Development of palliative medicine in the United Kingdom and Ireland
Eduardo Bruera, Irene Higginson, Charles F von Gunten, Tatsuya Morita in Textbook of Palliative Medicine and Supportive Care, 2015
SVCS results from the compression of the superior vena cava by the tumor arising in the mediastinum or in the right main or upper lobe bronchus or by large-volume mediastinal nodes (most commonly from the right paratracheal or precarinal lymph nodes). The superior vena cava carries blood to the heart from the head, arms, and upper torso. It is formed by the junction of the left and right brachiocephalic veins in the mid-third of the mediastinum and extends caudally for 6-8Â cm, coursing anterior to the right main-stem bronchus and insert into right atrium. It is joined posteriorly by the azygos vein as it loops over the right main-stem bronchus. It is a thin-walled vessel and the blood flows with relatively low intravascular pressure in it (2-8mmHg). Thus, when the superior vena cava is compressed, it leads to an increase in the pressure (to 20-40mmHg ) and it slows or even interrupts local flow. In this case, blood flows through a collateral vascular network to the inferior vena cava or the azygos system. This collateral flow dilates with the time and may accommodate to the flow of the superior vena cava after a few weeks.
Abdomen
David Heylings, Stephen Carmichael, Samuel Leinster, Janak Saada, Bari M. Logan, Ralph T. Hutchings in McMinn’s Concise Human Anatomy, 2017
Inferior vena cava - the principal vein of the body below the diaphragm, it lies on the right side of the aorta. It begins caudally at the level of the L5 vertebra by the union of the right and left common iliac veins (Figs.6.4, 6.8) and runs cranially to pierce the central tendon of the diaphragm posterior to the liver at the level of the T8- T9 vertebrae. The largest tributaries are the right and left renal veins. The gonadal vein (testicular or ovarian) drains directly into the vena cava on the right, but on the left it enters the left renal vein. The highest tributaries of the vena cava are the hepatic veins, which enter the vena cava where that vessel lies in the deep groove on the posterior of the liver (the hepatic veins therefore have no extrahepatic course). A number of small lumbar veins also enter the vena cava at various levels and connect with pelvic veins inferiorly, the azygos system superiorly and with the venous plexuses around the vertebral column.
Electrophysiology
A. Bakiya, K. Kamalanand, R. L. J. De Britto in Mechano-Electric Correlations in the Human Physiological System, 2021
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.
Variations in the vascular and biliary structures of the liver: a comprehensive anatomical study
Published in Acta Chirurgica Belgica, 2018
Burak Veli Ülger, Eyüp Savaş Hatipoğlu, Özgür Ertuğrul, Mehmet Cudi Tuncer, Cihan Akgül Özmen, Mesut Gül
Blood is supplied to the liver by the proper hepatic artery and drained from the liver by the hepatic portal vein. Other hepatic veins also provide venous drainage. The branches of the proper hepatic artery, hepatic portal vein, and common hepatic duct constitute the portal triad. The right portal triad exhibits a short course (1–1.5 cm) before entering the porta hepatis (a deep fissure on the inferior surface of the liver through which all neurovascular structures—except the hepatic veins—and the hepatic ducts enter or exit the liver). After entering the right lobe, the portal triad divides into anterior and posterior branches that supply the paramedian (V and VIII) and the lateral (VI and VII) segments [4]. The left portal triad continues to the top of the hepatoduodenal ligament and then moves 3–4 cm to the left to run under the quadrate lobe. The triad then turns forward, accessing segments II, III, and IV from the ligamentum venosum fissure [5,6]. The caudate lobe has a left portion of fixed size and a right portion that varies individually in size. Both the right and left portal triads drain blood from the caudate lobe and also drain bile. The caudate process, which is on the right, delivers venous blood to branches from the fork of the hepatic portal vein and the right branch of that vein; the left part of the caudate lobe delivers blood only to the left branch of the hepatic portal vein. The combined venous blood from the caudate lobe drains into the inferior vena cava via a single vein [7].
Hypoplastic left heart syndrome (HLHS): molecular pathogenesis and emerging drug targets for cardiac repair and regeneration
Published in Expert Opinion on Therapeutic Targets, 2021
Anthony T Bejjani, Neil Wary, Mingxia Gu
The most common treatment for HLHS consists of three consecutive procedures done within the first 4 years of life: the Norwood, Glenn, and Fontan procedures. In brief, the Norwood procedure creates a new systemic circuit in the heart by redirecting blood from the left atrium into the right ventricle and connecting the aorta to the main pulmonary artery via a BT or Sano shunt [66,67]. This leads to the mixing of oxygenated and deoxygenated blood in the right ventricle. Despite this connection, pulmonary and systemic circulations are still in parallel. The Glenn procedure separates the superior vena cava from the RA and connects it directly to the pulmonary artery to be taken to the lungs, while the inferior vena cava remains connected to the RA. Finally, the Fontan procedure joins the superior and inferior venae cavae to the pulmonary trunk which is separated from the right ventricle, joining the left and right atria, and connecting the aorta to the right ventricle [68]. At the end of these procedures, the right heart would be solely responsible for the systemic circulation, with the venae cavae emptying directly into the pulmonary artery. A fenestration between the inferior vena cava and the RA remains to help reduce pressure to the lungs, while they adjust to the new circulation. At the end of the Fontan procedure, oxygen-rich and oxygen-poor continue to mix in the single-ventricle heart, while the pulmonary and systemic circulations are effectively in series.
St. Thomas and del Nido cardioplegia are superior to Custodiol cardioplegia in a rat model of donor heart
Published in Scandinavian Cardiovascular Journal, 2021
Gulsum Karduz, Muhittin Onur Yaman, Mehmet Altan, Gulderen Sahin, Fevzi Toraman, Ugur Aksu
Animals were anaesthetized with intraperitoneal ketamine (70 mg/kg) and xylazine (10 mg/kg) mixture. Following sterile preparation of the chest, a median sternotomy was performed. Aorta was isolated and inferior vena cava was cut. Cold cardioplegia solution (Custodiol, del Nido or St. Thomas, approximately 10 mL) containing heparin (5 IU/g body weight) was infused into the aorta to wash the intracardiac vascular bed. Blood was removed via inferior vena cava. Hearts were excised after cardiac arrest and immediately placed into cardioplegia solution (+4 °C). Incubation was extended for 4 h in the cardioplegia solution of the related group of approximately 2–3 times the volume (10 mL). At the end of the fourth hour, incubation media was collected (T1) and used for biochemical measurements.
Related Knowledge Centers
- Abdominal Aorta
- Anatomy
- Inferior Vena Cava
- Superior Vena Cava
- Vein
- Atrium
- Heart
- Blood
- Coronary Sinus
- Great Vessels