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Surgery aorta damage

Shih-Yuan Fang, Jung-Shun Lee, Jun-Neng Roan, Yu-Chuan Tsai, Chen-Fuh Lam
BACKGROUND: Spinal cord ischemia (SCI) leads to variable degrees of neurologic deficit in patients undergoing major cardiovascular surgery. The effect of intraoperative neuroprotection against SCI and the subsequent ischemia-reperfusion injury is still limited. Because isoflurane is a commonly used anesthetic agent during major operation, and its neuroprotective and neurotoxicity effects have both been discussed, this study aimed to investigate the effect of isoflurane on the spinal cord's functional recovery in a rat model of cord ischemia...
January 2017: Anesthesia and Analgesia
Gulcin Sahin Ersoy, Meryem Kurek Eken, Ozge Cevik, Ozlem T Cilingir, Reshef Tal
This study evaluated the effect of mycophenolate mofetil (MMF) on uterine tissue preservation following ischaemia/reperfusion (I/R) injury. Uterine I/R injury was induced in rats by clamping the lower abdominal aorta and ovarian arteries for 30 min. Group I/R + V (n = 7) received vehicle alone while Group I/R + M (n = 7) received 20 mg/kg/day MMF. Control groups underwent sham surgery and received vehicle (Group C) or 20 mg/kg/day MMF (Group M) (n = 7 for both). Four hours after detorsion, uterine tissue 8-hydroxy-2'-deoxyguanosine (8-OHdG), glutathione, malondialdehyde (MDA), myeloperoxidase (MPO), superoxide dismutase (SOD) and serum ischaemia modified albumin (IMA) concentrations were measured...
November 21, 2016: Reproductive Biomedicine Online
Shamir O Cawich, Vijay Naraynsingh
An emergency thoracotomy may be life-saving by achieving four goals: (i) releasing cardiac tamponade, (ii) controlling haemorrhage, (iii) allowing access for internal cardiac massage and (iv) clamping the descending aorta to isolate circulation to the upper torso in damage control surgery. We theorize that a new goal should be achieving rapid, large-volume fluid resuscitation and we describe a technique to achieve this.
November 24, 2016: Journal of Surgical Case Reports
Mi-Hyeong Kim, Kang-Woong Jun, In-Sung Moon, Ji-Il Kim
Congenital anomalies of the inferior vena cava (IVC) are rare but important problems in living donors for kidney transplantation, especially in cases of a short left renal vein and accompanying vascular and urological anatomic variations. However, the clinical impacts of IVC anomalies in deceased donors have yet to be reported. The unexpected presence of an IVC in an unusual position poses challenges to surgeons and increases the risk of bleeding during organ removal. Accompanying vascular variations can cause unexpected bleeding and injury and therefore technical complications in procurement and subsequent implantation...
November 2016: Annals of Surgical Treatment and Research
Hong Zhang, Zhanhai Wan, Xiang Yan, De-Gui Wang, Yufang Leng, Yongqiang Liu, Yan Zhang, Haijun Zhang, Xuena Han
Lung ischemia-reperfusion injury remains a problem in thoracic surgery, as minimal progress has been made concerning its prevention and control. In the present study, the protective effects and the underlying mechanism of Shenfu injection preconditioning on a rat lung ischemia-reperfusion model was investigated. Shenfu injection is a well-known Chinese traditional medicine, which is composed of Red Radix Ginseng and Radix Aconitum carmichaelii, with ginseng saponin and aconitum alkaloids as the active ingredients...
September 2016: Experimental and Therapeutic Medicine
Emanuela Viviani, Anna Maria Giribono, Donatella Narese, Doriana Ferrara, Giuseppe Servillo, Luca Del Guercio, Umberto Marcello Bracale
Compartment syndrome (CS) is a pathological increase of the interstitial pressure within the closed osseous fascial compartments. Trauma is the most common cause, followed by embolization, burns, and iatrogenic injuries; it usually involves the limbs. The major issue when dealing with CS is the possibility to do an early diagnosis in order to intervene precociously, through a fasciotomy, reducing the risk of tissue, vascular and nervous damage. Although it is an infrequent condition, it is potentially life threatening...
August 31, 2016: International Journal of Lower Extremity Wounds
Christoph A Nienaber, Rachel E Clough, Natzi Sakalihasan, Toru Suzuki, Richard Gibbs, Firas Mussa, Michael T Jenkins, Matt M Thompson, Arturo Evangelista, James S M Yeh, Nicholas Cheshire, Ulrich Rosendahl, John Pepper
Aortic dissection is a life-threatening condition caused by a tear in the intimal layer of the aorta or bleeding within the aortic wall, resulting in the separation (dissection) of the layers of the aortic wall. Aortic dissection is most common in those 65-75 years of age, with an incidence of 35 cases per 100,000 people per year in this population. Other risk factors include hypertension, dyslipidaemia and genetic disorders that involve the connective tissue, such as Marfan syndrome. Swift diagnostic confirmation and adequate treatment are crucial in managing affected patients...
