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https://www.readbyqxmd.com/read/28538639/development-of-the-emergency-preservation-and-resuscitation-for-cardiac-arrest-from-trauma-epr-cat-clinical-trial
#1
Samuel A Tisherman, Hasan B Alam, Peter M Rhee, Thomas M Scalea, Tomas Drabek, Raquel M Forsythe, Patrick M Kochanek McCm
BACKGROUND: Patients who suffer a cardiac arrest from trauma rarely survive, even with aggressive resuscitation attempts, including an Emergency Department (ED) thoracotomy. Emergency Preservation and Resuscitation (EPR) was developed to utilize hypothermia to buy time to obtain hemostasis before irreversible organ damage occurs. Large animal studies have demonstrated that cooling to tympanic membrane temperature 10°C during exsanguination cardiac arrest can allow up to 2 hours of circulatory arrest and repair of simulated injuries with normal neurologic recovery...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28537973/identifying-variability-in-mental-models-within-and-between-disciplines-caring-for-the-cardiac-surgical-patient
#2
Evans K H Brown, Kathleen A Harder, Ioanna Apostolidou, Joyce A Wahr, Douglas C Shook, R Saeid Farivar, Tjorvi E Perry, Mojca R Konia
BACKGROUND: The cardiac operating room is a complex environment requiring efficient and effective communication between multiple disciplines. The objectives of this study were to identify and rank critical time points during the perioperative care of cardiac surgical patients, and to assess variability in responses, as a correlate of a shared mental model, regarding the importance of these time points between and within disciplines. METHODS: Using Delphi technique methodology, panelists from 3 institutions were tasked with developing a list of critical time points, which were subsequently assigned to pause point (PP) categories...
May 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28535202/clinical-implications-of-hypothermic-ventricular-fibrillation-versus-beating-heart-technique-during-cardiopulmonary-bypass-for-pulmonary-valve-replacement-in-patients-with-repaired-tetralogy-of-fallot
#3
Ji-Hyun Lee, Ji-Eun Lee, Jungho Shin, In-Kyung Song, Hee-Soo Kim, Chong-Sung Kim, Woong-Han Kim, Jin-Tae Kim
OBJECTIVES: This study aimed to compare the effects of hypothermic ventricular fibrillation and beating-heart techniques during cardiopulmonary bypass (CPB) on postoperative outcomes after simple pulmonary valve replacement in patients with repaired tetralogy of Fallot (TOF). METHODS: We retrospectively reviewed the data of 47 patients with repaired tetralogy of Fallot at a single institution, who received pulmonary valve replacement under the ventricular fibrillation or beating-heart technique without cardioplegic cardiac arrest during CPB between January 2005 and April 2015...
May 23, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28530132/development-of-a-high-fidelity-pressurized-porcine-beating-heart-simulator-for-cardiac-surgery-training
#4
Igo B Ribeiro, Janet M C Ngu, Gurinder Gill, Fraser D Rubens
BACKGROUND: Development of a high-fidelity cardiac surgery simulator (CSS) requires integration of a heart model with a mock cardiopulmonary bypass (CPB) circuit that can provide feedback to mimic the pathophysiology of cardiac surgery. However, the cost of commercially available simulators precludes regular use. We describe steps in the construction of a high-fidelity CSS that integrates a pulsatile paracorporeal ventricular-assist device (Pulse-VAD) and a commercially available CPB simulator...
May 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28529306/normalization-of-diffuse-st-depression-with-avr-elevation-after-rehydration-in-a-patient-with-severe-aortic-stenosis
#5
Sachin R Patel, Vikas J Patel, Brittany Clark, George Rust
BACKGROUND Isolated ST elevation in lead aVR in combination with global ST depression with normalization after rehydration is a unique electrocardiographic pattern that is associated with a broad range of diagnoses. Its association with left main coronary artery disease and other acute coronary syndromes suggest the need for early and aggressive cardiac evaluation. CASE REPORT A 53-year-old man presented with altered mental status and loss of consciousness. He was unresponsive, hypotensive, tachycardiac, and diaphoretic...
