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Perfusion cardiac surgery

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https://www.readbyqxmd.com/read/29346537/cerebral-mitochondrial-dysfunction-associated-with-deep-hypothermic-circulatory-arrest-in-neonatal-swine
#1
Constantine D Mavroudis, Michael Karlsson, Tiffany Ko, Marco Hefti, Javier I Gentile, Ryan W Morgan, Ross Plyler, Kobina G Mensah-Brown, Timothy W Boorady, Richard W Melchior, Tami M Rosenthal, Brandon C Shade, Kellie L Schiavo, Susan C Nicolson, Thomas L Spray, Robert M Sutton, Robert A Berg, Daniel J Licht, J William Gaynor, Todd J Kilbaugh
OBJECTIVES: Controversy remains regarding the use of deep hypothermic circulatory arrest (DHCA) in neonatal cardiac surgery. Alterations in cerebral mitochondrial bioenergetics are thought to contribute to ischaemia-reperfusion injury in DHCA. The purpose of this study was to compare cerebral mitochondrial bioenergetics for DHCA with deep hypothermic continuous perfusion using a neonatal swine model. METHODS: Twenty-four piglets (mean weight 3.8 kg) were placed on cardiopulmonary bypass (CPB): 10 underwent 40-min DHCA, following cooling to 18°C, 10 underwent 40 min DHCA and 10 remained at deep hypothermia for 40 min; animals were subsequently rewarmed to normothermia...
January 15, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29325034/ghrelin-preserves-ischemia-induced-vasodilation-of-male-rat-coronary-vessels-following-beta-adrenergic-receptor-blockade
#2
James T Pearson, Nicola Collie, Regis R Lamberts, Tadakatsu Inagaki, Misa Yoshimoto, Keiji Umetani, Philip Davis, Gerard Wilkins, Pete P Jones, Mikiyasu Shirai, Daryl O Schwenke
Acute myocardial infarction (MI) triggers an adverse increase in cardiac sympathetic nerve activity (SNA). While β-adrenergic receptor (β-AR)-blockers are routinely used for the management of MI, they may also counter β-AR-mediated vasodilation of coronary vessels. We have reported that ghrelin prevents sympathetic activation following MI. Whether ghrelin modulates coronary vascular tone following MI, either through the modulation of SNA, or directly as a vasoactive mediator, has never been addressed.We utilized synchrotron microangiography to image coronary perfusion and vessel internal diameter (ID) in anesthetized Sprague Dawley rats before, and then again 30 mins after induction of an MI (left coronary artery ligation)...
January 9, 2018: Endocrinology
https://www.readbyqxmd.com/read/29314257/contemporary-management-and-outcomes-of-acute-type-a-aortic-dissection-an-analysis-of-the-sts-adult-cardiac-surgery-database
#3
Teng C Lee, Zachary Kon, Faisal H Cheema, Maria V Grau-Sepulveda, Brian Englum, Sunghee Kim, Paramita S Chaudhuri, Vinod H Thourani, Gorav Ailawadi, G Chad Hughes, Matthew L Williams, J Matthew Brennan, Lars Svensson, James S Gammie
PURPOSE: Management of acute type A aortic dissection (AAAD) is challenging and operative strategies are varied. We used the STS Adult Cardiac Surgery Database (STS ACSD) to describe contemporary surgical strategies and outcomes for AAAD. METHODS: Between July 2011 and September 2012, 2982 patients with AAAD underwent operations at 640 centers in North America. RESULTS: In this cohort, median age was 60 years old, 66% were male, and 80% had hypertension...
January 4, 2018: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/29310552/prevention-of-acute-kidney-injury-in-children-undergoing-cardiac-surgery-a-narrative-review
#4
Esther Huimin Leow, Yoke Hwee Chan, Yong Hong Ng, Joel Kian Boon Lim, Masakazu Nakao, Jan Hau Lee
Children undergoing cardiac surgery are at risk of developing acute kidney injury (AKI). Preventing cardiac surgery-associated AKI (CS-AKI) is important as it is associated with increased early- and long-term mortality and morbidity. Targeting modifiable risk factors (eg, avoiding poor renal perfusion, nephrotoxic drugs, and fluid overload) reduces the risk of CS-AKI. There is currently no strong evidence for the routine use of pharmacological approaches (eg, aminophylline, dexmedetomidine, fenoldopam, and steroids) to prevent CS-AKI...
