scholarly journals Combined effect of left stellate ganglion blockade and topical administration of papaverine on left internal thoracic artery blood flow in patients undergoing coronary revascularization

2020 ◽  
Vol 23 (2) ◽  
pp. 170
Author(s):  
Rupa Sreedhar ◽  
Roshith Chandran ◽  
Shrinivas Gadhinglajkar ◽  
Prashantkumar Dash ◽  
Jayakumar Karunakaran ◽  
...  
Keyword(s):  
Blood Flow ◽  
Internal Thoracic Artery ◽  
Coronary Revascularization ◽  
Stellate Ganglion ◽  
Topical Administration ◽  
Combined Effect ◽  
Artery Blood Flow ◽  
Left Internal Thoracic Artery ◽  
Left Stellate Ganglion ◽  
Stellate Ganglion Blockade

Diastolic pressure and peripheral resistance during stellate ganglion stimulation

1963 ◽  
Vol 204 (1) ◽  
pp. 71-72 ◽  
Author(s):  
Edward D. Freis ◽  
Jay N. Cohn ◽  
Thomas E. Liptak ◽  
Aristide G. B. Kovach
Keyword(s):  
Heart Rate ◽  
Blood Flow ◽  
Cardiac Output ◽  
Total Peripheral Resistance ◽  
Diastolic Pressure ◽  
Stellate Ganglion ◽  
Peripheral Resistance ◽  
Resistance Vessels ◽  
Left Stellate Ganglion ◽  
Increased Blood Flow

The mechanism of the diastolic pressure elevation occurring during left stellate ganglion stimulation was investigated. The cardiac output rose considerably, the heart rate remained essentially unchanged, and the total peripheral resistance fell moderately. The diastolic rise appeared to be due to increased blood flow rather than to any active changes in resistance vessels.

Left Internal Thoracic Artery Graft Assessment by Firefly Fluorescence Imaging for Robot-Assisted Minimally Invasive Direct Coronary Artery Bypass

2019 ◽  
Vol 14 (2) ◽  
pp. 144-150
Author(s):  
Yoshitsugu Nakamura ◽  
Miho Kuroda ◽  
Yujiro Ito ◽  
Takahiko Masuda ◽  
Shuhei Nishijima ◽  
...  
Keyword(s):  
Blood Flow ◽  
Coronary Artery ◽  
Minimally Invasive ◽  
Fluorescence Imaging ◽  
Coronary Artery Bypass ◽  
Internal Thoracic Artery ◽  
Artery Bypass ◽  
Robot Assisted ◽  
Left Internal Thoracic Artery ◽  
Post Harvest

Objective The da Vinci Xi surgical system (Intuitive Surgical, Sunnyvale, CA, USA) cannot give tactile feedback to surgeons. This shortcoming may increase the risk of left internal thoracic artery (LITA) injury during its harvest. We utilized Firefly Fluorescence Imaging (Firefly) to assess LITA quality in robot-assisted minimally invasive direct coronary artery bypass (R-MIDCAB). Methods We retrospectively reviewed clinical records and intraoperative videos of 30 consecutive patients who underwent R-MIDCAB with LITA–left anterior descending (LAD) coronary bypass. All patients had post-harvest assessment of LITA blood flow by Firefly with 1 mL (2.5 mg/mL) of indocyanine green injection through a central line. Results Twenty-seven of the patients were male, mean age was 67.7 ± 10.7 years. In post-harvest assessment performed before transection of the distal LITA, blood flow in LITA was well visualized in 28 patients. In the remaining 2 patients, 1 had dissection and the other had severe spasm of the LITA. Firefly was also useful for locating LITA and LAD and for assessing blood flow of the graft after anastomosis. Time required for each Firefly assessment was approximately 20 seconds. There were no side effects or complications due to Firefly intraoperatively and postoperatively. Twenty-six patients had postoperative coronary computed tomography; LITA patency rate was 100% (26/26). Conclusion Firefly is fast, simple, and effective for locating and assessing flow in LITA and LAD before and after anastomosis in R-MIDCAB.

Is the Future of Coronary Arterial Revascularization a Hybrid Approach?

