantLy HiGHer tHan tHOse in tHe cOntrOL GrOup( P﹤0. 05). THere Was nO siGnificant difference in tHe incidence Of puLmOnary P Wave betWeen tHe tWO GrOups( P﹥0. 05),but tHe rates Of Left bundLe brancH bLOcK,persistent iscHemia,Left aXis deviatiOn,myOcardiaL infarctiOn perfOrmance,sustained atriaL fi-briLLatiOn Was siGnificantLy HiGHer in tHe ObservatiOn GrOup(P﹤0. 05),tHe rate Of riGHt aXis deviatiOn Was siGnificantLy LOW-er tHan tHOse in tHe cOntrOL GrOup(P﹤0. 05). Conclusions PuLmOnary Heart disease cOmpLicated WitH cOrOnary Heart dis-ease and HypertensiOn is severe,cHanGes quicKLy,tHere is HiGH mOrtaLity rate,requires tHe use Of an apprOpriate prOGram Of earLy diaGnOsis,misdiaGnOsis rate and reduce tHe rate Of misdiaGnOsis,tO Guard aGainst cOrOnary Heart disease-induced fac-tOrs,prOmpt treatment,tHe prOGnOsis can imprOve tHe deLivery Of strOnG prOtectiOn.%目的:探讨肺心病伴高血压冠心病的临床诊断。方法选取2013年5月至2014年5月收治的肺心病伴发高血压冠心病患者50例,设为观察组

  18. Congenital heart disease

    Institute of Scientific and Technical Information of China (English)

    1997-01-01

    970296 Evaluating the degree of pulmonary vascularlesions in congenital heart disease with selective pul-monary angiography. PAN Shiwei(潘世伟), et al.Fuwai Hosp, CAMS & PUMC, Beijing, 100037. Chin JCardiol 1997; 25(1): 39-41. Objective: To evaluate the degree of pulmonary vas-

  19. Post operative nursing of respiratory tract in patients with heart diseases and pulmonary hypertension%心脏疾病伴肺动脉高压术后患者呼吸道的护理

    Institute of Scientific and Technical Information of China (English)

    徐岩; 赵旭丹

    2014-01-01

    目的:总结心脏疾病伴肺动脉高压患者术后的呼吸道护理经验。方法对32例心脏疾病伴肺高压患者在围手术期进行针对性的护理,术后合理应用呼吸机,保持有效供氧,加强肺高压监护和呼吸道护理。结果30例患者术后肺动脉压力控制理想,治愈出院。2例死亡,死亡原因为严重低心排出量综合征和肺部感染。结论术后加强呼吸道管理,保证有效供氧,可以降低心脏疾病伴肺动脉高压术后死亡率和并发症发生率。%Objective To explore the postoperative nursing experience of respiratory tract in patients with heart disease and pulmonary hypertension.Method Thirty-two patients with adult heart disease combined with pulmonary hypertension were managed with perioperative pertinent care as well as postoperative rational use of ventilator and effective supply of oxygen,strengthened monitoring of pulmonary hypertension and respiratory care.Result The postoperative putrnonary infection pulmonary artery pressure were well controlled in all the patients even though two of them died of pulmonary hypertension crisis and pulmonary infection.Conclusion For patients with adult heart disease combined with pulmonary hypertension,nursing measures including strengthened care to the respiratory tract to ensure the effective supply of oxygen can reduce postoperative mortality and the incidence of complications.

  20. Relationship Between Prohormone Brain Natriuretic Peptide (NT-proBNP Level and Severity of Pulmonary Dysfunction in Patients With Chronic Congestive Heart Failure

    Directory of Open Access Journals (Sweden)

    Nazemiyeh Masoud

    2015-03-01

    Full Text Available Introduction: Congestive heart failure (CHF is a common disease and its prevalence is increasingin industrialized countries. NT-proBNP measurement is an established diagnostic test fordiagnosis of CHF in patients who present to emergency room with acute dyspnea. The primaryobject of this study was to determine the relationship between levels of brain natriuretic peptideprecursor and severity of lung function impairment in patients with chronic CHF.Methods: This cross-sectional and analytical study that performed in Tuberculosis andLung Disease Research Center of Tabriz University of Medical Sciences on 95 patients withchronic heart failure, and relation between NT-proBNP levels and pulmonary functionparameters were examined.Results: Sixty-four patients were male and 31 were female. The average age of male and femaleswas 62.90 ± 11.54 and 61.61 ± 11.98 years, respectively. A significant inverse linear correlationwas found between NT-proBNP and FEV1 (P<0.001, r = -0.367, FVC (P<0.001, r = -0.444,TLC (P=0.022, r = -0.238, maximal midexpiratory flow (MMEF (P=0.047, r = -0.207 andleft ventricular ejection fraction (LVEF (P<0.001, r = -0.461. A significant positive linearcorrelation was found between NT-proBNP and FEV1/FVC (P =0.013, r = 0.257, RV/TLC (P =0.003, r=0.303 and 5 Hz Raw (r = 0.231, P = 0.024.Conclusion: This study showed that, both restrictive and obstructive ventilator impairments canoccur in chronic CHF and as NT-proBNP increases appropriate to hemodynamic deterioration,pulmonary dysfunction increases.

  1. Four-dimensional modeling of the heart for image guidance of minimally invasive cardiac surgeries

    Science.gov (United States)

    Wierzbicki, Marcin; Drangova, Maria; Guiraudon, Gerard; Peters, Terry

    2004-05-01

    Minimally invasive surgery of the beating heart can be associated with two major limitations: selecting port locations for optimal target coverage from x-rays and angiograms, and navigating instruments in a dynamic and confined 3D environment using only an endoscope. To supplement the current surgery planning and guidance strategies, we continue developing VCSP - a virtual reality, patient-specific, thoracic cavity model derived from 3D pre-procedural images. In this work, we apply elastic image registration to 4D cardiac images to model the dynamic heart. Our method is validated on two image modalities, and for different parts of the cardiac anatomy. In a helical CT dataset of an excised heart phantom, we found that the artificial motion of the epicardial surface can be extracted to within 0.93 +/- 0.33 mm. For an MR dataset of a human volunteer, the error for different heart structures such as the myocardium, right and left atria, right ventricle, aorta, vena cava, and pulmonary artery, ranged from 1.08 +/- 0.18 mm to 1.14 +/- 0.22 mm. These results indicate that our method of modeling the motion of the heart is not only easily adaptable but also sufficiently accurate to meet the requirements for reliable cardiac surgery training, planning, and guidance.

  2. Genetics Home Reference: hereditary fibrosing poikiloderma with tendon contractures, myopathy, and pulmonary fibrosis

    Science.gov (United States)

    ... Fibrosis National Heart, Lung, and Blood Institute (NHLBI): Pulmonary Function Tests National Heart, Lung, and Blood Institute (NHLBI): What Is Pulmonary Rehabilitation? Pulmonary Fibrosis Foundation: Treatment Options General Information ...

  3. [Superior vena cava syndrome--surgical solution--case report].

    Science.gov (United States)

    Galie, N; Vasile, R; Savu, C; Petreanu, C; Grigorie, V; Tabacu, E

    2010-01-01

    The patient of 52-year-old smoker was admitted in emergency with headaches, dyspnea, oedema and cyanosis of the cephalic extremity and of the superior members. This signs and symptoms suggest a superior vena cava sindrom. Thoracic CT scan shows the thrombosis of the superior vena cava and a tumor localized in the Bariety's Lodge of about 30/40 mm witch is around the right lateral wall of the traheea.This tumor is also tangent to the superior the superior vena cava. The patient was operated by total median sternotomy. By this approach we performed a complete excision of the mediastinal tumor mass. After that we effected a longitudinal cavotomy, we took out the endoluminal clot and we sutured the superior vena cava. The histological diagnosis of the mediastinal tumor was adenocarcinoma tubular-papillary moderately differentiated. The evolution post operative period was favorable the superior vena cava sindrom was a complet remission. The thoracic CT scan control after 9 months later didn't show a local relapse and blood flow was normally throw the superior vena cava.

  4. A new type of inferior vena cava filter and its animal experiment

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    This article explains the definition of pulmonary embolism as well as its causes and elaborates on a new type of inferior vena cava filter(VCF)we have developed. Shaped like a waistdrum,the VCF is mainly made of TiNi shape memory alloy-wire. It has a subulate wire frame which can intercept the thrombus on each side. Its medial body is made up of straight shape memory alloywire . Every pillar is bound by several shape memory alloy springs. This type of inferior vena cava filter has a good resistance to fatigue and is hard to be broken. Through animal experiments its framework has been proved to be lasting. Neither deformation nor fragmentation happened when the VCF had been kept in the body for a long time. The thrombus interception efficiency of our VCF is higher than imported VCFs. The filter is unfavorable for thrombosis. After implantation,the IVC was completely unimpeded and no displacement occurred. Moreover the VCF did little damage to the Wall of vein. Neither IVC perforation nor haematoma occurred after the operation.

  5. Systemic-to-pulmonary collateral flow in patients with palliated univentricular heart physiology: measurement using cardiovascular magnetic resonance 4D velocity acquisition

    Directory of Open Access Journals (Sweden)

    Valverde Israel

    2012-04-01

    Full Text Available Abstract Background Systemic-to-pulmonary collateral flow (SPCF may constitute a risk factor for increased morbidity and mortality in patients with single-ventricle physiology (SV. However, clinical research is limited by the complexity of multi-vessel two-dimensional (2D cardiovascular magnetic resonance (CMR flow measurements. We sought to validate four-dimensional (4D velocity acquisition sequence for concise quantification of SPCF and flow distribution in patients with SV. Methods 29 patients with SV physiology prospectively underwent CMR (1.5 T (n = 14 bidirectional cavopulmonary connection [BCPC], age 2.9 ± 1.3 years; and n = 15 Fontan, 14.4 ± 5.9 years and 20 healthy volunteers (age, 28.7 ± 13.1 years served as controls. A single whole-heart 4D velocity acquisition and five 2D flow acquisitions were performed in the aorta, superior/inferior caval veins, right/left pulmonary arteries to serve as gold-standard. The five 2D velocity acquisition measurements were compared with 4D velocity acquisition for validation of individual vessel flow quantification and time efficiency. The SPCF was calculated by evaluating the disparity between systemic (aortic minus caval vein flows and pulmonary flows (arterial and venour return. The pulmonary right to left and the systemic lower to upper body flow distribution were also calculated. Results The comparison between 4D velocity and 2D flow acquisitions showed good Bland-Altman agreement for all individual vessels (mean bias, 0.05±0.24 l/min/m2, calculated SPCF (−0.02±0.18 l/min/m2 and significantly shorter 4D velocity acquisition-time (12:34 min/17:28 min,p 2; Fontan 0.62±0.82 l/min/m2 and not in controls (0.01 + 0.16 l/min/m2, (3 inverse relation of right/left pulmonary artery perfusion and right/left SPCF (Pearson = −0.47,p = 0.01 and (4 upper to lower body flow distribution trend related to the weight (r = 0.742, p  Conclusions 4D

  6. Vertebral uptake of Tc-99m macroaggregated albumin (MAA) with SPECT/CT occurring in superior vena cava obstruction

    Energy Technology Data Exchange (ETDEWEB)

    Karls, Shawn; Hassoun, Hani; Derbekyan, Vilma [Dept. of Nuclear Madicine, Royal Victoria Hospital, Montreal (Canada)

    2016-09-15

    A 67-year-old male presented with dyspnea for which lung scintigraphy was ordered to rule out pulmonary embolus. Planar images demonstrated abnormal midline uptake of Tc-99m macroaggregated albumin, which SPECT/CT localized to several thoracic vertebrae. Thoracic vertebral uptake on perfusion lung scintigraphy was previously described on planar imaging. Radionuclide venography and contrast-enhanced CT subsequently demonstrated superior vena cava (SVC) obstruction with collateralization through the azygous/hemiazygous system and vertebral venous plexus. SPECT/CT differentiated residual esophageal/tracheal ventilation activity, a clinically insignificant finding, from vertebral uptake indicative of SVC obstruction, a potentially life-threatening condition.

  7. Effect of milrinone in treating chronic pulmonary heart disease complicated with severe heart failure%米力农治疗慢性肺源性心脏病严重心力衰竭效果观察

    Institute of Scientific and Technical Information of China (English)

    葛慷艳; 徐海虹; 蒋鸽

    2016-01-01

    目的 探讨米力农治疗慢性肺源性心脏病严重心力衰竭的疗效.方法 选择2012年10月至2014年12月于浙江省临海市中医院住院的慢性肺源性心脏病严重心力衰竭患者68例,按入院先后顺序随机分为观察组和对照组,各34例.2组患者入院后均采用持续低流量吸氧、控制感染、纠正电解质紊乱及酸碱平衡、解痉平喘、止咳祛痰等基础治疗,根据病情适量利尿,积极治疗并发症;观察组在此基础上给予米力农0.5μg/(kg·min)静脉微量泵持续给药,7d为1个疗程.观察并比较2组患者治疗1个疗程后疗效、心功能指标[左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)、每搏输出量(SV)、肺动脉压]、N末端B型脑钠肽(NT-proBNP)水平以及不良反应发生情况.结果 观察组总有效率明显高于对照组[94.1% (32/34)比76.5% (26/34)],差异有统计学意义(P<0.05).治疗后,观察组和对照组LVEF、SV均明显高于治疗前[LVEF:(68±7)%比(45±6)%、(53±5)%比(47±6)%;SV:(70±6)ml比(51±5)ml、(57 ±6)ml比(51±5)ml],且观察组明显高于对照组;肺动脉压、NT-proBNP均明显低于治疗前[肺动脉压:(42±9)mmHg(1mmHg=0.133kPa)比(80±9)mmHg、(54±8)mmHg比(78±10)mmHg;NT-proBNP:(206±72)ng/L比(689±198) ng/L、(337±102) ng/L比(674 ±204) ng/L],且观察组明显低于对照组,差异均有统计学意义(均P<0.05).2组LVEDD治疗前后差异无统计学意义(P>0.05).2组患者治疗过程中均未出现严重不良反应.结论 米力农能有效改善慢性肺源性心脏病严重心力衰竭患者的心功能.%Objective To observe the therapeutic effect of milrinone in treating chronic pulmonary heart disease complicated with severe heart failure.Methods Totally 68 cases with chronic pulmonary heart disease complicated with severe heart failure were enrolled and randomly divided into observation group and control group (34 cases in each group).After admission,both groups

  8. Expression of ghrelin and insulin-like growth factor-1 in immature piglet model of chronic cyanotic congenital heart defects with decreased pulmonary blood flow

    Institute of Scientific and Technical Information of China (English)

    WANG Dong; LIU Ying-long; L(U) Xiao-dong; ZHU Yao-bin; LING Feng; LIU Ai-jun; LI Gang; XU Yu-lin

    2011-01-01

    Background Cyanotic patients have potential growth retardation and malnutrition due to hypoxemia and other reasons.Ghrelin is a novel endogenous growth hormone secretagogue that has effects on growth and cardiovascular activities.The aim of this study was to evaluate the plasma level and myocardial expression of ghrelin and insulin-like growth factor-1 (IGF-1) using an immature piglet model of chronic cyanotic congenital heart defects with decreased pulmonary blood flow. Methods Twelve weanling Chinese piglets underwent procedures of main pulmonary artery-left atrium shunt with pulmonary artery banding or sham operation as control. Four weeks later, hemodynamic parameters were measured.Enzyme-linked immunosorbent assay for plasma ghrelin and IGF-1 level measurement were performed. Ventricular ghrelin and IGF-1 mRNA expressions were measured by quantitative real-time polymerase chain reaction. Results Four weeks after surgical procedure, the cyanotic model produced lower arterial oxygen tension ((68.73 ±15.09) mmHg), arterial oxygen saturation ((82.35 ± 8.63)%), and higher arterial carbon dioxide tension ((51.83 ± 6.12)mmHg), hematocrit ((42.67 ± 3.83)%) and hemoglobin concentration ((138.17 ± 16.73) g/L) than the control piglets ((194.08 ± 98.79) mmHg, (96.43 ± 7.91)%, (36.9 ± 4.73) mmHg, (31.17 ± 3.71)%, (109.83 ± 13.75) g/L) (all P <0.05).Plasma ghrelin level was significantly higher in the cyanotic model group in comparison to the control (P=0.004), and the plasma IGF-1 level was significantly lower than control (P=0.030). Compared with control animals, the expression of ghrelin mRNAs in the ventricular myocardium was significantly decreased in the cyanotic model group (P=0.000), and the expression of IGF-1 mRNAs was elevated (P=0.001). Conclusions Chronic cyanotic congenital heart defects model was successfully established. Plasma ghrelin level and myocardial IGF-1 mRNA expression were significantly up-regulated, while plasma IGF-1 level and

  9. Pulmonary Hypertension in Scleroderma

    Science.gov (United States)

    ... is a reduced diffusing capacity (DL CO ) on pulmonary function tests (PFTs). The DL CO measures the ability of ... catheterization to measure the actual pressure in the pulmonary ... the PH; to assess the function of the left side of the heart; and ...

  10. [Predictors of Efficacy of Radiofrequency Ablation of Pulmonary Veins Performed During Coronary Bypass Surgery in Patients With Ischemic Heart Disease and Paroxysmal Atrial Fibrillation].

    Science.gov (United States)

    Iskenderov, B G; Rakhmatullov, A F

    2015-01-01

    We performed simultaneous coronary artery bypass grafting (CABG) and radiofrequency ablation (RFA) ostia of pulmonary veins in 254 patients (147 men and 107 women) with ischemic heart disease and paroxysmal atrial fibrillation (AF). In-hospital mortality in patients with early recurrence of AF was 8.4%, in patients without recurrence of AF 1.9% (χ2 = 4.65; p = 0.03). The patients were followed-up during 12 months after operation. During follow-up 166 patients (69.5%) had no recurrence of AF without receiving antiarrhythmic drugs (AAP), 33 patients (13.8%) had recurrences of AF, and 40 patients (16.7%) receiving AAD had repeated rare paroxysms of AF. Main predictors of late AF recurrence were age > 65 years, AF duration > 5 years, preoperative atrial effective refractory period 50 mm, glomerular filtration rate heart due to CABG and RFA, use of β-blockers, angiotensin converting enzyme inhibitors and aldosterone antagonists were associated with the preservation of a stable sinus rhythm. The cardiovascular mortality during 12 months follow-up accounted for 2.1% and 1.2% in groups of patients with and without late recurrences of AF respectively (p > 0.05) to coronary artery bypass grafting surgery and RFA, taking drugs--β-blockers, angiotensin converting enzyme inhibitors and aldosterone antagonists--were associated with the preservation of a stable sinus rhythm.

  11. Echocardiographic evaluation of heart in chronic obstructive pulmonary disease patient and its co-relation with the severity of disease

    Directory of Open Access Journals (Sweden)

    N K Gupta

    2011-01-01

    Full Text Available Background: Chronic obstructive pulmonary disease (COPD has considerable effects on cardiac functions, including those of the right ventricle, left ventricle, and pulmonary blood vessels. Most of the increased mortality associated with COPD is due to cardiac involvement. Echocardiography provides a rapid, noninvasive, portable, and accurate method to evaluate the cardiac changes. Aims: To assess the cardiac changes secondary to COPD by echocardiography and to find out the correlation between echocardiographic findings and severity of COPD, if there is any. Materials and Methods: A total 40 of patients of COPD were selected and staged by pulmonary function test (PFT and evaluated by echocardiography. Results: On echocardiographic evaluation of COPD, 50% cases had normal echocardiographic parameters. Measurable tricuspid regurgitation (TR was observed in 27/40 cases (67.5%. Pulmonary hypertension (PH, which is defined as systolic pulmonary arterial pressure (sPAP > 30 mmHg was observed in 17/27 (63% cases in which prevalence of mild, moderate, and severe PH were 10/17 (58.82%, 4/17 (23.53%, and 3/17 (17.65%, respectively. The frequencies of PH in mild, moderate, severe, and very severe COPD were 16.67%, 54.55%, 60.00%, and 83.33%, respectively. Right atrial pressure was 10 mmHg in 82.5% cases and 15 mmHg in 17.5% cases. Cor pulmonale was observed in 7/17 (41.17% cases; 7.50% cases had left ventricle (LV systolic dysfunction and 47.5% cases had evidence of LV diastolic dysfunction defined as A ≥ E (peak mitral flow velocity of the early rapid filling wave (E, peak velocity of the late filling wave caused by atrial contraction (A on mitral valve tracing. Left ventricle hypertrophy was found in 22.5% cases. Conclusion : Prevalence of PH has a linear relationship with severity of COPD and severe PH is almost associated with cor pulmonale. Echocardiography helps in early detection of cardiac complications in COPD cases giving time for early

  12. 前列地尔脂微球载体制剂对AECOPD合并慢性肺源性心脏病肺动脉高压疗效的临床研究%Clinical study of lipo-prostaglandin E1 on pulmonary hypertension in patients with AECOPD and chronic pulmonary heart disease

    Institute of Scientific and Technical Information of China (English)

    黄刚; 叶荣苹

    2011-01-01

    目的 评价前列地尔脂微球载体制剂(Lipo PGE1)治疗AECOPD合并慢性肺源性心脏病肺动脉高压患者的疗效.方法 60例AECOPD合并慢性肺源性心脏病肺动脉高压患者随机分为治疗组和对照组,治疗组在常规治疗的基础上加用Lipo PGE1 10 μg,对照组仅常规治疗.治疗前后检测肺动脉收缩压(SPAP)、肺动脉平均压(MPAP)、肺动脉舒张压(DPAP)、动脉血氧分压(PaO2)、动脉二氧化碳分压(PaCO2)、肺功能FEV1和FEV1/FVC.结果 治疗后SPAP、MPAP、DPAP、PaCO2较治疗前明显降低,PaO2、FEV1和FEV1/FVC较治疗前显著增加,与对照组相比有显著差异(P<0.05).结论 PGE1治疗AECOPD合并慢性肺源性心脏病肺动脉高压能降低肺动脉压力,改善动脉血气和肺功能.%Objective To evaluate the effects oflipo-prostaglandin El ( PGE1) on the AECOPD and chronic pulmonary heart disease with pulmonary hypertension.Methods 60 patients of AECOPD and chronic pulmonary heart disease with pulmonary hypertension were randomly divided into therapy group and control group.The patients in therapy group received therapy plus intravenous 10 μg PGE.And the patients in control group received routine therapy.Before and after therapy, systolic pulmonary artery pressure, mean pulmonary artery pressure ( MPAP), pulmonary artery diastolic pressure ( DPAP), arterial partial pressure of oxygen ( PaO2 ), arterial carbon dioxide tension (PaCO2), lung function FEV1 and FEV1/FVC were measured.Result Aftor treatment, SPAP, MPAP, DPAP, PaCO2 significantly lower than before treatment, PaO2, FEV1 and FEV1/FVC were significantly increased than that before treatment, compared with the control group were significantly different ( P <O.05 ).Conclusion PGE1 treatment of AECOPD and chronic pulmonary heart disesse with pulmonary hypertension reduces pulmonary artery pressure, improve arterial blood gas and pulmonary function.

  13. Anatomical and hemodynamic evaluations of the heart and pulmonary arterial pressure in healthy children residing at high altitude in China

    Directory of Open Access Journals (Sweden)

    Hai-Ying Qi

    2015-06-01

    Conclusions: Children living at high altitude in China have significantly higher mPAP, dilated right heart and slower regression of right ventricular hypertrophy in the first 14 years of life. Systolic and diastolic functions of both ventricles were reduced with a paradoxically higher CI. There was no significant difference in these features between the Hans and the Tibetans. These values provide references for the care of healthy children and the sick ones with cardiopulmonary diseases at high altitude.

  14. Pulmonary manifestations of heartworm disease.

    Science.gov (United States)

    Calvert, C A; Rawlings, C A

    1985-09-01

    The clinical signs associated with heartworm disease are the result of changes in the pulmonary arterial system. These clinical signs are the result of either pulmonary hypertension or lung parenchymal disease associated with vascular changes. An increase in pulmonary arterial pressure produces an increase in right ventricular afterload, which may lead to exercise intolerance, syncope, and right-sided congestive heart failure. Coughing, dyspnea, and hemoptysis are the results of pulmonary parenchymal disease.

  15. The North Atlantic Oscillation affects the quality of Cava (Spanish sparkling wine).

    Science.gov (United States)

    Real, Raimundo; Báez, José Carlos

    2013-05-01

    This study explores the possible effects of the North Atlantic Oscillation (NAO) on the quality of Spanish Cava. We found a significant negative relationship between the mean NAO for the months of March through August of each year between 1970 and 2008 and the probability of obtaining a top quality Cava. The NAO is associated with temperature and rainfall variations in the Cava region, which affect vine physiological processes during grape maturity. The probability of obtaining a top quality Cava was highest when the mean value of the NAO was negative, which causes the mean temperature in the Cava area to decrease, with positive consequences on Cava quality. Although the overall discrimination capacity and explanatory power of the model were low, 80% of clearly favorable years were classified correctly as corresponding to top quality Cava, and 70% of clearly unfavorable years were classified correctly as non top quality Cava.

  16. 慢性肺心病合并冠心病的临床诊治分析%Clinical diagnosis analysis on chronic pulmonary heart disease complicated with coronary artery disease

    Institute of Scientific and Technical Information of China (English)

    李顺辉; 涂颉洪; 张卫; 刘丽赟; 熊强珍

    2010-01-01

    目的 探讨慢性肺心病合并冠心病的临床特点和诊断依据,总结分析其治疗方法,从而提高临床诊断率、降低病死率.方法 回顾性分析98例慢性肺心病合并冠心病患者的临床特点、心电图、X线摄片、超声心电图以及治疗资料.结果 肺心病出现典型心绞痛、心肌梗死,心电图左心导联动态缺血性改变、左前半或完全性左束支传导阻滞,反复出现左心衰竭伴有左心扩大者,应考虑合并冠心病.处理时要在常规治疗的基础上区别对待.结论 肺心病合并冠心病引起的心力衰竭患者,要根据诊断结果,在常规基础治疗的同时,针对病因与并发症取有效的个体化治疗措施进行处理,可获得较满意的临床效果.%Objective To discuss the chronic pulmonary heart disease merge coronary artery disease's clinical characteristic and the diagnosis basis, then summarizes and analyzes its method of treatment,to improve the clinical diagnosis rates and reduce mortality. Methods Retrospective analyzing 98 cases of chronic pulmonary heart disease merge coronary artery disease patients' clinical characteristic, the electrocardiogram, X absorb the piece, the supersonic electrocardiogram and the treatment material. Results Pulmonary heart disease patients appear typical angina pectoris, myocardial infarction, 12-lead electrocardiography ischemic dynamic changes in ST-T segment, left anterior hemi block or CLBBB (Complete Left Bundle Branch Block), recurring the left heart failure with left heart amplification, we should consider merge coronary heart disease. When dealing with the disease, we must distinguish in the conventional treatment foundation. Conclusion Pulmonary heart disease merge coronary artery disease patients with heart failure, while taking conventional foundation treatment, aim at causes and complications to take effective measures to deal with individual treatment, can get a satisfactory clinical effect.

  17. Symptoms and impact of symptoms on function and health in patients with chronic obstructive pulmonary disease and chronic heart failure in primary health care

    Directory of Open Access Journals (Sweden)

    Theander K

    2014-07-01

    Full Text Available Kersti Theander,1,2 Mikael Hasselgren,2,3 Kristina Luhr,4 Jeanette Eckerblad,5 Mitra Unosson,5 Ingela Karlsson1 1Department of Nursing, Faculty of Health Science and Technology, Karlstad University, Karlstad, Sweden; 2Primary Care Research Unit, County Council of Värmland, Karlstad, Sweden; 3Department of Medicine, Örebro University, Örebro, Sweden; 4Family Medicine Research Centre, Örebro County Council, Örebro, Sweden; 5Department of Social and Welfare Studies, Faculty of Health Sciences, Linköping University, Linköping, Sweden Background: Patients with chronic obstructive pulmonary disease (COPD and chronic heart failure (CHF seem to have several symptoms in common that impact health. However, methodological differences make this difficult to compare. Aim: Comparisons of symptoms, impact of symptoms on function and health between patients with COPD and CHF in primary health care (PHC. Method: The study is cross sectional, including patients with COPD (n=437 and CHF (n=388, registered in the patient administrative systems of PHC. The patients received specific questionnaires – the Memorial Symptom Assessment Scale, the Medical Research Council dyspnea scale, and the Fatigue Impact Scale – by mail and additional questions about psychological and physical health. Results: The mean age was 70±10 years and 78±10 years for patients with COPD and CHF respectively (P=0.001. Patients with COPD (n=273 experienced more symptoms (11±7.5 than the CHF patients (n=211 (10±7.6. The most prevalent symptoms for patients with COPD were dyspnea, cough, and lack of energy. For patients with CHF, the most prevalent symptoms were dyspnea, lack of energy, and difficulty sleeping. Experience of dyspnea, cough, dry mouth, feeling irritable, worrying, and problems with sexual interest or activity were more common in patients with COPD while the experience of swelling of arms or legs was more common among patients with CHF. When controlling for background

  18. Leiomiossarcoma da veia cava inferior: relato de caso

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    Rafael Lemos Nascif

    2014-12-01

    Full Text Available Relatamos um caso de paciente do sexo feminino, 48 anos, com quadro clínico de dor abdominal de moderada intensidade e abaulamento do abdome. Ao exame físico constatou-se massa abdominal palpável. A tomografia computadorizada mostrou volumosa massa retroperitoneal, com realce heterogêneo e íntima relação com a veia cava inferior. Realizou-se ressecção em bloco da massa e do segmento invadido da veia cava. A histologia revelou leiomiossarcoma.

  19. Angiojet thrombolysis and vena cava filter insertion in a case of a duplicated inferior vena cava

    Directory of Open Access Journals (Sweden)

    Stuart Blackwood

    2015-02-01

    Full Text Available Objectives: Duplication of the inferior vena cava (IVC complicates interventional procedures. This case report aims to shed light on this unusual anomaly and the preoperative considerations necessary when treatment of venous thromboembolism is undertaken. Methods: An IRB approved case report of a 58 year old woman presented emergently with right lower extremity phlegmasia due to extensive thrombosis of her right iliofemoral and infrarenal portion of her duplicated IVC. Results: The patient underwent IVC filter placement and rheolytic thrombectomy with thrombolysis using the Angiojet device followed by venoplasty and stenting of the iliofemoral system and right IVC. Complete symptomatic and radiographic resolution on duplex imaging was achieved at 1 year follow up. Conclusions: With adequate preoperative awareness of IVC anomalies and treatment options available satisfactory results can be achieved and complications minimized for this unique patient population.

  20. Evaluation of pulmonary hypertension and surgical therapeutic effects using radionuclide pulmonary perfusion imaging in patients with pulmonary hypertension of valvular heart disease%核素肺灌注显像对瓣膜性心脏病合并肺动脉高压病人的手术疗效观察

    Institute of Scientific and Technical Information of China (English)

    潘世伟; 胡盛寿; 许建屏; 王巍; 王雪梅; 柳枫; 冯钧; 何卓祥; 苏文君

    2010-01-01

    Objective To evaluate pulmonary hypertension(PH) and surgical therapeutic effects using radionuclide pulmonary perfusion imaging in patients of valvular heart disease. Methods And material 115 patients accumulated with valvular disease were included from May 2001 to August 2007. Echocardiography and first-pass radionuclide pulmonary perfusion imaging(FPPPI) were performed in all patients before surgery,7days after surgery and 3 months after surgery(33cases). Patients were divided into four groups. Pulmonary artery pressure (PAP) is normal group[mean pulmonary arterial pressure (MPAP)≤20mm Hg(1 mm Hg =0. 133 kPa)]; PAP slightly rise group[20 mm Hg 50 mm Hg]. Results Lung Equilibrium Time (LET)by FPPPI were(18.87 ± 4.80) s, (26. 17 ± 7.09) s, (38.48 ± 7.09) s and (54.59 ± 7.96) s in this four groups before surgery. LET were 17.58 ±4.52, 21.51 ±6.44, 23.94 ±5.85, 27.29 ±6.70 in this four groups 7 days after surgery (P<0.001). There were no siguificantly differences of LET in 33 cases 3 months after surgery compared with those of 7 days after surgery. Conclusion Pulmonary arterial pressure siguificantly decreased 7 days after surgery in patients with PH of valvular heart disease, especially in those of slightly and moderate rise groups. FPPPI is an accuracy method in evaluating surgical therapeutic effects in valvular heart disease.%目的 探讨采用首次通过法核素肺灌注显像、通过放射性时间-计数曲线方法了解瓣膜性心脏病合并有肺动脉高压(PH)手术前、后肺动脉压力的变化规律的价值.方法 115例二尖瓣病变为主的瓣膜性心脏病病人均行瓣膜置换或成形术治疗.所有病人在手术前,手术后7天行核素肺灌注显像检查,33例在术后3个月进行第3次复查.另选10名健康者,测其肺循环平均时间(LET)作为正常对照组.结果 与术前相比,术后7天LET明显降低(P<0.001).33例术后3个月的LET与术后7天差异虽无统计学意义,但LET仍

  1. Myxoma of the Superior Vena Cava Origin Presented as a Right Atrial Mass

    Directory of Open Access Journals (Sweden)

    Feridoun Sabzi

    2015-10-01

    Full Text Available Myxomas are the most common benign cardiac tumors. Myxomas are more common in the left heart chamber than the right side chamber. An extracardiac origin presenting as a right atrial mass is very rare. We present a case of myxoma originating in the superior vena cava (SVC in a 24-year-old man, who underwent surgical resection. Preoperative two-dimensional echocardiography demonstrated a mass in the right atrium. Intraoperatively, the tumor was found to have originated from the SVC orifice. The tumor was excised from the SVC by opening the one-third proximal portion of the SVC. Pathological examination revealed a myxoma, and one-year follow-up showed no evidence of the recurrence of any tumors in the SVC.

  2. New auxiliary indicators for the differential diagnosis of functional cardiorespiratory limitation in patients with chronic obstructive pulmonary disease and congestive heart failure

    Directory of Open Access Journals (Sweden)

    Cesar Marcelo de Castro

    2003-01-01

    Full Text Available OBJECTIVE: To differentiate the nature of functional cardiorespiratory limitations during exercise in individuals with chronic obstructive pulmonary disease (COPD or congestive heart failure (CHF and to determine indicators that may help their classifications. METHODS: The study comprised 40 patients: 23 with COPD and 17 with CHF. All individuals underwent maximal cardiopulmonary exercise testing on a treadmill. RESULTS: The values of peak gas exchange ratio (R peak, peak carbon dioxide production (VCO2 peak, and peak oxygen ventilatory equivalent (V E O2 peak were higher in the patients with CHF than in those with COPD, and, therefore, those were the variables that characterized the differences between the groups. For group classification, the differentiating functions with the R peak, VCO2 peak (L/min, and V E O2 peak variables were used as follows: group COPD: - 44.886 + 78.832 x R peak + 5.442 x VCO2 peak + 0.336 x V E O2 peak; group CHF: - 69.251 + 89.740 x R peak + 8.461 x VCO2 peak + 0.574 x V E O2 peak. The differentiating function, whose result is greater, correctly classifies the patient's group as 90%. CONCLUSION: The R peak, VCO2 peak, and V E O2 peak values may be used to identify the cause of the functional cardiorespiratory limitations in patients with COPD and CHF.

  3. Iatrogenic migration of VenaTech LP IVC filter to superior vena cava secondary to guidewire entrapment: case report and review of literature.

    Science.gov (United States)

    Almestady, Rajaa; Spain, James; Bayona-Molano, Maria Del Pilar; Wang, Weiping

    2013-01-01

    Modern inferior vena cava (IVC) filters are generally safe devices for preventing pulmonary embolus, with fewer complications compared to earlier techniques of caval interruption. Despite continuing improvement in filter designs and insertion methods, complications still occur. The IVC filter complications resulting from iatrogenic causes are rare and include but are not limited to misplacement, filter tilting, incomplete deployment, and filter migration. We recently experienced a problem in which the Vena Tech LP filter (B. Braun, Bethlehem, Pennsylvania) migrated to the superior vena cava (SVC) immediately after successful deployment of the filter in the infrarenal venacava. The root cause analysis of this case revealed that the complication was related to blind pullout of the J-tipped guidewire following deployment of the filter in the IVC. This report highlights the potential risks of using a wire while an IVC filter is in place.

