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Deep hypothermic circulatory arrest

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https://www.readbyqxmd.com/read/28917595/perioperative-and-oncologic-outcomes-of-nephrectomy-and-caval-thrombectomy-using-extracorporeal-circulation-and-deep-hypothermic-circulatory-arrest-for-renal-cell-carcinoma-invading-the-supradiaphragmatic-inferior-vena-cava-and-or-right-atrium
#1
Alessandro Nini, Umberto Capitanio, Alessandro Larcher, Paolo Dell'Oglio, Federico Dehò, Nazareno Suardi, Fabio Muttin, Cristina Carenzi, Massimo Freschi, Roberta Lucianò, Giovanni La Croce, Alberto Briganti, Renzo Colombo, Andrea Salonia, Alessandro Castiglioni, Patrizio Rigatti, Francesco Montorsi, Roberto Bertini
BACKGROUND: Radical nephrectomy (RN) and caval thrombectomy (CT) for renal cell carcinoma, with extracorporeal circulation (ECC) and deep hypothermic circulatory arrest (DHCA) is a challenging surgical approach. OBJECTIVE: To assess peri-operative and oncologic outcomes of renal cell carcinoma patients treated with RN and CT, using ECC and DHCA. DESIGN, SETTING, AND PARTICIPANTS: We retrospectively evaluated 46 patients who underwent RN and CT using ECC and DHCA...
September 13, 2017: European Urology
https://www.readbyqxmd.com/read/28912778/neuroprotective-effects-of-annexin-a1-tripeptide-after-deep-hypothermic-circulatory-arrest-in-rats
#2
Zhiquan Zhang, Qing Ma, Bijal Shah, G Burkhard Mackensen, Donald C Lo, Joseph P Mathew, Mihai V Podgoreanu, Niccolò Terrando
Resolution agonists, including lipid mediators and peptides such as annexin A1 (ANXA1), are providing novel approaches to treat inflammatory conditions. Surgical trauma exerts a significant burden on the immune system that can affect and impair multiple organs. Perioperative cerebral injury after cardiac surgery is associated with significant adverse neurological outcomes such as delirium and postoperative cognitive dysfunction. Using a clinically relevant rat model of cardiopulmonary bypass (CPB) with deep hypothermic circulatory arrest (DHCA), we tested the pro-resolving effects of a novel bioactive ANXA1 tripeptide (ANXA1sp) on neuroinflammation and cognition...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28878585/selective-upper-body-perfusion-technique-for-removal-of-renal-cell-carcinoma-extending-into-the-inferior-vena-cava-and-right-atrium
#3
Selim Aydin, Bora Cengiz, Banu Vural Gokay, Anar Mammadov, Remzi Emiroglu, Saadettin Eskicorapci, Ersin Erek
Invasion of a renal cell carcinoma thrombus into the inferior vena cava and right atrium is infrequent. Reaching and completely excising a tumor from the inferior vena cava is particularly challenging because the liver covers the surgical field. We report the case of a 61-year-old man who underwent surgery for a renal cell carcinoma of the right kidney that extended into the inferior vena cava and right atrium. During dissection of the liver to expose the inferior vena cava, transesophageal echocardiograms revealed right atrial mass migration into the tricuspid valve...
August 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28868316/a-rare-and-late-complication-after-left-ventricular-assist-device-explantation
#4
George Gradinariu, André R Simon, Jullien Gaer
Late complications can arise after explantation of a left ventricular assist device. We report the case of a patient who presented at the age of 19 years with peri-partum cardiomyopathy and was initially managed with a biventricular support device, which was subsequently upgraded to an ambulatory left ventricular assist device. This was successfully explanted after myocardial recovery via a minimally invasive approach 7 months later. The patient re-presented 5 years following explantation with hemoptysis. At redo sternotomy, a 10-cm remnant of the outflow graft was found to be eroding the surface of the right lung...
April 2017: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/28844545/the-risk-of-neurological-dysfunctions-after-deep-hypothermic-circulatory-arrest-with-retrograde-cerebral-perfusion
#5
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/28760465/elective-aortic-arch-repair-factors-influencing-neurologic-outcome-in-791-patients
#6
Mariano Cefarelli, Giacomo Murana, Giuseppina G Surace, Sebastiano Castrovinci, Giuliano Jafrancesco, Johannes Christiaan Kelder, Patrick Klein, Uday Sonker, Wim J Morshuis, Robin H Heijmen
BACKGROUND: The aim of this study was to determine perioperative factors influencing neurologic outcome in a single-center cohort of patients undergoing elective aortic arch operations. METHODS: From January 2005 to June 2015, 791 consecutive patients received open aortic arch operations with either antegrade selective cerebral perfusion (ASCP) (636 patients [80.4%]) or deep hypothermic circulatory arrest (DHCA) (155 patients [19.6%]). Main indications were degenerative aneurysm (85%) and chronic postdissection aneurysm (9...
