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Cardiopulmonary bypass

Oded Volovelsky, Tara C Terrell, Hayley Swain, Michael R Bennett, David S Cooper, Stuart L Goldstein
BACKGROUND: Early detection of acute kidney injury (AKI) after cardiac surgery has improved recently with the discovery and validation of novel urinary biomarkers. However, objective tools to predict the risk of AKI before the insult are still missing. We tested the hypothesis that pre-operative serum fibroblast growth factor 23 (FGF23) concentrations would be elevated in children who develop AKI after heart surgery with cardiopulmonary bypass (CPB). We also compared post-operative FGF23 concentrations to other biomarkers for early detection of AKI...
July 19, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Jeong-Moo Lee, Kwang-Woong Lee, Suk Kyun Hong, Kyung Chul Yoon, Jae-Hyung Cho, Nam-Joon Yi, Kyung-Suk Suh
BACKGROUND: Status in terms of major vascular structure invasion is a crucial factor for successful major hepatic resection. In particular, surgery for advanced tumors with inferior vena cava (IVC) invasion is difficult and may even be dangerous for the patient, having high risk of massive bleeding and greater chance of embolic complications such as stroke, bowel ischemia, and pulmonary venous thrombosis. For such reasons, many surgeons hesitate to carry out such surgical resection, and even if they do so, may not totally remove the tumor including the part inside the IVC, achieving R1 resection...
July 17, 2018: Annals of Surgical Oncology
Raymond Stegeman, Kaya D Lamur, Agnes van den Hoogen, Johannes M P J Breur, Floris Groenendaal, Nicolaas J G Jansen, Manon J N L Benders
Background: Perinatal and perioperative brain injury is a fundamental problem in infants with severe congenital heart disease undergoing neonatal cardiac surgery with cardiopulmonary bypass. An impaired neuromotor and neurocognitive development is encountered and associated with a reduction in quality of life. New neuroprotective drugs during surgery are described to reduce brain injury and improve neurodevelopmental outcome. Therefore, our aim was to provide a systematic review and best-evidence synthesis on the effects of neuroprotective drugs on brain injury and neurodevelopmental outcome in congenital heart disease infants requiring cardiac surgery with cardiopulmonary bypass...
2018: Frontiers in Neurology
Stuart Moss, Daniel Tardo, Mathew Doyle, David Rees
Inherited disorders of lipid metabolism may cause a heavy burden of cardiovascular disease early in life. Familial hypercholesterolaemia (FH) with abnormalities of LDL metabolism results in marked LDL elevations and accelerated, multivessel atherosclerosis presenting in teenage or young adulthood. We describe the case of a 33-year-old woman who presented with exertional angina in the setting of pregnancy who was found post-partum to have severe triple-vessel disease including left main disease on coronary angiography (Figs...
July 5, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Xiao-Yu Zhou, Jing Xu
It is estimated that 15% of traffic accidents cause trauma to large vessels. In about 70%-95% of cases, aortic rupture took place in the distal ligament of the left subclavian artery, whereas in the remaining cases rupture occurred in the ascending aorta above the aortic valve. Trauma to the aortic sinus and coronary arteries is rarely found in traffic accident victims. Therefore, coronary artery trauma is often misdiagnosed as coronary atherosclerotic heart disease. The present case is a 42 years old male who survived from a traffic accident...
June 28, 2018: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
Taijyu Satoh, Qinzi Xu, Longfei Wang, Mark T Gladwin
No abstract text is available yet for this article.
July 17, 2018: American Journal of Respiratory and Critical Care Medicine
J A Peterson, S A Maroney, W Zwifelhofer, J P Wood, K Yan, R S Bercovitz, R K Woods, A E Mast
BACKGROUND: Neonates undergoing cardiopulmonary bypass (CPB) are at risk for excessive bleeding. Blood is anticoagulated with heparin during CPB. Heparin activity is reversed with protamine at the end of CPB. Paradoxically, protamine also inhibits blood coagulation when it is dosed in excess of heparin. OBJECTIVES: To evaluate heparin-protamine balance in neonates undergoing CPB using research and clinical assays and determine their association with post-operative bleeding...