May 22, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28528047/sclerosing-aortic-and-coronary-arteritis-due-to-igg4-related-disease
#6
Mikael Barbu, Ulf Lindström, Claes Nordborg, Andreas Martinsson, Christian Dworeck, Anders Jeppsson
We present the case of a 55-year-old woman admitted for a coronary artery bypass operation because of three-vessel coronary artery disease based on angiographic findings and clinical symptoms. Unexpected intraoperative findings with diffuse tissue thickening of the ascending aorta and coronary arteries indicated an alternate pathogenesis rather than coronary artery atherosclerosis. Histopathologic findings and clinical evaluation could confirm IgG4-related disease (IgG4-RD). IgG4-RD is a newly recognized fibroinflammatory condition that can present in a variety of organs and is characterized by common histopathologic features...
June 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28526092/transapical-aortic-perfusion-using-a-deep-hypothermic-procedure-to-prevent-dissecting-lung-injury-during-re-do-thoracoabdominal-aortic-aneurysm-surgery
#7
Yuya Kise, Yukio Kuniyoshi, Mizuki Ando, Hitoshi Inafuku, Takaaki Nagano, Satoshi Yamashiro
BACKGROUND: Avoiding various complications is a challenge during re-do thoracoabdominal aneurysm surgery. CASE PRESENTATION: A 56-year-old man had undergone surgery for type I aortic dissection four times. The residual thoracoabdominal aortic aneurysm that had severe adhesions to lung parenchyma was resected. Since the proximal anastomotic site was buried in lung parenchyma, deep hypothermia was essential to avoid lung dissection and to protect the spinal cord during the proximal anastomosis...
May 19, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28525553/evaluation-of-conventional-and-frozen-elephant-trunk-techniques-on-spinal-cord-blood-flow-in-an-animal-model%C3%A2
#8
Sergey Leontyev, Maja-Theresa Dieterlen, Michelle Halling, Franziska Schlegel, Alexandro Hoyer, Susann Ossmann, Kerstin Klaeske, Christian D Etz, Friedrich W Mohr
OBJECTIVES: The treatment of patients with extensive thoracic aortic disease involving the arch and descending aorta is often performed using the frozen elephant trunk technique (FET). Spinal cord blood flow (SCBF) in cervical, thoracic and lumbar sections prior, during and after aortic arch surgery were compared in conventional elephant trunk (cET) and FET technique in a pig model. METHODS: German Landrace pigs (75-85 kg) underwent aortic arch surgery using the FET ( n  = 8) or cET ( n  = 8) techniques...
May 18, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28525506/haptoglobin-administration-in-cardiovascular-surgery-patients-its-association-with-the-risk-of-postoperative-acute-kidney-injury
#9
Kenta Kubota, Moritoki Egi, Satoshi Mizobuchi
BACKGROUND: Acute kidney injury (AKI) often occurs after cardiac surgery. During cardiac surgery, plasma free hemoglobin (fHb) would increase due to hemolysis. Since plasma fHb is thought to be nephrotoxic, haptoglobin, which is an fHb scavenger, may have the potential to prevent postoperative AKI (pAKI). However, there have been few studies in which the association of intraoperative administration of haptoglobin with the incidence of AKI after cardiac surgery was assessed. METHODS: This study was a retrospective observational study to assess the independent association of intraoperative administration of haptoglobin with the incidence pAKI in cardiac surgery patients...
