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Cardiopulmonary bypass grafting

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https://www.readbyqxmd.com/read/29780728/intimal-re-layering-technique-for-type-a-acute-aortic-dissection-reconstructing-the-intimal-layer-continuity-to-induce-remodeling-of-the-false-channel
#1
Eugenio Neri, Enrico Tucci, Giulio Tommasino, Giulia Guaccio, Carmelo Ricci, Pierleone Lucatelli, Marco Cini, Roberto Ceresa, Antonio Benvenuti, Luigi Muzzi
Background: Residual false channel is common after repair of type A acute aortic dissection (TAAAD). Starting from our recent series of TAAAD patients we carried out a retrospective analysis, regarding the failure of primary exclusion at the time of the initial operation. We classified the location of the principal entry tears perfusing the residual false channel. The proposed technique represents our attempt to correct the mechanism of false channel perfusion during primary repair. We describe a new technique designed to address some limitations of standard hemiarch aortic replacement...
2018: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29780073/early-lvad-implantation-in-a-patient-with-left-ventricular-failure-after-aortic-dissection-with-left-main-stem-involvement
#2
Hazem El Beyrouti, Angela Kornberger, Nancy Halloum, Andres Beiras-Fernandez, Christian-Friedrich Vahl
BACKGROUND: Coronary involvement in aortic dissection heralds a poor outcome. Involvement of the left main stem may lead to left ventricular (LV) failure requiring mechanical circulatory support. CASE REPORT: A staged approach was applied in a 24-year-old female who suffered extensive infarction due to aortic dissection with left main stem involvement. After replacement of the ascending aorta and grafting of the left internal thoracic artery to the left anterior descending artery following a failed attempt at reconstruction of the left coronary ostium, she failed to wean from cardiopulmonary bypass (CPB) and underwent implantation of an extracorporeal life support (ECLS) system as a bridge to decision...
May 21, 2018: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29774399/endothelial-dysfunction-following-coronary-artery-bypass-grafting-influence-of-patient-and-procedural-factors
#3
J Hadem, R Rossnick, B Hesse, M Herr, M Hansen, A Bergmann, G Kensah, C Maess, H Baraki, P Kümpers, A Lukasz, I Kutschka
BACKGROUND: Angiopoietin-2 (Angpt2) mediates endothelial dysfunction (ED) following coronary artery bypass grafting (CABG). Its triggers are, however, poorly understood. METHODS: We examined the time course of ED beyond the early phase of postoperative recovery in 75 patients following CABG with a special focus on different cardiopulmonary bypass (CPB) modes as potential triggers of Angpt2 release. RESULTS: Nine patients (12.0%) underwent off-pump coronary artery bypass (OPCAB), 31 patients (41...
May 17, 2018: Herz
https://www.readbyqxmd.com/read/29771328/association-of-preoperative-plasma-fibrinogen-level-with-postoperative-bleeding-after-on-pump-coronary-bypass-surgery-does-plasma-fibrinogen-level-affect-the-amount-of-postoperative-bleeding
#4
Sameh Alagha, Murat Songur, Tugba Avci, Kerem Vural, Sadi Kaplan
OBJECTIVES: Our primary aim was to investigate the association between the preoperative concentration of plasma fibrinogen and the volume of postoperative bleeding. Our secondary aim was to identify whether there is a possible correlation between the patients' different characteristics and haemostatic laboratory variables and the postoperative amount of bleeding after on-pump coronary artery bypass grafting procedures. METHODS: A total of 550 adult patients undergoing isolated coronary artery bypass grafting on cardiopulmonary bypass in our hospital were enrolled and investigated retrospectively...