July 17, 2018: Journal of Thrombosis and Haemostasis: JTH
Charlene V Chabata, James W Frederiksen, Bruce A Sullenger, Ruwan Gunaratne
PURPOSE OF REVIEW: Since the selection of the first thrombin-binding aptamer in 1992, the use of nucleic acid aptamers to target specific coagulation factors has emerged as a valuable approach for generating novel anticoagulant and procoagulant therapeutics. Herein, we highlight the most recent discoveries involving application of aptamers for those purposes. RECENT FINDINGS: Learning from the successes and pitfalls of the FIXa-targeting aptamer pegnivacogin in preclinical and clinical studies, the latest efforts to develop antidote-controllable anticoagulation strategies for cardiopulmonary bypass that avoid unfractionated heparin involve potentiation of the exosite-binding factor X (FX)a aptamer 11F7t by combination with either a small molecule FXa catalytic site inhibitor or a thrombin aptamer...
July 12, 2018: Current Opinion in Hematology
Biljana Germanoska, Matthew Coady, Sheyin Ng, Gary Fermanis, Matthew Miller
Manual palpation of pulses is unreliable in detecting pulsatile flow in human participants, complicating the assessment of return of spontaneous circulation after cardiac arrest. Ultrasound may offer an alternative. This study's objective was to investigate whether return of pulsatile flow in humans can be reliably assessed by common carotid artery ultrasound. We conducted a single-blinded randomised study of common carotid artery ultrasound using 20 cardiopulmonary bypass patients to model the return of pulsatile flow...
May 2018: Ultrasound: Journal of the British Medical Ultrasound Society
Fernando A Atik, Gustavo G Gomes, Fillipe F Rodrigues, Armindo Jreige, Wagner L Gali, Claudio R da Cunha, Alvaro V Sarabanda
OBJECTIVE: To determine whether cut and sew Cox maze III procedure is still associated with adequate safety endpoints when performed in conjunction with other open-heart procedures. METHODS: Between January 2008 and January 2015, 113 consecutive adult patients were submitted to cut and sew Cox maze III procedure in association with other operations for structural heart disease. Mean age was 49 years and 80 (70.8%) were females. Long-standing persistent or persistent atrial fibrillation has occurred in 87...
July 13, 2018: Seminars in Thoracic and Cardiovascular Surgery
Katsuhide Maeda, Ingela Schnittger, Daniel J Murphy, Jennifer A Tremmel, Jack H Boyd, Lynn Peng, Kozo Okada, Vedant S Pargaonkar, Frank L Hanley, Robert Scott Mitchell, Ian S Rogers
BACKGROUND: Although myocardial bridges (MBs) are traditionally regarded as incidental findings, it has been reported that adult patients with symptomatic MBs refractory to medical therapy benefit from unroofing. However, there is limited literature in the pediatric population. The aim of our study was to evaluate the indications and outcomes for unroofing in pediatric patients. METHODS: We retrospectively reviewed all pediatric patients with MB in our institution who underwent surgical relief...
June 9, 2018: Journal of Thoracic and Cardiovascular Surgery
Jennifer L Hsu, Udit Bhatnagar, Maria Stys, Wendell Hoffman
We present the case of a 64-year-old man with Mycobacterium chimaera prosthetic aortic valve endocarditis likely acquired through exposure to a contaminated heater-cooler device used for cardiopulmonary bypass during valve replacement. This case demonstrates multi-system involvement with a non-tuberculous mycobacterial species that was previously not considered a significant human pathogen. We review the key features of the case and review published literature regarding an international outbreak of M. chimaera arising from point-source contamination during the manufacturing process...
June 2018: South Dakota Medicine: the Journal of the South Dakota State Medical Association
Shu-Jun Shi, Deng-Liang Wang, Wei Hu, Fei Peng, Quan Kang
Some primary and secondary liver carcinomas cannot be resected using a conventional approach due to their size, location, or major vascular invasion. The aim of this study was to explore the application of ex vivo liver resection and autotransplantation for complicated HB in children. A 1.5-year-old girl with HB after repeated chemotherapy was analyzed. In this patient, tumor invasion includes the IV, V, and VIII liver segments, and thrombosis formed in the inferior vena cava and right atrium. It is difficult to obtain complete tumor resection using conventional hepatectomy...
July 12, 2018: Pediatric Transplantation
Love Ahlström, Michal Odermarsky, Torsten Malm, Jens Johansson Ramgren, Petru Liuba
In transposition of the great arteries (TGA), certain coronary patterns have been associated with major adverse events early after the arterial switch operation (ASO). We sought to determine the impact of preoperative echocardiographic (ECHO) diagnosis on the intra- and postoperative morbidity. All patients with TGA born between June 2001 and June 2017 and who underwent ASO were reviewed. Data on presumed coronary anatomy (CA) preoperatively were obtained from the preoperative ECHO report. Intraoperative CA was categorized according to Yacoub classification...
