Chapters authored
Osteonecrosis and Hip Development Disorder
Blood vessel branching of the proximal femur by its scheme differs from all other major joints. This scheme changes during the individual's development, dynamically depending on age. Namely, the caliber, blood flow rate, and dominance of certain arteries from the entire network of blood vessels that participate in the vascular supply of the hip are not equally expressed in all stages of development. In each successive stage, blood supply is dominated by a different artery that, after a certain period of time, shifts its major role to another artery. Anastomoses between individual arteries are not constant in all stages of development, and they represent a great importance for compensatory mechanisms. The disturbance of local arterial blood vessels, at a time when they dominate the blood supply and affect the quality of hip development and maturation, leads to reduced perfusion, and consequently, to the lack of development, ossification, and possible osteonecrosis.
Part of the book: Osteonecrosis
Perioperative Ultrasound Flow Evaluation in Grafts and Native Vessel during CABG
New blood in the vascular bed after coronary artery bypass grafting (CABG) may represent a turning point between ischemia and normal tissue nutrition. Quality control during CABG preoperatively is essential because errors lead to immediate consequences. With an understanding of hemodynamics, we can now search for less invasive tools for quantification of coronary blood flow changes over time after CABG. Ultrasound is becoming a key player for that purpose and we will present its application. Perioperatively, quality control in CABG should include target selection of native coronary arteries, graft selection, anastomose checking, and long-term flow follow-up. Because some grafts are unreachable for ultrasound evaluation, we should examine both arterial venous sides of coronary circulation. We will present the use of classic, epicardial ultrasonography and TTFM probes by looking for stenoses and competitive flow. We will present our research for quantification of new blood in coronary vessels after CABG. There we found constant increase in flow over the early postoperative period (20% per graft). By increasing graft number, coronary flow increases first linearly and then stepwise. Measured data and trends can be used in ambulatory monitoring and screening of ischemic complications after CABG.
Part of the book: Coronary Artery Bypass Surgery