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Extracorporeal circulation

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https://www.readbyqxmd.com/read/29452395/mini-extracorporeal-circulation-technology-conventional-bypass-and-prime-displacement-in-isolated-coronary-and-aortic-valve-surgery-a-propensity-matched-in-hospital-and-survival-analysis
#1
Priyadharshanan Ariyaratnam, Lindsay A Mclean, Alexander Cale, Mubarak A Chaudhry, Ajith Vijayan, Neil Richards, Martin A Jarvis, Yama Haqzad, Dumbor Ngaage, Michael E Cowen, Mahmoud Loubani
OBJECTIVES: Conventional cardiopulmonary bypass is the most commonly used means of artificial circulation in cardiac surgery. However, it suffers from the effects of haemodilution and activation of inflammatory/coagulation cascades. Prime displacement (PD) can offset haemodilution and Mini-Extracorporeal Technology (MIECT) can offset both. So far, no study has compared all of these modalities together; hence, we compared the outcomes of these 3 modalities at our institution. METHODS: This was a retrospective analysis of our cardiac surgical database...
February 14, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29451667/approach-to-concurrent-coronary-and-carotid-artery-disease-epidemiology-screening-and-treatment
#2
Patrícia Feitosa Frota Dos Reis, Pedro Vieira Linhares, Fábio Grunspun Pitta, Eduardo Gomes Lima
The concomitance between coronary artery disease and carotid artery disease is known and well documented. However, it is a fact that, despite the screening methods for these conditions and the advances in surgical treatment, little has been achieved in terms of reducing the risk of complications in the perioperative period. Publications are scarce, being mostly composed of reports or case series. There is little agreement on the best initial therapeutic approach (myocardial versus carotid revascularization) or the best technique to be used (surgery with or without extracorporeal circulation, hybrid treatments, etc...
November 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/29447328/cardiac-surgery-in-adult-patients-with-remitted-or-active-malignancies-a-review-of-preoperative-screening-surgical-management-and-short-and-long-term-postoperative-results
#3
Roberto Lorusso, Enrico Vizzardi, Daniel M Johnson, Giovanni Mariscalco, Edoardo Sciatti, Jos Maessen, Elham Bidar, Sandro Gelsomino
Candidate patients for cardiac surgery procedures with a history of malignancies and antitumour therapy or with an active cancer and on antineoplastic treatment are increasingly common in daily practice. Oncological therapy can lead to cardiovascular injury and, therefore, has the potential for impacting operative risks and surgical strategies. This means that a number of considerations are essential to take into account prior to cardiac surgery. These include the type of cancer, previous cardiotoxicity or concomitant antitumour therapy, reversibility or irreversibility of such complications, the interaction between cancer disease course and extracorporeal circulation, the need for associated surgery and the impact of cancer on early and long-term outcomes...
February 13, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29443412/an-ex-vivo-comparison-of-vascular-access-devices-used-in-extracorporeal-photopheresis
#4
Jeffrey Szymanski, Priyank Shah, Marian Dynis, Donna Mansfield, Connie Hamilton, George Despotis
BACKGROUND: Central venous access devices are commonly used in extracorporeal photopheresis, but their performance has not been systematically evaluated. The primary objective of this study was to compare pressures at various flow rates for central venous access devices in an ex vivo simulation of photopheresis. STUDY DESIGN AND METHODS: Diluted, heparinized red blood cells were circulated through central access devices in series with a photopheresis system, and pressures at several flow rates were recorded...
February 2018: Transfusion
https://www.readbyqxmd.com/read/29435996/type-ii-minimal-invasive-extracorporeal-circuit-for-aortic-valve-replacement-a-randomized-controlled-trial
#5
Erich Gygax, Hans-Ulrich Kaeser, Mario Stalder, Brigitta Gahl, Robert Rieben, Thierry Carrel, Gabor Erdoes
Extracorporeal circulation triggers systemic inflammatory response and coagulation disorders which may lead to unfavorable clinical outcome. A type II minimally-invasive extracorporeal circuit (MiECC) is a closed system with markedly reduced artificial surface as compared to conventional extracorporeal circuits (CECC). The aim of this study was to investigate and compare inflammatory responses, complement activation and selected clinical end-points in isolated surgical aortic valve replacement (SAVR) performed with a type II MiECC circuit or a CECC...
