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Cardiopulmonary bypass surgery

Attila Magyar, Martin Wagner, Phillip Thomas, Carolin Malsch, Reinhard Schneider, Stefan Störk, Peter U Heuschmann, Rainer G Leyh, Mehmet Oezkur
Background: Acute kidney injury (AKI) is a serious complication after cardiac surgery that is associated with increased mortality and morbidity. Heme oxygenase-1 (HO-1) is an enzyme synthesized in renal tubular cells as one of the most intense responses to oxidant stress linked with protective, anti-inflammatory properties. Yet, it is unknown if serum HO-1 induction following cardiac surgical procedure involving cardiopulmonary bypass (CPB) is associated with incidence and severity of AKI...
2019: International Journal of Nephrology and Renovascular Disease
Enrico Squiccimarro, Cataldo Labriola, Pietro Giorgio Malvindi, Vito Margari, Pietro Guida, Giuseppe Visicchio, Georgios Kounakis, Antonella Favale, Pierpaolo Dambruoso, Giuseppe Mastrototaro, Roberto Lorusso, Domenico Paparella
OBJECTIVES: Cardiac surgery induces a systemic inflammatory reaction that has been associated with postoperative mortality and morbidity. Many studies have characterized this reaction through laboratory biomarkers while clinical studies generally are lacking. This study aimed to assess the incidence of postoperative systemic inflammation after cardiac surgery, and the association of postoperative systemic inflammation with preoperative patients' characteristics and postoperative outcomes...
January 17, 2019: Journal of Cardiothoracic and Vascular Anesthesia
Sukhi Singh, Tor Damén, Mikael Dellborg, Anders Jeppsson, Andreas Nygren
BACKGROUND: New approaches to prevent bleeding complications during cardiac surgery are needed. OBJECTIVE: To investigate if noradrenaline (NA) enhances platelet aggregation in CABG patients. PATIENTS/METHODS: Twenty-four CABG patients were included in a prospective parallel-group randomized study. All patients but one, were treated with acetylsalicylic acid (ASA). In the treatment group (n=12), mean arterial blood pressure (MAP) was maintained at pre-induction levels by NA infusion...
February 14, 2019: Journal of Thrombosis and Haemostasis: JTH
Lütfi Soylu, Oğuz Uğur Aydın, Mehmet Yıldız, Hacer Serdaroğlu, Murat Kurtoğlu, Sedat Karademir
Background/aim: Acute mesenteric ischemia (AMI), one of the gastrointestinal system complications, which occurs following cardiac surgery, is challenged in the literature with a diminished incidence of AMI by heart surgery without cardiopulmonary bypass (CPB) or with pulsatile CPB. This study aims to compare the incidence and mortality rate of mesenteric ischemia in a series of consecutive patients undergoing coronary artery bypass grafting (CABG) through on-pump and off-pump techniques...
February 11, 2019: Turkish Journal of Medical Sciences
Anne Kerling, Okan Toka, André Rüffer, Hanna Müller, Sheeraz Habash, Christel Weiss, Sven Dittrich, Julia Moosmann
BACKGROUND: Postoperative fluid management in critically ill neonates and infants with capillary leak syndrome (CLS) and extensive volume overload after cardiac surgery on cardiopulmonary bypass is challenging. CLS is often resistant to conventional diuretic therapy, aggravating the course of weaning from invasive ventilation, increasing length of stay on ICU and morbidity and mortality. METHODS: Tolvaptan (TLV, vasopressin type 2 receptor antagonist) was used as an additive diuretic in neonates and infants with CLS after cardiac surgery...
February 12, 2019: BMC Pediatrics
Jennifer Chung, Louis-Mathieu Stevens, Maral Ouzounian, Ismail El-Hamamsy, Ismail Bouhout, François Dagenais, Andréanne Cartier, Mark Peterson, Munir Boodhwani, Ming Hao Guo, John Bozinovski, Michael H Yamashita, Carly Lodewyks, Rony Atoui, Bindu Bittira, Darrin Payne, Christopher Tarola, Michael W A Chu
BACKGROUND: Contemporary outcomes following surgical management of thoracic aortic disease have improved; however, the impact of sex-related differences is poorly understood. METHODS: A total of 1653 patients (498 (30.1%) female) underwent thoracic aortic surgery with hypothermic circulatory arrest between 2002 and 2017 in ten institutions of the Canadian Thoracic Aortic Collaborative. Outcomes of interest were in-hospital death, stroke and a modified Society of Thoracic Surgeons-defined composite (STS-COMP) for mortality or major morbidity (stroke, renal failure, deep sternal wound infection, reoperation, prolonged ventilation)...
