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https://www.readbyqxmd.com/read/28734441/a-novel-and-successful-repair-of-a-left-atriogastric-fistula-after-esophagectomy
#1
Nikhil Panda, Eric N Feins, Andrea Axtell, Natalie Lui, Serguei I Melnitchouk, Dean M Donahue
Atriogastric fistulas remain a rare adverse event in patients who undergo esophagectomy with gastric pullthrough. The presentation of an atriogastric fistula ranges from self-limited gastrointestinal bleeding to life-threatening hemorrhage, end-organ dysfunction from septic emboli, or both. These fistulas are associated with significant mortality. Previous reports describe successful repairs of gastrocardiac fistulas with the use of cardiopulmonary bypass. This report describes a patient with a significant burden of cerebral embolic disease, which therefore required a unique approach to fistula repair...
August 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28728785/operative-strategies-to-reduce-cerebral-embolic-events-during-on-and-off-pump-coronary-artery-bypass-surgery-a-stratified-prospective-randomized-trial
#2
Michael E Halkos, Aaron Anderson, Jose Nilo G Binongo, Anthony Stringer, Yi Lasanajak, Vinod H Thourani, Omar M Lattouf, Robert A Guyton, Kim T Baio, Eric Sarin, William B Keeling, N Renee Cook, Katherine Carssow, Alexis Neill, Kathryn E Glas, John D Puskas
OBJECTIVE: To determine the impact of different aortic clamping strategies on the incidence of cerebral embolic events during coronary artery bypass grafting (CABG). METHODS: Between 2012 and 2015, 142 patients with low-grade aortic disease (epiaortic ultrasound grade I/II) undergoing primary isolated CABG were studied. Those undergoing off-pump CABG were randomized to a partial clamp (n = 36) or clampless facilitating device (CFD; n = 36) strategy. Those undergoing on-pump CABG were randomized to a single-clamp (n = 34) or double-clamp (n = 36) strategy...
June 16, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28720742/-two-cases-of-ruptured-blood-blister-like-aneurysm-treated-with-x-ray-angiography-perfusion-xap-analysis
#3
Shoichi Tani, Hirotoshi Imamura, Katsunori Asai, Kampei Shimizu, Hidemitsu Adachi, So Tokunaga, Takayuki Funatsu, Mikiya Beppu, Keita Suzuki, Hiromasa Adachi, Tomohiro Okuda, Yuichi Matsui, Yasunori Yoshida, Shuhei Kawabata, Ryo Akiyama, Kazufumi Horiuchi, Nobuyuki Sakai
Two cases of ruptured blood blister-like internal carotid artery aneurysms for which low flow bypass was sufficient to attain successful treatment of trapping are reported. In the acute stage of rupture, it is troublesome to perform accurate examinations of tolerance to ischemia like balloon occlusion test(BOT)for estimating the required amount of bypass flow. In our cases, X-ray angiography perfusion(XAP)analysis was introduced, which could be performed in a couple dozen seconds without room-to-room transfer of patients, following the ordinary examination of diagnostic digital subtraction angiography...
July 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28720528/postoperative-dilatation-of-superficial-temporal-artery-associated-with-transient-neurological-symptoms-after-direct-bypass-surgery-for-moyamoya-angiopathy
#4
Daizo Ishii, Takahito Okazaki, Toshinori Matsushige, Katsuhiro Shinagawa, Nobuhiko Ichinose, Shigeyuki Sakamoto, Kaoru Kurisu
OBJECTIVE: In moyamoya angiopathy (MMA), transient neurological symptoms (TNS) are occasionally observed after superficial temporal artery (STA)-middle cerebral artery (MCA) direct bypass surgery. The purpose of this study was to investigate the correlation between TNS and postoperative MR images, as well as perform a perfusion study. METHODS: A total of 52 hemispheres in 33 consecutive patients with MMA were reviewed. TNS were defined as reversible neurological dysfunction without any apparent intracranial infarction or hemorrhage...
July 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28719038/static-cerebrovascular-pressure-autoregulation-remains-intact-during-deep-hypothermia
#5
Dheeraj Goswami, Katherine McLeod, Samantha Leonard, Kathleen Kibler, Ronald Blaine Easley, Charles D Fraser, Dean Andropoulos, Ken Brady
BACKGROUND: Clinical studies measuring cerebral blood flow in infants during deep hypothermia have demonstrated diminished cerebrovascular pressure autoregulation. The coexistence of hypotension in these cohorts confounds the conclusion that deep hypothermia impairs cerebrovascular pressure autoregulation. AIM: We sought to compare the lower limit of autoregulation and the static rate of autoregulation between normothermic and hypothermic piglets. METHODS: Twenty anesthetized neonatal piglets (5-7 days old; 10 normothermic and 10 hypothermic to 20°C) had continuous measurements of cortical red cell flux using laser Doppler flowmetry, while hemorrhagic hypotension was induced without cardiopulmonary bypass...
