Here we present the case of a patient studied with multi-detector computed tomography (MDCT). Due to a severe three-vessel coronary artery disease he underwent coronary artery by-pass graft surgery. Two years later be...Here we present the case of a patient studied with multi-detector computed tomography (MDCT). Due to a severe three-vessel coronary artery disease he underwent coronary artery by-pass graft surgery. Two years later because of dyspnea and chest pain he was referred to have coronary computed tomography angiogram. We describe the coronary artery findings as well as the presence of a Vieussens’ arterial ring, which is not commonly visualized by traditional angiography. In the medical literature Vieussens’ arterial ring cases described by MDCT are extremely rare. This case shows how MDCT can be crucial in correctly understanding the anatomy of coronary artery disease patients.展开更多
The Vieussens’ arterial ring (VAR) is a rare coronary anomaly that may be associated with a pulmonary fistula, and has been linked to ischemia, myocardial infarction, heart failure, arrhythmias, and sudden death. We ...The Vieussens’ arterial ring (VAR) is a rare coronary anomaly that may be associated with a pulmonary fistula, and has been linked to ischemia, myocardial infarction, heart failure, arrhythmias, and sudden death. We present the case of a 54-year-old man who was admitted to the emergency room with angina and dyspnea on moderate exertion, in the context of atrial fibrillation and decompensated heart failure with left ventricular systolic dysfunction. In the study of its etiology, coronary computed tomography angiography (CCTA) identified an anomalous conal artery outflow (type C) as part of the VAR and a fistula to the pulmonary artery trunk (variant 1b), with an arterial flow linking the conal artery and the middle third of the left anterior descending artery (LAD), which then fistulized to the pulmonary artery trunk. The hemodynamic and clinical repercussions presented with signs of ischemia in the LAD territory and acute heart failure. In this case, CCTA identified the coronary anomaly and its trajectory with great precision through volume rendering reconstruction, as well as the dynamics of coronary flow in the presence of the pulmonary fistula. This anatomical variant is rarely described, and CCTA is of great utility in the therapeutic decision for fistula closure.展开更多
AIM To determine the optimum resting tension(ORT) for in vitro human pulmonary artery(PA) ring preparations.METHODS Pulmonary arteries were dissected from disease free sections of the resected lung in the operating th...AIM To determine the optimum resting tension(ORT) for in vitro human pulmonary artery(PA) ring preparations.METHODS Pulmonary arteries were dissected from disease free sections of the resected lung in the operating theatre and tissue samples were directly sent to the laboratory in Krebs-Henseleit solution(Krebs).The pulmonary arteries were then cut into 2 mm long rings.PA rings were mounted in 25 m L organ baths or 8 m L myograph chambers containing Krebs compound(37 ℃,bubbled with 21% O_2:5% CO_2) to measure changes in isometric tension.The resting tension was set at 1-gram force(gf) with vessels being left static to equilibrate for duration of one hour.Baseline contractile reactions to 40 mmol/L KCl were obtained from a resting tension of 1 gf.Contractile reactions to 40 mmol/L KCl were then obtained from stepwise increases in resting tension(1.2,1.4,1.6,1.8 and 2.0 gf).RESULTS Twenty PA rings of internal diameter between 2-4 mmwere prepared from 4 patients.In human PA rings incrementing the tension during rest stance by 0.6 gf,up to 1.6 gf significantly augmented the 40 mmol/L KCl stimulated tension.Further enhancement of active tension by 0.4 gf,up to 2.0 gf mitigate the 40 mmol/L KCl stimulated reaction.Both Myograph and the organ bath demonstrated identical conclusions,supporting that the radial optimal resting tension for human PA ring was 1.61 g.CONCLUSION The radial optimal resting tension in our experiment is 1.61 gf(15.78 m N) for human PA rings.展开更多
文摘Here we present the case of a patient studied with multi-detector computed tomography (MDCT). Due to a severe three-vessel coronary artery disease he underwent coronary artery by-pass graft surgery. Two years later because of dyspnea and chest pain he was referred to have coronary computed tomography angiogram. We describe the coronary artery findings as well as the presence of a Vieussens’ arterial ring, which is not commonly visualized by traditional angiography. In the medical literature Vieussens’ arterial ring cases described by MDCT are extremely rare. This case shows how MDCT can be crucial in correctly understanding the anatomy of coronary artery disease patients.
文摘The Vieussens’ arterial ring (VAR) is a rare coronary anomaly that may be associated with a pulmonary fistula, and has been linked to ischemia, myocardial infarction, heart failure, arrhythmias, and sudden death. We present the case of a 54-year-old man who was admitted to the emergency room with angina and dyspnea on moderate exertion, in the context of atrial fibrillation and decompensated heart failure with left ventricular systolic dysfunction. In the study of its etiology, coronary computed tomography angiography (CCTA) identified an anomalous conal artery outflow (type C) as part of the VAR and a fistula to the pulmonary artery trunk (variant 1b), with an arterial flow linking the conal artery and the middle third of the left anterior descending artery (LAD), which then fistulized to the pulmonary artery trunk. The hemodynamic and clinical repercussions presented with signs of ischemia in the LAD territory and acute heart failure. In this case, CCTA identified the coronary anomaly and its trajectory with great precision through volume rendering reconstruction, as well as the dynamics of coronary flow in the presence of the pulmonary fistula. This anatomical variant is rarely described, and CCTA is of great utility in the therapeutic decision for fistula closure.
文摘AIM To determine the optimum resting tension(ORT) for in vitro human pulmonary artery(PA) ring preparations.METHODS Pulmonary arteries were dissected from disease free sections of the resected lung in the operating theatre and tissue samples were directly sent to the laboratory in Krebs-Henseleit solution(Krebs).The pulmonary arteries were then cut into 2 mm long rings.PA rings were mounted in 25 m L organ baths or 8 m L myograph chambers containing Krebs compound(37 ℃,bubbled with 21% O_2:5% CO_2) to measure changes in isometric tension.The resting tension was set at 1-gram force(gf) with vessels being left static to equilibrate for duration of one hour.Baseline contractile reactions to 40 mmol/L KCl were obtained from a resting tension of 1 gf.Contractile reactions to 40 mmol/L KCl were then obtained from stepwise increases in resting tension(1.2,1.4,1.6,1.8 and 2.0 gf).RESULTS Twenty PA rings of internal diameter between 2-4 mmwere prepared from 4 patients.In human PA rings incrementing the tension during rest stance by 0.6 gf,up to 1.6 gf significantly augmented the 40 mmol/L KCl stimulated tension.Further enhancement of active tension by 0.4 gf,up to 2.0 gf mitigate the 40 mmol/L KCl stimulated reaction.Both Myograph and the organ bath demonstrated identical conclusions,supporting that the radial optimal resting tension for human PA ring was 1.61 g.CONCLUSION The radial optimal resting tension in our experiment is 1.61 gf(15.78 m N) for human PA rings.
基金The project supported by Provinicial Natural Science Foundation of Anhui Province(070413124)the Fresh Start Foundation of Wannan Medical College(BK00010804)~~
