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Heart lung machine

Sven Maier, Fabian Kari, Bartosz Rylski, Matthias Siepe, Christoph Benk, Friedhelm Beyersdorf
Open aortic arch replacement is a complex and challenging procedure, especially in post dissection aneurysms and in redo procedures after previous surgery of the ascending aorta or aortic root. We report our experience with the simultaneous selective perfusion of heart, brain, and remaining body to ensure optimal perfusion and to minimize perfusion-related risks during these procedures. We used a specially configured heart-lung machine with a centrifugal pump as arterial pump and an additional roller pump for the selective cerebral perfusion...
September 2016: Journal of Extra-corporeal Technology
Nicholas J Slater, Her J H Zegers, Benno Küsters, Thimpe Beune, Henri A van Swieten, Dietmar J O Ulrich
BACKGROUND: Under ideal circumstances, creation of the anastomosis during free flap transfer is a routine task and can be performed under short ischemia time. However, vessels may be in suboptimal state due to atherosclerosis, radiotherapy or trauma, increasing difficulties regarding receptor vessel identification, and anastomosis which in turn may lead to lengthening of ischemia time resulting in postoperative wound problems or even flap loss. In the current pilot study, a modified heart-lung machine was assembled to achieve continuous oxygenated extracoporeal perfusion using porcine myocutaneous rectus abdominis flaps, aimed at minimizing tissue damage occurring during ischemia time...
October 2016: Journal of Surgical Research
Oiva Arvola, Henri Haapanen, Johanna Herajärvi, Tuomas Anttila, Ulla Puistola, Peeter Karihtala, Vesa Anttila, Tatu Juvonen
BACKGROUND: Deep hypothermic circulatory arrest (DHCA) is used to overcome the threat of cerebral ischemia during complex surgical operations of the heart and the aortic arch. Remote ischemic preconditioning (RIPC) has been shown to mitigate neurological damage. METHODS: We analyzed blood samples in a consecutive series of 52 piglets that underwent a 60-min period of DHCA with RIPC (the RIPC group) or without (the control group), to reveal whether the protective effect to oxidative stress could be seen by measuring serum 8-hydroxydeoxyguanosine (8-OHdG)...
2016: Heart Surgery Forum
Hanife Karakaya Kabukcu, Nursel Sahin, Kezban Ozkaloglu, Ilhan Golbasi, Tulin Aydogdu Titiz
INTRODUCTION: To obtain the optimal anesthesia depth is not easy in cardiovascular surgery patients where the haemodynamic reserve is limited, due to reasons such as not being able to give the desired dose of anesthetic agent, or the change in the pharmacokinetics of the agent in the heart-lung machine. This study was planned to assess the contribution of bispectral index (BIS) monitoring in the depth of anesthesia. METHODS: The patients were divided into 2 groups, and BIS monitoring was used for each patient...
April 2016: Brazilian Journal of Cardiovascular Surgery
Laurent Godinas, Frédéric Lador, Rachel Schatzberger, Sven Günther, Michael J Segel, Yoram Palti, Ernesto Maisuls, Olivier Sitbon, Gérald Simonneau
Transthoracic Parametric Doppler (TPD) is a novel ultrasound technique recently developed for the investigation of pulmonary blood vessels. Lung Doppler Signals (LDS) recorded from TPD provide information regarding the functional mechanical characteristics of pulmonary blood vessels. We aimed to define the specific profile of LDS generated from TPD imaging in patients with pulmonary hypertension (PH), and to evaluate the diagnostic performance of LDS to detect PH using right heart catheterization (RHC) as gold standard reference...
August 19, 2016: Journal of Clinical Monitoring and Computing
Anna Paprocka-Lipińska
The first open-heart surgery in Gdansk took place in 1975. It was possible thanks to the gift of a Pemco extracorporeal circulation machine from the Netherlands to the Surgery Institute of the Medical Academy of Gdansk. The article presents additional, unpublished informations which enable a new interpretation of the previously known facts.
June 2016: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
Antonio Pinto, Annika Jahn, Moritz Benjamin Immohr, Alexander Jenke, Laura Döhrn, Markus Kornfeld, Artur Lichtenberg, Payam Akhyari, Udo Boeken
Everolimus (EVL) is widely used in solid organ transplantation. It is known to have antiproliferative and immunosuppressive abilities via inhibition of the mTOR pathway. Preventive EVL administration may lower inflammation induced by cardiopulmonary bypass (CPB) and reduce systemic inflammatory response syndrome (SIRS). After oral loading with EVL 2.5 mg/kg/day (n = 11) or placebo (n = 11) for seven consecutive days, male Wistar rats (400-500 g) were connected to a miniaturised heart-lung-machine performing a deep hypothermic circulatory arrest protocol...
