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Cardiopulmonary bypass grafting

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https://www.readbyqxmd.com/read/28432006/stepwise-use-of-circulatory-support-devices-in-a-patient-refractory-to-cardiopulmonary-resuscitation
#1
Marco Spartera, Richard J Jabbour, Mauro Chiarito, Michele De Bonis, Federico Pappalardo
This case describes the management of a patient admitted to an emergency department with general malaise, who deteriorated into cardiac arrest and refractory to advanced life support measures. After extracorporeal cardiopulmonary resuscitation (eCPR) with veno-arterial extracorporeal membrane oxygenation in association with an Impella 2.5 device, the patient underwent cardiac surgery (tissue aortic valve replacement, coronary artery bypass grafting and implantation of short-term paracorporeal left ventricular assist device)...
April 8, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28428523/-efficacy-of-total-debranching-thoracic-endovascular-aortic-repair-for-the-re-operation-of-aortic-arch-aneurysm
#2
Kyohei Ueno, Megumu Kanno, Hirofumi Midorikawa, Gaku Takinami, Rie Kageyama
Thoracic endovascular aortic repair (TEVAR) combined with all-neck-branch reconstruction (total debranching TEVAR)[td TEVAR] is applied to aortic arch aneurysms as a minimally invasive procedure to improve treatment results. We report the initial and long-term results of td TEVAR for the reoperation of aortic arch aneurysm. By September 2016, td TEVAR for reoperation had been applied in 5 cases. The reasons for the reoperation were dilation of the arch aneurysm after ascending aorta replacement in 4 cases and localized dissection of the proximal landing zone after zone 2 TEVAR in 1 case...
April 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28427403/preoperative-carbohydrate-load-and-intraoperatively-infused-omega-3-polyunsaturated-fatty-acids-positively-impact-nosocomial-morbidity-after-coronary-artery-bypass-grafting-a-double-blind-controlled-randomized-trial
#3
Gibran Roder Feguri, Paulo Ruiz Lúcio de Lima, Danilo de Cerqueira Borges, Laura Ramos Toledo, Larissa Nadaf Batista, Thaís Carvalho E Silva, Neuber José Segri, José Eduardo de Aguilar-Nascimento
BACKGROUND: A strategy of limited preoperative fasting, with carbohydrate (CHO) loading and intraoperative infusion of omega-3 polyunsaturated fatty acids (ω-3 PUFA), has seldom been tried in cardiovascular surgery. Brief fasting, followed by CHO intake 2 h before anesthesia, may improve recovery from CABG procedures and lower perioperative vasoactive drug requirements. Infusion of ω-3 PUFA may reduce occurrences of postoperative atrial fibrillation (POAF) and shorten hospital stays...
April 20, 2017: Nutrition Journal
https://www.readbyqxmd.com/read/28423997/do-lipid-microemboli-induce-acute-kidney-injury-during-cardiopulmonary-bypass
#4
Richard Issitt, Tim James, Bronagh Walsh, David Voegeli
BACKGROUND: Acute kidney injury (AKI) following cardiopulmonary bypass affects 5% of patients, representing significant postoperative morbidity and mortality. Animal models have shown an increased uptake of lipid microemboli (LME) into the renal vasculature, potentially indicating ischaemic causation. This study tested a new lipid filtration system (RemoweLL) against a conventional system with no lipid-depleting capacity to determine the efficacy of the filtration system and its effects on renal function...
April 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28423125/coronary-arteriovenous-fistulas-in-adult-patients-surgical-management-and-outcomes
#5
Sebnem Albeyoglu, Mustafa Aldag, Ufuk Ciloglu, Murat Sargin, Tugba Kemaloglu Oz, Hakan Kutlu, Sabri Dagsali
Objective: The aim of this study was to describe the demographic, clinical and anatomic characteristics of coronary arteriovenous fistulas in adult patients who underwent open cardiac surgery and to review surgical management and outcomes. Methods: Twenty-one adult patients (12 female, 9 male; mean age: 56.1±7.9 years) who underwent surgical treatment for coronary arteriovenous fistulas were retrospectively included in this study. Coronary angiography, chest X-ray, electrocardiography and transthoracic echocardiography were preoperatively performed in all patients...
