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Cardioplegia

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https://www.readbyqxmd.com/read/28329384/custodiol-versus-cold-calafiore-for-elective-cardiac-arrest-in-isolated-aortic-valve-replacement-a-propensity-matched-analysis-of-7263-patients%C3%A2
#1
Alexandro Hoyer, Sven Lehmann, Meinhard Mende, Thilo Noack, Philipp Kiefer, Martin Misfeld, Farhad Bakhtiary, Friedrich Wilhelm Mohr
OBJECTIVES: This study was designed to assess the impact of crystalloid cardioplegia (CCP) and blood cardioplegia (BCP) on short- and long-term outcome after isolated aortic valve replacement (AVR). METHODS: A total of 7263 patients undergoing AVR at our institution between November 1994 and June 2015 were identified. CCP (Custodiol ® ) was used in 83% ( n  = 5998) and intermittent cold BCP in 1007 patients (14%). For 4790 patients, propensity scores were calculated from baseline data, risk factors, comorbidities and characteristics of the disease, resulting in 825 pairs...
March 3, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28329148/myocardial-energy-metabolism-and-ultrastructure-with-polarizing-and-depolarizing-cardioplegia-in-a-porcine-model%C3%A2
#2
Terje Aass, Lodve Stangeland, David J Chambers, Seth Hallström, Christine Rossmann, Bruno K Podesser, Malte Urban, Knut Nesheim, Rune Haaverstad, Knut Matre, Ketil Grong
OBJECTIVES: This study investigated whether the novel St. Thomas' Hospital polarizing cardioplegic solution (STH-POL) with esmolol/adenosine/magnesium offers improved myocardial protection by reducing demands for high-energy phosphates during cardiac arrest compared to the depolarizing St. Thomas' Hospital cardioplegic solution No 2 (STH-2). METHODS: Twenty anaesthetised pigs on tepid cardiopulmonary bypass were randomized to cardiac arrest for 60 min with antegrade freshly mixed, repeated, cold, oxygenated STH-POL or STH-2 blood cardioplegia every 20 min...
March 2, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28329111/hypoplastic-left-heart-syndrome-a-novel-surgical-strategy-for-small-volume-centres-%C3%A2
#3
Margaux Pontailler, Régis Gaudin, Marien Lenoir, Ayman Haydar, Diala Kraiche, Damien Bonnet, Pascal Vouhé, Olivier Raisky
OBJECTIVES: We describe in a prospective study, a novel surgical technique for the management of hypoplastic left heart syndrome inspired by the hybrid Norwood approach. METHODS: This new neonatal palliation comprises replacement of the patent ductus arteriosus (PDA) and aortic arch plasty with a pulmonary homograft associated with the banding of both pulmonary arteries and atrial septectomy, under cardiopulmonary bypass without aortic clamping and cardioplegia...
February 17, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28327076/myocardial-protection-during-minimally-invasive-cardiac-surgery-through-right-mini-thoracotomy
#4
Micaela De Palo, Pietro Guida, Florinda Mastro, Daniela Nanna, Teresa A P Quagliara, Ruggiero Rociola, Giosuè Lionetti, Domenico Paparella
BACKGROUND: Myocardial damage is an independent predictor of adverse outcome following cardiac surgery and myocardial protection is one of the key factors to achieve successful outcomes. Cardioplegia with Custodiol is currently the most used cardioplegia during minimally invasive cardiac surgery (MICS). Different randomized controlled trials compared blood and Custodiol cardioplegia in the context of traditional cardiac surgery. No data are available for MICS. AIM: The aim of this study was to compare the efficacy of cold blood versus Custodiol cardioplegia during MICS...
