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Cardiopulmonary bypass surgery

Theoni Kanellopoulou, Theodora Kostelidou
BACKGROUND: Perioperative therapeutic plasma exchange in patients with cardiovascular diseases poses several challenges, including alterations in intravascular volume, serum electrolytes, the coagulation cascade, and drug pharmacokinetics. METHODS: This review article summarizes different indications of plasma exchange for patients requiring cardiac surgery based on reported case reports and case series. RESULTS: The most common reported indication is plasma exchange for the management of allosensitized cardiac transplant candidate patients in combination with immunosuppressive regimens, which increases the likelihood of obtaining a cross-match-negative allograft, improving post-transplant clinical outcome...
December 8, 2018: Journal of Clinical Apheresis
Mingyue Liu, Qingdong Zeng, Yongnan Li, Gang Liu, Bingyang Ji
Brain injury associated with deep hypothermic circulatory arrest (DHCA) has been recognized in patients with congenital heart diseases and those undergoing aortic arch surgeries. However, the preclinical investigation of long-term cerebral injury and recovery mechanisms related to DHCA has been restricted to a satisfactory recovery animal model with a determined recovery time. This study aimed to evaluate the feasibility of a long-term surviving DHCA model without blood priming in rats, in order to investigate the pathophysiology of long-term complications in further studies...
December 8, 2018: Artificial Organs
Graham R McClure, Emilie P Belley-Cote, John Harlock, Andre Lamy, Michael Stacey, P J Devereaux, Richard P Whitlock
PURPOSE: Postoperative infection, particularly in cardiac surgery, results in significant morbidity, mortality, and healthcare cost. Identification of novel predictors of postoperative infection can target high-risk populations for prophylactic intervention. METHODS: Steroids in cardiac surgery (SIRS) was a multi-centre randomized-controlled trial assessing intraoperative administration of methylprednisone during cardiac surgery, which enrolled 7,507 patients across 80 centres in 18 countries...
December 10, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Hosam Serag, Jonathan M Featherstone, David F Griffiths, Dheeraj Mehta, John Dunne, Owen Hughes, Philip N Matthews
Objective: To report our long-term outcomes of surgical treatment of renal tumours with inferior vena cava (IVC) tumour thrombus above the hepatic veins, utilising cardiopulmonary bypass (CBP) and hypothermic circulatory arrest (HCA), as surgical resection remains the only effective treatment for renal cancers with extensive IVC tumour thrombus. Patients and methods: We retrospectively reviewed 48 consecutive patients (median age 58 years) who underwent surgical treatment for non-metastatic renal cancer with IVC tumour thrombus extending above the hepatic veins...
December 2018: Arab Journal of Urology
Ziae Totonchi, Rasoul Azarfarin, Louise Jafari, Alireza Alizadeh Ghavidel, Bahador Baharestani, Azin Alizadehasl, Farideh Mohammadi Alasti, Mohammad Hassan Ghaffarinejad
Background: The use of short-acting anesthetics, muscle relaxation, and anesthesia depth monitoring allows maintaining sufficient anesthesia depth, fast recovery, and extubation of the patients in the operating room (OR). We evaluated the feasibility of extubation in the OR in cardiac surgery. Methods: This clinical trial was performed on 100 adult patients who underwent elective noncomplex cardiac surgery using cardiopulmonary bypass. Additional to the routine monitoring, the patients' depth of anesthesia and neuromuscular blocked were assessed by bispectral index and nerve stimulator, respectively...
October 2018: Anesthesiology and Pain Medicine
Sona Dave, Anand Nirgude, Pinakin Gujjar, Ritika Sharma
Background and Aims: Atrial fibrillation (AF) is a common postoperative complication after cardiac surgery due to multifactorial causes. The aim of this study was to evaluate the incidence and risk factors of postoperative atrial fibrillation (POAF) after cardiac surgery under cardiopulmonary bypass (CPB). Methods: A total of 150 adult patients undergoing coronary artery bypass graft (CABG) surgery and valvular surgeries were included. They were evaluated with respect to preoperative risk factors [age, use of β-blockers, left ventricular ejection fraction (LVEF), previous myocardial infarction (MI) and diabetes], intraoperative factors (CABG or valvular surgery, duration of CPB and aortic cross clamp time) and postoperative factors (duration of inotropic support and ventilatory support)...
