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Antonio M Calafiore - One of the best experts on this subject based on the ideXlab platform.

  • partial clamping of the Brachiocephalic Trunk for total ascending aorta replacement without circulatory arrest early and midterm results
    Heart Surgery Forum, 2004
    Co-Authors: Antonio M Calafiore, Michele Di Mauro, Carlosa Mestres, Gabriele Di Giammarco, Giovanni Teodori, Jose L Pomar, Luca Weltert, Antonio Bivona, Massimo Gagliardi, Angela L Iaco
    Abstract:

    BACKGROUND The aim of this study was to evaluate in elective patients the early and midterm results of partial clamping of the Brachiocephalic Trunk (BCT) for total ascending aorta replacement (TAAR) without circulatory arrest. Contraindications to the procedure were BCT/aortic arch calcifications and chronic aortic dissection. METHODS The right radial artery was cannulated to monitor the systemic pressure after the BCT was partially clamped. A specially designed clamp was applied obliquely to occlude approximately 50% of the BCT and part of the aortic arch. The distal tip of the clamp was positioned in front of the left subclavian artery. From January 2002 to October 2003, 92 patients underwent TAAR. In 62 patients (67.4%), partial clamping of the BCT was used. Twenty of these patients underwent isolated TAAR, 27 underwent aortic valve replacement and TAAR, 11 had a Bentall operation, and 2 had a Cabrol operation. The aortic valve was spared in the remaining 2 patients. The mean (+/- SD) aortic cross-clamping and cardiopulmonary bypass times were 96 +/- 31 minutes and 116 +/- 43 minutes, respectively. RESULTS Early mortality was 1.6% (1 patient). No cerebrovascular accidents occurred, demonstrating the safety of the technique. The major complications were acute respiratory insufficiency in 2 cases and acute renal failure in 5. The mean follow-up time was 9.0 +/- 6.5 months. The mean 18- month and event-free survival rate was 96.6% +/- 0.9%. CONCLUSION Partial clamping of the BCT for TAAR without circulatory arrest provides good early and midterm clinical results. Aortic arch clamping is not associated with cerebrovascular accidents.

  • Brachiocephalic Trunk partial clamping for total ascending aorta replacement without circulatory arrest
    The Annals of Thoracic Surgery, 2003
    Co-Authors: Antonio M Calafiore
    Abstract:

    In patients without aortic arch calcification, elective total ascending aorta replacement can be performed without circulatory arrest, by positioning obliquely a clamp from the Brachiocephalic Trunk, which is partially clamped, to the distal aortic arch. This technique was used in 8 consecutive patients in the first 3 months of 2002. None of them experienced any complication.

H Krishna R Rao - One of the best experts on this subject based on the ideXlab platform.

  • Brachiocephalic Trunk and left common carotid artery arising from aortic arch as a single Trunk
    2014
    Co-Authors: Raj K Ravi, Shakuntala N Rao, H Krishna R Rao
    Abstract:

    Branches of aortic arch usually are Brachiocephalic Trunk, left common carotid artery and left subclavian artery from right to left direction. Arch of aorta show more variations in branching patterns. One among which is origin of only two branches in which Brachiocephalic Trunk and left common carotid artery arise together as a common Trunk and other branch is left subclavian artery. The variations occur due to abnormal development of arch of aorta. During routine dissection of superior mediastinum of thoracic region, we have found the left common carotid artery and Brachiocephalic Trunk was arising from the arch of aorta as a common Trunk. These kinds of variations are very rare and knowledge of which is very important for neck surgeons, cardiologists and interventional radiologists while doing surgeries and instrumentation procedures.

