Ultrastructure of periprosthetic Dacron knee ligament tissue. Two cases of ruptured anterior cruciate ligament reconstruction.

Science.gov (United States)

Salvi, M; Velluti, C; Misasi, M; Bartolozzi, P; Quacci, D; Dell'Orbo, C

1991-04-01

Light- and electron-microscopic investigations were performed on two failed Dacron ligaments that had been removed from 2 patients shortly after failure of the implant 2-3 years after reconstruction of the anterior cruciate ligament. Two different cell populations and matrices were correlated with closeness to the Dacron threads. Fibroblasts surrounded by connective tissue with collagen fibrils were located far from the Dacron threads. Roundish cells, appearing to be myofibroblasts surrounded by a more lax connective tissue and elastic fibers, were found close to the Dacron threads. The presence of myofibroblasts and the matrix differentiation could be attributed to the different mechanical forces acting on the Dacron and on the connective tissue because of their different coefficients of elasticity. The sparse occurrence of inflammatory cells in the synovial membrane and in the connective tissue surrounding the Dacron supports the biologic inertness of this artificial material. However, the repair tissue was not structured to resist tension stresses.

Surgery for acute Type I aortic dissection without resection of supra-aortic entry sites leads to unfavourable aortic remodelling.

Science.gov (United States)

Heo, Woon; Song, Suk-Won; Lee, Kwang-Hun; Lee, Shin-Young; Kim, Tae-Hoon; Baek, Min-Young; Yoo, Kyung-Jong

2018-01-29

This study aimed to evaluate the impact of remnant re-entries in arch branches on postoperative change in the aortic arch and descending aortic diameters and the rate of major adverse aortic events. Between January 2010 and December 2016, 249 patients underwent surgery for acute Type I aortic dissection. Patients who underwent total arch replacement, had Marfan syndrome or had intramural haematoma were excluded. Seventy-two patients with predischarge and follow-up computed tomography scans were enrolled. Patients with and without re-entries in the arch branches after surgery were assigned to the supra-aortic entry (SAE, n = 21) and no supra-aortic entry (n = 51) groups, respectively. Diameters were measured at 7 levels: the innominate artery, left common carotid artery, left subclavian artery, 20 mm distal to the left subclavian artery, pulmonary artery bifurcation, coeliac axis and maximal diameter of the descending thoracic aorta. Growth rates at the levels of the pulmonary artery bifurcation and 20 mm distal to the left subclavian artery were significantly higher in the SAE group than in the no supra-aortic entry group. The rate of freedom from major adverse aortic events (annual growth >5 mm or maximal diameter of the descending thoracic aorta >50 mm) at 5 years was significantly higher in the no supra-aortic entry group than in the SAE group. Remnant SAE leads to unfavourable aortic remodelling after acute Type I aortic dissection repair. © The Author(s) 2018. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Aneurysm growth after late conversion of thoracic endovascular aortic repair

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Hirofumi Kasahara

2015-01-01

Full Text Available A 69-year-old man underwent thoracic endovascular aortic repair of a descending aortic aneurysm. Three years later, he developed impending rupture due to aneurysmal expansion that included the proximal landing zone. Urgent open surgery was performed via lateral thoracotomy, and a Dacron graft was sewn to the previous stent graft distally with Teflon felt reinforcement. Postoperatively, four sequential computed tomography scans demonstrated that the aneurysm was additionally increasing in size probably due to continuous hematoma production, suggesting a possibility of endoleaks. This case demonstrates the importance of careful radiologic surveillance after endovascular repair, and also after partial open conversion.

Hybrid treatment of a true thyreocervical trunk aneurysm in a patient with Type B aortic dissection

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Nikolaos G Baikoussis

2016-01-01

Full Text Available We would like to describe a case with a complex aortic disease treated in hybrid fashion. We present an interesting case of a 65-year-old man with a medical history of hypertension, hyperlipidemia, and coronary artery disease percutaneously treated. An acute Type B aortic dissection occurred and treated with the implantation of a stent-graft which occluded the left subclavian artery due to its extension to the aortic arch. This event required a carotid-subclavian artery bypass due to ischemia of the left arm. An aneurysm in the innominate artery also detected, was treated with another stent-graft implantation 3 months later. At 5-year follow-up, an aneurysm of the thyreocervical trunk was found while the stent-graft of the aorta was well-tolerated without endoleak and the carotid-subclavian graft was patent. The aneurysm was asymptomatic but considering the risk of spontaneous rupture of an aneurysm of this size, elective surgery was indicated. Because the aneurysm was very close to the brachiocephalic bifurcation, open surgical repair would require a sternotomy. The right common carotid artery and right subclavian artery were exposed. The thyrocervical trunk, right internal mammary artery and right vertebral artery were occluded by ligations to isolate the aneurysm. An 8-mm Dacron graft was anastomosed end-to-end to the distal part of subclavian artery. We would like through this case, discuss the role of the hybrid cardiovascular surgery to minimize the postoperative complications in complex cardiovascular pathology. We also discuss the international bibliography about the thyreocervical trunk aneurysm and the treatment options.

In vivo assessment of a novel dacron surface with covalently bound recombinant hirudin.

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Wyers, M C; Phaneuf, M D; Rzucidlo, E M; Contreras, M A; LoGerfo, F W; Quist, W C

1999-01-01

Prosthetic arterial graft surfaces are relatively thrombogenic and fail to heal with a cellular neointima. The goal of this study was to characterize the in vivo antithrombin properties of a novel Dacron surface with covalently linked recombinant hirudin (rHir) implanted in a canine thoracic aorta with high flow and shear rates. rHir was bound to a knitted Dacron patch using crosslinker-modified bovine serum albumin (BSA) as a basecoat protein. BSA was first reacted with the heterobifunctional crosslinker, sulfo-SMCC. This BSA-SMCC complex was then bound to the carboxylic acid groups of hydrolyzed Dacron patches using the carbodiimide crosslinker, 1-ethyl-3-(3-dimethylaminopropyl)carbodiimide hydrochloride. Iodinated, Traut's-modified rHir (125I-rHir-SH) was then reacted with the Dacron-BSA-SMCC surface, thereby covalently binding 125I-rHir. Graft segments were washed and sonicated to remove any nonspecifically bound 125I-rHir. Dacron-BSA-SMCC-S-125I-rHir patches (n = 5) and control Dacron-BSA patches (n = 5) were implanted in series in the thoracic aortas of canines. These patches were exposed to nonheparinized, arterial blood flow for 2 hours. Patches were explanted and assessed for 125I-rHir loss. Antithrombin activity of explanted 1-cm2 patch segments was evaluated using a chromogenic assay with 1, 5, 10, 15 units of added thrombin. Light microscopy was performed to qualitatively examine the pseudointima. Two animals were excluded from the study owing to excessive bleeding through the knitted 125I-rHir patch. Comparison of preoperative and postoperative 125I-rHir gamma counts revealed an overall decrease of 20+/-5.4% over the period studied. Explanted 125I-rHir patch segments were able to inhibit 1, 5, and 7 NIHU of thrombin, demonstrating retained antithrombin activity. Gross and microscopic examination of the control and test Dacron surfaces showed marked differences. Dacron surfaces with covalently bound 125I-rHir had no gross thrombus and a thin

Mortality and complications after aortic bifurcated bypass procedures for chronic aortoiliac occlusive disease

DEFF Research Database (Denmark)

Bredahl, Kim; Jensen, Leif Panduro; Schroeder, Torben V

2015-01-01

skills, particularly because open surgery is increasingly used in those patients who are unsuitable for endovascular repair and hence technically more demanding. We assessed the early outcome after aortic bifurcated bypass procedures during two decades of growing endovascular activity and identified...... preoperative risk factors. METHODS: Data on patients with chronic limb ischemia were prospectively collected during a 20-year period (1993 to 2012). The data were obtained from the Danish Vascular Registry, assessed, and merged with data from The Danish Civil Registration System. RESULTS: We identified 3623...... aortobifemoral and 144 aortobiiliac bypass procedures. The annual caseload fell from 323 to 106 during the study period, but the 30-day mortality at 3.6% (95% confidence interval [CI], 3.0-4.1) and the 30-day major complication rate remained constant at 20% (95% CI, 18-21). Gangrene (odds ratio [OR], 3.3; 95% CI...

Hybrid treatment of bullet embolism at the abdominal aortic bifurcation, complicated with thoracoabdominal aorta pseudoaneurysm and common iliac artery occlusion: case report

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Patrick Bastos Metzger

2014-03-01

Full Text Available Embolization due to a firearm projectile entering the bloodstream is a rare event that is unlikely to be suspected during initial treatment of trauma patients. We describe and discuss a case of bullet embolism of the abdominal aortic bifurcation, complicated by a pseudoaneurysm of the thoracoabdominal aorta and occlusion of the right common iliac artery, but successfully treated using a combination of endovascular methods and conventional surgery.

Fluoropolymer-coated dacron versus PTFE grafts for femorofemoral crossover bypass: randomised trial

DEFF Research Database (Denmark)

Eiberg, JP; Røder, Ole Christian; Stahl-Madsen, M

2006-01-01

To investigate whether patency of a thin walled 8 mm fluoropassivated Dacron graft was similar to that of a standard 8mm PTFE graft for femorofemoral crossover bypass surgery.......To investigate whether patency of a thin walled 8 mm fluoropassivated Dacron graft was similar to that of a standard 8mm PTFE graft for femorofemoral crossover bypass surgery....

Ex vivo repair of renal artery aneurysm associated with surgical treatment of abdominal aortic aneurysm

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Kostić Dušan M.

2004-01-01

Full Text Available INTRODUCTION Renal artery aneurysms is relatively uncommon with reported incidence ranges from 0.3% to 1%. However, considering all visceral artery aneurysms the percentage of renal artery aneurysms is relatively high between 15-25%. The distal forms of renal artery aneurysms sometimes require "ex vivo" reconstruction and kidney autotransplantation. CASE REPORT A 75-year-old male presented with the right abdominal and back pain. He suffered from a long history of arterial hypertension and chronic renal failure over the last few months (urea blood = 19.8 mmol/l; creatinine = 198 mmol/l. Duplex ultrasonography showed abdominal aortic aneurysm. Subsequent translumbarangiography revealed juxtarenal abdominal aortic aneurysm associated with distal right renal artery aneurysm. The operation was performed under combined thoracic epidural analgesia and general anesthesia using transperitoneal approach. After the laparotomy, the ascending colon was mobilized and reflected medially followed by Kocher maneuver. The result was visualization of the anterior aspect of the right kidney, the collecting system, ureter as well as the right renal vein and artery with large saccular aneurysm located distally. After mobilization of the renal vessels and careful dissection of the ureter, the kidney was explanted. The operation was continued by two surgical teams. The first team performed abdominal aortic aneurysm resection and reconstruction with bifurcated Dacron graft. The second team performed ex vivo reparation of renal artery aneurysm. All time during the explantation, the kidney was perfused by Collins' solution. The saccular right renal artery aneurysm 4 cm in diameter was located at the kidney hilus at the first bifurcation. Three branches originated from the aneurysm. The aneurysm was resected completely. The longest and widest of three branches arising from the aneurysmal sac was end-to-end anastomized with 6 mm PTFE graft. After this intervention, one of

Development of a New Intravascular Low-Profile Device for Exclusion of Aortic Aneurysm: An Experimental Pilot Study

International Nuclear Information System (INIS)

Strecker, Ernst-Peter; Haberstroh, Joerg; Boos, Irene; Metz, Stephan; Langer, Mathias; Moliner, Manuel Maynar

2004-01-01

Purpose: To present a new intravascular device for the treatment of aorto-iliac aneurysms. Methods: This new device was tested in five dogs with abdominal aortic aneurysm created experimentally by overdilation of a balloon-expandable stent with a 16 or 18 mm wide PTA balloon catheter. The design of the device is based on a self-expanding aortic stent which consists of two stretchable circular frames filled with a textile Dacron mesh membrane that is suspended horizontally into the infrarenal abdominal aorta proximally to the aneurysm. The frames are part of a preshaped double helical structure that is introduced longitudinally through a catheter in a parallel fashion and forming the desired shape at the vessel site to be occluded. Two iliac stent-grafts are introduced in a low-profile status through the membrane sealing the aneurysm sac and holding the stent-grafts in place. After stent-graft expansion, a new bifurcation located more proximally than the natural one is created. The follow-up of the dogs was performed clinically and angiographically, and specimens were evaluated histomorphologically. Results: The membrane device can be introduced through a 9 Fr vascular sheath. Technical success was achieved in four of five dogs. Nine of ten stent-grafts could be fixed securely within the membrane, thus preventing dislocation. Aneurysms were excluded immediately, and blood flow to the external iliac arteries was restored by the stent-grafts. At 6-9 months follow-up of technically successful implanted devices, there were no endoleaks, no migration, no stenoses at contact sites between the implant material and vascular wall, and no stenosis or occlusion of the stent-grafts. At microscopic evaluation, the interspace between the membranes was filled with thrombotic material, thus ensuring exclusion of the aneurysm. Conclusion: This new device was found to be flexible, low profile and useful in excluding abdominal aortic aneurysm in the experimental setting

Long-Term Results after Placement of Aortic Bifurcation Self-Expanding Stents: 10 Year Mortality, Stent Restenosis, and Distal Disease Progression

International Nuclear Information System (INIS)

Houston, J. Graeme; Bhat, Raj; Ross, Rose; Stonebridge, Peter A.

2007-01-01

Purpose. To retrospectively evaluate the 10 year follow-up results in patients who had 'kissing' self-expanding stent aortic bifurcation reconstruction. Methods. Forty-three patients were treated with 'kissing' self-expanding stents for aortoiliac occlusive disease. Early follow-up with clinical and ankle brachial pressure indices (ABPI) was performed at 3, 6, 12, and 24 months and with intra-arterial digital subtraction angiography at 12-24 months; clinical and angiographic follow-up was performed for symptom recurrence up to 10 years after treatment. Retrospective record review was performed to assess mortality, clinical patency, angiographic patency, and secondary assisted patency of both stents and downstream peripheral vessels at 5 and 10 years follow-up. Results. The 2 year primary angiographic and secondary assisted stent patencies were 89% and 93%, respectively. At 10 years follow-up in 40 patients the mortality was 38% (due to myocardial infarction, stroke, chronic renal failure, malignancy, and liver failure). At 5 and 10 years follow-up the primary clinical stent patency was 82% and 68%, and the secondary assisted stent patency 93% and 86%, respectively. At 5 and 10 years, the distal vessel patency was 86% and 72%, and the secondary assisted distal vessel patency treated by surgical or endovascular techniques was 94% and 88%, respectively. At 10 years there was no limb loss. Conclusion. The long-term (10 year) results of aortic bifurcation arterial self-expanding stent placement in patients with arterial occlusive disease show a 10 year primary stent patency rate of 68% but a secondary assisted patency rate of 86%. In addition there is a high overall mortality due to other cardiovascular causes and the rate of distal disease progression and loss of patency is similar to the loss of stent patency rate

Reimplantation valve-sparing aortic root replacement with the Valsalva graft: what have we learnt after 100 cases?

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Settepani, Fabrizio; Bergonzini, Marcello; Barbone, Alessandro; Citterio, Enrico; Basciu, Alessio; Ornaghi, Diego; Gallotti, Roberto; Tarelli, Giuseppe

2009-07-01

Reimplantation valve-sparing aortic root replacement has been increasingly performed with improving perioperative and mid-term results. The success of this operation primarily depends on preserving the highly sophisticated dynamic function of the aortic valve by recreating an anatomical three-dimensional configuration similar to the normal aortic root, thus minimizing the mechanical stress and strain on the cusps. Over the years several techniques have been proposed to reproduce the sinuses of Valsalva. We reviewed our experience with aortic valve reimplantation by means of a modified Dacron graft that incorporates sinuses of Valsalva, in a series of 100 consecutive patients. During a 60-month period, 100 patients with aortic root aneurysm underwent aortic valve reimplantation using the Gelweave Valsalva prosthesis. There were 74 males and the mean age was 60+/-12 years (range 28-83 years). Five patients had the Marfan's syndrome, 15 had a bicuspid aortic valve. Cusp repair was performed in five patients. The mean follow-up time was 28.6 months (range 1-60). Transesophageal echocardiogram was performed at the end of each procedure to assess the aortic valve in terms of competence, dynamic motion and level of coaptation within the graft. There was one hospital death and two late deaths. Overall survival at 60 months was 91.7+/-5.1%. Five patients developed severe aortic incompetence (AI) during follow-up requiring aortic valve replacement (AVR). The 60 months freedom from re-operation due to AI was 90.9+/-4.4%. One patient had moderate AI at latest echocardiographic study. The 60 months freedom from AI>2+ was 91.6+/-7.9%. Cox regression identified cusp's repair as independent risk factor (P=0.001) for late reimplantation failure (AVR or AI>2+). There were no episodes of endocarditis and the majority of the patients (88%) were in New York Heart Association functional class I. The aortic valve reimplantation with the Gelweave Valsalva prosthesis provided satisfactory

Aspirin decreases platelet uptake on Dacron vascular grafts in baboons

International Nuclear Information System (INIS)

Mackey, W.C.; Connolly, R.J.; Callow, A.D.

1984-01-01

The influence of a single dose of aspirin (5.4-7.4 mg/kg) on platelet uptake on 4-mm Dacron interposition grafts was studied in a baboon model using gamma camera scanning for 111-Indium labeled platelets. In vitro assessment of platelet function after aspirin administration revealed that in the baboon, as in the human, aspirin abolished arachidonic acid-induced platelet aggregation, prolonged the lag time between exposure to collagen and aggregation, and decreased plasma thromboxane B2 levels. Aspirin also prolonged the template bleeding time. Scans for 111-Indium labeled platelets revealed that pretreatment with a single dose of aspirin decreased platelet uptake on 4-mm Dacron carotid interposition grafts. This decrease in platelet uptake was associated with a significant improvement in 2-hour graft patency and with a trend toward improved 2-week patency

Endovascular Treatment of Late Thoracic Aortic Aneurysms after Surgical Repair of Congenital Aortic Coarctation in Childhood

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Juszkat, Robert; Perek, Bartlomiej; Zabicki, Bartosz; Trojnarska, Olga; Jemielity, Marek; Staniszewski, Ryszard; Smoczyk, Wiesław; Pukacki, Fryderyk

2013-01-01

Background In some patients, local surgery-related complications are diagnosed many years after surgery for aortic coarctation. The purposes of this study were: (1) to systematically evaluate asymptomatic adults after Dacron patch repair in childhood, (2) to estimate the formation rate of secondary thoracic aortic aneurysms (TAAs) and (3) to assess outcomes after intravascular treatment for TAAs. Methods This study involved 37 asymptomatic patients (26 female and 11 male) who underwent surgical repair of aortic coarctation in the childhood. After they had reached adolescence, patients with secondary TAAs were referred to endovascular repair. Results Follow-up studies revealed TAA in seven cases (19%) (including six with the gothic type of the aortic arch) and mild recoarctation in other six (16%). Six of the TAA patients were treated with stentgrafts, but one refused to undergo an endovascular procedure. In three cases, stengrafts covered the left subclavian artery (LSA), in another the graft was implanted distally to the LSA. In two individuals, elective hybrid procedures were performed with surgical bypass to the supraaortic arteries followed by stengraft implantation. All subjects survived the secondary procedures. One patient developed type Ia endoleak after stentgraft implantation that was eventually treated with a debranching procedure. Conclusions The long-term course of clinically asymptomatic patients after coarctation patch repair is not uncommonly complicated by formation of TAAs (particularly in individuals with the gothic pattern of the aortic arch) that can be treated effectively with stentgrafts. However, in some patients hybrid procedures may be necessary. PMID:24386233

Aortic anomalies in an adolescent with the Williams' elfin facies syndrome

International Nuclear Information System (INIS)

Williams, R.L.; Azouz, E.M.

1984-01-01

An adolescent with classical Williams' syndrome who presented with hypertensive encephalopathy is described. He had the unusual combination of supravalvular aortic stenosis, long segment coarctation of the aorta, aortic hypoplasia and a high bifurcation of the abdominal aorta. Surgical resection of the coarctation was required; however, the patient has remained moderately hypertensive. The aortic anomalies in this syndrome are reviewed and their frequency and importance examined. (orig.)

Initial Surgical Experience with Aortic Valve Repair: Clinical and Echocardiographic Results

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Francisco Diniz Affonso da Costa

Full Text Available Abstract Introduction: Due to late complications associated with the use of conventional prosthetic heart valves, several centers have advocated aortic valve repair and/or valve sparing aortic root replacement for patients with aortic valve insufficiency, in order to enhance late survival and minimize adverse postoperative events. Methods: From March/2012 thru March 2015, 37 patients consecutively underwent conservative operations of the aortic valve and/or aortic root. Mean age was 48±16 years and 81% were males. The aortic valve was bicuspid in 54% and tricuspid in the remaining. All were operated with the aid of intraoperative transesophageal echocardiography. Surgical techniques consisted of replacing the aortic root with a Dacron graft whenever it was dilated or aneurysmatic, using either the remodeling or the reimplantation technique, besides correcting leaflet prolapse when present. Patients were sequentially evaluated with clinical and echocardiographic studies and mean follow-up time was 16±5 months. Results: Thirty-day mortality was 2.7%. In addition there were two late deaths, with late survival being 85% (CI 95% - 68%-95% at two years. Two patients were reoperated due to primary structural valve failure. Freedom from reoperation or from primary structural valve failure was 90% (CI 95% - 66%-97% and 91% (CI 95% - 69%-97% at 2 years, respectively. During clinical follow-up up to 3 years, there were no cases of thromboembolism, hemorrhage or endocarditis. Conclusions: Although this represents an initial series, these data demonstrates that aortic valve repair and/or valve sparing aortic root surgery can be performed with satisfactory immediate and short-term results.

Dacron® vs. PTFE as bypass materials in peripheral vascular surgery – systematic review and meta-analysis

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Roll, Stephanie; Müller-Nordhorn, Jacqueline; Keil, Thomas; Scholz, Hans; Eidt, Daniela; Greiner, Wolfgang; Willich, Stefan N

2008-01-01

Background In peripheral vascular bypass surgery different synthetic materials are available for bypass grafting. It is unclear which of the two commonly used materials, polytetrafluoroethylene (PTFE) or polyester (Dacron®) grafts, is to be preferred. Thus, the aim of this meta-analysis and systematic review was to compare the effectiveness of these two prosthetic bypass materials (Dacron® and PTFE). Methods We performed a systematic literature search in MEDLINE, Cochrane-Library – CENTRAL, EMBASE and other databases for relevant publications in English and German published between 1999 and 2008. Only randomized controlled trials were considered for inclusion. We assessed the methodological quality by means of standardized checklists. Primary patency was used as the main endpoint. Random-effect meta-analysis as well as pooling data in life table format was performed to combine study results. Results Nine randomized controlled trials (RCT) were included. Two trials showed statistically significant differences in primary patency, one favouring Dacron® and one favouring PTFE grafts, while 7 trials did not show statistically significant differences between the two materials. Meta-analysis on the comparison of PTFE vs. Dacron® grafts yielded no differences with regard to primary patency rates (hazard ratio 1.04 (95% confidence interval [0.85;1.28]), no significant heterogeneity (p = 0.32, I2 = 14%)). Similarly, there were no significant differences with regard to secondary patency rates. Conclusion Systematic evaluation and meta-analysis of randomized controlled trials comparing Dacron® and PTFE as bypass materials for peripheral vascular surgery showed no evidence of an advantage of one synthetic material over the other. PMID:19099583

Topography of Aortic Bifurcation in a Black Kenyan Population ...

African Journals Online (AJOL)

After removal of abdominal viscera, peritoneum, fibrofatty connective tissue, inferior vena cava was removed to expose the termination of abdominal aorta. Vertebral level, angle and asymmetry of bifurcation were recorded. Data were analysed by SPSS version 17.0 for windows and are presented in tables and bar charts.

Early Results of the PETTICOAT Technique for the Management of Acute Type A Aortic Dissection.

Science.gov (United States)

Kotha, Vamshi Krishna; Pozeg, Zlatko I; Herget, Eric J; Moon, Michael C; Appoo, Jehangir J

2017-08-01

Conventional surgical techniques for acute Type A aortic dissection (ATAAD) generally fail to address residual dissection in the descending aorta. The persistence of a false lumen is associated with visceral malperfusion in the acute setting and adverse aortic remodeling in the chronic setting. Hybrid aortic arch repair techniques may improve perioperative and long-term mortality by expanding the true lumen and obliterating the false lumen. However, there is a limit to the extent of aortic coverage due to the concomitant risk of spinal cord ischemia. In Type B dissection, the PETTICOAT (Provisional Extension To Induce Complete Attachment) technique, which entails stent graft coverage of the primary intimal tear followed by bare metal stent placement distally, may improve true lumen caliber and promote false lumen thrombosis without increasing the risk of spinal cord ischemia, as intercostal branches remain perfused through the bare metal stents. The technique of hybrid arch with surgical creation of a Dacron landing zone covering a stent graft in the proximal descending aorta and bare metal stents in the thoraco-abdominal aorta is a promising concept in the treatment of ATAAD.

Dacron® vs. PTFE as bypass materials in peripheral vascular surgery – systematic review and meta-analysis

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Eidt Daniela

2008-12-01

Full Text Available Abstract Background In peripheral vascular bypass surgery different synthetic materials are available for bypass grafting. It is unclear which of the two commonly used materials, polytetrafluoroethylene (PTFE or polyester (Dacron® grafts, is to be preferred. Thus, the aim of this meta-analysis and systematic review was to compare the effectiveness of these two prosthetic bypass materials (Dacron® and PTFE. Methods We performed a systematic literature search in MEDLINE, Cochrane-Library – CENTRAL, EMBASE and other databases for relevant publications in English and German published between 1999 and 2008. Only randomized controlled trials were considered for inclusion. We assessed the methodological quality by means of standardized checklists. Primary patency was used as the main endpoint. Random-effect meta-analysis as well as pooling data in life table format was performed to combine study results. Results Nine randomized controlled trials (RCT were included. Two trials showed statistically significant differences in primary patency, one favouring Dacron® and one favouring PTFE grafts, while 7 trials did not show statistically significant differences between the two materials. Meta-analysis on the comparison of PTFE vs. Dacron® grafts yielded no differences with regard to primary patency rates (hazard ratio 1.04 (95% confidence interval [0.85;1.28], no significant heterogeneity (p = 0.32, I2 = 14%. Similarly, there were no significant differences with regard to secondary patency rates. Conclusion Systematic evaluation and meta-analysis of randomized controlled trials comparing Dacron® and PTFE as bypass materials for peripheral vascular surgery showed no evidence of an advantage of one synthetic material over the other.

A case of complete double aortic arch visualized by transthoracic echocardiography.

Science.gov (United States)

Saito, Naka; Kato, Shingo; Saito, Noritaka; Nakachi, Tatsuya; Fukui, Kazuki; Iwasawa, Tae; Kosuge, Masami; Kimura, Kazuo

2017-08-01

A case of double aortic arch that was well visualized using transthoracic echocardiography is reported. A 38-year-old man underwent transthoracic echocardiography for the evaluation of dyspnea. A suprasternal view of transthoracic echocardiography showed the ascending aorta bifurcate to left and right aortic arches, with blood flow from the ascending aorta to bilateral aortic arches. The diagnosis of right side-dominant double aortic arch was made, and the patient's symptom was conceivably related to compression of the trachea due to a vascular ring. This report indicates the potential usefulness of transthoracic echocardiography for noninvasive detection of double aortic arch in adults. © 2017, Wiley Periodicals, Inc.

Valve-sparing aortic root replacement in Marfan syndrome.

Science.gov (United States)

Cameron, Duke E; Vricella, Luca A

2005-01-01

Marfan syndrome is the most common inherited connective tissue disorder, affecting approximately 1 in 10,000 live births. The cardinal features of Marfan syndrome are the abnormalities of the skeleton (tall stature, arachnodactyly, and joint hyperelasticity), eye (lens subluxation), and aorta (root aneurysm with proclivity toward rupture and dissection). Aortic catastrophe accounts for most of the premature mortality among Marfan patients, a risk that climbs steeply during adolescence and results in death of half of Marfan patients by the age of 40 years. Most of the improvement in life expectancy that has been achieved in Marfan syndrome is attributable to early recognition of aortic root aneurysms and prophylactic replacement with composite grafts (mechanical valve prostheses within Dacron conduits) before rupture or dissection occurs. Despite the excellent early and late results with composite grafts, there has been growing interest in operative procedures that replace the sinuses but preserve the aortic valve leaflets, to avoid anticoagulation and minimize the risk of prosthesis-related endocarditis. These procedures are still in evolution and late results are not yet known, but as with mitral repair in the setting of myxomatous disease, valve-sparing procedures in Marfan syndrome have weathered a storm of initial criticism and skepticism and are steadily gaining acceptance.

Hybrid repair of a very late, post-aortic coarctation surgery thoracic aneurysm: a case report

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Tilea Ioan

2012-08-01

Full Text Available Abstract Introduction Local aneurysms after surgical repair of coarctation of the aorta occur mainly in patients surgically treated by Dacron patch plasty during adulthood. The management of these patients is always problematic, with frequent complications and increased mortality rates. Percutaneous stent-graft implantation avoids the need for surgical reintervention. Case presentation We report a case involving the hybrid treatment by stent-graft implantation and transposition of the left subclavian artery to the left common carotid artery of an aneurysmal dilatation of the thoracic aorta that occurred in a 64-year-old Caucasian man, operated on almost 40 years earlier with a Dacron patch plasty for aortic coarctation. Our patient presented to our facility for evaluation with back pain and shortness of breath after minimal physical effort. A physical examination revealed stony dullness to percussion of the left posterior thorax, with no other abnormalities. The results of chest radiography, followed by contrast-enhanced computed tomography and aortography, led to a diagnosis of giant aortic thoracic aneurysm. Successful treatment of the aneurysm was achieved by percutaneous stent-graft implantation combined with transposition of the left subclavian artery to the left common carotid artery. His post-procedural recovery was uneventful. Three months after the procedure, computed tomography showed complete thrombosis of the excluded aneurysm, without any clinical signs of left lower limb ischemia or new onset neurological abnormalities. Conclusions Our patient’s case illustrates the clinical outcomes of surgical interventions for aortic coarctation. However, the very late appearance of a local aneurysm is rather unusual. Management of such cases is always difficult. The decision-making should be multidisciplinary. A hybrid approach was considered the best solution for our patient.

Open Treatment of Blunt Injuries of Supra-Aortic Branches: Case Series.

Science.gov (United States)

Sladojevic, Milos; Markovic, Miroslav; Ilic, Nikola; Pejkic, Sinisa; Banzic, Igor; Djoric, Predrag; Koncar, Igor; Tomic, Ivan; Davidovic, Lazar

2016-02-01

Blunt injuries of the supra-aortic branches are rare entity, and majority of patients die before arrival at the hospital. Those who arrive alive require complex and fast procedure that requires sternotomy. We report 3 successfully managed cases. We report 3 patients with injury of supra-aortic branches. One was treated urgently due to longitudinal rupture on the posterior wall of innominate artery after car accident, and another 2 had chronic false aneurysm located at the very orifice of the right subclavian and left common carotid artery. In first and second patient bypass grafting with a hand-made, Y-shaped, 8-mm Dacron graft from the ascending aorta to the right common carotid and proximal right subclavian artery were performed, whereas in last 1 bypass grafting from the ascending aorta to the cervical part of the left common carotid artery was performed. In our facility, there were no possibilities for any endovascular treatment. When endovascular technology is not available, open surgical repair of blunt injuries of supra-aortic vessels can be performed without complications. No matter to that, endovascular and hybrid procedures should be considered whenever possible. Copyright © 2016 Elsevier Inc. All rights reserved.

Downstream anastomotic hyperplasia. A mechanism of failure in Dacron arterial grafts.

Science.gov (United States)

LoGerfo, F W; Quist, W C; Nowak, M D; Crawshaw, H M; Haudenschild, C C

1983-01-01

The precise location and progression of anastomotic hyperplasia and its possible relationship to flow disturbances was investigated in femoro-femoral Dacron grafts in 28 dogs. In 13 grafts, the outflow from the end-to-side downstream anastomosis was bidirectional (BDO), and in 15 it was unidirectional (UDO) (distally). Grafts were electively removed at intervals of two to 196 days or at the time of thrombosis. Each anastomosis and adjacent artery was perfusion-fixed and sectioned sagittally. The mean sagittal section was projected onto a digitized pad, and the total area of hyperplasia internal to the arterial internal elastic lamina and within the adjacent graft was integrated by computer. The location of the hyperplasia was compared with previously established sites of flow separation and stagnation. The observation was made that hyperplasia is significantly greater at the downstream, as compared with the upstream, anastomosis in both groups (BDO = p less than 0.001 and UDO = p less than 0.001) (analysis of variance for independent groups). Furthermore, this downstream hyperplasia was progressive with time (BDO p less than 0.01) (UDO p less than 0.01); Spearman Rank Correlation. There was no significant increase in the extent of downstream hyperplasia where flow separation was known to be greater (BDO). Five grafts failed (three BDO, two UDO), as a result of complete occlusion of the downstream anastomosis by fibrous hyperplasia. Transmission electron microscopy showed the hyperplasia to consist of collagen-producing smooth muscle cells. Anastomotic hyperplasia is significantly greater at the downstream anastomosis, is progressive with time, and is the primary cause of failure of Dacron arterial grafts in this model. Quantitative analysis of downstream anastomotic hyperplasia may be a valuable measure of the biocompatibility of Dacron grafts. Images Fig. 2. Fig. 3. Fig. 5. Fig. 6. Fig. 7. Fig. 8. PMID:6219641

[Case report of osteo-odonto keratoprosthesis (Strampelli) and of Dacron keratoprosthesis (Pintucci)].

Science.gov (United States)

Chammartin, M; Goldblum, D; Früh, B; Wilkens, L; Bosshardt, D; Sarra, G-M

2009-03-01

In severe forms of ocular surface disorders keratoprostheses provide the ultimate possibility to restore vision. They are made of an optical cylinder integrated with a supporting biocompatible or biological haptic. We report on two patients with different types of keratoprostheses. An 88-year-old woman with ocular pemphigoid received in 1970 a bilateral osteo-odonto-keratoprosthesis (Strampelli). A 59-year-old man with refractory corneal ulcer after corneal grafting received in 2003 a keratoprosthesis with supporting Dacron tissue (Pintucci). The course 35 years after implantation of the osteo-odonto-keratoprosthesis was uneventful. Histologically there were no signs of loosening, rejection or infection. The autologous dentin, which was used for the fixation, was still present. The eye with the Dacron fixated prosthesis (Pintucci) had to be enucleated due to a loosening with endophthalmitis one and a half year after implantation. Keratoprostheses with autologous fixation often show good long-term results. On the other hand, prostheses with synthetic material are more often complicated by dislocation and inflammation.

Dacron or PTFE for Above-knee Femoropopliteal Bypass. A Multicenter Randomised Study

DEFF Research Database (Denmark)

Jensen, L. P.; Lepäntalo, M.; Fossdal, J. E.

2007-01-01

more often than patients operated on for intermittent claudication, 10 and 3 respectively (p=0.003), and had higher mortality rates, 20% and 8% respectively (p=0.001). CONCLUSION: This trial confirms that Dacron is at least as durable as PTFE for above-knee bypass procedures, and might even be superior....

[False aneurysm on dacron prosthesis, 20 years after aortofemoral bypass].

Science.gov (United States)

Illuminati, G; Bertagni, A; Nasti, A G; Montesano, G

2001-10-01

A 85-year-old male developed a false, non septic, non anastomotic aneurysm, 20 years after right aorto-femoral Dacron grafting for claudication. On account of the proximity to the femoral anastomosis, and the association with a profunda femoris stenosis, a conventional surgical repair was preferred to an endovascular treatment. The patient underwent a successful aneurysm resection followed by PTFE interposition between the primary graft and the profunda femoris artery, with uneventful recovery.

Tissue Responses to Stent Grafts with Endo-Exo-Skeleton for Saccular Abdominal Aortic Aneurysms in a Canine Model

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Kim, Il Young; Chung, Jin Wook; Kim, Hyo Cheol [Dept. of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, Clinical Research Institute, Seoul (Korea, Republic of); Choi, Young Ho; So Young Ho [Dept. of Radiology, Seoul National University Boramae Hospital, Seoul (Korea, Republic of); Kim, Hyun Beom [Dept. of Radiology, National Cancer Center, Goyang (Korea, Republic of); Min, Seung Kee [Dept. of Surgery, Seoul National University College of Medicine, Seoul (Korea, Republic of); Park, Jae Hyung [Dept. of Radiology, Gachon University Gil Medical Center, Incheon (Korea, Republic of)

2014-10-15

We evaluated the effect of close contact between the stent and the graft on the induction of endothelial covering on the stent graft placed over an aneurysm. Saccular abdominal aortic aneurysms were made with Dacron patch in eight dogs. The stent graft consisted of an inner stent, a expanded polytetrafluoroethylene graft, and an outer stent. After sacrificing the animals, the aortas with an embedded stent graft were excised. The aortas were inspected grossly and evaluated microscopically. The animals were sacrificed at two (n = 3), six (n = 3), and eight months (n = 2) after endovascular repair. In two dogs, the aortic lumen was occluded at two months after the placement. On gross inspection of specimens from the other six dogs with a patent aortic lumen, stent grafts placed over the normal aortic wall were covered by glossy white neointima, whereas, stent grafts placed over the aneurysmal aortic wall were covered by brownish neointima. On microscopic inspection, stent grafts placed over the normal aortic wall were covered by thin neointima (0.27 ± 0.05 mm, mean ± standard deviation) with an endothelial layer, and stent grafts placed over the aneurysmal aortic wall were covered by thick neointima (0.62 ± 0.17 mm) without any endothelial lining. Transgraft cell migration at the normal aortic wall was more active than that at the aneurysmal aortic wall. Close contact between the stent and the graft, which was achieved with stent grafts with endo-exo-skeleton, could not enhance endothelial covering on the stent graft placed over the aneurysms.

Early results after implantation of a new geometric annuloplasty ring for aortic valve repair.

Science.gov (United States)

Mazzitelli, Domenico; Nöbauer, Christian; Rankin, J Scott; Badiu, Catalin C; Krane, Markus; Crooke, Philip S; Cohn, William E; Opitz, Anke; Schreiber, Christian; Lange, Rüdiger

2013-01-01

Aortic valve repair is associated with fewer long-term valve-related complications as compared with valve replacement, and repair is being performed increasingly. A current problem is the lack of a geometric annuloplasty ring to facilitate reconstruction. This paper describes the first clinical application of such a device designed to permanently restore physiologic annular size and geometry during aortic valve repair. Based on mathematical studies of human cadaver valves, as well as computed tomography angiographic analyses of awake patients with normal valves, a three-dimensional annuloplasty ring has been developed, consisting of low-profile, one-piece titanium construction and Dacron cloth covering. The ring design incorporates 2:3 elliptical base geometry and 10-degree outwardly flaring subcommissural posts. Appropriately sized rings were implanted in 5 patients with severe aortic insufficiency due to annular dilation and anatomic leaflet defects. The rings restored annular geometry and facilitated leaflet repairs in all patients. Each recovered excellent valve function with minimal residual leak. All patients convalesced uneventfully, were discharged within 7 days after surgery, and continue with stable valve function as long as 6 months after implantation. Initial clinical application of a geometric aortic annuloplasty ring was associated with excellent device performance and perhaps better repairs. Further clinical series and patient follow-up should identify potential benefits of the device, including improved applicability and stability of aortic valve repair. Copyright © 2013 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Abdominal aortic aneurysm neck remodeling after Anaconda stent graft implantation.

Science.gov (United States)

Vukovic, Elisabeth; Czerny, Martin; Beyersdorf, Friedhelm; Wolkewitz, Martin; Berezowski, Mikolaj; Siepe, Matthias; Blanke, Philipp; Rylski, Bartosz

2018-05-24

The aim of this study was to define how the proximal landing zone changes geometrically after endovascular abdominal aortic aneurysm repair (EVAR) with the Anaconda (Vascutek, Inchinnan, United Kingdom) stent graft. Among 230 patients who underwent Anaconda stent graft implantation between 2005 and 2014, we included 126 with adequate computed tomography (CT) image quality and follow-up. CT analysis entailed the geometric changes in the main body, proximal rings, and proximal landing zone. The median CT follow-up was 2.0 years (345.8 patients-years). The proximal portion of the main body ring system flattened within the first year after EVAR, resulting in an up to 30° increase in the upper ring's angle in 40% patients and up to 40° increase in 24% patients. One year after EVAR, the upper ring angle increase slowed down. Aortic diameter measured at the level of the upper and lower ring expanded by 2 to 4 mm within 1 year, but remained unchanged afterward. The main body migrated continuously down toward the aortic bifurcation, attaining an average 6-mm increase in the distance between the superior mesenteric artery and main body within 4 years. Freedom from endoleak type IA was 95 ± 2% and 93 ± 3% after 1 and 4 years, respectively. The Anaconda main body ring system in its proximal portion flattens within the first year after EVAR, leading to an increase of 2 to 4 mm in the proximal landing zone's aortic diameter. The main body migrates slowly but continuously down toward the aortic bifurcation. Copyright © 2018 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

Dynamics and Physiological Roles of Stochastic Firing Patterns Near Bifurcation Points

Science.gov (United States)

Jia, Bing; Gu, Huaguang

2017-06-01

Different stochastic neural firing patterns or rhythms that appeared near polarization or depolarization resting states were observed in biological experiments on three nervous systems, and closely matched those simulated near bifurcation points between stable equilibrium point and limit cycle in a theoretical model with noise. The distinct dynamics of spike trains and interspike interval histogram (ISIH) of these stochastic rhythms were identified and found to build a relationship to the coexisting behaviors or fixed firing frequency of four different types of bifurcations. Furthermore, noise evokes coherence resonances near bifurcation points and plays important roles in enhancing information. The stochastic rhythms corresponding to Hopf bifurcation points with fixed firing frequency exhibited stronger coherence degree and a sharper peak in the power spectrum of the spike trains than those corresponding to saddle-node bifurcation points without fixed firing frequency. Moreover, the stochastic firing patterns changed to a depolarization resting state as the extracellular potassium concentration increased for the injured nerve fiber related to pathological pain or static blood pressure level increased for aortic depressor nerve fiber, and firing frequency decreased, which were different from the physiological viewpoint that firing frequency increased with increasing pressure level or potassium concentration. This shows that rhythms or firing patterns can reflect pressure or ion concentration information related to pathological pain information. Our results present the dynamics of stochastic firing patterns near bifurcation points, which are helpful for the identification of both dynamics and physiological roles of complex neural firing patterns or rhythms, and the roles of noise.

Tratamento cirúrgico para ectasia ânulo-aórtica Surgical treatment for annulo-aortic ectasia

Directory of Open Access Journals (Sweden)

Ricardo García-Macedo

1986-08-01

Full Text Available Foram estudados 27 pacientes submetidos a implante de tubo de Dacron valvulado (segundo técnica de Bentall-De Bono, entre 1976 e 1985. Todos apresentavam ectasia ânulo-aórtica, que era devida a necrose cística da média em 23 pacientes (85,2%, dissecção crônica de aorta em 3 pacientes (11,1% e aortite luética em 1 paciente (3,7%. A faixa etária foi de 29 a 64 anos (m = 48 anos. Três eram do sexo feminino e 24, do masculino. Foi utilizado tubo de Dacron 28 ou 30 mm em todos. As válvulas utilizadas foram: de dura-máter em 7 pacientes, de aorta heteróloga em 9 e metálica em 11 pacientes. A classe funcional era I-II em 7 pacientes e III-IV em 19 pacientes (NYHA. Houve 1 óbito (3,7% pós-operatório imediato, por sangramento incontrolável e insuficiência renal aguda. As complicações mais freqüentes foram arritmias (13 pacientes, 48% e hemorragia (3 pacientes, 11 %. No pós-operatório tardio faleceram 9 pacientes, pelas seguintes causas: morte súbita (2 pacientes, 7,4%, insuficiência cardíaca aguda (2 pacientes, 7,4%, hemorragia após reoperação (1 paciente, 3,7%, infecção hospitalar (1 paciente, 3,7%, endocardite infecciosa (1 paciente, 3,7% e causa acidental (7,4%. Cinco pacientes (18,5% foram reoperados no pós-operatório tardio, 2 por disfunção de prótese, 2 por endocardite infecciosa sobre tubo de Dacron e 1 por fístula perivalvular. A curva atuarial mostrou uma probabilidade de sobrevida de 83,7% até o 3? ano, 61 % aos 5 anos e 42,7% do 6º ao 9º ano. No fim do período, os 17 pacientes sobreviventes encontram-se em classe funcional I-II (p This is a report of 27 patients presenting annulo-aortic ectasia submitted to surgical correction with a composite valve-tube graft (Bentall-De Bono technique, between 1976 and 1985. Twenty three (85.2% had cystic medial necrosis, 3 (11,1% were chronic aortic disections and 1 (3.7% was luetic aortitis. Age ranged from 29 to 64 years (m = 48. Three were female and 24 male

Reimplantation valve-sparing aortic root replacement in Marfan syndrome using the Valsalva conduit: an intercontinental multicenter study.

Science.gov (United States)

Settepani, Fabrizio; Szeto, Wilson Y; Pacini, Davide; De Paulis, Ruggero; Chiariello, Luigi; Di Bartolomeo, Roberto; Gallotti, Roberto; Bavaria, Joseph E

2007-02-01

Introduced by DePaulis in 2000, the Gelweave Valsalva graft (Sulzer Vascutek, Refrewshire, Scotland) is a modified Dacron conduit (DuPont, Wilmington, DE), with prefashioned sinuses of Valsalva. The aim of this study was to evaluate the mid-term results of the reimplantation valve-sparing aortic root replacement using the Gelweave Valsalva prosthesis in Marfan syndrome patients. A retrospective review was performed of 35 patients with Marfan syndrome in four centers who underwent the reimplantation valve-sparing aortic root replacement using the Gelweave Valsalva prosthesis. The patients were predominantly men, with a mean age of 36.5 +/- 12.6 years (range, 14 to 62 years). Two patients presented with acute type A dissections and underwent emergent operations. Elective hemiarch reconstruction using hypothermic circulatory arrest was required in 11 patients. Aortic valve cusp repair was performed in 2 patients. There were no operative or hospital deaths, and no patients died during follow-up. The mean follow-up was 19 months (range, 1 to 60 months). Significant (>2+) aortic insufficiency (AI), requiring aortic valve replacement, developed in 3 patients during follow-up that requiring aortic valve replacement. The 5-year freedom from reoperation owing to structural valve deterioration was 88.9% +/- 8.1%. There were no episodes of clinically significant thromboembolism. Reimplantation valve-sparing aortic root replacement with the Gelweave Valsalva prosthesis in Marfan patients provides satisfactory mid-term results, thus encouraging further use of this type of repair. However, long-term results are needed in order to define the durability of this technique.

A multiscale modelling approach to understand atherosclerosis formation: A patient-specific case study in the aortic bifurcation

Science.gov (United States)

Alimohammadi, Mona; Pichardo-Almarza, Cesar; Agu, Obiekezie; Díaz-Zuccarini, Vanessa

2017-01-01

Atherogenesis, the formation of plaques in the wall of blood vessels, starts as a result of lipid accumulation (low-density lipoprotein cholesterol) in the vessel wall. Such accumulation is related to the site of endothelial mechanotransduction, the endothelial response to mechanical stimuli and haemodynamics, which determines biochemical processes regulating the vessel wall permeability. This interaction between biomechanical and biochemical phenomena is complex, spanning different biological scales and is patient-specific, requiring tools able to capture such mathematical and biological complexity in a unified framework. Mathematical models offer an elegant and efficient way of doing this, by taking into account multifactorial and multiscale processes and mechanisms, in order to capture the fundamentals of plaque formation in individual patients. In this study, a mathematical model to understand plaque and calcification locations is presented: this model provides a strong interpretability and physical meaning through a multiscale, complex index or metric (the penetration site of low-density lipoprotein cholesterol, expressed as volumetric flux). Computed tomography scans of the aortic bifurcation and iliac arteries are analysed and compared with the results of the multifactorial model. The results indicate that the model shows potential to predict the majority of the plaque locations, also not predicting regions where plaques are absent. The promising results from this case study provide a proof of concept that can be applied to a larger patient population. PMID:28427316

Aneurisma de aorta com ruptura para esôfago Aortic aneurysm rupture into the esophagus

Directory of Open Access Journals (Sweden)

Christiano da Silveira de Barcellos

2008-12-01

Full Text Available Apresentamos o caso de uma paciente portadora de aneurisma de aorta descendente com ruptura para o esôfago que, após aortoplastia com interposição de tubo de dacron e rafia da laceração esofágica, evoluiu com fístula esôfago pleural no terceiro dia pós-operatório. A paciente necessitou de reintervenção e cuidados intensivos, reabilitando-se adequadamente. A propósito deste caso incomum e do aprendizado adquirido no seu manejo, revisamos a literatura a fim de discutir a melhor alternativa de correção desta rara e, freqüentemente, fatal forma de apresentação das doenças da aorta.We present the case of a patient with a descending aorta aneurysm rupture into the esophagus, which, after aortoplasty with Dacron tube interposition and suture of esophageal laceration, developed a pleural-esophagus fistula on the 3rd postoperative day. She needed re-intervention and intensive care, followed by adequate recovery. Considering this unusual case and the knowledge acquired through its management, we reviewed the literature in order to discuss the best alternative for the correction of this rare and often fatal form of presentation of aortic diseases.

Nonlinear dynamics of shells conveying pulsatile flow with pulse-wave propagation. Theory and numerical results for a single harmonic pulsation

Science.gov (United States)

Tubaldi, Eleonora; Amabili, Marco; Païdoussis, Michael P.

2017-05-01

In deformable shells conveying pulsatile flow, oscillatory pressure changes cause local movements of the fluid and deformation of the shell wall, which propagate downstream in the form of a wave. In biomechanics, it is the propagation of the pulse that determines the pressure gradient during the flow at every location of the arterial tree. In this study, a woven Dacron aortic prosthesis is modelled as an orthotropic circular cylindrical shell described by means of the Novozhilov nonlinear shell theory. Flexible boundary conditions are considered to simulate connection with the remaining tissue. Nonlinear vibrations of the shell conveying pulsatile flow and subjected to pulsatile pressure are investigated taking into account the effects of the pulse-wave propagation. For the first time in literature, coupled fluid-structure Lagrange equations of motion for a non-material volume with wave propagation in case of pulsatile flow are developed. The fluid is modeled as a Newtonian inviscid pulsatile flow and it is formulated using a hybrid model based on the linear potential flow theory and considering the unsteady viscous effects obtained from the unsteady time-averaged Navier-Stokes equations. Contributions of pressure and velocity propagation are also considered in the pressure drop along the shell and in the pulsatile frictional traction on the internal wall in the axial direction. A numerical bifurcation analysis employs a refined reduced order model to investigate the dynamic behavior of a pressurized Dacron aortic graft conveying blood flow. A pulsatile time-dependent blood flow model is considered by applying the first harmonic of the physiological waveforms of velocity and pressure during the heart beating period. Geometrically nonlinear vibration response to pulsatile flow and transmural pulsatile pressure, considering the propagation of pressure and velocity changes inside the shell, is here presented via frequency-response curves, time histories, bifurcation

Sixth International Symposium on Bifurcations and Instabilities in Fluid Dynamics (BIFD2015)

DEFF Research Database (Denmark)

Bar-Yoseph, P. Z.; Brøns, Morten; Gelfgat, A.

2016-01-01

dynamics and remain a challenge for experimental, theoretical and computational studies. Examples of prototypical hydrodynamic instabilities are the Rayleigh–Bénard, Taylor–Couette, Bénard–Marangoni, Rayleigh–Taylor, and Kelvin–Helmholtz instabilities. A fundamental understanding of bifurcation patterns...... diseases, such as atherosclerotic and vulnerable plaques, abdominal aortic aneurisms, carotid artery disease, and pulmonary embolisms and implications for vascular interventions such as grafting and stenting. The collection of papers in this issue is a selection of the presentations given at the Sixth...

PATTERNS OF SEVEN AND COMPLICATED MALARIA IN CHILDREN

African Journals Online (AJOL)

GB

revealed good function of repair aortic valve. Upon the redo ... cannulation, single right atrial cannulation). After aortic ... by bentall operation. Bleeding from surrounding tissue of right coronary artery .... dissected aortic wall to Dacron tube to prevent future residual ... a ridge in the direction of blood flow in the mid. B. A ...

Dextran/Albumin hydrogel sealant for Dacron(R) vascular prosthesis.

Science.gov (United States)

Lisman, Anna; Butruk, Beata; Wasiak, Iga; Ciach, Tomasz

2014-05-01

In this paper, the authors describe a novel type of hydrogel coating prepared from the copolymer of human serum albumin and oxidized dextran. The material was designed as a hydrogel sealant for polyester (Dacron®)-based vascular grafts. Dextran was chosen as a coating material due to its anti-thrombogenic properties. Prepared hydrogels were compared with similar, already known biomaterial made from gelatine with the same cross-linking agent. Obtained hydrogels, prepared from various ratios of oxidized dextran/albumin or oxidized dextran/gelatine, showed different cross-linking densities, which caused differences in swelling, degradation rate and mechanical properties. Permeability tests confirmed the complete tightness of the hydrogel-modified prosthesis. Results showed that application of the hydrogel coating provided leakage-free prosthesis and eliminated the need of pre-clotting.

Propagation of aortic dissection and visceral artery compromise. Three-dimensional analysis on CT angiography

International Nuclear Information System (INIS)

Minamiguchi, Hiroki

2003-01-01

The purpose of this study was to clarify the patterns of the propagation of aortic dissection with quantitative data from CT angiography and to verify the relationship between the propagation of aortic dissection and visceral artery compromise. The subjects were 67 cases (48 men, 19 women) with acute and subacute aortic dissection extending from the descending thoracic aorta to the aortic bifurcation. The mean age is 56.5±12.3 years old (range 34 to 80 years). Eight axial levels of the trunk of right pulmonary artery, left inferior pulmonary vein, coronary sinus, celiac axis, the orifice of superior mesenteric artery (SMA), the orifice of right real artery, the orifice of left renal artery and the orifice of inferior mesenteric artery were submitted to investigate the propagation of aortic dissection. The true lumen central angle was calculated in each level. The axial distance, branch angle difference and true distance between SMA and bilateral renal arteries were calculated. The trajectory of aortic dissection propagation from descending thoracic aorta to aortic bifurcation could be divided into two types of linear dissection type (n=41) and spiral dissection type (n=26). The latter were further subdivided into clockwise rotation type (n=14) and counter-clockwise rotation type (n=12). Younger age was significantly associated with the spiral dissection type as compared to older age (p=0.030). The spiral dissection type propagation pattern was found predominantly from the descending thoracic aorta to celiac axis, while at more distal levels linear type dissection was more common. The blood flow of SMA and celiac axis came from the true lumen or both lumens in all cases but single case from false lumen. The incidence (19.4%) of the right renal blood flow supplied from false lumen was lower than that (37.3%) of the left one supplied from false lumen. The shorter distance and the less angle difference between SMA and right renal artery than between SMA and left renal

Factors Affecting Optimal Aortic Remodeling After Thoracic Endovascular Aortic Repair of Type B (IIIb) Aortic Dissection

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Chen, I-Ming [National Yang Ming University, Institute of Clinical Medicine, School of Medicine (China); Chen, Po-Lin; Huang, Chun-Yang [National Yang Ming University, Department of Medicine, School of Medicine (China); Weng, Shih-Hsien; Chen, Wei-Yuan; Shih, Chun-Che, E-mail: ccshih@vghtpe.gov.tw [National Yang Ming University, Institute of Clinical Medicine, School of Medicine (China)

2017-05-15

PurposeThe purpose of this study was to determine factors associated with entire aortic remodeling after thoracic endovascular aortic repair (TEVAR) in patients with type B dissection.Materials and MethodsThe patients with type B (IIIb) dissections who underwent TEVAR from 2006 to 2013 with minimum of 2 years of follow-up computed tomography data were retrospectively reviewed. Based on the status of false lumen remodeling of entire aorta, patients were divided into three groups: complete regression, total thrombosis, and inadequate regression with patent abdominal false lumen.ResultsA total of 90 patients (72 males, 18 females; mean age 56.6 ± 16.4 years) were included and divided into the complete regression (n = 22), total thrombosis (n = 18), and inadequate regression (n = 50) groups. Multivariate logistic regression analysis indicated that dissection extension to iliac arteries, increased preoperative number of dissection tear over abdominal aorta, and decreased preoperative abdominal aorta bifurcation true lumen ratio, as compared between the inadequate and complete regression groups, were associated with a persistent false lumen (odds ratio = 33.33, 2.304, and 0.021; all, p ≤ 0.012). Comparison of 6, 12, and 24 months postoperative data revealed no significant differences at any level, suggesting that the true lumen area ratio might not change after 6 months postoperatively.ConclusionsIncreased preoperative numbers of dissection tear around the abdominal visceral branches, dissection extension to the iliac arteries, and decreased preoperative true lumen area ratio of abdominal aorta are predictive of entire aortic remodeling after TEVAR in patients with type B dissection.Level of EvidenceIII.

Factors Affecting Optimal Aortic Remodeling After Thoracic Endovascular Aortic Repair of Type B (IIIb) Aortic Dissection

International Nuclear Information System (INIS)

Chen, I-Ming; Chen, Po-Lin; Huang, Chun-Yang; Weng, Shih-Hsien; Chen, Wei-Yuan; Shih, Chun-Che

2017-01-01

PurposeThe purpose of this study was to determine factors associated with entire aortic remodeling after thoracic endovascular aortic repair (TEVAR) in patients with type B dissection.Materials and MethodsThe patients with type B (IIIb) dissections who underwent TEVAR from 2006 to 2013 with minimum of 2 years of follow-up computed tomography data were retrospectively reviewed. Based on the status of false lumen remodeling of entire aorta, patients were divided into three groups: complete regression, total thrombosis, and inadequate regression with patent abdominal false lumen.ResultsA total of 90 patients (72 males, 18 females; mean age 56.6 ± 16.4 years) were included and divided into the complete regression (n = 22), total thrombosis (n = 18), and inadequate regression (n = 50) groups. Multivariate logistic regression analysis indicated that dissection extension to iliac arteries, increased preoperative number of dissection tear over abdominal aorta, and decreased preoperative abdominal aorta bifurcation true lumen ratio, as compared between the inadequate and complete regression groups, were associated with a persistent false lumen (odds ratio = 33.33, 2.304, and 0.021; all, p ≤ 0.012). Comparison of 6, 12, and 24 months postoperative data revealed no significant differences at any level, suggesting that the true lumen area ratio might not change after 6 months postoperatively.ConclusionsIncreased preoperative numbers of dissection tear around the abdominal visceral branches, dissection extension to the iliac arteries, and decreased preoperative true lumen area ratio of abdominal aorta are predictive of entire aortic remodeling after TEVAR in patients with type B dissection.Level of EvidenceIII.

Modified conduit preparation creates a pseudosinus in an aortic valve-sparing procedure for aneurysm of the ascending aorta.