2016: Nature Reviews. Disease Primers
Josep M Alegret, Neus Martínez-Micaelo, Gerard Aragonès, Raúl Beltrán-Debón
BACKGROUND/OBJECTIVES: The mechanisms underlying aortic dilation in bicuspid aortic valve (BAV) disease are unknown. Circulating endothelial microparticles (EMPs) have emerged as biomarkers of endothelial damage. We sought to evaluate the relationships among EMPs, BAV disease, and aortic dilation. METHODS: Four evaluations were used. Circulating EMPs (PECAM(+), E-selectin(+)) were compared between BAV patients and tricuspid aortic valve (TAV) control subjects. The variables related to circulating EMPs were investigated in BAV patients...
August 15, 2016: International Journal of Cardiology
Timothy Keith Williams, Lucas P Neff, Michael Austin Johnson, Sarah-Ashley Ferencz, Anders J Davidson, Rachel M Russo, Todd E Rasmussen
BACKGROUND: The duration of use and efficacy of resuscitative endovascular balloon occlusion of the aorta (REBOA) is limited by distal ischemia. We developed a hybrid endovascular-extracorporeal circuit variable aortic control (VAC) device to extend REBOA duration in a lethal model of hemorrhagic shock to serve as an experimental surrogate to further the development of endovascular VAC (EVAC) technologies. METHODS: Nine Yorkshire-cross swine were anesthetized, instrumented, splenectomized, and subjected to 30% liver amputation...
August 2016: Journal of Trauma and Acute Care Surgery
L A Bokeria, E S Nikitin, V A Mironenko, S V Rychin, N B Vyganovskaya, I M Makrushin, S L Gordeev
Precapillary artery--arterial (bronchial artery--pulmonay artery) anastomoses, come into play in cases where the locking artery open and alveoli washed arterialized blood. Normally, these anastomoses are closed. Intrapulmonary shunts carry blood supply acinar hinder extraordinary circumstances (chronic pulmonary embolism, surgery, occurring in cardiopulmonary bypass, when the flaw of blood through the Iungs is suspended for the duration of cardiopulmonary bypass). Patients operated on the ascending aorta with the expansion of intervention on the nortic arch during the correction of pathology carry blood supply only the central nervous system...
September 2015: Anesteziologiia i Reanimatologiia
Roland Hetzer, Friedrich Kaufmann, Eva Maria Delmo Walter
This paper reviews the development and establishment of the Berlin Heart EXCOR® (BHE®) as a paediatric mechanical circulatory support and reports our entire experience with regard to indications, timing of implantation and explantation and outcome. The Berlin group reported the first successful paediatric bridge to transplantation using a pulsatile pneumatic paracorporeal biventricular assist device, the BHE®, in 1990 in an 8-year-old boy with end-stage heart failure and coarctation of the aorta. This experience prompted them to develop miniaturized pump systems for children through the company Berlin Heart Mediproduct GmbH...
August 2016: European Journal of Cardio-thoracic Surgery
A A Eremenko, N M Minbolatova
UNLABELLED: Acute kidney injury can greatly increase the severity of multiple organ dysfunction syndrome (MODS) and impair patient outcomes. OBJECTIVE: To study the clinical significance of acute kidney injury in patients with MODS in early postoperative period after cardiac surgety and its influence, on the severity of the patient condition and outcomes. MATERIALS AND METHODS: The study involved 117 patients aged 57.2 ± 1.2 years. The Group 1, control, included 74 patients with uncomplicated postoperative period; the Group 2--43 patients with MODS, who were divided into the survivors (33 patients, group 2a) and deaths (10 patients, group 2b)...
September 2015: Anesteziologiia i Reanimatologiia
J Gaudric, M Dennery, C Jouhannet, N Kagan, D Saadoun, L Chiche, F Koskas
Non-infectious aortitis are usually due to giant cell arteritis (temporal arteritis), Takayasu and Behçet's diseases. Aortitis should be suspected in the presence of aortic wall thickening or of aneurysm or occlusion of the aorta and its branches in the absence of characteristic cardiovascular risk factors. Surgery is required in case of severe damage. But the quiescence of the inflammatory disease must be obtained before endovascular or surgical treatment to prevent complications such as anastomotic false aneurysm or stent thrombosis, especially common in this disease...
