The heart surgery forum
-
The heart surgery forum · Jan 2006
Case ReportsAorto-carotid bypass for cerebral malperfusion after aortic dissection surgery: a case report.
Malperfusion syndrome may complicate the postoperative course in patients who have undergone surgery for aortic dissection. In these cases, open surgery or endovascular intervention may be required. We present a case of postoperative onset of intermittent severe neurological symptoms after surgery for type A aortic dissection. ⋯ All neurological symptoms were completely resolved. We advocate a high degree of vigilance for signs of cerebral malperfusion in the intensive care unit. Early intervention can result in a successful outcome, as illustrated by this case report.
-
The heart surgery forum · Jan 2006
Case ReportsProfound hypothermic cardiac arrest treated successfully using minimally invasive cardiopulmonary bypass: a case report.
Hypothermia is defined as a core temperature of less than 35 degrees C. The decision to resuscitate a hypothermic patient can be difficult, as consideration must be given to whether the patient died before the cooling process. The modality for rewarming must also be considered. ⋯ Cardiopulmonary bypass provides excellent circulatory support for profound hypothermia and allows rapid core rewarming. The femoro-femoral approach is the preferred method for this scenario.
-
The heart surgery forum · Jan 2006
Case ReportsDirect reimplantation technique via a right minithoracotomy for scimitar syndrome: a case report.
Scimitar syndrome (SS) is a rare congenital cardiac anomaly defined by an anomalous right pulmonary vein draining of the right lung into the inferior vena cava. We describe a direct reimplantation technique and atrial septal defect closure using cardiopulmonary bypass via a right minithoracotomy on a 24 year-old female SS patient who had an accompanying sinus venous atrial septal defect.
-
The heart surgery forum · Jan 2006
Clinical TrialAssessment of cardiac autonomic regulation and ventricular repolarization after off-pump coronary artery bypass grafting.
Altered autonomic regulation precipitates cardiac arrhythmias and increases the risk of sudden cardiac death. This risk is further increased by changes in ventricular repolarization. Autonomic regulation is deranged in patients after myocardial on-pump revascularization. We aimed to clarify how off-pump coronary artery bypass grafting (CABG) affects postoperative cardiac autonomic regulation and ventricular repolarization within 4 weeks after CABG. ⋯ Observed faster heart rates until 1 week after off-pump CABG imply excessive adrenergic activation, which is comparable to on-pump CABG procedure rates. The results indicate profound autonomic derangement and loss of rate-dependent regulation after off-pump CABG even 4 weeks after operation. Restituted repolarization as assessed by QT variability index 4 weeks postoperatively corresponded with decreased frequency of rhythm disturbances 4 weeks after CABG. The loss of coupling between QT and RR intervals shows increased electrical instability postoperatively, which may serve as an additional promoter for postoperative arrhythmias, especially at higher heart rates.
-
The heart surgery forum · Jan 2006
Pre-clinical validation of a new intra-operative "dual beam Doppler" blood flowmeter in an artificial circuit.
Intra-operative flow measurement during coronary or peripheral bypass operations is helpful for ruling out technical failures and for prediction of complication and patency rates. Preclinical validation of the flowmeters is required in order to rely on the intra-operatively measured results. The aim of this study is to evaluate a new "dual beam Doppler" blood flowmeter before clinical application and to compare it with the established "transit time flow measure-ment" technique in an artificial circuit. ⋯ All 3 tested flowmeters showed an excellent correlation to the true flow in an artificial circuit and the accuracy of the tested devices was within agreement limits. Reproducibility of all devices was good and linear. The new dual beam Doppler flow measurement technique compares favorably to the classic transit time method. Clinical use may depend on operator, location, and condition, thus more studies may be required to ensure uniform results using the currently available blood flow measurement devices.