Current state of heart surgery in relation to some views on modern surgical science

1927 ◽  
Vol 23 (4) ◽  
pp. 450-458
Author(s):  
V. L. Bogolyubov
Keyword(s):  
Cardiac Arrest ◽  
Cardiac Tamponade ◽  
Cardiac Dysfunction ◽  
Heart Surgery ◽  
Surgical Intervention ◽  
Significant Progress ◽  
Pericardial Cavity ◽  
Current State

Surgery is currently making quite significant progress in pericardial pouch diseases. First of all, surgical intervention is required in case of various fluid accumulations in the pericardial cavity (inflammatory exudates, stagnant and bloody effusions). The danger of such changes lies in the aforementioned cardiac tamponade, leading to heart distress and cardiac arrest due to compression of large veins flowing into the heart. Cardiac dysfunction with cardiac tamponade can occur with the accumulation of 150-300 cc of fluid in the pericardial cavity. The sooner the fluid accumulates, the sooner the danger is created.

Current state of heart surgery in relation to some views on modern surgical science

1927 ◽  
Vol 23 (3) ◽  
pp. 340-347
Author(s):  
V. L. Bogolyubov
Keyword(s):  
Internal Medicine ◽  
Gastrointestinal Tract ◽  
Biliary Tract ◽  
Heart Surgery ◽  
Surgical Intervention ◽  
Progressive Movement ◽  
Current State ◽  
Long Time ◽  
Sphere Of Influence

Modern surgery is taking over more and more organs, recapturing more and more areas of internal medicine. We see that in its great progressive movement surgery gradually involves within its sphere of influence a whole range of diseases that previously belonged exclusively to the sphere of internal medicine, such as some diseases of the gastrointestinal tract, biliary tract, lungs, etc. We see that even those organs, which until so recently were considered inaccessible to the art of the surgeon, are beginning to be subject to surgical intervention. Such last inviolable organ, on which the hand of the surgeon has not encroached for a long time, is the heart.

Steroids as a possible effective therapy in the management of large isolated chylopericardium following open heart surgery

2019 ◽  
Vol 29 (12) ◽  
pp. 1426-1431
Author(s):  
Ghina Fakhri ◽  
Mohammed Abutaqa ◽  
Nour Abdulhalim ◽  
Haytham Bou Houssein ◽  
Zohair Al Halees ◽  
...  
Keyword(s):  
Heart Surgery ◽  
Venous Return ◽  
Surgical Intervention ◽  
Open Heart Surgery ◽  
Future Research ◽  
Case Presentation ◽  
Pericardial Cavity ◽  
Cardiac Procedures ◽  
Anomalous Pulmonary Venous Return ◽  
Minimal Concentration

AbstractBackground:Chylopericardium is the collection of lymph fluid inside the pericardial cavity. The incidence of chylopericardium is very low, as this diagnosis is rarely reported following cardiac procedures in children. While some reports were published worldwide on isolated chylopericardium after cardiac surgeries for diverse reasons, it has never been reported after repair for partial anomalous pulmonary venous return. In addition, management of this diagnosis ends up being surgical with minimal concentration on medical treatment which proved unsuccessful. We present a medical approach with corticosteroids as an effective method to treat isolated chylopericardium.Case presentation:In this manuscript, we present an approach to treat isolated post-operative chylopericardium in a child following repair of partial anomalous pulmonary venous return. Chylous drainage responded to corticosteroids and completely ceased. There was no need for surgical intervention.Conclusion:Until now, isolated chylopericardium has never been reported to occur with partial anomalous pulmonary venous return repair. A review of the literature showed that most patients follow a conservative approach consisting of diuretics and non-steroidal anti-inflammatory agents with some of them undergoing surgical re-intervention. With future research on the topic still needed, we hope that this will encourage physicians worldwide to consider administering a trial of corticosteroids as an option to treat chylopericardium.

scholarly journals Selective Loss and Selective Sparing of Neurons in the Thalamic Reticular Nucleus following Human Cardiac Arrest