  4. 硝普钠、多巴胺、低分子肝素钙治疗肺源性心脏病顽固性心功能衰竭的临床研究%The Clinical Research of Sodium Nitroprusside,Dopamine Combined with Low Molecular Weight Heparin Treating Intractable Heart Failure of Pulmonary Heart Disease

    Institute of Scientific and Technical Information of China (English)

    王玉彩; 菅向东

    2013-01-01

    目的 总结硝普钠、多巴胺、低分子肝素钙治疗肺源性心脏病(肺心病)顽固性心功能衰竭的临床效果.方法 回顾性分析患者在原有治疗肺心病的基础上使用硝普钠、多巴胺、低分子肝素钙前后临床症状的变化、心功能改善情况及血压、心率、呼吸、24 h尿量改变的情况.结果 经硝普钠、多巴胺、低分子肝素钙治疗后,肺心病顽固性心功能衰竭疗效显著(P<0.05),且患者血压、心率、呼吸频率及24 h尿量均明显改善(P<0.05).结论 硝普钠、多巴胺、低分子肝素钙对治疗肺心病顽固性心功能衰竭疗效确切,值得临床推广.%Objective To study the effect of sodium nitroprusside,dopamine combined with low molecular weight heparin treating intractable heart failure of pulmonary heart disease. Methods The clinical of clinincal symptoms,cardiac function improvement and blood pressure,heart rate,breathing,24 h urine volume after the use of sodium nitroprusside, dopamine, low molecular weight heparin on the basis of pulmonary heart disease treatment were retrospectively analyzed. Results Sodium nitroprusside,dopamine,low molecular weight heparin calcium had significant effect on the intractable heart failure of pulmonary heart disease ( P <0.05 );blood pressure, heart rate, respiratory rate and 24 h urine volume were significantly improved (P<0.05). Conclusion Sodium nitroprusside, dopamine combined with low molecular weight heparin treating intractable heart failure of pulmonary heart disease is of affirmative effect,which is worthy of clinical promotion.

  5. Curative effect observation of alprostadil in the treatment of pulmonary heart disease when the cardiac decompensa-tion period%前列地尔对心功能失代偿期肺心病的疗效观察

    Institute of Scientific and Technical Information of China (English)

    寇民生

    2015-01-01

    目的:探讨前列地尔在心功能失代偿期肺心病的疗效.方法:收治肺心病患者98例,随机分为对照组(48例)与治疗组(50例),对照组给予常规治疗.治疗组在常规治疗的基础上,给予脂微球前列地尔静脉滴注.结果:治疗组临床症状的改善、心功能的改善显著优于对照组(P<0.05);治疗组血氧分压、二氧化碳分压、肺动脉压、射血分数等指标与对照组比较,有明显改善(P<0.05).结论:前列地尔治疗心功能失代偿期肺心病有较好的效果.前列地尔是治疗慢性失代偿期肺心病的有效药物.%Objective:To investigate the effect of alprostadil in the treatment of pulmonary heart disease when the cardiac decompensation period.Methods:98 patients with pulmonary heart disease were selected,they were randomly divided into the control group(48 cases) and the treatment group(50 cases),the control group received the conventional treatment.The treatment group given the lipid microsphere alprostadil intravenous infusion on the basis of the conventional treatment.Results:The improvement of clinical symptoms and heart function of the treatment group were significantly better than those of the control group(P<0.05);the blood oxygen partial pressure,carbon dioxide partial pressure,pulmonary arterial pressure,ejection fraction and other indexes of the treatment group were significantly improved compared with the control group(P<0.05).Conclusion:Alprostadil in the treatment of pulmonary heart disease when the cardiac decompensation period has a better curative effect. Alprostadil is an effective drug for the treatment of chronic decompensated pulmonary heart disease.

  6. Effect of Yiqifumai capsule on chronic pulmonary heart disease with heart failure%益气复脉胶囊治疗慢性肺源性心脏病心力衰竭疗效观察

    Institute of Scientific and Technical Information of China (English)

    代国军

    2014-01-01

    Objective It is to observe the clinical efficacy of Yiqifumai capsule on chronic pulmonary heart disease (CPHD) with heart failure.Methods 97 CPHD patients were randomly divided into 2 groups:Yiqifumai treatment group (n=54) and conventional treatment group ( n=43).All patients received the conventional treatments , including: expectorant, antiasthmatic , anti-inflammatory and heart failure treatment .In addition, Yanhuning treatment group also received Yanhun-ing capsule.The clinical curative effects were observed and several indics including :heart function, blood-gas analysis, lev-els of serum inflammation and oxidative stress before and after treatment in both groups were compared .Results The total ef-fective rate in Yiqifumai group was significantly higher than that in control group (P0.05).Adverse drug reaction was not found in the study .Conclusion Yiqifumai capsule could improve heart and lung function , reduce the levels of serum inflam-mation and oxidative stress in the patients with CPHD , the clinical curative effect is satisfied .%目的:观察益气复脉胶囊治疗慢性肺源性心脏病心力衰竭(肺心病心衰)的临床疗效。方法将97例肺心病心衰患者随机分为益气复脉组( n=54)与对照组( n=43)。所有患者均接受化痰、平喘、抗感染、抗心衰等常规治疗,益气复脉组在此治疗基础上加用益气复脉胶囊治疗。观察2组临床疗效,比较治疗前后心功能、血气分析、血清炎症因子与氧化应激水平。结果益气复脉组总有效率明显高于对照组( P<0.05)。治疗后,2组患者心功能好转,低氧血症及酸中毒得到纠正,机体炎症因子及氧化应激水平显著下降(P均<0.05),且益气复脉组改善更明显(P均<0.05),但不能进一步减缓心率(P>0.05)。整个研究中未发现药物不良反应。结论益气复脉胶囊可以明显改善慢性肺心病心衰患者的心肺功能

  7. 慢性肺源性心脏病合并冠心病临床研究%Clinical Study of Chronic Pulmonary Heart Disease Complicated With Coronary Heart Disease

    Institute of Scientific and Technical Information of China (English)

    郭睿蓉; 吴明; 张尧

    2015-01-01

    目的:探讨慢性肺源性心脏病(简称肺心病)合并冠心病的临床特点。方法选取2013年1~2014年12月于我院就诊的肺心病患者共134例作为研究对象,根据是否合并冠心病分为伴发组(n=64)和非伴发组(n=70)。比较两组患者易患因素、X线检查、治疗转归等临床特点。结果与非伴发组相比,伴发组高脂血症、高血压、糖尿病、肥胖发生率显著升高,比较有统计学差异(P均<0.05),而吸烟发生比例组间比较无统计学差异(P>0.05)。X线检查显示,伴发组左心室肥大和左右心室肥大的发生率分别为23.4%和14.06%,高于非伴发组10.0%和4.28%的发生率(P均<0.05)。治疗后,与非伴发组相比,伴发组好转比例降低,比较有统计学意义(P<0.05),治疗无效及死亡人数增加,但组间比较无统计学差异(P均>0.05)。结论肺心病合并冠心病患者病情复杂,高脂血症、高血压、糖尿病、肥胖等易患因素、左心室肥大及左右心室肥大发生率明显升高,且治疗转归效果还有待进一步改善,应综合考虑进行相关诊断及治疗。%Objective To investigate the clinical characteristic of chronic pulmonary heart disease complicated with coronary heart disease.Methods From January, 2014 to December, 2014, 134 cases were selected as research subjects to retrospectively analyze their clinical characteristics. Those cases were divided into the none concomitant coronary heart disease group (NCCHD, n=84) and the concomitant coronary heart disease group (CCHD, n=92) according to if they were complicated with coronary heart disease. Then, the susceptible factors, x-ray examination, and outcomes were compared between the two groups.ResultsCompared to NCCHD group, CCHD group has higher rates of hypertension, hyperlipemia, obesity, and diabetes and same rates of smoke. The x-ray examination indicates CCHD group has higher rates of

  8. INFERIOR VENA-CAVA OBSTRUCTION AFTER ORTHOTOPIC LIVER-TRANSPLANTATION

    NARCIS (Netherlands)

    BROUWERS, MAM; DEJONG, KP; PEETERS, PMJG; BIJLEVELD, CMA; KLOMPMAKER, IJ; SLOOFF, MJH

    1994-01-01

    Post-operative inferior vena cava (IVC) obstruction is reported as an uncommon complication after orthotopic liver transplantation (OLT). We report 6 cases after 245 OLT's in the period between March '79 and December '92. Compression or torsion of the IVC or a technical problem were underlying cause

  9. [Resection of leiomyosarcoma of the inferior vena cava].

    Science.gov (United States)

    Zotov, S P; Pyshkin, S A; Malyshev, M Iu; Safuanov, A Kh; Borovikov, D A; Siniukov, D M; Tereshin, O S; Panov, I O

    2013-01-01

    Experience in treatment of leiomyosarcoma of the retrohepatic segment of the inferior vena cava at any separately taken clinic is scarce. Given a rare nature of the pathology involved, whose diagnosis and management require joint participation of various-specialty physicians, we have considered it wise to present our own clinical case report.

  10. Congenital anomalies of the venae cavae: embryological origin, imaging features and report of three new variants

    Energy Technology Data Exchange (ETDEWEB)

    Minniti, S.; Visentini, S.; Procacci, C. [Department of Radiology, University of Verona, Policlinico ' ' GB Rossi' ' , Piazzale LA Scuro, 37134 Verona (Italy)

    2002-08-01

    Due to the complexity of their developmental stages, the venae cavae may undergo a very large number of congenital anomalies. All the possible abnormalities which, to our knowledge, have been observed in the literature are reported, differentiating those of the superior vena cava and the azygos system, those of the inferior vena cava and the complex anomalies that concern the venous system as a whole. Moreover, we present three new variants: a right double inferior vena cava with azygos continuation of the posterior-medial vein; an agenesis of the superior vena cava with drainage through the azygos and hemiazygos veins to the inferior vena cava; and a double inferior vena cava with hemiazygos and azygos continuation of the left one. (orig.)

  11. [EFFICIENCY OF COMBINATION OF ROFLUMILAST AND QUERCETIN FOR CORRECTION OXYGEN- INDEPENDENT MECHANISMS AND PHAGOCYTIC ACTIVITY OF MACROPHAGE CELLS OF PATIENTS WITH ACUTE EXACERBATION OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE WHEN COMBINED WITH CORONARY HEART DISEASE].

    Science.gov (United States)

    Gerych, P; Yatsyshyn, R

    2015-01-01

    Studied oxygen independent reaction and phagocytic activity of macrophage cells of patients with chronic obstructive pulmonary disease (COPD) II-III stage when combined with coronary heart disease (CHD). The increasing oxygen independent reactions monocytes and neutrophils and a decrease of the parameters that characterize the functional state of phagocytic cells, indicating a decrease in the functional capacity of macrophage phagocytic system (MPS) in patients with acute exacerbation of COPD, which runs as its own or in combination with stable coronary heart disease angina I-II. FC. Severity immunodeficiency state in terms of cellular component of nonspecific immunity in patients with acute exacerbation of COPD II-III stage in conjunction with the accompanying CHD increases with the progression of heart failure. Inclusion of basic therapy of COPD exacerbation and standard treatment of coronary artery disease and drug combinations Roflumilastand quercetin causes normalization of phagocytic indices MFS, indicating improved immune status and improves myocardial perfusion in terms of daily ECG monitoring.

  12. SUBCUTANEOUS PHEOHYPHOMYCOSIS CAUSED BY Phoma cava: REPORT OF A CASE AND REVIEW OF THE LITERATURE

    Directory of Open Access Journals (Sweden)

    Clarisse ZAITZ

    1997-01-01

    Full Text Available We report a case of subcutaneous pheohyphomycosis observed in a male patient presenting pulmonary sarcoidosis and submitted to corticosteroid treatment. He presented nodular erythematous-violaceous skin lesions in the dorsum of the right hand. Histopathological examination of the biopsied lesion revealed dematiaceous hyphae and yeast-like cells, with a granulomatous tissual reaction. The isolated fungus was identified as Phoma cava. A review of the literature on fungal infection caused by different Phoma species, is presented. The patient healed after therapy with amphotericin B, followed by itraconazoleO presente trabalho registra um caso de feo-hifomicose subcutânea em paciente do sexo masculino com o diagnóstico de sarcoidose pulmonar, submetido à terapêutica por corticosteróides quando apresentou no dorso da mão direita lesões cutâneas nodulares, eritêmato-violáceas, de aspecto infiltrado, exigindo biópsia para o diagnóstico. O exame histopatológico revelou processo granulomatoso, com a presença de hifas e células arredondadas demácias. Cultivo positivo para fungo identificado com Phoma cava. Os Autores fizeram revisão da literatura sobre as infecções fúngicas provocadas por diversas espécies de Phoma, mostrando a raridade desta observação. A evolução foi favorável com a administração da anfotericina B (via venosa seguida do itraconazol (via oral

  13. 氨溴索、酚妥拉明、多巴酚丁胺治疗肺心病顽固性心衰疗效观察%Ambroxol, Phentolamine,Dobutamine Treatment of Pulmonary Heart Disease, Refractory Heart Failure Patients

    Institute of Scientific and Technical Information of China (English)

    张振明; 黄琼霞; 何莉衍

    2011-01-01

    目的:探讨氨溴索,酚妥拉明,多巴酚丁胺联合治疗肺心病顽固性心衰的临床疗效.方法:选择综合治疗加合理应用强心剂利尿剂为对照组与综合治疗加用氨溴索,酚妥拉明,多巴酚丁胺为治疗组的对比治疗.结果:治疗组对缓解临床症状,改善肺心功能明显优于对照组.结论:此方案对治疗肺心病顽固性心衰是一种较为有效的方案,较好地改善患者的生活质量,降低死亡率.%Objective:To investigate the ambroxol,phentolamine,dobutamine treating pulmonary heart disease clinical efficacy of refractory heart failure.Methods:A comprehensive treatment and a reasonable application of cardiac,diuretic and comprehensive treatment for the control group plus ambroxol,phentolamine,doqa-tincture treatment group compared amine treatment.Results:The treatment group on the clinical symptoms,changes in heart and lung function than the control group.Conclusions:The program on the treatment of refractory heart failure with pulmonary heart disease is a more effective program.And improved quality of life of patients and reduced mortality.

  14. Pulmonary embolization as primary manifestation of hepatocellular carcinoma with intracardiac penetration: A case report

    Institute of Scientific and Technical Information of China (English)

    Elod Papp; Zsuzsanna Keszthelyi; Nagy Karoly Kalmar; Lajos Papp; Csaba Weninger; Tamas Tornoczky; Endre Kalman; Kalman Toth; Tamas Habon

    2005-01-01

    Intracardiac manifestation of hepatocellular carcinoma (HCC) is a rare condition and an uncommon finding even at autopsy. Pulmonary tumor embolism as a presenting feature of HCC has been published only twice previously.In our case report, a 63-year-old man presented with high fever and six episodes of recurrent pneumonias during the last half year. Echocardiography was performed, a solid mass was found in the right atrium. Transesophageal echocardiography proved a tumor mass in the inferior vena cava (ⅣC) extending into the right atrium, abdominal ultrasound revealed tumor mass in the ⅣC and a solid tumor in the liver. Combined liver and heart surgery was attempted in order to remove the tumor mass from both the liver and the right atrium. Acute cor pulmonale occurred during tumor removal from the right atrium and the patient expired. In addition to local factors the possibility of embolization should arise in the background of recurrent pneumonia. Occult carcinoma must be included in possible causes of recurrent pulmonary embolism. Searching for primary malignancy should include HCC as frequent cause of hypercoagulability. In case of HCC, echocardiography is suggested because of the possibility of expansion in MC or right atrium and tumor-embolization.

  15. Prevalence, predictors, and survival in pulmonary hypertension related to end-stage chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Andersen, Kasper Hasseriis; Iversen, Martin; Kjaergaard, Jesper;

    2012-01-01

    The prevalence, prognostic importance, and factors that predict the presence and degree of pulmonary hypertension (PH) diagnosed with right heart catheterization (RHC) in patients with end-stage chronic obstructive pulmonary disease (COPD) remain unclear.......The prevalence, prognostic importance, and factors that predict the presence and degree of pulmonary hypertension (PH) diagnosed with right heart catheterization (RHC) in patients with end-stage chronic obstructive pulmonary disease (COPD) remain unclear....

  16. Agenesia de veia cava inferior associada à trombose venosa profunda Agenesis of inferior vena cava associated with deep venous thrombosis

    Directory of Open Access Journals (Sweden)

    Clovis Luis Konopka

    2010-09-01

    Full Text Available A agenesia da veia cava inferior é uma anomalia congênita rara, que foi recentemente identificada como um importante fator de risco para o desenvolvimento e a recorrência de trombose venosa profunda de membros inferiores em jovens. O objetivo deste trabalho foi relatar o caso de uma paciente que apresentou trombose venosa profunda dois meses após a realização de cirurgia de varizes. A angiotomografia computadorizada demonstrou a presença de anomalia venosa complexa com ausência da veia cava inferior.The agenesis of the inferior vena cava is a rare congenital anomaly, which was recently identified as an important risk factor for the development and recurrence of deep venous thrombosis especially in young people. The goal of this work was to report the case of a patient who presented deep venous thrombosis approximately two months after varicose vein surgery. The computerized angiotomography demonstrated the presence of a complex venous anomaly with absence of the inferior vena cava.

  17. Clinical Value of Heart Type Fatty Acid-binding Protein in Pulmonary Disease%心型脂肪酸结合蛋白在肺疾病中的临床应用进展

    Institute of Scientific and Technical Information of China (English)

    王宇宏; 李敏

    2015-01-01

    The heart type fatty acid-binding protein (H-FABP) as a new biological marker receives closely attention in recent years. It characteristics of high specificity and strong sensitivity and has a value to screen early myocardial damage. When pulmonary parenchyma and pulmonary vascular disease involved right heart function, the prognosis is poor. Always, the majority of patients died from right heart failure. If we can early detect myocardial injury, we would take measures as soon as possible. H-FABP can be used as a marker of early myocardial damage caused by pulmonary disease. The detection of H-FABP can be help for assessment risk stratification and prognosis. In this paper, we reviewed the clinical value of H-FABP in acute pulmonary embolism (APE), chronic obstructive pulmonary disease (COPD), pulmonary hypertension (PH), obstructive sleep apnea hypopnea syndrome (OSAHS) in recent years.%心型脂肪酸结合蛋白(H-FABP)作为一种新生的生物学标志物近些年来获得研究者们的青睐,它是心肌损伤早期检测的标志物,具有高度特异性及敏感性。肺组织和肺血管疾病因并发右心功能不全而预后差,大部分患者死于右心衰竭。若临床早期发现肺疾病所致心肌受损,则有利于及早采取治疗措施,延缓病情进展。H-FABP可以作为所致肺疾病早期心肌损伤检测的标志物,用于评估病情危险程度及预后。本文就近年来H-FABP在急性肺栓塞(APE),慢性阻塞性肺疾病(COPD)、肺动脉高压(PH)、呼吸睡眠暂停(OSAHS)等疾病的临床应用进行综述。

  18. Pathological changes of the distal pulmonary vessels in complex congenital heart disease with diminutive pulmonary blood%肺血减少型先天性心脏病远端肺血管的病理形态学变化

    Institute of Scientific and Technical Information of China (English)

    王康武; 刘学刚; 刘戈; 张雷; 唐震; 王祖义; 刘以尧; 李小军

    2011-01-01

    目的:观察肺血减少型先天性心脏病远端肺细小动脉的病理学形态变化特点.方法:对28例肺血减少型先天性心脏病患者(研究组)及28例同年龄非心源性且对心脏及肺血管发育无直接影响疾病开胸手术的患者(对照组),于开胸后取右肺中叶小块肺组织约1 cm×1 cm×1 cm,Weihgt弹性纤维+Van Gieson染色,光学显微镜连接生物医学图像分析,选择直径≤100 μm、断面较圆整的5支肺细小动脉测量外径、内径,取平均值后计算平均中膜厚度百分比(mMTPA),并计算肺细小动脉的血管总面积(外弹力板以内)、血管腔面积(内膜表面以内)、血管壁面积(外弹力板与内膜表面之间)、血管壁面积/血管总面积(WA/TA)、血管腔面积/血管总面积(EA/TA)、单位面积肺细小动脉数目(APSC).结果:研究组肺细小动脉外径与对照组差异无统计学意义(P>0.05),且肺细小动脉内径明显高于对照组(P<0.01),肺细小动脉mMTPA、WA/TA 和APSC均明显低于对照组(P<0.01).结论:肺血减少型先天性心脏病肺细小动脉中膜変薄、管腔扩张、APSC减少.%Objective:To observe the features of pathological structure of pneum-arteriolar in complex congenital heart disease with diminutive pulmonary blood. Methods:Twenty-eight patients suffering from congenital heart disease with diminutive pulmonary blood (study group) and 28 matched volunteers( sex,age and body weight) without cardiopulmonary disease( control group) were select to obtain right middle lobe lung tissue pieces( 1 cm × 1 cm × 1 cm) after thoracotomy. Optical microscope was connected biomedical image analysis,the pulmonary arterioles with the diameter ≤ 100 μm and cross-section complete were select to measure the pulmonary arterioles outside and inside diameter of five pulmonary arterioles in lung tissue, and the average percentage of media thickness (mMTPA) was calculate. After taking the average the total vascular area of pulmonary

  19. 磷酸二酯酶5抑制剂治疗先天性心脏病合并肺动脉高压%Phosphodiesterase 5 inhibitors treatment of congenital heart disease with pulmonary arterial hypertension

    Institute of Scientific and Technical Information of China (English)

    龚霄雷; 徐卓明; 刘锦纷

    2010-01-01

    肺动脉高压在先天性心脏病中很常见,有效地降低患儿肺血管阻力,能够改善其远期生存率.对肺动脉高压病理生理的研究发现,使用磷酸二酯酶5抑制剂可使肺血管舒张,降低肺血管阻力.目前磷酸二酯酶5抑制剂西地那非在国外已用于治疗肺动脉高压.多个临床试验已经证明磷酸二酯酶5抑制剂能够显著降低肺血管阻力,改善患者远期生存率和生活质量,且能较好地被患者耐受.%Pulmonary arterial hypertension is common in patients with congenital heart disease.An effective reduction in pulmonary vascular resistance could improve the survival rate in the future.Research in the pathophysiology of pulmonary arterial hypertension shows that phosphodiesterase 5 inhibitors result in pulmonary vasodilation,decrease vascular resistance.Sildenafil,a inhibitor of phosphodiesterase 5 has been permitted to treat pulmonary arterial hypertension oversea now.Phosphodiesterase 5 inhibitors are proved to reduce pulmonary vascular resistance significantly,improve the survival rate in the future and be well tolerated.This review contains the changes of hemodynamics,exercise tolerance,side effect and pharmacokinetics of phosphodiesterase 5 inhibitors.

  20. Clinical Characteristics, Response to Exercise Training and Outcomes in Heart Failure Patients with Chronic Obstructive Pulmonary Disease: Findings from HF-ACTION

    Science.gov (United States)

    Mentz, Robert J.; Schulte, Phillip J.; Fleg, Jerome L.; Fiuzat, Mona; Kraus, William E.; Piña, Ileana L.; Keteyian, Steven J.; Kitzman, Dalane W.; Whellan, David J.; Ellis, Stephen J.; O’Connor, Christopher M.

    2013-01-01

    Background To investigate the clinical characteristics, exercise training response, beta-blocker selectivity and outcomes in heart failure (HF) patients with chronic obstructive pulmonary disease (COPD). Methods We performed an analysis of HF-ACTION, which randomized 2,331 HF patients with ejection fraction ≤35% to usual care with or without aerobic exercise training. We examined clinical characteristics and outcomes [mortality/hospitalization, mortality, cardiovascular (CV) mortality/CV hospitalization, and CV mortality/HF hospitalization] by physician-reported COPD status using adjusted Cox models and explored an interaction with exercise training. The interaction between beta-blocker cardioselectivity and outcomes was investigated. Results Of patients with COPD status documented (N=2311), 11% (N=249) had COPD. COPD patients were older, had more comorbidities, and lower use of beta-blockers compared to those without COPD. At baseline, COPD patients had lower peak VO2 and higher VE/VCO2 slope. During a median follow-up of 2.5 years, COPD was associated with increased mortality/hospitalization, mortality, and CV mortality/HF hospitalization. After multivariable adjustment, the risk of CV mortality/HF hospitalization remained increased (Hazard Ratio [HR] 1.46, 95% Confidence Interval [CI]: 1.14–1.87), while mortality/hospitalization (HR 1.15, 95% CI: 0.96–1.37) and mortality (HR 1.33, 95% CI: 0.99–1.76) were not significantly increased. There was no interaction between COPD and exercise training on outcomes or between COPD and beta-blocker selectivity on mortality/hospitalization (all P>0.1). Conclusions COPD in HF patients was associated with older age, more comorbidities, reduced exercise capacity, and increased CV mortality/HF hospitalization, but not a differential response to exercise training. Beta-blocker selectivity was not associated with differences in outcome for patients with versus without COPD. PMID:23351822

  1. Effect of dyspnea and clinical variables on the quality of life and functional capacity in patients with chronic obstructive pulmonary disease and congestive heart failure

    Institute of Scientific and Technical Information of China (English)

    Hale Karapolat; Sibel Eyigor; Alev Atasever; Mehdi Zoghi; Sanem Nalbantgil; Berrin Durmaz

    2008-01-01

    Background Chronic obstructive pulmonary disease(COPD)and congestive heart failure(CHF)are two chronic diseases that affect negatively the functional condition and quality of life of patients.We assessed the effect of symptoms and clinical variables on the functional capacity and quality of life in COPD and CHF patients.Methods The study included 42 COPD and 39 CHF patients.In both patient groups,dyspnea was assessed using Borg scale;functional capacity by shuttle-walk and cardiopulmonary exercise test and quailty of life by short fOrm-36 (SF36).Results No statistically significant difference was found in neither of the two disease groups regarding the dyspnea score,shuttle-walk test and the maiority of subgroup scores of SF36 (P>0.05).A statistically significant difference was obsewed in peak VO2 in favor of COPD group(P<0.05).No significant relationship was established between dyspnea score and forced expiratory volume in one second(FEV1)in COPD patients,and left ventricular ejection fraction(L.VEF)in CHF patients (P>0.05).A significant negative correlation was obsewed between dyspnea score and functional capacity tests in both disease groups(P<0.05).On the other hand,no relationship was found between L-VEF and FEV1 and quailty of life and functional capacity (P>0.05),Conclusions It was revealed that symptoms have an impact on functional capacity and quality of life in both disease groups,however,objective indicators of disease severity do not show a similar relationship.Therefore,in addition to the objective data related to the disease,we recommend that symptoms should also be taken into consideration to assess cardiopulmonary rehabilitation program and during following-up.

  2. Correlation of Echocardiography and Right Heart Catheterization in Measure of Total Pulmonary Resistance in Idiopathic Pulmonary Arterial Hypertension%超声心动图与右心导管对特发性肺动脉高压全肺阻力测量的相关性分析

    Institute of Scientific and Technical Information of China (English)

    王斌; 马小静; 张刚成; 何俊; 阳前华; 郑立娜; 严薇

    2014-01-01

    Objective To explore the correlation of echocardiography and right heart catheterization in measure of total pulmonary resistance ( TPR) in idiopathic pulmonary arterial hypertension ( IPAH) . Methods A total of IPAH 32 patients confirmed by right heart catheterization examination from January to December 2013 were recruited in the study. The values of pulmonary diagnostic endocardial surface of the inner diameter in the annulus ( Dpv ) , systolic pulmo-nary blood flow before the valve orifice speed ( Vpv ) and right atrial systolic tricuspid regurgitation of peak velocity max imum ( Vmax TR) were detected with ultrasoundcardiogram diagnostic apparatus, and the heart rates were recorded. The values of area of the pulmonary valve annulus ( APV ) , the pulmonary valve flow velocity-time integral ( VTIPV ) and mean pulmonary artery pressure ( PAMP) were calculated on the basis of the measure results, and values of pulmonary blood flow ( QP) and TPR were calculated according to the formula, and then the measure results of right heart catheterization were compared. Results Ultrasoundcardiogram diagnostic apparatus showed that values of PAMP, TPR and QP had a high positive correlation with the measure values of right heart catheterization by calculating with a formula ( r=0. 898, 0. 819, 0. 918, P<0. 01). Conclusion Ultrasoundcardiogram diagnostic apparatus is of important significance in clini-cal noninvasive diagnosis of IPAH by TPR measure.%目的:探讨超声心动图与右心导管测量特发性肺动脉高压( idiopathic pulmonary arterial hypertension, IPAH)全肺阻力( TPR)的相关性。方法对2013年1-12月在我院经右心导管检查确诊的IPAH 32例应用超声心动图诊断仪测量肺动脉瓣环心内膜面内径( DPV )、收缩期肺动脉瓣口前向血流速度( APV )和收缩期三尖瓣口右心房侧最大反流峰值速度( Vmax TR)并记录心率,根据测量结果计算肺动脉瓣环面积( APV )、

  3. Swan-Ganz - right heart catheterization

    Science.gov (United States)

    ... be due to: Blood flow problems, such as heart failure or shock Heart valve disease Lung disease Structural problems with the ... Burns Cardiac tamponade Congenital heart disease Heart attack Heart failure - overview Pulmonary ... Review Date 8/12/2014 Updated by: Michael ...

  4. Diagnosis and quantitative estimation of pulmonary congestion or edema by pulmonary CT numbers

    Energy Technology Data Exchange (ETDEWEB)

    Kato, Shiro; Nakamoto, Takaaki

    1987-12-01

    Pulmonary computed tomography (CT) was performed in 25 patients with left heart failure and 10 healthy persons to diagnose pulmonary congestion or edema associated with left heart failure. In an analysis of histogram for pulmonary CT numbers obtained from CT scans, CT numbers indicating pulmonary edema were defined as -650 to -750 H.U. This allowed pulmonary edema to be quantitatively estimated early when abnormal findings were not available on chest X-ray film or pulmonary circulation studies. Histograms for CT numbers could be displayed by colors on CT scans. (Namekawa, K.).

  5. Changes of the pulmonary function in the chronic heart failure after treatment%慢性心功能不全住院患者治疗前后肺功能的改变

    Institute of Scientific and Technical Information of China (English)

    文红; 欧雪珍; 卫展扬; 罗海波; 张平; 邓念强

    2011-01-01

    目的:探索慢性心功能不全患者治疗前后肺功能的变化.方法:选取临床诊断的慢性心功能不全患者49例,于治疗前后分别进行肺通气功能、肺弥散功能及超声心动图检查,分析治疗前后各项肺功能及心功能参数的变化.结果:81.63%的慢性心功能不全患者存在限制性或混合性通气功能障碍,治疗后多项肺功能指标如1 s用力呼气容积( FEV1)、FEV1占预计值%、用力肺活量(FVC)、FVC占预计值%、最大呼气中期流量(MMEF)、一氧化碳弥散量( DLCO)均显著改善(P<0.05),治疗后FEV1、FVC、MMEF及DLCO较治疗前分别提高6.5%、9.9%、22%和11.5%.超声心动图测出左室射血分数(LVEF)显著改善(P<0.05).结论:慢性心功能不全患者治疗后肺通气及肺弥散功能显著改善.%Aim: This study investigates the effects of congestive heart failure on pulmonary function and assesses the Changes in pulmonary function as the Chronic Heart Failure after was treated. Methods: 49 patients with chronic systolic heart failure were included. Patients had spirometry, diffusing capacity measurements and echocardiography before and after treatment for the chronic heart failure. Results-. A restrictive ventilatory defect was present in 81. 63 percent of the patients with systolic heart failure presence. The lung function parameters such as FEV1 ,FVC,FEVl%pre,FVC%pre,MMEF and DLCO were significant increased in the patients with systolic heart failure after treatment (P<0. 05). The mean FEV1, FVC, MMEF and DLCO improved 6. 5% ,9. 9% ,22% and 11. 5% respectively. Conclusion: Patients with systolic heart failure significant improve in lung function after treatment. Spirometry and diffusing capacity measurements can be used to assess in therapeutic effect of the congestive heart failure.

  6. Correlation of the pulmonary function in children with left-to-right shunt congenital heart disease%左向右分流型先天性心脏病患儿肺功能相关研究

    Institute of Scientific and Technical Information of China (English)

    杨轶男; 董湘玉; 常欲晓; 倪倩; 乐高钟; 沈阳

    2012-01-01

    Objective To investigate the correlation of the parameters of pulmonary function test in children with left-to-right shunt congenital heart disease, and study the interaction of eardiopulmonary function. Methods Sixty two children with congenital heart disease and 40 healthy children, as control group, were selected. The lung function, blood gas analysis (PaO2、 PaC02 、pH) and C-reaction protein were tested and the correlations were analyzed. Results Respiratory rate in congenital heart disease group was higher than that in control group. Tidal volume per kilogram (VT/kg) , peak tidal expiratory flow (PTEF) , ratio of time to peak tidal expiratory flow to total expiratory time (TPTEF/Te) , ratio of volume to peak expiratory flow to total expiratory volume (VPEF/Ve) were all lower in congenital heart disease group than those in control group. Respiratory rate level increased and VT/kg, PTEF, TPTEF/ Te and VPEF/Ve decreased gradually in conditions of simple congenital heart disease, congenital heart disease with pneumonia, and congenital heart disease and heart failure with pneumonia. Compared with control group, PaO2 level in simple congenital heart disease, congenital heart disease with pneumonia, congenital heart disease and heart failure with pneumonia groups gradually reduced, while C-reaction protein levels increased progressively. Conclusions Pulmonary function testing can reflect the features of pathophysiology of heart and lung function in children with the left-to-right shunt congenital heart disease, blood gas analysis and serum C-reaction protein can reflect the severity of the disease.%目的 探讨左向右分流型先天性心脏病患儿心肺功能的交互作用.方法 选择左向右分流型先天性心脏病患儿62例为先心组,健康体检儿童40例为对照组,进行肺功能检查与血气分析(PaO2、PaCO2、pH值)及血C-反应蛋白(CRP)测定,并进行相关性分析.结果 先心组患儿的呼吸频率(RR)高于对照

  7. 慢性肺源性心脏病并发心律失常68例临床诊断与治疗%Clinical Diagnosis and Treatment of 68 Cases of Chronic Pulmonary Heart Disease Complicated With Arrhythmia

    Institute of Scientific and Technical Information of China (English)

    许文华; 李志军

    2015-01-01

    Objective To investigate the clinical diagnosis and treatment of chronic pulmonary heart disease with arrhythmia. Methods The clinical data of 68 patients with chronic pulmonary heart disease with arrhythmia were retrospectively analyzed. Results Manifestation of cardiac arrhythmias with sinus bradycardia slow, sinus tachycardia, speed, atrial flutter, atrial fibrillation, paroxysmal supraventricular tachycardia tachycardia, paroxysmal atrial tachycardia, speed and other kinds of. Conclusion The clinical analysis of chronic pulmonary heart disease with arrhythmia patients, need to be based on the ECG in order to understand the use of how to diagnose and treatment.%目的:探讨慢性肺源性心脏病并发心律失常的临床诊断和治疗。方法对我院收治的68例慢性肺源性心脏病并发心律失常患者的临床资料进行回顾性分析。结果心律失常的表现类型有窦性心动过缓、窦性心动过速、心房扑动、心房颤动、阵发性室性心动过速、阵发性房性心动过速等多种。结论临床分析慢性肺源性心脏病并发心律失常患者时,需要依据心电图以便深入了解诊断和治疗的方法。

  8. Clinical observation of phentolamine and heparin in the treatment of pulmonary heart disease%酚妥拉明肝素治疗肺心病的临床观察

    Institute of Scientific and Technical Information of China (English)

    刘东辉

    2014-01-01

    Objective To analyze the clinical effect of phentolamine and heparin in the treatment of pulmonary heart disease.Methods A total of 85 patients with pulmonary heart disease were divided into treatment group and control group, according to their treatment methods. The control group with 40 cases received conventional treatment, and the treatment group with 45 cases was treated by additional phentolamine and heparin.Results The total effective rate of the treatment group was higher than that of the control group, and the improvement of hemorheology in the treatment group was better than the control group, and the difference had statistical significance (P<0.05). The patients were in good condition during the treatment.Conclusion The clinical effect of treatment by phentolamine and heparin for pulmonary heart disease is precise.%目的:分析酚妥拉明肝素治疗肺源性心脏病(肺心病)的临床疗效。方法85例肺心病患者根据治疗方式分为治疗组和对照组,对照组40例患者接受常规治疗,治疗组45例患者在对照组治疗基础上接受酚妥拉明、肝素治疗。结果治疗组治疗总有效率高于对照组,血液流变学改善情况优于对照组,差异具有统计学意义(P<0.05),患者治疗期间状况良好。结论酚妥拉明、肝素治疗肺心病的临床疗效经研究效果显著。

  9. Heart failure in COPD

    NARCIS (Netherlands)

    Rutten, Frans Hendrik

    2005-01-01

    The main aim of the thesis was to assess the prevalence of heart failure in patients with a diagnosis of chronic obstructive pulmonary disease (COPD). Furthermore, to explore diagnostic strategies (including natriuretic peptides and cardiovascular magnetic resonance imaging (CMR)) to identify heart

  10. Peripartum Primary Prophylaxis Inferior Vena Cava Filter Placement in a Patient with Stage IV B-Cell Lymphoma Presenting with a Pathologic Femur Fracture

    Directory of Open Access Journals (Sweden)

    David M. Sherer

    2015-10-01

    Full Text Available Background  -Pulmonary embolus (PE remains a leading etiology of maternal mortality in the developed world. Increasing utilization of retrievable inferior vena cava (IVC filter placement currently includes pregnant patients. Case - A 22-year-old woman at 27 weeks' gestation was diagnosed with Stage IV high-grade malignant B cell lymphoma following pathologic femur fracture. Significant risk factors for PE led to placement of primary prophylaxis IVC filter before cesarean delivery, open reduction and internal fixation of the fractured femur, and chemotherapy. Conclusion - This case supports that primary prophylaxis placement of IVC filters in highly selected pregnant patients may assist in decreasing PE-associated maternal mortality.

  11. [Surgical treatment of leiomyosarcoma of the inferior vena cava].