April 2017: Perfusion
https://www.readbyqxmd.com/read/28303868/-diagnostics-and-surgical-tactics-for-papillary-fibroelastomas-of-the-heart
#5
Yu V Belov, M A Nechaenko, V A Ivanov, D N Fedorov, A Yu Kiprensky
AIM: To investigate clinical, diagnostic and surgical aspects of papillary fibroelastomas of the heart. MATERIAL AND METHODS: Clinical, diagnostic and surgical aspects of papillary fibroelastomas of the heart were analyzed in 12 patients. RESULTS: Diagnosis was obtained using two-dimensional echocardiography and transesophageal echocardiography or computed tomography. Surgical treatment involved isolated excision of the tumor or combined with valve repair or replacement in case of valvular involvement...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28291141/antegrade-cardioplegia-decannulation-using-the-cor-knot-system-in-minimally-invasive-mitral-valve-surgery
#6
Sabet W Hashim, Philip Y K Pang
A right mini-thoracotomy approach may be used for mitral valve repair without compromising clinical outcomes. Compared with conventional sternotomy, there is an increased distance to the cardiac structures from the mini-thoracotomy incision, which makes certain technical acts more demanding. One particular challenge is hemostasis at the antegrade cardioplegia cannula site. We propose a novel technique to remove an antegrade cardioplegia cannula using the COR-KNOT system. This technique negates the need for tying with a knot pusher and reduces the risk of aortic injury and troublesome bleeding...
March 13, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28261878/hemodynamic-and-perioperative-management-in-two-different-preclinical-pig-to-baboon-cardiac-xenotransplantation-models
#7
Tanja Mayr, Andreas Bauer, Bruno Reichart, Sonja Guethoff, Uwe Schoenmann, Matthias Längin, Alessandro Panelli, Alexander Kind, Paolo Brenner, Jan-Michael Abicht
BACKGROUND: The perioperative phase of preclinical cardiac xenotransplantations significantly affects the experimental outcome. Moderate or even severe hemodynamic and respiratory impairment occurs frequently in baboons after receiving a cardiac transplant. The perioperative management of such postoperative instability is very demanding, especially in the experimental setting. We compared perioperative changes of hemodynamic and laboratory findings during orthotopic and heterotopic thoracic cardiac xenotransplantations and describe our monitoring, treatment and intensive care...
March 5, 2017: Xenotransplantation
https://www.readbyqxmd.com/read/28203541/anesthetic-considerations-in-robotic-mitral-valve-surgery
#8
Kent H Rehfeldt, J Valery Andre, Matthew J Ritter
The robotic approach to cardiac surgery offers patients numerous potential advantages compared with a traditional sternotomy approach including shorter hospital length of stay, reduced pain, fewer blood transfusions, and a quicker return to normal daily activities. At the same time, robotic cardiac surgery requires that the anesthesiologist employs several subspecialty skillsets in order to provide optimal care for these patients. Multiple different regional anesthesia techniques may be used to improve analgesia, reduce opioid dosages, and facilitate rapid extubation at the conclusion of the case...
January 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28190549/comparing-del-nido-and-conventional-cardioplegia-in-infants-and-neonates-in-congenital-heart-surgery
#9
Kamal K Pourmoghadam, Mark Ruzmetov, Michael C O'Brien, Kurt D Piggott, Gary Plancher, Sukumar Suguna Narasimhulu, Tavya Benjamin, William M Decampli
BACKGROUND: The aim of this study was to evaluate outcome measures after the use of del Nido (dN) cardioplegia compared with conventional multidose high-potassium (non-dN) cardioplegia in neonates and infants. METHODS: We retrospectively analyzed data in patients, aged younger than 1 year, undergoing cardiopulmonary bypass (CPB) from January 2012 to August 2015. We changed our cardioplegia protocol from non-dN to dN administered in a single or infrequently dosed strategy in September 2013...
February 9, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28152655/inflammatory-cytokine-response-and-cardiac-troponin-i-changes-in-cardiopulmonary-bypass-using-two-cardioplegia-solutions-del-nido-and-modified-st-thomas-a-randomized-controlled-trial
#10
Farhad Gorjipour, Maziar Gholampour Dehaki, Ziae Totonchi, Seyed Javad Hajimiresmaiel, Rasoul Azarfarin, Hamidreza Pazoki-Toroudi, Mohammad Mahdavi, Mahtab Korbi, Mahyar Gholampour Dehaki, Behrouz Soltani, Fazel Gorjipour
BACKGROUND: Long intervals of del Nido (DN) solution administration, 90 minutes, may result in rewarming of the myocardial tissue and elevate metabolic demand and hypoxia. This will potentially increase inflammatory response due to ischemia-reperfusion injury. We conducted this study to compare the inflammatory response between patients receiving DN and multi-dose St Thomas' cardioplegia solution (MST) in cardiopulmonary bypass (CPB) surgery for the correction of tetralogy of Fallot (TF)...