February 13, 2019: Circulation
Fei Meng, Jie Han, Jiangang Wang, Haibo Zhang, Chunlei Xu, Xu Meng
Background: Cardiac sympathetic nervous system is usually activated in cardiopulmonary bypass (CPB) surgery, accompanied by excessive release of norepinephrine (NE). Neuropeptide Y (NPY) has been shown to regulate NE release in the terminal of sympathetic fiber, which is a target for regulating heart function. The expression of NPY and NPY receptor (NPYR) genes in the human atrial tissues during CPB in cardiac surgery was investigated in the present study. Methods: A few discarded atrial tissues before and after CPB were collected in 22 patients with rheumatic cardiac valve diseases...
December 2018: Journal of Thoracic Disease
Amer Harky, Mohamad Bashir, Ciaran Grafton-Clarke, Martin Lees, Sarah Fendius, Neil Roberts
Intraventricular conduction abnormalities following cardiac surgery have been thoroughly described, especially after valvular surgery. It is also widely known that several anesthetic factors can cause autonomic disturbances resulting in the unmasking of sinus node dysfunction, significant bradycardia, and cardiovascular collapse during the intraoperative period. However, little is known about asymptomatic episodes, especially those occurring prior to coronary artery bypass grafting (CABG). We report a rare occurrence of an intraventricular conduction defect that presented in an asymptomatic patient following non-ST-elevation myocardial infarction prior to urgent CABG...
July 2018: Journal of Tehran Heart Center
Indah K Murni, Mulyadi M Djer, Piprim B Yanuarso, Sukman T Putra, Najib Advani, Jusuf Rachmat, Aries Perdana, Rubiana Sukardi
Background: Evaluating outcome and identifying predictors of major complications among children undergoing cardiac surgery are essential to improve care. We evaluated short-term outcomes of postcardiac surgery and predictors of major complications in a national referral hospital in Indonesia. Methods: A prospective cohort study was conducted from April 2014 to March 2015 on all children undergoing cardiac surgery. Participants were followed up from the time of surgery until hospital discharge and 30-day mortality...
January 2019: Annals of Pediatric Cardiology
Philippe Grieshaber, Sina Möller, Borros Arneth, Peter Roth, Bernd Niemann, Harald Renz, Andreas Böning
BACKGROUND:  Prediction, early diagnosis, and therapy of cardiac surgery-associated acute kidney injury (CSA-AKI) are challenging. We prospectively tested a staged approach to identify patients at high risk for CSA-AKI combining clinical risk stratification and early postoperative quantification of urinary biomarkers for AKI. METHODS:  All patients, excluding those on chronic hemodialysis, undergoing scheduled surgery with cardiopulmonary bypass between August 2015 and July 2016 were included...
February 11, 2019: Thoracic and Cardiovascular Surgeon
Christopher L Tarola, Sameer Hirji, Steven J Yule, Jennifer M Gabany, Alessandro Zenati, Roger D Dias, Marco A Zenati
To address the, currently unmet, need for intra-operative safety-critical cognitive support in cardiac surgery, we have developed, validated, and implemented a series of customized checklists to address intra-operative emergencies, using a simulated operative setting. These crisis checklists are designed to provide cognitive and communication support to the operative team to reduce the likelihood of adverse events and improve adherence to best-practice guidelines. We recruited a number of content specialists including members of the hospital safety network and intraoperative cardiac surgery team members, and utilized a Delphi consensus method to develop procedure-specific guidelines for select intraoperative crises...
June 2018: 2018 IEEE Conference on Cognitive and Computational Aspects of Situation Management (CogSIMA): proceedings: Boston, MA, USA, 11-14 June 2018
Cheng Zhang, Baoying Meng, Keye Wu, Yiqun Ding
INTRODUCTION: The existing cardiopulmonary bypass tubing system has already been significantly improved in our hospital by reducing the priming volume; thus, we further employed a new cardiopulmonary bypass strategy in children based on a miniaturized cardiopulmonary bypass circuit. We aimed to compare the effectiveness of new and conventional strategies by analyzing the outcomes after congenital heart surgery. METHODS: We performed a database analysis of all patients undergoing congenital heart surgery with cardiopulmonary bypass at Shenzhen Children's Hospital from 1 May 2015 to 30 June 2017...
February 10, 2019: Perfusion
Ravi Medikonda, Chin Siang Ong, Rajeev Wadia, Dheeraj Goswami, Jamie Schwartz, Larry Wolff, Narutoshi Hibino, Luca Vricella, Daniel Nyhan, Viachaslau Barodka, Jochen Steppan
Perfusion strategies for cardiopulmonary bypass have direct consequences on pediatric cardiac surgery outcomes. However, inconsistent study results and a lack of uniform evidence-based guidelines for pediatric cardiopulmonary bypass management have led to considerable variability in perfusion practices among, and even within, institutions. Important aspects of cardiopulmonary bypass that can be optimized to improve clinical outcomes of pediatric patients undergoing cardiac surgery include extracorporeal circuit components, priming solutions, and additives...
