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Point-of-Care Ultrasound
Published in Kajal Jain, Nidhi Bhatia, Acute Trauma Care in Developing Countries, 2023
The purpose is to identify volume status of the patient using ultrasound.Look for the status in subcostal view. If the walls of the left ventricles (LV) are approximating or “kissing” (gap between walls ≤ 2.5 cm), then hypovolaemia is likely. If the gap between the LV walls is approximately > 6 cm, then hypervolaemia/poor systolic function is likely.One can also look for the inferior vena cava (IVC) diameter.Correlation of IVC diameter with central venous pressure (CVP):IVC diameter < 1.5 cm with 100% collapsibility: Approximate CVP is 0–5 mmHg.IVC diameter 1.5–2.5 with > 50% collapsibility: CVP approximates 5–10 mmHg.IVC diameter 1.5–2.5 with < 50% collapsibility: CVP is 10–15 mmHg.IVC diameter > 2.5 with no collapsibility: CVP approximates > 20 mmHg.
Electrophysiology
Published in A. Bakiya, K. Kamalanand, R. L. J. De Britto, Mechano-Electric Correlations in the Human Physiological System, 2021
A. Bakiya, K. Kamalanand, R. L. J. De Britto
The cardiopulmonary system consists of blood vessels that carry nutrients and oxygen to the tissues and removes carbon dioxide from the tissues in the human body (Humphrey & McCulloch, 2003; Alberts et al., 1994). Blood is transported from the heart through the arteries and the veins transport blood back to the heart. The heart consists of two chambers on the top (right ventricle and left ventricle) and two chambers on the bottom (right atrium and left atrium). The atrioventricular valves separates the atria from the ventricles. Tricuspid valve separates the right atrium from the right ventricle, mitral valve separates the left atrium from the left ventricle, pulmonary valve situates between right ventricle and pulmonary artery, which carries blood to the lung and aortic valve situated between the left ventricle and the aorta which carries blood to the body (Bronzino, 2000). Figure 3.9 shows the schematic diagram of heart circulation and there are two components of blood circulation in the system, namely, pulmonary and systemic circulation (Humphrey, 2002; Opie, 1998; Milnor, 1990). In pulmonary circulation, pulmonary artery transports blood from heart to the lungs. The blood picks up oxygen and releases carbon dioxide at the lungs. The blood returns to the heart through the pulmonary vein. In the systemic circulation, aorta carries oxygenated blood from the heart to the other parts of the body through capillaries. The vena cava transports deoxygenated blood from other parts of the body to the heart.
Venous Return and Vascular Function
Published in Peter Kam, Ian Power, Michael J. Cousins, Philip J. Siddal, Principles of Physiology for the Anaesthetist, 2020
Peter Kam, Ian Power, Michael J. Cousins, Philip J. Siddal
As the large veins join, the venous cross-sectional area is reduced, and the velocity of blood flow increases. In the venae cavae, the velocity of blood flow is 12 cm/s – only slightly less than the aortic value of 20 cm/s. The mean pressure is 10–15 mmHg in the venules, 4–8 mmHg in the larger veins and 0–2 mmHg in the venae cavae. Right atrial contraction produces pressure pulsations in the venae cavae. The venous system is 25–30 times more compliant than the arterial system, systemic veins contain 60% of the total blood volume and veins can accommodate large volumes of blood with little rise in pressure. Any volume of blood lost from or added to the cardiovascular system is in the ratio 25:1 to 30:1 (venous:arterial) because of the high venous compliance.
Coronary Sinus Defect, Premature Restriction of Foramen Ovale and Cysto-Colic Peritoneal Band
Published in Fetal and Pediatric Pathology, 2023
The coronary sinus is formed by coalescence of venous tributaries comprised of a small, middle, great, and oblique cardiac vein; the left marginal vein; and the left posterior ventricular vein [5,6]. Together with the vena cavae (superior and inferior), the coronary sinus delivers deoxygenated blood to the right atrium [6]. Unroofed coronary sinus is a congenital cardiac anomaly first described by Raghib et al [1]. There is an overwhelming association of this anomaly with persistent left superior vena cava that drains the left internal jugular and subclavian veins into the coronary sinus [7]. A persistent left superior vena cava occurs in 0.1–0.5% of the general population, with 8% draining into the left atrium [2]. The morphologic type of unroofed coronary sinus have been classified as Kirklin and Barratt-Boyes types whereby (1) type I is completely unroofed with persistent left superior vena cava; (2) type II is completely unroofed but without persistent left superior vena cava; (3) type III shows partially unroofed midportion; and (4) type IV shows partially unroofed terminal portion [2,8,9].
Orthotopic kidney transplantation survival and complications: systematic review and meta-analysis
Published in Arab Journal of Urology, 2022
Carlos Alfredo Castillo-Delgado, Herney Andrés García-Perdomo, Mireia Musquera, Antonio Alcaraz
Although case reports were not included, we also wanted to describe a few characteristics from them. Three manuscripts reported cases from young people with specific conditions indicating the orthotopic transplant, such as multiple pelvic arteriovenous malformations, congenital abnormalities, multiple pelvic and abdominal surgeries, and twin pregnancy [18,21,22]. In addition, two papers described people older than 60 years with multiple comorbidities and severe aortoiliac atherosclerosis [23,24]. Rodrigues et al. described four cases (two young people and two older than 60 years old) with severe atherosclerosis [25]. Furthermore, Chan et al. showed three patients (two young and one older than 60 years old) with inferior vena cava (IVC) thrombosis or stenosis [26]. On the other side, Novotny et al. described a patient with a papillary renal cell carcinoma recurrence who underwent radical nephrectomy, along with an OKT [27]. Unfortunately, all those case reports did not show any overall or kidney survival information and associated complications.
Persistent Left Superior Vena Cava: Why is Prenatal Diagnosis Important?
Published in Fetal and Pediatric Pathology, 2022
Ayşe Keleş, Osman Yılmaz, Gülşah Dağdeviren, Özge Yücel Çelik, Aykan Yücel, Dilek Şahin
Persistent left superior vena cava (PLSVC) is the most common variation of the thoracic venous system [1,2]. It is found in 0.3%–0.5% of the general population and 4%–8% in those with congenital heart disease (CHD) [3,4]. In the embryonic period, anterior cardinal veins perform the venous drainage of the cephalic region and upper extremity. Except for a small part that constitutes the left superior intercostal vein, the left anterior cardinal vein regresses in the eighth week of embryogenesis. Failure of this regression results in PLSVC [4,5]. In most cases, the right and left superior vena cava coexist. The specific combination of a persistent LSVC and non-right superior vena cava was reported to be 0.05% in an autopsy series [6,7]. PLSVC typically empties into the right atrium via the coronary sinus, but may empty directly into the left atrium [8].