February 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28137992/coronary-sinus-injury-resulting-from-endarterectomy-during-multivessel-bypass-surgery
#11
Mehmet H Akay, Manish K Patel, Igor D Gregoric
Coronary sinus injury is a very rare complication of cardiac surgery and is usually related to coronary sinus perfusion catheter placement for retrograde cardioplegia infusion. It can be either a catheter-related perforation or high-perfusion pressure-related injury to the coronary sinus. Primary repair of the coronary sinus or over-sewing are two possible options to resolve this complication. Decellularized extracellular matrix from porcine intestinal submucosa is widely used as an approved material for repairing cardiac structures...
January 30, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28134010/noteworthy-literature-published-in-2016-for-cardiac-surgery
#12
Muhammad Aftab, Joseph C Cleveland, T Brett Reece
Cardiac surgical care of patients continued to evolve rapidly in 2016. In this article, 3 topics of considerable change are discussed based on recent publications. The first topic reviews the potential risks and benefits of newly instituted low-risk percutaneous aortic valve replacement. The second topic reviews the increasing utilization of more extensive arch replacements in acute type A dissection. The final topic reviews current trends and justification for changes in patterns of use of cardioplegia options...
March 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28099289/orthogonal-views-of-coronary-vessels-a-method-for-imaging-the-delivery-of-blood-cardioplegia-using-transesophageal-echocardiography
#13
Luiz F Maracaja Neto, Raj Modak, Robert B Schonberger
Coronary blood flow can be disrupted during cardiac interventions such as mitral valve surgeries, left atrial appendage ligation, transcatheter aortic valve implantation, and aortic procedures involving reimplantation of coronary buttons. Although difficult to accomplish, coronary imaging using transesophageal echocardiography can be performed by the use of orthogonal imaging with the ability for real-time tilt for angle adjustment. The technique described herein allows imaging of the right coronary artery, left main coronary artery bifurcation, left anterior descending, and circumflex coronary arteries...
April 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28096823/comparison-of-del-nido-cardioplegia-and-st-thomas-hospital-solution-two-types-of-cardioplegia-in-adult-cardiac-surgery
#14
Prashant Mishra, Ranjit B Jadhav, Chandan Kumar Ray Mohapatra, Jayant Khandekar, Chaitanya Raut, Ganesh Kumar Ammannaya, Harsh S Seth, Jaskaran Singh, Vaibhav Shah
INTRODUCTION: St. Thomas' cardioplegic solution No. 2 (ST), although most widely used in adult cardiac surgery, needs to be given at short intervals, causing additional myocardial injury. AIM: To determine whether del Nido (DN) cardioplegia, with longer periods of arrest, provides equivalent myocardial protection as compared to ST. MATERIAL AND METHODS: The study population comprised 100 patients who underwent elective coronary artery bypass grafting (CABG) or double valve replacement (DVR) surgery between January 2015 and January 2016...
December 2016: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/27979473/lazaroid-u-74389g-for-cardioplegia-related-ischemia-reperfusion-injury-an-experimental-study
#15
Panagiotis Dedeilias, Apostolos Papalois, Christos Angelidis, Georgios Giannopoulos, Spyridon Deftereos, Maria Chorti, Efstratios Apostolakis, Georgia Kostopanagiotou
BACKGROUND: The adverse effects of myocardial ischemia and reperfusion during cardiopulmonary bypass (CPB) have been thoroughly described. Lazaroid U-74389G, a 21 aminosteroid, has been shown to attenuate ischemia and reperfusion injury and improve recovery in a variety of experimental models. METHODS: Sixteen male swine were randomly divided in two groups. All animals underwent 45 min of ischemic cardioplegic arrest, with U-74389G addition to the standard cardioplegic solution, whereas controls underwent the same procedure without U-74389G...
