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cardiopulmonary bypass, perfusion, cardioplegia,

H Lan, Y G Cheng, B C Jia, Y L Chai
OBJECTIVE: To summarize the clinical outcome of totally thoracoscopic cardiac surgery for mitral valve replacement. METHODS: Clinical data of 634 cases undergoing totally thoracoscopic cardiac surgery for mitral valve replacement from May 2004 to February 2016 in Department of Thoracoscopic Cardiacsurgery, Shanghai Yodak Cardiothoracic Hospital was analyzed retrospectively. There were 292 male and 342 female patients, aged from 17 to 68 years with a mean of (45±13) years...
August 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
X Z Xu, W Yi, H Li, G Y Shi, Y W Chen, N Qiao, M Chen, Z X Jin, R Zhao, Y Jin, S Q Yu
OBJECTIVE: To summarize the experience of totally thoracoscopic cardiac surgical (TTCS) at congenital heart diseases (CHD) treatment. METHODS: From April 2000 to March 2016, 2 543 patients with CHD underwent TTCS in Department of Cardiovascular Surgery, Xijing Hospital, Fourth Military Medical University, including 957 male and 1 586 female patients. The age ranged from 0.5 to 66.0 years with a mean age of (21±18) years. The body weight ranged from 6 to 118 kg with a mean of (49±30) kg...
August 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Andreas Martens, Erik Beckmann, Tim Kaufeld, Julia Umminger, Felix Fleissner, Nurbol Koigeldiyev, Heike Krueger, Jakob Puntigam, Axel Haverich, Malakh Shrestha
OBJECTIVES: Aortic arch surgery is associated with substantial perioperative risks. New prostheses as well as novel perfusion techniques have been developed to reduce the risks of these procedures. The routine application of these new techniques warrants reassessment of risk factors of aortic arch repair. METHODS: Between April 2010 and December 2015, 199 patients [61% male, median age 63 years (interquartile range 52-70 years)] underwent total aortic arch repair in our institution...
May 26, 2016: European Journal of Cardio-thoracic Surgery
Yves Durandy
Cardiac surgery was developed thanks to the introduction of hypothermia and cardiopulmonary bypass in the early 1950s. The deep hypothermia protective effect has been essential to circulatory arrest complex cases repair. During the early times of open-heart surgery, a major concern was to decrease mortality and to improve short-term outcomes. Both mortality and morbidity dramatically decreased over a few decades. As a consequence, the drawbacks of deep hypothermia, with or without circulatory arrest, became more and more apparent...
2016: Frontiers in Pediatrics
Laura Rigg, Bruce Searles, Edward Morse Darling
Pressure data acquired from multiple sites of extracorporeal circuits can be an important parameter to monitor for the safe conduct of cardiopulmonary bypass (CPB). Although previous surveys demonstrate that CPB circuit pressure monitoring is widely used, there are very little data cataloging specific applications of this practice. Therefore, the purpose of this study is to survey the perfusion community to catalog 1) primary CPB circuit site pressure monitoring locations; 2) type of manometers used; 3) pressure monitoring interface and servoregulation with pump console; and 4) the rationale and documentation associated with pressure monitoring during CPB...
December 2014: Journal of Extra-corporeal Technology
Carina Janssen, Stephanie Kellermann, Frank Münch, Ariawan Purbojo, Robert Anton Cesnjevar, André Rüffer
BACKGROUND: Selective myocardial perfusion enables repair of congenital aortic arch obstruction without cardiac arrest. This study was inspired by the lack of prospective controlled studies of the beating heart (BH) technique compared with cold crystalloid cardioplegia (CC) regarding effects on myocardial performance, ischemic damage, and serum electrolyte levels. METHODS: In a prospective study, 20 male piglets weighing 11.1 ± 1.3 kg were operated on using cardiopulmonary bypass (CPB) and underwent 60 minutes of aortic cross-clamping...
November 2015: Annals of Thoracic Surgery
Brenda Cordeiro, Richard Clements
The following protocol is of use to evaluate impaired cardiac function or myocardial stunning following moderate ischemic insults. The technique is useful for modeling ischemic injury associated with numerous clinically relevant phenomenon including cardiac surgery with cardioplegic arrest and cardiopulmonary bypass, off-pump CABG, transplant, angina, brief ischemia, etc. The protocol presents a general method to model hypothermic hyperkalemic cardioplegic arrest and reperfusion in rodent hearts focusing on measurement of myocardial contractile function...