February 12, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29435994/evaluation-of-the-novel-centrifugal-pump-capiox-sl-in-chronic-large-animal-experiments
#6
Kei Iizuka, Nobumasa Katagiri, Yoshiaki Takewa, Tomonori Tsukiya, Toshihide Mizuno, Yosuke Itamochi, Kouko Kumano, Eisuke Tatsumi
In the development of a new device for extracorporeal circulation, long-term durability and biocompatibility are required. The CAPIOX SL Pump (SL pump, Terumo Corporation, Tokyo, Japan), which is a centrifugal pump using a two-pivot bearing, was developed with the hope of suppressing pump thrombus formation around the bearings. This study aimed to evaluate the in vivo performance of the SL pump in the condition assumed severe clinical situation for long-term extracorporeal membrane oxygenation (ECMO) support...
February 12, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29432362/left-axillary-artery-cannulation-facilitates-reoperative-total-aortic-arch-replacement
#7
Jonathan M Hemli, Bo Gu, S Jacob Scheinerman, Derek R Brinster
Total aortic arch replacement remains a technically formidable procedure, particularly in patients with previous proximal aortic dissection repair. Our case discussion highlights a useful strategy for extracorporeal support and circulation management to facilitate total arch reconstruction in the reoperative setting, based on cannulation of the left axillary artery. Our preference is to use a left axillary artery approach to initiate cardiopulmonary bypass and to ultimately revascularize the left arm via an extra-anatomic graft...
February 9, 2018: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29419934/evaluation-of-nafamostat-mesilate-as-an-alternative-anticoagulant-during-intermittent-hemodialysis-in-healthy-beagle-dogs
#8
Joon-Hyuk Choi, Seok-Yeong Byun, Aryung Nam, Sei-Myoung Han, Kyu-Pil Lee, Kun-Ho Song, Hwa-Young Youn, Kyoung-Won Seo
OBJECTIVE: To evaluate nafamostat mesilate (NM) as an alternative anticoagulant agent for intermittent hemodialysis (IHD). DESIGN: Prospective randomized study. SETTING: University teaching hospital. ANIMALS: Eighteen healthy Beagle dogs. INTERVENTIONS: In group 1 (n = 6), NM was administered at a dose of 0.5 mg/kg/h during IHD for 5 hours. In group 2 (n = 6), NM was administered at a low dose of 0...
February 8, 2018: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/29419538/percutaneous-mechanical-circulation-support-combined-with-extracorporeal-membrane-oxygenation-oxyrvad-in-secondary-right-heart-failure
#9
Philipp M Lepper, Sabrina I Hörsch, Frederik Seiler, Annegret Kamp, Sören L Becker, Christian Lensch, Lars O Conzelmann, Hendrik Haake, Ralf M Muellenbach, Robert Bals, Markus Kredel, Frank Langer, Heinrike Wilkens, Franziska C Trudzinski
Right heart failure (RHF) because of pulmonary hypertension (PH) is a frequently encountered clinical problem with high mortality. The last resort, if pharmacological therapy fails, is mechanical circulatory support. There is a lack of percutaneous systems to support the right ventricle (RV). Venoarterial extracorporeal membrane oxygenation is widely used as a bailout in acute RHF in non-left ventricular assist device patients. Venoarterial extracorporeal membrane oxygenation does not unload the left ventricle and may cause failure of the left ventricle if used for a longer period of time...
February 6, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29416039/bfgf-plays-a-neuroprotective-role-by-suppressing-excessive-autophagy-and-apoptosis-after-transient-global-cerebral-ischemia-in-rats
#10
Dawei Sun, Wenying Wang, Xintao Wang, Yan Wang, Xiaotao Xu, Feng Ping, Yu Du, Wei Jiang, Derong Cui
Transient global cerebral ischemia (tGCI) is a cerebrovascular disorder that can cause apoptotic neuronal damage and functional deficits. Basic fibroblast growth factor (bFGF) was reported to be highly expressed in the central nervous system (CNS) and to exert neuroprotective effects against different CNS diseases. However, the effects of bFGF on tGCI have not been studied intensively. This study was conducted to investigate the effect of bFGF and its underlying mechanism in an animal model of tGCI. After intracerebroventricular (i...
