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Artery Cannulation (artery + cannulation)
Selected AbstractsMinimized Mortality and Neurological Complications in Surgery for Chronic Arch Aneurysm:JOURNAL OF CARDIAC SURGERY, Issue 4 2004Axillary Artery Cannulation, Replacement of the Ascending, Selective Cerebral Perfusion, Total Arch Aorta For preventing this complication, axillary artery cannulation, selective cerebral perfusion, and replacement of the ascending and arch aorta were applied to thoracic aortic aneurysm involving aortic arch. Method: From May 1999 to July 2002, consecutive 39 patients with true aneurysm (29 patients) or chronic aortic dissection (10 patients) involving aortic arch underwent replacement of the ascending and arch aorta with an elephant trunk under hypothermic cardiopulmonary bypass through the axillary artery cannulation and selective cerebral perfusion. The brain was continuously perfused without any intermission through the axillary artery. Concomitant operation included coronary artery bypass grafting (CABG) in two patients, aortic valve replacement (AVR) in one, Bentall operation in two, mitral valve replacement (MVR) in one, and aortic valve sparing operation in one. Patient age at operation was 40,84 (72 + 9) years and 24 of them were older than 70 years of age. Results: There was one operative death (2.5%) due to bleeding from the left lung, and one hospital death due to respiratory failure. Postoperative permanent neurological dysfunction was found in one patient (2.5%). Two patients presented temporary neurological dysfunction (5%). Thirty-six of the 39 patients were discharged from hospital on foot. Conclusion: Continuous perfusion through the axillary artery with selective cerebral perfusion and replacement of the ascending and arch aorta may minimize cerebral complication leading to satisfactory results in patients with chronic aortic aneurysm involving aortic arch. [source] Vascular catheterization is difficult in infants with Down syndromeACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 1 2009D. S. SULEMANJI Background: Our aim was to compare difficulties in vascular access interventions in infants with and without Down Syndrome (DS) undergoing congenital heart surgery. Methods: The anesthesia records of infants with DS undergoing congenital heart surgery (Group DS, n=61) were reviewed and matched with records of infants without DS (Group ND, n=61). Vascular cannulation sites, the experience of the anesthesiologists performing each procedure, the number of clinicians who attempted each procedure until it was successfully performed, and the number of attempts for each catheterization were recorded. Results: The rate of unsuccessful peripheral venous cannulation in any of the four extremities was higher in Group DS (P=0.026). The success rate of radial artery cannulation was lower in Group DS (P=0.048). Although the total number of attempts for arterial cannulation was higher in Group DS, the difference was not statistically significant (P=0.058). However, in Group DS, the clinician who was able to cannulate the artery successfully required a significantly higher number of attempts at cannulation (P=0.011). For central venous catheterization, cannulation site and the number of attempts required before success was achieved were similar in both groups. The specialist-to-resident ratio was higher in Group DS (P=0.037). Conclusion: Our results indicate a trend toward clinicians having more difficulty performing arterial and peripheral venous catheterizations in infants with DS compared with performing the same procedure in infants without DS. Anesthesiologists should be prepared for catheterization difficulties in this patient population. In infants with DS, we recommend that catheterizations be performed by more experienced physicians. [source] The Receptors and Role of Angiotensin II in Knee Joint Blood Flow Regulation and Role of Nitric Oxide in Modulation of Their FunctionMICROCIRCULATION, Issue 5 2003H. NAJAFIPOUR ABSTRACT Objectives: Angiotensin-converting enzyme (ACE) upregulation in the stroma cells of arthritis rheumatoid joints may produce a higher tissue concentration of angiotensin II (angII), which is a vasoconstrictor and mitogen factor that causes local hypoxia and synovial proliferation. No study in the literature has examined the role of angII in joint blood flow (JBF) regulation and the potential