The Thoracic and cardiovascular surgeon
-
The use of mechanical circulatory support for the treatment of heart failure in the pediatric population has become increasingly important in pediatric heart surgery units; however, the treatment options for the pediatric population have not attained the same level of technological development as we have seen for the adult population. The use of mechanical assistance as a bridge to transplantation or a bridge to recovery are the main indications for mechanical circulatory support in infants and children. ⋯ Especially in Europe however, newly developed pulsatile, paracorporeal ventricular assist devices designed for long-term assist in children have demonstrated their ability to provide excellent results beyond the abilities of extracorporeal membrane oxygenation and centrifugal pumps, which are still the mainstay of mechanical support in children worldwide. Especially in the group of the smallest patients, the use of the most appropriate form of circulatory assistance has to be carefully considered as the co-incidence of respiratory failure as well as other complex physiological situations will severely influence the outcome.
-
Thorac Cardiovasc Surg · Feb 2005
ReviewSetup of neurophysiological monitoring with tcMEP/SSEP during thoracoabdominal aneurysm repair.
The article describes a procedure for the intraoperative neurophysiological placement of electrodes to control the spinal cord function during thoracoabdominal aortic aneurysm repair. ⋯ TcMEP and SSEP allow an adequate, direct, and reliable intraoperative assessment of spinal cord function, enabling the surgeon to diagnose an impending ischaemia and act accordingly. This measurement technique provides the surgical team with a means of integrating neurological aspects during thoracoabdominal aneurysm repair.