January 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28423123/n-acetylcysteine-versus-dopamine-to-prevent-acute-kidney-injury-after-cardiac-surgery-in-patients-with-preexisting-moderate-renal-insufficiency
#6
Omer Faruk Savluk, Fusun Guzelmeric, Yasemin Yavuz, Deniz Cevirme, Emre Gurcu, Halide Ogus, Tulay Orki, Tuncer Kocak
Objective: Acute kidney injury after cardiac surgery is associated with mortality and morbidity. Therefore, strategies to prevent acute kidney injury are very important. The aim of this placebo-controlled randomized double-blind study was to compare the prophylactic efficacy of N-Acetylcysteine and dopamine administration in patients with pre-existing moderate renal insufficiency who were undergoing cardiopulmonary bypass. Methods: This study included 135 patients with pre-existing moderate renal insufficiency who were scheduled for coronary artery bypass grafting surgery...
January 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28393784/myocardial-revascularization-without-extracorporeal-circulation-why-hasn-t-it-convinced-yet
#7
REVIEW
Efstratios Apostolakis, Nikolaos A Papakonstantinou, Ioanna Koniari
Extracorporeal circulation has led to a great development in cardiovascular surgery during the last five decades. Its time-proven efficacy and safety have made on-pump coronary artery bypass grafting (CABG) the gold standard method of surgical revascularization. However, coronary revascularization on cardiopulmonary bypass and the accompanying aortic manipulation are related to plenty of deleterious complications. Therefore, off-pump CABG surgery was established to avoid complications. Nevertheless, despite the initial enthusiasm on this technique, only 20% of myocardial revascularization procedures worldwide are performed off-pump...
April 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28393773/impact-of-dexmedetomidine-on-hemodynamic-changes-during-and-after-coronary-artery-bypass-grafting
#8
Morteza Hashemian, Mehdi Ahmadinejad, Seyed Amir Mohajerani, Alireza Mirkheshti
OBJECTIVE: To determine the effect of dexmedetomidine (Dex) on hemodynamic changes during cardiopulmonary pump and postoperative period in coronary artery bypass grafting (CABG). METHODS AND DESIGN: This study is designed as a double-blinded, randomized clinical trial. SETTING: University hospital and single center. PARTICIPANTS: patients candidate for elective CABG. INTERVENTION: Dex 0.5 μg/kg/h or placebo was infused from the initiation of anesthesia up to extubation in Intensive Care Unit (ICU)...
April 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28381258/metabolomic-profiling-in-patients-undergoing-off-pump-or-on-pump-coronary-artery-bypass-surgery
#9
H Kirov, M Schwarzer, S Neugebauer, G Faerber, M Diab, T Doenst
BACKGROUND: Coronary artery bypass surgery can be performed without (Off-Pump) or with cardiopulmonary bypass (On-Pump). Extracorporeal circulation and cardioplegic arrest may cause alterations in the plasma metabolome. We assessed metabolomic changes in patients undergoing On-Pump or Off-Pump coronary artery bypass surgery. METHODS: We assessed five analyte classes (41 acylcarnitines, 14 amino acids, 92 glycerophospholipids, 15 sphingolipids, sugars, lactate) using a mass-spectrometry-based kit (Biocrates AbsoluteIDQ® p150) in paired arterial and coronary sinus blood obtained from 10 consecutive On-Pump and 10 Off-Pump patients...
April 5, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28376720/dynamic-changes-of-paraoxonase-1-activity-towards-paroxon-and-phenyl-acetate-during-coronary-artery-surgery
#10
Anna Wysocka, Marek Cybulski, Henryk Berbeć, Andrzej Wysokiński, Janusz Stążka, Jadwiga Daniluk, Tomasz Zapolski
BACKGROUND: Serum paraoxonase 1 (PON1), an enzyme associated with high - density lipoproteins (HDL) particles, inhibits the oxidation of serum lipoproteins and cell membranes. PON1 activity is lower in patients with atherosclerosis and in inflammatory diseases. The systemic inflammatory response provoked during cardiopulmonary bypass grafting may contribute to the development of postoperative complications. The aim of the present study was to estimate the dynamic changes in paraoxonase 1 (PON1) activity towards paraoxon and phenyl acetate during and after coronary artery surgery...