June 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28523169/risk-factors-for-continuous-renal-replacement-therapy-after-surgical-repair-of-type-a-aortic-dissection
#10
Hai-Bo Wu, Wei-Guo Ma, Hong-Lei Zhao, Jun Zheng, Jian-Rong Li, Ou Liu, Li-Zhong Sun
BACKGROUND: To identify the risk factors for continuous renal replacement therapy (CRRT) following surgical repair of type A aortic dissection (TAAD) using the total arch replacement and frozen elephant trunk (TAR + FET) technique. METHODS: The study included 330 patients with TAAD repaired using TAR + FET between January 2014 and April 2015. Mean age was 47.1±10.2 years (range, 18-73 years) and 242 were male (73.3%). Univariate and multivariate analyses were used to identify the risk factors for CRRT...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28523031/myocardial-protection-with-glucose-insulin-potassium-infusion-during-adult-cardiac-surgery
#11
Suhail Ahmad, Rana Altaf Ahmad, Bilal Ahsan Qureshi, Mirza Ahmad Raza Baig
BACKGROUND & OBJECTIVE: Recent meta-analysis reports have called for more randomized trials to evaluate the effectiveness of GIK solution in patients of cardiac surgery. So this study was conducted to evaluate the effectiveness of Glucose-insulin-potassium (GIK) solutions in non-diabetic patients undergoing coronary artery bypass grafting. METHODS: A total number of one hundred and sixty (160) patients were randomized into two equal groups; GIK Group and non-GIK group...
March 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28520564/normothermic-cardiopulmonary-bypass-in-patient-with-waldenstr%C3%A3-m-s-macroglobulinemia-and-cryoglobulinemia-a-case-report
#12
Shiho Satomi, Asuka Kasai, Eisuke Hamaguchi, Yasuo M Tsutsumi, Katsuya Tanaka
Waldenström's macroglobulinemia (WM) manifests as hyperviscosity syndrome. Cryoglobulinemia, which may increase blood viscosity or induce thrombosis in association with decreased body temperature, can occur in combination with WM. We describe the management of an 82-year-old woman with WM, hyperviscosity syndrome, and cryoglobulinemia who required open aortic valve replacement. Decreased body temperature in this patient was prevented during cardiopulmonary bypass by using a forced air warming system and normothermic cardioplegia with continuous warm blood cardioplegia perfusion...
May 17, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28515825/late-presentation-of-aortic-aneurysm-and-dissection-following-cardiac-catheterization
#13
Abimbola Shofu, G Mustafa Awan, Bassam Omar, Ghazanfar Qureshi
We report a 63-year-old female with hypertension, hyperlipidemia, and prior pacemaker insertion for atrial fibrillation with symptomatic bradycardia, who was admitted with substernal chest pressure and diaphoresis. Her electrocardiogram revealed atrial fibrillation with demand ventricular pacing and her cardiac biomarkers were negative for acute coronary syndrome. Echocardiogram revealed normal left ventricular systolic function and normal aortic root diameter. Coronary angiography revealed 60-70% obtuse marginal lesion, otherwise mild disease...
April 2017: Cardiology Research
https://www.readbyqxmd.com/read/28515742/the-use-of-intraoperative-epiaortic-ultrasonography-in-monitoring-patients-over-75-years-old-treated-with-aortic-valve-replacement
#14
Tomasz Niklewski, Michał Zembala, Dariusz Puszczewicz, Paweł Nadziakiewicz, Wojciech Karolak, Marian Zembala
INTRODUCTION: Epiaortic ultrasound scanning (EAS) extended the use of ultrasound to the intraoperative diagnosis of aortic pathology. Surgical palpation of the ascending aorta underestimates the presence and severity of atherosclerotic plaques. Epiaortic ultrasound scanning has been used as an adjunct to transesophageal echocardiography (TEE) or as a primary direct diagnostic tool for imaging the ascending aorta as well as the aortic arch, which gained prominence as part of a multipronged intraoperative strategy to reduce atherosclerotic emboli...
March 2017: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28512782/aortocoronary-artery-dissection-a-partial-aortic-root-remodelling-aortic-valve-repair-and-coronary-artery-bypass
#15
Andrei M Beliaev, Jeevesh J Thomas, Peter N Ruygrok, Colleen Bergin, Sara J Allen, Sophie E Gormack, Jens Lund
No abstract text is available yet for this article.
