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Cardiopulmonary bypass surgery

Donata Ringaitiene, Lina Puodziukaite, Vaidas Vicka, Dalia Gineityte, Mindaugas Serpytis, Jurate Sipylaite
OBJECTIVE: To determine whether bioelectrical impedance-derived phase angle (PA) can be a predictor of red blood cell (RBC) transfusion in patients undergoing cardiac surgery. DESIGN: An observational retrospective study of prospectively collected data. SETTING: Single center, tertiary referral university hospital. PARTICIPANTS: The study sample comprised 642 adult patients undergoing elective cardiac surgery. INTERVENTIONS: Patient demographic and clinical variables were collected...
July 7, 2018: Journal of Cardiothoracic and Vascular Anesthesia
Gunnar Malmqvist, Helena Claesson Lingehall, Micael Appelblad, Staffan Svenmarker
INTRODUCTION: In the literature addressing cardiopulmonary bypass (CPB) prime composition, there is a considerable lack of discussion concerning plasma osmolality changes induced by using a hyperosmolar prime. With this study, we try to determine the magnitude and temporal relationship of plasma osmolality changes related to the use of a hyperosmolar CPB prime. METHOD: In this prospective observational study performed in a university hospital setting, we enrolled thirty patients scheduled for elective coronary bypass surgery...
August 16, 2018: Perfusion
Cenk Oezpeker, Fabian Barbieri, Vitalijs Zujs, Michael Grimm, Antonio Lio, Mattia Glauber, Nikolaos Bonaros
OBJECTIVES:  Increasing experience with minimally invasive cardiac (MIC) aortic valve (AV) replacement makes AV reoperations (rAVR) an appealing alternative to conventional redo surgery. The aim of the study was to compare the perioperative outcome after isolated MIC versus full-sternotomy (FS) rAVR. METHODS:  We retrospectively analyzed data of 116 patients from three centers who underwent rAVR by using a FS ( n  = 70, 60.3%) or a partial upper sternotomy approach ( n  = 46, 39...
August 16, 2018: Thoracic and Cardiovascular Surgeon
Lei Zou, Xiaochun Song, Liang Hong, Xiao Shen, Jiakui Sun, Cui Zhang, Xinwei Mu
During the perioperative period of cardiac disease, as many risk factors exist, such as primary cardiac diseases, the use of vasopressors, ischemia-reperfusion injury during cardiopulmonary bypass (CPB), and surgical stress, the gut suffered from ischemia, anoxia and oxidative stress, which would lead to the enterocyte injury. The aim of this study was to explore whether serum intestinal fatty acid-binding protein (IFABP), which is excreted specifically from damaged intestinal enterocytes, as a predictor of prognosis in postoperative cardiac surgery patients...
August 2018: Medicine (Baltimore)
George Drosos, Fotini Ampatzidou, Pantelis Sarafidis, Theodoros Karaiskos, Athanasios Madesis, Afroditi K Boutou
BACKGROUND: Most studies evaluating predictors of renal replacement therapy (RRT) following cardiac surgery use arbitrary defined limits of preoperative serum creatinine. The aim of this study was to evaluate the effect of preoperative renal function using either estimated-glomerular filtration rate (eGFR) derived using Chronic Kidney Disease-Epidemiology (CKD-EPI) or serum creatinine alone as a predictor for RRT after cardiac surgery. METHODS: In this prospective cohort study, baseline, intraoperative, and postoperative data of all patients who underwent an elective, urgent, or emergency cardiac surgery between 2012 and 2016 in a single center were analyzed in order to identify multivariate parameters determining the need for RRT after surgery...
August 15, 2018: American Journal of Nephrology
Qiang Lü, Deliang Wang, Dongli Xie
To explore the effect of ulinastatin on perioperative glycocalyx and lung function in patients undergoing mitral valve replacement surgery.
 Methods: Fourty patients, undergoing mitral valve replacement, were randomly allocated into a control group and an ulinastatin group, which were administrated 50 mL normal saline or 2×104 U/kg ulinastatin at the beginning of cardiopulmonary bypass (CPB), respectively. The radical artery blood was collected at 4 time points: After induction of anesthesia (T0), at 10 min after the start of CPB (T1), 1 h after the end of CPB (T2), and 8 h after operation...
June 28, 2018: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
Jae H Choi, Jessica G Y Luc, Ester Moncho Escrivá, Kevin Phan, Syed S A Rizvi, Sinal Patel, John W Entwistle, Rohinton J Morris, H T Massey, Vakhtang Tchantchaleishvili
The aim of this systematic review and meta-analysis was to evaluate the outcomes of concomitant mitral valve surgery for significant preexisting mitral regurgitation (MR) in patients undergoing continuous-flow left ventricular assist device (CF-LVAD) implantation. Electronic search was performed to identify all studies in the English literature examining concurrent mitral valve surgery in patients with CF-LVAD implantation. Identified articles were systematically assessed for inclusion and exclusion criteria...
