Neuroprotective effect of pressure-oriented flow regulation and pH-stat management in selective antegrade brain perfusion during total aortic arch repair.

Abstract:

OBJECTIVES:The aim of this study was to assess the safety and effectiveness of our selective antegrade brain perfusion (SABP) strategy, which is characterized by moderate hypothermic and low-pressure management under pH-stat using a completely closed cardiopulmonary bypass circuit with a single centrifugal pump. METHODS:Forty-nine consecutive patients (median age, 74) underwent total aortic arch replacement using a 4-branched graft. SABP was conducted with individual cannulation in all arch vessels. The SABP flow rate was monitored, and the flow rates of each arch vessel were also measured in patients with available data. RESULTS:One patient died of cerebral infarction, and 7 had transient neurological deficits without apparent findings on postoperative imaging studies and without residual sequels at hospital discharge. The operation, cardiopulmonary bypass, cardiac arrest, circulatory arrest and SABP times were 327 min (interquartile range, 292-381), 211 (184-247), 107 (84.8-138.3), 54.0 (48-68) and 137 (114-158), respectively. The total flow of the SABP was 18.1 ml/kg/min (15.7-20.9). The flow rates of the brachiocephalic, the left carotid and the left subclavian arteries were 9.5 ml/kg/min (7.7-11.5), 4.2 (2.8-5.7) and 4.5 (3.7-5.5), respectively. Only the flow rate of the brachiocephalic artery was significantly correlated with the total SABP flow rate (Spearman rank correlation coefficient, r = 0.58, P < 0.01). CONCLUSIONS:The moderate hypothermic, high-flow, low-pressure SABP strategy with pH-stat management can be applied in adult aortic surgery; however, the feasibility and effectiveness of this concept need further evaluation in a prospective controlled study.

authors

Ito H,Mizumoto T,Sawada Y,Fujinaga K,Tempaku H,Yamamoto Y,Tsutsui K,Shimpo H

doi

10.1093/icvts/ivx182

subject

Has Abstract

pub_date

2017-10-01 00:00:00

pages

565-570

issue

4

eissn

1569-9293

issn

1569-9285

pii

3872335

journal_volume

25

pub_type

杂志文章
  • Minimally invasive Ross procedure through partial upper sternotomy.

    abstract::The Ross procedure has gained increasing interest for therapy of aortic valve pathologies in young adults because of excellent long-term results. This case report describes the first published experiences of the Ross procedure performed through a minimally invasive access in two consecutive patients. The limited acces...

    journal_title:Interactive cardiovascular and thoracic surgery

    pub_type: 杂志文章

    doi:10.1510/icvts.2009.203067

    authors: Franke UF,Albert M,Rustenbach C,Baumbach H

    更新日期:2009-09-01 00:00:00

  • Aortic valve/root procedures in patients with an anomalous left circumflex coronary artery and a bicuspid aortic valve: anatomical and technical implications.

    abstract::An anomalous origin of the left circumflex coronary artery that arises as a side branch of the right coronary artery from the right coronary sinus of Valsalva encircling the aortic annulus is usually an incidental finding. However, in patients undergoing aortic valve procedures, its existence can significantly complic...

    journal_title:Interactive cardiovascular and thoracic surgery

    pub_type: 杂志文章

    doi:10.1093/icvts/ivv063

    authors: Liebrich M,Tzanavaros I,Scheid M,Voth W,Doll KN,Hemmer WB

    更新日期:2015-07-01 00:00:00

  • Quality of life in patients related to gender differences before and after coronary artery bypass surgery.

    abstract:OBJECTIVES:The different aspects of quality of life (QOL) in patients of different sex structure have been examined as well as the presumption that sex structure could be a predictor of QOL changes after coronary artery bypass grafting (CABG). METHODS:The study included 243 consecutive patients who underwent an electi...

    journal_title:Interactive cardiovascular and thoracic surgery

    pub_type: 杂志文章

    doi:10.1510/icvts.2009.208462

    authors: Peric V,Borzanovic M,Stolic R,Jovanovic A,Sovtic S,Djikic D,Marcetic Z,Dimkovic S

    更新日期:2010-02-01 00:00:00

  • Complete video-assisted thoracoscopic surgery anatomic segmentectomy for clinical stage I lung carcinoma - technique and feasibility.

    abstract::This paper describes a prospective, observational, single-centre study of 20 consecutive patients with clinical stage I lung carcinoma undergoing anatomical sublobar resections using complete video-assisted thoracoscopic surgery (cVATS). Thirteen male and seven female patients with a median age of 68 (range 57-84) yea...

