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Extracorporeal circulation

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https://www.readbyqxmd.com/read/29049834/percutaneous-left-atrial-unloading-to-prevent-pulmonary-oedema-and-to-facilitate-ventricular-recovery-under-extracorporeal-membrane-oxygenation-therapy
#1
Alexander M Bernhardt, Mathias Hillebrand, Yalin Yildirim, Samer Hakmi, Florian M Wagner, Stefan Blankenberg, Hermann Reichenspurner, Edith Lubos
OBJECTIVES: Left-sided unloading during extracorporeal membrane oxygenation (ECMO) therapy is crucial to prevent pulmonary oedema and facilitate ventricular recovery. We present the case of a 55-year-old man under ECMO therapy with pre-existing left ventricular (LV) thrombus formation and in need of ventricular unloading. METHODS: We implanted a 21-Fr TandemHeart Protek Solo trans-septal cannula into the left atrium using a trans-septal approach via the femoral vein...
September 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29049046/determination-of-death-in-donation-after-circulatory-death-an-ethical-propriety
#2
Andrew McGee, Dale Gardiner, Paul Murphy
PURPOSE OF REVIEW: The recently developed donation after circulatory death (DCD) heart transplant technique, pioneered by Papworth Hospital in the UK, involves the use of extracorporeal perfusion technologies to restart the donor heart in situ and thereby restore the donor's own circulation, after first isolating the donor's cerebral circulation. By restoring the circulation in the deceased donor, even if the cerebral circulation is excluded, the Papworth technique challenges the acceptability of death determination in DCD...
October 18, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29039829/-factors-for-the-development-of-persistent-postoperative-cognitive-dysfunction-in-patients-undergoing-coronary-artery-bypass-surgery-under-extracorporeal-circulation
#3
O A Trubnikova, I V Tarasova, O V Maleva, E S Kagan, O L Barbarash, L S Barbarash
AIM: To analyze the factors contributing to the increased risk of persistent postoperative cognitive dysfunction (POCD) in patients undergoing coronary artery bypass surgery (CABS) under extracorporeal circulation (EC). SUBJECTS AND METHODS: 257 male patients aged 45 to 69 years with coronary heart disease (CHD) undergoing elective CABS under EC were examined. In addition to conventional clinical examination, all the patients underwent neuropsychological testing 3-5 days before, 7-14 days and 1 year after CABS...
2017: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/29038406/-results-of-partial-atrial-resection-in-advanced-lung-cancer
#4
Yoshio Tsunezuka, Nobuhiro Tanaka, Hideki Fujimori, Isao Matsumoto, Junzo Shimizu
The present study analyzed double centers experiences with extended combined resection of the left atrium in patients with lung cancer. From January 1972 to May 2017, 32 patients underwent lung resection with partial resection of the left atrium for lung cancer. Of them,( median age 62 years, range 40 to 79 years), 25 were men (78%) and 7 were women. Twenty-three pneumonectomies (72%)were performed, of which 19 (59%) were right sided. Dissection of the interatrial groove was completed in 4 patients( 36.3%)...
October 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29033360/veno-arterial-ecmo-in-the-intensive-care-unit-from-technical-aspects-to-clinical-practice
#5
REVIEW
Arthur Le Gall, Arnaud Follin, Bernard Cholley, Jean Mantz, Nadia Aissaoui, Romain Pirracchio
The use of Veno-Arterial Extracorporeal Membrane Oxygenation (VA-ECMO) as a salvage therapy in cardiogenic shock is becoming of current practice. While VA-ECMO is potentially a life-saving technique, results are sometimes mitigated, emphasising the need for selecting the right indication in the right patient. This relies upon a clear definition of the individual therapeutic project, including the potential for recovery as well as the possible complications associated with VA-ECMO. To maximise the benefits of VA-ECMO, the basics of extracorporeal circulation should be perfectly understood since VA-ECMO can sometimes be detrimental...
