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Extracorporeal circulation

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https://www.readbyqxmd.com/read/28617371/-cognitive-dysfunction-and-content-of-inflammatory-markers-in-patients-after-coronary-artery-bypass-graft
#1
D A Ovchinnikov, D D Amosov, E A Vorobyov, V V Garnyuk, P P Beltiukov, V K Grebennik, M L Gordeev, E R Barantsevich
AIM: To study the relationship between the content of inflammatory biomarkers and cognitive function in patients after coronary artery bypass graft (CABG) performed in condition of artificial blood circulation (ABC) or open-heart surgery (OHS). MATERIAL AND METHODS: Twenty-nine patients with ischemic heart disease who survived CABG, mean age 62.4±6.2 years, were studied. The ABC group (n=18) and OHS group (n=11) were matched for age and sex. Patients underwent standard clinical examination as well as neurological examination and neuropsychological testing...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/28616347/intraoperative-care-for-aortic-surgery-using-circulatory-arrest
#2
REVIEW
Félix Ezequiel Fernández Suárez, David Fernández Del Valle, Adrián González Alvarez, Blanca Pérez-Lozano
The total circulatory arrest (CA) is necessary to achieve optimal surgical conditions in certain aortic pathologies, especially in those affecting the ascending aorta and aortic arch. During this procedure it is necessary to protect all the organs of ischemia, especially those of the central nervous system and for this purpose several strategies have been developed. The first and most important protective method is systemic hypothermia. The degree of hypothermia and the route of application have been evolving and currently tend to use moderate hypothermia (MH) (20...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28616343/debranching-aortic-surgery
#3
REVIEW
Manuel Alonso Pérez, José Manuel Llaneza Coto, José Antonio Del Castro Madrazo, Carlota Fernández Prendes, Mario González Gay, Amer Zanabili Al-Sibbai
Conventional open surgery still remains as the gold standard of care for aortic arch and thoracoabdominal pathology. In centers of excellence, open repair of the arch has been performed with 5% immediate mortality and a low rate of complications; however overall mortality rates are around 15%, being up to 40% of all patients rejected for treatment due to their age or comorbidities. For thoracoabdominal aortic pathology, data reported from centers of excellence show immediate mortality rates from 5% to 19%, spinal cord ischemia from 2...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28614862/-thoracic-trauma-prehospital-treatment
#4
Michael Hansen, Thomas Hachenberg
Penetrating thoracic injuries are rare in Germany and common in urban regions. 10 percent of the patients in Emergency Departments suffer from blunt thoracic trauma. Mechanism of trauma can predict the severity of the injuries. Very fast life-threatening injuries with hemodynamic problems like tension pneumothorax or cardiac tamponade have to be diagnosed. Prehospital emergency physicians need skills in ultrasound for diagnosis and in invasive therapy like chest tube or pericardium drainage tube. The application of an algorithm in exploration of a thoracic trauma seems to be useful...
June 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28612619/-isolated-perfusion-of-the-upper-extremity-with-tnf-%C3%AE-double-venous-cannulation
#5
M Špaček, P Mitáš, M Vočka, L Lacina, G Hodková, R Špunda, O Kodet, I Krajsová, L Petruželka, J Trnka, J Kubinyi, Z Matějovský, L Lambert, J Lindner
BACKGROUND: The authors present a technical variation of the standard cannulation for cardiopulmonary bypass perfusion during hyperthermic isolated limb perfusion (ILP) procedures in selected patients with unresectable soft tissue sarcoma or malignant melanoma. PATIENTS: Of 55 ILP procedures performed at our institution since the procedure was established in 2009, nine were performed at the upper extremity. Standard single venous cannulation was used in five cases, and extended, double venous cannulation in the last four...
2017: Klinická Onkologie: Casopis Ceské a Slovenské Onkologické Spolecnosti
https://www.readbyqxmd.com/read/28608432/xeno-pericardial-patch-repair-of-the-inferior-vena-cava-for-radical-resection-of-renal-cell-carcinoma-with-tumor-thrombus
#6
Satsuki Fukushima, Motohide Uemura, Kunihito Gotoh, Takeshi Ujike, Hiroshi Wada, Shigeru Miyagawa, Koichi Toda, Yoshiki Sawa
BACKGROUND AND OBJECTIVES: For tumor thrombus in the inferior vena cava (IVC) complicated with kidney cancer, we built a surgical team to achieve (1) en bloc tumor resection; (2) xeno-pericardial patch IVC repair; and (3) minimum organ damages. We reviewed outcome of the case series to verify rationale of this approach. METHODS: A consecutive series of 12 patients having the IVC tumor thrombus by renal cell carcinoma in the last 3 years was enrolled. Minimum kidney ischemia was induced in five cases (Procedure I), whereas liver and kidney ischemia was induced in five cases (Procedure II)...