    Science.gov (United States)

    Zotov, S P; Panov, I O; Tereshin, O S; Vazhenin, A V

    2012-01-01

    The presented review of the literature is generalization of the currently existing data of foreign and Russian literature concerning treatment of a rare non-organic retroperitoneal tumour from smooth-muscle tissue, i. e., leiomyosarcoma of the inferior vena cava. The authors also formulate and lay down the basic principles of surgical interventions depending on the scope and level of the lesion, as well statistical analysis of the outcomes of surgical management of the this severely ill patient cohort.

  12. Double vena cava inferior:A report of three cases

    Institute of Scientific and Technical Information of China (English)

    Isin Ureyen; Zeynep Kestel; Elif Gulsah Sahin; Alper Karalok; Taner Turan; Nurettin Boran; Gokhan Tulunay

    2013-01-01

    Congenital anomalies of the vena cava inferior (VCI) develop as a result of the persistence of the embryonic venous system. The majority of cases is clinically silent and is diagnosed in routine dissection studies, in retroperitoneal surgeries, or through imaging for other reasons. We report three cases with a double VCI. We outline our operative policy, summarize the embryological development of the VCI and present these cases as a reminder of this rare anatomical variation.

  13. Clinical application of radionuclide cardiac study to the right heart diseases

    Energy Technology Data Exchange (ETDEWEB)

    Shimizu, Tatsuro; Ozaki, Masaharu; Ikezono, Tohru (Yamaguchi Univ., Ube (Japan). School of Medicine)

    1984-12-01

    We experienced the four cases of rare right heart diseases: those are two-chambered right ventricle, ball thrombus in right ventricle, right ventricular hypertrophy and tricuspid valve regurgitation due to multiple pulmonary infarction, and right ventricular and right atrial infarction. The preoperative or ante mortem diagnosis of these diseases is difficult, especially by use of a noninvasive technique. This report shows the usefulness of radionuclide cardiac study for diagnosis of these cases. In the two-chambered right ventricle, abnormal muscle bundle was visualized by /sup 201/TlCl and was observed as the filling defect by sup(99m)Tc-HSA radionuclide angiography. The ball thrombus showed the filling defect of sup(99m)Tc-HSA in the right ventricle but was not extracted by /sup 201/TlCl in the site of the defect area. In the multiple pulmonary infarction, the right ventricular free wall was visualized by /sup 201/TlCl, and during right ventricular systole, regurgitation from right atrium to inferior vena cava was noticed by means of sup(99m)Tc-HSA radionuclide angiography. These findings suggested right ventricular hypertrophy and tricuspid valve regurgitation. In the right ventricular and right atrial infarction, right ventricular ejection fraction and right atrial fractional emptying were lower than those of normal controls.

  14. Three cases of pulmonary varix

    Energy Technology Data Exchange (ETDEWEB)

    Takishima, Teruo; Sakuma, Hajime; Tajima, Tsunemi; Okimoto, Takao; Yamamoto, Keiichiro; Dohi, Yutaka (Saitama Medical School (Japan))

    1982-06-01

    Three cases of pulmonary varix associated with valvular heart disease were reported. Round shadows were clearer on first oblique or lateral films of chest x-ray in all 3 cases. On chest tomograms, the shadows were substantial and round-elliptical. RI angiography with sup(99m)Tc-RBC demonstrated these shadows in agreement with the site of influx of the pulmonary vein into the left atrium in Cases 1 and 3 and with the pulmonary vein slightly apart from the left atrium in Case 2. On CT scans in Cases 1 and 3, enhancement with a contrast medium visualized dilatation of the pulmonary vein close to, and in continuation with, the shadow of the left atrium. The diagnosis of pulmonary varix in agreement with the venous phase of pulmonary angiography was made for all 3 cases. Non-surgical examinations (especially CT scan) proved highly useful for the diagnosis of pulmonary varix.

  15. Percutaneous transhepatic venous embolization of pulmonary artery aneurysm in Hughes-Stovin syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kyung Ah; Kim, Man Deuk; Oh, Do Yun; Park, Pil Won [Bundang CHA General Hospital, Pochon CHA University, Seongnam (Korea, Republic of)

    2007-08-15

    Hughes-Stovin syndrome is an extremely rare entity. We present a case of a 42-year-old man, who developed deep vein and inferior vena cava (IVC) thrombosis, repeated internal bleeding and pulmonary artery aneurysms (PAAs). The patient presented with massive hemoptysis and with PAAs of a 2.5 cm maximum diameter. We describe the successful percutaneous transhepatic venous embolization of the PAAs due to occluded common vascular pathways to the pulmonary artery.

  16. Three-dimensional reconstructed magnetic resonance imaging for diagnosing persistent left superior vena cava. Comparison with magnetic resonance angiography and plain chest radiography

    Energy Technology Data Exchange (ETDEWEB)

    Koito, Hitoshi; Suzuki, Junichi; Ohkubo, Naohiko; Ishiguro, Yuka; Iwasaka, Toshiji; Inada, Mitsuo; Nakano, Yoshihisa [Kansai Medical Univ., Moriguchi, Osaka (Japan)

    1996-09-01

    The usefulness of low-cost, three-dimensional (3D) images reconstructed from magnetic resonance (MR) imaging for investigating persistent left superior vena cava was assessed and compared to the diagnostic accuracy of chest radiography. MR imaging by the spin-echo technique and MR angiography were performed in 10 patients with this anomaly diagnosed previously by contrast echocardiography and radionuclide angiocardiography. Four patients had complicating cardiac anomalies, one with postoperative atrial septal defect, one with postoperative ventricular septal defect, one with atrial septal defect and partial anomalous pulmonary venous return, and one with aortic coarctation and patent ductus arteriosus. Multisectional and multiphasic MR images were used for the 3D-reconstruction of the cardiovascular and mediastinal structures with a NeXT workstation and a 3D-kit. The 3D-reconstructed MR imaging clearly showed the persistent left superior vena cava and the anatomical relationship with the other cardiovascular and mediastinal structures in all 10 patients. Vascular shadows were observed outside the upper left border of the aortic arch on the chest radiographs in seven patients, and the 3D-reconstructed MR images revealed these shadows to be compatible with superior caval vein. The ratios of the diameter between the left and right superior venae cavae with and without the left innominate vein were 0.63{+-}0.14 (mean{+-}SD) and 0.94{+-}0.08, respectively. Three-dimensional reconstructed MR imaging is a useful method for recognizing persistent left superior vena cava and precise examination of the chest radiographs often allowed detection of the vascular shadows caused by this anomaly. (author)

  17. Spiral CT in aplasia of the pre-renal inferior vena cava as a cause of phlebothrombosis from the femoral veins to the inferior vena cava; Spiral-CT einer Aplasie der praerenalen Vena cava inferior als Ursache einer Phlebothrombose von den Oberschenkelvenen bis in die Vena cava inferior

    Energy Technology Data Exchange (ETDEWEB)

    Schweiger, U. [Strahlenklinik und Poliklinik, Universitaetsklinikum Rudolf Virchow, Freie Univ. Berlin (Germany); Schedel, H. [Strahlenklinik und Poliklinik, Universitaetsklinikum Rudolf Virchow, Freie Univ. Berlin (Germany); Thiede, U. [Deutsches Herzzentrum Berlin (Germany). Arbeitsgruppe Digitale Bildbearbeitung; Felix, R. [Strahlenklinik und Poliklinik, Universitaetsklinikum Rudolf Virchow, Freie Univ. Berlin (Germany)

    1994-12-31

    The case report focuses on the computed tomography of the thrombotic okklusion of the inferior vena cava, venae iliacae and femorales communes due to congenital interruption of the prerenal inferior vena cava. The embryology of the abnormality was discussed. (orig.) [Deutsch] Anhand einer Fallstudie wurden die Moeglichkeiten der computertomographischen Diagnostik bei einer durch Teilplasie der `praerenalen` Vena cava inferior hervorgerufenen Thrombose der Vv. femorales superficiales et profundae, der grossen Beckenvenen und der Vena cava inferior erlaeutert. In der Diskussion wurde auf die Embryologie der Missbildung eingegangen. (orig.)

  18. Analysis of 36 cases of chronic pulmonary heart disease complicated with multiple organ dysfunction syndrome%慢性肺源性心脏病伴多器官功能障碍综合症36例分析

    Institute of Scientific and Technical Information of China (English)

    许丙俊; 刘志刚

    2012-01-01

    目的 探讨慢性肺源性心脏病伴发多器官功能障碍综合症的临床治疗.方法 对本院ICU诊治的36例慢性肺心病伴发多器官功能障碍综合症进行总结分析.结果 除肺、心以外,器官功能障碍发生比例由高到低依次为脑、肾、肝、胃肠.36例患者中17例死亡,死亡率为47%,其余患者好转出院或转其他相关科室继续治疗.结论 心肺功能越差,受累的脏器越多,则死亡率越高.%Objective To investigate the clinical treatment of chronir pulmonary heart disease romplirated with multiple organ dysiunction syndrome. Methods Clinical features of 36 cases of chronic pulmonary heart disease complicated with multiple organ dysfunr-tion syndrome in our hospital ICU from the 2007 ~ 2010 were retrospectively analyzed. Results Incidence of organ dysfunction from high to low was the brain, kidney, liver, gastrointestinal in addition to the lung and heart. In 36 patients, 17 patients died and the mortality rate was 47% . The other patients got better or transferred to other related departments to continue the treatment. Conclusion The Worser of heart and lung function, the number of organ involvement and the mortality is higher.

  19. Pulmonary embolism and stroke associated with mechanical thrombectomy

    Directory of Open Access Journals (Sweden)

    Paulo Bastianetto

    2014-04-01

    Full Text Available Mechanical thrombectomy offers the advantage of rapid removal of venous thrombi. It allows venous obstructions to be removed and requires shorter duration of infusion of thrombolytic agents. However, aspiration of thrombi can lead to complications, particularly pulmonary embolism and hemolysis. The validity of using vena cava filters during thrombectomy in order to avoid embolism has not yet been established. The authors report a case of massive pulmonary embolism associated with ischemic stroke in a patient with a hitherto undiagnosed patent foramen ovale. The patient developed respiratory failure and neurological deficit after thrombectomy. This case raise questions about the value of the thrombectomy for the treatment of proximal vein thrombosis due to the risks of this procedure. The authors also discuss the need for vena cava filters and ruling out a patent foramen ovale in patients undergoing thrombectomy.

  20. Orthotropic heart transplantation for adult congenital heart disease: a case with heterotaxy and dextrocardia.

    Science.gov (United States)

    Matsuda, Hikaru; Fukushima, Norihide; Ichikawa, Hajime; Sawa, Yoshiki

    2017-01-01

    A 41-year-old male with heterotaxy (left isomerism) and dextrocardia composed by single ventricle, absent inferior vena cava, bilateral superior vena cava (SVC), common atrioventricular valve has received orthotopic heart transplantation (HTx) after long waiting period as Status-1. Reconstructions of bilateral SVC and hepatic vein route were successful without use of prosthetic material, and the donor heart was placed in the left mediastinum. In spite of satisfactory early recovery, the patient expired 4 months after transplantation mainly from fungal infection which developed following humoral rejection. HTx for adult patients with complex congenital heart disease is demanding in technical as well as pre- and post-transplant management, and indication should be critically determined.

  1. Impact of β-blocker selectivity on long-term outcomes in congestive heart failure patients with chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Kubota Y

    2015-03-01

    Full Text Available Yoshiaki Kubota, Kuniya Asai, Erito Furuse, Shunichi Nakamura, Koji Murai, Yayoi Tetsuou Tsukada, Wataru Shimizu Department of Medicine (Division of Cardiology, Nippon Medical School, Bunkyo-ku, Tokyo, Japan Background: Chronic obstructive pulmonary disease (COPD is present in approximately one-third of all congestive heart failure (CHF patients, and is a key cause of underprescription and underdosing of β-blockers, largely owing to concerns about precipitating respiratory deterioration. For these reasons, the aim of this study was to evaluate the impact of β-blockers on the long-term outcomes in CHF patients with COPD. In addition, we compared the effects of two different β-blockers, carvedilol and bisoprolol. Methods: The study was a retrospective, non-randomized, single center trial. Acute decompensated HF patients with COPD were classified according to the oral drug used at discharge into β-blocker (n=86; carvedilol [n=52] or bisoprolol [n=34] and non-β-blocker groups (n=46. The primary endpoint was all-cause mortality between the β-blocker and non-β-blocker groups during a mean clinical follow-up of 33.9 months. The secondary endpoints were the differences in all-cause mortality and the hospitalization rates for CHF and/or COPD exacerbation between patients receiving carvedilol and bisoprolol. Results: The mortality rate was higher in patients without β-blockers compared with those taking β-blockers (log-rank P=0.039, and univariate analyses revealed that the use of β-blockers was the only factor significantly correlated with the mortality rate (hazard ratio: 0.41; 95% confidence interval: 0.17–0.99; P=0.047. Moreover, the rate of CHF and/or COPD exacerbation was higher in patients treated with carvedilol compared with bisoprolol (log-rank P=0.033. In the multivariate analysis, only a past history of COPD exacerbation significantly increased the risk of re-hospitalization due to CHF and/or COPD exacerbation (adjusted hazard

  2. Not all right-sided hearts are the same—the importance of identifying the correct diagnosis

    Science.gov (United States)

    Rubio, Edmundo Raul; Patel, Vishal M.; Aziz, Sameh; Ie, Susanti

    2016-01-01

    Scimitar syndrome is characterized by an anomalous venous return with the characteristic chest roentgenogram (CxR) appearance of the anomalous vein draining into the inferior vena cava (IVC). This appears as a curvilinear opacity paralleling the right border of the heart resembling a curved sword or Scimitar. A 27-year-old white woman with a reported history of dextrocardia was admitted after a drug overdose. Examination demonstrated an obtunded woman with tachycardia and right sided heart sounds. Her CxR revealed a right sided heart image with two curvilinear opacities in the retrocardiac area. Chest computed tomography (CT) demonstrated that these opacities join to represent an anomalous vein draining into IVC. Furthermore, an anomalous systemic artery arising from the abdominal aorta was seen to supply the right lower lobe. The patient was eventually diagnosed with Scimitar syndrome. This syndrome affects 1–3 in 100,000 live births while nearly half of the patients remain asymptomatic with some initially being misdiagnosed as dextrocardia, such as in our case. Correctly diagnosing these patients is of paramount importance as some can develop severe pulmonary hypertension and right ventricular failure. In turn, close ongoing echocardiographic monitoring can help identify those that may benefit from surgical interventions to prevent them from developing these complications. PMID:27294094

  3. Evaluation of left pulmonary artery sling, associated cardiovascular anomalies, and surgical outcomes using cardiovascular computed tomography angiography

    Science.gov (United States)

    Xie, Jiajun; Juan, Yu-Hsiang; Wang, Qiushi; Chen, Jimei; Zhuang, Jian; Xie, Zhaofeng; Liang, Changhong; Zhu, Yulei; Yu, Zhuliang; Li, Jinglei; Saboo, Sachin S.; Liu, Hui

    2017-01-01

    We evaluated the prevalence, image appearance, associated cardiovascular anomalies, and surgical outcomes of left pulmonary artery sling (LPAS) using cardiovascular computed tomography angiography (CCTA). A retrospective search of patients from our database between October 2007 and December 2014 identified 52,200 patients with congenital heart diseases (CHD) referred for CCTA, echocardiography, or magnetic resonance imaging. Clinical information, CCTA findings, associated cardiovascular anomalies, and surgical outcomes were analyzed. We showed a hospital-based prevalence of 71 patients with LPAS (0.14%, 71/52,200) among CHD patients. Of these, 47 patients with CCTA examinations were assessed further. Most patients (40/47, 85%) had associated cardiovascular anomalies, of which ventricular septal defects (22/47, 47%), atrial septal defects (20/47, 43%), patent ductus arteriosus (16/47, 34%), persistent left superior vena cava (14/47, 30%), and abnormal branching of the right pulmonary artery (ABRPA) (14/47, 30%) were most commonly identified. In total, 28 patients underwent LPA reanastomosis and/or tracheoplasty in our center, and 5 died. LPAS had a hospital-based prevalence of 0.14% among CHD patients. ABRPA is not uncommon and must be recognized. CCTA is a feasible method for demonstrating LPAS and its associated cardiovascular anomalies for an optimal pre-operative assessment of LPAS. PMID:28053308

  4. What Is Pulmonary Hypertension?

    Science.gov (United States)

    ... Artery Disease Venous Thromboembolism Aortic Aneurysm More Pulmonary Hypertension - High Blood Pressure in the Heart-to-Lung System Updated:Dec ... illness. This content was last reviewed October 2016. High Blood Pressure • Home • Get the Facts About HBP Introduction What ...

  5. The Inferior Vena Cava Diameter as a Marker of Dry Weight in Chronic Hemodialyzed Patients

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    We have previously reported that the diameter of the inferior vena cava(IVC) reflects the amount of body fluid in hemodialyzed (HD) patients. The present study was undertaken to depict the criteria of IVC diameters for determining dry weight (DW) in anuric HD patients. In healthy subjects, the maximal diameters during quiet expiration (IVCe) and the minimal diameters during quiet inspiration (IVCi) were (16.7±3.2) and (5.7±5.4)mm,respectively (mean±SD).The collapsibility index (CI,1-IVCi/IVCe), which inversely correlates with the central venous pressure,was 0.68±0.29. In anuric HD patients,the IVCe/CI values before and after HD were 14.9±3.2/0.68±0.24 and 8.2±2.3/0.94±0.09, respectively. IVCe decreased proportionally to the amount of ultrafiltration. In HD patients with hypervolemic pulmonary edema, the IVCe and CI values were 22.4±2.9 and 0.22±0.11, respectively. We proposed that IVCe/CI after HD is (8±3)mm/0.9 ± 0.1 as the markers of DW in anuric HD patients and that an IVCe value≥22mm together with a CI≤0.22 implies the warning level of body fluid retention.

  6. On determining the characteristics of a Greenfield Inferior Vena Cava Filter using CFD

    Science.gov (United States)

    Swaminathan, Tirumani; Hu, Howard; Patel, Aalpen

    2004-11-01

    In those patients with deep venous thrombosis (DVT) or those at a high risk for DVT, and who have contraindications to or are unresponsive to anticoagulation therapy, vena cava filters are often used to prevent recurrent pulmonary emboli. Ideally, the filter should be efficacious while being non-thrombogenic and non-impeding to the blood flow. In reality, the filter has to establish a balance between clot capture efficiency and flow impedance before and after clot capture. The development and use of numerical tools to study the characteristics of filters and its application to the case of a Greenfield filter has been presented here. A detailed model resolving the flow field around the filter to a fine detail is described. The thrombogenecity of the filter in un-occluded flows is determined by analyzing plots of shear stresses and velocity fields. To evaluate a filter's clot capturing efficacy, a Thin Wire Model (TWM) has been developed and used in conjunction with a moving finite element scheme to study the probability of clot capturing for the Greenfield filter.

  7. 浅析肺心病合并慢性呼吸衰竭30例临床护理%Clinical Nursing Care of 30 Cases of Pulmonary Heart Disease Complicated With Chronic Respiratory Failure

    Institute of Scientific and Technical Information of China (English)

    冯淑香

    2016-01-01

    ObjectiveStudy on clinical nursing of pulmonary heart disease complicated with chronic respiratory failure.Methods From January 2015 to January 2016,analyzed of 30 cases with chronic pulmonary heart disease respiratory failure in patients with clinical data and study effective nursing intervention.Results30 cases of patients with effective intervention to treat all patients were discharged,effective 7 cases, 21 cases,generally 2 cases,excellent recovery rate of 93.33%. This study had low incidence of adverse reactions in patients,2 patients with shock and 1 case of pulmonary cerebral hernia.Conclusion Clinic for patients with pulmonary heart disease complicated with chronic respiratory failure for targeted nursing intervention to better promote the recovery of patients, improve the excellent rate of recovery of patients, improve the prognosis of patients.%目的:研究肺心病合并慢性呼吸衰竭的临床护理措施。方法分析我院在2015年1月~2016年1月收治的30例肺心病合并慢性呼吸衰竭的患者的临床资料,研究患者的有效护理干预措施。结果30例患者经过有效的干预治疗所有患者均康复出院,所有患者当中康复显效7例,有效21例,一般2例,康复优良率为93.33%,本研究患者的不良症状发生率相对较低,出现2例休克患者和1例肺性脑病患者。结论临床上对于肺心病合并慢性呼吸衰竭的患者,配合有针对性的护理干预措施,更好地促进患者的恢复,提高患者恢复的优良率,提升患者的预后效果。

  8. Altered reactivity and nitric oxide signaling in the isolated thoracic duct from an ovine model of congenital heart disease with increased pulmonary blood flow.

    Science.gov (United States)

    Datar, Sanjeev A; Oishi, Peter E; Gong, Wenhui; Bennett, Stephen H; Sun, Christine E; Johengen, Michael; Maki, Jun; Johnson, Rebecca C; Raff, Gary W; Fineman, Jeffrey R

    2014-04-01

    We have previously shown decreased pulmonary lymph flow in our lamb model of chronically increased pulmonary blood flow, created by the in utero placement of an 8-mm aortopulmonary shunt. The purpose of this study was to test the hypothesis that abnormal lymphatic function in shunt lambs is due to impaired lymphatic endothelial nitric oxide (NO)-cGMP signaling resulting in increased lymphatic vascular constriction and/or impaired relaxation. Thoracic duct rings were isolated from 4-wk-old shunt (n = 7) and normal (n = 7) lambs to determine length-tension properties, vascular reactivity, and endothelial NO synthase protein. At baseline, shunt thoracic duct rings had 2.6-fold higher peak to peak tension and a 2-fold increase in the strength of contractions compared with normal rings (P < 0.05). In response to norepinephrine, shunt thoracic duct rings had a 2.4-fold increase in vascular tone compared with normal rings (P < 0.05) and impaired relaxation in response to the endothelium-dependent dilator acetylcholine (63% vs. 13%, P < 0.05). In vivo, inhaled NO (40 ppm) increased pulmonary lymph flow (normalized for resistance) ∼1.5-fold in both normal and shunt lambs (P < 0.05). Inhaled NO exposure increased bioavailable NO [nitrite/nitrate (NOx); ∼2.5-fold in normal lambs and ∼3.4-fold in shunt lambs] and cGMP (∼2.5-fold in both) in the pulmonary lymph effluent (P < 0.05). Chronic exposure to increased pulmonary blood flow is associated with pulmonary lymphatic endothelial injury that disrupts NO-cGMP signaling, leading to increased resting vasoconstriction, increased maximal strength of contraction, and impaired endothelium-dependent relaxation. Inhaled NO increases pulmonary lymph NOx and cGMP levels and pulmonary lymph flow in normal and shunt lambs. Therapies that augment NO-cGMP signaling within the lymphatic system may provide benefits, warranting further study.

  9. Study on lung biopsy in patients with severe pulmonary hypertension secondary to congenital heart disease%先天性心脏病继发重度肺动脉高压患者的肺活检研究

    Institute of Scientific and Technical Information of China (English)

    黄景彬; 梁健; 赵晓芳; 杜茗; 朱耀斌; 刘迎龙

    2014-01-01

    Objective To investigate the nature of the pulmonary arterioles in the patients with severe pulmonary hypertension secondary to congenital heart disease .Methods All patients with congenital heart disease and secondary severe pulmonary hyper‐tension(PH) were selected by using diagnostic‐treatment to undergo the radical repair(n= 49) .The lung biopsy specimens were ob‐tained during operation .The nature of pulmonary vascular disease (PVD) was determined by Heath‐Edwards classification system . All specimens were quantitatively analyzed by calculating the arteriole medial area percentage ,medial thickness percentage and arte‐riole density .Results The transcutaneous oxygen saturation in all selected patients was increased significantly after diagnostic‐treatment(P< 0 .01) .There was no case of operative death .The postoperative mean pulmonary artery pressure and pulmonary vas‐cular resistance were decreased significantly (P < 0 .01) .38 cases (77 .6% ) showed the H‐E grade Ⅰ change ,5 cases (10 .2% ) showed the H‐E grade Ⅱ change ,4 cases(8 .2% ) showed the H‐E grade Ⅲ chfange and only 2 cases (4% ) showed the H‐E gradeⅣ change with plexiform lesion .Conclusion The pulmonary vessels in the selected patients with severe PH secondary to congenital heart disease by using the diagnostic‐treatment are generally reversible and still feasible for performing the radical operation .%目的:研究先天性心脏病继发重度肺动脉高压患者肺小动脉病变的性质。方法先天性心脏病继发重度肺动脉高压患者均通过诊断性治疗选择后行根治性手术(n=49)。在心脏手术中取肺组织活检,用 Heath‐Edwards(H‐E)法分级,进行量化分析,计算肺小动脉中膜面积百分比,中膜厚度百分比和肺小动脉密度。结果诊断性治疗后患者经皮血氧饱和度明显提高(P<0.01),无手术死亡病例。术后平均肺动脉压和肺

  10. Clinical Analysis of Magnesium Sulfate and Phentolamine on Pulmonary Heart Disease in 32 Cases%硫酸镁与酚妥拉明联合治疗肺心病心衰32例临床分析

    Institute of Scientific and Technical Information of China (English)

    陈谷

    2015-01-01

    目的硫酸镁与酚妥拉明联合治疗肺心病心衰的疗效观察。方法2010年~2013年来,我院在综合治疗基础上应用硫酸镁联合酚妥拉明治疗肺心病(CPHD)心衰32例,同时以30例使用常规综合治疗作为对照,分析疗效。结果治疗组治愈9例,好转1例,无效6例,总有效率81.3%;对照组治愈1例,好转13例,无效16例,总有效率46.7%。结论小剂量的硫酸镁与酚妥拉明静滴,确能改善CPHD心衰患者呼吸衰竭和心力衰竭的临床状况,且疗效优于文献报道的单独使用任何一种药,比较安全且疗效肯定。%Objective To observe the curative ef ect of Magnesium sulfate combined with phentolamine in treatment of heart failure of pulmonary heart disease. Methods 2010~2013 years, my col ege application Magnesium sulfate combined with phentolamine in the treatment of pulmonary heart disease on the basis of the comprehensive treatment of heart failure (CPHD) in 32 cases, and 30 cases used routine treatment as a control, ef ect analysis. Results The treatment group 9 cases were cured, 1 cases improved, 6 cases inef ective, the total ef iciency of 81.3%;control group 1 cases were cured, 13 cases improved, 16 cases inef ective, the total ef iciency of 46.7%. Conclusion A smal dose of Magnesium sulfate and phentolamine intravenous drip, the clinical condition can improve the respiratory failure and heart failure in patients with CPHD heart failure, and the curative ef ect is bet er than those reported in the literature of any kind of drug used alone, compared the safety and curative ef ect af irmation.

  11. Inferior vena cava filters in cancer patients: to filter or not to filter

    Directory of Open Access Journals (Sweden)

    Hikmat Abdel-Razeq

    2011-03-01

    Full Text Available Hikmat Abdel-Razeq1, Asem Mansour2, Yousef Ismael1, Hazem Abdulelah11Department of Internal Medicine, 2Department of Radiology, King Hussein Cancer Center, Amman, JordanPurpose: Cancer and its treatment are recognized risk factors for venous thromboembolism (VTE; active cancer accounts for almost 20% of all newly diagnosed VTE. Inferior vena cava (IVC filters are utilized to provide mechanical thromboprophylaxis to prevent pulmonary embolism (PE or to avoid bleeding from systemic anticoagulation in high-risk situations. In this report, and utilizing a case study, we will address the appropriate utilization of such filters in cancer patients.Methods: The case of a 43-year-old female patient with rectal cancer, who developed deep vein thrombosis following a complicated medical course, will be presented. The patient was anticoagulated with a low molecular weight heparin, but a few months later and following an episode of bleeding, an IVC filter was planned. Using the PubMed database, articles published in English language addressing issues related to IVC filters in cancer patients were accessed and will be presented.Results: Many recent studies questioned the need to insert IVC filters in advanced-stage cancer patients, particularly those whose anticipated survival is short and prevention of PE may be of little clinical benefit and could be a poor utilization of resources.Conclusion: Systemic anticoagulation can be safely offered for the majority of cancer patients. When the risk of bleeding or pulmonary embolism is high, IVC filters can be utilized. However, placement of such filters should take into consideration the stage of disease and life expectancy of such patients.Keywords: anticoagulation, bleeding, chemotherapy

  12. Clinical analysis of serum levels of thyroid hormone chronic pulmonary heart disease patients with acute exacerbation%肺源性心脏病急性加重期甲状腺素变化

    Institute of Scientific and Technical Information of China (English)

    朱庆雄; 罗颖萍; 张婷容

    2009-01-01

    目的 探讨肺源性心脏病(肺心病)急性加重期患者甲状腺功能的变化特点及意义.方法 肺心病急性加重期200例作为观察组,同期健康体检者200例作为对照组,观察正常甲状腺病态综合征(ESS)发生情况,对比对照组与观察组中存活、病死患者的甲状腺素水平,ESS者治疗前后甲状腺素检查结果、ESS与死亡的关系.结果 肺心病急性加重期ESS发生率42.5%(85/200);观察组入院时T3、FT3低于对照组;观察组中存活和病死比较,TSH无显著性差异外、病死患者T3、FT3、T4、FT4均低于存活患者(P<0.05);原发病治疗好转后,甲状腺素可恢复或接近正常;发生ESS病死率30.59%.高于未发生变化的病死率13.04%.结论 血清甲状腺素水平变化反映了肺心病急性加重期患者的全身状态和严重程度,动态检测血清中甲状腺素水平可以预测肺心病的发展和转归.%Objective To investigate pulmonary heart disease acute exacerbation of changes in the characteristics of thyroid function and significance. Methods Pulmonary heart disease with acute exacerbation of 200 cases as the observation group,in the same period 200 cases of healthyas control group, observation euthyroid sick syndrome (euthyroid sick syndrome, ESS) occurred, compared the observe and control groups, observer group in the survival group died with the group,ESS thyroid hormone treatment before and after the test results,ESS and death. Results Pulmonary heart disease with acute exacerbation of ESS incidence of 42. 5% (85/200) ;section observe the admission T3 ,FT3 lower than the control group;observer group in the survival group died and TSH group no significant difference,the group died T3 ,FT3 ,T4 ,FT4 were lower than the survival group( P<0. 05 ) ;improvement in the treatment of primary disease, thyroid hormone, or return to near normal ; ESS mortality occurred in 30. 59% higher than a change of 13.04% mortality rate. Conclusion Serum thyroid

  13. Pulmonary embolus

    Science.gov (United States)

    ... Blood clot - lung; Embolus; Tumor embolus; Embolism - pulmonary; DVT-pulmonary embolism; Thrombosis - pulmonary embolism ... area). This type of clot is called a deep vein thrombosis (DVT) . The blood clot breaks off and travels ...

  14. The role of increased pulmonary blood flow in pulmonary arterial hypertension

    NARCIS (Netherlands)

    van Albada, ME; Schoemaker, RG; Kemna, MS; Cromme - Dijkhuis, A; van Veghel, R; Berger, RMF

    2005-01-01

    Chronic increased pulmonary blood flow is considered a pre-requisite for the induction of advanced vascular lesions in pulmonary arterial hypertension in congenital heart defects. The aim of the present study was to characterise the effects of increased pulmonary flow induced by an aortocaval shunt

  15. Effects of pravastatin on pulmonary arteries and aorta reactivity in monocrotalin-induced pulmonary hypertension

    Institute of Scientific and Technical Information of China (English)

    PGUERARD; 0BARTHEZ; FGOIRAND; LROCHETTE; MBARDOU; MDUMAS

    2004-01-01

    AIM: Vascular injury caused by monocrotalin (MC) can affect endothelial regulation and induces pulmonary hypertension and heart failure. We showed previously that pravastatin prevented the development of MC-induced pulmonary hypertension by improving pulmonary arteries (PA) endothelium dependent vasodilation. The aims of this study were to compare the protective

  16. Diagnosis and treatment analysis of elderly chronic pulmonary heart disease combined with left heart failure in 60 cases%老年慢性肺源性心脏病合并左心衰60例诊治探析

    Institute of Scientific and Technical Information of China (English)

    王建仙

    2016-01-01

    目的:分析老年慢性肺源性心脏病合并左心衰的诊治。方法:收治慢性肺源性心脏病合并左心衰老年患者60例,对患者的超声心动图、临床特点、具体治疗资料、胸部X线以及心电图进行回顾性分析。结果:52例治疗好转出院,5例患者病情危重转上级医院治疗,3例患者放弃继续抢救主动出院,1例患者呼吸衰竭死亡。结论:对于慢性肺源性心脏病合并左心衰老年患者,临床治疗中需要高度重视血管扩张剂、利尿剂和相应胶体的使用。%Objective:To analyze the diagnosis and treatment of elderly chronic pulmonary heart disease combined with left heart failure.Methods:60 elderly patients with chronic pulmonary heart disease combined with left heart failure were selected.The echocardiography,clinical features,specific treatment data,chest X-ray and electrocardiogram of patients were retrospectively analyzed.Results:52 cases were treatment improved and discharged.5 patients were transferred to higher level hospitals for treatment due to serious illness.3 patients given up continue to rescue and actively discharged.1 patient was died due to respiratory failure.Conclusion:For the elderly patients with chronic pulmonary heart disease combined with left heart failure,the clinical treatment needs to pay great attention to the use of vascular dilation agents,diuretics and the corresponding colloid.

  17. 冠心病患者血浆纤维蛋白原水平与肺功能相关性分析%Correlation between pulmonary function and plasma fibrinogen in patients with coronary heart disease

    Institute of Scientific and Technical Information of China (English)

    陈一冰; 曹璐; 郝峰英; 陈良安

    2015-01-01

    目的:通过研究冠心病患者血浆纤维蛋白原(plasma fibrinogen,PF)和肺功能的相关性,探讨冠心病(coronary heart disease,CHD)对肺功能的影响。方法选取2013年8月-2014年10月于本院心外科住院且术前诊断为冠心病的患者220例,男163例,女57例,年龄26~83岁。患者均完成肺功能检查,静脉取血行实验室检查。分组比较血浆纤维蛋白原和肺功能指标的相关性。结果男性冠心病患者PF与一秒量(forced expiratory volume in one second,FEV1%)、用力肺活量(forced vital capacity,FVC%)、肺活量(vital capacity,VC%)、肺一氧化碳弥散量(diffusion capacity of the lung for carbon monoxide, DLCO%)等指标均呈负相关。肺弥散功能(DLCO%)正常与异常组的血浆纤维蛋白原水平存在差异。结论男性冠心病患者的PF水平与肺功能指标显著相关,PF水平可能成为一项男性冠心病患者肺功能损害的预测指标。冠心病患者中,弥散功能的下降可能与血浆纤维蛋白原水平升高有关。%Objective To study the relationship between pulmonary function and plasma fibrinogen (PF) in patients with coronary heart disease (CHD), and investigate the effects of CHD on pulmonary function. Methods Clinical data about 220 CHD patients (163 males and 57 females, age range from 26 to 83 years) admitted to our department from August 2013 to October 2014 were collected. Venous blood samples were taken for laboratory testing. Pulmonary function was measured by our pulmonary function technicians. Patients were divided into groups by sex and pulmonary function. The relationship of PF level and pulmonary function was analyzed. Results In male CHD patients, PF was negatively related to forced expiratory volume in one second (FEV1%), forced vital capacity (FVC%), vital capacity (VC%), diffusion capacity of the lung for carbon monoxide (DLCO%). The DLCO%and PF in abnormal lung function group showed significant difference

  18. Application of vena cava intraluminal occlusion technique in minimally invasive isolated tricuspid valve surgery%腔静脉内阻断技术在单纯性三尖瓣微创手术中的应用

    Institute of Scientific and Technical Information of China (English)

    姜兆磊; 朱家全; 梅举; 丁芳宝; 沈赛娥; 黄健兵; 张俊文; 何毅; 蒋连勇

    2013-01-01

    Objective To summarize the experiences of appling vena cava intraluminal occlusion technique in minimally invasive repeated isolated tricuspid valve surgery.Methods Consecutive patients (n=46) with isolated significant late tricuspid regurgitation (TR) after previous cardiac surgery received minimally invasive repeated tricuspid valve surgery in beating heart without cmssclamping ascending aorta from 2002 to 2012.Computed tomography showed that severe adhesions exited in the pericardium and the posterior of the sternum.It was difficult to carry out the conventional median thoracotomy and segregate the vena cava.Cardiopulmonary bypass was initiated by cannulating the right femoral artery for arterial access.A right anterolateral thoracotomy incision was made over the fourth intercostal space.Under transoesophageal echocardiographic guidance,the balloon cannulas were insterted through the surface of the right atrium for the venous drainage both of the superior vena cava (SVC) and the inferior vena cava (IVC) respectively.The balloon of the cannula was inflated to obtain the occlusion of SVC and IVC when the nasopharyngeal temperature was about 32 ℃-33 ℃.After the endovascular occlusion of both the caval veins,the right atrium was opened and the tricuspid valve surgery was performed.Results The tricuspid valve was repaired in 12 patients and replaced in 34 patients.There was not cardiopulmonary bypass accident during the operation.The time of operation was (161±52) min.The time of building cardiopulmonary bypass(CPB) was (55±15) min and the time of CPB was (58±23) min.The postoperative drainage was (275±108) ml,and the postoperative inhospital time was (8±7) days.There was no death in hospital.During the follow-up,2 patients died.One died of pulmonary vascular rupture,and the other died of heart failure.There was no paravalvular leakage occurs in tricuspid valve replacement (TVR).Echocardiography showed that one patient who had tricuspid valve plasty (TVP

  19. A new Nitinol stent for use in superior vena cava syndrome

    DEFF Research Database (Denmark)

    Andersen, Poul Erik; Midtgaard, Annette; Brenøe, Anne-Sofie;

    2015-01-01

    AIM: The aim of the study was to assess the early clinical experience with the Zilver Vena stent in treating patients with malignant superior vena cava syndrome. METHODS: Demographic, procedural, and follow-up data of 12 patients (seven women; mean age 69 years) treated for superior vena cava syn...