August 12, 2018: Artificial Organs
Nicholas Sellke, Caroline Gordon, Isabella Lawandy, Anastassia Y Gorvitovskaia, Laura A Scrimgeour, James G Fingleton, Frank W Sellke, Jun Feng
BACKGROUND: We have previously found that hyperkalemic cardioplegic arrest in the setting of cardiopulmonary bypass (CP/CPB) is associated with impairment of the coronary arteriolar response to phenylephrine in nondiabetic (ND) patients. We hypothesized that diabetes may alter coronary arteriolar response to alpha-1 adrenergic agonist in the setting of CP/CPB. In this study, we further investigated the effects of diabetes on the altered coronary arteriolar response to phenylephrine in patients undergoing cardiac surgery...
October 2018: Journal of Surgical Research
Haci Ali Ucak, Hasan Uncu
PURPOSE: In this study, we aim to investigate the efficacy and clinical results of using Del Nido solution (DNS) in coronary artery bypass grafting (CABG) surgery by comparing with intermittent warm blood cardioplegia (IWBC). METHODS: Between March 2017 and February 2018, 297 adult patients who underwent primary isolated CABG surgery with cardiopulmonary bypass (CPB) were included in the study. We used DNS in 112 patients and IWBC was used in 185 patients. We compared both the clinical and the laboratory results...
August 9, 2018: Annals of Thoracic and Cardiovascular Surgery
Heidi Noels, Wendy Theelen, Marieke Sternkopf, Vera Jankowski, Julia Moellmann, Sandra Kraemer, Michael Lehrke, Nikolaus Marx, Lukas Martin, Gernot Marx, Joachim Jankowski, Andreas Goetzenich, Christian Stoppe
Cardiac surgery with cardiopulmonary bypass (CPB) triggers myocardial ischemia/reperfusion injury contributing to organ dysfunction. Preclinical studies revealed that dipeptidyl peptidase (DPP4) inhibition is protective during myocardial infarction. Here, we assessed for the first time the relation of peri-operative DPP4-activity in serum of 46 patients undergoing cardiac surgery with patients' post-operative organ dysfunction during intensive care unit (ICU) stay. Whereas a prior myocardial infarction significantly reduced pre-operative DDP4-activity, patients with preserved left ventricular function showed an intra-operative decrease of DPP4-activity...
August 7, 2018: Scientific Reports
Susan A Maroney, Julie A Peterson, Wes Zwifelhofer, Nicholas D Martinez, Ke Yan, Rachel S Bercovitz, Ronald K Woods, Alan E Mast
BACKGROUND:  Neonates undergoing cardiopulmonary bypass (CPB) surgery to correct congenital heart defects often experience excessive bleeding. Exposure of blood to artificial materials during CPB may activate coagulation, complement and inflammatory pathways. In addition, the surgical stress placed on the haemostatic system may result in cross-activation of other plasma proteolytic cascades, which could further complicate physiological responses to the surgical procedure and post-operative recovery...
August 7, 2018: Thrombosis and Haemostasis
Bo Yu, ZhenHua Liu, Chao Xue, JinCheng Liu, Jian Yang, ZhenXiao Jin, ShiQiang Yu, WeiXun Duan
OBJECTIVES: The aim of this study was to evaluate the safety and feasibility of total arch repair with open placement of a novel double-branched stent graft for acute Type A aortic dissection (TAAD). METHODS: We retrospectively analysed the effect of the double-branched stent graft for total aortic arch placement with acute TAAD from December 2013 to February 2015. The effectiveness of the open placement of the double-branched stent graft was estimated by complete thrombus obliteration of the false lumen surrounding it on computed tomography angiography...
August 1, 2018: Interactive Cardiovascular and Thoracic Surgery
Ayse Cetinkaya, Peter Bramlage, Markus Schönburg, Manfred Richter
We report on a 61-year-old man with a previously unknown interruption of the inferior vena cava who was scheduled to undergo minimally invasive mitral and tricuspid valve surgery. We aimed to establish a cardiopulmonary bypass using femorofemoral cannulation under transoesophageal echocardiography. In spite of multiple attempts, the positioning of the venous wire in the right atrium was not accomplished. The intervention was subsequently performed by an open sternotomy. Further to the intervention, the patient underwent thoraco-abdominal multislice computed tomography that excluded the presence of an abdominal tumour or vena cava thrombosis but revealed atresia of the inferior vena cava...
