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Cardiovascular system
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
The thoracic aorta commences at the aortic valve and passes into the abdomen by passing through the diaphragmatic hiatus at the level of the T12 vertebral body. It is divided into the ascending aorta, aortic arch and descending aorta. Major vessels arise from the ascending aorta and arch. The right and left coronary arteries arise from the root of the ascending aorta close to the aortic valve cusps. The aortic arch gives rise to three large vessels that supply the head and neck region and the upper limbs: the brachiocephalic artery (also known as the brachiocephalic trunk or innominate artery), the left common carotid artery and the left subclavian artery. The brachiocephalic artery divides and give rise to the right common carotid and right subclavian arteries. Each common carotid artery divides into the internal and external carotid arteries. The vertebral artery arises as the first branch of the subclavian artery on each side. The subclavian artery passes laterally to continue as the axillary artery at the lateral border of the first rib. The axillary artery continues down the arm and at the inferior margin of the teres major muscle it becomes the brachial artery. At the cubital fossa the brachial artery divides into the radial and ulnar arteries, which continue down the forearm to the hand.
Clinical Effects of Pollution
Published in William J. Rea, Kalpana D. Patel, Reversibility of Chronic Disease and Hypersensitivity, Volume 5, 2017
William J. Rea, Kalpana D. Patel
The vasa vasorum are specialized vessels. All types of arterial vasa vasorum (AVV) are recognized. The first type is the vasa vasorum interna, which originate from the large vessel going to the378 media359,379 and branching out into the adjacent artery wall.380 The second type is the vasa vasorum externa, which are found primarily in the adventitia at its border with the media. They originate from various anatomic locations like the nearby major branches (external vasa vasorum) of the large vessel. These small vessels nourish the larger vascular wall and clean them of toxic substances and debris. These vasa vasorum include the brachiocephalic and coronary arteries in the ascending aorta, the intercostal branches in the descending thoracic aorta, the lumbar and mesenteric arteries in the abdominal aorta, and bifurcation segments of epicardial vessels in coronary arteries.381 These vessels supply nutrients and oxygen to the arterial walls and microcirculation and help detoxify substances (Figure 2.19).
Forensic Radiology
Published in Paolo Russo, Handbook of X-ray Imaging, 2017
Claire Robinson, Bruno Morgan, Guy N. Rutty
The body is prepared in the mortuary or the scan room. A catheter is inserted into the left carotid artery through an incision made just above the clavicle. (The technique is fully described in Saunders et al. 2011 and University of Leicester 2016.) The catheter is positioned in the ascending aorta with the tip just above the aortic valve. The balloon on the catheter is inflated using 1% solution of contrast, to hold it in place and to occlude the aorta. The position of the catheter balloon is confirmed on the initial PMCT scan. If the balloon is occluding the coronary ostia, the balloon is deflated, retracted, and re-inflated. Contrast can then be introduced through the catheter at 6 mL/s for 300 mL of air and 3 mL/s for 150 mL of 10% urografin (Urografin® 150 mg/mL, Bayer Healthcare).
Mechanical circulatory support device selection for bridging to cardiac transplantation: a clinical guide
Published in Expert Review of Medical Devices, 2023
Tamari Miller, Veli K. Topkara
Alternative but less commonly used options for refractory cardiogenic shock include Tandem Heart and CentriMag™. TandemHeart® is a percutaneous centrifugal ventricular assist device which unloads the left ventricle by shuttling blood from the left atrium to the descending aorta. There is limited evidence for its use in cardiogenic shock but can provide up to 5 L/min of hemodynamic support. CentriMag™ is a surgically placed device which requires a median sternotomy and can support univentricular or biventricular dysfunction with up to 10 L/min of support. When serving as a left ventricular assist device the inflow cannula is placed in the left atrium or left ventricle with the outflow graft in the ascending aorta. As a right ventricular assist device, inflow is in the right atrium with outflow in the pulmonary artery. There is no randomized trial data to support its use but limited data suggests it has comparable post-transplant outcomes as continuous flow durable LVADs with 89.5% 1 year survival [35]. An oxygenator could be added on CentriMag™ as needed for severe respiratory failure resulting in poor oxygenation.
The effect of Womersley number and particle radius on the accumulation of lipoproteins in the human aorta
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2020
Xueping Chen, Jian Zhuang, Yueheng Wu
Figure 3 showed the spatial distributions of Cw under steady flow conditions for the three different lipoprotein radii. The values of Cw were significantly different amongst the three cases. As shown in Figure 3, the 1 nm lipoproteins exhibited the highest Cw relative to the larger lipoproteins. Moreover, for the 1 nm lipoproteins, low Cw regions were mainly located at the upstream of the ascending aorta, where the dividing border between high and low Cw was located at the beginning of the aortic arch (Figure 3(a)). For the 10 nm lipoproteins, Cw in the ascending aorta was relatively even, but quite uneven in the aortic arch. In addition, the inner wall of the aortic arch had much higher Cw than the outer wall areas (Figure 3(b)). Region F of the aortic arch has the highest Cw. For the lipoproteins radius of 100 nm, the spatial distribution of Cw was even and without obvious change, and the value of the normalized Cw tends to be constant 1 (Figure 3(c)).
1D simulation of blood flow characteristics in the circle of Willis using THINkS
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2018
George P. Huang, Hongtao Yu, Zifeng Yang, Ryan Schwieterman, Bryan Ludwig
In the flow simulation for the heart modeling, a lumped model of the circulation between the heart and the lungs was taken into account (Müller and Toro 2014; Huang and Muller 2015). A 4-chamber 0D model for the heart is used to simulate the blood flow from the superior vena cava and inferior vena cava, through the pulmonary system, and then to the ascending aorta. In addition to the 4 valves inside the heart, there are also 15 venous valves used in the venous system. The 1D model is intentionally constructed in such a way that each blood vessel is adjustable, replaceable and removable according to various blood vessel typologies. Therefore, in order to satisfy the patient’s vascular typologies, the computational code can be customized very easily. The individual physiological anomalies for the subject discussed in this study can also be found in the previous work (Müller and Toro 2014; Huang and Muller 2015). All 0D, 1D equations and modeling parameters were discussed and presented in detail in our previous work (Huang and Muller 2015). The equations used to describe the vessel junctions were formulated by Riemann variables, conservations of mass, and Bernoulli equation (Müller and Toro 2014). The 0D and 1D equations were solved using optimal third-order TVD Runge-Kutta method and shock-capturing TVD scheme.