Hypothermic cardiopulmonary bypass for spinal cord protection: rationale and clinical results

1999 ◽  
Vol 67 (6) ◽  
pp. 1940-1942 ◽  
Author(s):  
Nicholas T Kouchoukos ◽  
Chris K Rokkas
Keyword(s):  
Spinal Cord ◽  
Cardiopulmonary Bypass ◽  
Clinical Results ◽  
Hypothermic Cardiopulmonary Bypass ◽  
Spinal Cord Protection

Results of using cardiopulmonary bypass for spinal cord protection during surgical repair of complex aortic coarctation

2013 ◽  
Vol 24 (1) ◽  
pp. 113-119 ◽  
Author(s):  
Stany Sandrio ◽  
Matthias Karck ◽  
Matthias Gorenflo ◽  
Tsvetomir Loukanov
Keyword(s):  
Spinal Cord ◽  
Cardiopulmonary Bypass ◽  
Aortic Arch ◽  
Aortic Coarctation ◽  
Mild Hypothermia ◽  
Circulatory Arrest ◽  
Main Pulmonary Artery ◽  
Neurologic Complication ◽  
Spinal Cord Protection ◽  
Age Range

AbstractBackgroundThe aim of this study was to evaluate the surgical treatment of complex aortic coarctation using partial cardiopulmonary bypass to increase the spinal cord protection.MethodsA total of 15 patients (age range from 7 to 48 years) underwent coarctation repair through a left posterolateral thoracotomy with cardiopulmonary bypass. Cannulation was performed via the descending aorta and the main pulmonary artery. In all, six surgeries were performed under hypothermic circulatory arrest and nine repairs were performed under mild hypothermia. The clinical outcome regarding the development of restenosis, as well as major neurologic complication, was studied.ResultsThere was no mortality. None of the patients developed paraplegia. Of the 15 patients, two developed a recurrent stenosis at the proximal anastomosis between the aortic arch and the aortic prothesis at a mean follow-up of 5.5 years. In the remaining 13 patients, echocardiography and magnetic resonance imaging showed no evidence of a significant gradient.ConclusionComplex aortic coarctation without hypoplasia of the proximal aortic arch and intra-cardiac anomalies can be repaired with low mortality and neurologic morbidity via a left thoracotomy using cardiopulmonary bypass. The use of cardiopulmonary bypass goes along with a low risk of spinal cord and lower body ischaemia and provides a sufficient amount of time for the anastomoses.

The oxygen- and acid-base status during hypothermic cardiopulmonary bypass

1988 ◽  
Vol 48 ◽  
pp. 63-71 ◽  
Author(s):  
Ivar Gøthgen ◽  
Ole Siggaard-Andersen ◽  
Jens Rasmussen ◽  
Peter Wimberley ◽  
Niels Fogh. Andersen
Keyword(s):  
Cardiopulmonary Bypass ◽  
Acid Base ◽  
Hypothermic Cardiopulmonary Bypass ◽  
Acid Base Status

scholarly journals Clinical Outcome and Histological Findings After Induced Leakage of PMMA Loaded With Methotrexate and Cisplatin During Vertebroplasty: Experimental Model in Pigs

2021 ◽  
pp. 219256822199480
Author(s):  
Alvaro Silva González ◽  
Rafael Llombart-Blanco ◽  
Marcela Gallegos Angulo ◽  
Carlos Villas Tomé ◽  
Matías Alfonso Olmos-García
Keyword(s):  
Spinal Cord ◽  
Experimental Model ◽  
Motor Impairment ◽  
Clinical Results ◽  
Control Group ◽  
Safe Procedure ◽  
Group 4 ◽  
Cement Leak ◽  
Group 2 ◽  
Histological Results

Study Design: Animal experimental model. Objective: To study the clinical behavior and histological changes in the spinal cord, nerve roots and perivertebral muscles of the spine after induced leakage of polymethylmethacrylate (PMMA) loaded with antiblastic drugs during vertebroplasty in an animal model of pigs. Methods: We performed vertebroplasty on 25 pigs. The animals were divided into 3 groups: vertebroplasty with PMMA alone (control group), vertebroplasty with PMMA loaded with methotrexate (MTX) and vertebroplasty with PMMA loaded with cisplatin (CYS). At 2 vertebral levels, epidural and prevertebral, massive cement leaks were induced. Animals were evaluated daily. Two weeks later, the pigs were sacrificed, and the tissues that came in contact with the cement were analyzed. Results: The clinical results for each of the groups were reported. The control group had no clinical alterations. In the MTX group, 2 pigs died before 1 week due to pneumonitis. In the CYS group, 4 animals had motor impairment, and 3 of the 4 had paraplegia. The histological results were as follows: the control and MTX groups showed synovial metaplasia, inflammatory reaction, crystal deposits, and giant cell reaction in the dura mater and muscle and all the animals in the CYS group had spinal cord and muscular necrosis. Conclusions: Massive cement leak after vertebroplasty with PMMA loaded with cisplatin is extremely toxic to the spinal cord and muscles around the spine. Therefore, its use cannot be recommended for the treatment of vertebral metastases. Using PMMA loaded with methotrexate seems to be a safe procedure, but further research is needed.

Sign in / Sign up

Export Citation Format

Share Document