scholarly journals Captopril test identifies severity of residual pressure gradient in recoartation

2004 ◽  
Vol 17 (5) ◽  
pp. S157
Author(s):  
A MARINHODASILVA
Keyword(s):  
Pressure Gradient ◽  
Residual Pressure ◽  
Captopril Test

scholarly journals Balioninė plaučių arterijos valvuloplastika – tiesioginiai, tarpiniai ir vėlyvieji rezultatai: 20 metų patirtis

2009 ◽  
Vol 7 (3-4) ◽  
pp. 0-0
Author(s):  
Sigitas Čibiras ◽  
Eugenijus Kosinskas
Keyword(s):  
Surgical Treatment ◽  
Pulmonary Artery ◽  
Pressure Gradient ◽  
Heart Diseases ◽  
Heart Defects ◽  
Residual Pressure ◽  
Mean Pressure ◽  
Long Term Follow Up

Sigitas Čibiras, Eugenijus KosinskasVilniaus universiteto Širdies ir kraujagyslių ligų klinika, Vilniaus universiteto ligoninės Santariškių klinikos, Santariškių g. 2, LT-08661 VilniusE-mail: [email protected] Įvadas Darbo tikslas – apibendrinti 20 metų patirtį ir įvertinti įgimtos plaučių arterijos (PA) stenozės balioninės valvuloplastikos (BPV) tiesioginius, tarpinius ir vėlyvuosius rezultatus. Ligoniai ir metodai 1987–2007 metais Vilniaus širdies ligų klinikoje buvo atlikta 101 BPV, ligonių amžius nuo 1 paros iki – 39 metų. BPV atlikta esant spaudimo per PA vožtuvą skirtumui > 30 mm Hg. Ligoniai prieš BPV suskirstyti į dvi grupes pagal tai, ar pradinis spaudimo per PA vožtuvą skirtumas <50 mm Hg (1 gruoė), ar > 50 mm Hg (2 grupė). Analizuotas duomenų kitimas tiesiogiai po BPV, tarpiniu laikotarpiu (iki dvejų metų po BVP), vėlyvuoju laikotarpiu (praėjus daugiau kaip dvejiems metams). Ligoniai po BPV buvo suskirstyti į dvi grupes: turintys liekamąjį spaudimo skirtumą iki 36 mm Hg ir daugiau kaip 36 mm Hg. Rezultatai BPV atlikta 18 pacientų, kurių spaudimo per PA vožtuvą skirtumas < 50 mm Hg. Iškart po BVP spaudimo skirtumas per PA vožtuvą sumažėjo nuo 39,5 ± 5 iki 15,83 ± 8,37 mm Hg, tarpiniu laikotarpiu – iki 20 ± 6 mm Hg, vėlyvuoju – iki 21,5 ± 5 mm Hg. BPV atliktos 83 pacientams, kurių spaudimo per PA vožtuvą skirtumas > 50 mm Hg. Tiesiogiai po BVP vidutinis spaudimo skirtumas sumažėjo nuo 81,31 ± 21,28 iki 31,32 ± 13,82 mm Hg, tarpiniu laikotarpiu – iki 27,56 ± 12,71 mm Hg, vėlyvuoju – iki 19,89 ± 10,12 mm Hg. Esant liekamajam spaudimo skirtumui po BPV < 36 mm Hg (58 ligoniai), tarpiniu lakotarpiu vidutinis spaudimo skirtumas 23,66 ± 9,29 mm Hg, vėlyvuoju – 16,85 ± 7,98 mm Hg. Esant liekamajam spaudimo skirtumui po BPV > 36 mm Hg (21 ligonis), tarpiniu laikotarpiu vidutinis spaudimo skirtumas 51,99 ± 20,61 mm Hg, vėlyvuoju – 35,7 ± 16 mm Hg. Vėlyvuoju laikotarpiu spaudimo skirtumas mažėja, bet didėja PA nesandarumas. Tuoj po BPV nesandarumas nustatytas 7 %, tarpiniu laikotarpiu – 53 %, vėlyvuoju – 81,7 % ligonių. Išvados BPV yra gerai toleruojamas ir veiksmingas nechirurginis gydymo būdas. Daugumai ligonių išryškėja vėlyvasis nedidelis plaučių arterijos nesandarumas, kurį retai prireikia gydyti chirurginiu būdu. Mūsų studija rodo, kad tinkama ligonių atranka leidžia pasiekti gerų tiesioginių, tarpinius ir vėlyvųjų rezultatų. Reikšminiai žodžiai: įgimtos širdies ydos, įgimta plaučių arterijos vožtuvo stenozė, balioninė valvuloplastika. Balloon pulmonary artery valvuloplasty – immediate, mid-term and long-term follow-up results: 20-year experience Sigitas Čibiras, Eugenijus KosinskasVilnius University Clinic of Heart and Vascular Medicine, Vilnius University Hospital Santariškių Klinikos, Santariškių str. 2, LT-08661 Vilnius, LithuaniaE-mail: [email protected] Background To analyze immediate, mid-term and long-term follow-up results after percutaneous balloon pulmonary valvuloplasty (BPV) of congenital pulmonary artery (PA) stenosis for a 20-year period. Patients and methods During 1987–2007, in the Vilnius Clinic of Heart Diseases 101 BPV were performed, the patients’ age range being 1 day – 39 years. BPV was performed with the primary PA valvular pressure gradient > 30 mm Hg. Patients before BPV had been divided into two groups: (1) with primary PA pressure gradient < 50 mm Hg; (2) with primary PA pressure gradient > 50 mm Hg. Data were analyzed immediately after BPV, in a mid-term (2 years) and a long-term (more than 2 years) follow-up. The same patients after BPV were divided into two groups: with residual pressure gradient < 36 mmHg and > 36 mmHg. Results Eighteen BPV were performed with the primary PA pressure gradient < 50 mm Hg: the immediate mean pressure gradient decreased from 39.5  ±   5 to 15.83 ± 8.37 mm Hg, in the mid-term period to 20 ± 6 mm Hg, and in the long-term to 21.5 ± 5 mm Hg. Eighty-three BPV were performed with the primary PA pressure gradient > 50 mm Hg; the immediate mean pressure gradient decreased from 81.31 ± 21.28 mm Hg to 31.32 ± 13.82 mm Hg, in the mid-term period to 20 ± 6 mm Hg and in the long-term period to mm Hg. With the residual pressure gradient after BPV < 36 mm Hg (58 patients), in the mid-term period the pressure gradient decreased to 23.66 ± 9.29 mm Hg and in the long-term period to 16.85 ± 7.98 mm Hg. With the residual pressure gradient after BPV > 36 mm Hg (21 patients), in the mid-term period the pressure gradient decreased to 51.99 ± 20.61 mm Hg and in the long-term period to 35.7 ± 16 mm Hg. In the long-term follow-up, the pressure gradient decreased, but PA regurgitation (PAR) was progressive. Immediately after BPV, PAR was seen in 7%, in mid-term follow-up in 53 %, and in long-term follow-up in 81.7 % patients. Conclusions BPV is a well tolerated and effective non-surgical treatment method. Late trivial PAR develops in the majority of cases, but rarely requires surgical treatment. Our study has demonstrated that the appropriate patient selection enables achieving good immediate, mid-term and long-term follow-up results. Keywords: congenital heart defects, congenital pulmonary artery stenosis, balloon valvuloplasty.