November 2018: Indian Journal of Anaesthesia
Christian O'Donnell, Hanjay Wang, Phat Tran, Shari Miller, Paul Shuttleworth, Jack H Boyd
BACKGROUND: Studies assessing the safety and effectiveness of Del Nido cardioplegia for adult cardiac surgery remain limited. We investigated early outcomes after coronary artery bypass grafting (CABG) using single-dose Del Nido cardioplegia vs. conventional multi-dose blood cardioplegia. Methods and Results: The 81 consecutive patients underwent isolated CABG performed by a single surgeon. The initial 27 patients received anterograde blood cardioplegia, while the subsequent 54 patients received anterograde Del Nido cardioplegia...
December 7, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
Muath Bishawi, Giorgio Zanotti, Linda Shaw, Michael MacKenzie, Anthony Castleberry, Karsten Bartels, Jacob Schroder, Eric Velazquez, Madhav Swaminathan, Joseph Rogers, Carmelo Milano
BACKGROUND: Tricuspid valve regurgitation (TR) is a common finding immediately after cardiac transplantation. However, there is a scarcity of data regarding its implication if left untreated on long term outcomes and the role of early surgical repair. METHODS: We retrospectively reviewed the Duke University Medical Center transplant database from January 2000 to June 2012 and identified a total of 542 patients that underwent orthotropic heart transplantation (OHT)...
December 5, 2018: Annals of Thoracic Surgery
Kenji Minatoya, Yosuke Inoue, Hiroaki Sasaki, Hiroshi Tanaka, Yoshimasa Seike, Tatsuya Oda, Atsushi Omura, Yutaka Iba, Hitoshi Ogino, Junjiro Kobayashi
OBJECTIVE: Total arch replacement (TAR) is an established standard surgical procedure. We report >1000 cases of TAR using a 4-branched graft with antegrade cerebral perfusion (ACP) during a 15-year period. METHODS: Since May 2001, 1005 patients who underwent total aortic replacement (mean age 69.8 ± 11.2 years; range, 9-92 years; 744 male) underwent TAR with a 4-branched graft. All surgeries were performed under hypothermia with ACP. There were 252 emergent operations for acute aortic dissection or aneurysm rupture...
October 17, 2018: Journal of Thoracic and Cardiovascular Surgery
Andre Korshin, Lars Grønlykke, Jens Christian Nilsson, Hasse Møller-Sørensen, Nikolaj Ihlemann, Sven Morten Kjøller, Sune Damgaard, Per Lehnert, Christian Hassager, Jesper Kjaergaard, Hanne Berg Ravn
OBJECTIVES: Longitudinal shortening constitutes most of the right ventricle (RV) contraction in the normal heart. However, after even uncomplicated cardiac surgery with preserved RV function a significant and sustained decrease in longitudinal contraction expressed as a reduction in tricuspid annular plane systolic excursion (TAPSE) has been observed. Why and exactly when this happens remains unsettled. The aim of this study was to evaluate the magnitude and timing of changes in TAPSE in relation to sternotomy, pericardial opening, cardiopulmonary bypass (CPB), and chest closure...
October 17, 2018: Journal of Thoracic and Cardiovascular Surgery
Yutaka Seino, Nobuko Ohashi, Hidekazu Imai, Hiroshi Baba
OBJECTIVE: To examine the authors' hypothesis that during the cardiopulmonary bypass (CPB) in children, the inferior vena cava cannula tip placed proximal to the right hepatic vein orifice would produce a higher venous drainage compared with that placed distally. DESIGN: A prospective, randomized, controlled, double-blind study. SETTING: Single university hospital. PARTICIPANTS: Thirty-two patients aged <6 years, scheduled for elective cardiac surgery using CPB for congenital heart disease...
