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Extracorporeal circulation

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https://www.readbyqxmd.com/read/28538190/post-traumatic-inferior-vena-cava-thrombosis-a-case-report-and-review-of-literature
#1
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...
May 15, 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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
https://www.readbyqxmd.com/read/28486627/re-exploration-due-to-bleeding-is-not-associated-with-severe-postoperative-complications
#10
Sandeep P Tambe, Hans-Henrik Kimose, Jakob Raben Greisen, Carl-Johan Jakobsen
OBJECTIVES: In cardiac surgery, postoperative bleeding remains a frequent complication with various possible adverse outcomes. Re-exploration due to bleeding is frequent in this type of patient. Sternal wound infection is an infrequent but serious and devastating complication. Whether re-exploration due to bleeding significantly affects the incidence of sternal wound infection is uncertain. There is no consensus on allowed severity of bleeding and timing of intervention. METHODS: A retrospective, observational cohort study of 15 350 consecutive patients who underwent cardiac surgical procedures from 1 April 2006 through 31 December 2013 in 3 different university hospitals in Denmark was performed...
May 8, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28484359/evaluation-of-congenital-heart-defects-treatment-options-establishment-of-pediatric-cardiology-cardiosurgery-in-bosnia-and-herzegovina
#11
REVIEW
Zijo Begic, Sanko Pandur, Edo Omerbasic, Almira Kadic, Mirza Halimic
INTRODUCTION: Modern pediatric cardiology mainly deals with congenital heart defects (CHD), as the most common congenital anomalies. In most cases CHD requires surgical or interventional treatment. GOAL: The goal of the research was to evaluate CHD treatment at Pediatric Clinic, University Clinical Center (UCC) Sarajevo, Bosnia and Herzegovina (B&H). UCC Sarajevo is the only institution in B&H where cardiac treatment of CHD in pediatric population is performed. Pediatric cardiosurgery has started to develop in Bosnia and Herzegovina in April 1997...
March 2017: Materia Socio-medica
https://www.readbyqxmd.com/read/28473653/clinical-use-of-venoarterial-extracorporeal-membrane-oxygenation
#12
REVIEW
G Wy Ng, H J Yuen, K C Sin, A Kh Leung, K W Au Yeung, K Y Lai
With advances in mechanical circulation, venoarterial extracorporeal membrane oxygenation has become an established technique to provide cardiopulmonary support for patients with cardiovascular collapse. This article reviews the physiological principles of such extracorporeal technique and its interaction with the native heart. Practical aspects including equipment, patient selection, and common complications with their prevention and specific management are summarised. The strategy for weaning from venoarterial extracorporeal membrane oxygenation is also discussed...
May 5, 2017: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/28470926/prevalence-of-hemolysis-and-metabolic-acidosis-in-patients-with-circulatory-failure-supported-with-extracorporeal-life-support-a-marker-for-survival
#13
Karla Lehle, Matthias Lubnow, Alois Philipp, Maik Foltan, Florian Zeman, York Zausig, Dirk Lunz, Christof Schmid, Thomas Müller
AIMS: Elevated levels of plasma free hemoglobin (fHb) indicate red blood cell (RBC) damage. The aim of this study was to analyze the prevalence of hemolysis and metabolic acidosis in patients on extracorporeal life support (ECLS) and to investigate whether it is a marker for outcome. METHODS AND RESULTS: This retrospective analysis included 215 adult patients with cardiac failure treated with ECLS. The cohort was divided into three groups: ECLS (1) during ongoing cardiopulmonary resuscitation (CPR, n = 110); (2) after CPR with return of spontaneous circulation and sustained cardiogenic shock (n = 45); (3) in severe cardiogenic shock without previous CPR (n = 60)...
May 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28459322/fifty-years-of-research-in-ards-is-extracorporeal-circulation-the-future-of-acute-respiratory-distress-syndrome-management
#14
Alain Combes, Antonio Pesenti, V Marco Ranieri
Mechanical ventilation (MV) remains the cornerstone of acute respiratory distress syndrome (ARDS) management. It guarantees sufficient alveolar ventilation, high FiO2 concentration, and high positive end-expiratory pressure levels. However, experimental and clinical studies have accumulated, demonstrating that MV also contributes to the high mortality observed in patients with ARDS by creating ventilator-induced lung injury. Under these circumstances, extracorporeal lung support (ECLS) may be beneficial in two distinct clinical settings: to rescue patients from the high risk for death associated with severe hypoxemia, hypercapnia, or both not responding to maximized conventional MV, and to replace MV and minimize/abolish the harmful effects of ventilator-induced lung injury...
