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Cardioplegia

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https://www.readbyqxmd.com/read/28874030/synergistic-effects-of-remote-perconditioning-with-terminal-blood-cardioplegia-in-an-in-vivo-piglet-model
#1
Takayuki Abe, Kiyozo Morita, Gen Shinohara, Kazuhiro Hashimoto, Masako Nishikawa
OBJECTIVES: This study tested the hypothesis that remote perconditioning offers effective and synergistic cardioprotection to terminal warm blood cardioplegia for prompt ventricular recovery after prolonged cardioplegic arrest in an in vivo piglet model. METHODS: Twenty-four piglets were subjected to 120 min of single-dose cardioplegic arrest and were divided into 4 groups according to the mode of reperfusion: control (simple aortic unclamp), remote perconditioning, terminal warm blood cardioplegia or remote perconditioning + terminal warm blood cardioplegia; remote perconditioning (4 cycles of 5-min ischaemia-reperfusion of the lower limb) was applied prior to aortic unclamping...
September 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28863040/del-nido-cardioplegia-for-myocardial-protection-in-adult-cardiac-surgery-a-systematic-review-and-meta-analysis
#2
Yongnan Li, Hao Lin, Yinglu Zhao, Zhenzhen Li, Debin Liu, Xiangyang Wu, Bingyang Ji, Bingren Gao
Cardioplegia is an important strategy for myocardial protection during cardiac surgery. This meta-analysis was to compare the effects of del Nido and conventional cardioplegia in adult patients. Systematic searches were performed to identify studies using PubMed, Embase, the Cochrane Library, and the International Clinical Trials Registry Platform. A total of nine studies were included. Cardiopulmonary bypass and cross-clamp time were significantly shorter in the del Nido than conventional cardioplegia (mean difference [MD]: -7...
August 31, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28832794/coronary-perfusion-pressure-during-antegrade-cardioplegia-in-on-pump-cabg-patients
#3
Jackson Brandão Lopes, Carlos Cezar Monteiro Dos Santos
Objective: The aim of this study was to investigate whether aortic tension estimated by palpation and cardioplegia infusion line pressure provide results equivalent to those obtained with direct aortic intraluminal pressure measurement. Methods: Sixty consecutive patients who underwent coronary artery bypass graft surgeries with extracorporeal circulation were analyzed. Sanguineous cardioplegic solution in a ratio of 4:1 was administered using a triple lumen antegrade cannula...
May 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28790268/-perioperative-care-of-low-cardiac-output-syndrome
#4
Hiroki Kato, Yoshiro Matsui
Low cardiac syndrome( LOS) is the imbalance of the oxygen supply and demand at the tissue due to reduced oxygen supply by decreased cardiac function. The causes of the cardiac dysfunction are insufficient cardioplegia, elongation of aortic clamp or cardiopulmonary bypass (CPB) duration, incomplete revascularization, and so on. The preventions of LOS are myocardial protections intraoperatively. The most important myocardial protection is to accomplish more quickly, accurately and safety to operation. And today, cardioplegia is essential for surgery requiring CPB...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28758150/diabetes-and-cardioplegia
#5
Brittany A Potz, Laura A Scrimgeour, Jun Feng, Frank W Sellke
Cardiac surgery with cardiopulmonary bypass and cardioplegic arrest is associated with injury to the vasculature and microcirculation leading to coronary microvascular dysfunction, permeability changes and cardiac dysfunction. In the setting of cardiopulmonary bypass with cardioplegia, poorly-controlled diabetes is associated with significant changes in endothelium-dependent and independent vascular dysfunction, vascular reactivity, vascular permeability, protein expression, cell death, coronary/peripheral microcirculation and reduced vasomotor tone leading to hypotension and impaired endothelial function...
