Assessing the Relationship Between Right Atrial Stiffness and Chamber Pressure to Quantitatively Define Myocardial Tensile Properties

2017 ◽  
Author(s):  
Alexander R. Mattson ◽  
Michael D. Eggen ◽  
Vladimir Grubac ◽  
Paul A. Iaizzo
Keyword(s):  
Right Atrium ◽  
Right Atrial ◽  
Chamber Pressure ◽  
Detailed Knowledge ◽  
Cardiac Device ◽  
Clinical Procedures ◽  
Tensile Forces ◽  
Pacemaker Leads ◽  
Right Atrial Appendage ◽  
The Right

Developing a successful cardiac device requires detailed knowledge of cardiac mechanical properties. For example, tissue failure characteristics and compliance feed into design criteria for many pacemaker leads (Zhao et al., 2011). In the right atrium, tensile forces are exerted on the right atrial appendage in multiple clinical procedures. In a traditional lead implant, mechanical manipulations with a stylet aid a clinician in assessing lead fixation, with a seldom used “tug” test providing additional input. Atrial lead dislodgement remains one of the top complications for bradycardia pacing leads (Chahuan et al., 1994), in part because there is no standard mechanical assessment at implant to verify fixation. Thus, a deeper understanding of forces exerted on the atrium during implant, is fundamental to understanding the problem. Further characterization of the biomechanics relevant to atrial device implants will provide valuable design input for fixation tests and help drive research toward new atrial fixation mechanisms. This study aims to better define the relationships between right atrial stiffness and the chamber pressures within the right atrium, so to characterize the link between tensile displacement within the right atrium, and the force exerted on an implanted device in a functional heart. These experiments quantitatively define the fixation force of a fixed cardiac device with a given pulled displacement; i.e. displacing the device a given distance will effectively ensure the experimentally derived fixation force.

scholarly journals Transthoracic Right Atrial Cannulation for Total Parenteral Nutrition — Case Report

1981 ◽  
Vol 9 (1) ◽  
pp. 53-57 ◽  
Author(s):  
L. Hayden ◽  
G. Ramsey Stewart ◽  
D. C. Johnson ◽  
M. McD. Fisher
Keyword(s):  
Parenteral Nutrition ◽  
Total Parenteral Nutrition ◽  
Right Atrium ◽  
Venous Catheter ◽  
Right Atrial ◽  
X Ray ◽  
Right Thoracotomy ◽  
Right Atrial Appendage ◽  
The Right ◽  
Nutrition Programme

A man with severe peripheral vascular disease and requiring total parenteral nutrition because of short bowel syndrome was referred because a central venous catheter could not be inserted by conventional techniques. A right thoracotomy was performed and a Hickman catheter inserted via the right atrial appendage into the right atrium. This catheter was used for a total of seven months for total parenteral nutrition. For the last two months of this time, the patient was maintained at home on a Home Parenteral Nutrition Programme. After four months of total parenteral nutrition the patient developed recurrent fevers and the catheter was found to have migrated from the right atrium into the pulmonary artery. The catheter was resited under x-ray control and used for a further three months until the recurrence of fever and dyspnoea heralded the onset of septic pulmonary emboli resulting in his death.

scholarly journals Morphology and Position of the Right Atrioventricular Valve in Relation to Right Atrial Structures

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 960
Author(s):  
Jakub Hołda ◽  
Katarzyna Słodowska ◽  
Karolina Malinowska ◽  
Marcin Strona ◽  
Małgorzata Mazur ◽  
...  
Keyword(s):  
Right Atrium ◽  
Variable Structure ◽  
Atrial Appendage ◽  
Right Atrial ◽  
Variable Component ◽  
Atrioventricular Valve ◽  
Stable Point ◽  
Complex Anatomy ◽  
Right Atrial Appendage ◽  
The Right

