Assessment of Ascending Aortic Elasticity in Hypertension Patients by Quantitative Tissue Velocity Imaging

The elasticity of the ascending aorta in healthy volunteers and hypertension patients were examined by using quantitative tissue velocity imaging （QTVI）, and the age-related change in the as-cending aortic elasticity was investigated. The anterior and posterior walls of the ascending aorta were imaged with tissue Doppler method in all the subjects and QTVI was performed. Stable curves were obtained from 173 hypertension patients and 185 healthy adults. The peak early diastolic veloc-ity （Ve）, peak late diastolic velocity （Va） and peak systolic velocity （Vs） were measured. The relation of age with these measures was assessed. The results showed that the elasticity of the ascending aorta was much lower in the hypertension patients than in normal controls （P〈0.05）, and the elasticity was decreased with age in both groups （P〈0.05）. Our results suggested that QTVI, a new non-invasive ul-trasonic technique, is helpful for the assessment of the aortic elasticity in hypertension patients.

Single-Stage Repair of a Critical Aortic Coarctation, a Bicuspid Aortic Stenosis and an Ascending Aortic Aneurysm

We report a 26-year-old man with critical aortic coarctation, severe bicuspid aortic valve stenosis, infective endocarditis and ascending aortic aneurysm. He underwent simultaneously in singlestage a Bentall’s procedure and an extra-anatomic ascending-descending aortic bypass grafting by 14-mm Dacron tube, through median sternotomy. The immediate postoperative outcome was favourable. The CT scan control for 7 years after surgery showed a good patency of the extra-anatomic bypass.

Aortic Root and Ascending Aortic Aneurysm Related to One Case. Reimplantation of the Right Coronary Artery by 8 mm Dacron Tube (Cabrol Hemi Mustache) and Review of the Literature

The aortic aneurysm is the 13th leading cause of death in Western countries. The incidence of thoracic aortic aneurysms is estimated at 4.5 cases per 100,000. The diagnosis is often made on a chest x-ray or other imaging tests, such as an echocardiogram done for other heart diseases. Echocardiography is the first test to assess the diameter of the ascending aorta and its progression over time. Most patients are first assessed and followed up with spiral thoracic computed tomography with injection of contrast medium, supplemented by 3-dimensional reconstruction of the aneurysm in order to improve the accuracy of measurements, identification of its proximal part and distal. When dilation of the ascending aorta reaches the critical diameter of 50 mm, there is a risk of aortic dissection or rupture. Supravalvular aneurysms are treated by replacing the ectatic portion with a Dacron® tube in the supracoronary position. Aortic root aneurysms, including coronary ostia, require tube replacement, reimplantation of coronary ostia, as well as surgery on the aortic valve. In this article, we report a case of aneurysm of the aortic root and the ascending aorta treated by aortic valve replacement and the ascending aorta associated with the Cabrol hemi-mustache technique and we review the literature.

Clinical application of retrograde cerebral perfusion for brain protection during the surgery of ascending aortic aneurysm:50 cases report

Objective To assess retrospectively the effects of different protective methods on brain in ascending aortic aneurysm surgery. Methods In 65 patients, aneurysm was dissected to the aortic arch or right arch. To protect brain, deep hypotermic circulatory arrest ( DHCA.) combined with retrograde cerebral perfusion ( RCP) June 2003 Vol11 No2 through the superior vena cava ( n = 50) and simple DHCA ( n = 15) were used during the procedure. Blood samples for lactic acid level from the jugular vein were compared in both groups at different plase, and perfusion blood distribution and oxygen content difference between the perfused and returned blood were measured in some RCP patients. Results The DHCA time was 35.9 ± 8 min (10. 0 - 63. 0 min) and DHCA+ RCP time was 45.5 ± 17. 2 min (16. 0 - 81. 0 min)The resuscitationtime was 7.1 ± 1.6 h (4.4 - 9.4H)in DHCA patients and 5.4±2.2h(2.0-9.0 h)in RCP patients. Operation death was 3/15 in the DHCA group and 1/50 in the RCP patients. Central nervous complication

T-Y TUBE MODEL OF HUMAN ASCENDINGAORTIC INPUT IMPEDANCE

This paper proposed a T- Y tube model to simulate foe input impedance of arterial system. It improves and extends the asymmetric T-tube model which was firstproposed by O' Rourke[1] and developed laier by Liu et al.[2]. Based on foe asymmetricT-tube model. a T-Y tube model was proposed by adding branching tubes whichrepresem the iliac arteries.All the tubes are considered to be uniform,viscoelasticlongitudinally tethered cylindrical tubes.The upper tube terminates with a windkesselmodel, while the terminal arterioles of the lowr tube are expressed as a resistance.After proper eraluation of the parameters.the impedance of the arterial system iscalculated under normal physiological and hypertensive condition.The model canpredict impedance in good agreement with the experimentally obtained data no matterin normal physiological condition or in pathological condition In comparison with theasymmeric T-tube model,T- Y tube model is closer to anatomy structure of the human arlerial system and at the sametime much simpler than the extremely complex multiplebranching tube model Therefore it will be a valuable model in studying the influencesof various parameters on aorta impedance and ventricular-vascular coupling.

Surgical Treatment of Ascending Aortic Dissecting Aneurysm－Clinical Application of Modified Cabrol＇s Operation

This paper reported 3 cases of ascending aortic dissecting aneurysm treated by modified Cabrol's operation. An 8 mm Gore-Tex connected with coronary arteries was employed to prevent high tension, intimal tearing and bleeding of anastomosis. Unremoved aneurysmal wall used as a sac for enclosing conduit graft could minimize the bleeding and oozing so that leaked blood can be drained to right atrium via a bypass.

Surgical techniques for improving hemostasis during Bentall procedure

Objective:To evaluate the effect of modified surgical techniques on hemostasis used in aortic root replacement with a composite graft(Bentall procedure).Methods:Data on 15 patients who underwent Bentall procedure during 2005 to 2007 were analyzed.The first 5 patients(Group 1) received the standard procedure.Then next 10 patients(Group 2) received the modified procedure.Techniques including "tandem suture line","endo-button buttress","sandwich anastomosis" and "left ventricle filling" were added to the standard procedure.Perioperative bleeding and the volume of blood transfusion required were compared to estimate hemostasis in different groups.Results:Between groups 1 and 2,a significant difference was found in postoperative bleeding [(2193±383) ml vs(1012±258) ml,respectively;P<0.05] and in volume of blood transfusion required [(7242±1416) ml vs(2520±708) ml,respectively;P<0.05].Conclusion:The modified surgical techniques used in our study are effective in the improvement of the hemostasis in Bentall procedure.