October 2016: Inflammation
Gilmer Valdes, Timothy D Solberg, Marina Heskel, Lyle Ungar, Charles B Simone
To develop a patient-specific 'big data' clinical decision tool to predict pneumonitis in stage I non-small cell lung cancer (NSCLC) patients after stereotactic body radiation therapy (SBRT). 61 features were recorded for 201 consecutive patients with stage I NSCLC treated with SBRT, in whom 8 (4.0%) developed radiation pneumonitis. Pneumonitis thresholds were found for each feature individually using decision stumps. The performance of three different algorithms (Decision Trees, Random Forests, RUSBoost) was evaluated...
August 21, 2016: Physics in Medicine and Biology
S David, L C Napp, C Kühn, M M Hoeper
Extracorporeal membrane oxygenation (ECMO) is a special form of a miniaturized heart-lung machine with the ultimate goal to stabilize critically ill patients. Dependent on the cannulation strategy ECMO can support or replace heart and/or lung function. Medical indications and contraindications have to be evaluated thoroughly before cannulation. Moreover, before ECMO initiation a solid treatment aim has to be defined: bridge to recovery, bridge to decision, bridge to transplantation, and bridge to destination (i...
September 2016: Der Internist
Ayelet Akselrod-Ballin, Hagit Dafni, Yoseph Addadi, Inbal Biton, Reut Avni, Yafit Brenner, Michal Neeman
Segmentation of anatomical structures and particularly abdominal organs is a fundamental problem for quantitative image analysis in preclinical research. This paper presents a novel approach for whole body segmentation of small animals in a multimodal setting of MR, CT and optical imaging. The algorithm integrates multiple imaging sequences into a machine learning framework, which generates supervoxels by an efficient hierarchical agglomerative strategy and utilizes multiple SVM-kNN classifiers each constrained by a heatmap prior region to compose the segmentation...
2016: Scientific Reports
Simon Kargl, Roland Gitter, Wolfgang Pumberger
BACKGROUND: An association of heart disease and its treatment with biliary calculi is popularly accepted. We sought determine the prevalence and risk factors of paediatric gallstone disease in the presence of CHD and analyse the treatment options. We evaluated the role of open-heart surgery in the development of gallstones in patients with CHD. Patients and methods In a 10-year, retrospective, chart review (2005-2014), patients with CHD and cholelithiasis were identified and reviewed...
June 20, 2016: Cardiology in the Young
Bishav Mohan, Bhupinder Singh, Vivek Gupta, Sarju Ralhan, Dinesh Gupta, Sandeep Puri, Abhishek Goyal, Naved Aslam, Rohit Tandon, Gurpreet Singh Wander
INTRODUCTION: Aluminum phosphide (AlP) poisoning has a high mortality rate despite intensive care management, primarily because it causes severe myocardial depression and severe acute respiratory distress syndrome. The purpose of this study was to evaluate the impact of the novel use of extracorporeal membrane oxygenation (ECMO), a modified "heart-lung" machine, in a specific subset of AlP poisoning patients who had profound myocardial dysfunction along with either severe metabolic acidosis and/or refractory cardiogenic shock...
May 2016: Indian Heart Journal
K Nygaard, A S Thiara, C Tronstad, M A Ringdal, A E Fiane
BACKGROUND: Vacuum-assisted venous drainage (VAVD) is widely used to enhance venous blood return from patients undergoing cardiopulmonary bypass (CPB). This vacuum can accidentally reach the oxygenator of the heart-lung machine and draw gas bubbles into the blood. This is known as bubble transgression (BT) and may cause air emboli in the arterial blood line. In order to avoid BT and minimize the risk of patient injury, knowledge of oxygenator tolerance to vacuum load is critical. Thus, the main aim of this thesis was to investigate how much vacuum a membrane oxygenator can withstand before BT appears...
May 25, 2016: Perfusion
Holger Steinbrenner, Esra Bilgic, Antonio Pinto, Melanie Engels, Lena Wollschläger, Laura Döhrn, Kristine Kellermann, Udo Boeken, Payam Akhyari, Artur Lichtenberg
Ischemia/reperfusion injury (IRI) contributes to morbidity and mortality after cardiovascular surgery requiring cardiopulmonary bypass (CPB) and deep hypothermic circulatory arrest (DHCA). Multi-organ damage is associated with substantial decreases of blood selenium (Se) levels in patients undergoing cardiac surgery with CPB. We compared the influence of a dietary surplus of Se and pretreatment with ebselen, a mimic of the selenoenzyme glutathione peroxidase, on IRI-induced tissue damage and inflammation. Male Wistar rats were fed either a Se-adequate diet containing 0...
