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Deep hypothermic circulatory arrest

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https://www.readbyqxmd.com/read/29317058/whole-body-periodic-acceleration-pgz-as-a-non-invasive-preconditioning-strategy-for-pediatric-cardiac-surgery
#1
Jose A Adams, Peter Pastuszko, Arkady Uryash, David Wilson, Jose R Lopez Padrino, Vinay Nadkarni, Anna Pastuszko
We hypothesized that pGz has cardio and neuroprotective effects due to upregulation of pathways which include eNOS, anti-apoptotic, and anti-inflammatory pathways. We analyze protein expression of these pathways in the brain of neonatal piglets, as well as report on the myocardial function after Deep Hypothermic Circulatory Arrest (DHCA) and pGz preconditioning. Animal data affirms both a cardio and neuroprotective role for pGz. These findings suggest that pGz can be a simple, non-invasive cardio and neuroprotective strategy preconditioning strategy in children requiring surgical intervention...
January 2018: Medical Hypotheses
https://www.readbyqxmd.com/read/29258403/a-novel-augmented-venous-drainage-model-of-cardiopulmonary-bypass-for-deep-hypothermic-circulatory-arrest-without-blood-priming
#2
Xuan Jiang, Tianxiang Gu, Yu Liu, Chun Wang, Enyi Shi, Guangwei Zhang
OBJECTIVE: Cardiopulmonary bypass (CPB) and deep hypothermic circulatory arrest (DHCA) are commonly used in cardiac surgery. However, the mortality and morbidity are still high in practice. Developing novel protective stategies and elucidating the underlying mechanisms for the pathophysiological consequences of DHCA have been hampered because of the absence of a satisfactory recovery animal model. The aim of this study was to establish a novel and safe DHCA model without blood priming in rats to study the pathophysiology of potential complications...
December 1, 2017: Perfusion
https://www.readbyqxmd.com/read/29249769/open-conversion-for-type-a-ascending-aortic-dissection-after-thoracic-endovascular-aortic-repair-by-the-chimney-graft-technique
#3
Hirofumi Kasahara, Yoshito Inoue, Takashi Hachiya
An 83-year-old man with aortic arch aneurysm underwent zone 0 thoracic endovascular aortic repair (TEVAR) by the chimney graft technique with two supra-aortic arch debranching grafts and developed subacute type A ascending aortic dissection. We performed emergency open conversion with circulatory arrest under deep hypothermia. The tip of the chimney graft (around the sino-tubular junction in the ascending aorta) was stiff, making it difficult to inspect the lumen and perform anastomosis. Deep hypothermic circulatory arrest and cutting the endograft stents to mobilize the graft were necessary for secure anastomosis...
December 18, 2017: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29244151/diffusion-weighted-imaging-detects-early-brain-injury-after-hypothermic-circulatory-arrest-in-pigs
#4
Ren Wang, Guoxing Weng, Shun Yu, Shuangbo Dai, Weiwei Zhang, Feng Zhu
OBJECTIVES: Cerebral injury is a complication of surgery with deep hypothermic circulatory arrest (DHCA). This study aimed to evaluate diffusion-weighted imaging (DWI) for the early detection of brain injury after DHCA in an animal model. METHODS: Twelve healthy, adult, male miniature pigs were randomly divided into the DHCA (to receive DHCA; n = 6) and the control (sham surgery under anaesthesia; n = 6) groups. All animals received DWI, T1-weighted imaging (T1WI) and T2WI the day before surgery, 7 h postoperatively and 24 h postoperatively...
December 12, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29237361/hybrid-endovascular-aortic-arch-reconstruction-for-acute-aortic-dissection-an-endovascular-bridge-technique-for-complex-anatomy
#5
Michael P Rogers, Sophie M Reskin, Adam Ubert, Matthew C Black, Kendra J Grubb
Acute type A aortic dissections starting at the arch pose a challenge for cardiac surgeons. Open surgical repair requires deep hypothermic circulatory arrest for arch reconstruction and is associated with significant morbidity and mortality. Hybrid aortic repair techniques, with open arch debranching and thoracic endovascular aortic repair, have been employed in high-risk cases and challenging aortic pathology. Herein, we present a case of a 33-year-old African American male with a history of open thoracoabdominal aortic reconstruction and femoral-femoral artery bypass for a type B dissection who subsequently presented with new-onset chest pain and was found to have a retrograde type A dissection of a bovine arch with multiple dissection flaps and possible contrast extravasation on chest computed tomography...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29174662/keep-ventilating-the-lungs-while-the-heart-is-still-ejecting-on-femoro-femoral-cardiopulmonary-bypass
#6
Sisse Anette Thomassen, Dovile Leonaviciute, Poul Erik Haar, Jens Brøndum Frøkjær, Bodil Steen Rasmussen
Femoro-femoral cardiopulmonary bypass (CPB) followed by deep hypothermic circulatory arrest is one of the modalities used for ascending aortic pseudoaneurysm repair to achieve cardiac unloading and to avoid severe hemorrhage due to the risk of rupture during the sternal entry. However, due to the limited size of the cannulas, it can be challenging to achieve total cardiopulmonary support. Therefore, despite the achievement of total cardiopulmonary support, the heart may still be able to eject antegrade blood flow that meets the retrograde blood flow from the arterial side of the CPB...
