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Cardioplegia

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https://www.readbyqxmd.com/read/29781589/right-mini-thoracotomy-bentall-with-traditional-and-automated-suturing-devices
#1
Carl Johnson, Juan Siordia, Davida Robinson, Peter Knight
Bentall procedures are traditionally performed through a median sternotomy. However, minimally invasive approaches are increasingly being utilized. A right mini-thoracotomy approach may improve postoperative recovery.  A 5-cm mini-thoracotomy is performed in the right 2nd intercostal space. A camera port is placed lateral to this incision. Peripheral cannulation is performed. The ascending aorta is cross-clamped. Cardioplegia is administered and the patient is placed in deep hypothermic circulatory arrest to construct the distal aortic anastomosis...
May 18, 2018: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://www.readbyqxmd.com/read/29778750/our-modified-technique-of-combined-antegrade-vein-graft-cardioplegia-infusion-versus-conventional-antegrade-method-in-coronary-artery-bypass-grafting-a-randomized-clinical-trial
#2
Mehrzad Sharifi, Seyed Reza Mousavi, Mohammad Rafiei
BACKGROUND: To determine the efficacy of antegrade cardioplegia supplemented with venous graft perfusion in patients scheduled for coronary artery bypass grafting (CABG). METHODS: 223 consecutive patients scheduled for isolated CABG were randomized to receive either continuous crystalloid cardioplegia via vein grafts on completion of each distal anastomosis plus intermittent blood cardioplegia through aortic root (group 1, n = 110) or antegrade blood cardioplegia alone (group 2, n = 113)...
May 17, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29718234/technical-points-for-aortic-valve-replacement-through-right-anterior-minithoracotomy
#3
Olivier Bouchot, Andranik Petrosyan, Marie Catherine Morgant, Ghislain Malapert
After 8 years of practice and over 400 operated patients, we present a technique of minimally invasive aortic valve replacement that can be used by all surgeons on many patients. The access to the aorta is via the 2nd or 3rd right anterior intercostal space. Cardiopulmonary bypass is provided using the femoral artery and vein. The aorta is clamped directly. One shot of Custodiol (EUSA Pharma, Limonest, France) is the most commonly used cardioplegia. Aortic valve replacement is performed in the regular way...
May 1, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29707299/cold-crystalloid-versus-warm-blood-cardioplegia-in-patients-undergoing-aortic-valve-replacement
#4
Paolo Nardi, Sara R Vacirca, Marco Russo, Dionisio F Colella, Carlo Bassano, Antonio Scafuri, Antonio Pellegrino, Gerry Melino, Giovanni Ruvolo
Background: Myocardial protection techniques during cardiac arrest have been extensively investigated in the clinical setting of coronary revascularization. Fewer studies have been carried out of patients affected by left ventricular hypertrophy, where the choice of type and temperature of cardioplegia remain controversial. We have retrospectively investigated myocardial injury and short-term outcome in patients undergoing aortic valve replacement plus or minus coronary artery bypass grafting with using cold crystalloid cardioplegia (CCC) or warm blood cardioplegia (WBC)...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29707175/comparative-study-of-short-term-cardiovascular-autonomic-control-in-cardiac-surgery-patients-who-underwent-coronary-artery-bypass-grafting-or-correction-of-valvular-heart-disease
#5
Vladimir A Shvartz, Anton R Kiselev, Anatoly S Karavaev, Kristina A Vulf, Ekaterina I Borovkova, Mikhail D Prokhorov, Andrey D Petrosyan, Olga L Bockeria
Introduction: Our aim was to perform a comparative study of short-term cardiovascular autonomic control in cardiac surgery patients who underwent coronary artery bypass grafting (CABG) or surgical correction of valvular heart disease (SCVHD ). Methods: The synchronous 15 minutes records of heart rate variability (HRV) and finger's photoplethysmographic waveform variability (PPGV) were performed in 42 cardiac surgery patients (12 women) aged 61.8 ± 8.6 years (mean ± standard deviation), who underwent CABG, and 36 patients (16 women) aged 54...
