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Cardiopulmonary bypass AND carotid stenosis

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https://www.readbyqxmd.com/read/26980597/complete-carotid-and-coronary-revascularization-in-brain-malperfusion
#1
Claudia Aramendi, Alain Cubero, Andrés Cortés, Daniel Rivas, Alejandro Crespo, José I Aramendi
A 54-year-old man presented with unstable angina and stroke with right hemiplegia and aphasia due to left main coronary plus 3-vessel disease, severe stenosis of bilateral internal carotid, proximal left common carotid, and proximal left subclavian arteries. Simultaneous complete revascularization was undertaken with the use of conventional cardiopulmonary bypass and moderate hypothermia (25℃). The left internal mammary artery and two saphenous vein grafts were used for coronary artery bypass, and brain revascularization consisted of a left aorta-to-common carotid Dacron graft and bilateral carotid endarterectomy...
September 2016: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/26509349/is-carotid-artery-stenting-an-alternative-to-simultaneous-carotid-endarterectomy-performed-for-carotid-artery-stenosis-in-patients-undergoing-isolated-coronary-bypass-surgery
#2
Hüseyin Şaşkın, Cagri Duzyol, Kazım Serhan Ozcan, Rezan Aksoy, Mustafa Idiz
BACKGROUND: Treatment method in patients with coronary artery disease undergoing coronary bypass surgery with accompanying carotid artery disease is still a hot topic among clinicians. This study is designed to investigate if there is an effect on myocardial infarction, cerebrovascular events and mortality during postoperative period of simultaneous carotid endarterectomy with coronary bypass surgery compared to staged carotid artery stenting before coronary bypass surgery. METHODS: 102 patients (79 male, 23 female) who underwent simultaneous carotid endarterectomy with coronary bypass surgery or staged carotid artery stenting with coronary bypass surgery in the same center with the same surgical team were divided into 2 groups and retrospectively reviewed...
2015: Heart Surgery Forum
https://www.readbyqxmd.com/read/26313728/risk-factors-for-perioperative-ischemic-stroke-in-cardiac-surgery
#3
Mário Augusto Cray da Costa, Maria Fernanda Gauer, Ricardo Zaneti Gomes, Marcelo Derbli Schafranski
OBJECTIVE: The purpose of this study was to evaluate the risk factors for ischemic stroke in patients undergoing cardiac surgery. METHODS: From January 2010 to December 2012, 519 consecutive patients undergoing cardiac surgery were analyzed prospectively. The sample was divided into two groups: patients with stroke per and postoperative were allocated in Group GS (n=22) and the other patients in the group CCONTROL (n=497). The following variables were compared between the groups: gender, age, carotid stenosis > 70%, diabetes on insulin, chronic obstructive pulmonary disease, peripheral arteriopathy, unstable angina, kidney function, left ventricular function, acute myocardial infarction, pulmonary arterial hypertension, use of cardiopulmonary bypass...
July 2015: Revista Brasileira de Cirurgia Cardiovascular
https://www.readbyqxmd.com/read/26208801/predictors-associated-with-stroke-after-coronary-artery-bypass-grafting-a-systematic-review
#4
REVIEW
Zhifeng Mao, Xiaonan Zhong, Junjie Yin, Zhihua Zhao, Xueqiang Hu, Maree L Hackett
BACKGROUND: Stroke is a major cause of morbidity and mortality after coronary artery bypass grafting (CABG). The purpose of this systematic review was to evaluate the predictors of perioperative stroke after CABG. METHODS: We reviewed the published literature on prognostic factors for perioperative stroke after CABG in articles using multivariate regression models. The statistical validity of prognostic models and a qualitative synthesis were performed. RESULTS: We identified 14 studies...
October 15, 2015: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/26153474/stroke-associated-with-coronary-artery-bypass-grafting
#5
REVIEW
Keiji Oi, Hirokuni Arai
While coronary artery bypass grafting (CABG) has been playing a significant role in the revascularization for ischemic heart disease, neurological complications associated with CABG have been a primary concern. Stroke, although the incidence is low, is one of the most devastating complication of CABG. Many studies have identified the risk factors for stroke with CABG, such as prior stroke, carotid artery stenosis, aortic atherosclerosis, atrial fibrillation and cardiopulmonary bypass. Various rational approaches focusing on individual risk factor have been proposed for the stroke...
