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cardiopulmonary bypass and cardiac surgery

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https://www.readbyqxmd.com/read/28423997/do-lipid-microemboli-induce-acute-kidney-injury-during-cardiopulmonary-bypass
#1
Richard Issitt, Tim James, Bronagh Walsh, David Voegeli
BACKGROUND: Acute kidney injury (AKI) following cardiopulmonary bypass affects 5% of patients, representing significant postoperative morbidity and mortality. Animal models have shown an increased uptake of lipid microemboli (LME) into the renal vasculature, potentially indicating ischaemic causation. This study tested a new lipid filtration system (RemoweLL) against a conventional system with no lipid-depleting capacity to determine the efficacy of the filtration system and its effects on renal function...
April 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28423125/coronary-arteriovenous-fistulas-in-adult-patients-surgical-management-and-outcomes
#2
Sebnem Albeyoglu, Mustafa Aldag, Ufuk Ciloglu, Murat Sargin, Tugba Kemaloglu Oz, Hakan Kutlu, Sabri Dagsali
Objective: The aim of this study was to describe the demographic, clinical and anatomic characteristics of coronary arteriovenous fistulas in adult patients who underwent open cardiac surgery and to review surgical management and outcomes. Methods: Twenty-one adult patients (12 female, 9 male; mean age: 56.1±7.9 years) who underwent surgical treatment for coronary arteriovenous fistulas were retrospectively included in this study. Coronary angiography, chest X-ray, electrocardiography and transthoracic echocardiography were preoperatively performed in all patients...
January 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28423123/n-acetylcysteine-versus-dopamine-to-prevent-acute-kidney-injury-after-cardiac-surgery-in-patients-with-preexisting-moderate-renal-insufficiency
#3
Omer Faruk Savluk, Fusun Guzelmeric, Yasemin Yavuz, Deniz Cevirme, Emre Gurcu, Halide Ogus, Tulay Orki, Tuncer Kocak
Objective: Acute kidney injury after cardiac surgery is associated with mortality and morbidity. Therefore, strategies to prevent acute kidney injury are very important. The aim of this placebo-controlled randomized double-blind study was to compare the prophylactic efficacy of N-Acetylcysteine and dopamine administration in patients with pre-existing moderate renal insufficiency who were undergoing cardiopulmonary bypass. Methods: This study included 135 patients with pre-existing moderate renal insufficiency who were scheduled for coronary artery bypass grafting surgery...
January 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28421779/oral-glutamine-reduces-myocardial-damage-after-coronary-revascularization-under-cardiopulmonary-bypass-a-randomized-clinical-trial
#4
Mariana Chávez-Tostado, Fernando Carrillo-Llamas, Porfirio Eduardo Martínez-Gutiérrez, Araceli Alvarado-Ramírez, Jaime Gilberto López-Taylor, José Clemente Vásquez-Jiménez, Clotilde Fuentes-Orozco, Jorge Rendón-Félix, Leire Irusteta-Jiménez, Vanessa Carolina Calil-Romero, José Antonio Ramírez-Jiménez, Luis Rodrigo Michel-Espinoza, Carmen Karina Contreras-López, Lizbeth Araceli Cuesta-Maquez, Alejandro González-Ojeda
BACKGROUND: Glutamine is the most abundant free amino acid in the body. It modulates immune cell function and is an important energy substrate for cells in critically ill patients. Reduction of injury cardiac markers had been observed in patients receiving intravenous glutamine and in a pilot study with oral glutamine. The aim of this study was to analyze the effect of preoperative oral supplementation of glutamine on postoperative serum levels of cardiac injury markers. METHODS: A randomized clinical trial was performed in 28 Mexican patients with ischemic heart disease who underwent cardiopulmonary bypass with extracorporeal circulation...