2018: Journal of Cardiovascular and Thoracic Research
https://www.readbyqxmd.com/read/29701357/frozen-elephant-trunk-with-e-vita-open-hybrid-prosthesis-for-surgical-correction-of-multisegmental-thoracic-aortic-pathology-review-of-results
#6
António Cruz Tomás, Álvaro Laranjeira Santos, Jorge Pinheiro Santos, Daniela Varela-Afonso, José Fragata
INTRODUCTION: The Frozen Elephant Trunk (FET) surgery allows correction of ascending, arch and proximal descending aortic pathology, using a hybrid prosthesis at the same time. It is a complex intervention and requires a multidisciplinary team that, besides scheduling and performing the surgery, accompanies the patient (pt) throughout the postoperative period. OBJECTIVES: To review short and medium term clinical results with this technique. METHODS: Between January 2010 and September 2017, we operated 34 patients (pts) using FET...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29701336/cabg-to-cbp-or-not-to-cbp-a-propensity-score-matched-survival
#7
Pedro Magro, Sérgio Boshoff, José Calquinha, Miguel Sousa Uva, José Neves
INTRODUCTION: Over the past 3 decades two main strategies have been employed for surgical coronary revascularization (CABG): on- pump CABG with cardioplegia (ONCAB) and off-pump CABG (OPCAB). The objective of this study is to evaluate the short-term and long-term survival of the two strategies. METHODS: This study consists of 8-year cohort, retrospective single-center analysis with an intention-to-treat design. 2954 patients underwent CABG (OPCAB n=2123; ONCAB= 831) for CAD...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29682984/clinical-and-economic-benefits-of-advanced-microplegia-delivery-system-in-cardiac-surgery-evidence-from-250-hospitals
#8
Marc W Gerdisch, Scott Robinson, Guy David, Stephanie Makepeace, Michael P Ryan, Candace Gunnarsson
AIM: Determine the impact of a second generation microplegia delivery system (MPS2) compared with traditional cardioplegia. Materials &  methods: Multivariable difference-in-differences analysis using fixed effects was performed for each outcome: adverse event (AE) composite, total visit cost, medication cost, length of stay (LOS) and  intensive care unit (ICU) days. RESULTS: A 2.25% absolute risk reduction in AE composite was found with MPS2 compared with traditional cardioplegia, which equates to relative risk reduction of 5...
April 23, 2018: Journal of Comparative Effectiveness Research
https://www.readbyqxmd.com/read/29667902/myocardial-protection-following-del-nido-cardioplegia-in-pediatric-cardiac-surgery
#9
Debasish Panigrahi, Saibal Roychowdhury, Rahul Guhabiswas, Emmanuel Rupert, Mrinalendu Das, Pradeep Narayan
Background This study was designed to compare myocardial protection with del Nido cardioplegia and conventional blood cardioplegia in children undergoing cardiac surgery in Risk Adjustment for Congenital Heart Surgery categories 1 and 2. Methods Sixty patients were randomized into 2 groups receiving del Nido cardioplegia solution or conventional blood cardioplegia. Myocardial injury was assessed using biochemical markers (troponin I and creatine kinase-MB). Vasoactive-inotropic scores were calculated to compare inotropic requirements...
January 1, 2018: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/29643869/neurological-complications-are-avoidable-during-cabg
#10
Zulfiqar Haider, Anjum Jalal, Asif Rashid Alamgir, Irfan Rasheed
Objective: To review the incidence of stroke in patients undergoing CABG and the impact of a preventive strategy adopted at tertiary care unit of cardiac surgery. Methods: The data of all patients who underwent isolated CABG (N= 722) from July 2016 to August 2017 at Faisalabad Institute of Cardiology was retrieved for this retrospective study. All operations were done on cardiopulmonary bypass and cold blood cardioplegia. Numeric data was summarized as Mean ± Standard Deviation while categoric variables were summarized into frequency and percentage...
January 2018: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29617791/beating-heart-aortic-arch-surgery-in-neonates-and-infants
#11
Juan-Miguel Gil-Jaurena, María-Teresa González-López, Ana Pita, Ramón Pérez-Caballero, Mónica Herviás, Dorotea Blanco
OBJECTIVES: Aortic arch repair has been shifted from deep hypothermia plus circulatory arrest to cerebral perfusion at tepid temperatures. A step forward is a simultaneous brain-coronary perfusion, allowing beating-heart arch surgery. METHODS: A 'Y' cannula from the arterial line delivers oxygenated blood to brain and heart. The arch is repaired on a beating heart at 25°C. Intracardiac repair is performed after running cardioplegia through the root line. Fifty patients are classified into 3 groups: A, Norwood (8 neonates); B, aortic arch (14 children) and C, aortic arch plus intracardiac repair (28 patients)...
April 2, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29578128/hydrogen-sulfide-regulating-myocardial-structure-and-function-by-targeting-cardiomyocyte-autophagy
#12
REVIEW
Qing-You Zhang, Hong-Fang Jin, Selena Chen, Qing-Hua Chen, Chao-Shu Tang, Jun-Bao Du, Ya-Qian Huang
Objective: Hydrogen sulfide (H2 S), a gaseous signal molecule, plays a crucial role in many pathophysiologic processes in the cardiovascular system. Autophagy has been shown to participate in the occurrence of many cardiac diseases. Increasing evidences indicated that H2 S regulates myocardial structure and function in association with the altered autophagy and plays a "switcher" role in the autophagy of myocardial diseases. The aim of this review was to summarize these insights and provide the experimental evidence that H2 S targets cardiomyocyte autophagy to regulate cardiovascular function...
April 5, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29559754/does-the-type-of-cardioplegia-solution-affect-intraoperative-glucose-levels-a-propensity-matched-analysis
#13
Linda B Mongero, Eric A Tesdahl, Alfred H Stammers, Andrew J Stasko, Samuel Weinstein
Myocardial protection during cardiac surgery is a multifaceted process that is structured to limit injury and preserve function. Evolving techniques use solutions with varying constituents that enter the systemic circulation and alter intrinsic systemic concentrations. This study compared two distinct cardioplegia solutions on affecting intraoperative glucose levels. Data were abstracted from a multi-institutional perfusion registry, including a total of 1,188 propensity-matched cases performed from January through October 2016, at 17 cardiac surgical centers across the United States in which both del Nido and 4:1 cardioplegia were used during the study period...
