Open Shunt Research Articles

Minimally invasive management of a spinal arachnoid cyst with ultrasound-assisted catheter placement: illustrative case.

Spinal arachnoid cysts are cerebrospinal fluid-filled sacs that are frequently located within the thoracic spine and can lead to symptoms due to direct compression of the thoracic spinal cord. These lesions are typically treated with laminectomy and fenestration of the cyst, with or without shunting. However, with recurrence, treatment is often more complex and sometimes requires re-exposure and fenestration or shunting. Here, the authors describe a 57-year-old female with a thoracic intradural arachnoid cyst that recurred despite extensive and initially successful fenestration. Given the failure of fenestration, the authors instead attempted to place a cystoperitoneal shunt. Given how extensive her laminectomy was, the authors elected to perform the procedure under ultrasonic guidance to avoid the large incision required for open shunt placement. The procedure was successful, with gradual improvement in the size of the arachnoid cyst as well as symptomatic improvement. Here, the authors present a unique minimally invasive technique to treat recurrent spinal arachnoid cysts. They successfully demonstrated the feasibility and safety of this approach in shunting the cyst while avoiding the extensive re-exposure often required in such complex cases. https://thejns.org/doi/10.3171/CASE24461.

Assessment of the CHIVA and the ASVAL Method.

In this article, the CHIVA and ASVAL methods are assessed from the hemodynamic point of view. The CHIVA method comprises complicated, unusual terminology and new perceptions, such as closed and open shunts, fractionation of the hydrostatic pressure, subdivision of the venous network. The principal part of the CHIVA theory is the drainage of venous blood from the thigh saphenous system into the deep lower leg veins through the preserved saphenous trunk after high ligation at the saphenofemoral junction, which is considered as a beneficial, physiological phenomenon. In reality, this is recurrent reflux producing ambulatory venous hypertension. The main impact of the CHIVA procedure is the elimination of the saphenous reflux by high ligation at the saphenofemoral junction; thus it can be presumed that the CHIVA procedure yields similar results like the crossectomy. The ASVAL procedure is de facto the modification of the old Madelung method that was the prevalent surgical procedure before the Trendelenburg era in the 19th century. The results after ASVAL were not checked by plethysmography; there is a good case to suppose that the results after the ASVAL method would comply with those after sclerotherapy.

Optimal Planning of Active Distribution Network Based on Soft Open Point and Shunt Capacitors

As the penetration of distributed wind power in the distribution network continues to increase, the uncertainty of its output has a serious impact on the stable operation of the distribution network. It is difficult to meet the voltage regulation requirements when the wind power fluctuates frequently only by relying on shunt capacitors. Therefore, a coordinated optimization planning method based on soft open point (SOP) and shunt capacitors is proposed. Firstly, the bidirectional generative adversarial network (BIGAN) is used to characterize the uncertainty of wind power output and generate typical scenarios of wind power output. Secondly, a multi-objective optimization planning model of SOP and shunt capacitors is proposed based on the scene analysis method; Then, a solution strategy based on the improved elitist non-dominated sorting genetic algorithm (NSGA-II) is proposed. Finally, the proposed planning model and solution are verified and analyzed in the improved IEEE 33-bus system.

Laparoscopic vs. open shunt placement: a two-year single centre experience

Laparoscopic vs. open shunt placement: a two-year single centre experience

Balloon venoplasty as primary modality of treatment in children with Budd–Chiari syndrome

IntroductionBudd–Chiari syndrome (BCS) is a rare condition affecting children. It is characterized by occlusion of venous outflow from liver at the level of hepatic veins (HV) or inferior vena cava (IVC). The management of BCS in children revolves around forming new collaterals for venous outflow or by elimination of blockage in the venous outflow tracts. These can be achieved by balloon venoplasty (BV), transjugular intrahepatic portosystemic shunting (TIPSS) or open shunt surgeries. AimThe aim of this study is to evaluate the management of BCS in children with balloon venoplasty as primary modality of treatment. Materials and methodsThis is a retrospective study which includes children diagnosed with BCS managed by balloon venoplasty by a single surgeon at a single institute. Once confirmed, the child was posted for balloon venoplasty and liver biopsy. When venoplasty was successful, child was subsequently heparinized and dose titrated. Routine follow up was mandated and dose adjustments were continued during follow up. In case of unsuccessful venoplasty, depending on the liver biopsy report, shunt procedure or liver transplantation is offered to patients. An algorithm was then designed for management of BCS in children. ResultsA total of 35 children who underwent evaluation of symptoms associated with Budd–Chiari syndrome were included in the study. Of all the children, 14 are alive and symptom free, 9 are deceased and 12 lost to follow up. Hepatic vein was the most common site of obstruction (85%), followed by both IVC and HV (15%). Overall, in 35 children, 26 had a successful balloon venoplasty, in 3 venoplasty was not done (2 spontaneous resolution and 1 died awaiting), in 6 it was unsuccessful (3 technical failures: 1 underwent TIPSS and 2 lost to follow up, 3 clinical failures: portocaval shunt for failed venoplasty). ConclusionBudd–Chiari syndrome is a rare condition affecting children. Balloon venoplasty as a primary modality of treatment for BCS is a promising option for management in children. Early and aggressive use of radiological intervention can help achieve recanalization in children. Type of studyClinical research paper. Level of evidenceLevel IV.

