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Perfusion cardiac surgery

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https://www.readbyqxmd.com/read/29155938/cerebral-autoregulation-in-cardiopulmonary-bypass-surgery-a-systematic-review
#1
Juliana R Caldas, Victoria J Haunton, Ronney B Panerai, Ludhmila A Hajjar, Thompson G Robinson
Cardiopulmonary bypass surgery is associated with a high incidence of neurological complications, including stroke, delirium and cognitive impairment. The development of strategies to reduce the incidence of such neurological events has been hampered by the lack of a clear understanding of their pathophysiology. Cerebral autoregulation (CA), which describes the ability of the brain to maintain a stable cerebral blood flow over a wide range of cerebral perfusion pressures despite changes in blood pressure, is known to be impaired in various neurological disorders...
November 16, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29127739/renal-haemodynamics-and-oxygenation-during-and-after-cardiac-surgery-and-cardiopulmonary-bypass
#2
REVIEW
Roger G Evans, Yugeesh R Lankadeva, Andrew D Cochrane, Bruno Marino, Naoya Iguchi, Michael Z L Zhu, Sally G Hood, Julian A Smith, Rinaldo Bellomo, Bruce S Gardiner, Chang-Joon Lee, David W Smith, Clive N May
Acute kidney injury (AKI) is a common complication following cardiac surgery performed on cardiopulmonary bypass (CPB) and has important implications for prognosis. The aetiology of cardiac surgery-associated AKI is complex, but renal hypoxia, particularly in the medulla, is thought to play at least some role. There is strong evidence from studies in experimental animals, clinical observations and computational models, that medullary ischaemia and hypoxia occurs during CPB. There are no validated methods to monitor or improve renal oxygenation during CPB, and thus possibly decrease the risk of AKI...
November 11, 2017: Acta Physiologica
https://www.readbyqxmd.com/read/29126685/cerebral-hypoxia-caused-by-flow-confliction-during-minimally-invasive-cardiac-surgery-with-retrograde-perfusion-a-word-of-caution
#3
Hirotsugu Kanda, Takayuki Kunisawa, Hiroto Kitahara, Takafumi Iida, Yuki Toyama, Megumi Kanao-Kanda, Chie Mori, Hiroyuki Kamiya
No abstract text is available yet for this article.
October 6, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29082864/fitness-to-drive-in-cardiovascular-disease
#4
Hermann H Klein, Udo Sechtem, Hans-Joachim Trappe
BACKGROUND: Medical students are taught little or nothing about the medical considerations related to the driving of motor vehicles. Physicians treating patients with cardiovascular disease need to acquire competence in traffic medicine in order to be able to advise them about their fitness to drive. METHODS: We present the current governmental regulations and recommendations concerning fitness to drive in patients with cardiovascular disease. We also review pertinent publications that were retrieved by a selective search in PubMed with the search terms "cardiovascular disease and traffic accidents" and "cardiovascular disease and traffic deaths" for the decade 2007-2016, as well as further publications collected by us individually...
October 13, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/29075895/cerebral-ischaemia-following-anterior-upper-thoracic-spinal-surgery-utilizing-a-partial-manubrial-resection
#5
David Christopher Kieser, Derek Thomas Cawley, Takashi Fujishiro, Cecile Roscop, Louis Boissiere, Ibrahim Obeid, Olivier Gille, Jean-Marc Vital, Vincent Pointillart
PURPOSE: Firstly, to describe two cases of cerebral ischaemia complicating anterior upper thoracic spinal surgery and define the likely cause of this complication. Secondly, to describe preventative measures and the effect these have had in reducing this complication within our institution. METHODS: Firstly, a review of two cases of cerebral ischaemia complicating anterior upper thoracic spinal surgery utilizing a partial manubrial resection. Secondly, cadaveric dissections of the carotid arteries to determine the effect of neck positioning and aortic arch retraction during a simulated procedure...