May 15, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29756691/cerebrovascular-autoregulation-impairments-during-cardiac-surgery-with-cardiopulmonary-bypass-are-related-to-postoperative-cognitive-deterioration-prospective-observational-study
#5
Birute Kumpaitiene, Milda Svagzdiene, Edmundas Sirvinskas, Virginija Adomaitiene, Vytautas Petkus, Rolandas Zakelis, Solventa Krakauskaite, Romanas Chomskis, Arminas Ragauskas, Teodoro F Dagi, Rimantas Benetis
BACKGROUND: Post-operative cognitive dysfunction (POCD) occurs in approximately 33-83% of patients after cardiac surgery with cardiopulmonary bypass (CPB). Recent clinical data suggest that real-time, intraoperative monitoring of patient- specific cerebrovascular autoregulation (CA) may help to prevent POCD by detecting individual critical limits for mean arterial pressure (MAP) outside which CA is impaired. Objectives of the study were to detect the episodes of impaired CA during cardiac surgery with CPB, and to investigate the association between CA impairment and POCD...
May 11, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29755089/-surgical-repair-of-kommerell-s-diverticulum-with-right-sided-aortic-arch-report-of-a-case
#6
Hiromitsu Kawasaki, Yoshihiro Nakayama, Yuichi Koga, Baku Takahashi, Hisashi Sato
A 54-year-old woman was referred for assessment of dysphagia and extrinsic compression of the esophagus detected by upper gastrointestinal endoscopy. Computed tomography revealed the rightsided aortic arch with mirror image branching and Kommerell's diverticulum. To relieve the esophageal compression, surgical intervention was indicated. Descending aortic replacement with a Dacron graft was performed through right thoracotomy under partial cardiopulmonary bypass. The patient was discharged without any complication, and her dysphagia disappeared...
May 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29755086/-total-arch-replacement-with-concomitant-thoracic-endovascular-aortic-repair-via-the-ascending-aorta-for-extended-thoracic-aneurysm-report-of-a-case
#7
Yoshiki Endo, Yoshihito Irie, Kousuke Nishida, Tsuyoshi Fujimiya, Yoshiaki Katada
The patient was a 66 year-old male. Computed tomography (CT) angiography showed a huge aneurysm(120 mm) in the aortic arch and chronic type B aortic dissection(45 mm) in the descending aorta. Echocardiography showed patent ductus arteriosus( PDA). Because of pulmonary hypertension due to PDA, it was considered unacceptable to put him under general anesthesia twice. We performed thoracic endovascular aortic repair (TEVAR) via the ascending aorta and total arch replacement (TAR) simultaneously to prevent paraplegia...
May 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29754790/aortic-clamping-strategy-and-postoperative-stroke
#8
Mohamad Alaeddine, Vinay Badhwar, Maria V Grau-Sepulveda, Lawrence M Wei, Chris C Cook, Michael E Halkos, Vinod H Thourani, Jeffrey P Jacobs, Roland Matsouaka, James Meza, Matthew Brennan, Thomas G Gleason, Danny Chu
OBJECTIVE: The effect of aortic clamping strategy on short-term stroke during proximal graft construction for coronary artery bypass grafting (CABG) remains undefined. The aim of this study was to test the hypothesis that partial occluding clamp (POC) technique does not increase incidence of postoperative stroke compared with single clamp (SC) technique for performing proximal coronary anastomoses. METHODS: We identified 52,611 patients who underwent on-pump CABG in the Society of Thoracic Surgeons Adult Cardiac Surgery Database from July 1, 2014 to March 31, 2015...
April 13, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29754402/impact-of-mean-arterial-pressure-on-sublingual-microcirculation-during-cardiopulmonary-bypass-secondary-outcome-from-a-randomised-clinical-trial
#9
Frederik Holmgaard, Anne G Vedel, Hanne Berg Ravn, Jens C Nilsson, Lars S Rasmussen
OBJECTIVE: In this substudy of a randomised, clinical trial, we explored the sublingual microcirculation during cardiac surgery at two different levels of blood pressure. We hypothesised that a higher mean arterial pressure during cardiopulmonary bypass would cause higher Microvascular Flow Index. METHODS: Thirty-six cardiac surgery patients undergoing coronary artery bypass grafting were included and randomised to either low (40-50 mmHg) or high (70-80 mmHg) mean arterial pressure during cardiopulmonary bypass...