September 2015: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/26050596/a-study-on-the-occurrence-and-prevention-of-perioperative-stroke-after-coronary-artery-bypass-grafting
#6
Akira Sezai, Kin-Ichi Nakata, Mitsuru Iida, Isamu Yoshitake, Shinji Wakui, Shunji Osaka, Haruka Kimura, Kana Takahashi, Yusuke Ishi, Hiroko Yaoita, Munehito Arimoto, Hiroaki Hata, Motomi Shiono, Tadateru Takayama, Atsushi Hirayama
Cerebral infarction after coronary artery bypass grafting (CABG) is a serious complication and a problem that remains unsolved. We will report the onset of cerebral infarction in CABG patients in our institution, and its cause, preventive method. The subjects of this research were 761 patients who underwent on-pump isolated CABG. Preoperative, intraoperative and postoperative factors, onset of cerebral infarction and atrial fibrillation were investigated. Postoperative cerebral infarction and postoperative atrial fibrillation were recognized in 1...
June 25, 2015: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/25948696/cerebral-oxygen-saturation-during-pulsatile-and-non-pulsatile-cardiopulmonary-bypass-in-patients-with-carotid-stenosis
#7
COMPARATIVE STUDY
T Tovedal, S Thelin, F Lennmyr
Pulsatile and non-pulsatile cardiopulmonary bypass (CPB) flows may have different impact on cerebral oxygen saturation in patients with restricted cerebral arterial blood supply. Twenty patients, ten diagnosed with carotid stenosis (CS, n = 10) and ten without known carotid disease (Controls, n = 10), were subjected to one period of pulsatile and one period of non-pulsatile flow (6-8 min each) during CPB at 32°C. Cerebral oxygen saturation was registered by near-infrared light spectroscopy (NIRS).The mean arterial pressure (MAP) was significantly lowered by pulsatile CPB flow...
January 2016: Perfusion
https://www.readbyqxmd.com/read/25646403/effect-of-carotid-revascularization-on-cerebral-autoregulation-in-combined-cardiac-surgery%C3%A2
#8
Daijiro Hori, Masahiro Ono, Hideo Adachi, Charles W Hogue
OBJECTIVES: Combined carotid artery endarterectomy (CEA) and coronary artery bypass grafting surgery is considered to reduce long-term stroke risk for patients with severe carotid artery stenosis. The benefits of CEA for improving cerebral perfusion during subsequent cardiopulmonary bypass (CPB) are unclear. The purpose of this pilot study was to assess cerebral autoregulation and cerebral oximetry in patients undergoing combined CEA and cardiac surgery with those undergoing cardiac surgery without significant carotid artery stenosis or with uncorrected stenosis...
January 2016: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/23863488/selective-cerebral-perfusion-with-aortic-cannulation-and-short-term-hypothermic-circulatory-arrest-in-aortic-arch-reconstruction
#9
R Turkoz, B Saritas, E Ozker, C Vuran, U Yoruker, S Balci, D Altun, A Turkoz
BACKGROUND: The deep hypothermic circulatory arrest (DHCA) technique has been used in aortic arch and isthmus hypoplasia for many years. However, with the demonstration of the deleterious effects of prolonged DHCA, selective cerebral perfusion (SCP) has started to be used in aortic arch repair. For SCP, perfusion via the innominate artery route is generally preferred (either direct innominate artery cannulation or re-routing of the cannula in the aorta is used). Herein, we describe our technique and the result of arch reconstruction in combination with selective cerebral and myocardial perfusion (SCMP) and short-term total circulatory arrest (TCA) (5-10 min) through ascending aortic cannulation...
January 2014: Perfusion
https://www.readbyqxmd.com/read/22575432/effect-of-atherothrombotic-aorta-on-outcomes-of-total-aortic-arch-replacement
#10
Kenji Okada, Atsushi Omura, Hiroya Kano, Takeshi Inoue, Takanori Oka, Hitoshi Minami, Yutaka Okita
OBJECTIVE: The effect of an atherothrombotic aorta on the short- and long-term outcomes of total aortic arch replacement, including postoperative neurologic deficits, remains unknown. We evaluated this relationship and also elucidated the synergistic effect of multiple other risk factors, in addition to an atherothrombotic aorta, on the neurologic outcome. METHODS: A group of 179 consecutive patients undergoing total aortic arch replacement were studied. An atherothrombotic aorta was present in 34 patients (19%), more than moderate leukoaraiosis in 71 (39...