effect of ACE inhibitors on JBF. Methods: The study was performed on 20 Dutch white rabbits to examine the JBF response to angII, angII receptor subtypes, and the role of nitric oxide (NO) in angII effects in knee joint blood vessels. Drugs were administered locally through retrograde saphenous artery cannulation. Joint vascular resistance (JVR) was calculated by dividing the arterial blood pressure by the JBF. Results: AngII increased JVR dose dependently. The angII type 1 (AT1) receptor antagonist losartan did not change the basal JVR but completely blocked the effect of angII on JVR. N, -nitro-L-arginin methyl ester (L-NAME) increased JVR by a mean (±SEM) of 25.8 ± 8.7% (p < 0.05) but did not affect the joint vessel response to angII and losartan. Conclusions: AngII receptors are from the AT1 subtype in normal joint blood vessels, but angII plays no significant role in JBF regulation. The basal release of NO plays a role in resting JBF regulation, but NO does not affect the AT1 receptor-mediated vasoconstriction of joint blood vessels. [source] Subcutaneous administration of nitroglycerin to facilitate radial artery cannulationCATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 3 2006FSCAI, Samir B. Pancholy MD Abstract Objectives: To study the effect of sublingual versus subcutaneous nitroglycerin on radial artery spasm caused by failed access attempts. Background: Radial artery spasm is the leading reason for failed radial access. We studied the efficacy of systemic versus local nitroglycerin in relieving radial artery spasm caused by needle entry resulting in failed cannulation. Methods: Fifty-two consecutive patients were studied. All patients had failed attempt at radial artery cannulation, resulting in loss of radial pulse. Patients were divided in three groups, group I (n = 11), observed without additional treatment, group II (n = 20), administered 400 mcg of sublingual nitroglycerin, and group III (n = 21), administered 400 mcg of subcutaneous nitroglycerin at the site of the lost radial pulse. All patients were monitored for the return of radial pulse. Demographics, hemodynamics, and time to return of radial pulse as well as ability to successfully cannulate the radial artery were recorded. Results: Seventy-two percent of group I patients, 90% of group II patients, and 100% of group III patients had re-establishment of radial pulse. The time to return of radial pulse was significantly shorter for group III compared with that for group II (3 ± 1 min vs. 8 ± 1 min respectively, P < 0.001). Re-establishment of radial pulse was faster in group II and group III compared with that in group I (18 ± 5 min, P < 0.001). Systolic blood pressure changes and headaches were less common in group III. Conclusion: Subcutaneous administration of nitroglycerin is superior in facilitating radial artery cannulation after initial failed attempt. © 2006 Wiley-Liss, Inc. [source] Fluoroscopic localization of the femoral head as a landmark for common femoral artery cannulation,CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 2 2005Paul D. Garrett MD Abstract We sought to determine the reliability of frequently used landmarks for femoral arterial access in patients undergoing cardiac catheterization. The common femoral artery (CFA) is the most frequently used arterial access in cardiac catheterization. Arterial sheath placement into the CFA has been shown to decrease vascular complications. Some authors recommend locating the inferior border of the femoral head using fluoroscopy due to the relationship of the femoral head and the bifurcation of the CFA. We performed a descriptive study in a prospective design of 158 patients undergoing catheterization from the femoral approach. A femoral angiogram was performed, and the CFA bifurcation location was recorded in relation to the inguinal ligament, middle and inferior border of the femoral head, and the inguinal skin crease. The CFA bifurcation was distal to the inguinal ligament, middle femoral head, and inferior femoral head in most patients with mean distances (cm ± SD) of 7.5 ± 1.7, 2.9 ± 1.5, and 0.8 ± 1.2, respectively. The inguinal skin crease was below the bifurcation in 78% of patients (,1.8 ± 1.6 cm). The CFA overlies the femoral head in 92% of cases. The femoral head has a consistent relationship to the CFA, and localization using fluoroscopy is a useful landmark. © 2005 Wiley-Liss, Inc. [source] | ||||||||||