Successful Treatment of Accidental Air Embolism in Warm Heart Surgery

2003 ◽  
Vol 11 (1) ◽  
pp. 68-69 ◽  
Author(s):  
Walter J Gomes ◽  
David A Strisiver ◽  
Albert JF Penco ◽  
Kamal Rampersad ◽  
Gianni D Angelini
Keyword(s):  
Cardiopulmonary Bypass ◽  
Cerebral Perfusion ◽  
Coronary Artery Bypass Surgery ◽  
Bypass Surgery ◽  
Heart Surgery ◽  
Artery Bypass ◽  
Air Embolism ◽  
Induced Hypothermia ◽  
Retrograde Cerebral Perfusion ◽  
Warm Heart Surgery

Normothermic cardiopulmonary bypass has recently been proposed as a superior technique for maintaining body metabolism. However, its use remains controversial since the degree of cerebral protection provided might be inferior to that conferred by conventional hypothermic techniques. We report a case of accidental massive air embolism during coronary artery bypass surgery under normothermia, which was successfully managed with induced hypothermia at 20°C and retrograde cerebral perfusion.

“Beyond Beating Heart Surgery” Heartstring Device Protects against Perioperative Neurological Events

2010 ◽  
Vol 5 (2) ◽  
pp. 118-121 ◽  
Author(s):  
Andreas G. Sakopoulos ◽  
John G. Jacobson ◽  
Don R. Wilson ◽  
Wilfred M. Huse
Keyword(s):  
Cardiopulmonary Bypass ◽  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Coronary Artery Bypass Surgery ◽  
Bypass Surgery ◽  
Heart Surgery ◽  
Artery Bypass ◽  
Myocardial Revascularization ◽  
Off Pump ◽  
Mammary Arteries

Objective There is a growing body of evidence favoring off-pump coronary artery bypass surgery (OPCAB) over traditional coronary artery bypass surgery (CABG) with cardiopulmonary bypass as a method for reducing perioperative neurologic events. Aortic manipulation, whether with OPCAB or coronary artery bypass surgery with cardiopulmonary bypass, is strongly linked with adverse neurologic outcomes. Although the aortic “no-touch” technique has merit, most cardiac surgeons are reluctant to base entire myocardial revascularization exclusively on mammary pedicles. The purpose of this study was to analyze our experience with OPCAB combined with the use of a Heartstring proximal anastomotic device, as a strategy for reducing clinically evident cerebrovascular accidents. Methods Two hundred twenty-seven consecutive isolated OPCAB were performed without the use of a side-biting aortic clamp. In all these operations, a Heartstring device was used, permitting clampless hand-sutured proximal anastomoses. All patients were managed in this fashion regardless of the status of their ascending aorta. A mean of 3.4 bypasses were performed during each operation, with one or two mammary arteries harvested routinely. In 98% of patients, a single proximal anastomosis was performed; there was liberal use of sequential bypass grafts. Results Mean age was 69.3 years, with 17% octogenarians. Preexisting cerebrovascular disease was present in 22.4% of patients. There were no clinically evident perioperative neurologic events in any patients. There were no operative deaths. Conclusions This series suggests that OPCAB performed with a single, clampless, proximal aortic anastomosis, and with a Heartstring device may protect against perioperative strokes.

Miniaturized versus conventional cardiopulmonary bypass in high-risk patients undergoing coronary artery bypass surgery

Perfusion ◽  
2010 ◽  
Vol 25 (2) ◽  
pp. 65-70 ◽  
Author(s):  
Simo-Pekka Koivisto ◽  
Jan-Ola Wistbacka ◽  
Riikka Rimpiläinen ◽  
Juha Nissinen ◽  
Pertti Loponen ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Coronary Artery ◽  
High Risk ◽  
Coronary Artery Bypass ◽  
Coronary Artery Bypass Surgery ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
High Risk Patients ◽  
Risk Patients
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