scholarly journals Evaluation of cerebral pathologic changes and long-term behavioral disorder after deep hypothermic circulatory arrest in dogs

2003 ◽  
Vol 2 (4) ◽  
pp. 466-471
Author(s):  
H Shimura
Keyword(s):  
Circulatory Arrest ◽  
Deep Hypothermic Circulatory Arrest ◽  
Hypothermic Circulatory Arrest ◽  
Behavioral Disorder

scholarly journals Long-term outcomes after resection of Stage IV cavoatrial tumour extension using deep hypothermic circulatory arrest

2016 ◽  
Vol 50 (5) ◽  
pp. 892-897 ◽  
Author(s):  
Alexey Dashkevich ◽  
Erik Bagaev ◽  
Christian Hagl ◽  
Maximilian Pichlmaier ◽  
Maximilian Luehr ◽  
...  
Keyword(s):  
Circulatory Arrest ◽  
Stage Iv ◽  
Deep Hypothermic Circulatory Arrest ◽  
Hypothermic Circulatory Arrest ◽  
Long Term Outcomes ◽  
Tumour Extension

Cardiac standstill for cerebral aneurysms in 103 patients: an update on the experience at the Barrow Neurological Institute

2011 ◽  
Vol 114 (3) ◽  
pp. 877-884 ◽  
Author(s):  
Francisco A. Ponce ◽  
Robert F. Spetzler ◽  
Patrick P. Han ◽  
Scott D. Wait ◽  
Brendan D. Killory ◽  
...  
Keyword(s):  
Circulatory Arrest ◽  
Deep Hypothermic Circulatory Arrest ◽  
Hypothermic Circulatory Arrest ◽  
Posterior Circulation ◽  
Superior Cerebellar Artery ◽  
Small Subset ◽  
Long Term Follow Up ◽  
Posterior Circulation Aneurysms

Object The aim of this study was to clarify the surgical indications, risks, and long-term clinical outcomes associated with the use of deep hypothermic circulatory arrest for the surgical treatment of intracranial aneurysms. Methods The authors retrospectively reviewed 105 deep hypothermic circulatory arrest procedures performed in 103 patients (64 females and 39 males, with a mean age of 44.8 years) to treat 104 separate aneurysms. Patients' clinical histories, radiographs, and operative reports were evaluated. There were 97 posterior circulation aneurysms: at the basilar apex in 60 patients, midbasilar artery in 21, vertebrobasilar junction in 11, superior cerebellar artery in 4, and posterior cerebral artery in 1. Seven patients harbored anterior circulation aneurysms. Two additional patients harbored nonaneurysmal lesions. Results Perioperatively, 14 patients (14%) died. Five patients (5%) were lost to late follow-up. At a mean long-term follow-up of 9.7 years, 65 patients (63%) had the same or a better status after surgical intervention, 10 (10%) were worse, and 9 (9%) had died. There were 19 cases (18%) of permanent or severe complications. The combined rate of permanent treatment-related morbidity and mortality was 32%. The mean late follow-up Glasgow Outcome Scale score was 4, and the annual hemorrhage rate after microsurgical clipping during cardiac standstill was 0.5%/year. Ninety-two percent of patients required no further treatment of their aneurysm at the long-term follow-up. Conclusions Cardiac standstill remains an important treatment option for a small subset of complex and giant posterior circulation aneurysms. Compared with the natural history of the disease, the risk associated with this procedure is acceptable.

scholarly journals Long-Term Out come Evaluation in Patient Undergoing Deep Hypo-thermic Circulatory Arrest in Aortic Arch Surgery

2021 ◽  
Vol 04 (05) ◽  
Author(s):  
Leibuss Roberts ◽  
Keyword(s):  
Quality Of Life ◽  
Aortic Arch ◽  
Circulatory Arrest ◽  
Deep Hypothermic Circulatory Arrest ◽  
Hypothermic Circulatory Arrest ◽  
Aortic Arch Surgery ◽  
Questionnaire Score ◽  
Increased Risk

