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Deep hypothermic circulatory arrest

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https://www.readbyqxmd.com/read/28079659/suspected-malignant-hyperthermia-in-the-setting-of-hypothermic-circulatory-arrest-for-type-a-aortic-dissection-repair-a-case-report
#1
Bryant Bunting, Joshua Knight, Stephen M McHugh
Malignant Hyperthermia (MH) is a life-threatening biochemical process of hypermetabolism brought about in susceptible individuals by a triggering drug or event. Type A aortic dissections are surgical emergencies requiring cardiopulmonary bypass and frequently deep hypothermic circulatory arrest. We present a case of suspected MH in a patient undergoing emergent repair of a type A aortic dissection. Upon arrival at our institution, the patient had multiple signs of MH. However, no known triggering agent had been administered...
January 11, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28067688/perioperative-near-infrared-spectroscopy-monitoring-in-neonates-with-congenital-heart-disease-relationship-of-cerebral-tissue-oxygenation-index-variability-with-neurodevelopmental-outcome
#2
Michael C Spaeder, Darren Klugman, Kami Skurow-Todd, Penny Glass, Richard A Jonas, Mary T Donofrio
OBJECTIVES: To evaluate the value of perioperative cerebral near-infrared spectroscopy monitoring using variability analysis in the prediction of neurodevelopmental outcomes in neonates undergoing surgery for congenital heart disease. DESIGN: Retrospective cohort study. SETTING: Urban, academic, tertiary-care children's hospital. PATIENTS: Neonates undergoing surgery with cardiopulmonary bypass for congenital heart disease...
January 6, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28018819/a-technical-modification-for-establishing-selective-antegrade-cerebral-perfusion-during-pulmonary-endarterectomy
#3
Martin Czerny, Patrick von Samson, Bernward Passlick, Friedhelm Beyersdorf, Johannes Kroll
Pulmonary endarterectomy (PEA) due to chronic thromboembolic pulmonary hypertension (CTEPH) is mainly performed in deep hypothermic circulatory arrest without additional cerebroprotective means. A 49-year-old man was treated by PEA for CTEPH by using selective antegrade cerebral perfusion by advancing the tip of the systemic perfusion cannula into the brachiocephalic trunk. The postoperative course was uneventful.
December 2016: Thoracic and Cardiovascular Surgeon Reports
https://www.readbyqxmd.com/read/27999072/the-extracellular-isoform-of-superoxide-dismutase-has-a-significant-impact-on-cardiovascular-ischaemia-and-reperfusion-injury-during-cardiopulmonary-bypass
#4
Antonio Pinto, Moritz Benjamin Immohr, Annika Jahn, Alexander Jenke, Udo Boeken, Artur Lichtenberg, Payam Akhyari
OBJECTIVES: Cardiac surgery with cardiopulmonary bypass (CPB) provokes ischaemia and reperfusion injury (IRI). Superoxide is a main mediator of IRI and is detoxified by superoxide dismutases (SODs). Extracellular SOD (SOD3) is the prevailing isoform in the cardiovascular system. Its mutation is associated with elevated risk for ischaemic heart disease as epidemiological and experimental studies suggest. We investigated the influence of SOD3 on IRI in the context of CPB and hypothesized a protective role for this enzyme...
December 2016: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/27909278/-surgical-treatment-of-right-atrial-malignant-tumor-thrombus-under-deep-hypothermia-with-intermittent-circulatory-arrest-report-of-two-cases
#5
Akira Fujita, Toshiro Kobayashi, Hideharu Hironaka, Mitsutaka Jinbou, Naomasa Uesugi, Satoshi Saito, Tsuyoshi Takahashi, Hidenori Gohra
Right atrial tumor thrombus is rare in patients with visceral malignant tumors and can cause right heart failure or sudden death. We present 2 cases of right atrial tumor thrombus treated under deep hypothermic intermittent circulatory arrest (DHICA). A 45-year-old man with right heart failure was diagnosed with right renal cancer extending to the right atrium. Computed tomography revealed no metastasis. He underwent right nephrectomy and tumor thrombus resection under DHICA. He was discharged on postoperative day 11 in good clinical course...