March 2018: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29552521/video-assisted-right-mini-thoracotomy-for-aortic-valve-replacement
#14
Carl A Johnson, Amber L Melvin, Brandon F Lebow, Amanda Yap, Peter A Knight
Aortic valve replacement through minimally invasive access is increasing. These procedures have several advantages over conventional sternotomy including decreased intensive care unit and hospital length of stay and decreased ventilation time. The right anterior mini-thoracotomy (RAM) approach is potentially attractive in that it completely spares the sternum leading to improved cosmesis, reduced blood loss, and improved patient satisfaction. However, this approach is underutilized due to anticipated technical challenges including difficulty with visualization and annular suture placement...
2018: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29552520/video-assisted-right-mini-thoracotomy-for-aortic-root-replacement
#15
Carl A Johnson, Katherine L Wood, Amber L Melvin, Brandon F Lebow, Peter A Knight
Aortic root replacement is typically performed through a median sternotomy. The right anterior mini-thoracotomy approach has been shown to decrease hospital length of stay in aortic valve surgery when compared to sternotomy. This approach is rare in ascending aortic surgery due to technical challenges which include exposure and annular suture placement. Automated suturing technology is now available to facilitate the placement of annular sutures. The use of a camera greatly enhances visualization of the aortic root...
2018: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29547976/argon-preconditioning-enhances-postischaemic-cardiac-functional-recovery-following-cardioplegic-arrest-and-global-cold-ischaemia
#16
Attila Kiss, Huaqing Shu, Ouafa Hamza, David Santer, Eva Verena Tretter, Shanglong Yao, Klaus Markstaller, Seth Hallström, Bruno K Podesser, Klaus Ulrich Klein
OBJECTIVES: Previous studies demonstrated that preconditioning with argon gas provided a marked reduction in inflammation and apoptosis and increased myocardial contractility in the setting of acute myocardial ischaemia-reperfusion (IR). There is substantial evidence that myocardial IR injury following cardioplegic arrest is associated with the enhancement of apoptosis and inflammation, which is considered to play a role in cardiac functional impairment. Therefore, the present study was designed to clarify whether preconditioning with argon gas enhances recovery of cardiac function following cardioplegic arrest...
March 13, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29531820/warm-blood-cardioplegia-versus-cold-crystalloid-cardioplegia-for-myocardial-protection-during-coronary-artery-bypass-grafting-surgery
#17
Paolo Nardi, Calogera Pisano, Fabio Bertoldo, Sara R Vacirca, Guglielmo Saitto, Antonino Costantino, Emanuele Bovio, Antonio Pellegrino, Giovanni Ruvolo
We retrospectively analyzed early results of coronary artery bypass grafting (CABG) surgery using two different types of cardioplegia for myocardial protection: antegrade intermittent warm blood or cold crystalloid cardioplegia. From January 2015 to October 2016, 330 consecutive patients underwent isolated on-pump CABG. Cardiac arrest was obtained with use of warm blood cardioplegia (WBC group, n  = 297) or cold crystalloid cardioplegia (CCC group, n  = 33), according to the choice of the surgeon. Euroscore II and preoperative characteristics were similar in both groups, except for the creatinine clearance, slightly lower in WBC group (77...
December 2018: Cell Death Discovery
https://www.readbyqxmd.com/read/29525190/pro-in-favor-of-more-generalized-use-of-del-nido-cardioplegia-in-adult-patients-undergoing-cardiac-surgery
#18
Jessica Spellman
No abstract text is available yet for this article.
January 31, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29521662/adjusted-calculation-model-of-heparin-management-during-cardiopulmonary-bypass-in-obese-patients-a-randomised-controlled-trial
#19
Matthias Vienne, Emmanuel Haas, Thibaut Wipf, Lelia Grunebaum, François Levy, Laurent Sattler, Tam Hoang Minh, François Severac, Charles Tacquard, Olivier Collange, Paul-Michel Mertes, Annick Steib
BACKGROUND: Anticoagulation during cardiopulmonary bypass (CPB) is usually adapted to total body weight (TBW). This may be inaccurate in obese patients and lead to heparin overdose with a risk of bleeding. OBJECTIVES: To validate the efficacy and safety of an adjusted calculation model of heparin dosing based on ideal body weight (IBW) rather than TBW in obese CPB patients, with an expected target mean plasma heparin concentration of 4.5 IU ml after onset of CPB in the experimental group...
March 7, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29496435/coronary-sinus-rupture-repair-patency-is-important
#20
Toshinobu Kazui, Theodore M Lin, Scott D Lick
We report a case of coronary sinus (CS) injury with a retrograde cardioplegia catheter and repair compromising CS patency. This resulted in acute global cardiac dysfunction shortly after weaning from bypass, which reversed after patch repair with confirmed CS patency. The case shows that acute CS occlusion may not be tolerated in some humans.
February 26, 2018: Annals of Thoracic Surgery
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