October 23, 2018: Journal of Cardiothoracic and Vascular Anesthesia
Piotr Nikodem Rudziński, Barbara Lubiszewska, Jacek Różański, Ilona Michałowska, Mariusz Kruk, Cezary Kepka, Karolina Kryczka, Andrzej Kurowski, Wieslawa Grajkowska, Maciej Pronicki, Marcin Demkow
A 62-years-old woman was admitted to the hospital because of chronic cough, expectoration of thick mucus, hoarseness and tightness in the precordial area. Computed Tomography (CT) examination revealed the presence of a giant intrapericardial tumor with the dimensions of 80 × 38 × 32 mm. It was located anteriorly and laterally to the left atrium, posteriorly to the pulmonary trunk and the ascending aorta. This hypodense change modeled the left atrium without evidence of invasion. CT coronary angiography and 3-dimensional reconstruction were applied to enable precise planning of cardiac surgery...
2018: Frontiers in Oncology
Ilias P Doulamis, Despina N Perrea, George Mastrokostopoulos, Konstantina Drakopoulou, Konstantinos Voutetakis, Aspasia Tzani, Ioannis A Chloroyiannis
The restoration of left ventricular (LV) geometry in combination with coronary artery bypass grafting for the treatment of ischemic cardiac disease remains controversial. We hereby present the experience of our center with total arterial myocardial revascularization (TAMR) and spiral aneurysmorrhaphy for ischemic heart disease. A retrospective analysis of 101 patients with advanced cardiovascular disease who underwent TAMR and spiral aneurysmorrhaphy was performed. Spiral aneurysmorrhaphy is a modification of the linear aneurysmorrhaphy and was applied to patients who had a LV aneurysm with a diameter of less than 5 cm...
December 6, 2018: Heart and Vessels
Kristen Overton, Vidthyia Mennon, Nomvuyo Mothobi, Blake Neild, Elena Martinez, Jeffrey Masters, Peter Grant, Zakir Akhunji, Wei-Yuen Su, Adrienne Torda, Claudia M Whyte, Andrew Lloyd, Chris Weatherall, Ann Hofmeyr, Hong Foo, Kim Brookes, Debbie Marriott, Vitali Sintchenko, Kate Clezy, Pam Konecny, Jeffrey J Post
There is a global outbreak of infections due to Mycobacterium chimaera associated with cardiac surgery. The most serious infections involve prosthetic material implantation, and all have followed surgical procedures involving cardiopulmonary bypass. We describe a cluster of four cases following cardiac surgery at a tertiary referral centre in Sydney, Australia. We report novel clinical findings, including haemolysis and kidney rupture possibly related to immune reconstitution inflammatory syndrome. The positive effect of corticosteroids on haemodynamic function in two cases and the failure of currently recommended antimicrobial therapy to sterilise prosthetic valve material in the absence of surgery despite months of treatment are also critically examined...
December 2018: Internal Medicine Journal
Paulo Roberto Barbosa Évora, Agnes Afrodite Sumarelli Albuquerque, Tales Rubens de Nadai, Enio David Mente, Ajith Kumar Sankarankuty, Orlando Castro-E-Silva
Early cancer diagnosis, new therapies that increased survival of patients, besides the increasingly elderly population are some factors would be associated with possible cancer dissemination in patients under cardiopulmonary bypass (CPB) cardiac surgery. Also, the benefits, and risks, regarding long-term survival, have not yet been established. Therefore, cardiac surgery morbimortality may be superior in patients with cancer disease. Also, immunologic and inflammatory changes secondary to CPB can also increase tumor recurrence...