October 12, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29027034/low-intensity-led-therapy-%C3%AE-640%C3%A2-%C3%A2-%C3%A2-20%C3%A2-nm-on-saphenectomy-healing-in-patients-who-underwent-coronary-artery-bypass-graft-a-randomized-double-blind-study
#6
Raimundo de Barros Araújo Júnior, Isabel Clarisse Albuquerque Gonzaga, Gilderlene Alves Fernandes, Andréa Conceição Gomes Lima, Paulo Sergio Tajra Cortelazzi, Rauirys Alencar de Oliveira, Renata Amadei Nicolau
Myocardial revascularization surgery (CABG) is the most appropriate treatment for coronary artery disease. Currently, the great challenge is to reduce postoperative complications, such as wound infections, dehiscence, pain, and patients' quality of life. The saphenectomy is the target of complications in 10% of cases, which can cause greater morbidity, time, and cost of hospitalization. Studies show that low-intensity laser or light-emitted diode (LED) therapy promotes positive biomodulation of the tissue repair process, culminating in a lower incidence of dehiscence, pain reduction, and improvement in quality of life...
October 13, 2017: Lasers in Medical Science
https://www.readbyqxmd.com/read/29020775/portable-nitric-oxide-no-generator-based-on-electrochemical-reduction-of-nitrite-for-potential-applications-in-inhaled-no-therapy-and-cardiopulmonary-bypass-surgery
#7
Yu Qin, Joanna Zajda, Elizabeth J Brisbois, Hang Ren, John Toomasian, Terry Major, Alvaro Rojas-Pena, Benjamin Carr, Thomas Johnson, Jonathan Haft, Robert H Bartlett, Andrew Hunt, Nicolai Lehnert, Mark E Meyerhoff
A new portable gas phase nitric oxide (NO) generator is described for potential applications in inhaled NO (INO) therapy and during cardiopulmonary bypass (CPB) surgery. In this system, NO is produced at the surface of a large area mesh working electrode by electrochemical reduction of nitrite ions in the presence of a soluble copper(II)-ligand electron transfer mediator complex. The NO generated is then transported into gas phase by either direct purging with nitrogen or via circulating the electrolyte/nitrite solution through a gas extraction silicone fiber-based membrane-dialyzer assembly...
October 11, 2017: Molecular Pharmaceutics
https://www.readbyqxmd.com/read/29017847/the-biomarkers-neuron-specific-enolase-and-s100b-measured-the-day-following-admission-for-severe-accidental-hypothermia-have-high-predictive-values-for-poor-outcome
#8
Sebastian Wiberg, Jesper Kjaergaard, Benedict Kjærgaard, Bjarne Møller, Bo Nørnberg, Anne Marie Sørensen, Christian Hassager, Michael Wanscher
AIM: The aim of the present study was to assess the ability of the biomarkers neuron-specific enolase (NSE) and S100 calcium-binding protein b (S100b) to predict mortality and poor neurologic outcome after 30days in patients admitted with severe accidental hypothermia. METHODS: Consecutive patients with severe accidental hypothermia, defined as a core temperature <32°C, were included. Patients were treated with active rewarming and/or extracorporeal life support (ECLS) using extra corporeal circulation (ECC) and/or extra corporeal membrane oxygenation (ECMO)...
October 7, 2017: Resuscitation
https://www.readbyqxmd.com/read/28994765/cardiopulmonary-bypass-in-a-mouse-model-a-novel-approach
#9
Nodir Madrahimov, Ruslan Natanov, Erin C Boyle, Tobias Goecke, Ann-Kathrin Knöfel, Valentyna Irkha, Anna Solovieva, Klaus Höffler, Ulrich Maus, Christian Kühn, Issam Ismail, Gregor Warnecke, Malakh-Lal Shrestha, Serghei Cebotari, Axel Haverich
As prolonged cardiopulmonary bypass becomes more essential during cardiac interventions, an increasing clinical demand arises for procedure optimization and for minimizing organ damage resulting from prolonged extracorporal circulation. The goal of this paper was to demonstrate a fully functional and clinically relevant model of cardiopulmonary bypass in a mouse. We report on the device design, perfusion circuit optimization, and microsurgical techniques. This model is an acute model, which is not compatible with survival due to the need for multiple blood drawings...
September 22, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28977412/distal-embolization-of-a-transcatheter-valve-in-a-valve-complex-a-bail-out-surgical-approach
#10
Matthew Panagiotou, Athanasios Manginas, Charalampos Kyriazis, Dimos Karangelis
Transcatheter aortic valve replacement has emerged as an alternative to surgical aortic valve replacement for high-risk and inoperable patients. Although transcatheter aortic valve replacement avoids the use of extracorporeal circulation and sternotomy, it is nonetheless associated with inherent complications. We aim to present an embolized valve-in-valve complex in the ascending aorta, which required emergency surgery with deep hypothermic circulatory arrest and proximal aortic cannulation.
