Variability in Ventricular Wall Motion Pattern
If one questions now whether a SF of 10 indicates regular or hypokinetic wall motion, you should ask for the circumstances like site and orientation of measurement, species, at rest or during exercise, etc. To classify a ventricular wall segment as a regularly or less efficient contracting part of the ventricle is possible only after the response to variations in pressure load or wall stress, in work and power is analyzed. As soon as ventricular wall regions dilate during systole dyskinesia or...
Assessment of Cardioplegia Flow Using Myocardial Contrast Echocardiography
Myocardial contrast echocardiography utilizes the intravascular injection of air-filled micro-bubbles which produce myocardial opacification during simultaneously performed echocar-diographic imaging.35 This technique has been shown to quantify myocardial flow during antegrade infusion of cardioplegia.36 The myocardial 'wash-in' parameters of these microbubbles, such as time-to-peak contrast effect, have been shown by us to correlate closely with antegrade cardioplegia flow measured using...
The Venous Drainage of the Myocardium in the Human Heart
Michael von L dinghausen, Nobuko Ohmachi and Shoji Chiba Introduction The coronary sinus cs is the anatomically appropriate location for the placement of a balloon catheter for retrograde perfusion or revascularization, in particular of the vessels of the left ventricular myocardium, in a case of severe stenosing coronary heart disease and jeopardized myocardium. However, the results of invasive cardiological procedures via the cs are not satisfactory and are even inadequate in 1-5 of...
References Eah
1. Schreiner W, Neumann F, Mohl W. The role of intramyocardial pressure during coronary sinus interventions A computer model study. IEEE Trans Biomed Eng 1990 37 956-67. 2. Sun Y, Gewirtz H. Estimation of intramyocardial pressure and coronary blood flow distribution. Am J Physiol 1988 255 H664-72. 3. Bruinsma P, Arts T, Dankelman J et al. Model of the coronary circulation based on pressure dependence of coronary resistance and compliance. Bas Res Cardiol 1988 83 510-24. 4. Rooz E, Wiesner TF,...
Surgeon Physiologist SurgeonPhysiologist
The surgeon pays attention to the detail described in his findings. This information must be listened to by the physiologist. The physiologist does not believe the surgeon can think, while the surgeon thinks the physiologist cannot be practical. The surgeon-physiologist team is needed and this may occur in the same person. If so, the surgeon must possess basic physiologic knowledge and bring this to the practical area the Operating Room. Solid surgical physiology must be converted to practical...
Blood Cardioplegia
A similar back door approach led to our development of blood cardioplegia for myocardial protection. Not surprisingly, this concept emanated from carefully listening to the clear thinking and thoughtful questions of a master surgeon physiologist named John Kirklin, M.D. In 1974, our studies using microspheres to measure perfusion showed subendocardial ischemia during ventricular fibrillation. This finding led to avoidance of ventricular fibrillation during valve replacement in hypertrophied...
Retrograde Cardioplegia
The back door approach exists because basic concepts remain basic concepts, even though the ideas underlying formation of a concept come from apparently unrelated sources. My studies of retrograde cardioplegia developed from lung experiments where I looked for a cause of pulmonary edema after massive transfusion. I was in the Air Force in 1968, and lung problems occurred in wounded Vietnam soldiers who were quickly removed from the battlefield and treated by massive fluid infusion a traumatic...