May 13, 2018: Microcirculation: the Official Journal of the Microcirculatory Society, Inc
https://www.readbyqxmd.com/read/29753665/off-pump-versus-on-pump-coronary-artery-bypass-grafting-a-systematic-review-and-analysis-of-clinical-outcomes
#10
REVIEW
Shahzad Shaefi, Aaron Mittel, Dan Loberman, Harish Ramakrishna
Surgical coronary artery bypass grafting (CABG) is the standard of care for revascularization of left main or three-vessel coronary artery disease. The off-pump coronary artery bypass graft (OPCAB) procedure avoids the use of cardiopulmonary bypass. Theoretically, OPCAB may improve long-term outcomes by reducing the rates of perioperative myocardial injury, stroke, neurocognitive impairment, and cardiac-related mortality. Several high-quality clinical trials have been conducted since OPCAB became popular in the 1990s and have demonstrated no benefit of OPCAB over traditional CABG with respect to these outcomes despite favorable short-term reductions in transfusion requirements and other postoperative complications...
April 4, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29742686/a-rare-case-report-of-one-stage-surgical-treatment-for-left-renal-cell-carcinoma-with-level-iv-intravenous-tumor-thrombus-combined-with-severe-coronary-artery-stenosis
#11
Zhenqing Wang, Keqin Zhang, Hui Zhang, Dingqi Sun, Yong Li, Qi Tan, Qiang Fu
RATIONALE: Renal cell carcinoma (RCC) exhibits a natural tendency to extend from the kidney into inferior vena cava (IVC) and growing into the right atrium is a rare complication. We report a 65-year-old patient with an RCC with intravascular extension through renal vein into the IVC and right atrial combined with severe coronary artery disease. This case has not been described in the literature and there is no treatment guideline for it. PATIENT CONCERNS: A 65-year-old patient was admitted to our clinic with complaints of edema of both lower extremities...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29742534/sutureless-prosthesis-implantation-and-ascending-aorta-replacement-through-a-ministernotomy-approach
#12
Antonio Lio, Matteo Ferrarini, Antonio Miceli, Mattia Glauber
A significant proportion of patients undergoing aortic valve replacement have a dilated ascending aorta; presence of an ascending aorta aneurysm is viewed as a contraindication for sutureless valve implantation for the potential risk of prosthesis dislodgment. We describe our technique of sutureless prosthesis implantation and concomitant ascending aorta replacement through an upper ministernotomy. Seven patients underwent aortic valve replacement with a sutureless prosthesis and concomitant ascending aorta replacement between November 2014 and October 2016...
May 4, 2018: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29731241/validation-of-renal-risk-score-models-for-coronary-artery-bypass-surgery-in-diabetic-patients
#13
Mehmet Kalender, Taylan Adademir, Deniz Çevirme, Mehmet Atay, Kamil Boyacioglu, Mehmet Tasar, Fuat Buyukbayrak
BACKGROUND: Coronary artery bypass grafting is applicable with very low mortality and morbidity rates around the world. However, exposure to even one of the risk factors increases mortality and morbidity significantly. There are three acute kidney injury definitions, and classification methods are applicable (Kidney Disease: Improving Global Outcomes (KDIGO); Risk, Injury, and Failure; and Loss; and End-stage kidney disease (RIFLE); and Acute Kidney Injury Network (AKIN)), for understanding and grading of renal impairment...
April 18, 2018: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29726039/relationship-between-intraoperative-serum-lactate-and-hemoglobin-levels-on-postoperative-renal-function-in-patients-undergoing-elective-cardiac-surgery
#14
Steven C Mitchell, Anirudh Vinnakota, Salil V Deo, Alan H Markowitz, Basar Sareyyupoglu, Yakov Elgudin, Benjamin Medalion, Adam Tzagournis, Joseph Sabik, Soon J Park
BACKGROUND AND AIM: We examined the relationship between serum lactate and hemoglobin levels on renal function and postoperative outcome in low-risk elective coronary artery bypass graft (CABG) patients. METHODS: Intraoperative hemoglobin and lactate levels were measured in elective isolated CABG patients. Patients with renal dysfunction (baseline creatinine>2 mg/dL) were excluded. Multivariate logistic regression was used to determine associations between lactate, hemoglobin, and acute kidney injury (AKI)...
