			Home About us Contact

Right Subclavian Artery (right + subclavian_artery)

Distribution by Scientific Domains

Medical Sciences	75%

Selected Abstracts

Aortic Arch Aneurysm Associated with Arch Vessel Anomalies: Truncus Bicaroticus and Retroesophageal Right Subclavian Artery

JOURNAL OF CARDIAC SURGERY, Issue 4 2009
Namhee Park M.D.
An aberrant right subclavian artery is just as rare, especially with a retroesophageal course. A combination of these two conditions, we believe, has never been reported. [source]

Neonatal Congestive Heart Failure Due to a Subclavian Artery to Subclavian Vein Fistula Diagnosed by Noninvasive Procedures

CONGENITAL HEART DISEASE, Issue 3 2006
Gregory H. Tatum MD
ABSTRACT Congestive heart failure in the neonate is usually due to intracardiac anomalies or cardiac dysfunction. Extracardiac causes are rare. Patient., We report a newborn infant who presented with respiratory distress and cardiomegaly. Result., Echocardiography identified a dilated right subclavian artery and vein and superior vena cava. Magnetic resonance imaging confirmed a subclavian artery to subclavian vein fistula that was treated with surgical ligation. The infant recovered fully. This case underscores the need for clinical suspicion of fistulous connection in unusual locations in the face of unexplained heart failure in the neonate. Conclusion., Echocardiographic and magnetic resonance imaging are effective noninvasive modalities to confirm the diagnosis prior to surgical intervention. [source]

Aberrant subclavian artery causing difficulty in transhiatal esophageal dissection

DISEASES OF THE ESOPHAGUS, Issue 2 2003
C. S. Pramesh
SUMMARY The right subclavian artery normally arises from the brachiocephalic artery. Anomalies in development may lead to peculiar problems during surgery. We report a patient with esophageal carcinoma who had an aberrant right subclavian artery, posing specific difficulties during a transhiatal esophagectomy, requiring conversion of the procedure into a transthoracic approach. The embryologic basis of this anomaly and the clinical significance are discussed. [source]

Aortic Arch Aneurysm Associated with Arch Vessel Anomalies: Truncus Bicaroticus and Retroesophageal Right Subclavian Artery

Noninvasive Control of Adequate Cerebral Oxygenation During Low-Flow Antegrade Selective Cerebral Perfusion on Adults and Infants in the Aortic Arch Surgery

JOURNAL OF CARDIAC SURGERY, Issue 5 2008
Álvaro Rubio M.D.
Background: Aortic arch repair techniques using low-flow antegrade selective cerebral perfusion have been standardized to a certain degree. However, some of the often-stated beneficial effects have never been proven. Especially, the existence of an adequate continuous flow in both cerebral hemispheres during the surgical procedure still remains unclear as the monitoring of an effective perfusion remains a nonstandardized technique. Methods: Seventeen patients underwent surgical reconstruction of the aortic arch due to aortic aneurysm surgery (adult group n = 8 patients) or of the hypoplastic aortic arch due to hypoplastic left heart syndrome (HLHS) or aortic coarctation (infant group n = 9 patients) under general anesthesia and mild hypothermia (adult group 28 °C; infant group 25 °C). Mean weights were 92.75 ± 14.00 kg and 4.29 ± 1.32 kg, and mean ages were 58.25 ± 10.19 years and 55.67 ± 51.11 days in the adult group and the infant group, respectively. The cerebral O2 saturation measurement was performed by continuous plotting of the somatic reflectance oximetry of the frontal regional tissue on both cerebral hemispheres (rSO2, INVOS®; Somanetics Corporation, Troy, MI, USA). Results: During low-flow antegrade perfusion via innominate artery, continuous plots with similar values of O2 saturation (rSO2) in both cerebral hemispheres were observed, whereas a decrease in the rSO2 values below the desaturation threshold correlated with a displacement or an incorrect positioning of the arterial cannula in the right subclavian artery. Conclusions: Continuous monitorization of the cerebral O2 saturation during aortic arch surgery in adults and infants is a feasible technique to control an adequate cannula positioning and to optimize clinical outcomes avoiding neurological complications related to cerebral malperfusion. [source]

Occlusion of the right subclavian artery after insertion of a transoesophageal echocardiography probe in a neonate

PEDIATRIC ANESTHESIA, Issue 7 2003
Herbert Koinig MD
Summary We present a case of occlusion of the right arm's blood supply in a neonate with a lusorian artery, a rare anomaly of the right subclavian artery, after insertion of a transoesophageal echocardiography (TOE) probe and discuss the impact of a lusorian artery on intraoperative TOE monitoring. [source]

Flow Distribution During Cardiopulmonary Bypass in Dependency on the Outflow Cannula Positioning