May 1, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28451038/-myxoma-involving-posterolateral-leaflet-about-a-case
#15
Fouad Nya, Abdessamad Abdou, Mehdi Bamous, Younes Moutakiallah, Noureddine Atmani, Aniss Seghrouchni, Mahdi Aithoussa, Abdellatif Boulahya
Cardiac myxomas are the most common type of primary cardiac tumors. They mainly affect the interatrial septum and exceptionally the heart valves. Surgical excision remains the only therapeutic alternative. We here report the case of a 69-year old patient with no significant pathological history suffering from NYHA class II-III dyspnea associated with lipothymia. Transthoracic echocardiography showed a tight calcified aortic narrowing with aortic valve gradient of 58 mmHg. A sessile mass of 15mm diameter inserted into the posterolateral leaflet, without stenosis or mitral regurgitation evoking an atypical localization of myxomaor or fibroelastoma was detected at the level of the mitral valve...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28440792/an-extra-uterine-system-to-physiologically-support-the-extreme-premature-lamb
#16
Emily A Partridge, Marcus G Davey, Matthew A Hornick, Patrick E McGovern, Ali Y Mejaddam, Jesse D Vrecenak, Carmen Mesas-Burgos, Aliza Olive, Robert C Caskey, Theodore R Weiland, Jiancheng Han, Alexander J Schupper, James T Connelly, Kevin C Dysart, Jack Rychik, Holly L Hedrick, William H Peranteau, Alan W Flake
In the developed world, extreme prematurity is the leading cause of neonatal mortality and morbidity due to a combination of organ immaturity and iatrogenic injury. Until now, efforts to extend gestation using extracorporeal systems have achieved limited success. Here we report the development of a system that incorporates a pumpless oxygenator circuit connected to the fetus of a lamb via an umbilical cord interface that is maintained within a closed 'amniotic fluid' circuit that closely reproduces the environment of the womb...
April 25, 2017: Nature Communications
https://www.readbyqxmd.com/read/28429535/a-cross-circulated-bicephalic-model-of-head-transplantation
#17
Peng-Wei Li, Xin Zhao, Yun-Long Zhao, Bing-Jian Wang, Yang Song, Zi-Long Shen, Hong-Jun Jiang, Hai Jin, Sergio Canavero, Xiao-Ping Ren
AIMS: A successful cephalosomatic anastomosis ("head transplant") requires, among others, the ability to control long-term immune rejection and avoidance of ischemic events during the head transference phase. We developed a bicephalic model of head transplantation to study these aspects. METHODS AND RESULTS: The thoracic aorta and superior vena cava of a donor rat were anastomosed with the carotid artery and extracorporeal veins of a recipient rat by vascular grafts...
April 21, 2017: CNS Neuroscience & Therapeutics
https://www.readbyqxmd.com/read/28421779/oral-glutamine-reduces-myocardial-damage-after-coronary-revascularization-under-cardiopulmonary-bypass-a-randomized-clinical-trial
#18
Mariana Chávez-Tostado, Fernando Carrillo-Llamas, Porfirio Eduardo Martínez-Gutiérrez, Araceli Alvarado-Ramírez, Jaime Gilberto López-Taylor, José Clemente Vásquez-Jiménez, Clotilde Fuentes-Orozco, Jorge Rendón-Félix, Leire Irusteta-Jiménez, Vanessa Carolina Calil-Romero, José Antonio Ramírez-Jiménez, Luis Rodrigo Michel-Espinoza, Carmen Karina Contreras-López, Lizbeth Araceli Cuesta-Márquez, Alejandro González-Ojeda
BACKGROUND: Glutamine is the most abundant free amino acid in the body. It modulates immune cell function and is an important energy substrate for cells in critically ill patients. Reduction of injury cardiac markers had been observed in patients receiving intravenous glutamine and in a pilot study with oral glutamine. The aim of this study was to analyze the effect of preoperative oral supplementation of glutamine on postoperative serum levels of cardiac injury markers. METHODS: A randomized clinical trial was performed in 28 Mexican patients with ischemic heart disease who underwent cardiopulmonary bypass with extracorporeal circulation...
March 30, 2017: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
https://www.readbyqxmd.com/read/28407819/-association-between-fluid-overload-and-acute-renal-injury-after-congenital-heart-disease-surgery-in-infants
#19
De-Qiang Luo, Zi-Li Chen, Wei Dai, Feng Chen
OBJECTIVE: To study the association between fluid overload and acute kidney injury (AKI) after congenital heart disease surgery in infants. METHODS: A retrospective analysis was performed on 88 infants aged less than 6 months who underwent a radical surgery for congenital heart disease. The treatment outcomes were compared between the infants with AKI after surgery and those without. The effect of cumulative fluid overload on treatment outcomes 2 days after surgery was analyzed...
April 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/28403531/short-term-effects-of-extracorporeal-graft-rinse-versus-circulatory-graft-rinse-in-living-donor-liver-transplantation-a-prospective-randomized-controlled-trial
#20
Amr M Yassen, Waleed R Elsarraf, Mohamed A Elmorshedi, Mohamed Abdel Wahab, Tarek Salah, Ahmed M Sultan, Ahmed N Elghawalby, Mohamed M Elshobari, Mohamed Elsadany, Khaled Zalata, Usama Shiha
BACKGROUND: Living donor liver transplantation has shorter cold ischemia time, less preservative volume and lower metabolic load compared to transplantation from deceased donors. We investigated the impact of rinsing the graft contents into the systemic circulation on operative course and post-operative outcomes. PATIENTS AND METHODS: Donors had right hepatectomy and grafts were preserved with cold Histidine-Tryptophan-Ketoglutarate solution. On ending portal vein anastomosis, grafts were flushed by patient's portal blood; either through incompletely anastomosed hepatic vein (Extracorporeal Rinse group, EcRg, n=40) or into systemic circulation (Circulatory Rinse group, CRg, n=40)...
April 12, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
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