March 30, 2017: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
https://www.readbyqxmd.com/read/28418362/-individual-learning-curves-for-microsurgical-myocardial-revascularization
#5
A N Semchenko, A A Sadykov
AIM: To create individual learning curves for microsurgical myocardial revascularization. MATERIAL AND METHODS: It was analyzed duration of the individual stages of the first 100 CABG procedures which were performed using microsurgical technique and surgical microscope. Graphs reflecting correlation between duration of the individual surgical stages and their number were framed. RESULTS: Improvement in distal anastomosis time, aortic cross-clamping time, cardiopulmonary bypass time and duration of surgery was observed with increased surgeon's experience...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28413285/disseminated-intravascular-and-intracardiac-thrombosis-after-cardiopulmonary-bypass
#6
Deepak K Tempe, Parin Lalwani, Kapil Chaudhary, Harpreet S Minas, Akhlesh S Tomar
Massive intracardiac and intravascular thrombosis is a rare complication following cardiopulmonary bypass (CPB). Most of the cases of the disseminated thrombosis have been reported in patients undergoing complex cardiac surgeries and those receiving antifibrinolytic agents during CPB. We report the occurrence of disseminated intravascular and intracardiac thrombosis after CPB in a patient undergoing mitral valve replacement in which no antifibrinolytic agent was used. The possible pathophysiology and management of the patient is discussed...
January 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28411047/immunodepression-after-cpb-cytokine-dynamics-and-clinics-after-pediatric-cardiac-surgery-a-prospective-trial
#7
Georgia Justus, Christoph Walker, Lisa-Maria Rosenthal, Felix Berger, Oliver Miera, Katharina Rose Luise Schmitt
BACKGROUND: Corrective surgery for congenital heart defects is known to trigger a severe immune reaction. There has been extensive research on the effects of inflammation after cardiopulmonary bypass (CPB). Interestingly, monocytes are observed to be non-responsive to stimulation with lipopolysaccharide (LPS) under these conditions, indicating a state of immunodepression, which lays the ground for second hit infections after cardiosurgery with CPB. OBJECTIVES: The aim of this prospective study was to analyze immunodepression after pediatric cardiopulmonary bypass and to differentiate the effects of monocytic anergy on postoperative outcome...
April 11, 2017: Cytokine
https://www.readbyqxmd.com/read/28407211/long-term-alterations-in-monocyte-function-after-elective-cardiac-surgery
#8
M Zawadka, J Wahome, H Oszkiel, W Y Szeto, B Cobb, K Laudanski
Optimal immunological homoeostasis determines the long-term recovery of patients in the postoperative period. The functional adaptability of monocytes plays a pivotal role in adjusting the host's response to an insult, immunostasis and long-term health, and may help to determine successful recovery. We undertook a longitudinal analysis of the functional adaptability of monocytes in 20 patients undergoing heart surgery with cardiopulmonary bypass, as a model of severe stress. Using each patient's pre-cardiopulmonary bypass data as a baseline, we investigated the characteristics of peripheral blood monocytes' functional plasticity in-vitro before elective bypass, and three months afterwards...
April 13, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28403869/debulking-surgery-for-venous-hemangioma-arising-from-the-epicardium-report-of-a-case
#9
Daichi Shikata, Takahiro Nakagomi, Yujiro Yokoyama, Yukiko Yamada, Masato Nakajima, Toshio Oyama, Taichiro Goto
BACKGROUND: Cardiac hemangiomas are rare benign vascular tumors that can occur in any cardiac layer: endocardium, myocardium, or epicardium. Histologically, cardiac hemangiomas may be classified as capillary, cavernous, or arteriovenous; venous hemangiomas are extremely rare. CASE PRESENTATION: A 46-year-old man reported experiencing precordial discomfort. Computed tomography revealed a massive tumor adjacent to the right ventricle. The right coronary artery was found to be located at the center of the tumor...
April 12, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28395591/volatile-anaesthetics-added-to-cardiopulmonary-bypass-are-associated-with-reduced-cardiac-troponin
#10
Elena Bignami, Marcello Guarnieri, Marina Pieri, Francesco De Simone, Alcira Rodriguez, Luigi Cassarà, Rosalba Lembo, Giovanni Landoni, Alberto Zangrillo
BACKGROUND: Every year, over 1 million cardiac surgical procedures are performed all over the world. Reducing myocardial necrosis could have strong implications in postoperative clinical outcomes. Volatile anaesthetics have cardiac protective properties in the perioperative period of cardiac surgery. However, little data exists on the administration of volatile agents during cardiopulmonary bypass. The aim of this study was to assess if volatile anaesthetics administration during cardiopulmonary bypass reduces cardiac troponin release after cardiac surgery...