June 2017: Journal of Nature and Science
https://www.readbyqxmd.com/read/28712580/single-dose-del-nido-cardioplegia-in-minimally-invasive-aortic-valve-surgery
#6
Daniel Ziazadeh, Regina Mater, Ben Himelhoch, Andrew Borgman, Jessica L Parker, Charles L Willekes, Tomasz A Timek
BACKGROUND: The del Nido cardioplegia (DC) procedure offers prolonged cardiac protection with single-dose administration and has proven safe in adult coronary artery bypass grafting (CABG) surgery. We set out to evaluate the efficacy of cardiac protection and clinical outcomes of DC versus standard blood cardioplegia (BC) in minimally invasive aortic valve surgery. METHODS: Between August 2011 and May 2016, 178 patients underwent minimally invasive aortic valve replacement (AVR) with BC (n = 101) or DC (n = 77)...
June 12, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28698413/-aortic-stenosis-combined-with-cold-agglutinin-disease
#7
Zaiqiang Yu, Masahito Minakawa, Takashi Aoki, Norihiro Kondo, Kazuyuki Daitoku, Yasuyuki Suzuki, Ikuo Fukuda
Cardiac surgery on a patient with cold agglutinin disease is high risk for thromboembolism due to hypothermia perioperative. A 75-year-old woman with cold agglutinin disease underwent aortic valve replacement for severe aortic stenosis. Cold antibody was detected by preoperative screening test for blood transfusion. In order to prevent thromboembolic event during the operation, we maintained rectal temperature at around 36 degrees centigrade during the cardiopulmonary bypass by warming blood in the bypass circuit...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28655533/a-unique-hybrid-approach-to-complex-re-do-aortic-root-surgery
#8
Fiona Doig, Rishen Naidoo, Vinod Sharma, Peter Tesar
BACKGROUND: We present the case of a 23-year-old male with ventriculo-aortic dehiscence and a retrosternal false aneurysm communicating to the left ventricular outflow tract (LVOT) and ascending aorta. His history included aortic valve replacement (AVR) and mitral valve (MV) repair remotely, followed by two further operations for endocarditis and aortic root abscess. METHODS: The risk associated with the redo surgery required detailed planning and innovative techniques to allow it to be performed safely...
June 1, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28638157/complex-cardiac-surgery-on-patients-with-a-body-weight-of-less-than-5-kg-without-donor-blood-transfusion
#9
Wolfgang Boettcher, Frank Dehmel, Mathias Redlin, Oliver Miera, Michele Musci, Mi-Young Cho, Joachim Photiadis
Performing safe cardiac surgery in neonates or infants whose parents are Jehovah's Witnesses is only possible in a coordinated team approach. An unconditional prerequisite is a cardiopulmonary bypass (CPB) circuit with a very low priming volume to minimize hemodilution. In the past decade, we have developed a functional blood-sparing approach at our institution. The extracorporeal circuit was miniaturized. This had to be recently adapted, faced with a challenge associated with the switch to high-volume crystalloid cardioplegia...
June 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/28614119/pump-priming-practices-and-anticoagulation-in-cardiac-surgery-results-from-the-global-cardiopulmonary-bypass-survey
#10
Lachlan F Miles, Timothy G Coulson, Carlos Galhardo, Florian Falter
BACKGROUND: Regional patterns of practice in cardiopulmonary bypass remain poorly understood with conflicting evidence regarding the best choices in pump priming preferences with respect to colloid and crystalloid and different types of fluid within these categories. In light of the variation in the literature, we hypothesized there would be considerable regional differences in cardiopulmonary bypass practice, particularly with respect to the type of fluid used to prime the extracorporeal circuit...