  20. Recurrent cerebral venous infarcts and superior vena cava obstruction: case report

    Energy Technology Data Exchange (ETDEWEB)

    Bozzao, A. [Department of Radiology, University of Rome ``Tor Vergata``, Rome (Italy)]|[Istituto di Radiologia, Ospedale S. Eugenio, Piazzale dell`Umanesimo 10 I-00144 Roma (Italy); Gallucci, M. [Department of Neuroradiology, University of L`Aquila, L`Aquila (Italy); Marsili, L. [Department of Neuroradiology, University of L`Aquila, L`Aquila (Italy); Cerone, G. [Department of Neurology, Collemaggio Hospital, L`Aquila (Italy)

    1997-06-01

    We report a patient with repeated venous infarcts in the occipital lobe and occlusion of the superior vena cava. The pathogenetic relationships between the superior vena cava occlusion and the brain infarcts are discussed. High pressure in the superior venous territory and incomplete patency of the transverse sinus are probably responsible for the venous infarcts. (orig.). With 4 figs.

  1. Deep venous thrombosis in a young woman with hypoplastic inferior vena cava.

    Science.gov (United States)

    Lavens, Matthias; Moors, Boudewijn; Thomis, Sarah

    2014-05-01

    We present a 33-year-old woman with deep venous thrombosis of the left iliac vein and the left lower limb. A computed tomography scan of her abdomen revealed a hypoplastic inferior vena cava and agenesis of the right kidney. Congenital anomalies of the inferior vena cava are uncommon and are sometimes an unrecognized cause of deep venous thrombosis.

  2. Percutaneous closure of huge patent ductus arterious associated with anomalous inferior vein cava drainage and dextrocardia with muscular ventricular septal defect occluder

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    @@ Transcatheter occlusion of patent ductus arterious (PDA) using various occluders and coils has been a well-established method1-5 since Porstmann and colleagues6 reported the first case in 1967. However, when patients associated with anomalous inferior vein cava drainage or/and huge high pulmonary artery pressure ductus (HPAP-PDA), the method is not suitable. First, it is unfeasible to carry out the procedure via femoral vein. Second, in the presence of high pulmonary artery pressure such devices including the Amplatzer ductu occluder carry the risk of embolising into the aorta.7 The muscular ventricular septal defect occluder (MVSDO), which is a device for transcatheter closure of muscular ventricular septal defect, may be more suitable for using with HPAP-PDA as its double disk tends to anchor the device, preventing embolisation into the aorta. We present a patient, who is suffering from huge PDA associated with anomalous inferior vein cava drainage and dextrocardia, in whom percutaneous closure of PDA using MVSDO was successfully accomplished via transjugular approach.

  3. Leiomioma benigno metastatizante de veia cava inferior: rara complicação tardia de histerectomia Benign metastasizing leiomyoma of inferior vena cava: a rare condition following hysterectomy

    Directory of Open Access Journals (Sweden)

    Marcos Filgueiras

    2008-08-01

    Full Text Available Large vessel tumors diagnosis is usually difficult. Benign metastasizing leiomyoma is a rare condition occurring inside peripheral vessels. There are few publications about this tumor inside inferior vena cava. A 54 years old female patient is presented with a previous hysterectomy for myomas. She complained of no specific symptoms 18 months after surgery. Computer tomography revealed a 7.5 x 3.5 x 4.0 cm mass at inferior vena cava and right psoas muscle. After surgical management and immunohistochemical screening biopsy, the diagnosis was benign metastasizing leiomyoma of inferior vena cava. The patient recovery was uneventful. Benign metastasizing leiomyoma of inferior vena cava is a very rare condition, and must be suspected in patients with primary leiomyosarcoma, especially in women previously submitted to hysterectomy for leiomyomatosis.

  4. Duplicate inferior vena cava filters: more is not always better.

    Science.gov (United States)

    Katyal, Anup; Javed, Muhammad Ali

    2016-01-01

    Duplication of the inferior vena cava (IVC) has been reported in literature. This achieves clinical significance in the setting of lower extremity venous thromboembolism with a contraindication for anticoagulation. We describe a case of lower extremity deep vein thrombosis with duplicate IVC. Anticoagulation was contraindicated in this case leading to successful treatment with double IVC filters. We conducted a PubMed search for all current English language published literature, where filters were placed in the presence of duplicate IVC. We suggest that patients with deep vein thrombosis should have an accurate assessment of venous anatomy before IVC filter placement. Duplication of IVC, although rare, should be considered as this has management implications.

  5. Concomitant Persistent Left Superior Vena Cava and Horseshoe Kidney

    Directory of Open Access Journals (Sweden)

    Faraz Jaffer

    2015-01-01

    Full Text Available Persistent left superior vena cava (PLSVC and horseshoe kidney (HSK are common congenital abnormalities; however presence of both in the same person is extremely rare. A patient with hepatitis C cirrhosis awaiting transplant presented with worsening liver dysfunction, diagnosed with acute renal failure secondary to hepatorenal syndrome, and required X-ray fluoroscopy guided tunneled venous catheter placement for hemodialysis. Review of imaging studies demonstrated coexistence of PLSVC and HSK. PLSVC in adulthood is usually incidental with the most common drainage pattern being without physiologic dysfunction. Isolated horseshoe kidney is still the most common of renal fusion anomalies; however etiology of coexistent PLSVC remains unknown.

  6. Renal transplantation in a child with thrombosed inferior vena cava

    Directory of Open Access Journals (Sweden)

    Surjeet Kumar

    2014-01-01

    Full Text Available The external iliac vein is commonly used in renal transplantation for vascular anastomosis of the allograft renal vein. However, there are rare instances when the transplant surgeon may encounter thrombosis of the ilio-caval vein during surgery, making renal transplantation a challenge. Often, these patients are considered unsuitable for renal transplantation. We report a case of thrombosis of the inferior vena cava in an asymptomatic pediatric patient in whom the splenic vein was used, at transplantation, for venous drainage. This case highlights that pre-operative Doppler screening should be performed in all potential renal transplant recipients.

  7. Complication of Right Subclavian Vein Catheterization: Superior Vena Cava Perforation

    OpenAIRE

    ÇELİK, B.; KOCAMANOĞLU, S.; BÜYÜKKARABACAK, Y. B.; SARIHASAN, E.

    2013-01-01

    Central venous catheterization is an invasive approach which is routinely used in thoracic surgery operations. Pneumothorax and hemothorax are among the most frequent complications. Vena cava superior (VCS) perforation (0.5 %) is very rarely observed. A 65-year-old male patient was admitted to the hospital with the complaint of cough. With the examinations performed, he was diagnosed with epidermoid lung cancer located in the right lower lobe of the lung (Stage IB, T2N0M0). To prepare the pat...

  8. An unusual cause of intraoperative acute superior vena cava syndrome

    Directory of Open Access Journals (Sweden)

    Adam W Amundson

    2013-01-01

    Full Text Available Acute intraoperative superior vena cava (SVC syndrome is an exceedingly rare complication in the cardiac surgical population. We describe the case of a 71-year-old female undergoing multi-vessel coronary artery bypass grafting who developed acute intraoperative SVC syndrome following internal thoracic artery harvest retractor placement. Her symptoms included severe plethora, facial engorgement and scleral edema, which was associated with hypotension and severe elevation of central venous pressure. Transesophageal echocardiography was crucial in the diagnosis, management, and optimal retractor placement ensuring adequate SVC flow. Potential causes of intraoperative SVC syndrome are reviewed as well as management options.

  9. Clinical observation on effect of Milrinon inhalation treatment on valvular heart disease of people with pulmonary hypertension%雾化吸入米力农对合并肺动脉高压心脏瓣膜病患者的临床观察

    Institute of Scientific and Technical Information of China (English)

    崔振田; 姚建民; 赵向东

    2012-01-01

    Objective To study the effect of Milrinon inhalation treatment on pulmonary artery pressure (PAP) and pulmonary function of patients with pulmonary hypertension (PH) and valvular heart disease. Methods We measure the results of PAP, pulmonary function and blood gas index, before and after Milrinon inhalation treatment in patients with pulmonary hypertension and valvular heart disease. Results Milrinon inhalation treatment can reduce the PAP obviously, but no effect on their pulmonary function , blood gas index and systemic blood pressure. Conclusion Milrinon inhalation method can be a new treatment means on the valvular heart disease of people with pulmonary hypertension, bad pulmonary function and abnormal blood gas index.%目的 探讨雾化吸入米力农对合并肺动脉高压心脏瓣膜病患者肺动脉压力、肺功能等的影响.方法 测定合并肺动脉高压心脏瓣膜病患者雾化吸入米力农治疗前后的肺动脉压力(PAP)、肺功能及血气指标.结果 米力农雾化吸入能明显降低合并肺动脉高压心脏瓣膜病患者肺动脉压力,但对肺功能血气指标及体循环血压无影响.结论 心脏瓣膜病患者术前肺动脉压力过高,肺功能差,血气指标异常的病人,雾化吸入米力农可作为新的术前治疗手段用于临床.

  10. Different cava reconstruction techniques in liver transplantation:piggyback versus cava resection

    Institute of Scientific and Technical Information of China (English)

    Volker Schmitz; Wenzel Schoening; Ines Jelkmann; Brigitta Globke; Andreas Pascher; Marcus Bahra; Peter Neuhaus and Gero Puhl

    2014-01-01

    BACKGROUND: Originally, cava reconstruction (CR) in liver transplantation meant complete resection and reinsertion of the donor cava. Alternatively, preservation of the recipients inferior  vena  cava  (IVC)  with  side-to-side  anastomosis (known  as  "piggyback")  can  be  performed.  Here,  partial clamping maintains blood lfow of the IVC, which may improve cardiovascular stability, reduce blood loss and stabilize kidney function. The aim of this study was to compare both techniques with particular focus on kidney function. METHODS: A series of 414 patients who had had adult liver transplantations  (2006-2009)  were  included.  Among  them, 176  (42.5%)  patients  had  piggyback  and  238  had  classical CR  operation,  112  (27.1%)  of  the  patients  underwent  CR accompanied with veno-venous bypass (CR-B) and 126 (30.4%) without a bypass. The choice of either technique was based on the surgeons' individual preference. Kidney function [serum creatinine, calculated glomerular ifltration rate (GFR), RIFLE stages] was assessed over 14 days. RESULTS: Lab-MELD scores were signiifcantly higher in CR-B (22.5±11.0) than in CR (17.3±9.0) and piggyback (18.8±10.0) (P=0.008). Unexpectedly, the incidences of arterial stenoses (P=0.045)  and  biliary  leaks  (P=0.042)  were  signiifcantly increased in piggyback. Preoperative serum creatinine levels were the highest in CR-B [1.45±1.17 vs 1.25±0.85 (piggyback) and 1.13±0.60 mg/dL (CR); P=0.033]. Although a worsening of postoperative kidney function was observed among all groups,

  11. Síndrome de veia cava superior Superior vena cava syndrome

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    SAMUEL ZUÍNGLIO DE BIASI CORDEIRO

    2002-09-01

    Full Text Available A obstrução ao fluxo sanguíneo na VCS e suas manifestações clínicas têm hoje como causa principal o câncer de pulmão. A história relata que no século XVIII a sífilis e a tuberculose eram responsáveis por 40% dos casos conhecidos. O conhecimento das alterações hemodinâmicas compreendidas nesta síndrome assim como a apuração das técnicas de diagnóstico de imagem e de citopatologia permitem hoje que o médico possa tratar de seu paciente com mais segurança e conforto do que há 10 anos. A TC contrastada e a RM auxiliam no diagnóstico de localização da obstrução e técnicas mais antigas como a cavografia puderam ser abandonadas. O diagnóstico de obstrução da VCS e o estudo por Doppler realizado à beira do leito em muito contribuem para a realização de procedimentos de desobstrução como a angioplastia transluminal percutânea nos casos de trombose ou estenose do vaso. Também a utilização de próteses como PTFE é de importância fundamental na condução de casos de lesão traumática da VCS durante cirurgias para câncer pulmonar ou mediastinal. No campo da radioterapia, a técnica de fracionamento permite que altas doses de irradiação sejam administradas aos pacientes portadores de neoplasias malignas, com benefícios em 70% dos casos.Lung cancer is now the main cause of blood flow obstruction in the superior vena cava and of its clinical manifestations. History tells that in the 18th Century, syphilis and tuberculosis were responsible for 40% of the known cases. The knowledge of hemodynamic changes seen in this syndrome and the improvement of diagnostic and cytopathologic techniques allow for a safer and more comfortable treatment of the patient than 10 years ago. Contrast CT and MR added to the identification and location of the obstruction, and older techniques such as cavography could be abandoned. SVC obstruction diagnosis and Doppler studies carried out at the bed of the patient contribute to

  12. Phentolamine plus Ginkgo Dipyridamole Injection for Chronic Pulmonary Heart Disease%酚妥拉明联合银杏达莫治疗慢性肺源性心脏病疗效观察

    Institute of Scientific and Technical Information of China (English)

    马继扬; 高健; 梁民勇; 陈继兴; 文启孝

    2011-01-01

    Objective: To observe the clinical effect of phentolamine combined with ginkgo dipyridamole injection in the treatment of chronic pulmonary heart disease with heart failure.Methods: A total of 90 patients were randomly divided into control group (n=45) and therapy group (n=45).Two groups were treated with medical treatment such as control infection, oxygentherapy, cardiotonic and diuresis.On the basis of the above therapy, the treatment group were added phentolamine 20 mg combined with ginkgo dipyridamole injection 25 mL with 10% Glucose 500 ml in intravenous drip, quotidie, 10 days for a course of treatment. Results: The therapeutic effect, results of blood gas analysis and blood rheology, and heart function in therapy group were better than the control group, with statistically significant difference (P<0.05). Conclusion: Phentolamine combined with ginkgo dipyridamole injection in treatment of chronic pulmonary heart disease with heart failure is effective and safe. It deserves to be popularized.%观察酚妥拉明联合银杏达莫对慢性肺源性心脏病心衰患者的疗效,为临床治疗提供依据.方法:将90例患者随机分为治疗组和对照组各45例.两组采用常规内科治疗如控制感染、氧疗、强心、利尿等,治疗组在上述治疗基础上加用酚妥拉明20mg+银杏达莫25 mL于10%葡萄糖注射液500mL中静脉滴注,1次/d,疗程均为10d.结果:治疗组的疗效、血气分析、血液流变学、功能的改善优于对照组,差异具有统计学意义(P<0.05).结论:酚妥拉明联合银杏达莫对慢性肺源性心脏病心衰患者具有良好的疗效及安全性,值得临床推广应用.

  13. Filtros de vena cava en pacientes con cáncer Vena cava filters in cancer patients

    Directory of Open Access Journals (Sweden)

    Fernando A. Díaz Couselo

    2012-08-01

    Full Text Available Los pacientes con tromboembolismo venoso (TEV y cáncer tienen más complicaciones vinculadas al tratamiento anticoagulante que la población general. Los filtros de vena cava constituyen una herramienta útil para el tratamiento del TEV y su utilización es controvertida en estadios avanzados de la enfermedad. En este trabajo se revisaron las indicaciones, complicaciones y frecuencia de retiro de los filtros de vena cava en una población de pacientes oncológicos con TEV. Se analizaron 27 pacientes a quienes se les había colocado filtros de vena cava. Veinticinco tenían tumores sólidos y dos linfomas no Hodgkin. Veinticinco estaban bajo tratamiento activo (cirugía y/o quimioterapia. Diecinueve se hallaban en estadio IV de su enfermedad. El motivo de su indicación fue profilaxis en el período perioperatorio en 14 casos (51.9%, hemorragia (n = 5, trombocitopenia (n = 4, metástasis en sistema nervioso central (n = 2, accidente cerebrovascular (n = 1 y neurocirugía previa no reciente (n = 1. Se retiraron 8 (29.6% filtros. La mediana del tiempo de permanencia fue 21 días (6-75. No hubo diferencias estadísticamente significativas en la frecuencia de retiro entre los filtros colocados en el perioperatorio (6/14 y los colocados por otras contraindicaciones para la anticoagulación (2/13; p = 0.2087. No hubo fracasos ni complicaciones en los procedimientos de colocación y retiro.Cancer patients with venous thromboembolism (VTE have more complications related to the anticoagulation treatment than the general population. Vena cava filters are a useful tool in cancer patients, but their use in advanced disease is controversial. In this paper, we reviewed the indications, complications and frequency of retrieval of vena cava filters in cancer patients with VTE. Twenty seven patients with vena cava filter placements were analyzed. Twenty five had solid tumors and two non Hodgkin lymphomas. Twenty five were under active treatment (surgery and

  14. Rapid intra-hepatic dissemination of hepatocellular carcinoma with pulmonary metastases following combined loco-regional therapy

    Energy Technology Data Exchange (ETDEWEB)

    Pua, Uei [Dept. of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore (Singapore)

    2013-08-15

    This manuscript describes an unusual case of rapid intra-hepatic dissemination of hepatocellular carcinoma with pulmonary metastases occurring 1 month after combined chemoembolization and radiofrequency ablation. Inferior vena cava and portal vein invasion tumor thrombus was also detected, possibly accounting for the mechanism of disease dissemination route of disease.

  15. Yougui Pill with the Treatment of Pulmonary Heart Disease Complicated with Chronic Obstructive Pulmonary Disease Re-mission Period of Curative Effect Observation Transfer Factor Capsules%右归丸配合转移因子胶囊治疗慢阻肺合并肺心病缓解期的疗效观察

    Institute of Scientific and Technical Information of China (English)

    赵兵; 周燕

    2015-01-01

    目的:观察右归丸配合转移因子胶囊治疗慢阻肺合并肺心病缓解期的临床疗效.方法:将92例慢性肺心病患者随机分为治疗组48例和对照组44例.治疗组在肺心病缓解期基础治疗 ,加用右归丸、转移因子胶囊口服 ,2周为1个疗程.休息3~5d ,进行下1个疗程 ,长期规律治疗.对照组给予慢性肺心病缓解期基础治疗.结果:治疗组症状评分较治疗前明显改善 ,治疗组总显效率为70 .8% ,对照组为45 .5% ,两组比较差异具有统计学意义( P<0 .05 ).治疗后治疗组平均急性发作次数为2 .4次/年 ,对照组为4.2次/年 ,两组比较结果有显著差异(P<0 .05).结论:右归丸配合转移因子胶囊治疗慢阻肺合并肺心病缓解期可显著减少急性发作次数.%Objective:To observe the Yougui Pill combined with Transfer Factor Capsules treatment of pulmonary heart disease complicated with chronic obstructive pulmonary disease clinical remission .Methods:92 patients with chro-nic pulmonary heart disease were randomly divided into treatment group 48 cases and control group with 44 cases .The treatment group remission therapy in pulmonary heart disease ,with Transfer Factor Capsules Yougui Pill ,oral ,2 weeks as a course of treatment .Rest 3~5 days ,proceed to the next course ,long-term regular treatment .The control group was treated with chronic cor pulmonale foundation treatment .Results:In treatment group ,the symptom score significantly improved compared with before treatment ,the total obvious effective rate of the treatment group was 70.8% ,the control group was 45 .5% efficiency .Results there were significant differences between the two groups (P<0 .05) .The treatment group the number of acute attack for an average of 2 .4 times per year ,controls the number of acute attack on average 4 .2 times per year .Results there were significant differences between the two groups (P<0.05) .Conclusion:Yougui Pill combined with

  16. Curative effect of the electron bronchoscopy alveolar lavage treatment combined with atomization inhalation on COPD pulmonary heart disease combined with pulmonary infection%电子纤维支气管镜肺泡灌洗联合雾化吸入治疗 COPD肺源性心脏病合并肺部感染的临床研究

    Institute of Scientific and Technical Information of China (English)

    林秾威; 林福筹

    2016-01-01

    Objective To study the curative effect of the electron bronchoscopy alveolar lavage treatment combined with at-omization inhalation on COPD pulmonary heart disease combined with pulmonary infection. Methods The patients with COPD pulmonary heart disease combined with pulmonary infection were divided into two groups. The normal-care group was given oxy-gen therapy,anti-infection treatment,spasmolysis treatment and symptomatic treatment. The patients in integrated treatment group were given electron bronchoscopy alveolar lavage combined with atomization inhalation in addition. After 4 days,the X-ray changes,arterial blood gas indexes,improvement condition of lung function was compared. Results Comparing with the normal-care group,pneumonia absorption time of patients in the integrated treatment group decreased obviously;the oxygen saturation in-creased significantly and the time of correcting redress hypoxemia and carbon dioxide retention decreased obviously. The life qual-ity and lung function of the patients in the integrated treatment group improved obviously. Conclusion Electron bronchoscopy alveolar lavage treatment combined with atomization inhalation in treatment of COPD pulmonary heart disease combined with pul-monary infection,can improve the condition of the lung function obviously,shorten the pulmonary infection adsorption time obvi-ously;reduce the total medical costs,alleviate the pain of patients,and reduce the time in hospital. This kind of treatment has a good social benefit.%目的:研究电子纤维支气管镜肺泡灌洗联合雾化吸入治疗慢性阻塞性肺疾病( COPD)肺心病合并肺部感染的疗效。方法将 COPD 肺源性心脏病合并肺部感染患者分两组,常规治疗组给予常规氧疗、抗感染、解痉、对症治疗;综合治疗组在常规治疗基础上,采用电子纤维支气管镜肺泡灌洗联合雾化吸入治疗。治疗4 d 后,对比两组患者胸片变化和动脉血气指标、肺功能改

  17. Comportamento da dor e da função pulmonar em pacientes submetidos à cirurgia cardíaca via esternotomia Pain and pulmonary function in patients submitted to heart surgery via sternotomy

    Directory of Open Access Journals (Sweden)

    Maria Cristina dos Santos Baumgarten

    2009-12-01

    Full Text Available OBJETIVO: Avaliar o comportamento da função pulmonar e da dor em pacientes adultos submetidos à cirurgia cardíaca por esternotomia. Além de verificar possíveis correlações e comparações dessas variáveis com as características do procedimento cirúrgico e o tempo de internação hospitalar. MÉTODOS: Foi realizado estudo de coorte composto de 70 indivíduos, nos quais foi avaliada a função pulmonar préoperatória por espirometria e inspirometria de incentivo. Os pacientes foram acompanhados no pós-operatório, por meio de protocolo com informações da cirurgia, função pulmonar e um protocolo de avaliação álgica (escala análoga visual e desenho do corpo humano. RESULTADOS: Os valores de função pulmonar do período pós-operatório apresentaram diminuição significativa em relação ao pré-operatório (POBJECTIVE: To investigate the pulmonary function and pain in adult patients undergoing heart surgery via sternotomy and to verify possible correlations of these variables with the characteristics of the surgical procedure and hospital stay. METHODS: A cross-sectional study was carried out of 70 individuals undergoing heart surgery. The lung function was assessed before and after surgery by spirometry and incentive spirometry. Details of the surgical procedure were studied and patients were followed up postoperatively using a visual analogue scale and design of the human body to evaluate pain. RESULTS: The pulmonary function was significantly impaired in the postoperative compared to preoperative period (P <0.01. The pain was centered in the region of the sternotomy and persisted until at least the 5th postoperative day. There was a correlation between pain and the parameters of pulmonary function (forced expiratory volume in 1 second - percentage: r = -0.271, P <0.047; peak expiratory flow: r = 0.357, P <0.008; and maximum inspiratory volume: r = -0.293, P <0.032. There was no significant correlation between pain and other

  18. Pulmonary edema: radiographic differential diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Yoo, Dong Soo; Choi, Young Hi; Kim, Seung Cheol; An, Ji Hyun; Lee, Jee Young; Park, Hee Hong [Dankook Univ. College of Medicine, Chonan (Korea, Republic of)

    1997-04-01

    To evaluate the feasibility of using chest radiography to differentiate between three different etiologies of pulmonary edema. Plain chest radiographs of 77 patients, who were clinically confirmed as having pulmonary edema, were retrospectively reviewed. The patients were classified into three groups : group 1 (cardiogenic edema : n = 35), group 2 (renal pulmonary edema : n = 16) and group 3 (permeability edema : n = 26). We analyzed the radiologic findings of air bronchogram, heart size, peribronchial cuffing, septal line, pleural effusion, vascular pedicle width, pulmonary blood flow distribution and distribution of pulmonary edema. In a search for radiologic findings which would help in the differentiation of these three etiologies, each finding was assessed. Cardiogenic and renal pulmonary edema showed overlapping radiologic findings, except for pulmonary blood flow distribution. In cardiogenic pulmonary edema (n=35), cardiomegaly (n=29), peribronchial cuffing (n=29), inverted pulmonary blood flow distribution (n=21) and basal distribution of edema (n=20) were common. In renal pulmonary edema (n=16), cardiomegaly (n=15), balanced blood flow distribution (n=12), and central (n=9) or basal distribution of edema (n=7) were common. Permeability edema (n=26) showed different findings. Air bronchogram (n=25), normal blood flow distribution (n=14) and peripheral distribution of edema (n=21) were frequent findings, while cardiomegaly (n=7), peribronchial cuffing (n=7) and septal line (n=5) were observed in only a few cases. On plain chest radiograph, permeability edema can be differentiated from cardiogenic or renal pulmonary edema. The radiographic findings which most reliably differentiated these two etiologies were air bronchogram, distribution of pulmonary edema, peribronchial cuffing and heart size. Only blood flow distribution was useful for radiographic differentiation of cardiogenic and renal edema.

  19. 酚妥拉明治疗慢性肺源性心脏病的疗效观察%Efficacy of Phentolamine Treatment of Chronic Pulmonary Heart Disease

    Institute of Scientific and Technical Information of China (English)

    朱振清

    2013-01-01

    Objective To observe the efficacy of phentolamine on chronic pulmonary heart disease. Methods 172 patients with chronic pulmonary heart disease from January 2012 to April 2013 in cardiovascular internal medicine department of our hospital were selected and randomly divided into observation group and control group. On the basis of conventional treatment, the observation group received phentolamine. Result In control group, the total effective rate was 76.7%;the data in observation group was 90.7%, implying a better efficacy than control group, the differences have statistical significance (P<0.05). Conclusions Based on the conventional treatment, phentolamine can significantly improve the efficacy in treating chronic pulmonary heart disease.%目的:观察酚妥拉明对慢性肺源性心脏病的疗效。方法选取我院心血管内科在2012年1月至2013年4月期间的慢性肺源性心脏病患者172例,按照随机化原则分为观察和对照组。观察组则在对照组的基础上予以酚妥拉明处理,将两组的疗效对比。结果对照组的治疗总有效率76.7%;观察组的治疗总有效率90.7%,观察组优于对照组,两组差异具有统计学意义(P<0.05)。结论对于慢性肺源性心脏病患者,在常规综合治疗基础上,予以酚妥拉明处理,能显著提高疗效,值得在临床心血管内科推行。

  20. 机械通气治疗113例ICU重症肺心病呼吸衰竭的分析%Analysis of Mechanical Ventilation Therapy of 113 Cases of ICU Severe Pulmonary Heart Disease Patients with Respiratory Failure

    Institute of Scientific and Technical Information of China (English)

    陈光梅

    2016-01-01

    目的:探讨机械通气法治疗重症肺心病呼吸衰竭的临床效果。方法选取收治的113例重症肺心病呼吸衰竭患者使用机械通气法对患者进行治疗,比较患者治疗前后呼吸频率和血气分析指标:动脉血氧分压(PaO2)和动脉血二氧化碳分压(PaCO2)变化。结果患者治疗前后的呼吸频率和PaO2、PaCO2均有明显变化,差异具有统计学意义(P<0.05)。结论使用机械通气法治疗重症肺心病呼吸衰竭可以有效改善患者呼吸衰竭的症状,提高患者的成活率,值得在临床应用中进行推广。%Objective To explore the effect of mechanical ventilation therapy of severe pulmonary heart disease with respiratory failure.Methods 113 cases of severe pulmonary heart disease with respiratory failure were selected retrospectively for the study, who were treated with mechanical ventilation method. Respiratory rate and blood gas analysis indicators including changes of arterial oxygen tension (PaO2) and arterial carbon dioxide tension (PaCO2) of patients before and after treatment were compared.Results The respiratory rate, PaO2, and PaCO2 of patients before and after treatment changed signiifcantly, the differences were statistically signiifcant (P<0.05).Conclusion The use of mechanical ventilation method of severe pulmonary heart disease with respiratory failure can improve respiratory failure symptoms and survival rate of patients, which is worth promoting in clinical applications.

  1. Fatal dissection of the pulmonary artery in pulmonary arterial hypertension

    Directory of Open Access Journals (Sweden)

    B. Degano

    2009-09-01

    Full Text Available A 41-yr-old patient with chronic stable idiopathic pulmonary arterial hypertension (PAH presented with sudden chest pain and unusual dyspnoea during physical exertion. The patient had been diagnosed with PAH at the age of 12 yrs and was in New York Heart Association functional class I/II. The patient was being treated with an anticoagulant regimen, low-dose diuretics and continuous intravenous epoprostenol therapy. A computed tomography scan showed ancient massive thrombi in dilated central pulmonary arteries, which were not haemodynamically significant (perfusion lung scans did not demonstrate segmental or larger defects, and extensive dissection of the right pulmonary artery starting from the intermediate branch. Due to the extensiveness of the dissection, the patient was immediately considered for heart–lung transplantation, but died 72 h after the onset of symptoms. Permission for post mortem examination was denied. Pulmonary artery dissection should be suspected in PAH patients presenting with chest pain and worsening dyspnoea. In the current case, the factors possibly associated with increased risk for dissection may include dilatation of the pulmonary artery, local inflammation favoured by in situ thrombosis, and acute increase of pulmonary pressure secondary to physical exertion. Extensive pulmonary artery dissection is a life-threatening complication of PAH, and urgent heart/lung transplantation might be the treatment of choice in eligible patients. In addition, better identification of the risk factors for pulmonary artery dissection may help in considering transplantation for selected patients at risk.

  2. Hybrid Surgery Options for Complex Clinical Scenarios in Adult Patients with Congenital Heart Disease: Three Case Reports

    Science.gov (United States)

    Rapetto, Filippo; Kenny, Damien; Turner, Mark; Parry, Andrew; Stoica, Serban; Uzun, Orhan; Caputo, Massimo

    2017-01-01

    The strategy for the management of adult patients with congenital heart disease (CHD) often represents a challenge for cardiac surgeons and cardiologists due to complex anatomy, wide range of clinical presentations, and a high-risk profile. However, hybrid approach may represent an attractive solution. We report three cases of adult patients previously operated for CHD and recently treated with a hybrid approach in our institution. Case 1: a 76-year-old woman with permanent atrial fibrillation, lung disease, chronic kidney disease, microcytic anemia, and type II diabetes mellitus, previously operated for atrial septal defect closure and pulmonary valvotomy, presented with severe pulmonary regurgitation and advanced right ventricular failure. In order to minimize the surgical risk, a hybrid approach was used: an extensive right ventricular outflow tract (RVOT) plication was followed by implantation of an Edwards Sapien XT prosthesis in the RVOT through the right ventricular apex, without cardiopulmonary bypass. Case 2: a 64-year-old man with previous atrial septum excision and pericardial baffle for partial anomalous pulmonary venous drainage with intact interatrial septum, presented with worsening dyspnea, right ventricular failure, and pulmonary hypertension caused by baffle stenosis. His comorbidities included coronary artery disease, atrial flutter, and previous left pneumonectomy. After performing a redo longitudinal median sternotomy, a 20-mm stent was implanted in the baffle with access through the superior vena cava. Case 3: a 50-year-old man, with previous atrioventricular septal defect repair, followed by mitral valve replacement with a mechanical prosthesis, subsequently developed a paravalvular leak (PVL) with severe mitral regurgitation and severe left ventricular dysfunction. He underwent a transapical PVL device closure with two Amplatzer Vascular Plugs. In our opinion, hybrid surgery is a promising therapeutic modality that increases the available

  3. Current practice for pulmonary hypertension

    Institute of Scientific and Technical Information of China (English)

    Toru Satoh

    2014-01-01

    Objective To investigate the current practice of pulmonary hypertension including current epidemiology,diagnosis and treatment.Data sources The review was based on data obtained from the published articles and guidelines.Study selection Articles with high level of evidence or current best evidence in each issue were selected to be reviewed.Results Overall prevalence of pulmonary hypertension was 0.3% to 6% with left heart disease occupying the most proportion,followed by pulmonary disease,pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension.In diagnosis,a flow diagram of diagnosis of pulmonary hypertension,differential diagnosis of pulmonary hypertension and how to determine the severity of pulmonary hypertension are explained including recent development of magnetic resonance imaging and gene abnormality study on bone morphogenetic protein receptor Ⅱ.In treatment,newlydeveloped pulmonary vasodilators and the way to use them are shown to treat pulmonary hypertension.Conclusion Safer and more effective treatment algorithm and basic researches and clinical trials are warranted to be explored.

  4. Use of β-Blockers in Pulmonary Hypertension.

    Science.gov (United States)

    Perros, Frédéric; de Man, Frances S; Bogaard, Harm J; Antigny, Fabrice; Simonneau, Gérald; Bonnet, Sébastien; Provencher, Steeve; Galiè, Nazzareno; Humbert, Marc

    2017-04-01

    Contrasting with the major attention that left heart failure has received, right heart failure remains understudied both at the preclinical and clinical levels. However, right ventricle failure is a major predictor of outcomes in patients with precapillary pulmonary hypertension because of pulmonary arterial hypertension, and in patients with postcapillary pulmonary hypertension because of left heart disease. In pulmonary hypertension, the status of the right ventricle is one of the most important predictors of both morbidity and mortality. Paradoxically, there are currently no approved therapies targeting the right ventricle in pulmonary hypertension. By analogy with the key role of β-blockers in the management of left heart failure, some authors have proposed to use these agents to support the right ventricle function in pulmonary hypertension. In this review, we summarize the current knowledge on the use of β-blockers in pulmonary hypertension.

  5. Surgical treatment and perioperative management of congenital heart disease with severe pulmonary hypertension%先心病合并重度肺动脉高压的手术及相关治疗

    Institute of Scientific and Technical Information of China (English)

    陈元恒; 张红超; 于鲁峰; 李令珂; 侯迈; 杨军民; 徐金星

    2009-01-01

    AIM: To review the results and methods of surgical treatment and perioperative management of congenital heart disease (CHD) with severe pulmonary hypertension (PH). METHODS: Thirty-six patients (17 males, 19 females, aging from 1-41 years) of congenital heart disease with severe pulmonary hypertension were included in the study, among whom were 9 cases of atrial septal defect and 20 cases of ventricular septal defect. The saturation of artery oxygen ranged from 0.85-0.94 and echocardiograpby showed left to right slow velocity shunt in 23 cases, double direction shunt in 10 cases and no shunt in 3 cases. The pulmonary pressure was 80 to 130 mmHg(1 mmHg=0.133 kPa), the pulmonary pressure/systemic pressure varied from 0.75-1.0 and the pulmonary resistance was 8-27.2 Wood unit. All the patients were treated with corrective surgery, and one way shunt valve (size 0.5-0.6 cm) from right to left shunt on the repaired patch was created especially for the treatment of extremely severe pulmonary hypertension. The therapy of oxygen inhalation, oral intake of captopril and sildenafil, and intravenous injection of sodium nitroprusside and prostaglandin E1 were routinely administrated perioperatively to reduce pulmonary hyper-tension. Nitric oxide and sildenafil were applied especially for the treatment of extremely severe pulmonary hypertension or pulmonary hypertension crisis. RESULTS: Only one early postoperative death occurred due to low output syndrome, and the other 35 patients were recovered and discharged from the hospital. The 0.5 -7 years follow-up showed that the patients were well recovered with NYHA Ⅰ heart function. CONCLUSION: Satisfactory outcome can be achieved in surgical treatment of CHD with severe pulmonary hypertension by meticulous preoperative analysis of surgical indications, selection of appropriate operative procedures and multiple perioperative therapies.%目的:对36例先心病合并重度肺动脉高压患者手术及综合治疗的经验

  6. Ellis-van Creveld syndrome and congenital heart defects: presentation of an additional 32 cases.

    Science.gov (United States)

    Hills, Christine B; Kochilas, Lazaros; Schimmenti, Lisa A; Moller, James H

    2011-10-01

    Ellis-van Creveld (EVC) syndrome is a rare genetic abnormality that has been linked to a mutation in the EVC or EVC2 genes. Common atrium (CA) is an uncommon cardiac malformation, and yet it is commonly found in patients with EVC. We performed a retrospective review of the cases submitted to the Pediatric Cardiac Care Consortium (PCCC) between 1982 and 2007. A review of the English-language literature for previously published cases, as well as current genetic research findings, was also performed. Thirty-two pediatric patients with congenital heart disease (CHD) and EVC syndrome were identified in the PCCC database. Twenty-eight (88%) had an endocardial cushion defect, with 15 of these having primary failure of atrial septation resulting in CA. Persistent left superior vena cava (LSVC) and pulmonary venous connection abnormalities were common. The incidence of persistent LSVC and pulmonary venous abnormalities were greater than previously reported for patients with EVC. Our study reviews the reported literature and adds 32 additional cases from the PCCC database. Review of the cardiac phenotype in patients with EVC syndrome reveals a characteristic pattern of atrioventricular canal defects with systemic and pulmonary venous abnormalities. The frequent association of these abnormalities is strongly reminiscent of the cardiac phenotype found in patients with heterotaxy syndromes. Emerging molecular and developmental studies suggest that EVC and EVC2 proteins may be important for cilia function, which is implicated in the pathogenesis of heterotaxy syndromes. It is speculated that coordinate function between the EVC proteins is required for a cilia-dependent cardiac morphogenesis.

