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Kyobu Geka. the Japanese Journal of... Apr 2014Bilateral pulmonary artery banding( BPAB), though a less-invasive surgical option for hypoplastic left heart syndrome (HLHS), entails considerable risk of residual...
Bilateral pulmonary artery banding( BPAB), though a less-invasive surgical option for hypoplastic left heart syndrome (HLHS), entails considerable risk of residual pulmonary artery stenosis after de-banding. Autologous aortic reconstruction in Norwood procedure is attractive in terms of growth potential, but technically demanding. To overcome these drawbacks, we modified the 2 techniques. Eight patients with HLHS underwent BPAB whereby ligation clips were half-closed into rhombic shape to deform bilateral pulmonary arteries. The arterial duct was kept patent by prostaglandin E1 infusion. One patient died of sepsis( age 8 months), while the 7 survivors underwent Norwood-Glenn procedure. Both pulmonary arteries were excised from the pulmonary trunk with minimal cuffs. Resultant defect in the pulmonary trunk was longitudinally closed. After arterial duct excision, pulmonary trunk-to descending aorta continuity was reconstructed by end-to-end anastomosis. Ascending aorta-to-aortic arch complex was anastomosed to the pulmonary trunk in a side-to-side fashion. After bilateral pulmonary artery continuity was reconstructed, Glenn anastomosis was made. One patient died of pneumonia(age 5 months). Currently, the 6 surviving patients(age 4∼30 months), enjoy good health. Four of them have completed Fontan procedure. Our modified techniques are facile, reproducible, and pose low risk of residual pulmonary artery stenosis or aortic stenosis.
Topics: Humans; Hypoplastic Left Heart Syndrome; Infant; Norwood Procedures; Pulmonary Artery; Surgical Instruments
PubMed: 24917155
DOI: No ID Found -
Cardiology in the Young Dec 2010In the past, coronary arterial anomalies have been difficult to diagnose by non-invasive methods. Identification of coronary arterial origins is now a routine part of... (Review)
Review
In the past, coronary arterial anomalies have been difficult to diagnose by non-invasive methods. Identification of coronary arterial origins is now a routine part of the standard paediatric echocardiogram. Anomalous origin of a coronary artery from the pulmonary trunk is an extremely important diagnosis to make. Many echocardiographic features are not directly related to the visualisation of the coronary arterial origin. Left ventricular dilation and abnormal ventricular performance are common, along with mitral regurgitation and evidence of collateralisation of the flow from the coronary artery that has an aortic origin. In some cases, the anomalous coronary artery can be seen to arise directly from the pulmonary trunk. Congenital atresia of the main stem of the left coronary artery has a similar echocardiographic presentation, except that its aortic origin is not determined. Anomalous aortic origin of the coronary artery has important implications, as the first presenting symptom can be sudden death. With meticulous attention to the origins of the coronary arteries, echocardiographic diagnosis can also be achieved. In contrast to the anomalous origin of a coronary artery from the pulmonary trunk, ventricular performance is usually normal. Whenever there is doubt as to the definition of the origin of the coronary arteries and, indeed, when there is serious clinical concern that a coronary artery has an anomalous origin, other testing, such as cine-computed tomography, magnetic resonance imaging, or cardiac catheterisation may be indicated for confirmation or to provide greater anatomic detail.
Topics: Abnormalities, Multiple; Child; Coronary Vessel Anomalies; Humans; Pulmonary Artery; Ultrasonography
PubMed: 21087557
DOI: 10.1017/S104795111000106X -
International Journal of Cardiology Jul 1988We report a case of pulmonary atresia with ventricular septal defect and absent pulmonary trunk. The sources of pulmonary blood supply were the arterial duct and...
We report a case of pulmonary atresia with ventricular septal defect and absent pulmonary trunk. The sources of pulmonary blood supply were the arterial duct and systemic pulmonary collateral arteries. The left lung received blood from both sources which is very rare. One of the systemic pulmonary collateral arteries arose from the right coronary artery in an unusual fashion.