May 16, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28511707/rapid-deployment-valve-system-shortens-operative-times-for-aortic-valve-replacement-through-right-anterior-minithoracotomy
#16
Constanze Bening, Khaled Hamouda, Mehmet Oezkur, Christoph Schimmer, Ina Schade, Armin Gorski, Ivan Aleksic, Rainer Leyh
BACKGROUND: There is growing evidence from the literature that right anterior minithoracotomy aortic valve replacement (RAT-AVR) improves clinical outcome. However, increased cross clamp time is the strongest argument for surgeons not performing RAT-AVR. Rapid deployment aortic valve systems have the potential to decrease cross-clamp time and ease this procedure. We assessed clinical outcome of rapid deployment and conventional valves through RAT. METHODS: Sixty-eight patients (mean age 76 ± 6 years, 32% females) underwent RAT-AVR between 9/2013 and 7/2015...
May 16, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28510809/transcatheter-arterial-embolization-for-intercostal-arterio-esophageal-fistula-in-esophageal-cancer
#17
Tetsuya Tajima, Shigeo Haruki, Shinsuke Usui, Koji Ito, Akiyo Matsumoto, Akiyuki Matsuhisa, Noriaki Takiguchi
BACKGROUND: While esophageal fistula formation in the adjacent organs is associated with high rates of morbidity and mortality, the management of non-aortic arterio-esophageal fistula has not been frequently reported. CASE PRESENTATION: A 69-year-old Japanese man who had undergone definitive chemoradiotherapy for esophageal cancer was admitted to our hospital with hematemesis. He was diagnosed with mediastinal abscess caused by esophageal perforation, and esophageal bypass surgery was performed...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28506648/antegrade-versus-continuous-retrograde-del-nido-cardioplegia-in-the-david-i-operation
#18
Xuan Jiang, Tianxiang Gu, Enyi Shi, Chun Wang, Zongyi Xiu, Guangwei Zhang
BACKGROUND: The efficacy of continuous retrograde del Nido cardioplegia for myocardial protection is still controversial. We hypothesised that antegrade and retrograde cardioplegia offer equivalent safety for myocardial protection in the David I procedure. METHODS: We retrospectively reviewed 33 patients undergoing the David I operation with antegrade or retrograde del Nido solution from June 2014 to January 2016. The outcomes were compared. The follow-up was 1 month to 15 months...
April 26, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28506542/coronary-sinus-isoflurane-concentration-in-cardiac-surgery
#19
Ka Ting Ng, R Peter Alston, George Just, Chris McKenzie
OBJECTIVE: Volatile anesthetic agents such as isoflurane may be associated with fewer adverse myocardial events compared with total intravenous anesthesia in cardiac surgery. The authors aimed to determine whether reasonable isoflurane concentrations at tissue level were being achieved to protect the myocardium using this agent. The isoflurane concentration in myocardium has never been measured. The primary aim was to sample coronary sinus (CS) blood and measure its isoflurane concentration...
March 9, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28506475/a-novel-perfused-porcine-simulator-for-teaching-aortic-anastomosis-increases-resident-interest-in-vascular-surgery
#20
Peter B Bartline, Jennie O'Shea, James M McGreevy, Michelle T Mueller
OBJECTIVE: This report describes a novel simulator, euthanized pigs on cardiopulmonary bypass, and validates this simulator with a controlled trial in general surgery residents learning aortic anastomosis. We evaluated this novel simulator with the following hypothesis: our porcine perfused simulator is as good as or better than the standard rubber tubing, low-fidelity models used for vascular anastomotic training. METHODS: Euthanized pigs were placed on cardiopulmonary bypass, creating a perfused, ex vivo model on which to perform surgical procedures...
May 12, 2017: Journal of Vascular Surgery
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