December 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/27887900/pro-antegrade-retrograde-cerebral-perfusion-should-be-used-during-major-aortic-surgery-with-deep-hypothermic-circulatory-arrest
#6
Nicoleta Stoicea, Sergio D Bergese, Nicholas Joseph, Sujatha Bhandary, Michael Essandoh
No abstract text is available yet for this article.
September 15, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27887023/a-case-of-primary-intracardiac-yolk-sac-tumour-with-extracardiac-extension
#7
Moosa Kunhi, Sachin Sanagar, N Jagadeesh, Vadanattathil P Gangadharan, Anand Kumar, Pushpa Mahadevan
Primary cardiac tumour is a rare entity as secondaries in the heart are more common. A 2-year-old child was having repeated respiratory tract infection with poor oral intake and poor activity for 3 months. His symptoms progressed from New York Heart Association (NYHA) Class II to IV. On evaluation he had an intracardiac mass with extracardiac extension. Emergency tumour excision under deep hypothermic circulatory arrest was performed with provisional diagnosis of sarcoma. But Serum markers, histopathological examination and immunohistochemistry confirmed diagnosis of yolk sac tumour...
November 24, 2016: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/27867562/analysis-of-risk-factors-for-and-the-prognosis-of-postoperative-acute-respiratory-distress-syndrome-in-patients-with-stanford-type-a-aortic-dissection
#8
Mei-Fang Chen, Liang-Wan Chen, Hua Cao, Yong Lin
BACKGROUND: To explore the risk factors for and the prognosis of postoperative acute respiratory distress syndrome (ARDS) in patients with Stanford type A aortic dissection (AD). METHODS: This retrospective nested case-control study included 527 Stanford type A AD patients who were divided into ARDS groups and non-ARDS groups. The clinical features of the groups were examined. RESULTS: The fifty-nine patients in the ARDS group exhibited extended durations of cardiopulmonary bypass (CPB) (P=0...
October 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27766272/single-stage-aortic-arch-replacement-without-circulatory-arrest
#9
Ricardo G Marenchino, Alberto Domenech
A 78-year-old man with a Kommerell diverticulum and aberrant right subclavian artery was admitted for thoracic pain and severe malnutrition due to esophageal compression. We performed an atypical surgical procedure including extra-anatomical debranching and direct aortic repair, trying to avoid deep hypothermic circulatory arrest and shorten the cardiopulmonary bypass time.
February 2016: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/27766271/complete-resolution-of-wegener-s-granulomatosis-lung-granuloma-after-aortic-root-replacement
#10
Sarah-Jayne Edmondson, Saina Attaran, Ulrich P Rosendahl
Wegner's granulomatosis (WG) is an autoimmune systemic vasculitis that results in necrotizing granulomas. We report a WG patient with a lung granuloma and aortic root dilatation, who underwent aortic root replacement on cardiopulmonary bypass (CPB). Intraoperatively, the patient suffered an aortic dissection, which was repaired immediately under deep hypothermic circulatory arrest (DHCA). Follow-up imaging showed complete granuloma resolution, despite absence of immunosuppressive therapy. Immune stimulation following CPB is well described; here, the opposite was observed and DHCA effects are discussed...
February 2016: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/27756811/risk-factors-for-hypoxemia-following-surgical-repair-of-acute-type-a-aortic-dissection
#11
Nan Liu, Wei Zhang, Weiguo Ma, Wei Shang, Jun Zheng, Lizhong Sun
OBJECTIVES: To identify the risk factors for hypoxaemia following surgical repair of acute type A aortic dissection. METHODS: This was a retrospective study of patients treated between October 2013 and December 2014 at the Department of Cardiovascular Surgery, Anzhen Hospital, China. Univariable and multivariable analyses were performed on the clinical data of 160 patients with acute type A dissection and who underwent ascending aortic and arch replacement under deep hypothermic circulatory arrest...