1993 ◽  
Vol 13 (4) ◽  
pp. 558-567 ◽  
Author(s):  
Douglas T. Ross ◽  
David I. Graham
Keyword(s):  
Cardiac Arrest ◽  
Heart Surgery ◽  
Neuronal Damage ◽  
Open Heart Surgery ◽  
Thalamic Reticular Nucleus ◽  
Global Cerebral Ischemia ◽  
Reticular Nucleus ◽  
Thalamic Nuclei ◽  
Attentional Processing ◽  
Thalamic Relay Nuclei

Neurons in the portion of the human thalamic reticular nucleus (RT) associated with the prefrontal cortex and mediodorsal thalamic nuclei were found to be selectively vulnerable to ischemic neuronal damage following relatively short (≤5-min) duration cardiac arrest. In contrast, selective sparing of these RT neurons occurred in cases with longer (>10-min) duration of arrest that was sufficient to produce extensive ischemic neuronal damage throughout the cerebral cortex and thalamic relay nuclei. The selective degeneration of RT neurons appears to require the sustained activity of corticothalamic or thalamocortical projections to the RT following the ischemic insult. Loss of RT neurons associated with the frontal cortex and mediodorsal thalamus may be the biological basis of some types of persisting cognitive deficits in attentional processing experienced by patients following cardiac arrest, open heart surgery, or other forms of brief global cerebral ischemia.

Cardiac tamponade as a late complication of open heart surgery

1968 ◽  
Vol 76 (1) ◽  
pp. 139-141 ◽  
Author(s):  
Taylor A. Prewitt ◽  
Charles E. Rackley ◽  
Benson R. Wilcox ◽  
James H. Scatliff ◽  
Daniel T. Young
Keyword(s):  
Cardiac Tamponade ◽  
Heart Surgery ◽  
Late Complication ◽  
Open Heart Surgery ◽  
Open Heart

Morbidity of in-hospital purulent-septic infections of adults patients after different types of endovascular cardiosurgical operations

2020 ◽  
pp. 13-19
Author(s):  
Viktor Ivanovich Sergevnin ◽  
Larisa Gennadievna Kudryavtseva ◽  
Anna Igorevna Zolotukhina
Keyword(s):  
Medical Records ◽  
Heart Surgery ◽  
Surgical Intervention ◽  
Heart Rhythm ◽  
Community Acquired Pneumonia ◽  
Short Term ◽  
Intervention Community ◽  
Duration Of Surgery ◽  
Different Types ◽  
Low Incidence

An estimate of the incidence of nosocomial purulent-septic infections (GSI) of adult patients after various types of closed heart surgery according to the results of a study of medical records of 3275 patients is presented. It was established that the incidence rate of typical GSI after endovascular cardiac surgery was 3.1, with prenosological forms — 3.9 per 1000 operations. The main clinical options for postoperative GSI were infections in the field of surgical intervention, community-acquired pneumonia, urinary tract infection and bloodstream infection. There were no statistically significant differences between the incidence of GSI after stenting of the coronary arteries, operations for heart rhythm disturbances, stenosis of the carotid artery and other operations. The low incidence of GSI after closed heart surgery is due to the short duration of surgery, as well as the absence or short-term resuscitation of patients.

Abstract 15210: Do Idiopathic Ventricular Fibrillation and Brugada Syndrome Patients Have Favor Outcomes in the Targeted Temperature Management Era?

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Eisuke Kagawa ◽  
Masaya Kato ◽  
Noboru Oda ◽  
Eiji Kunita ◽  
Michiaki NAGAI ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Survival Rate ◽  
Ventricular Fibrillation ◽  
Brugada Syndrome ◽  
Cardiac Dysfunction ◽  
Targeted Temperature Management ◽  
Temperature Management ◽  
Circulatory Support ◽  
Idiopathic Ventricular Fibrillation ◽  
Coronary Syndrome