July 18, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28711531/transdural-indocyanine-green-videography-for-sta-mca-bypass-technical-note
#6
Hiroshi Yokota, Taiji Yonezawa, Tomonori Yamada, Seisuke Miyamae, Taekyun Kim, Yoshiaki Takamura, Katsuya Masui, Shuta Aketa
BACKGROUND: Neurosurgical application of indocyanine green (ICG) videography prior to performing a dural opening has been reported as transdural ICG videography and used during surgery of meningiomas associated with venous sinuses, as well as cranial and spinal arteriovenous malformations. However, its use for a superficial temporal artery to middle cerebral artery (STA-MCA) bypass has not been reported. METHODS: We performed a retrospective analysis of medical records of patients who underwent a transdural ICG videography technique during STA-MCA bypass procedures performed between January 2012 and March 2015...
July 12, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28709918/unroofed-coronary-sinus-syndrome-an-easily-corrected-congenital-anomaly-but-more-diagnostic-suspicions-are-needed
#7
Changcheng Chen, Lili Xu, Yi Xu, Ping Li, Shuo Liu, Bin You
BACKGROUND: Unroofed coronary sinus syndrome (URCSS) is a spectrum of cardiac anomalies in which part (partial type) or the entire common wall (complete type) between the coronary sinus (CS) and left atrium is absent. It is commonly associated with a persistent left superior vena cava (PLSVC). The PLSVC can even anomalously connect to the left atrium in complete type anomaly. URCSS has been reported to be associated with delayed diagnosis and life-threatening cerebral injury. The purpose of the present study was to review our experience with surgical correction of this often-concealed malformation and discuss methods for reducing diagnostic omission...
June 22, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28709662/neonatal-aortic-arch-reconstruction-with-direct-splanchnic-perfusion-avoids-deep-hypothermia
#8
Muhammad Aanish Raees, Clinton D Morgan, Venessa L Pinto, Ashly C Westrick, Chevis N Shannon, Karla G Christian, Bret A Mettler, David P Bichell
BACKGROUND: Neonatal aortic arch reconstruction, typically performed with deep hypothermia and selective cerebral perfusion, leaves splanchnic organ protection dependent on hypothermia alone. A simplified method of direct in-field descending aortic perfusion during neonatal arch reconstruction permits the avoidance of deep hypothermia. We hypothesize that direct splanchnic perfusion at mild hypothermia provides improved or equivalent safety compared with deep hypothermia and may contribute to postoperative extracardiac organ recovery...
July 11, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28708772/successful-laparoscopic-harvesting-of-omental-pedicle-flap-for-salvage-cerebral-revascularization-in-2-adults-with-moyamoya-disease-technique-and-lessons-learned
#9
Max Schumm, Kathleen Simon, Rapheal Sacho, Jon C Gould
Moyamoya is an idiopathic and progressive disease that leads to occlusion of intracranial arteries. When other methods of revascularization fail, omentum can be used as an indirect bypass to improve cerebral perfusion. Laparoscopic mobilization of a pedicled omental flap with subcutaneous tunneling to the brain has been described in small case series in children. We report our techniques and outcomes in 2 adults with Moyamoya to undergo such a procedure. An omental flap based on the right gastroepiploic artery was created and intraoperative fluorescence imaging using indocyanine green was used to assess the viability of the flap and to guide lengthening of the pedicle...
July 13, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28694612/cerebral-and-coronary-vasculature-in-disease-associations-and-dissociations-in-the-south-indian-population
#10
Krishnan Srinivasan, Srinivasan Ravikumar, Sadanandavalli Retnaswami Chandra, Selva Ganapathy, G S Ravi
INTRODUCTION: Cerebrovascular accidents constitute the most common cause of disability all over the world. In India prevalence rate is 545 per 100000 and mortality rate is around 7.5 per thousand. Therefore the authors undertook a study on patients who underwent coronary artery bypass surgery (CABG). They were investigated for clinical and/or radiological evidence of cerebrovascular disease (CVD) with the aim to decide on early neurological intervention. PATIENTS AND METHODS: 210 patients who had undergone CABG were evaluated with neck vessel Doppler using high resolution duplex scanner system and computed tomography (CT) scan as well as MR angiogram (MRA) in addition to assessment of co morbid risk factors...