Science.gov (United States)

Cochran, R P; Kunzelman, K S; Eddy, A C; Hofer, B O; Verrier, E D

1995-06-01

Mechanical valved conduit replacement of the aortic root is a durable and appropriate procedure for many diseases of the ascending aorta, but may sacrifice an anatomically salvageable aortic valve. For young active patients and for patients with "systemic" arterial disease (atherosclerosis, Marfan's syndrome) who may require future operations, life-long anticoagulation with its attendant thromboembolic versus hemorrhagic risks is not ideal. Several techniques have been suggested as aortic valve-sparing options. Recently, a procedure was described that combines the freehand homograft techniques with the standard Bentall techniques (David procedure). This innovative technique replaces the ascending aorta with a Dacron cylinder, spares the aortic valve, and restores competence and thus offers an excellent alternative. The durability of this procedure that places the aortic valve inside a cylindrical conduit without sinuses of Valsalva is unknown. In selected patients, we have used this technique to spare the aortic valve. On the basis of experimental data and preliminary computer modeling, with the hope of improving the durability, we have modified the conduit to create a "pseudosinus" in our most recent nine patients. We have done the David procedure in 10 patients. The pseudosinus modification was done in the most recent nine patients. Patients' ages ranged from 37 to 71 years (mean 49.9 years). There were five female and five male patients. Five patients had Marfan's syndrome and five patients had annuloaortic ectasia. There has been no mortality and all patients have had both early and late follow-up echocardiography. Five patients have zero to trace aortic insufficiency, four patients have trace to mild aortic insufficiency, and one patient has mild or "1+" aortic insufficiency. Aortic insufficiency has not progressed in any patient during the 18 months of follow-up. The patient with 1+ aortic insufficiency has no activity limits, good ventricular function, and

Measurement of the aortic diameter in the asymptomatic Korean population: Assessment with multidetector CT

International Nuclear Information System (INIS)

Lee, Sang Hwan; Lee, Whal; Choi, Hyuck Jae; Kim, Dae Jin; Park, Eun Ah; Chung, Jin Wook; Park, Jae Hyung

2013-01-01

To determine normal reference values for aortic diameters in asymptomatic Korean adults. Three hundred adults without signs or symptoms of cardiovascular diseases were enrolled in this study. Aortic diameters were measured at nine predetermined levels on CT images. Aortic diameter measurements were adjusted for body surface area. Analysis of data was performed with regard to age, sex, weight, height and hypertension. Aortic diameters were 2.99 ± 0.57 cm at the ascending aorta, 2.54 ± 0.35 cm at the transverse aortic arch, 2.36 ± 0.35 cm at the proximal descending thoracic aorta (DTA), 2.23 ± 0.37 cm at the mid DTA, 2.17 ± 0.38 cm at the distal DTA, 2.16 ± 0.37 cm at the thoracoabdominal junction, 2.10, 00B1, 0.35 cm at the level of the celiac axis, 1.94, 00B1, 0.36 cm at the suprarenal aorta, 1.58 ± 0.24 cm at the aortic bifurcation. Men had slightly larger diameters than women (p < 0.05). All diameters increased with age and hypertension, with statistical significance (p < 0.01). And all aortic diameters increased with height (p < 0.05) except at the level of the aortic arch (p = 0.056), and increased with weight (p < 0.05) except at the level of the suprarenal aorta (p = 0.067). Male sex, higher weight and height, age and hypertension are associated with larger aortic diameters in asymptomatic Korean adults.

Contrast volume reduction using third generation dual source computed tomography for the evaluation of patients prior to transcatheter aortic valve implantation

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Bittner, Daniel O. [University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuernberg (FAU), Department of Internal Medicine 2 (Cardiology), Erlangen (Germany); Harvard Medical School, Cardiac MR PET CT Program, Massachusetts General Hospital, Boston, MA (United States); Arnold, Martin; Klinghammer, Lutz; Schuhbaeck, Annika; Hell, Michaela M.; Muschiol, Gerd; Gauss, Soeren; Achenbach, Stephan; Marwan, Mohamed [University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuernberg (FAU), Department of Internal Medicine 2 (Cardiology), Erlangen (Germany); Lell, Michael; Uder, Michael [University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuernberg (FAU), Department of Radiology, Erlangen (Germany); Hoffmann, Udo [Harvard Medical School, Cardiac MR PET CT Program, Massachusetts General Hospital, Boston, MA (United States)

2016-12-15

Chronic renal failure is common in patients referred for transcatheter aortic valve implantation (TAVI). CT angiography is recommended and provides crucial information prior to TAVI. We evaluated the feasibility of a reduced contrast volume protocol for pre-procedural CT imaging. Forty consecutive patients were examined with prospectively ECG-triggered high-pitch spiral acquisition using a novel third-generation dual-source CT system; 38 ml contrast agent was used. Image quality was graded on a visual scale (1-4). Contrast attenuation was measured at the level of the aortic root and at the iliac bifurcation. Mean patient age was 82 ± 6 years (23 males; 58 %). Mean attenuation/average image quality was 285 ± 60 HU/1.5 at the aortic annulus compared to 289 ± 74 HU/1.8 at the iliac bifurcation (p = 0.77/p = 0.29). Mean estimated effective radiation dose was 2.9 ± 0.3 mSv. A repeat acquisition was necessary in one patient due to image quality. Out of the 35 patients who underwent TAVI, 31 (89 %) patients had no or mild aortic regurgitation. Thirty-two (91 %) patients were discharged successfully. Pre-procedural CTA with a total of 38 ml contrast volume is feasible and clinically useful, using third-generation dual-source CT, allowing comprehensive imaging for procedural success. (orig.)

Unusual presentation of aortic dissection: Post-coital acute paraplegia with renal failure

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Dinith P Galabada

2014-01-01

Full Text Available We report the case of a 45-year-old chronic smoker who presented with acute paraplegia occurring during coitus and subsequently developed acute renal failure (ARF requiring dialysis. He had absent peripheral pulses in the lower limbs with evidence of acute ischemia. Doppler study showed dissecting aneurysm of thoracic aorta, thrombotic occlusion of the distal aorta from L1 level up to bifurcation and occlusion of the right renal artery by a thrombus that was confirmed by magnetic resonance imaging of the spine. He was not subjected to any vascular intervention as his lower limbs were not salvageable due to delay in the diagnosis. Post-coital aortic dissection and aortic dissection presenting with acute paraplegia and ARF are very rare. This is probably the first case report with post-coital acute aortic dissection presenting with paraplegia and ARF. This case emphasizes the importance of a careful examination of peripheral pulses in patients presenting with ARF and paraplegia.

Unfolding the Riddling Bifurcation

DEFF Research Database (Denmark)

Maistrenko, Yu.; Popovych, O.; Mosekilde, Erik

1999-01-01

We present analytical conditions for the riddling bifurcation in a system of two symmetrically coupled, identical, smooth one-dimensional maps to be soft or hard and describe a generic scenario for the transformations of the basin of attraction following a soft riddling bifurcation.......We present analytical conditions for the riddling bifurcation in a system of two symmetrically coupled, identical, smooth one-dimensional maps to be soft or hard and describe a generic scenario for the transformations of the basin of attraction following a soft riddling bifurcation....

Percutaneous endovascular stent-graft treatment of aortic aneurysms and dissections: new techniques and initial experience

Energy Technology Data Exchange (ETDEWEB)

Lee, Do Yun; Choi, Dong Hoon; Kang, Sung Gwon; Lee, Kwang Hoon; Won, Jong Yun [Yonsei University College of Medicine, Seoul (Korea, Republic of); Kang, Sung Gwon [Chosun University College of Medicine, Gwangju (Korea, Republic of); Won, Je Whan [Aju University College of Medicine, Suwon (Korea, Republic of); Song, Ho Young [Ulsan University College of Medicine, Seoul (Korea, Republic of)

2003-01-01

To evaluate the feasibility, safety and effectiveness of a newly designed percutaneously implanted separate stent-graft (SSG) for the treatment of aortic aneurysms and dissections. Using a percutaneous technique, SSG placement (in the descending thoracic aorta in 26 cases and infrarenal abdominal aorta in 24) was attempted in 50 patients with aortic aneurysms (n=27) or dissection (n=23). All SSGs were individually constructed using self-expandable nitinol stents and a Dacron graft, and were introduced through a 12 F sheath and expanded to a diameter of 20-34 mm. In all cases, vascular access was through the femoral artery. The clinical status of each patient was monitored, and postoperative CT was performed within one week of the procedure and at 3-6 month intervals afterwards. Endovascular stent-graft deployment was technically successful in 49 of 50 patients (98%). The one failure was due to torsion of the unsupported graft during deployment. Successful exclusion of aneurysms and the primary entry tears of dissections was achieved in all but three patients with aortic dissection. All patients in whom technical success was achieved showed complete thrombosis of the thoracic false lumen or aneurysmal sac, and the overall technique success rate was 92%. In addition, sixteen patients demonstrated complete resolution of the dissected thoracic false lumen (n=9) or aneurysmal sac (n=7). Immediate post-operative complications occurred at the femoral puncture site in one patient with an arteriovenous fistula, and in two, a new saccular aneurysm developed at the distal margin of the stent. No patients died, and there was no instance of paraplegia, stroke, side-branch occlusion or infection during the subsequent mean follow-up period of 9.4 (range, 2 to 26) months. In patients with aortic aneurysm and dissection, treatment with a separate percutaneously inserted stent-graft is technically feasible, safe, and effective.

Familial Thoracic Aortic Aneurysm with Dissection Presenting as Flash Pulmonary Edema in a 26-Year-Old Man

Directory of Open Access Journals (Sweden)

Sabry Omar

2014-01-01

Full Text Available We are reporting a case of familial thoracic aortic aneurysm and dissection in a 26-year-old man with no significant past medical history and a family history of dissecting aortic aneurysm in his mother at the age of 40. The patient presented with cough, shortness of breath, and chest pain. Chest X-ray showed bilateral pulmonary infiltrates. CT scan of the chest showed a dissection of the ascending aorta. The patient underwent aortic dissection repair and three months later he returned to our hospital with new complaints of back pain. CT angiography showed a new aortic dissection extending from the left carotid artery through the bifurcation and into the iliac arteries. The patient underwent replacement of the aortic root, ascending aorta, total aortic arch, and aortic valve. The patient recovered well postoperatively. Genetic studies of the patient and his children revealed no mutations in ACTA2, TGFBR1, TGFBR2, TGFB2, MYH11, MYLK, SMAD3, or FBN1. This case report focuses on a patient with familial TAAD and discusses the associated genetic loci and available screening methods. It is important to recognize potential cases of familial TAAD and understand the available screening methods since early diagnosis allows appropriate management of risk factors and treatment when necessary.

Bifurcations sights, sounds, and mathematics

CERN Document Server

Matsumoto, Takashi; Kokubu, Hiroshi; Tokunaga, Ryuji

1993-01-01

Bifurcation originally meant "splitting into two parts. " Namely, a system under­ goes a bifurcation when there is a qualitative change in the behavior of the sys­ tem. Bifurcation in the context of dynamical systems, where the time evolution of systems are involved, has been the subject of research for many scientists and engineers for the past hundred years simply because bifurcations are interesting. A very good way of understanding bifurcations would be to see them first and study theories second. Another way would be to first comprehend the basic concepts and theories and then see what they look like. In any event, it is best to both observe experiments and understand the theories of bifurcations. This book attempts to provide a general audience with both avenues toward understanding bifurcations. Specifically, (1) A variety of concrete experimental results obtained from electronic circuits are given in Chapter 1. All the circuits are very simple, which is crucial in any experiment. The circuits, howev...

Quantitative angiography methods for bifurcation lesions

DEFF Research Database (Denmark)

Collet, Carlos; Onuma, Yoshinobu; Cavalcante, Rafael

2017-01-01

Bifurcation lesions represent one of the most challenging lesion subsets in interventional cardiology. The European Bifurcation Club (EBC) is an academic consortium whose goal has been to assess and recommend the appropriate strategies to manage bifurcation lesions. The quantitative coronary...... angiography (QCA) methods for the evaluation of bifurcation lesions have been subject to extensive research. Single-vessel QCA has been shown to be inaccurate for the assessment of bifurcation lesion dimensions. For this reason, dedicated bifurcation software has been developed and validated. These software...

Treatment of a Ruptured Anastomotic Esophageal Stricture Following Bougienage with a Dacron-Covered Nitinol Stent

International Nuclear Information System (INIS)

Heindel, Walter; Gossmann, Axel; Fischbach, Roman; Michel, Olaf; Lackner, Klaus

1996-01-01

A patient suffering from esophagorespiratory fistula after bougienage of a benign stricture at the site of the anastomosis between a jejunal interposition and the esophagus was referred for interventional treatment. A prototype nitinol stent centrally covered with Dacron was implanted under regional anesthesia and fluoroscopic guidance. The self-expanding prosthesis dilated the stenosis completely and closed the fistula, with consequent improvement in respiratory and nutritional status and thus the general quality of life. The patient was able to eat and drink normally until death 3 months later due to progression of his underlying malignant disease

Management of carotid Dacron patch infection: a case report using median sternotomy for proximal common carotid artery control and in situ polytetrafluoroethylene grafting.

Science.gov (United States)

Illuminati, Giulio; Calio', Francesco G; D'Urso, Antonio; Ceccanei, Gianluca; Pacilè, Maria Antonietta

2009-01-01

We report on a 58-year-old male who presented with an enlarging cervical hematoma 3 months following carotid endarterectomy with Dacron patch repair, due to septic disruption of the Dacron patch secondary to presumed infection. The essential features of this case are the control of the proximal common carotid artery gained through a median sternotomy, because the patient was markedly obese with minimal thyromental distance, and the treatment consisting of in situ polytetrafluoroethylene bypass grafting, due to the absence of a suitable autogenous saphenous vein. Median sternotomy is rarely required in case of reintervention for septic false aneurysms and hematomas following carotid endarterectomy but should be considered whenever difficult control of the common carotid artery, when entering the previous cervicotomy, is anticipated. In situ polytetrafluoroethylene grafting can be considered if autogenous vein material is lacking.

Simple or Complex Stenting for Bifurcation Coronary Lesions: A Patient-Level Pooled-Analysis of the Nordic Bifurcation Study and the British Bifurcation Coronary Study

DEFF Research Database (Denmark)

Behan, Miles W; Holm, Niels Ramsing; Curzen, Nicholas P

2011-01-01

Background— Controversy persists regarding the correct strategy for bifurcation lesions. Therefore, we combined the patient-level data from 2 large trials with similar methodology: the NORDIC Bifurcation Study (NORDIC I) and the British Bifurcation Coronary Study (BBC ONE). Methods and Results— B...

Morphometric analysis of torso arterial anatomy with implications for resuscitative aortic occlusion.

Science.gov (United States)

Stannard, Adam; Morrison, Jonathan J; Sharon, Danny J; Eliason, Jonathan L; Rasmussen, Todd E

2013-08-01

Hemorrhage is a leading cause of death in military and civilian trauma. Despite the importance of the aorta as a site of hemorrhage control and resuscitative occlusion, detailed knowledge of its morphometry is lacking. The objective of this study was to characterize aortic morphometry in a trauma population, including quantification of distances as well as and diameters and definition of relevant aortic zones. Center line measures were made (Volume Viewer) from contrast computed tomography (CT) scans of male trauma patients (18-45 years). Aortic zones were defined based on branch arteries. Zone I includes left subclavian to celiac; Zone II includes celiac to caudal renal; Zone III includes caudal renal to aortic bifurcation. Zone lengths were calculated and correlated to a novel external measure of torso extent (symphysis pubis to sternal notch). Eighty-eight males (mean [SD], 28 [4] years) had CT scans for the study. The median (interquartile range) lengths (mm) of Zones I, II, and III were 210 mm (202-223 mm), 33 mm (28-38 mm), and 97 mm (91-103 mm), respectively. Median aortic diameters at the left subclavian, celiac, and lowest renal arteries were 21 mm (20-23 mm), 18 mm (16-19 mm), and 15 mm (14-16 mm), respectively, and the terminal aortic diameter was 14 mm (13-15 mm). The correlation of determination for descending aortic length (all zones) against torso extend was r = 0.454. This study provides a morphometric analysis of the aorta in a male population, demonstrating consistency of length and diameter while defining distinct axial zones. Findings suggest that center line aortic distances correlate with a simple, external measure of torso extent. Morphometric study of the aorta using CT data may facilitate the development and implementation of occlusion techniques to manage noncompressible torso, pelvic, and junctional femoral hemorrhage.

Bifurcation structure of parameter plane for a family of unimodal piecewise smooth maps: Border-collision bifurcation curves

International Nuclear Information System (INIS)

Sushko, Iryna; Agliari, Anna; Gardini, Laura

2006-01-01

We study the structure of the 2D bifurcation diagram for a two-parameter family of piecewise smooth unimodal maps f with one break point. Analysing the parameters of the normal form for the border-collision bifurcation of an attracting n-cycle of the map f, we describe the possible kinds of dynamics associated with such a bifurcation. Emergence and role of border-collision bifurcation curves in the 2D bifurcation plane are studied. Particular attention is paid also to the curves of homoclinic bifurcations giving rise to the band merging of pieces of cyclic chaotic intervals

Relative Lyapunov Center Bifurcations

DEFF Research Database (Denmark)

Wulff, Claudia; Schilder, Frank

2014-01-01

Relative equilibria (REs) and relative periodic orbits (RPOs) are ubiquitous in symmetric Hamiltonian systems and occur, for example, in celestial mechanics, molecular dynamics, and rigid body motion. REs are equilibria, and RPOs are periodic orbits of the symmetry reduced system. Relative Lyapunov...... center bifurcations are bifurcations of RPOs from REs corresponding to Lyapunov center bifurcations of the symmetry reduced dynamics. In this paper we first prove a relative Lyapunov center theorem by combining recent results on the persistence of RPOs in Hamiltonian systems with a symmetric Lyapunov...... center theorem of Montaldi, Roberts, and Stewart. We then develop numerical methods for the detection of relative Lyapunov center bifurcations along branches of RPOs and for their computation. We apply our methods to Lagrangian REs of the N-body problem....

Coating of Dacron vascular grafts with an ionic polyurethane: a novel sealant with protein binding properties.

Science.gov (United States)

Phaneuf, M D; Dempsey, D J; Bide, M J; Quist, W C; LoGerfo, F W

2001-03-01

The purpose of this study was to develop a novel sealant that would seal prosthetic vascular graft interstices and be accessible for protein binding. Crimped knitted Dacron vascular grafts were cleaned (CNTRL) and hydrolyzed in boiling sodium hydroxide (HYD). These HYD grafts were sealed using an 11% solids solution of a polyether-based urethane with carboxylic acid groups (PEU-D) via a novel technique that employs both trans-wall and luminal perfusion. Carboxylic acid content, determined via methylene blue dye uptake, was 2.3- and 4.2-fold greater in PEU-D segments (1.0+/-0.27 nmol/mg) as compared to HYD and CNTRL segments, respectively. Water permeation through PEU-D graft (1.1+/-2 ml/cm2 min(-1)) was comparable to collagen-impregnated Dacron (9.8+/-10 ml/cm2 min(-1)). Non-specific 125I-albumin (125I-Alb) binding to PEU-D segments (18+/-3 ng/mg) was significantly lower than HYD and CNTRL segments. 125I-Alb linkage to PEU-D using the crosslinker EDC resulted in 5.7-fold greater binding (103+/-2 ng/mg) than non-specific PEU-D controls. However, covalent linkage of 125I-Alb to PEU-D was 4.9- and 5.9-fold less than CNTRL and HYD segments with EDC, respectively. Thus, ionic polyurethane can be applied to a pre-formed vascular graft, seal the interstices and create "anchor" sites for protein attachment.

Dynamic Bifurcations

CERN Document Server

1991-01-01

Dynamical Bifurcation Theory is concerned with the phenomena that occur in one parameter families of dynamical systems (usually ordinary differential equations), when the parameter is a slowly varying function of time. During the last decade these phenomena were observed and studied by many mathematicians, both pure and applied, from eastern and western countries, using classical and nonstandard analysis. It is the purpose of this book to give an account of these developments. The first paper, by C. Lobry, is an introduction: the reader will find here an explanation of the problems and some easy examples; this paper also explains the role of each of the other paper within the volume and their relationship to one another. CONTENTS: C. Lobry: Dynamic Bifurcations.- T. Erneux, E.L. Reiss, L.J. Holden, M. Georgiou: Slow Passage through Bifurcation and Limit Points. Asymptotic Theory and Applications.- M. Canalis-Durand: Formal Expansion of van der Pol Equation Canard Solutions are Gevrey.- V. Gautheron, E. Isambe...

Nonlinear stability control and λ-bifurcation

International Nuclear Information System (INIS)

Erneux, T.; Reiss, E.L.; Magnan, J.F.; Jayakumar, P.K.

1987-01-01

Passive techniques for nonlinear stability control are presented for a model of fluidelastic instability. They employ the phenomena of λ-bifurcation and a generalization of it. λ-bifurcation occurs when a branch of flutter solutions bifurcates supercritically from a basic solution and terminates with an infinite period orbit at a branch of divergence solutions which bifurcates subcritically from the basic solution. The shape of the bifurcation diagram then resembles the greek letter λ. When the system parameters are in the range where flutter occurs by λ-bifurcation, then as the flow velocity increase the flutter amplitude also increases, but the frequencies of the oscillations decrease to zero. This diminishes the damaging effects of structural fatigue by flutter, and permits the flow speed to exceed the critical flutter speed. If generalized λ-bifurcation occurs, then there is a jump transition from the flutter states to a divergence state with a substantially smaller amplitude, when the flow speed is sufficiently larger than the critical flutter speed

Clinical applications of Ga-67 DFO-DAS-fibrinogen

International Nuclear Information System (INIS)

Iio, Masahiro; Ohtake, Tohru; Nishikawa, Junichi; Watanabe, Toshiaki; Yasuhara, Hiroshi; Ohashi, Shigenobu; Takayama, Yutaka; Tada, Yusuke; Shirakawa, Motoaki

1987-01-01

Ga-67 DFO-DAS-fibrinogen scanning was performed in 15 patients to detect fresh arterial thrombus. Seven patients were preoperative cases of aortic aneurysm and eight were postoperative cases of graft bypass. Scanning was performed on the first and second days after the injection. Nine of 13 grafts in eight cases were visualized by 67 Ga-DFO-DAS-fibrinogen scan. Velour Dacron grafts were more strongly visualized compared with woven Dacron or Goatex. In three patients with aortic aneurysm in whom fresh thrombus was identified by operative findings, arterial thrombus was clearly visualized by 67 Ga-DFO-DAS-fibrinogen scan, whereas in three other patients with aortic aneurysm, thrombus was not visualized, although it was identified by other examinations. In one case, a marked accumulation was observed in the abdominal aorta, although no arterial thrombus was found at operation. This was thought to be an accumulation in a blood pool because it decreased on the second day. We think it important to observe the relative changes of accumulation. (author)

Scientific and industrial status of tissue engineering

African Journals Online (AJOL)

SERVER

2007-12-28

Dec 28, 2007 ... with artificial materials e.g. replacement of aortic artery with Dacron. ... Employment of living cells to replace the lost tissue, which is the basis of tissue ...... by the US National Intelligence Council, the Intelligence. Technology ...

Enxerto venoso intercoronariano na revascularização de artéria coronária comprometida por dissecção de aorta tipo I Intercoronary venous graft in revascularization of the coronary artery involved by aortic dissection type I

Directory of Open Access Journals (Sweden)

Carlos Alberto C Abreu Filho

1995-03-01

Full Text Available Paciente de 39 anos, portador de hipertensão arterial não controlada, submetido a cirurgia para tratamento de dissecção aguda de aorta tipo I. Devido ao grande envolvimento do óstio coronário direito pela dissecção aórtica, optou-se pela ressecção da porção comprometida do vaso, com interposição de tubo não valvulado de Dacron na aorta ascendente, suspensão da valva aórtica e ligadura do óstio da artéria coronária direita. Como não havia presença de aterosclerose no ramo interventricular anterior e na artéria coronária direita, decidimos realizar um enxerto venoso entre as artérias. O enxerto intercoronário apresentou bom funcionamento e todo o território dependente da coronária direita manteve boa contratilidade. O paciente recebeu alta hospitalar em boas condições clínicas, com função rniocárdica preservada.A thirty nine-year-old patient presenting arterial hypertension was operated upon for type I acute aortic dissection. Due to important alterations in the ascendent aorta with involvement of the right coronary ostium, the surgical procedure included resection of the segment of aorta containing the intimal tear and replacement with a Dacron prosthesis, suspension of the aortic valve and ligadure of the right coronary ostium. Technical difficulties brought the necessity of a different approach for the myocardium revascularization. Instead of the traditional described procedures, an intercoronary venous graft was put between the anterior interventricular artery (branch of the left coronary artery and the right coronary artery. The intercoronary graft presented a good flow since the begining, keeping a good myocardial contratility. Patient left the hospital in a good clinical condition, with preserved myocardial function. Intercoronary graft should be an efficient alternative for revascularization of a corohary artery involved by aortic dissections.

Electron microscopy study of a vascular prosthesis destructed in vivo reveals fractures in Dacron fibers.

Science.gov (United States)

Woźniak, Witold; Olszewski, Wojciech; Górski, Grzegorz

2016-02-01

The genuine destruction of a synthetic prosthesis wall, as a late complication of vascular surgery, is extremely rare. We report a case of a 64-year-old male who had his 12-year-old femoropopliteal synthetic graft explanted due to two large pseudoaneurysms in the middle section of the graft. Microscopic evaluation demonstrated the areas of focal thinning along the entire prosthesis wall, with "foreign body" type reaction in the adjacent connective tissue. Transmission electron microscopy showed longitudinal fractures of Dacron fibers interposed with cellular structures, suggesting that destruction must have taken place significantly earlier. The problems of limited graft durability and graft surveillance are discussed. © The Author(s) 2015.

[Change of paradigms in the surgical treatment of complex thoracic aortic disease].

Science.gov (United States)

Herold, Ulf; Tsagakis, Konstantinos; Kamler, Markus; Massoudy, Parwis; Assenmacher, Eva; Eggebrecht, Holger; Buck, Thomas; Jakob, Heinz

2006-08-01

group. The experience gained with these devices revealed the limitations of the devices designed for pure retrograde aortic delivery. This required a complete redesign and new construction of the stent graft itself as well as the introducer system. In a preliminary series of 14 patients the required stent-graft properties were presented in detail and resulted in the first industrially manufactured standardized and CE-marked Hybrid stent graft (Essen 1 prosthesis, E-vita Open, Jotec), especially made for antegrade open stent grafting of the descending aorta. This device consists of a stent graft with an integrated Dacron vascular prosthesis, enabling for direct and continuous aortic arch replacement after stent grafting of the descending aorta. From 01/2005 to 03/2006, this hybrid prosthesis was implanted in 16 patients (one aneurysm and 15 aortic dissections). In all cases, the underlying pathology within the thoracic aspect of the aorta could be excluded in a one-stage approach. In case of aortic dissection, thrombosis of the false lumen was detectable by transesophageal echocardiography already at the end of surgery. Though long-term results using this new method are not yet available, the initial promising results postoperatively are encouraging toward true one-stage repair by combining classic aortic surgery with open antegrade stent grafting utilizing the newly designed hybrid prosthesis. While surgical trauma is markedly reduced, this treatment option can be offered to elderly patients as well.

Cadaveric aorta implantation for aortic graft infection.

Science.gov (United States)

Ali, Asad; Bahia, Sandeep S S; Ali, Tahir

2016-01-01

This case report describes a 73-year-old gentleman who underwent explantation of an infected prosthetic aorto-iliac graft and replacement with a cryopreserved thoracic and aorto-iliac allograft. The patient has been followed up a for more than a year after surgery and remains well. After elective tube graft repair of his abdominal aortic aneurysm (AAA) in 2003, he presented to our unit in 2012 in cardiac arrest as a result of a rupture of the distal graft suture line due to infection. After resuscitation he underwent aorto-bifemoral grafting using a cuff of the original aortic graft proximally. Distally the new graft was anastomosed to his common femoral arteries, with gentamicin beads left in situ. Post discharge the patient was kept under close surveillance with serial investigations including nuclear scanning, however it became apparent that his new graft was infected and that he would require aortic graft replacement, an operation with a mortality of at least 50%. The patient underwent the operation and findings confirmed a synthetic graft infection. This tube graft was explanted and a cryopreserved aorta was used to the refashion the abdominal aorta and its bifurcation. The operation required a return to theatre day one post operatively for a bleeding side branch, which was repaired. The patient went on to make a full recovery stepping down from the intensive therapy unit day 6 post operatively and went on to be discharged 32 days after his cryopreserved aorta implantation. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Impact of Aortic Insufficiency on Ascending Aortic Dilatation and Adverse Aortic Events After Isolated Aortic Valve Replacement in Patients With a Bicuspid Aortic Valve.

Science.gov (United States)

Wang, Yongshi; Wu, Boting; Li, Jun; Dong, Lili; Wang, Chunsheng; Shu, Xianhong

2016-05-01

Aberrant flow pattern and congenital fragility bestows bicuspid aortic valve (BAV) with a propensity toward ascending aorta dilatation, aneurysm, and dissection. Whether isolated aortic valve replacement (AVR) can prevent further dilatation in BAV ascending aorta and what indicates concurrent aortic intervention in the case of valve operation remain controversial. From June 2006 to January 2009, patients with a BAV who underwent isolated AVR were consecutively included and categorized into aortic insufficiency (BAV-AI, n = 84) and aortic stenosis (n = 112) groups, and another population of patients with a tricuspid aortic valve with aortic insufficiency (n = 149) was also recruited during the same period for comparison of annual aortic dilatation rate and adverse aortic events after isolated AVR. With a median follow-up period of 72 months (interquartile range, 66 to 78 months), ascending aorta dilatation rates were faster in the BAV-AI group than the BAV plus aortic stenosis and tricuspid aortic valve with aortic insufficiency groups (both p regression analysis identified aortic insufficiency (hazard ratio, 3.7; 95% confidence interval, 1.2 to 11.1; p = 0.019) as an independent risk factor for adverse aortic events among patients with BAV in general, whereas preoperative ascending aortic diameter larger than 45 mm (hazard ratio, 13.8; 95% confidence interval, 3.0 to 63.3; p = 0.001) served as a prognostic indicator in the BAV-AI group. An aggressive policy of preventive aortic interventions seemed appropriate in patients with BAV-AI during AVR, and BAV phenotype presenting as either insufficiency or stenosis should be taken into consideration when contemplating optimal surgical strategies for BAV aortopathy. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Bifurcation in a buoyant horizontal laminar jet

Science.gov (United States)

Arakeri, Jaywant H.; Das, Debopam; Srinivasan, J.

2000-06-01

The trajectory of a laminar buoyant jet discharged horizontally has been studied. The experimental observations were based on the injection of pure water into a brine solution. Under certain conditions the jet has been found to undergo bifurcation. The bifurcation of the jet occurs in a limited domain of Grashof number and Reynolds number. The regions in which the bifurcation occurs has been mapped in the Reynolds number Grashof number plane. There are three regions where bifurcation does not occur. The various mechanisms that prevent bifurcation have been proposed.

Bifurcations of Tumor-Immune Competition Systems with Delay

Directory of Open Access Journals (Sweden)

Ping Bi

2014-01-01

Full Text Available A tumor-immune competition model with delay is considered, which consists of two-dimensional nonlinear differential equation. The conditions for the linear stability of the equilibria are obtained by analyzing the distribution of eigenvalues. General formulas for the direction, period, and stability of the bifurcated periodic solutions are given for codimension one and codimension two bifurcations, including Hopf bifurcation, steady-state bifurcation, and B-T bifurcation. Numerical examples and simulations are given to illustrate the bifurcations analysis and obtained results.

Determination of entry site for acute type A aortic dissection by initial enhanced CT-scan

International Nuclear Information System (INIS)

Mase, Takenori; Narumiya, Chihiro; Aoyama, Takahiko; Nagata, Yoshihisa

2002-01-01

Acute type A aortic dissection presents a surgical emergency because conservative therapy is not effective in the majority of instances. Enhanced CT-scan of the chest is commonly available and is considered to be an optimal diagnostic method for this disease. The operative strategy is to resect the primary tear to close the entry site of the aortic dissection and replace it with a tubular Dacron graft. Therefore, the existence of the entry site is important in determining the operative procedure. Based on the numerical value of the enhanced CT-scan inspection, the present study seeks to preoperatively identify the location of the presumed entry site in aortic dissection. From May 1996 to June 1999, 21 consecutive patients (Marfan's syndrome excluded) with acute type A aortic dissection underwent surgical treatment. Nineteen patients were preoperatively examined by enhanced CT-scan: 11 men and 8 women, with a mean age of 61 years. CT-scan slices used for early diagnosis were of the ascending aorta, aortic arch, descending aorta, and thoracoabdominal aorta. The largest diameters of the whole and true lumen were measured from cross-sectional aortic images with a personal computer, and the areas of the whole and true lumen were obtained by the manual tracing method. The true ratio was calculated for the largest diameter and area of the whole lumen. The nineteen patients were divided into two groups according to the location of the entry site based on the operating views. Seven patients with the entry site in the ascending aorta were classified as group A, and twelve patients with the entry site further in the aortic arch and descending aorta were classified as group B. Comparisons were performed by non-parametric analysis. Moreover, a discriminant analysis was applied to evaluate the classification between the two groups. The ratio of the largest diameter of the true lumen in group A at the level of the ascending and descending aorta was significantly greater than that

Determination of entry site for acute type A aortic dissection by initial enhanced CT-scan

Energy Technology Data Exchange (ETDEWEB)

Mase, Takenori; Narumiya, Chihiro; Aoyama, Takahiko; Nagata, Yoshihisa [Aichi Medical Univ., Nagakute (Japan). School of Medicine

2002-01-01

Acute type A aortic dissection presents a surgical emergency because conservative therapy is not effective in the majority of instances. Enhanced CT-scan of the chest is commonly available and is considered to be an optimal diagnostic method for this disease. The operative strategy is to resect the primary tear to close the entry site of the aortic dissection and replace it with a tubular Dacron graft. Therefore, the existence of the entry site is important in determining the operative procedure. Based on the numerical value of the enhanced CT-scan inspection, the present study seeks to preoperatively identify the location of the presumed entry site in aortic dissection. From May 1996 to June 1999, 21 consecutive patients (Marfan's syndrome excluded) with acute type A aortic dissection underwent surgical treatment. Nineteen patients were preoperatively examined by enhanced CT-scan: 11 men and 8 women, with a mean age of 61 years. CT-scan slices used for early diagnosis were of the ascending aorta, aortic arch, descending aorta, and thoracoabdominal aorta. The largest diameters of the whole and true lumen were measured from cross-sectional aortic images with a personal computer, and the areas of the whole and true lumen were obtained by the manual tracing method. The true ratio was calculated for the largest diameter and area of the whole lumen. The nineteen patients were divided into two groups according to the location of the entry site based on the operating views. Seven patients with the entry site in the ascending aorta were classified as group A, and twelve patients with the entry site further in the aortic arch and descending aorta were classified as group B. Comparisons were performed by non-parametric analysis. Moreover, a discriminant analysis was applied to evaluate the classification between the two groups. The ratio of the largest diameter of the true lumen in group A at the level of the ascending and descending aorta was significantly greater than

Vascular geometry as a risk factor for non-penetrating traumatic injuries of the aortic arch.

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Andreas Schicho

Full Text Available To assess biomechanical factors in aortic arch geometry contributing to the development of non-penetrating aortic arch injury (NAAI in multiply injured patients with an Injury Severity Score (ISS ≥ 16.230 consecutive multiply injured trauma patients with an ISS ≥ 16 admitted to our Level-I trauma center during a consecutive 24-month period were prospectively included of whom 13 presented with NAAI (5.7%. Standardized whole-body CT in a 2x128-detector-row scanner included a head-and-neck CTA. Aortic arch diameters, width, height, angles and thoracic width and height were measured in individuals with NAAI and ISS-, sex-, age-, and trauma mechanism-matched controls.There was no difference between groups regarding sex, age, ISS, and aortic diameters. The aortic arch angle in individuals with NAAI (71.3° ± 14.9° was larger than in healthy control (60.7° ± 8.6°; p*<0.05. In patients with NAAI, the distance between ascendent and descendent aorta was larger (5.2 cm ± 1.9 cm than in control (2.8 ± 0.5 cm; ***p<0.001. The aortic arch is higher above tracheal bifurcation in NAAI (3.6 cm ± 0.6 cm than in matched control (2.4 cm ± 0.3 cm; ***p<0.001. Accordingly, the area under the aortic arch, calculated as half of an eliptic shape, is significantly larger in patients with NAAI (15.0 cm2 ± 6.5 cm2 when compared to age- and sex-matched controls without NAAI (5.5 cm2 ± 1.3 cm2; ***p<0.001.Besides the magnitude of deceleration and direction of impact, width and height of the aortic arch are the 3rd and 4th factor directly contributing to the risk of developing traumatic NAAI in severely injured patients.

Recent perspective on coronary artery bifurcation interventions.

Science.gov (United States)

Dash, Debabrata

2014-01-01

Coronary bifurcation lesions are frequent in routine practice, accounting for 15-20% of all lesions undergoing percutaneous coronary intervention (PCI). PCI of this subset of lesions is technically challenging and historically has been associated with lower procedural success rates and worse clinical outcomes compared with non-bifurcation lesions. The introduction of drug-eluting stents has dramatically improved the outcomes. The provisional technique of implanting one stent in the main branch remains the default approach in most bifurcation lesions. Selection of the most effective technique for an individual bifurcation is important. The use of two-stent techniques as an intention to treat is an acceptable approach in some bifurcation lesions. However, a large amount of metal is generally left unapposed in the lumen with complex two-stent techniques, which is particularly concerning for the risk of stent thrombosis. New technology and dedicated bifurcation stents may overcome some of the limitations of two-stent techniques and revolutionise the management of bifurcation PCI in the future.

Bifurcation of the spin-wave equations

International Nuclear Information System (INIS)

Cascon, A.; Koiller, J.; Rezende, S.M.

1990-01-01

We study the bifurcations of the spin-wave equations that describe the parametric pumping of collective modes in magnetic media. Mechanisms describing the following dynamical phenomena are proposed: (i) sequential excitation of modes via zero eigenvalue bifurcations; (ii) Hopf bifurcations followed (or not) by Feingenbaum cascades of period doubling; (iii) local and global homoclinic phenomena. Two new organizing center for routes to chaos are identified; in the classification given by Guckenheimer and Holmes [GH], one is a codimension-two local bifurcation, with one pair of imaginary eigenvalues and a zero eigenvalue, to which many dynamical consequences are known; secondly, global homoclinic bifurcations associated to splitting of separatrices, in the limit where the system can be considered a Hamiltonian subjected to weak dissipation and forcing. We outline what further numerical and algebraic work is necessary for the detailed study following this program. (author)

A composed graft for subclavian artery reconstruction in case of redo surgery for aortic coarctation

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Fabrizio Sansone

2013-01-01

Full Text Available We report the case of a 66-year-old woman admitted to the intensive care unit (ICU for ongoing dyspnea and hemoptoe. She was operated upon in 1979 for aortic coarctation by the interposition of a 14 mm Dacron prosthesis from the left subclavian artery to descending aorta. Clinical evaluation performed over the years was normal with no signs of cardiac failure or prosthesis malfunctioning. The computed tomography scans (CT showed a progressive increase of the descending aorta diameters and the onset of a pseudo-aneurysm of 50 mm in diameter. Patient was re-operated through a median sternotomy enlarged by a left thoracotomy and intra-operative findings revealed the pseudo-aneurysm originating from a dehiscence of the proximal suture. In order to allow a safe reconstruction of the dilated subclavian artery, a T-shaped composed graft was confectioned and then sutured to the descending aorta and the subclavian artery, respectively. Post-operative course was uneventful and three months CT scan showed a normal position of the composed graft.

Long-term results after aortic valve-sparing operation (David I).

Science.gov (United States)

Shrestha, Malakh; Baraki, Hassina; Maeding, Ilona; Fitzner, Sebastian; Sarikouch, Samir; Khaladj, Nawid; Hagl, Christian; Haverich, Axel

2012-01-01

Aortic valve-sparing David procedure has gained broad acceptance. However, few long-term results have been published. We present our results. More than 450 David procedures have been performed in our institution so far. Of these, 126 patients were operated between July 1993 and December 2000. Median age was 57 (8-83) years and 46 (36.5%) were female. As many as 26 (20.6%) had Marfan syndrome, 21 (16.7%) had acute aortic dissection type A (AADA) and 67 (53.2%) had additional procedures. There were six (4.8%) deaths in 30 post-operative period (POD), four of whom had AADA. In the follow-up, there were 32 (25.4%) late deaths, 11 (34.4%) of these were caused by cardiac or underlying disease or op-related. As many as 15 (11.9%) patients were re-operated; six (40%) were Marfan patients and two (13.3%) had early endocarditis. Follow-up echocardiography of 76 (60.3%) event-free patients showed valve insufficiency (AI)≤AI I° in 68 (89.5%) and grade II in 7 (9.2%) patients. Leaflet degeneration due to proposed leaflet contact with the straight Dacron graft was not observed. A total of 36 (47.4%) patients were in New York Heart Association (NYHA) class I, 33 (43.4%) in NYHA II, and five (6.6%) were in class III. During the entire follow-up of 790 patient-years, there was no stroke or major bleeding. Survival at 1, 5 and 10 years was 93%, 85% and 70%, respectively. Freedom from valve replacement at 1, 5 and 10 years was 96%, 91% and 87%, respectively. Regardless of the underlying pathology, valve-sparing David I procedure has acceptable long-term results. Valve-related complications such as stroke or major bleeding is exceedingly low.

Quantification of progression and regression of descending thoracic aortic wall thickness by enhanced computed tomography

International Nuclear Information System (INIS)

Yokoyama, Kenichi; Takasu, Junichiro; Yamamoto, Rie; Taguchi, Rie; Itani, Yasutaka; Ito, Yuichi; Watanabe, Shigeru; Masuda, Yoshiaki

2001-01-01

The purpose of this study is to verify the usefulness of the quantification of aortic wall involvement by enhanced computed tomography (CT). One-hundred thirteen Japanese patients underwent two enhanced CT of the descending thoracic aorta at intervals. We sliced the descending thoracic aorta continuously from the level of the tracheal bifurcation with 1 cm intervals, and we defined aortic wall volume (AWV) (cm 3 ) as the sum of a 7-slice area of aortic wall involving calcification. The average of AWV increased from 7.95±2.92 cm 3 to 8.70±2.98 cm 3 . The developmental rate of AWV (ΔAWV) was 0.270±0.281 cm 3 /year. ΔAWV did not have a significant correlation with any risk factor at the baseline. ΔAWV had significant correlation with total cholesterol, (LDL-C) low-density lipoprotein cholesterol and LDL-C/(HDL-C) high-density lipoprotein cholesterol ratio at the follow-up, and by multivariate analysis with only the LDL-C/HDL-C ratio. ΔAWV was not correlated with the intake status of hypoglycemic, antihypertensive or lipid-lowering drugs. The cut-off level of total cholesterol with the most significant odds ratio for progression of aortic wall was 190 mg/dl, and that of LDL-C was 130 mg/dl. This method proved to be useful for the non-invasive assessment of aortic wall thickness. (author)

[Supra-aortic trunks occlusive disease: three different treatment approaches].

Science.gov (United States)

Dias, P; Almeida, P; Sampaio, S; Silva, A; Leite-Moreira, A; Pinho, P; Roncon de Albuquerque, R

2010-01-01

Unlike carotid bifurcation atherosclerotic stenosis, supra-aortic trunks (SAT) occlusive disease is rare and its revascularization uncommon, accouting for less than 10% of the operations performed on the extracranial brain-irrigating arteries. There are three different treatment approaches: transthoracic, extra-anatomic cervical and endovascular. Endovascular repair is gaining popularity as first-line therapy for proximal lesions with favorable anatomy because of its low morbidity and rare mortality. Extra-anatomic bypass is a safe and durable reconstruction and should be considered in patients with single vessel disease, with cardiopulmonary high-risk or with limited life expectancy. If cardiac surgery is needed, central transthoracic reconstruction is preferable, and the two procedures should be combined. The long-term patency of bypasses with aortic origin, specially when multiple vessels are involved, is superior to other repair techniques. We present three clinical cases that illustrate each of these therapeutic strategies: central brachiocephalic revascularization and synchronous cardiac surgery in a patient with complex SAT atherosclerosis disease; subclavian-carotid transposition for disabling upper limb claudication; and subclavian artery stenting for subclavian-steal syndrome. Surgical approach selection should be based on the individual patient's anatomy and operative risk.

Bifurcation and chaos in neural excitable system

International Nuclear Information System (INIS)

Jing Zhujun; Yang Jianping; Feng Wei

2006-01-01

In this paper, we investigate the dynamical behaviors of neural excitable system without periodic external current (proposed by Chialvo [Generic excitable dynamics on a two-dimensional map. Chaos, Solitons and Fractals 1995;5(3-4):461-79] and with periodic external current as system's parameters vary. The existence and stability of three fixed points, bifurcation of fixed points, the conditions of existences of fold bifurcation, flip bifurcation and Hopf bifurcation are derived by using bifurcation theory and center manifold theorem. The chaotic existence in the sense of Marotto's definition of chaos is proved. We then give the numerical simulated results (using bifurcation diagrams, computations of Maximum Lyapunov exponent and phase portraits), which not only show the consistence with the analytic results but also display new and interesting dynamical behaviors, including the complete period-doubling and inverse period-doubling bifurcation, symmetry period-doubling bifurcations of period-3 orbit, simultaneous occurrence of two different routes (invariant cycle and period-doubling bifurcations) to chaos for a given bifurcation parameter, sudden disappearance of chaos at one critical point, a great abundance of period windows (period 2 to 10, 12, 19, 20 orbits, and so on) in transient chaotic regions with interior crises, strange chaotic attractors and strange non-chaotic attractor. In particular, the parameter k plays a important role in the system, which can leave the chaotic behavior or the quasi-periodic behavior to period-1 orbit as k varies, and it can be considered as an control strategy of chaos by adjusting the parameter k. Combining the existing results in [Generic excitable dynamics on a two-dimensional map. Chaos, Solitons and Fractals 1995;5(3-4):461-79] with the new results reported in this paper, a more complete description of the system is now obtained

Hopf bifurcation in an Internet congestion control model

International Nuclear Information System (INIS)

Li Chunguang; Chen Guanrong; Liao Xiaofeng; Yu Juebang

2004-01-01

We consider an Internet model with a single link accessed by a single source, which responds to congestion signals from the network, and study bifurcation of such a system. By choosing the gain parameter as a bifurcation parameter, we prove that Hopf bifurcation occurs. The stability of bifurcating periodic solutions and the direction of the Hopf bifurcation are determined by applying the normal form theory and the center manifold theorem. Finally, a numerical example is given to verify the theoretical analysis

Multiple Re-entry Closures After TEVAR for Ruptured Chronic Post-dissection Thoraco-abdominal Aortic Aneurysm

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R. Kinoshita

Full Text Available Introduction: Although thoracic endovascular aortic repair (TEVAR has become a promising treatment for complicated acute type B dissection, its role in treating chronic post-dissection thoraco-abdominal aortic aneurysm (TAA is still limited owing to persistent retrograde flow into the false lumen (FL through abdominal or iliac re-entry tears. Report: A case of chronic post-dissection TAA treatment, in which a dilated descending FL ruptured into the left thorax, is described. The primary entry tear was closed by emergency TEVAR and multiple abdominal re-entries were closed by EVAR. In addition, major re-entries at the detached right renal artery and iliac bifurcation were closed using covered stents. To close re-entries as far as possible, EVAR was carried out using the chimney technique, and additional aortic extenders were placed above the coeliac artery. A few re-entries remained, but complete FL thrombosis of the rupture site was achieved. Follow-up computed tomography showed significant shrinkage of the FL. Discussion: In treating post-dissection TAA, entry closure by TEVAR is sometimes insufficient, owing to persistent retrograde flow into the FL from abdominal or iliac re-entries. Adjunctive techniques are needed to close these distal re-entries to obtain complete FL exclusion, especially in rupture cases. Recently, encouraging results of complete coverage of the thoraco-abdominal aorta with fenestrated or branched endografts have been reported; however, the widespread employment of such techniques appears to be limited owing to technical difficulties. The present method with multiple re-entry closures using off the shelf and immediately available devices is an alternative for the endovascular treatment of post-dissection TAA, especially in the emergency setting. Keywords: Aortic dissection, Ruptured aortic aneurysm, Post-dissection thoracoabdominal aortic aneurysm, Endovascular aortic repair, Reentry closure, Endovascular procedures

Acute Aortic Arch Perforation During Transcatheter Aortic Valve Replacement in Bicuspid Aortic Stenosis and a Gothic Aortic Arch.

Science.gov (United States)

Millan-Iturbe, Oscar; Sawaya, Fadi J; Bieliauskas, Gintautas; Chow, Danny H F; De Backer, Ole; Søndergaard, Lars

2017-09-01

Transcatheter aortic valve replacement (TAVR) has evolved from a novel technology to an established therapy for high/intermediate-risk patients with severe symptomatic aortic stenosis (AS). Although TAVR is used to treat bicuspid severe AS, the large randomized trials typically excluded bicuspid AS because of its unique anatomic features. This case report describes an acute aortic perforation during delivery of a transcatheter heart valve to treat a severe bicuspid AS with a "gothic aortic arch"; more careful evaluation of the preprocedural multislice computed tomographic scan would have unveiled a sharply angulated aortic arch. This life-threatening complication was successfully treated by thoracic endovascular aortic repair. Copyright © 2017 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

Voltage stability, bifurcation parameters and continuation methods

Energy Technology Data Exchange (ETDEWEB)

Alvarado, F L [Wisconsin Univ., Madison, WI (United States)

1994-12-31

This paper considers the importance of the choice of bifurcation parameter in the determination of the voltage stability limit and the maximum power load ability of a system. When the bifurcation parameter is power demand, the two limits are equivalent. However, when other types of load models and bifurcation parameters are considered, the two concepts differ. The continuation method is considered as a method for determination of voltage stability margins. Three variants of the continuation method are described: the continuation parameter is the bifurcation parameter the continuation parameter is initially the bifurcation parameter, but is free to change, and the continuation parameter is a new `arc length` parameter. Implementations of voltage stability software using continuation methods are described. (author) 23 refs., 9 figs.

Bifurcation Behavior Analysis in a Predator-Prey Model

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Nan Wang

2016-01-01

Full Text Available A predator-prey model is studied mathematically and numerically. The aim is to explore how some key factors influence dynamic evolutionary mechanism of steady conversion and bifurcation behavior in predator-prey model. The theoretical works have been pursuing the investigation of the existence and stability of the equilibria, as well as the occurrence of bifurcation behaviors (transcritical bifurcation, saddle-node bifurcation, and Hopf bifurcation, which can deduce a standard parameter controlled relationship and in turn provide a theoretical basis for the numerical simulation. Numerical analysis ensures reliability of the theoretical results and illustrates that three stable equilibria will arise simultaneously in the model. It testifies the existence of Bogdanov-Takens bifurcation, too. It should also be stressed that the dynamic evolutionary mechanism of steady conversion and bifurcation behavior mainly depend on a specific key parameter. In a word, all these results are expected to be of use in the study of the dynamic complexity of ecosystems.

Long-term results after aortic valve-sparing operation (David I)†

Science.gov (United States)

Shrestha, Malakh; Baraki, Hassina; Maeding, Ilona; Fitzner, Sebastian; Sarikouch, Samir; Khaladj, Nawid; Hagl, Christian; Haverich, Axel

2012-01-01

OBJECTIVE Aortic valve-sparing David procedure has gained broad acceptance. However, few long-term results have been published. We present our results. METHODS More than 450 David procedures have been performed in our institution so far. Of these, 126 patients were operated between July 1993 and December 2000. Median age was 57 (8–83) years and 46 (36.5%) were female. As many as 26 (20.6%) had Marfan syndrome, 21 (16.7%) had acute aortic dissection type A (AADA) and 67 (53.2%) had additional procedures. RESULTS There were six (4.8%) deaths in 30 post-operative period (POD), four of whom had AADA. In the follow-up, there were 32 (25.4%) late deaths, 11 (34.4%) of these were caused by cardiac or underlying disease or op-related. As many as 15 (11.9%) patients were re-operated; six (40%) were Marfan patients and two (13.3%) had early endocarditis. Follow-up echocardiography of 76 (60.3%) event-free patients showed valve insufficiency (AI) ≤ AI I° in 68 (89.5%) and grade II in 7 (9.2%) patients. Leaflet degeneration due to proposed leaflet contact with the straight Dacron graft was not observed. A total of 36 (47.4%) patients were in New York Heart Association (NYHA) class I, 33 (43.4%) in NYHA II, and five (6.6%) were in class III. During the entire follow-up of 790 patient-years, there was no stroke or major bleeding. Survival at 1, 5 and 10 years was 93%, 85% and 70%, respectively. Freedom from valve replacement at 1, 5 and 10 years was 96%, 91% and 87%, respectively. CONCLUSIONS: Regardless of the underlying pathology, valve-sparing David I procedure has acceptable long-term results. Valve-related complications such as stroke or major bleeding is exceedingly low. PMID:21632258

Bifurcation structure of a model of bursting pancreatic cells

DEFF Research Database (Denmark)

Mosekilde, Erik; Lading, B.; Yanchuk, S.

2001-01-01

One- and two-dimensional bifurcation studies of a prototypic model of bursting oscillations in pancreatic P-cells reveal a squid-formed area of chaotic dynamics in the parameter plane, with period-doubling bifurcations on one side of the arms and saddle-node bifurcations on the other. The transit......One- and two-dimensional bifurcation studies of a prototypic model of bursting oscillations in pancreatic P-cells reveal a squid-formed area of chaotic dynamics in the parameter plane, with period-doubling bifurcations on one side of the arms and saddle-node bifurcations on the other....... The transition from this structure to the so-called period-adding structure is found to involve a subcritical period-doubling bifurcation and the emergence of type-III intermittency. The period-adding transition itself is not smooth but consists of a saddle-node bifurcation in which (n + 1)-spike bursting...

NUMERICAL HOPF BIFURCATION OF DELAY-DIFFERENTIAL EQUATIONS

Institute of Scientific and Technical Information of China (English)

无

2006-01-01

In this paper we consider the numerical solution of some delay differential equations undergoing a Hopf bifurcation. We prove that if the delay differential equations have a Hopf bifurcation point atλ=λ*, then the numerical solution of the equation also has a Hopf bifurcation point atλh =λ* + O(h).

Bifurcation of solutions to Hamiltonian boundary value problems

Science.gov (United States)

McLachlan, R. I.; Offen, C.

2018-06-01

A bifurcation is a qualitative change in a family of solutions to an equation produced by varying parameters. In contrast to the local bifurcations of dynamical systems that are often related to a change in the number or stability of equilibria, bifurcations of boundary value problems are global in nature and may not be related to any obvious change in dynamical behaviour. Catastrophe theory is a well-developed framework which studies the bifurcations of critical points of functions. In this paper we study the bifurcations of solutions of boundary-value problems for symplectic maps, using the language of (finite-dimensional) singularity theory. We associate certain such problems with a geometric picture involving the intersection of Lagrangian submanifolds, and hence with the critical points of a suitable generating function. Within this framework, we then study the effect of three special cases: (i) some common boundary conditions, such as Dirichlet boundary conditions for second-order systems, restrict the possible types of bifurcations (for example, in generic planar systems only the A-series beginning with folds and cusps can occur); (ii) integrable systems, such as planar Hamiltonian systems, can exhibit a novel periodic pitchfork bifurcation; and (iii) systems with Hamiltonian symmetries or reversing symmetries can exhibit restricted bifurcations associated with the symmetry. This approach offers an alternative to the analysis of critical points in function spaces, typically used in the study of bifurcation of variational problems, and opens the way to the detection of more exotic bifurcations than the simple folds and cusps that are often found in examples.

Energetics and monsoon bifurcations

Science.gov (United States)

Seshadri, Ashwin K.

2017-01-01

Monsoons involve increases in dry static energy (DSE), with primary contributions from increased shortwave radiation and condensation of water vapor, compensated by DSE export via horizontal fluxes in monsoonal circulations. We introduce a simple box-model characterizing evolution of the DSE budget to study nonlinear dynamics of steady-state monsoons. Horizontal fluxes of DSE are stabilizing during monsoons, exporting DSE and hence weakening the monsoonal circulation. By contrast latent heat addition (LHA) due to condensation of water vapor destabilizes, by increasing the DSE budget. These two factors, horizontal DSE fluxes and LHA, are most strongly dependent on the contrast in tropospheric mean temperature between land and ocean. For the steady-state DSE in the box-model to be stable, the DSE flux should depend more strongly on the temperature contrast than LHA; stronger circulation then reduces DSE and thereby restores equilibrium. We present conditions for this to occur. The main focus of the paper is describing conditions for bifurcation behavior of simple models. Previous authors presented a minimal model of abrupt monsoon transitions and argued that such behavior can be related to a positive feedback called the `moisture advection feedback'. However, by accounting for the effect of vertical lapse rate of temperature on the DSE flux, we show that bifurcations are not a generic property of such models despite these fluxes being nonlinear in the temperature contrast. We explain the origin of this behavior and describe conditions for a bifurcation to occur. This is illustrated for the case of the July-mean monsoon over India. The default model with mean parameter estimates does not contain a bifurcation, but the model admits bifurcation as parameters are varied.

Bifurcations of non-smooth systems

Science.gov (United States)

Angulo, Fabiola; Olivar, Gerard; Osorio, Gustavo A.; Escobar, Carlos M.; Ferreira, Jocirei D.; Redondo, Johan M.

2012-12-01

Non-smooth systems (namely piecewise-smooth systems) have received much attention in the last decade. Many contributions in this area show that theory and applications (to electronic circuits, mechanical systems, …) are relevant to problems in science and engineering. Specially, new bifurcations have been reported in the literature, and this was the topic of this minisymposium. Thus both bifurcation theory and its applications were included. Several contributions from different fields show that non-smooth bifurcations are a hot topic in research. Thus in this paper the reader can find contributions from electronics, energy markets and population dynamics. Also, a carefully-written specific algebraic software tool is presented.

Bifurcations of a class of singular biological economic models

International Nuclear Information System (INIS)

Zhang Xue; Zhang Qingling; Zhang Yue

2009-01-01

This paper studies systematically a prey-predator singular biological economic model with time delay. It shows that this model exhibits two bifurcation phenomena when the economic profit is zero. One is transcritical bifurcation which changes the stability of the system, and the other is singular induced bifurcation which indicates that zero economic profit brings impulse, i.e., rapid expansion of the population in biological explanation. On the other hand, if the economic profit is positive, at a critical value of bifurcation parameter, the system undergoes a Hopf bifurcation, i.e., the increase of delay destabilizes the system and bifurcates into small amplitude periodic solution. Finally, by using Matlab software, numerical simulations illustrate the effectiveness of the results obtained here. In addition, we study numerically that the system undergoes a saddle-node bifurcation when the bifurcation parameter goes through critical value of positive economic profit.

Analysis of Vehicle Steering and Driving Bifurcation Characteristics

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Xianbin Wang

2015-01-01

Full Text Available The typical method of vehicle steering bifurcation analysis is based on the nonlinear autonomous vehicle model deriving from the classic two degrees of freedom (2DOF linear vehicle model. This method usually neglects the driving effect on steering bifurcation characteristics. However, in the steering and driving combined conditions, the tyre under different driving conditions can provide different lateral force. The steering bifurcation mechanism without the driving effect is not able to fully reveal the vehicle steering and driving bifurcation characteristics. Aiming at the aforementioned problem, this paper analyzed the vehicle steering and driving bifurcation characteristics with the consideration of driving effect. Based on the 5DOF vehicle system dynamics model with the consideration of driving effect, the 7DOF autonomous system model was established. The vehicle steering and driving bifurcation dynamic characteristics were analyzed with different driving mode and driving torque. Taking the front-wheel-drive system as an example, the dynamic evolution process of steering and driving bifurcation was analyzed by phase space, system state variables, power spectral density, and Lyapunov index. The numerical recognition results of chaos were also provided. The research results show that the driving mode and driving torque have the obvious effect on steering and driving bifurcation characteristics.

Bifurcation scenarios for bubbling transition.

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Zimin, Aleksey V; Hunt, Brian R; Ott, Edward

2003-01-01

Dynamical systems with chaos on an invariant submanifold can exhibit a type of behavior called bubbling, whereby a small random or fixed perturbation to the system induces intermittent bursting. The bifurcation to bubbling occurs when a periodic orbit embedded in the chaotic attractor in the invariant manifold becomes unstable to perturbations transverse to the invariant manifold. Generically the periodic orbit can become transversely unstable through a pitchfork, transcritical, period-doubling, or Hopf bifurcation. In this paper a unified treatment of the four types of bubbling bifurcation is presented. Conditions are obtained determining whether the transition to bubbling is soft or hard; that is, whether the maximum burst amplitude varies continuously or discontinuously with variation of the parameter through its critical value. For soft bubbling transitions, the scaling of the maximum burst amplitude with the parameter is derived. For both hard and soft transitions the scaling of the average interburst time with the bifurcation parameter is deduced. Both random (noise) and fixed (mismatch) perturbations are considered. Results of numerical experiments testing our theoretical predictions are presented.

Attractors near grazing–sliding bifurcations

International Nuclear Information System (INIS)

Glendinning, P; Kowalczyk, P; Nordmark, A B

2012-01-01

In this paper we prove, for the first time, that multistability can occur in three-dimensional Fillipov type flows due to grazing–sliding bifurcations. We do this by reducing the study of the dynamics of Filippov type flows around a grazing–sliding bifurcation to the study of appropriately defined one-dimensional maps. In particular, we prove the presence of three qualitatively different types of multiple attractors born in grazing–sliding bifurcations. Namely, a period-two orbit with a sliding segment may coexist with a chaotic attractor, two stable, period-two and period-three orbits with a segment of sliding each may coexist, or a non-sliding and period-three orbit with two sliding segments may coexist

Bifurcation with memory

International Nuclear Information System (INIS)

Olmstead, W.E.; Davis, S.H.; Rosenblat, S.; Kath, W.L.