    journal_title:Interactive cardiovascular and thoracic surgery

    pub_type: 杂志文章

    doi:10.1510/icvts.2010.260315

    authors: Witte B,Wolf M,Hillebrand H,Huertgen M

    更新日期:2011-08-01 00:00:00

  • Stent graft perforation of a frozen elephant prosthesis: does design matter?

    abstract::The frozen elephant procedure, as a hybrid method to treat aortic pathologies involving the aortic arch and the proximal descending aorta, has become an accepted treatment option. We report two late fractures of the nitinol stents of the endograft of an early frozen elephant trunk prosthesis. One patient suffered from...

    journal_title:Interactive cardiovascular and thoracic surgery

    pub_type: 杂志文章

    doi:10.1093/icvts/ivv201

    authors: Fleissner F,Haverich A,Shrestha M,Martens A

    更新日期:2015-11-01 00:00:00

  • A statistical primer on subgroup analyses.

    abstract::Resources for clinical research are limited. With increasing demand for patient-centred care, which is growing into an integral component of modern medicine, studying outcomes of patients with specific clinical characteristics is becoming increasingly important. Given the high cost of clinical trials and the time it t...

    journal_title:Interactive cardiovascular and thoracic surgery

    pub_type: 杂志文章,评审

    doi:10.1093/icvts/ivaa042

    authors: Milojevic M,Nikolic A,Jüni P,Head SJ

    更新日期:2020-06-01 00:00:00

  • Efficacy of adjuvant chemotherapy for lung adenocarcinoma patients with positive pleural lavage cytology findings.

    abstract:OBJECTIVES:Positive pleural lavage cytology (PLC) findings are considered to be predictive of a poor prognosis in patients with non-small-cell lung cancer (NSCLC). We investigated the clinical benefit of adjuvant chemotherapy for lung adenocarcinoma patients with positive PLC findings. METHODS:We retrospectively revie...

    journal_title:Interactive cardiovascular and thoracic surgery

    pub_type: 杂志文章

    doi:10.1093/icvts/ivv098

    authors: Ogawa H,Uchino K,Tanaka Y,Shimizu N,Okuda Y,Tane K,Tauchi S,Nishio W,Maniwa Y,Yoshimura M

    更新日期:2015-07-01 00:00:00

  • Mitral implant of the Inovare transcatheter heart valve in failed surgical bioprostheses: a novel alternative for valve-in-valve procedures.

    abstract:Objectives:Reoperative procedure for the treatment of a failed mitral bioprosthesis is associated with considerable risk. In some cases, mortality is high and might contraindicate the benefit of the procedure. The minimally invasive valve-in-valve (ViV) transcatheter mitral valve implant offers an alternative less-inva...

    journal_title:Interactive cardiovascular and thoracic surgery

    pub_type: 杂志文章

    doi:10.1093/icvts/ivw368

    authors: Gaia DF,Braz AM,Simonato M,Dvir D,Breda JR,Ribeiro GC,Ferreira CB,Souza JAM,Buffolo E,Palma JH

    更新日期:2017-04-01 00:00:00

  • Results of clinical application of the modified maze procedure as concomitant surgery.

    abstract:OBJECTIVES:Atrial fibrillation is the most common cardiac arrhythmia and is associated with significant morbidity and mortality. The classic cut-and-sew maze procedure is successful in 85-95% of patients. However, the technical complexity has prompted modifications of the maze procedure. The objective of this study was...

    journal_title:Interactive cardiovascular and thoracic surgery

    pub_type: 杂志文章

    doi:10.1093/icvts/ivs440

    authors: Bakker RC,Akin S,Rizopoulos D,Kik C,Takkenberg JJ,Bogers AJ

    更新日期:2013-02-01 00:00:00

  • Prognostic significance and possibility in guiding adjuvant therapy of the pleural lavage cytology in patients with non-small cell lung cancer.

    abstract::Pleural lavage cytology (PLC) has been reported to be a significant prognostic factor in patients with operable non-small cell lung cancer (NSCLC). PLC may detect micro metastasis in patients without apparent pleural effusion or dissemination. Although many studies have reported PLC as a good predictor of postoperativ...

    journal_title:Interactive cardiovascular and thoracic surgery

    pub_type: 杂志文章

    doi:10.1510/icvts.2008.185702

    authors: Nakamura T,Suzuki K,Mochizuki T,Ohde Y,Kobayashi H,Nakamura H,Toyoda F

    更新日期:2009-03-01 00:00:00

  • Surgical outcomes of newly categorized peripheral T3 non-small cell lung cancers: comparisons between chest wall invasion and large tumors (>7 cm).