October 26, 2017: European Spine Journal
https://www.readbyqxmd.com/read/29074047/outcomes-of-surgical-intervention-for-anomalous-aortic-origin-of-a-coronary-artery-a-large-contemporary-prospective-cohort-study
#6
Carlos M Mery, Luis E De León, Silvana Molossi, S Kristen Sexson-Tejtel, Hitesh Agrawal, Rajesh Krishnamurthy, Prakash Masand, Athar M Qureshi, E Dean McKenzie, Charles D Fraser
OBJECTIVE: The purpose of this study was to prospectively analyze the outcomes of patients with anomalous aortic origin of a coronary artery undergoing surgical intervention according to a standardized management algorithm. METHODS: All patients aged 2 to 18 years undergoing surgical intervention for anomalous aortic origin of a coronary artery between December 2012 and April 2017 were prospectively included. Patients underwent stress nuclear perfusion imaging, stress cardiac magnetic resonance imaging, and retrospectively electrocardiogram-gated computed tomography angiography preoperatively...
September 14, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29049525/impact-of-the-haga-braincare-strategy-on-the-burden-of-haemodynamic-and-embolic-strokes-related-to-cardiac-surgery
#7
Friso Duynstee, Ruud W M Keunen, Agnes van Sonderen, Ali M Keyhan-Falsafi, Gerard J F Hoohenkerk, Gayleen Stephens, Erik Teeuws, Jan W K van Alphen, Dénes L J Tavy, Arne Mosch, Sebastiaan F T M de Bruijn, Hans van Overhagen, Frank E E Treurniet, Lucas C van Dijk, Paulien M van Kampen
OBJECTIVES: This study prospectively evaluates the impact of the Haga Braincare Strategy (HBS) on the occurrence of haemodynamic and embolic stroke in a cohort of patients who underwent coronay artery bypass grafting (CABG), valve replacement of a combination of both types of surgery between 2012 and 2015 at the Haga Teaching Hospitals. METHODS: The HBS is a dual strategy based on a preoperative vascular work-up of the cerebral circulation by transcranial Doppler and a perioperative monitoring of the cerebral circulation by cerebral oximetry...
November 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29049074/physiology-and-role-of-intraocular-pressure-in-contemporary-anesthesia
#8
Dermot J Kelly, Sinéad M Farrell
More than 26 million Americans suffer with cataracts, and with 3.6 million cataract extractions performed annually in the United States, it is the most common surgical procedure. The integrity of the delicate structures of the eye that mediate vision is dependent on the intraocular pressure (IOP). Yet, IOP acts to compress the vessels within the globe-akin to a Starling resistor-and is a key component that determines the ocular perfusion pressure, defined as the difference between arterial pressure and IOP...
October 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28980283/low-diastolic-blood-pressure-is-associated-with-a-high-atherosclerotic-burden-in-patients-with-obstructive-coronary-artery-disease
#9
Vichai Senthong, Upa Kukongviriyapan, Nongnuch Settasatian, Chatri Settasatian, Nantarat Komanasin
BACKGROUND: The optimal blood pressure (BP) treatment target is still being debated, specifically diastolic BP in patients with obstructive coronary artery disease (CAD); a diastolic BP which is too low could compromise myocardial perfusion and is associated with adverse outcomes. METHODS: This study examined the relationship between diastolic BP (DBP) levels and the severity and atherosclerotic burden of CAD in 231 consecutive stable patients with evidence of obstructive CAD as detected by elective coronary angiography...
October 5, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28979041/endothelial-glycocalyx-and-cardiopulmonary-bypass
#10
REVIEW
Gerard J Myers, Julie Wegner
On the outer surface of a human cell there is a dense layer of complex carbohydrates called glycocalyx, also referred to as glycans or the sugar coating on the cell surface, which is composed of a complex array of oligosaccharide and polysaccharide glucose chains that are covalently bonded to proteoglycans and lipids bound to the cell membrane surface. Studies of an intact endothelial glycocalyx layer (EGL) have revealed a number of critical functions that relate the importance of this protective layer to vascular integrity and permeability...