October 17, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/27734011/neurologic-injury-associated-with-rewarming-from-hypothermia-is-mild-hypothermia-on-bypass-better-than-deep-hypothermic-circulatory-arrest
#12
Utpal S Bhalala, Elumalai Appachi, Muhammad Ali Mumtaz
Many known risk factors for adverse cardiovascular and neurological outcomes in children with congenital heart defects (CHD) are not modifiable; however, the temperature and blood flow during cardiopulmonary bypass (CPB), are two risk factors, which may be altered in an attempt to improve long-term neurological outcomes. Deep hypothermic circulatory arrest, traditionally used for aortic arch repair, has been associated with short-term and long-term neurologic sequelae. Therefore, there is a rising interest in using moderate hypothermia with selective antegrade cerebral blood flow on CPB during aortic arch repair...
2016: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/27709094/goal-directed-perfusion-in-neonatal-aortic-arch-surgery
#13
Robert Anton Cesnjevar, Ariawan Purbojo, Frank Muench, Joerg Juengert, André Rueffer
Reduction of mortality and morbidity in congenital cardiac surgery has always been and remains a major target for the complete team involved. As operative techniques are more and more standardized and refined, surgical risk and associated complication rates have constantly been reduced to an acceptable level but are both still present. Aortic arch surgery in neonates seems to be of particular interest, because perfusion techniques differ widely among institutions and an ideal form of a so called "total body perfusion (TBP)" is somewhat difficult to achieve...
July 2016: Translational pediatrics
https://www.readbyqxmd.com/read/27708177/neurophysiological-intraoperative-monitoring-during-aortic-arch-surgery
#14
REVIEW
Jeffrey E Keenan, Ehsan Benrashid, Emily Kale, Alina Nicoara, Aatif M Husain, G Chad Hughes
Circulatory management during replacement of the aortic arch is complex and involves a period of circulatory arrest to provide a bloodless field during arch vessel anastomosis. To guard against ischemic brain injury, tissue metabolic demand is reduced by systemically cooling the patient prior to circulatory arrest. Neurophysiological intraoperative monitoring (NIOM) is often used during the course of these procedures to provide contemporaneous assessment of brain status to help direct circulatory management decisions and detect brain ischemia...
December 2016: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27699112/continuous-cerebral-hemodynamic-measurement-during-deep-hypothermic-circulatory-arrest
#15
David R Busch, Craig G Rusin, Wanda Miller-Hance, Kathy Kibler, Wesley B Baker, Jeffrey S Heinle, Charles D Fraser, Arjun G Yodh, Daniel J Licht, Kenneth M Brady
While survival of children with complex congenital heart defects has improved in recent years, roughly half suffer neurological deficits suspected to be related to cerebral ischemia. Here we report the first demonstration of optical diffuse correlation spectroscopy (DCS) for continuous and non-invasive monitoring of cerebral microvascular blood flow during complex human neonatal or cardiac surgery. Comparison between DCS and Doppler ultrasound flow measurements during deep hypothermia, circulatory arrest, and rewarming were in good agreement...
September 1, 2016: Biomedical Optics Express
https://www.readbyqxmd.com/read/27685257/moderate-hypothermia-provides-better-protection-of-the-intestinal-barrier-than-deep-hypothermia-during-circulatory-arrest-in-a-piglet-model-a-microdialysis-study
#16
Mengya Liang, Kangni Feng, Xiao Yang, Guangxian Chen, Zhixian Tang, Weibin Lin, Jian Rong, Zhongkai Wu
INTRODUCTION: This study aimed to assess the effects of different temperature settings of hypothermic circulatory arrest (HCA) on intestinal barrier function in a piglet model. METHODS: Twenty Wuzhishan piglets were randomly assigned to 40 min of HCA at 18°C (DHCA group, n = 5), 40 min of HCA at 24°C (MHCA group, n = 5), normothermic cardiopulmonary bypass (CPB group, n = 5) or sham operation (SO group, n = 5). Serum D-lactate (SDL) and lipopolysaccharide (LPS) levels were determined...