A case report of endovascular treatment of patient with infrareneral aorta occlusion

Diseases of peripheral arteries are considered to be one of the main reasons for hospitalization of patients in specialized departments of vascular surgery. Patients with atherosclerotic lesions of the lower limb vessels, especially with prolonged occlusions of the aorto-iliac arterial segments, usually undergo open shunt interventions. The aim of the case is to demonstrate successful endovascular treatment of prolonged occlusion of the aorta and iliac arteries. A 54-year-old patient complained of pain in both legs while walking for more than 100 m. The history of the disease was at least 5 years. The examination revealed occlusion of the abdominal aorta at the level of the lower third, common iliac arteries. Given the anatomical features of atherosclerotic lesion, the presence of a residual aortic lumen that could be used as a guiding cult for recanalization of the occluded aorto-iliac segment and a pronounced comorbid background, it was decided to perform endovascular surgery. Stenting of the infrarenal aorta, right and left common iliac arteries yielded good angiographic and clinical results. The case report demonstrates high efficiency of endovascular treatment of the Lerish syndrome and thus reducing the risk of perioperative complications, the length of the patient's stay in the hospital. Such complex and volumetric operations can be performed only with the appropriate equipment, the presence of a hybrid operating room and coordinated work of the “vascular” team the members of which have complete mastery over open and endovascular surgery. Received 14 May 2018. Revised 18 July 2018. Accepted 30 July 2018. Informed consent: The patient’s informed consent to use his records for medical purposes is obtained. Funding: The study had no sponsorship. Conflict of interest: The authors declare no conflict of interest. ORCID IDB.S. Artyushin, https://orcid.org/0000-0003-2734-1641N.N. Zherdev, https://orcid.org/0000-0003-2500-2320

Wideband and Compact Wilkinson Power Divider Utilizing Series Delta-Stub and Folded Stepped-Impedance Transmission Line

In this paper, a Wilkinson power divider is modified using four-series delta-stub and folded steppedimpedance transmission line (FSITL) in order to achieve a reduced circuit size of 84% and fractional bandwidth of 116%. Series delta-stubs are used instead of open shunt stubs to obtain an optimum shifting frequency and wider bandwidth. Folded stepped-impedance transmission line (FSITL) is used to achieve reduced circuit size. The proposed power divider is fabricated using RT/duroid 5880 substrate with thickness of 0.38 mm. The dimension of the power divider is 13 mm × 6.5 mm. The proposed power divider has typical power division of -3 dB and insertion loss less than -1 dB, better than -13 dB of isolation, less than -10 dB return loss and phase imbalances less than 2° from 1.5 to 3 GHz. Both simulation and measurement results show a good agreement.

A compact triple-band microwave filter using symmetrically placed stub-loaded open-loop resonators

ABSTRACTIn this paper, symmetrically placed stub-loaded open-loop resonators with magnetic coupling are used to design compact triple-band band pass filter (BPF) with improved insertion loss at passbands. Three bands of the proposed triple-band stub-loaded open-loop resonator filter are achieved by tuning length and position of open shunt stub which is connected with open-loop resonators. A lossless transmission line model is used to calculate the resonator properties. Theoretical design procedures are verified with an example of triple-band BPF design. Three passbands at 2.85, 5.9 and 8.15 GHz are achieved with reduced insertion loss. The insertion loss measured at first, second and third passbands are 0.47, 0.77 and 1.41 dB, respectively. First passband 2.76–2.9 GHz is used for the airport surveillance radar system and weather monitoring system. Second frequency band 5.82–6.16 GHz is used for the intelligent transportation system and third band 8.1–8.7 GHz is useful for satellite communication.