Introduction: Idiopathic ventricular fibrillation (IVF) including Brugada syndrome (BS) is one of causes of cardiac arrest without prior overt cardiac dysfunction. Hypothesis: We assessed the hypothesis that patents of IVF had favor outcomes than those of non-IVF after cardiac arrest treated with targeted temperature management (TTM). Methods: Patients who were treated with TTM after cardiac arrest between 2000 and 2019 were enrolled in the study. Patients were divided into 2 groups according to whether the patients were diagnosed as IVF or not. The patients treated with TTM were routinely performed coronary angiography. Results: Among the study patients (N = 306), 35 (11%) patients were IVF and 7 were BS. The patients of the IVF group were significantly younger (median 53 y vs. 64 y) than those of the non-IVF group. The prevalence of initial rhythm was shockable (69% vs. 47%, P = 0.02) was significantly higher in the patients of the IVF group than those of the non-IVF group. Among the patients in the non-IVF group, 114 patients (42%) were diagnosed as acute coronary syndrome and 93 patients (35%) were treated with coronary revascularization. The prevalence of male sex (77% vs 74%, P = 0.70) and witnessed to arrest (80% vs. 81%, P = 0.87), and low-flow time (29 min vs. 38 min [20 - 43 min vs. 21 - 52 min, P = 0.15]) were similar between the 2 groups. The prevalence of performing extracorporeal resuscitation (9% s 43%, P < 0.001) were lower in the patients of the IVF group. The 8-y survival rate were shown in the figure. All of the BS patients were witnessed arrest and were discharged without severe neurological deficit. The IVF as the cause of arrest was independently associated with 8-y survival. Conclusions: The patients of IVF had favor outcomes than those of non-VF. One of causes may be the lower prevalence of requiring extracorporeal circulatory support due to less cardiac dysfunction. The patients of BS had the tendency toward higher survival rate than those of non-BS IVF patients.

AR- und VR-Brillen in der Fabrikplanung*/Current AR- and VR-glasses in factory planning

2018 ◽  
Vol 108 (04) ◽  
pp. 251-256
Author(s):  
U. Bracht ◽  
M. Schlegel
Keyword(s):  
Virtual Reality ◽  
Augmented Reality ◽  
Significant Progress ◽  
Factory Planning ◽  
Current State ◽  
Virtual And Augmented Reality ◽  
Stand Der Technik

Augmented- und Virtual-Reality-Brillen haben signifikante Fortschritte in ihrer technischen Leistungsfähigkeit gemacht. In diesem Fachartikel wird der aktuelle Stand der Technik von AR- und VR-Brillen beschrieben, die bisherigen Hemmnisse für die Verwendung in der Fabrikplanung erörtert und Einsatzpotenziale aufgezeigt, die sich durch die verbesserte Hardware erschließen lassen. &nbsp; Virtual and Augmented Reality Glasses have made significant progress. This paper shows the current state of technology as well as previous impediments in usage and points out applications for an efficient factory planning.

scholarly journals Postoperative Pericardial Adhesion Prevention Using Collagen Membrane in Pigs: A Pilot Study

2017 ◽  
Vol 9 ◽  
pp. 117906521772090 ◽  
Author(s):  
Noppon Taksaudom ◽  
Metus Ketwong ◽  
Nirush Lertprasertsuke ◽  
Aphisek Kongkaew
Keyword(s):  
Heart Surgery ◽  
Open Heart Surgery ◽  
The Body ◽  
Adhesion Prevention ◽  
Control Group ◽  
Collagen Membrane ◽  
Pericardial Cavity ◽  
True Value ◽  
Collagen Membranes ◽  
Experimental Group

Objective: The operating procedure of a resternotomy in open-heart surgery is a complicated procedure with potentially problematic outcomes partly due to potential adhesions in the pericardial cavity and retrosternal space. Use of a collagen membrane has shown encouraging results in adhesion prevention in several regions of the body. This study was designed to evaluate the effectiveness of the use of this collagen membrane in the prevention of pericardial adhesions. Materials and methods: A total of 12 pigs were divided randomly into 2 groups: an experimental group in which collagen membranes were used and a control group. After sternotomy and an anterior pericardiectomy, the epicardial surface was exposed to room air and irrigated with saline, and an epicardial abrasion was performed using a sponge. The pericardial defect was repaired using a collagen membrane in the experimental group or left uncovered in the control group. After 8 to 12 weeks, the pigs were killed, and a resternotomy was performed by a single-blinded surgeon enabling the evaluation of adhesions. The heart was then removed and sent for microscopic assessment conducted by a single-blinded pathologist. Results: The resternotomy operations performed using a collagen membrane demonstrated a nonstatistically significant trend of fewer macroscopic and microscopic adhesions in all regions ( P > .05), particularly in the retrosternal and defect regions. Conclusions: This study showed nonstatistically significant differences between the outcomes in the collagen membrane group and the control group in both macroscopic and microscopic adhesion prevention. Due to the many limitations in animal study design, further studies in human models will be needed before the true value of this procedure can be evaluated.

