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Laser cardiac bypass

F Neunhoeffer, M Wiest, K Sandner, H Renk, E Heimberg, C Haller, M Kumpf, C Schlensak, M Hofbeck
BACKGROUND: The pathophysiology of acute kidney injury (AKI) after cardiopulmonary bypass surgery for congenital heart disease is not completely understood. The aim of this study was to carry out a prospective analysis of the diagnostic value of non-invasive monitoring of renal oxygenation and microcirculation by combining laser Doppler flowmetry and tissue spectrometry. METHODS: In 50 neonates and infants who underwent repair (n = 31) or neonatal palliation (n = 19) of congenital heart disease with cardiopulmonary bypass, renal oxygenation, and microcirculatory flow, the approximate renal metabolic rate of oxygen and Doppler-based renal resistive index were determined after surgery...
November 2016: British Journal of Anaesthesia
Jamil Bashir, Lynn M Fedoruk, John Ofiesh, Shahzad S Karim, G Frank O Tyers
BACKGROUND: Injuries to cardiac and venous structures during pacemaker and defibrillator lead extraction are serious complications that have been studied poorly. The incidence of these injuries is unknown but likely underestimated. No systematic multicenter review of these injuries or their management has been undertaken. METHODS AND RESULTS: We interrogated our mandatory administrative database for all excimer laser extractions that sustained a cardiac or venous injury in the province of British Columbia...
September 2016: Circulation. Arrhythmia and Electrophysiology
Umar A R Chaudhry, Leanne Harling, Hutan Ashrafian, Christina Athanasiou, Pantelis Tsipas, John Kokotsakis, Thanos Athanasiou
The growing use of cardiac implantable electronic devices (CIED) has led to infections requiring intervention. These are traditionally managed using a percutaneous transvenous approach to fully extract the culpable leads. Indications for such strategies are well-established and range from simple traction to the use of powered extraction tools including laser sheaths. Where such attempts fail, or if there are further complications, then there may be need for a cardiothoracic surgical approach. Limited evidence is currently available on the merits of individual strategies, and these are mainly drawn from case reports or series...
January 15, 2016: International Journal of Cardiology
Breno Bernardes de Souza, Peyman Benharash, Fardad Esmailian, Jason Bradfield, Noel G Boyle
We report three cases of vascular injury during laser lead extractions, requiring urgent surgical correction. Immediate sternotomy and cardiopulmonary bypass were possible because of an institutional collaboration where cardiac surgeon and cardiac electrophysiologist jointly perform these cases, and all patients survived. We propose this joint approach is ultimately the best option for patients undergoing lead extraction.
November 2015: Journal of Cardiac Surgery
Song Wu, Feng Wan, Zhe Zhang, Hong Zhao, Zhong-qi Cui, Ji-yan Xie
OBJECTIVE: To analyze the short-term outcomes of redo coronary artery bypass grafting (CABG) using on-pump and off-pump CABG techniques. METHODS: From January 2003 to August 2013, non-randomized 80 patients were treated with redo CABG in the Department of Cardiac Surgery, Peking University Third Hospital. Among these patients, 40 underwent on-pump CABG technique (redo-ONCAB group) and 40 underwent off-pump CABG technique (redo-OPCAB group). Furthermore, transmyocardial laser revascularization was performed in high-risk patients who were not suitable to conventional grafting...
March 2015: Chinese Medical Sciences Journal, Chung-kuo i Hsüeh K'o Hsüeh Tsa Chih
T A Kniazeva, M V Nikitin, M P Otto, N V Trukhacheva, I V Cherkashina
We have studied the influence of enhanced external counterpulsation (EECP) applied in the combination with gaseous carbon dioxide baths and infrared laser therapy on the dynamics of clinical and functional abnormalities in the patients presenting with coronary heart disease (CHD) including those after surgical myocardial revascularization. The study was conducted on 40 patients of whom 20 suffered from chronic coronary heart disease and FC II-III angina of effort and the remaining 20 ones presented with coronary artery disease following myocardial revascularization (including 5 patients six months after coronary bypass grafting (CBG) and 15 ones three months after translumbar angioplasty (TLAP) in the combination with stenting of the coronary arteries)...
November 2014: Voprosy Kurortologii, Fizioterapii, i Lechebnoĭ Fizicheskoĭ Kultury
Nooshafarin Kazemi Khoo, Kamran Babazadeh, Marjan Lajevardi, Fataneh Hashem Dabaghian, Ehsan Mostafavi
INTRODUCTION: An attack of acute myocardial infarction (MI) poses the threat of great damage to cardiac tissue. Operative therapeutic modalities such as coronary artery bypass grafting (CABG) may enhance myocardial perfusion in high-grade coronary vasculature occlusions. It has been shown previously that Low-Level Laser Therapy (LLLT) significantly reduces infarct size following induction of myocardial infarction in rats and dogs. The aim of this study was to investigate the effects of LLLT on cardiac tissue healing markers following grafting operations for coronary vessel occlusion...