July 21, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28977367/novel-mouse-model-of-cardiopulmonary-bypass
#11
Nodir Madrahimov, Erin C Boyle, Faikah Gueler, Tobias Goecke, Ann-Kathrin Knöfel, Valentyna Irkha, Lavinia Maegel, Klaus Höffler, Ruslan Natanov, Issam Ismail, Ulrich Maus, Christian Kühn, Gregor Warnecke, Malakh-Lal Shrestha, Serghei Cebotari, Axel Haverich
OBJECTIVES: Cardiopulmonary bypass (CPB) is an essential component of many cardiac interventions, and therefore, there is an increasing critical demand to minimize organ damage resulting from prolonged extracorporeal circulation. Our goal was to develop the first clinically relevant mouse model of CPB and to examine the course of extracorporeal circulation by closely monitoring haemodynamic and oxygenation parameters. METHODS: Here, we report the optimization of device design, perfusion circuit and microsurgical techniques as well as validation of physiological functions during CPB in mice after circulatory arrest and reperfusion...
July 18, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28977201/relationship-between-high-red-cell-distribution-width-and-systemic-inflammatory-response-syndrome-after-extracorporeal-circulation
#12
Harsh Sateesh Seth, Prashant Mishra, Jayant V Khandekar, Chaitanya Raut, Chandan Kumar Ray Mohapatra, Ganesh Kumar K Ammannaya, Jaskaran Singh Saini, Vaibhav Shah
OBJECTIVE: Cardiac surgical operations involving extracorporeal circulation may develop severe inflammatory response. This severe inflammatory response syndrome (SIRS) is usually associated with poor outcome with no predictive marker. Red cell distribution width (RDW) is a routine hematological marker with a role in inflammation. We aim to determine the relationship between RDW and SIRS through our study. METHODS: A total of 1250 patients who underwent cardiac surgery with extracorporeal circulation were retrospectively analyzed out of which 26 fell into the SIRS criteria and 26 consecutive control patients were taken...
July 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28977196/coronary-artery-bypass-graft-surgery-cost-coverage-by-the-brazilian-unified-health-system-sus
#13
Gilmara Silveira da Silva, Flávia Cortez Colósimo, Alexandre Gonçalves de Sousa, Raquel Ferrari Piotto, Valéria Castilho
INTRODUCTION: Cost management has been identified as an essential tool for the general control and evaluation of health organizations. OBJECTIVES: To identify the coverage percentage of transferred funds from the Unified Health System for coronary artery bypass grafts in a philanthropic hospital having a consolidated costing system in the municipality of São Paulo. METHODS: A quantitative, descriptive and cross-sectional research with information provided from a database composed of 1913 patients undergoing coronary artery bypass graft from March 13 to September 30, 2012, including isolated elective coronary artery bypass graft with the use of extracorporeal circulation...
July 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28962493/first-results-of-heartware-left-ventricular-assist-device-implantation-with-tunnelling-of-the-outflow-graft-through-the-transverse-sinus
#14
Jasmin S Hanke, Sebastian V Rojas, Tomislav Cvitkovic, Bettina Wiegmann, Alexander Horke, Gregor Warnecke, Axel Haverich, Jan D Schmitto
OBJECTIVES: The number of left ventricular assist device (LVAD) implants for the treatment of advanced heart failure is increasing tremendously. The main therapeutic goal of this operation is to provide a bridge to transplant for patients awaiting a donor heart. In 2011, we developed a novel, minimally invasive surgical technique for LVAD implantation. To avoid possible outflow graft injuries during redo sternotomies as well as to provide a more physiological outflow towards the aortic arch, a further modification of this approach was made with outflow graft tunnelling through the transverse sinus...
October 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28962216/assessing-the-impact-of-total-extracorporeal-circulation-on-hemodynamics-in-an-ovine-fetal-model
#15
Fei Xiao, Jian Zhuang, Cheng-Bin Zhou, Ji-Mei Chen, Jian-Zheng Cen, Gang Xu, Shu-Sheng Wen
The present study aimed to evaluate the impact of total extracorporeal circulation on hemodynamics and placental function in an ovine fetal model. Mid-term ovine fetuses (n=6) underwent extracorporeal circulation (30 min), cardioplegic arrest (20 min) and monitoring (120 min). The ascending aorta and umbilical cords of the fetuses were occluded during the bypass and an extracorporeal membrane oxygenator was used as the oxygen source. Biventricular intracardiac pressures, echocardiographic data, blood gas levels and placental function variables were recorded, and statistical analysis was performed using the repeated-measure analysis of variance test...