April 4, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28359715/simplified-total-aortic-arch-replacement-with-an-in-situ-stent-graft-fenestration-technique-for-acute-type-a-aortic-dissection
#11
Xiaoping Hu, Zhiwei Wang, Zongli Ren, Rui Hu, Hongbing Wu
OBJECTIVE: Total arch replacement combined with stented elephant trunk implantation in the descending aorta has successfully improved the outcomes of acute type A aortic dissection (AAAD). However, the optimal surgical strategy for the left subclavian artery (LSA) during the procedure remains a challenge. This study aimed to present our new technique of in situ stent graft fenestration to simplify the surgical procedure for suitable cases of AAAD. METHODS: From August 2008 to December 2015, a total of 106 patients underwent simplified total aortic arch replacement with an in situ stent graft fenestration technique...
March 27, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28355758/-progress-and-challenge-of-stanford-type-a-aortic-dissection-in-china
#12
L Z Sun, J R Li
In recent 20 years, the rapid development of acute Stanford type A aortic dissection in China has been mainly due to three aspects: (1) the refined classification of aortic dissection based on Stanford classification, (2) right axillary artery canal and selective cerebral perfusion technology become basic cardiopulmonary bypass strategy for Stanford type A aortic dissection, and (3) total aortic arch replacement and descending aortic stent graft surgery (Sun's surgery) become the standard treatment of Stanford type A aortic dissection...
April 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28332137/correction-of-dilutional-anemia-induces-renal-dysfunction-in-diabetic-patients-undergoing-coronary-artery-bypass-grafting-a-consequence-of-microcirculatory-alterations
#13
Güçlü Aykut, Meltem Kilercik, Cem Arıtürk, Halim Ulugöl, Uğur Aksu, Türkan Kudsioğlu, Nazan Atalan, Nihan Yapıcı, Hasan Karabulut, Fevzi Toraman
BACKGROUND: In this study we aimed to evaluate the effects of dilutional anemia resulting from cardiopulmonary bypass (CPB) and its correction with red blood cell (RBC) transfusion on tissue oxygenation and renal function in diabetic patients undergoing coronary artery bypass grafting (CABG). METHOD: 70 diabetic patients who underwent elective CABG and whose hematocrit values had been between 24-28% at any time during CBP were prospectively randomized and equally allocated to two groups: patients who received RBC during CPB (group I, n = 35) vs...
March 22, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28331446/lung-transplantation-and-the-routine-use-of-cardiopulmonary-bypass-and-median-sternotomy-experience-at-the-ochsner-multi-organ-transplant-institute
#14
Michael Bates, Matthew Factor, P Eugene Parrino, Aditya Bansal, Reinaldo Rampolla, Leonardo Seoane, Jose Mena, Matthew Gaudet, William Smith, P Michael McFadden
BACKGROUND: From 1990-2005 at Ochsner Medical Center in New Orleans, LA, cardiopulmonary bypass (CPB) was used only when necessary during lung transplantation surgeries. Ochsner's lung transplant program was closed for more than 4 years after Hurricane Katrina, and since the program's reestablishment in 2010, the majority of lung transplantation surgeries have been performed with the patient on CPB and with a median sternotomy incision. The purpose of this study was to compare the outcomes of the CPB and non-CPB groups...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28329189/mid-term-results-of-zone-0-thoracic-endovascular-aneurysm-repair-after-ascending-aorta-wrapping-and-supra-aortic-debranching-in-high-risk-patients
#15
Felice Pecoraro, Mario Lachat, Michael Hofmann, Neal S Cayne, Lyubov Chaykovska, Zoran Rancic, Gilbert Puippe, Thomas Pfammatter, Nicola Mangialardi, Frank J Veith, Dominique Bettex, Francesco Maisano, Thomas A Neff
OBJECTIVES: Surgical repair of aneurysmal disease involving the ascending aorta, aortic arch and eventually the descending aorta is generally associated with significant morbidity and mortality. A less invasive approach with the ascending wrapping technique (WT), supra-aortic vessel debranching (SADB) and thoracic endovascular aneurysm repair (TEVAR) in zone 0 was developed to reduce the associated risk in these patients. METHODS: During a 10-year period, consecutive patients treated by the ascending WT, SADB and TEVAR in zone 0 were included...
