Hybrid approach to myocardial protection in redo aortic valve replacement in patient with functioning mammary graft

2017 ◽  
Vol 10 (5) ◽  
pp. 69
Author(s):  
M. S. Kamenskikh ◽  
M. A. Novikov ◽  
A. S. Vasil’ev ◽  
A. V. Zyryanova ◽  
M. S. Stolyarov ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Myocardial Protection ◽  
Hybrid Approach

scholarly journals Myocardial protection during aortic valve replacement

1981 ◽  
Vol 82 (6) ◽  
pp. 837-847 ◽  
Author(s):  
Christian L. Olin ◽  
Vollmer Bomfim ◽  
Rutger Bendz ◽  
Lennart Kaijser ◽  
Stellan J. Strom ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Myocardial Protection

scholarly journals Late iatrogenic coronary stenosis after selective intraoperative antegrade myocardial protection for stentless aortic valve replacement

2006 ◽  
Vol 132 (2) ◽  
pp. 420-421 ◽  
Author(s):  
Simon Maltais ◽  
Ismail El-Hamamsy ◽  
Anique Ducharme ◽  
Michel Carrier ◽  
Michel Pellerin ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Coronary Stenosis ◽  
Myocardial Protection

scholarly journals Effects of Transcutaneous Electrical Nerve Stimulation on Myocardial Protection in Patients Undergoing Aortic Valve Replacement: A Randomized Clinical Trial

2021 ◽  
Author(s):  
Youn Joung Cho ◽  
Dhong-Eun Jung ◽  
Karam Nam ◽  
Jinyoung Bae ◽  
Seohee Lee ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Infarct Size ◽  
Valve Replacement ◽  
Nerve Stimulation ◽  
Myocardial Protection ◽  
Myocardial Infarct ◽  
Ischemia Reperfusion ◽  
Myocardial Infarct Size ◽  
Electrical Nerve Stimulation

Abstract BackgroundTranscutaneous electrical nerve stimulation (TENS) has been found to have cardioprotective effects. However, its effects on adult cardiac surgery patients remain unclear. We investigated the effects of TENS on myocardial protection in patients undergoing aortic valve replacement surgery using cardiopulmonary bypass.MethodsThirty patients were randomized to receive TENS or sham in three different anesthetic states – pre-anesthesia, sevoflurane, or propofol (each n = 5). TENS was applied at the upper arm for 30 min. Sham treatment was provided without nerve stimulation. The primary outcome was the difference in myocardial infarct size following ischemia-reperfusion injury in rat hearts perfused with pre- and post-TENS dialysate from the patients using Langendorff perfusion system.ResultsThere were no differences in myocardial infarct size between pre- and post-treatment in any group (41.4 ± 4.3% vs. 36.7 ± 5.3%, 39.8 ± 7.3% vs. 27.8 ± 12.0%, and 41.6 ± 2.2% vs. 37.8 ± 7.6%; p = 0.080, 0.152, and 0.353 in the pre-anesthesia, sevoflurane, and propofol groups, respectively).ConclusionsTENS did not have a cardioprotective effect in patients undergoing aortic valve replacement surgery.Trial registrationThis study was registered at clinicaltrials.gov (NCT03859115, on March 1, 2019).

Aortic Valve Replacement through Right Minithoracotomy in 306 Consecutive Patients

2010 ◽  
Vol 5 (5) ◽  
pp. 326-330 ◽  
Author(s):  
Donald D. Glower ◽  
Teng Lee ◽  
Bhargavi Desai
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Hybrid Approach ◽  
Median Sternotomy ◽  
Aortic Disease ◽  
Percutaneous Coronary Angioplasty ◽  
Early Results ◽  
The Right ◽  
Aortic Root Disease