January 9, 2019: Journal of Cardiothoracic and Vascular Anesthesia
Yasser Menaissy, Ihab Omar, Basem Mofreh, Mohamed Alassal
BACKGROUND:  The timing of surgical repair of tetralogy of Fallot (TOF) is a key to alleviate complications and for long-term survival. Total correction was usually performed at the age of 6 months or older under the notion of decreasing the surgical risk. However, avoiding palliation with an aortopulmonary shunt and early correction of systemic hypoxia appear to be of more benefit than the inborn surgical risk in low body weight patients. Our objective was to assess early/midterm survival and operative complications and to analyze patients, surgical techniques, and morphological risk factors to determine their effects on outcomes...
February 9, 2019: Thoracic and Cardiovascular Surgeon
Abhijit Mondal, John Lackey, Mossab Saeed, Fei-Yi Wu, Jordan Johnson, Chao Huang, Frank Sachse, Robert Hitchcock, Aditya Kaza
OBJECTIVES: We performed preclinical validation of intraoperative fiber-optic confocal microscopy (FCM) and assessed its safety and efficacy in an ovine model of the pediatric heart. METHODS: Intraoperative imaging was performed using an FCM system (Cellvizio, Mauna Kea Technology, Paris, France) with specialized imaging miniprobe (GastroFlex UHD, Mauna Kea Technologies). Before imaging, we applied an extracellular fluorophore, sodium fluorescein, to fluorescently label extracellular space...
February 6, 2019: Seminars in Thoracic and Cardiovascular Surgery
Ezeldeen Abuelkasem, Michael A Mazzeffi, Reney A Henderson, Camron Wipfli, Angie Monroe, Erik R Strauss, Jonathan H Chow, Kenichi A Tanaka
OBJECTIVES: A hemostasis management system (HMS) is a point-of-care method for heparin and protamine titration. The authors hypothesized that protamine dosing over the HMS estimate would be associated with elevated activated clotting time (ACT), increased bleeding, and transfusion owing to protamine's anticoagulant activity. DESIGN: A retrospective cohort study. SETTING: Single-center university hospital. PARTICIPANTS: One hundred eighty-nine patients undergoing elective coronary artery bypass grafting surgery...
January 10, 2019: Journal of Cardiothoracic and Vascular Anesthesia
Ekaterina Baryshnikova, Umberto Di Dedda, Marco Ranucci
OBJECTIVES: Coagulation point-of-care tests for the diagnosis and management of bleeding commonly are used in cardiac surgery. Recently, a new viscoelastic point-of-care device, Quantra (HemoSonics, Charlottesville, VA), which is based on sonic estimation of elasticity via resonance sonorheometry, entered the market. Prior studies have compared the Quantra parameters with conventional coagulation tests and thromboelastography or rotational thromboelastography, but no study has assessed the correlation of the platelet-derived Quantra parameter platelet contribution to stiffness (PCS) with platelet function assays...
January 4, 2019: Journal of Cardiothoracic and Vascular Anesthesia
Bo Yang, Elizabeth L Norton, Reilly Hobbs, Linda Farhat, Xiaoting Wu, Whitney E Hornsby, Karen M Kim, Himanshu J Patel, G Michael Deeb
OBJECTIVE: The study objective was to evaluate the perioperative and long-term outcomes of aortic root repair and aortic root replacement and provide evidence for root management in acute type A aortic dissection. METHODS: From 1996 to 2017, 491 patients underwent aortic root repair (n = 307) or aortic root replacement (n = 184) (62% bioprosthesis) for acute type A aortic dissection. Indications for aortic root replacement were intimal tear at the aortic root, root measuring 4...
December 21, 2018: Journal of Thoracic and Cardiovascular Surgery
Neerod Kumar Jha, Laszlo Kiraly, Nishant Shah, Arif Al Mulla, Bassem Mora
BACKGROUND: Congenital coronary artery fistula in association with aneurysm of the involved coronary artery in adults is rare. Moreover, the right coronary artery- left atrial fistula is also uncommon. Most of the cases are asymptomatic. However, symptomatic patients need therapeutic interventions. The potential complications associated with this anomaly are life-threatening, therefore, there is a need to explore more on differential diagnosis, investigations, management strategies and prevention of complications...
February 8, 2019: Journal of Cardiothoracic Surgery
Yongfeng Zhu, Hewen Qi, Yunzhou Jin
OBJECTIVE: The efficacy of using a sutureless approach in order to surgically manage postoperative pulmonary vein stenosis following total anomalous pulmonary venous drainage (TAPVD) has been reported, though outcomes of primary treatment of supracardiac TAPVD remain unclear. We retrospectively reviewed our cardiac center experience, and compared the differences in mid-term outcomes for those patients that received conventional surgery and those that underwent sutureless technique for the primary repair of supracardiac TAPVD...
February 8, 2019: Journal of Cardiothoracic Surgery
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