April 2016: La Revue de Médecine Interne
Satoshi Yamashiro, Ryoko Arakaki, Yuya Kise, Hitoshi Inafuku, Yukio Kuniyoshi
OBJECTIVES: The extent of visceral malperfusion due to acute type A aortic dissection remains difficult to assess in view of the clinical signs that typically present at a late stage. We suspected that visceral malperfusion can persist after proximal aortic graft replacement despite redirecting blood flow into the true lumen. We therefore evaluated the operative outcomes of visceral malperfusion complicated with acute type A aortic dissection. METHODS: Among 121 patients with acute type A aortic dissection treated at our hospital between January 2000 and December 2014, 10 (8...
September 2015: Interactive Cardiovascular and Thoracic Surgery
M Katsimpoulas, L Morticelli, E Michalopoulos, I Gontika, C Stavropoulos-Giokas, A Kostakis, A Haverich, S Korossis
OBJECTIVES: The loss or damage of an organ or tissue is one of the most common and devastating problems in healthcare today. Tissue engineering applies the principles of engineering and biology toward the development of functional biological replacements that are able to maintain, improve, or restore the function of pathological tissues. The aim of the overall project is to study an already existing method for the decellularization of homograft vascular grafts for use in vascular surgery...
May 2015: Transplantation Proceedings
V A Reva, I M Samokhvalov
Rapid growth of medical technologies has led to implementation of endovascular methods of diagnosis and treatment into rapidly developing battlefield surgery. This work based on analysing all available current publications generalizes the data on using endovascular surgery in combat vascular injury. During the Korean war (1950-1953) American surgeons for the first time performed endovascular balloon occlusion of the aorta - the first intravascular intervention carried out in a zone of combat operations. Half a century thereafter, with the beginning of the war in Afghanistan (2001) and in Iraq (2003) surgeons of central hospitals of the USA Armed Forces began performing delayed endovascular operations to the wounded...
2015: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
Hung-Tao Chou, Jen-Ping Lo, Chai-Hock Chua, Ming-Jen Lu, Chia-Hsun Lin
BACKGROUND: We report the initial experience of modified four-branched graft technique for proximal aorta and arch repair, feasibly combined with antegrade thoracic endovascular aortic repair (TEVAR) to extend distal aortic reconstruction in acute type A aortic dissection. METHODS: From 2011 to 2013, 12 consecutive patients with acute type A aortic dissection were indicated for arch surgery and underwent surgical replacement of proximal aorta, arch replacement or debranching procedure, and concomitant TEVAR for distal aortic repair...
2015: Annals of Thoracic and Cardiovascular Surgery
Zhongzhao Teng, Jiaxuan Feng, Yongxue Zhang, Yuan Huang, Michael P F Sutcliffe, Adam J Brown, Zaiping Jing, Jonathan H Gillard, Qingsheng Lu
Mechanical analysis has the potential to provide complementary information to aneurysm morphology in assessing its vulnerability. Reliable calculations require accurate material properties of individual aneurysmal components. Quantification of extreme extensibility and ultimate material strength of the tissue are important if rupture is to be modelled. Tissue pieces from 11 abdomen aortic aneurysm (AAA) from patients scheduled for elective surgery and from 8 normal aortic artery (NAA) from patients who scheduled for kidney/liver transplant were collected at surgery and banked in liquid nitrogen with the use of Cryoprotectant solution to minimize frozen damage...
November 2015: Annals of Biomedical Engineering
Shi-Min Yuan
OBJECTIVE: The present study is to describe the clinical impact of S100 and S100β for the evaluation of cerebral damage in cardiac surgery with or without the use of cardiopulmonary bypass (CPB). METHODS: Quantitative results of S100 and S100β reported in the literature of the year range 1990-2014 were collected, screened and analyzed. RESULTS: Cerebrospinal fluid and serum S100 levels showed a same trend reaching a peak at the end of CPB...
October 2014: Revista Brasileira de Cirurgia Cardiovascular
Anne C Kraima, Jan van Schaik, Serhat Susan, Cornelius J H van de Velde, Jaap F Hamming, Egbert A J F Lakke, Marcus C DeRuiter
BACKGROUND: The superior hypogastric plexus (SHP) is an autonomic plexus, located ventrally to the abdominal aorta and its bifurcation, innervating pelvic viscera. It is classically described as being composed of merely sympathetic fibres. However, post-operative complications after surgery damaging the peri-aortic retroperitoneal compartment suggest the existence of parasympathetic fibres. This immunohistochemical study describes the neuroanatomical composition of the human mature SHP...
May 2015: Autonomic Neuroscience: Basic & Clinical
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