July 28, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28750453/overexpression-of-microrna-106b-5p-attenuates-kidney-injuries-after-deep-hypothermic-circulatory-arrest-in-rats
#7
Lei Yu, Tianxiang Gu, Yu Liu, Xuan Jiang, Enyi Shi
No abstract text is available yet for this article.
July 27, 2017: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/28723765/perioperative-management-of-intracardiac-leiomyomatosis-an-observational-cohort-study
#8
Jiaying Xu, Min Wei, Qi Miao, Bin Zhu, Chunhua Yu, Yuguang Huang
Intracardiac leiomyomatosis (ICLM) is a rare condition in which the benign tumor extends into the right heart chambers through inferior vena cava. The best surgical approach still remains unclear.We present a retrospective cohort of 36 patients diagnosed with ICLM in Peking Union Medical College Hospital between 2002 and 2016.The mean patient age was 44.5 (range 25-55) years. The clinical manifestations were various, including shortness of breath, chest tightness, edema of the lower extremities, palpitations, syncope, etc...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28712584/the-advantage-of-early-plication-in-children-diagnosed-with-diaphragm-paresis
#9
Alejandro A Floh, Intikhab Zafurallah, Cathy MacDonald, Osami Honjo, Chun-Po S Fan, Peter C Laussen
BACKGROUND: In this single-center study, we sought to determine the frequency of phrenic nerve injury leading to diaphragm paresis (DP) in children following open cardiac surgery over the last 10 years, and to identify possible variables that predict the need for plication and associated clinical outcomes. METHODS: Patients diagnosed with DP were identified from departmental databases and a review of clinical diaphragm ultrasound images. A cohort was analyzed for predictors of diaphragm plication and associations with clinical outcomes...
June 15, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28691213/central-cannulation-strategy-for-extent-i-thoracoabdominal-aneurysm-repair-of-chronic-type-b-aortic-dissection
#10
Reilly D Hobbs, Tyler J Wallen, Caroline M Komlo, Patrick J Moeller, Alberto Pochettino, Joseph E Bavaria, Prashanth Vallabhajosyula
INTRODUCTION: We evaluated the safety profile of a central cardiopulmonary bypass (CPB) cannulation strategy for repair of extent I thoracoabdominal aortic aneurysms (TAAA) with chronic type B dissection in comparison to traditional peripheral CPB cannulation strategies. METHODS: Patients undergoing extent I TAAA repair for chronic type B dissection from 2002 to 2011 were retrospectively reviewed. Patients were grouped by their CPB cannulation strategy. Patients in Group I underwent central aortic cannulation (n = 28) through a left thoracotomy incision...
August 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28683997/is-less-more-or-is-more-less
#11
EDITORIAL
Leonard N Girardi, Lucas B Ohmes
Although aortic hemiarch replacement without the use of deep hypothermic circulatory arrest may be feasible in experienced centers, manipulation of the aortic arch and great vessels is of concern. Additional research is necessary before widespread adoption of this technique.
April 2017: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28683996/an-alternative-technique-for-hemiarch-replacement-without-using-deep-hypothermic-circulatory-arrest
#12
Michael Scott Halbreiner, Michael Yamashita, Ryan Plichta, Lars G Svensson
We describe an alternate technique to perform a replacement of the aortic hemiarch without the need for hypothermic circulatory arrest by axillary cannulation and arch vessel isolation. In 2015, 3 patients underwent hemiarch reconstructions for ascending aortic aneurysms that extended into the arch. Each was performed using right axillary cannulation, isolation and clamping of the innominate artery with isolation, and tangential clamping of the aorta distal to the innominate. There were no neurologic events and no perioperative morbidity or mortality...
April 2017: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28633254/successful-surgical-treatment-of-an-aggressive-pelvic-angiomyxoma-with-intracardiac-extension
#13
Annastiina Husso, Jukka Savola, Jarmo Gunn
We present a case of an intravenous tumor with extension into the right atrium and right ventricle of the heart. Pelvic angiomyxoma is a rare benign tumor, which in this case carried a significant operative risk due to its extension. The patient initially presented with suspected caval and intracardiac thrombus, but unsuccessful treatment led to further investigations. The tumor was extensively dissected from the right atrium, suprarenal vena cava, and left iliac vein on cardiopulmonary bypass and deep hypothermic circulatory arrest...
July 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28622752/microvascular-fluid-exchange-during-cpb-with-deep-hypothermia-circulatory-arrest-or-low-flow
#14
Bjørg Elvevoll, Paul Husby, Venny L Kvalheim, Lodve Stangeland, Arve Mongstad, Øyvind S Svendsen
OBJECTIVE: Use of deep hypothermic low-flow (DHLF) cardiopulmonary bypass (CPB) has been associated with higher fluid loading than the use of deep hypothermia circulatory arrest (DHCA). We evaluated whether these perfusion strategies influenced fluid extravasation rates and edema generation differently per-operatively. MATERIALS AND METHODS: Twelve anesthetized pigs, randomly allocated to DHLF (n = 6) or DHCA (n = 6), underwent 2.5 hours CPB with cooling to 20°C for 30 minutes (min), followed by 30 min arrested circulation (DHCA) or 30 min low-flow circulation (DHLF) before 90 min rewarming to normothermia...
