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Perfusion cardiac surgery

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https://www.readbyqxmd.com/read/28922269/extubation-failure-is-associated-with-increased-mortality-following-first-stage-single-ventricle-reconstruction-operation
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
https://www.readbyqxmd.com/read/28844545/the-risk-of-neurological-dysfunctions-after-deep-hypothermic-circulatory-arrest-with-retrograde-cerebral-perfusion
#8
Giuseppe Gatti, Bernardo Benussi, Placido Currò, Gabriella Forti, Elisabetta Rauber, Alessandro Minati, Marco Gabrielli, Umberto Tognolli, Gianfranco Sinagra, Aniello Pappalardo
OBJECTIVE: Retrograde cerebral perfusion (RCP) is a brain protection technique that is adopted generally for anticipated short periods of deep hypothermic circulatory arrest (DHCA). However, the real impact of this technique on cerebral protection during DHCA remains a controversial issue. METHODS: For 344 (59.5%) of 578 consecutive patients (mean age, 66.9 ± 10.9 years) who underwent cardiovascular surgery under DHCA at the present authors' institution (1999-2015), RCP was the sole technique of cerebral protection that was adopted in addition to deep hypothermia...
August 22, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28834795/microvascular-reactivity-monitored-with-near-infrared-spectroscopy-is-impaired-after-induction-of-anaesthesia-in-cardiac-surgery-patients-an-observational-study
#9
Lien Vandenbulcke, Koen G Lapage, Katrien V Vanderstraeten, Filip M De Somer, Stefan G De Hert, Annelies T Moerman
BACKGROUND: Induction of anaesthesia causes significant macrohaemodynamic changes, but little is known about its effects on the microcirculation. However, alterations in microvascular perfusion are known to be associated with impaired tissue oxygenation and organ dysfunction. Microvascular reactivity can be assessed with vascular occlusion testing, which evaluates the response of tissue oxygen saturation to transient ischaemia and reperfusion. OBJECTIVE: The aim of the current study was to evaluate the effects of an opioid-based anaesthesia induction on microvascular reactivity...
August 23, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28803773/low-dose-versus-high-dose-tranexamic-acid-reduces-the-risk-of-nonischemic-seizures-after-cardiac-surgery-with-cardiopulmonary-bypass
#10
Pierre Couture, Jean-Sébastien Lebon, Éric Laliberté, Georges Desjardins, Marie-Ève Chamberland, Christian Ayoub, Antoine Rochon, Jennifer Cogan, André Denault, Alain Deschamps
OBJECTIVE: The incidence of postoperative nonischemic seizures associated with the use of tranexamic acid (TXA) and the possibility of prevention with a low-dose regimen of TXA were evaluated. DESIGN: Retrospective study. SETTING: Tertiary care university hospital. PARTICIPANTS: A total of 12,195 patients who underwent cardiac surgical procedures under cardiopulmonary bypass (CPB) were evaluated. INTERVENTIONS: The files of every clinical seizure case diagnosed in the surgical intensive care unit between April 2006 and April 2014 were reviewed...
April 15, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28803639/atrial-fibrillation-and-stroke-as-initial-manifestations-of-painless-type-a-aortic-dissection
#11
Claudia Stöllberger, Lilian Schäffl-Doweik, Maria Korn, Josef Finsterer
Aortic dissection is diagnostically challenging, especially in pain-free patients. Detection of acute ischemic stroke secondary to painless aortic dissection is a challenge for emergency physicians and neurologists. We report a previously healthy 58-years old female, admitted because of nausea, dizziness, somnolence, a left-sided hemiparesis and arterial hypotension. The electrocardiogram showed atrial fibrillation with ST-elevations and ST-depressions. Perfusion CT-imaging showed a dilatation of the aortic arch and intraluminal structures indicating an intima flap of aortic dissection...
July 21, 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/28761401/modified-port-access-technique-for-the-treatment-of-aortic-dissection-after-previous-cardiac-surgery
#12
Edvin Prifti, Aurel Demiraj, Roland Xhaxho
One of the most challenging conditions to manage after previous cardiac surgery is chronic dissection of the ascending aorta. We operated on a 54-year-old man who had aortic dissection in addition to large aortic dimensions very close to the sternum, severe aortic regurgitation, and a false lumen in the descending aorta. We used a combination of perfusion and myocardial protection techniques, arising from port-access technology, that enabled antegrade flow into the aorta, endoclamping of the ascending aorta, the administration of cardioplegic solution before opening the sternum, and left ventricular venting to prevent ventricular distention...
June 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28718260/cerebral-oximetry-use-for-cardiac-surgery
#13
Syed Shahmeer Raza, Farhan Ullah, Chandni, Edward Bruce Savage
BACKGROUND: Studies have shown maintaining good cerebral perfusion during Cardiac Surgeries is very important in terms of patient outcomes and reducing the hospital stay, which may have its financial and clinical implications. The aim of this review study was to determine the effectiveness of Cerebral Oximetry (Transcranial Near-Infrared Spectroscopy-NIRS to monitor cerebral oxygenation) for Cardiac Surgery and to propose a possible concluding remark about its potential applications, overall clinical value and whether to keep using it or not...