November 2018: Acta Cirúrgica Brasileira
Mustafa Aldag, Cemal Kocaaslan, Mehmet Senel Bademci, Zeynep Yildiz, Aydin Kahraman, Ahmet Oztekin, Mehmet Yilmaz, Tamer Kehlibar, Bulend Ketenci, Ebuzer Aydin
INTRODUCTION: The aim of this study was to determine the outcomes of patients developing ischemic stroke after coronary artery bypass grafting (CABG). METHODS: From March 2012 to January 2017, 5380 consecutive patients undergoing elective coronary surgery were analyzed. Ninety-five patients who developed ischemic strokes after on-pump coronary surgery were included in the study, retrospectively. The cohort was divided into four subgroups [total anterior circulation infarction (TACI), partial anterior circulation infarction (PACI), posterior circulation infarction (POCI), and lacunar infarction (LACI)] according to the Oxfordshire Community Stroke Project (OCSP) classification...
September 2018: Brazilian Journal of Cardiovascular Surgery
Onur Sen, Unal Aydin, Ersin Kadirogullari, Muhammed Bayram, Mehmet Karacalilar, Erhan Kutluk, Burak Onan
INTRODUCTION: Various surgical procedures for minimally invasive cardiac surgery have been described in recent decades as alternatives to median sternotomy. Cardiopulmonary bypass via femoral arterial and venous cannulation is the foundation of these procedures. In this study, we evaluated the mid-term outcomes of femoral cannulation performed with U-suture technique in patients undergoing robotic heart surgery. METHODS: A total of 216 patients underwent robotic-assisted cardiac surgery between January 2013 and April 2017...
September 2018: Brazilian Journal of Cardiovascular Surgery
Vladimir Milovanovic, Dejan Bisenic, Branko Mimic, Bilal Ali, Massimiliano Cantinotti, Ivan Soldatovic, Irena Vulicevic, Bruno Murzi, Slobodan Ilic
OBJECTIVE(S): Modified ultrafiltration has gained wide acceptance as a powerful tool against cardiopulmonary bypass morbidity in pediatric cardiac surgery. The aim of our study was to assess the importance of modified ultrafiltration within conditions of contemporary cardiopulmonary bypass characteristics. METHODS: Ninety⁻eight patients (overall cohort) weighing less than 12 kg undergoing surgical repair with cardiopulmonary bypass were prospectively enrolled in a randomized protocol to receive modified and conventional ultrafiltration (MUF group) or just conventional ultrafiltration (non-MUF group)...
December 1, 2018: Journal of Clinical Medicine
Laetitia Desplanque, Florent Hamaide-Defrocourt, Ilham Berkia, Tiffany Tourneur, Souha Albinni, Mirela Bojan
PURPOSE: Measurement of lactate concentrations during cardiac surgery with cardiopulmonary bypass (CPB) is a reliable monitoring tool for the assessment of the adequacy of perfusion, and a predictor of poor outcome. However, increased lactate production, which is multifactorial (anaerobic metabolism, hyperglycemia), increased lactate load by packed red blood cell (PRBC) transfusions, and decreased lactate clearance may all result in hyperlactatemia. The aim of this study was to estimate the clearance of lactate in infants undergoing surgery with CPB, using the lactate load from the PRBCs transfusions received during CPB...
December 4, 2018: Artificial Organs
Christian Stoppe, Julia Ney, Vladimir V Lomivorotov, Sergey M Efremov, Carina Benstoem, Aileen Hill, Ekaterina Nesterova, Elena Laaf, Andreas Goetzenich, Bernard McDonald, Arne Peine, Gernot Marx, Karl Fehnle, Daren K Heyland
BACKGROUND: Cardiovascular surgery patients with a prolonged intensive care unit (ICU) stay may benefit most from early nutrition support. Using established scoring systems for nutrition assessment and operative risk stratification, we aimed to develop a model to predict a prolonged ICU stay ≥5 days in order to identify patients who will benefit from early nutrition interventions. METHODS: This is a retrospective analysis of a prospective observational study of patients undergoing elective valvular, coronary artery bypass grafting, or combined cardiac surgery...
December 2, 2018: JPEN. Journal of Parenteral and Enteral Nutrition
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