May 3, 2018: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/29715703/icu-readmission-after-cardiac-surgery-still-a-matter-of-concern
#15
Philipp Kolat, Patricia Guttenberger, Michael Ried, Julia Kapahnke, Assad Haneya, Christof Schmid, Claudius Diez
BACKGROUND:  Despite improvements in diagnostics and perioperative care, readmission to intensive care unit (ICU) after cardiac surgery is still a severe drawback for patients with considerable morbidity, mortality, and costs. Aim of this retrospective analysis was to disentangle independent risk factors for ICU readmission. MATERIAL AND METHODS:  Between 01/2004 and 12/2012, 336 out of 9,555 (3.5%) patients undergoing cardiac surgery at the Department of Cardiothoracic Surgery in Regensburg (Germany) were readmitted to ICU...
May 1, 2018: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/29707299/cold-crystalloid-versus-warm-blood-cardioplegia-in-patients-undergoing-aortic-valve-replacement
#16
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/29701805/cardiac-rehabilitation-fitness-changes-and-subsequent-survival
#17
Alban De Schutter, Sergey Kachur, Carl J Lavie, Arthur Menezes, Kelly K Shum, Sripal Bangalore, Ross Arena, Richard V Milani
Aims: Assessments of cardiac rehabilitation (CR) in coronary heart disease (CHD) cohorts usually examine mortality in aggregate. The current study examines the prognosis and characteristics of patients who enrolled and completed CR, stratified by their level of improvement in cardiorespiratory fitness (CRF) by examining the characteristics, outcomes and predictors of non-response in CRF (NonRes) compared to low-responders (LowRes) and high-Responders (HighRes) after CR. Methods And Results: 1171 CHD patients were referred for a phase II CR program after therapy for an acute coronary syndrome, coronary artery bypass graft procedure or a percutaneous coronary intervention between January 1, 2000 and June 30, 2013 underwent cardiopulmonary exercise testing before and after CR...
April 26, 2018: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/29701386/simplified-technique-for-aortic-arch-replacement-in-patients-at-high-risk-for-frozen-elephant-trunk
#18
Álvaro Laranjeira Santos, António Cruz Tomás, Jorge Pinheiro Santos, Daniela Varela-Afonso, José Fragata
INTRODUCTION: Surgical approach of multisegmental pathology of the thoracic aorta, namely aortic arch / descending aorta is challenging. The Frozen Elephant Trunk (FET) has good results, with acceptable risk. However, in the subgroup of patients (pts) older than 75 years and with important comorbidities, the surgical risk is very high. OBJECTIVES: Review short-term results of this original, simplified and potentially hybrid technique developed in our Department for this subgroup of patients...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29701361/postoperative-atrial-fibrillation-after-coronary-artery-bypass-grafting-surgery
#19
Ana Filipa Ferreira, Francisca A Saraiva, Raquel Moreira, Rui J Cerqueira, Mário J Amorim, Paulo Pinho, André P Lourenço, Adelino F Leite-Moreira
INTRODUCTION: Postoperative atrial fibrillation (PoAF) is the most common arrhythmia following cardiac surgery, which increase the patient's morbidity and mortality. PURPOSE: The aim of this study was to evaluate new onset of atrial fibrillation (AF) after isolated coronary artery bypass grafting (CABG) surgery, its clinical and surgical predictors, and its impact in immediate and long-term outcomes. METHODS: Retrospective study including all CABG surgeries performed in a tertiary centre, between 2004 and 2011...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29701358/carotid-stenosis-in-cardiac-surgery-patients
#20
Pedro Pinto Sousa, Gabriela Teixeira, João Gonçalves, Carlos Veiga, Pedro Sá Pinto, Pedro Brandão, Alexandra Canedo, Luis Vouga, Rui Almeida
INTRODUCTION: Ischemic stroke is a potential perioperative complication after an open heart surgery (OHS). Whether a carotid stenosis or occlusion is associated with an increased risk of perioperative stroke in patients or just a risk factor has been a concern of intense debate in the literature. METHODS: We retrospectively analyzed patients submitted to OHS between January and December2016 with known asymptomatic carotid disease. The data from 85 consecutive patients undergoing coronary artery bypass grafting, valve replacement, or both was collected...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
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