1986-01-01

A model equation containing a memory integral is posed. The extent of the memory, the relaxation time lambda, controls the bifurcation behavior as the control parameter R is increased. Small (large) lambda gives steady (periodic) bifurcation. There is a double eigenvalue at lambda = lambda 1 , separating purely steady (lambda 1 ) from combined steady/T-periodic (lambda > lambda 1 ) states with T → infinity as lambda → lambda + 1 . Analysis leads to the co-existence of stable steady/periodic states and as R is increased, the periodic states give way to the steady states. Numerical solutions show that this behavior persists away from lambda = lambda 1

A case study in bifurcation theory

Science.gov (United States)

Khmou, Youssef

This short paper is focused on the bifurcation theory found in map functions called evolution functions that are used in dynamical systems. The most well-known example of discrete iterative function is the logistic map that puts into evidence bifurcation and chaotic behavior of the topology of the logistic function. We propose a new iterative function based on Lorentizan function and its generalized versions, based on numerical study, it is found that the bifurcation of the Lorentzian function is of second-order where it is characterized by the absence of chaotic region.

Accidental Coverage of Both Renal Arteries during Infrarenal Aortic Stent-Graft Implantation: Cause and Treatment

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Umberto Marcello Bracale

2014-01-01

Full Text Available The purpose of this paper is to report a salvage maneuver for accidental coverage of both renal arteries during endovascular aneurysm repair (EVAR of an infrarenal abdominal aortic aneurysm (AAA. A 72-year-old female with a 6 cm infrarenal abdominal aortic aneurysm was treated by endovascular means with a standard bifurcated graft. Upon completing an angiogram, both renal arteries were found to be accidentally occluded. Through a left percutaneous brachial approach, the right renal artery was catheterized and a chimney stent was deployed; however this was not possible for the left renal artery. A retroperitoneal surgical approach was therefore carried out with a retrograde chimney stent implanted to restore blood flow. After three months, both renal arteries were patent and renal function was not different from the baseline. Both endovascular with percutaneous access via the brachial artery and open retroperitoneal approaches with retrograde catheterization are feasible rescue techniques to recanalize the accidentally occluded renal arteries during EVAR.

Aortic insufficiency

Science.gov (United States)

... page, please enable JavaScript. Aortic insufficiency is a heart valve disease in which the aortic valve does not close ... aortic insufficiency Images Aortic insufficiency References Carabello BA. Valvular heart disease. In: Goldman L, Schafer AI, eds. Goldman-Cecil ...

Tube Stent-Grafts for Infrarenal Aortic Aneurysm: A Matched-Paired Analysis Based on EUROSTAR Data

International Nuclear Information System (INIS)

Ruppert, Volker; Leurs, Lina J.; Hobo, Roel; Buth, Jacob; Rieger, Johannes; Umscheid, Thomas

2007-01-01

Objective. Tube stent-grafts for treatment of infrarenal aortic aneurysms (AAAs) are a nearly forgotten concept. For focal aortic pathologies tube stent-grafts may be a treatment option. We have performed a retrospective matched-paired analysis of the EUROSTAR registry regarding the outcome of tube vs. bifurcated stent-grafts for AAA. Tapered aortomonoiliac stent-grafts were not the objective of this study. Materials and methods. From July 1997 to June 2006, 7581 patients who underwent an endovascular AAA repair were entered in the EUROSTAR registry by 164 centers. One hundred fifty-three patients were treated with tube stent-grafts. For each of these 153 patients we selected one patient from a bifurcated stent-graft group (BGG-original, 7428 patients) matched according to gender, ASA, age, AAA diameter, and type of anesthesia. Differences in preoperative details between the two study groups were analyzed using chi-square test for discrete variables and Wilcoxon rank-sum test for continuous variables. Multivariate logistic regression analysis was performed on early complications. Midterm outcomes (>30 days) were analyzed by Kaplan-Meier and multivariate Cox proportional hazard model. Results. The duration of the procedure was shorter in the tube stent-graft group (TGG; 102.3 ± 52.2) than in BGG (128.3 ± 55.0; p 0.0002). Type II endoleak was less frequent in TGG (4.0%; mean follow-up, 23.12 ± 23.9 months) than in BGG (14.3%; mean follow-up, 20.77 ± 20.0 months; p = 0.0394). Type I endoleaks and migration were distributed equally, without significant differences between the groups. Combined 30-day and late mortality was higher for TGG (p = 0.0346) and was obviously not aneurysm related. Conclusions. We conclude that after selection of patients, tube stent-grafts for infrarenal aortic repair can be performed with great safety regarding endoleaks and migration. The combined higher 30-day mortality and non-aneurysm-related mortality during follow-up were mainly

Bifurcation structure of a model of bursting pancreatic cells

DEFF Research Database (Denmark)

Mosekilde, Erik; Lading, B.; Yanchuk, S.

2001-01-01

. The transition from this structure to the so-called period-adding structure is found to involve a subcritical period-doubling bifurcation and the emergence of type-III intermittency. The period-adding transition itself is not smooth but consists of a saddle-node bifurcation in which (n + 1)-spike bursting...... behavior is born, slightly overlapping with a subcritical period-doubling bifurcation in which n-spike bursting behavior loses its stability.......One- and two-dimensional bifurcation studies of a prototypic model of bursting oscillations in pancreatic P-cells reveal a squid-formed area of chaotic dynamics in the parameter plane, with period-doubling bifurcations on one side of the arms and saddle-node bifurcations on the other...

Early results of valve-sparing ascending aortic replacement in type A aortic dissection and aortic insufficiency

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М. Л. Гордеев

2016-08-01

Full Text Available Aim: The study was designed to investigate predictors of effective valve-sparing ascending aortic replacement in patients with Stanford type A aortic dissection combined with aortic insufficiency and to analyze efficacy and safety of this kind of surgery.Methods: From January 2010 to December 2015, 49 patients with Stanford type A aortic dissection combined with aortic insufficiency underwent ascending aortic replacement. All patients were divided into 3 groups: valve-sparing procedures (group 1, n = 11, combined aortic valve and supracoronary ascending aortic replacement (group 2, n = 12, and Bentall procedure (group 3, n = 26. We assessed the initial status of patients, incidence of complications and efficacy of valve-sparing ascending aortic replacement.Results: The hospital mortality rate was 8.2% (4/49 patients. The amount of surgical correction correlated with the initial diameter of the aorta at the level of the sinuses of Valsalva. During the hospital period, none of patients from group 1 developed aortic insufficiency exceeding Grade 2 and the vast majority of patients had trivial aortic regurgitation. The parameters of cardiopulmonary bypass, cross-clamp time and circulatory arrest time did not correlate with the initial size of the ascending aorta and aortic valve blood flow impairment, neither did they influence significantly the incidence and severity of neurological complications. The baseline size of the ascending aorta and degree of aortic regurgitation did not impact the course of the early hospital period.Conclusions: Supracoronary ascending aortic replacement combined with aortic valve repair in ascending aortic dissection and aortic regurgitation is effective and safe. The initial size of the ascending aorta and aortic arch do not influence immediate results. The diameter of the aorta at the level of the sinuses of Valsalva and the condition of aortic valve leaflets could be considered as the limiting factors. Further long

Bifurcation theory for finitely smooth planar autonomous differential systems

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Han, Maoan; Sheng, Lijuan; Zhang, Xiang

2018-03-01

In this paper we establish bifurcation theory of limit cycles for planar Ck smooth autonomous differential systems, with k ∈ N. The key point is to study the smoothness of bifurcation functions which are basic and important tool on the study of Hopf bifurcation at a fine focus or a center, and of Poincaré bifurcation in a period annulus. We especially study the smoothness of the first order Melnikov function in degenerate Hopf bifurcation at an elementary center. As we know, the smoothness problem was solved for analytic and C∞ differential systems, but it was not tackled for finitely smooth differential systems. Here, we present their optimal regularity of these bifurcation functions and their asymptotic expressions in the finite smooth case.

Discretization analysis of bifurcation based nonlinear amplifiers

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Feldkord, Sven; Reit, Marco; Mathis, Wolfgang

2017-09-01

Recently, for modeling biological amplification processes, nonlinear amplifiers based on the supercritical Andronov-Hopf bifurcation have been widely analyzed analytically. For technical realizations, digital systems have become the most relevant systems in signal processing applications. The underlying continuous-time systems are transferred to the discrete-time domain using numerical integration methods. Within this contribution, effects on the qualitative behavior of the Andronov-Hopf bifurcation based systems concerning numerical integration methods are analyzed. It is shown exemplarily that explicit Runge-Kutta methods transform the truncated normalform equation of the Andronov-Hopf bifurcation into the normalform equation of the Neimark-Sacker bifurcation. Dependent on the order of the integration method, higher order terms are added during this transformation.A rescaled normalform equation of the Neimark-Sacker bifurcation is introduced that allows a parametric design of a discrete-time system which corresponds to the rescaled Andronov-Hopf system. This system approximates the characteristics of the rescaled Hopf-type amplifier for a large range of parameters. The natural frequency and the peak amplitude are preserved for every set of parameters. The Neimark-Sacker bifurcation based systems avoid large computational effort that would be caused by applying higher order integration methods to the continuous-time normalform equations.

Quantum entanglement and fixed-point bifurcations

International Nuclear Information System (INIS)

Hines, Andrew P.; McKenzie, Ross H.; Milburn, G.J.

2005-01-01

How does the classical phase-space structure for a composite system relate to the entanglement characteristics of the corresponding quantum system? We demonstrate how the entanglement in nonlinear bipartite systems can be associated with a fixed-point bifurcation in the classical dynamics. Using the example of coupled giant spins we show that when a fixed point undergoes a supercritical pitchfork bifurcation, the corresponding quantum state--the ground state--achieves its maximum amount of entanglement near the critical point. We conjecture that this will be a generic feature of systems whose classical limit exhibits such a bifurcation

Dedicated bifurcation stents

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Ajith Ananthakrishna Pillai

2012-03-01

Full Text Available Bifurcation percutaneous coronary intervention (PCI is still a difficult call for the interventionist despite advancements in the instrumentation, technical skill and the imaging modalities. With major cardiac events relate to the side-branch (SB compromise, the concept and practice of dedicated bifurcation stents seems exciting. Several designs of such dedicated stents are currently undergoing trials. This novel concept and pristine technology offers new hope notwithstanding the fact that we need to go a long way in widespread acceptance and practice of these gadgets. Some of these designs even though looks enterprising, the mere complex delivering technique and the demanding knowledge of the exact coronary anatomy makes their routine use challenging.

Codimension-2 bifurcations of the Kaldor model of business cycle

International Nuclear Information System (INIS)

Wu, Xiaoqin P.

2011-01-01

Research highlights: → The conditions are given such that the characteristic equation may have purely imaginary roots and double zero roots. → Purely imaginary roots lead us to study Hopf and Bautin bifurcations and to calculate the first and second Lyapunov coefficients. → Double zero roots lead us to study Bogdanov-Takens (BT) bifurcation. → Bifurcation diagrams for Bautin and BT bifurcations are obtained by using the normal form theory. - Abstract: In this paper, complete analysis is presented to study codimension-2 bifurcations for the nonlinear Kaldor model of business cycle. Sufficient conditions are given for the model to demonstrate Bautin and Bogdanov-Takens (BT) bifurcations. By computing the first and second Lyapunov coefficients and performing nonlinear transformation, the normal forms are derived to obtain the bifurcation diagrams such as Hopf, homoclinic and double limit cycle bifurcations. Some examples are given to confirm the theoretical results.

Perioperative management of endovascular abdominal aortic aneurysm repair

International Nuclear Information System (INIS)

Wang Haofu; Wang Yuwei; Li Jun; Zhao Zonggang; Qi Sen

2010-01-01

Objective: To summarize the clinical experience of perioperative management in performing endovascular abdominal aortic aneurysm repair (EVAR). Methods: EVAR was performed in 22 patients with abdominal aortic aneurysm. The clinical data were retrospectively analyzed. Before treatment the functions of main organs were evaluated and certain measures were adopted in order to protect them. Useful parameters, including the length, diameter, angle and configuration of the proximal and distal aneurysmal neck, the relationship of the aneurysm to aortic branches, the distance from the lowest renal artery to the bifurcation of abdominal aorta, and the quality of access vessels (such as diameter, tortuosity and calcification degree) were determined and assessed with CTA. According to the parameters thus obtained, the suitable stent-graft with ideal diameter and length was selected, and the optimal surgery pattern was employed. Local anesthesia was employed in 20 patients, among them the local anesthesia had to be changed to general anesthesia in one. Epidural anesthesia was carried out in one patient through the surgically-reconstructed iliac artery access,and general anesthesia was employed in one patient who had Stanford type A aortic dissection. The lowest renal artery must be accurately localized before deployment of stent-graft was started. At least one patent internal iliac artery should be reserved when bilateral internal iliac arteries needed to be covered, to be covered by stages or to be reconstructed. After stent-graft placement, angiography must be performed to find out if there was any endoleak and, if any, to determine the type of endoleak and to deal with it properly. Two cases had proximal type I endoleak, so balloon dilation was employed in one and cuff implantation in another one. Distal type I endoleak occurred in one case, but, unfortunately, the iliac artery ruptured when balloon dilation was employed, therefore the patient had to receive vascular repair

Critical bifurcation surfaces of 3D discrete dynamics

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Michael Sonis

2000-01-01

Full Text Available This paper deals with the analytical representation of bifurcations of each 3D discrete dynamics depending on the set of bifurcation parameters. The procedure of bifurcation analysis proposed in this paper represents the 3D elaboration and specification of the general algorithm of the n-dimensional linear bifurcation analysis proposed by the author earlier. It is proven that 3D domain of asymptotic stability (attraction of the fixed point for a given 3D discrete dynamics is bounded by three critical bifurcation surfaces: the divergence, flip and flutter surfaces. The analytical construction of these surfaces is achieved with the help of classical Routh–Hurvitz conditions of asymptotic stability. As an application the adjustment process proposed by T. Puu for the Cournot oligopoly model is considered in detail.

Reinforced aortic root reconstruction for acute type A aortic dissection involving the aortic root

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Han Qing-qi

2013-06-01

Full Text Available OBJECTIVE: There are debates regarding the optimal approach for AAAD involving the aortic root. We described a modified reinforced aortic root reconstruction approach for treating AAAD involving the aortic root. METHODS: A total of 161 patients with AAAD involving the aortic root were treated by our modified reinforced aortic root reconstruction approach from January 1998 to December 2008. Key features of our modified approach were placement of an autologous pericardial patch in the false lumen, lining of the sinotubular junction lumen with a polyester vascular ring, and wrapping of the vessel with Teflon strips. Outcome measures included post-operative mortality, survival, complications, and level of aortic regurgitation. RESULTS: A total of 161 patients were included in the study (mean age: 43.3 1 15.5 years. The mean duration of follow-up was 5.1 1 2.96 years (2-12 years. A total of 10 (6.2% and 11 (6.8% patients died during hospitalization and during follow-up, respectively. Thirty-one (19.3% patients experienced postoperative complications. The 1-, 3-, 5-, and 10-year survival rates were 99.3%, 98%, 93.8%, and 75.5%, respectively. There were no instances of recurrent aortic dissection, aortic aneurysm, or pseudoaneurysm during the entire study period. The severity of aortic regurgitation dramatically decreased immediately after surgery (from 28.6% to 0% grade 3-4 and thereafter slightly increased (from 0% to 7.2% at 5 years and 9.1% at 10 years. CONCLUSION: This modified reinforced aortic root reconstruction was feasible, safe and durable/effective, as indicated by its low mortality, low postoperative complications and high survival rate.

A comparison in vivo dacron wool (Swank) and polyester mesh (Pall) micropore blood transfusion filters in the prevention of pulmonary microembolism associated with massive transfusion.

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Barrett, J; Dhurandhar, H N; Miller, E; Litwin, M S

1975-01-01

Experiments were performed to compare the effectiveness in vivo of the two most widely used micropore blood transfusion filters in preventing detrimental physiologic changes associated with transfusion of microaggregate-containing blood. Exchange transfusion with stored blood having an elevated screen filtration pressure (SFP) through polyester mesh (Pall) filters (Group PM) was followed by decreases in arterial blood pH and O2 consumption, increases in arterial blood pyruvate and lactate concentrations, and a decrease in pulmonary DO2. The lungs of 5 of 6 animals revealed emboli far out in the pulmonary microcirculation. These changes did not occur in animals transfused through dacron wool (Swank) filters (Group DW). Even though an increase after transfusion in pulmonary Qs/Qt in Group PM did not achieve statistical significance when compared to pretransfusion Qs/Qt, it was significantly higher than that in animals in Group DW. Both filters removed considerable quantities of microaggregates; however, the polyester mesh (Pall) filters permitted passage of small microaggregates and development of ditrimental physiologic changes. Dacron wool (Swank) filters completely removed measurable microaggregates and detrimental changes did not occur. Images Fig. 1. Fig. 2. Fig. 3. PMID:242282

Resonant Homoclinic Flips Bifurcation in Principal Eigendirections

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Tiansi Zhang

2013-01-01

Full Text Available A codimension-4 homoclinic bifurcation with one orbit flip and one inclination flip at principal eigenvalue direction resonance is considered. By introducing a local active coordinate system in some small neighborhood of homoclinic orbit, we get the Poincaré return map and the bifurcation equation. A detailed investigation produces the number and the existence of 1-homoclinic orbit, 1-periodic orbit, and double 1-periodic orbits. We also locate their bifurcation surfaces in certain regions.

Bifurcation analysis of a three dimensional system

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Yongwen WANG

2018-04-01

Full Text Available In order to enrich the stability and bifurcation theory of the three dimensional chaotic systems, taking a quadratic truncate unfolding system with the triple singularity equilibrium as the research subject, the existence of the equilibrium, the stability and the bifurcation of the system near the equilibrium under different parametric conditions are studied. Using the method of mathematical analysis, the existence of the real roots of the corresponding characteristic equation under the different parametric conditions is analyzed, and the local manifolds of the equilibrium are gotten, then the possible bifurcations are guessed. The parametric conditions under which the equilibrium is saddle-focus are analyzed carefully by the Cardan formula. Moreover, the conditions of codimension-one Hopf bifucation and the prerequisites of the supercritical and subcritical Hopf bifurcation are found by computation. The results show that the system has abundant stability and bifurcation, and can also supply theorical support for the proof of the existence of the homoclinic or heteroclinic loop connecting saddle-focus and the Silnikov's chaos. This method can be extended to study the other higher nonlinear systems.

MMP-2 Isoforms in Aortic Tissue and Serum of Patients with Ascending Aortic Aneurysms and Aortic Root Aneurysms

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Tscheuschler, Anke; Meffert, Philipp; Beyersdorf, Friedhelm; Heilmann, Claudia; Kocher, Nadja; Uffelmann, Xenia; Discher, Philipp; Siepe, Matthias; Kari, Fabian A.

2016-01-01

Objective The need for biological markers of aortic wall stress and risk of rupture or dissection of ascending aortic aneurysms is obvious. To date, wall stress cannot be related to a certain biological marker. We analyzed aortic tissue and serum for the presence of different MMP-2 isoforms to find a connection between serum and tissue MMP-2 and to evaluate the potential of different MMP-2 isoforms as markers of high wall stress. Methods Serum and aortic tissue from n = 24 patients and serum from n = 19 healthy controls was analyzed by ELISA and gelatin zymography. 24 patients had ascending aortic aneurysms, 10 of them also had aortic root aneurysms. Three patients had normally functioning valves, 12 had regurgitation alone, eight had regurgitation and stenosis and one had only stenosis. Patients had bicuspid and tricuspid aortic valves (9/15). Serum samples were taken preoperatively, and the aortic wall specimen collected during surgical aortic repair. Results Pro-MMP-2 was identified in all serum and tissue samples. Pro-MMP-2 was detected in all tissue and serum samples from patients with ascending aortic/aortic root aneurysms, irrespective of valve morphology or other clinical parameters and in serum from healthy controls. We also identified active MMP-2 in all tissue samples from patients with ascending aortic/aortic root aneurysms. None of the analyzed serum samples revealed signals relatable to active MMP-2. No correlation between aortic tissue total MMP-2 or tissue pro-MMP-2 or tissue active MMP-2 and serum MMP-2 was found and tissue MMP-2/pro-MMP-2/active MMP-2 did not correlate with aortic diameter. This evidence shows that pro-MMP-2 is the predominant MMP-2 species in serum of patients and healthy individuals and in aneurysmatic aortic tissue, irrespective of aortic valve configuration. Active MMP-2 species are either not released into systemic circulation or not detectable in serum. There is no reliable connection between aortic tissue—and serum MMP-2

Results of aortic root reimplantation in patients with ascending aortic aneurysm and concomitant aortic insufficiency

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А. М. Чернявский

2016-01-01

Full Text Available Objective. The research was designed to evaluate the results of valve-sparing operations: aortic root reimplantation versus aortic valve reimplantation when repairing an ascending aortic aneurysm with concomitant aortic insufficiency.Methods. Within a blind prospective randomized study conducted over a period from 2011 to 2015, 64 patients underwent aortic valve-sparing surgery. The inclusion criteria were the presence of an aortic aneurysm of the ascending aorta exceeding 4.5 cm and concomitant aortic insufficiency. All patients were divided into two groups: FS-group, aortic root reimplantation (modified Florida Sleeve technique (n = 32 and D-group, aortic valve reimplantation (David procedure (n = 32. The average age of patients was 57±13 (23–73 years in the FS-group and 55±11 (15–72 years in the D-group (p = 0.54. Both groups had 78% of males (p>0.99. A Marfan syndrome was identified in 6% and 9% in the FS-group and D-group respectively (p>0.99. Mean diameter of the sinuses of Valsalva was 51±7 mm and 56±10 mm (p = 0.09, aortic insufficiency 2.6±0.7 and 2.8±0.8 (p = 0.15 in the FS-group and D-group respectively. In the FS-group and D-group LVEDD amounted to 5.5±0.7 mm and 5.9±1.0 mm (p = 0.09 respectively. All patients took echocardiography in the preoperative, postoperative and follow-up periods.Results. In the long-term period, the degree of aortic regurgitation was 1.2±0.1 in the FS-group and 1.3±0.6 in the D-group (p = 0.72. LVEDD was 123±23 mm in the FS-group and 139.6±80 mm in the D-group at follow-up (p = 0.77. There were no statistically significant differences in the analysis of complications. Overall 30-day in-hospital mortality was 7.8%. There were 2 (6.3% deaths in the FS-group and 3 (9.4% in the D-group (p = 0.5.Late mortality was 6.3% in the FS-group and 3.1% in the D-group (p>0.99. Cumulative survival at 4 years was 84.3% and 84.8% in the FS-group and the D-group respectively (p = 0.94. Cumulative freedom from

Endovascular Treatment of Infrarenal Abdominal Aortic Aneurysm with Short and Angulated Neck in High-Risk Patient

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Stylianos Koutsias

2013-01-01

Full Text Available Endovascular treatment of abdominal aortic aneurysms (AAA is an established alternative to open repair. However lifelong surveillance is still required to monitor endograft function and signal the need for secondary interventions (Hobo and Buth 2006. Aortic morphology, especially related to the proximal neck, often complicates the procedure or increases the risk for late device-related complications (Hobo et al. 2007 and Chisci et al. 2009. The definition of a short and angulated neck is based on length (60° (Hobo et al. 2007 and Chisci et al. 2009. A challenging neck also offers difficulties during open repairs (OR, necessitating extensive dissection with juxta- or suprarenal aortic cross-clamping. Patients with extensive aneurysmal disease typically have more comorbidities and may not tolerate extensive surgical trauma (Sarac et al. 2002. It is, therefore, unclear whether aneurysms with a challenging proximal neck should be offered EVAR or OR (Cox et al. 2006, Choke et al. 2006, Robbins et al. 2005, Sternbergh III et al. 2002, Dillavou et al. 2003, and Greenberg et al. 2003. In our case the insertion of a thoracic endograft followed by the placement of a bifurcated aortic endograft for the treatment of a very short and severely angulated neck proved to be feasible offering acceptable duration of aneurysm exclusion. This adds up to our armamentarium in the treatment of high-risk patients, and it should be considered in emergency cases when the fenestrated and branched endografts are not available.

Local bifurcation analysis in nuclear reactor dynamics by Sotomayor’s theorem

International Nuclear Information System (INIS)

Pirayesh, Behnam; Pazirandeh, Ali; Akbari, Monireh

2016-01-01

Highlights: • When the feedback reactivity is considered as a nonlinear function some complex behaviors may emerge in the system such as local bifurcation phenomenon. • The qualitative behaviors of a typical nuclear reactor near its equilibrium points have been studied analytically. • Comprehensive analytical bifurcation analyses presented in this paper are transcritical bifurcation, saddle- node bifurcation and pitchfork bifurcation. - Abstract: In this paper, a qualitative approach has been used to explore nuclear reactor behaviors with nonlinear feedback. First, a system of four dimensional ordinary differential equations governing the dynamics of a typical nuclear reactor is introduced. These four state variables are the relative power of the reactor, the relative concentration of delayed neutron precursors, the fuel temperature and the coolant temperature. Then, the qualitative behaviors of the dynamical system near its equilibria have been studied analytically by using local bifurcation theory and Sotomayor’s theorem. The results indicated that despite the uncertainty of the reactivity, we can analyze the qualitative behavior changes of the reactor from the bifurcation point of view. Notably, local bifurcations that were considered in this paper include transcritical bifurcation, saddle-node bifurcation and pitchfork bifurcation. The theoretical analysis showed that these three types of local bifurcations may occur in the four dimensional dynamical system. In addition, to confirm the analytical results the numerical simulations are given.

Global Bifurcation of a Novel Computer Virus Propagation Model

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Jianguo Ren

2014-01-01

Full Text Available In a recent paper by J. Ren et al. (2012, a novel computer virus propagation model under the effect of the antivirus ability in a real network is established. The analysis there only partially uncovers the dynamics behaviors of virus spread over the network in the case where around bifurcation is local. In the present paper, by mathematical analysis, it is further shown that, under appropriate parameter values, the model may undergo a global B-T bifurcation, and the curves of saddle-node bifurcation, Hopf bifurcation, and homoclinic bifurcation are obtained to illustrate the qualitative behaviors of virus propagation. On this basis, a collection of policies is recommended to prohibit the virus prevalence. To our knowledge, this is the first time the global bifurcation has been explored for the computer virus propagation. Theoretical results and corresponding suggestions may help us suppress or eliminate virus propagation in the network.

Decreased expression of fibulin-4 in aortic wall of aortic dissection.

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Huawei, P; Qian, C; Chuan, T; Lei, L; Laing, W; Wenlong, X; Wenzhi, L

2014-02-01

In this research, we will examine the expression of Fibulin-4 in aortic wall to find out its role in aortic dissection development. The samples of aortic wall were obtained from 10 patients operated for acute ascending aortic dissection and five patients for chronic ascending aortic dissection. Another 15 pieces of samples from patients who had coronary artery bypass were as controls. The aortic samples were stained with aldehyde magenta dyeing to evaluate the arrangement of elastic fibers. The Fibulin-4 protein and mRNA expression were both determined by Western blot and realtime quantitative polymerase chain reaction. Compared with the control group, both in acute and chronic ascending aortic dissection, elastic fiber fragments increased and the expression of fibulin-4 protein significantly decreased (P= 0.045 < 0.05). The level of fibulin-4 mRNA decreased in acute ascending aortic dissection (P= 0.034 < 0.05), while it increased in chronic ascending aortic dissection (P=0.004 < 0.05). The increased amounts of elastic fiber fragments were negatively correlated with the expression of fibulin-4 mRNA in acute ascending aortic dissection. In conclusion, in aortic wall of ascending aortic dissection, the expression of fibulin-4 protein decreased and the expression of fibulin-4 mRNA was abnormal. Fibulin-4 may play an important role in the pathogenesis of aortic dissection.

Reoperative Aortic Root Replacement in Patients with Previous Aortic Root or Aortic Valve Procedures

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Byung Kwon Chong

2016-08-01

Full Text Available Background: Generalization of standardized surgical techniques to treat aortic valve (AV and aortic root diseases has benefited large numbers of patients. As a consequence of the proliferation of patients receiving aortic root surgeries, surgeons are more frequently challenged by reoperative aortic root procedures. The aim of this study was to evaluate the outcomes of redo-aortic root replacement (ARR. Methods: We retrospectively reviewed 66 patients (36 male; mean age, 44.5±9.5 years who underwent redo-ARR following AV or aortic root procedures between April 1995 and June 2015. Results: Emergency surgeries comprised 43.9% (n=29. Indications for the redo-ARR were aneurysm (n=12, pseudoaneurysm (n=1, or dissection (n=6 of the residual native aortic sinus in 19 patients (28.8%, native AV dysfunction in 8 patients (12.1%, structural dysfunction of an implanted bioprosthetic AV in 19 patients (28.8%, and infection of previously replaced AV or proximal aortic grafts in 30 patients (45.5%. There were 3 early deaths (4.5%. During follow- up (median, 54.65 months; quartile 1–3, 17.93 to 95.71 months, there were 14 late deaths (21.2%, and 9 valve-related complications including reoperation of the aortic root in 1 patient, infective endocarditis in 3 patients, and hemorrhagic events in 5 patients. Overall survival and event-free survival rates at 5 years were 81.5%±5.1% and 76.4%±5.4%, respectively. Conclusion: Despite technical challenges and a high rate of emergency conditions in patients requiring redo-ARR, early and late outcomes were acceptable in these patients.

Wall stress on ascending thoracic aortic aneurysms with bicuspid compared with tricuspid aortic valve.

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Xuan, Yue; Wang, Zhongjie; Liu, Raymond; Haraldsson, Henrik; Hope, Michael D; Saloner, David A; Guccione, Julius M; Ge, Liang; Tseng, Elaine

2018-03-08

Guidelines for repair of bicuspid aortic valve-associated ascending thoracic aortic aneurysms have been changing, most recently to the same criteria as tricuspid aortic valve-ascending thoracic aortic aneurysms. Rupture/dissection occurs when wall stress exceeds wall strength. Recent studies suggest similar strength of bicuspid aortic valve versus tricuspid aortic valve-ascending thoracic aortic aneurysms; thus, comparative wall stress may better predict dissection in bicuspid aortic valve versus tricuspid aortic valve-ascending thoracic aortic aneurysms. Our aim was to determine whether bicuspid aortic valve-ascending thoracic aortic aneurysms had higher wall stresses than their tricuspid aortic valve counterparts. Patients with bicuspid aortic valve- and tricuspid aortic valve-ascending thoracic aortic aneurysms (bicuspid aortic valve = 17, tricuspid aortic valve = 19) greater than 4.5 cm underwent electrocardiogram-gated computed tomography angiography. Patient-specific 3-dimensional geometry was reconstructed and loaded to systemic pressure after accounting for prestress geometry. Finite element analyses were performed using the LS-DYNA solver (LSTC Inc, Livermore, Calif) with user-defined fiber-embedded material model to determine ascending thoracic aortic aneurysm wall stress. Bicuspid aortic valve-ascending thoracic aortic aneurysms 99th-percentile longitudinal stresses were 280 kPa versus 242 kPa (P = .028) for tricuspid aortic valve-ascending thoracic aortic aneurysms in systole. These stresses did not correlate to diameter for bicuspid aortic valve-ascending thoracic aortic aneurysms (r = -0.004) but had better correlation to tricuspid aortic valve-ascending thoracic aortic aneurysms diameter (r = 0.677). Longitudinal stresses on sinotubular junction were significantly higher in bicuspid aortic valve-ascending thoracic aortic aneurysms than in tricuspid aortic valve-ascending thoracic aortic aneurysms (405 vs 329 kPa, P = .023). Bicuspid

Bifurcation and instability problems in vortex wakes

DEFF Research Database (Denmark)

Aref, Hassan; Brøns, Morten; Stremler, Mark A.

2007-01-01

A number of instability and bifurcation problems related to the dynamics of vortex wake flows are addressed using various analytical tools and approaches. We discuss the bifurcations of the streamline pattern behind a bluff body as a vortex wake is produced, a theory of the universal Strouhal......-Reynolds number relation for vortex wakes, the bifurcation diagram for "exotic" wake patterns behind an oscillating cylinder first determined experimentally by Williamson & Roshko, and the bifurcations in topology of the streamlines pattern in point vortex streets. The Hamiltonian dynamics of point vortices...... in a periodic strip is considered. The classical results of von Kármán concerning the structure of the vortex street follow from the two-vortices-in-a-strip problem, while the stability results follow largely from a four-vortices-in-a-strip analysis. The three-vortices-in-a-strip problem is argued...

Aortic Annular Enlargement during Aortic Valve Replacement

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Selman Dumani

2016-09-01

Full Text Available In the surgery of aortic valve replacement is always attempted, as much as possible, to implant the larger prosthesis with the mains goals to enhance the potential benefits, to minimise transvalvular gradient, decrease left ventricular size and avoid the phenomenon of patient-prosthesis mismatch. Implantation of an ideal prosthesis often it is not possible, due to a small aortic annulus. A variety of aortic annulus enlargement techniques is reported to avoid patient-prosthesis mismatch. We present the case that has submitted four three times open heart surgery. We used Manouguian technique to enlarge aortic anulus with excellent results during the fourth time of surgery.

Hopf bifurcation analysis of Chen circuit with direct time delay feedback

International Nuclear Information System (INIS)

Hai-Peng, Ren; Wen-Chao, Li; Ding, Liu

2010-01-01

Direct time delay feedback can make non-chaotic Chen circuit chaotic. The chaotic Chen circuit with direct time delay feedback possesses rich and complex dynamical behaviours. To reach a deep and clear understanding of the dynamics of such circuits described by delay differential equations, Hopf bifurcation in the circuit is analysed using the Hopf bifurcation theory and the central manifold theorem in this paper. Bifurcation points and bifurcation directions are derived in detail, which prove to be consistent with the previous bifurcation diagram. Numerical simulations and experimental results are given to verify the theoretical analysis. Hopf bifurcation analysis can explain and predict the periodical orbit (oscillation) in Chen circuit with direct time delay feedback. Bifurcation boundaries are derived using the Hopf bifurcation analysis, which will be helpful for determining the parameters in the stabilisation of the originally chaotic circuit

Identification of neural firing patterns, frequency and temporal coding mechanisms in individual aortic baroreceptors

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Huaguang eGu

2015-08-01

Full Text Available In rabbit depressor nerve fibers, an on-off firing pattern, period-1 firing, and integer multiple firing with quiescent state were observed as the static pressure level was increased. A bursting pattern with bursts at the systolic phase of blood pressure, continuous firing, and bursting with burst at diastolic phase and quiescent state at systolic phase were observed as the mean level of the dynamic blood pressure was increased. For both static and dynamic pressures, the firing frequency of the first two firing patterns increased and of the last firing pattern decreased due to the quiescent state. If the quiescent state is disregarded, the spike frequency becomes an increasing trend. The instantaneous spike frequency of the systolic phase bursting, continuous firing, and diastolic phase bursting can reflect the temporal process of the systolic phase, whole procedure, and diastolic phase of the dynamic blood pressure signal, respectively. With increasing the static current corresponding to pressure level, the deterministic Hodgkin-Huxley (HH model manifests a process from a resting state first to period-1 firing via a subcritical Hopf bifurcation and then to a resting state via a supercritical Hopf bifurcation, and the firing frequency increases. The on-off firing and integer multiple firing were here identified as noise-induced firing patterns near the subcritical and supercritical Hopf bifurcation points, respectively, using the stochastic HH model. The systolic phase bursting and diastolic phase bursting were identified as pressure-induced firings near the subcritical and supercritical Hopf bifurcation points, respectively, using an HH model with a dynamic signal. The firing, spike frequency, and instantaneous spike frequency observed in the experiment were simulated and explained using HH models. The results illustrate the dynamics of different firing patterns and the frequency and temporal coding mechanisms of aortic baroreceptor.

A codimension two bifurcation in a railway bogie system

DEFF Research Database (Denmark)

Zhang, Tingting; True, Hans; Dai, Huanyun

2017-01-01

In this paper, a comprehensive analysis is presented to investigate a codimension two bifurcation that exists in a nonlinear railway bogie dynamic system combining theoretical analysis with numerical investigation. By using the running velocity V and the primary longitudinal stiffness (Formula...... coexist in a range of the bifurcation parameters which can lead to jumps in the lateral oscillation amplitude of the railway bogie system. Furthermore, reduce the values of the bifurcation parameters gradually. Firstly, the supercritical Hopf bifurcation turns into a subcritical one with multiple limit...

Hopf Bifurcation of Compound Stochastic van der Pol System

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Shaojuan Ma

2016-01-01

Full Text Available Hopf bifurcation analysis for compound stochastic van der Pol system with a bound random parameter and Gaussian white noise is investigated in this paper. By the Karhunen-Loeve (K-L expansion and the orthogonal polynomial approximation, the equivalent deterministic van der Pol system can be deduced. Based on the bifurcation theory of nonlinear deterministic system, the critical value of bifurcation parameter is obtained and the influence of random strength δ and noise intensity σ on stochastic Hopf bifurcation in compound stochastic system is discussed. At last we found that increased δ can relocate the critical value of bifurcation parameter forward while increased σ makes it backward and the influence of δ is more sensitive than σ. The results are verified by numerical simulations.

Stochastic bifurcation in a model of love with colored noise

Science.gov (United States)

Yue, Xiaokui; Dai, Honghua; Yuan, Jianping

2015-07-01

In this paper, we wish to examine the stochastic bifurcation induced by multiplicative Gaussian colored noise in a dynamical model of love where the random factor is used to describe the complexity and unpredictability of psychological systems. First, the dynamics in deterministic love-triangle model are considered briefly including equilibrium points and their stability, chaotic behaviors and chaotic attractors. Then, the influences of Gaussian colored noise with different parameters are explored such as the phase plots, top Lyapunov exponents, stationary probability density function (PDF) and stochastic bifurcation. The stochastic P-bifurcation through a qualitative change of the stationary PDF will be observed and bifurcation diagram on parameter plane of correlation time and noise intensity is presented to find the bifurcation behaviors in detail. Finally, the top Lyapunov exponent is computed to determine the D-bifurcation when the noise intensity achieves to a critical value. By comparison, we find there is no connection between two kinds of stochastic bifurcation.

Valve-sparing aortic root replacement and aortic valve repair in a patient with acromegaly and aortic root dilatation

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Karel Van Praet

2015-07-01

Full Text Available Aortic regurgitation and dilatation of the aortic root and ascending aorta are severe complications of acromegaly. The current trend for management of an aortic root aneurysm is valve-sparing root replacement as well as restoring the diameter of the aortic sinotubular junction (STJ and annulus. Our case report supports the recommendation that in patients with acromegaly, severe aortic root involvement may indicate the need for surgery.

Travelling waves and their bifurcations in the Lorenz-96 model

Science.gov (United States)

van Kekem, Dirk L.; Sterk, Alef E.

2018-03-01

In this paper we study the dynamics of the monoscale Lorenz-96 model using both analytical and numerical means. The bifurcations for positive forcing parameter F are investigated. The main analytical result is the existence of Hopf or Hopf-Hopf bifurcations in any dimension n ≥ 4. Exploiting the circulant structure of the Jacobian matrix enables us to reduce the first Lyapunov coefficient to an explicit formula from which it can be determined when the Hopf bifurcation is sub- or supercritical. The first Hopf bifurcation for F > 0 is always supercritical and the periodic orbit born at this bifurcation has the physical interpretation of a travelling wave. Furthermore, by unfolding the codimension two Hopf-Hopf bifurcation it is shown to act as an organising centre, explaining dynamics such as quasi-periodic attractors and multistability, which are observed in the original Lorenz-96 model. Finally, the region of parameter values beyond the first Hopf bifurcation value is investigated numerically and routes to chaos are described using bifurcation diagrams and Lyapunov exponents. The observed routes to chaos are various but without clear pattern as n → ∞.

Comments on the Bifurcation Structure of 1D Maps

DEFF Research Database (Denmark)

Belykh, V.N.; Mosekilde, Erik

1997-01-01

-within-a-box structure of the total bifurcation set. This presents a picture in which the homoclinic orbit bifurcations act as a skeleton for the bifurcational set. At the same time, experimental results on continued subharmonic generation for piezoelectrically amplified sound waves, predating the Feigenbaum theory......, are called into attention....

Predicting bifurcation angle effect on blood flow in the microvasculature.

Science.gov (United States)

Yang, Jiho; Pak, Y Eugene; Lee, Tae-Rin

2016-11-01

Since blood viscosity is a basic parameter for understanding hemodynamics in human physiology, great amount of research has been done in order to accurately predict this highly non-Newtonian flow property. However, previous works lacked in consideration of hemodynamic changes induced by heterogeneous vessel networks. In this paper, the effect of bifurcation on hemodynamics in a microvasculature is quantitatively predicted. The flow resistance in a single bifurcation microvessel was calculated by combining a new simple mathematical model with 3-dimensional flow simulation for varying bifurcation angles under physiological flow conditions. Interestingly, the results indicate that flow resistance induced by vessel bifurcation holds a constant value of approximately 0.44 over the whole single bifurcation model below diameter of 60μm regardless of geometric parameters including bifurcation angle. Flow solutions computed from this new model showed substantial decrement in flow velocity relative to other mathematical models, which do not include vessel bifurcation effects, while pressure remained the same. Furthermore, when applying the bifurcation angle effect to the entire microvascular network, the simulation results gave better agreements with recent in vivo experimental measurements. This finding suggests a new paradigm in microvascular blood flow properties, that vessel bifurcation itself, regardless of its angle, holds considerable influence on blood viscosity, and this phenomenon will help to develop new predictive tools in microvascular research. Copyright © 2016 Elsevier Inc. All rights reserved.

Bursting oscillations, bifurcation and synchronization in neuronal systems

Energy Technology Data Exchange (ETDEWEB)

Wang Haixia [School of Science, Nanjing University of Science and Technology, Nanjing 210094 (China); Wang Qingyun, E-mail: drwangqy@gmail.com [Department of Dynamics and Control, Beihang University, Beijing 100191 (China); Lu Qishao [Department of Dynamics and Control, Beihang University, Beijing 100191 (China)

2011-08-15

Highlights: > We investigate bursting oscillations and related bifurcation in the modified Morris-Lecar neuron. > Two types of fast-slow bursters are analyzed in detail. > We show the properties of some crucial bifurcation points. > Synchronization transition and the neural excitability are explored in the coupled bursters. - Abstract: This paper investigates bursting oscillations and related bifurcation in the modified Morris-Lecar neuron. It is shown that for some appropriate parameters, the modified Morris-Lecar neuron can exhibit two types of fast-slow bursters, that is 'circle/fold cycle' bursting and 'subHopf/homoclinic' bursting with class 1 and class 2 neural excitability, which have different neuro-computational properties. By means of the analysis of fast-slow dynamics and phase plane, we explore bifurcation mechanisms associated with the two types of bursters. Furthermore, the properties of some crucial bifurcation points, which can determine the type of the burster, are studied by the stability and bifurcation theory. In addition, we investigate the influence of the coupling strength on synchronization transition and the neural excitability in two electrically coupled bursters with the same bursting type. More interestingly, the multi-time-scale synchronization transition phenomenon is found as the coupling strength varies.

Defining Electron Bifurcation in the Electron-Transferring Flavoprotein Family.

Science.gov (United States)

Garcia Costas, Amaya M; Poudel, Saroj; Miller, Anne-Frances; Schut, Gerrit J; Ledbetter, Rhesa N; Fixen, Kathryn R; Seefeldt, Lance C; Adams, Michael W W; Harwood, Caroline S; Boyd, Eric S; Peters, John W

2017-11-01

Electron bifurcation is the coupling of exergonic and endergonic redox reactions to simultaneously generate (or utilize) low- and high-potential electrons. It is the third recognized form of energy conservation in biology and was recently described for select electron-transferring flavoproteins (Etfs). Etfs are flavin-containing heterodimers best known for donating electrons derived from fatty acid and amino acid oxidation to an electron transfer respiratory chain via Etf-quinone oxidoreductase. Canonical examples contain a flavin adenine dinucleotide (FAD) that is involved in electron transfer, as well as a non-redox-active AMP. However, Etfs demonstrated to bifurcate electrons contain a second FAD in place of the AMP. To expand our understanding of the functional variety and metabolic significance of Etfs and to identify amino acid sequence motifs that potentially enable electron bifurcation, we compiled 1,314 Etf protein sequences from genome sequence databases and subjected them to informatic and structural analyses. Etfs were identified in diverse archaea and bacteria, and they clustered into five distinct well-supported groups, based on their amino acid sequences. Gene neighborhood analyses indicated that these Etf group designations largely correspond to putative differences in functionality. Etfs with the demonstrated ability to bifurcate were found to form one group, suggesting that distinct conserved amino acid sequence motifs enable this capability. Indeed, structural modeling and sequence alignments revealed that identifying residues occur in the NADH- and FAD-binding regions of bifurcating Etfs. Collectively, a new classification scheme for Etf proteins that delineates putative bifurcating versus nonbifurcating members is presented and suggests that Etf-mediated bifurcation is associated with surprisingly diverse enzymes. IMPORTANCE Electron bifurcation has recently been recognized as an electron transfer mechanism used by microorganisms to maximize

Dynamic bifurcations on financial markets

International Nuclear Information System (INIS)

Kozłowska, M.; Denys, M.; Wiliński, M.; Link, G.; Gubiec, T.; Werner, T.R.; Kutner, R.; Struzik, Z.R.

2016-01-01

We provide evidence that catastrophic bifurcation breakdowns or transitions, preceded by early warning signs such as flickering phenomena, are present on notoriously unpredictable financial markets. For this we construct robust indicators of catastrophic dynamical slowing down and apply these to identify hallmarks of dynamical catastrophic bifurcation transitions. This is done using daily closing index records for the representative examples of financial markets of small and mid to large capitalisations experiencing a speculative bubble induced by the worldwide financial crisis of 2007-08.

Hopf bifurcation for tumor-immune competition systems with delay

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Ping Bi

2014-01-01

Full Text Available In this article, a immune response system with delay is considered, which consists of two-dimensional nonlinear differential equations. The main purpose of this paper is to explore the Hopf bifurcation of a immune response system with delay. The general formula of the direction, the estimation formula of period and stability of bifurcated periodic solution are also given. Especially, the conditions of the global existence of periodic solutions bifurcating from Hopf bifurcations are given. Numerical simulations are carried out to illustrate the the theoretical analysis and the obtained results.

Aortic valve bypass

DEFF Research Database (Denmark)

Lund, Jens T; Jensen, Maiken Brit; Arendrup, Henrik

2013-01-01

In aortic valve bypass (AVB) a valve-containing conduit is connecting the apex of the left ventricle to the descending aorta. Candidates are patients with symptomatic aortic valve stenosis rejected for conventional aortic valve replacement (AVR) or transcatheter aortic valve implantation (TAVI). ...

Pierce instability and bifurcating equilibria

International Nuclear Information System (INIS)

Godfrey, B.B.

1981-01-01

The report investigates the connection between equilibrium bifurcations and occurrence of the Pierce instability. Electrons flowing from one ground plane to a second through an ion background possess a countable infinity of static equilibria, of which only one is uniform and force-free. Degeneracy of the uniform and simplest non-uniform equilibria at a certain ground plan separation marks the onset of the Pierce instability, based on a newly derived dispersion relation appropriate to all the equilibria. For large ground plane separations the uniform equilibrium is unstable and the non-uniform equilibrium is stable, the reverse of their stability properties at small separations. Onset of the Pierce instability at the first bifurcation of equilibria persists in more complicated geometries, providing a general criterion for marginal stability. It seems probable that bifurcation analysis can be a useful tool in the overall study of stable beam generation in diodes and transport in finite cavities

Correction of aortic insufficiency with an external adjustable prosthetic aortic ring.

Science.gov (United States)

Gogbashian, Andrew; Ghanta, Ravi K; Umakanthan, Ramanan; Rangaraj, Aravind T; Laurence, Rita G; Fox, John A; Cohn, Lawrence H; Chen, Frederick Y

2007-09-01

Less invasive, valve-sparing options are needed for patients with aortic insufficiency (AI). We sought to evaluate the feasibility of reducing AI with an external adjustable aortic ring in an ovine model. To create AI, five sheep underwent patch plasty enlargement of the aortic annulus and root by placement of a 10 x 15 mm pericardial patch between the right and noncoronary cusps. An adjustable external ring composed of a nylon band was fabricated and placed around the aortic root. Aortic flow, aortic pressure, and left ventricular pressures were measured with the ring loose (off) and tightened (on). Mean regurgitant orifice area decreased by 86%, from 0.07 +/- 0.03 cm2 (ring loose, off) to 0.01 +/- 0.00 cm2 (ring tightened, on) [p < 0.01]. The regurgitant fraction decreased from 18 +/- 4% to 2 +/- 1% [p < 0.01]. The ring did not significantly affect stroke volume and aortic pressure. An ovine model of aortic root dilatation resulting in acute AI has been developed. In this model, application of an external, adjustable constricting aortic ring eliminated AI. An aortic ring may be a useful adjunct in reducing AI secondary to annular dilatation.

Aortic compliance in patients with aortic regurgitation. Evaluation with magnetic resonance imaging

International Nuclear Information System (INIS)

Murai, Sachiko; Hamada, Seiki; Ueguchi, Takashi

2005-01-01

The purpose of this study was to assess by means of cine magnetic resonance imaging (MRI) aortic compliance before and after aortic valve replacement (AVR with SJM (St. Jude Medical, St paul, MN) valve) in patients with aortic regurgitation (AR). Two groups (healthy controls and patients with severe isolated AR) of 10 subjects each were included in this study. Cine MRI was performed at three locations of the aorta, and aortic compliance was calculated by dividing the maximum change in the aortic area by pulse pressure. Cine MRI is useful to assess abnormalities of aortic compliance in patients with AR. Compared with the control group, aortic compliance in the AR group was significantly less in the ascending aorta (p<0.05), decreasing in order of aortic location. After AVR, aortic compliance improved for all locations. Cine MRI enables assessment of aortic biophysical properties such as a compliance for evaluating the progression of AR and the efficacy of treatment. (author)

Bifurcations of optimal vector fields: an overview

NARCIS (Netherlands)

Kiseleva, T.; Wagener, F.; Rodellar, J.; Reithmeier, E.

2009-01-01

We develop a bifurcation theory for the solution structure of infinite horizon optimal control problems with one state variable. It turns out that qualitative changes of this structure are connected to local and global bifurcations in the state-costate system. We apply the theory to investigate an

Acute Type II Aortic Dissection with Severe Aortic Regurgitation and Chronic Descending Aortic Dissection in Pregnant Patient with Marfan Syndrome.

Science.gov (United States)

Lee, Seok-Soo; Jung, Tae-Eun; Lee, Dong Hyup

2012-12-01

Aortic dilatation and dissection are severe complications during pregnancy that can be fatal to both the mother and the fetus. The risks of these complications are especially high in pregnant patients with Marfan syndrome; however, incidents of descending aortic dissection are very rare. This case report involves a successful Bentall procedure for and recovery from a rare aortic dissection in a pregnant Marfan patient who developed acute type II aortic dissection with severe aortic regurgitation and chronic descending aortic dissection immediately after Cesarean section. Regular follow-up will be needed to monitor the descending aortic dissection.

Bifurcations of transition states: Morse bifurcations

International Nuclear Information System (INIS)

MacKay, R S; Strub, D C

2014-01-01

A transition state for a Hamiltonian system is a closed, invariant, oriented, codimension-2 submanifold of an energy level that can be spanned by two compact codimension-1 surfaces of unidirectional flux whose union, called a dividing surface, locally separates the energy level into two components and has no local recrossings. For this to happen robustly to all smooth perturbations, the transition state must be normally hyperbolic. The dividing surface then has locally minimal geometric flux through it, giving an upper bound on the rate of transport in either direction. Transition states diffeomorphic to S 2m−3 are known to exist for energies just above any index-1 critical point of a Hamiltonian of m degrees of freedom, with dividing surfaces S 2m−2 . The question addressed here is what qualitative changes in the transition state, and consequently the dividing surface, may occur as the energy or other parameters are varied? We find that there is a class of systems for which the transition state becomes singular and then regains normal hyperbolicity with a change in diffeomorphism class. These are Morse bifurcations. Various examples are considered. Firstly, some simple examples in which transition states connect or disconnect, and the dividing surface may become a torus or other. Then, we show how sequences of Morse bifurcations producing various interesting forms of transition state and dividing surface are present in reacting systems, by considering a hypothetical class of bimolecular reactions in gas phase. (paper)

Regularization of the Boundary-Saddle-Node Bifurcation

Directory of Open Access Journals (Sweden)

Xia Liu

2018-01-01

Full Text Available In this paper we treat a particular class of planar Filippov systems which consist of two smooth systems that are separated by a discontinuity boundary. In such systems one vector field undergoes a saddle-node bifurcation while the other vector field is transversal to the boundary. The boundary-saddle-node (BSN bifurcation occurs at a critical value when the saddle-node point is located on the discontinuity boundary. We derive a local topological normal form for the BSN bifurcation and study its local dynamics by applying the classical Filippov’s convex method and a novel regularization approach. In fact, by the regularization approach a given Filippov system is approximated by a piecewise-smooth continuous system. Moreover, the regularization process produces a singular perturbation problem where the original discontinuous set becomes a center manifold. Thus, the regularization enables us to make use of the established theories for continuous systems and slow-fast systems to study the local behavior around the BSN bifurcation.

Codimension-Two Bifurcation Analysis in DC Microgrids Under Droop Control

Science.gov (United States)

Lenz, Eduardo; Pagano, Daniel J.; Tahim, André P. N.

This paper addresses local and global bifurcations that may appear in electrical power systems, such as DC microgrids, which recently has attracted interest from the electrical engineering society. Most sources in these networks are voltage-type and operate in parallel. In such configuration, the basic technique for stabilizing the bus voltage is the so-called droop control. The main contribution of this work is a codimension-two bifurcation analysis of a small DC microgrid considering the droop control gain and the power processed by the load as bifurcation parameters. The codimension-two bifurcation set leads to practical rules for achieving a robust droop control design. Moreover, the bifurcation analysis also offers a better understanding of the dynamics involved in the problem and how to avoid possible instabilities. Simulation results are presented in order to illustrate the bifurcation analysis.

Aortic root replacement after previous surgical intervention on the aortic valve, aortic root, or ascending aorta.

Science.gov (United States)

Kirsch, E W Matthias; Radu, N Costin; Mekontso-Dessap, Armand; Hillion, Marie-Line; Loisance, Daniel

2006-03-01

Aortic root replacement after a previous operation on the aortic valve, aortic root, or ascending aorta remains a major challenge. Records of 56 consecutive patients (44 men; mean age, 56.4 +/- 13.6 years) undergoing reoperative aortic root replacement between June 1994 and June 2005 were reviewed retrospectively. Reoperation was performed 9.4 +/- 6.7 years after the last cardiac operation. Indications for reoperation were true aneurysm (n = 14 [25%]), false aneurysm (n = 10 [18%]), dissection or redissection (n = 9 [16%]), structural or nonstructural valve dysfunction (n = 10 [18%]), prosthetic valve-graft infection (n = 12 [21%]), and miscellaneous (n = 1 [2%]). Procedures performed were aortic root replacement (n = 47 [84%]), aortic root replacement plus mitral valve procedure (n = 5 [9%]), and aortic root replacement plus arch replacement (n = 4 [7%]). In 14 (25%) patients coronary artery bypass grafting had to be performed unexpectedly during the same procedure or immediately after the procedure to re-establish coronary perfusion. Hospital mortality reached 17.9% (n = 10). Multivariate logistic regression analysis revealed the need for unplanned perioperative coronary artery bypass grafting as the sole independent risk factor for hospital death (P = .005). Actuarial survival was 83.8% +/- 4.9% at 1 month, 73.0% +/- 6.3% at 1 year, and 65.7% +/- 9.0% at 5 years after the operation. One patient had recurrence of endocarditis 6.7 months after the operation and required repeated homograft aortic root replacement. Reoperative aortic root replacement remains associated with a high postoperative mortality. The need to perform unplanned coronary artery bypass grafting during reoperative aortic root replacement is a major risk factor for hospital death. The optimal technique for coronary reconstruction in this setting remains to be debated.

Bifurcation diagram of a cubic three-parameter autonomous system

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Lenka Barakova

2005-07-01

Full Text Available In this paper, we study the cubic three-parameter autonomous planar system $$displaylines{ dot x_1 = k_1 + k_2x_1 - x_1^3 - x_2,cr dot x_2 = k_3 x_1 - x_2, }$$ where $k_2, k_3$ are greater than 0. Our goal is to obtain a bifurcation diagram; i.e., to divide the parameter space into regions within which the system has topologically equivalent phase portraits and to describe how these portraits are transformed at the bifurcation boundaries. Results may be applied to the macroeconomical model IS-LM with Kaldor's assumptions. In this model existence of a stable limit cycles has already been studied (Andronov-Hopf bifurcation. We present the whole bifurcation diagram and among others, we prove existence of more difficult bifurcations and existence of unstable cycles.

Bifurcation of transition paths induced by coupled bistable systems.

Science.gov (United States)

Tian, Chengzhe; Mitarai, Namiko

2016-06-07

We discuss the transition paths in a coupled bistable system consisting of interacting multiple identical bistable motifs. We propose a simple model of coupled bistable gene circuits as an example and show that its transition paths are bifurcating. We then derive a criterion to predict the bifurcation of transition paths in a generalized coupled bistable system. We confirm the validity of the theory for the example system by numerical simulation. We also demonstrate in the example system that, if the steady states of individual gene circuits are not changed by the coupling, the bifurcation pattern is not dependent on the number of gene circuits. We further show that the transition rate exponentially decreases with the number of gene circuits when the transition path does not bifurcate, while a bifurcation facilitates the transition by lowering the quasi-potential energy barrier.

Repair of Multiple Subclavian and Axillary Artery Aneurysms in a 58-Year-Old Man with Marfan Syndrome.

Science.gov (United States)

Dolapoglu, Ahmet; de la Cruz, Kim I; Preventza, Ourania; Coselli, Joseph S

2016-10-01

Dilation of the ascending aorta and aortic dissections are often seen in Marfan syndrome; however, true aneurysms of the subclavian and axillary arteries rarely seem to develop in patients who have this disease. We present the case of a 58-year-old man with Marfan syndrome who had undergone a Bentall procedure and thoracoabdominal aortic repair for an aortic dissection and who later developed multiple aneurysmal dilations of his right subclavian and axillary arteries. The aneurysms were successfully repaired by means of a surgical bypass technique in which a Dacron graft was placed between the carotid and brachial arteries. We also discuss our strategy for determining the optimal surgical approach in these patients.

Ruptured tuberculous false aneurysm of the abdominal aorta: a case report.

Science.gov (United States)

Mechchat, Alae; Lekehal, Brahim; Mesnaoui, Abbes; Ammar, Fannid; Bensaid, Younes

2011-01-01

Tuberculous false aneurysm of the aorta is rare and has an unpredictable complication of aneurysm rupture. We report a case of a 32-year old woman who was referred to the Department of Vascular Surgery, Avicenne Hospital for severe abdominal pain. Chest x-ray revealed miliary tuberculosis. Contrast enhanced computed tomography (CT) scan showed a false aortic aneurysm involving the juxtarenal aorta. Antituberculous treatment was started because of high presumption of tuberculosis. Five days later, the patient presented with symptoms of aneurysm rupture. She underwent an emergency a surgical resection of the aneurysm with repair of the aortic wall defect by a Dacron Silver patch. The histopathologic examination of the aortic wall showed features of tuberculosis.

Percutaneous coronary intervention for the left main stem and other bifurcation lesions: 12th consensus document from the European Bifurcation Club.

Science.gov (United States)

Lassen, Jens Flensted; Burzotta, Francesco; Banning, Adrian P; Lefèvre, Thierry; Darremont, Olivier; Hildick-Smith, David; Chieffo, Alaide; Pan, Manuel; Holm, Niels Ramsing; Louvard, Yves; Stankovic, Goran

2018-01-20

The European Bifurcation Club (EBC) was initiated in 2004 to support a continuous overview of the field of coronary artery bifurcation interventions and aims to facilitate a scientific discussion and an exchange of ideas on the management of bifurcation disease. The EBC hosts an annual, two-day compact meeting, dedicated to bifurcations, which brings together physicians, pathologists, engineers, biologists, physicists, mathematicians, epidemiologists and statisticians for detailed discussions. Every meeting is finalised with a consensus statement that reflects the unique opportunity of combining the opinion of interventional cardiologists with the opinion of a large variety of other scientists on bifurcation management. A series of consensus sessions dedicated to specific topics, to strengthen the consensus debates and focus the discussions, was introduced at this year's meeting. The sessions comprise an intensive overview of the present literature, a pro and con debate and a voting system, to guide the consensus-building process. The present document represents the summary of the up-to-date EBC consensus and recommendations from the 12th annual EBC meeting in 2016 in Rotterdam.