February 7, 2018: Cell Death & Disease
https://www.readbyqxmd.com/read/29399761/kinetics-of-common-inflammatory-biomarkers-in-postoperative-course-after-congenital-heart-defects-procedures-with-extracorporeal-circulation-in-children
#11
Ireneusz Haponiuk, Radosław Jaworski, Konrad Paczkowski, Maciej Chojnicki, Mariusz Steffens, Aneta Szofer-Sendrowska, Katarzyna Gierat-Haponiuk, Ewelina Kwaśniak, Marta Paśko-Majewska, Katarzyna Leszczyńska, Jacek Zieliński, Wiktor Szymanowicz
BACKGROUND: The extracorporeal circulation is associated with systemic inflammatory response syndrome. Therefore, the diagnosis of infection should be differenced from typical postoperative course. AIM: Evaluation of kinetics of inflammatory biomarkers in children in the first days after cardiac surgery with extracorporeal circulation. METHODS: Prospective data collection from 51 consecutive children referred for surgical treatment [the Institution], between February 2015 and August 2015...
February 5, 2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29395828/4-valve-heart-disease-and-right-heart-failure
#12
McKenzie Hollon, Kathyrn Glas, Michele Sumler
Carcinoid heart disease is a rare form of heart disease due to secretion of vasoactive compounds, including serotonin, from gastrointestinal tumors. This E-challenge examines the case of a patient with advanced carcinoid heart disease who presented to the operating room (OR) for a tricuspid valve replacement. Once the patient was in the OR, intraoperative transesophageal echocardiography was used to discover a patent foramen ovale and involvement of all 4 valves with regurgitant lesions. The patient underwent tricuspid valve replacement, pulmonic valve replacement, right ventricular outflow tract reconstruction, and patent foramen closure in the OR and experienced subsequent fulminant right heart failure...
October 13, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29394948/high-energy-extracorporeal-shock-wave-therapy-for-nontraumatic-osteonecrosis-of-the-femoral-head
#13
Kai Xie, Yuanqing Mao, Xinhua Qu, Kerong Dai, Qingwei Jia, Zhenan Zhu, Mengning Yan
BACKGROUND: Nontraumatic osteonecrosis of the femoral head (ONFH) is treated with a series of methods. High-energy extracorporeal shock wave therapy (ESWT) is an option with promising mid-term outcomes. The objective of this study was to determine the long-term outcomes of ESWT for ONFH. METHODS: Fifty-three hips in 39 consecutive patients were treated with ESWT in our hospital between January 2005 and July 2006. Forty-four hips in 31 patients with stage I-III nontraumatic ONFH, according to the Association Research Circulation Osseous (ARCO) system, were reviewed in the current retrospective study...
February 2, 2018: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29380387/platelet-sequestration-with-a-new-generation-autotransfusion-device
#14
Timo F Seyfried, Fabian Streithoff, Michael Gruber, Christoph Unterbuchner, Nina Zech, Martin Kieninger, Ernil Hansen
BACKGROUND: Autologous platelet-rich plasma (PRP) can be used either to prevent platelets (PLTs) from lesions during extracorporeal circulation or for wound therapy, when processed into PLT gel. The aim of this study was to evaluate the PLT sequestration abilities of a new-generation autotransfusion device. STUDY DESIGN AND METHODS: In this experimental study the discontinuous, new-generation autotransfusion device XTRA was evaluated using fresh donor blood. The blood was processed in four different size bowls (X55, X125, X175, X225 [bowls' size in mL]) using the device's built-in "PLT sequestration program...
January 30, 2018: Transfusion
https://www.readbyqxmd.com/read/29370357/ultra-fast-track-minimally-invasive-aortic-valve-replacement-going-beyond-reduced-incisions
#15
Marco Di Eusanio, Walter Vessella, Roberto Carozza, Filippo Capestro, Alessandro D'Alfonso, Carlo Zingaro, Christopher Munch, Paolo Berretta
Aortic valve replacement (AVR) via a median sternotomy approach has been largely reported to be safe and long-term efficacious, and currently represents the 'gold standard' approach for aortic stenosis treatment. However, aortic valve surgery has undergone continuous development over the last years, involving less invasive techniques and new technologies to reduce the traumatic impact of the intervention and extend the operability toward increasingly high-risk patients. Indeed, minimally invasive AVR and transcatheter aortic valve replacement caseload have steadily increased leading to a paradigm shift in the treatment of aortic valve disease...
