This study was undertaken to verify efficacy of the arch-first technique in the light of its learning curve. From April 2002 to September 2005, 10 consecutive elective cases of total arch replacement were retrospectively examined. The learning curve of the arch-first technique was constructed using cumulative sum analysis. There were no operative deaths. The mean deep hypothermic circulatory arrest time was 28.4 +/- 13.7 min, the lower body ischemic time was 91.3 +/- 35.1 min, aortic cross clamp time was 133.2 +/- 18.1 min, cardiopulmonary bypass time was 198.8 +/- 21.5 min, and operation time was 383 +/- 24 min. The durations of deep hypothermic circulatory arrest, bypass, and operation were under the 90% lower alarm line in all 10 cases. The lower body ischemic time and cardiac arrest time were between the 80% upper and lower alert lines. Cumulative sum analysis of total arch replacement using the arch-first technique showed satisfactory rates of improvement in reconstruction of the 3 arch vessels, cardiopulmonary bypass time, and overall mortality.
Time-resolved fluorescence measurements of malachite green dye molecules doped in onion cells were carried out. The fluorescence decay time was dependent on the individual cell and on the position of the dye in a cell, which reflect the microscopic dynamics of each bound site. Upon cooling, the decay time increased and this increase was accelerated at around the freezing point of the onion cell.
A 59-year-old woman has presented symptoms of fatigue since January 1996. Atypical coarctation due to aortitis syndrome had been diagnosed 8 years earlier. Her upper-limb blood pressure was 200mmHgand antihypertensive drugs were administered. An aortogram showed severe stenoses of the aorta at the level of the diaphragm and renal artery.A computed tomogram showed extensive calcification of the aorta below the origin of the left subclavian artery. She underwent a bypass operation with a 16-mm-diameter prosthetic graft from the ascending aorta to the infrarenal abdominal aorta.She has progressed well after the bypass and her upper-limb blood pressure is almost normal.
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