Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

Distal aortic pressure during coarctation operation.

K G Watterson1, J P Dhasmana, J W O'Higgins

  • 1Department of Cardiac Surgery, Bristol Royal Hospital for Sick Children, England.

The Annals of Thoracic Surgery
|June 1, 1990
PubMed
Summary

Continuous monitoring of distal aortic pressure (DAP) during coarctation of the aorta repair in children helped surgeons adjust clamps and medications. This improved DAP, reducing the need for hypotensive agents and supporting better surgical outcomes.

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Management of Pulmonary Metastases in Osteogenic Sarcoma.

Bristol medico-chirurgical journal (1963)·2017
Same author

Outcome after extended arch repair for aortic coarctation.

Heart (British Cardiac Society)·2005
Same author

Surgical and transcatheter (Amplatzer) closure of atrial septal defects: a prospective comparison of results and cost.

Heart (British Cardiac Society)·2002
Same author

Distribution of hepatic venous blood in the total cavo pulmonary connection: an in vitro study into the effects of connection geometry.

Journal of biomechanical engineering·2002
Same author

A region of homozygosity within 22q11.2 associated with congenital heart disease: recessive DiGeorge/velocardiofacial syndrome?

Journal of medical genetics·2001
Same author

Assessment of mortality rates for congenital heart defects and surgeons' performance.

The Annals of thoracic surgery·2001

Area of Science:

  • Cardiovascular Surgery
  • Pediatric Cardiology
  • Anesthesiology

Background:

  • Coarctation of the aorta repair requires careful hemodynamic management.
  • Distal aortic pressure (DAP) is a critical indicator of distal perfusion during aortic cross-clamping.
  • Optimizing DAP is essential for preventing intraoperative complications in pediatric aortic surgery.

Purpose of the Study:

  • To evaluate the impact of continuous distal aortic pressure (DAP) monitoring on surgical management during coarctation of the aorta repair in children.
  • To assess the effectiveness of clamp adjustments and hypotensive agent use in achieving adequate DAP.
  • To determine if DAP monitoring guides necessary intraoperative interventions.

Main Methods:

  • Continuous monitoring of mean distal aortic pressure (DAP) in 67 children undergoing coarctation of the aorta repair.

Related Experiment Videos

  • Establishing an adequate DAP threshold of 45 mm Hg for proceeding with the operation.
  • Implementing adjustments to proximal/distal clamp positions and hypotensive agents when DAP was below the threshold.

    • Main Results:

    • In 25 patients with initial DAP < 45 mm Hg, adjustments increased DAP to 50.6 mm Hg (p < 0.001).
    • Adjustments led to increased left subclavian artery patency (60% vs 28%, p < 0.02) and reduced intercostal artery clamping.
    • Continuous DAP monitoring identified the need for clamp/medication adjustments, improving distal perfusion and reducing hypotensive agent use.

    Conclusions:

    • Continuous DAP monitoring is a valuable tool for guiding operative management during coarctation of the aorta repair.
    • Adjusting clamp positions and minimizing hypotensive agents can effectively improve DAP.
    • Achieving and maintaining adequate DAP is crucial for successful surgical outcomes in pediatric aortic arch reconstruction.