April 2013: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/22569491/-staged-carotid-artery-stent-and-cardiac-surgery-under-cardiopulmonary-bypass
#11
J Yunoki, Y Nakayama, H Oonishi, H Tanaka, Y Oda
The presence of carotid disease in patients undergoing cardiac surgery has been known to increase the risk of peri-operative strokes. However, there are some controversies surrounding carotid artery stenting (CAS) in patients undergoing cardiac surgery with carotid disease. We experienced 5 cases of staged carotid artery stent and cardiac surgery under cardiopulmonary bypass. These cases represent 1.7% of the cardiac surgery between August 2006 and June 2009 at our hospital. There were 4 male and 1 female patient whose ages range from 58 to 81 years old (mean 73...
May 2012: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/22314162/-surgical-treatment-of-coronary-aneurysm-after-percutaneous-coronary-intervention
#12
Mayuko Uehara, Satoshi Muraki, Yohsuke Yanase, Kazutoshi Tachibana, Akihiko Yamauchi, Nobuyuki Takagi, Tetsuya Higami
A 61-year-old man with acute myocardial infarction underwent percutaneous coronary intervention with stent for the left main coronary artery (LMT) and the left anterior descending artery (LAD). Three months later, we recognized the LMT aneurysm complicated with possible thrombus formation, which developed in size during 6 months. In addition, the LAD stent showed significant in-stent stenosis. For the purpose of supplying blood flow to the distal of LAD, and avoiding myocardial infarction due to distal thrombosis possibly originated from LMT aneurysm, we decided to perform surgical operation...
February 2012: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/22219416/aortic-arch-enlargement-and-coarctation-repair-through-a-left-thoracotomy-significance-of-ductal-perfusion
#13
Hitendu Dave, Barbara Rosser, Kim Reineke, Sylvie Nguyen-Minh, Walter Knirsch, René Prêtre
OBJECTIVE: To analyse the technique of neonatal aortic arch enlargement without cardiopulmonary bypass through a left posterior thoracotomy, as an adjunct to extended resection for Coarctation and severe arch hypoplasia. METHODS: Ten neonates with coarctation, severe arch hypoplasia and a persistent ductus arteriosus (PDA) were subjected to arch repair through a left posterior thoracotomy. Nine of these patients had associated significant intracardiac anomalies; three of them received pulmonary artery (PA) banding...
April 2012: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/22195291/microembolus-detection-by-transcranial-doppler-sonography-review-of-the-literature
#14
Vlasta Vuković-Cvetković
Transcranial Doppler can detect microembolic signals which are characterized by unidirectional high intensity increase, short duration, random occurrence, and a "whistling" sound. Microembolic signals have been detected in a number of clinical settings: carotid artery stenosis, aortic arch plaques, atrial fibrillation, myocardial infarction, prosthetic heart valves, patent foramen ovale, valvular stenosis, during invasive procedures (angiography, percutaneous transluminal angioplasty), surgery (carotid, cardiopulmonary bypass, orthopedic), and in certain systemic diseases...
2012: Stroke Research and Treatment
https://www.readbyqxmd.com/read/22167492/case-of-ischemic-optic-neuropathy-developed-eleven-days-after-an-aortic-arch-replacement
#15
Kazuo Kanabuchi, Masaomi Yamaguchi, Toshihiko Ueda, Hidekazu Furuya, Noriko Uchimua
We present a case of ischemic optic neuropathy (ION) developed 11 days after an aortic arch replacement in a 59 year-old male who had a history of untreated hypertension. Thoracic CT revealed severe stenosis of the right common carotid artery with poor blood flow. Aortic clamping time was 96 minutes, and selective cerebral perfusion time was 48 minutes. The lowest hemoglobin concentration of venous blood during cardiopulmonary bypass was 8.1 g/dl and the lowest arterial pressure was 60 mmHg. Due to pulmonary congestion, artificial ventilation was required until 11 post-surgical days...