June 12, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28582551/beating-heart-mitral-valve-surgery-results-in-120-consecutive-patients-considered-unsuitable-for-conventional-mitral-valve-surgery%C3%A2
#11
Miralem Pasic, Simon Sündermann, Axel Unbehaun, Jörg Kempfert, Stephan Jacobs, Volkmar Falk
OBJECTIVES: The purpose of the study was to test whether a beating heart mitral valve operation was a valuable option in a heterogeneous group of patients considered very high risk for conventional mitral valve surgery. METHODS: We conducted a retrospective, single-centre, observational cohort study of 120 patients (mean age 63.7 ± 12.1 years, range 25.3-88.8 years; mean logistic EuroSCORE 26.1 ± 20.6%, range 1.5-84.3%) undergoing beating heart mitral valve operations using normothermic cardiopulmonary bypass without aortic cross-clamping and without cardioplegia between September 2002 and April 2014...
June 3, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28581447/time-window-is-important-for-adenosine-preventing-cold-induced-injury-to-the-endothelium
#12
Yan Li, Xiao-Xia Hu, Li Fu, Jing Chen, Li-He Lu, Xiang Liu, Zhe Xu, Li Zhou, Zhi-Ping Wang, Xi Zhang, Zhi-Jun Ou, Jing-Song Ou
Cold cardioplegia is used to induce heart arrest during cardiac surgery. However, endothelial function may be compromised after this procedure. Accordingly, interventions such as adenosine, that mimic the effects of preconditioning, may minimize endothelial injury. Herein, we investigated whether adenosine prevents cold-induced injury to the endothelium. Cultured human cardiac microvascular endothelial cells were treated with adenosine for different durations. Phosphorylation and expression of endothelial nitric oxide synthase (eNOS), p38MAPK, ERK1/2, and p70S6K6 were measured along with nitric oxide (NO) production using diaminofluorescein-2 diacetate (DAF-2DA) probe...
June 2017: Journal of Cardiovascular Pharmacology
https://www.readbyqxmd.com/read/28579963/olesoxime-inhibits-cardioplegia-induced-ischemia-reperfusion-injury-a-study-in-langendorff-perfused-rabbit-hearts
#13
Aida Salameh, Maren Keller, Ingo Dähnert, Stefan Dhein
Objective: During cardioplegia, which is often used in cardiac surgery, the heart is subjected to global ischemia/reperfusion injury, which can result in a post-operative impairment of cardiac function. Mitochondria permeability transition pores (MPTP) play a key role in cardiomyocyte survival after ischemia/reperfusion injury. It was shown in clinical settings that blockers of MPTP like cyclosporine might have a positive influence on cardiac function after cardioplegic arrest. Olesoxime, which is a new drug with MPTP blocking activity, has been introduced as a neuroprotective therapeutic agent...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28575225/single-stage-repair-for-multiple-muscular-septal-defects-a-single-centre-experience-across-16-years
#14
Varun Shetty, Deviprasad Shetty, Julius Punnen, Binoy Chattuparambil, Richard Whitlock, Deepak Bohra
OBJECTIVES: Multiple muscular ventricular septal defects (VSDs) are surgically challenging and its management remains controversial. We present a technique of surgical repair for muscular VSDs, which includes surgical exposure and detection of these defects and has excellent clinical outcomes. METHODS: We have analysed consecutive patients who underwent surgical repair of isolated multiple muscular VSDs under cardiopulmonary bypass over a 16-year period (from January 2001 to November 2016) in a single centre from the southern part of India...
September 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28574033/-the-phenomenon-of-ischaemic-postconditioning-of-the-heart-analysis-of-clinical-data
#15
REVIEW
L N Maslov, A Iu Podoksenov, I G Khaliulin
Data concerning the effectiveness of ischaemic postconditioning (IPost) in treatment of acute ST-segment elevation myocardial infarction (STEMI) are controversial. The authors of the majority of studies have reported an anti-apoptotic and infarct reducing effect of IPost. There is evidence that IPost reduces the microvascular obstruction zone, increases coronary flow reserve, and improves the pumping functions of the heart. At the same time, there are publications reporting that IPost does not influence the course of acute STEMI...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28573043/a-safety-evaluation-of-profound-hypothermia-induced-suspended-animation-for-delayed-resuscitation-at-90-or-120%C3%A2-min
#16
Yu Liu, Shu Li, Zhi Li, Jian Zhang, Jin-Song Han, Yong Zhang, Zong-Tao Yin, Hui-Shan Wang
BACKGROUND: The successful treatment of military combat casualties with penetrating injuries is significantly dependent on the time needed to get the patient to an adequate treatment facility. Profound hypothermia-induced suspended animation for delayed resuscitation (SADR) is a novel approach for inducing cardiac arrest and buying additional time for such injuries. However, the time used to safely administer circulatory arrest (CA) is controversial. The goal of this study was to evaluate the safety of hypothermia-induced SADR over 90 and 120 min time intervals...