scholarly journals Residual pressure gradient across the implanted stent: An important factor of post-PCI physiological results

2018 ◽  
Vol 71 (5) ◽  
pp. 458-463 ◽  
Author(s):  
Yoshiaki Kawase ◽  
Masanori Kawasaki ◽  
Jun Kikuchi ◽  
Tetsuo Hirata ◽  
Syuuichi Okamoto ◽  
...  
Keyword(s):  
Pressure Gradient ◽  
Residual Pressure

scholarly journals Bovine monocusp in surgery for tetralogy of Fallot

2020 ◽  
Vol 24 (4) ◽  
pp. 42
Author(s):  
A. A. Svobodov ◽  
E. G. Levchenko ◽  
G. S. Netalieva ◽  
V. T. Kostava ◽  
M. V. Zelivyanskaya ◽  
...  
Keyword(s):  
Right Ventricle ◽  
Pressure Gradient ◽  
Tetralogy Of Fallot ◽  
Conflict Of Interest ◽  
Pulmonary Valve ◽  
Long Term Results ◽  
Residual Pressure ◽  
Valve Regurgitation ◽  
One Year

<p><strong>Aim.</strong> To evaluate the functionality of a bovine monocusp in surgery for tetralogy of Fallot.</p><p><strong>Methods.</strong> We analyzed the results of surgical treatment in the early postoperative period in eight infants and one year after surgery in seven infants (age range, 0–12 months; mean weight = 7.5 ± 2.3 kg). We used echocardiography to evaluate the residual pressure gradient between the right ventricle and the pulmonary artery, the degree of regurgitation on the pulmonary valve after surgery and to calculate Z-score and the fibrous ring diameter of the pulmonary valve in the late follow-up period. The degree of insufficiency was assessed by the width and depth of the regurgitation flow using the color Doppler mode.</p><p><strong>Results.</strong> The pressure gradient on the eve of discharge did not exceed 25 mmHg for any patient. Pulmonary valve regurgitation was mild in four patients and moderate in the remaining patients. Seven children passed the observation one year after surgery. In one case, we discovered a right ventricle outflow tract obstruction. In other cases, the systolic pressure gradient did not exceed 25 mmHg. Four patients in the late follow-up period had severe valve regurgitation. Despite such valve insufficiency, the leaflet mobility in the bovine jugular vein patch was normal.</p><p><strong>Conclusion.</strong> Early postoperative results for reconstructive surgery to repair tetralogy of Fallot with a bovine monocusp were promising. However, long-term results are comparable with those using other materials. The mobility of the native leaflet remains full even a year after surgery. Consequently, we have positive prospects in material improvement for making patches with native monocusps.</p><p>Received 14 May 2020. Revised 8 June 2020. Accepted 10 June 2020.</p><p><strong>Funding:</strong> The study did not have sponsorship.</p><p><strong>Conflict of interest:</strong> Authors declare no conflict of interest.</p><p><strong>Author contributions</strong><br />Conception and study design: A.A. Svobodov, E.G. Levchenko, V.T. Kostava<br />Data collection and analysis: G.S. Netalieva, M.V. Zelivyanskaya<br />Statistical analysis: E.G. Levchenko, M.V. Zelivyanskaya<br />Drafting the article: A.A. Svobodov, V.S. Rasumovsky<br />Critical revision of the article: V.S. Rasumovsky<br />Final approval of the version to be published: A.A. Svobodov, E.G. Levchenko, G.S. Netalieva, V.T. Kostava, M.V. Zelivyanskaya, V.S. Rasumovsky</p>