March 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28394022/limited-versus-full-sternotomy-for-aortic-valve-replacement
#11
REVIEW
Bilal H Kirmani, Sion G Jones, S C Malaisrie, Darryl A Chung, Richard Jnn Williams
BACKGROUND: Aortic valve disease is a common condition that is easily treatable with cardiac surgery. This is conventionally performed by opening the sternum longitudinally down the centre ("median sternotomy") and replacing the valve under cardiopulmonary bypass. Median sternotomy is generally well tolerated, but as less invasive options have become available, the efficacy of limited incisions has been called into question. In particular, the effects of reducing the visibility and surgical access has raised safety concerns with regards to the placement of cannulae, venting of the heart, epicardial wire placement, and de-airing of the heart at the end of the procedure...
April 10, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28393793/transient-cortical-blindness-following-intracardiac-repair-of-congenital-heart-disease-in-an-11-year-old-boy
#12
Saswata Bharati, Manish Kumar Sharma, Amitabha Chattopadhay, Debasis Das
Postoperative blindness (PB) primarily involves reception and conductance parts of the visual pathway due to ischemia following cessation of blood supply, for example, retinal vascular occlusion. Although a rare cause of PB, cortical blindness (CB), which results from ischemia/infarction of visual cortex, has a poor outcome due to its mostly nonreversible nature. Ischemic optic neuropathy is the most common cause of PB following cardiac surgeries. CB following cardiac surgeries involving cardiopulmonary bypass has been rarely reported...
April 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28393784/myocardial-revascularization-without-extracorporeal-circulation-why-hasn-t-it-convinced-yet
#13
REVIEW
Efstratios Apostolakis, Nikolaos A Papakonstantinou, Ioanna Koniari
Extracorporeal circulation has led to a great development in cardiovascular surgery during the last five decades. Its time-proven efficacy and safety have made on-pump coronary artery bypass grafting (CABG) the gold standard method of surgical revascularization. However, coronary revascularization on cardiopulmonary bypass and the accompanying aortic manipulation are related to plenty of deleterious complications. Therefore, off-pump CABG surgery was established to avoid complications. Nevertheless, despite the initial enthusiasm on this technique, only 20% of myocardial revascularization procedures worldwide are performed off-pump...
April 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28393783/coagulopathies-in-cyanotic-cardiac-patients-an-analysis-with-three-point-of-care-testing-devices-thromboelastography-rotational-thromboelastometry-and-sonoclot-analyzer
#14
Vandana Bhardwaj, Poonam Malhotra, Suruchi Hasija, Ujjwal Kumar Chowdury, Neha Pangasa
INTRODUCTION: In the last few years, viscoelastic point-of-care (POC) coagulation devices such as thromboelastography (TEG), rotational thromboelastometry (ROTEM), and Sonoclot (SON) analyzer have been increasingly used in major surgeries for timely assessment and management of coagulopathies. The aim of the present study was to evaluate coagulation profile of cyanotic cardiac patients with TEG, ROTEM, and SON analyzer. In addition, we assessed the correlation of standard laboratory coagulation tests and postoperative chest drain output (CDO) with the parameters of POC testing devices...
April 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28393773/impact-of-dexmedetomidine-on-hemodynamic-changes-during-and-after-coronary-artery-bypass-grafting
#15
Morteza Hashemian, Mehdi Ahmadinejad, Seyed Amir Mohajerani, Alireza Mirkheshti
OBJECTIVE: To determine the effect of dexmedetomidine (Dex) on hemodynamic changes during cardiopulmonary pump and postoperative period in coronary artery bypass grafting (CABG). METHODS AND DESIGN: This study is designed as a double-blinded, randomized clinical trial. SETTING: University hospital and single center. PARTICIPANTS: patients candidate for elective CABG. INTERVENTION: Dex 0.5 μg/kg/h or placebo was infused from the initiation of anesthesia up to extubation in Intensive Care Unit (ICU)...