2014: Journal of Lasers in Medical Sciences
Arndt-H Kiessling, Christian Reyher, Michael Philipp, Andres Beiras-Fernandez, Anton Moritz
OBJECTIVES: Mesenteric ischemia is still a fatal event after cardiac procedures. No adequate intraoperative methods are available to monitor the gastrointestinal mucosal microcirculation in real-time conditions. The aim of the study was to assess a newly designed microprobe using laser Doppler flowmetry and remission spectroscopy. DESIGN: One-group, prospective, nonrandomized, open, pilot diagnostic study. SETTING: Monocenter university hospital...
February 2015: Journal of Cardiothoracic and Vascular Anesthesia
Louis A Brunsting, Averel B Snyder, Eric A Espinal, Sudhir P Srivastava
OBJECTIVE: The purpose of this study was to assess the feasibility of an endoscopic, optical-fiber-based, laser delivery system (LDS) developed to perform sole-therapy transmyocardial revascularization (TMR) in a totally endoscopic, robotically assisted operation. METHODS: Forty-two patients were enrolled in a multicenter, prospective, single-arm clinical trial conducted at four US centers between 2005 and 2007. Transmyocardial revascularization was performed completely endoscopically with robotic assistance, introducing the Holmium:Yttrium aluminum garnet (YAG) LDS via a 5-mm port...
September 2014: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Simona M Cristescu, Rudolf Kiss, Sacco te Lintel Hekkert, Miles Dalby, Frans J M Harren, Terence H Risby, Nandor Marczin
Pulmonary and systemic organ injury produced by oxidative stress including lipid peroxidation is a fundamental tenet of ischemia-reperfusion injury, inflammatory response to cardiac surgery, and cardiopulmonary bypass (CPB) but is not routinely measured in a surgically relevant time frame. To initiate a paradigm shift toward noninvasive and real-time monitoring of endogenous lipid peroxidation, we have explored pulmonary excretion and dynamism of exhaled breath ethylene during cardiac surgery to test the hypothesis that surgical technique and ischemia-reperfusion triggers lipid peroxidation...
October 1, 2014: American Journal of Physiology. Lung Cellular and Molecular Physiology
Maria A M Salgado, Marcelo F Salgado-Filho, José O Reis-Brito, Marcos A Lessa, Eduardo Tibirica
OBJECTIVES: To evaluate the effectiveness of single-point laser Doppler perfusion monitoring (LDPM) in the assessment of microvascular reactivity in the skin during cardiopulmonary bypass (CPB). DESIGN: Cross-sectional observational study. SETTING: Government-affiliated teaching hospital. PARTICIPANTS: Twenty male patients aged 60 ± 2 years who underwent coronary artery bypass grafting under CPB. INTERVENTIONS: The authors assessed the endothelium-dependent vasodilation of the skin microcirculation at the forehead and forearm using LDPM coupled with thermal hyperemia...
October 2014: Journal of Cardiothoracic and Vascular Anesthesia
Alexander Assmann, Michael Heke, Patric Kröpil, Lena Ptok, Dieter Hafner, Christian Ohmann, Andreas Martens, Antje Karluβ, Maximilian Y Emmert, Ingo Kutschka, Hans-Hinrich Sievers, Hans-Michael Klein
OBJECTIVES: This study evaluates the safety, principal feasibility and restoration potential of laser-supported CD133+ intramyocardial cell transplantation in patients with ischemic cardiomyopathy. METHODS: Forty-two patients with severe ischemic cardiomyopathy (left ventricular ejection fraction (LVEF) >15% and <35%) were included in this prospective multicenter phase I trial. They underwent coronary artery bypass grafting (CABG) with subsequent transepicardial low-energy laser treatment and autologous CD133+ cell transplantation, and were followed up for 12 months...
2014: PloS One
Shvetank Agarwal, M Vinayak Kamath, Manuel R Castresana
No abstract text is available yet for this article.
May 2014: Anesthesia and Analgesia
V Gomes, M B Gomes, E Tibirica, M A Lessa
BACKGROUND: Coronary artery bypass graft (CABG) surgery with cardiopulmonary bypass (CPB) is associated with systemic inflammatory response and endothelial dysfunction. Our hypothesis is that CPB-induced post-operative endothelial dysfunction may be detected using laser Doppler perfusion monitoring (LDPM) in the skin microcirculation. METHODS: We used LDPM to investigate the subacute effects of the CPB on systemic microvascular reactivity among patients undergoing CABG surgery with CPB...
