1
|
Kvitka D, Pauza DH. Pathways and morphologic pattern of blood supply of epicardial ganglionated nerve plexus. Ann Anat 2024; 252:152201. [PMID: 38128744 DOI: 10.1016/j.aanat.2023.152201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 11/29/2023] [Accepted: 12/14/2023] [Indexed: 12/23/2023]
Abstract
Detailed cardiac neuroanatomy is critical for understanding cardiac function and its pathology. However, there remains a significant gap in knowledge regarding the blood supply to the intrinsic cardiac ganglionated plexus (GP). This study addresses this by mapping the routes and morphological pattern of blood supply to the epicardial GP in a large-animal pig model (Sus scrofa domesticus). Twenty-five domestic pigs were used in the study. We demonstrate that the epicardial ganglionated nerves receive blood from both coronary and extra-cardiac arteries. The coronary arterial branches supply blood to all five subplexuses constituting the epicardial GP. In contrast, the branches of extra-cardiac arteries supply blood to target heart areas: 1) the venous part of the heart hilum on the left atrium, 2) the walls of the sinuses of the right cranial (superior cava) and 3) pulmonary veins. Uniformly, epicardial nerves and ganglia are supplied with blood via a sole epineurial arteriole which, in most cases, is the fifth/sixth-order branch of the coronary arteries. The extra-cardiac arteries supplying blood to the epicardial GP accompanied the mediastinal nerves entering the epicardium within the limits of the heart hilum. Together, the dual and triple blood supply of the epicardial nerves and ganglia suggests a protective role from an ischemic event and/or ischemic heart disease. STUCTURED ABSTRACT: This study details the anatomy of the blood supply of epicardial ganglionated nerve plexus, from which nerve fibres extend to the myocardium, heart conduction system, coronary vessels, and endocardium, in the most popular animal model of experimental cardiology and cardiac surgery - the domestic pig. Our observations demonstrate that the epicardial nerves and ganglia receive blood from both coronary and extra-cardiac arteries. The multi-source blood supply to the cardiac nerves and ganglia may offer protection against myocardial infarction ant other ischemic heart disorders.
Collapse
Affiliation(s)
- Dmitrij Kvitka
- Institute of Anatomy, Faculty of Medicine, Lithuanian University of Health Sciences, A. Mickeviciaus Street 9, Kaunas LT 44307, Lithuania.
| | - Dainius H Pauza
- Institute of Anatomy, Faculty of Medicine, Lithuanian University of Health Sciences, A. Mickeviciaus Street 9, Kaunas LT 44307, Lithuania.
| |
Collapse
|
2
|
Chen Y, Ge Y, Chao T, Huan N, Liu W, Chu G, Wang C. Refractory angina pectoris: a 20-year (2003-2022) bibliometric analysis. Front Cardiovasc Med 2023; 10:1228201. [PMID: 37692051 PMCID: PMC10484221 DOI: 10.3389/fcvm.2023.1228201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 08/10/2023] [Indexed: 09/12/2023] Open
Abstract
Background The increasing number of patients with refractory angina pectoris, combined with the aging population and improved survival rates among coronary heart disease patients, presents a significant challenge in contemporary cardiovascular medicine. The treatment of refractory angina has been an ongoing area of exploration, yet a comprehensive analysis of the existing literature on this topic is currently lacking. Therefore, this study aims to provide the first bibliometric analysis of publications related to refractory angina. Methods A systematic search was conducted in the Web of Science database to identify articles related to refractory angina published between 2003 and 2022. The inclusion criteria were limited to articles and reviews written in English. CiteSpace software was utilized to conduct a collaborative network analysis of countries/regions, institutions and authors, co-occurrence analysis of keywords, and co-citation analysis of authors and references. Results A total of 1,386 publications were identified, with an annual publication volume exhibiting fluctuation over time. American and European countries and institutions demonstrated a leading position in terms of research output. Henry TD emerged as the most prolific researcher in the field, while Mannheimer C received the highest number of citations. The primary research hotspot within this field focused on the treatment of refractory angina, with recent emphasis on emerging treatments such as stem cell therapy and the coronary sinus reducer. A significant number of clinical trials have been conducted, with a continuous focus on patient benefits, quality of life, and survival prognosis. Conclusion Significant progress has been made in the field of refractory angina pectoris in recent years. Novel treatment methods, including spinal cord stimulation, enhanced external counterpulsation, stem cell therapy, and the coronary sinus reducer, hold promising therapeutic prospects. However, further high-quality evidence-based research is essential to support these emerging interventions. Additionally, the development of comprehensive evidence-based guidelines for refractory angina treatment is crucial. Such guidelines would provide clinicians with a framework to navigate the complexities of treatment choices and optimize patient care in this challenging condition.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Chenglong Wang
- Center for Cardiovascular Disease, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| |
Collapse
|
5
|
Cruz YLDL, Quintero-Fleites YF, Abi-Rezk MN. A Simplest Method to Enhance the Benefits of Internal Thoracic Artery Distal Occlusion. Braz J Cardiovasc Surg 2021; 36:416-419. [PMID: 33355807 PMCID: PMC8357378 DOI: 10.21470/1678-9741-2020-0308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A common element of internal thoracic artery harvesting techniques is a distal vascular clamp placement at the end of the procedure, not only to avoid bleeding, but also to increase the internal hydrostatic pressure, diameter and flow. The logic indicates that the placement of this clamp at the beginning of the dissection will allow the artery to benefit earlier from these advantages. After more than five years of experience, we present a modification in the classical technique of skeletonized harvesting of the internal thoracic artery, consisting of artery distal occlusion at the beginning of the procedure. Some of its advantages are discussed.