April 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28393462/current-use-of-factor-concentrates-in-pediatric-cardiac-anesthesia
#16
REVIEW
Nina A Guzzetta, Glyn D Williams
Excessive bleeding following pediatric cardiopulmonary bypass is associated with increased morbidity and mortality, both from the effects of hemorrhage and the therapies employed to achieve hemostasis. Neonates and infants are especially at risk because their coagulation systems are immature, surgeries are often complex, and cardiopulmonary bypass technologies are inappropriately matched to patient size and physiology. Consequently, these young children receive substantial amounts of adult-derived blood products to restore adequate hemostasis...
April 10, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28388941/prediction-of-the-optimal-depth-for-superior-vena-cava-cannulae-with-cardiac-computed-tomography-during-minimally-invasive-cardiac-surgery-a-prospective-observational-cohort-study
#17
Ji-Hyun Chin, Eun-Ho Lee, Jong-Il Kim, In-Cheol Choi
BACKGROUND: The determination of the adequate depth of superior vena cava cannulae during minimally invasive cardiac surgery is important for warranting venous drainage and preventing complications during cardiopulmonary bypass. We investigated whether preoperative cardiac computed tomography might be useful for predicting the optimal depth of superior vena cava cannulae. METHODS: The patients who required superior vena cava cannulation and had cardiac tomographic image among those scheduled to undergo a minimally invasive cardiac surgery were evaluated...
April 7, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28388863/perioperative-coagulation-management-of-a-hemophilia-a-patient-during-cardiac-surgery
#18
Patrick Odonkor, Archana Srinivas, Erik Strauss, Brittney Williams, Michael Mazzeffi, Kenichi A Tanaka
Perioperative management of cardiovascular surgical procedures requiring cardiopulmonary bypass (CPB) in patients with hemophilia A poses a clinical challenge in coagulation management. Use of CPB requires the administration of an anticoagulant, usually unfractionated heparin, and also causes dilutional coagulopathy, platelet dysfunction or platelet consumption coagulopathy. Hypothermia and activation of the inflammatory cascade also affect coagulation. The effects of CPB on circulating levels of factor VIII have not been clearly defined...
April 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28384188/baroreflex-sensitivity-and-outcomes-following-coronary-surgery
#19
Marco Ranucci, Alberto Porta, Vlasta Bari, Valeria Pistuddi, Maria Teresa La Rovere
Postoperative atrial fibrillation, acute kidney dysfunction and low cardiac output following coronary surgery are associated with morbidity and mortality. The purpose of this study is to determine if the preoperative autonomic control is a determinant of these postoperative complications. This is a prospective cohort study on 150 adult patients undergoing surgical coronary revascularization with cardiopulmonary bypass. The patients received an autonomic control assessment after the induction of anesthesia. Baroreflex sensitivity was computed by spectral analysis and expressed as BRSαHF and BRSαLF for measure respectively in the high and low frequency domains...
2017: PloS One
https://www.readbyqxmd.com/read/28382566/kinetics-of-the-cell-cycle-arrest-biomarkers-timp-2-igfbp-7-for-prediction-of-acute-kidney-injury-in-infants-after-cardiac-surgery
#20
Katja M Gist, Stuart L Goldstein, Julia Wrona, Jeffrey A Alten, Rajit K Basu, David S Cooper, Danielle E Soranno, Jane Duplantis, Christopher Altmann, Zhiqian Gao, Sarah Faubel
BACKGROUND: Tissue inhibitor metalloproteinase-2 (TIMP-2) and insulin-like growth factor binding protein-7 (IGFBP-7) are cell-cycle arrest biomarkers that have been shown to be predictive of acute kidney injury (AKI) in critically ill adults. AKI affects a large proportion (40%) of children following cardiac surgery. The aim of this study was to describe the kinetics of TIMP-2*IGFBP-7 and test its ability to predict AKI in infants following cardiac surgery. METHODS: A multicenter prospective study was performed in infants undergoing cardiac surgery with cardiopulmonary bypass (CPB) from October 2013 to January 2015...
April 5, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
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