2017 ◽  
Vol 12 (2) ◽  
pp. 82-86 ◽  
Author(s):  
Vincenzo Giambruno ◽  
Ahmad Hafiz ◽  
Stephanie A. Fox ◽  
Hugues Jeanmart ◽  
Richard C. Cook ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Internal Thoracic Artery ◽  
Coronary Revascularization ◽  
Surgical Trauma ◽  
Stent Patency ◽  
Left Internal Thoracic Artery ◽  
The Mean ◽  
Hybrid Coronary Revascularization

Objective Hybrid coronary revascularization offers and combines the advantages of both surgical and percutaneous revascularization and eliminates at the same time the disadvantages of both procedures. The objective of this study was to assess graft and stent patency at 6 months, rate of bleeding, intensive care unit and hospital stay, rate of reintervention, and long-term clinical follow-up. Methods From March 2004 to November 2015, a total of 203 patients underwent robotic-assisted minimally invasive direct coronary artery bypass graft of the left internal thoracic artery to the left anterior descending artery and PCI of a non-left anterior descending vessel in a single or two stage, at three different centers. Patients underwent 6-month angiographic follow-up. The mean ± SD clinical follow-up was 77.82 ±41.4 months. Results Successful hybrid coronary revascularization occurred in 196 of the 203 patients. One hundred forty-six patients underwent simultaneous surgical and percutaneous intervention. Nineteen patients underwent PCI before surgery, and 38 patient underwent PCI after surgery. No in-hospital mortality occurred. The mean ± SD ICU stay was 1 ± 1 days and the mean ± SD hospital stay was 5 ± 2 days. Only 13.3% of the patients required a blood transfusion. Six-month angiographic follow-up has been performed in the 95 patients, and it demonstrated a left internal thoracic artery anastomotic patency of 97.9% and stent patency of 92.6%. A total of 77.8 ± 41.4-month clinical follow-up demonstrated 95.1% survival, 92.6% freedom from angina, and 90.7% freedom from any form of coronary revascularization. Conclusions Hybrid coronary revascularization seems to be a promising and safe revascularization strategy. It provides selected patients with an alternative, functionally complete revascularization with minimal surgical trauma and good long-term clinical outcomes.

Coronary blood flow changes following activation of adrenergic receptors in the conscious dog

1982 ◽  
Vol 243 (1) ◽  
pp. H13-H19 ◽  
Author(s):  
P. A. Gwirtz ◽  
H. L. Stone
Keyword(s):  
Blood Flow ◽  
Adrenergic Receptors ◽  
Stellate Ganglion ◽  
Receptor Blockade ◽  
Circumflex Artery ◽  
Left Circumflex Artery ◽  
Left Stellate Ganglion ◽  
Before And After ◽  
Alpha Receptors ◽  
Beta 2

The role of coronary vascular adrenergic receptors in changing coronary flow was studied in dogs instrumented to measure left circumflex artery blood flow (CBF), mean coronary artery blood pressure (CBP), and heart rate (HR). Norepinephrine (NE), isoproterenol (IP), and phenylephrine (PH) were injected into the left circumflex artery before and after selective intracoronary alpha- and beta 1- or combined beta 1- and beta 2-receptor blockade. NE, IP, and PH did not alter CBP (112 +/- 6 mmHg). In addition, IP and PH did not affect HR (103 +/- 4 beats/min). NE increased HR to 150 +/- 6 beats/min, which was eliminated by blocking beta 1-receptors with atenolol and by removing the left stellate ganglion. IP increased CBF from 65 +/- 9 to 115 +/- 16 ml/min (mediated by both beta 1- and beta 2-receptors). PH caused an alpha-receptor-mediated coronary vasoconstriction (42 +/- 5 ml/min), which was potentiated by beta 1- and beta 2-receptor blockade. NE caused a biphasic flow response. CBF initially increased to 117 +/- 14 ml/min (mediated predominantly by beta 1-receptors) followed by a prolonged decrease to 54 +/- 7 ml/min (mediated by alpha-receptors). Removing the left stellate ganglion did not affect the CBF response to NE. These data indicate that PH directly stimulates coronary alpha-receptors and IP stimulates myocardial beta 1- and coronary beta 2-receptors. NE also stimulates myocardial cells causing a reflex that increases HR and indirectly increases CBF. The vasoconstriction to NE and PH was not evident after pentobarbital anesthesia, whereas the coronary vasodilation and increase in HR to NE was still present.

Internal Thoracic Artery Blood Flow Is Not Affected by Major Side Branch

2004 ◽  
Vol 19 (4) ◽  
pp. 346-348 ◽  
Author(s):  
Franz F. Immer ◽  
Friedrich S. Eckstein ◽  
Pascal A. Berdat ◽  
Thierry P. Carrel
Keyword(s):  
Blood Flow ◽  
Internal Thoracic Artery ◽  
Side Branch ◽  
Artery Blood Flow
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