January 23, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29369890/cyclosporine-before-coronary-artery-bypass-grafting-does-not-prevent-postoperative-decreases-in-renal-function-a-randomized-clinical-trial
#16
Per Ederoth, Alain Dardashti, Edgars Grins, Björn Brondén, Carsten Metzsch, André Erdling, Shahab Nozohoor, Arash Mokhtari, Magnus J Hansson, Eskil Elmér, Lars Algotsson, Stefan Jovinge, Henrik Bjursten
BACKGROUND: Acute kidney injury is a common complication after cardiac surgery, leading to increased morbidity and mortality. One suggested cause for acute kidney injury is extracorporeal circulation-induced ischemia-reperfusion injury. In animal studies, cyclosporine has been shown to reduce ischemia-reperfusion injury in the kidneys. We hypothesized that administering cyclosporine before extracorporeal circulation could protect the kidneys in patients undergoing cardiac surgery. METHODS: The Cyclosporine to Protect Renal Function in Cardiac Surgery (CiPRICS) study was an investigator-initiated, double-blind, randomized, placebo-controlled, single-center study...
January 25, 2018: Anesthesiology
https://www.readbyqxmd.com/read/29359096/development-of-a-real-time-and-quantitative-thrombus-sensor-for-an-extracorporeal-centrifugal-blood-pump-by-near-infrared-light
#17
Daisuke Sakota, Tatsuki Fujiwara, Katsuhiro Ohuchi, Katsuyuki Kuwana, Hiroyuki Yamazaki, Ryo Kosaka, Masahiro Nishida, Tomohiro Mizuno, Hirokuni Arai, Osamu Maruyama
We developed an optical thrombus sensor for a monopivot extracorporeal centrifugal blood pump. In this study, we investigated its quantitative performance for thrombus detection in acute animal experiments of left ventricular assist using the pump on pathogen-free pigs. Optical fibers were set in the driver unit of the pump. The incident light at the near-infrared wavelength of 810 nm was aimed at the pivot bearing, and the resulting scattered light was guided to the optical fibers. The detected signal was analyzed to obtain the thrombus formation level...
January 1, 2018: Biomedical Optics Express
https://www.readbyqxmd.com/read/29355381/detection-of-microembolic-signals-in-the-common-carotid-artery-using-doppler-sonography-in-the-porcine-model-of-acute-heart-failure-treated-by-veno-arterial-extracorporeal-membrane-oxygenation
#18
D Janák, P Hála, M Mlček, M Popková, S Lacko, J Kudlička, O Kittnar
Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is a method used for the treatment most severe cases of decompensated heart failure. The purpose of this study was to evaluate the risk of the formation of microembolisms during VA-ECMO-based therapy. Heart failure was induced with simultaneous detection of microembolisms and the measurement of blood flow rate in the common carotid artery (CCA) without VA-ECMO (0 l/min) and at the VA-ECMO blood flow rate of 1, 2, 3 and 4 l/min. If embolisms for VA-ECMO 0 l/min and the individual regimes for VA-ECMO 1, 2, 3, 4 l/min are compared, a higher VA-ECMO flow rate is accompanied by a higher number of microembolisms...
December 30, 2017: Physiological Research
https://www.readbyqxmd.com/read/29349805/hybrid-continuous-flow-total-artificial-heart
#19
Carson Fox, Steven Chopski, Nohra Murad, Paul Allaire, Robert Mentzer, Joseph Rossano, Francisco Arabia, Amy Throckmorton
Clinical studies using total artificial hearts (TAHs) have demonstrated that pediatric and adult patients derive quality-of-life benefits from this form of therapy. Two clinically-approved TAHs and other pumps under development, however, have design challenges and limitations, including thromboembolic events, neurologic impairment, infection risk due to large size and percutaneous drivelines, and lack of ambulation, to name a few. To address these limitations, we are developing a hybrid-design, continuous-flow, implantable or extracorporeal, magnetically-levitated TAH for pediatric and adult patients with heart failure...
January 18, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29338755/hyperhomocysteinemia-in-bilateral-anterior-ischemic-optic-neuropathy-after-conventional-coronary-artery-bypass-graft-a-case-report
#20
A Niro, G Sborgia, A Sborgia, G Alessio
BACKGROUND: The incidence of anterior ischemic optic neuropathy after coronary artery bypass graft procedures ranges from 1.3 to 0.25%. The mechanisms of anterior ischemic optic neuropathy after cardiovascular procedures remain undefined but many systemic and related-to-surgery risk factors could underlie anterior ischemic optic neuropathy. In this case, we report a rare presentation of a bilateral anterior ischemic optic neuropathy after coronary artery bypass graft and speculate on the preoperative hyperhomocysteinemia as an independent risk factor for anterior ischemic optic neuropathy...
January 17, 2018: Journal of Medical Case Reports
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