Vascular surgery

vascular surgeonvascularvascular surgeons
Conclusion: Intraoperative heparin, given before aortic cross clamping, is an important prophylaxic against perioperative MI in aortic aneurysm surgery. Society for Vascular Surgery, the major American professional society. Ischemia-repurfusion injuries of the appendicular musculoskeletal system. Society for Vascular Surgery (U.S.). European Society for Vascular Surgery.

Shock (circulatory)

shockcirculatory shockhemorrhagic shock
Aortic stenosis hinders circulation by obstructing the ventricular outflow tract. Hypertrophic sub-aortic stenosis is overly thick ventricular muscle dynamically occludes the ventricular outflow tract. Septic shock is the most common cause of distributive shock. Caused by an overwhelming systemic infection resulting in vasodilation leading to hypotension.

Carotid artery stenosis

carotid stenosiscarotid artery diseaseCarotid artery
Atherosclerotic aortic aneurysm (AAA). Two or more of the following risk factors:. High blood pressure (hypertension). High cholesterol (hyperlipidemia). Tobacco smoking. Family history – First degree relative diagnosed with atherosclerosis before age 60 or who suffered an ischemic stroke. Medications alone (an antiplatelet drug (or drugs) and control of risk factors for atherosclerosis). Medical management plus carotid endarterectomy or carotid stenting, which is preferred in patients at high surgical risk and in younger patients. Control of smoking, high blood pressure, and high levels of lipids in the blood.

Hemodynamics

blood flowhemodynamichaemodynamic
Under normal conditions, to avoid atherogenesis, thrombosis, smooth muscle proliferation and endothelial apoptosis, shear stress maintains its magnitude and direction within an acceptable range. In some cases occurring due to blood hammer, shear stress reaches larger values. While the direction of the stress may also change by the reverse flow, depending on the hemodynamic conditions. Therefore, this situation can lead to atherosclerosis disease. Veins are described as the "capacitance vessels" of the body because over 70% of the blood volume resides in the venous system. Veins are more compliant than arteries and expand to accommodate changing volume.

Intermittent claudication

claudication intermittensvascular claudication
The following signs are general signs of atherosclerosis of the lower extremity arteries: All the "P"s Most commonly, intermittent (or vascular or arterial) claudication is due to peripheral arterial disease which implies significant atherosclerotic blockages resulting in arterial insufficiency. Other uncommon causes are Trousseau disease, Beurger's disease (Thromboangiitis obliterans), in which vasculitis occurs. Raynaud's phenomenon functional vasospasm. It is distinct from neurogenic claudication, which is associated with lumbar spinal stenosis. It is strongly associated with smoking, hypertension, and diabetes.

Lipoprotein(a)

lipoprotein (a)LPAlipoprotein A
Animal studies have shown that Lp(a) may directly contribute to atherosclerotic damage by increasing plaque size, inflammation, instability, and smooth muscle cell growth. Genetic data also support the theory that Lp(a) causes cardiovascular disease. The European Atherosclerosis Society currently recommends that patients with a moderate or high risk of cardiovascular disease have their lipoprotein(a) levels checked. Any patient with one of the following risk factors should be screened, If the level is elevated, treatment should be initiated with a goal of bringing the level below 50 mg/dL.

Systemic lupus erythematosus

lupusSLEsystemic lupus
Atherosclerosis also occurs more often and advances more rapidly than in the general population. SLE can cause pleuritic pain as well as inflammation of the pleurae known as pleurisy, which can rarely give rise to shrinking lung syndrome involving a reduced lung volume. Other associated lung conditions include pneumonitis, chronic diffuse interstitial lung disease, pulmonary hypertension, pulmonary emboli, and pulmonary hemorrhage. Painless passage of blood or protein in the urine may often be the only presenting sign of kidney involvement. Acute or chronic renal impairment may develop with lupus nephritis, leading to acute or end-stage kidney failure.

Doppler ultrasonography

Dopplerduplex ultrasonographyDoppler ultrasound
Applying spectral Doppler to the renal artery and selected interlobular arteries, peak systolic velocities, resistive index and acceleration curves can be estimated (Figure 4), e.g., peak systolic velocity of the renal artery above 180 cm/s is a predictor of renal artery stenosis of more than 60%, and the resistive index, which is a calculated from peak systolic and end systolic velocity, above 0.70 is indicative of abnormal renovascular resistance. Doppler echocardiography is the use of Doppler ultrasonography to examine the heart.

