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https://www.readbyqxmd.com/read/25673099/short-term-clinical-outcomes-between-intermittent-cold-versus-intermittent-warm-blood-cardioplegia-in-2200-adult-cardiac-surgery-patients
#1
K Trescher, A Gleiss, M Boxleitner, W Dietl, H Kassal, C Holzinger, B K Podesser
AIM: Aim of the present study was to compare clinical outcome of intermittent cold (ICC) versus intermittent warm (IWC) blood cardioplegia in different cardiosurgical procedures. METHODS: 2188 patients were retrospectively divided into 5 groups: isolated coronary artery bypass surgery (CABG,n=1203), isolated aortic valve surgery (AVR,n=374), isolated mitral valve surgery (MVR,n=151), combined AVR+CABG (n=390), and combined MVR+CABG (n=70). Myocardial protection was performed by ICC (n=1578) or IWC (n=610) blood cardioplegia...
February 12, 2015: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/25366352/impact-of-novel-intraoperative-evaluation-for-mitral-valve-regurgitation-the-retrograde-cardio-protective-beating-test
#2
Kazutoshi Tachibana, Tetsuya Higami, Yasuko Miyaki, Tomohiro Nakagima, Toshiro Ito, Nobuyuki Takagi
PURPOSE: The saline injection test is commonly employed during mitral valvuloplasty. However, discrepancies in regurgitation between the naked eye findings during the saline injection test and the postoperative echocardiographic findings have been noted. Here, we describe the new retrograde cardio-protective beating test (RC-beating test) which allows direct transatrial evaluation of the valve in the fully loaded, beating heart under cross-clamping by means of the retrograde perfusion of warm oxygenated blood into the coronary sinus...
September 2015: Surgery Today
https://www.readbyqxmd.com/read/24053647/randomized-trial-of-htk-versus-warm-blood-cardioplegia-for-right-ventricular-protection-in-mitral-surgery
#3
RANDOMIZED CONTROLLED TRIAL
Mario Gaudino, Claudio Pragliola, Amedeo Anselmi, Maurizio Pieroni, Stefano De Paulis, Alessandro Leone, Alberto Ranieri De Caterina, Massimo Massetti
OBJECTIVES: To clarify the reliability of the one-shot histidine-tryptophane-ketoglutarate (HTK) cardioplegia for right ventricular (RV) myocardial protection during mitral surgery, in patients with or without pre-operative RV dysfunction. DESIGN: Sixty patients undergoing isolated mitral surgery were randomized to myocardial protection with either one-shot HTK or intermittent warm blood cardioplegia (WBC). The RV function was assessed by echocardiography and hemodynamic assessment...
December 2013: Scandinavian Cardiovascular Journal: SCJ
https://www.readbyqxmd.com/read/23939325/clinical-and-ultramicroscopic-myocardial-randomized-study-of-beating-versus-arrested-heart-for-mitral-surgery
#4
RANDOMIZED CONTROLLED TRIAL
Clotario Neptali Carrasco Cueva, Maiara dos Santos Rocha, Carlos Maurício Cardeal Mendes, Luiz Antonio Rodrigues de Freitas, José Augusto Baucia, Roberto Badaró
INTRODUCTION: Beating heart surgery on normothermic bypass simulates physiologic cardiac status. OBJECTIVES: This study compared clinical and transmission electron microscopic aspects of myocardial protection during mitral valve replacement using warm retrograde perfusion in empty beating versus arrested heart with cold blood anterograde cardioplegia. METHODS: Randomized study to evaluate myocardial cellular ischemia-reperfusion of both techniques to replace the mitral valve...
June 2013: Revista Brasileira de Cirurgia Cardiovascular
https://www.readbyqxmd.com/read/23924929/intraoperative-assessment-for-mitral-valve-competency-in-a-beating-heart-under-retrograde-coronary-perfusion
#5
COMPARATIVE STUDY
Takeshi Miyairi, Sumio Miura, Tsuyoshi Taketani, Takayoshi Kusuhara, Yangsin Lee, Shinya Unai, Takayuki Ohno, Sachito Fukuda, Shinichi Takamoto
Intraoperative assessment of a repaired mitral valve is of paramount importance for reparative mitral surgery. From September 2010 through November 2012, 20 consecutive patients underwent mitral valve plasty for mitral regurgitation. The patients who underwent surgery after June 2012 received assessment of the repair with the heart beating (HB group, n = 10), and the patients who underwent the operation before May 2012 were assessed for the repair only under cardioplegic heart arrest (non-HB group, n = 10)...