September 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/28962211/clinical-comparative-analysis-of-histidine-tryptophan-ketoglutarate-solution-and-st-thomas-crystalloid-cardioplegia-a-12-year-study-from-a-single-institution
#11
Ying-Zhong Lin, Jing-Bin Huang, Xiang-Wei Li, Xian-Ming Tang, Wei-Jun Lu, Zhao-Ke Wen, Jian Liang, Dian-Yuan Li, Hao Wang
Cardioplegic reperfusion during a long-term ischemic period interrupts cardiac surgery and increases cellular edema due to repeated administration. The present clinical study compared the protective effects of histidine-ketoglutarate-tryptophan (HTK) solution and St. Thomas crystalloid cardioplegia. Clinical experiences of the myocardial protection induced by one single perfusion with HTK were reviewed in high-risk patients with severe pulmonary arterial hypertension associated with complex congenital heart disease...
September 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28926643/skin-perfusion-pressure-as-an-indicator-of-tissue-perfusion-in-valvular-heart-surgery-preliminary-results-from-a-prospective-observational-study
#12
Young Song, Sarah Soh, Jae-Kwang Shim, Kyoung-Un Park, Young-Lan Kwak
Hemodynamic management aims to provide adequate tissue perfusion, which is often altered during cardiac surgery with cardiopulmonary bypass (CPB). We evaluated whether skin perfusion pressure (SPP) can be used for monitoring of adequacy of tissue perfusion in patients undergoing valvular heart surgery. Seventy-two patients undergoing valve replacement were enrolled. SPP and serum lactate level were assessed after anaesthesia induction (baseline), during CPB, after CPB-off, end of surgery, arrival at intensive care unit, and postoperative 6 h...
2017: PloS One
https://www.readbyqxmd.com/read/28925651/exercise-stress-testing-indications-and-common-questions
#13
Kathryn K Garner, William Pomeroy, James J Arnold
Exercise stress testing is a validated diagnostic test for coronary artery disease in symptomatic patients, and is used in the evaluation of patients with known cardiac disease. Testing of asymptomatic patients is generally not indicated. It may be performed in select deconditioned adults before starting a vigorous exercise program, but no studies have compared outcomes from preexercise testing vs. encouraging light exercise with gradual increases in exertion. Preoperative exercise stress testing is helpful for risk stratification in patients undergoing vascular surgery or who have active cardiac symptoms before undergoing nonemergent noncardiac surgery...
September 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28922269/extubation-failure-is-associated-with-increased-mortality-following-first-stage-single-ventricle-reconstruction-operation
#14
Thomas Scodellaro, Jane M McKenzie, Yves d'Udekem, Warwick Butt, Siva P Namachivayam
OBJECTIVES: To identify the prevalence, causes, risk factors, and outcomes associated with extubation failure following first stage single ventricle reconstruction surgery. DESIGN: Retrospective cohort analysis of neonates who underwent a first stage single ventricle reconstruction operation. Extubation failure was defined as endotracheal reintubation within 48 hours of first extubation attempt. SETTING: The Royal Children's Hospital, Melbourne...
September 15, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28903760/feasibility-of-detecting-myocardial-infarction-in-the-sheep-fetus-using-late-gadolinium-enhancement-cmr-imaging
#15
An Qi Duan, Mitchell C Lock, Sunthara Rajan Perumal, Jack R Darby, Jia Yin Soo, Joseph B Selvanayagam, Christopher K Macgowan, Mike Seed, Janna L Morrison
BACKGROUND: Late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) imaging has enabled the accurate assessment of myocardial infarction (MI). However, LGE CMR has not been performed successfully in the fetus, where it could be useful for animal studies of interventions to promote cardiac regeneration. We believe that LGE imaging could allow us to document the presence, extent and effect of MI in utero and would thereby expand our capacity for conducting fetal sheep MI research...