  • origin of left vertebral artery from aortic arch and thyroidea ima artery from Brachiocephalic Trunk
    2014
    Co-Authors: Ravi K Raj, H Krishna R Rao
    Abstract:

    Vertebral artery usually arises from the first part of subclavian artery and supplies mainly brain and part of the spinal cord. Knowledge of abnormal origin of vertebral artery from aortic arch can increase blood pressure, which can lead to atherosclerosis resulting in cerebrovascular accidents. Knowledge of rarely seen thyroidea ima artery is very important for surgeons especially during thyroidectomy and tracheostomy because this abnormal artery can cause bleeding during and after the surgery as well. During routine academic dissection we have observed the origin of left vertebral artery directly from the aortic arch between left common carotid and left subclavian arteries and thyroidea ima artery was arising from Brachiocephalic Trunk and was supplying the thyroid gland.Knowledge of these variations is very important for general surgeons, head & neck surgeons and radiologists.

Friedrich W Mohr - One of the best experts on this subject based on the ideXlab platform.

Paulina A Bortolin - One of the best experts on this subject based on the ideXlab platform.

  • tronco braquiocefalico variaciones anatomicas e implicancias clinicas Brachiocephalic Trunk anatomical variations and clinical implications
    Revista Argentina de Anatomía Clínica, 2016
    Co-Authors: Susana N Biasutto, Rodolfo R Cecenarro, Gabriel A F Ceccon, Maria L Alvarez, Matias De La Rosa, Paulina A Bortolin
    Abstract:

    Las anomalias y variaciones anatomicas del tronco braquiocefalico (TBC) pueden tener importantes implicancias en la practica medica, en especial en la interpretacion de estudios de diagnostico por imagenes, en procedimientos quirurgicos toracicos y cervicales, e incluso pueden ser incompatibles con la vida. Nuestro objetivo es realizar una revision que permita considerar las variaciones anatomicas del TBC y sus manifestaciones clinicas a partir de la bibliografica relacionada a hallazgos anatomicos y estudios clinicos. Realizamos una extensa busqueda bibliografica y sintetizamos los resultados obtenidos considerando las anomalias en el origen, el recorrido y la distribucion del TBC. Acompanamos la informacion anatomica con los datos correspondientes a las manifestaciones clinicas que presentaron y algunos procedimientos terapeuticos que se encuentran descriptos en la literatura.Knowledge of anatomical anomalies and variations on the Brachiocephalic Trunk is important in medical practice, mainly for the interpretation of diagnostic images, in surgical procedures of thorax and neck, and may also be of high risk for life. Our objective was to perform a review to consider the anatomical variations of the Brachiocephalic Trunk and the clinical expressions published in the literature, most of them as eventual findings. We carried on a wide literature research and summarized the results considering the anomalies at the origin, in the way and in the braching of the Brachiocephalic Trunk. The anatomical information was associated to the clinical aspects presented in the published papers and some therapeutic procedures described in the literature.

  • clinically important formations on the interior surface of the Brachiocephalic Trunk formaciones clinicamente importantes en la superficie interna del tronco braquiocefalico
    Revista Argentina de Anatomía Clínica, 2016
    Co-Authors: Susana N Biasutto, Gabriel A F Ceccon, Paulina A Bortolin, Matias De La Rosa
    Abstract:

    Las caracteristicas de la division arterial representan un factor de riesgo para la oclusion arterial y causa frecuente de dificultad para la cateterizacion. Su forma de presentacion depende de la union del 3o y 4o arcos aorticos. Con el objetivo de evidenciar las caracteris-ticas del tronco braquiocefalico (TBC) se estudiaron 40 fetos de entre 12 y 23 semanas de gestacion. Se disecaron los grandes vasos y el TBC fue seccionado en su origen y resecado conjuntamente con la porcion proximal de las arterias carotida comun derecha (CCD) y subclavia derecha (SD). Se midio la longitud, el ancho y los angulos interno y geometrico entre las arterias CCD y SD. Abrimos las arterias para observar la luz vascular. Se documento fotograficamente. La longitud promedio fue de 4,25 mm y el ancho promedio de 1,53 mm. No se evidencio relacion directa entre las medidas de los TBC y la edad fetal. La mediana del angulo interno fue de 62o. Solo el 50% de los TBC pudieron ser abiertos, permitiendo observar la presencia de tabiques parciales entre ambos vasos en el 20% de los casos y de espolones a nivel de la bifurcacion en otro 10%. No hallamos descripciones sobre estos relieves en la literatura. El angulo interno entre ambas arterias fue significativa-mente mayor en los casos que presentaron relieves. En conclusion, la presencia de relieves en la superficie interna del TBC tiene origen embriologico y representaria un factor importante de riesgo para patologia obstructiva vascular y causa de dificultad para la cateterizacion. Arterial division features constitute risk factors for arterial occlusion and frequently cause difficulties in catheterization. In this case the relevant feature is the junction of the 3 rd and 4 th aortic arches. With the aim of displaying the features of the Brachiocephalic Trunk (BCT), we studied 40 fetuses of between 12 and 23 weeks of gestation. Great vessels were dissected and the BCT was cut and resected at its origin within the proximal portion of the right common carotid (RCC) and right subclavian (RS) arteries. The arteries were opened to observe their internal surface. Findings were documented photographically. In each case, the internal and geometric angles were measured. Their average length was 4.25 mm, and average width was 1.53 mm. There was no evidence of a direct relationship between the measurements of the BCT and fetal age. The median value of the internal angle was 62o. Only 50% of the BCT could be opened, allowing the observation of a partial septum in 20% of the cases, or ridges at the arterial bifurcation in another 10%. No descriptions of these formations were found in the literature. The average internal angle between both arteries (RCC and RS) was significantly greater in those cases having intraluminal formations. In conclusion, formations on the inner surface of the BCT are of embryological origin and represent a major risk factor for vascular obstructive disease and a cause of difficulty in catheterization.

  • clinically important formations on the interior surface of the Brachiocephalic Trunk
    2012
    Co-Authors: Susana N Biasutto, Gabriel A F Ceccon, Paulina A Bortolin
    Abstract:

    Arterial division features constitute risk factors for arterial occlusion and frequently cause difficulties in catheterization. In this case the relevant feature is the junction of the 3 and 4 aortic arches. With the aim of displaying the features of the Brachiocephalic Trunk (BCT), we studied 40 fetuses of between 12 and 23 weeks of gestation. Great vessels were dissected and the BCT was cut and resected at its origin within the proximal portion of the right common carotid (RCC) and right subclavian (RS) arteries. The arteries were opened to observe their internal surface. Findings were documented photographically. In each case, the internal and geometric angles were measured. Their average length was 4.25 mm, and average width was 1.53 mm. There was no evidence of a direct relationship between the measurements of the BCT and fetal age. The median value of the internal angle was 62o. Only 50% of the BCT could be opened, allowing the observation of a partial septum in 20% of the cases, or ridges at the arterial bifurcation in another 10%. No descriptions of these formations were found in the literature. The average internal angle between both arteries (RCC and RS) was significantly greater in those cases having intraluminal formations. In conclusion, formations on the inner surface of the BCT are of embryological origin and represent a major risk factor for vascular obstructive disease and a cause of difficulty in catheterization.

Paula Sinclair - One of the best experts on this subject based on the ideXlab platform.

  • origin of the Brachiocephalic Trunk left carotid and left subclavian arteries from the arch of the human aorta
    Investigative Radiology, 1991
    Co-Authors: M Zamir, Paula Sinclair
    Abstract:

    We measured branching angles of the Brachiocephalic Trunk, left carotid, and left subclavian arteries at their points of origin from the arch in 117 human specimens. We compared the measured angles with theoretical values commonly used in the study of arterial branching, and examined possible correlations with age and with the presence of atherosclerotic lesions. The results may be useful in the modelling and analysis of hemodynamic factors in the pathogenesis of vascular disease at these junctions and may be of some interest in clinical angiography. The junctions are important gateways for blood supply to the head and upper limbs and often are involved with lesions that affect blood supply to the brain.