Topics: Collateral Circulation; Coronary Vessel Anomalies; Heart Septal Defects, Ventricular; Humans; Infant, Newborn; Lung; Male; Pulmonary Artery; Pulmonary Valve
PubMed: 3403079
DOI: 10.1016/0167-5273(88)90327-0 -
Hellenic Journal of Cardiology : HJC =... 2013
Topics: Blood Flow Velocity; Child; Coronary Vessel Anomalies; Coronary Vessels; Diagnosis, Differential; Diastole; Echocardiography, Doppler, Color; Electrocardiography; Humans; Infant; Male; Pulmonary Artery; Regional Blood Flow
PubMed: 23685659
DOI: No ID Found -
Circulation Jun 1963
Topics: Humans; Pulmonary Artery
PubMed: 13991048
DOI: 10.1161/01.cir.27.6.1086 -
Early Human Development Oct 1993In situ cross-sectional morphology of the pulmonary arteries, veins, and lung volumes were studied following rapid whole-body freezing of the fetal and neonatal rat. In...
In situ cross-sectional morphology of the pulmonary arteries, veins, and lung volumes were studied following rapid whole-body freezing of the fetal and neonatal rat. In the fetus, the right and left main pulmonary arteries were much smaller than the pulmonary trunk, and the ratio of the internal diameter of the right or the left pulmonary artery to the diameter of the pulmonary trunk was 0.44 and 0.38, respectively. One day after birth, the right and the left main pulmonary arteries enlarged, and the ratio of the right pulmonary artery to the pulmonary trunk increased to 0.82. The proximal right and left pulmonary arteries immediately adjacent to the bifurcation enlarged slowly, and showed diffuse narrowing at the proximal portions adjacent to the bifurcation. The narrowing disappeared 3 and 4 days after birth as the proximal pulmonary artery enlarged and the ratio of the right pulmonary artery to the pulmonary trunk reached 0.8. The pulmonary vein showed rapid enlargement in these neonates, concordant with the enlargement of the pulmonary arteries. Lung volume increased to 131% of the fetal volume 10 min after caesarean section. These studies quantitated neonatal pulmonary vascular adaptation. Delayed enlargement of the pulmonary arteries adjacent to the bifurcation in the neonatal period was shown, and presented a morphologic basis for the physiologic gradient and transient systolic murmur in the pulmonary arteries in human neonates.
Topics: Animals; Animals, Newborn; Fetus; Lung; Morphogenesis; Pulmonary Artery; Rats; Rats, Wistar; Total Lung Capacity
PubMed: 8287804
DOI: 10.1016/0378-3782(93)90176-u -
Archivos de Bronconeumologia Feb 2017
Calcified atherosclerosis of the pulmonary trunk, stenosis of the main pulmonary arteries, and post-stenotic dilation of segmental pulmonary arteries in a patient with Alagille syndrome.
Topics: Alagille Syndrome; Atherosclerosis; Calcinosis; Dilatation, Pathologic; Humans; Kidney Transplantation; Liver Transplantation; Male; Middle Aged; Postoperative Complications; Pulmonary Artery; Pulmonary Valve Stenosis
PubMed: 27242248
DOI: 10.1016/j.arbres.2016.04.006 -
Life Sciences Mar 2000The presence of the angiotensin AT1A-like receptor subtype in the pulmonary artery and AT1B-like receptor subtype in the pulmonary trunk of the rabbit has been reported...
The presence of the angiotensin AT1A-like receptor subtype in the pulmonary artery and AT1B-like receptor subtype in the pulmonary trunk of the rabbit has been reported in two earlier studies. The present study further investigated these receptor subtypes using five other angiotensins (namely angiotensin II, angiotensin III, angiotensin IV, angiotensin-(1-7) and angiotensin-(4-8)). The direct action of the angiotensins on the rabbit pulmonary arterial and trunk sections and the ability of each angiotensin to further contract or relax preconstricted sections of the pulmonary artery and trunk were studied using the organ bath set-up. The effects of angiotensin III on the 3H overflow from re-uptaken [3H]noradrenaline in the electrically-contracted rabbit pulmonary arterial and trunk sections were also studied. The contractile response of the arterial and trunk section had the following rank order potency: angiotensin II > angiotensin III > angiotensin IV. The contractile response to these angiotensins was greatly reduced or absent in the pulmonary trunk. Angiotensin II further contracted the preconstricted arterial and trunk sections. In contrast, angiotensin III further contracted the preconstricted arterial section but relaxed the preconstricted trunk section. Angiotensin IV similarly relaxed the preconstricted trunk section but had minimum effect on the preconstricted arterial section. Angiotensin-(1-7) and angiotensin-(4-8) had no effect on both sections. The actions of the three angiotensins were inhibited by losartan, an AT1-selective antagonist. Indomethacin, a cyclo-oxygenase inhibitor, inhibited the relaxation caused by angiotensin III and angiotensin IV in the trunk section. The effects of angiotensin III on the electrically preconstricted sections of the pulmonary trunk and artery were not accompanied by any significant changes in 3H overflow. The differential responses produced by angiotensin II and its immediate metabolites via two positionally located and functionally opposing receptor subtypes suggest that the pulmonary trunk and artery is not a passive conduit but an important regulator of blood flow from the heart to the lung.