ARTIFICIAL ORGANS, Issue 11 2009
Tim A.S. Kaufmann
Abstract Oxygen deficiency in the right brain is a common problem during cardiopulmonary bypass (CPB). This is linked to an insufficient perfusion of the carotid and vertebral artery. The flow to these vessels is strongly influenced by the outflow cannula position, which is traditionally located in the ascending aorta. Another approach however is to return blood via the right subclavian artery. A computational fluid dynamics (CFD) study was performed for both methods and validated by particle image velocimetry (PIV). A 3-dimensional computer aided design model of the cardiovascular (CV) system was generated from realtime computed tomography and magnetic resonance imaging data. Mesh generation (CFD) and rapid prototyping (PIV) were used for the further model creation. The simulations were performed assuming usual CPB conditions, and the same boundary conditions were applied for the PIV validation. The flow distribution was analyzed for 55 cannula positions inside the aorta and in relation to the distance between the cannula tip and the vertebral artery branch for subclavian cannulation. The study reveals that the Venturi effect due to the cannula jet appears to be the main reason for the loss in cerebral perfusion seen clinically. It provides a PIV-validated CFD method of analyzing the flow distribution in the CV system and can be transferred to other applications. [source]

The Impact of Aortic/Subclavian Outflow Cannulation for Cardiopulmonary Bypass and Cardiac Support: A Computational Fluid Dynamics Study

ARTIFICIAL ORGANS, Issue 9 2009
Tim A.S. Kaufmann
Abstract Approximately 100 000 cases of oxygen deficiency in the brain occur during cardiopulmonary bypass (CPB) procedures each year. In particular, perfusion of the carotid and vertebral arteries is affected. The position of the outflow cannula influences the blood flow to the cardiovascular system and thus end organ perfusion. Traditionally, the cannula returns blood into the ascending aorta. But some surgeons prefer cannulation to the right subclavian artery. A computational fluid dynamics study was initially undertaken for both approaches. The vessel model was created from real computed tomography/magnetic resonance imaging data of young healthy patients. The simulations were run with usual CPB conditions. The flow distribution for different cannula positions in the aorta was studied, as well as the impact of the cannula tip distance to vertebral artery for the subclavian position. The study presents a fast method of analyzing the flow distribution in the cardiovascular system, and can be adapted for other applications such as ventricular assist device support. It revealed that two effects cause the loss of perfusion seen clinically: a vortex under the brachiocephalic trunk and low pressure regions near the cannula jet. The results suggest that cannulation to the subclavian artery is preferred if the cannula tip is sufficiently far away from the branch of the vertebral artery. For the aortic positions, however, the cannula should be injected from the left body side. [source]

Anomalous origin and cervical course of the vertebral artery in the presence of a retroesophageal right subclavian artery

CLINICAL ANATOMY, Issue 4 2004
Valéria Paula Sassoli Fazan
Abstract The vertebral artery is usually described as the first branch of the subclavian artery, originating medial to the scalenus anterior muscle. During its cervical course, the vertebral artery presents a prevertebral segment and then enters the foramen transversarium of the sixth cervical vertebra. We describe a case of an unusual origin and course of the right vertebral artery in a cadaver specimen wherein the right vertebral artery originates from the right common carotid artery at the inferior border of the thyroid gland. In its cervical course the vertebral artery ascends outside and anteriorly to the foramen transversarium of vertebrae C VI to C III, and enters the foramen transversarium of the axis. In the same specimen, a retroesophageal right subclavian artery is also present. These vascular abnormalities are presented for physicians to keep in mind such variations during diagnostic investigation and surgical procedures of the neck. Clin. Anat. 17:354,357, 2004. © 2004 Wiley-Liss, Inc. [source]

Isomerism of the right atrial appendages: Clinical, anatomical, and microscopic study of a long-surviving case with asplenia and ciliary abnormalities

CLINICAL ANATOMY, Issue 3 2003
R. Raman
Abstract This study describes a case of isomerism of the right atrial appendages (bilateral morphologically right atrial appendages associated with complex congenital cardiac lesions) with ciliary abnormalities. Detailed investigation included gross anatomic dissection, review of the clinical history, and light, confocal, and electron microscopy. Clinically, this 40-year-old, long-surviving male patient had relatively good health until 4 years before death, which was due to cardiac failure. Surgical intervention consisted only of a Blalock-Taussig shunt (anastomosis of the right subclavian artery to the right pulmonary artery) at 6 years of age. Despite the presence of complex cardiac malformations and asplenia, his longevity may be attributed to the connection of the pulmonary veins to the atrium without pulmonary venous obstruction, pulmonary valvar stenosis rather than atresia, no significant atrioventricular valve regurgitation, and no serious infections during his life. Microscopic examination of bronchial epithelium revealed a narrow, disorganized epithelium with abundant goblet cells and short, angulated cilia with a random orientation and possibly an abnormal central microtubule doublet. These abnormalities were not present in controls, and have been noted in primary ciliary dyskinesia (PCD) or Kartagener's syndrome. Because this syndrome has classically been thought to cause random lateralization resulting in a mirror-imaged arrangement of the organs, the occurrence of truly isomeric patterns is not widely recognized. Whereas polysplenia and left bronchial isomerism have been reported to occur in immotile cilia syndrome, this is the first report to present detailed postmortem anatomic evidence of isomerism of the right atrial appendages, right bronchial isomerism, and asplenia in association with microscopy suggesting ciliary abnormalities. Clin. Anat. 16:269,276, 2003. © 2003 Wiley-Liss, Inc. [source]