January 2018: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/29301459/the-effect-of-ultrafiltration-on-end-cardiopulmonary-bypass-hematocrit-during-cardiac-surgery
#5
Linda Mongero, Alfred Stammers, Eric Tesdahl, Andrew Stasko, Samuel Weinstein
OBJECTIVE: Ultrafiltration (UF) during cardiopulmonary bypass (CPB) is a well-accepted method for hemoconcentration to reduce excess fluid and increase hematocrit, platelet count and plasma constituents. The efficacy of this technique may confer specific benefit to certain patients presenting with acquired cardiac defects. The purpose of this study was to retrospectively evaluate the effect of UF on end-CPB hematocrit by cardiac surgical procedure type. METHODS: A review of 73,506 cardiac procedures from a national registry (SCOPE) was conducted between April 2012 and October 2016 at 197 institutions...
January 1, 2018: Perfusion
https://www.readbyqxmd.com/read/29289366/comparison-of-endoaortic-and-transthoracic-aortic-clamping-in-less-invasive-mitral-valve-surgery
#6
Cristina Barbero, Ralph Krakor, Mohamed Bentala, Filip Casselman, Pascal Candolfi, Jacques Goldstein, Mauro Rinaldi
BACKGROUND: Less-invasive mitral valve surgery has become a widespread procedure in recent years, although mode of perfusion and aortic clamping are still debated questions. The aim of this study was to compare the results between transthoracic aortic clamping (TTC) and endoaortic clamping (EAC) in a multicenter, retrospective study. METHODS: Data from 3 centers experienced in both TTC and EAC were retrospectively analyzed. Five hundred consecutive patients undergoing less-invasive mitral valve surgery received either TTC (n = 250) or EAC (n = 250)...
December 27, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29287674/-effects-of-cerebral-oxygen-changes-during-coronary-bypass-surgery-on-postoperative-cognitive-dysfunction-in-elderly-patients-a-pilot-study
#7
Cenk Şahan, Zerrin Sungur, Emre Çamcı, Nükhet Sivrikoz, Ömer Sayin, Hakan Gurvit, Mert Şentürk
BACKGROUND AND OBJECTIVES: Postoperative cognitive dysfunction is common after cardiac surgery. Adequate cerebral perfusion is essential and near infrared spectroscopy (NIRS) can measure cerebral oxygenation. Aim of this study is to compare incidence of early and late postoperative cognitive dysfunction in elderly patients treated with conventional or near infrared spectroscopy monitoring. METHODS: Patients undergoing coronary surgery above 60 years, were included and randomized to 2 groups; control and NIRS groups...
December 26, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29286394/processing-of-human-cardiac-tissue-toward-extracellular-matrix-self-assembling-hydrogel-for-in-vitro-and-in-vivo-applications
#8
Matthias Becker, Janita A Maring, Barbara Oberwallner, Benjamin Kappler, Oliver Klein, Volkmar Falk, Christof Stamm
Acellular extracellular matrix preparations are useful for studying cell-matrix interactions and facilitate regenerative cell therapy applications. Several commercial extracellular matrix products are available as hydrogels or membranes, but these do not possess tissue-specific biological activity. Because perfusion decellularization is usually not possible with human heart tissue, we developed a 3-step immersion decellularization process. Human myocardial slices procured during surgery are first treated with detergent-free hyperosmolar lysis buffer, followed by incubation with the ionic detergent, sodium dodecyl sulfate, and the process is completed by exploiting the intrinsic DNase activity of fetal bovine serum...
December 4, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29284341/cerebral-perfusion-monitoring-in-adult-patients-following-cardiac-surgery-an-observational-study
#9
Tammy Slater, Julie Stanik-Hutt, Patricia Davidson
BACKGROUND: Strokes following adult cardiac surgery contribute to burdensome neurocognitive complications, which are often difficult to detect during the perioperative period. Fluctuations in regional cerebral perfusion and co-morbid conditions, such as hypertension, diabetes, prior stroke, symptomatic carotid stenosis, aortic atherosclerotic disease, and peripheral vascular disease are associated with perioperative strokes. Approaches to achieve optimal cerebral perfusion remain elusive and traditional strategies for perioperative monitoring are not always sufficiently sensitive to detect acute changes in cerebral perfusion...
December 28, 2017: Contemporary Nurse
https://www.readbyqxmd.com/read/29244159/pre-clinical-model-of-severe-glutathione-peroxidase-3-deficiency-and-chronic-kidney-disease-results-in-coronary-artery-thrombosis-and-depressed-left-ventricular-function
#10
Paul Pang, Molly Abbott, Malyun Abdi, Quynh-Anh Fucci, Nikita Chauhan, Murti Mistri, Brandon Proctor, Matthew Chin, Bin Wang, Wenqing Yin, Tzong-Shi Lu, Arvin Halim, Kenneth Lim, Diane E Handy, Joseph Loscalzo, Andrew M Siedlecki
Background: Chronic kidney disease (CKD) patients have deficient levels of glutathione peroxidase-3 (GPx3). We hypothesized that GPx3 deficiency may lead to cardiovascular disease in the presence of chronic kidney disease due to an accumulation of reactive oxygen species and decreased microvascular perfusion of the myocardium. Methods: To isolate the exclusive effect of GPx3 deficiency in kidney disease-induced cardiac disease, we studied the GPx3 knockout mouse strain (GPx3-/-) in the setting of surgery-induced CKD...