December 2011: Tokai Journal of Experimental and Clinical Medicine
https://www.readbyqxmd.com/read/21703806/short-term-results-of-a-randomized-trial-examining-timing-of-carotid-endarterectomy-in-patients-with-severe-asymptomatic-unilateral-carotid-stenosis-undergoing-coronary-artery-bypass-grafting
#16
RANDOMIZED CONTROLLED TRIAL
Giulio Illuminati, Jean-Baptiste Ricco, Francesco Caliò, Maria Antonietta Pacilè, Fabio Miraldi, Giacomo Frati, Francesco Macrina, Michele Toscano
OBJECTIVE: This study evaluated the timing of carotid endarterectomy (CEA) in the prevention of stroke in patients with asymptomatic carotid stenosis >70% receiving a coronary artery bypass graft (CABG). METHODS: From January 2004 to December 2009, 185 patients with unilateral asymptomatic carotid artery stenosis >70%, candidates for CABG, were randomized into two groups. In group A, 94 patients received a CABG with previous or simultaneous CEA. In group B, 91 patients underwent CABG, followed by CEA...
October 2011: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/21642289/asymptomatic-carotid-artery-disease-in-valvular-heart-surgery-impact-of-systematic-screening-on-surgical-strategy-and-neurological-outcome
#17
Amedeo Anselmi, Mario Gaudino, Nicola Risalvato, Giuseppe Lauria, Franco Glieca
We evaluated the prevalence of asymptomatic carotid artery disease in patients scheduled for valvular cardiac surgery. Preoperative screening of the carotid arteries was performed. Among 1012 patients scheduled for valvular cardiac surgery, 267 (26.4%) had carotid stenosis graded >50%; 37 had carotid stenosis >70% and underwent combined valvular surgery and carotid endarterectomy (CEA); and 230 (86%) had carotid stenosis >50% to ≤ 69% and received valvular cardiac surgery under hypothermic cardiopulmonary bypass...
April 2012: Angiology
https://www.readbyqxmd.com/read/21418607/carotid-shunt-provides-cerebral-protection-during-emergency-coronary-artery-bypass-grafting-in-a-patient-with-bilateral-high-grade-carotid-stenosis-a-case-report
#18
John K Bellos, Nektarios Kogerakis, Charalampos Kiriazis, Alexandros Gougoulakis, Matthew Panagiotou
BACKGROUND: Management of patients with co-existent coronary and carotid disease is a controversial and challenging issue. The risk for stroke after coronary artery bypass grafting (CABG) in patients with hemodynamically significant carotid stenosis is up to 30%. In these patients a common practice is to proceed first with the restoration of cerebral perfusion and then perform the coronary revascularization. The rationale is that this strategy will reduce perioperative neurological morbidity and mortality...
March 20, 2011: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/21276685/endovascular-management-of-ascending-aortic-pathology
#19
Ralf R Kolvenbach, Ron Karmeli, Lazlo S Pinter, Yuefeng Zhu, Fan Lin, Sergej Wassiljew, Markus Meyer-Gaessner
BACKGROUND: Endovascular treatment of the ascending aorta is particularly challenging because of the anatomic features of this aortic segment. Only patients without connective tissue disorders, clinically relevant aortic regurgitation or stenosis, or concomitant coronary artery disease can be considered for an endovascular procedure. We report our results in a series of patients with aneurysms or intramural hematoma, penetrating ulcers, or floating thrombus who were scheduled for stent grafting...
May 2011: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/21191693/surgical-outcome-of-simultaneous-carotid-and-cardiac-surgery
#20
Masataka Yoda, Mitsumasa Hata, Akira Sezai, Kazutomo Minami
PURPOSE: The surgical outcome of a simultaneous carotid endarterectomy and cardiac surgery has not been clarified. This study retrospectively reviewed short- and mid-term outcomes after a carotid endarterectomy combined with valvular surgery or coronary artery bypass grafting (CABG). METHODS: Fifteen patients (12 males and 3 females, mean age 68.9 ± 6.7, range 59-86 years) underwent a carotid endarterectomy combined with cardiac surgery. The main indication for carotid endarterectomy was more than 75% carotid stenosis with or without cerebral ischemic symptom...
January 2011: Surgery Today
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