Nonlinear physical systems spectral analysis, stability and bifurcations

CERN Document Server

Kirillov, Oleg N

2013-01-01

Bringing together 18 chapters written by leading experts in dynamical systems, operator theory, partial differential equations, and solid and fluid mechanics, this book presents state-of-the-art approaches to a wide spectrum of new and challenging stability problems.Nonlinear Physical Systems: Spectral Analysis, Stability and Bifurcations focuses on problems of spectral analysis, stability and bifurcations arising in the nonlinear partial differential equations of modern physics. Bifurcations and stability of solitary waves, geometrical optics stability analysis in hydro- and magnetohydrodynam

Fractional noise destroys or induces a stochastic bifurcation

Energy Technology Data Exchange (ETDEWEB)

Yang, Qigui, E-mail: qgyang@scut.edu.cn [School of Sciences, South China University of Technology, Guangzhou 510640 (China); Zeng, Caibin, E-mail: zeng.cb@mail.scut.edu.cn [School of Sciences, South China University of Technology, Guangzhou 510640 (China); School of Automation Science and Engineering, South China University of Technology, Guangzhou 510640 (China); Wang, Cong, E-mail: wangcong@scut.edu.cn [School of Automation Science and Engineering, South China University of Technology, Guangzhou 510640 (China)

2013-12-15

Little seems to be known about the stochastic bifurcation phenomena of non-Markovian systems. Our intention in this paper is to understand such complex dynamics by a simple system, namely, the Black-Scholes model driven by a mixed fractional Brownian motion. The most interesting finding is that the multiplicative fractional noise not only destroys but also induces a stochastic bifurcation under some suitable conditions. So it opens a possible way to explore the theory of stochastic bifurcation in the non-Markovian framework.

Global Hopf Bifurcation for a Predator-Prey System with Three Delays

Science.gov (United States)

Jiang, Zhichao; Wang, Lin

2017-06-01

In this paper, a delayed predator-prey model is considered. The existence and stability of the positive equilibrium are investigated by choosing the delay τ = τ1 + τ2 as a bifurcation parameter. We see that Hopf bifurcation can occur as τ crosses some critical values. The direction of the Hopf bifurcations and the stability of the bifurcation periodic solutions are also determined by using the center manifold and normal form theory. Furthermore, based on the global Hopf bifurcation theorem for general function differential equations, which was established by J. Wu using fixed point theorem and degree theory methods, the existence of global Hopf bifurcation is investigated. Finally, numerical simulations to support the analytical conclusions are carried out.

Codimension-two bifurcation analysis on firing activities in Chay neuron model

International Nuclear Information System (INIS)

Duan Lixia; Lu Qishao

2006-01-01

Using codimension-two bifurcation analysis in the Chay neuron model, the relationship between the electric activities and the parameters of neurons is revealed. The whole parameter space is divided into two parts, that is, the firing and silence regions of neurons. It is found that the transition sets between firing and silence regions are composed of the Hopf bifurcation curves of equilibrium states and the saddle-node bifurcation curves of limit cycles, with some codimension-two bifurcation points. The transitions from silence to firing in neurons are due to the Hopf bifurcation or the fold limit cycle bifurcation, but the codimension-two singularities lead to complexity in dynamical behaviour of neuronal firing

Codimension-two bifurcation analysis on firing activities in Chay neuron model

Energy Technology Data Exchange (ETDEWEB)

Duan Lixia [School of Science, Beijing University of Aeronautics and Astronautics, Beijing 100083 (China); Lu Qishao [School of Science, Beijing University of Aeronautics and Astronautics, Beijing 100083 (China)]. E-mail: qishaolu@hotmail.com

2006-12-15

Using codimension-two bifurcation analysis in the Chay neuron model, the relationship between the electric activities and the parameters of neurons is revealed. The whole parameter space is divided into two parts, that is, the firing and silence regions of neurons. It is found that the transition sets between firing and silence regions are composed of the Hopf bifurcation curves of equilibrium states and the saddle-node bifurcation curves of limit cycles, with some codimension-two bifurcation points. The transitions from silence to firing in neurons are due to the Hopf bifurcation or the fold limit cycle bifurcation, but the codimension-two singularities lead to complexity in dynamical behaviour of neuronal firing.

Tratamento cirúrgico dos aneurismas toracoabdominais da aorta Surgical treatment of thoracoabdominal aortic aneurysms

Directory of Open Access Journals (Sweden)

Januário M Souza

1991-04-01

Full Text Available Foram operados, em nosso Serviço, 161 aneurismas da aorta, sendo 99 por dissecção e 62 por outras causas. Em cinco pacientes, os aneurismas eram de localização toracoabdominal, sendo três por degeneração aterosclerótica e dois por dissecção; três pacientes eram do sexo feminino e a idade variou de 31 a 71 anos. Dois pacientes submeteram-se a aneurismectomia previamente (um da aorta ascendente e outro da porção proximal da aorta torácica. Revascularização miocárdica foi feita em um paciente, 40 dias antes da aneurismectomia. A indicação em todos os pacientes foi dor, causada por compressão do aneurisma, sendo que, em dois, havia insuficiência respiratória associada. Todos os pacientes foram operados através de incisão toracoabdominal e abertura do diafragma. A aorta foi substituída por tubo de Dacron, desde sua porção proximal até sua bifurcação, e as artérias viscerais foram implantadas no tubo. Quatro pacientes foram operados com pinçamento da aorta; um paciente necessitou emprego de circulação extracorpórea e parada circulatória, por impossibilidade de pinçamento da aorta junto à artéria subclávia. Todos os pacientes sobreviveram ao ato cirúrgico, ocorrendo dois óbitos no pós-operatório, um subitamente no 12º dia e outro por coma neurológico secundário a parada cardíaca causada por hipoxia.Five patients have been operated on of thoracoabdominal aortic aneurysms. The mean age was 53 years (range 31-71 and three were women. All the patients were symptomatic, three of them had arteriosclerotic aneurysms, and the other two had dissecting aneurysms. Three patients had been operated on previously. The exposure of aneurysm was made through a thoracoabdominal incision, in four patients clamps were placed above and below the aneurysm and it was incised longitudinally. Bypass between left atrium and left femoral artery with hypothermia and circulatory arrest was used in the other patients, since the

Delayed Presentation of a Giant Ascending Aortic Aneurysm following Aortic Valve Replacement

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Tugrul Göncü

2009-01-01

Full Text Available Giant ascending aortic aneurysm formation following aortic valve replacement is rare. A 28-year-old man who underwent aortic valve replacement with a prosthetic valve for aortic regurgitation secondary to congenital bicuspid aortic valve about 10 years ago was diagnosed with a giant ascending aortic aneurysm about 16 cm in diameter in follow-up. The aneurysm was resected leaving the functional old mechanical prosthesis in place and implanted a 34-mm Hemashield woven graft, associated with the left and right coronary artery button implantation. Histological findings of the aortic aneurysm wall showed cystic medial necrosis. The postoperative course was uneventful and postoperative examination demonstrated good surgical results.

Bifurcation of self-folded polygonal bilayers

Science.gov (United States)

Abdullah, Arif M.; Braun, Paul V.; Hsia, K. Jimmy

2017-09-01

Motivated by the self-assembly of natural systems, researchers have investigated the stimulus-responsive curving of thin-shell structures, which is also known as self-folding. Self-folding strategies not only offer possibilities to realize complicated shapes but also promise actuation at small length scales. Biaxial mismatch strain driven self-folding bilayers demonstrate bifurcation of equilibrium shapes (from quasi-axisymmetric doubly curved to approximately singly curved) during their stimulus-responsive morphing behavior. Being a structurally instable, bifurcation could be used to tune the self-folding behavior, and hence, a detailed understanding of this phenomenon is appealing from both fundamental and practical perspectives. In this work, we investigated the bifurcation behavior of self-folding bilayer polygons. For the mechanistic understanding, we developed finite element models of planar bilayers (consisting of a stimulus-responsive and a passive layer of material) that transform into 3D curved configurations. Our experiments with cross-linked Polydimethylsiloxane samples that change shapes in organic solvents confirmed our model predictions. Finally, we explored a design scheme to generate gripper-like architectures by avoiding the bifurcation of stimulus-responsive bilayers. Our research contributes to the broad field of self-assembly as the findings could motivate functional devices across multiple disciplines such as robotics, artificial muscles, therapeutic cargos, and reconfigurable biomedical devices.

Bifurcation magnetic resonance in films magnetized along hard magnetization axis

Energy Technology Data Exchange (ETDEWEB)

Vasilevskaya, Tatiana M., E-mail: t_vasilevs@mail.ru [Ulyanovsk State University, Leo Tolstoy 42, 432017 Ulyanovsk (Russian Federation); Sementsov, Dmitriy I.; Shutyi, Anatoliy M. [Ulyanovsk State University, Leo Tolstoy 42, 432017 Ulyanovsk (Russian Federation)

2012-09-15

We study low-frequency ferromagnetic resonance in a thin film magnetized along the hard magnetization axis performing an analysis of magnetization precession dynamics equations and numerical simulation. Two types of films are considered: polycrystalline uniaxial films and single-crystal films with cubic magnetic anisotropy. An additional (bifurcation) resonance initiated by the bistability, i.e. appearance of two closely spaced equilibrium magnetization states is registered. The modification of dynamic modes provoked by variation of the frequency, amplitude, and magnetic bias value of the ac field is studied. Both steady and chaotic magnetization precession modes are registered in the bifurcation resonance range. - Highlights: Black-Right-Pointing-Pointer An additional bifurcation resonance arises in a case of a thin film magnetized along HMA. Black-Right-Pointing-Pointer Bifurcation resonance occurs due to the presence of two closely spaced equilibrium magnetization states. Black-Right-Pointing-Pointer Both regular and chaotic precession modes are realized within bifurcation resonance range. Black-Right-Pointing-Pointer Appearance of dynamic bistability is typical for bifurcation resonance.

Bifurcation magnetic resonance in films magnetized along hard magnetization axis

International Nuclear Information System (INIS)

Vasilevskaya, Tatiana M.; Sementsov, Dmitriy I.; Shutyi, Anatoliy M.

2012-01-01

We study low-frequency ferromagnetic resonance in a thin film magnetized along the hard magnetization axis performing an analysis of magnetization precession dynamics equations and numerical simulation. Two types of films are considered: polycrystalline uniaxial films and single-crystal films with cubic magnetic anisotropy. An additional (bifurcation) resonance initiated by the bistability, i.e. appearance of two closely spaced equilibrium magnetization states is registered. The modification of dynamic modes provoked by variation of the frequency, amplitude, and magnetic bias value of the ac field is studied. Both steady and chaotic magnetization precession modes are registered in the bifurcation resonance range. - Highlights: ► An additional bifurcation resonance arises in a case of a thin film magnetized along HMA. ► Bifurcation resonance occurs due to the presence of two closely spaced equilibrium magnetization states. ► Both regular and chaotic precession modes are realized within bifurcation resonance range. ► Appearance of dynamic bistability is typical for bifurcation resonance.

Bifurcation and Fractal of the Coupled Logistic Map

Science.gov (United States)

Wang, Xingyuan; Luo, Chao

The nature of the fixed points of the coupled Logistic map is researched, and the boundary equation of the first bifurcation of the coupled Logistic map in the parameter space is given out. Using the quantitative criterion and rule of system chaos, i.e., phase graph, bifurcation graph, power spectra, the computation of the fractal dimension, and the Lyapunov exponent, the paper reveals the general characteristics of the coupled Logistic map transforming from regularity to chaos, the following conclusions are shown: (1) chaotic patterns of the coupled Logistic map may emerge out of double-periodic bifurcation and Hopf bifurcation, respectively; (2) during the process of double-period bifurcation, the system exhibits self-similarity and scale transform invariability in both the parameter space and the phase space. From the research of the attraction basin and Mandelbrot-Julia set of the coupled Logistic map, the following conclusions are indicated: (1) the boundary between periodic and quasiperiodic regions is fractal, and that indicates the impossibility to predict the moving result of the points in the phase plane; (2) the structures of the Mandelbrot-Julia sets are determined by the control parameters, and their boundaries have the fractal characteristic.

Inverse bifurcation analysis: application to simple gene systems

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Schuster Peter

2006-07-01

Full Text Available Abstract Background Bifurcation analysis has proven to be a powerful method for understanding the qualitative behavior of gene regulatory networks. In addition to the more traditional forward problem of determining the mapping from parameter space to the space of model behavior, the inverse problem of determining model parameters to result in certain desired properties of the bifurcation diagram provides an attractive methodology for addressing important biological problems. These include understanding how the robustness of qualitative behavior arises from system design as well as providing a way to engineer biological networks with qualitative properties. Results We demonstrate that certain inverse bifurcation problems of biological interest may be cast as optimization problems involving minimal distances of reference parameter sets to bifurcation manifolds. This formulation allows for an iterative solution procedure based on performing a sequence of eigen-system computations and one-parameter continuations of solutions, the latter being a standard capability in existing numerical bifurcation software. As applications of the proposed method, we show that the problem of maximizing regions of a given qualitative behavior as well as the reverse engineering of bistable gene switches can be modelled and efficiently solved.

Deformable 4DCT lung registration with vessel bifurcations

International Nuclear Information System (INIS)

Hilsmann, A.; Vik, T.; Kaus, M.; Franks, K.; Bissonette, J.P.; Purdie, T.; Beziak, A.; Aach, T.

2007-01-01

In radiotherapy planning of lung cancer, breathing motion causes uncertainty in the determination of the target volume. Image registration makes it possible to get information about the deformation of the lung and the tumor movement in the respiratory cycle from a few images. A dedicated, automatic, landmark-based technique was developed that finds corresponding vessel bifurcations. Hereby, we developed criteria to characterize pronounced bifurcations for which correspondence finding was more stable and accurate. The bifurcations were extracted from automatically segmented vessel trees in maximum inhale and maximum exhale CT thorax data sets. To find corresponding bifurcations in both data sets we used the shape context approach of Belongie et al. Finally, a volumetric lung deformation was obtained using thin-plate spline interpolation and affine registration. The method is evaluated on 10 4D-CT data sets of patients with lung cancer. (orig.)

The bicuspid aortic valve and its relation to aortic dilation

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Shi-Min Yuan

2010-01-01

Full Text Available BACKGROUND: A bicuspid aortic valve (BAV is a common congenital heart disease, which affects 1-2% of the population. However, the relationship between BAVs and aortic dilation has not been sufficiently elucidated. METHODS: A total of 241 BAV patients who were referred to this hospital for cardiac surgey over a 4.75-year period were included in this study. In addition to the clinical characteristics of the included patients, the morphological features of the aortic valve and aorta, the length of the left main coronary artery, and the laboratory findings (the coagulation and hematological parameters as well as the total cholesterol concentration were determined and compared with those of the tricuspid aortic valve (TAV patients. RESULTS: The BAV patients were younger than the TAV patients for a valve surgery in the last 3 months of the study period. The BAV patients were predominantly male. Most of the BAVs that were surgically treated were stenotic, regurgitant, or combined, and only 19 (7.88% were normally functioning valves. According to echocardiography or operative records, 148 (78.31% were type A, 31 (16.40% were type B, and 10 (5.29% were type C. The left main coronary artery was much shorter in the BAV patients than it was in the TAV patients. There was no significant difference between BAV and TAV patients in the total cholesterol concentrations; whereas differences were noted between patients receiving lipid-lowering therapy and those not receiving lipid-lowering therapy. The dimensions of the aortic root, sinotubular junction, and ascending aorta were beyond normal limits, while they were significantly smaller in the BAV patients than in the TAV patients. They were also much smaller in patients receiving statin therapy than those not receiving statin therapy in both groups. Moreover, the aortic dilation in the BAV group was found to be significantly associated with patient age. CONCLUSIONS: The BAV patients developed aortic wall and

Aortic root reimplantation procedure: a new milestone in aortic valve-sparing operations

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А. М. Чернявский

2016-08-01

Full Text Available Aim: Emphasis in this study was placed on clinical and functional assessment of a modified "Florida Sleeve" procedure during surgical correction of ascending aorta aneurysms with concomitant aortic insufficiency.Methods: 32 patients with an aneurysm of the ascending aorta and aortic insufficiency underwent a modified "Florida Sleeve" procedure. The average follow-up was 17 (0-60 months. The average age of patients was 57±13 (23-73 years 56±13 years.Results: The expected 4-year cumulative survival rate was 84.3%. Overall freedom from aortic insufficiency in the late period was 88.9%. Median aortic regurgitation was 1+ (1; 2. Long-term follow-up revealed no valve-associated complications.Conclusion: The aortic root reimplantation procedure enables optimal correction of the existing lesions of the aortic root without performing aortic valve replacement and demonstrates stable clinical and functional outcomes in the long-term period.Key words: aortic aneurysm; aortic valve; valve-sparing operations.FundingThe study had no sponsorship.Conflict of interestThe authors declare no conflict of interest.

Acute Type II Aortic Dissection with Severe Aortic Regurgitation and Chronic Descending Aortic Dissection in Pregnant Patient with Marfan Syndrome

OpenAIRE

Lee, Seok-Soo; Jung, Tae-Eun; Lee, Dong Hyup

2012-01-01

Aortic dilatation and dissection are severe complications during pregnancy that can be fatal to both the mother and the fetus. The risks of these complications are especially high in pregnant patients with Marfan syndrome; however, incidents of descending aortic dissection are very rare. This case report involves a successful Bentall procedure for and recovery from a rare aortic dissection in a pregnant Marfan patient who developed acute type II aortic dissection with severe aortic regurgitat...

Aortic valve replacement for aortic stenosis caused by alkaptonuria.

Science.gov (United States)

Hiroyoshi, Junko; Saito, Aya; Panthee, Nirmal; Imai, Yasushi; Kawashima, Dai; Motomura, Noboru; Ono, Minoru

2013-03-01

We report a case of aortic stenosis associated with ochronosis in a 70-year-old man who underwent biologic aortic valve replacement. Intraoperative findings included ochronosis of a severely calcified pigmented aortic valve along with pigmentation of the intima of the aorta. Copyright © 2013 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Acute Aortic Arch Perforation During Transcatheter Aortic Valve Replacement in Bicuspid Aortic Stenosis and a Gothic Aortic Arch

DEFF Research Database (Denmark)

Millan-Iturbe, Oscar; Sawaya, Fadi J.; Bieliauskas, Gintautas

2017-01-01

AS because of its unique anatomic features. This case report describes an acute aortic perforation during delivery of a transcatheter heart valve to treat a severe bicuspid AS with a “gothic aortic arch”; more careful evaluation of the preprocedural multislice computed tomographic scan would have unveiled...

Stability and bifurcation analysis in a delayed SIR model

International Nuclear Information System (INIS)

Jiang Zhichao; Wei Junjie

2008-01-01

In this paper, a time-delayed SIR model with a nonlinear incidence rate is considered. The existence of Hopf bifurcations at the endemic equilibrium is established by analyzing the distribution of the characteristic values. A explicit algorithm for determining the direction of the Hopf bifurcation and the stability of the bifurcating periodic solutions are derived by using the normal form and the center manifold theory. Numerical simulations to support the analytical conclusions are carried out

Bifurcation theory for hexagonal agglomeration in economic geography

CERN Document Server

Ikeda, Kiyohiro

2014-01-01

This book contributes to an understanding of how bifurcation theory adapts to the analysis of economic geography. It is easily accessible not only to mathematicians and economists, but also to upper-level undergraduate and graduate students who are interested in nonlinear mathematics. The self-organization of hexagonal agglomeration patterns of industrial regions was first predicted by the central place theory in economic geography based on investigations of southern Germany. The emergence of hexagonal agglomeration in economic geography models was envisaged by Krugman. In this book, after a brief introduction of central place theory and new economic geography, the missing link between them is discovered by elucidating the mechanism of the evolution of bifurcating hexagonal patterns. Pattern formation by such bifurcation is a well-studied topic in nonlinear mathematics, and group-theoretic bifurcation analysis is a well-developed theoretical tool. A finite hexagonal lattice is used to express uniformly distri...

Bifurcating fronts for the Taylor-Couette problem in infinite cylinders

Science.gov (United States)

Hărăguş-Courcelle, M.; Schneider, G.

We show the existence of bifurcating fronts for the weakly unstable Taylor-Couette problem in an infinite cylinder. These fronts connect a stationary bifurcating pattern, here the Taylor vortices, with the trivial ground state, here the Couette flow. In order to show the existence result we improve a method which was already used in establishing the existence of bifurcating fronts for the Swift-Hohenberg equation by Collet and Eckmann, 1986, and by Eckmann and Wayne, 1991. The existence proof is based on spatial dynamics and center manifold theory. One of the difficulties in applying center manifold theory comes from an infinite number of eigenvalues on the imaginary axis for vanishing bifurcation parameter. But nevertheless, a finite dimensional reduction is possible, since the eigenvalues leave the imaginary axis with different velocities, if the bifurcation parameter is increased. In contrast to previous work we have to use normalform methods and a non-standard cut-off function to obtain a center manifold which is large enough to contain the bifurcating fronts.

Secondary Channel Bifurcation Geometry: A Multi-dimensional Problem

Science.gov (United States)

Gaeuman, D.; Stewart, R. L.

2017-12-01

The construction of secondary channels (or side channels) is a popular strategy for increasing aquatic habitat complexity in managed rivers. Such channels, however, frequently experience aggradation that prevents surface water from entering the side channels near their bifurcation points during periods of relatively low discharge. This failure to maintain an uninterrupted surface water connection with the main channel can reduce the habitat value of side channels for fish species that prefer lotic conditions. Various factors have been proposed as potential controls on the fate of side channels, including water surface slope differences between the main and secondary channels, the presence of main channel secondary circulation, transverse bed slopes, and bifurcation angle. A quantitative assessment of more than 50 natural and constructed secondary channels in the Trinity River of northern California indicates that bifurcations can assume a variety of configurations that are formed by different processes and whose longevity is governed by different sets of factors. Moreover, factors such as bifurcation angle and water surface slope vary with discharge level and are continuously distributed in space, such that they must be viewed as a multi-dimensional field rather than a single-valued attribute that can be assigned to a particular bifurcation.

Bifurcations of a periodically forced microbial continuous culture model with restrained growth rate

Science.gov (United States)

Ren, Jingli; Yuan, Qigang

2017-08-01

A three dimensional microbial continuous culture model with a restrained microbial growth rate is studied in this paper. Two types of dilution rates are considered to investigate the dynamic behaviors of the model. For the unforced system, fold bifurcation and Hopf bifurcation are detected, and numerical simulations reveal that the system undergoes degenerate Hopf bifurcation. When the system is periodically forced, bifurcation diagrams for periodic solutions of period-one and period-two are given by researching the Poincaré map, corresponding to different bifurcation cases in the unforced system. Stable and unstable quasiperiodic solutions are obtained by Neimark-Sacker bifurcation with different parameter values. Periodic solutions of various periods can occur or disappear and even change their stability, when the Poincaré map of the forced system undergoes Neimark-Sacker bifurcation, flip bifurcation, and fold bifurcation. Chaotic attractors generated by a cascade of period doublings and some phase portraits are given at last.

The use of transcatheter aortic valve replacement vs surgical aortic valve replacement for the treatment of aortic stenosis

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Jensen HA

2015-08-01

Full Text Available Hanna A Jensen, Lillian L Tsai, Vinod H Thourani Division of Cardiothoracic Surgery, Joseph B Whitehead Department of Surgery, Structural Heart and Valve Center, Emory University School of Medicine, Atlanta, GA, USA Abstract: Severe aortic stenosis (AS is associated with considerable morbidity and mortality and is increasing in prevalence as the global population increases. Since AS primarily affects the elderly, many of these patients have comorbidities that make them poor candidates for the gold standard treatment for AS, surgical aortic valve replacement. Transcatheter aortic valve replacement has emerged as a novel technology for the management of AS in higher risk patients over the past decade. Randomized trials have established the safety and efficacy of transcatheter aortic valve replacement, and the medical community has rallied to identify the patients who are most suitable for this transformative treatment. This review focuses on outlining the key procedural differences, describing the unique challenges of both operations, and finally assessing and comparing outcomes both on a general level and in challenging patient subgroups. Keywords: aortic valve replacement, transcatheter aortic valve replacement, surgical aortic valve replacement 

Bifurcation dynamics of the tempered fractional Langevin equation

Energy Technology Data Exchange (ETDEWEB)

Zeng, Caibin, E-mail: macbzeng@scut.edu.cn; Yang, Qigui, E-mail: qgyang@scut.edu.cn [School of Mathematics, South China University of Technology, Guangzhou 510640 (China); Chen, YangQuan, E-mail: ychen53@ucmerced.edu [MESA LAB, School of Engineering, University of California, Merced, 5200 N. Lake Road, Merced, California 95343 (United States)

2016-08-15

Tempered fractional processes offer a useful extension for turbulence to include low frequencies. In this paper, we investigate the stochastic phenomenological bifurcation, or stochastic P-bifurcation, of the Langevin equation perturbed by tempered fractional Brownian motion. However, most standard tools from the well-studied framework of random dynamical systems cannot be applied to systems driven by non-Markovian noise, so it is desirable to construct possible approaches in a non-Markovian framework. We first derive the spectral density function of the considered system based on the generalized Parseval's formula and the Wiener-Khinchin theorem. Then we show that it enjoys interesting and diverse bifurcation phenomena exchanging between or among explosive-like, unimodal, and bimodal kurtosis. Therefore, our procedures in this paper are not merely comparable in scope to the existing theory of Markovian systems but also provide a possible approach to discern P-bifurcation dynamics in the non-Markovian settings.

Altered aortic shape in bicuspid aortic valve relatives influences blood flow patterns.

Science.gov (United States)

Schnell, Susanne; Smith, Danielle A; Barker, Alex J; Entezari, Pegah; Honarmand, Amir R; Carr, Maria L; Malaisrie, S Chris; McCarthy, Patrick M; Collins, Jeremy; Carr, James C; Markl, Michael

2016-11-01

Bicuspid aortic valve (BAV) is known to exhibit familial inheritance and is associated with aortopathy and altered aortic haemodynamics. However, it remains unclear whether BAV-related aortopathy can be inherited independently of valve morphology. Four-dimensional flow magnetic resonance imaging for the in vivo assessment of thoracic aortic 3D blood flow was performed in 24 BAV relatives with trileaflet aortic valves (age = 40 ± 14 years) and 15 healthy controls (age = 37 ± 10 years). Data analysis included aortic dimensions, shape (round/gothic/cubic), and 3D blood flow characteristics (semi-quantitative vortex/helix grading and peak velocities). Cubic and gothic aortic shapes were markedly more prevalent in BAV relatives compared with controls (38 vs. 7%). Ascending aorta (AAo) vortex flow in BAV relatives was significantly increased compared with controls (grading = 1.5 ± 1.0 vs. 0.6 ± 0.9, P = 0.015). Aortic haemodynamics were influenced by aortic shape: peak velocities were reduced for gothic aortas vs. round aortas (P = 0.003); vortex flow was increased for cubic aortas in the AAo (P gothic aortas in the AAo and descending aorta (P = 0.003, P = 0.029). Logistic regression demonstrated significant associations of shape with severity of vortex flow in AAo (P < 0.001) and aortic arch (P = 0.016) in BAV relatives. BAV relatives expressed altered aortic shape and increased vortex flow despite the absence of valvular disease or aortic dilatation. These data suggest a heritable component of BAV-related aortopathy affecting aortic shape and aberrant blood flow, independent of valve morphology. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: journals.permissions@oup.com.

Tracheal replacement by autogenous aorta.

Science.gov (United States)

Anoosh, Farhad; Hodjati, Hossain; Dehghani, Seifollah; Tanideh, Nader; Kumar, Perikala V

2009-06-09

Tracheal defects may occur after trauma or prolonged intubation. Resection of tracheal tumors also poses a major challenge for substitution. In an effort to solve this problem, different techniques have been tried with little success. We report on a new animal model which showed acceptable results with fewer complications. We replaced 5 cm of cervical trachea in 10 dogs with harvested infra-renal aorta and repaired the aortic defect with Dacron graft. Necropsy of the grafted aorta and anastomotic site revealed well healed anastomosis in all animals together with ciliated columnar epithelium coverage of grafted aorta and neovascularization of aortic wall. Aortic graft is preferable to other substitutes because of less antigenicity, less vascularity, and no mucous secretions or peristalsis.

Bifurcation of learning and structure formation in neuronal maps

DEFF Research Database (Denmark)

Marschler, Christian; Faust-Ellsässer, Carmen; Starke, Jens

2014-01-01

to map formation in the laminar nucleus of the barn owl's auditory system. Using equation-free methods, we perform a bifurcation analysis of spatio-temporal structure formation in the associated synaptic-weight matrix. This enables us to analyze learning as a bifurcation process and follow the unstable...... states as well. A simple time translation of the learning window function shifts the bifurcation point of structure formation and goes along with traveling waves in the map, without changing the animal's sound localization performance....

An Extensive Stanford Type A Aortic Dissection Involving Bilateral Carotid and Iliac Arteries

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E. W. Lee

2013-01-01

Full Text Available We present a rare case of continuous, extensive aortic dissection (AD involving the bilateral common carotid arteries, the ascending, thoracic, and abdominal aorta, and bifurcation of the right common iliac artery. A 61-year-old man with history of chronic hypertension presented with a one-day history of chest pain, vertigo, left facial drooping, and left hemiparesis. Despite the presence of bilateral carotid bruits, doppler ultrasound of the neck was postponed, and the patient was treated with thrombolytic therapy for a presumed ischemic stroke. The patient's symptoms began to resolve within an hour of treatment, at which time treatment was withheld. Ultrasound performed the following day showed dissection of bilateral common carotid arteries, and CT angiography demonstrated extensive AD as described earlier. The patient subsequently underwent cardiovascular surgery and has been doing clinically well since then. AD has a myriad of manifestations depending on the involvement of aortic branches. Our paper illustrates the importance of having a high index of suspicion for AD when a patient presents with a picture of ischemic stroke, since overlapping signs and symptoms exist between AD and stroke. Differentiating between the two conditions is central to patient care as thrombolytic therapy can be helpful in stroke, but detrimental in AD.

Hopf bifurcation in a delayed reaction-diffusion-advection population model

Science.gov (United States)

Chen, Shanshan; Lou, Yuan; Wei, Junjie

2018-04-01

In this paper, we investigate a reaction-diffusion-advection model with time delay effect. The stability/instability of the spatially nonhomogeneous positive steady state and the associated Hopf bifurcation are investigated when the given parameter of the model is near the principle eigenvalue of an elliptic operator. Our results imply that time delay can make the spatially nonhomogeneous positive steady state unstable for a reaction-diffusion-advection model, and the model can exhibit oscillatory pattern through Hopf bifurcation. The effect of advection on Hopf bifurcation values is also considered, and our results suggest that Hopf bifurcation is more likely to occur when the advection rate increases.

Bifurcation of rupture path by linear and cubic damping force

Science.gov (United States)

Dennis L. C., C.; Chew X., Y.; Lee Y., C.

2014-06-01

Bifurcation of rupture path is studied for the effect of linear and cubic damping. Momentum equation with Rayleigh factor was transformed into ordinary differential form. Bernoulli differential equation was obtained and solved by the separation of variables. Analytical or exact solutions yielded the bifurcation was visible at imaginary part when the wave was non dispersive. For the dispersive wave, bifurcation of rupture path was invisible.

Long-Term Risk for Aortic Complications After Aortic Valve Replacement in Patients With Bicuspid Aortic Valve Versus Marfan Syndrome.

Science.gov (United States)

Itagaki, Shinobu; Chikwe, Joanna P; Chiang, Yuting P; Egorova, Natalia N; Adams, David H

2015-06-09

Bicuspid aortic valves are associated with valve dysfunction, ascending aortic aneurysm and dissection. Management of the ascending aorta at the time of aortic valve replacement (AVR) in these patients is controversial and has been extrapolated from experience with Marfan syndrome, despite the absence of comparative long-term outcome data. This study sought to assess whether the natural history of thoracic aortopathy after AVR in patients with bicuspid aortic valve disease is substantially different from that seen in patients with Marfan syndrome. In this retrospective comparison, outcomes of 13,205 adults (2,079 with bicuspid aortic valves, 73 with Marfan syndrome, and 11,053 control patients with acquired aortic valve disease) who underwent primary AVR without replacement of the ascending aorta in New York State between 1995 and 2010 were compared. The median follow-up time was 6.6 years. The long-term incidence of thoracic aortic dissection was significantly higher in patients with Marfan syndrome (5.5 ± 2.7%) compared with those with bicuspid valves (0.55 ± 0.21%) and control group patients (0.41 ± 0.08%, p Marfan syndrome (10.8 ± 4.4%) compared with those with bicuspid valves (4.8 ± 0.8%) and control group patients (1.4 ± 0.2%) (p Marfan syndrome were significantly more likely to undergo thoracic aortic surgery in late follow-up (10.4 ± 4.3%) compared with those with bicuspid valves (2.5 ± 0.6%) and control group patients (0.50 ± 0.09%) (p Marfan syndrome compared with those with bicuspid aortic valves confirm that operative management of patients with bicuspid aortic valves should not be extrapolated from Marfan syndrome and support discrete treatment algorithms for these different clinical entities. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Bifurcation structures of a cobweb model with memory and competing technologies

Science.gov (United States)

Agliari, Anna; Naimzada, Ahmad; Pecora, Nicolò

2018-05-01

In this paper we study a simple model based on the cobweb demand-supply framework with costly innovators and free imitators. The evolutionary selection between technologies depends on a performance measure which is related to the degree of memory. The resulting dynamics is described by a two-dimensional map. The map has a fixed point which may lose stability either via supercritical Neimark-Sacker bifurcation or flip bifurcation and several multistability situations exist. We describe some sequences of global bifurcations involving attracting and repelling closed invariant curves. These bifurcations, characterized by the creation of homoclinic connections or homoclinic tangles, are described through several numerical simulations. Particular bifurcation phenomena are also observed when the parameters are selected inside a periodicity region.

Analysis of stability and Hopf bifurcation for a delayed logistic equation

International Nuclear Information System (INIS)

Sun Chengjun; Han Maoan; Lin Yiping

2007-01-01

The dynamics of a logistic equation with discrete delay are investigated, together with the local and global stability of the equilibria. In particular, the conditions under which a sequence of Hopf bifurcations occur at the positive equilibrium are obtained. Explicit algorithm for determining the stability of the bifurcating periodic solutions and the direction of the Hopf bifurcation are derived by using the theory of normal form and center manifold [Hassard B, Kazarino D, Wan Y. Theory and applications of Hopf bifurcation. Cambridge: Cambridge University Press; 1981.]. Global existence of periodic solutions is also established by using a global Hopf bifurcation result of Wu [Symmetric functional differential equations and neural networks with memory. Trans Amer Math Soc 350:1998;4799-38.

Bifurcation of Jovian magnetotail current sheet

Directory of Open Access Journals (Sweden)

P. L. Israelevich

2006-07-01

Full Text Available Multiple crossings of the magnetotail current sheet by a single spacecraft give the possibility to distinguish between two types of electric current density distribution: single-peaked (Harris type current layer and double-peaked (bifurcated current sheet. Magnetic field measurements in the Jovian magnetic tail by Voyager-2 reveal bifurcation of the tail current sheet. The electric current density possesses a minimum at the point of the Bx-component reversal and two maxima at the distance where the magnetic field strength reaches 50% of its value in the tail lobe.

Discretizing the transcritical and pitchfork bifurcations – conjugacy results

KAUST Repository

Ló czi, Lajos

2015-01-01

© 2015 Taylor & Francis. We present two case studies in one-dimensional dynamics concerning the discretization of transcritical (TC) and pitchfork (PF) bifurcations. In the vicinity of a TC or PF bifurcation point and under some natural assumptions

Shells, orbit bifurcations, and symmetry restorations in Fermi systems

Energy Technology Data Exchange (ETDEWEB)

Magner, A. G., E-mail: magner@kinr.kiev.ua; Koliesnik, M. V. [NASU, Institute for Nuclear Research (Ukraine); Arita, K. [Nagoya Institute of Technology, Department of Physics (Japan)

2016-11-15

The periodic-orbit theory based on the improved stationary-phase method within the phase-space path integral approach is presented for the semiclassical description of the nuclear shell structure, concerning themain topics of the fruitful activity ofV.G. Soloviev. We apply this theory to study bifurcations and symmetry breaking phenomena in a radial power-law potential which is close to the realistic Woods–Saxon one up to about the Fermi energy. Using the realistic parametrization of nuclear shapes we explain the origin of the double-humped fission barrier and the asymmetry in the fission isomer shapes by the bifurcations of periodic orbits. The semiclassical origin of the oblate–prolate shape asymmetry and tetrahedral shapes is also suggested within the improved periodic-orbit approach. The enhancement of shell structures at some surface diffuseness and deformation parameters of such shapes are explained by existence of the simple local bifurcations and new non-local bridge-orbit bifurcations in integrable and partially integrable Fermi-systems. We obtained good agreement between the semiclassical and quantum shell-structure components of the level density and energy for several surface diffuseness and deformation parameters of the potentials, including their symmetry breaking and bifurcation values.

CISM Session on Bifurcation and Stability of Dissipative Systems

CERN Document Server

1993-01-01

The first theme concerns the plastic buckling of structures in the spirit of Hill’s classical approach. Non-bifurcation and stability criteria are introduced and post-bifurcation analysis performed by asymptotic development method in relation with Hutchinson’s work. Some recent results on the generalized standard model are given and their connection to Hill’s general formulation is presented. Instability phenomena of inelastic flow processes such as strain localization and necking are discussed. The second theme concerns stability and bifurcation problems in internally damaged or cracked colids. In brittle fracture or brittle damage, the evolution law of crack lengths or damage parameters is time-independent like in plasticity and leads to a similar mathematical description of the quasi-static evolution. Stability and non-bifurcation criteria in the sense of Hill can be again obtained from the discussion of the rate response.

Bifurcation of elastic solids with sliding interfaces

Science.gov (United States)

Bigoni, D.; Bordignon, N.; Piccolroaz, A.; Stupkiewicz, S.

2018-01-01

Lubricated sliding contact between soft solids is an interesting topic in biomechanics and for the design of small-scale engineering devices. As a model of this mechanical set-up, two elastic nonlinear solids are considered jointed through a frictionless and bilateral surface, so that continuity of the normal component of the Cauchy traction holds across the surface, but the tangential component is null. Moreover, the displacement can develop only in a way that the bodies in contact do neither detach, nor overlap. Surprisingly, this finite strain problem has not been correctly formulated until now, so this formulation is the objective of the present paper. The incremental equations are shown to be non-trivial and different from previously (and erroneously) employed conditions. In particular, an exclusion condition for bifurcation is derived to show that previous formulations based on frictionless contact or `spring-type' interfacial conditions are not able to predict bifurcations in tension, while experiments-one of which, ad hoc designed, is reported-show that these bifurcations are a reality and become possible when the correct sliding interface model is used. The presented results introduce a methodology for the determination of bifurcations and instabilities occurring during lubricated sliding between soft bodies in contact.

Bifurcations and degenerate periodic points in a three dimensional chaotic fluid flow

International Nuclear Information System (INIS)

Smith, L. D.; Rudman, M.; Lester, D. R.; Metcalfe, G.

2016-01-01

Analysis of the periodic points of a conservative periodic dynamical system uncovers the basic kinematic structure of the transport dynamics and identifies regions of local stability or chaos. While elliptic and hyperbolic points typically govern such behaviour in 3D systems, degenerate (parabolic) points also play an important role. These points represent a bifurcation in local stability and Lagrangian topology. In this study, we consider the ramifications of the two types of degenerate periodic points that occur in a model 3D fluid flow. (1) Period-tripling bifurcations occur when the local rotation angle associated with elliptic points is reversed, creating a reversal in the orientation of associated Lagrangian structures. Even though a single unstable point is created, the bifurcation in local stability has a large influence on local transport and the global arrangement of manifolds as the unstable degenerate point has three stable and three unstable directions, similar to hyperbolic points, and occurs at the intersection of three hyperbolic periodic lines. The presence of period-tripling bifurcation points indicates regions of both chaos and confinement, with the extent of each depending on the nature of the associated manifold intersections. (2) The second type of bifurcation occurs when periodic lines become tangent to local or global invariant surfaces. This bifurcation creates both saddle–centre bifurcations which can create both chaotic and stable regions, and period-doubling bifurcations which are a common route to chaos in 2D systems. We provide conditions for the occurrence of these tangent bifurcations in 3D conservative systems, as well as constraints on the possible types of tangent bifurcation that can occur based on topological considerations.

Bifurcation analysis and stability design for aircraft longitudinal motion with high angle of attack

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Xin Qi

2015-02-01

Full Text Available Bifurcation analysis and stability design for aircraft longitudinal motion are investigated when the nonlinearity in flight dynamics takes place severely at high angle of attack regime. To predict the special nonlinear flight phenomena, bifurcation theory and continuation method are employed to systematically analyze the nonlinear motions. With the refinement of the flight dynamics for F-8 Crusader longitudinal motion, a framework is derived to identify the stationary bifurcation and dynamic bifurcation for high-dimensional system. Case study shows that the F-8 longitudinal motion undergoes saddle node bifurcation, Hopf bifurcation, Zero-Hopf bifurcation and branch point bifurcation under certain conditions. Moreover, the Hopf bifurcation renders series of multiple frequency pitch oscillation phenomena, which deteriorate the flight control stability severely. To relieve the adverse effects of these phenomena, a stabilization control based on gain scheduling and polynomial fitting for F-8 longitudinal motion is presented to enlarge the flight envelope. Simulation results validate the effectiveness of the proposed scheme.

Bifurcations of heterodimensional cycles with two saddle points

Energy Technology Data Exchange (ETDEWEB)

Geng Fengjie [School of Information Technology, China University of Geosciences (Beijing), Beijing 100083 (China)], E-mail: gengfengjie_hbu@163.com; Zhu Deming [Department of Mathematics, East China Normal University, Shanghai 200062 (China)], E-mail: dmzhu@math.ecnu.edu.cn; Xu Yancong [Department of Mathematics, East China Normal University, Shanghai 200062 (China)], E-mail: yancongx@163.com

2009-03-15

The bifurcations of 2-point heterodimensional cycles are investigated in this paper. Under some generic conditions, we establish the existence of one homoclinic loop, one periodic orbit, two periodic orbits, one 2-fold periodic orbit, and the coexistence of one periodic orbit and heteroclinic loop. Some bifurcation patterns different to the case of non-heterodimensional heteroclinic cycles are revealed.

Bifurcations of heterodimensional cycles with two saddle points

International Nuclear Information System (INIS)

Geng Fengjie; Zhu Deming; Xu Yancong

2009-01-01

The bifurcations of 2-point heterodimensional cycles are investigated in this paper. Under some generic conditions, we establish the existence of one homoclinic loop, one periodic orbit, two periodic orbits, one 2-fold periodic orbit, and the coexistence of one periodic orbit and heteroclinic loop. Some bifurcation patterns different to the case of non-heterodimensional heteroclinic cycles are revealed.

Emergence of the bifurcation structure of a Langmuir–Blodgett transfer model

KAUST Repository

Köpf, Michael H

2014-10-07

© 2014 IOP Publishing Ltd & London Mathematical Society. We explore the bifurcation structure of a modified Cahn-Hilliard equation that describes a system that may undergo a first-order phase transition and is kept permanently out of equilibrium by a lateral driving. This forms a simple model, e.g., for the deposition of stripe patterns of different phases of surfactant molecules through Langmuir-Blodgett transfer. Employing continuation techniques the bifurcation structure is numerically investigated using the non-dimensional transfer velocity as the main control parameter. It is found that the snaking structure of steady front states is intertwined with a large number of branches of time-periodic solutions that emerge from Hopf or period-doubling bifurcations and end in global bifurcations (sniper and homoclinic). Overall the bifurcation diagram has a harp-like appearance. This is complemented by a two-parameter study in non-dimensional transfer velocity and domain size (as a measure of the distance to the phase transition threshold) that elucidates through which local and global codimension 2 bifurcations the entire harp-like structure emerges.

Sediment discharge division at two tidally influenced river bifurcations

NARCIS (Netherlands)

Sassi, M.G.; Hoitink, A.J.F.; Vermeulen, B.; Hidayat, H.

2013-01-01

[1] We characterize and quantify the sediment discharge division at two tidally influenced river bifurcations in response to mean flow and secondary circulation by employing a boat-mounted acoustic Doppler current profiler (ADCP), to survey transects at bifurcating branches during a semidiurnal

Stability of River Bifurcations from Bedload to Suspended Load Dominated Conditions

Science.gov (United States)

de Haas, T.; Kleinhans, M. G.

2010-12-01

Bifurcations (also called diffluences) are as common as confluences in braided and anabranched rivers, and more common than confluences on alluvial fans and deltas where the network is essentially distributary. River bifurcations control the partitioning of both water and sediment through these systems with consequences for immediate river and coastal management and long-term evolution. Their stability is poorly understood and seems to differ between braided rivers, meandering river plains and deltas. In particular, it is the question to what extent the division of flow is asymmetrical in stable condition, where highly asymmetrical refers to channel closure and avulsion. Recent work showed that bifurcations in gravel bed braided rivers become more symmetrical with increasing sediment mobility, whereas bifurcations in a lowland sand delta become more asymmetrical with increasing sediment mobility. This difference is not understood and our objective is to resolve this issue. We use a one-dimensional network model with Y-shaped bifurcations to explore the parameter space from low to high sediment mobility. The model solves gradually varied flow, bedload transport and morphological change in a straightforward manner. Sediment is divided at the bifurcation including the transverse slope effect and the spiral flow effect caused by bends at the bifurcation. Width is evolved whilst conserving mass of eroded or built banks with the bed balance. The bifurcations are perturbed from perfect symmetry either by a subtle gradient advantage for one branch or a gentle bend at the bifurcation. Sediment transport was calculated with and without a critical threshold for sediment motion. Sediment mobility, determined in the upstream channel, was varied in three different ways to isolate the causal factor: by increasing discharge, increasing channel gradient and decreasing particle size. In reality the sediment mobility is mostly determined by particle size: gravel bed rivers are near

Aortic regurgitation after valve-sparing aortic root replacement: modes of failure.

Science.gov (United States)

Oka, Takanori; Okita, Yutaka; Matsumori, Masamichi; Okada, Kenji; Minami, Hitoshi; Munakata, Hiroshi; Inoue, Takeshi; Tanaka, Akiko; Sakamoto, Toshihito; Omura, Atsushi; Nomura, Takuo

2011-11-01

Despite the positive clinical results of valve-sparing aortic root replacement, little is known about the causes of reoperations and the modes of failure. From October 1999 to June 2010, 101 patients underwent valve-sparing aortic root replacement using the David reimplantation technique. The definition of aortic root repair failure included the following: (1) intraoperative conversion to the Bentall procedure; (2) reoperation performed because of aortic regurgitation; and (3) aortic regurgitation equal to or greater than a moderate degree at the follow-up. Sixteen patients were considered to have repair failure. Three patients required intraoperative conversion to valve replacement, 3 required reoperation within 3 months, and another 8 required reoperation during postoperative follow-up. At initial surgery 5 patients had moderate to severe aortic regurgitation, 6 patients had acute aortic dissections, 3 had Marfan syndrome, 2 had status post Ross operations, 3 had bicuspid aortic valves, and 1 had aortitis. Five patients had undergone cusp repair, including Arantius plication in 3 and plication at the commissure in 2. The causes of early failure in 6 patients included cusp perforation (3), cusp prolapse (3), and severe hemolysis (1). The causes of late failure in 10 patients included cusp prolapse (4), commissure dehiscence (3), torn cusp (2), and cusp retraction (1). Patients had valve replacements at a mean of 23 ± 20.9 months after reimplantation and survived. Causes of early failure after valve-sparing root replacement included technical failure, cusp lesions, and steep learning curve. Late failure was caused by aortic root wall degeneration due to gelatin-resorcin-formalin glue, cusp degeneration, or progression of cusp prolapse. Copyright © 2011 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Aortic intramural hematoma : assessment of clinical and radiological features in comparison to acute aortic dissection

International Nuclear Information System (INIS)

Yoon, Kwon Ha; Hwang, Jae Cheol; Lee, Jin Seong; Kang, Duk Hyun; Song, Jae Kwan; Song, Koun Sik; Lim, Tae Hwan

1996-01-01

To compare the clinical and radiological features of aortic intramural hematoma(IMH) to those of acute aortic dissection(AD). We analyzed the clinical and radiological features of 12 patients with aortic IMH and 43 patients with acute AD. In aortic IMH, the diagnoses were made by means of both CT and transesophageal echocardiography(TEE) and included two surgically proven cases. In acute AD, the diagnoses were made by means of CT and TEE and included 21 surgically proven cases. We compared patients ages, etiologies, the extent of the disease, the presence or absence of aortic branch involvement, complications, and outcomes. Aortic IMH tended to develop in older patients (67.8±7.9 vs. 50.4±13.4, P .05). In aortic IMH, there was no involvement of aortic branches, whereas in acute AD, 14(33%) patients showed involvement of one or more aortic branches. Complications of aortic IMH included pericardial effusion (n=2) and pleural effusion (n=4);in acute AD, pericardial effusion (n=7), pleural effusion (n=4), aortic insufficiency (n=8), cerebral infarction (n=3), renal infarction (n=4) and spinal infarction (n=1) were seen. There was one (8%) death due to aortic IMH and ten (23%) deaths due to acute AD (p<.01). Aortic IMH is characterized by its occurrence in older patients with hypertension, a less frequent incidence of complications, and a more favorable outcome than acute AD

Transcatheter aortic valve replacement

Science.gov (United States)

... gov/ency/article/007684.htm Transcatheter aortic valve replacement To use the sharing features on this page, please enable JavaScript. Transcatheter aortic valve replacement (TAVR) is surgery to replace the aortic valve. ...

Left Ventricular Assist Device Implantation with Concomitant Aortic Valve and Ascending Aortic Replacement.

Science.gov (United States)

Huenges, Katharina; Panholzer, Bernd; Cremer, Jochen; Haneya, Assad

2018-01-01

Left ventricular assist device (LVAD) is nowadays a routine therapy for patients with advanced heart failure. We present the case of a 74-year-old male patient who was admitted to our center with terminal heart failure in dilated cardiomyopathy and ascending aortic aneurysm with aortic valve regurgitation. The LVAD implantation with simultaneous aortic valve and supracoronary ascending aortic replacement was successfully performed.

Bifurcation of Jovian magnetotail current sheet

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P. L. Israelevich

2006-07-01

Full Text Available Multiple crossings of the magnetotail current sheet by a single spacecraft give the possibility to distinguish between two types of electric current density distribution: single-peaked (Harris type current layer and double-peaked (bifurcated current sheet. Magnetic field measurements in the Jovian magnetic tail by Voyager-2 reveal bifurcation of the tail current sheet. The electric current density possesses a minimum at the point of the B_x-component reversal and two maxima at the distance where the magnetic field strength reaches 50% of its value in the tail lobe.

Riddling bifurcation and interstellar journeys

International Nuclear Information System (INIS)

Kapitaniak, Tomasz

2005-01-01

We show that riddling bifurcation which is characteristic for low-dimensional attractors embedded in higher-dimensional phase space can give physical mechanism explaining interstellar journeys described in science-fiction literature

Arctic melt ponds and bifurcations in the climate system

Science.gov (United States)

Sudakov, I.; Vakulenko, S. A.; Golden, K. M.

2015-05-01

Understanding how sea ice melts is critical to climate projections. In the Arctic, melt ponds that develop on the surface of sea ice floes during the late spring and summer largely determine their albedo - a key parameter in climate modeling. Here we explore the possibility of a conceptual sea ice climate model passing through a bifurcation point - an irreversible critical threshold as the system warms, by incorporating geometric information about melt pond evolution. This study is based on a bifurcation analysis of the energy balance climate model with ice-albedo feedback as the key mechanism driving the system to bifurcation points.

Stochastic Bifurcation Analysis of an Elastically Mounted Flapping Airfoil

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Bose Chandan

2018-01-01

Full Text Available The present paper investigates the effects of noisy flow fluctuations on the fluid-structure interaction (FSI behaviour of a span-wise flexible wing modelled as a two degree-of-freedom elastically mounted flapping airfoil. In the sterile flow conditions, the system undergoes a Hopf bifurcation as the free-stream velocity exceeds a critical limit resulting in a stable limit-cycle oscillation (LCO from a fixed point response. On the other hand, the qualitative dynamics changes from a stochastic fixed point to a random LCO through an intermittent state in the presence of irregular flow fluctuations. The probability density function depicts the most probable system state in the phase space. A phenomenological bifurcation (P-bifurcation analysis based on the transition in the topology associated with the structure of the joint probability density function (pdf of the response variables has been carried out. The joint pdf corresponding to the stochastic fixed point possesses a Dirac delta function like structure with a sharp single peak around zero. As the mean flow speed crosses the critical value, the joint pdf bifurcates to a crater-like structure indicating the occurrence of a P-bifurcation. The intermittent state is characterized by the co-existence of the unimodal as well as the crater like structure.

Infected aortic aneurysm and inflammatory aortic aneurysm. In search of an optimal differential diagnosis

International Nuclear Information System (INIS)

Ishizaka, Nobukazu; Sohmiya, Koichi; Miyamura, Masatoshi; Umeda, Tatsuya; Tsuji, Motomu; Katsumata, Takahiro; Miyata, Tetsuro

2012-01-01

Infected aortic aneurysm and inflammatory aortic aneurysm each account for a minor fraction of the total incidence of aortic aneurysm and are associated with periaortic inflammation. Despite the similarity, infected aortic aneurysm generally shows a more rapid change in clinical condition, leading to a fatal outcome; in addition, delayed diagnosis and misuse of corticosteroid or immunosuppressing drugs may lead to uncontrolled growth of microorganisms. Therefore, it is mandatory that detection of aortic aneurysm is followed by accurate differential diagnosis. In general, infected aortic aneurysm appears usually as a saccular form aneurysm with nodularity, irregular configuration; however, the differential diagnosis may not be easy sometimes for the following reasons: symptoms, such as abdominal and/or back pain and fever, and blood test abnormalities, such as elevated C-reactive protein and enhanced erythrocyte sedimentation rate, are common in infected aortic aneurysm, but they are not found infrequently in inflammatory aortic aneurysm; some inflammatory aortic aneurysms are immunoglobulin (Ig) G4-related, but not all of them; the prevalence of IgG4 positivity in infected aortic aneurysm has not been well investigated; enhanced uptake of 18F-fluorodeoxyglucose (FDG) by 18F-FDG-positron emission tomography may not distinguish between inflammation mediated by autoimmunity and that mediated by microorganism infection. Here we discuss the characteristics of these two forms of aortic aneurysm and the points of which we have to be aware before reaching a final diagnosis. (author)

Bifurcation diagram features of a dc-dc converter under current-mode control

International Nuclear Information System (INIS)

Ruzbehani, Mohsen; Zhou Luowei; Wang Mingyu

2006-01-01

A common tool for analysis of the systems dynamics when the system has chaotic behaviour is the bifurcation diagram. In this paper, the bifurcation diagram of an ideal model of a dc-dc converter under current-mode control is analysed. Algebraic relations that give the critical points locations and describe the pattern of the bifurcation diagram are derived. It is shown that these simple algebraic and geometrical relations are responsible for the complex pattern of the bifurcation diagrams in such circuits. More explanation about the previously observed properties and introduction of some new ones are exposited. In addition, a new three-dimensional bifurcation diagram that can give better imagination of the parameters role is introduced

Modified jailed balloon technique for bifurcation lesions.

Science.gov (United States)

Saito, Shigeru; Shishido, Koki; Moriyama, Noriaki; Ochiai, Tomoki; Mizuno, Shingo; Yamanaka, Futoshi; Sugitatsu, Kazuya; Tobita, Kazuki; Matsumi, Junya; Tanaka, Yutaka; Murakami, Masato

2017-12-04

We propose a new systematic approach in bifurcation lesions, modified jailed balloon technique (M-JBT), and report the first clinical experience. Side branch occlusion brings with a serious complication and occurs in more than 7.0% of cases during bifurcation stenting. A jailed balloon (JB) is introduced into the side branch (SB), while a stent is placed in the main branch (MB) as crossing SB. The size of the JB is half of the MB stent size. While the proximal end of JB attaching to MB stent, both stent and JB are simultaneously inflated with same pressure. JB is removed and then guidewires are recrossed. Kissing balloon dilatation (KBD) and/or T and protrusion (TAP) stenting are applied as needed. Between February 2015 and February 2016, 233 patients (254 bifurcation lesions including 54 left main trunk disease) underwent percutaneous coronary intervention (PCI) using this technique. Procedure success was achieved in all cases. KBD was performed for 183 lesions and TAP stenting was employed for 31 lesions. Occlusion of SV was not observed in any of the patients. Bench test confirmed less deformity of MB stent in M-JBT compared with conventional-JBT. This is the first report for clinical experiences by using modified jailed balloon technique. This novel M-JBT is safe and effective in the preservation of SB patency during bifurcation stenting. © 2017 Wiley Periodicals, Inc.

A bench top experimental model of bubble transport in multiple arteriole bifurcations

International Nuclear Information System (INIS)

Eshpuniyani, Brijesh; Fowlkes, J. Brian; Bull, Joseph L.

2005-01-01

Motivated by a novel gas embolotherapy technique, a bench top vascular bifurcation model is used to investigate the splitting of long bubbles in a series of liquid-filled bifurcations. The developmental gas embolotherapy technique aims to treat cancer by infarcting tumors with gas emboli that are formed by selective acoustic vaporization of ∼6 μm, intravascular, perfluorcarbon droplets. The resulting gas bubbles are large enough to extend through several vessel bifurcations. The current bench top experiments examine the effects of gravity and flow on bubble transport through multiple bifurcations. The effect of gravity is varied by changing the roll angle of the bifurcating network about its parent tube. Splitting at each bifurcation is nearly even when the roll angle is zero. It is demonstrated that bubbles can either stick at one of the second bifurcations or in the second generation daughter tubes, even though the flow rate in the parent tube is constant. The findings of this work indicate that both gravity and flow are important in determining the bubble transport, and suggest that a treatment strategy that includes multiple doses may be effective in delivering emboli to vessels not occluded by the initial dose

Aortic root surgery in Marfan syndrome: Comparison of aortic valve-sparing reimplantation versus composite grafting.

Science.gov (United States)

Karck, Matthias; Kallenbach, Klaus; Hagl, Christian; Rhein, Christine; Leyh, Rainer; Haverich, Axel

2004-02-01

The objective of this study was to compare the results of aortic valve-sparing reimplantation and aortic root replacement with mechanical valve conduits in patients with Marfan syndrome undergoing operation for aortic root aneurysms. Patients and methods Between March 1979 and April 2002, 119 patients with clinical evidence of Marfan syndrome underwent composite graft replacement with mechanical valve conduits (n = 74) or aortic valve-sparing reimplantation according to David (n = 45). The underlying causes were aortic dissection type A (43 patients) and aneurysms (76 patients). Patients undergoing aortic valve reimplantation were younger compared with patients undergoing composite grafting (28 vs 35 years, P =.002) and had longer intraoperative aortic crossclamp times (125 vs 78 minutes, P valve reimplantation (P =.15). Mean follow-up was 30 months for patients undergoing aortic valve reimplantation and 114 months for patients undergoing composite grafting. Freedom from reoperation and death after 5 years postoperatively was 92% and 89% in patients undergoing composite grafting and 84% and 96% in patients undergoing aortic valve reimplantation (P =.31; P =.54), respectively. Thromboembolic complications or late postoperative bleeding occurred in 17 patients undergoing composite grafting, and an early postoperative event occurred in 1 patient undergoing aortic valve reimplantation. The results of aortic valve reimplantation and composite grafting of the aortic valve and ascending aorta with mechanical valve conduits are similar with regard to early and mid-term postoperative mortality and to the incidence of late reoperations in patients with Marfan syndrome. The low risk of thromboembolic or bleeding complications favors aortic valve reimplantation in these patients.