Serial Spot Urine Sodium as a Marker for Patency of Splenorenal Shunt

IntroductionIn portal hypertension patient, there will be splanchnic vasodilatation resulting in decreased effective arterial volume hence activation of antinaturetic factors causing sodium retention with impaired free water excretion. A patent shunt should reverse this sodium imbalance to normal. Hence, serial spot urine sodium is used as surrogate marker for shunt patency.BackgroundAn open shunt can frequently be estimated clinically by measuring serial urinary sodium concentrations. If the concentration is higher than 10 mg/dL, the shunt is almost certainly open. Our prospective study is designed to verify how best serial spot sodium predicts the patency of the shunt and its clinical relevance.Materials and Methods9 portal hypertensive patients with CHILDS A underwent splenorenal shunt for upper GI bleed. These patients serially followed with spot urine sodium on PRE OP base line, POD 1, POD 5, and at the time of discharge with simultaneous Doppler study of the shunt.Results2 patients had complete shunt obstruction with serial spot sodium of less than 10mg/dl. 3 patients had trickle flow of blood with partial thrombotic obstruction with serial spot sodium greater than 10mg/dl. 4 patients with patent shunt also showed greater than 10 mg/dl.ConclusionSerial Urine spot sodium as marker of shunt patency is correlating well for complete obstruction of the shunt. But, it could not differentiate partial shunt occlusion from patent shunt. Interestingly, it predicted the re-bleed earlier than clinical presentation in those complete shunt obstruction patients. IntroductionIn portal hypertension patient, there will be splanchnic vasodilatation resulting in decreased effective arterial volume hence activation of antinaturetic factors causing sodium retention with impaired free water excretion. A patent shunt should reverse this sodium imbalance to normal. Hence, serial spot urine sodium is used as surrogate marker for shunt patency. In portal hypertension patient, there will be splanchnic vasodilatation resulting in decreased effective arterial volume hence activation of antinaturetic factors causing sodium retention with impaired free water excretion. A patent shunt should reverse this sodium imbalance to normal. Hence, serial spot urine sodium is used as surrogate marker for shunt patency. BackgroundAn open shunt can frequently be estimated clinically by measuring serial urinary sodium concentrations. If the concentration is higher than 10 mg/dL, the shunt is almost certainly open. Our prospective study is designed to verify how best serial spot sodium predicts the patency of the shunt and its clinical relevance. An open shunt can frequently be estimated clinically by measuring serial urinary sodium concentrations. If the concentration is higher than 10 mg/dL, the shunt is almost certainly open. Our prospective study is designed to verify how best serial spot sodium predicts the patency of the shunt and its clinical relevance. Materials and Methods9 portal hypertensive patients with CHILDS A underwent splenorenal shunt for upper GI bleed. These patients serially followed with spot urine sodium on PRE OP base line, POD 1, POD 5, and at the time of discharge with simultaneous Doppler study of the shunt. 9 portal hypertensive patients with CHILDS A underwent splenorenal shunt for upper GI bleed. These patients serially followed with spot urine sodium on PRE OP base line, POD 1, POD 5, and at the time of discharge with simultaneous Doppler study of the shunt. Results2 patients had complete shunt obstruction with serial spot sodium of less than 10mg/dl. 3 patients had trickle flow of blood with partial thrombotic obstruction with serial spot sodium greater than 10mg/dl. 4 patients with patent shunt also showed greater than 10 mg/dl. 2 patients had complete shunt obstruction with serial spot sodium of less than 10mg/dl. 3 patients had trickle flow of blood with partial thrombotic obstruction with serial spot sodium greater than 10mg/dl. 4 patients with patent shunt also showed greater than 10 mg/dl. ConclusionSerial Urine spot sodium as marker of shunt patency is correlating well for complete obstruction of the shunt. But, it could not differentiate partial shunt occlusion from patent shunt. Interestingly, it predicted the re-bleed earlier than clinical presentation in those complete shunt obstruction patients. Serial Urine spot sodium as marker of shunt patency is correlating well for complete obstruction of the shunt. But, it could not differentiate partial shunt occlusion from patent shunt. Interestingly, it predicted the re-bleed earlier than clinical presentation in those complete shunt obstruction patients.

A modified Glenn shunt reduces right ventricular stroke work during left ventricular assist device therapy.

