Search results for "Bypass"
showing 10 items of 232 documents
How to do it: direct true lumen cannulation technique of the ascending aorta in acute aortic dissection type A†
2012
In acute aortic dissection type A (AADA), direct true lumen cannulation (DTLC) of the ascending aorta is a fast and safe cannulation site providing antegrade perfusion of the supraaortic and visceral vessels. An Overholt clamp is passed around the ascending aorta to place a Mersilene tape for later securing of the arterial cannula. After draining venous blood into the cardiopulmonary bypass system (CPB), the ascending aorta is transected and the aortic lumen inspected. The true lumen is identified and an arterial cannula inserted directly. Finally, the cannula is secured with the previously placed tape and CPB is initiated. DTLC can be used as arterial cannulation standard technique in oper…
Aortic valve-sparing root replacement from inside the aorta using three Dacron skirts preserving the native Valsalva sinuses geometry and stabilizing…
2009
We present an alternative idea for valve-sparing technique combining the advantages of the reimplantation and the benefits of the remodeling techniques. We replace the sinuses of Valsalva using three Dacron skirts from inside of the aorta. The physiological anatomy of the Valsalva sinuses and their dynamic properties are preserved and the aortic commissures displacement avoided. The distal rim of each Dacron skirt was anchored to the aorto-ventricular junction using Ticron (2-0) U stitches placed from the ventricular side to the aortic side. We stabilize the base of the aortic annulus to prevent future dilation.
‘Soft’ Snaring of the Coronary Artery in Minimally-Invasive Coronary Surgery
1998
A technique is described that allows a simple and safe temporary occlusion of the coronary artery in beating heart procedures using monofilament stay sutures underlaid with small pericardial pads. Postoperative serial levels of Troponin I remained low (<4 ng/L) and control angiography revealed no stenosis in the distal coronary artery.
Evaluation of gastric intramucosal pH during and after pediatric cardiac surgery.
1997
Objectives: In adult patients, intramucosal pH (pHi) has been advocated to detect postoperative complications. The purpose of our study was to evaluate this technique in pediatric patients during and after cardiac surgery. Methods: Thirty-five infants (age: 5 days to 15 years, median 1.8 years; and weight: 3.2‐32 kg, median 9.8 kg) were studied. pHi was measured before cardiopulmonary bypass (CPB), after 30 min of CPB, prior to weaning off CPB, at intensive care unit arrival, and 6, 12, 24, 48 and 72 h after surgery. Results: There were no complications related to the tonometer. A pathologically low pHiB 7.32 was found during surgery in less than 17%, at intensive care unit arrival in 83% a…
Evidence for a negative inotropic effect of obesity in human myocardium?
2009
Objective: The present study was performed as an attempt to analyze the relationship between body weight and human myocardial performance. As overweight is frequently associated with hypertension, stenosis of epimyocardial coronary arteries and other factors that influence myocardial performance, the experimental model of isolated human atrial myocardium was selected. Atrial contractile performance does neither depend on the extent of stenosis of epicardial coronary arteries nor on the degree of hypertension and its secondary pathology. Methods:Rightatrialmusclepreparations(0.5 6 mm)of183patientsundergoingcoronaryarterybypasssurgerywereelectricallystimulatedat optimal length. Active tension…
Survival and reinterventions after isolated proximal aortic repair in acute type A aortic dissection.
2018
OBJECTIVES Conventional treatment for acute type A dissection is the replacement of the ascending aorta. This study demonstrates the results of a conventional approach with isolated proximal repair combined with concomitant endovascular procedures. METHODS Replacement of the ascending aorta with or without an open distal anastomosis was defined as isolated proximal repair and was performed in 562/588 patients between January 2004 and June 2017. A total of 68% were DeBakey type I and 32% were DeBakey type II aortic dissections. Concomitant procedures were thoracic endovascular aortic repair (3.6%); visceral, renal and iliac stents (2%); and peripheral bypasses (1.1%). Mean follow-up was 4.6 …
External reinforcement of varicose veins with PTFE prosthesis in infrainguinal bypass surgery -- clinical results.
2003
OBJECTIVE Segmental varicose degeneration of the autogenous greater saphenous vein may limit its use in infrainguinal bypass surgery. Wrapping a PTFE prosthesis around dilated veins has emerged as an option to create externally reinforced vein bypasses. Results regarding graft patency and limb salvage were analyzed. METHODS Between September 1995 and January 2001, 35 infrainguinal bypass operations in 33 patients were performed with greater saphenous veins exhibiting segmental varicose dilatation. Grafts were followed by duplex scan and retrospective analysis of graft patency and limb salvage was performed. RESULTS One bypass prompted successful revision for early occlusion. Four bypasses r…
Regulation of endothelial nitric oxide synthase (eNOS) in myocardium subjected to cardioplegic arrest.
2009
BACKGROUND: Nitric oxide (NO) production by both coronary endothelial cells and cardiomyocytes is thought to play a significant role in myocardial pathophysiology following ischemia/reperfusion (I/R). METHODS: In thirteen pigs subjected to 1 hour cardioplegic arrest (CA) on CPB, left ventricular (LV) biopsies were collected prior to CPB (baseline), at 60 min CPA, at 15 and 30 min reperfusion on CPB, and at 120 min post CPB. LV specimens were immunocytochemically stained against phospho-eNOS Ser1177 , phospho-eNOS Thr495 , phosphorylated ERK1/2, and AKT/PKB. Four additional pigs without CA served as controls. Cardiomyocytes were quantitatively investigated using TV densitometry (gray units: …
Training Cardiac Surgeons: Safety and Requirements.
2021
To analyze whether cardiac surgical residents can perform their first surgeries without compromising patients' safety or outcomes, by comparing their performance and results to those of senior surgeons. All documented CABGs conducted between 2002 and 2020 were included. Surgeries were divided according to the experience level of the main surgeon (defined by the number of CABG conducted by him/her) using the following thresholds: 1000; 150; 80 and 35. This resulted in 5 groups: senior surgeons (the reference group); attending surgeons; fellow surgeons; advanced residents and new residents. Primary endpoint was 30 day mortality. Secondary endpoints included a list of intra and post-operative …
A New Technical Approach For Retrograde Administration of Cardioplegic Solutions
1989
Myocardial protection via the coronary sinus is now currently used by several groups. Although it has generally provided satisfactory results, some of its problems are still not completely resolved. We present a new technique of cardioplegia delivery through the coronary sinus with a Pezzer catheter inserted into it and secured in place by a purse string suture. We believe that this method is safer and more reliable than others.