June 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28478907/con-routine-use-of-brain-perfusion-techniques-is-not-supported-in-deep-hypothermic-circulatory-arrest
#15
Mariya Geube, Shiva Sale, Lars Svensson
No abstract text is available yet for this article.
February 4, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28460021/hypothermia-and-cerebral-protection-strategies-in-aortic-arch-surgery-a-comparative-effectiveness-analysis-from-the-sts-adult-cardiac-surgery-database
#16
Brian R Englum, Xia He, Brian C Gulack, Asvin M Ganapathi, Joseph P Mathew, J Matthew Brennan, T Brett Reece, W Brent Keeling, Bradley G Leshnower, Edward P Chen, Jeffrey P Jacobs, Vinod H Thourani, G Chad Hughes
OBJECTIVES: Hypothermic circulatory arrest is essential to aortic arch surgery, although consensus regarding optimal cerebral protection strategy remains lacking. We evaluated the current use and comparative effectiveness of hypothermia/cerebral perfusion (CP) strategies in aortic arch surgery. METHODS: Using the Society of Thoracic Surgeons Database, cases of aortic arch surgery with hypothermic circulatory arrest from 2011 to 2014 were categorized by hypothermia strategy-deep/profound (D/P; ≤20°C), low-moderate (L-M; 20...
September 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28457174/repair-of-ascending-aortic-pseudoaneurysm-eroding-through-the-sternum
#17
Sulaiman B Hasan, Fazal W Khan, Shiraz Hashmi, Mohammad Tariq, Ghufranullah Khan
In reoperation for an ascending aortic pseudoaneurysm eroding through the sternum, a left ventricular vent allows careful unhurried sternal division under deep hypothermic circulatory arrest. We repaired ascending aortic pseudoaneurysms in 2 patients who had undergone aortic valve implantation 6 and 21 months earlier. A minithoracotomy was made in the left 5th intercostal space, and a vent was placed in the left ventricular apex. Repair was accomplished with a bovine pericardial patch reinforced with a Teflon felt strip...
January 1, 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/28437236/temperature-variation-after-rewarming-from-deep-hypothermic-circulatory-arrest-is-associated-with-survival-and-neurologic-outcome
#18
Alessio Rungatscher, Giovanni Battista Luciani, Daniele Linardi, Elisabetta Milani, Leonardo Gottin, Beat Walpoth, Giuseppe Faggian
Therapeutic hypothermia is recommended by international guidelines after cardio-circulatory arrest. However, the effects of different temperatures during the first 24 hours after deep hypothermic circulatory arrest (DHCA) for aortic arch surgery on survival and neurologic outcome are undefined. We hypothesize that temperature variation after aortic arch surgery is associated with survival and neurologic outcome. In the period 2010-2014, a total of 210 consecutive patients undergoing aortic arch surgery with DHCA were included...
June 2017: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/28434264/exploring-effects-of-remote-ischemic-preconditioning-in-a-pig-model-of-hypothermic-circulatory-arrest
#19
Johanna Herajärvi, Tuomas Anttila, Elitsa Y Dimova, Tuomas Laukka, Mikko Myllymäki, Henri Haapanen, Benjamin A Olenchock, Hannu Tuominen, Ulla Puistola, Peeter Karihtala, Kai Kiviluoma, Peppi Koivunen, Vesa Anttila, Tatu Juvonen
OBJECTIVES: During aortic and cardiac surgery, risks for mortality and morbidity are inevitable. Surgical setups involving deep hypothermic circulatory arrest (DHCA) are effective to achieve organ protection against ischemic injury. The aim of this study was to identify humoural factors mediating additive protective effects of remote ischemic preconditioning (RIPC) in a porcine model of DHCA. DESIGN: Twenty-two pigs were randomized into the RIPC group (n = 11) and the control group (n = 11)...
August 2017: Scandinavian Cardiovascular Journal: SCJ
https://www.readbyqxmd.com/read/28402418/an-alternative-cardiopulmonary-bypass-strategy-for-intracaval-baffle-repair-of-scimitar-syndrome
#20
Duccio Federici, Gianfranco Montesi, Davide Ghitti, Lorenzo Galletti
Intracaval buffle repair of scimitar syndrome is classically performed under deep hypothermic circulatory arrest or using low-flow modalities of cardiopulmonary bypass with peripheral cannulation. We propose an alternative perfusion approach to the procedure using total intrapericardial cannulation under full-flow normothermic cardiopulmonary bypass.
June 1, 2017: European Journal of Cardio-thoracic Surgery
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