2015: Journal of Visualized Experiments: JoVE
L Zou, J Liu, H Zhang, S Wu, C Long, B Ji, Z Yu, Y Tang, L Meng, A Wu
OBJECTIVE: Due to the weak ascending aorta, it is extremely challenging to establish an anterograde selective cerebral perfusion (ASCP) model in rabbits, especially when cardioplegic arrest is required. Herein, the aim of this study was to establish a rabbit ASCP model with cardiac arrest being easily performed and being similar to the clinical scenario. MATERIALS AND METHODS: Twenty-two adult New Zealand white rabbits were selected for ASCP model establishment and another 22 rabbits were utilized for blood donation...
May 2016: Perfusion
Christian P Brizard, Jeffrey Y J Looi, Joseph J Smolich, Stephen B Horton, Julie Angerosa, Ngaire J Elwood, Salvatore Pepe
BACKGROUND: One potential approach for advancing univentricular heart surgical palliation outcomes is by stem cell therapy to augment right ventricular function and muscle mass. Whether the stem cell-inclusive cord blood mononuclear cells (CBMNCs) are safe to perfuse into the coronary vasculature during neonatal cardiopulmonary bypass (CPB) is unknown. We evaluated the acute safety, functional effects, and fate of human CBMNCs in a novel model of coronary vasculature delivery in a lamb model of infant CPB...
September 2015: Annals of Thoracic Surgery
Mustafa Zakkar, Gustavo Guida, M-Saadeh Suleiman, Gianni D Angelini
The development of the cardiopulmonary bypass (CPB) revolutionized cardiac surgery and contributed immensely to improved patients outcomes. CPB is associated with the activation of different coagulation, proinflammatory, survival cascades and altered redox state. Haemolysis, ischaemia, and perfusion injury and neutrophils activation during CPB play a pivotal role in oxidative stress and the associated activation of proinflammatory and proapoptotic signalling pathways which can affect the function and recovery of multiple organs such as the myocardium, lungs, and kidneys and influence clinical outcomes...
2015: Oxidative Medicine and Cellular Longevity
Andreas Martens, Nurbol Koigeldiyev, Erik Beckmann, Felix Fleissner, Tim Kaufeld, Heike Krueger, Detlev Stanelle, Jakob Puntigam, Axel Haverich, Malakh Shrestha
OBJECTIVES: Myocardial protection with cardioplegia alone may be inadequate during complex aortic arch surgery, potentially resulting in postoperative myocardial insufficiency. We hypothesized that non-cardioplegic continuous myocardial perfusion (CMP) is feasible and safe to protect the heart while operating on the aortic arch, and improves cardiac outcome. METHODS: Between April 2010 and April 2014, 144 patients (60% male, age: 60 ± 13 years) underwent complex aortic arch repair in our institution using prefabricated, branched aortic arch grafts...
January 2016: European Journal of Cardio-thoracic Surgery
Dmitry I Kurapeev, Viktor O Kabanov, Vadim K Grebennik, Tatyana A Sheshurina, Vladimir V Dorofeykov, Michael M Galagudza, Eugene V Shlyakhto
BACKGROUND: Several studies have demonstrated that local ischemic preconditioning can reduce myocardial ischemia-reperfusion injury in cardiac surgery patients; however, preconditioning has not become a standard cardioprotective intervention, primarily because of the increased risk of atheroembolism during repetitive aortic cross-clamping. In the present study, we aimed to describe and validate a novel technique of preconditioning induction. METHODS: Patients undergoing coronary artery bypass grafting (12 women and 78 men; mean age, 56 ± 11 years) were randomized into 3 groups: (1) Controls (n = 30), (2) Perfusion (n = 30), and (3) Preconditioning (n = 30)...
2015: Journal of Cardiothoracic Surgery
Youmei Zuo, Xinqi Cheng, Erwei Gu, Xunqin Liu, Lei Zhang, Yuanyuan Cao
OBJECTIVE: This study investigated the effects of aortic root infusion of sufentanil on myocardial ischemia/reperfusion injury in patients undergoing elective mitral valve replacement (MVR) with cardiopulmonary bypass (CPB). DESIGN: A prospective, randomized, clinical study. SETTING: A university-affiliated teaching hospital. PARTICIPANTS: Fifty-three adult patients undergoing elective MVR with CPB. INTERVENTIONS: Bolus infusions of sufentanil (0...
December 2014: Journal of Cardiothoracic and Vascular Anesthesia
Susan Walker, Mark H D Danton, Alexander D Lang, Fiona Lyall
BACKGROUND AND AIMS: In human adults, and animals, the Apelin-APJ ligand-receptor system is emerging as having a role in the pathogenesis of cardiovascular function and heart failure. The aim was to investigate expression, and regulation by oxygen, of the Apelin APJ receptor (APJ) in myocardium obtained from children undergoing corrective surgery with cardiopulmonary bypass for repair of congenital heart defects. METHODS: Western blotting and Real-time PCR were used to determine if APJ was expressed in the infant myocardium, if expression was influenced by the duration of myocardial ischemia and if any relationship existed between APJ expression and early post-operative outcome...