    abstract::The prognosis for non-small cell lung cancer (NSCLC) with chest wall invasion can vary due to the heterogeneous nature of the cell population. Because NSCLC with large tumors (>7 cm) have been reclassified as T3, the applicability of the new designation must be evaluated. We reviewed 140 patients with chest wall T3 an...

    journal_title:Interactive cardiovascular and thoracic surgery

    pub_type: 杂志文章

    doi:10.1510/icvts.2010.242743

    authors: Suzuki M,Yoshida S,Moriya Y,Hoshino H,Mizobuchi T,Okamoto T,Yoshino I

    更新日期:2010-10-01 00:00:00

  • Right paracardiac mass due to organized pericardial hematoma around retained epicardial pacing wires following aortic valve replacement.

    abstract::The use of temporary epicardial pacing wires during cardiac surgery is a routine procedure and has been associated with low morbidity. We describe a rare case of right paracardiac mass due to organized pericardial hematoma with right atrial compression around the epicardial pacing wires left in-situ, presenting three ...

    journal_title:Interactive cardiovascular and thoracic surgery

    pub_type: 杂志文章

    doi:10.1510/icvts.2010.264853

    authors: Kapoor A,Syal S,Gupta N,Gupta A

    更新日期:2011-07-01 00:00:00

  • In cardiac surgery patients does Voluven(R) impair coagulation less than other colloids?

    abstract::Hydroxyethyl starch (HES) solutions are commonly used for volume replacement in cardiac surgery patients. The degree of impairment of the haemostatic system depends on the molecular weight and substitution degree of HES solutions. It is claimed that as HES 130/0.4 (Voluven(®)) exhibits a lower in vitro molecular weigh...

    journal_title:Interactive cardiovascular and thoracic surgery

    pub_type: 杂志文章,评审

    doi:10.1510/icvts.2010.263939

    authors: Raja SG,Akhtar S,Shahbaz Y,Masood A

    更新日期:2011-06-01 00:00:00

  • Combination of continuous irrigation and vacuum-assisted closure is effective for mediastinitis after cardiac surgery in small children.

    abstract::There is still no consensus on the optimal management to treat pediatric mediastinitis. We assessed the efficacy of continuous irrigation and vacuum-assisted closure (VAC) for mediastinitis in children. This study retrospectively reviewed 20 patients aged <5 years with mediastinitis from December 2002 to December 2009...

    journal_title:Interactive cardiovascular and thoracic surgery

    pub_type: 杂志文章

    doi:10.1510/icvts.2010.235903

    authors: Ugaki S,Kasahara S,Arai S,Takagaki M,Sano S

    更新日期:2010-09-01 00:00:00

  • A modified suturing technique for the implantation of the apical cannula of the HeartMate II left ventricular assist device.

    abstract::The secure and haemostatic implantation of the left ventricular assist device (LVAD) apex inflow cannula can sometimes be challenging, especially in the setting of an acute myocardial infarction or significant ventricular wall thinning, when the myocardial tissue may be friable and tissue strength may be compromised. ...

    journal_title:Interactive cardiovascular and thoracic surgery

    pub_type: 杂志文章

    doi:10.1510/icvts.2010.244509

    authors: Charitos EI,Sievers HH

    更新日期:2010-10-01 00:00:00

  • The impact of cardiopulmonary bypass management on outcome: a propensity matched comparison between minimally invasive and conventional valve surgery.

    abstract:OBJECTIVES:Research concerning cardiopulmonary bypass (CPB) management during minimally invasive cardiac surgery (MICS) is scarce. We investigated the effect of CPB parameters such as pump flow, haemoglobin concentration and oxygen delivery on clinical outcome and renal function in a propensity matched comparison betwe...

    journal_title:Interactive cardiovascular and thoracic surgery

    pub_type: 杂志文章

    doi:10.1093/icvts/ivaa052

    authors: Vandewiele K,De Somer F,Vandenheuvel M,Philipsen T,Bové T

    更新日期:2020-07-01 00:00:00

  • Video-assisted thoracoscopic surgical excision of paravertebral neurogenic tumour manifesting with unilateral facial and upper limb anhydrosis.

    abstract::A 21-year-old man presented with a recent onset history of tingling and numbness of his left upper limb. He also had a 3 year history of anhydrosis affecting the left half of his face and left upper limb. Clinical and Doppler assessment did not reveal any vascular cause for his symptoms. However, a chest roentgenogram...