2013: International Heart Journal
https://www.readbyqxmd.com/read/22928009/early-reperfusion-hemodynamics-predict-recovery-in-rat-hearts-a-potential-approach-towards-evaluating-cardiac-grafts-from-non-heart-beating-donors
#6
Monika Dornbierer, Mathieu Stadelmann, Joevin Sourdon, Brigitta Gahl, Stéphane Cook, Thierry P Carrel, Hendrik T Tevaearai, Sarah L Longnus
AIMS: Cardiac grafts from non-heartbeating donors (NHBDs) could significantly increase organ availability and reduce waiting-list mortality. Reluctance to exploit hearts from NHBDs arises from obligatory delays in procurement leading to periods of warm ischemia and possible subsequent contractile dysfunction. Means for early prediction of graft suitability prior to transplantation are thus required for development of heart transplantation programs with NHBDs. METHODS AND RESULTS: Hearts (n = 31) isolated from male Wistar rats were perfused with modified Krebs-Henseleit buffer aerobically for 20 min, followed by global, no-flow ischemia (32°C) for 30, 50, 55 or 60 min...
2012: PloS One
https://www.readbyqxmd.com/read/22196924/cardiopulmonary-bypass-transiently-inhibits-intraventricular-vortex-ring-formation-in-patients-undergoing-coronary-artery-bypass-graft-surgery
#7
Paul S Pagel, Sweeta D Gandhi, Zafar Iqbal, Judith A Hudetz
OBJECTIVE: Transmitral blood flow during early left ventricular (LV) filling produces an intraventricular rotational body of fluid known as a "vortex ring" that enhances the hydraulic efficiency of early LV filling. The authors tested the hypothesis that exposure to cardiopulmonary bypass (CPB) attenuates intraventricular vortex formation time (VFT) in patients with normal preoperative LV systolic and diastolic function undergoing coronary artery bypass graft (CABG) surgery. DESIGN: A prospective, observational study...
June 2012: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/21295314/sutureless-mitral-valve-replacement-with-bioprostheses-and-nitinol-attachment-rings-feasibility-in-acute-pig-experiments
#8
Eric Berreklouw, Sergey Leontyev, Susann Ossmann, Christian Velten, Bernd Vogel, Stephan Dhein, Friedrich W Mohr
OBJECTIVE: There is a need for fast, minimally invasive sutureless replacement of mitral valves. METHODS: Unchanged FDA-approved biological valve prostheses were sutured to Nitinol attachment rings (Endosmart, Stutensee, Germany) that were covered with textile (devices). The lower flange of the device was stretched in ice water and maintained in a stretched position with stretching sutures. In 9 acute pig experiments through a limited left thoracotomy, a single suture was placed around the mitral annulus, the device was positioned, the annular suture tied, the stretching sutures retracted, and the device activated by warm saline...
August 2011: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/19918501/concurrent-reactive-arthritis-graves-disease-and-warm-autoimmune-hemolytic-anemia-a-case-report
#9
Elizabeth Chiang, Clifford D Packer
Warm antibody autoimmune hemolytic anemia is due to the presence of warm agglutinins that react with protein antigens on the surface of red blood cells causing premature destruction of circulating red blood cells. We report the first case of concurrent reactive arthritis, Graves' disease, and autoimmune hemolytic anemia. A 40-year-old man with reactive arthritis, Graves' disease, type 2 diabetes mellitus, mitral valve prolapse, and Gilbert's disease presented with a one month history of jaundice, fatigue, and black stools...
August 13, 2009: Cases Journal
https://www.readbyqxmd.com/read/19808709/warm-beating-heart-aortic-valve-replacement-in-a-sickle-cell-patient
#10
Saif Usman, Faisal B Saiful, Joseph DiNatale, Joseph T McGinn
Patients with sickle cell abnormalities undergoing surgery are generally considered to be at greater risk for perioperative complications. We present a 25-year-old woman with sickle cell disease (SCD) and severe aortic insufficiency. A minimally invasive, warm, beating heart approach was adopted to try and minimize the risk of sickling due to cardiopulmonary bypass (CPB), low-flow states, cold cardioplegia and aortic cross-clamping. Compared to classical methods, we believe our technique further reduces the risk of systemic and organ hypothermia and thus, sickling...
