“Objective: The objective was to report our experience with a simplified procedure of ascending aorta and hemiarch replacement with a stent-graft elephant trunk in type A dissections. The efficacy of innominate artery cannulation was investigated.
Methods: From January 2007 to January 2010, 46 patients (35 men, 11 women; mean age, 52.7 +/- 12.3 years) with acute type A dissection with 3 vessels of the arch free of lesions received ascending aorta and hemiarch replacement with implantation of a stent graft into the descending aorta under hypothermic circulatory arrest and selective antegrade cerebral perfusion. The innominate artery
was used for artery cannulation.
Results: Cardiopulmonary WH-4-023 Lonafarnib cell line bypass time was 107.9 +/- 17.7 minutes, and the time of selective antegrade cerebral perfusion was 35.5 +/- 7.1 minutes. The in-hospital mortality was 2.2% (1/46). No permanent neurologic dysfunction and paraplegia were observed. Three patients were lost to follow-up. The average follow-up time was 13.7 +/- 7.4 months. Three months after the operation, the false lumen of the distal aorta decreased significantly with thrombosis around the stent graft in all the patients (42/42), at the level of the middle descending aorta in 81.1% (37/42) of the patients, and at the diaphragmatic level in 73.8% (31/42) of the
patients. No reoperation related to residual dissected aorta was carried out.
Conclusions: The simplified procedure of ascending aorta and hemiarch replacement with a stent-graft elephant trunk performed by using innominate artery cannulation is safe and effective in
patients with acute type A dissection without involvement of 3 vessels of the arch. (J Thorac Cardiovasc Surg 2011;142:1458-63)”
“Introduction: Measurement of regional cerebral blood flow (rCBF) in rodents can provide knowledge of pathophysiology of the cerebral circulation, but generally requires blood sampling for analysis during positron emission tomography (PET). unless We therefore tested the feasibility of using an arteriovenous (AV) shunt in rats for less invasive blood analysis.
Methods: Six anesthetized rats received [O-15]H2O and [O-15]CO PET scans with their femoral artery and vein connected by an AV shunt, the activity within which was measured with a germanium ortho-oxysilicate scintillation detector. The [O-15]H2O was intravenously injected either at a faster or slower injection rate, while animals were placed either with their head or heart centered in the gantry. The time activity curve (TAG) from the AV shunt was compared with that from the cardiac ventricle in PET image. The rCBF values were calculated by a nonlinear least-square method using the dispersion-corrected AV-shunt TAG as an input.
Results: The AV-shunt TAG had higher signal-to-noise ratio, but also had delay and dispersion compared with the image-derived TAG.