Minimally invasive procedures

minimally invasiveminimally invasive surgeryinvasive
Some examples of open surgery used, are for herniated disc commonly called a "slipped disc", and most types of cardiac surgery and neurosurgery. • Anesthesia • ASA physical status classification system • Medicine • Natural orifice translumenal endoscopic surgery • Traumatology • Biomedical engineering • Molecular Imaging • Venipuncture * Minimally invasive heart surgery. Medical Encyclopedia, MedlinePlus.

Hyperlipidemia

hyperlipoproteinemiahyperlipidaemiahyperlipemia
The elevated triglyceride levels (>5 mmol/l) are generally due to an increase in very low density lipoprotein (VLDL), a class of lipoprotein prone to cause atherosclerosis. Types Both conditions are treated with fibrate drugs, which act on the peroxisome proliferator-activated receptors (PPARs), specifically PPARα, to decrease free fatty acid production. Statin drugs, especially the synthetic statins (atorvastatin and rosuvastatin) can decrease LDL levels by increasing hepatic reuptake of LDL due to increased LDL-receptor expression.

Common carotid artery

carotidcarotid arteriescarotid artery
Carotid stenosis may occur in patients with atherosclerosis. The intima-media thickness of the carotid artery wall is a marker of subclinical atherosclerosis, it increases with age and with long-term exposure to particulate air pollution. * Blood flow numerical simulations in stenosed carotid Internal relations of organs present inside the carotid sheath. two external relations of carotid sheath. Head and neck anatomy. Carotid sheath. Carotid sinus. Carotid body. Carotid Doppler machine. Carotidynia.

Cardiothoracic surgery

cardiothoracic surgeoncardiac surgeonthoracic surgery
During the 1990s, the Canadian cardiac surgery training programs changed to six-year "direct-entry" programs following medical school. The direct-entry format provides residents with experience related to cardiac surgery they would not receive in a general surgery program (e.g. echocardiography, coronary care unit, cardiac pathology, etc.). Typically, this is followed by a fellowship in either Adult Cardiac Surgery, Heart Failure/Transplant, Minimally Invasive Cardiac Surgery, Aortic Surgery, Thoracic Surgery, Pediatric Cardiac Surgery or Cardiac ICU.

Metabolic syndrome

syndrome XCardio metabolic riskinsulin resistance
In 1947, Vague observed that upper body obesity appeared to predispose to diabetes, atherosclerosis, gout and calculi. In the late 1950's, the term metabolic syndrome was first used. In 1967, Avogadro, Crepaldi and coworkers described six moderately obese patients with diabetes, hypercholesterolemia, and marked hypertriglyceridemia, all of which improved when the patients were put on a hypocaloric, low-carbohydrate diet. In 1977, Haller used the term "metabolic syndrome" for associations of obesity, diabetes mellitus, hyperlipoproteinemia, hyperuricemia, and hepatic steatosis when describing the additive effects of risk factors on atherosclerosis.

Acute decompensated heart failure

acute heart failureacute cardiac failureacute decompensated congestive heart failure
Heart failure due to acute aortic regurgitation is a surgical emergency associated with high mortality. Heart failure may occur after rupture of ventricular aneurysm. These can form after myocardial infarction. If it ruptures on the free wall, it will cause cardiac tamponade. If it ruptures on the intraventricular septum, it can create a ventricular septal defect. Other causes of cardiac tamponade may also require surgical intervention, although emergent treatment at the bedside may be adequate.

Mitral valve repair

mitral-valve heart surgeryrepair a damaged valvesurgically
Aortic valve repair. Cardiac surgery. Mitral valve insufficiency.

Arterial switch operation

arterial switchJatene operation
If the aortic commissure has not previously been marked, the excised coronary arteries will be used to determine the implantation position of the aorta. The aorta is then transplanted onto the pulmonary root, using either absorbable or permanent continuous suture. The aortic clamp is temporarily removed while small sections of the neo-aorta are cut away to accommodate the coronary ostia, and a continuous absorbable suture is then used to anastomose each coronary "button" into the prepared space.

Nicorandil

This can be caused by diseases such as atherosclerosis, coronary artery disease and aortic stenosis. Angina commonly arises from vasospasm of the coronary arteries. There are multiple mechanisms causing the increased smooth muscle contraction involved in coronary vasospasm, including increased Rho-kinase activity. Increased levels of Rho-kinase inhibit myosin phosphatase activity, leading to increased calcium sensitivity and hypercontraction. Rho-kinase also decreases nitric oxide synthase activity, which reduces nitric oxide concentrations. Lower levels of nitric oxide are present in spastic coronary arteries.