January 2010: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/18593653/prosthetic-mitral-leaflet-malfunction-due-to-inappropriate-size-of-implant
#11
Yuet-Tong Ng, Peter Chi-Ho Chung, Wai-Meng Lau
We report a case of unexpected malfunction of prosthetic mitral leaflets, discovered by transesophageal echocardiography (TEE) immediately after implantation, due to selection of an inappropriate size of prosthesis; the problem was amended immediately by surgical revision. The subject was a 48-year-old man admitted for mitral valve replacement because of severe mitral stenosis. He had undergone mitral commissurotomy 21 years previously. Preoperative echo findings showed severe mitral stenosis with regurgitation and a huge thrombus in the left atrial chamber...
June 2008: Acta Anaesthesiologica Taiwanica: Official Journal of the Taiwan Society of Anesthesiologists
https://www.readbyqxmd.com/read/18304136/mitral-and-tricuspid-valve-surgery-in-homozygous-sickle-cell-disease-perioperative-considerations-for-a-successful-outcome
#12
Anand Sachithanandan, Prakash Nanjaiah, Christine J Wright, Stephen J Rooney
Homozygous sickle cell disease (SCD) presents a multitude of challenges in patients undergoing cardiac surgery with cardiopulmonary bypass. Special consideration must be made in such patients and routine practice modified to prevent hypoxia, hypothermia, acidaemia and low-flow states which may potentially trigger a fatal sickling crisis perioperatively. We discuss several perioperative management strategies including a preoperative exchange transfusion, high flow normothermic bypass and warm blood cardioplegia that was utilized in a woman with homozygous SCD who underwent a successful double valve procedure...
March 2008: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/18069678/paradoxical-septal-motion-after-cardiac-surgery-a-review-of-3-292-cases
#13
Harmony R Reynolds, Paul A Tunick, Eugene A Grossi, Hajir Dilmanian, Stephen B Colvin, Itzhak Kronzon
BACKGROUND: Paradoxical septal motion (PSM) is the systolic movement of the interventricular septum toward the right ventricle despite normal thickening. The PSM is a frequent echocardiographic finding after cardiac surgery. Although it is universally recognized, there has been no large-scale study to correlate PSM with the type of surgical procedure. The cause of PSM is unknown; prevailing theories include: (1) operation on the heart alters the degree to which it is restrained by the pericardium and the chest wall and (2) transient ischemia alters septal motion...
December 2007: Clinical Cardiology
https://www.readbyqxmd.com/read/18039204/surgery-for-cardiac-valves-and-aortic-root-without-cardioplegic-arrest-beating-heart-experience-with-a-new-method-of-myocardial-perfusion
#14
Tomas A Salerno, Anthony L Panos, Ganghong Tian, Roxanne Deslauriers, Domenico Calcaterra, Marco Ricci
Simultaneous antegrade/retrograde warm blood perfusion with a beating heart has not been previously reported as a mean of protecting hypertrophied hearts in cardiac valve and aortic root surgeries. Similarly, beating heart mitral valve surgery via the trans-septal approach with the aorta unclamped, is a novel technique. We, herein, report a series of 346 patients with a variety of cardiac pathologies who were operated upon utilizing a new modality of myocardial perfusion. Among this group of patients, there were 55 patients who were diagnosed with endocarditis of one or more valves...
November 2007: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/16551821/terminal-warm-blood-cardioplegia-in-mitral-valve-replacement-prospective-study
#15
RANDOMIZED CONTROLLED TRIAL
Chareonkiat Rergkliang, Apirak Chetpaophan, Voravit Chittithavorn, Prasert Vasinanukorn, Vorapong Chowchuvech
Terminal warm blood cardioplegia has had a profound impact on cardiac surgery, especially in coronary artery bypass surgery, but there have been few studies on its use in mitral valve replacement. The purpose of this study was to determine whether terminal warm blood cardioplegia offers any advantages in mitral valve replacement. Forty patients with mitral valve disease were prospectively randomized to one of two groups of 20 with different techniques of myocardial protection: group A had cold blood cardioplegia, and group B had cold blood cardioplegia with terminal warm blood cardioplegia...