Transcatheter valve-in-valve implantation due to severe aortic regurgitation in a degenerated aortic homograft

DEFF Research Database (Denmark)

Olsen, Lene Kjaer; Engstrøm, Thomas; Søndergaard, Lars

2009-01-01

Transcatheter aortic valve implantation (TAVI) in severe aortic stenosis has proven to be a feasible and effective treatment modality for inoperable patients. Until now, neither aortic regurgitation nor degenerated bioprostheses has been an indication for TAVI. However, this article reports...... a successful valve-in-valve implantation of a CoreValve aortic valve prosthesis through the right subclavian artery in a case of severe aortic regurgitation within a degenerated aortic homograft. The case exemplifies the possibilities of expanding the indications for TAVI, as well as other vascular access...

A case of acute ischemic colitis after endovascular abdominal aortic aneurysm repair

Directory of Open Access Journals (Sweden)

Grigorios Voulalas

2016-01-01

Full Text Available Colonic ischemia is a recognized complication of either open or endovascular abdominal aortic aneurysm repair. The clinical difficulty in establishing the diagnosis, the severity of this complication and the patient's poor physiological status may lead to a fatal outcome. We presented a case of ischemic colitis in a patient with patent hypogastric arteries that occurred after an endovascular abdominal aortic aneurysm repair as well as a review of the available literature. The patient's preoperative, intraoperative and postoperative data were recorded. A thorough search through the Google data and Medline to review similar cases or any analyses that referred to ischemic colitis after endovascular abdominal aneurysm repair was conducted. A 76-year-old male was admitted to our department for an elective endovascular repair of an 8 cm in diameter abdominal aortic aneurysm. A Zenith bifurcation graft was implanted. The whole procedure was uneventful and the final angiogram showed an accurate deployment of the endograft without endoleaks and patency of both hypogastric arteries. During the 1st postoperative day, the patient developed symptoms of acute abdomen in combination with metabolic acidosis and oliguria. He underwent an exploratory laparotomy, which revealed necrosis of the sigmoid. A Hartmann's procedure was performed; the patient was transferred to the intensive care unit where he deceased after 24 h. Postoperative ischemic colitis has been described after open abdominal aneurysm repair. The description of this complication has been reported since the early phase of endovascular abdominal aneurysm repair development with a current incidence of 1.5%–3.0%. Possible mechanisms that may contribute to ischemic colitis in spite of the presence of patent hypogastric arteries include atheroembolization, shock, vasopressive drugs and inferior mesenteric artery occlusion.

Experimental Investigation of Bifurcations in a Thermoacoustic Engine

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Vishnu R. Unni

2015-06-01

Full Text Available In this study, variation in the characteristics of the pressure oscillations in a thermoacoustic engine is explored as the input heat flux is varied. A bifurcation diagram is plotted to study the variation in the qualitative behavior of the acoustic oscillations as the input heat flux changes. At a critical input heat flux (60 Watt, the engine begins to produce acoustic oscillations in its fundamental longitudinal mode. As the input heat flux is increased, incommensurate frequencies appear in the power spectrum. The simultaneous presence of incommensurate frequencies results in quasiperiodic oscillations. On further increase of heat flux, the fundamental mode disappears and second mode oscillations are observed. These bifurcations in the characteristics of the pressure oscillations are the result of nonlinear interaction between multiple modes present in the thermoacoustic engine. Hysteresis in the bifurcation diagram suggests that the bifurcation is subcritical. Further, the qualitative analysis of different dynamic regimes is performed using nonlinear time series analysis. The physical reason for the observed nonlinear behavior is discussed. Suggestions to avert the variations in qualitative behavior of the pressure oscillations in thermoacoustic engines are also provided.

Anatomy of the Portal Vein Bifurcation: Implication for Transjugular Intrahepatic Portal Systemic Shunts

International Nuclear Information System (INIS)

Kwok, Philip Chong-hei; Ng, Wai Fu; Lam, Christine Suk-yee; Tsui, Polly Po; Faruqi, Asma

2003-01-01

Purpose: The relationship of the portalvein bifurcation to the liver capsule in Asians, which is an important landmark for transjugular intrahepatic portosystemic shunt, has not previously been described. Methods: The anatomy of the portal vein bifurcation was studied in 70 adult Chinese cadavers; it was characterized as intrahepatic or extrahepatic. The length of the exposed portion of the right and left portal veins was measured when the bifurcation was extrahepatic. Results: The portal vein bifurcation was intrahepatic in 37 cadavers (53%) and extrahepatic in 33 cadavers (47%). The mean length of the right and left extrahepatic portal veins was 0.96 cm and 0.85 cm respectively.Both were less than or equal to 2 cm in 94% of the cadavers with extrahepatic bifurcation. There was no correlation between the presence of cirrhosis and the location of the portal vein bifurcation(p 1.0). There was no statistically significant difference in liver mass in cadavers with either extrahepatic or intrahepatic bifurcation (p =0.40). Conclusions: These findings suggest that fortransjugular intrahepatic portosystemic shunt placement, a portal vein puncture 2 cm from the bifurcation will be safe in most cases

Bifurcation Analysis and Spatiotemporal Patterns in Unidirectionally Delay-Coupled Vibratory Gyroscopes

Science.gov (United States)

Li, Li; Xu, Jian

Time delay is inevitable in unidirectionally coupled drive-free vibratory gyroscope system. The effect of time delay on the gyroscope system is studied in this paper. To this end, amplitude death and Hopf bifurcation induced by small time delay are first investigated by analyzing the related characteristic equation. Then, the direction of Hopf bifurcations and stability of Hopf-bifurcating periodic oscillations are determined by calculating the normal form on the center manifold. Next, spatiotemporal patterns of these Hopf-bifurcating periodic oscillations are analyzed by using the symmetric bifurcation theory of delay differential equations. Finally, it is found that numerical simulations agree with the associated analytic results. These phenomena could be induced although time delay is very small. Therefore, it is shown that time delay is an important factor which influences the sensitivity and accuracy of the gyroscope system and cannot be neglected during the design and manufacture.

Tracheal replacement by autogenous aorta

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Anoosh Farhad

2009-06-01

Full Text Available Abstract Background Tracheal defects may occur after trauma or prolonged intubation. Resection of tracheal tumors also poses a major challenge for substitution. In an effort to solve this problem, different techniques have been tried with little success. We report on a new animal model which showed acceptable results with fewer complications. Methods We replaced 5 cm of cervical trachea in 10 dogs with harvested infra-renal aorta and repaired the aortic defect with Dacron graft. Results Necropsy of the grafted aorta and anastomotic site revealed well healed anastomosis in all animals together with ciliated columnar epithelium coverage of grafted aorta and neovascularization of aortic wall. Conclusion Aortic graft is preferable to other substitutes because of less antigenicity, less vascularity, and no mucous secretions or peristalsis

Aortic valve-sparing operations in aortic root aneurysms: remodeling or reimplantation?

Science.gov (United States)

Rahnavardi, Mohammad; Yan, Tristan D; Bannon, Paul G; Wilson, Michael K

2011-08-01

A best evidence topic was written according to a structured protocol. The question addressed was whether the reimplantation (David) technique or the remodeling (Yacoub) technique provides the optimum event free survival in patients with an aortic root aneurysm suitable for an aortic valve-sparing operation. In total, 392 papers were found using the reported search criteria, of which 14 papers provided the best evidence to answer the clinical question. A total of 1338 patients (Yacoub technique in 606 and David technique in 732) from 13 centres were included. In most series, cardiopulmonary bypass time and aortic cross-clamp time were longer for the David technique compared to the Yacoub technique. Early mortality was comparable between the two techniques (0-6.9% for the Yacoub technique and 0-6% for the David technique). There is a tendency for a higher freedom from significant long-term aortic insufficiency in the David group than the Yacoub group, which does not necessarily result in a higher reoperation rate in the Yacoub group. In the largest series reported, freedom from a moderate-to-severe aortic insufficiency at 12 years was 82.6 ± 6.2% in the Yacoub and 91.0 ± 3.8% in the David group (P=0.035). Freedom from reoperation at the same time point was 90.4 ± 4.7% in the Yacoub group and 97.4 ± 2.2% in the David group (P=0.09). In another series, freedom from reoperation at a follow-up time of about four years was 89 ± 4% in the Yacoub group and 98 ± 2% in the David group. Although some authors merely preferred the Yacoub technique for a bicuspid aortic valve, the accumulated evidence in the current review indicates comparable results for both techniques in a bicuspid aortic valve. Current evidence is in favour of the David rather than the Yacoub technique in pathologies such as Marfan syndrome, acute type A aortic dissection, and excessive annular dilatation that may impair aortic root integrity. Careful selection of patients for each technique and

Incidence and progression of mild aortic regurgitation after Tirone David reimplantation valve-sparing aortic root replacement.

Science.gov (United States)

Stephens, Elizabeth H; Liang, David H; Kvitting, John-Peder Escobar; Kari, Fabian A; Fischbein, Michael P; Mitchell, R Scott; Miller, D Craig

2014-01-01

The study objective was to determine whether recurrent or residual mild aortic regurgitation, which occurs after valve-sparing aortic root replacement, progresses over time. Between 2003 and 2008, 154 patients underwent Tirone David-V valve-sparing aortic root replacement; 96 patients (62%) had both 1-year (median, 12 ± 4 months) and mid-term (62 ± 22 months) transthoracic echocardiograms available for analysis. Age of patients averaged 38 ± 13 years, 71% were male, 31% had a bicuspid aortic valve, 41% had Marfan syndrome, and 51% underwent aortic valve repair, predominantly cusp free margin shortening. Forty-one patients (43%) had mild aortic regurgitation on 1-year echocardiogram. In 85% of patients (n = 35), mild aortic regurgitation remained stable on the most recent echocardiogram (median, 57 ± 20 months); progression to moderate aortic regurgitation occurred in 5 patients (12%) at a median of 28 ± 18 months and remained stable thereafter; severe aortic regurgitation developed in 1 patient, eventually requiring reoperation. Five patients (5%) had moderate aortic regurgitation at 1 year, which did not progress subsequently. Two patients (2%) had more than moderate aortic regurgitation at 1 year, and both ultimately required reoperation. Although mild aortic regurgitation occurs frequently after valve-sparing aortic root replacement, it is unlikely to progress over the next 5 years and should not be interpreted as failure of the valve-preservation concept. Further, we suggest that mild aortic regurgitation should not be considered nonstructural valve dysfunction, as the 2008 valve reporting guidelines would indicate. We need 10- to 15-year follow-up to learn the long-term clinical consequences of mild aortic regurgitation early after valve-sparing aortic root replacement. Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

Initial clinical experience with a sac-anchoring endoprosthesis for aortic aneurysm repair.

Science.gov (United States)

Donayre, Carlos E; Zarins, Christopher K; Krievins, Dainis K; Holden, Andrew; Hill, Andrew; Calderas, Carlos; Velez, Jaime; White, Rodney A

2011-03-01

All current aortic endografts depend on proximal and distal fixation to prevent migration. However, migration and rupture can occur, particularly in patients with aortic necks that are short or angulated, or both. We present our initial clinical experience with a new sac-anchoring endoprosthesis designed to anchor and seal the device within the aneurysm sac. The initial worldwide experience using a new endoprosthesis for the treatment of aortic aneurysms (Nellix Endovascular, Palo Alto, Calif) was reviewed. The endoprosthesis consists of dual balloon-expandable endoframes surrounded by polymer-filled endobags designed to obliterate the aneurysm sac and maintain endograft position. Clinical results and follow-up contrast computed tomography (CT) scans at 30 days and 6 and 12 months were reviewed. The endograft was successfully deployed in 21 patients with infrarenal aortic aneurysms measuring 5.7 ± 0.7 cm (range, 4.3-7.4 cm). Two patients with common iliac aneurysms were treated with sac-anchoring extenders that maintained patency of the internal iliac artery. Infusion of 71 ± 37 mL of polymer (range, 19-158 mL) into the aortic endobags resulted in complete aneurysm exclusion in all patients. Mean implant time was 76 ± 35 minutes, with 33 ± 17 minutes of fluoroscopy time and 180 ± 81 mL of contrast; estimated blood loss was 174 ± 116 mL. One patient died during the postoperative period (30-day mortality, 4.8%), and one died at 10 months from non-device-related causes. During a mean follow-up of 8.7 ± 3.1 months and a median of 6.3 months, there were no late aneurysm- or device-related adverse events and no secondary procedures. CT imaging studies at 6 months and 1 year revealed no increase in aneurysm size, no device migration, and no new endoleaks. One patient had a limited proximal type I endoleak at 30 days that resolved at 60 days and remained sealed. One patient has an ongoing distal type I endoleak near the iliac bifurcation, with no change in aneurysm

Analysis of the flow at a T-bifurcation for a ternary unit

International Nuclear Information System (INIS)

Campero, P; Beck, J; Jung, A

2014-01-01

The motivation of this research is to understand the flow behavior through a 90° T- type bifurcation, which connects a Francis turbine and the storage pump of a ternary unit, under different operating conditions (namely turbine, pump and hydraulic short-circuit operation). As a first step a CFD optimization process to define the hydraulic geometry of the bifurcation was performed. The CFD results show the complexity of the flow through the bifurcation, especially under hydraulic short-circuit operation. Therefore, it was decided to perform experimental investigations in addition to the CFD analysis, in order to get a better understanding of the flow. The aim of these studies was to investigate the flow development upstream and downstream the bifurcation, the estimation of the bifurcation loss coefficients and also to provide comprehensive data of the flow behavior for the whole operating range of the machine. In order to evaluate the development of the velocity field Stereo Particle Image Velocimetry (S-PIV) measurements at different sections upstream and downstream of the bifurcation on the main penstock and Laser Doppler Anemometrie (LDA) measurements at bifurcation inlet were performed. This paper presents the CFD results obtained for the final design for different operating conditions, the model test procedures and the model test results with special attention to: 1) The bifurcation head loss coefficients, and their extrapolation to prototype conditions, 2) S-PIV and LDA measurements. Additionally, criteria to define the minimal uniformity conditions for the velocity profiles entering the turbine are evaluated. Finally, based on the gathered flow information a better understanding to define the preferred location of a bifurcation is gained and can be applied to future projects

Bovine aortic arch: A novel association with thoracic aortic dilation

International Nuclear Information System (INIS)

Malone, C.D.; Urbania, T.H.; Crook, S.E.S.; Hope, M.D.

2012-01-01

Aim: To investigate whether there is a link between bovine arch and thoracic aortic aneurysm. Materials and methods: Computed tomography (CT) and magnetic resonance imaging (MRI) images of the thorax of 191 patients with dilated thoracic aortas and 391 consecutive, unselected patients as controls were retrospectively reviewed. Bovine arch was considered present if either a shared origin of the left common carotid and innominate arteries or an origin of the left common carotid from the innominate artery was identified. A chi-square test was used to evaluate the significance of differences between subgroups. Results: A trend towards increased prevalence of bovine arch was seen in patients with dilated aortas (26.2%) compared to controls (20.5%, p = 0.12). The association was statistically significant in patients over 70 years old (31.9%, p = 0.019) and when dilation involved the aortic arch (47.6%, p = 0.003). Conclusions: An association between bovine arch and aortic dilation is seen in older patients, and when dilation involves the aortic arch. Bovine arch should be considered a potential risk factor for thoracic aortic aneurysm.

Energized Oxygen : Speiser Current Sheet Bifurcation

Science.gov (United States)

George, D. E.; Jahn, J. M.

2017-12-01

A single population of energized Oxygen (O+) is shown to produce a cross-tail bifurcated current sheet in 2.5D PIC simulations of the magnetotail without the influence of magnetic reconnection. Treatment of oxygen in simulations of space plasmas, specifically a magnetotail current sheet, has been limited to thermal energies despite observations of and mechanisms which explain energized ions. We performed simulations of a homogeneous oxygen background, that has been energized in a physically appropriate manner, to study the behavior of current sheets and magnetic reconnection, specifically their bifurcation. This work uses a 2.5D explicit Particle-In-a-Cell (PIC) code to investigate the dynamics of energized heavy ions as they stream Dawn-to-Dusk in the magnetotail current sheet. We present a simulation study dealing with the response of a current sheet system to energized oxygen ions. We establish a, well known and studied, 2-species GEM Challenge Harris current sheet as a starting point. This system is known to eventually evolve and produce magnetic reconnection upon thinning of the current sheet. We added a uniform distribution of thermal O+ to the background. This 3-species system is also known to eventually evolve and produce magnetic reconnection. We add one additional variable to the system by providing an initial duskward velocity to energize the O+. We also traced individual particle motion within the PIC simulation. Three main results are shown. First, energized dawn- dusk streaming ions are clearly seen to exhibit sustained Speiser motion. Second, a single population of heavy ions clearly produces a stable bifurcated current sheet. Third, magnetic reconnection is not required to produce the bifurcated current sheet. Finally a bifurcated current sheet is compatible with the Harris current sheet model. This work is the first step in a series of investigations aimed at studying the effects of energized heavy ions on magnetic reconnection. This work differs

FFT Bifurcation Analysis of Routes to Chaos via Quasiperiodic Solutions

Directory of Open Access Journals (Sweden)

L. Borkowski

2015-01-01

Full Text Available The dynamics of a ring of seven unidirectionally coupled nonlinear Duffing oscillators is studied. We show that the FFT analysis presented in form of a bifurcation graph, that is, frequency distribution versus a control parameter, can provide a valuable and helpful complement to the corresponding typical bifurcation diagram and the course of Lyapunov exponents, especially in context of detailed identification of the observed attractors. As an example, bifurcation analysis of routes to chaos via 2-frequency and 3-frequency quasiperiodicity is demonstrated.

EXPERIMENTAL STUDY ON SEDIMENT DISTRIBUTION AT CHANNEL BIFURCATION

Institute of Scientific and Technical Information of China (English)

G.M. Tarekul ISLAM; M.R. KABIR; Ainun NISHAT

2002-01-01

This paper presents the experimental results on the distribution of sediments at channel bifurcation.The experiments have been conducted in a physical model of channel bifurcation. It consists of a straight main channel which bifurcates into two branch channels of different widths. The test rig is a mobile bed with fixed bank. Four different noses have been used to study the phenomenon. For each nose, three upstream discharges viz. 20 l/s, 30 l/s and 40 l/s have been employed. From the measured data, discharges and sediment transport ratios per unit width are calculated in the downstream branches.These data have been set to the general nodal point relation and a set of equations has been developed to describe the distribution of sediments to the downstream branches for different nose angles.

Long-Term Results After Simple Versus Complex Stenting of Coronary Artery Bifurcation Lesions Nordic Bifurcation Study 5-Year Follow-Up Results

DEFF Research Database (Denmark)

Maeng, M.; Holm, N. R.; Erglis, A.

2013-01-01

Objectives This study sought to report the 5-year follow-up results of the Nordic Bifurcation Study. Background Randomized clinical trials with short-term follow-up have indicated that coronary bifurcation lesions may be optimally treated using the optional side branch stenting strategy. Methods...... complex strategy of planned stenting of both the main vessel and the side branch. (C) 2013 by the American College of Cardiology Foundation...

Hopf bifurcations of a ratio-dependent predator–prey model involving two discrete maturation time delays

International Nuclear Information System (INIS)

Karaoglu, Esra; Merdan, Huseyin

2014-01-01

Highlights: • A ratio-dependent predator–prey system involving two discrete maturation time delays is studied. • Hopf bifurcations are analyzed by choosing delay parameters as bifurcation parameters. • When a delay parameter passes through a critical value, Hopf bifurcations occur. • The direction of bifurcation, the period and the stability of periodic solution are also obtained. - Abstract: In this paper we give a detailed Hopf bifurcation analysis of a ratio-dependent predator–prey system involving two different discrete delays. By analyzing the characteristic equation associated with the model, its linear stability is investigated. Choosing delay terms as bifurcation parameters the existence of Hopf bifurcations is demonstrated. Stability of the bifurcating periodic solutions is determined by using the center manifold theorem and the normal form theory introduced by Hassard et al. Furthermore, some of the bifurcation properties including direction, stability and period are given. Finally, theoretical results are supported by some numerical simulations

Magneto-elastic dynamics and bifurcation of rotating annular plate*

International Nuclear Information System (INIS)

Hu Yu-Da; Piao Jiang-Min; Li Wen-Qiang

2017-01-01

In this paper, magneto-elastic dynamic behavior, bifurcation, and chaos of a rotating annular thin plate with various boundary conditions are investigated. Based on the thin plate theory and the Maxwell equations, the magneto-elastic dynamic equations of rotating annular plate are derived by means of Hamilton’s principle. Bessel function as a mode shape function and the Galerkin method are used to achieve the transverse vibration differential equation of the rotating annular plate with different boundary conditions. By numerical analysis, the bifurcation diagrams with magnetic induction, amplitude and frequency of transverse excitation force as the control parameters are respectively plotted under different boundary conditions such as clamped supported sides, simply supported sides, and clamped-one-side combined with simply-anotherside. Poincaré maps, time history charts, power spectrum charts, and phase diagrams are obtained under certain conditions, and the influence of the bifurcation parameters on the bifurcation and chaos of the system is discussed. The results show that the motion of the system is a complicated and repeated process from multi-periodic motion to quasi-period motion to chaotic motion, which is accompanied by intermittent chaos, when the bifurcation parameters change. If the amplitude of transverse excitation force is bigger or magnetic induction intensity is smaller or boundary constraints level is lower, the system can be more prone to chaos. (paper)

Bifurcation Analysis of the QI 3-D Four-Wing Chaotic System

International Nuclear Information System (INIS)

Sun, Y.; Qi, G.; Wang, Z.; Wyk, B.J. van

2010-01-01

This paper analyzes the pitchfork and Hopf bifurcations of a new 3-D four-wing quadratic autonomous system proposed by Qi et al. The center manifold technique is used to reduce the dimensions of this system. The pitchfork and Hopf bifurcations of the system are theoretically analyzed. The influence of system parameters on other bifurcations are also investigated. The theoretical analysis and simulations demonstrate the rich dynamics of the system. (authors)

Bifurcation Control of an Electrostatically-Actuated MEMS Actuator with Time-Delay Feedback

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Lei Li

2016-10-01

Full Text Available The parametric excitation system consisting of a flexible beam and shuttle mass widely exists in microelectromechanical systems (MEMS, which can exhibit rich nonlinear dynamic behaviors. This article aims to theoretically investigate the nonlinear jumping phenomena and bifurcation conditions of a class of electrostatically-driven MEMS actuators with a time-delay feedback controller. Considering the comb structure consisting of a flexible beam and shuttle mass, the partial differential governing equation is obtained with both the linear and cubic nonlinear parametric excitation. Then, the method of multiple scales is introduced to obtain a slow flow that is analyzed for stability and bifurcation. Results show that time-delay feedback can improve resonance frequency and stability of the system. What is more, through a detailed mathematical analysis, the discriminant of Hopf bifurcation is theoretically derived, and appropriate time-delay feedback force can make the branch from the Hopf bifurcation point stable under any driving voltage value. Meanwhile, through global bifurcation analysis and saddle node bifurcation analysis, theoretical expressions about the system parameter space and maximum amplitude of monostable vibration are deduced. It is found that the disappearance of the global bifurcation point means the emergence of monostable vibration. Finally, detailed numerical results confirm the analytical prediction.

Reverse extra-anatomic aortic arch debranching procedure allowing thoracic endovascular aortic repair of a chronic ascending aortic aneurysm

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Ludovic Canaud, MD, PhD

2018-06-01

Full Text Available A 79-year-old woman was admitted with a large chronic dissecting ascending aortic aneurysm starting 5 mm distal to the ostia of the left coronary artery and ending immediately proximal to the innominate artery. A reverse extra-anatomic aortic arch debranching procedure was performed. During the same operative time, through a transapical approach, a thoracic stent graft was deployed with the proximal landing zone just distal to the coronary ostia and the distal landing zone excluding the origin of the left common carotid artery. The postoperative course was uneventful. Computed tomography at 12 months documented patent extra-anatomic aortic arch debranching and no evidence of endoleak. Keywords: Ascending aorta, Thoracic aorta, Aortic dissection, Stent graft

Retrograde ascending aortic dissection during or after thoracic aortic stent graft placement: insight from the European registry on endovascular aortic repair complications

DEFF Research Database (Denmark)

Eggebrecht, Holger; Thompson, Matt; Rousseau, Hervé

2009-01-01

BACKGROUND: Single-center reports have identified retrograde ascending aortic dissection (rAAD) as a potentially lethal complication of thoracic endovascular aortic repair (TEVAR). METHODS AND RESULTS: Between 1995 and 2008, 28 centers participating in the European Registry on Endovascular Aortic...

Local stability and Hopf bifurcation in small-world delayed networks

International Nuclear Information System (INIS)

Li Chunguang; Chen Guanrong

2004-01-01

The notion of small-world networks, recently introduced by Watts and Strogatz, has attracted increasing interest in studying the interesting properties of complex networks. Notice that, a signal or influence travelling on a small-world network often is associated with time-delay features, which are very common in biological and physical networks. Also, the interactions within nodes in a small-world network are often nonlinear. In this paper, we consider a small-world networks model with nonlinear interactions and time delays, which was recently considered by Yang. By choosing the nonlinear interaction strength as a bifurcation parameter, we prove that Hopf bifurcation occurs. We determine the stability of the bifurcating periodic solutions and the direction of the Hopf bifurcation by applying the normal form theory and the center manifold theorem. Finally, we show a numerical example to verify the theoretical analysis

Local stability and Hopf bifurcation in small-world delayed networks

Energy Technology Data Exchange (ETDEWEB)

Li Chunguang E-mail: cgli@uestc.edu.cn; Chen Guanrong E-mail: gchen@ee.cityu.edu.hk

2004-04-01

The notion of small-world networks, recently introduced by Watts and Strogatz, has attracted increasing interest in studying the interesting properties of complex networks. Notice that, a signal or influence travelling on a small-world network often is associated with time-delay features, which are very common in biological and physical networks. Also, the interactions within nodes in a small-world network are often nonlinear. In this paper, we consider a small-world networks model with nonlinear interactions and time delays, which was recently considered by Yang. By choosing the nonlinear interaction strength as a bifurcation parameter, we prove that Hopf bifurcation occurs. We determine the stability of the bifurcating periodic solutions and the direction of the Hopf bifurcation by applying the normal form theory and the center manifold theorem. Finally, we show a numerical example to verify the theoretical analysis.

Iterative Controller Tuning for Process with Fold Bifurcations

DEFF Research Database (Denmark)

Huusom, Jakob Kjøbsted; Poulsen, Niels Kjølstad; Jørgensen, Sten Bay

2007-01-01

Processes involving fold bifurcation are notoriously difficult to control in the vicinity of the fold where most often optimal productivity is achieved . In cases with limited process insight a model based control synthesis is not possible. This paper uses a data driven approach with an improved...... version of iterative feedback tuning to optimizing a closed loop performance criterion, as a systematic tool for tuning process with fold bifurcations....

Nonresonant Double Hopf Bifurcation in Toxic Phytoplankton-Zooplankton Model with Delay

Science.gov (United States)

Yuan, Rui; Jiang, Weihua; Wang, Yong

This paper investigates a toxic phytoplankton-zooplankton model with Michaelis-Menten type phytoplankton harvesting. The model has rich dynamical behaviors. It undergoes transcritical, saddle-node, fold, Hopf, fold-Hopf and double Hopf bifurcation, when the parameters change and go through some of the critical values, the dynamical properties of the system will change also, such as the stability, equilibrium points and the periodic orbit. We first study the stability of the equilibria, and analyze the critical conditions for the above bifurcations at each equilibrium. In addition, the stability and direction of local Hopf bifurcations, and the completion bifurcation set by calculating the universal unfoldings near the double Hopf bifurcation point are given by the normal form theory and center manifold theorem. We obtained that the stable coexistent equilibrium point and stable periodic orbit alternate regularly when the digestion time delay is within some finite value. That is, we derived the pattern for the occurrence, and disappearance of a stable periodic orbit. Furthermore, we calculated the approximation expression of the critical bifurcation curve using the digestion time delay and the harvesting rate as parameters, and determined a large range in terms of the harvesting rate for the phytoplankton and zooplankton to coexist in a long term.

Geometric Deformations of the Thoracic Aorta and Supra-Aortic Arch Branch Vessels Following Thoracic Endovascular Aortic Repair.

Science.gov (United States)

Ullery, Brant W; Suh, Ga-Young; Hirotsu, Kelsey; Zhu, David; Lee, Jason T; Dake, Michael D; Fleischmann, Dominik; Cheng, Christopher P

2018-04-01

To utilize 3-D modeling techniques to better characterize geometric deformations of the supra-aortic arch branch vessels and descending thoracic aorta after thoracic endovascular aortic repair. Eighteen patients underwent endovascular repair of either type B aortic dissection (n = 10) or thoracic aortic aneurysm (n = 8). Computed tomography angiography was obtained pre- and postprocedure, and 3-D geometric models of the aorta and supra-aortic branch vessels were constructed. Branch angle of the supra-aortic branch vessels and curvature metrics of the ascending aorta, aortic arch, and stented thoracic aortic lumen were calculated both at pre- and postintervention. The left common carotid artery branch angle was lower than the left subclavian artery angles preintervention ( P Supra-aortic branch vessel angulation remains relatively static when proximal landing zones are distal to the left common carotid artery.

Aortic obstruction: anatomy and echocardiography

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Keirns Candace

2006-09-01

Full Text Available Abstract Echocardiography is a valuable non-invasive technique for identifying the site and type of aortic obstruction. Knowledge of the morphological details of each type of obstruction is the basis for correct interpretation of the diagnostic images and clinical decisions. This study was undertaken to correlate the echocardiographic images with anatomic specimens of equivalent valvular and supravalvular aortic obstruction. Specimens were part of the collection of the Department of Embryology. Fifty six patients were studied, and forty specimens with aortic obstruction were analyzed. Echocardiographic characteristics: Thirty one (55.3% patients were women and twenty five (44.7% men. Valvular aortic obstruction was found in Thirty six patients (64.3 % and supravalvular aortic obstruction in twenty (35.7%. Anatomic characteristics: Of the forty specimens examined, twenty one (52.5% had valvular aortic obstruction and nineteen (47.5% supravalvular aortic obstruction. The anatomoechocardiographic correlation clearly showed that the anatomic findings of the specimen hearts and aortas corresponded to echocardiographic images of valvular and supravalvular aortic obstruction and provided solid corroboration of echocardiographic diagnoses.

Numerical bifurcation analysis of a class of nonlinear renewal equations

NARCIS (Netherlands)

Breda, Dimitri; Diekmann, Odo; Liessi, Davide; Scarabel, Francesca

2016-01-01

We show, by way of an example, that numerical bifurcation tools for ODE yield reliable bifurcation diagrams when applied to the pseudospectral approximation of a one-parameter family of nonlinear renewal equations. The example resembles logistic-and Ricker-type population equations and exhibits

Unusual Case of Overt Aortic Dissection Mimicking Aortic Intramural Hematoma

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Kushtrim Disha

2016-04-01

Full Text Available We report an interesting case in which overt aortic dissection mimicked two episodes of aortic intramural hematoma (IMH (Stanford A, DeBakey I. This took place over the course of four days and had a major influence on the surgical treatment strategy. The first episode of IMH regressed completely within 15 hours after it was clinically diagnosed and verified using imaging techniques. The recurrence of IMH was detected three days thereafter, resulting in an urgent surgical intervention. Overt aortic dissection with evidence of an intimal tear was diagnosed intraoperatively.

Supra-aortic interventions for endovascular exclusion of the entire aortic arch.

Science.gov (United States)

Andrási, Terézia B; Grossmann, Marius; Zenker, Dieter; Danner, Bernhard C; Schöndube, Friedrich A

2017-07-01

Our aim was to analyze the outcomes of endovascular exclusion of the entire aortic arch (proximal landing in zone 0, distal landing in zone III or beyond, after Ishimaru) in which complete surgical debranching of the supra-aortic vessels (I), endovascular supra-aortic revascularization (chimney, fenestrated, or branched grafts) with partial surgical debranching (II), or total endovascular supra-aortic revascularization (III) was additionally performed. Publications describing endovascular repair of the aortic arch (2000-2016) were systematically searched and reviewed. From a total of 53 relevant studies including 1853 patients, only 1021 patients undergoing 35 different total aortic arch procedures were found eligible for further evaluation and included in group I, II, or III (429, 190, and 402 patients, respectively). Overall early mortality was higher in group I vs groups II and III (P = .001; 1 - β = 95.6%) but exceeded in group III (18.6%) and group II (14.0%) vs group I (8.0%; P = .044; 1 - β = 57.4%) for diseases involving zone 0. Mortality was higher in all subgroups treated for zone 0 disease compared with corresponding subgroups treated for zone I to zone III disease. The incidence of cerebral ischemic events was increased in groups I and II vs group III (7.5% and 11% vs 1.7%; P = .0001) and correlated with early mortality (R 2  = .20; P = .033). The incidence of type II endoleaks and endovascular reintervention was similar between groups and correlated with each other (R 2  = .37; P = .004). Type Ia endoleak occurred more often in groups II and III than in group I (7.1% and 12.1% vs 5.8%; P = .023) and correlated with midterm mortality (R 2  = .53; P = .005). Retrograde type A dissection was low in all groups, whereas aneurysm growth was higher in group III (2.6%, 4.2%, 10.7%; P = .002), correlating with midterm mortality (R 2  = .311; P = .009). Surgical revision slightly correlated with surgical complications (R 2  = .18; P = .044

Hopf-pitchfork bifurcation and periodic phenomena in nonlinear financial system with delay

International Nuclear Information System (INIS)

Ding Yuting; Jiang Weihua; Wang Hongbin

2012-01-01

Highlights: ► We derive the unfolding of a financial system with Hopf-pitchfork bifurcation. ► We show the coexistence of a pair of stable small amplitudes periodic solutions. ► At the same time, also there is a pair of stable large amplitudes periodic solutions. ► Chaos can appear by period-doubling bifurcation far away from Hopf-pitchfork value. ► The study will be useful for interpreting economics phenomena in theory. - Abstract: In this paper, we identify the critical point for a Hopf-pitchfork bifurcation in a nonlinear financial system with delay, and derive the normal form up to third order with their unfolding in original system parameters near the bifurcation point by normal form method and center manifold theory. Furthermore, we analyze its local dynamical behaviors, and show the coexistence of a pair of stable periodic solutions. We also show that there coexist a pair of stable small-amplitude periodic solutions and a pair of stable large-amplitude periodic solutions for different initial values. Finally, we give the bifurcation diagram with numerical illustration, showing that the pair of stable small-amplitude periodic solutions can also exist in a large region of unfolding parameters, and the financial system with delay can exhibit chaos via period-doubling bifurcations as the unfolding parameter values are far away from the critical point of the Hopf-pitchfork bifurcation.

Aorto-right atrial fistula after ascending aortic replacement or aortic value replacement

International Nuclear Information System (INIS)

Zhi Aihua; Dai Ruping; Jiang Shiliang; Lu Bin

2012-01-01

Objective: To evaluate the CT features of aorto-right atrial fistula after aortic valve replacement (AVR) or ascending aortic replacement. Methods: Eighty-seven patients with aortic-right atrial fistula underwent CT after operation. The CT features were retrospectively analyzed. Fistula was measured according to maximum width of the shunt. Results: Aorto-right atrial fistula was detected in 87 patients after aortic valve replacement or ascending aortic replacement by CT scan. Among them, 25 patients were diagnosed as mild aorto-right atrial fistula, 47 patients as moderate, and 15 patients as severe. Thirty-seven patients underwent follow-up CT.Among them, 10 patients with mild to moderate aorto-right atrial fistula were considered to have complete regression, 8 patients with mild aorto-right atrial fistula considered to have incomplete regression, 14 patients with mild to moderate aorto-right atrial fistula considered to have stable condition, and 5 patients with moderate aorto-right atrial fistula considered to have progression at the 3-month follow-up. Conclusion: CT is a useful tool for defining aorto-right atrial fistula after AVR or ascending aortic replacement and for evaluating it in follow-up. (authors)

Traumatic Aortic Injury

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Brianna Miner

2016-09-01

Full Text Available History of present illness: A 48-year-old male with unknown past medical history presents as a trauma after being hit by a car traveling approximately 25 miles per hour. On initial presentation, the patient is confused, combative, and not answering questions appropriately. The patient is hypotensive with a blood pressure of 68/40 and a heart rate of 50 beats per minute, with oxygen saturation at 96% on room air. FAST scan is positive for fluid in Morrison’s pouch, splenorenal space, and pericardial space. Significant findings: The initial chest x-ray showed an abnormal superior mediastinal contour (blue line, suggestive of a possible aortic injury. The CT angiogram showed extensive circumferential irregularity and outpouching of the distal aortic arch (red arrows compatible with aortic transection. In addition, there was a circumferential intramural hematoma, which extended through the descending aorta to the proximal infrarenal abdominal aorta (green arrow. There was also an extensive surrounding mediastinal hematoma extending around the descending aorta and supraaortic branches (purple arrows. Discussion: Traumatic aortic injury is a life-threatening event. The incidence of blunt thoracic aortic injury is low, between 1 to 2 percent of those patients with blunt thoracic trauma.1 However, approximately 80% of patients with traumatic aortic injury die at the scene.2 Therefore it is imperative to diagnose traumatic aortic injury in a timely fashion. The diagnosis can be difficult due to the non-specific signs and symptoms and other distracting injuries. Clinical suspicion should be based on the mechanism of the injury and the hemodynamic status of the patient. In any patient with blunt or penetrating trauma to the chest that is hemodynamically unstable, traumatic aortic injury should be on the differential. Chest x-ray can be used as a screening tool. A normal chest x-ray has a negative predictive value of approximately 97%. CTA chest is the

The role of aortic wall CT attenuation measurements for the diagnosis of acute aortic syndromes

Energy Technology Data Exchange (ETDEWEB)

Knollmann, Friedrich D., E-mail: friedrich.knollmann@ucdmc.ucdavis.edu [Department of Radiology, University of California, Davis, 4860 Y Street, Sacramento, CA 95817 (United States); Departments of Radiology and Cardiothoracic Surgery, University of Pittsburgh, 200 Lothrop Street, Pittsburgh, PA 15213 (United States); Lacomis, Joan M.; Ocak, Iclal; Gleason, Thomas [Department of Radiology, University of California, Davis, 4860 Y Street, Sacramento, CA 95817 (United States); Departments of Radiology and Cardiothoracic Surgery, University of Pittsburgh, 200 Lothrop Street, Pittsburgh, PA 15213 (United States)

2013-12-01

Objectives: To determine if measurements of aortic wall attenuation can improve the CT diagnosis of acute aortic syndromes. Methods: CT reports from a ten year period were searched for acute aortic syndromes (AAS). Studies with both an unenhanced and a contrast enhanced (CTA) series that had resulted in the diagnosis of intramural hematoma (IMH) were reviewed. Diagnoses were confirmed by medical records. The attenuation of aortic wall abnormalities was measured. The observed attenuation threshold was validated using studies from 39 new subjects with a variety of aortic conditions. Results: The term “aortic dissection” was identified in 1206, and IMH in 124 patients’ reports. IMH was confirmed in 31 patients, 21 of whom had both unenhanced and contrast enhanced images. All 21 had pathologic CTA findings, and no CTA with IMH was normal. Attenuation of the aortic wall was greater than 45 HUs on the CTA images in all patients with IMH. When this threshold was applied to the new group, sensitivity for diagnosing AAS was 100% (19/19), and specificity 94% (16/17). Addition of unenhanced images did not improve accuracy. Conclusions: Measurements of aortic wall attenuation in CTA have a high negative predictive value for the diagnosis of acute aortic syndromes.

The role of aortic wall CT attenuation measurements for the diagnosis of acute aortic syndromes

International Nuclear Information System (INIS)

Knollmann, Friedrich D.; Lacomis, Joan M.; Ocak, Iclal; Gleason, Thomas

2013-01-01

Objectives: To determine if measurements of aortic wall attenuation can improve the CT diagnosis of acute aortic syndromes. Methods: CT reports from a ten year period were searched for acute aortic syndromes (AAS). Studies with both an unenhanced and a contrast enhanced (CTA) series that had resulted in the diagnosis of intramural hematoma (IMH) were reviewed. Diagnoses were confirmed by medical records. The attenuation of aortic wall abnormalities was measured. The observed attenuation threshold was validated using studies from 39 new subjects with a variety of aortic conditions. Results: The term “aortic dissection” was identified in 1206, and IMH in 124 patients’ reports. IMH was confirmed in 31 patients, 21 of whom had both unenhanced and contrast enhanced images. All 21 had pathologic CTA findings, and no CTA with IMH was normal. Attenuation of the aortic wall was greater than 45 HUs on the CTA images in all patients with IMH. When this threshold was applied to the new group, sensitivity for diagnosing AAS was 100% (19/19), and specificity 94% (16/17). Addition of unenhanced images did not improve accuracy. Conclusions: Measurements of aortic wall attenuation in CTA have a high negative predictive value for the diagnosis of acute aortic syndromes

Bubble transport in bifurcations

Science.gov (United States)

Bull, Joseph; Qamar, Adnan

2017-11-01

Motivated by a developmental gas embolotherapy technique for cancer treatment, we examine the transport of bubbles entrained in liquid. In gas embolotherapy, infarction of tumors is induced by selectively formed vascular gas bubbles that originate from acoustic vaporization of vascular droplets. In the case of non-functionalized droplets with the objective of vessel occlusion, the bubbles are transported by flow through vessel bifurcations, where they may split prior to eventually reach vessels small enough that they become lodged. This splitting behavior affects the distribution of bubbles and the efficacy of flow occlusion and the treatment. In these studies, we investigated bubble transport in bifurcations using computational and theoretical modeling. The model reproduces the variety of experimentally observed splitting behaviors. Splitting homogeneity and maximum shear stress along the vessel walls is predicted over a variety of physical parameters. Maximum shear stresses were found to decrease with increasing Reynolds number. The initial bubble length was found to affect the splitting behavior in the presence of gravitational asymmetry. This work was supported by NIH Grant R01EB006476.

3D echocardiographic analysis of aortic annulus for transcatheter aortic valve replacement using novel aortic valve quantification software: Comparison with computed tomography.

Science.gov (United States)

Mediratta, Anuj; Addetia, Karima; Medvedofsky, Diego; Schneider, Robert J; Kruse, Eric; Shah, Atman P; Nathan, Sandeep; Paul, Jonathan D; Blair, John E; Ota, Takeyoshi; Balkhy, Husam H; Patel, Amit R; Mor-Avi, Victor; Lang, Roberto M

2017-05-01

With the increasing use of transcatheter aortic valve replacement (TAVR) in patients with aortic stenosis (AS), computed tomography (CT) remains the standard for annulus sizing. However, 3D transesophageal echocardiography (TEE) has been an alternative in patients with contraindications to CT. We sought to (1) test the feasibility, accuracy, and reproducibility of prototype 3DTEE analysis software (Philips) for aortic annular measurements and (2) compare the new approach to the existing echocardiographic techniques. We prospectively studied 52 patients who underwent gated contrast CT, procedural 3DTEE, and TAVR. 3DTEE images were analyzed using novel semi-automated software designed for 3D measurements of the aortic root, which uses multiplanar reconstruction, similar to CT analysis. Aortic annulus measurements included area, perimeter, and diameter calculations from these measurements. The results were compared to CT-derived values. Additionally, 3D echocardiographic measurements (3D planimetry and mitral valve analysis software adapted for the aortic valve) were also compared to the CT reference values. 3DTEE image quality was sufficient in 90% of patients for aortic annulus measurements using the new software, which were in good agreement with CT (r-values: .89-.91) and small (software can accurately measure aortic annulus in patients with severe AS undergoing TAVR, in better agreement with CT than the existing methodology. Accordingly, intra-procedural TEE could potentially replace CT in patients where CT carries significant risk. © 2017, Wiley Periodicals, Inc.

Dynamics of the aortic annulus in 4D CT angiography for transcatheter aortic valve implantation patients

NARCIS (Netherlands)

Elattar, Mustafa A.; Vink, Leon W.; van Mourik, Martijn S.; Baan, Jan; Vanbavel, Ed T.; Planken, R. Nils; Marquering, Henk A.

2017-01-01

Transcatheter aortic valve implantation (TAVI) is a well-established treatment for patients with severe aortic valve stenosis. This procedure requires pre-operative planning by assessment of aortic dimensions on CT Angiography (CTA). It is well-known that the aortic root dimensions vary over the

Pathogenetic Basis of Aortopathy and Aortic Valve Disease

Science.gov (United States)

2018-02-19

Aortopathies; Thoracic Aortic Aneurysm; Aortic Valve Disease; Thoracic Aortic Disease; Thoracic Aortic Dissection; Thoracic Aortic Rupture; Ascending Aortic Disease; Descending Aortic Disease; Ascending Aortic Aneurysm; Descending Aortic Aneurysm; Marfan Syndrome; Loeys-Dietz Syndrome; Ehlers-Danlos Syndrome; Shprintzen-Goldberg Syndrome; Turner Syndrome; PHACE Syndrome; Autosomal Recessive Cutis Laxa; Congenital Contractural Arachnodactyly; Arterial Tortuosity Syndrome

Aortic valvuloplasty of calcific aortic stenosis with monofoil and trefoil balloon catheters: practical considerations

NARCIS (Netherlands)

S. Plante (Sylvain); M.J.B.M. van den Brand (Marcel); L.C.P. van Veen; C. di Mario (Carlo); C.E. Essed; K.J. Beatt (Kevin); P.W.J.C. Serruys (Patrick)

1990-01-01

textabstractIn order to evaluate the relation between balloon design (monofoil, trefoil) and valvular configuration, experimental aortic valvuloplasty was performed in four post-mortem hearts with calcific aortic stenosis of various morphology. The degree of obstruction of the aortic orifice was

Bunch lengthening with bifurcation in electron storage rings

Energy Technology Data Exchange (ETDEWEB)

Kim, Eun-San; Hirata, Kohji [National Lab. for High Energy Physics, Tsukuba, Ibaraki (Japan)

1996-08-01

The mapping which shows equilibrium particle distribution in synchrotron phase space for electron storage rings is discussed with respect to some localized constant wake function based on the Gaussian approximation. This mapping shows multi-periodic states as well as double bifurcation in dynamical states of the equilibrium bunch length. When moving around parameter space, the system shows a transition/bifurcation which is not always reversible. These results derived by mapping are confirmed by multiparticle tracking. (author)

Adaptive Control of Electromagnetic Suspension System by HOPF Bifurcation

Directory of Open Access Journals (Sweden)

Aming Hao

2013-01-01

Full Text Available EMS-type maglev system is essentially nonlinear and unstable. It is complicated to design a stable controller for maglev system which is under large-scale disturbance and parameter variance. Theory analysis expresses that this phenomenon corresponds to a HOPF bifurcation in mathematical model. An adaptive control law which adjusts the PID control parameters is given in this paper according to HOPF bifurcation theory. Through identification of the levitated mass, the controller adjusts the feedback coefficient to make the system far from the HOPF bifurcation point and maintain the stability of the maglev system. Simulation result indicates that adjusting proportion gain parameter using this method can extend the state stability range of maglev system and avoid the self-excited vibration efficiently.

Stability, bifurcation and a new chaos in the logistic differential equation with delay

International Nuclear Information System (INIS)

Jiang Minghui; Shen Yi; Jian Jigui; Liao Xiaoxin

2006-01-01

This Letter is concerned with bifurcation and chaos in the logistic delay differential equation with a parameter r. The linear stability of the logistic equation is investigated by analyzing the associated characteristic transcendental equation. Based on the normal form approach and the center manifold theory, the formula for determining the direction of Hopf bifurcation and the stability of bifurcation periodic solution in the first bifurcation values is obtained. By theoretical analysis and numerical simulation, we found a new chaos in the logistic delay differential equation

Thoracic Endovascular Aortic Repair (TEVAR) in Proximal (Type A) Aortic Dissection: Ready for a Broader Application?

OpenAIRE

Nienaber, Christoph A.; Sakalihasan, Natzi; Clough, Rachel E.; Aboukoura, Mohamed; Mancuso, Enrico; Yeh, James S.M.; Defraigne, Jean-Olivier; Cheshire, Nick; Rosendahl, Ulrich Peter; Quarto, Cesare; Pepper, John

2016-01-01

ObjectiveThoracic endovascular aortic repair (TEVAR) has demonstrated encouraging results and is gaining increasing acceptance as a treatment option for aortic aneurysms and dissections. Yet, its role in managing proximal aortic pathologies is unknown - this is important because in proximal (Stanford type A) aortic dissections, 10-30% are not accepted for surgery, and 30-50% are technically amenable for TEVAR. We describe our case series of type A aortic dissections treated using TEVAR.Method...

Small-bubble transport and splitting dynamics in a symmetric bifurcation

KAUST Repository

Qamar, Adnan

2017-06-28

Simulations of small bubbles traveling through symmetric bifurcations are conducted to garner information pertinent to gas embolotherapy, a potential cancer treatment. Gas embolotherapy procedures use intra-arterial bubbles to occlude tumor blood supply. As bubbles pass through bifurcations in the blood stream nonhomogeneous splitting and undesirable bioeffects may occur. To aid development of gas embolotherapy techniques, a volume of fluid method is used to model the splitting process of gas bubbles passing through artery and arteriole bifurcations. The model reproduces the variety of splitting behaviors observed experimentally, including the bubble reversal phenomenon. Splitting homogeneity and maximum shear stress along the vessel walls is predicted over a variety of physical parameters. Small bubbles, having initial length less than twice the vessel diameter, were found unlikely to split in the presence of gravitational asymmetry. Maximum shear stresses were found to decrease exponentially with increasing Reynolds number. Vortex-induced shearing near the bifurcation is identified as a possible mechanism for endothelial cell damage.

Multiple bifurcations and periodic 'bubbling' in a delay population model

International Nuclear Information System (INIS)

Peng Mingshu

2005-01-01

In this paper, the flip bifurcation and periodic doubling bifurcations of a discrete population model without delay influence is firstly studied and the phenomenon of Feigenbaum's cascade of periodic doublings is also observed. Secondly, we explored the Neimark-Sacker bifurcation in the delay population model (two-dimension discrete dynamical systems) and the unique stable closed invariant curve which bifurcates from the nontrivial fixed point. Finally, a computer-assisted study for the delay population model is also delved into. Our computer simulation shows that the introduction of delay effect in a nonlinear difference equation derived from the logistic map leads to much richer dynamic behavior, such as stable node → stable focus → an lower-dimensional closed invariant curve (quasi-periodic solution, limit cycle) or/and stable periodic solutions → chaotic attractor by cascading bubbles (the combination of potential period doubling and reverse period-doubling) and the sudden change between two different attractors, etc

Small-bubble transport and splitting dynamics in a symmetric bifurcation.

Science.gov (United States)

Qamar, Adnan; Warnez, Matthew; Valassis, Doug T; Guetzko, Megan E; Bull, Joseph L

2017-08-01

Simulations of small bubbles traveling through symmetric bifurcations are conducted to garner information pertinent to gas embolotherapy, a potential cancer treatment. Gas embolotherapy procedures use intra-arterial bubbles to occlude tumor blood supply. As bubbles pass through bifurcations in the blood stream nonhomogeneous splitting and undesirable bioeffects may occur. To aid development of gas embolotherapy techniques, a volume of fluid method is used to model the splitting process of gas bubbles passing through artery and arteriole bifurcations. The model reproduces the variety of splitting behaviors observed experimentally, including the bubble reversal phenomenon. Splitting homogeneity and maximum shear stress along the vessel walls is predicted over a variety of physical parameters. Small bubbles, having initial length less than twice the vessel diameter, were found unlikely to split in the presence of gravitational asymmetry. Maximum shear stresses were found to decrease exponentially with increasing Reynolds number. Vortex-induced shearing near the bifurcation is identified as a possible mechanism for endothelial cell damage.

Small-bubble transport and splitting dynamics in a symmetric bifurcation

KAUST Repository

Qamar, Adnan; Warnez, Matthew; Valassis, Doug T.; Guetzko, Megan E.; Bull, Joseph L.

2017-01-01

Simulations of small bubbles traveling through symmetric bifurcations are conducted to garner information pertinent to gas embolotherapy, a potential cancer treatment. Gas embolotherapy procedures use intra-arterial bubbles to occlude tumor blood supply. As bubbles pass through bifurcations in the blood stream nonhomogeneous splitting and undesirable bioeffects may occur. To aid development of gas embolotherapy techniques, a volume of fluid method is used to model the splitting process of gas bubbles passing through artery and arteriole bifurcations. The model reproduces the variety of splitting behaviors observed experimentally, including the bubble reversal phenomenon. Splitting homogeneity and maximum shear stress along the vessel walls is predicted over a variety of physical parameters. Small bubbles, having initial length less than twice the vessel diameter, were found unlikely to split in the presence of gravitational asymmetry. Maximum shear stresses were found to decrease exponentially with increasing Reynolds number. Vortex-induced shearing near the bifurcation is identified as a possible mechanism for endothelial cell damage.

Period-doubling bifurcation and chaos control in a discrete-time mosquito model

Directory of Open Access Journals (Sweden)

Qamar Din

2017-12-01

Full Text Available This article deals with the study of some qualitative properties of a discrete-time mosquito Model. It is shown that there exists period-doubling bifurcation for wide range of bifurcation parameter for the unique positive steady-state of given system. In order to control the bifurcation we introduced a feedback strategy. For further confirmation of complexity and chaotic behavior largest Lyapunov exponents are plotted.

Bifurcation and synchronization of synaptically coupled FHN models with time delay

International Nuclear Information System (INIS)

Wang Qingyun; Lu Qishao; Chen Guanrong; Feng Zhaosheng; Duan Lixia

2009-01-01

This paper presents an investigation of dynamics of the coupled nonidentical FHN models with synaptic connection, which can exhibit rich bifurcation behavior with variation of the coupling strength. With the time delay being introduced, the coupled neurons may display a transition from the original chaotic motions to periodic ones, which is accompanied by complex bifurcation scenario. At the same time, synchronization of the coupled neurons is studied in terms of their mean frequencies. We also find that the small time delay can induce new period windows with the coupling strength increasing. Moreover, it is found that synchronization of the coupled neurons can be achieved in some parameter ranges and related to their bifurcation transition. Bifurcation diagrams are obtained numerically or analytically from the mathematical model and the parameter regions of different behavior are clarified.

Stroke Volume estimation using aortic pressure measurements and aortic cross sectional area: Proof of concept.

Science.gov (United States)

Kamoi, S; Pretty, C G; Chiew, Y S; Pironet, A; Davidson, S; Desaive, T; Shaw, G M; Chase, J G

2015-08-01

Accurate Stroke Volume (SV) monitoring is essential for patient with cardiovascular dysfunction patients. However, direct SV measurements are not clinically feasible due to the highly invasive nature of measurement devices. Current devices for indirect monitoring of SV are shown to be inaccurate during sudden hemodynamic changes. This paper presents a novel SV estimation using readily available aortic pressure measurements and aortic cross sectional area, using data from a porcine experiment where medical interventions such as fluid replacement, dobutamine infusions, and recruitment maneuvers induced SV changes in a pig with circulatory shock. Measurement of left ventricular volume, proximal aortic pressure, and descending aortic pressure waveforms were made simultaneously during the experiment. From measured data, proximal aortic pressure was separated into reservoir and excess pressures. Beat-to-beat aortic characteristic impedance values were calculated using both aortic pressure measurements and an estimate of the aortic cross sectional area. SV was estimated using the calculated aortic characteristic impedance and excess component of the proximal aorta. The median difference between directly measured SV and estimated SV was -1.4ml with 95% limit of agreement +/- 6.6ml. This method demonstrates that SV can be accurately captured beat-to-beat during sudden changes in hemodynamic state. This novel SV estimation could enable improved cardiac and circulatory treatment in the critical care environment by titrating treatment to the effect on SV.

In vivo quantitation of platelet deposition on human peripheral arterial bypass grafts using indium-111-labeled platelets. Effect of dipyridamole and aspirin

International Nuclear Information System (INIS)

Pumphrey, C.W.; Chesebro, J.H.; Dewanjee, M.K.; Wahner, H.W.; Hollier, L.H.; Pairolero, P.C.; Fuster, V.

1983-01-01

Indium-111-labeled autologous platelets, injected 48 hours after operation, were used to evaluate the thrombogenicity of prosthetic material and the effect of platelet inhibitor therapy in vivo. Dacron double-velour (Microvel) aortofemoral artery bifurcation grafts were placed in 16 patients and unilateral polytetrafluoroethylene femoropopliteal grafts were placed in 10 patients. Half the patients in each group received platelet inhibitors before operation (dipyridamole, 100 mg 4 times a day) and after operation (dipyridamole, 75 mg, and acetylsalicylic acid, 325 mg 3 times a day); the rest of the patients served as control subjects. Five-minute scintigrams of the graft region were taken with a gamma camera interfaced with a computer 48, 72, and 96 hours after injection of the labeled platelets. Platelet deposition was estimated from the radioactivities of the grafts and expressed as counts per 100 pixels per microcurie injected. Dipyridamole and aspirin therapy significantly reduced the number of platelets deposited on Dacron grafts and prevented platelet accumulation over 3 days. With the small amount of platelet deposition on polytetrafluoroethylene femoropopliteal artery grafts even in control patients, platelet inhibitor therapy had no demonstrable effect on platelet deposition on these grafts. It is concluded that (1) platelet deposition on vascular grafts in vivo can be quantitated by noninvasive methods, and (2) dipyridamole and aspirin therapy reduced platelet deposition on Dacron aortofemoral artery grafts

Bifurcation structure of localized states in the Lugiato-Lefever equation with anomalous dispersion

Science.gov (United States)

Parra-Rivas, P.; Gomila, D.; Gelens, L.; Knobloch, E.

2018-04-01

The origin, stability, and bifurcation structure of different types of bright localized structures described by the Lugiato-Lefever equation are studied. This mean field model describes the nonlinear dynamics of light circulating in fiber cavities and microresonators. In the case of anomalous group velocity dispersion and low values of the intracavity phase detuning these bright states are organized in a homoclinic snaking bifurcation structure. We describe how this bifurcation structure is destroyed when the detuning is increased across a critical value, and determine how a bifurcation structure known as foliated snaking emerges.

Multidirectional flow analysis by cardiovascular magnetic resonance in aneurysm development following repair of aortic coarctation

Directory of Open Access Journals (Sweden)

Stalder Aurelien F

2008-06-01

Full Text Available Abstract Aneurysm formation is a life-threatening complication after operative therapy in coarctation. The identification of patients at risk for the development of such secondary pathologies is of high interest and requires a detailed understanding of the link between vascular malformation and altered hemodynamics. The routine morphometric follow-up by magnetic resonance angiography is a well-established technique. However, the intrinsic sensitivity of magnetic resonance (MR towards motion offers the possibility to additionally investigate hemodynamic consequences of morphological changes of the aorta. We demonstrate two cases of aneurysm formation 13 and 35 years after coarctation surgery based on a Waldhausen repair with a subclavian patch and a Vosschulte repair with a Dacron patch, respectively. Comprehensive flow visualization by cardiovascular MR (CMR was performed using a flow-sensitive, 3-dimensional, and 3-directional time-resolved gradient echo sequence at 3T. Subsequent analysis included the calculation of a phase contrast MR angiography and color-coded streamline and particle trace 3D visualization. Additional quantitative evaluation provided regional physiological information on blood flow and derived vessel wall parameters such as wall shear stress and oscillatory shear index. The results highlight the individual 3D blood-flow patterns associated with the different vascular pathologies following repair of aortic coarctation. In addition to known factors predisposing for aneurysm formation after surgical repair of coarctation these findings indicate the importance of flow sensitive CMR to follow up hemodynamic changes with respect to the development of vascular disease.

Stability and Hopf bifurcation for a delayed SLBRS computer virus model.

Science.gov (United States)

Zhang, Zizhen; Yang, Huizhong

2014-01-01

By incorporating the time delay due to the period that computers use antivirus software to clean the virus into the SLBRS model a delayed SLBRS computer virus model is proposed in this paper. The dynamical behaviors which include local stability and Hopf bifurcation are investigated by regarding the delay as bifurcating parameter. Specially, direction and stability of the Hopf bifurcation are derived by applying the normal form method and center manifold theory. Finally, an illustrative example is also presented to testify our analytical results.

Stability and Hopf Bifurcation for a Delayed SLBRS Computer Virus Model

Directory of Open Access Journals (Sweden)

Zizhen Zhang

2014-01-01

Full Text Available By incorporating the time delay due to the period that computers use antivirus software to clean the virus into the SLBRS model a delayed SLBRS computer virus model is proposed in this paper. The dynamical behaviors which include local stability and Hopf bifurcation are investigated by regarding the delay as bifurcating parameter. Specially, direction and stability of the Hopf bifurcation are derived by applying the normal form method and center manifold theory. Finally, an illustrative example is also presented to testify our analytical results.