    journal_title:Interactive cardiovascular and thoracic surgery

    pub_type: 杂志文章

    doi:10.1016/j.icvts.2003.11.003

    authors: Karthik S,Smith J,Thorpe JA

    更新日期:2004-06-01 00:00:00

  • Transapical access for thoracic endovascular aortic repair to elephant trunk completion.

    abstract::The 2-stage elephant trunk procedure is widely used to treat extensive disease of the aortic arch and descending thoracic aorta. The 2nd stage of the procedure can be accomplished with both a standard surgical procedure and a retrograde transfemoral endovascular approach using the dangling graft as proximal landing zo...

    journal_title:Interactive cardiovascular and thoracic surgery

    pub_type: 杂志文章

    doi:10.1093/icvts/ivy074

    authors: Agostinelli A,Carino D,Borrello B,Nicolini F

    更新日期:2018-08-01 00:00:00

  • Minimal invasive direct coronary artery bypass in moyamoya disease.

    abstract::A 56-year-old woman with moyamoya disease presented with angina pectoris. Coronary artery stenosis of atherosclerosis origin was resistant to repeated transluminal angioplasty. Coronary artery bypass grafting was performed by minimal invasive direct coronary artery bypass (MIDCAB), avoiding cardiopulmonary bypass and ...

    journal_title:Interactive cardiovascular and thoracic surgery

    pub_type: 杂志文章

    doi:10.1016/S1569-9293(02)00100-7

    authors: Komiyama M,Ishikawa T,Takanashi S,Shimizu Y

    更新日期:2003-03-01 00:00:00

  • Rescue extracorporeal membrane oxygenation in children with refractory cardiac arrest.

    abstract::We describe our experience with extracorporeal cardiopulmonary resuscitation (CPR) using extracorporeal membrane oxygenation (ECMO) in children with refractory cardiac arrest, and determine predictors for mortality. ECMO support was instituted on 42 children, median age 0.7 years (1 day-17.8 years), median weight 7.05...

    journal_title:Interactive cardiovascular and thoracic surgery

    pub_type: 杂志文章

    doi:10.1510/icvts.2010.254193

    authors: Delmo Walter EM,Alexi-Meskishvili V,Huebler M,Redlin M,Boettcher W,Weng Y,Berger F,Hetzer R

    更新日期:2011-06-01 00:00:00

  • Surgical management of Ebstein anomaly: impact of the adult congenital heart disease anatomical and physiological classifications.

    abstract:OBJECTIVES:Our goal was to evaluate the impact of the adult congenital heart disease anatomical and physiological (ACHD AP) classification system on the surgical management of Ebstein anomaly (EA) in adult patients. METHODS:From February 2000 through August 2017, data of patients aged at least 16 years, who underwent ...

    journal_title:Interactive cardiovascular and thoracic surgery

    pub_type: 杂志文章

    doi:10.1093/icvts/ivaa294

    authors: Homzova L,Photiadis J,Sinzobahamvya N,Ovroutski S,Cho MY,Schulz A

    更新日期:2020-12-13 00:00:00

  • One-stage repair of an aortic dissection and aortic coarctation.

    abstract::Ascending aortic dissection with aortic coarctation has a high mortality. There are few reports of successful surgical management of the combined condition. We report a case of a successful one-stage repair of type A aortic dissection with aortic coarctation, using an extra-anatomic bypass to connect the ascending to ...

    journal_title:Interactive cardiovascular and thoracic surgery

    pub_type: 杂志文章

    doi:10.1510/icvts.2007.157685

    authors: Cranfield KR,Brackenbury ET,Fraser SC

    更新日期:2008-02-01 00:00:00

  • Solitary pulmonary metastasis of mucoepidermoid carcinoma of the palate 43 years after the initial treatment.

    abstract::This report describes the case of a 71-year-old female presenting with a metastatic mucoepidermoid carcinoma (MEC) in the lung 43 years after the initial treatment for the primary tumor. This case represents a very long period between initial diagnosis and distant metastasis with a pathological examination of both the...

    journal_title:Interactive cardiovascular and thoracic surgery

    pub_type: 杂志文章

    doi:10.1510/icvts.2009.211755

    authors: Okami J,Tomita Y,Higashiyama M,Kodama K

    更新日期:2009-10-01 00:00:00

  • Complications in atrial septal defect device closure.

    abstract::Atrial septal defect (ASD) is a common congenital cardiac anomaly. Even though surgery is the gold standard, percutaneous device closure is gaining popularity because of the short learning curve, cosmetic advantage and relative safety. The long-term implications are open to question. We report here two cases where sur...