Embolic stroke of undetermined source

Aortic arch atherosclerosis is believed to be a specific cause of ESUS, particularly with plaques >4 mm diameter. Further cardiopathies: the risk of ischaemic stroke is increased by supraventricular tachycardias. This also applies to patients with elevated NT-proBNP levels and patients with atrial enlargement in cardiac ultrasound. Other causes: Arterial dissections, infection-related vasculopathies (esp. Varicella zoster virus), thrombophilia, cancer-related thrombosis, migraine, Fabry disease and other genetic, autoimmune or rheumatic causes. 58% were male. the mean age was 65 years. the average annualized rate of stroke recurrence was 4.5%. mean NIHSS at stroke onset was 5.

Fractional flow reserve

Fractional flow reserve (FFR) is a technique used in coronary catheterization to measure pressure differences across a coronary artery stenosis (narrowing, usually due to atherosclerosis) to determine the likelihood that the stenosis impedes oxygen delivery to the heart muscle (myocardial ischemia). FFR is a novel and potentially clinically useful mathematical model for estimation of stenotic coronary artery atherosclerosis. Reliability/collaborative (easily reproducible) measurement between competing laboratories in measuring this essential metric remains muddled in a proprietary race to claim cardiac mathematics dedicated to risk in ischemic cardiac disease.

Elizabeth Nabel

Elizabeth
These basic studies were instrumental in designing device therapies, in combination with genes or drugs, to treat the vascular disease restenosis. Nabel’s research focused on the molecular genetics of vascular diseases. She conducted clinical studies to understand the contribution of genetic factors to proliferative and inflammatory diseases in blood vessels, including common diseases like atherosclerosis and the rare, premature aging in Hutchinson Gilford progeria syndrome. Nabel delineated the mechanisms by which cell cycle and growth factor proteins regulate the proliferation of vascular cells in blood vessels, a process important for the development of atherosclerosis and restenosis.

Vein graft failure

chronic graft occlusionGraft failurevein graft disease
Over time continued SMC migration and proliferation cause extracellular matrix deposition and fibrotic change that lead to development of intimal hyperplasia, which results in luminal loss that makes the graft more susceptible to atherosclerosis. Progressive atherosclerosis is the primarily cause of late vein graft failure. Vein graft atherosclerotic lesions are more diffuse and concentric, yet less calcified, compared to native atherosclerotic lesions, and are more susceptible to thrombosis formation and rupture. Statins and antiplatelets such as aspirin, are the only medications recommended by the ESC guidelines and the ACC/AHA Task Force guidelines for the prevention of VGF.

Paresthesia

paraesthesiatinglingpins and needles
Spinal stenosis. Stinging nettles. Syringomyelia. Transverse myelitis. Vitamin B 5 deficiency. Vitamin B 12 deficiency. Withdrawal from certain selective serotonin reuptake inhibitors (or serotonin-specific reuptake inhibitors) (SSRIs), such as paroxetine or serotonin-norepinephrine reuptake inhibitors (SNRIs) such as venlafaxine.

Cerebral infarction

cerebral infarctbrain infarctionblockage of a blood vessel in the brain
In a systematic review of six uncontrolled, single-center trials, involving a total of 300 patients, of intra-cranial stenting in symptomatic intracranial arterial stenosis, the rate of technical success (reduction to stenosis of

List of circulatory system conditions

Aortic insufficiency. Mitral stenosis. Tricuspid valve stenosis. Pulmonary valve stenosis. Mitral insufficiency/regurgitation. Tricuspid insufficiency/regurgitation. Pulmonary insufficiency/regurgitation.

Atherectomy

rotablator
Atherectomy is a minimally invasive endovascular surgery technique for removing atherosclerosis from blood vessels within the body. It is an alternative to angioplasty for the treatment of peripheral artery disease, but the studies that exist are not adequate to determine if it is superior to angioplasty. It has also been used to treat coronary artery disease, albeit ineffectively. Atherectomy is used to treat narrowing in arteries caused by peripheral artery disease. Unlike angioplasty and stents, which push plaque into the vessel wall, atherectomy cuts plaque from the wall of the artery.