Aortic root reconstruction by aortic valve-sparing operation (David type I reimplantation) in Marfan syndrome accompanied by annuloaortic ectasia and acute type-A aortic dissection.

Science.gov (United States)

Inamura, Shunichi; Furuya, Hidekazu; Yagi, Kentarou; Ikeya, Eriko; Yamaguchi, Masaomi; Fujimura, Takabumi; Kanabuchi, Kazuo

2006-09-20

To reconstruct the aortic root for aneurysm of the ascending aorta accompanied by aortic regurgitation, annuloaortic ectasia (AAE) and acute type-A dissection with root destruction, the Bentall operation using a prosthetic valve still is the standard procedure today. Valve-sparing procedures have actively been used for aortic root lesions, and have also been attempted in aortic root reconstruction for Marfan syndrome which may have abnormalities in the valve leaflets. We conducted a valve-sparing procedure in a female patient with Marfan syndrome who had AAE accompanied by type-A acute aortic dissection. The patient was a 37-year-old woman complaining of severe pain from the chest to the back. The limbs were long, and funnel breast was observed. Diastolic murmurs were heard. On chest computed tomography, a dissection cavity was present from the ascending aorta to the left common iliac artery, and the root dilated to 55 mm. Grade II aortic regurgitation was observed on ultrasound cardiography. Regarding her family history, her father had died suddenly at 54 years of age. She was diagnosed with type-A acute dissection concurrent with Marfan syndrome and AAE. The structure of the aortic valve was normal, and root reconstruction by a valve-sparing operation and total replacement of the aortic arch was conducted. On postoperative ultrasound cardiography, the aortic regurgitation was within the allowable range, and the shortterm postoperative results were good.

Microarray analysis to identify the similarities and differences of pathogenesis between aortic occlusive disease and abdominal aortic aneurysm.

Science.gov (United States)

Wang, Guofu; Bi, Lechang; Wang, Gaofeng; Huang, Feilai; Lu, Mingjing; Zhu, Kai

2018-06-01

Objectives Expression profile of GSE57691 was analyzed to identify the similarities and differences between aortic occlusive disease and abdominal aortic aneurysm. Methods The expression profile of GSE57691 was downloaded from Gene Expression Omnibus database, including 20 small abdominal aortic aneurysm samples, 29 large abdominal aortic aneurysm samples, 9 aortic occlusive disease samples, and 10 control samples. Using the limma package in R, the differentially expressed genes were screened. Followed by enrichment analysis was performed for the differentially expressed genes using database for annotation, visualization, and integrated discovery online tool. Based on string online tool and Cytoscape software, protein-protein interaction network and module analyses were carried out. Moreover, integrated TF platform database and Cytoscape software were used for constructing transcriptional regulatory networks. Results As a result, 1757, 354, and 396 differentially expressed genes separately were identified in aortic occlusive disease, large abdominal aortic aneurysm, and small abdominal aortic aneurysm samples. UBB was significantly enriched in proteolysis related pathways with a high degree in three groups. SPARCL1 was another gene shared by these groups and regulated by NFIA, which had a high degree in transcriptional regulatory network. ACTB, a significant upregulated gene in abdominal aortic aneurysm samples, could be regulated by CLIC4, which was significantly enriched in cell motions. ACLY and NFIB were separately identified in aortic occlusive disease and small abdominal aortic aneurysm samples, and separately enriched in lipid metabolism and negative regulation of cell proliferation. Conclusions The downregulated UBB, NFIA, and SPARCL1 might play key roles in both aortic occlusive disease and abdominal aortic aneurysm, while the upregulated ACTB might only involve in abdominal aortic aneurysm. ACLY and NFIB were specifically involved in aortic occlusive

Abdominal aortic aneurysm development in men following a "normal" aortic ultrasound scan.

Science.gov (United States)

Hafez, H; Druce, P S; Ashton, H A

2008-11-01

To determine predictors related to abdominal aortic aneurysm (AAA) development following a "normal" aortic ultrasound scan. Over a 23-year period, 22 961 men participated in an AAA screening programme. Maximum aortic diameter of less than 30 mm was deemed "normal". 4308 of these "normal" individuals were later re-scanned at intervals for research purposes. AAA prevalence was 4.4% at initial scanning. In those with a normal scan, 46 patients subsequently presented with AAAs incidentally detected and 120 (2.8%) had AAAs identified as part of the ongoing surveillance. The median initial aortic size of these 166 men was 25 mm (range 15-29 mm). Over the follow-up period, there have been 24 (14%) AAA-related deaths, 24 patients underwent successful AAA surgery and 36 died of unrelated causes. In those with an initial aortic diameter of <25 mm who later developed an AAA, the odds ratio for AAA-related mortality was 2 (95% CI 1-4.1, p=0.03, x(2)). AAAs can develop following an initial "normal" scan and men with an aortic diameters of 25-29 mm appear to be at greater risk. Surveillance for this sub-group may further reduce the incidence of undiagnosed AAA and AAA-related mortality.

Transportation and concentration inequalities for bifurcating Markov chains

DEFF Research Database (Denmark)

Penda, S. Valère Bitseki; Escobar-Bach, Mikael; Guillin, Arnaud

2017-01-01

We investigate the transportation inequality for bifurcating Markov chains which are a class of processes indexed by a regular binary tree. Fitting well models like cell growth when each individual gives birth to exactly two offsprings, we use transportation inequalities to provide useful...... concentration inequalities.We also study deviation inequalities for the empirical means under relaxed assumptions on the Wasserstein contraction for the Markov kernels. Applications to bifurcating nonlinear autoregressive processes are considered for point-wise estimates of the non-linear autoregressive...

Optimization Design and Application of Underground Reinforced Concrete Bifurcation Pipe

Directory of Open Access Journals (Sweden)

Chao Su

2015-01-01

Full Text Available Underground reinforced concrete bifurcation pipe is an important part of conveyance structure. During construction, the workload of excavation and concrete pouring can be significantly decreased according to optimized pipe structure, and the engineering quality can be improved. This paper presents an optimization mathematical model of underground reinforced concrete bifurcation pipe structure according to real working status of several common pipe structures from real cases. Then, an optimization design system was developed based on Particle Swarm Optimization algorithm. Furthermore, take the bifurcation pipe of one hydropower station as an example: optimization analysis was conducted, and accuracy and stability of the optimization design system were verified successfully.

Stability and bifurcation of a discrete BAM neural network model with delays

International Nuclear Information System (INIS)

Zheng Baodong; Zhang Yang; Zhang Chunrui

2008-01-01

A map modelling a discrete bidirectional associative memory neural network with delays is investigated. Its dynamics is studied in terms of local analysis and Hopf bifurcation analysis. By analyzing the associated characteristic equation, its linear stability is investigated and Hopf bifurcations are demonstrated. It is found that there exist Hopf bifurcations when the delay passes a sequence of critical values. Numerical simulation is performed to verify the analytical results

Multimodality Imaging Approach towards Primary Aortic Sarcomas Arising after Endovascular Abdominal Aortic Aneurysm Repair: Case Series Report

Energy Technology Data Exchange (ETDEWEB)

Kamran, Mudassar, E-mail: kamranm@mir.wustl.edu; Fowler, Kathryn J., E-mail: fowlerk@mir.wustl.edu; Mellnick, Vincent M., E-mail: mellnickv@mir.wustl.edu [Washington University School of Medicine, Mallinckrodt Institute of Radiology (United States); Sicard, Gregorio A., E-mail: sicard@wudosis.wustl.edu [Washington University School of Medicine, Department of Surgery (United States); Narra, Vamsi R., E-mail: narrav@mir.wustl.edu [Washington University School of Medicine, Mallinckrodt Institute of Radiology (United States)

2016-06-15

Primary aortic neoplasms are rare. Aortic sarcoma arising after endovascular aneurysm repair (EVAR) is a scarce subset of primary aortic malignancies, reports of which are infrequent in the published literature. The diagnosis of aortic sarcoma is challenging due to its non-specific clinical presentation, and the prognosis is poor due to delayed diagnosis, rapid proliferation, and propensity for metastasis. Post-EVAR, aortic sarcomas may mimic other more common aortic processes on surveillance imaging. Radiologists are rarely knowledgeable about this rare entity for which multimodality imaging and awareness are invaluable in early diagnosis. A series of three pathologically confirmed cases are presented to display the multimodality imaging features and clinical presentations of aortic sarcoma arising after EVAR.

Bovine aortic arch with supravalvular aortic stenosis

Directory of Open Access Journals (Sweden)

Mohammed Idhrees

2016-09-01

Full Text Available A 5-year-old boy was diagnosed to have supravalvular aortic stenosis (SVAS. On evaluation of CT angiogram, there was associated bovine aortic arch (BAA. Association of BAA with SVAS has not been previously reported in literature, and to best of our knowledge, this is the first case report of SVAS with BAA. Recent studies show BAA as a marker for aortopathy. SVAS is also an arteriopathy. In light of this, SVAS can also possibly be a manifestation of aortopathy associated with BAA.

Bifurcation Control of Chaotic Dynamical Systems

National Research Council Canada - National Science Library

Wang, Hua O; Abed, Eyad H

1992-01-01

A nonlinear system which exhibits bifurcations, transient chaos, and fully developed chaos is considered, with the goal of illustrating the role of two ideas in the control of chaotic dynamical systems...

Stability and Hopf Bifurcation in a Computer Virus Model with Multistate Antivirus

Directory of Open Access Journals (Sweden)

Tao Dong

2012-01-01

Full Text Available By considering that people may immunize their computers with countermeasures in susceptible state, exposed state and using anti-virus software may take a period of time, a computer virus model with time delay based on an SEIR model is proposed. We regard time delay as bifurcating parameter to study the dynamical behaviors which include local asymptotical stability and local Hopf bifurcation. By analyzing the associated characteristic equation, Hopf bifurcation occurs when time delay passes through a sequence of critical value. The linerized model and stability of the bifurcating periodic solutions are also derived by applying the normal form theory and the center manifold theorem. Finally, an illustrative example is also given to support the theoretical results.

Stochastic stability and bifurcation in a macroeconomic model

International Nuclear Information System (INIS)

Li Wei; Xu Wei; Zhao Junfeng; Jin Yanfei

2007-01-01

On the basis of the work of Goodwin and Puu, a new business cycle model subject to a stochastically parametric excitation is derived in this paper. At first, we reduce the model to a one-dimensional diffusion process by applying the stochastic averaging method of quasi-nonintegrable Hamiltonian system. Secondly, we utilize the methods of Lyapunov exponent and boundary classification associated with diffusion process respectively to analyze the stochastic stability of the trivial solution of system. The numerical results obtained illustrate that the trivial solution of system must be globally stable if it is locally stable in the state space. Thirdly, we explore the stochastic Hopf bifurcation of the business cycle model according to the qualitative changes in stationary probability density of system response. It is concluded that the stochastic Hopf bifurcation occurs at two critical parametric values. Finally, some explanations are given in a simply way on the potential applications of stochastic stability and bifurcation analysis

Bifurcations of propellant burning rate at oscillatory pressure

Energy Technology Data Exchange (ETDEWEB)

Novozhilov, Boris V. [N. N. Semenov Institute of Chemical Physics, Russian Academy of Science, 4 Kosygina St., Moscow 119991 (Russian Federation)

2006-06-15

A new phenomenon, the disparity between pressure and propellant burning rate frequencies, has revealed in numerical studies of propellant burning rate response to oscillatory pressure. As is clear from the linear approximation, under small pressure amplitudes, h, pressure and propellant burning rate oscillations occur with equal period T (T-solution). In the paper, however, it is shown that at a certain critical value of the parameter h the system in hand undergoes a bifurcation so that the T-solution converts to oscillations with period 2T (2T-solution). When the bifurcation parameter h increases, the subsequent behavior of the system becomes complicated. It is obtained a sequence of period doubling to 4T-solution and 8T-solution. Beyond a certain value of the bifurcation parameter h an apparently fully chaotic solution is found. These effects undoubtedly should be taken into account in studies of oscillatory processes in combustion chambers. (Abstract Copyright [2006], Wiley Periodicals, Inc.)

Dynamical systems V bifurcation theory and catastrophe theory

CERN Document Server

1994-01-01

Bifurcation theory and catastrophe theory are two of the best known areas within the field of dynamical systems. Both are studies of smooth systems, focusing on properties that seem to be manifestly non-smooth. Bifurcation theory is concerned with the sudden changes that occur in a system when one or more parameters are varied. Examples of such are familiar to students of differential equations, from phase portraits. Moreover, understanding the bifurcations of the differential equations that describe real physical systems provides important information about the behavior of the systems. Catastrophe theory became quite famous during the 1970's, mostly because of the sensation caused by the usually less than rigorous applications of its principal ideas to "hot topics", such as the characterization of personalities and the difference between a "genius" and a "maniac". Catastrophe theory is accurately described as singularity theory and its (genuine) applications. The authors of this book, the first printing of w...

Indexing aortic valve area by body surface area increases the prevalence of severe aortic stenosis

DEFF Research Database (Denmark)

Jander, Nikolaus; Gohlke-Bärwolf, Christa; Bahlmann, Edda

2014-01-01

To account for differences in body size in patients with aortic stenosis, aortic valve area (AVA) is divided by body surface area (BSA) to calculate indexed AVA (AVAindex). Cut-off values for severe stenosis are......To account for differences in body size in patients with aortic stenosis, aortic valve area (AVA) is divided by body surface area (BSA) to calculate indexed AVA (AVAindex). Cut-off values for severe stenosis are...

Bifurcated equilibria in two-dimensional MHD with diamagnetic effects

International Nuclear Information System (INIS)

Ottaviani, M.; Tebaldi, C.

1998-12-01

In this work we analyzed the sequence of bifurcated equilibria in two-dimensional reduced magnetohydrodynamics. Diamagnetic effects are studied under the assumption of a constant equilibrium pressure gradient, not altered by the formation of the magnetic island. The formation of an island when the symmetric equilibrium becomes unstable is studied as a function of the tearing mode stability parameter Δ' and of the diamagnetic frequency, by employing fixed-points numerical techniques and an initial value code. At larger values of Δ' a tangent bifurcation takes place, above which no small island solutions exist. This bifurcation persists up to fairly large values of the diamagnetic frequency (of the order of one tenth of the Alfven frequency). The implications of this phenomenology for the intermittent MHD dynamics observed in tokamaks is discussed. (authors)

Current indications for stentless aortic bioprostheses.

Science.gov (United States)

Hegazy, Yasser Y; Rayan, Amr; Bauer, Stefan; Keshk, Noha; Bauer, Kerstin; Ennker, Ina; Ennker, Jürgen

2018-01-01

The best aortic prostheses have been debated for decades. The introduction of stentless aortic bioprostheses was aimed at improving hemodynamics and potentially the durability of aortic bioprostheses. Despite the good short- and long-term outcomes after implantation of stentless aortic bioprostheses, their use remains limited owing to the technically demanding implantation techniques. Nevertheless, stentless aortic bioprostheses might be of special benefit in certain indications, where they could be a valuable addition to the surgical armamentarium.

Analytical determination of bifurcations of periodic solution in three-degree-of-freedom vibro-impact systems with clearance

International Nuclear Information System (INIS)

Liu, Yongbao; Wang, Qiang; Xu, Huidong

2017-01-01

The smooth bifurcation and non-smooth grazing bifurcation of periodic solution of three-degree-of-freedom vibro-impact systems with clearance are studied in this paper. Firstly, six-dimensional Poincaré maps are established through choosing suitable Poincaré section and solving periodic solutions of vibro-impact system. Then, as the analytic expressions of all eigenvalues of Jacobi matrix of six-dimensional map are unavailable, the numerical calculations to search for the critical bifurcation values point by point is a laborious job based on the classical critical criterion described by the properties of eigenvalues. To overcome the difficulty from the classical bifurcation criteria, the explicit critical criterion without using eigenvalues calculation of high-dimensional map is applied to determine bifurcation points of Co-dimension-one bifurcations and Co-dimension-two bifurcations, and then local dynamical behaviors of these bifurcations are further analyzed. Finally, the existence of the grazing periodic solution of the vibro-impact system and grazing bifurcation point are analyzed, the discontinuous grazing bifurcation behavior is studied based on the compound normal form map near the grazing point, the discontinuous jumping phenomenon and the co-existing multiple solutions near the grazing bifurcation point are revealed.

Sliding bifurcations and chaos induced by dry friction in a braking system

International Nuclear Information System (INIS)

Yang, F.H.; Zhang, W.; Wang, J.

2009-01-01

In this paper, non-smooth bifurcations and chaotic dynamics are investigated for a braking system. A three-degree-of-freedom model is considered to capture the complicated nonlinear characteristics, in particular, non-smooth bifurcations in the braking system. The stick-slip transition is analyzed for the braking system. From the results of numerical simulation, it is observed that there also exist the grazing-sliding bifurcation and stick-slip chaos in the braking system.

Acute Type A Aortic Dissection Successfully Managed with One-stage Surgery of Total Aortic Arch Replacement with Supra-aortic Transposition Plus Frozen Elephant Trunk Technique

Directory of Open Access Journals (Sweden)

Meng-Lin Lee

2014-09-01

Full Text Available Acute type A aortic dissection has long been a challenging issue. The surgical techniques traditionally vary with the anatomic extent of the aortic dissection. Simple ascending aortic grafting can be lifesaving, but the lesions beyond the aorta, which include the arch vessels and descending aorta, remain potential hazards. In this paper, we present a patient in which acute type A aortic dissection with lesions extending into descending thoracic aorta was successfully managed by total arch replacement with supra-aortic transposition plus the frozen elephant trunk technique to the descending aorta. A 67-year-old gentleman presented with severe tearing pain from the anterior to posterior chest. Computed tomography confirmed the diagnosis of acute type A dissection extending to the level of the right common iliac artery. An emergent operation was performed as in the aforementioned technique. The surgery went well and the patient was discharged without comorbidities on postoperative day 25. The patient had regular outpatient clinical follow-up. The follow-up computed tomography images showed adequate results with the obliteration of the false lumen. In conclusion, total aortic arch replacement with supra-aortic transposition plus frozen elephant trunk technique is a safe and feasible operative method for patients with detrimental acute type A aortic dissection.

Stability and bifurcation analysis in a kind of business cycle model with delay

International Nuclear Information System (INIS)

Zhang Chunrui; Wei Junjie

2004-01-01

A kind of business cycle model with delay is considered. Firstly, the linear stability of the model is studied and bifurcation set is drawn in the appropriate parameter plane. It is found that there exist Hopf bifurcations when the delay passes a sequence of critical values. Then the explicit algorithm for determining the direction of the Hopf bifurcations and the stability of the bifurcating periodic solutions are derived, using the normal form method and center manifold theorem. Finally, a group conditions to guarantee the global existence of periodic solutions is given, and numerical simulations are performed to illustrate the analytical results found

Aortopathy in Congenital Heart Disease in Adults: Aortic Dilatation with Decreased Aortic Elasticity that Impacts Negatively on Left Ventricular Function.

Science.gov (United States)

Niwa, Koichiro

2013-04-01

Bicuspid aortic valve and/or coarctation of the aorta are consistently associated with ascending aortic and para-coarctation medial abnormalities. Medial abnormalities in the ascending aorta are prevalent in other types of patients with a variety of forms congenital heart disease (CHD), such as single ventricle, persistent truncus arteriosus, transposition of the great arteries, hypoplastic left heart syndrome, tetralogy of Fallot. These abnormalities encompass a wide age range, and may predispose to dilatation, aneurysm, and rupture that necessitates aortic valve and root surgery. This dilatation can develop in CHD patients without stenotic region. These CHDs exhibit ongoing dilatation of the aortic root and reduced aortic elasticity and increased aortic stiffness that may relate to intrinsic properties of the aortic root. The concept of aortic dilatation is shifting a paradigm of aortic dilatation, as so called post stenotic dilatation, to primary intrinsic aortopahy. These aortic dilatation and increased stiffness can induce aortic aneurysm, rupture of the aorta and aortic regurgitation, but also provoke left ventricular hypertrophy, reduced coronary artery flow and left ventricular failure. We can recognize this association of aortic pathophysiological abnormality, aortic dilation and aorto-left ventricular interaction as a new clinical entity: "aortopathy".

Fate of remnant sinuses of Valsalva in patients with bicuspid and trileaflet valves undergoing aortic valve, ascending aorta, and aortic arch replacement.

Science.gov (United States)

Milewski, Rita Karianna; Habertheuer, Andreas; Bavaria, Joseph E; Siki, Mary; Szeto, Wilson Y; Krause, Eric; Korutla, Varun; Desai, Nimesh D; Vallabhajosyula, Prashanth

2017-08-01

In patients presenting with aortic valvulopathy with concomitant ascending aortic aneurysm, surgical management of the sinus of Valsalva segment remains undefined, especially for moderately dilated aortic roots. In patients with this pathology undergoing aortic valve replacement with supracoronary ascending aorta replacement, we assessed the fate of the remnant preserved sinus of Valsalva segment stratified by aortic valve morphology and pathology. From 2002 to 2015, 428 patients underwent elective aortic valve replacement with supracoronary ascending aorta replacement. Patients were stratified on the basis of valvular morphology (bicuspid aortic valve [n = 254] and tricuspid aortic valve [n = 174]), valvular pathology (bicuspid aortic valve with aortic stenosis [n = 178], bicuspid aortic valve with aortic insufficiency [n = 76], tricuspid aortic valve with aortic stenosis [n = 61], tricuspid aortic valve with aortic insufficiency [n = 113]), and preoperative sinus of Valsalva dimensions (45 mm). Kaplan-Meier analysis revealed no significant difference in freedom from reoperation in tricuspid aortic valve versus bicuspid aortic valve (P = .576). Multivariable Cox regression model performed with sinus of Valsalva dimensions at baseline and follow-up as time-varying covariates did not adversely affect survival. A repeated-measure, mixed-effects model constructed to assess longitudinal sinus of Valsalva trends revealed that the retained sinus of Valsalva dimensions remain stable over long-term follow-up (discharge to ≥10 years), irrespective of valvular morphology/pathology (bicuspid aortic valve with aortic insufficiency, tricuspid aortic valve with aortic insufficiency, tricuspid aortic valve with aortic stenosis) and preoperative sinus of Valsalva groups (45 mm). In patients with nonaneurysmal sinuses of Valsalva undergoing aortic valve replacement with supracoronary ascending aorta replacement, the sinus segment can be preserved irrespective of

Minimally invasive aortic valve replacement

DEFF Research Database (Denmark)

Foghsgaard, Signe; Schmidt, Thomas Andersen; Kjaergard, Henrik K

2009-01-01

In this descriptive prospective study, we evaluate the outcomes of surgery in 98 patients who were scheduled to undergo minimally invasive aortic valve replacement. These patients were compared with a group of 50 patients who underwent scheduled aortic valve replacement through a full sternotomy...... operations were completed as mini-sternotomies, 4 died later of noncardiac causes. The aortic cross-clamp and perfusion times were significantly different across all groups (P replacement...... is an excellent operation in selected patients, but its true advantages over conventional aortic valve replacement (other than a smaller scar) await evaluation by means of randomized clinical trial. The "extended mini-aortic valve replacement" operation, on the other hand, is a risky procedure that should...

Stability of Bifurcating Stationary Solutions of the Artificial Compressible System

Science.gov (United States)

Teramoto, Yuka

2018-02-01

The artificial compressible system gives a compressible approximation of the incompressible Navier-Stokes system. The latter system is obtained from the former one in the zero limit of the artificial Mach number ɛ which is a singular limit. The sets of stationary solutions of both systems coincide with each other. It is known that if a stationary solution of the incompressible system is asymptotically stable and the velocity field of the stationary solution satisfies an energy-type stability criterion, then it is also stable as a solution of the artificial compressible one for sufficiently small ɛ . In general, the range of ɛ shrinks when the spectrum of the linearized operator for the incompressible system approaches to the imaginary axis. This can happen when a stationary bifurcation occurs. It is proved that when a stationary bifurcation from a simple eigenvalue occurs, the range of ɛ can be taken uniformly near the bifurcation point to conclude the stability of the bifurcating solution as a solution of the artificial compressible system.

A correlative study of aortic valve rotation angle and thoracic aortic sizes using ECG gated CT angiography

Energy Technology Data Exchange (ETDEWEB)

Saremi, Farhood, E-mail: fsaremi@usc.edu; Cen, Steven; Tayari, Nazila; Alizadeh, Houman; Emami, Amir; Lin, Leah; Fleischman, Fernando

2017-04-15

Objective: Various degrees of aortic valve rotation may be seen in individuals with no history of congenital cardiovascular malformations, but its association with aortic sizes has not been studied. Methods: Gated computed tomographic (CT angiograms in 217 patients were studied (66.7 ± 15; 22–97 years old)). Aortic diameters were determined at 5 anatomic locations. The length of the aorta from sinus to left subclavian artery was measured. The angle of valve rotation was recorded by measuring the angle between a line connecting the midpoint of the non-coronary sinus to the anterior commissure and another line along the interatrial septum. Rotation angles were correlated with aortic measurements. Patients were separated into two groups based on aortic sizes and into three groups based on age. The threshold for aortic dilatation was set at maximum ascending aorta diameter ≥40 mm (≥21 mm body surface area [BSA] indexed). Results: No significant difference in rotation angles was seen between the three age groups or between genders. Rotation angles were significantly correlated with maximal, average, and BSA adjustment of the aortic root and ascending aortic measurements. The aortic root angles were significantly different between the dilated versus nondilated aortas. There was no significant association between the rotation angles and age, length of ascending aorta, or diameters of descending aorta. Multivariate adaptive regression splines showed 25° of aortic root rotation as the diagnostic cut off for ascending aorta dilation. Above the 25° rotation, every 10° of increasing rotation was associated with a 3.78 ± 0.87 mm increase in aortic diameter (p < 0.01) and a 1.73 ± 0.25 times increased risk for having a dilated aorta (p < 0.01). Conclusion: Rotation angles of the aortic valve may be an independent non-invasive imaging marker for dilatation of the ascending aorta. Patients with increased rotation angle of the aortic valve may have higher risk for

Endovascular Repair of Abdominal Aortic Aneurysms in the Presence of a Transplanted Kidney

International Nuclear Information System (INIS)

Silverberg, Daniel; Yalon, Tal; Halak, Moshe

2015-01-01

PurposeTo present our experience performing endovascular repair of abdominal aortic aneurysms in kidney transplanted patients.MethodsA retrospective review of all patients who underwent endovascular aneurysm repair (EVAR) for abdominal aortic aneurysms (AAA) performed at our institution from 2007 to 2014. We identified all patients who had previously undergone a kidney transplant. Data collected included: comorbidities, preoperative imaging modalities, indication for surgery, stent graft configurations, pre- and postoperative renal function, perioperative complications, and survival rates.ResultsA total of 267 EVARs were performed. Six (2 %) had a transplanted kidney. Mean age was 74 (range, 64–82) years; five were males. Mean time from transplantation to EVAR was 7.5 (range, 2–12) years. Five underwent preoperative planning with noncontrast modalities only. Devices used included bifurcated (n = 3), aortouniiliac (n = 2), and tube (n = 1) stent grafts. Technical success was achieved in all patients. None experienced deterioration in renal function. Median follow-up was 39 (range, 6–51) months. Four patients were alive at the time of the study. Two patients expired during the period of follow-up from unrelated causes.ConclusionsEVAR is an effective modality for the management of AAAs in the coexistence of a transplanted kidney. It can be performed with minimal morbidity and mortality without harming the transplanted kidney. Special consideration should be given to device configuration to minimize damage to the renal graft

Endovascular Repair of Abdominal Aortic Aneurysms in the Presence of a Transplanted Kidney

Energy Technology Data Exchange (ETDEWEB)

Silverberg, Daniel, E-mail: silverberg-d@msn.com; Yalon, Tal; Halak, Moshe [The Chaim Sheba Medical Center, The Department of Vascular Surgery (Israel)

2015-08-15

PurposeTo present our experience performing endovascular repair of abdominal aortic aneurysms in kidney transplanted patients.MethodsA retrospective review of all patients who underwent endovascular aneurysm repair (EVAR) for abdominal aortic aneurysms (AAA) performed at our institution from 2007 to 2014. We identified all patients who had previously undergone a kidney transplant. Data collected included: comorbidities, preoperative imaging modalities, indication for surgery, stent graft configurations, pre- and postoperative renal function, perioperative complications, and survival rates.ResultsA total of 267 EVARs were performed. Six (2 %) had a transplanted kidney. Mean age was 74 (range, 64–82) years; five were males. Mean time from transplantation to EVAR was 7.5 (range, 2–12) years. Five underwent preoperative planning with noncontrast modalities only. Devices used included bifurcated (n = 3), aortouniiliac (n = 2), and tube (n = 1) stent grafts. Technical success was achieved in all patients. None experienced deterioration in renal function. Median follow-up was 39 (range, 6–51) months. Four patients were alive at the time of the study. Two patients expired during the period of follow-up from unrelated causes.ConclusionsEVAR is an effective modality for the management of AAAs in the coexistence of a transplanted kidney. It can be performed with minimal morbidity and mortality without harming the transplanted kidney. Special consideration should be given to device configuration to minimize damage to the renal graft.

Bifurcations in the optimal elastic foundation for a buckling column

International Nuclear Information System (INIS)

Rayneau-Kirkhope, Daniel; Farr, Robert; Ding, K.; Mao, Yong

2010-01-01

We investigate the buckling under compression of a slender beam with a distributed lateral elastic support, for which there is an associated cost. For a given cost, we study the optimal choice of support to protect against Euler buckling. We show that with only weak lateral support, the optimum distribution is a delta-function at the centre of the beam. When more support is allowed, we find numerically that the optimal distribution undergoes a series of bifurcations. We obtain analytical expressions for the buckling load around the first bifurcation point and corresponding expansions for the optimal position of support. Our theoretical predictions, including the critical exponent of the bifurcation, are confirmed by computer simulations.

Bifurcations in the optimal elastic foundation for a buckling column

Energy Technology Data Exchange (ETDEWEB)

Rayneau-Kirkhope, Daniel, E-mail: ppxdr@nottingham.ac.u [School of Physics and Astronomy, University of Nottingham, Nottingham, NG7 2RD (United Kingdom); Farr, Robert [Unilever R and D, Olivier van Noortlaan 120, AT3133, Vlaardingen (Netherlands); London Institute for Mathematical Sciences, 22 South Audley Street, Mayfair, London (United Kingdom); Ding, K. [Department of Physics, Fudan University, Shanghai, 200433 (China); Mao, Yong [School of Physics and Astronomy, University of Nottingham, Nottingham, NG7 2RD (United Kingdom)

2010-12-01

We investigate the buckling under compression of a slender beam with a distributed lateral elastic support, for which there is an associated cost. For a given cost, we study the optimal choice of support to protect against Euler buckling. We show that with only weak lateral support, the optimum distribution is a delta-function at the centre of the beam. When more support is allowed, we find numerically that the optimal distribution undergoes a series of bifurcations. We obtain analytical expressions for the buckling load around the first bifurcation point and corresponding expansions for the optimal position of support. Our theoretical predictions, including the critical exponent of the bifurcation, are confirmed by computer simulations.

Delay-induced stochastic bifurcations in a bistable system under white noise

International Nuclear Information System (INIS)

Sun, Zhongkui; Fu, Jin; Xu, Wei; Xiao, Yuzhu

2015-01-01

In this paper, the effects of noise and time delay on stochastic bifurcations are investigated theoretically and numerically in a time-delayed Duffing-Van der Pol oscillator subjected to white noise. Due to the time delay, the random response is not Markovian. Thereby, approximate methods have been adopted to obtain the Fokker-Planck-Kolmogorov equation and the stationary probability density function for amplitude of the response. Based on the knowledge that stochastic bifurcation is characterized by the qualitative properties of the steady-state probability distribution, it is found that time delay and feedback intensity as well as noise intensity will induce the appearance of stochastic P-bifurcation. Besides, results demonstrated that the effects of the strength of the delayed displacement feedback on stochastic bifurcation are accompanied by the sensitive dependence on time delay. Furthermore, the results from numerical simulations best confirm the effectiveness of the theoretical analyses

Local and global bifurcations at infinity in models of glycolytic oscillations

DEFF Research Database (Denmark)

Sturis, Jeppe; Brøns, Morten

1997-01-01

We investigate two models of glycolytic oscillations. Each model consists of two coupled nonlinear ordinary differential equations. Both models are found to have a saddle point at infinity and to exhibit a saddle-node bifurcation at infinity, giving rise to a second saddle and a stable node...... at infinity. Depending on model parameters, a stable limit cycle may blow up to infinite period and amplitude and disappear in the bifurcation, and after the bifurcation, the stable node at infinity then attracts all trajectories. Alternatively, the stable node at infinity may coexist with either a stable...... sink (not at infinity) or a stable limit cycle. This limit cycle may then disappear in a heteroclinic bifurcation at infinity in which the unstable manifold from one saddle at infinity joins the stable manifold of the other saddle at infinity. These results explain prior reports for one of the models...

Delay-induced stochastic bifurcations in a bistable system under white noise

Energy Technology Data Exchange (ETDEWEB)

Sun, Zhongkui, E-mail: sunzk@nwpu.edu.cn; Fu, Jin; Xu, Wei [Department of Applied Mathematics, Northwestern Polytechnical University, Xi' an 710072 (China); Xiao, Yuzhu [Department of Mathematics and Information Science, Chang' an University, Xi' an 710086 (China)

2015-08-15

In this paper, the effects of noise and time delay on stochastic bifurcations are investigated theoretically and numerically in a time-delayed Duffing-Van der Pol oscillator subjected to white noise. Due to the time delay, the random response is not Markovian. Thereby, approximate methods have been adopted to obtain the Fokker-Planck-Kolmogorov equation and the stationary probability density function for amplitude of the response. Based on the knowledge that stochastic bifurcation is characterized by the qualitative properties of the steady-state probability distribution, it is found that time delay and feedback intensity as well as noise intensity will induce the appearance of stochastic P-bifurcation. Besides, results demonstrated that the effects of the strength of the delayed displacement feedback on stochastic bifurcation are accompanied by the sensitive dependence on time delay. Furthermore, the results from numerical simulations best confirm the effectiveness of the theoretical analyses.

Imaging techniques in transcatheter aortic valve replacement

Directory of Open Access Journals (Sweden)

Quaife RA

2013-11-01

Full Text Available Robert A Quaife, Jennifer Dorosz, John C Messenger, Ernesto E Salcedo Division of Cardiology, University of Colorado, Aurora, CO, USA Abstract: Calcific aortic stenosis is now understood as a complex valvular degenerative process sharing many risk factors with atherosclerosis. Once patients develop symptomatic calcific aortic stenosis, the only effective treatment is aortic valve replacement. In the past decade, transcatheter aortic valve replacement (TAVR has been developed as an alternative to surgery to treat severe calcific aortic stenosis. Cardiac imaging plays a pivotal role in the contemporary management of patients with calcific aortic stenosis, and particularly in patients being considered for TAVR, who demand detailed imaging of the aortic valve apparatus. In this review, we highlight the role of cardiac imaging for patient selection, procedural guidance, and evaluation of results of TAVR. Keywords: aortic stenosis, cardiovascular imaging, transcutaneous aortic valve replacement

Bifurcation analysis on a generalized recurrent neural network with two interconnected three-neuron components

International Nuclear Information System (INIS)

Hajihosseini, Amirhossein; Maleki, Farzaneh; Rokni Lamooki, Gholam Reza

2011-01-01

Highlights: → We construct a recurrent neural network by generalizing a specific n-neuron network. → Several codimension 1 and 2 bifurcations take place in the newly constructed network. → The newly constructed network has higher capabilities to learn periodic signals. → The normal form theorem is applied to investigate dynamics of the network. → A series of bifurcation diagrams is given to support theoretical results. - Abstract: A class of recurrent neural networks is constructed by generalizing a specific class of n-neuron networks. It is shown that the newly constructed network experiences generic pitchfork and Hopf codimension one bifurcations. It is also proved that the emergence of generic Bogdanov-Takens, pitchfork-Hopf and Hopf-Hopf codimension two, and the degenerate Bogdanov-Takens bifurcation points in the parameter space is possible due to the intersections of codimension one bifurcation curves. The occurrence of bifurcations of higher codimensions significantly increases the capability of the newly constructed recurrent neural network to learn broader families of periodic signals.

Bifurcation-free design method of pulse energy converter controllers

International Nuclear Information System (INIS)

Kolokolov, Yury; Ustinov, Pavel; Essounbouli, Najib; Hamzaoui, Abdelaziz

2009-01-01

In this paper, a design method of pulse energy converter (PEC) controllers is proposed. This method develops a classical frequency domain design, based on the small signal modeling, by means of an addition of a nonlinear dynamics analysis stage. The main idea of the proposed method consists in fact that the PEC controller, designed with an application of the small signal modeling, is tuned after with taking into the consideration an essentially nonlinear nature of the PEC that makes it possible to avoid bifurcation phenomena in the PEC dynamics at the design stage (bifurcation-free design). Also application of the proposed method allows an improvement of the designed controller performance. The application of this bifurcation-free design method is demonstrated on an example of the controller design of direct current-direct current (DC-DC) buck converter with an input electromagnetic interference filter.

Cutting Balloon Angioplasty in the Treatment of Short Infrapopliteal Bifurcation Disease.

Science.gov (United States)

Iezzi, Roberto; Posa, Alessandro; Santoro, Marco; Nestola, Massimiliano; Contegiacomo, Andrea; Tinelli, Giovanni; Paolini, Alessandra; Flex, Andrea; Pitocco, Dario; Snider, Francesco; Bonomo, Lorenzo

2015-08-01

To evaluate the safety, feasibility, and effectiveness of cutting balloon angioplasty in the management of infrapopliteal bifurcation disease. Between November 2010 and March 2013, 23 patients (mean age 69.6±9.01 years, range 56-89; 16 men) suffering from critical limb ischemia were treated using cutting balloon angioplasty (single cutting balloon, T-shaped double cutting balloon, or double kissing cutting balloon technique) for 47 infrapopliteal artery bifurcation lesions (16 popliteal bifurcation and 9 tibioperoneal bifurcation) in 25 limbs. Follow-up consisted of clinical examination and duplex ultrasonography at 1 month and every 3 months thereafter. All treatments were technically successful. No 30-day death or adverse events needing treatment were registered. No flow-limiting dissection was observed, so no stent implantation was necessary. The mean postprocedure minimum lumen diameter and acute gain were 0.28±0.04 and 0.20±0.06 cm, respectively, with a residual stenosis of 0.04±0.02 cm. Primary and secondary patency rates were estimated as 89.3% and 93.5% at 6 months and 77.7% and 88.8% at 12 months, respectively; 1-year primary and secondary patency rates of the treated bifurcation were 74.2% and 87.0%, respectively. The survival rate estimated by Kaplan-Meier analysis was 82.5% at 1 year. Cutting balloon angioplasty seems to be a safe and effective tool in the routine treatment of short/ostial infrapopliteal bifurcation lesions, avoiding procedure-related complications, overcoming the limitations of conventional angioplasty, and improving the outcome of catheter-based therapy. © The Author(s) 2015.

Non-robust dynamic inferences from macroeconometric models: Bifurcation stratification of confidence regions

Science.gov (United States)

Barnett, William A.; Duzhak, Evgeniya Aleksandrovna

2008-06-01

Grandmont [J.M. Grandmont, On endogenous competitive business cycles, Econometrica 53 (1985) 995-1045] found that the parameter space of the most classical dynamic models is stratified into an infinite number of subsets supporting an infinite number of different kinds of dynamics, from monotonic stability at one extreme to chaos at the other extreme, and with many forms of multiperiodic dynamics in between. The econometric implications of Grandmont’s findings are particularly important, if bifurcation boundaries cross the confidence regions surrounding parameter estimates in policy-relevant models. Stratification of a confidence region into bifurcated subsets seriously damages robustness of dynamical inferences. Recently, interest in policy in some circles has moved to New-Keynesian models. As a result, in this paper we explore bifurcation within the class of New-Keynesian models. We develop the econometric theory needed to locate bifurcation boundaries in log-linearized New-Keynesian models with Taylor policy rules or inflation-targeting policy rules. Central results needed in this research are our theorems on the existence and location of Hopf bifurcation boundaries in each of the cases that we consider.

Analysis of the magnetohydrodynamic equations and study of the nonlinear solution bifurcations

International Nuclear Information System (INIS)

Morros Tosas, J.

1989-05-01

The nonlinear saturation of a plasma magnetohydrodynamic instabilities is studied, by means of a bifurcation theory. The work includes: an accurate mathematical method to study the MHD equations, in which the physical content is clear; and the study of the nonlinear solutions of the branch bifurcations, applied to different unstable plasma models. A scalar function representation is proposed for the MHD equations. This representation is characterized by a reference steady magnetic field and by a velocity field, which allow to write the equations for the scalar functions. An approximation method, leading to the obtention of the reduced equations applied in the instability study, is given. The cylindrical or toroidal plasmas are studied by using the nonlinear solutions bifurcation. Concerning the cylindrical plasma, the representation leads to a reduced system which enables the analytical calculations: two different steady bifurcation solutions are obtained. In the case of the toroidal plasma, an appropriate reduced equations system, is obtained. A qualitative approach of the Kink-type steady solution bifurcation, in a toroidal geometry, is performed [fr

Bifurcation of steady tearing states

International Nuclear Information System (INIS)

Saramito, B.; Maschke, E.K.

1985-10-01

We apply the bifurcation theory for compact operators to the problem of the nonlinear solutions of the 3-dimensional incompressible visco-resistive MHD equations. For the plane plasma slab model we compute branches of nonlinear tearing modes, which are stationary for the range of parameters investigated up to now

Three dimensional nilpotent singularity and Sil'nikov bifurcation

International Nuclear Information System (INIS)

Li Xindan; Liu Haifei

2007-01-01

In this paper, by using the normal form, blow-up theory and the technique of global bifurcations, we study the singularity at the origin with threefold zero eigenvalue for nonsymmetric vector fields with nilpotent linear part and 4-jet C ∼ -equivalent toy-bar -bar x+z-bar -bar y+ax 3 y-bar -bar z,with a 0, and analytically prove the existence of Sil'nikov bifurcation, and then of the strange attractor for certain subfamilies of the nonsymmetric versal unfoldings of this singularity under some conditions

Bifurcation analysis of nephron pressure and flow regulation

DEFF Research Database (Denmark)

Barfred, Mikael; Mosekilde, Erik; Holstein-Rathlou, N.-H.

1996-01-01

One- and two-dimensional continuation techniques are applied to study the bifurcation structure of a model of renal flow and pressure control. Integrating the main physiological mechanisms by which the individual nephron regulates the incoming blood flow, the model describes the interaction between...... the tubuloglomerular feedback and the response of the afferent arteriole. It is shown how a Hopf bifurcation leads the system to perform self-sustained oscillations if the feedback gain becomes sufficiently strong, and how a further increase of this parameter produces a folded structure of overlapping period...

Association Between Gout and Aortic Stenosis.

Science.gov (United States)

Chang, Kevin; Yokose, Chio; Tenner, Craig; Oh, Cheongeun; Donnino, Robert; Choy-Shan, Alana; Pike, Virginia C; Shah, Binita D; Lorin, Jeffrey D; Krasnokutsky, Svetlana; Sedlis, Steven P; Pillinger, Michael H

2017-02-01

An independent association between gout and coronary artery disease is well established. The relationship between gout and valvular heart disease, however, is unclear. The aim of this study was to assess the association between gout and aortic stenosis. We performed a retrospective case-control study. Aortic stenosis cases were identified through a review of outpatient transthoracic echocardiography (TTE) reports. Age-matched controls were randomly selected from patients who had undergone TTE and did not have aortic stenosis. Charts were reviewed to identify diagnoses of gout and the earliest dates of gout and aortic stenosis diagnosis. Among 1085 patients who underwent TTE, 112 aortic stenosis cases were identified. Cases and nonaortic stenosis controls (n = 224) were similar in age and cardiovascular comorbidities. A history of gout was present in 21.4% (n = 24) of aortic stenosis subjects compared with 12.5% (n = 28) of controls (unadjusted odds ratio 1.90, 95% confidence interval 1.05-3.48, P = .038). Multivariate analysis retained significance only for gout (adjusted odds ratio 2.08, 95% confidence interval 1.00-4.32, P = .049). Among subjects with aortic stenosis and gout, gout diagnosis preceded aortic stenosis diagnosis by 5.8 ± 1.6 years. The age at onset of aortic stenosis was similar among patients with and without gout (78.7 ± 1.8 vs 75.8 ± 1.0 years old, P = .16). Aortic stenosis patients had a markedly higher prevalence of precedent gout than age-matched controls. Whether gout is a marker of, or a risk factor for, the development of aortic stenosis remains uncertain. Studies investigating the potential role of gout in the pathophysiology of aortic stenosis are warranted and could have therapeutic implications. Published by Elsevier Inc.

Detecting atheromatous plaques in the aortic arch or supra-aortic arteries for more accurate stroke subtype classification.

Science.gov (United States)

Cui, Xiaoyang; Wu, Simiao; Zeng, Quantao; Xiao, Jiahe; Liu, Ming

2015-02-01

To investigate the correlations of atheromatous plaques in the aortic arch or supra-aortic arteries with intracranial arterial stenosis and carotid plaques in stroke patients, and to determine whether taking these plaques into account will reduce the proportion of patients in the undetermined etiology group. We prospectively enrolled 308 ischemic stroke patients, whose clinical characteristics and A-S-C-O classifications were compared with analyses of intracranial arteries, carotid arteries, aortic arch, and supra-aortic arteries. 125(40.6%) patients had plaques in the aortic arch or supra-aortic arteries, of which 106 (84.8%) had complex plaques. No correlations were observed between these plaques and carotid plaques ( p = 0.283) or intracranial arterial stenosis ( p = 0.097). After detecting the mobile thrombi in the aortic arch and supra-aortic arteries, the proportion of patients in the atherothrombosis group was increased from 33.8% to 55.5% ( p = 0.00), whereas the proportion of patients in stroke of undetermined etiology group was decreased from 19.2% to 11.0% ( p = 0.00). Examining only the carotid and intracranial arteries may not provide adequate information about large arteries in stroke patients. Therefore, it would be better to include a search for relevant plaques in the aortic arch or supra-aortic arteries in modern stroke workup, for it may lead to more accurate stroke subtype classification and guide secondary prevention.

The period adding and incrementing bifurcations: from rotation theory to applications

DEFF Research Database (Denmark)

Granados, Albert; Alseda, Lluis; Krupa, Maciej

2017-01-01

This survey article is concerned with the study of bifurcations of piecewise-smooth maps. We review the literature in circle maps and quasi-contractions and provide paths through this literature to prove sufficient conditions for the occurrence of two types of bifurcation scenarios involving rich...

The changing course of aortic valve disease in Scotland: temporal trends in hospitalizations and mortality and prognostic importance of aortic stenosis.

Science.gov (United States)

Berry, Colin; Lloyd, Suzanne M; Wang, Yanzhong; Macdonald, Alyson; Ford, Ian

2013-06-01

To investigate the contemporary clinical course of aortic valve disease types. We performed a retrospective population-level epidemiological study of hospitalized care in Scotland from 1 January 1997 to 31 December 2005 using electronic case identification of hospital admissions and deaths. Time-to-event analyses were performed using Cox Proportional-Hazards models. A total of 19 733 adults with an index hospitalization and a final diagnosis of non-congenital aortic valve disease were identified. Aortic stenosis, aortic insufficiency, mixed aortic valve disease, or unspecified aortic valve disease occurred in 13 220 (67.0%), 2807 (14.2%), 699 (3.5%), and 3007 (15.2%), individuals, respectively. The majority of hospitalizations occurred in elderly persons aged 80 and older. In total, 9981 (50.6%) patients had died by 31 December 2006. When compared with aortic stenosis, the risk of death was less with aortic insufficiency [hazard ratio (95% confidence interval) 0.79 (0.74, 0.84)] and mixed aortic valve disease [0.83 (0.74, 0.93)]. Female gender, admission year, and hypertension were associated with lower mortality in patients with aortic stenosis. Patients with aortic stenosis had increased risk of death or heart failure (adjusted P valve replacement of whom 73.2% had aortic stenosis, 11.9% aortic valve disease (unspecified),10.0% aortic insufficiency, and 4.9% aortic stenosis with insufficiency. Patients with aortic stenosis with insufficiency had increased likelihood of aortic valve replacement [1.19 (1.02, 1.38)]. Age, female gender, and co-morbidity reduced the likelihood of aortic valve replacement. The incidence of aortic valve stenosis has substantially increased in Scotland in recent years. Aortic stenosis predicts morbidity and mortality when compared with other types of aortic valve disease.

Analytical determination of the bifurcation thresholds in stochastic differential equations with delayed feedback.

Science.gov (United States)

Gaudreault, Mathieu; Drolet, François; Viñals, Jorge

2010-11-01

Analytical expressions for pitchfork and Hopf bifurcation thresholds are given for a nonlinear stochastic differential delay equation with feedback. Our results assume that the delay time τ is small compared to other characteristic time scales, not a significant limitation close to the bifurcation line. A pitchfork bifurcation line is found, the location of which depends on the conditional average , where x(t) is the dynamical variable. This conditional probability incorporates the combined effect of fluctuation correlations and delayed feedback. We also find a Hopf bifurcation line which is obtained by a multiple scale expansion around the oscillatory solution near threshold. We solve the Fokker-Planck equation associated with the slowly varying amplitudes and use it to determine the threshold location. In both cases, the predicted bifurcation lines are in excellent agreement with a direct numerical integration of the governing equations. Contrary to the known case involving no delayed feedback, we show that the stochastic bifurcation lines are shifted relative to the deterministic limit and hence that the interaction between fluctuation correlations and delay affect the stability of the solutions of the model equation studied.

Multistability and gluing bifurcation to butterflies in coupled networks with non-monotonic feedback

International Nuclear Information System (INIS)

Ma Jianfu; Wu Jianhong

2009-01-01

Neural networks with a non-monotonic activation function have been proposed to increase their capacity for memory storage and retrieval, but there is still a lack of rigorous mathematical analysis and detailed discussions of the impact of time lag. Here we consider a two-neuron recurrent network. We first show how supercritical pitchfork bifurcations and a saddle-node bifurcation lead to the coexistence of multiple stable equilibria (multistability) in the instantaneous updating network. We then study the effect of time delay on the local stability of these equilibria and show that four equilibria lose their stability at a certain critical value of time delay, and Hopf bifurcations of these equilibria occur simultaneously, leading to multiple coexisting periodic orbits. We apply centre manifold theory and normal form theory to determine the direction of these Hopf bifurcations and the stability of bifurcated periodic orbits. Numerical simulations show very interesting global patterns of periodic solutions as the time delay is varied. In particular, we observe that these four periodic solutions are glued together along the stable and unstable manifolds of saddle points to develop a butterfly structure through a complicated process of gluing bifurcations of periodic solutions

Bifurcation analysis of a discrete SIS model with bilinear incidence depending on new infection.

Science.gov (United States)

Cao, Hui; Zhou, Yicang; Ma, Zhien

2013-01-01

A discrete SIS epidemic model with the bilinear incidence depending on the new infection is formulated and studied. The condition for the global stability of the disease free equilibrium is obtained. The existence of the endemic equilibrium and its stability are investigated. More attention is paid to the existence of the saddle-node bifurcation, the flip bifurcation, and the Hopf bifurcation. Sufficient conditions for those bifurcations have been obtained. Numerical simulations are conducted to demonstrate our theoretical results and the complexity of the model.

Numerical analysis of bifurcations

International Nuclear Information System (INIS)

Guckenheimer, J.

1996-01-01

This paper is a brief survey of numerical methods for computing bifurcations of generic families of dynamical systems. Emphasis is placed upon algorithms that reflect the structure of the underlying mathematical theory while retaining numerical efficiency. Significant improvements in the computational analysis of dynamical systems are to be expected from more reliance of geometric insight coming from dynamical systems theory. copyright 1996 American Institute of Physics

Bifurcation Analysis with Aerodynamic-Structure Uncertainties by the Nonintrusive PCE Method

Directory of Open Access Journals (Sweden)

Linpeng Wang

2017-01-01

Full Text Available An aeroelastic model for airfoil with a third-order stiffness in both pitch and plunge degree of freedom (DOF and the modified Leishman–Beddoes (LB model were built and validated. The nonintrusive polynomial chaos expansion (PCE based on tensor product is applied to quantify the uncertainty of aerodynamic and structure parameters on the aerodynamic force and aeroelastic behavior. The uncertain limit cycle oscillation (LCO and bifurcation are simulated in the time domain with the stochastic PCE method. Bifurcation diagrams with uncertainties were quantified. The Monte Carlo simulation (MCS is also applied for comparison. From the current work, it can be concluded that the nonintrusive polynomial chaos expansion can give an acceptable accuracy and have a much higher calculation efficiency than MCS. For aerodynamic model, uncertainties of aerodynamic parameters affect the aerodynamic force significantly at the stage from separation to stall at upstroke and at the stage from stall to reattach at return. For aeroelastic model, both uncertainties of aerodynamic parameters and structure parameters impact bifurcation position. Structure uncertainty of parameters is more sensitive for bifurcation. When the nonlinear stall flutter and bifurcation are concerned, more attention should be paid to the separation process of aerodynamics and parameters about pitch DOF in structure.

Analysis of stability and Hopf bifurcation for a viral infectious model with delay

International Nuclear Information System (INIS)

Sun Chengjun; Cao Zhijie; Lin Yiping

2007-01-01

In this paper, a four-dimensional viral infectious model with delay is considered. The stability of the two equilibria and the existence of Hopf bifurcation are investigated. It is found that there are stability switches and Hopf bifurcations occur when the delay τ passes through a sequence of critical values. Using the normal form theory and center manifold argument [Hassard B, Kazarino D, Wan Y. Theory and applications of Hopf bifurcation. Cambridge: Cambridge University Press; 1981], the explicit formulaes which determine the stability, the direction and the period of bifurcating periodic solutions are derived. Numerical simulations are carried out to illustrate the validity of the main results

Aortic Blood Flow Reversal Determines Renal Function: Potential Explanation for Renal Dysfunction Caused by Aortic Stiffening in Hypertension.

Science.gov (United States)

Hashimoto, Junichiro; Ito, Sadayoshi

2015-07-01

Aortic stiffness determines the glomerular filtration rate (GFR) and predicts the progressive decline of the GFR. However, the underlying pathophysiological mechanism remains obscure. Recent evidence has shown a close link between aortic stiffness and the bidirectional (systolic forward and early diastolic reverse) flow characteristics. We hypothesized that the aortic stiffening-induced renal dysfunction is attributable to altered central flow dynamics. In 222 patients with hypertension, Doppler velocity waveforms were recorded at the proximal descending aorta to calculate the reverse/forward flow ratio. Tonometric waveforms were recorded to measure the carotid-femoral (aortic) and carotid-radial (peripheral) pulse wave velocities, to estimate the aortic pressure from the radial waveforms, and to compute the aortic characteristic impedance. In addition, renal hemodynamics was evaluated by duplex ultrasound. The estimated GFR was inversely correlated with the aortic pulse wave velocity, reverse/forward flow ratio, pulse pressure, and characteristic impedance, whereas it was not correlated with the peripheral pulse wave velocity or mean arterial pressure. The association between aortic pulse wave velocity and estimated GFR was independent of age, diabetes mellitus, hypercholesterolemia, and antihypertensive medication. However, further adjustment for the aortic reverse/forward flow ratio and pulse pressure substantially weakened this association, and instead, the reverse/forward flow ratio emerged as the strongest determinant of estimated GFR (P=0.001). A higher aortic reverse/forward flow ratio was also associated with lower intrarenal forward flow velocities. These results suggest that an increase in aortic flow reversal (ie, retrograde flow from the descending thoracic aorta toward the aortic arch), caused by aortic stiffening and impedance mismatch, reduces antegrade flow into the kidney and thereby deteriorates renal function. © 2015 American Heart Association

Extended aortic repair using frozen elephant trunk technique for Marfan syndrome with acute aortic dissection.

Science.gov (United States)

Uchida, Naomichi; Katayama, Akira; Kuraoka, Masatsugu; Katayama, Keijiro; Takahashi, Shinya; Takasaki, Taiichi; Sueda, Taijiro

2013-01-01

The aim of this study was to analyze midterm results of frozen elephant trunk technique for Marfan syndrome with acute aortic dissection. Between February 1999 and August 2011 we performed arch replacement uisng frozen elephant trunk technique for acute aortic dissection in 8 patients with Marfan syndrome containing two complicated type B dissections and six type A dissections.Five patients compromised annulo-aortic ectasia who performed Bentall operation. No patients died in the initial operation. Fate of false lumen on the stent graft border was expressed by CT scan follow-up that were patent in 0, thrombosis in 5 and absorption in 3 patients. One patient who had new aortic dissection 8 years after initial surgery required the Crawford V operation. Ten-years-survival rate was 100% and ten years-event free rate was 67%. Frozen elephant trunk technique was feasible for Marfan syndrome with acute aortic dissection and might become alternative prophylactic treatment to the downstream aorta for acute aortic dissection.

Effect of personalized external aortic root support on aortic root motion and distension in Marfan syndrome patients.

Science.gov (United States)

Izgi, Cemil; Nyktari, Evangelia; Alpendurada, Francisco; Bruengger, Annina Studer; Pepper, John; Treasure, Tom; Mohiaddin, Raad

2015-10-15

Personalized external aortic root support (PEARS) is a novel surgical approach with the aim of stabilizing the aortic root size and decreasing risk of dissection in Marfan syndrome patients. A bespoke polymer mesh tailored to each patient's individual aorta shape is produced by modeling and then surgically implanted. The aim of this study is to assess the mechanical effects of PEARS on the aortic root systolic downward motion (an important determinant of aortic wall stress), aortic root distension and on the left ventricle (LV). A cohort of 27 Marfan patients had a prophylactic PEARS surgery between 2004 and 2012 with 24 having preoperative and follow-up cardiovascular magnetic resonance imaging studies. Systolic downward aortic root motion, aortic root distension, LV volumes/mass and mitral annular systolic excursion before the operation and in the latest follow-up were measured randomly and blinded. After a median follow-up of 50.5 (IQR 25.5-72) months following implantation of PEARS, systolic downward motion of aortic root was significantly decreased (12.6±3.6mm pre-operation vs 7.9±2.9mm latest follow-up, p<0.00001). There was a tendency for a decrease in systolic aortic root distension but this was not significant (median 4.5% vs 2%, p=0.35). There was no significant change in LV volumes, ejection fraction, mass and mitral annular systolic excursion in follow-up. PEARS surgery decreases systolic downward aortic root motion which is an important determinant of longitudinal aortic wall stress. Aortic wall distension and Windkessel function are not significantly impaired in the follow-up after implantation of the mesh which is also supported by the lack of deterioration of LV volumes or mass. Crown Copyright © 2015. Published by Elsevier Ireland Ltd. All rights reserved.

Bovine aortic arch with supravalvular aortic stenosis.

Science.gov (United States)

Idhrees, Mohammed; Cherian, Vijay Thomas; Menon, Sabarinath; Mathew, Thomas; Dharan, Baiju S; Jayakumar, K

2016-09-01

A 5-year-old boy was diagnosed to have supravalvular aortic stenosis (SVAS). On evaluation of CT angiogram, there was associated bovine aortic arch (BAA). Association of BAA with SVAS has not been previously reported in literature, and to best of our knowledge, this is the first case report of SVAS with BAA. Recent studies show BAA as a marker for aortopathy. SVAS is also an arteriopathy. In light of this, SVAS can also possibly be a manifestation of aortopathy associated with BAA. Copyright © 2015 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.

Bifurcation and Control in a Singular Phytoplankton-Zooplankton-Fish Model with Nonlinear Fish Harvesting and Taxation

Science.gov (United States)

Meng, Xin-You; Wu, Yu-Qian

In this paper, a delayed differential algebraic phytoplankton-zooplankton-fish model with taxation and nonlinear fish harvesting is proposed. In the absence of time delay, the existence of singularity induced bifurcation is discussed by regarding economic interest as bifurcation parameter. A state feedback controller is designed to eliminate singularity induced bifurcation. Based on Liu’s criterion, Hopf bifurcation occurs at the interior equilibrium when taxation is taken as bifurcation parameter and is more than its corresponding critical value. In the presence of time delay, by analyzing the associated characteristic transcendental equation, the interior equilibrium loses local stability when time delay crosses its critical value. What’s more, the direction of Hopf bifurcation and stability of the bifurcating periodic solutions are investigated based on normal form theory and center manifold theorem, and nonlinear state feedback controller is designed to eliminate Hopf bifurcation. Furthermore, Pontryagin’s maximum principle has been used to obtain optimal tax policy to maximize the benefit as well as the conservation of the ecosystem. Finally, some numerical simulations are given to demonstrate our theoretical analysis.