  7. Clinical analysis of early complications in patients with severe pulmonary hypertension undergoing congenital heart surgery%先天性心脏病伴重度肺动脉高压术后早期并发症分析

    Institute of Scientific and Technical Information of China (English)

    张文波; 张希; 孙培吾; 殷胜利; 王治平; 唐白云

    2009-01-01

    Objective A clinical analysis of early complications in patients with severe pulmonary hypertension(PH)undergoing congenital heart surgery with cardiopulmonary bypass(CPB)is reported.Methods A retrospective study of 45 patients with severe PH undergoing congenital heart surgery with CPB in our hospital from June 2003 to June 2009 was completed.The cause of death and the major complications in the early postoperative period were discussed.Results The major complications were severe hypoxemia,anoxic spell and low cardiac output.The mortality was 6.67%.The causes of death were all low cardiac output,which manifested decompensation of right ventricular function.By multivariate regression,Hypothermic CPB(OR=0.56;95%CI 0.35-0.89)was a risk factor for severe hypoxemia.Conclusion Early postoperative complications were mainly due to impaired function of heart and lungs,which based upon postoperative PH.Selective postoperative monitoring for pulmonary arterial pressure and right heart function,and prolonged mechanical ventilation for high risk patients may help to guide treatment and to prevent and cure early complications in these patients.%目的 探讨先天性心脏病(CHD)伴重度肺动脉高压(PH)体外循环(CPB)术后早期并发症及处理.方法 对本科2003年6月至2009年6月行CPB手术的45例CHD伴重度PH患者进行回顾分析,讨论术后早期主要并发症和死亡原因.结果 术后早期主要并发症有严重低氧血症(13.33%)、缺氧发作(11.11%)、低心排(6.67%).住院死亡率6.67%,死亡原因均为低心排,主要为右心室功能失代偿.多因素分析显示,低温CPB(OR=0.56;95%CI 0.35-0.89)是严重低氧血症的一个危险因素.结论 术后早期并发症主要由术后PH为基础的心肺功能不全所导致,对术后高危患者动态监测肺动脉压、右心功能和延长呼吸机支持,有助于防治并发症.

  8. Thrombosis of the superior vena cava and auxiliary branches in patients with indwelling catheterization of the internal jugular vein

    Institute of Scientific and Technical Information of China (English)

    LI Han; WANG Shi-xiang; WANG Wei; XU Chen; SHEN Shen; YU Ling; ZHANG Gui-zhi

    2009-01-01

    Background Central venous thrombosis is a serious and life-threatening complication in hemodialysis (HD) patients with an indwelling catheter. The present study aimed to investigate the prevalence and characteristics of thrombosis of the superior vena cava and auxiliary branches in Chinese HD patients with an indwelling internal jugular venous catheter and to explore its risk factors.Methods Fifty-four patients on maintenance hemodialysis (MHD) with an indwelling catheter were enrolled in this cross-sectional study. The thrombosis of the internal jugular vein, subclavical vein, brachiocephalic vein and superior vena cava was assessed by vascular ultrasound. Collected were data on age, gender, ultrafiltration volume, Kt/V, blood pressure, levels of hemoglobin, serum albumin, lipid, calcium, and phosphorus, and parathyroid hormone.Results The patients were given short- or long-term double lumen central venous catheters. Among them, 42 patients had the catheter placed into the right internal jugular vein, and 12 patients into the left internal jugular vein. Different degrees of central venous thrombosis were found in 33 patients (61.1%). The prevalence of thrombosis in the jugular vein, brachiocephalic vein, subclavical vein and superior vena cava was 61.1% (33/54), 44.4% (24/54), 16.7% (9/54) and 5.6% (3/54), respectively. Among the 33 HD patients with central venous thrombosis, the percentages for one, two, three and four affected veins were 27.3% (9/33), 45.4% (15/33), 18.2% (6/33) and 9.1% (3/33), respectively. Twelve (12/33, 36.4%) of the 33 HD patients with central venous thrombosis had clinical symptoms. Nine patients (27.3%) had edema of the upper extremity and 3 (9.1%) had new-onset symptoms of pulmonary embolism such as cough, chest distress and short breath. The incidences of diabetes mellitus and malignant tumor and levels of lipoprotein a and homocysteic acid were significantly higher in the HD patients with central venous thrombosis than in those without

  9. Pulmonary Thromboendarterectomy for Pulmonary Hypertension Before Considering Transplant

    Science.gov (United States)

    Kooperkamp, Hannah; Mehta, Inder; Fary, David; Bates, Michael

    2017-01-01

    Background: In cases of chronic thromboembolic pulmonary hypertension (CTEPH), referral for possible surgical intervention is important because surgery can be curative. Surgery necessitates cardiopulmonary bypass and deep circulatory arrest with pulmonary thrombectomy and bilateral endarterectomy (PTE). If surgery fails, lung transplant is the next best surgical option. Medical treatment is also an important adjunct. Case Report: A 35-year-old female presented 3 months after a pulmonary embolus was found to be completely occluding her left pulmonary artery. She was found to have pulmonary hypertension with a pulmonary artery pressure of 81/33 mmHg, with a mean pressure of 52 mmHg. The right atrial pressure was also severely elevated at 29 mmHg, and her echocardiogram revealed severe tricuspid regurgitation and severe right ventricular dysfunction. She underwent PTE and postoperatively was followed by the heart failure team. Her 6-minute walk distance improved from 396 meters at 1 month to 670 meters at 7 months, and her pulmonary artery pressure improved significantly to 55/17 mmHg with a mean pressure of 31 mmHg. The patient's right atrial pressure also improved significantly from 29 mmHg to 13 mmHg. Conclusion: CTEPH is likely underrecognized, and patients with pulmonary hypertension or a history of pulmonary embolism should be screened for CTEPH. This case illustrates the surgical treatment for CTEPH and discusses alternative and adjunctive treatments. Residual pulmonary hypertension after PTE occurs in approximately 35% of patients. Overall, 4-year mortality rates after surgery appear to be approximately 15%, and mortality rates correlate with the postoperative pulmonary vascular resistance. Recognition of chronic pulmonary thromboembolic disease as the etiology of pulmonary hypertension warrants evaluation for surgery.

  10. Analysis the Effect of Phentolamine Joint Compound Danshenm Injection in Treatment of Pulmonary Heart Disease Heart Failure%肺心病心力衰竭通过酚妥拉明联合复方丹参注射液治疗的效果分析

    Institute of Scientific and Technical Information of China (English)

    金敏

    2016-01-01

    Objective To investigate pulmonary heart disease by phentolamine Danshen injection therapy.Methods Randomly selected in our hospital from June 2014 to January 2016, 100 cases of pulmonary heart disease were randomly divided into control group and observation group, each group had 50 cases, including the control group using conventional treatment, conventional treatment in the observation group Add phentolamine and Salvia injection treatment.Results In the treatment efifciency, the observation group was 92%, higher than the control gorup 78%,P<0.05, cyanosis subsided, the heart rate slows, swelling subsided and long on hospitalization, the observation group was signiifcantly shorter than the control group,P<0.05. Conclusion The pulmonary heart disease by phentolamine Danshen injection treatment can effectively accelerate the symptoms of sustained speed, improve treatment efifcacy.%目的:探讨肺心病心衰通过酚妥拉明联合复方丹参注射液治疗的效果。方法随机抽取2014年6月~2016年1月我院100例肺心病心衰患者,分为对照组与观察组,各50例,其中对照组运用常规治疗,观察组在常规治疗上添加酚妥拉明与复方丹参注射液治疗,分析两组患者治疗效果差异。结果观察组治疗有效率92%,高于对照组78%,P<0.05;观察组紫绀消退、心率减缓、浮肿消退与住院时长短于对照组,P<0.05。结论肺心病心衰通过酚妥拉明联合复方丹参注射液治疗可以有效加快症状缓释速度,提升治疗疗效。

  11. Alterações da função pulmonar após tratamento cirúrgico de cardiopatias congênitas com hiperfluxo pulmonar Changes in pulmonary function after surgical treatment of congenital heart disease with pulmonary hyperflow

    Directory of Open Access Journals (Sweden)

    Lilian Goraieb

    2008-08-01

    Full Text Available FUNDAMENTO: Análise das condições pulmonares dos pacientes no pós-operatório de cirurgia cardíaca pediátrica. OBJETIVO: Avaliar o comportamento da complacência pulmonar e resistência da via aérea nos pacientes portadores de cardiopatias congênitas com hiperfluxo pulmonar, submetidos a tratamento cirúrgico com auxílio de circulação extracorpórea. MÉTODOS: Avaliaram-se, durante a cirurgia, 35 pacientes com medidas de complacência estática e resistência da via aérea, em quatro instantes distintos. As medidas pulmonares foram feitas de forma não-invasiva, com o método de oclusão da via aérea ao final da inspiração e uso de fórmulas matemáticas específicas. As variáveis observadas e relacionadas às alterações pulmonares foram: no período pré-operatório, idade, peso e relação entre fluxo sangüíneo sistêmico e pulmonar; no intra-operatório, tempos de perfusão, de anóxia e temperatura mínima; no pós-operatório, tempo de ventilação mecânica e de permanência na unidade de terapia intensiva. RESULTADOS: Ao final da cirurgia, a complacência pulmonar mostrou aumento significativo imediato (p BACKGROUND: Analysis of pulmonary status of pediatric patients in the postoperative phase of cardiac surgery. OBJECTIVE: To assess pulmonary compliance and airway resistance in patients with congenital heart disease and pulmonary hyperflow submitted to surgical treatment with the use of extracorporeal circulation. METHODS: Thirty-five patients were evaluated during surgery with measurements of static compliance and airway resistance at four different timepoints. Pulmonary measurements were performed non-invasively using end-inspiratory airway occlusion and specific mathematical formulas. The variables examined and related to pulmonary changes were: preoperative - age, weight, and relationship between systemic and pulmonary blood flow; intraoperative - perfusion times, anoxia times and minimum temperature; postoperative

  12. Hemodynamic effects and safety of pulmonary angiography in Chinese patients with pulmonary hypertension

    Institute of Scientific and Technical Information of China (English)

    ZHANG Hong-liang; SUN Xing-guo; WANG Yong; LIU Zhi-hong; XIONG Chang-ming; NI Xin-hai; HE Jian-guo; LUO Qin; ZHAO Zhi-hui; ZHAO Qing

    2011-01-01

    Background Pulmonary angiography is widely performed in pulmonary hypertension patients,but its immediate effects on right heart hemodynamics and safety are not well known.The objective of this study was to investigate the right heart hemodynamic effects and safety of pulmonary angiography in Chinese patients with pulmonary hypertension.Methods Between January 2008 and June 2009,pulmonary hypertension patients undergoing pulmonary angiography were consecutively enrolled.Pulmonary angiography was performed during breath-holding after deep breathing.The baselineclinical data,hemodynamic measurements before and after pulmonary angiography and complications occurring within 48hours after angiography were recorded.Results Ninety-five patients were included.All received non-ionic contrast medium with a volume of (75.7±29.8) ml.Angiography reduced heart rate in patients with baseline mean pulmonary arterial pressure ≥ 60 mmHg (change of heart rate:(-3.1±7.0) beats/min,P=0.005),increased mean right atrial pressure,diastolic and end-diastolic right ventricular pressure in patients with baseline mean pulmonary arterial pressure <60 mmHg (all P <0.05).Patients with decreased mean pulmonary arterial pressure (change of mean pulmonary arterial pressure ≤ -10 mmHg) had the highest total pulmonary resistance (P=0.009 vs.no change in mean pulmonary arterial pressure (change of mean pulmonary arterial pressure,-10 mmHg to 10 mmHg); P=0.03 vs.increased mean pulmonary arterial pressure (change of mean pulmonary arterial pressure ≥ 10 mmHg)) and the lowest cardiac output (P=0.018 vs.no change in mean pulmonary arterial pressure; P=0.013 vs.increased mean pulmonary arterial pressure).There were 7 complications (7%),with 6 related to catheter and only 1 directly related to angiography.All complications were mild and no death occurred.Conclusion Pulmonary angiography has minimal effect on right heart hemodynamics and is safe in pulmonary hypertension patients.

  13. [Massive inferior vena cava thrombosis in a patient with autosomal dominant polycystic hepatorenal disease].

    Science.gov (United States)

    Peces, R; Gil, F; Costero, O; Pobes, A

    2002-01-01

    We report a 68-year-old man with autosomal dominant polycystic kidney disease, who developed multiple venous thromboses (inferior vena cava, left renal vein and iliofemoral veins) caused by local compression of the intrahepatic inferior vena cava by hepatic cysts. To our knowledge this is the first reported case of inferior vena cava thrombosis caused by hepatic cysts compression. Doppler ultrasound, computed tomography, and magnetic resonance imaging were effective in documenting the venous thromboses and the underlying lesions non-invasively. Long-term anticoagulation was an efficient and safe treatment.

  14. Pulmonary artery haemodynamic properties in patients with pulmonary hypertension secondary to rheumatic mitral stenosis.

    Science.gov (United States)

    Yan, Tao; Zhang, Guan-xin; Li, Bai-lin; Zhong, Keng; Xu, Zhi-yun; Han, Lin

    2012-12-01

    We sought to explore the pulmonary haemodynamic changes in rheumatic mitral stenosis patients with secondary pulmonary hypertension. The pulmonary artery resistance and compliance of 35 patients with rheumatic mitral stenosis and 12 controls without cardiopulmonary vascular disease were evaluated by using an improved method, which is based on making calculations with parameters obtained from right heart catheterisation. The results are as follows: (1) pulmonary artery compliance in patients with secondary pulmonary hypertension was significantly lower than that of the control group (P0.05) The walls of pulmonary artery vessels in patients with pulmonary hypertension secondary to rheumatic mitral stenosis appeared to be remodelled by varying degrees as indicated by their haemodynamic properties. Structural remodelling may be a factor affecting preoperative pulmonary artery pressure. Mitral stenosis patients with severe pulmonary hypertension have significantly lower responses to sodium nitroprusside possibly due to aggradation and deposition of collagen in the artery walls, decreasing constriction and dilation, or atrophy of smooth muscle cells.

  15. Preservation of the recipient inferior vena cava in liver transplantation.

    Science.gov (United States)

    Pereira, F; Herrera, J; Mora, N P; Nuño, J; Turrión, V S; Vicente, E; Ardaiz, J

    1994-01-01

    Twenty piggy-back (PB) liver transplantations (LT) were compared with 20 LT performed by the standard technique in order to evaluate whether or not the theoretical haemodynamic advantages of the preservation of the inferior vena cava (IVC) have any impact on the final results of the LT. Statistically significant differences were observed in the duration of the hepatectomy, which was longer for PB LT (192 min vs. 146 min), and in the duration of the anhepatic phase, which was shorter in that group (52 min vs. 76 min). There were no differences in the duration of the complete surgical procedure, consumption of blood products, incidence of postoperative acute renal failure, number of reoperations or survival.

  16. Infrahepatic inferior vena cava agenesis with bilateral renal vein thrombosis.

    Science.gov (United States)

    Skeik, Nedaa; Wickstrom, Kelly K; Schumacher, Clark W; Sullivan, Timothy M

    2013-10-01

    Congenital anomalies of the inferior vena cava (IVC) are rare and are estimated to be present in 0.07-8.7% of the general population. IVC agenesis (IVCA) is found in approximately 5% of cases of unprovoked lower extremity deep vein thrombosis in patients Renal vein thrombosis (RVT) is an extremely rare and unusual presentation of IVCA. We report a unique case of a 23-year-old previously healthy man presenting with infrahepatic IVCA-induced bilateral RVT with azygos and hemiazygos continuation. To our knowledge, this is the third reported case in the literature of IVCA-induced RVT and the first to affect the bilateral renal veins in the absence of any other thrombogenic risk factors or any lower extremity venous complications. We also present a literature review of IVCA-induced vein thrombosis and highlight the lack of literature to manage this condition.

  17. Unilateral absence of a pulmonary artery: Report of 3 cases

    Energy Technology Data Exchange (ETDEWEB)

    Bae, Oh Keun; Choi, Chul Seung; Choi, Yo Won; Jeon, Seok Cheol; Seo, Heung Suk; Hahm, Chang Kok [College of Medicine, Hanyang University, Seoul (Korea, Republic of)

    1994-07-15

    Unilateral absence of a pulmonary artery is an uncommon anomaly, which presents as an isolated lesion or in combination with other congenital heart disease such as TOF or PDA. We encountered three cases of isolated unilateral absence of a pulmonary artery; one was left pulmonary artery agenesis with right sided aortic arch and the others were right pulmonary artery agenesis with left sided aortic arch. Plain chest radiograph showed considerable loss of unilateral lung volume and lack of ipsilateral hilar shadow. Pulmonary angiogram which was done in two cases, revealed proximal interruption of a pulmonary artery. Chest CT was done in only one case, on which right pulmonary artery was absent and was replaced by adipose tissue. CT with its clean demonstration pulmonary artery without any evidence of acquired obstruction of a pulmonary artery by pulmonary embolism or tumor invasion, maybe a valuable method for evaluation of the unilateral absence of a pulmonary artery.

  18. Treatment options for paediatric pulmonary arterial hypertension

    NARCIS (Netherlands)

    Berger, R M F; Bonnet, D

    2010-01-01

    Pulmonary arterial hypertension (PAH) is a serious, progressive condition, which can present idiopathically or secondary to conditions such as systemic sclerosis or congenital heart disease. The condition exists in both adult and paediatric forms, which possess several similar characteristics. Adult

  19. Histidine-tryptophan-ketoglutarate solution decreases mortality and morbidity in high-risk patients with severe pulmonary arterial hypertension associated with complex congenital heart disease: an 11-year experience from a single institution

    Science.gov (United States)

    Li, X.W.; Lin, Y.Z.; Lin, H.; Huang, J.B.; Tang, X.M.; Long, X.M.; Lu, W.J.; Wen, Z.K.; Liang, J.; Li, D.Y.; Zhao, X.F.

    2016-01-01

    Cardioplegic reperfusion during a long term ischemic period interrupts cardiac surgery and also increases cellular edema due to repeated solution administration. We reviewed the clinical experiences on myocardial protection of a single perfusion with histidine-tryptophan-ketoglutarate (HTK) for high-risk patients with severe pulmonary arterial hypertension associated with complex congenital heart disease. This retrospective study included 101 high-risk patients undergoing arterial switch operation between March 2001 and July 2012. We divided the cohort into two groups: HTK group, myocardial protection was carried out with one single perfusion with HTK solution; and St group, myocardial protection with conventional St. Thomas' crystalloid cardioplegic solution. The duration of cardiopulmonary bypass did not differ between the two groups. The mortality, morbidity, ICU stay, post-operative hospitalization time, and number of transfusions in HTK group were lower than those in St group (P<0.05). Univariate and multivariate analysis showed that HTK is a statistically significant independent predictor of decreased early mortality and morbidity (P<0.05). In conclusion, HTK solution seems to be an effective and safe alternative to St. Thomas' solution for cardioplegic reperfusion in high-risk patients with complex congenital heart disease. PMID:27191607

  20. Pulmonary Fibrosis

    Science.gov (United States)

    Pulmonary fibrosis is a condition in which the tissue deep in your lungs becomes scarred over time. This ... blood may not get enough oxygen. Causes of pulmonary fibrosis include environmental pollutants, some medicines, some connective tissue ...

  1. Pulmonary Rehabilitation

    Science.gov (United States)

    ... shortness of breath and increase your ability to exercise. You may have heard that pulmonary rehabilitation is only for people with COPD (chronic obstructive pulmonary disease). We now know that ...

  2. Fetal MR imaging diagnosis of pulmonary agenesis.

    Science.gov (United States)

    Kuwashima, Shigeko; Kaji, Yasushi

    2010-01-01

    A woman was referred to our institution with an ultrasound (US) suggestive of right-sided heart in fetus at 34 weeks' gestation. Magnetic resonance (MR) imaging revealed right-sided heart, small right hemithorax, and completely absent right main bronchus and right pulmonary artery. From our experience with this case, we point out 5 important MR imaging findings needed for prenatal diagnosis of pulmonary agenesis. Fetal MR imaging also provided information about anomalies of other organs.

  3. Novitates Gabonenses 63. Illigera cava (Hernandia-ceae), a new species from Gabon and Congo (Brazzaville)

    NARCIS (Netherlands)

    Breteler, F.J.; Wieringa, J.J.

    2008-01-01

    Illigera cava, endemic to Lower Guinea, is described, illustrated, and mapped. The new taxon brings the number of African Illigera species to four. Maps, and a key to the four species of Africa are presented.

  4. Deep Venous Thrombosis Associated With Inferior Vena Cava Abnormalities And Hypoplastic Kidney In Siblings

    Directory of Open Access Journals (Sweden)

    Duicu Carmen

    2016-06-01

    Full Text Available Congenital inferior vena cava anomalies have a reduced frequency in general population, many times being an asymptomatic finding. Patients caring such anomalies are at risk to develop deep vein thrombosis. In this paper, we present 2 siblings with deep venous thrombosis and inferior vena cava abnormalities, with a symptomatic onset at similar age. The inferior vena cava abnormality was documented by an angio-CT in each case. The thrombophilic workup was negative. Patients were treated with conservative therapy: low molecular weight heparin anticoagulants converted later to oral anticoagulant with resolution of symptoms and disappearance of the thrombus. Finally, in the absence of any risk factor in a young patient admitted with deep vein thrombosis investigations to exclude inferior vena cava anomalies are mandatory.

  5. Challenges in pulmonary hypertension: managing the unexpected

    OpenAIRE

    Olsson, Karen M; Massimiliano Palazzini

    2015-01-01

    The diverse challenges associated with diagnosis and management of patients with pulmonary hypertension are illustrated in this case-based review. Case 1 describes a patient diagnosed with pulmonary arterial hypertension (PAH) with right heart failure and active systemic lupus erythematosus who was effectively treated with an up-front triple combination of PAH therapies and immunosuppressive therapy. In case 2, a diagnosis of pulmonary veno-occlusive disease was reached after a combined appro...

  6. Anesthetic Management of Pediatric Pulmonary Arterial Hypertension

    Directory of Open Access Journals (Sweden)

    Mediha Turktan

    2015-06-01

    Full Text Available Pulmonary arterial hypertension is the most important cause of morbidity and mortality associated with congenital heart disease. Patients in this group have a greater peroperative cardiovascular risks including cardiac arrest, pulmonary hypertensive crisis and death compared the normal population. The main purpose of anesthesia is to avoid increased pulmonary vascular resistance and myocardial depression. [Archives Medical Review Journal 2015; 24(2.000: 149-158

  7. Sickle Cell Disease and Pulmonary Hypertension

    Science.gov (United States)

    Sickle Cell Disease Pulmonary & PH Hypertension Did you know that if you have Sickle Cell Disease you are at risk for Pulmonary Hypertension? ... for example), chronic liver disease, congenital heart disease, sickle cell disease and HIV infection. Finally, PAH can be ...

  8. Inferior vena cava aneurysm in an infant presenting with a renal mass.

    Science.gov (United States)

    Unzueta-Roch, José L; García-Abós, Miriam; Sirvent-Cerdá, Sara; de Prada, Inmaculada; Martínez de Azagra, Amelia; Ollero, Jose M; Madero-López, Luis

    2014-10-01

    Aneurysm of the inferior vena cava is a rare finding in the pediatric population. We report the case of a 5-month-old infant presenting with anemia, hypertension, and dehydration in the emergency room. A renal mass was found with ultrasound and MRI and a renal tumor was first considered. Histopathologic review of the surgical specimen led to the diagnosis of aneurysmal dilatation of the vena cava.

  9. Bilateral agenesis of the superior vena cava associated with congenital hydrothorax.

    Science.gov (United States)

    Römer, S; Opgen-Rhein, B; Chaoui, R; Scheer, I; Czernik, C; Obladen, M

    2006-11-01

    Agenesis of the superior vena cava is a rare anomaly that is generally asymptomatic in the neonate. We report a male neonate with bilateral (total) agenesis of the superior vena cava with obstructed thoracic duct and subsequent congenital hydrothorax, anomalies that were detected by prenatal ultrasound at 25 weeks' gestation. The cardiac anomaly was confirmed by postnatal magnetic resonance angiography. The chylothorax disappeared with conservative therapy.

  10. Dynamic changes of plasma levels of BNP and CRP in patients with congestive heart failure and patients with pulmonary heart disease%血浆BNP及CRP水平在充血性心衰与肺心病患者的动态变化

    Institute of Scientific and Technical Information of China (English)

    韦彩雯; 李宏松; 章敬玉; 姚能才; 窦存芳; 石来新; 卢英民

    2012-01-01

    Objective: To investigate changes of plasma levels of brain natriuretic peptide (BNP) and C reactive protein (CRP) in patients with congestive heart failure (CHF) and patients with pulmonary heart disease (PHD) at onset of acute dyspnea and a week after remission and analyze their clinical significance. Methods: A total of 55 CHF patients (CHF group) and 47 PHD patients (PHD group) were selected. The plasma levels of BNP and CRP were measured respectively in both groups at onset of acute dyspnea and one week after remission. Results: Compared with onset of dyspnea, there were significant decrease in plasma levels of BNP [ (1885 ± 745) ng/L vs. (207 ± 124) ng/L] and CRP [ (36 ± 11) mg/L vs. (8 ± 6) mg/L] in CHF group at one week after remission, P<0. 05 both; there were also significant decrease in plasma levels of BNP [ (584 ± 178) ng/L vs. (162 ± 59) ng/L] and CRP [ (68 ±24) mg/L vs. (15±7) mg/L] in PHD group at one week after remission, P<0. 05 both; At onset of dyspnea, plasma BNP level in CHF group was significantly higher than that of PHD group (P<0. 05) and plasma CRP level in CHF group was significantly lower than that of PHD group (P<0. 05). There were no significant differences in a-bove indexes between two groups at one week after remission. Conclusion: Levels of brain natriuretic peptide and C reactive protein are related with severity of congestive heart failure and pulmonary heart disease. Measurements of their levels at onset of acute dyspnea can help to identify congestive heart failure or pulmonary heart disease.%目的:探讨血浆脑钠肽(BNP)及C反应蛋白(CRP)水平在充血性心力衰竭(CHF)及肺源性心脏病(PHD)患者急性呼吸困难发作时及缓解后1周的变化并分析其临床意义.方法:入选CHF患者55例(CHF组),PHD患者47例(PHD组),分别测定各组患者急性呼吸困难发作时及缓解后1周血浆BNP及CRP水平.结果:与呼吸困难发作时比较,病情缓解后1周CHF患者血浆BNP[(1885±745) ng

  11. Interrupted inferior vena cava with hemiazygos continuation in an adult with a persistent left superior vena cava and left single coronary artery: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yeo Jin; Kwon, Se Hwan; Ahn, Sung Eun; Kim, Soo Joong; Oh, Joo Hyeong [College of Medicine, Kyung Hee University, Seoul (Korea, Republic of); Shin, Jong Soo [Dept. of Radiology, Kyung Hee University Hospital at Gangdong, Seoul (Korea, Republic of)

    2016-06-15

    A 50-year-old woman was referred to our institution for medical screening due to an incidental finding on abdominal ultrasonography. She underwent chest, abdomen and cardiac multi-detector computed tomography (MDCT). Her MDCT revealed absence of the hepatic segment of the inferior vena cava (IVC), with hemiazygos continuation and a left single coronary artery. The dilated hemiazygos vein drained directly into the persistent left superior vena cava (SVC). Herein, we reported a very rare case combining an incidentally found interrupted IVC with hemiazygos vein continuation, persistent left SVC and a left single coronary artery diagnosed by MDCT.

  12. Pulmonary vasculitis.

    Science.gov (United States)

    Lally, Lindsay; Spiera, Robert F

    2015-05-01

    Pulmonary vasculitis encompasses inflammation in the pulmonary vasculature with involved vessels varying in caliber from large elastic arteries to capillaries. Small pulmonary capillaries are the vessels most commonly involved in vasculitis affecting the lung. The antineutrophil cytoplasmic antibody-associated vasculitides, which include granulomatosis with polyangiitis (formerly Wegener granulomatosis), microscopic polyangiitis, and eosinophilic granulomatosis with polyangiitis (formerly Churg-Strauss syndrome), are the small vessel vasculitides in which pulmonary vasculitis is most frequently observed and are the major focus of this review. Vasculitic involvement of the large pulmonary vessels as may occur in Behçet syndrome and Takayasu arteritis is also discussed.

  13. Pressão pulmonar aferida pela ecocardiografia em pacientes chagásicos indicados para transplante cardíaco Pulmonary pressure by echocardiophy in chagasic patients on heart transplant waiting list

    Directory of Open Access Journals (Sweden)

    Cláudio Léo Gelape

    2011-03-01

    Full Text Available INTRODUÇÃO: O paciente com insuficiência cardíaca desenvolve aumento da pressão pulmonar por mecanismo retrógrado e a hipertensão arterial pulmonar (HP é um marcador de mau prognóstico. OBJETIVO: Correlacionar pressão pulmonar ao ecogardiograma (eco e ao cateterismo, em pacientes em lista de espera para transplante cardíaco (TC, especialmente nos chagásicos. MÉTODOS: Avaliamos 90 pacientes no HC-UFMG entre 2004 e 2009. Todos realizaram cateterismo e eco no pré-transplante. A idade média foi de 45,5 anos, sendo 68(75,6% homens, 42(46,7% chagásicos, 32(35,6% portadores de miocardiopatia dilatada e 10(11,1% isquêmicos. RESULTADOS: A eco-PSAP (pressão sistólica arterial pulmonar média foi de 45 ± 12mmHg. A cat-PSAP média foi de 47 ± 14mmHg. A eco-PSAP-chagásicos foi 41,7 ±12,5 mmHg e não-chagásicos, 47,6 ±12,8 mmHg P=0,04. A cat-PSAP-chagásicos foi de 46 ±12,1 mmHg e não-chagásicos 48,7±12,8mmHg; P=0,43. Oito pacientes apresentavam cat-PSAP>60. A correlação entre a eco-PSAP e o cat-PSAP nos chagásicos foi r=0,45, P=0,008 e nos não-chagásicos de r=0,66, P32,5mmHg tem uma sensibilidade de 79% e especificidade de 75% para diagnosticar HP, com área sob a curva ROC de 0,819. A eco-PSAP-não chagásico>35,5 mmHg tem sensibilidade de 82% e especificidade de 70% para HP, com área sob a curva ROC de 0,776. CONCLUSÕES: Há boa correlação entre a eco-PSAP e a cat-PSAP (r=0,54 entre os pacientes em fila de espera. A eco-PSAP foi menor no grupo dos chagásicos. O ecocardiograma é um método útil para diagnosticar e monitorar a pressão pulmonar previamente ao TC, especialmente em pacientes chagásicos. Entretanto, não é possível prescindirmos do cateterismo para avaliar a reatividade pulmonar com o teste com vasodilatador e indicar com segurança o TC mesmo nos pacientes chagásicos.INTRODUCTION: The patients suffering heart failure develop an increase in pulmonary pressure because of a retrograde mechanism. The

  14. Lungs in Heart Failure

    Directory of Open Access Journals (Sweden)

    Anna Apostolo

    2012-01-01

    Full Text Available Lung function abnormalities both at rest and during exercise are frequently observed in patients with chronic heart failure, also in the absence of respiratory disease. Alterations of respiratory mechanics and of gas exchange capacity are strictly related to heart failure. Severe heart failure patients often show a restrictive respiratory pattern, secondary to heart enlargement and increased lung fluids, and impairment of alveolar-capillary gas diffusion, mainly due to an increased resistance to molecular diffusion across the alveolar capillary membrane. Reduced gas diffusion contributes to exercise intolerance and to a worse prognosis. Cardiopulmonary exercise test is considered the “gold standard” when studying the cardiovascular, pulmonary, and metabolic adaptations to exercise in cardiac patients. During exercise, hyperventilation and consequent reduction of ventilation efficiency are often observed in heart failure patients, resulting in an increased slope of ventilation/carbon dioxide (VE/VCO2 relationship. Ventilatory efficiency is as strong prognostic and an important stratification marker. This paper describes the pulmonary abnormalities at rest and during exercise in the patients with heart failure, highlighting the principal diagnostic tools for evaluation of lungs function, the possible pharmacological interventions, and the parameters that could be useful in prognostic assessment of heart failure patients.

  15. Stenting of the Superior Vena Cava and Left Brachiocephalic Vein with Preserving the Central Venous Catheter in Situ

    Energy Technology Data Exchange (ETDEWEB)

    Isfort, Peter; Penzkofer, Tobias; Goerg, Fabian; Mahnken, Andreas H. [University Hospital RWTH Aachen, Aachen(Korea, Republic of)

    2011-10-15

    Stenting of the central veins is well established for treating localized venous stenosis. The techniques regarding catheter preservation for central venous catheters in the superior vena cava have been described. We describe here a method for stent implantation in the superior vena cava and the left brachiocephalic vein, and principally via a single jugular venous puncture, while saving a left sided jugular central venous catheter in a patient suffering from central venous stenosis of the superior vena cava and the left brachiocephalic vein.

  16. Nursing considerations in the care of patients with pulmonary hypertension.

    Science.gov (United States)

    Nieves, Jo Ann; Kohr, Lisa

    2010-03-01

    Pulmonary hypertension is a potentially lethal condition that may be encountered during the entire life span of patients with many forms of congenital or acquired heart disease, pulmonary disorders, and other diseases. Each pulmonary hypertensive patient requires anticipatory interventions geared to prevent severe exacerbations of the pulmonary hypertensive condition, promote pulmonary vasodilation, and optimize ventricular function. Patients with pulmonary hypertension are at higher risk for developing pulmonary hypertensive episodes in the immediate postoperative period after cardiac surgery, as well as during nonsurgical admissions. Nurses are in a critical position to provide anticipatory care to prevent the development of pulmonary hypertensive events. Nurses can be instrumental in optimizing outcomes for patients with pulmonary hypertension by providing immediate care upon the development of a pulmonary hypertension event and by monitoring ongoing responses to adjustments in therapeutic interventions.