What’s So Special about the Developing Immune System?

2008 ◽  
Vol 27 (2) ◽  
pp. 223-254 ◽  
Author(s):  
Leigh Ann Burns-Naas ◽  
Kenneth L. Hastings ◽  
Gregory S. Ladics ◽  
Susan L. Makris ◽  
George A. Parker ◽  
...  
Keyword(s):  
Immune System ◽  
Toxicity Testing ◽  
Life Stages ◽  
Significant Progress ◽  
Immune Development ◽  
Immune Parameters ◽  
Current State ◽  
State Of The Science ◽  
Developmental Immunotoxicity ◽  
Nonhuman Species

The evolution of the subdiscipline of developmental immunotoxicology (DIT) as it exists today has been shaped by significant regulatory pressures as well as key scientific advances. This review considers the role played by legislation to protect children’s health, and on the emergence of immunotoxcity and developmental immunotoxicity guidelines, as well as providing some context to the need for special attention on DIT by considering the evidence that the developing immune system may have unique susceptibilities when compared to the adult immune system. Understanding the full extent of this potential has been complicated by a paucity of data detailing the development of the immune system during critical life stages as well as by the complexities of comparisons across species. Notably, there are differences between humans and nonhuman species used in toxicity testing that include specific differences relative to the timing of the development of the immune system as well as more general anatomic differences, and these differences must be factored into the interpretation of DIT studies. Likewise, understanding how the timing of the immune development impacts on various immune parameters is critical to the design of DIT studies, parameters most extensively characterized to date in young adult animals. Other factors important to DIT, which are considered in this review, are the recognition that effects other than suppression (e.g., allergy and autoimmunity) are important; the need to improve our understanding of how to assess the potential for DIT in humans; and the role that pathology has played in DIT studies in test animals. The latter point receives special emphasis in this review because pathology evaluations have been a major component of standard nonclinical toxicology studies, and could serve an important role in studies to evaluate DIT. This possibility is very consistent with recommendations to incorporate a DIT evaluation into standard developmental and reproductive toxicology (DART) protocols. The overall objective of this review is to provide a ‘snapshot’ of the current state-of-the-science of DIT. Despite significant progress, DIT is still evolving and it is our hope that this review will advance the science.

scholarly journals Cardiac Arrest due to Tamponade during Endovascular Stent Implantation: a Case Report

2021 ◽  
Author(s):  
Rou Yu ◽  
Jun Zeng
Keyword(s):  
Cardiac Arrest ◽  
Cardiac Tamponade ◽  
Stent Implantation ◽  
Venous Pressure ◽  
Type I ◽  
Endovascular Stent ◽  
Hemodynamic Changes ◽  
Case Presentation ◽  
Heart Injury ◽  
Multidisciplinary Teamwork

Hemorrhagic cardiac tamponade is one of potentially fatal complications of endovascular intervention. Usually it is because of perforation of heart or rupture of aorta. Cases of pericardial effusion without any arterial or heart injury are rare. Case presentation we reported is a clinical case of cardiac arrest due to tamponade in a patient with DeBakey type I aortic dissection (AD) undergoing thoracic aortic stent implantation. In the early phase of the procedure, hemodynamic changes of increased central venous pressure and decreased blood pressure - by tamponade were noticed but unrecognized and lead to cardiac arrest ultimately. During resuscitation, cardiac tamponade was suspected and confirmed by transesophageal echocardiography (TEE). The patient was successfully resuscitated after pericardiocentesis. Conclusion This case of cardiac tamponade emphasizes the importance of vigilant clinical and echo assessments, efficient multidisciplinary teamwork in deal with the rare but severe complication.

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