June 12, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28562481/extracorporeal-life-support-increases-survival-after-prolonged-ventricular-fibrillation-cardiac-arrest-in-the-rat
#7
Ingrid Anna Maria Magnet, Florian Ettl, Andreas Schober, Alexandra-Maria Warenits, Daniel Grassmann, Michael Wagner, Christoph Schriefl, Christian Clodi, Ursula Teubenbacher, Sandra Högler, Wolfgang Weihs, Fritz Sterz, Andreas Janata
BACKGROUND: Extracorporeal life support (ECLS) for cardiopulmonary resuscitation (CPR) may increase end organ perfusion and thus survival when conventional CPR fails. The aim was to investigate, if after ventricular fibrillation cardiac arrest in rodents ECLS improves outcome compared to conventional CPR. METHODS: In 24 adult male Sprague-Dawley rats (460 to 510 g) resuscitation was started after 10 min of no-flow with ECLS (consisting of an open reservoir, roller pump and membrane oxygenator, connected to a cannulas in the jugular vein and femoral artery, n = 8) or CPR (mechanical chest compressions plus ventilations, n = 8) and compared to a sham group (n = 8)...
May 29, 2017: Shock
https://www.readbyqxmd.com/read/28558082/analysis-of-the-use-of-extracorporeal-circulation-on-the-in-hospital-outcomes-of-dialytic-patients-who-underwent-myocardial-revascularization-surgery
#8
Matheus Miranda, João Nelson Rodrigues Branco, Guilherme Flora Vargas, Nelson Americo Hossne, Michele Costa Yoshimoto, José Honorio de Almeida Palma da Fonseca, José Osmar Medina de Abreu Pestana, Enio Buffolo
BACKGROUND: Myocardial revascularization surgery is the best treatment for dyalitic patients with multivessel coronary disease. However, the procedure still has high morbidity and mortality. The use of extracorporeal circulation (ECC) can have a negative impact on the in-hospital outcomes of these patients. OBJECTIVES: To evaluate the differences between the techniques with ECC and without ECC during the in-hospital course of dialytic patients who underwent surgical myocardial revascularization...
December 2016: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/28553780/a-comparison-between-minimized-extracorporeal-circuits-and-conventional-extracorporeal-circuits-in-patients-undergoing-aortic-valve-surgery-is-minimally-invasive-extracorporeal-circulation-just-low-prime-or-closed-loop-perfusion
#9
Pascal Starinieri, Peter E Declercq, Boris Robic, Alaaddin Yilmaz, Michiel Van Tornout, Jasperina Dubois, Urbain Mees, Marc Hendrikx
INTRODUCTION: Even though results have been encouraging, an unequivocal conclusion on the beneficial effect of minimally invasive extracorporeal circulation (MiECC) in patients undergoing aortic valve surgery cannot be derived from previous publications. Long-term outcomes are rarely reported and a significant decrease in operative mortality has not been shown. Most studies have a limited number of patients and are underpowered. They merely report on short-term results of a heterogeneous intraoperative group using different types of ECC system in aortic valve surgery...
July 2017: Perfusion
https://www.readbyqxmd.com/read/28552656/prevalence-natural-history-and-time-dependent-outcomes-of-a-multi-center-north-american-cohort-of-out-of-hospital-cardiac-arrest-extracorporeal-cpr-candidates
#10
Joshua C Reynolds, Brian E Grunau, Jonathan Elmer, Jon C Rittenberger, Kelly N Sawyer, Michael C Kurz, Ben Singer, Alastair Proudfoot, Clifton W Callaway
AIM: Estimate prevalence of ECPR-eligible subjects in a large, North American, multi-center cohort, describe natural history with conventional resuscitation, and predict optimal timing of transition to ECPR. METHODS: Secondary analysis of clinical trial enrolling adults with non-traumatic OHCA. Primary outcome was survival to discharge with favorable outcome (mRS 0-3). Subjects were additionally classified as survival with unfavorable outcome (mRS 4-5), ROSC without survival (mRS 6), or without ROSC...