  17. 基于现代文献的慢性肺源性心脏病中医证候研究%Study on TCM Syndrome Types of Chronic Pulmonary Heart Disease Based on Modern Literatures

    Institute of Scientific and Technical Information of China (English)

    王彬; 刘惠梅; 吴蔚; 高峰

    2011-01-01

    Objective To study the TCM syndrome characteristics of chronic pulmonary heart disease and to summarize its basic law. Methods Literatures on chronic pulmonary heart disease since 1989 to 2009 were searched. The TCM syndromes involved were organized and a database was established. Then the names of those syndromes were standardized. The data of syndrome frequency before and after standardization were analyzed by statistical software. Results Totel of 120 articles were involved, including 225 kinds of TCM syndromes. The syndromes whose frequency> 1% had a proportion of 7.6% (17/225). While after the standardization, the syndromes reduced to 122 kinds. The syndromes whose frequency >1% had a proportion of 18.9% (23/122). After the standardization, there were 73 kinds during acute exacerbation period and 77 kinds for unstaged ones, and the syndromes whose frequency>l% had a proportion of 43.8% (32/73), 35.1% (27/77). The syndrome types on remission stage were relatively less. Conclusion There are various kinds of TCM syndrome types on chronic pulmonary heart disease, the use of terms is lack of standardization, the study on remission stage is not enough. So the distribution of TCM syndrome types found now can not fully reflect the syndrome law on the disease.%目的 研究慢性肺源性心脏病中医证候分布特点,总结其基本规律.方法 检索1989 - 2009年与中医证候相关的慢性肺源性心脏病文献,对中医证候分类进行整理,建立数据库,对所涉及的中医证候名称进行规范,对规范前后的中医证候进行频次统计分析.结果 纳入文献120篇,涉及中医证候类型225种,出现频率>1%的证候类型占7.6%(17/225);进行证候规范后,证候类型减至1 22种,出现频率>1%的证候类型占18.9%(23/122).规范后,急性加重期证候类型73种,不分期证候类型77种,出现频率>1%的证候类型分别占43.8% (32/73)、35.1%(27/77);缓解期证候类型相对较少.结论 目前

  18. The evaluation by pulmonary wedge angiography of children with pulmonary artery hypertension ;associated with congenital heart disease%肺小动脉楔入造影对先天性心脏病患儿肺动脉高压的评估价值

    Institute of Scientific and Technical Information of China (English)

    肖书娜; 尚小珂; 张刚成; 宋艳清; 张长东; 卢蓉; 王利军; 颜梦欢

    2016-01-01

    Objective To study pulmonary wedge angiography ( PWA ) with hemodynamic the evaluation of children with congenital heart disease and pulmonary artery hypertension ( PAH) . Methods Hemodynamic measurement and pulmonary wedge angiography were performed in 50 children with congenital heart disease. Comparison and analysis were made from the data obtained from PWA and catheterization. Results After PWA, the patients were categorized into 3 groups according to the measured hemodynamics parameters:group A [ n=15, patients with normal mean pulmonary artery pressure ( mPAP≤25 mmHg) and normal pulmonary vessel resistance (PVR﹤300 dyne•s•cm5)], group B [n=24, patients with PAH (mPAP﹥25 mmHg) but normal PVR] and group C (n=11, patients with PAH and elevated PVR (PVR≥300 dyne•s•cm5). Rote of tapering (ROT) was significant lower in group C than in group A and B (F=42. 559,P﹤0. 05). Pulmonary circulation time (PCT) was higher in group C than in group A and B (F=6. 037,P﹤0. 05). ROT correlated negatively with PVR (r = -0. 606, P ﹤0. 05). PCT index correlated positively with PVR (r=0. 783,P=0. 01). There was no significant correlation between PCT and mean pulmonary artery hypertension (mPAP). Conclusions PWA may help to make quantitative analysis of the pulmonary vascular status in patients with congenital heart disease.%目的:通过对肺小动脉行肺小动脉楔入造影( PWA ),分析 PWA 对先天性心脏病( CHD)相关肺动脉高压( PAH)的评估价值。方法对50例CHD患儿进行心导管及PWA检查,根据肺动脉压力分为肺动脉压力、阻力正常组[ A 组,15例,肺平均动脉压( mPAP )≤25 mmHg (1 mmHg=0.133 kPa)、全肺阻力(PVR)﹤300 dyne•s•cm5],肺动脉压力升高、阻力正常组(B组,24例,mPAP﹥25 mmHg、PVR﹤300 dyne•s•cm5),肺动脉压力、阻力均升高组(C组,11例,mPAP﹥25 mmHg、PVR≥300 dyne•s•cm5)。观察肺小动脉逐渐变细速率( ROT)、肺循环时间( PCT

  19. 小儿先天性心脏病合并肺动脉高压的麻醉管理%Anesthesia management of children with congenital heart disease and pulmonary hypertension

    Institute of Scientific and Technical Information of China (English)

    苗玉良; 郭文治; 安丽娜; 钟京

    2012-01-01

    目的 探讨小儿先天性心脏病合并肺动脉高压的麻醉处理.方法 先天性心脏病合并肺动脉高压的小儿63例,年龄3月~3岁,ASAⅢ~Ⅳ级.大剂量芬太尼静脉复合七氟烷吸入全身麻醉,浅低温体外循环下行房室间隔缺损修补术和(或)动脉导管未闭结扎术.体外循环中至手术结束维持PEEP 2~5 mmHg,以减少肺水.维持PCO2在30~35 mmHg,CVP在7~15 mmHg.开放主动脉前10 rmin开始静脉泵人多巴胺5~10 μg/(kg· min)、硝普钠0.5~2.0 μg/(kg· min)和米力农0.5~1.0 μg/( kg·min).其中,在术前肺动脉压>45mmHg的患儿中,多巴胺的给药途径为经左房导管泵入.结果 所有患儿术中血流动力学均稳定,开放升主动脉后,58例心脏自动复跳,4例心内1~2 J除颤1次,1例除颤2次后复跳.所有患儿均顺利停体外循环辅助.术前彩超提示有8例右向左或双向分流的患儿在术后2d脱离呼吸机拔除气管导管,其余患儿均在术后1d拔除气管导管.所有患儿均痊愈出院,无严重并发症.结论 先天性心脏病合并肺动脉高压的患儿,首先应保证合理的容量负荷,体外循环转机前保持一定的体循环压力以减少右向左分流,体外循环后通过血管活性药物的合理使用,降低肺动脉压并维持体循环阻力,以使血流动力学平稳.%Objective To discuss the anaesthesia methods of children combined with congenital heart disease and pulmonary hypertension. Methods 63 children with congenital heart disease and pulmonary hypertension received operation and anaesthesia, which aged from three months to three years and ASA classified as M - IV degree. The children accepted open heart operation of at-rial and ventricuiar sepatl defect and/or patent ductus arteriosus under general anaesthesia of combined intravenous and inhalation and mild hypothermic cardiopulmonary bypass. CVP was maintained between 7 - 15mmHg. In order to minimize the extravasculur lung water and

  20. Operação de Blalock-Taussig modificada para o tratamento paliativo de cardiopatias congênitas com hipofluxo pulmonar Blalock-Taussig operation for palliative treatment of congenital heart disease with low pulmonary flow

    Directory of Open Access Journals (Sweden)

    Miguel A Maluf

    1995-09-01

    úrgica. A operação de Blalock-Taussig modificada demonstrou ser um método confiável e seguro no tratamento paliativo das cardiopatias com hipofluxo pulmonarFrom January 1990 to November 1994, 72 patients with congenital heart defects and low pulmonary flow underwent modified Blalock-Taussig produce. There were 44 (61.1% males and 28 (38.8% females with ages ranging from 2 days to 11 years (average 9 months. Thirty eight (52,8% patients had Tetralogy of Fallot; 7 (9,7% had pulmonary atresia with intact ventricular septum (PA/IVS; 6 (8.4%, had transposition of the great arteries (TGA with pulmonary stenosis (PS; 6 (8,4% had tricuspid atresia (TA with PS; 6 (8.4% had double inlet of right ventricle (RV or left ventricle (LV and PS; 3 (4.2% had corrected transposition of the great arteries (CTGA with ventricular septal defects (VSD and PS; 2 (2.7% had double outlet of RV or LV and PS; 2 (2.7% had atrio-ventricular canal defects (A-VC and PS; 2 (2.7% patients had right or left Isomerism and PS. The decision to surgical indication was based on: a new borns with "ductus dependent" heart defects; b lactents with important cianosis or hypoxia; c infants with heart defects without possibilities of biventricular correction. The surgical technique employed was the Blalock-Taussig operation using 4 or 5 mm Polytetrafluoroethy (PTFE prosthesis in 69 (94.5% cases, umbilical vein in 3 (4.1% cases and bovine thoracic artery in 1 (1.4% case. Before the arteries were clamped 1 mg/kg of héparine was given without mobilization, with protamine, after the procedure. During the post-operative period, anticoagulants were not given. The prosthesis obstruction was the main cause of death and was related to artery anatomy: subclavian and pulmonary artery diameter and/or problems with the technique. The modified Blalock-Taussig operation showed itself to be a reliable palliative treatment to heart defects with low pulmonary flow

  1. Body mass, fat-free body mass, and prognosis in patients with chronic obstructive pulmonary disease from a random population sample: findings from the Copenhagen City Heart Study

    DEFF Research Database (Denmark)

    Vestbo, Jørgen; Prescott, Eva; Almdal, Thomas Peter

    2006-01-01

    Rationale: Low body mass index (BMI) is a marker of poor prognosis in chronic obstructive pulmonary disease (COPD). In the general population the harmful effect of low BMI is due to the deleterious effects of a low fat free mass index (FFMI, fat free mass/weight(2)). Objectives: We explored...... distribution of low FFMI and its association with prognosis in a population based cohort of COPD patients. Methods: We used data on 1,898 COPD patients identified in a population-based epidemiological study in Copenhagen. Fat free mass was measured using bioelectrical impedance analysis. Patients were followed...... the lowest FFMI 10(th) percentile of the general population. BMI and FFMI were significant predictors of mortality, independent of relevant covariates. Being in the lowest FFMI 10(th) percentile of the general population was associated with a hazard ratio of 1.5 (95% confidence interval 1.2-1.8) for overall...

  2. Evaluation of the safety of right heart catheterization in patients with pulmonary hypertension%肺高压患者行右心导管检查及急性肺血管扩张试验的安全性

    Institute of Scientific and Technical Information of China (English)

    刘永太; 田庄; 郭潇潇; 李梦涛; 曾小峰; 朱文玲; 方全

    2012-01-01

    Objective To evaluate the safety of right heart catheterization ( RHC) and acute vasodilator test in patients with pulmonary hypertension. Methods A prospective research of the patients diagnosed as pulmonary hypertension by RHC between January 2007 and September 2010 was performed, Acute vasodilator test was done if necessary. The complications of RHC and side effects of acute vasodilator test were recorded. Results There were 152 patients enrolled with a median age of (41. 7 ?13. 2) years. The median time of RHC was 21 minutes. Incidence of complications or side effects of acute vasodilator test was 12% (18/152). There were no pneumothoraxes, pulmonary hemorrhage, or deaths related to the procedure. Complications occurred in 8 patients (5% ) including carotid artery mistake puncture ( n = 1) , hematoma (n =2) , arrhythmia (n =4) and vasovagal reaction (n = 1 ) which disappeared spontaneously without hemodynamic changes. Side effects occurred in 10 patients (7%) during acute vasodilator test, which included tachycardia (n =5) , severe hypotension (n =3) and acute pulmonary edema (n =2). After discontinuation of vasodilator and usage of vasoactive agent, the side effects disappeared. Conclusions When performed by experienced operators, RIIC in patients wilh pulmonary hypertension is safe with low morbidity and mortality rates.%目的 探讨肺高压患者行右心导管检查和急性肺血管扩张试验的安全性.方法 前瞻性入选2007年1月至2010年9月间经右心导管检查证实为肺高压的患者,并根据临床情况进行急性肺血管扩张试验.记录操作并发症和急性肺血管扩张试验的不良反应.结果 152例患者入选,其中女性122例,男性30例,平均年龄(41.7±13 2)岁.右心导管操作的平均时间为21 min.102例患者进行了急性肺血管扩张试验.共18例(12%)患者出现了并发症或不良反应,8例(5%)并发症包括穿刺至颈动脉(1例)、局部血肿(2例)、快速性心律失常(4

  3. Pulmonary agenesis: two cases reported

    Directory of Open Access Journals (Sweden)

    Denis Yaraví Solano-Vázquez

    2014-11-01

    Full Text Available Background: Pulmonary agenesis is a rare anomaly (1 in 15 000 live births which consists in a total absence or severe hypoplasia of one or both lungs. The clinical spectrum of the unilateral agenesis could vary from early and severe respiratory distress, recurrent pneumonia to being an incidental finding. The prognosis is based on the presence of associated congenital abnormalities. Material and methods: We present two cases of unilateral pulmonary agenesis in patients at Tlaxcala’s Children Hospital during 2012. Results: Report details the case of a one-month old boy with left pulmonary agenesis and interatrial communication and mild pulmonary arterial hypertension. He had two resolved pneumonia incidents. The other case was a one-month old girl with right pulmonary agenesis, associated to multiple heart malformations who evolved to respiratory failure, heart failure and death.Conclusions: Pulmonary agenesis is a rare anomaly. Its outcome and prognosis varies with the hemodynamics related to its location and associated malformations.

  4. Treatment of pediatric pulmonary hypertension

    Directory of Open Access Journals (Sweden)

    Amy Hawkins

    2009-06-01

    Full Text Available Amy Hawkins, Robert TullohDepartment of Congenital Heart Disease, Bristol Royal Hospital for Children, Bristol UKAbstract: Pulmonary hypertension was once thought to be a rare condition and only managed in specialized centers. Now however, with the advent of echocardiography, it is found in many clinical scenarios, in the neonate with chronic lung disease, in the acute setting in the intensive care unit, in connective tissue disease and in cardiology pre- and postoperatively. We have a better understanding of the pathological process and have a range of medication which is starting to be able to palliate this previously fatal condition. This review describes the areas that are known in this condition and those that are less familiar. The basic physiology behind pulmonary hypertension and pulmonary vascular disease is explained. The histopathologic process and the various diagnostic tools are described and are followed by the current and future therapy at our disposal.Keywords: pulmonary hypertension, congenital heart disease, pulmonary vascular resistance, pulmonary vasodilators

  5. Migration of central lines from the superior vena cava to the azygous vein

    Energy Technology Data Exchange (ETDEWEB)

    Haygood, T.M., E-mail: tamara.haygood@mdanderson.org [University of Texas, MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1475, Houston, TX 77030 (United States); Malhotra, K., E-mail: kmalhotra@mdanderson.org [University of Texas, MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1475, Houston, TX 77030 (United States); Ng, C., E-mail: cng@mdanderson.org [University of Texas, MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1475, Houston, TX 77030 (United States); Chasen, B., E-mail: beth.chasen@mdanderson.org [University of Texas, MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1475, Houston, TX 77030 (United States); McEnery, K.W., E-mail: kmcenery@mdanderson.org [University of Texas, MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1475, Houston, TX 77030 (United States); Chasen, M., E-mail: mchasen@mdanderson.org [University of Texas, MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1475, Houston, TX 77030 (United States)

    2012-01-15

    Aim: To report 11 cases of central venous access catheters migrating from the superior vena cava to the azygos vein in order to raise radiologists' awareness of this possibility. Materials and methods: This is a retrospective review of the clinical history and imaging of 11 patients whose central line migrated from the superior vena cava to the azygos vein. The time course of migration, access route of the catheters, outcome, and depth of placement in the superior vena cava were evaluated. Results: All of these catheters were placed from the left; six through the subclavian vein, four as PICC lines, and one from the left internal jugular vein. Seven of the catheters were originally positioned in the superior vena cava. Four of the catheters were originally positioned in the azygos vein and were repositioned into the superior vena cava at the time of placement. The time to migration ranged from 2 to 126 days, average 43 days. In three cases, the migration was not reported at the first opportunity, resulting in a delay in diagnosis ranging from 10 to 27 days. All but one of the catheters extended at least 3.5 cm (range 1.8-7 cm) below the top of the right mainstem bronchus when in the superior vena cava. Conclusion: Risk factors for migration into the azygos vein include placement from a left-sided approach and original positioning in the azygos vein with correction at placement. The depth of placement in the superior vena cava was not a protective factor. It is important to recognize migration because of the elevated risk of complications when central lines are placed in the azygos vein.

  6. Gallbladder cancer with tumor thrombus in the superior vena cava

    Institute of Scientific and Technical Information of China (English)

    Sandeep Batra; Dinesh Chandra Doval; Ullas Batra; Pandalanghat Suresh; Amit Dhiman; Vineet Talwar

    2010-01-01

    BACKGROUND: Gastrointestinal cancers, especially pancreato-biliary cancers, are frequently associated with or are complicated by thromboembolic phenomena due to hypercoagulability and/or altered venous drainage, especially of the abdomen and lower limbs. This report describes an unusual and interesting case of gallbladder carcinoma developing a viable tumor thrombus in the superior vena cava (SVC) with resultant SVC obstruction, while on geiftinib-based anti-epidermal growth factor receptor (EGFR) therapy. METHODS: A 60-year-old woman was incidentally diagnosed to have gallbladder cancer on cholecystectomy. She had disease recurrence and received systemic chemotherapy followed by geiftinib-based anti-EGFR therapy. Subsequently, while on geiftinib-based therapy, she presented with clinical signs and symptoms suggestive of SVC thrombosis. RESULTS: A whole body PET scan revealed a metabolically active tumor thrombus in the SVC, besides other sites of metabolically active disease inclusive of the lung parenchyma, lymph nodes and abdomen. She was treated with anti-thrombotics and external beam radiotherapy directed to the SVC thrombus leading to symptomatic relief. She continues to survive on the day of writing this report. CONCLUSIONS: This rare complication, though theoretically possible, is unreported because of the short overall survival of advanced gallbladder cancer patients. This highlights that with the availability of better chemotherapeutic/biotherapeutic agents for increasing in the lifespan of cancer patients, we may come across such cases more frequently in the future.

  7. Heart Health - Brave Heart

    Science.gov (United States)

    ... Robert's (left) three heart attacks, he and his wife Sue began volunteering for The Mended Hearts, a ... arrest. "It scared the heck out of my wife," Robert remembers. He was operated on and doctors ...

  8. 下腔静脉过滤器对骨水泥植入综合征的预防作用研究%Prevention of bone cement implantation syndrome by inferior vena cava filter

    Institute of Scientific and Technical Information of China (English)

    师晓琴; 汪晨; 郭万刚; 彭娜; 郭征; 韩保君; 赵雄; 罗中华; 于茗; 刘利荀

    2009-01-01

    目的 研究下腔静脉过滤器(rvcr)对骨水泥植入综合征(BCIS)的预防作用. 方法雄性绵羊10只,体质量25~30 kg,随机分为A组(不植入IVCF)和B组(植入IVCF)(n=5).麻醉后B组绵羊先在1250 mA透视机透视下,由颈内静脉经右心房在.肾下极5 cm处下腔静脉内植入IVCF.后将两组绵羊离断股骨颈扩髓腔,植入10 mL骨水泥,并逐渐增加髓腔内压,同期观测血压、心率、中心静脉压(CVP)和血气变化,心前区超声心动图动态实时显示心腔内情况改变.术毕分离肺脏,油红染色观察肺组织病理变化.结果 A组绵羊植入骨水泥后,当将股骨髓腔压力增加至120mm Hg时,右心房、右心室内即出现了点状不均匀回声,且随髓腔压力继续增加,点状回声变成大量雪花状叫声影,并伴血压、PaO2明显下降,25 min后收缩压下降至(80±11)mm Hg(P<0.01),Pa02降至最低(P<0.05),而心率、CVP进行性升高,血气分析示呼吸性酸中毒合并代谢性酸中毒,病理提示肺动脉血管内广泛散布大量脂肪栓子,血管腔阻塞;而B组绵羊在植入骨水泥后,在股骨髓腔内压升至400 mm№时尚未观察到右心腔出现脂肪栓子回声影,且血压、PaO2、心率、CVP较植入前未见明显降低或升高(P>0.05),血气分析结果示通气正常,肺组织脂肪油红染色阴性. 结论 IVCF可有效预防骨水泥植入而引起的BCIS的发生.%Objective To observe the effect of inferior vena cava filter (IVCF) on prevention of bone cement implantation syndrome (BCIS). Methods Ten sheep were divided into 2 even groups, BCIS and LVCF intervention ones. First IVCF was implanted into the inferior vena cava through cervical vena-right atrium pathway under fluoroscopic monitoring to observe the influence of IVCF on BCIS. Then BCIS was es-tablished in the same sheep by compressing 10 mL of bone cement into a sheep medullary canal after mutilation of the left femur. Arterial blood pressure, heart rate, central

  9. Brain natriuretic peptide measurement in pulmonary medicine.

    Science.gov (United States)

    Salerno, Daniel; Marik, Paul E

    2011-12-01

    Serum levels of natriuretic peptides are well established as important biomarkers in patients with cardiac disease. Less attention has been placed on the role of natriuretic peptides in patients with pulmonary conditions. In several well-defined groups of patients with pulmonary disease natriuretic peptides provide the clinician with clinically valuable information. A limitation of the interpretation of natriuretic peptides in pulmonary disease is the confounding effect of concurrent conditions such as heart failure, hypoxia, sepsis and renal failure. The present paper reviews the role of natriuretic peptides for diagnosis, risk stratification and prognosis of several pulmonary disorders.

  10. Pulmonary arterial hypertension: Basic knowledge for clinicians.

    Science.gov (United States)

    Santos-Ribeiro, Diana; Mendes-Ferreira, Pedro; Maia-Rocha, Carolina; Adão, Rui; Leite-Moreira, Adelino F; Brás-Silva, Carmen

    2016-10-01

    Pulmonary arterial hypertension is a progressive syndrome based on diverse aetiologies, which is characterized by a persistent increase in pulmonary vascular resistance and overload of the right ventricle, leading to heart failure and death. Currently, none of the available treatments is able to cure pulmonary arterial hypertension; additional research is therefore needed to unravel the associated pathophysiological mechanisms. This review summarizes current knowledge related to this disorder, and the several experimental animal models that can mimic pulmonary arterial hypertension and are available for translational research.

  11. Functional pulmonary atresia in newborn with normal intracardiac anatomy: Successful treatment with inhaled nitric oxide and pulmonary vasodilators

    Directory of Open Access Journals (Sweden)

    Gürkan Altun

    2013-01-01

    Full Text Available Functional pulmonary atresia is characterized by a structurally normal pulmonary valve that does not open during right ventricular ejection. It is usually associated with Ebstein′s anomaly, Uhl′s anomaly, neonatal Marfan syndrome and tricuspid valve dysplasia. However, functional pulmonary atresia is rarely reported in newborn with anatomically normal heart. We report a newborn with functional pulmonary atresia who had normal intracardiac anatomy, who responded to treatment with nitric oxide and other vasodilator therapy successfully.

  12. [Unilateral pulmonary artery agenesis with ipsilateral pulmonary hypoplasia as incidental finding in an asthmatic patient].

    Science.gov (United States)

    Contreras-Arias, Catalina; Duarte, Diana; Ramírez, Luis F; Serrano, Carlos D

    2014-01-01

    Unilateral absence of a pulmonary artery is an uncommon congenital heart disease. It can be related to respiratory symptoms such as asthma, an unusual finding in some of these patients. This paper reports the case of a 4-year-old male with recurrent respiratory infections and asthma symptoms, in who further studies found agenesia of right pulmonary artery with pulmonary hypoplasia of the same side.

  13. Relationship between clinical pathophysiology and pulmonary pathology in patients with congenital heart defects and decreased pulmonary artery blood flow%肺血少型先天性心脏病肺血管病理变化及临床病理生理关系

    Institute of Scientific and Technical Information of China (English)

    许耀强; 刘迎龙; 阮英茆; 吕小东; 于存涛; 李莉

    2008-01-01

    Objective To investigate the relationship between pulmonary pathological features and clinical physiology of congenital heart defects (CHD) with decreased pulmonary artery blood flow.Methods Between July 2001 and May 2006,18 patients with CHD with decreased pulmonary artery blood flow undergoing palliative or definitive repair and having lung biopsy intraoperatively were enrolled in this study.The patients'age was 0.4-8.0 years,and body weight was 6.0-20.0 kg.The method of semi-quantitative morphometric technique and an image analyzer were applied to measure the following indices of pulmonary microveszels:the percentage of media thickness (MT%),the percentage of media section area(MS%) and numbers of microvessels per square centimeter (VPSC).The diameters of left pulmonary artery (LPA) and right pulmonary artery (RPA)were measured with two-dimensional echocardiography.The percutaneous oxygen saturation (SpO2),hemoglobin concentration (HB) and hematocrit value (HCT) were examined and recorded preoperatively.Results There was a significant negative correlation between SpO2 and HCT or lib (R2=0.4914,P=0.001 and R2=0.5505,P <0.001),the variation trend of these three variables was linked.There was a negative correlation between SpO2 and the body weight (R2=0.2208,P=0.049),which is in accordance with clinical features of aggravated process of cyanosis and hypoxia.The morphological observation of lung biopsy specimens indicated that most of peripheral pulmonary arteries were distended,irregular and their walls were uneven,and "lake" type of pulmonary AV malformations were observed.There was a positive correlation between VPSC and the body weight or BSA (R2=0.5472,P <0.001 and R2=0.5233,P=0.001).There was a significant correlation between VPSC and LPA or RPA (R2=0.4312,P=0.003 and R2=0.2463,P=0.036).It was shown that the diameter of central pulmonary arteries could be a reflection of peripheral pulmonary artery growth.The diameter of LPA also correlated with the

  14. Pulmonary hypertension

    Directory of Open Access Journals (Sweden)

    Lauro Martins Júnior

    2014-12-01

    Full Text Available Pulmonary hypertension is a pathological condition associated with various diseases, which must be remembered by the physicians, since early diagnosis may anticipate and avoid dangerous complications and even death if appropriate measures were not taken. The relationship with chronic obstructive pulmonary disease (COPD, important pathological process that is in increasing prevalence in developing countries, and leading position as cause of death, emphasizes its importance. Here are presented the classifications, pathophysiology, and general rules of treatment of pulmonary hypertension.

  15. Successful cases of difficult inferior vena cava filter retrieval with the use of biopsy forceps: Biopsy forceps technique

    Directory of Open Access Journals (Sweden)

    Masaya Nakashima

    2014-12-01

    Full Text Available Objectives: For treatment and prevention of deep vein thrombosis(DVT and pulmonary embolism(PE, retrievable inferior vena cava(IVC filters have commonly been used as an effective bridge to anticoagulation. However, we experienced unexpected difficulty in endovascular retrieval of some IVC filters. Most problems were due to endovascular treatment devices issues, filter intimal migration, filter disintegration, filter-associated thrombosis, and right atrium/ventricle migration. Methods: Disposable biopsy forceps was used to engage the filter hook and reform the shape of the filter struts. Endovascular retrieval assisted by use of the biopsy forceps via a similar vein was effective and provided a less-invasive, low cost method for removal of problematic IVC filters. Results: We described easily performed methods that uses disposable biopsy forceps for the retrieval of IVC filters that are difficult to remove because of filter hook migration into the caval wall. Conclusion: We developed an easily performed method that uses intestine biopsy forceps for the retrieval of IVC filter that are difficult to remove.

  16. Segmentation of the heart and major vascular structures in cardiovascular CT images

    Science.gov (United States)

    Peters, J.; Ecabert, O.; Lorenz, C.; von Berg, J.; Walker, M. J.; Ivanc, T. B.; Vembar, M.; Olszewski, M. E.; Weese, J.

    2008-03-01

    Segmentation of organs in medical images can be successfully performed with shape-constrained deformable models. A surface mesh is attracted to detected image boundaries by an external energy, while an internal energy keeps the mesh similar to expected shapes. Complex organs like the heart with its four chambers can be automatically segmented using a suitable shape variablility model based on piecewise affine degrees of freedom. In this paper, we extend the approach to also segment highly variable vascular structures. We introduce a dedicated framework to adapt an extended mesh model to freely bending vessels. This is achieved by subdividing each vessel into (short) tube-shaped segments ("tubelets"). These are assigned to individual similarity transformations for local orientation and scaling. Proper adaptation is achieved by progressively adapting distal vessel parts to the image only after proximal neighbor tubelets have already converged. In addition, each newly activated tubelet inherits the local orientation and scale of the preceeding one. To arrive at a joint segmentation of chambers and vasculature, we extended a previous model comprising endocardial surfaces of the four chambers, the left ventricular epicardium, and a pulmonary artery trunk. Newly added are the aorta (ascending and descending plus arch), superior and inferior vena cava, coronary sinus, and four pulmonary veins. These vessels are organized as stacks of triangulated rings. This mesh configuration is most suitable to define tubelet segments. On 36 CT data sets reconstructed at several cardiac phases from 17 patients, segmentation accuracies of 0.61-0.80mm are obtained for the cardiac chambers. For the visible parts of the newly added great vessels, surface accuracies of 0.47-1.17mm are obtained (larger errors are asscociated with faintly contrasted venous structures).

  17. PULMONARY BLOOD DISTRIBUTION AFTER TOTAL CAVOPULMONARY CONNECTION OF DIFFERENT TYPES

    Institute of Scientific and Technical Information of China (English)

    楚军民; 吴清玉; 王文明

    2003-01-01

    Objective.To assess the feature of pulmonary blood flow distribution after total cavopulmonary connection(TCPC)of different types,and to provide the selection of the best type.Methods. Thirty-two consecutive survival patients after TCPC underwent radionuclide lung perfusion imaging. According to the radionuclide counts in the left and right lungs,analyses of the distribution of blood flow from superior venous cava(SVC) and inferior venous cava(IVC)and the whole pulmonary blood flow in both lungs were made. All patients were divided into 4 groups by the the anastomosis between IVC and pulmonary artery.Results. GroupⅠ:The flow ratio of the IVC to left lung was greater than that to the right lung,P≤0.01;the flow ratio of the SVC to right lung was greater than that to the left lung,P≤0.01;and the whole pulmonary blood flow went dominantly to the left lung,P≤0.05,which is not in line with physiological distribution. GroupⅡ:the flows from the SVC and IVC were mixed in the middle of the junction and ran evenly into the right and left lungs,the whole pulmonary blood flow went to both lungs,P≥0.05. Group Ⅲ:the flow ratio of the SVC to both lungs were the same,P≥0.05,and major part from IVC went to the right lung,P≤0.01;the pulmonary blood flow go dominantly to the right lung,P≤0.05,which is in accord with physiological distribution. Group Ⅳ:the flows from the right SVC went to right lung by 100%,P≤0.01,and that from the left SVC went to left lung by 100% too,P≤0.01;the flows from IVC went dominantly to the left lung,with little part to the right lung ,P≤0.05.Conclusions. Different types of TCPC can result in different pulmonary blood distributions. The best flow distribution between the left and right lungs can be obtained by an offset of the IVC anastomosis toward the RPA with widening anastomosis for the patients without persist left superior venous cava(PLSVC).

  18. Study on tissue Doppler imaging in diagnosis of right ventricular hypertrophy in patients with silicosis complicated by chronic pulmonary heart disease%组织多普勒成像技术诊断矽肺肺心病患者右心室肥大的研究

    Institute of Scientific and Technical Information of China (English)

    陈功泉

    2014-01-01

    Objective To investigate the value of tissue Doppler imaging (TDI) in the diagnosis of right ventricular hypertrophy in patients with silicosis complicated by chronic pulmonary heart disease.Methods A total of 50 cases of silicosis complicated by chronic pulmonary heart disease in our hospital underwent conventional electrocardiography (ECG) and TDI.The detection rates for right ventricular hypertrophy by two methods were compared.Results Of 50 cases of silicosis complicated by chronic pulmonary heart disease,19 were diagnosed with right ventricular hypertrophy by ECG,with a detection rate of 38.0%; 29 were diagnosed with right ventricular hypertrophy by TDI,with a detection rate off 58.0%.Statistical analysis suggested that TDI leads to a significantly higher detection rate for right ventricular hypertrophy in patients with silicosis complicated by chronic pulmonary heart disease (x2=4.006,P=0.036).Conclusion Both TDI and ECG can be used for detecting right ventricular hypertrophy in patients with silicosis complicated by chronic pulmonary heart disease,but the detection rate is higher when TDI is employed.In addition,ECG cannot directly reflect the increase in pulmonary artery pressure.Therefore,TDI is more suitable for the diagnosis of right ventricular hypertrophy in patients with silicosis complicated by chronic pulmonary heart disease and provides a strong diagnostic basis for the clinical treatment of silicosis complicated by pulmonary heart disease.%目的 探讨组织多普勒成像在矽肺并发慢性肺源性心脏病患者右心室肥大的诊断价值.方法 将本院50例矽肺并发慢性肺源性心脏病患者,分别行常规心电图和组织多普勒成像检查,比较两种方法右心室肥大检出率.结果 入组的50例矽肺并发慢性肺源性心脏病患者经心电图检查,发现右心室肥大患者19例,检出率为38.0%,而组织多普勒成像技术检查发现右心室肥大患者29例,检出率为58.0%,组织多

  19. Effect of Dieckol, a Component of Ecklonia cava, on the Promotion of Hair Growth

    Directory of Open Access Journals (Sweden)

    Sang-Cheol Kim

    2012-05-01

    Full Text Available This study was conducted to evaluate the effect of Ecklonia cava, a marine alga native to Jeju Island in Korea, on the promotion of hair growth. When vibrissa follicles were cultured in the presence of E. cava enzymatic extract (which contains more than 35% of dieckol for 21 days, E. cava enzymatic extract increased hair-fiber length. In addition, after topical application of the 0.5% E. cava enzymatic extract onto the back of C57BL/6 mice, anagen progression of the hair-shaft was induced. The treatment with E. cava enzymatic extract resulted in the proliferation of immortalized vibrissa dermal papilla cells (DPC. Especially, dieckol, among the isolated compounds from the E. cava enzymatic extract, showed activity that increased the proliferation of DPC. When NIH3T3 fibroblasts were treated with the E. cava enzymatic extract and the isolated compounds from the E. cava enzymatic extract, the E. cava enzymatic extract increased the proliferation of NIH3T3 fibroblasts, but the isolated compounds such as eckol, dieckol, phloroglucinol and triphlorethol-A did not affect the proliferation of NIH3T3 fibroblasts. On the other hand, the E. cava enzymatic extract and dieckol significantly inhibited 5α-reductase activity. These results suggest that dieckol from E. cava can stimulate hair growth by the proliferation of DPC and/or the inhibition of 5α-reductase activity.

  20. 酚妥拉明与多巴酚丁胺治疗慢性肺心病重度心衰的疗效观察%The observation of the curative offects on 26cases about treating the acute tert failure of the chronic pulmonary heart disease with Phentolamine and Dobutamine

    Institute of Scientific and Technical Information of China (English)

    张福财

    2001-01-01

    Objectives To study the curative effects about treating the acute heart failure of the chronic pulmonary heart disease with Phentolamine and Dobutamine.Methods Based on the integrated treatment,the treatment of the 26 patients who suffered from the acute heart failure of the chronic pulmonary heart disease was co-operatively dealt with by Phentolamine and Dobutamine.Results  After the curative courses enden,the total rate of the effect of the treatment group was 92.1%,while that of the control group was 67.0%.There was a very obvious significance(P<0.01).The former have some obvious effect on Grade IV heart function,significantly shorten the time of improving the heart function(P<0.05),resist the irregularity in the rhythem of the heart's beating and also stabilize the blood pressure and the heart rate(P>0.05).Conclusions Phentolamine and dobutamine are the safe and effective medicines which can be used to treat the acute heart failure of the chronic pulmonary heart disease with very good curative effects and without any side effects.%目的探讨酚妥拉明与多巴酚丁胺在肺心病重度心衰中的疗效。方法对26例肺心病重度心衰患者在综合治疗的基础上,应用酚妥拉明与多巴酚丁胺进行联合治疗。结果疗程结束后,治疗组总有效率为92.1%,对照组为67.0%,两组疗效有非常显著性差异(P<0.01)。前者对心功能Ⅳ级有显著疗效,心功能改善时间显著缩短(P<0.05),且有抗心律失常作用,对血压、心率有稳定(P>0.05)作用。结论酚妥拉明与多巴酚丁胺是治疗肺心病重度心衰安全有效的药物,疗效高,副作用少。

  1. The Edible Brown Seaweed Ecklonia cava Reduces Hypersensitivity in Postoperative and Neuropathic Pain Models in Rats

    Directory of Open Access Journals (Sweden)

    Jae Goo Kim

    2014-06-01

    Full Text Available The current study was designed to investigate whether edible brown seaweed Ecklonia cava extracts exhibits analgesic effects in plantar incision and spared nerve injury (SNI rats. To evaluate pain-related behavior, we performed the mechanical withdrawal threshold (MWT and thermal hypersensitivity tests measured by von Frey filaments and a hot/cold plate analgesia meter. Pain-related behavior was also determined through analysis of ultrasonic vocalization. The results of experiments showed MWT values of the group that was treated with E. cava extracts by 300 mg/kg significantly increased; on the contrary, number of ultrasonic distress vocalization of the treated group was reduced at 6 h and 24 h after plantar incision operation (62.8%, p < 0.05. Moreover, E. cava 300 mg/kg treated group increased the paw withdrawal latency in hot-and cold-plate tests in the plantar incision rats. After 15 days of continuous treatment with E. cava extracts at 300 mg/kg, the treated group showed significantly alleviated SNI-induced hypersensitivity response by MWT compared with the control group. In conclusion, these results suggest that E. cava extracts have potential analgesic effects in the case of postoperative pain and neuropathic pain in rats.

  2. [Parasitism of the vena cava and adrenal veins in chronic chagasic patients].

    Science.gov (United States)

    Teixeira, V de P; Almeida, H de O; dos Reis, M A; Silveira, S A; Araujo, M B

    1989-01-01

    The occurrence of nest of trypanosoma cruzi in the smooth muscle cells of the central veins of the adrenal glands and the inferior vena cava was studied in 21 chronic Chagas' patients, by serial sections. Nine patients presented parasites in the adrenal veins, with a total of 24 nests, and only one nest was found in the inferior vena cava. The area of muscular tissue examined was of 2944.3 mm2 for the adrenal veins and of 47808.6 mm2 for the vena cava, giving a relation of 0.815 nests/100 mm2 for the adrenal vein and of 0.002 for the vena cava. Thus the smooth muscle of the adrenal vein was 407 times more parasited than the muscular wall of the inferior vena cava. This higher parasitism of the adrenal vein by trypanosoma cruzi in chronic Chagas' disease may be determined by its greater corticosteroid concentration, which can reduce the anti-trypanosomal defenses.

  3. A Study on the Role of Sildenafil Citrate Effecting on Pulmonary Hypertension Secondary to Congenital Heart Disease%西地那非治疗先天性心脏病肺动脉高压的疗效观察

    Institute of Scientific and Technical Information of China (English)

    程国栋

    2012-01-01

    目的 肺动脉高压( pulmonary arterial hypertention,PAH)是左向右分流型先天性心脏病(congenital heart disease,CHD)常见且严重的并发症,是影响先心病外科治疗效果的重要因素,本文探讨西地那非治疗CHD合并PAH的临床治疗效果.方法 研究对象为2009年8月至2011年3月我院收治的20例心内左向右分流、平均肺动脉平均压>25mmHg的CHD患者,给予西地那非口服,一次20mg,每6 小时一次,对比用药前后患者平均肺动脉平均压力的变化.结果 西地那非连续使用5d后,患者平均肺动脉压力明显下降.结论 在CHD合并PAH的治疗中,西地那非可以特异地降低肺动脉压力,改善心功能,降低死亡率,其使用方便,可为CHD合并PAH治疗的首选.