April 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28701611/the-utility-of-targeted-perioperative-transthoracic-echocardiography-in-managing-an-adult-patient-with-anomalous-origin-of-the-left-coronary-artery-pulmonary-artery-for-noncardiac-surgery
#14
Anudeep Jafra, Suman Arora, Aveek Jayant
Congenital coronary artery anomalies as a whole are uncommon. Abnormal origin of the left coronary artery from the pulmonary artery (ALCAPA) is probably the most common congenital coronary defect. An overwhelming majority of the patients with untreated ALCAPA do not survive to adulthood. As yet, there is no consensus on the management of adults with ALCAPA. We describe a patient with breast malignancy and incidentally detected ALCAPA; primacy was given to treatment of the oncologic condition as a first step...
July 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28692337/a-multidisciplinary-perioperative-strategy-for-attaining-more-physiologic-cardiac-surgery
#15
Kyriakos Anastasiadis, Polychronis Antonitsis, Apostolos Deliopoulos, Helena Argiriadou
BACKGROUND: Cardiac surgery is, by definition, a "non-physiologic" intervention associated with systemic adverse effects. Despite advances in surgical technique, cardiopulmonary bypass (CPB) technology as well as anaesthesia management and patient care, there is still significant morbidity and subsequent mortality. AIM: We consider that the contemporary demand for further improving patient outcome mandates the upgrade from optimal perfusion during the procedure as the gold standard to the concept of a "more physiologic" cardiac surgery...
March 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28683908/aortic-arch-pathology-surgical-options-for-the-aortic-arch-replacement
#16
REVIEW
Giorgio Zanotti, Thomas Brett Reece, Muhammad Aftab
Aortic arch surgery remains one of the most technically challenging procedures in cardiac surgery. It demands consideration of myocardial, brain, spinal cord, and lower body protection and rigorous surgical technique. Novel surgical approaches and refinements in brain and end organ protection strategies, liberal use of antegrade cerebral perfusion and moderate hypothermia have made arch repair safer. As endovascular technology and open surgical techniques evolve, aortic surgeons will need to continue to learn and incorporate these methods into practice in order to improve outcomes...
August 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/28671861/the-transcranial-doppler-sonography-for-optimal-monitoring-and-optimization-of-cerebral-perfusion-in-aortic-arch-surgery-a-case-series
#17
Tamer Ghazy, Ayham Darwisch, Torsten Schmidt, Phong Nguyen, Sohaila Elmihy, Zuzana Fajfrova, Claudia Zickmüller, Klaus Matschke, Utz Kappert
OBJECTIVE: To analyze the feasibility and advantages of transcranial doppler sonography (TCD) for monitoring and optimization of selective cerebral perfusion (SCP) in aortic arch surgery. METHODS: From April 2013 to April 2014, nine patients with extensive aortic pathology underwent surgery under moderate hypothermic cardiac arrest with unilateral antegrade SCP under TCD monitoring in our institution. Adequate sonographic window and visualization of circle of Willis were to be confirmed...
June 16, 2017: Heart Surgery Forum
https://www.readbyqxmd.com/read/28670826/current-practices-are-variable-in-the-evaluation-and-management-of-patients-with-anomalous-aortic-origin-of-a-coronary-artery-results-of-a-survey
#18
Hitesh Agrawal, Carlos M Mery, Patrick E Day, S Kristen Sexson Tejtel, E Dean McKenzie, Charles D Fraser, Athar M Qureshi, Silvana Molossi
BACKGROUND: Anomalous aortic origin of a coronary artery (AAOCA) is the second leading cause of sudden cardiac death in young athletes in the USA. Long-term outcome data for these patients are lacking to date. There is insufficient knowledge on the best approach to these patients and they are managed in a nonuniform manner. METHODS: An online survey of 15 questions regarding management of AAOCA was sent out to 198 cardiac healthcare providers. The goal was to define gaps in knowledge to justify a dedicated scientific forum for discussion of AAOCA...
July 2, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28665964/therapy-options-in-deep-sternal-wound-infection-sternal-plating-versus-muscle-flap
#19
Martin Grapow, Martin Haug, Chistopher Tschung, Bernhard Winkler, Prerana Banerjee, Paul Philipp Heinisch, Jens Fassl, Oliver Reuthebuch, Friedrich Eckstein
BACKGROUND: Management of deep sternal wound infection (DSWI) in cardiac surgical patients still remains challenging. A variety of treatment strategies has been described. Aim of this cohort study was to analyse two different treatment strategies for DSWI: titanium sternal plating system (TSFS) and muscle flap coverage (MFC). METHODS: Between January 2007 and December 2011, from 3122 patients undergoing cardiac surgery 42 were identified with DSWI and treated with one of the above mentioned strategies...
2017: PloS One
https://www.readbyqxmd.com/read/28638156/goal-directed-perfusion-methodology-for-determining-oxygenator-performance-during-clinical-cardiopulmonary-bypass
#20
Alfred H Stammers, Randi Miller, Stephen G Francis, Laszlo Fuzesi, Anthony Nostro, Eric Tesdahl
New generation oxygenators incorporate arterial line filtration either sequential to, or directly in, the gas exchange module. This unique design may affect gas exchange performance by altering the operational characteristics of the device. The present study was designed to evaluate three oxygenators in a clinical setting using a goal-directed perfusion algorithm during cardiopulmonary bypass (CPB). After institutional review board approval, 60 adult patients undergoing cardiac surgery for acquired heart disease were matched for disease state and body size into three groups based on oxygenator type: Terumo SX18(™) (n = 20), Terumo FX15(™) (n = 20), and LivaNova Inspire6F(™) 6 Dual (n = 20)...
June 2017: Journal of Extra-corporeal Technology
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