2014: PloS One
Hiromitsu Nota, Tohru Asai, Tomoaki Suzuki, Takeshi Kinoshita, Hirohisa Ikegami, Noriyuki Takashima
OBJECTIVES: Previous studies have reported a high incidence of acute kidney injury (AKI) after thoracic aortic surgery. However, the incidence of AKI in patients undergoing total arch replacement (TAR) with selective cerebral perfusion (SCP) and mild hypothermic lower body circulatory arrest (mild HLBCA) with a tympanic temperature of 25°C remains unknown. We studied AKI incidence and associated risk factors, as defined by the Acute Kidney Injury Network (AKIN). METHODS: We examined 116 consecutive patients with aortic arch aneurysm undergoing non-emergency TAR...
December 2014: Interactive Cardiovascular and Thoracic Surgery
Jens Garbade, Piroze Davierwala, Joerg Seeburger, Bettina Pfannmueller, Martin Misfeld, Michael A Borger, Friedrich-Wilhelm Mohr
Effective myocardial protection and perfusion strategies during minimally invasive mitral valve surgery (Mini-MV) have evolved over the last decade. Our institutional approach for right-sided Mini-MV has been standardized over the last 15 years in more than 4,500 cases. Cardiopulmonary bypass (CPB) is usually instituted by right-sided femoral arterial and venous cannulation with additional cannulation of the right jugular vein in patients with a body weight greater than 75 kg or when a concomitant tricuspid valve (TV) procedure and/or atrial septal defect closure is performed...
November 2013: Annals of Cardiothoracic Surgery
Clotario Neptali Carrasco Cueva, Maiara dos Santos Rocha, Carlos Maurício Cardeal Mendes, Luiz Antonio Rodrigues de Freitas, José Augusto Baucia, Roberto Badaró
INTRODUCTION: Beating heart surgery on normothermic bypass simulates physiologic cardiac status. OBJECTIVES: This study compared clinical and transmission electron microscopic aspects of myocardial protection during mitral valve replacement using warm retrograde perfusion in empty beating versus arrested heart with cold blood anterograde cardioplegia. METHODS: Randomized study to evaluate myocardial cellular ischemia-reperfusion of both techniques to replace the mitral valve...
June 2013: Revista Brasileira de Cirurgia Cardiovascular
Takeshi Miyairi, Sumio Miura, Tsuyoshi Taketani, Takayoshi Kusuhara, Yangsin Lee, Shinya Unai, Takayuki Ohno, Sachito Fukuda, Shinichi Takamoto
Intraoperative assessment of a repaired mitral valve is of paramount importance for reparative mitral surgery. From September 2010 through November 2012, 20 consecutive patients underwent mitral valve plasty for mitral regurgitation. The patients who underwent surgery after June 2012 received assessment of the repair with the heart beating (HB group, n = 10), and the patients who underwent the operation before May 2012 were assessed for the repair only under cardioplegic heart arrest (non-HB group, n = 10)...
2013: International Heart Journal
Yasuhiro Kotani, James Tweddell, Peter Gruber, Christian Pizarro, Erle H Austin, Ronald K Woods, Colleen Gruenwald, Christopher A Caldarone
BACKGROUND: There are a wide variety of reported techniques with few comparative trials and no current data available by which surgeons can compare their myopreservation strategies across the specialty. We therefore surveyed congenital heart surgeons to develop a profile of current practice. METHODS: One hundred twenty-two members of the Congenital Heart Surgeons' Society were surveyed, and 56 responses were analyzed. The survey focused on cardioplegia formulations, dosage and administration, and perfusion strategies for four age groups: neonates, infants, children, and adolescents...
September 2013: Annals of Thoracic Surgery
Christopher W White, Ayyaz Ali, Devin Hasanally, Bo Xiang, Yun Li, Paul Mundt, Matthew Lytwyn, Simon Colah, Julianne Klein, Amir Ravandi, Rakesh C Arora, Trevor W Lee, Larry Hryshko, Stephen Large, Ganghong Tian, Darren H Freed
BACKGROUND: Ex vivo heart perfusion (EVHP) has been proposed as a means to facilitate the resuscitation of donor hearts after cardiocirculatory death (DCD) and increase the donor pool. However, the current approach to clinical EVHP may exacerbate myocardial injury and impair function after transplant. Therefore, we sought to determine if a cardioprotective EVHP strategy that eliminates myocardial exposure to hypothermic hyperkalemia cardioplegia and minimizes cold ischemia could facilitate successful DCD heart transplantation...
July 2013: Journal of Heart and Lung Transplantation
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