    journal_title:Interactive cardiovascular and thoracic surgery

    pub_type: 杂志文章

    doi:10.1510/icvts.2007.165647

    authors: Raghuram AR,Krishnan R,Kumar S,Balamurugan K

    更新日期:2008-02-01 00:00:00

  • Beating-heart approach and moderately delayed surgical management of postinfarction ventricular septal rupture: an advisable approach to improve results?

    abstract::Early repair of postinfarction ventricular septal rupture is usually associated with significant mortality and morbidity. Assessing conditions to moderately delay the surgical intervention and reduce cardioplegic arrest may be an interesting approach to improve hospital results. Results of five non-selected patients i...

    journal_title:Interactive cardiovascular and thoracic surgery

    pub_type: 杂志文章

    doi:10.1510/icvts.2004.100255

    authors: Grandmougin D,Fayad G,Delolme MC,Metton O,Vola M,Azzaoui R,Barral X,Warembourg H

    更新日期:2005-06-01 00:00:00

  • An aggregate score to stratify the technical complexity of video-assisted thoracoscopic lobectomy.

    abstract:OBJECTIVES:The purpose of this study was to develop a score to predict the complexity of video-assisted thoracoscopic surgery (VATS) lobectomies preoperatively. METHODS:One hundred and thirty-nine consecutive patients undergoing VATS lobectomy operated on by a single surgeon as the first operator were included. Comple...

    journal_title:Interactive cardiovascular and thoracic surgery

    pub_type: 杂志文章

    doi:10.1093/icvts/ivy319

    authors: Miyazaki T,Imperatori A,Jimenez M,Drosos P,Gomez-Hernandez MT,Varela G,Novoa N,Nagayasu T,Brunelli A

    更新日期:2019-05-01 00:00:00

  • Cardiac tumors in adults: surgical management and follow-up of 19 patients in an Australian tertiary hospital.

    abstract::The objective of this report is to share our experience with the different types of cardiac tumors, surgical management, postoperative complications and mid-term outcome of patients in an Australian tertiary hospital. Nineteen patients underwent cardiac surgery for tumors between 2001 and 2008. Their data was prospect...

    journal_title:Interactive cardiovascular and thoracic surgery

    pub_type: 杂志文章

    doi:10.1510/icvts.2009.230029

    authors: Matebele MP,Peters P,Mundy J,Shah P

    更新日期:2010-06-01 00:00:00

  • Outcome reporting for surgical treatment of degenerative mitral valve disease: a systematic review and critical appraisal.

    abstract:OBJECTIVES:Standardized outcome reporting is of critical importance for performance monitoring, improvement of existing techniques and introduction of novel technologies. Whether outcome reporting for surgical treatment of degenerative mitral valve disease complies with the guidelines has not been assessed to date. ME...

    journal_title:Interactive cardiovascular and thoracic surgery

    pub_type: 杂志文章

    doi:10.1093/icvts/ivx370

    authors: Tomšic A,Arabkhani B,Schoones JW,van Brakel TJ,Takkenberg JJM,Palmen M,Klautz RJM

    更新日期:2018-04-01 00:00:00

  • Venous obstruction and cerebral perfusion during experimental cardiopulmonary bypass.

    abstract::To investigate the effects on cerebral perfusion by experimental venous congestion of the superior vena cava (SVC) during bicaval cardiopulmonary bypass (CPB) at 34 °C, pigs were subjected to SVC obstruction at levels of 75%, 50%, 25% and 0% of baseline SVC flow at two arterial flow levels (low, LQ, high, HQ). The cer...

    journal_title:Interactive cardiovascular and thoracic surgery

    pub_type: 杂志文章

    doi:10.1510/icvts.2010.238535

    authors: Tovedal T,Jonsson O,Zemgulis V,Myrdal G,Thelin S,Lennmyr F

    更新日期:2010-11-01 00:00:00

  • Predictive factors for complications of anatomical pulmonary segmentectomies.

    abstract:OBJECTIVES:The role of anatomical pulmonary segmentectomy is increasing, but there are few data about its complication rate. We have analysed the postoperative morbidity, mortality and risk factors in a consecutive series of 228 segmentectomies performed in our department. METHODS:Between January 2007 and December 201...

    journal_title:Interactive cardiovascular and thoracic surgery

    pub_type: 杂志文章

    doi:10.1093/icvts/ivt292

    authors: Traibi A,Grigoroiu M,Boulitrop C,Urena A,Masuet-Aumatell C,Brian E,Stern JB,Zaimi R,Gossot D

    更新日期:2013-11-01 00:00:00