July 31, 2018: Interactive Cardiovascular and Thoracic Surgery
Carlos A Mestres, Eduard Quintana, Tomislav Kopjar, Juan Ambrosioni, Manuel Almela, David Fuster, Salvador Ninot, José M Miró
OBJECTIVES: The aim of this study was to analyse outcomes over 2 decades using cryopreserved vascular allografts to treat vascular infection. METHODS: We conducted a retrospective study of patients identified from our institutional database who were treated for primary or secondary vascular infection using implanted allografts. RESULTS: Between October 1992 and May 2014, 54 patients underwent surgery for vascular infection out of 118 patients implanted with cryopreserved vascular allografts...
August 1, 2018: European Journal of Cardio-thoracic Surgery
Saygin Turkyilmaz, Ali Aycan Kavala
PURPOSE: To compare the operative and post-operative outcomes of mitral valve surgery (MVS) with a superior transseptal (STS) approach and a left atriotomy (LA) approach. METHODS: In a tertiary academic center, the charts of patients who underwent MVS between 2012 and 2016 were analyzed retrospectively. A total of 135 patients underwent MVS. Forty patients who underwent MVS with the STS approach were enrolled in the study as the STS group. In the same period, we selected 40 patients who underwent MVS with the LA approach to serve as the control group (LA group)...
July 26, 2018: Heart Surgery Forum
Hunbo Shim, Chang Seok Jeon, Pyo Won Park, Wook Sung Kim, Young Tak Lee, Dong Seop Jeong, Yang-Hyun Cho, Kiick Sung
ackground: Repeated thoracic aorta repair is increasingly common. With the increase in hybrid procedures, determination of the best treatment strategy requires evaluation of the clinical outcomes of classic open surgery.  Methods: We retrospectively reviewed 119 patients (84 men and 35 women, aged 51.0 ± 16.7 years) with a history of open repair involving the thoracic aorta above the diaphragm. The patients underwent an average of 1.3 ± 0.8 surgeries (range: 1-8) on the thoracic aorta before the final operation...
June 18, 2018: Heart Surgery Forum
Ania Kaiser, Kati Miller, Ganzhong Tian, Reneé H Moore, Nina A Guzzetta
INTRODUCTION: Allogeneic blood product transfusion is common in pediatric patients undergoing cardiopulmonary bypass although it is associated with an increased risk for adverse events. Furthermore, numerous donor exposures may affect future blood transfusion needs and human leukocyte antigen matching for patients who may ultimately require cardiac transplantation. Autologous intraoperative blood collection and retransfusion is a known method of blood preservation, but has not been extensively practiced in pediatric patients...
August 5, 2018: Paediatric Anaesthesia
Marco Ranucci, Tommaso Aloisio, Anna Cazzaniga, Umberto Di Dedda, Chiara Gallazzi, Valeria Pistuddi
BACKGROUND: Cardiac surgery-associated acute kidney injury (AKI) is a serious complication of cardiac surgery, even when renal replacement therapy (RRT) is not required. The existing risk models for cardiac surgery associated AKI are designed to predict AKI requiring RRT (RRT-AKI). The aim of this study is to validate three risk models for the prediction of RRT-dependent and non-RRT AKI after cardiac surgery. METHODS: Retrospective analysis on 7675 consecutive adult patients undergoing cardiac surgery with cardiopulmonary bypass...
July 24, 2018: International Journal of Cardiology
Yusuke Kusaka, Fumihiro Ohchi, Toshiaki Minami
OBJECTIVES: The aim of this study was to evaluate the accuracy, precision, and trending ability of the fourth-generation FloTrac/Vigileo system (version 4.00; Edwards Lifesciences, Irvine, CA) by comparing cardiac output derived from FloTrac/Vigileo system (COAP ) with that measured by a pulmonary artery catheter (COTD ), and to determine the effects of hemodynamic variables on the bias between COTD and COAP . DESIGN: A prospective study. SETTING: University hospital...
June 28, 2018: Journal of Cardiothoracic and Vascular Anesthesia
Hassan Mohamed, Hisham Hosny, Pierre Tawadros Md, Mohamed Elayashy Md Desa Fcai, Hossam El-Ashmawi Md
OBJECTIVES: Cardiac surgery is characterized by attenuation of microcirculatory perfusion. Dexmedetomidine has been proved to attenuate the microcirculatory derangements evoked by experimental sepsis. The authors investigated the effects of dexmedetomidine infusion on sublingual microcirculation in patients undergoing on-pump coronary artery bypass graft (CABG) surgery. DESIGN: Prospective, randomized blinded study. SETTINGS: Tertiary university hospital...
June 28, 2018: Journal of Cardiothoracic and Vascular Anesthesia
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