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Thorax
Published in Dave Maudgil, Anthony Watkinson, The Essential Guide to the New FRCR Part 2A and Radiology Boards, 2017
Dave Maudgil, Anthony Watkinson
The coronary sinus opens into the posterior wall of the right atrium and lies in the posterior interventricular groove. The great cardiac vein ascends in the anterior interventricular groove, the middle cardiac vein ascends in the posterior interventricular groove. The internal thoracic veins drain into the inferior aspect of both brachiocephalic veins. The bronchial arteries arise directly from the aorta in 90% of cases – one on the right and one on the left being the commonest configuration. The right bronchial vein typically drains into the azygos system and the left drains into the hemiazygos system.
Sternal Route More Effective than Tibial Route for Intraosseous Amiodarone Administration in a Swine Model of Ventricular Fibrillation
Published in Prehospital Emergency Care, 2018
James M. Burgert, Andre Martinez, Mara O'Sullivan, Dawn Blouin, Audrey Long, Arthur D. Johnson
Intuitively, the SIO route may be an advantageous infusion site for the administration of resuscitative drugs during cardiac arrest in civilian populations. The SIO infusion site is rapidly and easily located as the sternal notch is readily palpable and there is usually little subcutaneous tissue overlying the manubrium. There are IO devices specifically designed to safely access the sternal manubrium, the FAST- 1 and the more recent FAST Responder (Pyng Medical, Vancouver, BC, Canada).47,48 The venous drainage of the manubrium leads directly to the central circulation, and the effect site of many resuscitative drugs, via the right and left internal thoracic veins, to the brachiocephalic veins, and then to the superior vena cava. The hydraulic action of chest compressions could accelerate the movement of SIO administered drugs into the circulation compared to the TIO, HIO, and IV routes that do not benefit from pumping action. The combination of proximity to the heart and rapid hydraulic movement of drugs during CPR make the SIO an appealing choice for the administration of resuscitative drugs during cardiac arrest when IV access cannot be rapidly obtained.
Chylothorax in Behçet’s disease
Published in Canadian Journal of Respiratory, Critical Care, and Sleep Medicine, 2021
Sophie B. Kermelly, Marie-Ève Boucher, François Côté, François Maltais
Chest and abdominal computed tomography (CT) showed bilateral dilatation of internal thoracic veins, mesorectal and inferior mesenteric venous vessels compatible with extensive collateralization of the venous system. To provide conclusive evidence of a thrombosis of the vena cava and to rule out a lymphatic leak, a venography (Figure 4; 4a) and a lymphangiography (Figure 5) were performed, confirming the presence of an extensive thrombosis of both superior and inferior vena cava with no evidence of lymphatic leak. Renal and cutaneous biopsies were compatible with an IgA vasculitis with immune complex deposition.
Retrograde venography and three-dimensional mapping of a great cardiac vein with separate drainage into the high right atrium in a patient with Wolf-Parkinson-White syndrome
Published in Baylor University Medical Center Proceedings, 2018
Keith Suarez, Javier E. Banchs, Judith P. Lazol, James N. Black
Abnormal drainage of the GCV into other structures has been reported. In a review of 250 hearts, there was a case of a GCV draining into the anterior cardiac veins, which drain the anterior wall of the right ventricle.9 Drainage into the left internal thoracic vein was found during surgery in a 17-month-old girl who was undergoing repair of a ventricular septal defect.10 Drainage into the left atrium was incidentally discovered during computed tomography of the coronaries in a patient with chest pain and in another patient who underwent surgical revascularization.11