The right atrioventricular valve (RAV) is an important anatomical structure that prevents blood backflow from the right ventricle to the right atrium. The complex anatomy of the RAV has lowered the success rate of surgical and transcatheter procedures performed within the area. The aim of this study was to describe the morphology of the RAV and determine its spatial position in relation to selected structures of the right atrium. We examined 200 randomly selected human adult hearts. All leaflets and commissures were identified and measured. The position of the RAV was defined. Notably, 3-leaflet configurations were present in 67.0% of cases, whereas 4-leaflet configurations were present in 33.0%. Septal and mural leaflets were both significantly shorter and higher in 4-leaflet than in 3-leaflet RAVs. Significant domination of the muro-septal commissure in 3-leflet valves was noted. The supero-septal commissure was the most stable point within RAV circumference. In 3-leaflet valves, the muro-septal commissure was placed within the cavo-tricuspid isthmus area in 52.2% of cases, followed by the right atrial appendage vestibule region (20.9%). In 4-leaflet RAVs, the infero-septal commissure was located predominantly in the cavo-tricuspid isthmus area and infero-mural commissure was always located within the right atrial appendage vestibule region. The RAV is a highly variable structure. The supero-septal part of the RAV is the least variable component, whereas the infero-mural is the most variable. The number of detected RAV leaflets significantly influences the relative position of individual valve components in relation to right atrial structures.

scholarly journals A challenging pacemaker implantation in the presence of a giant right coronary aneurysm compressing the right atrium

2021 ◽  
Author(s):  
Stefano Maffè ◽  
Paola Paffoni ◽  
Luca Bergamasco ◽  
Eleonora Prenna ◽  
Giulia Careri ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Right Atrium ◽  
Pacemaker Implantation ◽  
Artery Aneurysm ◽  
Giant Aneurysm ◽  
Coronary Aneurysm ◽  
Right Atrial ◽  
Cardiac Device ◽  
Extrinsic Compression ◽  
The Right

Giant coronary artery aneurysm is an uncommon disease, treated with surgical intervention or percutaneous coil embolization. A thrombosed aneurysm can cause extrinsic compression on the cardiac chambers, with potential hemodynamic effects and may cause problems when we need to implant a cardiac device. We present a case of difficult pacemaker implantation in a patient with 3 syncopes, first-degree AV block and complete left bundle branch block on electrocardiogram. The patient presented a giant aneurysm of the right coronary artery (85 x 90 mm), thrombosed, with right atrial compression. The pacemaker implantation was hampered by the difficulty of passing the lead through the compressed right atrium; indeed, only with   simultaneous echocardiographic and fluoroscopic guidance, was it possible to complete the procedure. This case demonstrates the utility of echocardiogram, in particular settings, in cardiac stimulation procedures.

Antegrade Cardioplegia Decannulation Made Simple With the Cor-Knot System: Technique and Tips After 20 Consecutive and Controlled Patients

2020 ◽  
Vol 15 (5) ◽  
pp. 494-496
Author(s):  
Aristotelis Panos ◽  
Kyriakos Mpellos ◽  
Sylvio Vlad ◽  
Patrick O. Myers
Keyword(s):  
Minimally Invasive ◽  
Right Atrium ◽  
Right Atrial ◽  
Video Assisted ◽  
Cannulation Site ◽  
System Technique ◽  
Prolene Suture ◽  
Right Atrial Appendage ◽  
The Right

Closing the cardioplegia cannulation site can be challenging in minimally invasive video-assisted cardiac surgery. The Cor-Knot system is used to tie down valve sutures within the heart efficiently, although erosions to neighboring structures are reported. We hypothesized that a modification of the Cor-Knot system could enable safe hemostasis of the cardioplegia aortic root site and avoid erosions of the aorta or right atrium. This is a single-arm prospective study including 20 consecutive patients operated through a video-assisted method at our clinic between January 2019 and February 2019. At the end of the procedure, the suture was passed through a Cor-Knot device and crimped on a band of Teflon-felt. The two tips of the Teflon-felt toward the right atrium were put together and tightened with a 5/0 Prolene suture in order to protect the sharp ends of the device. Hemostasis was achieved using the technique in all 20 patients, with no requirement for further suture placement to ensure hemostasis of the cardioplegia cannulation site. The device was protected from the right atrial appendage and there was no bleeding. At 6-month follow-up, no patients required a reoperation for aortic or right atrial erosion. The Cor-Knot system was used off-label to close the cardioplegia cannulation site in minimally invasive surgery. This appears safe and effective in our initial 20-patient experience.