August 2016: Inflammation
R A F M Chamuleau
In 2016, an intensive-care physician has at his disposal a number of artificial organs for the support of patients with organ failure. Examples are the artificial kidney and the heart-lung machine. Artificial livers are being developed for patients with severe liver failure whose lives can only be saved at the present time by a transplant with a donor liver. These artificial livers are based either on a device that removes toxic materials from the patient's blood with, for example, albumin dialysis, or make use of bio-reactors filled with functioning liver cells, the so-called bio-artificial liver...
May 2016: Nederlands Tijdschrift Voor Tandheelkunde
Mehmet Özülkü, Fatih Aygün
OBJECTIVE: The present study investigated effect of using pump on postoperative pleural effusion in patients who underwent coronary artery bypass grafting. METHODS: A total of 256 patients who underwent isolated coronary artery bypass grafting surgery in the Cardiovascular Surgery clinic were enrolled in the study. Jostra-Cobe (Model 043213 105, VLC 865, Sweden) heart-lung machine was used in on-pump coronary artery bypass grafting. Off-pump coronary artery bypass grafting was performed using Octopus and Starfish...
July 2015: Revista Brasileira de Cirurgia Cardiovascular
Lisbeth Evered, Brendan Silbert, David A Scott
Changes in cognition are known to follow anesthesia and surgery in older individuals (Evered et al., 2011). Although survival per se was the prime outcome in the 19th and early 20th centuries for invasive procedures, a link was none-the-less observed with adverse cognitive outcomes as far back as 1887 (Savage, 1887). Historical reports of "insanity" or "weak mindedness" after anesthesia appeared within 40 years of the first anesthetic having been administered and anecdotal and retrospective reports have implicated anesthesia ever since...
July 2016: International Psychogeriatrics
Eike Kleinert, Martin C Langenmayer, Bruno Reichart, Jana Kindermann, Barbara Griemert, Andreas Blutke, Kerstin Troidl, Tanja Mayr, Tobias Grantzow, Fatih Noyan, Jan-Michael Abicht, Silvia Fischer, Klaus T Preissner, Ruediger Wanke, Elisabeth Deindl, Sonja Guethoff
BACKGROUND: Cell damage, tissue and vascular injury are associated with the exposure and release of intracellular components such as RNA, which promote inflammatory reactions and thrombosis. Based on the counteracting anti-inflammatory and cardioprotective functions of ribonuclease A (RNase A) in this context, its role in an experimental model of heart transplantation in rats was studied. METHODS AND RESULTS: Inbred BN/OrlRj rat cardiac allografts were heterotopically transplanted into inbred LEW/OrlRj rats...
May 2016: Journal of the American Heart Association
Joe Y Chang, Salma K Jabbour, Dirk De Ruysscher, Steven E Schild, Charles B Simone, Ramesh Rengan, Steven Feigenberg, Atif J Khan, Noah C Choi, Jeffrey D Bradley, Xiaorong R Zhu, Antony J Lomax, Bradford S Hoppe
Radiation dose escalation has been shown to improve local control and survival in patients with non-small cell lung cancer in some studies, but randomized data have not supported this premise, possibly owing to adverse effects. Because of the physical characteristics of the Bragg peak, proton therapy (PT) delivers minimal exit dose distal to the target volume, resulting in better sparing of normal tissues in comparison to photon-based radiation therapy. This is particularly important for lung cancer given the proximity of the lung, heart, esophagus, major airways, large blood vessels, and spinal cord...
May 1, 2016: International Journal of Radiation Oncology, Biology, Physics
A Kirschbaum, N Mirow
Carcinomas of the lung that infiltrate the blood vessels close to the heart (left atrium, pulmonary artery and aorta) without spreading to mediastinal lymph nodes or developing distant metastases are rare overall. Such situations are often classified as primarily inoperable by interdisciplinary tumour boards. This is only the case if, for technical reasons, an experienced thoracic surgeon does not feel able to perform a resection with a surrounding margin of healthy tissue. The surgical strategy to be employed must be chosen individually depending on the infiltrated structure...
March 30, 2016: Zentralblatt Für Chirurgie
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