April 2014: Acta Anaesthesiologica Scandinavica
Hans Michael Klein, Alexander Assmann, Artur Lichtenberg, Michael Heke
If traditional treatment of coronary artery disease has failed, intramyocardial transplantation of CD133+ stem cells with the potential to improve myocardial function is an alternative approach to treating ischemic cardiomyopathy. The INSTEM trial aims at evaluating safety and feasibility of isolation and subsequent intramyocardial transplantation of CD133+ cells in combination with coronary artery bypass grafting (CABG). Patients suffering from severe ischemic cardiomyopathy (ejection fraction ≫15% and ≪35%) are enrolled in this trial...
January 1, 2010: Multimedia Manual of Cardiothoracic Surgery: MMCTS
Manisha Mishra, Ravindra Sawhney, Anil Kumar, Kumar Ramesh Bapna, Vijay Kohli, Harpreet Wasir, Naresh Trehan
The fetal death rate associated with cardiac surgery with cardiopulmonary bypass (CPB) is as high as 9.5-29%. We report continuous monitoring of fetal heart rate and umbilical artery flow-velocity waveforms by transvaginal ultrasonography and their analyses in relation to events of the CPB in two cases in second trimester of pregnancy undergoing mitral valve replacement. Our findings suggest that the transition of circulation from corporeal to extracorporeal is the most important event during surgery; the associated decrease in mean arterial pressure (MAP) at this stage potentially has deleterious effects on the fetus, which get aggravated with the use of vasopressors...
January 2014: Annals of Cardiac Anaesthesia
Lu Yuan, Diansan Su, Xiaohua Liu, Hongyang Lu, Yao Li, Shanbao Tong
Cardiopulmonary bypass (CPB) and deep hypothermic circulatory arrest (DHCA) are important techniques often used in complex cardiac surgery for neonates and infants heart diseases. Cerebral blood flow (CBF) serves as an important physiological parameter and provides valuable hemodynamic information during the surgery. Laser speckle imaging (LSI), as an optical imaging technique, can provide full-field CBF information with a high spatiotemporal resolution. In this preliminary study, we acquired the real-time CBF images with a self-developed miniaturized head-mounted LSI system during the whole CPBillHCA rat model...
2013: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Spencer J Melby, Richard B Schuessler, Ralph J Damiano
The Cox maze procedure for the surgical treatment of atrial fibrillation has been simplified from its original cut-and-sew technique. Various energy sources now exist which create linear lines of ablation that can be used to replace the original incisions, greatly facilitating the surgical approach. This review article describes the anatomy of the atria that must be considered in choosing a successful energy source. Furthermore the device characteristics, safety profile, mechanism of tissue injury, and ability to create transmural lesions of the various energy sources that have been used in the Cox maze procedure, along with the strengths and weaknesses of each device is discussed...
September 2013: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Janusz Konstanty-Kalandyk, Jacek Piątek, Tomasz Miszalski-Jamka, Paweł Rudziński, Zbigniew Walter, Krzysztof Bartuś, Małgorzata Urbańczyk-Zawadzka, Jerzy Sadowski
BACKGROUND: There are a growing number of patients with end-stage coronary artery disease (CAD) and refractory angina. Angiogenesis may be induced by intramyocardial injection of autologous bone marrow stem cells, intensified by inflammation around channels performed by laser. AIM: To assess the effect of a combined treatment consisting of transmyocardial laser revascularisation (TLMR) and intramyocardial injection of bone-marrow derived stem cells (bone marrow laser revascularisation, BMLR) in patients with refractory angina one year after the procedure...
2013: Kardiologia Polska
Daisuke Shishikura, Satoru Otsuji, Shin Takiuchi, Atsushi Fukumoto, Katsuaki Asano, Masashi Ikushima, Tokuki Yasuda, Katsuyuki Hasegawa, Toshikazu Kashiyama, Masanori Yabuki, Toshiaki Hanafusa, Yorihiko Higashino
BACKGROUND:  Mechanical reperfusion has proven to be an unquestionably superior treatment strategy over that of thrombolytic therapy in patients with acute coronary syndrome (ACS). Excimer laser coronary angioplasty (ELCA) is a unique revascularization device that has a lytic effect on thrombus, in addition to its debulking effect on the atherosclerotic plaque beneath the thrombus. METHODS AND RESULTS:  This single-center retrospective analysis consisted of consecutive ACS patients treated with ELCA (n=50) and age- and sex-matched ACS patients treated with manual aspiration (n=48) without use of a distal protection device...
2013: Circulation Journal: Official Journal of the Japanese Circulation Society
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