scholarly journals Stenting aortic coarctation in children: Immediate and midterm results

2011 ◽  
Vol 139 (11-12) ◽  
pp. 728-735
Author(s):  
Jovan Kosutic ◽  
Sergej Prijic ◽  
Vladislav Vukomanovic ◽  
Sanja Rakic ◽  
Vladimir Kuburovic
Keyword(s):  
Body Weight ◽  
Pressure Gradient ◽  
Aortic Arch ◽  
Stent Implantation ◽  
Aortic Coarctation ◽  
Objective Evaluation ◽  
Vessel Diameter ◽  
Residual Pressure ◽  
Aneurysm Formation ◽  
Intimal Injury

Introduction. Stent implantation, in patients with different forms of aortic coarctation, has significant theoretical advantages over primary balloon dilatation (BD). It can achieve overdilatation of the coarcted segment with the rigid endoprothesis maintaining the increase in vessel diameter regardless of the intimal injury and, thus, reducing the likelihood of restenosis. Moreover, by preventing vascular recoil, stents can successfully expand long-segment tubular coarctations, hypoplastic isthmus and hypoplastic transverse aortic arch. Finally, by facilitating good apposition of the torn intima to the aortic wall, they can significantly reduce the incidence of aneurysm formation. Objective. Evaluation of the immediate and mid-term results of stent implantation in patients with different forms of aortic coarctation. Methods. Between February 2005 and March 2010 eleven stents were implanted in nine patients (two female and seven male) either with post surgical or post primary BD residual coarctation/recoarctation or with native aortic coarcatation. Mean age of our patients was 14?3 years (9.4-18.1 years) and mean body weight 54?18 kg (29-76 kg). Results. Pressure gradient across the coarctation site was reduced from 24.9?12.4 mm Hg before to 3.9?5.0 mm Hg after stenting (p=0.000). There were no complications. Mean followup was 2.0?1.5 years (range 0.1-5.2 years). In patients with localised aortic arch narrowing no restenosis or aneurysm formation was observed (residual pressure gradient 0-5 mm Hg). Conclusion. In properly selected children (body weight >25 kg), adolescents and young adults stenting is the method of choice for patients with various forms of aortic arch obstruction.

Activated Prominences; Mechanisms for Activation and Eruption

1979 ◽  
Vol 44 ◽  
pp. 307-313
Author(s):  
D.S. Spicer
Keyword(s):  
Pressure Gradient ◽  
Density Gradient ◽  
Current Density ◽  
Convective Instability ◽  
Tearing Mode ◽  
Magnetic Shear ◽  
Long Wavelength ◽  
Ideal Mhd ◽  
Gradient Change ◽  
Accelerated Particles

A possible relationship between the hot prominence transition sheath, increased internal turbulent and/or helical motion prior to prominence eruption and the prominence eruption (“disparition brusque”) is discussed. The associated darkening of the filament or brightening of the prominence is interpreted as a change in the prominence’s internal pressure gradient which, if of the correct sign, can lead to short wavelength turbulent convection within the prominence. Associated with such a pressure gradient change may be the alteration of the current density gradient within the prominence. Such a change in the current density gradient may also be due to the relative motion of the neighbouring plages thereby increasing the magnetic shear within the prominence, i.e., steepening the current density gradient. Depending on the magnitude of the current density gradient, i.e., magnetic shear, disruption of the prominence can occur by either a long wavelength ideal MHD helical (“kink”) convective instability and/or a long wavelength resistive helical (“kink”) convective instability (tearing mode). The long wavelength ideal MHD helical instability will lead to helical rotation and thus unwinding due to diamagnetic effects and plasma ejections due to convection. The long wavelength resistive helical instability will lead to both unwinding and plasma ejections, but also to accelerated plasma flow, long wavelength magnetic field filamentation, accelerated particles and long wavelength heating internal to the prominence.

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