  4. 肺心病加重并发低钠血症40例临床分析%Pulmonary heart disease complicated with hyponatremia clinical analysis of 40 cases

    Institute of Scientific and Technical Information of China (English)

    汪凤娥

    2014-01-01

    Objective to study the heavier cor pulmonale complicated with hyponatremia in clinical manifestations, etiology, mechanism and prevention measures. Methods 40 patients were retrospectively analyzed the clinical data of patients with cor pulmonale increasing complicated with hyponatremia. Results the patients who suffered heart disease from lung disorders in acute aggravating period occurring hyponatremia probability is 40%, its clinical manifestations are easy to be misdiagnosed as pulmonary encephalopathy. Conclusion to enhance awareness of cor pulmonale is aggravating merger hyponatremia, is the key to improve the survival rate for patients with the diagnosis and treatment in time.%目的:探讨肺心病加重并发低钠血症的临床表现、病因机制及防治措施。方法回顾性分析40例肺心病加重并发低钠血症患者的临床资料。结果肺心病患者急性加重期发生低钠血症概率为40%,其临床表现容易被误诊为肺性脑病。结论增强对肺心病加重合并低钠血症的认识,及时诊断治疗是提高患者存活率的关键。

  5. Primary pulmonary hypertension.

    Science.gov (United States)

    Rashid, A; Lehrman, S; Romano, P; Frishman, W; Dobkin, J; Reichel, J

    2000-01-01

    Primary pulmonary hypertension (PPH) is a condition characterized by sustained elevation of pulmonary artery pressure (PAP) without demonstrable cause. The most common symptom at presentation is dyspnea. Other complaints include fatigue, chest pain, syncope, leg edema, and palpitations. Right heart catheterization is diagnostic, showing a mean PAP >25 mmHg at rest and >30 mmHg during exercise, with a normal pulmonary capillary wedge pressure. In the National Institutes of Health-PPH registry, the median survival period was 2.8 years. Treatment is aimed at lowering PAP, increasing cardiac output, and decreasing in situ thrombosis. Vasodilators have been used with some success in the treatment of PPH. They include prostacyclin, calcium-channel blockers, nitric oxide and adenosine. Anticoagulation has also been advised for the prevention of deep vein thrombosis, pulmonary embolism, and in situ thromboses of the lungs. New drug treatments under investigation include L-arginine, plasma endothelin-I, and bosentan. Use of oxygen, digoxin, and diuretics for symptomatic relief have also been recommended. Patients with severe PPH refractory to medical management should be considered for surgery.

  6. Postoperative pulmonary hypertensive crisis caused by inverted left atrial appendage after cardiopulmonary bypass surgery for congenital heart disease in a neonate.

    Science.gov (United States)

    Zhao, Qifeng; Hu, Xingti

    2013-09-01

    Postoperative pulmonary hypertensive crisis (PHC) caused by an inverted left atrial appendage (ILAA) is a rare complication following cardiac surgery. We present a case of 23 day-old male infant who developed postoperative PHC attacks after undergoing cardiopulmonary bypass (CPB) surgery for repair of the coactation of aorta. A hyperechogenic left atrial mass was detected via bedside transthoracic echocardiography (TTE), which was identified as an ILAA and corrected following repeat surgery. In this case, both the negative pressure in vent catheter and the long left atrial appendage (LAA) with a narrow base led to an irreversible ILAA. As in this neonate, ILAA had significant influence on the left atrial volume and caused PHC since the ILAA was located on the mitral valve orifice and interfered with the blood flow through the valve. Therefore, we recommend that the vent catheter should be turned off before removing to avoid this potential complication. Additionally, LAA should be carefully inspected after CPB surgery, and intra-operative and post-operative transoesophageal echocardiography (TEE) should be performed to detect ILAA intraoperatively so as to avoid the reoperation. When an ILAA is diagnosed postoperatively, whether conservative treatment or surgery will depend on the balance of benefit and risk for a particular patient.

  7. The dynamic study of the pulmonary artery obstruction degree and the right ventricular function in massive pulmonary embolism on CT pulmonary angiography

    Institute of Scientific and Technical Information of China (English)

    Jianguo Wang; Yulin Guo; Xiaojuan Guo; Min Liu; Youmin Guo; Chen Wang; Yuanhua Yang; Zhenguo Zhai; Li Zhu; Hongxia Ma

    2008-01-01

    Objective: To analyze the value of CTPA in assessing the dissolve of embolus and the function of the fight ventricle dynamically.Methods:Twenty-three cases of massive pulmonary embolism were analyzed retrospectively. The pulmonary artery obstruction index and the fight ventricular function parameters were collected and analyzed on CTPA before thrombolytic therapy, 24 hours and 14 days after therapy, respectively. Results:The pulmonary artery obstruction index decreased gradually, and there was significant difference before therapy, 24 hours and 2 weeks after therapy. Twenty-four hours after therapy, the maximal short axes diameter and the maximal transverse area of fight ventricle(RVd, RVs) decreased significantly, the maximal short axes diameter and the maximal transverse area of left ventricle(LVd, LVs) increased significantly, and the RVd/LVd, RVs/LVs decreased apparently. The pulmonary artery symbolic pressure before and 24 hours after therapy were apparently different. There was no significant difference between azygos vein, the super vena cava, the main pulmonary artery and vein reflux before and after therapy. Conclusion:CTPA can evaluate the pulmonary artery obstruction degree and right ventricular function dynamically.

  8. Heart transplantation in adults with congenital heart disease.

    Science.gov (United States)

    Houyel, Lucile; To-Dumortier, Ngoc-Tram; Lepers, Yannick; Petit, Jérôme; Roussin, Régine; Ly, Mohamed; Lebret, Emmanuel; Fadel, Elie; Hörer, Jürgen; Hascoët, Sébastien

    2017-02-22

    With the advances in congenital cardiac surgery and postoperative care, an increasing number of children with complex congenital heart disease now reach adulthood. There are already more adults than children living with a congenital heart defect, including patients with complex congenital heart defects. Among these adults with congenital heart disease, a significant number will develop ventricular dysfunction over time. Heart failure accounts for 26-42% of deaths in adults with congenital heart defects. Heart transplantation, or heart-lung transplantation in Eisenmenger syndrome, then becomes the ultimate therapeutic possibility for these patients. This population is deemed to be at high risk of mortality after heart transplantation, although their long-term survival is similar to that of patients transplanted for other reasons. Indeed, heart transplantation in adults with congenital heart disease is often challenging, because of several potential problems: complex cardiac and vascular anatomy, multiple previous palliative and corrective surgeries, and effects on other organs (kidney, liver, lungs) of long-standing cardiac dysfunction or cyanosis, with frequent elevation of pulmonary vascular resistance. In this review, we focus on the specific problems relating to heart and heart-lung transplantation in this population, revisit the indications/contraindications, and update the long-term outcomes.

  9. What Are Heart Disease and Stroke?

    Science.gov (United States)

    ... Aortic Aneurysm More What Are Heart Disease and Stroke? Updated:Dec 8,2015 There are many types ... build-up in the lungs, called “pulmonary congestion”. STROKE and TIA happen when a blood vessel that ...

  10. 心脏型脂肪酸结合蛋白对急性肺栓塞早期预后评估的价值%Prognostic Value of Heart Type Fatty Acid Binding Protein in Acute Pulmonary Embolism

    Institute of Scientific and Technical Information of China (English)

    黄奕奕; 沈翔; 张淑云

    2015-01-01

    Objective To assess the value of heart type fat y acid binding protein (H-FABP)for prognosis of patients with acute pulmonary embolism(APE).Methods There were 51 patients with APE, divided into two groups:H-FABP≥10μg/l group (n=21)and H-FABP<10μg/l group (n=30),The relations between H-FABP and risk stratification and prognosis evaluating were evaluated in the two groups.Results In the positive group,there were 9 high-risk PE,10 middle-risk PE,2 low-risk PE,6 died within 1 months.In the negative group,there were 4 high-risk PE,14 middle-risk PE,12 low-risk PE,2 died within 1 months. There was statistical significance in the occur ence of hypotension,right heart dysfunction and myocardial damage between the two groups ( <0.05).Also there was statistical significance in the cases with high-risk,low-risk and death( <0.05).Conclusion H-FABP is a reliable predictor of short-term of patient with APE.%目的:探讨心脏型脂肪酸结合蛋白(heart type fat y acid binding protein,H-FABP)水平对急性肺栓塞(acute pulmonary embolism,APE)早期预后的评估价值。方法51例急性肺栓塞患者根据H-FABP测定值分为阳性组21例(H-FABP≥10μg/l)及阴性组30例(H-FABP<10μg/l),分析H-FABP升高对APE患者危险分层与临床预后的关系。结果阳性组中高危9例,中危10例,低危2例,死亡6例。阴性组中高危4例,中危14例,低危12例,死亡2例。两组比较低血压、右心室功能不全以及心肌损伤的发生率之间差异有统计学意义(<0.05);在高危、低危及1月内死亡人数方面相比差异亦具有统计学意义(<0.05)。结论 H-FABP对急性肺栓塞患者的早期预后判定有着很好的相关性。

  11. Percutaneous treatment of superior vena cava syndrome using metallic stents

    Energy Technology Data Exchange (ETDEWEB)

    De Gregorio Ariza, Miguel Angel; Gimeno, Maria Jose; Alfonso, Eduardo; Mainar, Antonio; Medrano, Joaquin; Lopez-Marin, Paloma [Department of Interventional Radiology, ' ' Lozano Blesa' ' University Hospital, Avda. San Juan Bosco 15, 50009 Zaragoza (Spain); Gamboa, Pablo [Division of Interventional Radiology, Ohio State University Hospital, Columbus, Ohio (United States); Tobio, Ricardo [Interventional Radiology, Clinica de la Zarzuela, Madrid (Spain); Herrera, Marcos [Division of Interventional Radiology, University of Minnesota, Minneapolis, Minnesota (United States)

    2003-04-01

    The purpose of this study was to evaluate the results of treatment of superior vena cava syndrome (SVCS) in patients with benign and malignant disease using expandable metallic stent. From January 1995 to April 2000, 87 expandable stents were implanted in 82 patients (59 men, 23 women; mean age 57.8 years, age range 39-79 years) for the treatment of SVCS. The SVCS was defined as symptomatic bilateral obstruction of venous drainage from head, neck and upper extremities. In 68 patients SVCS was due to malignant neoplasia, and in 14 cases it was due to benign aetiology. All patients were treated with expandable stent. We implanted 81 Wallstent prostheses and 6 Palmaz stents. Adjuvant thrombolysis was applied in 12 patients who required fibrinolysis. After recanalization, the stent was implanted in all cases in SVC (infra- or supra-azygos vein). All patients were treated with heparin of low molecular weight (HBPM) during 6 months. Patency was analyzed according to clinical symptoms and Doppler US or venograms exploration. Technical success was observed in all cases. Clinical success was reached in 78 of 82 patients (95.1%) (absence of symptoms in 2 or 3 days). Four patients suffered immediate thrombosis which required fibrinolitic treatment with a new prosthesis placement in 1 case. The follow-up for the malignant process was of 7.1 months (range 1-39 months) and in benign cases was 31.2 months (range 11-61 months). Sixty-two (91.1%) patients with malignancy died without SVCS symptomatology. All the patients with benign pathology are alive. Clinical primary patency in malignant cases was 87% with assisted patency of 96.2%. Endovascular therapy using metallic stent and thrombolysis is a successful method to treat SVCS due to benign or malignant aetiology. (orig.)

  12. Rapid Fatal Outcome from Pulmonary Arteries Compression in Transitional Cell Carcinoma

    Directory of Open Access Journals (Sweden)

    Ioannis A. Voutsadakis

    2009-01-01

    Full Text Available Transitional cell carcinoma of the urinary bladder is a malignancy that metastasizes frequently to lymph nodes including the mediastinal lymph nodes. This occurrence may produce symptoms due to compression of adjacent structures such as the superior vena cava syndrome or dysphagia from esophageal compression. We report the case of a 59-year-old man with metastatic transitional cell carcinoma for whom mediastinal lymphadenopathy led to pulmonary artery compression and a rapidly fatal outcome. This rare occurrence has to be distinguished from pulmonary embolism, a much more frequent event in cancer patients, in order that proper and prompt treatment be initiated.

  13. Isolated right pulmonary artery agenesis with aplasia of right upper lobe and with anomalous arterial supply from celiac axis, anomalous venous drainage

    Directory of Open Access Journals (Sweden)

    Tushar Madhav Kalekar

    2015-01-01

    Full Text Available Pulmonary artery agenesis is the complete absence of the right or left pulmonary artery. This lesion is commonly associated with other cardiac anomalies and is usually diagnosed incidentally. Unilateral absence of pulmonary artery with lung hypoplasia is very rare. Ipsilateral hypoplastic or absent central pulmonary artery in these patients will have a systemic arterial supply to peripheral pulmonary arteries of the affected lung from the descending thoracic or upper abdominal aorta. These findings are usually characterized as pulmonary veno lobar syndrome or scimitar syndrome when associated with ipsilateral total or partial anomalous pulmonary venous return from the lower lobe which drains into the inferior vena cava or less commonly to the hepatic, azygous, or portal vein, or into the right atrium and lung agenesis/hypoplasia.

  14. Pulmonary arterial hypertension secondary to chronic left-sided cardiac dysfunction in dogs.

    Science.gov (United States)

    Stepien, Rebecca L

    2009-09-01

    Pulmonary arterial hypertension is a description of a physiological finding rather than a diagnosis. Pulmonary arterial pressure is the result of interactions among pulmonary blood flow (right ventricular cardiac output), pulmonary vascular impedance and post-capillary pressure (typically reflecting left atrial pressure). When elevations in pulmonary arterial pressure (systolic/diastolic pulmonary arterial pressure > approximately 30/19 mmHg at rest) are accompanied by increased left atrial pressure, pulmonary arterial hypertension may be considered secondary to left-heart failure. Introduction of Doppler methods to diagnose pulmonary arterial hypertension has increased the awareness of the prevalence and importance of pulmonary arterial hypertension dogs with left-heart failure. Increasing understanding of the mechanism of development of pulmonary venous hypertension and reactive pulmonary arterial hypertension in dogs with left-heart disease has led to the development of successful additive therapies for progressive clinical signs in the setting of chronic therapy for congestive heart failure due to left-sided valvular and myocardial dysfunction. Because effective therapies for pulmonary arterial hypertension secondary to chronic left-sided cardiac dysfunction are now available, screening for pulmonary arterial hypertension should be a regular part of the Doppler echocardiographic examination in a clinical setting of chronic therapy for left-sided congestive heart failure due to valvular or myocardial disease.

  15. Nursing strategy about severe pulmonary hypertension associated with congenital heart disease after cardiac surgery in neonatal period%新生儿期先天性心脏病术后合并重度肺动脉高压的护理

    Institute of Scientific and Technical Information of China (English)

    刘晓聪; 葛振香; 范丽萍

    2011-01-01

    Objective : To explore nursing strategy about severe pulmonary hypertension associated with congenital heart disease after cardiac surgery in neonatal period. Methods:155 patients with severe pulmonary hypertension associated with congenital heart disease after cardiac surgery were treated in our department from January 2005 to Octoher 2010, through the intensive care, changing neonates' lung compliance, decreasing pulmonary vascular resistance and pulmonary hypertension , increasing pulmonary blood flow , improving the proportion of pulmonarv ventilation to blood flow , increasing pulmonary arterial oxygen pressure, improving patient's hypoxia, improving heart function, and strengthening the lower respiratory care to decrease the incidence of pulmonary complications. we could prevent pulmonary hypertension and avoid the occurrence of pulmonary hypertension crisis. Results:127 patients were cured,3 patients died,25 patients gave up treatment and left hospital because of financial condition, the average hospital stay was 22 days, the average time of using the breathing machine was 4 days. Conclusion : The postoperative nursing care of severe pulmonary hypertension associated with congenital heart disease after cardiac surgery was difficult and dangerous, comprehensive and standardized nursing care was essential to improve the success rate of surgery, reduce the operative mortality greatly and improve the quality of life.%目的:探讨新生儿期先天性心脏术后合并重度肺动脉高压的护理策略.方法:2005年1月~2010年10月我科共收治155例新生儿先天性心脏病术后并发重度肺动脉高压的患儿,通过严密监护加强护理,改变患儿肺顺应性,降低肺血管阻力和肺动脉高压,提高肺血流量,改善肺通气-血流比例,提高肺动脉血氧压力,改善患儿缺氧状态,改善心功能,加强呼吸道护理,降低了肺部并发症的发生,避免了肺高压危象的发生.结果:治愈127例,死亡3例,25例

  16. Persistence of left supracardinal vein in an adult patient with heart-hand syndrome and cardiac pacemaker.

    Science.gov (United States)

    Nemec, Jan; Heifetz, Steven

    2008-01-01

    A patient with a sporadic heart-hand syndrome, which includes thumb hypoplasia, septum primum atrial septal defect, and cleft mitral valve is described. During attempted placement of a pacemaker lead, persistence of left superior and inferior vena cava was found in addition to the right-sided caval veins. This corresponds to persistence of left-sided supracardinal vein present during fetal development.

  17. Advanced Hepatocellular Carcinoma with Subtotal Occlusion of the Inferior Vena Cava and a Right Atrial Mass

    Directory of Open Access Journals (Sweden)

    Christian Steinberg

    2013-01-01

    Full Text Available Hepatocellular carcinoma usually metastasizes to regional lymph nodes, lung, and bones but can rarely invade the inferior vena cava with intravascular extension to the right atrium. We present the case of a 75-year-old man who was admitted for generalized oedema and was found to have advanced HCC with invasion of the inferior vena cava and endovascular extension to the right atrium. In contrast to the great majority of hepatocellular carcinoma, which usually develops on the basis of liver cirrhosis due to identifiable risk factors, none of those factors were present in our patient.

  18. Creating a Fontan fenestration in a child with dextrocardia and interrupted inferior vena cava.

    Science.gov (United States)

    Charlagorla, Pradeepkumar; Breinholt, John P

    2016-01-01

    Plastic bronchitis is a rare life-threatening complication of the Fontan operation. Transcatheter Fontan fenestration can ameliorate symptoms by decompressing elevated venous pressures. Transcatheter creation of a fenestration can be technically challenging in cases with complex venous anatomy. We report a case of a 5-year-old boy with heterotaxy, dextrocardia with unbalanced atrioventricular canal (AVC), atrial and visceral situs inversus, left-sided superior vena cava (SVC), and left-sided interrupted inferior vena cava (IVC) with azygos continuation. With few modifications to the equipment, a successful Fontan fenestration with stent implantation was performed via transjugular approach. At 2-year follow-up, his symptoms of plastic bronchitis improved significantly.

  19. A Combination of Persistent Left Superior Vena Cava and Subaortic Discrete Membrane

    Directory of Open Access Journals (Sweden)

    Sait Demirkol

    2013-08-01

    Full Text Available A persistent left superior vena cava is the most common congenital anomaly involving the systemic veins. It occurs in approximately 0.5% of the general population and 3% to 10% of patients with other cardiovascular abnormalities including atrial septal defect, ventricular septal defect, bicuspid aortic valve, coarctation of aorta, and cor-triatriatum. A discrete subaortic membrane is a rare cause of subaortic stenosis in adult. It may present as in an isolated form as fibrous or fibromuscular ring below the aortic valve or in association with other congenital anomalies. This is the case of a persistent left vena cava superior associated with a subaortic discrete membrane.

  20. A new Nitinol stent for use in superior vena cava syndrome

    DEFF Research Database (Denmark)

    Andersen, Poul Erik; Midtgaard, Annette; Brenøe, Anne-Sofie;

    2015-01-01

    syndrome with in all 21 Zilver Vena stents between March 2012 and October 2013 were retrospectively reviewed. All cavographies and contrast enhanced CT related to the treatment and during follow-up were evaluated and the patients had clinical follow-up until dead. They were all in terminal state...... at the time of stent deployment. RESULTS: All patients had superior vena cava obstruction and clinical superior vena cava syndrome caused by malignant expansive mediastinal disease (eight patients non-small cell lung cancer and four small cell lung cancer). The technical success with deployment of the stents...

  1. [An exceptional case of renal angiomyolipoma extended to the inferior vena cava. Successfull surgical management].

    Science.gov (United States)

    Dinis da Gama, A; Cunha e Sá, Diogo; Alves, José Maria; Carneiro de Moura, J L; Lopez, Dolores; Fernandes, Afonso

    2008-01-01

    The clinical case of a 39 years old female is reported, with the diagnosis of tumor of the right kidney extending into the infra-hepatic vena cava, assuming the shape of a floating thrombus. The patient underwent right radical nephrectomy, followed by resection of the intra caval tumor. Both the procedure and post operative course were uneventfull. Histopathological evaluation of the specimens, associated to specific imunohistochemistry studies, confirmed the diagnosis of angiomyolipoma of the kidney. A review of the literature concluded that this is the 27th case published of a kidney angiomyolipoma extending into the inferior vena cava, thus justifying its presentation and divulgation.

  2. Investigation of the Related Factors and Clinical Diagnosis and Treatment Methods of Elderly Patients with Chronic Pulmonary Heart Disease with Heart Failure%老年慢性肺源性心脏病心力衰竭的相关因素及临床诊治方法探讨

    Institute of Scientific and Technical Information of China (English)

    杨海忠

    2015-01-01

    目的:探讨老年慢性肺源性心脏病心力衰竭的相关因素及临床诊治方法。方法:采用回顾性方法,选取2012年9月-2014年10月本院收治的124例老年慢性肺源性心脏病心力衰竭患者作为观察组,同时选择同期124例老年慢性肺源性心脏病的患者作为对照组,比较分析两组患者的临床资料。结果:通过单因素分析发现,有不良嗜好、年龄≥80岁、体重指数>25、病程≥10年、有冠心病、雾霾影响较重等情况的观察组患者发病率均明显高于对照组,差异均有统计学意义(P25、有烟酒等不良嗜好、病程≥10年为老年慢性肺源性心脏病心力衰竭的独立危险因素(P25,course of disease≥10 years,with coronary heart disease and heavy effects of haze were significantly higher than the control group,the differences were statistically significant(P25,with bad habits such as alcohol and tobacco,course of disease≥10 years were independent risk factors of elderly patients with chronic pulmonary heart disease with heart failure (P<0.05).After a series of treatment,in 124 cases,116 patients were cured and 7 patients transfered to another hospital, 1 patient gave up treatment.Conclusion:According to the risk factors and patients’ individual condition,the comprehensive treatment can effectively reduce the incidence of heart failure and improve treatment.

  3. Clinical Observation of 60 Cases of Chronic Pulmonary Heart Disease Treated with Safflower Yellow Pigment%红花黄色素治疗慢性肺源性心脏病60例临床观察

    Institute of Scientific and Technical Information of China (English)

    孙其兰

    2015-01-01

    Objective Observe the curative ef ect of treatment of chronic cor pulmonale saf lower yel ow pigment. Methods 60 patients with chronic cor pulmonale were randomly divided into control group and treatment group, control group given conventional therapy for patients of cor pulmonale, the treatment group on the basis of conventional treatment combined with intra-- infusion, saf lower yel ow pigment were observed before and after treatment in patients with ecg, heart colour to exceed, pulmonary artery pressure, blood lipid level, and clinical symptoms change. Results After treatment, the treatment group compared with control group lipid levels improve, pulmonary hypertension significantly decreased, electrocardiogram (ecg)have improved significantly, dif erences were statistical y significant.Saf lower yel ow pigment ( <0.05) .Conclusion The treatment of chronic cor pulmonale has exact curative ef ect.%目的:观察红花黄色素治疗慢性肺源性心脏病的疗效。方法将60例慢性肺源性心脏病患者随机分为对照组和治疗组,对照组的肺心病患者给以常规治疗,治疗组在常规治疗的基础上加用红花黄色素静脉输注,观察治疗前后患者心电图、心脏彩超、肺动脉压力、血脂水平、及临床症状变化。结果治疗后,治疗组与对照组比较血脂水平改善,肺动脉高压明显下降,心电图有明显改善,差异均有统计学意义(<0.05)。结论红花黄色素治疗慢性肺源性心脏病有确切疗效。

  4. Emergency hepatectomy for hepatic arteriovenous malformation combined with pulmonary hypertension in an infant

    Directory of Open Access Journals (Sweden)

    Naruhiko Murase

    2015-12-01

    Full Text Available Patients with hepatic arteriovenous malformations rarely present with pulmonary hypertension. We report the case of a 3-month-old boy who developed severe pulmonary hypertension due to a hepatic arteriovenous malformation. The use of pulmonary vasodilators to treat the patient's pulmonary hypertension worsened his high-output heart failure. This is the first case in which emergency hepatectomy rescued a patient with hepatic arteriovenous malformations who developed pulmonary hypertension.

  5. Pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension: pathophysiology

    Directory of Open Access Journals (Sweden)

    M. Humbert

    2010-03-01

    Full Text Available Pulmonary arterial hypertension (PAH and chronic thromboembolic pulmonary hypertension (CTEPH are two of the key subgroups of pulmonary hypertension. They are characterised by different risk factors. PAH can be associated with mutations in the gene encoding bone morphogenetic protein receptor type II (BMPR2, HIV infection, congenital heart disease, connective tissue disease (such as systemic sclerosis, and exposure to particular drugs and toxins including fenfluramine derivatives. In contrast, CTEPH can be associated with anti-phospholipid antibodies, splenectomy and the presence of a ventriculo-atrial shunt or an infected pacemaker. The first-line therapies used to treat PAH and CTEPH also differ. While medical therapy tends to be used for patients with PAH, pulmonary endarterectomy is the treatment of choice for patients with CTEPH. However, there are possible common mechanisms behind the two diseases, including endothelial cell dysfunction and distal pulmonary artery remodelling. Further research into these similarities is needed to assist the development of targeted pharmacological therapies for patients with inoperable CTEPH and patients who have persistent pulmonary hypertension after endarterectomy.

  6. Activation of circulating platelets and platelet response to activating agents in children with cyanotic congenital heart disease: their relevance to palliative systemic-pulmonary shunt.

    Science.gov (United States)

    Kierzkowska, B; Stańczyk, J; Wiectawska, B; Rózalski, M; Boncler, M; Chrul, S; Watala, C

    2001-06-01

    Abnormal platelet function has been hypothesised to play a role in the haemostatic abnormalities in cyanotic congenital heart disease (CCHD) patients. Using whole blood flow cytometry we found that platelets from cyanotic patients were hyperreactive and we related such hyperreactivity directly to young age, unoperated state, high haematocrit, reduced saturation with oxygen and low platelet count. Circulating platelets from CCHD children showed significantly enhanced P-selectin expression (Pplatelet 'priming' largely concerned CCHD children who were not subjected to modified Blalock-Taussig shunts in the past (non-MBTS). Only non-MBTS cyanotic children, but not MBTS-operated patients, showed significantly higher platelet reactivity compared to controls in response to ADP or 1 microM TRAP with respect to P-selectin expression (pchildren and reduced GPIb expression in non-MBTS patients, especially in younger patients, were positively associated with the occurrence of the polymorphic variant Pl(A2) of platelet membrane glycoprotein IIIa gene. Altered blood morphology parameters (elevated RBC, Hb, Hct and MCHC, for all Pchildren correlated with the enhanced degranulation of circulating blood platelets and their hyperreactivity in response to some agonists (Pplatelets are remarkably hyperreactive in non-MBTS cyanotic children, which are at higher risk to often encounter platelets activation in circulation. It seems unlikely that the apparently unchanged platelet reactivity in MBTS-operated children is due to the advantageous effects of the shunt, since these patients showed neither altered haematological parameters nor improved oxygen carrying capacity. Otherwise, it may rather result from more frequent episodes of platelet degranulation and preactivation in the past, and/or post-operative enhanced platelet consumption.

  7. Percutaneous transluminal angioplasty in a patient with chronic cerebrospinal venous insufficiency and persistent left superior vena cava.

    Science.gov (United States)

    Lupattelli, T; Benassi, F; Righi, E; Bavera, P; Bellagamba, G

    2014-04-01

    Chronic cerebrospinal venous insufficiency (CCSVI) is a syndrome characterized by stenoses of the internal jugular veins (IJVs) and/or azygos veins and formation of collateral venous channels. A case of a 57-year-old patient with CCSVI in whom the venous outflow from the left IJV to the right atrium occurred through a venous anomaly, the persistent left superior vena cava (PLSVC), is reported. PLSVC is caused by persistence of the left anterior cardinal vein that drains blood from the limb effluent from the left and the left side of head and neck into coronary sinus (Type a), or in the left atrium (Type b). PLSVC can be associated either with innominate vein hypoplasia or other congenital heart abnormalities. Because of evidence of left innominate vein hypoplasia, angioplasty was not performed using the ordinary route but passing with the balloon directly through the PLSVC up to the left IJV. Finally, angioplasty was carried out in a standard manner in the right IJV as well as in the azygous vein. Confirmation angiogram revealed complete reopening of all treated vessels with no evidence of peri- and postoperative complications. The patient was discharged home the following day in good general conditions. PLSVC is a rare congenital vein anomaly but in case of concomitant innominate vein hypoplasia may prove to be a valuable alternative to treat patients with IJV diseases.

  8. Experience of valve replacement under mild hypothermia on pump-beating heart:an analysis of 800 cases

    Institute of Scientific and Technical Information of China (English)

    陈柏成; 肖颖彬; 陈林; 钟前进; 王学锋; 周骐; 易广兵

    2004-01-01

    Objective: To assess the outcome of valve replacement under mild hypothermia on pump-beating heart and to discuss the risk factors of cardiac valve surgery. Methods: In the period from November 1997 to May 2003, a total of 800cases of valve replacement were carried out in our institute. The clinical data were reviewed and the technique of mild hypothermia and pump-beating heart to replace cardiac valve was described in detail. Results: 800 patients, 308 male and 492female, with age range from 8 to 66 years, weighing 19 to 88 kg, underwent operation. The average cardiopulmonary bypass time was (109.38 ± 40.64) min, the average clamping time of the vena cava was (77.87 ± 27.99) min and the average mechanical ventilation time was (17.78 ± 12.21) h. There were 17 patients died in the early postoperative stage with an early mortality rate of 2.13%. The causes of death were failure in the weaning of extracorporeal circulation in 2 cases, severe low output syndrome in 3 cases, ventricular fibrillation in 3 cases, obstruction of coronary ostium of mechanical prosthetic valve in 1 case, hepatic failure in 2 cases, pulmonary failure in 1 case, multiorgan failure in 4 cases, and prosthetic valve dysfunction in 1 case. Severe postopertive complications occurred in 51 cases (6.375%), which included reexploration because of excessive bleeding in 16 cases (2.0%), lavage of poststemal infection in 2 cases (0.25%), postoperative strike in 7 cases (0.875%), pulmonary failure in 5 cases (0.625%), hepatic failure in 4 cases (0.5%), multiorgan failure in 11 cases (1.375 % ), ventricular arrhythmia in 5 cases (0.625%) and peripheral circulation failure in 1 case(0. 125 % ). Conclusion: Mild hypothermia and pump-beating heart result in satisfying clinical outcome in patients undergoing valve replacement. The integrated sequenced deairing procedure ensures the avoidance of air embolism during operation.Pump-beating heart technique offers a safe and practical option especially in

  9. Pulmonary aspergilloma

    Science.gov (United States)

    ... grows on dead leaves, stored grain, bird droppings, compost piles, and other decaying vegetation. Cavities in the ... Histoplasmosis Lung cancer - small cell Pulmonary tuberculosis Sarcoidosis Review Date 8/31/2014 Updated by: Jatin M. ...

  10. Study of heart-rate corrected QT interval and QT dispersion in patients with pulmonary hypertension%肺动脉高压患者心率校正QT间期和QT离散度的研究

    Institute of Scientific and Technical Information of China (English)

    张洪亮; 王勇; 罗勤; 柳志红; 赵智慧; 熊长明; 倪新海; 何建国

    2010-01-01

    目的:检测肺动脉高压(pulmonary hypertension,PH)患者的心率校正的QT间期(heart rate-corrected QT interval,QTc)和QTc离散度(QTc dispersion,QTcd),并评价其与肺动脉压力的关系.方法:入选2003年12月至2008年7月因初步诊断为PH而进行有心导管术的患者.记录静息12导联心电图,手工测量QT间期并用Bazett公式进行校正.根据平均肺动脉压,将患者分为对照组,轻-中度PH 组和重度PH组.结果:共入选201例患者.男性患者的QTc和QTcd在3组间差异无统计学意义.女性患者中,重度PH组的QTc比对照组高[(436.1±39.4)ms vs.(407.6±24.8)ms,P=0.037],重度PH组的QTcd(68.5 ±20.9)ms高于对照组(45.1 ±12.6)ms和轻-中度组(58.6 ±14.7)ms(P=0.002;P=0.003).此外,女性患者的QTc和QTcd与平均肺动脉压正相关(r=0.207,P=0.03;r=0.236,P=0.012).结论:本组资料中女性PH患者的QTc和QTcd与平均肺动脉压正相关,且在重度PH患者中显著增高,有待于进一步探讨.

  11. Pulmonary hypertension

    OpenAIRE

    2016-01-01

    In 2015, more than 800 papers were published in the field of pulmonary hypertension. A Clinical Year in Review article cannot possibly incorporate all this work and needs to be selective. The recently published European guidelines for the diagnosis and treatment of pulmonary hypertension contain an inclusive summary of all published clinical studies conducted until very recently. Here, we provide an overview of papers published after the finalisation of the guideline. In addition, we summaris...

  12. Pulmonary Agenesis.

    Science.gov (United States)

    Chawla, Rakesh K; Madan, Arun; Chawla, Aditya; Arora, Harsh Nandini; Chawla, Kiran

    2015-01-01

    Unilateral opaque lung with ipsilateral mediastinal shift is an uncommon cause of respiratory distress in newborn which can be found on simple radiograph of the chest. Pulmonary agenesis is a rare cause of unilateral opaque lung in the newborn. Nearly 50% cases of pulmonary agenesis are associated with other congenital defects including cardiovascular, skeletal, gastrointestinal or genitourinary systems. We report an infant with agenesis of the right lung associated with other congenital anomalies.

  13. Management of pulmonary arterial hypertension.

    Science.gov (United States)

    McLaughlin, Vallerie V; Shah, Sanjiv J; Souza, Rogerio; Humbert, Marc

    2015-05-12

    Pulmonary hypertension (PH) is common and may result from a number of disorders, including left heart disease, lung disease, and chronic thromboembolic disease. Pulmonary arterial hypertension (PAH) is an uncommon disease characterized by progressive remodeling of the distal pulmonary arteries, resulting in elevated pulmonary vascular resistance and, eventually, in right ventricular failure. Over the past decades, knowledge of the basic pathobiology of PAH and its natural history, prognostic indicators, and therapeutic options has exploded. A thorough evaluation of a patient is critical to correctly characterize the PH. Cardiac studies, including echocardiography and right heart catheterization, are key elements in the assessment. Given the multitude of treatment options currently available for PAH, assessment of risk and response to therapy is critical in long-term management. This review also underscores unique situations, including perioperative management, intensive care unit management, and pregnancy, and highlights the importance of collaborative care of the PAH patient through a multidisciplinary approach.

  14. [Bilateral deep venous thrombosis and vena cava aplasia treated with local thrombolysis

    DEFF Research Database (Denmark)

    Pelta, A.M.; Jørgensen, Maja; Just, Sven Richardt Lundgren;

    2008-01-01

    In this case report the treatment of a young man with bilateral iliaco-femoral DVT and vena cava aplasia is presented. The patient was treated with catheter-directed thrombolysis; the catheters were introduced in the thrombus of both legs via v. popliteae. The treatment led to almost complete...

  15. Bilateral dyb venos trombose og vena cava-aplasi behandlet med lokal trombolyse

    DEFF Research Database (Denmark)

    Pelta, A.M.; Jorgensen, M.; Jensen, L.P.;

    2008-01-01

    In this case report the treatment of a young man with bilateral iliaco-femoral DVT and vena cava aplasia is presented. The patient was treated with catheter-directed thrombolysis; the catheters were introduced in the thrombus of both legs via v. popliteae. The treatment led to almost complete...

  16. Thrombosis caused by polyurethane double-lumen subclavian superior vena cava catheter and hemodialysis

    DEFF Research Database (Denmark)

    Wanscher, Maria Rørbæk; Frifelt, J J; Smith-Sivertsen, C

    1988-01-01

    During an 18-month period, 82 consecutive patients (37 women and 45 men), with a mean age of 50 yr (range 15 to 74), underwent hemodialysis with 91 polyurethane double-lumen subclavian superior vena cava catheters inserted via the right subclavian vein. Upon catheter removal, venograms were...

  17. Cranial vena cava syndrome secondary to cryptococcal mediastinal granuloma in a cat

    OpenAIRE

    2015-01-01

    The successful management of cranial vena cava syndrome with suspected secondary chylothorax due to mediastinal cryptococcal granuloma in a 4-year-old male domestic shorthair cat is described. Treatment included long-term antifungal medication, short-term corticosteroids, intermittent thoracocentesis, rutin, octreotide, and enalapril.