July 12, 2018: Pediatric Cardiology
Yoshitsugu Nakamura, Sam Emmanuel, Fumiaki Shikata, Chihiro Shirai, Yujiro Ito, Miho Kuroda
OBJECTIVE: To investigate whether radial artery pressure is a reliable surrogate measure of central arterial pressure as approximated by femoral artery pressure in minimally invasive cardiac surgery with retrograde perfusion via femoral cannulation. METHOD: Fifty-two consecutive patients undergoing minimally invasive cardiac surgery were prospectively included in this study. Cardiopulmonary bypass was established via a femoral artery cannulation and femoral vein...
July 1, 2018: International Journal of Artificial Organs
Yajuan Zhang, Yabing Duan, Jun Yan, Qiang Wang, Shoujun Li, Haitao Xu
OBJECTIVE: The purpose of the study is to compare the effects of nesiritide on the discharge time and pleural effusion in children with total cavopulmonary connection (TCPC), and to provide a more reasonable clinical method for these children. METHODS: Forty-four who children underwent cavopulmonary connection between January 2016 and 2017 were retrospectively collected, and 5 children were excluded from analysis due to postoperative thrombosis or second Fontan surgery due to high pulmonary hypertension...
July 12, 2018: Pediatric Cardiology
Meng-Lin Lee, Thay-Hsiung Chen, Hsien-Da Huang, Shaw-Min Hou
Background: The optimal management of ischemic mitral regurgitation (IMR) is controversial. The aim of this study was to examine our eight years' experience of surgical treatment in patients with IMR, and to compare outcomes of mitral valve repair versus replacement with concomitant coronary artery bypass grafting (CABG). Methods: A retrospective, observational, cohort study was undertaken to collect data on consecutive patients with IMR and coronary artery disease who received CABG and mitral valve surgery in our hospital between January 2008 and December 2015...
May 2018: Journal of Thoracic Disease
Ho Jin Kim, You Na Oh, Min Ho Ju, Joon Bum Kim, Sung-Ho Jung, Cheol Hyun Chung, Jae Won Lee, Suk Jung Choo
Background: We reviewed our experience with on-pump beating (OPB) heart coronary artery bypass grafting (CABG) to evaluate the impacts of obviating aortic cross-clamping and cardioplegic arrest on clinical outcomes compared with conventional CABG (C-CABG). Methods: Between 2006 and 2012, elective isolated cardiopulmonary bypass (CPB)-assisted CABG was consecutively performed in 645 patients (mean patient age 63.3±9.1 years, 471 women) with 254 (39.4%) undergoing OPB-CABG and 391 (60...
May 2018: Journal of Thoracic Disease
Sima Rafieyian, Shahla Roodpeyma, Kourosh Vahidshahi, Alireza Moghadasi
Background: Tissue Doppler imaging yields useful information about regional myocardial function. The purpose of this study was to investigate myocardial function by strain and strain rate in a group of patients with congenital heart disease (CHD) before and after cardiac surgery. Methods: Three consecutive tissue Doppler echocardiographic examinations were performed on 25 patients with CHD, who underwent open-heart surgery. The study was conducted from April 2013 to April 2014 in a university hospital, and the assessments were done 1 day before and 1 week and 1 month after surgery...
January 2018: Journal of Tehran Heart Center
William A Kofke, Yue Ren, John G Augoustides, Hongzhe Li, Katherine Nathanson, Robert Siman, Qing Cheng Meng, Weiming Bu, Sukanya Yandrawatthana, Guy Kositratna, Cecilia Kim, Joseph E Bavaria
Background: Neuroprotection studies are generally unable to demonstrate efficacy in humans. Our specific hypothesis is that multiple pathophysiologic pathways, of variable importance, contribute to ischemic brain damage. As a corollary to this, we discuss the broad hypothesis that a multifaceted approach will improve the probability of efficacious neuroprotection. But to properly test this hypothesis the nature and importance of the multiple contributing pathways needs elucidation. Our aim is to demonstrate, using functional genomics, in human cardiac surgery procedures associated with cerebral ischemia, that the pathogenesis of perioperative human ischemic brain damage involves the function of multiple variably weighted proteins involving several pathways...
2018: Frontiers in Neurology
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