Right ventricular (RV) failure is a major cause of morbidity and mortality after left ventricular assist device (LVAD) placement and remains hard to predict. We hypothesized that partial surgical exclusion of the RV with a modified Glenn shunt during LVAD treatment would reduce RV stroke work. An LVAD was implanted in eight pigs and a modified Glenn shunt was constructed. A conductance pressure-volume catheter was placed in the right ventricle through the apex. Haemodynamic data and pressure-volume loops were obtained at the following time periods: (i) baseline, (ii) open shunt, (iii) LVAD with closed shunt and (iii) LVAD and open shunt. During LVAD therapy, the right atrial (RA) pressure increased from 9 mmHg (9-9) to 15 mmHg (12-15), P = 0.01. RV stroke volume increased from 30 ml (29-40) to 51 ml (42-53), P < 0.01. Also, RV stroke work increased to 708 mmHg ml (654-1193) from 535 mmHg ml (424-717), P = 0.04, compared with baseline. During LVAD therapy in combination with a Glenn shunt, the RA pressure decreased from 15 mmHg (12-15) to 10 mmHg (7-11) when compared with LVAD therapy only, P = 0.01. A decrease in RV stroke work from 708 mmHg ml (654-1193) to 465 mmHg ml (366-711), P = 0.04, was seen when the LVAD was combined with a shunt, not significantly different from the baseline value (535 mmHg ml). The developed pressure in the right ventricle decreased from 29 mmHg (26-32) to 21 mmHg (20-24), P < 0.01. The pressure-volume loops of the RV show a significant reduction of RV stroke work during the use of the shunt with LVAD treatment. A modified Glenn shunt reduced RV volumes, RV stroke work and RA pressure during LVAD therapy in an experimental model of heart failure in pigs.

Effect of waveguide impedance on radiation in underwater acoustic leaky wave antennas

Leaky wave antennas (LWAs) have been examined for decades as a way to steer electromagnetic waves as indexed by input frequency, enabling rapid video scanning of an environment with a simple compact device. Recently, an LWA device constructed of a rigid waveguide with open shunts was shown to produce a similar steering effect for acoustic waves in air [Naify et al., Appl. Phys Lett. 102, 203508 (2013)]. The shunts serve two purposes, to couple acoustic energy from the waveguide to the surrounding area, as well as control directionality of the radiated wave by changing the impedance, and thus modulating the phase speed of the waves in the waveguide. While this impedance contrast of the waveguide wall relative to that of the surrounding fluid is very large for an air background, when designing a structure for use in water the material of the waveguide can drastically change the directionality of the radiation profile. This study examines the effect of waveguide wall impedance on directionality of an acoustic LWA using both numerical and finite element methods. Three material impedance conditions are examined, including acoustically rigid, and two materials with finite impedance. [Work sponsored by the Office of Naval Research.]

Laparoscopic Shunt Revision Avoids Many Complications of Open Shunt Revision and Has Outcomes Similar to First-time Shunt Placement

Open revision of abdominal shunts is associated with increased risk of wound infection, visceral injury, hernia, and shunt complications. We hypothesized that laparoscopic revision mitigates these risks to a level similar to initial (i.e., first-time) shunt placement. This was a single-center, multisurgeon, retrospective cohort study of patients who underwent either laparoscopic initial shunt placement or laparoscopic shunt revision over a 5-year period. Outcomes were operative time, length of stay, and 30-day complication rate. Sixty-nine patients underwent laparoscopic shunt revision and 99 patients underwent laparoscopic initial shunt placement. Operative times were nearly identical (75 vs 73 minutes, P = 0.63). There were no significant differences in blood loss or hospital length of stay. Abdominal complications and total complications did not differ between groups. Laparoscopic shunt revision avoided many of the known complications of open shunt revision and had outcomes similar to initial laparoscopic shunt placement.

AB06. Shunting for prolonged ischemic priapism: a 50-year mistake?

Ischemic priapism Low flow (ischemic) priapism is a penile erection persisting beyond four hours unrelated to sexual interest or stimulation. This type of priapism causes a compartment syndrome of the corporal bodies with progressive hypoxia, hypercarbia and acidosis. Clinically, it is typified by progressive penile pain with rigid, tender corporal bodies and soft glans penis and corpus spongiosum. Treatment of ishemic priapism is an emergency and should begin in a stepwise fashion. The duration of priapism is the most significant predictor of future erectile function. Ischemic priapism longer than 4 hours in duration should begin immediately with aspiration and intracavernosal injection of sympathomimetic medication. If fails, one should proceed with a shunt procedure. The objective of shunt surgery is to re-establish outflow from the cavernosal bodies to the glans, corpus spongiosum or vein. Typically distal shunt procedures should be attempted before proximal shunt procedures.The first shunting procedure, the cavernosum-saphenous vein shunt, was published by Grayhack in 1964. About the same time, Al Ghorab devised an open cavernosum-glans shunt. In the next 50 years, many methods of creating shunt between the corpus cavernosum and the glans, the corpus spongiosum or the dorsal vein have been reported. However, the early recurrence rate remains high and a significant percentage of men developed severe penile fibrosis and erectile dysfunction.Recent model of coagulation cascade identifies exposed collagen as the most important initiating factor of blood clotting. About two years ago, we recognized that clotting of the newly created shunt was the main reason of early priapism recurrence. We have since institute peri-operative anticoagulation as a part of the shunting procedure. We have successfully reversed ischemic priapism in ALL cases in the past two years.