May 25, 2017: Resuscitation
https://www.readbyqxmd.com/read/28550170/right-atrial-pressure-and-venous-return-during-cardiopulmonary-bypass
#11
Per Werner Moller, Berhard Winkler, Samuel Hurni, Paul Philipp Heinisch, Andreas Martin Bloch, Soren Sondergaard, Stephan M Matthias Jakob, Jukka Takala, David Christian Berger
The relevance of right atrial pressure (RAP) as the back-pressure for venous return (QVR) and mean systemic filling pressure (MSFP) as up-stream pressure is controversial during dynamic changes of circulation. To examine the immediate response of QVR (sum of caval vein flows) to changes in RAP and pump function we used a closed chest, central cannulation, heart bypass porcine preparation (n=10) with veno-arterial extracorporeal membrane oxygenation (ECMO). MSFP was determined by clamping ECMO tubing with open or closed arterio-venous shunt at Euvolemia, Volume Expansion (9...
May 26, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/28538190/post-traumatic-inferior-vena-cava-thrombosis-a-case-report-and-review-of-literature
#12
Amine Chakroun, Mohamed Said Nakhli, Mohamed Kahloul, Mohamed Amine Harrathi, Walid Naija
INTRODUCTION: Post traumatic inferior vena cava (IVC) thrombosis is a rare and not well described entity with nonspecific clinical presentation. It remains a therapeutic challenge in traumatic context because of haemorrhagic risk due to anticoagulation. PRESENTATION OF CASE: We report a case of IVC thrombosis in an 18 year-old man who presented with liver injury following a traffic crash. The thrombosis was incidentally diagnosed on admission by computed tomography...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28532425/combined-pulmonary-and-left-ventricular-support-with-veno-pulmonary-ecmo-and-impella-5-0-for-cardiogenic-shock-after-coronary-surgery
#13
Sameh Sayed, Christoph Schimmer, Ina Shade, Rainer Leyh, Ivan Aleksic
BACKGROUND: Mechanical circulatory support is a common practice nowadays in the management of patients after cardiogenic shock due to myocardial infarction. The single or combined use of one or more devices for mechanical support depends not only on the advantage or disadvantage of these devices but also on the timing of use of these devices before the development of multi organ failure. In our case we used more than one tool for mechanical circulatory support during the prolonged and complicated course of our patient with postcardiotomy cardiogenic shock after coronary artery bypass surgery...
May 22, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28528032/a-surprising-alliance-two-giants-of-the-20th-century
#14
Robert M Sade
Alexis Carrel and Charles Lindbergh were among the most famous international figures in the 20th century: Carrel, the surgeon-scientist who won a Nobel prize as a young surgeon, and Lindbergh, the aviator-engineer who pioneered aviation and promoted commercial flight throughout his life. Surprisingly, these two amazing individuals came together to collaborate on the early development of extracorporeal circulation. Their work was interrupted by the onset of World War II, which destroyed one of them and nearly destroyed the other...
June 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28521602/dynamic-alterations-in-cerebral-celiac-and-renal-flows-resulting-from-ascending-aorta-subclavian-artery-and-femoral-artery-cannulations-of-extracorporeal-devices
#15
Sahin Iscan, Habib Cakir, Bortecin Eygi, Ismail Yurekli, Koksal Donmez, Pınar Unde Ayvat, Derya Sarıkaya Pekel, Mert Kestelli
INTRODUCTION: The aim of this study was to assess the relationships among cardiac output, extracorporeal blood flow, cannulation site, right (RCa) and left carotid (LCa), celiac (Ca) and renal artery (Ra) flows during extracorporeal circulation. METHODS: A mock circulatory circuit was assembled, based on a compliant anatomical aortic model. The ascending aorta, right subclavian and femoral artery cannulations were created and flow was provided by a centrifugal pump (Cp); cardiac output was provided by a roller pump (Rp)...