September 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28958185/targeting-the-endothelial-glycocalyx-in-acute-critical-illness-as-a-challenge-for-clinical-and-laboratory-medicine
#16
Vladimir Cerny, David Astapenko, Florian Brettner, Jan Benes, Radomir Hyspler, Christian Lehmann, Zdenek Zadak
The purpose of this manuscript is to review the role of endothelial glycocalyx (EG) in the field of critical and perioperative medicine and to discuss possible future directions for investigations in this area. Under physiological conditions, EG has several well-defined functions aimed to prevent the disruption of vessel wall integrity. Under pathological conditions, the EG represent one of the earliest sites of injury during inflammation. EG structure and function distortion contribute to organ dysfunction related to sepsis, trauma, or global ischemia of any origin...
August 2017: Critical Reviews in Clinical Laboratory Sciences
https://www.readbyqxmd.com/read/28958067/an-intra-aortic-floating-metastatic-malignancy-of-unknown-primary-origin
#17
Yoshinori Kuroda, Tetsuro Uchida, Jun Hayashi, Mitsuaki Sadahiro
A 69-year-old man with sudden strong back pain was transported to our hospital by ambulance. The computed tomography scan revealed an intra-aortic floating mass with a stalk arising from the descending aortic wall, which was thought to be a thrombus. The floating mass displayed the characteristics of a thrombus rather than a neoplastic tumour on magnetic resonance imaging scan. Under extracorporeal circulation, the descending aorta was cut open, and the mass was resected. Subsequently, a stent graft was placed to cover the abnormal aortic intima to prevent recurrent thrombus formation...
August 29, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28951873/multiple-targets-for-novel-therapy-of-fsgs-associated-with-circulating-permeability-factor
#18
REVIEW
Virginia J Savin, Mukut Sharma, Jianping Zhou, David Genochi, Ram Sharma, Tarak Srivastava, Amna Ilahe, Pooja Budhiraja, Aditi Gupta, Ellen T McCarthy
A plasma component is responsible for altered glomerular permeability in patients with focal segmental glomerulosclerosis. Evidence includes recurrence after renal transplantation, remission after plasmapheresis, proteinuria in infants of affected mothers, transfer of proteinuria to experimental animals, and impaired glomerular permeability after exposure to patient plasma. Therapy may include decreasing synthesis of the injurious agent, removing or blocking its interaction with cells, or blocking signaling or enhancing cell defenses to restore the permeability barrier and prevent progression...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28937313/shed-blood-separation-and-cell-saver-an-integral-part-of-miecc-shed-blood-separation-and-its-influence-on-the-perioperative-inflammatory-response-during-coronary-revascularization-with-minimal-invasive-extracorporeal-circulation-systems-a-randomized-controlled
#19
Adrian Bauer, Harald Hausmann, Jan Schaarschmidt, Martin Scharpenberg, Dirk Troitzsch, Peter Johansen, Hans Nygaard, Thomas Eberle, J Michael Hasenkam
OBJECTIVE: The postoperative systemic inflammatory response after cardiopulmonary bypass (CPB) is still an undesirable side-effect after cardiac surgery. It is most likely caused by blood contact with foreign surfaces and by the surgical trauma itself. However, the recirculation of activated shed mediastinal blood is another main cause of blood cell activation and cytokine release. Minimal invasive extracorporeal circulation (MiECC) comprises a completely closed circuit, coated surfaces and the separation of suction blood...
September 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28924110/bloody-bronchial-cast-formation-due-to-alveolar-hemorrhage-associated-with-h1n1-influenza-infection
#20
Yohei Okada, Asami Okada, Hiromichi Narumiya, Ryoji Iiduka, Kanade Katsura
A previously healthy 55-year-old man with H1N1 influenza A presented with severe respiratory failure and cardiac arrest. Following the return of spontaneous circulation, venovenous extracorporeal membrane oxygenation was required to maintain oxygenation. On day 2, bronchoscopy revealed a bloody bronchial cast obstructing the right main bronchus. A pathological examination revealed that it was composed of intrabronchial and intra-alveolar hemorrhagic tissue. Unfortunately, the patient died due to severe brain ischemia; a subsequent autopsy revealed marked alveolar hemorrhage...
September 15, 2017: Internal Medicine
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