Early dynamic PET/CT shows open portocaval shunt in a patient with liver cirrhosis

Early dynamic PET/CT shows open portocaval shunt in a patient with liver cirrhosis

Perioperative Strategies and Thrombophilia in Children with Extrahepatic Portal Vein Obstruction Undergoing the Meso-Rex Bypass

Background/PurposeExtrahepatic portal vein obstruction (EHPVO) is an important cause of chronic portal hypertension in children. Although usually idiopathic in etiology, genetic and acquired thrombophilia have been implicated in EHPVO. Meso-Rex bypass is increasingly used to treat EHPVO in children. ObjectiveThe objective of this study is to assess the relationship of postoperative anticoagulation strategies and thrombophilic risk factors to the development of bypass thrombosis following the meso-Rex bypass. MethodsRecords of children who underwent meso-Rex bypass for EHPVO at a single institution from 1999 to 2009 were reviewed, and preoperative thrombophilia testing, perioperative anticoagulation strategies, and postoperative bypass patency based on imaging at last follow-up were examined. ResultsSixty-five children with EHPVO underwent a first time meso-Rex bypass during the study period, and 9 of 65 (14 %) developed bypass thrombosis. The use of warfarin in the postoperative period was more common among children with thrombosed shunts than among those with open shunts [63 % vs. 20 %; OR, 6.5 (95 % CI, 1.3–31.5), p = 0.022]. The contribution of genetic or acquired thrombophilia to shunt thrombosis was inconclusive given variability in testing. ConclusionsChoice of anticoagulation following meso-Rex bypass may affect postoperative incidence of bypass thrombosis. Role of thrombophilic risk factors in the development of shunt thrombosis remains unclear.

Point Contact Admittance Spectroscopy of Thin Film Solar Cells

ABSTRACTWe present the new characterization technique of multi-dimensional admittance measurements. In standard admittance measurements, a semiconductor device is probed in the transverse dimension, between flat plate contacts. We extend such measurements to distributed, possibly non-uniform solar cells where one of the two contacts has very small (point-like) dimensions. As a result, both the real and displacement currents spread into lateral directions while flowing between the electrodes. Correspondingly, the probing electric field may result in contact voltages that are laterally not equipotential. The spatial voltage distribution will depend on the probing DC bias and AC frequency. The resulting measurement will give information about the system’s lump parameters, such as open circuit voltage, sheet and shunt resistances, as well as the presence and location of shunts. Understanding of the measurement is developed through intuitive and analytic models. Numerical models, utilizing finite element circuits, are used to verify the analytic results, and also may be directly compared to or used to fit experimental data. While our focus is on introducing the physical theory, early experimental results demonstrating spatial scaling are shown.

A DESIGN OF MINIATURIZED ULTRA–WIDEBAND PRINTED SLOT ANTENNA WITH 3.5/5.5 GHZ DUAL BAND–NOTCHED CHARACTERISTICS: ANALYSIS AND IMPLEMENTATION

A design and analysis of a novel proximity-fed printed slot antenna with 3.5/5.5GHz dual band-notched characteristics are presented. To obtain an ultra-wideband (UWB) response, a circular patch with a rectangular conjunction arm is etched concentrically inside a ground plane aperture. The antenna is proximity-fed by a microstrip line with an open shunt stub on the other side of the substrate. The designed antenna satisfles a i10dB return loss requirement in the frequency band from 2.7 to 17GHz. In order to obtain dual band-notched properties at 3.5 and 5.5GHz, an open ring slot is etched ofi the circular patch and a …-shaped slot is etched ofi the microstrip feeding line, respectively. A curve fltting formulation is obtained to describe the in∞uences of the notched resonators on the corresponding notched frequencies. The proposed antenna is designed, simulated and fabricated. The measured data show a good agreement with the simulated results and the equivalent circuit results through the use of a modifled Vector Fitting technique for a rational function approximation. The proposed antenna provides almost omnidirectional radiation patterns, relatively ∞at gain and high radiation e-ciency over the entire UWB frequency excluding the two rejected bands.