May 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28510738/pharmacokinetic-pharmacodynamic-model-for-unfractionated-heparin-dosing-during-cardiopulmonary-bypass
#16
X Delavenne, E Ollier, S Chollet, F Sandri, J Lanoiselée, S Hodin, A Montmartin, J-F Fuzellier, P Mismetti, L Gergelé
Background: High-dose heparin is used during cardiopulmonary bypass (CPB) to prevent thrombosis in the circuits used for extracorporeal circulation. The aim of this study was, initially, to develop a population pharmacokinetic/pharmacodynamic (PK/PD) model to assess the variability of PK/PD parameters and their correlation with the results of the routine haemostatic test activated clotting time (ACT) and thereafter to develop a Bayesian estimator enabling an individualized dosing strategy...
May 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28505628/markers-of-intestinal-damage-and-their-relation-to-cytokine-levels-in-cardiac-surgery-patients
#17
Quirine L M Habes, Vera Linssen, Suzan Nooijen, Dorien Kiers, Jelle Gerretsen, Peter Pickkers, Gert Jan Scheffer, Matthijs Kox
OBJECTIVES: In patients undergoing cardiac surgery, both extracorporeal circulation (ECC) and intraoperative mesenterial hypoperfusion may account for increased cytokine levels and lead to postoperative gastrointestinal (GI) symptoms. METHODS: We investigated levels of the intestinal damage markers intestinal fatty acid binding protein (I-FABP in plasma [n = 72] and urine [n = 37]), citrulline (in plasma [n = 35]), and claudin-3 (in urine [n = 37]) in patients undergoing aortic or mitral valve surgery with or without coronary artery bypass grafting...
June 2017: Shock
https://www.readbyqxmd.com/read/28502887/open-surgical-treatment-of-secondary-aorto-esophageal-and-aortobronchial-fistula-after-thoracic-endovascular-aortic-repair-and-esophagocoloplasty-in-a-second-procedure
#18
Milos Sladojevic, Milos Bjelovic, Nikola Ilic, Perica Mutavdzic, Igor Koncar, Marko Dragas, Lazar Davidovic
INTRODUCTION: Aorto-esophageal (AEF) and aortobronchial fistula (ABF) after TEVAR are rare complications with catastrophic consequences without treatment. In this case report we presented a patient with AEF and ABF after TEVAR successfully treated with endograft explantation and replaced by Dacron graft followed by esophagectomy and left principal bronchus repairing. CASE REPORT: We report a patient with AEF and ABF after TEVAR who was evaluated due to dysphagia and chest pain followed by hematemesis and hemoptysis...
May 11, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28499654/hybrid-extracorporeal-membrane-oxygenation-using-avalon-elite-double-lumen-cannula-ensures-adequate-heart-brain-oxygen-supply
#19
Ju Zhao, Dongfang Wang, Cherry Ballard-Croft, Jingkun Wang, Po-Lin Hsu, Matthew Bacchetta, Joseph B Zwischenberger
BACKGROUND: Differential hypoxia exists in peripheral venoarterial (VA) extracorporeal membrane oxygenation (ECMO) patients with compromised lungs, causing hypoxic damage to heart or brain. We proposed an Avalon Elite (Maquet, Rastatt, Germany) double lumen cannula-based hybrid ECMO to add a venovenous (VV) blood flow into the pulmonary circulation onto the existing VA ECMO circuit to increase oxygen saturation in the left ventricle and ascending aorta, mitigating heart/brain hypoxia...
May 9, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28498910/extra-anatomical-bypass-in-complex-and-recurrent-aortic-coarctation-and-hypoplastic-arch%C3%A2
#20
Eva Maria Delmo Walter, Mariano Francisco Del Maria Javier, Roland Hetzer
OBJECTIVES: Our goal was to report the selection schemes, technical variations and long-term outcome of extra-anatomical bypass to correct complex, recurrent aortic coarctation and hypoplastic aortic arch. METHODS: Between 1989 and 2012, 53 patients (mean age 13.2 ± 4.3, median 11.6, range 9-23 years) with complex aortic coarctation ( n  = 33; long-segment hypoplastic aortic arch in 15), recurrent coarctation ( n  = 20; anastomosic pseudoaneurysm in 10), underwent correction using extra-anatomical bypass, either with ( n  = 18: femoral bypass = 13, left heart bypass = 5) or without ( n  = 35) extracorporeal circulation via a left lateral thoracotomy ( n = 48) and combined median sternotomy and median laparotomy ( n  = 5)...
May 11, 2017: Interactive Cardiovascular and Thoracic Surgery
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