scholarly journals Sensing and pacing with floating electrodes in the right atrium and right atrial appendage

1987 ◽  
Vol 9 (2) ◽  
pp. 308-315 ◽  
Author(s):  
André E. Aubert ◽  
Bruce N. Goldreyer ◽  
Milford G. Wyman ◽  
Hugo Ector ◽  
Bart G. Denys ◽  
...  
Keyword(s):  
Right Atrium ◽  
Atrial Appendage ◽  
Right Atrial ◽  
Right Atrial Appendage ◽  
The Right

scholarly journals Prominent Eustachian Valve Mimicking Thrombus in Right Atrium Diagnosed with Computed Tomography in a Patient with Atrial Fibrillation

2020 ◽  
pp. 1-2
Author(s):  
Ibrahim SARI ◽  
Gülsüm Bingöl ◽  
Ibrahim SARI ◽  
Muharrem Nasıfov ◽  
Özge Özden Tok ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Right Atrium ◽  
Left Atrial Appendage ◽  
Thrombus Formation ◽  
Correct Diagnosis ◽  
Atrial Appendage ◽  
Right Atrial ◽  
Eustachian Valve ◽  
Right Atrial Appendage ◽  
The Right

A 51-year-old man presented with paroxsysmal atrial fibrillation (AF). Transthoracic echocardiography revealed mass of 2.3x0.6 cm adjacent to the superior part of the right atrium (RA) compatible with thrombus. Although thrombus formation in the setting of AF is more common in left atrial appendage and left atrium it can also be seen in right atrial appendage and RA. We performed cardiac computerized tomography (CCT) in order to clarify the nature of mass in RA and exclude coronary stenosis. CCT showed prominent eustachian valve measuring 3.2 cm which was not clear on echocardiography. This case underscores the importance of complementary cardiovascular imaging to facilitate the correct diagnosis.

Evidence of nonuniform sympathetic neural activity to heart regions in guinea pigs

1979 ◽  
Vol 237 (5) ◽  
pp. H606-H611 ◽  
Author(s):  
P. G. Schmid ◽  
R. H. Dykstra ◽  
H. E. Mayer ◽  
R. P. Oda ◽  
J. J. Donnell
Keyword(s):  
Neural Activity ◽  
Right Atrium ◽  
Atrial Appendage ◽  
Right Atrial ◽  
Guinea Pig Heart ◽  
Sa Node ◽  
Norepinephrine Turnover ◽  
Cardiac Regulation ◽  
Right Atrial Appendage ◽  
The Right

Central neutral activity may selectively influence cardiac regions. As an index of this, rate constants of norepinephrine turnover, KNE, in regions of guinea pig heart were determined by 1) disappearance of [3H]NE from tissues, and 2) conversion of [3H]tyrosine to [3H]NE. In sinoatrial (SA) node and right atrial appendage, KNE averaged 0.084 +/- 0.014 and 0.066 +/- 0.004 (SE) h-1, respectively (P greater than 0.05). In other specialized regions, KNE was lower than in SA node (P less than 0.05). In other contractile regions, KNE was lower than in right atrial appendage (P less than 0.05). Ganglionic blockade reduced KNE to uniform values in all heart regions. Cold stress increased KNE markedly (P less than 0.05) throughout the heart, but selectively more in SA node, AV node, proximal conduction bundles, and right atrial appendage (P less than 0.05). At room temperature, neural activity is greater to the right atrium including SA node than to other cardiac regions. At 4 degrees C, neural activity increases selectively in the right atrium and the conduction system. This suggests that central neural mechanisms contribute significantly to nonuniform cardiac regulation under conditions of progressive sympathetic activation.