March 8, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28302346/postoperative-acute-kidney-injury-and-blood-product-transfusion-after-synthetic-colloid-use-during-cardiac-surgery
#16
Rajika Tobey, Hao Cheng, Mei Gao, Zhongmin Li, J Nilas Young, W Douglas Boyd, Fuhai Ji, Hong Liu
OBJECTIVES: This study assessed the effect of 2 types of hydroxyethyl starches (HES) on renal integrity and blood transfusion in cardiac surgery patients. DESIGN: Retrospective investigation. SETTING: Patients from a single tertiary medical center. PARTICIPANTS: Inclusion criteria included coronary artery bypass graft (CABG) and/or valve surgery that included cardiopulmonary bypass with aortic cross-clamping. INTERVENTIONS: Intraoperative HES and blood product administration...
December 28, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28301911/the-prevalence-and-clinical-relevance-of-asa-nonresponse-after-cardiac-surgery
#17
Saskia Wand, Elisabeth Hannah Adam, Anna Julienne Wetz, Patrick Meybohm, Nils Kunze-Szikszay, Kai Zacharowski, Aron Frederick Popov, Anton Moritz, Lisa Moldenhauer, Julia Kaiser, Martin Bauer, Christian Friedrich Weber
We aimed to identify the prevalence of acetylsalicylic acid (ASA) nonresponse in patients after coronary artery bypass graft (CABG) surgery and the possible consequences for the rate of major cardiovascular events. This prospective, observational, bicentric cohort study was conducted in two German University hospitals. A total of 400 patients (200 in each study center) undergoing elective CABG surgery were enrolled after written informed consent. Platelet function was analyzed on day 3 (d3) and day 5 (d5) postoperatively following stimulation with arachidonic acid (ASPItest) and with thrombin receptor-activating peptide 6 (TRAPtest) using multiple electrode aggregometry (Multiplate)...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28290819/-volume-of-coronary-artery-bypass-surgery-and-risk-of-postoperative-atrial-fibrillation
#18
O A Rubanenko, O V Fatenkov, S M Khokhlunov, D V Duplyakov
PURPOSE: To identify prevalence of atrial fibrillation (AF) in dependence of volume of coronary artery bypass grafting (CABG) as assessed by the number of grafts. MATERIAL AND METHODS: The study included 431 patients with ischemic heart disease (IHD) who underwent CABG. Group 1 comprised patients with single-vessel bypass graft (n=47, 78.7% men, mean age 59.6+/-5.6 years), group 2 - with multivessel bypass grafts (n=384, 76.8% men, mean age 61.0+/-8,1 years). During the observation period postoperative AF developed in 3 patients (6...
December 2016: Kardiologiia
https://www.readbyqxmd.com/read/28290812/-transaortic-implantation-of-aortic-valve-bioprosthesis-in-high-risk-patient-with-simultaneous-off-pump-coronary-artery-bypass-grafting
#19
R S Akchurin, T J Imaev, A E Komlev, P M Lepilin, A S Kolegaev, M E Nikonova
Transaortic approach represents an alternative variant of transcatheter aortic valve implantation (TAVI) which combines benefits of antegrade transapical approach and high safety profile characteristic of transfemoral approach. This method has substantial advantages over subclavian and transapical approaches in cases of pronounced myocardial hypertrophy, left ventricular dysfunction, thinning of left ventricular wall. We describe here a hybrid intervention with simultaneous coronary artery bypass grafting and TAVI in a patient from high surgical risk group with multivessel coronary artery involvement and critical aortic stenosis...
December 2016: Kardiologiia
https://www.readbyqxmd.com/read/28286090/surgical-revascularisation-in-the-early-phase-of-st-segment-elevation-myocardial-infarction-haemodynamic-status-is-more-important-than-the-timing-of-the-operation
#20
Vilem Rohn, Tomas Grus, Jan Belohlavek, Jan Horak
BACKGROUND: Surgical revascularisation in patients with acute myocardial infarction with ST-Segment Elevation (STEMI) is usually considered as a second choice when direct angioplasty/stent fails. However, improvements in surgical technique and postoperative care may justify coronary artery bypass grafting (CABG) in STEMI. METHODS: This was a retrospective analysis of prospectively gathered data of 135 patients with acute STEMI, treated with CABG in our department from February 2008 to December 2012...
February 28, 2017: Heart, Lung & Circulation
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