December 13, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29241990/influence-of-metformin-and-insulin-on-myocardial-substrate-oxidation-under-conditions-encountered-during-cardiac-surgery
#11
Cyonna Holmes, LaShondra Powell, Nicholas S Clarke, Michael E Jessen, Matthias Peltz
BACKGROUND: The influence of diabetic therapies on myocardial substrate selection during cardiac surgery is unknown but may be important to ensure optimal surgical outcomes. We hypothesized that metformin and insulin alter myocardial substrate selection during cardiac surgery and may affect reperfusion cardiac function. METHODS: Rat hearts (n = 8 per group) were evaluated under 3 metabolic conditions: normokalemia, cardioplegia, or bypass. Groups were perfused with Krebs-Henseleit buffer in the presence of no additives, metformin, insulin, or both insulin and metformin...
December 11, 2017: Surgery
https://www.readbyqxmd.com/read/29240067/-myocardial-protection-during-left-ventricular-reconstruction-in-patients-with-an-ejection-fraction-below-30
#12
V V Bazylev, E V Rosseĭkin, E E Kobzev, M E Evdokimov
Surgical reconstruction of the left ventricle is an effective method of treatment for ischaemic cardiomyopathy. One of the conditions of successful intervention is correctly choosing a method of intraoperative myocardial protection. Currently, two techniques of myocardial protection are used: cardioplegic cardiac arrest and continuous myocardial perfusion on the beating heart. A series of experimental studies demonstrated that myocardial oxygen requirements in ischaemic cardiomyopathy during permanent perfusion are three times higher than during cardioplegic cardiac arrest...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/29239149/agreement-between-ccnexfin-co-trek-cardiac-output-and-intermittent-cold-bolus-pulmonary-thermodilution-in-a-prospective-multi-centre-study
#13
Nicolaas H Sperna Weiland, Jim W de Wever, Yoni van Duivenvoorde, Christa Boer, Ludmil Mitrev, Muhammad Muntazar, Kinjal Patel, Markus W Hollmann, Benedikt Preckel
BACKGROUND: The ccNexfin system uses the CO-trek algorithm to analyse a non-invasively obtained arterial pressure waveform and calculate cardiac output (NEXCO). It remains matter of debate whether NEXCO can replace invasive, pulmonary artery catheter derived, cold-bolus pulmonary thermodilution cardiac output measurement (PACCO). This study aimed at testing NEXCO-PACCO agreement in a large sample size, multi-centre study. We hypothesized that agreement between NEXCO and PACCO would be demonstrated by a mean accuracy (bias) < 0...
December 13, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29229895/prevalence-and-predictors-of-myocardial-ischemia-by-preoperative-myocardial-perfusion-single-photon-emission-computed-tomography-in-patients-undergoing-noncardiac-surgery
#14
Abdelkareem Saleh Al-Oweidi, Hesham Albabtain, Suleiman M Kharabsheh, Peter Kimme, Mahmoud Almustafa, Samer Seder, Mohamed Shoukri, Ahmed L Fathala
BACKGROUND: The prevalence and predictors of myocardial ischemia before noncardiac surgery are unknown. In addition the predictive value of myocardial perfusion single-photon emission computed tomography (SPECT) before noncardiac in individual patients is uncertain. OBJECTIVE: Evaluate the prevalence and predictors of myocardial ischemia before noncardiac surgery, and determine the postoperative cardiac outcome based on results of myocardial perfusion SPECT. DESIGN: Retrospective...
November 2017: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/29229261/preliminary-experience-in-combined-somatic-and-cerebral-oximetry-monitoring-in-liver-transplantation
#15
Tina Hu, Yves Collin, Réal Lapointe, François Martin Carrier, Luc Massicotte, Annik Fortier, Jean Lambert, Franck Vandenbroucke-Menu, André Y Denault
OBJECTIVE: The use of cerebral near-infrared spectroscopy (NIRS) has become widespread in cardiac surgery after research demonstrated an association between perioperative cerebral desaturations and postoperative complications. Somatic NIRS desaturation also is associated with an increased risk of postoperative complications and mortality. The objective of this study was to explore the trends of both somatic and cerebral NIRS during liver transplantation. DESIGN: A prospective, single-site, observational case series...