A COMPACT ULTRA-WIDE BAND MICROSTRIP SLOTTED ANTENNA WITH DUAL BAND NOTCHED

This paper presents a design of a compact and simp le ultra-wide band planar antenna with dual band notched. The antenna consists of a microstrip-fed line and two rectangular slots in the ground plane. The design produces a wide band operation with return loss less than -10dB in the f requency range of 2 to 9.5 GHz. By using a rectangular patch in conjunction wi th a U patch and etching a U-shaped slot in the feed line, the band of the ant enna is increased with two notched bands of central frequencies at 3.5GHz and 5.5 GHz. Defected ground plane and an open shunt stub are proposed to improve the impedance bandwidth of the presented antenna. Parametric stud ies of antenna elements are presented. The proposed antenna is fabricated. The measured data show very good agreement with the simulated results.

A modified Glenn shunt improves haemodynamics in acute right ventricular failure in an experimental model

Right heart failure is a major cause of morbidity and mortality after left ventricular assist device implantation and is still hard to predict. This study investigated the haemodynamic effect of a modified Glenn shunt on induced right ventricular (RV) failure. Isolated RV failure was induced by coronary ligation in 11 pigs. A modified Glenn shunt was established by a superior vena cava to pulmonary artery connection. Haemodynamic data were obtained at baseline, RV failure, and RV failure and open shunt. Myocardial biopsies were taken to ascertain established heart failure. RV failure defined as right atrial pressure ≥20 mmHg was achieved in all 11 animals. A reduction in cardiac output (CO) from 3.7 (3.5-4.2) to 2.3 l/min (2.0-2.6) and mean arterial pressure (MAP) from median 72.7 (70.1-82.2) to 55.9 mmHg (52.6-59.8) was seen during heart failure. The median flow in the shunt was 681 ml. Right atrial pressures decreased from 20.3 (19.6-21.1) to 13.4 mmHg (12.7-14.0), and RV pressures decreased from 18.1 (16.4-20.1) to 13.6 mmHg (13.5-14.2) with open shunt (P = 0.001 for both). CO increased to 2.9 l/min (2.4-3.3) when the shunt was in use. Mixed venous oxygen saturation increased with the shunt from 32 (27-38) to 49% (45-56), P = 0.001. Genes associated with heart failure were upregulated during heart failure. A modified Glenn shunt improved haemodynamics by reduced right atrial pressure, increased CO, MAP and mixed venous oxygen saturation in an experimental model of induced RV failure.

Multi-layer radial systolic strain vs. one-layer strain for confirming reperfusion from a significant non-occlusive coronary stenosis

The aim of this study was to investigate whether multi-layer radial strain and strain rate analysis is superior to one-layer strain analysis for confirming reperfusion following a non-occlusive coronary stenosis. In 10 anaesthetized pigs, an extracorporeal shunt was inserted from the brachiocephalic to the left anterior descending coronary artery. Microspheres were injected and left ventricular (LV) short- and long-axis echocardiographic views were recorded with the open shunt, during the 120 min of severe stenosis and 20 min (early) and 100 min (late) after reperfusion. The anterior wall was analysed for radial one-layer and three-layer tissue Doppler imaging (TDI) strain and strain rate, in addition to radial, circumferential, and longitudinal speckle-tracking echocardiography (STE) strain. During stenosis, perfusion was reduced in the two inner wall layers (P< 0.01). All peak systolic strain and strain rate parameters were reduced, whereas post-systolic longitudinal strain and post-systolic strain in the two inner layers increased (P< 0.001). At early reperfusion, hyperaemia was evident in all layers (P< 0.01). Peak systolic TDI strain and strain rate increased in the mid- and subendocardial layer, whereas post-systolic strain decreased (P< 0.05). Peak systolic STE strain increased in the circumferential and longitudinal direction, whereas post-systolic longitudinal strain decreased (P< 0.05). At late reperfusion, strain and strain rate were unchanged while perfusion returned to baseline values in the mid- and subendocardium. Both multi-layer radial TDI strain and strain rate and one-layer STE strain measurements in the circumferential and longitudinal direction can confirm reperfusion early after a non-occlusive coronary stenosis. An advantage of multi-layer analysis was not evident.