January 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/27942403/the-future-of-off-pump-coronary-artery-bypass-grafting-a-north-american-perspective
#16
Bobby Yanagawa, Rashmi Nedadur, John D Puskas
Off-pump coronary artery bypass graft (OPCAB) is currently performed routinely in a minority of specialized centers and in many more centers, utilized only when a porcelain aorta mandates a no-touch aortic technique. The OPCAB literature can be summarized as follows: (I) large-scale randomized trials in relatively low risk patients that include surgeons with a range of experience demonstrating no consistent beneficial differences in major cardiovascular and cerebrovascular outcomes but lower transfusion rates and shorter length of stay, tempered by some reports of higher rates of incomplete revascularization and lower rates of long term graft patency; (II) smaller randomized controlled trials (RCTs) from highly specialized programs demonstrating equivalent or superior outcomes with OPCAB and similar completeness of revascularization and graft patency; and (III) observational data from large databases demonstrating a consistent benefit of OPCAB, especially in higher-risk patient subsets...
November 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27941300/reperfusion-damage%C3%A3-a-story-of-success-failure-and-hope
#17
REVIEW
Roberto Ferrari, Cristina Balla, Michele Malagù, Gabriele Guardigli, Giampaolo Morciano, Matteo Bertini, Simone Biscaglia, Gianluca Campo
Tissue salvage of severely ischemic myocardium requires timely reperfusion by thrombolysis, angioplasty, or bypass. However, recovery of left ventricular function is rare. It may be absent or, even worse, reperfusion can induce further damage. Laboratory studies have shown convincingly that reperfusion can increase injury over and above that attributable to the pre-existing ischemia, precipitating arrhythmias, suppressing the recovery of contractile function ("stunning") and possibly even causing cell death in potentially salvable ischemic tissue...
January 25, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/27935874/-ischaemic-postconditioning-of-the-heart-analysis-of-experimental-findings
#18
REVIEW
L N Maslov, A Yu Podoksenov, I G Khaliulin
The data of publications regarding the influence of experimental atherosclerosis on the infarct-limiting effect of ischaemic postconditioning (IPost) are controversial. The presented information is suggestive that ageing removes or attenuates the infarct-limiting effect of postconditioning but does not influence the antiarrhythmic effect of IPost. The majority of experimental data report that streptozotocin-induced diabetes removes the infarct-limiting effect of IPost. The data concerning type 2 diabetes mellitus are controversial: some authors state that such diabetes completely levels the cardioprotecting effect of IPost; others tell that it only attenuates but does not remove the infarct-limiting effect of IPost...
2016: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/27932571/esmolol-before-cardioplegia-and-as-cardioplegia-adjuvant-reduces-cardiac-troponin-release-after-cardiac-surgery-a-randomized-trial
#19
Elena Bignami, Marcello Guarnieri, Annalisa Franco, Chiara Gerli, Monica De Luca, Fabrizio Monaco, Giovanni Landoni, Alberto Zangrillo
BACKGROUND: Cardioplegic solutions are the standard in myocardial protection during cardiac surgery, since they interrupt the electro-mechanical activity of the heart and protect it from ischemia during aortic cross-clamping. Nevertheless, myocardial damage has a strong clinical impact. We tested the hypothesis that the short-acting beta-blocker esmolol, given immediately before cardiopulmonary bypass and as a cardioplegia additive, would provide an extra protection to myocardial tissue during cardiopulmonary bypass by virtually reducing myocardial activity and, therefore, oxygen consumption to zero...
December 8, 2016: Perfusion
https://www.readbyqxmd.com/read/27925238/danshen-enhanced-cardioprotective-effect-of-cardioplegia-on-ischemia-reperfusion-injury-in-a-human-induced-pluripotent-stem-cell-derived-cardiomyocytes-model
#20
Wei Wei, Yiwei Liu, Qiang Zhang, Yangming Wang, Xiaoling Zhang, Hao Zhang
Myocardial ischemia-reperfusion (I/R) injury is unavoidable during cardioplegic arrest and open-heart surgery. Danshen is one of the most popular traditional herbal medicines in China, which has entered the Food and Drug Administration-approved phase III clinical trial. This study was aimed to develop a human-induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) model to mimic I/R injury and evaluate the cardioprotective effect of regular cardioplegic solution with Danshen. hiPSC-CMs were cultured with the crystalloid cardioplegic solution (Thomas group) and Thomas solution with 2 or 10 µg/mL Danshen (Thomas plus Danshen groups)...
December 7, 2016: Artificial Organs
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