  18. Medical image of the week: duplicate superior vena cava

    Directory of Open Access Journals (Sweden)

    L'Heureux D

    2013-04-01

    Full Text Available A persistent left SVC is the most common thoracic venous anomaly and usually opens into the right atrium via the coronary sinus. A central line inserted into the left SVC may be mistaken for placement in other sites such as the subclavian or carotid artery, the mediastinum, the pericardium or pleural space. A duplicate SVC may cause difficulty in introducing central venous catheters or pulmonary artery catheters because of the narrow opening of the coronary sinus to reach the right atrium. In addition, a duplicate SVC is associated with important cardiac conditions such as atrial septal defects and ventricular arrhythmias.

  19. Value of echocardiography in predicting the parameters of pulmonary arterial hypertension in pa-tients with congenital heart disease%超声心动图预测先天性心脏病相关性肺动脉高压患者参数的价值

    Institute of Scientific and Technical Information of China (English)

    丁春丽

    2016-01-01

    目的:评价超声心动图预测先天性心脏病相关性肺动脉高压患者肺循环参数的临床价值。方法选择2011年3月至2014年3月收治的38例肺动脉高压患者,21例有先天性心脏病,17例无先天性心脏病。经胸超声心动图(TTE)及心导管测量肺循环参数,同时应用 Fick 法、TTE 测定心输出量(CO),比较二者之间的关系。结果肺动脉压力测量值,无论有无先天性心脏病,TTE 法测量值与心导管法测量值均有相关性,无先天性心脏病患者的相关性高于有先天性心脏病患者的相关性,两者比较差异均未见统计学意义。心输出量测量值,TTE法与 Fick 法之间的相关性,无先天性心脏病患者高于有先天性心脏病患者;有先天性心脏病患者的 CO、TTE 与Fick 法测量值之间的曲线回归模型比较差异未见统计学意义,而无先天性心脏病患者差异有统计学意义。结论 TTE可以用来预测肺动脉高压患者的肺动脉压力,预测先天性心脏病相关性患者的肺动脉压力的准确性低于无先天性心脏病患者的肺动脉压力;在估测心输出量时需慎重,尤其是存在先天性心脏病时。%Objective To evaluate the clinical value of echocardiography in predicting the pa-rameters of pulmonary arterial hypertension( PAH ) in patients with congenital heart disease. Methods From March 2011 to March 2014,38 patients with PAH hospitalized were selected, 21 patients with congenital heart disease and 17 patients without congenital heart disease. Pulmonary hemodynamic parameters were measured by transthoracic echocardiography( TTE ) and right catheterization(RCH)examination. Cardiac output(CO)were obtained with Fick’s principle and TTE. Results Pulmonary arterial pressures(PAP)by TTE and RCH were more correlative in patients without congenital heart disease than in patients with congenital heart disease. The CO by TTE and Fick’s principle

  20. Diagnosing chronic thromboembolic pulmonary hypertension: current perspectives

    Directory of Open Access Journals (Sweden)

    Hadinnapola C

    2014-09-01

    Full Text Available Charaka Hadinnapola, Deepa Gopalan, David P Jenkins Papworth Hospital National Health Service Foundation Trust, Papworth Everard, Cambridge, United Kingdom Abstract: Chronic thromboembolic pulmonary hypertension is a rare and relatively poorly understood disease. It remains underdiagnosed and is often not recognized in primary and secondary care, as its symptoms are nonspecific and there are few clinical signs until late in the disease process. However, pulmonary endarterectomy (PEA offers a potential cure for patients with this type of pulmonary hypertension; therefore, it is important that they are identified and diagnosed in a timely manner. PEA is associated with a 2.2%–5% risk of significant morbidity and mortality, even in experienced PEA centers. Therefore, once chronic thromboembolic pulmonary hypertension is diagnosed, further assessment of operability and patient selection is crucial. Assessment of operability involves determining the distribution and burden of chronic thromboembolic disease, assessing pulmonary hemodynamics, and assessing the functional impairment of the patient. Ventilation perfusion scintigraphy is of value in screening for the presence of chronic thromboembolic disease. However, computer tomography pulmonary angiography and magnetic resonance pulmonary angiography are now increasingly used to image the vascular occlusions directly. This allows assessment of the surgically accessible disease burden. Some centers still advocate conventional selective pulmonary angiography for the latter. Right-heart catheterization remains the gold standard for assessing pulmonary hemodynamics. Higher pulmonary vascular resistances are associated with poorer outcomes as well as increased risks at the time of surgery. This is in part because of the presence of more distal chronic thromboembolic material and distal pulmonary artery remodeling. However, in experienced centers, these patients are being operated on safely and with good

  1. Congenital heart defect in a patient with deletion of chromosome 7q.

    Science.gov (United States)

    Tiller, G E; Watson, M S; Duncan, L M; Dowton, S B

    1988-02-01

    We describe a premature male infant with a terminal deletion of 7q [del(7) (pter----q34:)]. Manifestations include low birth weight, hypertelorism, bilateral cleft lip and palate, cryptorchidism, and a complex congenital heart defect. The latter consisted of hypoplasia of the main pulmonary artery, absent pulmonary valve, ventricular septal defect, and anomalous right pulmonary artery. We briefly review the spectrum of heart defects seen with chromosome 7 deletions, and comment on the incidence of this unusual heart lesion.

  2. [Agenesis of the infrarenal inferior vena cava with thrombosis of the renal vein in a fetus: a case report].

    Science.gov (United States)

    Raposo Rodríguez, L; Recio Rodríguez, M; Alvarez Moreno, E; López Azorín, M

    2012-01-01

    Agenesis of the inferior vena cava, especially of the infrarenal segment, is exceptional. This condition is thought to result from thrombosis during gestation rather than from a true congenital malformation. Agenesis of the inferior vena cava can be associated with renal vein thrombosis, which in turn is related to suprarenal hemorrhage in the fetus. We present a case of agenesis of the inferior vena cava with preservation of the hepatic segment, thrombosis of the left renal vein, and secondary bilateral suprarenal hemorrhage diagnosed prenatally using sonography and magnetic resonance imaging.

  3. To Observe the Curative Effect of Phentolamine Combined With Low Molecular Weight Heparin in Treatment of Acute Exacerbation of Chronic Pulmonary Heart Disease%酚妥拉明与低分子肝素联合治疗肺心病急性加重期的疗效观察

    Institute of Scientific and Technical Information of China (English)

    吕一敏

    2015-01-01

    Objective To analyzed the clinical effect of low molecular heparin combine with phentolamine in treatment of acute exacerbation of pulmonary heart disease. Methods 69 cases of pulmonary heart disease in acute exacerbation period were randomly divided into two groups,compared two groups of patients with therapeutic effect. Results The total effective rate of the treatment group was signiifcantly higher than that of the control group, the whole blood viscosity, plasma viscosity, erythrocyte aggregation index improved signiifcantly than the control group, PaO2 was signiifcantly higher than the control group, PaCO2 was significantly lower than the control group, P<0.05. Conclusion Phentolamine and low molecular weight heparin combination therapy pulmonary heart disease acute exacerbation has signiifcant effect.%目的:分析酚妥拉明与低分子肝素联合治疗肺心病急性加重期的疗效。方法将69例肺心病急性加重期患者随机分为两组,对比两组患者治疗效果。结果治疗组治疗总有效率较对照组提高,治疗后全血粘度、血浆粘度、红细胞聚集指数改善程度优于对照组,PaO2较对照组提高,PaCO2较对照组降低,P<0.05。结论酚妥拉明与低分子肝素联合治疗肺心病急性加重期取得显著效果,显著改善患者心肺功能。

  4. Evaluation of pulmonary arterial hypertension with simple congenital heart disease using tissue Doppler imaging%组织多普勒对单纯先天性心脏病相关肺动脉高压的再评估

    Institute of Scientific and Technical Information of China (English)

    杜佩; 杜国庆; 李海茹; 陈双; 吴言; 田家玮

    2014-01-01

    pulmonary arterial hypertension(PAH) with common simple congenital heart disease(CHD).Methods 104 patients of CHD approved by operation or intervention were retrospectively analyzed.Both TDI and right cardiac catheterization were performed in all patients,whose were divided into PAH and non-PAH groups according to mean pulmonary arterial pressure (mPAP) on diagnostic right cardiac catheterization:60 PAH patients[mPAP ≥25 mmHg(1 mmHg =0.133 kPa) and pulmonary arterial capillary wedge pressure ≤15 mmHg],44 non-PAH patients (mPAP <25 mmHg).The PAH group was divided into mild (25 mmHg≤ mPAP≤35 mmHg),moderate (36 mmHg≤mPAP≤50 mmHg) and severe (mPAP>50 mmHg) subgroups.The tricuspid annular systolic peak velocity (TS'),early diastolic peak velocity (TE'),late diastolic peak velocity (TA') were measured by TDI and TE'/TA' and Tei index were calculated.The correlation between TDI parameters and the cardiac catheterization findings (sPAP,mPAP and dPAP) were assessed.Results ①TS' and TE' in PAH group were significantly lower than those in non-PAH(P < 0.05),but Tei in PAH group were significantly higher than that in non-PAH (P <0.001),however,there were no significant difference in TA' and TE'/TA' between two groups (P > 0.05).②Tei correlated positively with pulmonary arterial pressure (P <0.001),TS' was found to be negatively correlated with pulmonary arterial pressure(P <0.05),but no correlation between TE',TA',TE'/TA' and pulmonary arterial pressure(P >0.05).③ROC analysis showed the area under curves for Tei index and TS' diagnosis for PAH was 0.893 and 0.699,respectively.At the cutoff of Tei>0.49 and TS'<16 cm/s for indicating PAH,the sensitivity were 86.67 % and 80.00%,respectively and the specificity were 79.55 % and 45.45 %,respectively.④Tei in the moderate and severe PAH were significantly higher than that in mild PAH (P < 0.05),TS' and TE' in severe PAH were significantly lower than those in mild and moderate PAH (P < 0

  5. Analysis of serum level of SDF-1 in patients with congenital heart disease and pulmonary hypertension%先天性心脏病伴肺动脉高压患儿血清基质细胞衍生因子1水平变化

    Institute of Scientific and Technical Information of China (English)

    刘丽华; 李亚蕊

    2013-01-01

    Objective To assess the serum level of stromal-cell-derived factor 1 (SDF-1) in patients with congenital heart disease (CHD) and pulmonary arterial hypertension. Methods The heart color Doppler ultrasound was conducted to measure the tricuspid regurgitation velocity, in order to estimate pulmonary artery systolic pressure. According to the existing standards, a total of 86 patients were divided into CHD without pulmonary hypertension group (n=16), mild pulmonary hypertension group (n=18), moderate pulmonary hypertension group (n=17), severe pulmonary hypertension group (n=15). Another 20 healthy chil-dren were recruited as control group (n=20), The serum level of SDF-1 was detected by the ELISA method. Results The serum SDF-1 levels were signiifcantly lower in CHD groups than in control group (F=27.793, P<0.001). In CHD groups, CHD with se-vere pulmonary hypertension group had the lowest SDF-1 level, and CHD without pulmonary hypertension group had the highest SDF-1 level. There were signiifcant differences between CHD groups (P<0.05). The pulmonary artery systolic pressure was cor-related with serum SDF-1 levels (r=-0.737, P<0.001). Conclusions The serum level of SDF-1 is decreased in patients with CHD, and is negatively correlated with the severity of pulmonary arterial hypertension.%目的:探讨先天性心脏病(CHD)伴肺动脉高压患儿血清基质细胞衍生因子1(SDF-1)水平的变化。方法66例CHD患儿,采用心脏彩色多普勒超声测算三尖瓣返流速度,并估算肺动脉收缩压;根据肺动脉压,分为无肺高压组16例,轻度肺高压组18例,中度肺高压组17例,重度肺高压组15例;另20例健康儿童作为对照组。以ELISA法检测并比较各组患儿血清SDF-1水平。结果各组CHD患儿与对照组的血清SDF-1水平差异有统计学意义(F=27.793,P<0.001)。各组CHD患儿的SDF-1水平均低于对照组;CHD患儿中,重度肺高压组的血清SDF-1水平最低

  6. [Atrial fibrillation concomitant with valvular heart disease].

    Science.gov (United States)

    Ishii, Yosuke

    2013-01-01

    Patients with valvular heart disease frequently have atrial fibrillation(AF) due to elevated pressure and dilatation of the left and right atria and pulmonary veins. Guidelines for valvular heart disease and AF recommend that surgical treatment for the valvular heart disease should be performed concomitantly with AF surgery. The Full-Maze procedure has evolved into the gold standard of treatment for medically refractory AF. In addition to the pulmonary vein isolation, the right and left atrial incisions of the Full-Maze procedure are designed to block potential macroreentrant pathways. According to the mechanisms of AF with valvular heart disease, the Full-Maze procedure is more effective for the patients than the pulmonary vein isolation alone.

  7. Hypertrophic Cardiomyopathy Complicated by Pulmonary Edema in the Postpartum Period

    Directory of Open Access Journals (Sweden)

    Kate Hanneman

    2013-01-01

    Full Text Available We report the case of a 42-year-old patient with hypertrophic cardiomyopathy (HCM who presented to the emergency department with severe shortness of breath one week following uneventful cesarean delivery. Thoracic CT ruled out pulmonary embolus and confirmed pulmonary edema. Asymmetric interventricular septal thickening was clearly identified, demonstrating that the heart may be evaluated even on a non-ECG gated study. Acute pulmonary edema in the postpartum period is an unusual clinical presentation of HCM.

  8. Multifactorial Etiology Pulmonary Hypertension in a Patient with Sarcoidosis

    Directory of Open Access Journals (Sweden)

    Barreto Ana Terra Fonseca

    2016-01-01

    Full Text Available Differential diagnosis between pre- and postcapillary pulmonary hypertension (PH in patients with diastolic heart failure (DHF is a challenge in clinical practice. The presence of PH is implicated in worse prognosis in patients with this disease. This case report approaches the process of investigation of pulmonary hypertension in adult patient with DHF, double mitral lesion, and sarcoidosis with poor clinical outcome.

  9. Multifactorial Etiology Pulmonary Hypertension in a Patient with Sarcoidosis

    Science.gov (United States)

    Lucas Vinícius da Fonseca, Barreto; Felipe Naze Rodrigues, Cavalcante; Joselina Luzia Menezes, Oliveira; Marcos Antônio, Almeida-Santos; José Augusto Soares, Barreto-Filho; Antônio Carlos Sobral, Sousa

    2016-01-01

    Differential diagnosis between pre- and postcapillary pulmonary hypertension (PH) in patients with diastolic heart failure (DHF) is a challenge in clinical practice. The presence of PH is implicated in worse prognosis in patients with this disease. This case report approaches the process of investigation of pulmonary hypertension in adult patient with DHF, double mitral lesion, and sarcoidosis with poor clinical outcome.

  10. Effects of erythropoietin on advanced pulmonary vascular remodelling

    NARCIS (Netherlands)

    van Albada, M. E.; Sarvaas, G. J. du Marchie; Koster, J.; Houwertjes, M. C.; Berger, R. M. F.; Schoemaker, R. G.

    2008-01-01

    Erythropoietin (EPO) mobilises endothelial progenitor cells and promotes neovascularisation in heart failure. The present authors studied the effects of EPO on pulmonary vascular and cardiac remodelling in a model for flow-associated pulmonary arterial hypertension (PAH). PAH was induced in adult ma

  11. Implante de filtro de veia cava com uso de dióxido de carbono como meio de contraste: série de casos Carbon dioxide use as contrast for vena cava filter implantation: case series

    Directory of Open Access Journals (Sweden)

    Matheus Pessanha de Rezende

    2012-03-01

    Full Text Available OBJETIVO: Avaliar o resultado do implante de filtro em veia cava inferior empregando angiografia digital por subtração com dioxide de carbono (CO2 como meio de contraste. MÉTODOS: No período de abril de 2010 a fevereiro de 2011, sete pacientes foram submetidos ao implante de filtro na veia cava inferior, utilizando-se CO2 como meio de contraste em subtração digital. Os pacientes apresentaram como critério de inclusão trombose venosa profunda no setor ilíaco-femoral e contraindicação à anticoagulação. RESULTADOS: Foi obtido sucesso técnico em todos os casos, com adequada visualização da veia cava e veias renais, não havendo complicações relacionadas ao uso do CO2 ou ao procedimento. CONCLUSÃO: O implante de filtro de veia cava utilizando o CO2 como meio de contraste é segura e efetiva em pacientes portadores de alergia ao contraste iodado ou com insuficiência renal não dialítica.OBJECTIVE: To assess the use of digital subtraction with carbon dioxide (CO2 for vena cava filter implant. METHODS: From April (2010 to February (2011, seven patients underwent inferior vena cava filter placement with digital subtraction angiography with the use of CO2 as contrast media. All patients had iliac and femoral deep venous thrombosis and contraindications for anticoagulation. RESULTS: Technical success was achieved in all cases. Inferior vena cava e renal veins were identified in all cases. There were no evidences of complications related to the use of CO2 during or after the procedure. CONCLUSION: The placement of inferior vena cava filter with CO2 and digital subtraction angiography is safe and effective with good results in patients with renal insufficiency and allergy to iodine.

  12. Heart Disease

    Science.gov (United States)

    ... daily aspirin to prevent heart attack? Does taking birth control pills increase my risk for heart disease? Does using ... tells you to. Return to top Does taking birth control pills increase my risk for heart disease? Taking birth ...

  13. Heart-lung transplantation for end-stage heart disease with Eisenmenger's syndrome: report of two cases

    Institute of Scientific and Technical Information of China (English)

    ZHANG Xi; XIONG Mai; WANG Zhi-ping; YIN Sheng-li; WU Zhong-kai; XU Ying-qi; TANG Bai-yun; YAO Jian-ping; CHEN Guang-xian

    2009-01-01

    @@ From September 2006 to January 2007, 2 patients with end-staged heart and lung disease (congenital disease, Eisenmenger's syndrome, severe pulmonary artery hypertension and heart failure) underwent heart and lung transplantation (HLT) at the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.

  14. Malformação de veia cava inferior e trombose venosa profunda: fator de risco de trombose venosa em jovens Inferior vena cava malformation and deep venous thrombosis: a risk factor of venous thrombosis in the young

    Directory of Open Access Journals (Sweden)

    Renan Roque Onzi

    2007-06-01

    Full Text Available A ausência da veia cava inferior, alteração no processo de formação embriológica que ocorre entre a sexta e a oitava semanas de gestação, é uma rara anomalia congênita. Porém, recentemente foi confirmada como sendo um fator de risco importante para o desenvolvimento de trombose venosa profunda, especialmente em jovens. Apresentamos um caso de trombose em veias cava inferior, ilíacas, femorais e poplíteas num jovem de 16 anos com agenesia de um segmento de veia cava infra-renal e veia renal esquerda retroaórtica.Absence of inferior vena cava, caused by aberrant development within the sixth to eighth weeks of gestation, is a rare congenital anomaly. However, it has been recently confirmed as a major risk factor for the development of deep venous thrombosis, especially in young patients. We report a case of inferior vena cava, iliac, femoral and popliteal vein thrombosis in a 16-year-old patient with inferior vena cava agenesis and retroaortic left renal vein.

  15. Sinus node, phrenic nerve and electrical connections between superior vena cava and right atrium: lessons learned from a prospective study

    Institute of Scientific and Technical Information of China (English)

    LONG De-yong; MA Chang-sheng; JIANG Hong; DONG Jian-zeng; LIU Xing-peng; HUANG He; TANG Yan-hong; WU Gang; HUANG Cong-xin

    2009-01-01

    Background When performing superior vena cava isolation, the major concerns are inadvertent ablation on sinus node and right phrenic nerve. However, little is known about the spatial relationship of electrical connections between superior vena cava and right atrium with the sinus node and phrenic nerve locations among individual patients.Methods We studied 87 patients (male/female 60/27, mean age of (51±9) years) with atrial fibrillation. Before superior vena cava isolation, the sinus node site was defined by right atrium activation mapping during sinus rhythm and the right phrenic nerve site was localized via pacing manoeuvre. Superior vena cava was isolated by ablation at the electrical connection under the guidance of circular mapping catheter. The sites of sinus node, phrenic nerve and electrical connections were noted. Continuous variables were compared using Student's t test. A P value <0.05 was considered statistically significant.Results Right atrium activation mapping revealed that the sinus node located at the anterior lateral segment of superior vena cava-right atrium junction in all patients, in 82 patients with detectable diaphragmatic stimulations, the phrenic nerve sites were predominantly at the lateral segment (70/82) with anterior lateral and anterior segments for a few patients. A total of 165 electrical connections were located among all 87 patients, and this averaged 1.8±0.6 (1-3) per patient. The anterior septum (72 patients (43.6%)), the anterior wall (40 (24.2%)), and the posterior septum (35 (35.4%)) of superior vena cava-right atrium junction were the electrical connection regular sites. Superior vena cava was isolated in all patients. Two patients developed sinus bradycardia, with 3 mild superior vena cava stenosis and 2 phrenic nerve palsy.Conclusions The sinus node, phrenic nerve and electrical connection sites were distributed along the superior vena cava-right atrium junctions at expected locations for most patients. The electrical

  16. Self-perceived symptoms and care needs of patients with severe to very severe chronic obstructive pulmonary disease, congestive heart failure or chronic renal failure and its consequences for their closest relatives: the research protocol

    Directory of Open Access Journals (Sweden)

    Schols Jos MGA

    2008-05-01

    Full Text Available Abstract Background Recent research shows that the prevalence of patients with very severe chronic obstructive pulmonary disease (COPD, congestive heart failure (CHF and chronic renal failure (CRF continues to rise over the next years. Scientific studies concerning self-perceived symptoms and care needs in patients with severe to very severe COPD, CHF and CRF are scarce. Consequently, it will be difficult to develop an optimal patient-centred palliative care program for patients with end-stage COPD, CHF or CRF. The present study has been designed to assess the symptoms, care needs, end-of-life care treatment preferences and communication needs of patients with severe to very severe COPD, CHF or CRF. Additionally, family distress and care giving burden of relatives of these patients will be assessed. Methods/design A cross-sectional comparative and prospective longitudinal study in patients with end-stage COPD, CHF or CRF has been designed. Patients will be recruited by their treating physician specialist. Patients and their closest relatives will be visited at baseline and every 4 months after baseline for a period of 12 months. The following outcomes will be assessed during home visits: self-perceived symptoms and care needs; daily physical functioning; general health status; end-of-life care treatment preferences; end-of-life care communication and care-giver burden of family caregivers. Additionally, end-of-life care communication and prognosis of survival will be assessed with the physician primarily responsible for the management of the chronic organ failure. Finally, if patients decease during the study period, the baseline preferences with regard to life-sustaining treatments will be compared with the real end-of-life care. Discussion To date, the symptoms, care needs, caregiver burden, end-of-life care treatment preferences and communication needs of patients with very severe COPD, CHF or CRF remain unknown. The present study will

  17. Prevalência e preditores de embolia pulmonar em pacientes com insuficiência cardíaca agudamente descompensada Prevalence and predictors of pulmonary embolism in patients with acutely decompensated heart failure

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    Luís C. L. Correia

    2012-02-01

    Full Text Available FUNDAMENTO: Não existe descrição da prevalência de Embolia Pulmonar (EP em pacientes internados por quadro clássico de Insuficiência Cardíaca descompensada (IC. OBJETIVO: Em pacientes internados por IC, (1 descrever a prevalência de EP, e (2 avaliar a acurácia diagnóstica dos Escores de Wells e de Genebra. MÉTODOS: Pacientes internados primariamente por IC realizaram sistematicamente cintilografia pulmonar de ventilação/perfusão, sendo EP definida por laudo de alta probabilidade. Para fins de interpretação, definimos baixa probabilidade clínica de EP como prevalência BACKGROUND: The prevalence of pulmonary embolism (PE has not been reported in patients hospitalized due to classical findings of decompensated heart failure (HF. OBJECTIVE: To describe the prevalence of PE and to assess the diagnostic accuracy of the Wells and Geneva scores in patients hospitalized due to HF. METHODS: Patients hospitalized primarily due to HF underwent systematic ventilation-perfusion lung scan, and PE was defined by a result of high probability. Aiming at interpreting, low clinical probability of PE was defined as prevalence < 5%, according to the literature. When calculating the sample size, 49 patients were required to provide a 95% confidence interval with ±10% accuracy, estimating an a priori prevalence of 15%. RESULTS: Of 51 patients studied, six had a high probability of PE on lung scan, resulting in 12% prevalence (95% CI = 5% - 23%. The Wells and Geneva scores had an area under the ROC curve of 0.53 (95% CI = 0.27 - 0.80; p = 0.80 and 0.43 (95% CI = 0.13 - 0.73; p = 0.56, respectively, indicating lack of accuracy for the diagnosis of PE. Alternatively, variables related to HF showed a tendency towards association with PE, and an exploratory model formed by that type of variable showed diagnostic accuracy for PE (ROC = 0.81; 95% CI = 0.66 - 0.96; p = 0.01. CONCLUSION: (1 Despite the lack of primary suspicion, patients admitted with HF have

  18. [Duplication of the superior vena cava and other malformations discovered at insertion of a port-a-cath].

    Science.gov (United States)

    Hammerer, V; Jeung, M; Mennecier, B; Demian, M; Pauli, G; Quoix, E

    2005-09-01

    We report a clinical case of a persistent left superior vena cava discovered in a 50-year-old female patient when a port-a-cath was inserted. This already seldom malformation was associated with an arteria lusoria and polysplenia with left inferior vena cava with hemiazygos continuation, right-sided stomach, short pancreas, preduodenal portal vein and intestinal malrotation, but without any cardiac abnormalities.

  19. Dialysis catheter-related superior vena cava syndrome with patent vena cava: Long term efficacy of unilateral viatorr stent-graft avoiding catheter manipulation

    Energy Technology Data Exchange (ETDEWEB)

    Quaretti, Pietro; Galli, Franco; Maramarco, Lorenzo Paplo; Corti, Riccardo; Leati, Giovanni; Fiorina, Ilaria; Maestri, Marcello [IRCCS Policlinico San Matteo Foundation, Pavia (Italy)

    2014-06-15

    Central venous catheters are the most frequent causes of benign central vein stenosis. We report the case of a 79-year-old woman on hemodialysis through a twin catheter in the right internal jugular vein, presenting with superior vena cava (SVC) syndrome with patent SVC. The clinically driven endovascular therapy was conducted to treat the venous syndrome with a unilateral left brachiocephalic stent-graft without manipulation of the well-functioning catheter. The follow-up was uneventful until death 94 months later.

  20. Is the inferior vena cava diameter measured by bedside ultrasonography valuable in estimating the intravascular volume in patients with septic shock?

    Directory of Open Access Journals (Sweden)

    Mortaza Talebi Doluie

    2016-07-01

    Full Text Available Introduction:Resuscitation should be initiated immediately in shock. Early goal-directed therapy is an established algorithm for the resuscitation in septic shock. The first step is to maintain cardiac preload. Central venous pressure (CVP plays an important role in goal-directed therapy. Central venous catheterization is invasive and time-consuming in emergency conditions. There are some alternative and noninvasive methods for estimating the intravascular volume such as measuring the inferior vena cava (IVC diameter by ultrasonography. Methods: We searched PubMed, Google scholar, and Scopus databases with keywords (central venous pressure OR venous pressure OR CVP AND (ultrasonography OR sonography AND (sepsis OR septic shock AND (inferior vena cava OR IVC.Result: The search resulted in 2550 articles. The articles were appraised regarding the relevance, type of article, and statistical methods. Finally, 12 articles were selected. The number of patients was between 30 and 83 cases (mean age=57-67 years, intubated and non-intubated in each study. The IVC diameter was measured in respiratory cycle by bedside ultrasonography in longitudinal subxiphoid view and caval index was calculated, then they were compared with the CVP measured by central venous catheter.Discussion: CVP is an indicator of intravascular fluid status and right heart function. CVP measurement is an invasive method and of course with some complications. The IVC is the biggest vein of venous system with low-pressure; expansion of the vein reflects intravascular volume.Conclusion: It seems that IVC diameter measured by ultrasonography could be used as an alternative method for the determination of CVP in the emergency or critical patients.

  1. Congenital inferior vena cava anomalies: a review of findings at multidetector computed tomography and magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Catherine; Trad, Clovis Simao [Central de Diagnostico Ribeirao Preto (CEDIRP), SP (Brazil); Trad, Henrique Simao, E-mail: hstrad@terra.com.br [Central de Diagnostico Ribeirao Preto (CEDIRP), SP (Brazil); Universidade de Sao Paulo (HC-FMRPUSP), Ribeirao Preto, SP (Brazil). Fac. de Medicina. Hospital das Clinicas; Mendonca, Silvana Machado [Clinica de Diagnostico por Imagem (CDPI), Rio de Janeiro, RJ (Brazil)

    2013-06-15

    Inferior vena cava anomalies are rare, occurring in up to 8.7% of the population, as left renal vein anomalies are considered. The inferior vena cava develops from the sixth to the eighth gestational weeks, originating from three paired embryonic veins, namely the subcardinal, supracardinal and postcardinal veins. This complex ontogenesis of the inferior vena cava, with multiple anastomoses between the pairs of embryonic veins, leads to a number of anatomic variations in the venous return from the abdomen and lower limbs. Some of such variations have significant clinical and surgical implications related to other cardiovascular anomalies and in some cases associated with venous thrombosis of lower limbs, particularly in young adults. The authors reviewed images of ten patients with inferior vena cava anomalies, three of them with deep venous thrombosis. The authors highlight the major findings of inferior vena cava anomalies at multidetector computed tomography and magnetic resonance imaging, correlating them the embryonic development and demonstrating the main alternative pathways for venous drainage. The knowledge on the inferior vena cava anomalies is critical in the assessment of abdominal images to avoid misdiagnosis and to indicate the possibility of associated anomalies, besides clinical and surgical implications. (author)

  2. Congenital inferior vena cava anomalies: a review of findings at multidetector computed tomography and magnetic resonance imaging

    Directory of Open Access Journals (Sweden)

    Catherine Yang

    2013-07-01

    Full Text Available Inferior vena cava anomalies are rare, occurring in up to 8.7% of the population, as left renal vein anomalies are considered. The inferior vena cava develops from the sixth to the eighth gestational weeks, originating from three paired embryonic veins, namely the subcardinal, supracardinal and postcardinal veins. This complex ontogenesis of the inferior vena cava, with multiple anastomoses between the pairs of embryonic veins, leads to a number of anatomic variations in the venous return from the abdomen and lower limbs. Some of such variations have significant clinical and surgical implications related to other cardiovascular anomalies and in some cases associated with venous thrombosis of lower limbs, particularly in young adults. The authors reviewed images of ten patients with inferior vena cava anomalies, three of them with deep venous thrombosis. The authors highlight the major findings of inferior vena cava anomalies at multidetector computed tomography and magnetic resonance imaging, correlating them the embryonic development and demonstrating the main alternative pathways for venous drainage. The knowledge on the inferior vena cava anomalies is critical in the assessment of abdominal images to avoid misdiagnosis and to indicate the possibility of associated anomalies, besides clinical and surgical implications.

  3. Influence of enteral nutrition duration in treatment of cardiac function and inflammatory factors in patients with elderly chronic pulmonary heart failure%肠内营养不同治疗时限对老年肺心病心衰患者炎性因子及心功能的影响

    Institute of Scientific and Technical Information of China (English)

    王瑞萍; 杨莉; 王俊; 王煜; 李轶炜

    2012-01-01

    目的 探讨肠内营养不同治疗时限对老年肺心病心衰患者血清炎性因子及心功能的影响.方法 以90例老年肺心病心衰患者为研究对象,将患者随机分为三组,三组在常规治疗心衰同时,A组给予自由饮食,B组给予肠内营养治疗1月,C组给予肠内营养治疗6月.各组治疗前后均检测各营养指标,用放免发测TNF-α、IL-6,用心脏超声检测左室射血分数LVEF.结果 肠内营养组患者在治疗后各营养指标均有改善,炎性因子水平均有降低,心功能均有所改善,治疗前后比较有统计学意义(P<0.05),尤其在C组中改善更为明显(P<0.01).自由饮食组中,治疗后各营养指标无改善,血清炎性因子水平及心功能有所改善,但治疗前后比较无统计学意义(P>0.05).结论 老年肺心病心衰患者,在常规治疗心衰同时重视肠内营养治疗,可以改善患者营养状况从而改善免疫功能,调节炎性因子水平,进一步改善患者心功能,并且治疗时限越长心功能及炎性因子水平改善越明显.%Objectives To investigate the influence of enteral nutrition duration in treatment of cardiac function and inflammatory factors in patients with elderly chronic pulmonary heart failure. Methods The patients were randomly divided into three groups for the study ,90 cases of senile pulmonary heart disease in patients with heart failure. Three groups in the conventional treatment of heart failure at the same time, group A given free diet, group B enteral nutrition in the treatment for one month,group C enteral nutrition therapy for 6 months. Various nutrition indicators in each group before and after treatment to detect the nutritional index, measured by RIA hair TNF - α, IL - 6, with a heart ultrasonic testing of left ventricular ejection fraction LVEF. Results Enteral nutrition in patients after treatment were significantly decreased, inflammatory cytokines were reduced,heart function improved after treatment

  4. Pulmonary hypertension with a huge thrombosis in main stem of pulmonary artery

    Institute of Scientific and Technical Information of China (English)

    杨萍; 曾红; 孟繁波; 赵林阳

    2001-01-01

    @@A huge thrombosis in the main stem of the pulmonary artery (PA) with pulmonary hypertension has rarely been reported. We present two cases diagnosed and treated in our hospital. One suffered from polyarteritis with a huge thrombus in PA revealed at autopsy. The second case had congenital heart disease of the patent artery duct; and the huge thrombus was found on echocardiogram and extirpated in surgery.

  5. Entrapment of Guide Wire in an Inferior Vena Cava Filter: A Technique for Removal

    Energy Technology Data Exchange (ETDEWEB)

    Abdel-Aal, Ahmed Kamel, E-mail: akamel@uabmc.edu; Saddekni, Souheil [University of Alabama at Birmingham, Department of Radiology (United States); Hamed, Maysoon Farouk [University of Alabama at Birmingham, Department of Anesthesia (United States); Fitzpatrick, Farley [Radiology Specialists of Louisville (United States)

    2013-04-15

    Entrapment of a central venous catheter (CVC) guide wire in an inferior vena cava (IVC) filter is a rare, but reported complication during CVC placement. With the increasing use of vena cava filters (VCFs), this number will most likely continue to grow. The consequences of this complication can be serious, as continued traction upon the guide wire may result in filter dislodgement and migration, filter fracture, or injury to the IVC. We describe a case in which a J-tipped guide wire introduced through a left subclavian access without fluoroscopic guidance during CVC placement was entrapped at the apex of an IVC filter. We describe a technique that we used successfully in removing the entrapped wire through the left subclavian access site. We also present simple useful recommendations to prevent this complication.

  6. Spanish sparkling wines (Cavas) as inhibitors of in vitro human low-density lipoprotein oxidation.

    Science.gov (United States)

    Satué-Gracia, M T; Andrés-Lacueva, C; Lamuela-Raventós, R M; Frankel, E N

    1999-06-01

    Forty-seven dealcoholized sparkling wines (cava) from the Penedès area in Spain were tested for their antioxidant activity in a low-density lipoprotein system. The effect of different quality-related parameters, such as harvest year or grape variety, was investigated. Twenty-two phenolic compounds were separated by high-performance liquid chromatography and identified by comparing their retention time and their ultraviolet spectra with those of pure standards. When tested at the same total phenol concentration, the antioxidant activity of these white sparkling wines was found to be similar to that reported for red wines. This activity was positively correlated with the total phenolic content, trans-caffeic acid, coumaric acid, protocatechuic acid, and quercetin 3-glucuronide. The wines made of the classic cava wine coupage had superior antioxidant activity compared to those of other cultivars.

  7. Creating a Fontan fenestration in a child with dextrocardia and interrupted inferior vena cava

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    Pradeepkumar Charlagorla

    2016-01-01

    Full Text Available Plastic bronchitis is a rare life-threatening complication of the Fontan operation. Transcatheter Fontan fenestration can ameliorate symptoms by decompressing elevated venous pressures. Transcatheter creation of a fenestration can be technically challenging in cases with complex venous anatomy. We report a case of a 5-year-old boy with heterotaxy, dextrocardia with unbalanced atrioventricular canal (AVC, atrial and visceral situs inversus, left-sided superior vena cava (SVC, and left-sided interrupted inferior vena cava (IVC with azygos continuation. With few modifications to the equipment, a successful Fontan fenestration with stent implantation was performed via transjugular approach. At 2-year follow-up, his symptoms of plastic bronchitis improved significantly.

  8. MALIGNANT LYMPHOMA DEMONESTRATING SICK SINUS SYNDROME AND SUPERIOR VENA CAVA SYNDROME

    OpenAIRE

    S K Forouzannia; M h Abdollahi; Mirhosseini, S. J.; S H Moshtaghion; HOSSEINI, H; Jorat, M. V.; M Moeeni; M A Karimi-Zarchi

    2008-01-01

    "nReports which describe sick sinus syndrome due to malignant lymphoma have been rare and only eight cases have been reported until now. This is a case of sick sinus syndrome and superior ve