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3 results

  • Chapter 10 - Endometrial and subendometrial blood flow and pregnancy rate of in vitro fertilization treatment

  • from Section 4: - Deep placentation
  • Edited by Robert Pijnenborg, Ivo Brosens, Roberto Romero
  • Book:
    Placental Bed Disorders
    Published online:
    06 July 2010
    Print publication:
    03 June 2010, pp 85-96

  • Summary

    The origin of placental septa and the orifices of spiral arteries have been the subject of great controversy. The anatomy of the venous drainage has also been the subject of much discussion. The intrusive cells in the lumen as described by C. Friedlander were intensively studied by J. D. Boyd and W. J. Hamilton using their large collection of uterine specimens with the placenta in situ. The delivered placenta and fetal membranes were for many years the commonest method of obtaining material for the study of spiral artery pathology, and there were large discrepancies between the findings in this material. The method of placental bed biopsy produced useful material, but nevertheless was criticized by Hamilton and Boyd. The spiral artery anatomy as well as the vascular pathology were only revealed after studying uteri with in situ placentae pregnancy that compromise both maternal and fetal health.

  • Chapter 12 - Cerebral morbidity in adult cardiac surgery

  • Sunit Ghosh, Papworth Hospital, Cambridge, Florian Falter, Papworth Hospital, Cambridge, David J. Cook
  • Book:
    Cardiopulmonary Bypass
    Published online:
    15 December 2009
    Print publication:
    17 September 2009, pp 153-166

  • Summary

    The management of cardiopulmonary bypass (CPB) involves a multi-disciplinary approach with coordinated actions and precise communication being crucial for a safe, and effective outcome. Before each case the conduct of CPB should be planned. All members of the team need to be aware of the intended method for cannulation, the systemic and myocardial temperatures required during surgery, the technique of myocardial protection to be used, whether deep hypothermic circulatory arrest (DHCA) will be required and the most appropriate sites for monitoring during CPB. The arterial cannula is the narrowest part of the CPB circuit with resultant high resistance, pressure gradients, high velocity jets and turbulence. Venous blood inflow to the CPB circuit is usually achieved by gravity drainage, using the siphon effect, but earlier CPB circuits used suction to aid venous drainage; in pediatric cases, drainage is often aided by applying suction to the venous lines.

  • Anatomical variations in the pattern of the right hepatic veins: possibilities for type classification

  • LUCIO DE CECCHIS, MARIJA HRIBERNIK, DEAN RAVNIK, ELDAR M. GADŽIJEV
  • Journal:
    The Journal of Anatomy / Volume 197 / Issue 3 / October 2000
    Published online by Cambridge University Press:
    23 November 2000, pp. 487-493
    Print publication:
    October 2000

  • A morphological study of the right hepatic veins (RHVv) was conducted based on the shape and the confluence pattern of the superior right hepatic vein (SRHV) and the presence of accessory right hepatic veins. The study was performed in 110 undamaged, randomly selected, cadaveric human livers prepared using the corrosion cast methodology. The principles for classifying the RHVv into types were as follows: the length of the vein trunk, the confluence of 2 or 3 main tributaries that form a trunk, and the accessory right hepatic veins that modify the venous drainage of the right side of the liver. Four types of SRHV were identified. Type 1 (20%), type 2 (40%) and type 3 (25%) were the most common, while type 4 (15%) was linked to the accessory right hepatic veins in cases where they drain a surgically important part of the liver. Accessory right hepatic veins were found in a total of 31 casts (28%). The hepatocaval confluence was studied and the tributary-free part of the SRHV trunk before it entered the inferior vena cava was measured. The tributary-free part of the SRHV was longer than 1 cm in 77% of the casts. Anastomoses between the terminal tributaries of the veins involved in the drainage of the right side of the liver were also investigated.