Topics: Angiotensin II; Angiotensin III; Angiotensin Receptor Antagonists; Angiotensins; Animals; Cyclooxygenase Inhibitors; Electric Stimulation; In Vitro Techniques; Indomethacin; Male; Muscle Contraction; Muscle, Smooth, Vascular; Norepinephrine; Peptides; Pulmonary Artery; Rabbits; Receptor, Angiotensin, Type 1; Receptor, Angiotensin, Type 2; Vasoconstriction; Vasoconstrictor Agents; Vasodilation
PubMed: 10809181
DOI: 10.1016/s0024-3205(00)00507-5 -
Anatomischer Anzeiger 1986The corrected circumference of the pulmonary trunk, its branches and ascending aorta as well as the maximum diameter of the principal bronchi, were measured in 120 human...
The corrected circumference of the pulmonary trunk, its branches and ascending aorta as well as the maximum diameter of the principal bronchi, were measured in 120 human fresh cadavers of subjects (60 males and 60 females) aged between 27 and 91 years, died of natural causes. The statistical analysis of the obtained data yielded the following main results: 1) the corrected circumference of the pulmonary trunk, smaller than that of the aorta, is not statistically correlated with the age of the subjects and does not present significant degrees between the 2 sexes; 2) the right and left pulmonary arteries have a corrected circumference quite similar in the 2 sexes and statistically correlated with that of the vessel of origin; 3) both the right pulmonary artery and the right principal bronchus have sizes greater than the left ones, possibly due to the greatest volume and weight of the right lung; 4) the lackness of a correlation between the size of the pulmonary arteries and those of the respective bronchi shows once more the difficulty of identifying general rules concerning the interrelationship between vascular and ductal human structures.
Topics: Adult; Aged; Aged, 80 and over; Aorta, Thoracic; Biometry; Bronchi; Female; Humans; Male; Middle Aged; Pulmonary Artery
PubMed: 3813040
DOI: No ID Found -
Anatomy and Embryology 1983Nerve fibres reactive to acetyl-thiocholine, and tissues showing catecholamine fluorescence were examined in the pulmonary trunk, ductus arteriosus and aorta of 28 pig...
Nerve fibres reactive to acetyl-thiocholine, and tissues showing catecholamine fluorescence were examined in the pulmonary trunk, ductus arteriosus and aorta of 28 pig fetuses between 31 and 113 days of gestation (term = 114 +/- 1 days). Eight additional fetuses, which had been decapitated in utero at 40-43 days, were also studied at ages between 51 and 114 days of gestation. Spherical micro-networks of nervous tissue reactive to acetyl-thiocholine are present in the adventitia on the cranial aspect of the pulmonary trunk and ductus arteriosus, between the aorta and pulmonary trunk, and on the caudal aspects of the pulmonary trunk and the pulmonary arteries. These fibres invest spherical clusters of catecholamine containing cells which are well supplied with blood vessels. Nerve fibres which fluoresce are also found in association with these cells. Decapitation in utero does not appear to affect the distribution of morphology of these structures. The observations show that structures are present in the major arteries of the fetal pig which may act as sensory receptors, and that these structures are unaffected by chronic vagotomy of the fetus produced by decapitation early in gestation.
Topics: Animals; Aorta; Catecholamines; Ductus Arteriosus; Fetus; Histocytochemistry; Nerve Endings; Pulmonary Artery; Swine; Vagotomy
PubMed: 6673611
DOI: 10.1007/BF00304276