October 20, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29167026/safety-of-moderate-hypothermia-with-antegrade-cerebral-perfusion-in-total-aortic-arch-replacement
#7
W Brent Keeling, David H Tian, Brad G Leshnower, Satoshi Numata, G Chad Hughes, George Matalanis, Yutaka Okita, Tristan D Yan, Nicholas Kouchoukos, Edward P Chen
BACKGROUND: Total aortic arch replacement (TOTAL) is a complicated operation and has traditionally required deep hypothermic circulatory arrest. In this study, the impact of moderate hypothermic circulatory arrest (MHCA) and antegrade cerebral perfusion (ACP) for TOTAL were examined. METHODS: The ARCH International aortic database was queried and 3,265 patients undergoing TOTAL using ACP were identified. Patients were divided into groups based on lowest cooling temperature: MHCA (20° to 28°C) or deep hypothermia (DHCA) (12° to 20°C)...
November 19, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29126676/deep-hypothermic-circulatory-arrest-in-a-patient-with-severe-g6pd-deficiency
#8
Genevieve E Staudt, Jason Zhensheng Qu
No abstract text is available yet for this article.
August 2, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29100641/retrograde-cerebral-perfusion-is-effective-for-prolonged-circulatory-arrest-in-arch-aneurysm-repair
#9
Christopher Lau, Mario Gaudino, Erin Mills Iannacone, Ivancarmine Gambardella, Monica Munjal, Lucas B Ohmes, Benjamin C Degner, Leonard N Girardi
BACKGROUND: The optimal brain protection strategy for prolonged periods of circulatory arrest is still controversial. This study evaluated whether retrograde cerebral perfusion (RCP) provides adequate brain protection for prolonged periods of deep hypothermic circulatory arrest (DHCA). METHODS: From January 1997 to December 2014, 1,043 patients underwent aortic arch operations using RCP and DHCA at 18°C. The DHCA time for 993 patients was 49 minutes or less and the DHCA time for the remaining 50 patients was 50 minutes or more...
November 1, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29049808/cold-inducible-ribonucleic-acid-binding-protein-attenuates-acute-kidney-injuries-after-deep-hypothermic-circulatory-arrest-in-rats
#10
Lei Yu, Tianxiang Gu, Yu Liu, Xuan Jiang, Enyi Shi
OBJECTIVES: Cold-inducible ribonucleic acid-binding protein (CIRP) has been identified to play a role in the antiapoptotic effect of hypothermia. We sought to investigate the renoprotection of CIRP in a rat model of deep hypothermic circulatory arrest. METHODS: Overexpression and knockdown of CIRP were achieved in vivo by directly injecting lentivirus vectors containing packaging lentivirus (pL)/internal ribosome entry site (IRES)/green fluorescent protein (GFP)-CIRP or pL/short hairpin RNA (shRNA)/F-cold inducible RNA binding protein (F-CIRP)-A into the renal parenchyma of rats 7 days before deep hypothermic circulatory arrest under the ultrasound guidance...
August 14, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28994683/sutureless-aortic-valve-implantation-in-patient-with-porcelain-aorta-via-unclamped-aorta-and-deep-hypothermic-circulatory-arrest
#11
Vagelis Boultadakis, Nikolaos G Baikoussis, Victoras Panagiotakopoulos, Nikolaos A Papakonstantinou, Polyxeni Xelidoni, Stratos Anagnostou, Christos Charitos
Severe atherosclerotic calcification of the ascending aorta, the so-called porcelain aorta, precludes cardiac surgeons from placing an aortic cross-clamp and direct aortic cannulation due to the increased risk of systemic embolism and stroke. In the present report, we support the option of sutureless valve implantation in a case of a porcelain ascending aorta, with deep hypothermic circulatory arrest and also without aortic cross-clamp.