July 20, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29212547/restrictive-surgical-approach-to-palliate-angina-in-a-patient-with-coronary-three-vessel-disease-and-biventricular-metastatic-hepatocellular-carcinoma
#16
Angela Kornberger, Tillmann Emrich, Andres Beiras-Fernandez, Christian-Friedrich Vahl
BACKGROUND: Metastatic cardiac tumors may cause different symptoms including angina, symptoms of heart failure and/or arrhythmia. In patients with concomitant coronary artery disease, it may be difficult to distinguish between angina caused by metastases to the heart, for example, by stealing perfusion from the coronary arteries, and angina caused by coronary stenosis. Identifying the origin of the symptoms is, however, essential for designing appropriate surgical strategies. CASE PRESENTATION: A 69-year-old male with multifocal recurrence of a hepatocellular carcinoma (HCC) presented with increasing ventricular arrhythmia and angina several weeks after posterior myocardial infarction and PCI of the RCA culprit lesion during which two further lesions present in the distal RCX and a posterolateral branch, and a chronically occluded LAD had not been addressed...
December 7, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29202817/use-of-cardiovascular-magnetic-resonance-in-the-evaluation-of-a-giant-right-atrial-appendage-aneurysm-a-case-report-and-review-of-the-literature
#17
Lojan Sivakumaran, Karl Sayegh, Emile Mehanna, Frank W Sanchez, Jonathan Fields, Ricardo Cury
BACKGROUND: Right atrial appendage aneurysms are rare entities that may have significant clinical consequences. When co-existing with atrial fibrillation, patients are at risk of developing pulmonary or paradoxical systemic emboli. CASE PRESENTATION: An elderly patient presented to medical attention with symptoms of acute diverticulitis. On abdominal computed tomography, a massively enlarged right atrial appendage aneurysm was discovered incidentally. The aneurysm caused marked compression of the right ventricle and contained an area of hypoenhancement concerning for an intraluminal thrombus...
December 4, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/29202543/-experts-consensus-on-the-management-of-the-right-heart-function-in-critically-ill-patients
#18
X T Wang, D W Liu, H M Zhang, Y Long, X D Guan, H B Qiu, K J Yu, J Yan, H Zhao, Y Q Tang, X Ding, X C Ma, W Du, Y Kang, B Tang, Y H Ai, H W He, D C Chen, H Chen, W Z Chai, X Zhou, N Cui, H Wang, X Rui, Z J Hu, J G Li, Y Xu, Y Yang, B Ouyan, H Y Lin, Y M Li, X Y Wan, R L Yang, Y Z Qin, Y G Chao, Z Y Xie, R H Sun, Z Y He, D F Wang, Q Q Huang, D P Jiang, X Y Cao, R G Yu, X Wang, X K Chen, J F Wu, L N Zhang, M G Yin, L X Liu, S W Li, Z J Chen, Z Luo
To establish the experts consensus on the right heart function management in critically ill patients. The panel of consensus was composed of 30 experts in critical care medicine who are all members of Critical Hemodynamic Therapy Collaboration Group (CHTC Group). Each statement was assessed based on the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) principle. Then the Delphi method was adopted by 52 experts to reassess all the statements. (1) Right heart function is prone to be affected in critically illness, which will result in a auto-exaggerated vicious cycle...
December 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29190218/validation-of-a-real-time-minute-to-minute-urine-output-monitor-and-the-feasibility-of-its-clinical-use-for-patients-undergoing-cardiac-surgery
#19
Aaron J Chang, Yohei Nomura, Viachaslau M Barodka, Daijiro Hori, Jonathan T Magruder, Nevin M Katz, Dan E Berkowitz, Charles W Hogue
Acute kidney injury after cardiac surgery is associated with increased morbidity and mortality. Methods for measuring urine output in real time may better ensure renal perfusion perioperatively in contrast to the current standard of care where urine output is visually estimated after empiric epochs of time. In this study, we describe an accurate method for monitoring urine output continuously during cardiopulmonary bypass. This may provide a means for setting patient-specific targets for blood pressure and cardiopulmonary bypass flow as a potential strategy to reduce the risk for acute kidney injury...
December 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29177264/results-of-performing-or-not-cardiac-resynchronization-therapy-for-live-assessment-of-lv-function-and-mechanical-systole-synchrony-using-gated-myocardial-perfusion-imaging-and-real-time-three-dimensional-echocardiography-seven-months-follow-up
#20
Ling Yang, Jianfeng Wang, Yuetao Wang, Xiaoying Zhang
We studied a 50 years old male patient who underwent cardiac resynchronization therapy on and off (CRT-on and CRT-off) for assessment of left ventricular (LV) function and mechanical systole synchrony using gated myocardial perfusion imaging (gMPI) and real-time three-dimensional echocardiography (RT3DE). The patient was reexamined after seven months. The comparison of these two modalities showed consistent results on assessing both the CRT-on and CRT-off conditions. This result may indicate that an immediate synchronization parameter change during CRT-on may be valuable for predicting response to CRT surgery...
November 27, 2017: Hellenic Journal of Nuclear Medicine
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