2017: Military Medical Research
https://www.readbyqxmd.com/read/28551786/mitochondrial-bioenergetics-during-ischemia-and-reperfusion
#17
REVIEW
Alicia E Consolini, María I Ragone, Patricia Bonazzola, Germán A Colareda
During ischemia and reperfusion (I/R) mitochondria suffer a deficiency to supply the cardiomyocyte with chemical energy, but also contribute to the cytosolic ionic alterations especially of Ca(2+). Their free calcium concentration ([Ca(2+)]m) mainly depends on mitochondrial entrance through the uniporter (UCam) and extrusion in exchange with Na(+) (mNCX) driven by the electrochemical gradient (ΔΨm). Cardiac energetic is frequently estimated by the oxygen consumption, which determines metabolism coupled to ATP production and to the maintaining of ΔΨm...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28549029/a-contemporary-approach-to-reoperative-aortic-valve-surgery-when-is-less-more
#18
Deane E Smith, Michael S Koeckert, Patrick F Vining, Elias A Zias, Eugene A Grossi, Aubrey C Galloway
OBJECTIVE: Although the benefits of minimally invasive valvular surgery are well established, the applicability of extending these techniques to reoperative aortic valve surgery is unknown. We evaluated our experience with a minimally invasive approach to this patient population. METHODS: From January 2010 to September 2015, 21 patients underwent reoperative isolated aortic valve replacement via a minimally invasive approach by a single surgeon. All patients had preoperative evaluation with computerized tomography and coronary catheterization...
May 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28548476/is-cold-blood-cardioplegia-absolutely-superior-to-cold-crystalloid-cardioplegia-in-aortic-valve-surgery
#19
Daniel A Lerman, Matilde Otero-Losada, Kiddy Ume, Pablo A Salgado, Sai Prasad, Kelvin Lim, Bruno Péault, Nasri Alotti
BACKGROUND: Experimental evidence suggests that blood cardioplegia (BCP) may be superior to cold crystalloid cardioplegia (CCP) for myocardial protection. However, robust clinical data are lacking. We compared post-operative outcome of patients undergoing aortic valve replacement (AVR) using cold anterograde-retrograde intermittent BCP versus anterograde (CCP). METHODS: Adult consecutive isolated AVR performed between April 2006 and February 2011 at the Royal Infirmary Hospital of Edinburgh were retrospectively analyzed...
May 26, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28520861/influence-of-practice-patterns-on-outcome-among-countries-enrolled-in-the-syntax-trial-5-year-results-between-percutaneous-coronary-intervention-and-coronary-artery-bypass-grafting
#20
Milan Milojevic, Stuart J Head, Michael J Mack, Friedrich W Mohr, Marie-Claude Morice, Keith D Dawkins, David R Holmes, Patrick W Serruys, Arie Pieter Kappetein
OBJECTIVES: To examine differences among participating countries in baseline characteristics, clinical practice, medication strategies and outcomes of patients randomized to coronary artery bypass grafting and percutaneous coronary intervention in the SYNTAX trial. METHODS: In SYNTAX, centres in 18 different countries enrolled 1800 patients, of which 8 countries enrolled ≥80 patients, what was projected to be a large enough sample size to be included in the analysis...
September 1, 2017: European Journal of Cardio-thoracic Surgery
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