2016: PloS One
https://www.readbyqxmd.com/read/27637729/predictors-of-adverse-outcome-and-transient-neurological-dysfunction-following-aortic-arch-replacement-in-626-consecutive-patients-in-china
#17
Hong Liu, Qian Chang, HaiTao Zhang, CunTao Yu
BACKGROUND: Early mortality and cerebral injury are severe complications of aortic arch surgery, but data from Asian countries are scarce. We reviewed the results of patients who underwent aortic arch replacement with deep hypothermic circulatory arrest (DHCA) and antegrade selective cerebral perfusion (ASCP) at our institution to analyse pre- and intraoperative predictors of early death and neurological complications. METHODS: Clinical data of adult patients who underwent aortic arch surgery with DHCA plus ASCP between January 2005 and December 2011 were retrospectively analysed...
February 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/27621905/mycotic-aortic-arch-aneurysm-coexistent-with-constrictive-pericarditis-is-surgery-a-dangerous-resort
#18
Peter S Y Yu, Simon C H Yu, Cheuk-Man Chu, Micky W T Kwok, Yuk-Hoi Lam, Malcolm J Underwood, Randolph H L Wong
An elderly man presented with fever and evidence of Salmonella infection, and was diagnosed to have coexisting constrictive pericarditis and mycotic aneurysm of the aortic arch. Pericardiectomy was performed under cardiopulmonary bypass with good result. To avoid deep hypothermic circulatory arrest, an aorto-brachiocephalic bypass, instead of total arch replacement, was performed. This was followed by a staged carotid-carotid bypass, thoracic endovascular stent graft placement. He was subsequently treated with prolonged antibiotics, and inflammatory marker normalized afterwards...
August 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27604310/selective-cerebral-perfusion-prevents-abnormalities-in-glutamate-cycling-and-neuronal-apoptosis-in-a-model-of-infant-deep-hypothermic-circulatory-arrest-and-reperfusion
#19
Masaki Kajimoto, Dolena R Ledee, Aaron K Olson, Nancy G Isern, Isabelle Robillard-Frayne, Christine Des Rosiers, Michael A Portman
Deep hypothermic circulatory arrest is often required for the repair of complex congenital cardiac defects in infants. However, deep hypothermic circulatory arrest induces neuroapoptosis associated with later development of neurocognitive abnormalities. Selective cerebral perfusion theoretically provides superior neural protection possibly through modifications in cerebral substrate oxidation and closely integrated glutamate cycling. We tested the hypothesis that selective cerebral perfusion modulates glucose utilization, and ameliorates abnormalities in glutamate flux, which occur in association with neuroapoptosis during deep hypothermic circulatory arrest...
November 2016: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/27594158/surgical-treatment-strategies-of-intravenous-leiomyomatosis-withright-cardiac-cavities-extension
#20
Guo-Tao Ma, Qi Miao, Xing-Rong Liu, Chao-Ji Zhang, Yue-Hong Zheng, Jiang Shao, Ning-Hai Cheng, Shun-da DU, Jian-Zhou Liu, Chao Jiang
Objective To investigate the diagnosis and surgical treatment strategies of intravenous leiomyomatosis(IVL)extending through inferior vena cava into the right cardiac cavities. Methods Thirty patients of IVL extending through inferior vena cava into the right cardiac cavities were treated in Peking Union Medical College Hospital from November 2002 to January 2015.The following variables were studied: age,cardiopulmonary bypass time,deep hypothermic circulatory arrest time,origins of IVL,blood loss,duration of post-operative hospital stay,hospitalization expenses,edema of lower extremity,blood transfusion,postoperative complication,residual IVL,and re-grow or recurrence...
August 2016: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
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