October 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28977412/distal-embolization-of-a-transcatheter-valve-in-a-valve-complex-a-bail-out-surgical-approach
#12
Matthew Panagiotou, Athanasios Manginas, Charalampos Kyriazis, Dimos Karangelis
Transcatheter aortic valve replacement has emerged as an alternative to surgical aortic valve replacement for high-risk and inoperable patients. Although transcatheter aortic valve replacement avoids the use of extracorporeal circulation and sternotomy, it is nonetheless associated with inherent complications. We aim to present an embolized valve-in-valve complex in the ascending aorta, which required emergency surgery with deep hypothermic circulatory arrest and proximal aortic cannulation.
December 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28966309/impact-of-presurgical-mild-acute-respiratory-distress-syndrome-on-surgical-mortality-after-surgical-repair-of-acute-type-a-aortic-dissection
#13
Qiang Ji, Hao Lai, YongXin Sun, Zhe Luo, Lan Liu, Chen Liu, JiaWei Gu, YuLin Wang, WenJun Ding, ChunSheng Wang
To evaluate the impact of presurgical mild acute respiratory distress syndrome (ARDS) on surgical mortality in patients undergoing surgical repair of acute type A aortic dissection by means of deep hypothermic circulatory arrest (DHCA) in a single-center, retrospective study.From January 2011 to December 2015, 333 eligible patients were divided into either a mild-ARDS group (n = 136) or a no-ARDS group (n = 197). The definition of mild ARDS referred to the recent revision of ARDS definition (Berlin criteria)...
October 21, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28962511/granulocyte-colony-stimulating-factor-significantly-decreases-density-of-hippocampal-caspase-3-positive-nuclei-thus-ameliorating-apoptosis-mediated-damage-in-a-model-of-ischaemic-neonatal-brain-injury
#14
Peter Pastuszko, Gregory J Schears, Joanna Kubin, David F Wilson, Anna Pastuszko
OBJECTIVES: Ischaemic brain injury is a major complication in patients undergoing surgery for congenital heart disease, with the hippocampus being a particularly vulnerable region. We hypothesized that neuronal injury resulting from cardiopulmonary bypass and associated circulatory arrest is ameliorated by pretreatment with granulocyte colony-stimulating factor (G-CSF), a cytokine and an anti-apoptotic neurotrophic factor. METHODS: In a model of ischaemic brain injury, 4 male newborn piglets were anaesthetized and subjected to deep hypothermic circulatory arrest (DHCA) (cooled to 18°C, DHCA maintained for 60 min, rewarmed and recovered for 8-9 h), while 4 animals received G-CSF (34 µg/kg, intravenously) 2 h prior to the DHCA procedure...
October 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28951082/favorable-late-survival-after-aortic-surgery-under-straight-deep-hypothermic-circulatory-arrest
#15
Anneke Damberg, Davide Carino, Paris Charilaou, Sven Peterss, Maryann Tranquilli, Bulat A Ziganshin, John A Rizzo, John A Elefteriades
BACKGROUND: Surgical and cerebral protection strategies in aortic arch surgery remain under debate. Perioperative results using deep hypothermic circulatory arrest (DHCA) have been associated with favorable short-term mortality and stroke rates. The present study focuses on late survival in patients undergoing aortic surgery using DHCA. METHODS: A total of 613 patients (mean age, 63.7 years) underwent aortic surgery between January 2003 and December 2015 using DHCA, with 77...
August 31, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28932974/japanese-perspective-in-surgery-for-thoracoabdominal-aortic-aneurysms
#16
Norihiko Shiiya, Naoki Washiyama, Kazumasa Tsuda, Ken Yamanaka, Daisuke Takahashi, Katsushi Yamashita, Kayoko Natsume, Yuki Takeuchi, Suguru Kubota, Yoshiro Matsui
OBJECTIVE: Operative mortality and morbidity after thoracoabdominal aortic surgery remain high. We report our strategy and outcomes, especially those of spinal cord protection. METHODS: Outcomes of 178 patients (age: 26-88 years) who underwent thoracoabdominal aortic replacement were retrospectively analyzed. 65 had aortic dissection, 14 had infected aneurysms, and 22 presented with rupture. Operations were non-elective in 24 and redo through re-thoracotomy in 21...
September 20, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28923506/straight-deep-hypothermic-circulatory-arrest-for-aortic-arch-surgery-going-the-way-of-the-dinosaurs
#17
EDITORIAL
Nicholas T Kouchoukos
No abstract text is available yet for this article.
December 2017: Journal of Thoracic and Cardiovascular Surgery
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
#18
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
#19
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
#20
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
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