Emergency Endovascular Treatment of Abdominal Aortic Aneurysms: Feasibility and Results

International Nuclear Information System (INIS)

Lagana, Domenico; Carrafiello, Gianpaolo; Mangini, Monica; Fontana, Federico; Caronno, Roberto; Castelli, Patrizio; Cuffari, Salvatore; Fugazzola, Carlo

2006-01-01

Purpose. To assess the feasibility and effectiveness of emergency endovascular treatment of abdominal aortic aneurysms (AAAs). Methods. During 36 months we treated, on an emergency basis, 30 AAAs with endovascular exclusion. In 21 hemodynamically stable patients preoperative CT angiography (CTA) was performed to confirm the diagnosis and to plan the treatment; 9 patients with hemorrhagic shock were evaluated with angiography performed in the operating room. Twenty-two Excluder (Gore) and 8 Zenith (Cook) stent-grafts (25 bifurcated and 5 aorto-uni-iliac) were used. The follow-up was performed by CTA at 1, 3, 6, and 12 months. Results. Technical success was achieved in 100% of cases with a 10% mortality rate. The total complication rate was 23% (5 increases in serum creatinine level and 2 wound infections). During the follow-up, performed in 27 patients (1-36 months, mean 15.2 months), 4 secondary endoleaks (15%) (3 type II, 2 spontaneously thrombosed and 1 under observation, and 1 type III treated by iliac extender insertion) and 1 iliac leg occlusion (treated with femoro-femoral bypass) occurred. We observed a shrinkage of the aneurysmal sac in 8 of 27 cases and stability in 19 of 27 cases; we did not observe any endotension. Conclusions. Endovascular repair is a good option for emergency treatment of AAAs. The team's experience allows correct planning of the procedure in emergency situations also, with technical results comparable with elective repair. In our experience the bifurcated stent-graft is the device of choice in patients with suitable anatomy because the procedure is less time-consuming than aorto-uni-iliac stent-grafting with surgical crossover, allowing faster aneurysm exclusion. However, further studies are required to demonstrate the long-term efficacy of endovascular repair compared with surgical treatment

Hopf bifurcation in a environmental defensive expenditures model with time delay

International Nuclear Information System (INIS)

Russu, Paolo

2009-01-01

In this paper a three-dimensional environmental defensive expenditures model with delay is considered. The model is based on the interactions among visitors V, quality of ecosystem goods E, and capital K, intended as accommodation and entertainment facilities, in Protected Areas (PAs). The tourism user fees (TUFs) are used partly as a defensive expenditure and partly to increase the capital stock. The stability and existence of Hopf bifurcation are investigated. It is that stability switches and Hopf bifurcation occurs when the delay t passes through a sequence of critical values, τ 0 . It has been that the introduction of a delay is a destabilizing process, in the sense that increasing the delay could cause the bio-economics to fluctuate. Formulas about the stability of bifurcating periodic solution and the direction of Hopf bifurcation are exhibited by applying the normal form theory and the center manifold theorem. Numerical simulations are given to illustrate the results.

Phase-flip bifurcation in a coupled Josephson junction neuron system

Energy Technology Data Exchange (ETDEWEB)

Segall, Kenneth, E-mail: ksegall@colgate.edu [Department of Physics and Astronomy, Colgate University, Hamilton, NY 13346 (United States); Guo, Siyang; Crotty, Patrick [Department of Physics and Astronomy, Colgate University, Hamilton, NY 13346 (United States); Schult, Dan [Department of Mathematics, Colgate University, Hamilton, NY 13346 (United States); Miller, Max [Department of Physics and Astronomy, Colgate University, Hamilton, NY 13346 (United States)

2014-12-15

Aiming to understand group behaviors and dynamics of neural networks, we have previously proposed the Josephson junction neuron (JJ neuron) as a fast analog model that mimics a biological neuron using superconducting Josephson junctions. In this study, we further analyze the dynamics of the JJ neuron numerically by coupling one JJ neuron to another. In this coupled system we observe a phase-flip bifurcation, where the neurons synchronize out-of-phase at weak coupling and in-phase at strong coupling. We verify this by simulation of the circuit equations and construct a bifurcation diagram for varying coupling strength using the phase response curve and spike phase difference map. The phase-flip bifurcation could be observed experimentally using standard digital superconducting circuitry.

Phase-flip bifurcation in a coupled Josephson junction neuron system

International Nuclear Information System (INIS)

Segall, Kenneth; Guo, Siyang; Crotty, Patrick; Schult, Dan; Miller, Max

2014-01-01

Aiming to understand group behaviors and dynamics of neural networks, we have previously proposed the Josephson junction neuron (JJ neuron) as a fast analog model that mimics a biological neuron using superconducting Josephson junctions. In this study, we further analyze the dynamics of the JJ neuron numerically by coupling one JJ neuron to another. In this coupled system we observe a phase-flip bifurcation, where the neurons synchronize out-of-phase at weak coupling and in-phase at strong coupling. We verify this by simulation of the circuit equations and construct a bifurcation diagram for varying coupling strength using the phase response curve and spike phase difference map. The phase-flip bifurcation could be observed experimentally using standard digital superconducting circuitry

Concepts to optimize stent-grafting of abdominal aortic aneurysms based on results of experimental studies

International Nuclear Information System (INIS)

Chavan, A.; Kirchhoff, T.; Baus, S.; Galanski, M.; Pichlmaier, M.

2001-01-01

Purpose. In the endoluminal therapy of abdominal aortic aneurysms, a short proximal aneurysm neck, endoleaks and the large size and stiffness of the introducer systems are responsible for many of the complications and sub-optimal outcomes. The purpose of the present review article is to to suggest strategies to minimize these complications based on the results of experimental studies in animals. Material and methods. After implanting various types of stents across the renal artery origins, the functional and morphological changes in the kidneys and renal vessels were studied by various authors. In order to prevent progressive widening of the proximal aneurysmal neck and graft dislocation, Sonesson et al. performed a laparoscopic banding around the proximal neck in pigs. To study the effects of endoleaks, Marty, Schurink and Pitton carried out pressure measurements in experimental aneurysms with and without endoleaks. Sakaguchi and Pavcnik developed the 'Twin-tube endografts' (TTEG) and the 'Bifurcated drum occluder endografts' (BDOEG) and tested them in dogs. Results. Up to 3 months after suprarenal stent placement, Chavan et al. detected no significant fall in the mean inulin clearance in sheep (140±46 ml/min before, 137±58 ml/min after). Nasim et al. and Malina et al. reported similar observations with respect to renal function. Suprarenal fixation may result in isolated thrombotic occlusions of the renal arteries and microinfarcts in the kidneys. Mean aortic diameters at the level of banding were significantly smaller in the animals with aortic banding as opposed to those in the control group without banding (8 mm vs 11 mm, p=0.004). The banding caused a secure proximal fixation of the stent-graft. Persistent endoleaks resulted in significantly higher intraaneurysmal pressures. Although the TTEG and the BDOEG stent-grafts required smaller sheaths, occlusions were observed in 8% (TTEG) and 60% (BDOEG) of the graft limbs. (orig.) [de

Ergodicity-breaking bifurcations and tunneling in hyperbolic transport models

Science.gov (United States)

Giona, M.; Brasiello, A.; Crescitelli, S.

2015-11-01

One of the main differences between parabolic transport, associated with Langevin equations driven by Wiener processes, and hyperbolic models related to generalized Kac equations driven by Poisson processes, is the occurrence in the latter of multiple stable invariant densities (Frobenius multiplicity) in certain regions of the parameter space. This phenomenon is associated with the occurrence in linear hyperbolic balance equations of a typical bifurcation, referred to as the ergodicity-breaking bifurcation, the properties of which are thoroughly analyzed.

Bifurcated states of the error-field-induced magnetic islands

International Nuclear Information System (INIS)

Zheng, L.-J.; Li, B.; Hazeltine, R.D.

2008-01-01

We find that the formation of the magnetic islands due to error fields shows bifurcation when neoclassical effects are included. The bifurcation, which follows from including bootstrap current terms in a description of island growth in the presence of error fields, provides a path to avoid the island-width pole in the classical description. The theory offers possible theoretical explanations for the recent DIII-D and JT-60 experimental observations concerning confinement deterioration with increasing error field

Bifurcation structure of successive torus doubling

International Nuclear Information System (INIS)

Sekikawa, Munehisa; Inaba, Naohiko; Yoshinaga, Tetsuya; Tsubouchi, Takashi

2006-01-01

The authors discuss the 'embryology' of successive torus doubling via the bifurcation theory, and assert that the coupled map of a logistic map and a circle map has a structure capable of generating infinite number of torus doublings

Experimental observation of bifurcation nature of radial electric field in CHS heliotron/torsatron

International Nuclear Information System (INIS)

Fujisawa, Akihide; Iguchi, Harukazu; Yoshimura, Yasuo; Minami, Takashi; Tanaka, Kenji; Okamura, Shoichi; Matsuoka, Keisuke; Fujiwara, Masami

1999-01-01

Several interesting phenomena, such as the formation of a particular potential profile with a protuberance around the core and oscillatory stationary states termed electric pulsation, have been discovered using a heavy ion beam probe in the electron cyclotron heated plasmas of the CHS. This paper presents experimental observations which indicate that bifurcation of the radial electric field is responsible for such phenomena; existence of an ECH power threshold to obtain the profile with a protuberance, and its striking sensitivity to density. In particular, Flip-flop behavior of the potential near the power threshold clearly demonstrates bifurcation characteristics. Bifurcation of radial electric field in neoclassical theory is presented, and its qualitative expectation is discussed in the bifurcation phenomena. The neoclassical transition time scale between two bifurcative sates is compared with the experimental observations during the electric pulsation. It is confirmed that the neoclassical transition time is not contradictory with the experimental one. (author)

Hybrid aortic repair with antegrade supra-aortic and renovisceral debranching from ascending aorta.

Science.gov (United States)

Del Castro-Madrazo, José Antonio; Rivas-Domínguez, Margarita; Fernández-Prendes, Carlota; Zanabili Al-Sibbai, Amer; Llaneza-Coto, José Manuel; Alonso-Pérez, Manuel

2017-05-01

Aortic dissection is a life threatening condition. Hybrid repair has been described for the treatment of complex aortic pathology such as thoracoabdominal aortic aneurysms (TAAA) and type A and B dissections, although open and total endovascular repair are also possible. Open surgery is still associated with substantial perioperative morbi-mortality rates, thus less invasive techniques such as endovascular repair and hybrid procedures can achieve good results in centers with experience. We present the case of a patient with a chronic type B dissection and TAAA degeneration that was treated in a single stage hybrid procedure with antegrade supra-aortic and renovisceral debranching from the ascending aorta and TEVAR. At three-year follow up, the patient is free of intervention-related complications.

Necessary and sufficient conditions for Hopf bifurcation in tri-neuron equation with a delay

International Nuclear Information System (INIS)

Liu Xiaoming; Liao Xiaofeng

2009-01-01

In this paper, we consider the delayed differential equations modeling three-neuron equations with only a time delay. Using the time delay as a bifurcation parameter, necessary and sufficient conditions for Hopf bifurcation to occur are derived. Numerical results indicate that for this model, Hopf bifurcation is likely to occur at suitable delay parameter values.

Homoclinic bifurcation in Chua's circuit

Indian Academy of Sciences (India)

spiking and bursting behaviors of neurons. Recent experiments ... a limit cycle increases in a wiggle with alternate sequences of stable and unstable orbits via ... further changes in parameter, the system shows period-adding bifurcation when .... [21–23] transition from limit cycle to single scroll chaos via PD and then to alter-.

Aortic Disease in the Young: Genetic Aneurysm Syndromes, Connective Tissue Disorders, and Familial Aortic Aneurysms and Dissections

Directory of Open Access Journals (Sweden)

Marcelo Cury

2013-01-01

Full Text Available There are many genetic syndromes associated with the aortic aneurysmal disease which include Marfan syndrome (MFS, Ehlers-Danlos syndrome (EDS, Loeys-Dietz syndrome (LDS, familial thoracic aortic aneurysms and dissections (TAAD, bicuspid aortic valve disease (BAV, and autosomal dominant polycystic kidney disease (ADPKD. In the absence of familial history and other clinical findings, the proportion of thoracic and abdominal aortic aneurysms and dissections resulting from a genetic predisposition is still unknown. In this study, we propose the review of the current genetic knowledge in the aortic disease, observing, in the results that the causative genes and molecular pathways involved in the pathophysiology of aortic aneurysm disease remain undiscovered and continue to be an area of intensive research.

Bifurcation Analysis and Chaos Control in a Discrete Epidemic System

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Wei Tan

2015-01-01

Full Text Available The dynamics of discrete SI epidemic model, which has been obtained by the forward Euler scheme, is investigated in detail. By using the center manifold theorem and bifurcation theorem in the interior R+2, the specific conditions for the existence of flip bifurcation and Neimark-Sacker bifurcation have been derived. Numerical simulation not only presents our theoretical analysis but also exhibits rich and complex dynamical behavior existing in the case of the windows of period-1, period-3, period-5, period-6, period-7, period-9, period-11, period-15, period-19, period-23, period-34, period-42, and period-53 orbits. Meanwhile, there appears the cascade of period-doubling 2, 4, 8 bifurcation and chaos sets from the fixed point. These results show the discrete model has more richer dynamics compared with the continuous model. The computations of the largest Lyapunov exponents more than 0 confirm the chaotic behaviors of the system x→x+δ[rN(1-N/K-βxy/N-(μ+mx], y→y+δ[βxy/N-(μ+dy]. Specifically, the chaotic orbits at an unstable fixed point are stabilized by using the feedback control method.

Heteroclinic Bifurcation Behaviors of a Duffing Oscillator with Delayed Feedback

Directory of Open Access Journals (Sweden)

Shao-Fang Wen

2018-01-01

Full Text Available The heteroclinic bifurcation and chaos of a Duffing oscillator with forcing excitation under both delayed displacement feedback and delayed velocity feedback are studied by Melnikov method. The Melnikov function is analytically established to detect the necessary conditions for generating chaos. Through the analysis of the analytical necessary conditions, we find that the influences of the delayed displacement feedback and delayed velocity feedback are separable. Then the influences of the displacement and velocity feedback parameters on heteroclinic bifurcation and threshold value of chaotic motion are investigated individually. In order to verify the correctness of the analytical conditions, the Duffing oscillator is also investigated by numerical iterative method. The bifurcation curves and the largest Lyapunov exponents are provided and compared. From the analysis of the numerical simulation results, it could be found that two types of period-doubling bifurcations occur in the Duffing oscillator, so that there are two paths leading to the chaos in this oscillator. The typical dynamical responses, including time histories, phase portraits, and Poincare maps, are all carried out to verify the conclusions. The results reveal some new phenomena, which is useful to design or control this kind of system.

Factors associated with the development of aortic valve regurgitation over time after two different techniques of valve-sparing aortic root surgery.

Science.gov (United States)

Hanke, Thorsten; Charitos, Efstratios I; Stierle, Ulrich; Robinson, Derek; Gorski, Armin; Sievers, Hans-H; Misfeld, Martin

2009-02-01

Early results after aortic valve-sparing root reconstruction are excellent. Longer-term follow-up, especially with regard to aortic valve function, is required for further judgment of these techniques. Between July of 1993 and September of 2006, 108 consecutive patients (mean age 53.0 +/- 15.8 years) underwent the Yacoub operation (group Y) and 83 patients underwent the David operation (group D). Innovative multilevel hierarchic modeling methods were used to analyze aortic regurgitation over time. In general, aortic regurgitation increased with time in both groups. Factors associated with the development of a significant increase in aortic regurgitation were Marfan syndrome, concomitant cusp intervention, and preoperative aortic anulus dimension. In Marfan syndrome, the initial aortic regurgitation was higher in group Y versus group D (0.56 aortic regurgitation vs 0.29 aortic regurgitation, P = .049), whereas the mean annual progression rate of aortic regurgitation was marginally higher in group Y (0.132 aortic regurgitation vs 0.075 aortic regurgitation, P = .1). Concomitant cusp intervention was associated with a significant aortic regurgitation increase in both groups (P Marfan syndrome and a large preoperative aortic annulus diameter were better treated with the reimplantation technique, whereas those with a smaller diameter were better treated with the remodeling technique. Concomitant free-edge plication of prolapsing cusps was disadvantageous in both groups. Considering these factors may serve to improve the aortic valve longevity after valve-sparing aortic root surgery.

Aortic valve surgery - open

Science.gov (United States)

... gov/ency/article/007408.htm Aortic valve surgery - open To use the sharing features on this page, ... separates the heart and aorta. The aortic valve opens so blood can flow out. It then closes ...

Clip reconstruction of a large right MCA bifurcation aneurysm. Case report

Directory of Open Access Journals (Sweden)

Giovani A.

2014-06-01

Full Text Available We report a case of complex large middle cerebral artery (MCA bifurcation aneurysm that ruptured during dissection from the very adherent MCA branches but was successfully clipped and the MCA bifurcation reconstructed using 4 Yasargill clips. Through a right pterional craniotomy the sylvian fissure was largely opened as to allow enough workspace for clipping the aneurysm and placing a temporary clip on M1. The pacient recovered very well after surgery and was discharged after 1 week with no neurological deficit. Complex MCA bifurcation aneurysms can be safely reconstructed using regular clips, without the need of using fenestrated clips or complex by-pass procedures.

Bifurcation analysis of the logistic map via two periodic impulsive forces

International Nuclear Information System (INIS)

Jiang Hai-Bo; Li Tao; Zeng Xiao-Liang; Zhang Li-Ping

2014-01-01

The complex dynamics of the logistic map via two periodic impulsive forces is investigated in this paper. The influences of the system parameter and the impulsive forces on the dynamics of the system are studied respectively. With the parameter varying, the system produces the phenomenon such as periodic solutions, chaotic solutions, and chaotic crisis. Furthermore, the system can evolve to chaos by a cascading of period-doubling bifurcations. The Poincaré map of the logistic map via two periodic impulsive forces is constructed and its bifurcation is analyzed. Finally, the Floquet theory is extended to explore the bifurcation mechanism for the periodic solutions of this non-smooth map. (general)

Aortic annulus eccentricity before and after transcatheter aortic valve implantation: Comparison of balloon-expandable and self-expanding prostheses

International Nuclear Information System (INIS)

Schuhbaeck, Annika; Weingartner, Christina; Arnold, Martin; Schmid, Jasmin; Pflederer, Tobias; Marwan, Mohamed; Rixe, Johannes; Nef, Holger; Schneider, Christian; Lell, Michael; Uder, Michael; Ensminger, Stephan; Feyrer, Richard; Weyand, Michael; Achenbach, Stephan

2015-01-01

Highlights: • Post-implant geometry of catheter-based aortic valve prostheses is influenced by aortic valve calcification. • Balloon-expandable prostheses are more circular as compared to self-expanding prostheses. • The impact of post-implant geometry on valve function needs to be investigated. - Abstract: Introduction: The geometry of the aortic annulus and implanted transcatheter aortic valve prosthesis might influence valve function. We investigated the influence of valve type and aortic valve calcification on post-implant geometry of catheter-based aortic valve prostheses. Methods: Eighty consecutive patients with severe aortic valve stenosis (mean age 82 ± 6 years) underwent computed tomography before and after TAVI. Aortic annulus diameters were determined. Influence of prosthesis type and degree of aortic valve calcification on post-implant eccentricity were analysed. Results: Aortic annulus eccentricity was reduced in patients after TAVI (0.21 ± 0.06 vs. 0.08 ± 0.06, p < 0.0001). Post-TAVI eccentricity was significantly lower in 65 patients following implantation of a balloon-expandable prosthesis as compared to 15 patients who received a self-expanding prosthesis (0.06 ± 0.05 vs. 0.15 ± 0.07, p < 0.0001), even though the extent of aortic valve calcification was not different. After TAVI, patients with a higher calcium amount retained a significantly higher eccentricity compared to patients with lower amounts of calcium. Conclusions: Patients undergoing TAVI with a balloon-expandable prosthesis show a more circular shape of the implanted prosthesis as compared to patients with a self-expanding prosthesis. Eccentricity of the deployed prosthesis is affected by the extent of aortic valve calcification

Equivariant bifurcation in a coupled complex-valued neural network rings

International Nuclear Information System (INIS)

Zhang, Chunrui; Sui, Zhenzhang; Li, Hongpeng

2017-01-01

Highlights: • Complex value Hopfield-type network with Z4 × Z2 symmetry is discussed. • The spatio-temporal patterns of bifurcating periodic oscillations are obtained. • The oscillations can be in phase or anti-phase depending on the parameters and delay. - Abstract: Network with interacting loops and time delays are common in physiological systems. In the past few years, the dynamic behaviors of coupled interacting loops neural networks have been widely studied due to their extensive applications in classification of pattern recognition, signal processing, image processing, engineering optimization and animal locomotion, and other areas, see the references therein. In a large amount of applications, complex signals often occur and the complex-valued recurrent neural networks are preferable. In this paper, we study a complex value Hopfield-type network that consists of a pair of one-way rings each with four neurons and two-way coupling between each ring. We discuss the spatio-temporal patterns of bifurcating periodic oscillations by using the symmetric bifurcation theory of delay differential equations combined with representation theory of Lie groups. The existence of multiple branches of bifurcating periodic solution is obtained. We also found that the spatio-temporal patterns of bifurcating periodic oscillations alternate according to the change of the propagation time delay in the coupling, i.e., different ranges of delays correspond to different patterns of neural network oscillators. The oscillations of corresponding neurons in the two loops can be in phase or anti-phase depending on the parameters and delay. Some numerical simulations support our analysis results.

Classification of coronary artery bifurcation lesions and treatments: Time for a consensus!

DEFF Research Database (Denmark)

Louvard, Yves; Thomas, Martyn; Dzavik, Vladimir

2007-01-01

by intention to treat, it is necessary to clearly define which vessel is the distal main branch and which is (are) the side branche(s) and give each branch a distinct name. Each segment of the bifurcation has been named following the same pattern as the Medina classification. The classification......, heterogeneity, and inadequate description of techniques implemented. Methods: The aim is to propose a consensus established by the European Bifurcation Club (EBC), on the definition and classification of bifurcation lesions and treatments implemented with the purpose of allowing comparisons between techniques...... in various anatomical and clinical settings. Results: A bifurcation lesion is a coronary artery narrowing occurring adjacent to, and/or involving, the origin of a significant side branch. The simple lesion classification proposed by Medina has been adopted. To analyze the outcomes of different techniques...

Views on the Hopf bifurcation with respect to voltage instabilities

Energy Technology Data Exchange (ETDEWEB)

Roa-Sepulveda, C A [Universidad de Concepcion, Concepcion (Chile). Dept. de Ingenieria Electrica; Knight, U G [Imperial Coll. of Science and Technology, London (United Kingdom). Dept. of Electrical and Electronic Engineering

1994-12-31

This paper presents a sensitivity study of the Hopf bifurcation phenomenon which can in theory appear in power systems, with reference to the dynamics of the process and the impact of demand characteristics. Conclusions are drawn regarding power levels at which these bifurcations could appear and concern the concept of the imaginary axis as a `hard` limit eigenvalue analyses. (author) 20 refs., 31 figs.

Aortic valve replacement and prosthesis-patient mismatch in the era of trans-catheter aortic valve implantation.

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Morita, Shigeki

2016-08-01

The treatment strategy for aortic stenosis (AS) has been changing due to newly developed valvular prostheses and trans-catheter aortic valve implantation (TAVI). To determine the role of new modalities for AS with a small aortic root, papers using the concept of prosthesis-patient mismatch (PPM) were reviewed. First, to determine the cut-off value of the indexed effective orifice area (IEOA) for defining PPM, the studies of surgical aortic valve replacement (SAVR) with a follow-up longer than 5 years and a patient number larger than 500 were reviewed. Second, the papers comparing TAVI and SAVR were reviewed. Furthermore, the prevalence of PPM was reviewed, with the addition of papers on aortic root enlargement, sutureless AVR, and aortic valve reconstruction with autologous pericardium. The results of the long-term survival after aortic valve replacement (AVR) have indicated that an IEOA less than 0.65 cm(2)/m(2) should be avoided in all cases, whereas the indications for patients with an IEOA between 065 and 0.85 cm(2)/m(2) should be determined by considering multiple factors. A large body size and younger age have a significantly negative influence on the long-term survival. In Asian population, the prevalence of PPM was low, despite the fact that the size of the aortic annulus was small. The IEOA after TAVI was larger than after surgical AVR in population-matched studies. To evaluate the role of TAVI and other modalities for a small aortic root, studies with a longer follow-up and larger volume are thus warranted.

Invariants, Attractors and Bifurcation in Two Dimensional Maps with Polynomial Interaction

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Hacinliyan, Avadis Simon; Aybar, Orhan Ozgur; Aybar, Ilknur Kusbeyzi

This work will present an extended discrete-time analysis on maps and their generalizations including iteration in order to better understand the resulting enrichment of the bifurcation properties. The standard concepts of stability analysis and bifurcation theory for maps will be used. Both iterated maps and flows are used as models for chaotic behavior. It is well known that when flows are converted to maps by discretization, the equilibrium points remain the same but a richer bifurcation scheme is observed. For example, the logistic map has a very simple behavior as a differential equation but as a map fold and period doubling bifurcations are observed. A way to gain information about the global structure of the state space of a dynamical system is investigating invariant manifolds of saddle equilibrium points. Studying the intersections of the stable and unstable manifolds are essential for understanding the structure of a dynamical system. It has been known that the Lotka-Volterra map and systems that can be reduced to it or its generalizations in special cases involving local and polynomial interactions admit invariant manifolds. Bifurcation analysis of this map and its higher iterates can be done to understand the global structure of the system and the artifacts of the discretization by comparing with the corresponding results from the differential equation on which they are based.

Numerical Hopf bifurcation of Runge-Kutta methods for a class of delay differential equations

International Nuclear Information System (INIS)

Wang Qiubao; Li Dongsong; Liu, M.Z.

2009-01-01

In this paper, we consider the discretization of parameter-dependent delay differential equation of the form y ' (t)=f(y(t),y(t-1),τ),τ≥0,y element of R d . It is shown that if the delay differential equation undergoes a Hopf bifurcation at τ=τ * , then the discrete scheme undergoes a Hopf bifurcation at τ(h)=τ * +O(h p ) for sufficiently small step size h, where p≥1 is the order of the Runge-Kutta method applied. The direction of numerical Hopf bifurcation and stability of bifurcating invariant curve are the same as that of delay differential equation.

Thoracic aortic aneurysms and dissections: endovascular treatment.

Science.gov (United States)

Baril, Donald T; Cho, Jae S; Chaer, Rabih A; Makaroun, Michel S

2010-01-01

The treatment of thoracic aortic disease has changed radically with the advances made in endovascular therapy since the concept of thoracic endovascular aortic repair was first described 15 years ago. Currently, there is a diverse array of endografts that are commercially available to treat the thoracic aorta. Multiple studies, including industry-sponsored and single-institution reports, have demonstrated excellent outcomes of thoracic endovascular aortic repair for the treatment of thoracic aortic aneurysms, with less reported perioperative morbidity and mortality in comparison with conventional open repair. Additionally, similar outcomes have been demonstrated for the treatment of type B dissections. However, the technology remains relatively novel, and larger studies with longer term outcomes are necessary to more fully evaluate the role of endovascular therapy for the treatment of thoracic aortic disease. This review examines the currently available thoracic endografts, preoperative planning for thoracic endovascular aortic repair, and outcomes of thoracic endovascular aortic repair for the treatment of both thoracic aortic aneurysms and type B aortic dissections. Mt Sinai J Med 77:256-269, 2010. (c) 2010 Mount Sinai School of Medicine.

Hopf bifurcation of the stochastic model on business cycle

International Nuclear Information System (INIS)

Xu, J; Wang, H; Ge, G

2008-01-01

A stochastic model on business cycle was presented in thas paper. Simplifying the model through the quasi Hamiltonian theory, the Ito diffusion process was obtained. According to Oseledec multiplicative ergodic theory and singular boundary theory, the conditions of local and global stability were acquired. Solving the stationary FPK equation and analyzing the stationary probability density, the stochastic Hopf bifurcation was explained. The result indicated that the change of parameter awas the key factor to the appearance of the stochastic Hopf bifurcation

Aortic valve function after bicuspidization of the unicuspid aortic valve.

Science.gov (United States)

Aicher, Diana; Bewarder, Moritz; Kindermann, Michael; Abdul-Khalique, Hashim; Schäfers, Hans-Joachim

2013-05-01

Unicuspid aortic valve (UAV) anatomy leads to dysfunction of the valve in young individuals. We introduced a reconstructive technique of bicuspidizing the UAV. Initially we copied the typical asymmetry of a normal bicuspid aortic valve (BAV) (I), later we created a symmetric BAV (II). This study compared the hemodynamic function of the two designs of a bicuspidized UAV. Aortic valve function was studied at rest and during exercise in 28 patients after repair of UAV (group I, n = 8; group II, n = 20). There were no differences among the groups I and II with respect to gender, age, body size, or weight. All patients were in New York Heart Association class I. Six healthy adults served as control individuals. All patients were studied with transthoracic echocardiography between 4 and 65 months postoperatively. Systolic gradients were assessed by continuous wave Doppler while patients were at rest and exercising on a bicycle ergometer. Aortic regurgitation was grade I or less in all patients. Resting gradients were significantly elevated in group I compared with group II and control individuals (group I, peak 33.8 ± 7.8 mm Hg; mean 19.1 ± 5.4 mm Hg; group II, peak 15.8 ± 5.4, mean 8.2 ± 2.8 mm Hg; control individuals, peak 6.0 ± 1.6, mean 3.2 ± 0.8 mm Hg; p competence. A symmetric repair design leads to improved systolic aortic valve function at rest and during exercise. Copyright © 2013 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Aortic annulus and ascending aorta: Comparison of preoperative and periooperative measurement in patients with aortic stenosis

International Nuclear Information System (INIS)

Smid, Michal; Ferda, Jiri; Baxa, Jan; Cech, Jakub; Hajek, Tomas; Kreuzberg, Boris; Rokyta, Richard

2010-01-01

Background: Precise determination of the aortic annulus size constitutes an integral part of the preoperative evaluation prior to aortic valve replacement. It enables the estimation of the size of prosthesis to be implanted. Knowledge of the size of the ascending aorta is required in the preoperative analysis and monitoring of its dilation enables the precise timing of the operation. Our goal was to compare the precision of measurement of the aortic annulus and ascending aorta using magnetic resonance (MR), multidetector-row computed tomography (MDCT), transthoracic echocardiography (TTE), and transoesophageal echocardiography (TEE) in patients with degenerative aortic stenosis. Methods and results: A total of 15 patients scheduled to have aortic valve replacement were enrolled into this prospective study. TTE was performed in all patients and was supplemented with TEE, CT and MR in the majority of patients. The values obtained were compared with perioperative measurements. For the measurement of aortic annulus, MR was found to be the most precise technique, followed by MDCT, TTE, and TEE. For the measurement of ascending aorta, MR again was found to be the most precise technique, followed by MDCT, TEE, and TTE. Conclusion: In our study, magnetic resonance was found to be the most precise technique for the measurement of aortic annulus and ascending aorta in patients with severe degenerative aortic stenosis.

Aortic arch malformations

Energy Technology Data Exchange (ETDEWEB)

Kellenberger, Christian J. [University Children' s Hospital, Department of Diagnostic Imaging, Zuerich (Switzerland)

2010-06-15

Although anomalies of the aortic arch and its branches are relatively uncommon malformations, they are often associated with congenital heart disease. Isolated lesions may be clinically significant when the airways are compromised by a vascular ring. In this article, the development and imaging appearance of the aortic arch system and its various malformations are reviewed. (orig.)

Aortic arch malformations

International Nuclear Information System (INIS)

Kellenberger, Christian J.

2010-01-01

Although anomalies of the aortic arch and its branches are relatively uncommon malformations, they are often associated with congenital heart disease. Isolated lesions may be clinically significant when the airways are compromised by a vascular ring. In this article, the development and imaging appearance of the aortic arch system and its various malformations are reviewed. (orig.)

Bifurcation analysis of a delayed mathematical model for tumor growth

International Nuclear Information System (INIS)

Khajanchi, Subhas

2015-01-01

In this study, we present a modified mathematical model of tumor growth by introducing discrete time delay in interaction terms. The model describes the interaction between tumor cells, healthy tissue cells (host cells) and immune effector cells. The goal of this study is to obtain a better compatibility with reality for which we introduced the discrete time delay in the interaction between tumor cells and host cells. We investigate the local stability of the non-negative equilibria and the existence of Hopf-bifurcation by considering the discrete time delay as a bifurcation parameter. We estimate the length of delay to preserve the stability of bifurcating periodic solutions, which gives an idea about the mode of action for controlling oscillations in the tumor growth. Numerical simulations of the model confirm the analytical findings

Electron Bifurcation: Thermodynamics and Kinetics of Two-Electron Brokering in Biological Redox Chemistry.

Science.gov (United States)

Zhang, Peng; Yuly, Jonathon L; Lubner, Carolyn E; Mulder, David W; King, Paul W; Peters, John W; Beratan, David N

2017-09-19

How can proteins drive two electrons from a redox active donor onto two acceptors at very different potentials and distances? And how can this transaction be conducted without dissipating very much energy or violating the laws of thermodynamics? Nature appears to have addressed these challenges by coupling thermodynamically uphill and downhill electron transfer reactions, using two-electron donor cofactors that have very different potentials for the removal of the first and second electron. Although electron bifurcation is carried out with near perfection from the standpoint of energy conservation and electron delivery yields, it is a biological energy transduction paradigm that has only come into focus recently. This Account provides an exegesis of the biophysical principles that underpin electron bifurcation. Remarkably, bifurcating electron transfer (ET) proteins typically send one electron uphill and one electron downhill by similar energies, such that the overall reaction is spontaneous, but not profligate. Electron bifurcation in the NADH-dependent reduced ferredoxin: NADP + oxidoreductase I (Nfn) is explored in detail here. Recent experimental progress in understanding the structure and function of Nfn allows us to dissect its workings in the framework of modern ET theory. The first electron that leaves the two-electron donor flavin (L-FAD) executes a positive free energy "uphill" reaction, and the departure of this electron switches on a second thermodynamically spontaneous ET reaction from the flavin along a second pathway that moves electrons in the opposite direction and at a very different potential. The singly reduced ET products formed from the bifurcating flavin are more than two nanometers distant from each other. In Nfn, the second electron to leave the flavin is much more reducing than the first: the potentials are said to be "crossed." The eventually reduced cofactors, NADH and ferredoxin in the case of Nfn, perform crucial downstream redox

Aortic distensibility after aortic root replacement assessed with cardiovascular magnetic resonance.

Science.gov (United States)

Melina, Giovanni; Rajappan, Kim; Amrani, Mohamed; Khaghani, Asghar; Pennell, Dudley J; Yacoub, Magdi H

2002-01-01

The changes in geometry of the aortic root during the cardiac cycle are thought to be essential for optimal valve function, both in terms of leaflet stress and dynamic behavior. Using cardiac magnetic resonance (CMR), the study aim was to determine aortic root distensibility of the homograft (group H) and the Medtronic Freestyle xenograft (group F) after aortic root replacement, from a prospective randomized trial. CMR was performed in 15 patients (six homografts, nine Freestyle) at six months and one year after surgery. Percentage change in aortic radius (PCR) and pressure strain elastic modulus (PSEM) were measured as indices of distensibility, and results related to left ventricular mass (LVM). At six months after surgery, mean PCR was 12+/-2.5 in group H and 12.9+/-6.1 in group F (p = NS), and PSEM was 428.5+/-69.8 and 493.5+/-72.7 g/cm2, respectively (p = NS). PCR was reduced to 10+/-1.7% in group H, and by 8.5+/-2.8% in group F (p = NS), while PSEM was increased to 520.5+/-87.3 and 825+/-420.4, respectively (p = NS) at the one-year follow up. Regression analysis showed a correlation between PCR and LVM (r = 0.52, p = 0.08) and LVM index (r = 0.46, p = 0.14), respectively. In addition, there was a relationship between PSEM, LVM and LVM index, suggesting that the stiffer the root wall, the higher the postoperative LVM. Up to one year after aortic root replacement, the wall of both the allogenic and xenogenic valves retained near-normal distensibility. For the first time, a correlation was demonstrated between the elastic properties of the aortic root and LVM. The longer-term behavior and clinical implications of these findings require further investigation.

Bifurcation of Mobility, Bifurcation of Law : Externalization of migration policy before the EU Court of Justice

NARCIS (Netherlands)

Spijkerboer, T.P.

2017-01-01

The externalization of European migration policy has resulted in a bifurcation of global human mobility, which is divided along a North/South axis. In two judgments, the EU Court of Justice was confronted with cases challenging the exclusion of Syrian refugees from Europe. These cases concern core

Bifurcation in autonomous and nonautonomous differential equations with discontinuities

CERN Document Server

Akhmet, Marat

2017-01-01

This book is devoted to bifurcation theory for autonomous and nonautonomous differential equations with discontinuities of different types. That is, those with jumps present either in the right-hand-side or in trajectories or in the arguments of solutions of equations. The results obtained in this book can be applied to various fields such as neural networks, brain dynamics, mechanical systems, weather phenomena, population dynamics, etc. Without any doubt, bifurcation theory should be further developed to different types of differential equations. In this sense, the present book will be a leading one in this field. The reader will benefit from the recent results of the theory and will learn in the very concrete way how to apply this theory to differential equations with various types of discontinuity. Moreover, the reader will learn new ways to analyze nonautonomous bifurcation scenarios in these equations. The book will be of a big interest both for beginners and experts in the field. For the former group o...

Ascending aortic injuries following blunt trauma.

Science.gov (United States)

Sun, Xiumei; Hong, Jenny; Lowery, Robert; Goldstein, Steven; Wang, Zuyue; Lindsay, Joseph; Hill, Peter C; Corso, Paul J

2013-11-01

The diagnosis and the management of traumatic thoracic aortic injuries have undergone significant changes due to new technology and improved prehospital care. Most of the discussions have focused on descending aortic injuries. In this review, we discuss the recent management of ascending aortic injuries. We found 5 cohort studies on traumatic aortic injuries and 11 case reports describing ascending aortic injuries between 1998 to the present through Medline research. Among case reports, 78.9% of cases were caused by motor vehicle accidents (MVA). 42.1% of patients underwent emergent open repair and the operative mortality was 12.5%. 36.8% underwent delayed repair. Associated injuries occurred in 84.2% of patients. Aortic valve injury was concurrent in 26.3% of patients. The incidence of ascending aortic injury ranged 1.9-20% in cohort studies. Traumatic injuries to the ascending aorta are relatively uncommon among survivors following blunt trauma. Aortography has been replaced by computed tomography and echocardiography as a diagnostic tool. Open repair, either emergent or delayed, remains the treatment of choice. © 2013 Wiley Periodicals, Inc.

Can early aortic root surgery prevent further aortic dissection in Marfan syndrome?

Science.gov (United States)

Shimizu, Hideyuki; Kasahara, Hirofumi; Nemoto, Atsushi; Yamabe, Kentaro; Ueda, Toshihiko; Yozu, Ryohei

2012-02-01

We reviewed 50 patients with Marfan syndrome who underwent surgery for aortic root pathologies comprising a root aneurysm without (n = 25; group A) and with (n = 25; group B) dissection. Aortic root repair included Bentall (n = 37) and valve-sparing (n = 13) procedures. Hospital mortality was 4.0%. Twenty-two patients required 36 repeat surgeries on the distal aorta. The main indication for re-intervention was the dilation of the false lumen. In group A, the distal aorta was stable for up to 7 years, but new dissection developed in 5 (33.3%) of the 15 patients who were followed up for >7 years after the root repair. Actuarial survival including operative mortality was 88.1 and 65.0% at 10 and 20 years, respectively; groups A and B did not significantly differ. Rates of freedom from all-cause death, new dissection or repeated aortic surgery were 60.1, 44.5 and 26.0% at 5, 10 and 15 years, respectively. Group A was significantly better than group B. Prophylactic aortic root repair apparently reduces the likelihood of overall adverse events, but it cannot guarantee the prevention of further aortic dissection. A multidisciplinary approach is needed for patients with Marfan syndrome.

Abdominal Aortic Aneurysm (AAA)

Science.gov (United States)

... Professions Site Index A-Z Abdominal Aortic Aneurysm (AAA) Abdominal aortic aneurysm (AAA) occurs when atherosclerosis or plaque buildup causes the ... weak and bulge outward like a balloon. An AAA develops slowly over time and has few noticeable ...

Symmetry breaking bifurcations of a current sheet

International Nuclear Information System (INIS)

Parker, R.D.; Dewar, R.L.; Johnson, J.L.

1990-01-01

Using a time evolution code with periodic boundary conditions, the viscoresistive hydromagnetic equations describing an initially static, planar current sheet with large Lundquist number have been evolved for times long enough to reach a steady state. A cosh 2 x resistivity model was used. For long periodicity lengths L p , the resistivity gradient drives flows that cause forced reconnection at X point current sheets. Using L p as a bifurcation parameter, two new symmetry breaking bifurcations were found: a transition to an asymmetric island chain with nonzero, positive, or negative phase velocity, and a transition to a static state with alternating large and small islands. These states are reached after a complex transient behavior, which involves a competition between secondary current sheet instability and coalescence

A History of Thoracic Aortic Surgery.

Science.gov (United States)

McFadden, Paul Michael; Wiggins, Luke M; Boys, Joshua A

2017-08-01

Ancient historical texts describe the presence of aortic pathology conditions, although the surgical treatment of thoracic aortic disease remained insurmountable until the 19th century. Surgical treatment of thoracic aortic disease then progressed along with advances in surgical technique, conduit production, cardiopulmonary bypass, and endovascular technology. Despite radical advances in aortic surgery, principles established by surgical pioneers of the 19th century hold firm to this day. Copyright © 2017 Elsevier Inc. All rights reserved.

Effects of acute dietary nitrate supplementation on aortic blood pressure and aortic augmentation index in young and older adults.

Science.gov (United States)

Hughes, William E; Ueda, Kenichi; Treichler, David P; Casey, Darren P

2016-09-30

Aging is associated with elevated blood pressure (peripheral and aortic; BP) and aortic augmentation index (AIx) which may contribute to aortic BP. Although inorganic nitrate consumption reduces peripheral BP in both young and older adults, the effects of nitrate consumption on aortic BP and wave reflection in young and older adults is unknown. Therefore, we sought to characterize the effects of nitrate consumption on aortic BP and AIx in young and older adults. Noninvasive aortic pressure waveforms were synthesized from high-fidelity radial pressure waveforms via applanation tonometry before and following (60, 90, 120, 150, and 180 min) consumption of a nitrate-rich beetroot juice in 26 healthy adults (young: 25 ± 4 years, n = 14; older: 64 ± 5 years, n = 12). Aortic BP and indices of aortic wave reflection (AIx and AIx normalized for heart rate; AIx@75bpm) were calculated from the generated aortic pressure waveform. Nitrate consumption increased plasma nitrite in both groups 60-180 min following beetroot consumption (P young and older adults (P age groups. Conversely, indices of aortic wave reflection were reduced only in young adults following nitrate consumption (range of change from baseline over time: AIx@75bpm, -4.3 to -8.8%, P adults. Taken together, our results suggest that acute dietary nitrate supplementation reduces peripheral and aortic BP similarly in young and older adults despite differential effects on aortic AIx between age groups. Copyright © 2016 Elsevier Inc. All rights reserved.

Bifurcation and Nonlinear Oscillations.

Science.gov (United States)

1980-09-28

Structural stability and bifurcation theory. pp. 549-560 in Dinamical Systems (Ed. MI. Peixoto), Academic Press, 1973. [211 J. Sotomayor, Generic one...Dynamical Systems Brown University ELECTP" 71, Providence, R. I. 02912 1EC 2 4 1980j //C -*)’ Septabe-4., 1980 / -A + This research was supported in...problems are discussed. The first one deals with the characterization of the flow for a periodic planar system which is the perturbation of an autonomous

Bifurcation routes and economic stability

Czech Academy of Sciences Publication Activity Database

Vošvrda, Miloslav

2001-01-01

Roč. 8, č. 14 (2001), s. 43-59 ISSN 1212-074X R&D Projects: GA ČR GA402/00/0439; GA ČR GA402/01/0034; GA ČR GA402/01/0539 Institutional research plan: AV0Z1075907 Keywords : macroeconomic stability * foreign investment phenomenon * the Hopf bifurcation Subject RIV: AH - Economics

Bifurcation and chaos in a Tessiet type food chain chemostat with pulsed input and washout

International Nuclear Information System (INIS)

Wang Fengyan; Hao Chunping; Chen Lansun

2007-01-01

In this paper, we introduce and study a model of a Tessiet type food chain chemostat with pulsed input and washout. We investigate the subsystem with substrate and prey and study the stability of the periodic solutions, which are the boundary periodic solutions of the system. The stability analysis of the boundary periodic solution yields an invasion threshold. By use of standard techniques of bifurcation theory, we prove that above this threshold there are periodic oscillations in substrate, prey and predator. Simple cycles may give way to chaos in a cascade of period-doubling bifurcations. Furthermore, by comparing bifurcation diagrams with different bifurcation parameters, we can see that the impulsive system shows two kinds of bifurcations, whose are period doubling and period halving

Association of aortic valve calcification severity with the degree of aortic regurgitation after transcatheter aortic valve implantation.

Science.gov (United States)

Koos, Ralf; Mahnken, Andreas Horst; Dohmen, Guido; Brehmer, Kathrin; Günther, Rolf W; Autschbach, Rüdiger; Marx, Nikolaus; Hoffmann, Rainer

2011-07-15

This study sought to examine a possible relationship between the severity of aortic valve calcification (AVC), the distribution of AVC and the degree of aortic valve regurgitation (AR) after transcatheter aortic valve implantation (TAVI) for severe aortic stenosis (AS). 57 patients (22 men, 81 ± 5 years) with symptomatic AS and with a logistic EuroSCORE of 24 ± 12 were included. 38 patients (67%) received a third (18F)-generation CoreValve® aortic valve prosthesis, in 19 patients (33%) an Edwards SAPIEN™ prosthesis was implanted. Prior to TAVI dual-source computed tomography for assessment of AVC was performed. To determine the distribution of AVC the percentage of the calcium load of the most severely calcified cusp was calculated. After TAVI the degree of AR was determined by angiography and echocardiography. The severity of AR after TAVI was related to the severity and distribution of AVC. There was no association between the distribution of AVC and the degree of paravalvular AR after TAVI as assessed by angiography (r = -0.02, p = 0.88). Agatston AVC scores were significantly higher in patients with AR grade ≥ 3 (5055 ± 1753, n = 3) than in patients with AR grade AVC scores > 3000 were associated with a relevant paravalvular AR and showed a trend for increased need for second manoeuvres. There was a significant correlation between the severity of AVC and the degree of AR after AVR (r = 0.50, p AVC have an increased risk for a relevant AR after TAVI as well as a trend for increased need for additional procedures. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Stability and Bifurcation Analysis of a Modified Epidemic Model for Computer Viruses

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Chuandong Li

2014-01-01

Full Text Available We extend the three-dimensional SIR model to four-dimensional case and then analyze its dynamical behavior including stability and bifurcation. It is shown that the new model makes a significant improvement to the epidemic model for computer viruses, which is more reasonable than the most existing SIR models. Furthermore, we investigate the stability of the possible equilibrium point and the existence of the Hopf bifurcation with respect to the delay. By analyzing the associated characteristic equation, it is found that Hopf bifurcation occurs when the delay passes through a sequence of critical values. An analytical condition for determining the direction, stability, and other properties of bifurcating periodic solutions is obtained by using the normal form theory and center manifold argument. The obtained results may provide a theoretical foundation to understand the spread of computer viruses and then to minimize virus risks.

Von Bertalanffy's dynamics under a polynomial correction: Allee effect and big bang bifurcation

Science.gov (United States)

Leonel Rocha, J.; Taha, A. K.; Fournier-Prunaret, D.

2016-02-01

In this work we consider new one-dimensional populational discrete dynamical systems in which the growth of the population is described by a family of von Bertalanffy's functions, as a dynamical approach to von Bertalanffy's growth equation. The purpose of introducing Allee effect in those models is satisfied under a correction factor of polynomial type. We study classes of von Bertalanffy's functions with different types of Allee effect: strong and weak Allee's functions. Dependent on the variation of four parameters, von Bertalanffy's functions also includes another class of important functions: functions with no Allee effect. The complex bifurcation structures of these von Bertalanffy's functions is investigated in detail. We verified that this family of functions has particular bifurcation structures: the big bang bifurcation of the so-called “box-within-a-box” type. The big bang bifurcation is associated to the asymptotic weight or carrying capacity. This work is a contribution to the study of the big bang bifurcation analysis for continuous maps and their relationship with explosion birth and extinction phenomena.

Homoclinic connections and subcritical Neimark bifurcation in a duopoly model with adaptively adjusted productions

International Nuclear Information System (INIS)

Agliari, Anna

2006-01-01

In this paper we study some global bifurcations arising in the Puu's oligopoly model when we assume that the producers do not adjust to the best reply but use an adaptive process to obtain at each step the new production. Such bifurcations cause the appearance of a pair of closed invariant curves, one attracting and one repelling, this latter being involved in the subcritical Neimark bifurcation of the Cournot equilibrium point. The aim of the paper is to highlight the relationship between the global bifurcations causing the appearance/disappearance of two invariant closed curves and the homoclinic connections of some saddle cycle, already conjectured in [Agliari A, Gardini L, Puu T. Some global bifurcations related to the appearance of closed invariant curves. Comput Math Simul 2005;68:201-19]. We refine the results obtained in such a paper, showing that the appearance/disappearance of closed invariant curves is not necessarily related to the existence of an attracting cycle. The characterization of the periodicity tongues (i.e. a region of the parameter space in which an attracting cycle exists) associated with a subcritical Neimark bifurcation is also discussed

On period doubling bifurcations of cycles and the harmonic balance method

International Nuclear Information System (INIS)

Itovich, Griselda R.; Moiola, Jorge L.

2006-01-01

This works attempts to give quasi-analytical expressions for subharmonic solutions appearing in the vicinity of a Hopf bifurcation. Starting with well-known tools as the graphical Hopf method for recovering the periodic branch emerging from classical Hopf bifurcation, precise frequency and amplitude estimations of the limit cycle can be obtained. These results allow to attain approximations for period doubling orbits by means of harmonic balance techniques, whose accuracy is established by comparison of Floquet multipliers with continuation software packages. Setting up a few coefficients, the proposed methodology yields to approximate solutions that result from a second period doubling bifurcation of cycles and to extend the validity limits of the graphical Hopf method

Voltage Stability Bifurcation Analysis for AC/DC Systems with VSC-HVDC

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Yanfang Wei

2013-01-01

Full Text Available A voltage stability bifurcation analysis approach for modeling AC/DC systems with VSC-HVDC is presented. The steady power model and control modes of VSC-HVDC are briefly presented firstly. Based on the steady model of VSC-HVDC, a new improved sequential iterative power flow algorithm is proposed. Then, by use of continuation power flow algorithm with the new sequential method, the voltage stability bifurcation of the system is discussed. The trace of the P-V curves and the computation of the saddle node bifurcation point of the system can be obtained. At last, the modified IEEE test systems are adopted to illustrate the effectiveness of the proposed method.

Robotic aortic surgery.

Science.gov (United States)

Duran, Cassidy; Kashef, Elika; El-Sayed, Hosam F; Bismuth, Jean

2011-01-01

Surgical robotics was first utilized to facilitate neurosurgical biopsies in 1985, and it has since found application in orthopedics, urology, gynecology, and cardiothoracic, general, and vascular surgery. Surgical assistance systems provide intelligent, versatile tools that augment the physician's ability to treat patients by eliminating hand tremor and enabling dexterous operation inside the patient's body. Surgical robotics systems have enabled surgeons to treat otherwise untreatable conditions while also reducing morbidity and error rates, shortening operative times, reducing radiation exposure, and improving overall workflow. These capabilities have begun to be realized in two important realms of aortic vascular surgery, namely, flexible robotics for exclusion of complex aortic aneurysms using branched endografts, and robot-assisted laparoscopic aortic surgery for occlusive and aneurysmal disease.

Bifurcation Analysis of Gene Propagation Model Governed by Reaction-Diffusion Equations

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Guichen Lu

2016-01-01

Full Text Available We present a theoretical analysis of the attractor bifurcation for gene propagation model governed by reaction-diffusion equations. We investigate the dynamical transition problems of the model under the homogeneous boundary conditions. By using the dynamical transition theory, we give a complete characterization of the bifurcated objects in terms of the biological parameters of the problem.

Hopf bifurcation in a dynamic IS-LM model with time delay

International Nuclear Information System (INIS)

Neamtu, Mihaela; Opris, Dumitru; Chilarescu, Constantin

2007-01-01

The paper investigates the impact of delayed tax revenues on the fiscal policy out-comes. Choosing the delay as a bifurcation parameter we study the direction and the stability of the bifurcating periodic solutions. We show when the system is stable with respect to the delay. Some numerical examples are given to confirm the theoretical results

[Aortic valve-sparing root reconstruction in Marfan syndrome].

Science.gov (United States)

Ogino, H; Sasaki, H; Hanafusa, Y; Hirata, M; Numata, S; Ando, M; Yagihara, T; Kitamura, S

2002-07-01

The outcome of aortic valve-sparing root reconstruction in Marfan syndrome was reviewed. Thirteen patients with Marfan syndrome underwent aortic valve-sparing root reconstruction for annuloaortic ectasia or aortic root dissection between 1994 and 1999. The grade of preoperative aortic regurgitation was I in 4, II in 2, III in 5, IV in 2 patients. The procedures of aortic valve-sparing were reimplantation in 7 and remodeling in 5 patients. There was no hospital and late death. Recurrence of aortic regurgitation greater than moderate grade developed in 1 patient immediately after the surgery and in the other 4 patients in the late stage. One patient of them required aortic valve replacement for it. Aortic valve-sparing root reconstruction is applicable in Marfan patients, although the indication should be cautious. Close observation is needed for recurrence of aortic regurgitation.

Endodontic-periodontic bifurcation lesions: a novel treatment option.

Science.gov (United States)

Lin, Shaul; Tillinger, Gabriel; Zuckerman, Offer

2008-05-01

The purpose of this preliminary clinical report is to suggest a novel treatment modality for periodontal bifurcation lesions of endodontic origin. The study consisted of 11 consecutive patients who presented with periodontal bifurcation lesions of endodontic origin (endo-perio lesions). All patients were followed-up for at least 12 months. Treatment included calcium hydroxide with iodine-potassium iodide placed in the root canals for 90 days followed by canal sealing with gutta-percha and cement during a second stage. Dentin bonding was used to seal the furcation floor to prevent the ingress of bacteria and their by-products to the furcation root area through the accessory canals. A radiographic examination showed complete healing of the periradicular lesion in all patients. Probing periodontal pocket depths decreased to 2 to 4 mm (mean 3.5 mm), and resolution of the furcation involvement was observed in post-operative clinical evaluations. The suggested treatment of endo-perio lesions may result in complete healing. Further studies are warranted. This treatment method improves both the disinfection of the bifurcation area and the healing process in endodontically treated teeth considered to be hopeless.

Bicuspid aortic valves: Diagnostic accuracy of standard axial 64-slice chest CT compared to aortic valve image plane ECG-gated cardiac CT

Energy Technology Data Exchange (ETDEWEB)

Murphy, David J., E-mail: david.murphy@st-vincents.ie [Department of Radiology, St Vincent' s University Hospital, Elm Park, Dublin 4 (Ireland); McEvoy, Sinead H., E-mail: s.mcevoy@st-vincents.ie [Department of Radiology, St Vincent' s University Hospital, Elm Park, Dublin 4 (Ireland); Iyengar, Sri, E-mail: sri.iyengar@nhs.net [Department of Radiology, Plymouth Hospitals NHS Trust, Plymouth Devon PL6 8DH (United Kingdom); Feuchtner, Gudrun, E-mail: Gudrun.Feuchtner@i-med.ac.at [Department of Radiology, Innsbruck Medical University, Anichstr. 35, A-6020 Innsbruck (Austria); Cury, Ricardo C., E-mail: r.cury@baptisthealth.net [Department of Radiology, Baptist Cardiac and Vascular Institute, 8900 North Kendall Drive, Miami, FL 33176 (United States); Roobottom, Carl, E-mail: carl.roobottom@nhs.net [Department of Radiology, Plymouth Hospitals NHS Trust, Plymouth Devon PL6 8DH (United Kingdom); Plymouth University Peninsula Schools of Medicine and Dentistry (United Kingdom); Baumueller, Stephan, E-mail: Hatem.Alkadhi@usz.ch [Institute for Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistrasse 100, CH-8091 Zurich (Switzerland); Alkadhi, Hatem, E-mail: stephan.baumueller@usz.ch [Institute for Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistrasse 100, CH-8091 Zurich (Switzerland); Dodd, Jonathan D., E-mail: jonniedodd@gmail.com [Department of Radiology, St Vincent' s University Hospital, Elm Park, Dublin 4 (Ireland)

2014-08-15

Objectives: To assess the diagnostic accuracy of standard axial 64-slice chest CT compared to aortic valve image plane ECG-gated cardiac CT for bicuspid aortic valves. Materials and methods: The standard axial chest CT scans of 20 patients with known bicuspid aortic valves were blindly, randomly analyzed for (i) the appearance of the valve cusps, (ii) the largest aortic sinus area, (iii) the longest aortic cusp length, (iv) the thickest aortic valve cusp and (v) valve calcification. A second blinded reader independently analyzed the appearance of the valve cusps. Forty-two age- and sex-matched patients with known tricuspid aortic valves were used as controls. Retrospectively ECG-gated cardiac CT multiphase reconstructions of the aortic valve were used as the gold-standard. Results: Fourteen (21%) scans were scored as unevaluable (7 bicuspid, 7 tricuspid). Of the remainder, there were 13 evaluable bicuspid valves, ten of which showed an aortic valve line sign, while the remaining three showed a normal Mercedes-Benz appearance owing to fused valve cusps. The 35 evaluable tricuspid aortic valves all showed a normal Mercedes-Benz appearance (P = 0.001). Kappa analysis = 0.62 indicating good interobserver agreement for the aortic valve cusp appearance. Aortic sinus areas, aortic cusp lengths and aortic cusp thicknesses of ≥3.8 cm{sup 2}, 3.2 cm and 1.6 mm respectively on standard axial chest CT best distinguished bicuspid from tricuspid aortic valves (P < 0.0001 for all). Of evaluable scans, the sensitivity, specificity, positive and negative predictive values of standard axial chest CT in diagnosing bicuspid aortic valves was 77% (CI 0.54–1.0), 100%, 100% and 70% respectively. Conclusion: The aortic valve is evaluable in approximately 80% of standard chest 64-slice CT scans. Bicuspid aortic valves may be diagnosed on evaluable scans with good diagnostic accuracy. An aortic valve line sign, enlarged aortic sinuses and elongated, thickened valve cusps are specific CT

Aortic aneurysm disease vs. aortic occlusive disease - differences in outcome and intensive care resource utilisation after elective surgery

DEFF Research Database (Denmark)

Bisgaard, Jannie; Gilsaa, Torben; Rønholm, Ebbe

2013-01-01

clamping is more pronounced in patients with aortic aneurysm disease, which may affect outcome. OBJECTIVES: The aim of this observational cohort study was to evaluate outcome after open elective abdominal aortic surgery, hypothesising a higher 30-day mortality, a higher incidence of postoperative organ...... dysfunction and a longer length of stay in patients with aortic aneurysm compared with aortic occlusive disease. DESIGN: Cohort observational study based on prospective registrations from national databases. SETTING: Eight Danish hospitals, including four university and four non-university centres, from 1...... or inotropes, ICU stay more than 24 h, hospital length of stay and mortality. RESULTS: Compared with aortic occlusive disease, more patients with aortic aneurysm disease had ICU stays more than 24 h (62 vs. 45%, P ...

Resource competition: a bifurcation theory approach.

NARCIS (Netherlands)

Kooi, B.W.; Dutta, P.S.; Feudel, U.