Objective To define the role and early results of aortic valve surgery through a right minithoracotomy. Methods A retrospective analysis was performed on 306 consecutive patients undergoing aortic valve replacement through an 8-cm right minithoracotomy in the second intercostal space. The initial experience was included. The right second and third ribs were detached from the sternum in most cases and repaired at the end of each case. Most operations were performed using anterograde and retrograde cardioplegic arrest with percutaneous femoral venous cannulation and direct aortic cannulation through the incision. Standard instruments were used with direct digital knot tying. Results Mean age was 65 ± 14 (range, 20–90) years. Aortic valve disease cause was calcific disease in 160 of 306 (52%) patients, bicuspid disease in 95 of 306 (31%) patients, and endocarditis in 9 of 306 (3%) patients. Previous cardiac surgery was present in 13 of 306 (4%) patients. Biologic prostheses were used in 240 of 306 (78%) patients. Median valve size was 23 mm. Mean clamp times and pump times were 103 ± 26 and 158 ± 35 minutes, respectively. Median postoperative length of stay was 5 days. Thirty-day mortality was found in 4 of 306 (1%) cases. There were no deep wound infections or mediastinitis. Stroke occurred in 5 of 306 (1.6%) patients, and new pacemaker required in 11 of 306 (4%) patients. Reoperation for bleeding occurred in 2 of 306 (1%) patients. Conversion to median sternotomy occurred in 15 of 306 (5%) patients caused by chest wall anatomy (n = 7), bleeding (n = 3), coronary disease (n = 2), or aortic disease (n = 3). Patients were allowed to return to driving or preoperative activity in 2 weeks. With a mean follow-up of 2.8 ± 2.2 years, one patient required reoperation for aortic root disease. Conclusions Right minithoracotomy is a safe but limited alternative to sternotomy in isolated aortic valve replacement. This approach may be particularly valuable in some higher risk, elderly patients and opens options for a hybrid approach combined with percutaneous coronary angioplasty.

Celsior Versus Microplegia: Analysis of Myocardial Protection in Elective Aortic Valve Replacement

2017 ◽  
Vol 103 (1) ◽  
pp. 25-31 ◽  
Author(s):  
Jose López-Menéndez ◽  
Javier Miguelena ◽  
Carlos Morales ◽  
Carmen L. Díaz ◽  
Francisco Callejo ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Myocardial Protection

Comparison of Del Nido Cardioplegia with Blood Cardioplegia in Adult Combined Surgery

2017 ◽  
Vol 12 (5) ◽  
pp. 356-362 ◽  
Author(s):  
Raphael Hamad ◽  
Anthony Nguyen ◽  
Éric Laliberté ◽  
Denis Bouchard ◽  
Yoan Lamarche ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Myocardial Protection ◽  
Troponin T ◽  
Hospital Death ◽  
Vasoactive Agent ◽  
Blood Cardioplegia ◽  
Creatine Kinase Mb

Objective del Nido solution (DNS) is a single-dose cardioplegia designed for pediatric use proposed to offer superior myocardial protection in adults. However, few data support this claim. We hypothesized that DNS and modified blood cardioplegia solution (BS) provide equivalent safety in combined adult valve surgery. Methods Between November 2014 and December 2015, 25 patients underwent primary aortic valve replacement and concomitant coronary artery bypass grafting (CABG) with DNS. Outcomes were compared with 25 patients who underwent the same surgery with BS between September 2013 and August 2015. Results All preoperative characteristics, comorbidities, and number of CABG performed were similar between groups. One hospital death occurred in the BS group. Postoperative creatine kinase, MB isotype (16.7 ± 5.3 μg/L vs. 22.1 ± 8.9 μg/L, P = 0.011) and troponin T levels (260 ± 105.3 ng/L vs. 370.5 ±218.4 ng/L, P =0.028) were significantly lower in the DNS group. There was no difference in inotropic or vasoactive agent use ( P = 0.512). Cardiopulmonary bypass times (65.5 ± 12.5 min vs. 76.6 ± 19.1 min, P = 0.019) and cross-clamp times (55.6 ± 11.2 min vs. 64.3 ± 18.9 min, P = 0.05) were lower in the DNS group but total operating room times ( P = 0.198) were similar. Peak postoperative creatinine levels were similar in both groups ( P = 0.063). There was no difference in postoperative outcomes including acute renal failure ( P > 0.999), atrial fibrillation ( P = 0.773), acute respiratory failure ( P > 0.999), nor stroke or transient ischemic attack ( P > 0.999). Intensive care unit stay ( P = 0.213) and hospital stay ( P = 0.1) did not differ between groups. Conclusions The DNS can be used as an alternative to BS in adult concomitant aortic valve replacement + CABG surgery. This supports our hypothesis that in this specific setting, DNS provides comparable myocardial protection as BS, with possibly shorter cardiopulmonary bypass and cross-clamp times.

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