Collapse
Affiliation(s)
- Yoandy López-de la Cruz
- Department of Cardiovascular Surgery, Santa Clara Cardiac Center, Santa Clara, Villa Clara, Cuba
| | | | - Manuel Nafeh Abi-Rezk
- Department of Cardiovascular Surgery, Hermanos Ameijeiras Hospital, Havana Center, Havana, Cuba
| |
Collapse
|
9
|
Tarantino N, Della Rocca DG, Faggioni M, Zhang XD, Mohanty S, Anannab A, Canpolat U, Ayhan H, Bassiouny M, Sahore A, Aytemir K, Sarcon A, Forleo GB, Lavalle C, Horton RP, Trivedi C, Al-Ahmad A, Romero J, Burkhardt DJ, Gallinghouse JG, Di Biase L, Natale A. Epicardial Ablation Complications. Card Electrophysiol Clin 2020; 12:409-418. [PMID: 32771194 DOI: 10.1016/j.ccep.2020.06.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The percutaneous epicardial approach has become an adjunctive tool for electrophysiologists to treat disparate cardiac arrhythmias, including accessory pathways, atrial tachycardia, and particularly ventricular tachycardia. This novel technique prompted a strong impulse to perform epicardial access as an alternative strategy for pacing and defibrillation, left atrial appendage exclusion, heart failure with preserved ejection fraction, and genetically engineered tissue delivery. However, because of the incremental risk of major complications compared with stand-alone endocardial ablation, it is still practiced in a limited number of highly experienced centers across the world.
Collapse
Affiliation(s)
- Nicola Tarantino
- Arrhythmia Services, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, 110 East 210th Street, Bronx, NY 10467, USA
| | - Domenico G Della Rocca
- Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 919 East 32nd Street, Austin, TX 78705, USA.
| | - Michela Faggioni
- Icahn School of Medicine at Mount Sinai, New York, NY, USA; James J Peters Veterans Affairs Medical Center, Bronx, NY, USA
| | - Xiao-Dong Zhang
- Arrhythmia Services, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, 110 East 210th Street, Bronx, NY 10467, USA
| | - Sanghamitra Mohanty
- Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 919 East 32nd Street, Austin, TX 78705, USA
| | - Alisara Anannab
- Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 919 East 32nd Street, Austin, TX 78705, USA; Department of Cardiovascular Intervention, Central Chest Institute of Thailand, Nonthaburi, Thailand
| | - Ugur Canpolat
- Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 919 East 32nd Street, Austin, TX 78705, USA; Department of Cardiology, Hacettepe University Faculty of Medicine, Sıhhiye, Ankara 06100, Turkey
| | - Huseyin Ayhan
- Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 919 East 32nd Street, Austin, TX 78705, USA; Department of Cardiology, Faculty of Medicine, Yıldırım Beyazıt University, Ankara, Turkey
| | - Mohamed Bassiouny
- Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 919 East 32nd Street, Austin, TX 78705, USA
| | - Anu Sahore
- Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 919 East 32nd Street, Austin, TX 78705, USA
| | - Kudret Aytemir
- Department of Cardiology, Hacettepe University Faculty of Medicine, Sıhhiye, Ankara 06100, Turkey
| | - Annahita Sarcon
- Division of Electrophysiology, University of California San Francisco, San Francisco, CA, USA
| | - Giovanni B Forleo
- Department of Cardiology, Azienda Ospedaliera-Universitaria "Luigi Sacco", Milano, Italy
| | - Carlo Lavalle
- Department of Cardiology, Policlinico Universitario Umberto I, Policlinico Street, Roma 155-00161, Italy
| | - Rodney P Horton
- Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 919 East 32nd Street, Austin, TX 78705, USA
| | - Chintan Trivedi
- Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 919 East 32nd Street, Austin, TX 78705, USA
| | - Amin Al-Ahmad
- Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 919 East 32nd Street, Austin, TX 78705, USA
| | - Jorge Romero
- Arrhythmia Services, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, 110 East 210th Street, Bronx, NY 10467, USA
| | - David J Burkhardt
- Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 919 East 32nd Street, Austin, TX 78705, USA
| | - Joseph G Gallinghouse
- Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 919 East 32nd Street, Austin, TX 78705, USA
| | - Luigi Di Biase
- Arrhythmia Services, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, 110 East 210th Street, Bronx, NY 10467, USA; Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 919 East 32nd Street, Austin, TX 78705, USA; Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Andrea Natale
- Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 919 East 32nd Street, Austin, TX 78705, USA; Interventional Electrophysiology, Scripps Clinic, La Jolla, CA, USA; Department of Cardiology, MetroHealth Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA; Division of Cardiology, Stanford University, Stanford, CA, USA
| |
Collapse
|