Background: Aortic dissection is usually associated with low survival rates due to high prehospital and perioperative mortality, in addition with increased risk of postoperative complication in survivals. Since 1985, deep hypothermic circulatory arrest (DHCA) is often used in aortic arch surgery with main advantage to provide bloodless surgical field while protecting brain tissue during hypothermia. Nevertheless, it still raises concern of increasing neurologic sequelae and a potential decrease of long-term quality of life. The aim of study: To evaluate the effect of DHCA used in aortic surgery on long-term quality of life. Methods: In this observational case series we included a total of 24 patients who had aortic arch surgery requiring DHCA in the Pauls Stradins Clinical University Hospital Cardiac Surgery center, from January 2019 to December 2020. Seven patients were excluded due to intrahospital death. For the rest of the patients Quality of life (QOL) was evaluated using RAND SF36 questionnaire and MMSE test. Data regarding demographics, clinical characteristics, surgery type, duration of circulatory arrest, rectal and bladder temperatures were collected and analyzed using the SPSS 23 Statistics software IBM SPSS Statistics 21 (IBM Corporation, NY, USA). Statistical significance was assumed as two- tailed p <0.05. Results: A total of 17 patients were analyzed, we had 12 (71%) males and 5 (29%) females. A mean age was 60.71 (±13.8 SD) years, leading co-morbidity was hypertension – 11 (64.7%). There were 6 (35.3%) elective and 11 (64.7%) acute surgeries. Stan-ford A dissection (82.4%) constituted the main part of all cases. A 94.7% had aortic arch replacement. Most common postopera-tive complication was wound infection- 29.4%. The mean cardiopulmonary bypass time, aortic cross-clamping and reperfusion time was 212 (±38.3, SD), 124 (±33.8, SD) and 70.2 (±32.9, SD) minutes, respectively. Core temperature during DHCA was 23.2 Cº (±3.2, SD) and a rewarming rate was 0.12 (±0.07, SD) Cº/min. No significance correlation between RAND SF36 questionnaire score (QoL questionnaire) and lowest DHCA temperature, aortic cross - clamping, reperfusion time, CPB time was observed, respectively - p=0.367, p=0.544, p=0.619, p=0. We found statistically significant moderate strength correlation between QOL and rewarming rate (r=0.550; p=0.022). Mean RAND SF36 questionnaire score was 71.9±10. and mean MMSE score was 27.9±5,3. Conclusions: We found no correlation between quality of life and lowest temperature during surgery, aortic cross- clamping time, reperfusion time, however we found positive moderate strength correlation between rewarming rate and quality of life. Patient quality of life after surviving aortic arch surgery and deep hypothermic circulatory arrest compared to general healthy population quality of life is slightly reduced. Mini-mental state exam and RANDO short form health survey can be useful scoring system to evaluate patient quality of life.

Open Distal Anastomosis Technique for Ascending Aortic Aneurysm Repair without Cerebral Perfusion

2015 ◽  
Vol 18 (4) ◽  
pp. 124
Author(s):  
Mehmet Kaplan ◽  
Bahar Temur ◽  
Tolga Can ◽  
Gunseli Abay ◽  
Adlan Olsun ◽  
...  
Keyword(s):  
Aortic Aneurysm ◽  
Cerebral Perfusion ◽  
Circulatory Arrest ◽  
Deep Hypothermic Circulatory Arrest ◽  
Hypothermic Circulatory Arrest ◽  
Distal Anastomosis ◽  
Ascending Aortic Aneurysm ◽  
Aortic Aneurysm Surgery ◽  
Aneurysm Repair ◽  
Aortic Aneurysm Repair

<p><strong>Background</strong><strong>: </strong>This study aimed to report the outcomes of patients who underwent proximal thoracic aortic aneurysm surgery with open distal anastomosis technique but without cerebral perfusion, instead under deep hypothermic circulatory arrest.</p><p><strong>Methods: </strong>Thirty patients (21 male, 9 female) who underwent ascending aortic aneurysm repair with open distal anastomosis technique were included. The average age was 60.2±11.7 years. Operations were performed under deep hypothermic circulatory arrest and the cannulation for cardiopulmonary bypass was first done over the aneurysmatic segment and then moved over the graft. Intraoperative and early postoperative mortality and morbidity outcomes were reported.</p><p><strong>Results</strong><strong>: </strong>Average duration of cardiopulmonary bypass and cross-clamps were 210.8±43 and 154.9±35.4 minutes, respectively. Average duration of total circulatory arrest was 25.2±2.4 minutes. There was one hospital death (3.3%) due to chronic obstructive pulmonary disease at postoperative day 22. No neurological dysfunction was observed during the postoperative period.<strong></strong></p><p><strong>Conclusion: </strong>These results demonstrate that open distal anastomosis under less than 30 minutes of deep hypothermic circulatory arrest without antegrade or retrograde cerebral perfusion and cannulation of the aneurysmatic segment is a safe and reliable procedure in patients undergoing proximal thoracic aortic aneurysm surgery.</p><p> </p>

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