July 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28689345/extensive-brain-infarction-involving-deep-structures-during-an-acetazolamide-challenged-single-photon-emission-computed-tomography-scan-in-a-patient-with-moyamoya-disease
#11
Sangjoon Chong, June Dong Park, Jong Hee Chae, Jung-Eun Cheon, Seung-Ki Kim, Ji Hoon Phi, Ji Yeoun Lee, Jin Chul Paeng, Kyu-Chang Wang
BACKGROUND: Acetazolamide-challenged brain single-photon emission computed tomography (SPECT) is used for the evaluation of cerebral perfusion in cerebrovascular diseases including moyamoya disease (MMD). Not a few patients experience adverse side effects during the acetazolamide-challenged brain SPECT, but most of the symptoms are mild and transient. To our knowledge, this is the first case report of severe brain infarction leading to death during the examination of an acetazolamide-challenged brain SPECT in a patient with MMD...
July 8, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28686113/effects-of-different-surgical-modalities-on-the-clinical-outcome-of-patients-with-moyamoya-disease-a-prospective-cohort-study
#12
Xiaofeng Deng, Faliang Gao, Dong Zhang, Yan Zhang, Rong Wang, Shuo Wang, Yong Cao, Yuanli Zhao, Yuesong Pan, Xun Ye, Xingju Liu, Qian Zhang, Jia Wang, Ziwen Yang, Meng Zhao, Jizong Zhao
OBJECTIVE Bypass surgery is the most common treatment for moyamoya disease (MMD), but there is controversy over which surgical modality is best. The objective of this study was to evaluate the clinical outcome of patients with MMD after undergoing different surgical modalities. METHODS A series of 696 consecutive MMD patients treated between June 2009 and May 2015 were screened in this prospective cohort study. Patients who did not undergo revascularization surgeries and those who underwent different surgical modalities in bilateral hemispheres were excluded...
July 7, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28684367/endovascular-therapy-for-the-steal-phenomenon-due-to-the-innominate-artery-severe-stenosis-and-bilateral-internal-carotid-artery-severe-stenosis-case-report
#13
Shuta Aketa, Daisuke Wajima, Masahiro Kishi, Yudai Morisaki, Taiji Yonezawa, Ichiro Nakagawa, Hiroyuki Nakase
BACKGROUND: Symptomatic innominate artery stenosis as hemodynamic bilateral cerebral ischemia is uncommon. We present a rare case of an innominate artery origin severe stenosis and bilateral internal carotid artery (ICA) severe stenosis, inducing hemodynamic cerebral ischemia after ipsilateral axillary artery-bilateral femoral artery bypass, and treated with stent replacement of innominate artery and right ICA. CASE REPORT: A 64-year-old female, who had received previously right axillary artery-bilateral femoral artery anastomosis for abdominal aorta high obstruction, had been suffered from chronic dizziness, so visited our department...
July 3, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28674346/diagnosis-and-treatment-of-traumatic-cerebrovascular-injury-pitfalls-in-the-management-of-neurotrauma
#14
Hitoshi Kobata
Traumatic cerebrovascular injury (TCVI) is an uncommon clinical entity in traumatic brain injury (TBI), yet it may cause devastating brain injury with high morbidity and mortality. Early recognition and prioritized strategic treatment are of paramount importance. A total of 1966 TBI patients admitted between 1999 and 2015 in our tertiary critical care center were reviewed. Screening of TCVI was based on the Guidelines for the Management of Severe Head Injury in Japan. TCVI was confirmed in 33 (1.7%) patients; 29 blunt and 4 penetrating injuries...
June 30, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28666915/dr-norman-chater-and-chater-s-point-a-historical-vignette
#15
REVIEW
Lauren E Rotman, Mark R Harrigan
Dr. Norman Chater, a University of California, San Francisco-trained microvascular neurosurgeon, dedicated his career to the development of surgical bypass techniques. His work contributed to advancements in microvascular anatomy and the development of cerebral revascularization techniques. He identified Chater's point, an extracranial landmark that marks the posterior extent of the Sylvian fissure, which upon craniectomy reliably exposes vessels of the angular gyrus, vasculature found to be most appropriate for bypass procedures due to their accessibility and vascular diameter...