Closure of Secundum Atrial Septal Defect with Autologous Right Atrial Patch: Case Report

2005 ◽  
Vol 8 (2) ◽  
pp. 96 ◽  
Author(s):  
Osman Tansel Dar�in ◽  
Alper Sami Kunt ◽  
Mehmet Halit Andac
Keyword(s):  
Atrial Septal Defect ◽  
Right Atrium ◽  
Septal Defect ◽  
Complete Recovery ◽  
Interatrial Septum ◽  
Right Atrial ◽  
Atrial Wall ◽  
Residual Shunt ◽  
Asd Closure ◽  
The Right

Background: Although various synthetic materials and pericardium have been used for atrial septal defect (ASD) closure, investigators are continuing to search for an ideal material for this procedure. We report and evaluate a case in which autologous right atrial wall tissue was used for ASD closure. Case: In this case, we closed a secundum ASD of a 22-year-old woman who also had right atrial enlargement due to the defect. After establishing standard bicaval cannulation and total cardiopulmonary bypass, we opened the right atrium with an oblique incision in a superior position to a standard incision. After examining the secundum ASD, we created a flap on the inferior rim of the atrial wall. A stay suture was stitched between the tip of the flap and the superior rim of the defect, and suturing was continued in a clockwise direction thereafter. Considering the size and shape of the defect, we incised the inferior attachment of the flap, and suturing was completed. Remnants of the flap on the inferior rim were resected, and the right atrium was closed in a similar fashion. Results: During an echocardiographic examination, neither a residual shunt nor perigraft thrombosis was seen on the interatrial septum. The patient was discharged with complete recovery. Conclusion: Autologous right atrial patch is an ideal material for ASD closure, especially in patients having a large right atrium. A complete coaptation was achieved because of the muscular nature of the right atrial tissue and its thickness, which is a closer match to the atrial septum than other materials.

scholarly journals P686 Right atrial, right ventricular and pulmonary cement embolism: a rare complication of percutaneous vertebroplasty

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
S Akhunova ◽  
R Khayrullin ◽  
N Stekolshchikova ◽  
M Samigullin ◽  
V Padiryakov
Keyword(s):  
Pulmonary Artery ◽  
Right Ventricle ◽  
Right Atrium ◽  
Percutaneous Vertebroplasty ◽  
Rare Complication ◽  
Clinical Manifestations ◽  
Stable Condition ◽  
Right Atrial ◽  
Cement Embolism ◽  
The Right

Abstract A 68-year-old man was admitted to the hospital with complaints of pain in the lumbar spine. He had L5 disc herniation, Spinal stenosis of the L5 root canal - S1 on the right in the past medical history. Percutaneous vertebroplasty at the level of L3 and Th8 vertebral bodies was performed six months ago due to painful vertebral hemangioma. The man is suffering from arterial hypertension, receives antihypertensive therapy. During routine transthoracic echocardiography, a hyperechoic structure with a size of 9.5 x 0.9 cm was found in the right atrium and right ventricle. Chest computed tomography with contrast enhancement revealed signs of bone cement in the right atrium and right ventricle, in the right upper lobe artery, in the branches of the upper lobe artery, in the paravertebral venous plexuses. Considering the duration of the disease, the stable condition, the absence of clinical manifestations and disorders of intracardiac hemodynamics, it was decided to refrain from surgical treatment. Antiplatelet therapy and dynamic observation were recommended. Conclusion Percutaneous vertebroplasty is a modern minimally invasive surgical procedure for the treatment of degenerative-dystrophic diseases of the spine. However, the cement can penetrate into the paravertebral veins and migrate to the right chambers of the heart and the pulmonary artery. This clinical case demonstrates asymptomatic cement embolism of the right chambers of the heart and pulmonary artery after percutaneous vertebroplasty, detected incidentally during routine echocardiography. Abstract P686 Figure.

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