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Cardiopulmonary bypass AND carotid stenosis

Yu Shao, Lei Wan, Jianhua Zhang, Zhengdong Li, Ningguo Liu, Ping Huang, Donghua Zou, Yijiu Chen
Post-mortem computed tomography (PMCT) and PMCT angiography (PMCTA) are rapidly becoming effective and practical methods in forensic medicine. In this article, the authors introduce a whole-body PMCTA approach involving left ventricle cardiac puncture. This procedure was performed in 9 males and 3 females. PMCT was performed first. Then a biopsy core needle was used for a percutaneous puncture into the left ventricle through the intercostal area under CT guidance. 1000 mL of contrast media (diatrizoate meglumine and normal saline [0...
2017: PloS One
Kenji Okada
Although short and long-term outcomes of aortic surgeries have been improving over the past decade, the procedure is likely to be asscociated with life-threatening complications such as neurological deficits caused by suboptimal brain protection or heavily diseased aorta. Contemporary strategies for brain protection are deep hypothermic arrest with or without retrograde cerebral perfusion retrograde cerebral perfusion or selective antegrade cerebral perfusion. At the moment, majority of evidences failed to show the superiority of selective antegrade cerebral perfusion to retrograde one...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Edin Kabil, Bedrudin Banjanović, Emir Mujanović
OBJECTIVE: The aim of this study was to show perioperative complications of CABG procedure with and without cardiopulmonary bypass (CPB) in patients with combined coronary and carotid disease. PATIENTS AND METHODS: This retrospective survey included patients with left main stenosis greater than 50% and carotid stenosis over 50%, who had undergone CABG without carotid endarterectomy at the BH Heart Centre, from May 2009 to May 2014. The patients were divided into two groups according to the surgical method used...
May 2017: Acta Medica Academica
Zühre Uz, Dan M J Milstein, Can Ince, Bastian A J M de Mol
Postoperative stroke and encephalopathy are potentially serious complications associated with coronary artery bypass grafting. In this case report a 78-year-old male patient receiving routine elective cardiac surgery presented with microaggregations in the sublingual microcirculation while on cardiopulmonary bypass that was undetected by routine intraoperative anticoagulation assessment. Microaggregates identified using video microscopy on his sublingual microcirculation during the procedure preceded a stroke postoperatively...
July 2017: Journal of Thrombosis and Thrombolysis
Parthasarathy D Thirumala, Sruthi Muluk, Reshmi Udesh, Amol Mehta, John Schindler, Suresh Mulukutla, Vinodh Jeevanantham, Lawrence Wechsler, Thomas Gleason
OBJECTIVE/BACKGROUND: To examine the role of carotid stenosis (CS) and other independent risk factors of perioperative stroke, following transcatheter aortic valve implantation (TAVI). MATERIALS AND METHODS: Using data from the National Inpatient Sample database for analysis, patients who underwent TAVI were identified using the International Classification of Diseases, Ninth Revision, Clinical Modification codes. Various preoperative and perioperative risk factors and their association with perioperative strokes were studied...
April 2017: Annals of Cardiac Anaesthesia
Bowen Li, Xiaoping Hu, Zhiwei Wang
BACKGROUD: Unilateral and bilateral antegrade cerebral perfusions (ACP) are recognized methods of cerebral protection in aortic arch surgery. However, the adequacy of cerebral protection in aortic arch surgery with deep hypothermic circulatory arrest is controversial. In this study, we compared unilateral and bilateral ACP of cerebral protection in aortic arch surgery by assessing the patient's intraoperative and postoperative brain function. METHODS: A total of 77 patients undergoing aortic arch surgery were included in this study...
April 2017: International Journal of Surgery
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
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...
October 28, 2015: Heart Surgery Forum
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
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
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
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
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
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
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
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
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
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
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
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
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