Neurologic Complications of Aortic Disease and Surgery

Goodin, Douglas S.

doi:10.1016/b978-0-12-407710-2.00002-3

Cited by 4 publications

(2 citation statements)

References 84 publications

(120 reference statements)

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“…While surgical implementation of IVC assist is perhaps less complex, the model revealed that the pressure generated by the pump even at the lowest speed was excessively high (7mmHg at 1.66 L/min of flow) and resulted in elevation of the SVC and pulmonary pressure to above 22mmHg and out of acceptable physiological ranges. Cerebral venous thrombosis, a result of elevated central venous pressure, is frequent after the Fontan operation (occurring in 21% of patients) [37]- [39]. Precipitous rise of the SVC pressure due to an IVC assist pump transmitted to the cerebral venous circulation could further predispose the patient to thrombosis.…”

Section: Discussionmentioning

confidence: 99%

Risks and Benefits of Using a Commercially Available Ventricular Assist Device for Failing Fontan Cavopulmonary Support: A Modeling Investigation

Farahmand

Kavarana

Kung

2020

IEEE Trans. Biomed. Eng.

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Fontan patients often develop circulatory failure and are in desperate need of a therapeutic solution. A blood pump surgically placed in the cavopulmonary pathway can substitute the function of the absent sub-pulmonary ventricle by generating a mild pressure boost. However, there is currently no commercially available device designed for the cavopulmonary application; and the risks and benefits of implanting a ventricular assist device (VAD) originally designed for the left ventricular application on the right circulation of failing Fontan patients is not yet clear. Moreover, further research is needed to compare the hemodynamics between the two clinically-considered surgical configurations for cavopulmonary assist, with Full and IVC Support corresponding to the entire venous return or only the inferior venous return, respectively, being routed through the VAD. In this study, we used a numerical model of the failing Fontan physiology to evaluate the Fontan hemodynamic response to a left VAD during the IVC and Full support scenarios. We observed that during Full support the VAD improved the cardiac output while maintaining blood pressures within safe ranges, and lowered the IVC pressure to <15mmHg; however, we found a potential risk of lung damage at higher pump speeds due to the excessive pulmonary pressure elevation. IVC support, on the other hand, did not benefit the hemodynamics in the patient cases simulated, resulting in the superior vena cava pressure increasing to an unsafe level of >20 mmHg. The findings in this study may be helpful to surgeons for recognizing the risks of a cavopulmonary VAD and developing coherent clinical strategies for the implementation of cavopulmonary support. Index Terms-Ventricular assist device (VAD), lumped parameter network model, congenital heart disease, Fontan

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Section: Discussionmentioning

confidence: 99%

Risks and Benefits of Using a Commercially Available Ventricular Assist Device for Failing Fontan Cavopulmonary Support: A Modeling Investigation

Farahmand

Kavarana

Kung

2020

IEEE Trans. Biomed. Eng.

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“…The accumulation of calcium and fat-based plaque on the inner aorta wall that results in artery hardening is known as aortic atherosclerosis [1]. As cholesterol and low-density lipoproteins build up in the arteries, to make them thickener and less flexible.…”

Section: Introductionmentioning

confidence: 99%

Effect liposome Nanoparticles Loaded with Natural Products Isolated From Commiphora myrrh on Plasminogen Activator Inhibitor-1 in Mice Induced Aortic Atherosclerosis

Yahya,

Bahry Hassin Al-Sadoon

2024

Egyptian Journal of Veterinary Sciences

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HE study included the separation and diagnosis of various natural products from the Myrrh plant, where the oily substance and its fatty acids were separated, which were identified by applying capillary column gas chromatography (CGC) technology. Some flavonoids and alkaloids were also separated. The flavonoids were identified by applying high-performance liquid chromatography (HPLC) technology. The effect of these products on plasminogen activator inhibitor-1 (PAI-1) was studied and it was found that they had a positive effect in reducing the level of PAI-1 and some other measured variables. In addition, the study examined the effect of these natural products on some biochemical parameters related to aortic stiffness in the blood serum of mice induced with the disease. Biochemical variables included: low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC), triglycerides (TG), interleukin 6 (IL-6), and... Tumor necrosis alpha (TNF-alpha). The results showed that the concentrations of PAI-1, IL-6, LDL, TG, TC, and TNF-α increased significantly in infected mice, compared to healthy mice, and a significant decrease in the concentration of HDL was observed. Liposome nanoparticles (LNPs) were prepared from natural products of myrrh plant and characterized using field emission scanning electron microscopy (FE-SEM). Nanoparticles loaded with natural products showed a positive therapeutic effect in mice in which the disease was established through tissue sections of experimental animals.

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