April 2006: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/12635060/effects-of-positive-pressure-ventilation-pericardial-effusion-and-cardiac-tamponade-on-respiratory-variation-in-transmitral-flow-velocities
#16
Jana A Faehnrich, Robert B Noone, William D White, Bruce J Leone, Andrew K Hilton, Gautam M Sreeram, Jonathan B Mark
OBJECTIVE: To determine the effects of positive-pressure ventilation and experimentally induced pericardial effusion and tamponade on transmitral flow velocities in dogs. DESIGN: Descriptive. SETTING: University laboratory. PARTICIPANTS: Eleven tracheally intubated and mechanically ventilated dogs. INTERVENTIONS: Experimental pericardial effusion and cardiac tamponade were created by pericardial injection of warm saline...
February 2003: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/12238823/efficacy-and-safety-of-on-pump-beating-heart-surgery-for-valvular-disease
#17
RANDOMIZED CONTROLLED TRIAL
Yasushi Matsumoto, Go Watanabe, Masamitsu Endo, Hisao Sasaki, Fuminori Kasashima, Ikuko Kosugi
BACKGROUND: This study was conducted to assess the efficacy and applicability of on-pump beating heart valvular operations using retrograde coronary sinus perfusion. METHODS: A prospective, randomized study was conducted. A total of 50 patients participated in this study after having been allocated to one of two groups. On-pump beating heart valvular operations using retrograde coronary sinus perfusion as myocardial protection were performed in 25 patients (beating heart procedure group: aortic = 8 patients, mitral = 15 patients, double = 2 patients)...
September 2002: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/12220071/beating-heart-valvular-surgery-a-possible-alternative-for-patients-with-severely-compromised-ventricular-function
#18
Richard J Kaplon, Si M Pham, Tomas A Salerno
Cardioplegic arrest of the severely compromised ventricle may make weaning from cardiopulmonary bypass problematic. We report a novel approach to myocardial protection in a patient requiring multi-valve surgery who had an ejection fraction of 15%. Warm oxygenated blood was infused continuously both antegrade and retrograde during aortic valve replacement and mitral and tricuspid valve repair. Adequacy of perfusion was confirmed by the absence of electrocardiographic changes. Clinical improvement suggests that this strategy of myocardial protection warrants further investigation...
March 2002: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/12125670/aortic-and-mitral-valve-surgery-on-the-beating-heart-is-lowering-cardiopulmonary-bypass-and-aortic-cross-clamp-time
#19
Borut Gersak, Zeljko Sutlic
OBJECTIVE: The concept of cardiac surgery on the beating heart is acceptable rationale for the cardiac surgery in the next millenium. Beating heart (off-pump) coronary artery bypass grafting (CABG) techniques have led us to consider the possibility for performing the aortic and mitral valve surgery (mitral valve repairs and replacements - with or without CABG) on the beating heart with the technique of retrograde oxygenated coronary sinus perfusion. METHODS: We used the technique of retrograde oxygenated blood coronary sinus perfusion in 78 patients (Group All) - (36 patients were with extremely low ejection fraction (Group X) - 62% of whom were in New York Heart Association (NYHA) class 4 and 34% of whom were in NYHA class 3)...
2002: Heart Surgery Forum
https://www.readbyqxmd.com/read/11899181/aortic-valve-surgery-after-previous-coronary-artery-bypass-grafting-with-functioning-internal-mammary-artery-grafts
#20
John G Byrne, Alexandros N Karavas, Farzan Filsoufi, Tomislav Mihaljevic, Lishan Aklog, David H Adams, Lawrence H Cohn, Sary F Aranki
BACKGROUND: Aortic valve surgery after coronary artery bypass grafting (CABG) in the setting of patent pedicled internal mammary artery (IMA) grafts poses a high risk because of the underlying ischemic and valve disease. Unlike mitral valve surgery or CABG, in which aortic clamping (AoX) may be optional, aortic valve surgery uniformly requires AoX unless circulatory arrest is used. Management of the IMA graft in these circumstances has traditionally involved dissection and clamping to prevent regional myocardial warming and cardioplegia "washout" during AoX...
March 2002: Annals of Thoracic Surgery
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