June 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28664022/intracerebral-hemorrhage-caused-by-cerebral-hyperperfusion-after-superficial-temporal-artery-to-middle-cerebral-artery-bypass-for-atherosclerotic-occlusive-cerebrovascular-disease
#16
Fumihiro Matano, Yasuo Murai, Takayuki Mizunari, Koji Adachi, Shiro Kobayashi, Akio Morita
Few papers have reported detailed accounts of intracerebral hemorrhage caused by cerebral hyperperfusion after superficial temporal artery to middle cerebral artery bypass (STA-MCA) bypass for atherosclerotic occlusive cerebrovascular disease. We report a case of vasogenic edema and subsequent intracerebral hemorrhage caused by the cerebral hyperperfusion syndrome (CHS) after STA-MCA bypass for atherosclerotic occlusive cerebrovascular disease disease without intense postoperative blood pressure control. A 63-year-old man with repeating left hemiparesis underwent magnetic resonance angiography (MRA), which revealed right internal carotid artery (ICA) occlusion...
January 2017: NMC Case Rep J
https://www.readbyqxmd.com/read/28660303/the-role-of-eeg-recordings-in-children-undergoing-cardiac-surgery-for-congenital-heart-disease
#17
Sascha Meyer, Martin Poryo, Mohammed Shatat, Ludwig Gortner, Hashim Abdul-Khaliq
BACKGROUND: Neurological dysfunction may occur after corrective cardiac surgery using cardio-pulmonary bypass (CPB) with or without circulatory arrest. Different neurophysiological monitoring systems have been employed to detect neurological complications and possible brain injury in infants and children during and after cardiac surgery. The value of Elecetroencephalogram (EEG) in infants and children at risk for neurological sequelae has not been systematically studied. METHODS: Sequential performance of two EEGs before and after cardiac surgery at a tertiary University Hospital to screen for possible brain injury after cardiac surgery in neonates and children undergoing CPB surgery...
June 28, 2017: Wiener Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28653939/report-cerebral-electrical-impedance-value-reflects-brain-edema-caused-by-cardiopulmonary-bypass-in-infants
#18
Mingqing Peng, Chunbao Guo, Fang Gong, Min Li, Yuan Li, Qiang Peng, Lin Bo
The study aimed to investigate if the dynamic changes in cerebral electrical impedance (CEI) values could be used to monitor brain edema during cardiopulmonary bypass (CPB) in infants. Forty infants (mean age: 1.4±0.38y) with acyanotic congenital heart disease who underwent CPB open-heart surgery between September 2009 and March 2010 were prospectively enrolled, and divided into 2 groups based on aortic cross-clamping (ACC) time: CPB-A (ACC<50 min) and CPB-B (ACC<50 min). During the same period, twenty infants (aged 1-3y) who underwent surgery for indirect inguinal hernias were selected as controls...
May 2017: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28653463/does-hypothermia-impair-cerebrovascular-autoregulation-in-neonates-during-cardiopulmonary-bypass
#19
Brendan Smith, Eric Vu, Kathleen Kibler, Craig Rusin, Ronald B Easley, Dean Andropoulos, Jeffrey Heinle, Marek Czosnyka, Daniel Licht, Jennifer Lynch, Ken Brady
BACKGROUND: Autoregulation monitoring has been proposed as a means to identify optimal arterial blood pressure goals during cardiopulmonary bypass, but it has been observed that cerebral blood flow is pressure passive during hypothermic bypass. When neonates cooled during cardiopulmonary bypass are managed with vasodilators and controlled hypotension, it is not clear whether hypothermia or hypotension were the cause of impaired autoregulation. AIM: We sought to measure the effect of both arterial blood pressure and hypothermia on autoregulation in a cohort of infants cooled for bypass, hypothesizing a collinear relationship between hypothermia, hypotension, and dysautoregulation...
June 27, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28648536/outcomes-of-elective-aortic-hemiarch-reconstruction-for-aneurysmal-disease-in-the-elderly
#20
Arman Kilic, George J Arnaoutakis, Joseph E Bavaria, Ibrahim Sultan, Nimesh D Desai, Prashanth Vallabhajosyula, Matthew L Williams, Rita K Milewski, Wilson Y Szeto
BACKGROUND: This study evaluated outcomes of elective aortic hemiarch reconstruction for aneurysmal disease in the elderly. METHODS: Patients undergoing elective aortic hemiarch reconstruction for aneurysmal disease at a single institution between 2009 and 2014 were retrospectively reviewed. Patients were stratified into nonelderly (aged less than 75 years) versus elderly (aged 75 years or more). Outcomes included operative mortality and morbidity. RESULTS: In all, 629 patients (95 elderly; 15%) were included...
June 22, 2017: Annals of Thoracic Surgery
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