2013-01-01

We develop a framework for analysing the outcome of resource competition based on bifurcation theory. We elaborate our methodology by readdressing the problem of competition of two species for two resources in a chemostat environment. In the case of perfect-essential resources it has been

MRI evaluation of the aortic disease

International Nuclear Information System (INIS)

Kapuscinski, O.; Polkowski, J.; Zaleska, T.; Walecki, J.; Biesiadko, M.

1994-01-01

The goal of our study was to establish the value of MRI in diagnosing aortic disease. During 3 years period 46 patients were examined (12 women aged from 6 to 62 years and 34 men aged from 8 to 72 years). In 28 cases the thoracic aorta was examined, in 6 cases the abdominal aorta and in 12 - both the thoracic and the abdominal aorta. MR images were performed on MRT 50 A Toshiba unit 0.5 T. MR images demonstrated aortic aneurysm (caused by atherosclerosis or trauma), aortic dissections, aortic anomalies (i.e. in Turner syndrome) and non-specific aortitis and vasculitis. We regard MRI as preferable noninvasive imaging technique in diagnosing aortic disease. (author)

Aortic allografts in treatment of aortic valve and ascending aorta prosthetic endocarditis

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S.V. Spiridonov

2017-03-01

Full Text Available The aim – to assess short- and long-term results of aortic root replacement using aortic allografts in patients with prosthetic endocarditis. Materials and methods. Since February 2009 until June 2016 aortic valve and ascending aorta replacement using aortic allografts was performed in 26 patients with prosthetic endocarditis. In 50 % of cases at initial operation aortic valve replacement was performed, in another 50 % of cases – aortic valve and ascending aorta replacement. Echocardiography was performed 10 days, 3, 6 and 12 months, 2, 3 and 5 years after surgery. Analysis of long-term results included all cases of deaths, prosthesis-related complications and recurrence of endocarditis. Results. 30-day mortality was 23.1 %. Extracorporeal membranous oxygenation (ECMO was used only in 5 patients (19.2 %. Four patients were weaned from ECMO. We did not observe any allograft-related complications. During follow-up period there were no cases of reoperation due to structural allograft failure. Relapse of infection occurred in 1 patient (3.8 % four years after the operation and led to lethal outcome. Conclusion. Reoperations using allografts are an effective surgical treatment of prosthetic endocarditis. In majority of cases prosthetic endocarditis was caused by gram-positive cocci (Staphylococcus. In 84.6 % of cases it was associated with destruction of paravalvular structures and abscesses formation. Heart failure was a causative factor of different complications in these patients, which required ECMO in 19.2 % of patients. In 80 % of cases patients were weaned from ECMO. Allografts using for the treatment of prosthetic endocarditis is associated with high resistance to infection and with a significant rate of freedom from recurrence of endocarditis within 3 years after surgery.

Stability and Hopf Bifurcation in a Delayed SEIRS Worm Model in Computer Network

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Zizhen Zhang

2013-01-01

Full Text Available A delayed SEIRS epidemic model with vertical transmission in computer network is considered. Sufficient conditions for local stability of the positive equilibrium and existence of local Hopf bifurcation are obtained by analyzing distribution of the roots of the associated characteristic equation. Furthermore, the direction of the local Hopf bifurcation and the stability of the bifurcating periodic solutions are determined by using the normal form theory and center manifold theorem. Finally, a numerical example is presented to verify the theoretical analysis.

Endovascular Treatment of Ruptured Abdominal Aortic Aneurysm with Aortocaval Fistula

International Nuclear Information System (INIS)

Guzzardi, Giuseppe; Fossaceca, Rita; Divenuto, Ignazio; Musiani, Antonello; Brustia, Piero; Carriero, Alessandro

2010-01-01

Aortocaval fistula (ACF) is a rare complication of abdominal aortic aneurysm (AAA). We report the endovascular repair of an AAA rupture into the inferior vena cava. A 78-year-old woman was admitted to our hospital for acute hypotension. She presented with a pulsatile abdominal mass and became rapidly anuric. Abdominal computed tomography (CT) showed an AAA rupture into the inferior vena cava. The features of the AAA made it suitable for endovascular repair. To prevent pulmonary embolism caused by the presence of sac thrombosis near the vena cava lumen, a temporary vena cava filter was deployed before the procedure. A bifurcated stent-graft was placed with the patient under local anaesthesia, and the AAA was successfully treated. A transient type II endoleak was detected on CT 3 days after endograft placement. At routine follow-up 6 and 12 months after the procedure, the patient was in good clinical condition, and the type II endoleak had sealed completely. Endovascular treatment offers an attractive therapeutic alternative to open repair in case of ACF; however, only small numbers of patients have been treated, and long-term follow-up interval is lacking.

Sufficient conditions for a period incrementing big bang bifurcation in one-dimensional maps

International Nuclear Information System (INIS)

Avrutin, V; Granados, A; Schanz, M

2011-01-01

Typically, big bang bifurcation occurs for one (or higher)-dimensional piecewise-defined discontinuous systems whenever two border collision bifurcation curves collide transversely in the parameter space. At that point, two (feasible) fixed points collide with one boundary in state space and become virtual, and, in the one-dimensional case, the map becomes continuous. Depending on the properties of the map near the codimension-two bifurcation point, there exist different scenarios regarding how the infinite number of periodic orbits are born, mainly the so-called period adding and period incrementing. In our work we prove that, in order to undergo a big bang bifurcation of the period incrementing type, it is sufficient for a piecewise-defined one-dimensional map that the colliding fixed points are attractive and with associated eigenvalues of different signs

Sufficient conditions for a period incrementing big bang bifurcation in one-dimensional maps

Science.gov (United States)

Avrutin, V.; Granados, A.; Schanz, M.

2011-09-01

Typically, big bang bifurcation occurs for one (or higher)-dimensional piecewise-defined discontinuous systems whenever two border collision bifurcation curves collide transversely in the parameter space. At that point, two (feasible) fixed points collide with one boundary in state space and become virtual, and, in the one-dimensional case, the map becomes continuous. Depending on the properties of the map near the codimension-two bifurcation point, there exist different scenarios regarding how the infinite number of periodic orbits are born, mainly the so-called period adding and period incrementing. In our work we prove that, in order to undergo a big bang bifurcation of the period incrementing type, it is sufficient for a piecewise-defined one-dimensional map that the colliding fixed points are attractive and with associated eigenvalues of different signs.

Bifurcation in the Lengyel–Epstein system for the coupled reactors with diffusion

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Shaban Aly

2016-01-01

Full Text Available The main goal of this paper is to continue the investigations of the important system of Fengqi et al. (2008. The occurrence of Turing and Hopf bifurcations in small homogeneous arrays of two coupled reactors via diffusion-linked mass transfer which described by a system of ordinary differential equations is considered. I study the conditions of the existence as well as stability properties of the equilibrium solutions and derive the precise conditions on the parameters to show that the Hopf bifurcation occurs. Analytically I show that a diffusion driven instability occurs at a certain critical value, when the system undergoes a Turing bifurcation, patterns emerge. The spatially homogeneous equilibrium loses its stability and two new spatially non-constant stable equilibria emerge which are asymptotically stable. Numerically, at a certain critical value of diffusion the periodic solution gets destabilized and two new spatially nonconstant periodic solutions arise by Turing bifurcation.

Visualization and analysis of flow patterns of human carotid bifurcation by computational fluid dynamics

International Nuclear Information System (INIS)

Xue Yunjing; Gao Peiyi; Lin Yan

2007-01-01

Objective: To investigate flow patterns at carotid bifurcation in vivo by combining computational fluid dynamics (CFD)and MR angiography imaging. Methods: Seven subjects underwent contrast-enhanced MR angiography of carotid artery in Siemens 3.0 T MR. Flow patterns of the carotid artery bifurcation were calculated and visualized by combining MR vascular imaging post-processing and CFD. Results: The flow patterns of the carotid bifurcations in 7 subjects were varied with different phases of a cardiac cycle. The turbulent flow and back flow occurred at bifurcation and proximal of internal carotid artery (ICA) and external carotid artery (ECA), their occurrence and conformation were varied with different phase of a cardiac cycle. The turbulent flow and back flow faded out quickly when the blood flow to the distal of ICA and ECA. Conclusion: CFD combined with MR angiography can be utilized to visualize the cyclical change of flow patterns of carotid bifurcation with different phases of a cardiac cycle. (authors)

Overexpression of interleukin-1β and interferon-γ in type I thoracic aortic dissections and ascending thoracic aortic aneurysms: possible correlation with matrix metalloproteinase-9 expression and apoptosis of aortic media cells.

Science.gov (United States)

Zhang, Lei; Liao, Ming-fang; Tian, Lei; Zou, Si-li; Lu, Qing-sheng; Bao, Jun-min; Pei, Yi-fei; Jing, Zai-ping

2011-07-01

To examine the expression of interleukin-1β and interferon-γ and their possible roles in aortic dissections and aneurysms. Aortic specimens were obtained from patients with type I thoracic aortic dissection, ascending thoracic aortic aneurysms, and control organ donors. The expression of interleukin-1β, interferon-γ, matrix metalloproteinase-9, and signal transduction factors phospho-p38 and phosphorylated c-jun N-terminal kinase (phospho-JNK) were detected by real time reverse transcription-polymerase chain reaction (real time RT-PCR), Western blot, and immunohistochemistry, respectively. Terminal deoxynucleotidyl transferase dUTP nick-end labeling (TUNEL) staining was performed to detect apoptosis of media cells. The correlation of these factors and apoptosis was also studied. Apoptosis in the media of thoracic aortic dissection and in ascending thoracic aortic aneurysms was dramatically higher than in the control group. The expression of interleukin-1β gradually increased from the control group, thoracic aortic dissection to ascending thoracic aortic aneurysms (p matrix metalloproteinase-9 was significantly increased in the media of thoracic aortic dissection and ascending thoracic aortic aneurysms compared with the control group (p correlations between interleukin-1β versus matrix metalloproteinase-9, interleukin-1β versus phospho-p38 in thoracic aortic dissection (p matrix metalloproteinase-9, interferon-γ versus phospho-JNK, interferon-γ versus apoptosis, and interleukin-1β versus apoptosis in ascending thoracic aortic aneurysms (p = 0.02, 0.02, p matrix metalloproteinase-9 and the apoptosis of media cells in humans. Copyright © 2010 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.

A geometric reappraisal of proximal landing zones for thoracic endovascular aortic repair according to aortic arch types

NARCIS (Netherlands)

Marrocco-Trischitta, Massimiliano M.; de Beaufort, Hector W.; Secchi, Francesco; van Bakel, Theodorus M.; Ranucci, Marco; van Herwaarden, Joost A.; Moll, Frans L.; Trimarchi, Santi

Objective: This study assessed whether the additional use of the aortic arch classification in type I, II, and III may complement Ishimaru's aortic arch map and provide valuable information on the geometry and suitability of proximal landing zones for thoracic endovascular aortic repair. Methods:

A Method to Determine Oscillation Emergence Bifurcation in Time-Delayed LTI System with Single Lag

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Yu Xiaodan

2014-01-01

Full Text Available One type of bifurcation named oscillation emergence bifurcation (OEB found in time-delayed linear time invariant (abbr. LTI systems is fully studied. The definition of OEB is initially put forward according to the eigenvalue variation. It is revealed that a real eigenvalue splits into a pair of conjugated complex eigenvalues when an OEB occurs, which means the number of the system eigenvalues will increase by one and a new oscillation mode will emerge. Next, a method to determine OEB bifurcation in the time-delayed LTI system with single lag is developed based on Lambert W function. A one-dimensional (1-dim time-delayed system is firstly employed to explain the mechanism of OEB bifurcation. Then, methods to determine the OEB bifurcation in 1-dim, 2-dim, and high-dimension time-delayed LTI systems are derived. Finally, simulation results validate the correctness and effectiveness of the presented method. Since OEB bifurcation occurs with a new oscillation mode emerging, work of this paper is useful to explore the complex phenomena and the stability of time-delayed dynamic systems.

Aortic elongation in aortic aneurysm and dissection: the Tübingen Aortic Pathoanatomy (TAIPAN) project.

Science.gov (United States)

Krüger, Tobias; Sandoval Boburg, Rodrigo; Lescan, Mario; Oikonomou, Alexandre; Schneider, Wilke; Vöhringer, Luise; Lausberg, Henning; Bamberg, Fabian; Blumenstock, Gunnar; Schlensak, Christian

2018-01-24

To study the lengths and diameters of aortic segments in healthy and diseased aortas and to assess the role of aortic elongation in Type A aortic dissection (TAD) prediction. Ectasia and aneurysm were defined by ascending aorta diameters of 45-54 mm and ≥55 mm, respectively. Computed tomography angiography studies of 256 healthy, 102 ectasia, 38 aneurysm, 17 pre-TAD and 166 TAD aortas were analysed using curved multiplanar reformats. The study groups were structurally equal. The diameter of the ascending aorta was 35 mm in the control group and was larger (P TAD (43 mm) and TAD (56 mm) groups. The length of the ascending aorta from the aortic annulus to the brachiocephalic trunk was 92 mm in the control group, 113 mm in the ectasia group, 120 mm in the aneurysm group and 111 mm and 118 mm in the pre-TAD and TAD groups (all P TAD group and 48% of the TAD group. The correlation between the diameter and the length of the ascending aorta was r = 0.752; therefore, both parameters must be examined separately. A score considering both parameters identified 23.5% of pre-TAD patients, significantly more than the diameter alone, and 31.4% of ectasia aortas were elongated. Patients with ectatic (45-54 mm diameter) and elongated (≥120 mm) ascending aortas represent a high-risk subpopulation for TAD. © The Author(s) 2018. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Turing-Hopf bifurcations in a predator-prey model with herd behavior, quadratic mortality and prey-taxis

Science.gov (United States)

Liu, Xia; Zhang, Tonghua; Meng, Xinzhu; Zhang, Tongqian

2018-04-01

In this paper, we propose a predator-prey model with herd behavior and prey-taxis. Then, we analyze the stability and bifurcation of the positive equilibrium of the model subject to the homogeneous Neumann boundary condition. By using an abstract bifurcation theory and taking prey-tactic sensitivity coefficient as the bifurcation parameter, we obtain a branch of stable nonconstant solutions bifurcating from the positive equilibrium. Our results show that prey-taxis can yield the occurrence of spatial patterns.

Bifurcating Particle Swarms in Smooth-Walled Fractures

Science.gov (United States)

Pyrak-Nolte, L. J.; Sun, H.

2010-12-01

Particle swarms can occur naturally or from industrial processes where small liquid drops containing thousands to millions of micron-size to colloidal-size particles are released over time from seepage or leaks into fractured rock. The behavior of these particle swarms as they fall under gravity are affected by particle interactions as well as interactions with the walls of the fractures. In this paper, we present experimental results on the effect of fractures on the cohesiveness of the swarm and the formation of bifurcation structures as they fall under gravity and interact with the fracture walls. A transparent cubic sample (100 mm x 100 mm x 100 mm) containing a synthetic fracture with uniform aperture distributions was optically imaged to quantify the effect of confinement within fractures on particle swarm formation, swarm velocity, and swarm geometry. A fracture with a uniform aperture distribution was fabricated from two polished rectangular prisms of acrylic. A series of experiments were performed to determine how swarm movement and geometry are affected as the walls of the fracture are brought closer together from 50 mm to 1 mm. During the experiments, the fracture was fully saturated with water. We created the swarms using two different particle sizes in dilute suspension (~ 1.0% by mass). The particles were 3 micron diameter fluorescent polymer beads and 25 micron diameter soda-lime glass beads. Experiments were performed using swarms that ranged in size from 5 µl to 60 µl. The swarm behavior was imaged using an optical fluorescent imaging system composed of a CCD camera illuminated by a 100 mW diode-pumped doubled YAG laser. As a swarm falls in an open-tank of water, it forms a torroidal shape that is stable as long as no ambient or background currents exist in the water tank. When a swarm is released into a fracture with an aperture less than 5 mm, the swarm forms the torroidal shape but it is distorted because of the presence of the walls. The

Symmetry breaking bifurcations of a current sheet

International Nuclear Information System (INIS)

Parker, R.D.; Dewar, R.L.; Johnson, J.L.

1988-08-01

Using a time evolution code with periodic boundary conditions, the viscoresistive hydromagnetic equations describing an initially static, planar current sheet with large Lundquist number have been evolved for times long enough to reach a steady state. A cosh 2 x resistivity model was used. For long periodicity lengths, L p , the resistivity gradient drives flows which cause forced reconnection at X point current sheets. Using L p as a bifurcation parameter, two new symmetry breaking bifurcations were found - a transition to an asymmetric island chain with nonzero, positive or negative phase velocity, and a transition to a static state with alternating large and small islands. These states are reached after a complex transient behavior which involves a competition between secondary current sheet instability and coalescence. 31 refs., 6 figs

Experimental Study of Flow in a Bifurcation

Science.gov (United States)

Fresconi, Frank; Prasad, Ajay

2003-11-01

An instability known as the Dean vortex occurs in curved pipes with a longitudinal pressure gradient. A similar effect is manifest in the flow in a converging or diverging bifurcation, such as those found in the human respiratory airways. The goal of this study is to characterize secondary flows in a bifurcation. Particle image velocimetry (PIV) and laser-induced fluorescence (LIF) experiments were performed in a clear, plastic model. Results show the strength and migration of secondary vortices. Primary velocity features are also presented along with dispersion patterns from dye visualization. Unsteadiness, associated with a hairpin vortex, was also found at higher Re. This work can be used to assess the dispersion of particles in the lung. Medical delivery systems and pollution effect studies would profit from such an understanding.

Aortic Root Enlargement or Sutureless Valve Implantation?

Directory of Open Access Journals (Sweden)

Nikolaos G. Baikoussis

2016-11-01

Full Text Available Aortic valve replacement (AVR in patients with a small aortic annulus is a challenging issue. The importance of prosthesis–patient mismatch (PPM post aortic valve replacement (AVR is controversial but has to be avoided. Many studies support the fact that PPM has a negative impact on short and long term survival. In order to avoid PPM, aortic root enlargement may be performed. Alternatively and keeping in mind that often some comorbidities are present in old patients with small aortic root, the Perceval S suturelles valve implantation could be a perfect solution. The Perceval sutureless bioprosthesis provides reasonable hemodynamic performance avoiding the PPM and providing the maximum of aortic orifice area. We would like to see in the near future the role of the aortic root enlargement techniques in the era of surgical implantation of the sutureless valve (SAVR and the transcatheter valve implantation (TAVI.

Molecular and cellular mechanisms of aortic stenosis.

Science.gov (United States)

Yetkin, Ertan; Waltenberger, Johannes

2009-06-12

Calcific aortic stenosis is the most common cause of aortic valve replacement in developed countries, and this condition increases in prevalence with advancing age. The fibrotic thickening and calcification are common eventual endpoint in both non-rheumatic calcific and rheumatic aortic stenoses. New observations in human aortic valves support the hypothesis that degenerative valvular aortic stenosis is the result of active bone formation in the aortic valve, which may be mediated through a process of osteoblast-like differentiation in these tissues. Additionally histopathologic evidence suggests that early lesions in aortic valves are not just a disease process secondary to aging, but an active cellular process that follows the classical "response to injury hypothesis" similar to the situation in atherosclerosis. Although there are similarities with the risk factor and as well as with the process of atherogenesis, not all the patients with coronary artery disease or atherosclerosis have calcific aortic stenosis. This review mainly focuses on the potential vascular and molecular mechanisms involved in the pathogenesis of aortic valve stenosis. Namely extracellular matrix remodeling, angiogenesis, inflammation, and eventually osteoblast-like differentiation resulting in bone formation have been shown to play a role in the pathogenesis of calcific aortic stenosis. Several mediators related to underlying mechanisms, including growth factors especially transforming growth factor-beta1 and vascular endothelial growth factors, angiogenesis, cathepsin enzymes, adhesion molecules, bone regulatory proteins and matrix metalloproteinases have been demonstrated, however the target to be attacked is not defined yet.

Hopf bifurcation and chaos from torus breakdown in voltage-mode controlled DC drive systems

International Nuclear Information System (INIS)

Dai Dong; Ma Xikui; Zhang Bo; Tse, Chi K.

2009-01-01

Period-doubling bifurcation and its route to chaos have been thoroughly investigated in voltage-mode and current-mode controlled DC motor drives under simple proportional control. In this paper, the phenomena of Hopf bifurcation and chaos from torus breakdown in a voltage-mode controlled DC drive system is reported. It has been shown that Hopf bifurcation may occur when the DC drive system adopts a more practical proportional-integral control. The phenomena of period-adding and phase-locking are also observed after the Hopf bifurcation. Furthermore, it is shown that the stable torus can breakdown and chaos emerges afterwards. The work presented in this paper provides more complete information about the dynamical behaviors of DC drive systems.

Application of thoracic endovascular aortic repair (TEVAR) in treating dwarfism with Stanford B aortic dissection

Science.gov (United States)

Qiu, Jian; Cai, Wenwu; Shu, Chang; Li, Ming; Xiong, Qinggen; Li, Quanming; Li, Xin

2018-01-01

Abstract Rationale: To apply thoracic endovascular aortic repair (TEVAR) to treat dwarfism complicated with Stanford B aortic dissection. Patient concerns: In this report, we presented a 63-year-old male patient of dwarfism complicated with Stanford B aortic dissection successfully treated with TEVAR. Diagnoses: He was diagnosed with dwarfism complicated with Stanford B aortic dissection. Interventions: After conservative treatment, the male patient underwent TEVAR at 1 week after hospitalization. After operation, he presented with numbness and weakness of his bilateral lower extremities, and these symptoms were significantly mitigated after effective treatment. At 1- and 3-week after TEVAR, the aorta status was maintained stable and restored. Outcomes: The patient obtained favorable clinical prognosis and was smoothly discharged. During subsequent follow-up, he remained physically stable. Lessons: TEVAR is probably an option for treating dwarfism complicated with Stanford B aortic dissection, which remains to be validated by subsequent studies with larger sample size. PMID:29703033

Bifurcation of cubic nonlinear parallel plate-type structure in axial flow

International Nuclear Information System (INIS)

Lu Li; Yang Yiren

2005-01-01

The Hopf bifurcation of plate-type beams with cubic nonlinear stiffness in axial flow was studied. By assuming that all the plates have the same deflections at any instant, the nonlinear model of plate-type beam in axial flow was established. The partial differential equation was turned into an ordinary differential equation by using Galerkin method. A new algebraic criterion of Hopf bifurcation was utilized to in our analysis. The results show that there's no Hopf bifurcation for simply supported plate-type beams while the cantilevered plate-type beams has. At last, the analytic expression of critical flow velocity of cantilevered plate-type beams in axial flow and the purely imaginary eigenvalues of the corresponding linear system were gotten. (authors)

Angular (Gothic) aortic arch leads to enhanced systolic wave reflection, central aortic stiffness, and increased left ventricular mass late after aortic coarctation repair: evaluation with magnetic resonance flow mapping.

Science.gov (United States)

Ou, Phalla; Celermajer, David S; Raisky, Olivier; Jolivet, Odile; Buyens, Fanny; Herment, Alain; Sidi, Daniel; Bonnet, Damien; Mousseaux, Elie

2008-01-01

We sought to investigate the mechanism whereby a particular deformity of the aortic arch, an angulated Gothic shape, might lead to hypertension late after anatomically successful repair of aortic coarctation. Fifty-five normotensive patients with anatomically successful repair of aortic coarctation and either a Gothic (angulated) or a Romanesque (smooth and rounded) arch were studied with magnetic resonance angiography and flow mapping in both the ascending and descending aortas. Systolic waveforms, central aortic stiffness, and pulse velocity were measured. We hypothesized that arch angulation would result in enhanced systolic wave reflection with loss of energy across the aortic arch, as well as increased central aortic stiffness. Twenty patients were found to have a Gothic, and 35 a Romanesque, arch. Patients with a Gothic arch showed markedly augmented systolic wave reflection (12 +/- 6 vs 5 +/- 0.3 mL, P Gothic arch (5.6 +/- 1.1 vs 4.1 +/- 1 m/s, P Gothic aortic arch is associated with increased systolic wave reflection, as well as increased central aortic stiffness and left ventricular mass index. These findings explain (at least in part) the association between this pattern of arch geometry and late hypertension at rest and on exercise in subjects after coarctation repair.

On the analysis of local bifurcation and topological horseshoe of a new 4D hyper-chaotic system

International Nuclear Information System (INIS)

Zhou, Leilei; Chen, Zengqiang; Wang, Zhonglin; Wang, Jiezhi

2016-01-01

Highlights: • A new 4D smooth quadratic autonomous system with complex hyper-chaotic dynamics is presented. • The stability of equilibria is observed near the bifurcation points. • The Hopf bifurcation and pitchfork bifurcation are analyzed by using the center manifold theorem and bifurcation theory. • A horseshoe with two-directional expansions in the 4D hyper-chaotic system has been found, which rigorously proves the existence of hyper-chaos in theory. - Abstract: In this paper, a new four-dimensional (4D) smooth quadratic autonomous system with complex hyper-chaotic dynamics is presented and analyzed. The Lyapunov exponent (LE) spectrum, bifurcation diagram and various phase portraits of the system are provided. The stability, Hopf bifurcation and pitchfork bifurcation of equilibrium point are discussed by using the center manifold theorem and bifurcation theory. Numerical simulation results are consistent with the theoretical analysis. Besides, by combining the topological horseshoe theory with a computer-assisted method of Poincaré maps and utilizing the algorithm for finding horseshoes in 3D hyper-chaotic maps, a horseshoe with two-directional expansions in the 4D hyper-chaotic system is successfully found, which rigorously proves the existence of hyper-chaos in theory.

Effect of force-induced mechanical stress at the coronary artery bifurcation stenting: Relation to in-stent restenosis

Energy Technology Data Exchange (ETDEWEB)

Lee, Cheng-Hung [Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou, Chang Gung University College of Medicine, Tao-Yuan, Taiwan (China); Department of Mechanical Engineering, Chang Gung University, Tao-Yuan, Taiwan (China); Jhong, Guan-Heng [Graduate Institute of Medical Mechatronics, Chang Gung University, Tao-Yuan, Taiwan (China); Hsu, Ming-Yi; Wang, Chao-Jan [Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou, Tao-Yuan, Taiwan (China); Liu, Shih-Jung, E-mail: shihjung@mail.cgu.edu.tw [Department of Mechanical Engineering, Chang Gung University, Tao-Yuan, Taiwan (China); Hung, Kuo-Chun [Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou, Chang Gung University College of Medicine, Tao-Yuan, Taiwan (China)

2014-05-28

The deployment of metallic stents during percutaneous coronary intervention has become common in the treatment of coronary bifurcation lesions. However, restenosis occurs mostly at the bifurcation area even in present era of drug-eluting stents. To achieve adequate deployment, physicians may unintentionally apply force to the strut of the stents through balloon, guiding catheters, or other devices. This force may deform the struts and impose excessive mechanical stresses on the arterial vessels, resulting in detrimental outcomes. This study investigated the relationship between the distribution of stress in a stent and bifurcation angle using finite element analysis. The unintentionally applied force following stent implantation was measured using a force sensor that was made in the laboratory. Geometrical information on the coronary arteries of 11 subjects was extracted from contrast-enhanced computed tomography scan data. The numerical results reveal that the application of force by physicians generated significantly higher mechanical stresses in the arterial bifurcation than in the proximal and distal parts of the stent (post hoc P < 0.01). The maximal stress on the vessels was significantly higher at bifurcation angle <70° than at angle ≧70° (P < 0.05). The maximal stress on the vessels was negatively correlated with bifurcation angle (P < 0.01). Stresses at the bifurcation ostium may cause arterial wall injury and restenosis, especially at small bifurcation angles. These finding highlight the effect of force-induced mechanical stress at coronary artery bifurcation stenting, and potential mechanisms of in-stent restenosis, along with their relationship with bifurcation angle.

Effect of force-induced mechanical stress at the coronary artery bifurcation stenting: Relation to in-stent restenosis

International Nuclear Information System (INIS)

Lee, Cheng-Hung; Jhong, Guan-Heng; Hsu, Ming-Yi; Wang, Chao-Jan; Liu, Shih-Jung; Hung, Kuo-Chun

2014-01-01

The deployment of metallic stents during percutaneous coronary intervention has become common in the treatment of coronary bifurcation lesions. However, restenosis occurs mostly at the bifurcation area even in present era of drug-eluting stents. To achieve adequate deployment, physicians may unintentionally apply force to the strut of the stents through balloon, guiding catheters, or other devices. This force may deform the struts and impose excessive mechanical stresses on the arterial vessels, resulting in detrimental outcomes. This study investigated the relationship between the distribution of stress in a stent and bifurcation angle using finite element analysis. The unintentionally applied force following stent implantation was measured using a force sensor that was made in the laboratory. Geometrical information on the coronary arteries of 11 subjects was extracted from contrast-enhanced computed tomography scan data. The numerical results reveal that the application of force by physicians generated significantly higher mechanical stresses in the arterial bifurcation than in the proximal and distal parts of the stent (post hoc P < 0.01). The maximal stress on the vessels was significantly higher at bifurcation angle <70° than at angle ≧70° (P < 0.05). The maximal stress on the vessels was negatively correlated with bifurcation angle (P < 0.01). Stresses at the bifurcation ostium may cause arterial wall injury and restenosis, especially at small bifurcation angles. These finding highlight the effect of force-induced mechanical stress at coronary artery bifurcation stenting, and potential mechanisms of in-stent restenosis, along with their relationship with bifurcation angle.

Aortic events in a nationwide Marfan syndrome cohort

DEFF Research Database (Denmark)

Groth, Kristian A; Krag, Kirstine Stochholm; Hove, Hanne

2017-01-01

BACKGROUND: Marfan syndrome is associated with morbidity and mortality due to aortic dilatation and dissection. Preventive aortic root replacement has been the standard treatment in Marfan syndrome patients with aortic dilatation. In this study, we present aortic event data from a nationwide Marfan...... syndrome cohort. METHOD: The nationwide cohort of Danish Marfan syndrome patients was established from the Danish National Patient Registry and the Cause of Death Register, where we retrieved information about aortic surgery and dissections. We associated aortic events with age, sex, and Marfan syndrome...

Stability and Hopf Bifurcation of Fractional-Order Complex-Valued Single Neuron Model with Time Delay

Science.gov (United States)

Wang, Zhen; Wang, Xiaohong; Li, Yuxia; Huang, Xia

2017-12-01

In this paper, the problems of stability and Hopf bifurcation in a class of fractional-order complex-valued single neuron model with time delay are addressed. With the help of the stability theory of fractional-order differential equations and Laplace transforms, several new sufficient conditions, which ensure the stability of the system are derived. Taking the time delay as the bifurcation parameter, Hopf bifurcation is investigated and the critical value of the time delay for the occurrence of Hopf bifurcation is determined. Finally, two representative numerical examples are given to show the effectiveness of the theoretical results.

Delay Induced Hopf Bifurcation of an Epidemic Model with Graded Infection Rates for Internet Worms

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Tao Zhao

2017-01-01

Full Text Available A delayed SEIQRS worm propagation model with different infection rates for the exposed computers and the infectious computers is investigated in this paper. The results are given in terms of the local stability and Hopf bifurcation. Sufficient conditions for the local stability and the existence of Hopf bifurcation are obtained by using eigenvalue method and choosing the delay as the bifurcation parameter. In particular, the direction and the stability of the Hopf bifurcation are investigated by means of the normal form theory and center manifold theorem. Finally, a numerical example is also presented to support the obtained theoretical results.

Bifurcation parameters of a reflected shock wave in cylindrical channels of different roughnesses

Science.gov (United States)

Penyazkov, O.; Skilandz, A.

2018-03-01

To investigate the effect of bifurcation on the induction time in cylindrical shock tubes used for chemical kinetic experiments, one should know the parameters of the bifurcation structure of a reflected shock wave. The dynamics and parameters of the shock wave bifurcation, which are caused by reflected shock wave-boundary layer interactions, are studied experimentally in argon, in air, and in a hydrogen-nitrogen mixture for Mach numbers M = 1.3-3.5 in a 76-mm-diameter shock tube without any ramp. Measurements were taken at a constant gas density behind the reflected shock wave. Over a wide range of experimental conditions, we studied the axial projection of the oblique shock wave and the pressure distribution in the vicinity of the triple Mach configuration at 50, 150, and 250 mm from the endwall, using side-wall schlieren and pressure measurements. Experiments on a polished shock tube and a shock tube with a surface roughness of 20 {μ }m Ra were carried out. The surface roughness was used for initiating small-scale turbulence in the boundary layer behind the incident shock wave. The effect of small-scale turbulence on the homogenization of the transition zone from the laminar to turbulent boundary layer along the shock tube perimeter was assessed, assuming its influence on a subsequent stabilization of the bifurcation structure size versus incident shock wave Mach number, as well as local flow parameters behind the reflected shock wave. The influence of surface roughness on the bifurcation development and pressure fluctuations near the wall, as well as on the Mach number, at which the bifurcation first develops, was analyzed. It was found that even small additional surface roughness can lead to an overshoot in pressure growth by a factor of two, but it can stabilize the bifurcation structure along the shock tube perimeter.

Asymmetry of blood flow and cancer cell adhesion in a microchannel with symmetric bifurcation and confluence.

Science.gov (United States)

Ishikawa, Takuji; Fujiwara, Hiroki; Matsuki, Noriaki; Yoshimoto, Takefumi; Imai, Yohsuke; Ueno, Hironori; Yamaguchi, Takami

2011-02-01

Bifurcations and confluences are very common geometries in biomedical microdevices. Blood flow at microchannel bifurcations has different characteristics from that at confluences because of the multiphase properties of blood. Using a confocal micro-PIV system, we investigated the behaviour of red blood cells (RBCs) and cancer cells in microchannels with geometrically symmetric bifurcations and confluences. The behaviour of RBCs and cancer cells was strongly asymmetric at bifurcations and confluences whilst the trajectories of tracer particles in pure water were almost symmetric. The cell-free layer disappeared on the inner wall of the bifurcation but increased in size on the inner wall of the confluence. Cancer cells frequently adhered to the inner wall of the bifurcation but rarely to other locations. Because the wall surface coating and the wall shear stress were almost symmetric for the bifurcation and the confluence, the result indicates that not only chemical mediation and wall shear stress but also microscale haemodynamics play important roles in the adhesion of cancer cells to the microchannel walls. These results provide the fundamental basis for a better understanding of blood flow and cell adhesion in biomedical microdevices.

Impact of leakage delay on bifurcation in high-order fractional BAM neural networks.

Science.gov (United States)

Huang, Chengdai; Cao, Jinde

2018-02-01

The effects of leakage delay on the dynamics of neural networks with integer-order have lately been received considerable attention. It has been confirmed that fractional neural networks more appropriately uncover the dynamical properties of neural networks, but the results of fractional neural networks with leakage delay are relatively few. This paper primarily concentrates on the issue of bifurcation for high-order fractional bidirectional associative memory(BAM) neural networks involving leakage delay. The first attempt is made to tackle the stability and bifurcation of high-order fractional BAM neural networks with time delay in leakage terms in this paper. The conditions for the appearance of bifurcation for the proposed systems with leakage delay are firstly established by adopting time delay as a bifurcation parameter. Then, the bifurcation criteria of such system without leakage delay are successfully acquired. Comparative analysis wondrously detects that the stability performance of the proposed high-order fractional neural networks is critically weakened by leakage delay, they cannot be overlooked. Numerical examples are ultimately exhibited to attest the efficiency of the theoretical results. Copyright © 2017 Elsevier Ltd. All rights reserved.

Ultrasonic delineation of aortic microstructure: The relative contribution of elastin and collagen to aortic elasticity

Science.gov (United States)

Marsh, Jon N.; Takiuchi, Shin; Lin, Shiow Jiuan; Lanza, Gregory M.; Wickline, Samuel A.

2004-05-01

Aortic elasticity is an important factor in hemodynamic health, and compromised aortic compliance affects not only arterial dynamics but also myocardial function. A variety of pathologic processes (e.g., diabetes, Marfan's syndrome, hypertension) can affect aortic elasticity by altering the microstructure and composition of the elastin and collagen fiber networks within the tunica media. Ultrasound tissue characterization techniques can be used to obtain direct measurements of the stiffness coefficients of aorta by measurement of the speed of sound in specific directions. In this study we sought to define the contributions of elastin and collagen to the mechanical properties of aortic media by measuring the magnitude and directional dependence of the speed of sound before and after selective isolation of either the collagen or elastin fiber matrix. Formalin-fixed porcine aortas were sectioned for insonification in the circumferential, longitudinal, or radial direction and examined using high-frequency (50 MHz) ultrasound microscopy. Isolation of the collagen or elastin fiber matrices was accomplished through treatment with NaOH or formic acid, respectively. The results suggest that elastin is the primary contributor to aortic medial stiffness in the unloaded state, and that there is relatively little anisotropy in the speed of sound or stiffness in the aortic wall.

Analysis of the magnetohydrodynamic equations and study of the nonlinear solution bifurcations

International Nuclear Information System (INIS)

Morros Tosas, J.

1989-01-01

The nonlinear problems related to the plasma magnetohydrodynamic instabilities are studied. A bifurcation theory is applied and a general magnetohydrodynamic equation is proposed. Scalar functions, a steady magnetic field and a new equation for the velocity field are taken into account. A method allowing the obtention of suitable reduced equations for the instabilities study is described. Toroidal and cylindrical configuration plasmas are studied. In the cylindrical configuration case, analytical calculations are performed and two steady bifurcated solutions are found. In the toroidal configuration case, a suitable reduced equation system is obtained; a qualitative approach of a steady solution bifurcation on a toroidal Kink type geometry is carried out [fr

Coordinating bifurcated remediation of soil and groundwater at sites containing multiple operable units

International Nuclear Information System (INIS)

Laney, D.F.

1996-01-01

On larger and/or more complex sites, remediation of soil and groundwater is sometimes bifurcated. This presents some unique advantages with respect to expedited cleanup of one medium, however, it requires skillful planning and significant forethought to ensure that initial remediation efforts do not preclude some long-term options, and/or unduly influence the subsequent selection of a technology for the other operable units and/or media. this paper examines how the decision to bifurcate should be approached, the various methods of bifurcation, the advantages and disadvantages of bifurcation, and the best methods to build flexibility into the design of initial remediation systems so as to allow for consideration of a fuller range of options for remediation of other operable units and/or media at a later time. Pollutants of concern include: metals; petroleum hydrocarbons; and chlorinated solvents

Hopf bifurcation and chaos in macroeconomic models with policy lag

International Nuclear Information System (INIS)

Liao Xiaofeng; Li Chuandong; Zhou Shangbo

2005-01-01

In this paper, we consider the macroeconomic models with policy lag, and study how lags in policy response affect the macroeconomic stability. The local stability of the nonzero equilibrium of this equation is investigated by analyzing the corresponding transcendental characteristic equation of its linearized equation. Some general stability criteria involving the policy lag and the system parameter are derived. By choosing the policy lag as a bifurcation parameter, the model is found to undergo a sequence of Hopf bifurcation. The direction and stability of the bifurcating periodic solutions are determined by using the normal form theory and the center manifold theorem. Moreover, we show that the government can stabilize the intrinsically unstable economy if the policy lag is sufficiently short, but the system become locally unstable when the policy lag is too long. We also find the chaotic behavior in some range of the policy lag

Hopf Bifurcation Analysis for a Stochastic Discrete-Time Hyperchaotic System

Directory of Open Access Journals (Sweden)

Jie Ran

2015-01-01

Full Text Available The dynamics of a discrete-time hyperchaotic system and the amplitude control of Hopf bifurcation for a stochastic discrete-time hyperchaotic system are investigated in this paper. Numerical simulations are presented to exhibit the complex dynamical behaviors in the discrete-time hyperchaotic system. Furthermore, the stochastic discrete-time hyperchaotic system with random parameters is transformed into its equivalent deterministic system with the orthogonal polynomial theory of discrete random function. In addition, the dynamical features of the discrete-time hyperchaotic system with random disturbances are obtained through its equivalent deterministic system. By using the Hopf bifurcation conditions of the deterministic discrete-time system, the specific conditions for the existence of Hopf bifurcation in the equivalent deterministic system are derived. And the amplitude control with random intensity is discussed in detail. Finally, the feasibility of the control method is demonstrated by numerical simulations.

Climate bifurcation during the last deglaciation?

NARCIS (Netherlands)

Lenton, T.M.; Livina, V.N.; Dakos, V.; Scheffer, M.

2012-01-01

There were two abrupt warming events during the last deglaciation, at the start of the Bolling-Allerod and at the end of the Younger Dryas, but their underlying dynamics are unclear. Some abrupt climate changes may involve gradual forcing past a bifurcation point, in which a prevailing climate state

Numerical bifurcation analysis of conformal formulations of the Einstein constraints

International Nuclear Information System (INIS)

Holst, M.; Kungurtsev, V.

2011-01-01

The Einstein constraint equations have been the subject of study for more than 50 years. The introduction of the conformal method in the 1970s as a parametrization of initial data for the Einstein equations led to increased interest in the development of a complete solution theory for the constraints, with the theory for constant mean curvature (CMC) spatial slices and closed manifolds completely developed by 1995. The first general non-CMC existence result was establish by Holst et al. in 2008, with extensions to rough data by Holst et al. in 2009, and to vacuum spacetimes by Maxwell in 2009. The non-CMC theory remains mostly open; moreover, recent work of Maxwell on specific symmetry models sheds light on fundamental nonuniqueness problems with the conformal method as a parametrization in non-CMC settings. In parallel with these mathematical developments, computational physicists have uncovered surprising behavior in numerical solutions to the extended conformal thin sandwich formulation of the Einstein constraints. In particular, numerical evidence suggests the existence of multiple solutions with a quadratic fold, and a recent analysis of a simplified model supports this conclusion. In this article, we examine this apparent bifurcation phenomena in a methodical way, using modern techniques in bifurcation theory and in numerical homotopy methods. We first review the evidence for the presence of bifurcation in the Hamiltonian constraint in the time-symmetric case. We give a brief introduction to the mathematical framework for analyzing bifurcation phenomena, and then develop the main ideas behind the construction of numerical homotopy, or path-following, methods in the analysis of bifurcation phenomena. We then apply the continuation software package AUTO to this problem, and verify the presence of the fold with homotopy-based numerical methods. We discuss these results and their physical significance, which lead to some interesting remaining questions to

Luminal flow amplifies stent-based drug deposition in arterial bifurcations.

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Vijaya B Kolachalama

2009-12-01

Full Text Available Treatment of arterial bifurcation lesions using drug-eluting stents (DES is now common clinical practice and yet the mechanisms governing drug distribution in these complex morphologies are incompletely understood. It is still not evident how to efficiently determine the efficacy of local drug delivery and quantify zones of excessive drug that are harbingers of vascular toxicity and thrombosis, and areas of depletion that are associated with tissue overgrowth and luminal re-narrowing.We constructed two-phase computational models of stent-deployed arterial bifurcations simulating blood flow and drug transport to investigate the factors modulating drug distribution when the main-branch (MB was treated using a DES. Simulations predicted extensive flow-mediated drug delivery in bifurcated vascular beds where the drug distribution patterns are heterogeneous and sensitive to relative stent position and luminal flow. A single DES in the MB coupled with large retrograde luminal flow on the lateral wall of the side-branch (SB can provide drug deposition on the SB lumen-wall interface, except when the MB stent is downstream of the SB flow divider. In an even more dramatic fashion, the presence of the SB affects drug distribution in the stented MB. Here fluid mechanic effects play an even greater role than in the SB especially when the DES is across and downstream to the flow divider and in a manner dependent upon the Reynolds number.The flow effects on drug deposition and subsequent uptake from endovascular DES are amplified in bifurcation lesions. When only one branch is stented, a complex interplay occurs - drug deposition in the stented MB is altered by the flow divider imposed by the SB and in the SB by the presence of a DES in the MB. The use of DES in arterial bifurcations requires a complex calculus that balances vascular and stent geometry as well as luminal flow.

Bifurcation and complex dynamics of a discrete-time predator-prey system

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S. M. Sohel Rana

2015-06-01

Full Text Available In this paper, we investigate the dynamics of a discrete-time predator-prey system of Holling-I type in the closed first quadrant R+2. The existence and local stability of positive fixed point of the discrete dynamical system is analyzed algebraically. It is shown that the system undergoes a flip bifurcation and a Neimark-Sacker bifurcation in the interior of R+2 by using bifurcation theory. It has been found that the dynamical behavior of the model is very sensitive to the parameter values and the initial conditions. Numerical simulation results not only show the consistence with the theoretical analysis but also display the new and interesting dynamic behaviors, including phase portraits, period-9, 10, 20-orbits, attracting invariant circle, cascade of period-doubling bifurcation from period-20 leading to chaos, quasi-periodic orbits, and sudden disappearance of the chaotic dynamics and attracting chaotic set. In particular, we observe that when the prey is in chaotic dynamic, the predator can tend to extinction or to a stable equilibrium. The Lyapunov exponents are numerically computed to characterize the complexity of the dynamical behaviors. The analysis and results in this paper are interesting in mathematics and biology.

Hybrid treatment of penetrating aortic ulcer

International Nuclear Information System (INIS)

Lara, Juan Antonio Herrero; Martins-Romeo, Daniela de Araujo; Escudero, Carlos Caparros; Falcon, Maria del Carmen Prieto; Batista, Vinicius Bianchi; Vazquez, Rosa Maria Lepe

2015-01-01

Penetrating atherosclerotic aortic ulcer is a rare entity with poor prognosis in the setting of acute aortic syndrome. In the literature, cases like the present one, located in the aortic arch, starting with chest pain and evolving with dysphonia, are even rarer. The present report emphasizes the role played by computed tomography in the diagnosis of penetrating atherosclerotic ulcer as well as in the differentiation of this condition from other acute aortic syndromes. Additionally, the authors describe a new therapeutic approach represented by a hybrid endovascular surgical procedure for treatment of the disease. (author)

Hybrid treatment of penetrating aortic ulcer

Energy Technology Data Exchange (ETDEWEB)

Lara, Juan Antonio Herrero; Martins-Romeo, Daniela de Araujo; Escudero, Carlos Caparros; Falcon, Maria del Carmen Prieto; Batista, Vinicius Bianchi, E-mail: jaherrero5@hotmail.com [Unidade de Gestao Clinica (UGC) de Diagnostico por Imagem - Hosppital Universitario Virgen Macarena, Sevilha (Spain); Vazquez, Rosa Maria Lepe [Unit of Radiodiagnosis - Hospital Nuestra Senora de la Merced, Osuna, Sevilha (Spain)

2015-05-15

Penetrating atherosclerotic aortic ulcer is a rare entity with poor prognosis in the setting of acute aortic syndrome. In the literature, cases like the present one, located in the aortic arch, starting with chest pain and evolving with dysphonia, are even rarer. The present report emphasizes the role played by computed tomography in the diagnosis of penetrating atherosclerotic ulcer as well as in the differentiation of this condition from other acute aortic syndromes. Additionally, the authors describe a new therapeutic approach represented by a hybrid endovascular surgical procedure for treatment of the disease. (author)

New-Onset Atrial Fibrillation After Surgical Aortic Valve Replacement and Transcatheter Aortic Valve Implantation

DEFF Research Database (Denmark)

Jørgensen, Troels Højsgaard; Thygesen, Julie Bjerre; Thyregod, Hans Gustav

2015-01-01

Surgical aortic valve replacement (SAVR) and, more recently, transcatheter aortic valve implantation (TAVI) have been shown to be the only treatments that can improve the natural cause of severe aortic valve stenosis. However, after SAVR and TAVI, the incidence of new-onset atrial fibrillation...... (NOAF) is 31%-64% and 4%-32%, respectively. NOAF is independently associated with adverse events such as stroke, death, and increased length of hospital stay. Increasing the knowledge of predisposing factors, optimal postprocedural monitoring, and prophylactic antiarrhythmic and antithrombotic therapy...

New-onset atrial fibrillation after surgical aortic valve replacement and transcatheter aortic valve implantation

DEFF Research Database (Denmark)

Jørgensen, Troels Højsgaard; Thygesen, Julie Bjerre; Thyregod, Hans Gustav

2015-01-01

Surgical aortic valve replacement (SAVR) and, more recently, transcatheter aortic valve implantation (TAVI) have been shown to be the only treatments that can improve the natural cause of severe aortic valve stenosis. However, after SAVR and TAVI, the incidence of new-onset atrial fibrillation...... (NOAF) is 31%-64% and 4%-32%, respectively. NOAF is independently associated with adverse events such as stroke, death, and increased length of hospital stay. Increasing the knowledge of predisposing factors, optimal postprocedural monitoring, and prophylactic antiarrhythmic and antithrombotic therapy...

Aortic valve ochronosis: a rare manifestation of alkaptonuria.

Science.gov (United States)

Steger, Christina Maria

2011-07-28

Alkaptonuric ochronosis is a heritable disorder of tyrosine metabolism, with various systemic abnormalities related to pigment deposition and degeneration of collagen and other tissues, including the heart and aorta. A 65-year-old woman with alkaptonuric ochronosis and a history of four joint replacements required aortic valve replacement for severe aortic stenosis. Operative findings included ochronosis of a partly calcified aortic valve and the aortic intima. The aortic valve was removed at surgery and histologically investigated. Light microscopic examination of the aortic valve revealed intracellular and extracellular deposits of ochronotic pigment and a chronic inflammatory infiltrate. Beside the case representation, the disease history, aetiology, pathogenesis, clinical presentation and treatment of aortic valve ochronosis are reviewed.

Abnormalities of aortic arch shape, central aortic flow dynamics, and distensibility predispose to hypertension after successful repair of aortic coarctation.

Science.gov (United States)

Donazzan, Luca; Crepaz, Robert; Stuefer, Josef; Stellin, Giovanni

2014-10-01

Systemic hypertension (HT) is a major long-term complication even after successful repair of aortic coarctation (CoA), and many factors are involved in this pathophysiology. To investigate the role of abnormalities in the aortic arch shape, central aortic flow dynamics, and distensibility in developing HT after successful repair of CoA. We selected a group of 26 normotensive patients (mean age 16.9±7.3 years, range 9-32 years) with anatomically successful repair of CoA among 140 patients regularly followed after repair of CoA and analyzed their last clinical and echocardiographic data. Bicycle exercise test and ambulatory blood pressure monitoring (ABPM) were also obtained. Mean age at surgical repair was 3.2±3.9 years (range 10 days-15 years); 12 patients underwent surgical correction during the first year of life. Repair of CoA was performed by end-to-end anastomosis (TT) in 23 patients (extended TT in 6 patients with arch hypoplasia), patch aortoplasty in 2, and subcalvian flap aortoplasty in 1. The postsurgical follow-up was 13.8±7.2 years (range 3.5-29.4 years). The shape of the aortic arch was defined by magnetic resonance imaging (MRI) on this global geometry (normal-gothic-crenel), ratio of the height-transverse diameter (A/T), percentage of residual stenosis, and growth index of the transverse arch segments. Flow mapping by phase-contrast imaging in the ascending and descending aorta was performed in order to measure the systolic waveforms and central aortic distensibility. Twenty normal age-matched patients submitted to the same MRI protocol were used as controls. Six patients were found to have a gothic and 20 a normal aortic arch shape. Patients with gothic aortic arch shape had an increased A/T ratio (0.80±0.07 vs 0.58±0.05, P135 mm Hg on ABPM were higher in the gothic than in the normal arch group. There was a correlation between nocturnal SBP, 24 hours pulse pressure on ABPM in the whole group, and different MRI variables (A/T, distensibility of

Aortic stiffness and diameter predict progressive aortic dilatation in patients with Marfan syndrome

NARCIS (Netherlands)

Nollen, Gijs J.; Groenink, Maarten; Tijssen, Jan G. P.; van der Wall, Ernst E.; Mulder, Barbara J. M.

2004-01-01

Aim Patients with Marfan syndrome may develop dissection due to progressive dilatation in the entire aorta, which is not always predictable by mere anatomic assessment of the aortic diameter, especially of the descending aorta. The aim of this study was to identify the predictive value of aortic

A bifurcation analysis for the Lugiato-Lefever equation

Science.gov (United States)

Godey, Cyril

2017-05-01

The Lugiato-Lefever equation is a cubic nonlinear Schrödinger equation, including damping, detuning and driving, which arises as a model in nonlinear optics. We study the existence of stationary waves which are found as solutions of a four-dimensional reversible dynamical system in which the evolutionary variable is the space variable. Relying upon tools from bifurcation theory and normal forms theory, we discuss the codimension 1 bifurcations. We prove the existence of various types of steady solutions, including spatially localized, periodic, or quasi-periodic solutions. Contribution to the Topical Issue: "Theory and Applications of the Lugiato-Lefever Equation", edited by Yanne K. Chembo, Damia Gomila, Mustapha Tlidi, Curtis R. Menyuk.

Detection of bifurcations in noisy coupled systems from multiple time series

International Nuclear Information System (INIS)

Williamson, Mark S.; Lenton, Timothy M.

2015-01-01

We generalize a method of detecting an approaching bifurcation in a time series of a noisy system from the special case of one dynamical variable to multiple dynamical variables. For a system described by a stochastic differential equation consisting of an autonomous deterministic part with one dynamical variable and an additive white noise term, small perturbations away from the system's fixed point will decay slower the closer the system is to a bifurcation. This phenomenon is known as critical slowing down and all such systems exhibit this decay-type behaviour. However, when the deterministic part has multiple coupled dynamical variables, the possible dynamics can be much richer, exhibiting oscillatory and chaotic behaviour. In our generalization to the multi-variable case, we find additional indicators to decay rate, such as frequency of oscillation. In the case of approaching a homoclinic bifurcation, there is no change in decay rate but there is a decrease in frequency of oscillations. The expanded method therefore adds extra tools to help detect and classify approaching bifurcations given multiple time series, where the underlying dynamics are not fully known. Our generalisation also allows bifurcation detection to be applied spatially if one treats each spatial location as a new dynamical variable. One may then determine the unstable spatial mode(s). This is also something that has not been possible with the single variable method. The method is applicable to any set of time series regardless of its origin, but may be particularly useful when anticipating abrupt changes in the multi-dimensional climate system

Detection of bifurcations in noisy coupled systems from multiple time series

Science.gov (United States)

Williamson, Mark S.; Lenton, Timothy M.

2015-03-01

We generalize a method of detecting an approaching bifurcation in a time series of a noisy system from the special case of one dynamical variable to multiple dynamical variables. For a system described by a stochastic differential equation consisting of an autonomous deterministic part with one dynamical variable and an additive white noise term, small perturbations away from the system's fixed point will decay slower the closer the system is to a bifurcation. This phenomenon is known as critical slowing down and all such systems exhibit this decay-type behaviour. However, when the deterministic part has multiple coupled dynamical variables, the possible dynamics can be much richer, exhibiting oscillatory and chaotic behaviour. In our generalization to the multi-variable case, we find additional indicators to decay rate, such as frequency of oscillation. In the case of approaching a homoclinic bifurcation, there is no change in decay rate but there is a decrease in frequency of oscillations. The expanded method therefore adds extra tools to help detect and classify approaching bifurcations given multiple time series, where the underlying dynamics are not fully known. Our generalisation also allows bifurcation detection to be applied spatially if one treats each spatial location as a new dynamical variable. One may then determine the unstable spatial mode(s). This is also something that has not been possible with the single variable method. The method is applicable to any set of time series regardless of its origin, but may be particularly useful when anticipating abrupt changes in the multi-dimensional climate system.

Detection of bifurcations in noisy coupled systems from multiple time series

Energy Technology Data Exchange (ETDEWEB)

Williamson, Mark S., E-mail: m.s.williamson@exeter.ac.uk; Lenton, Timothy M. [Earth System Science Group, College of Life and Environmental Sciences, University of Exeter, Laver Building, North Park Road, Exeter EX4 4QE (United Kingdom)

2015-03-15

We generalize a method of detecting an approaching bifurcation in a time series of a noisy system from the special case of one dynamical variable to multiple dynamical variables. For a system described by a stochastic differential equation consisting of an autonomous deterministic part with one dynamical variable and an additive white noise term, small perturbations away from the system's fixed point will decay slower the closer the system is to a bifurcation. This phenomenon is known as critical slowing down and all such systems exhibit this decay-type behaviour. However, when the deterministic part has multiple coupled dynamical variables, the possible dynamics can be much richer, exhibiting oscillatory and chaotic behaviour. In our generalization to the multi-variable case, we find additional indicators to decay rate, such as frequency of oscillation. In the case of approaching a homoclinic bifurcation, there is no change in decay rate but there is a decrease in frequency of oscillations. The expanded method therefore adds extra tools to help detect and classify approaching bifurcations given multiple time series, where the underlying dynamics are not fully known. Our generalisation also allows bifurcation detection to be applied spatially if one treats each spatial location as a new dynamical variable. One may then determine the unstable spatial mode(s). This is also something that has not been possible with the single variable method. The method is applicable to any set of time series regardless of its origin, but may be particularly useful when anticipating abrupt changes in the multi-dimensional climate system.

Aortic events in a nationwide Marfan syndrome cohort.

Science.gov (United States)

Groth, Kristian A; Stochholm, Kirstine; Hove, Hanne; Kyhl, Kasper; Gregersen, Pernille A; Vejlstrup, Niels; Østergaard, John R; Gravholt, Claus H; Andersen, Niels H

2017-02-01

Marfan syndrome is associated with morbidity and mortality due to aortic dilatation and dissection. Preventive aortic root replacement has been the standard treatment in Marfan syndrome patients with aortic dilatation. In this study, we present aortic event data from a nationwide Marfan syndrome cohort. The nationwide cohort of Danish Marfan syndrome patients was established from the Danish National Patient Registry and the Cause of Death Register, where we retrieved information about aortic surgery and dissections. We associated aortic events with age, sex, and Marfan syndrome diagnosis prior or after the first aortic event. From the total cohort of 412 patients, 150 (36.4 %) had an aortic event. Fifty percent were event free at age 49.6. Eighty patients (53.3 %) had prophylactic surgery and seventy patients (46.7 %) a dissection. The yearly event rate was 0.02 events/year/patient in the period 1994-2014. Male patients had a significant higher risk of an aortic event at a younger age with a hazard ratio of 1.75 (CI 1.26-2.42, p = 0.001) compared with women. Fifty-three patients (12.9 %) were diagnosed with MFS after their first aortic event which primarily was aortic dissection [n = 44 (83.0 %)]. More than a third of MFS patients experienced an aortic event and male patients had significantly more aortic events than females. More than half of the total number of dissections was in patients undiagnosed with MFS at the time of their event. This emphasizes that diagnosing MFS is lifesaving and improves mortality risk by reducing the risk of aorta dissection.

Selective Aortic Arch and Root Replacement in Repair of Acute Type A Aortic Dissection.

Science.gov (United States)

Fleischman, Fernando; Elsayed, Ramsey S; Cohen, Robbin G; Tatum, James M; Kumar, S Ram; Kazerouni, Kayvan; Mack, Wendy J; Barr, Mark L; Cunningham, Mark J; Hackmann, Amy E; Baker, Craig J; Starnes, Vaughn A; Bowdish, Michael E

2018-02-01

Controversy exists regarding the optimal extent of repair for type A aortic dissection. Our approach is to replace the ascending aorta, and only replace the aortic root or arch when intimal tears are present in those areas. We examined intermediate outcomes with this approach to acute type A aortic dissection repair. Between March 2005 and October 2016, 195 patients underwent repair of acute type A aortic dissection. Repair was categorized by site of proximal and distal anastomosis and extent of repair. Mean follow-up was 31.0 ± 30.9 months. Kaplan-Meier analysis was used to assess survival. Multiple variable Cox proportional hazards modeling was utilized to identify factors associated with overall mortality. Overall survival was 85.1%, 83.9%, 79.1%, and 74.4% at 6, 12, 36, and 60 months, respectively. Eight patients required reintervention. The cumulative incidence of aortic reintervention at 1 year with death as a competing outcome was 3.95%. Multiple variable regression analysis identified factors such as age, preoperative renal failure, concomitant thoracic endograft, postoperative myocardial infarction and sepsis, and need for extracorporeal membrane oxygenation as predictive of overall mortality. Neither proximal or distal extent of repair, nor need for reintervention affected overall survival (proximal: hazard ratio 1.63, 95% confidence interval: 0.75 to 3.51, p = 0.22; distal: hazard ratio 1.12, 95% confidence interval: 0.43 to 2.97, p = 0.81; reintervention: hazard ratio 0.03, 95% confidence interval: 0.002 to 0.490, p < 0.01). A selective approach to root and arch repair in acute type A aortic dissection is safe. If aortic reintervention is needed, survival does not appear to be affected. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Stability and Hopf Bifurcation of a Reaction-Diffusion Neutral Neuron System with Time Delay