September 13, 2017: Journal of Cardiovascular Magnetic Resonance
https://www.readbyqxmd.com/read/28880931/restrictive-intraoperative-fluid-optimisation-algorithm-improves-outcomes-in-patients-undergoing-pancreaticoduodenectomy-a-prospective-multicentre-randomized-controlled-trial
#16
RANDOMIZED CONTROLLED TRIAL
Laurence Weinberg, Damian Ianno, Leonid Churilov, Ian Chao, Nick Scurrah, Clive Rachbuch, Jonathan Banting, Vijaragavan Muralidharan, David Story, Rinaldo Bellomo, Chris Christophi, Mehrdad Nikfarjam
We aimed to evaluate perioperative outcomes in patients undergoing pancreaticoduodenectomy with or without a cardiac output goal directed therapy (GDT) algorithm. We conducted a multicentre randomised controlled trial in four high volume hepatobiliary-pancreatic surgery centres. We evaluated whether the additional impact of a intraoperative fluid optimisation algorithm would influence the amount of fluid delivered, reduce fluid related complications, and improve length of hospital stay. Fifty-two consecutive adult patients were recruited...
2017: PloS One
https://www.readbyqxmd.com/read/28877873/the-in-vitro-zebrafish-heart-as-a-model-to-investigate-the-chronotropic-effects-of-vapor-anesthetics
#17
Matthew R Stoyek, Michael K Schmidt, Florentin M Wilfart, Roger P Croll, Frank M Smith
In addition to their intended clinical actions, all general anesthetic agents in common use have detrimental intra- and post-surgical side effects on organs and systems including the heart. The major cardiac side effect of anesthesia is bradycardia, which increases the probability of insufficient systemic perfusion during surgery. These side effects also occur in all vertebrate species so far examined, but the underlying mechanisms are not clear. The zebrafish heart is a powerful model for studying cardiac electrophysiology, employing the same pacemaker system and neural control as do mammalian hearts...
September 6, 2017: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/28863956/stent-graft-balloon-occlusion-with-selective-cerebral-perfusion-for-cardiac-surgery-after-proximal-aortic-arch-stent-grafting-a-case-report
#18
Takayuki Shijo, Akira Marumoto, Keiji Iwata
No abstract text is available yet for this article.
August 4, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28863155/electrophysiological-characteristics-of-pressure-overload-induced-cardiac-hypertrophy-and-its-influence-on-ventricular-arrhythmias
#19
Xiaowei Chen, Mu Qin, Weifeng Jiang, Yu Zhang, Xu Liu
OBJECTIVE: To explore the cardiac electrophysiological characteristics of cardiac hypertrophy and its influence on the occurrence of ventricular tachyarrhythmias. METHODS: Adult C57BL6 mice were randomly divided into a surgery group and a control group. Thoracic aortic constriction was performed on mice in the surgery group, and cardiac anatomical and ultrasonic evaluations were performed to confirm the success of the cardiac hypertrophy model 4 weeks after the operation...
2017: PloS One
https://www.readbyqxmd.com/read/28856715/feasibility-of-quantitative-regional-ventilation-and-perfusion-mapping-with-phase-resolved-functional-lung-preful-mri-in-healthy-volunteers-and-copd-cteph-and-cf-patients
#20
Andreas Voskrebenzev, Marcel Gutberlet, Filip Klimeš, Till F Kaireit, Christian Schönfeld, Alexander Rotärmel, Frank Wacker, Jens Vogel-Claussen
PURPOSE: In this feasibility study, a phase-resolved functional lung imaging postprocessing method for extraction of dynamic perfusion and ventilation parameters using a conventional 1H lung MRI Fourier decomposition acquisition is introduced. METHODS: Time series of coronal gradient-echo MR images with a temporal resolution of 288 to 324 ms of two healthy volunteers, one patient with chronic thromboembolic hypertension, one patient with cystic fibrosis, and one patient with chronic obstructive pulmonary disease were acquired at 1...
August 30, 2017: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
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