scholarly journals Size of Left Cardiac Chambers Correlates with Cerebral Microembolic Load in Open Heart Operations

2010 ◽  
Vol 2010 ◽  
pp. 1-5 ◽  
Author(s):  
Elena Z. Golukhova ◽  
Anna G. Polunina ◽  
Svetlana V. Zhuravleva ◽  
Natalia P. Lefterova ◽  
Alexey V. Begachev
Keyword(s):  
Carbon Dioxide ◽  
Cardiac Surgery ◽  
Risk Factor ◽  
Cardiopulmonary Bypass ◽  
Left Ventricular ◽  
Open Heart ◽  
Left Heart ◽  
Carbon Dioxide Insufflation ◽  
Doppler System ◽  
Cerebral Microembolism

Background. Microemboli are a widely recognized etiological factor of cerebral complications in cardiac surgery patients. The present study was aimed to determine if size of left cardiac chambers relates to cerebral microembolic load in open heart operations.Methods. Thirty patients participated in the study. Echocardiography was performed in 2-3 days before surgery. A transcranial Doppler system was used for registering intraoperative microemboli.Results. Preoperative left atrium and left ventricular end-systolic and end-diastolic sizes significantly correlated with intraoperative microembolic load (, 0.57 and 0.53, , resp.). The associations between left ventricular diameters and number of cerebral microemboli remained significant when cardiopulmonary bypass time was included as a covariate into the analysis.Conclusions. The present results demonstrate that increased size of left heart chambers is an influential risk factor for elevated cerebral microembolic load during open heart operations. Mini-invasive surgery and carbon dioxide insufflation into wound cavity may be considered as neuroprotective approaches in patients with high risk of cerebral microembolism.

Carbon dioxide field flooding techniques for open heart surgery: monitoring and minimizing potential adverse effects

Perfusion ◽  
2000 ◽  
Vol 15 (2) ◽  
pp. 151-153 ◽  
Author(s):  
Edward M Nadolny ◽  
Lars G Svensson
Keyword(s):  
Carbon Dioxide ◽  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Adverse Effects ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Open Heart ◽  
Blood Gas

The use of carbon dioxide for displacement of air in cardiac surgery can have potential adverse effects on blood gas strategies. Presented is a method of monitoring carbon dioxide in the cardiopulmonary bypass circuit and limiting the potential for severe hypercarbia during cardiopulmonary bypass.

scholarly journals Pre-operative and peri operative predictors of acute renal failure after cardiac surgery

2019 ◽  
Vol 6 (3) ◽  
pp. 756
Author(s):  
Praveen Dhaulta ◽  
Vikas Panwar
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Ejection Fraction ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Clinical Variable ◽  
Open Heart ◽  
Multiple Variables

Background: Acute kidney injury (AKI) is one of the most serious complications during the postoperative period of cardiac surgery. Multiple variables predict the ARF after cardiac surgery. Objective of this study was to evaluate the significance of pre and peri-operative variables which may help in predicting the chances of developing ARF after cardiac surgery.Methods: This study was an observational, prospective study conducted among patients who were scheduled to undergo open heart surgery under cardiopulmonary bypass.Results: In total, 50 patients who underwent open-heart surgery, ARF was seen in 5 patients, with the incidence rate of 10%. Acute renal failure was present in one patient with ejection fraction <35, 2 patients had ejection fraction between 35 to 50 and 2 patients with ejection fraction >50. It was seen in 4 patients with 1-2 hrs of cardiopulmonary bypass and in 1 patient with >2 hrs of cardiopulmonary bypass. ARF was also seen in 4 patients with hematocrit between 22-26% and in 1 patient with >26%.Conclusions: The study provided a clinical variable score that can predict ARF after open-heart surgery. The score enhances the accuracy of prediction by accounting for the effect of all major risk factors of ARF.

Severe Hypercapnia during Cardiopulmonary Bypass due to Carbon Dioxide Insufflation - A case report -

2008 ◽  
Vol 54 (1) ◽  
pp. 94
Author(s):  
Hyun Soo Moon ◽  
Soo Kyung Lee ◽  
Young Mi Kim ◽  
Han Seok Kim ◽  
Jin Woo Shin ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Case Report ◽  
Cardiopulmonary Bypass ◽  
Carbon Dioxide Insufflation

scholarly journals Carbon Dioxide Insufflation During Cardiac Surgery: A Meta-analysis of Randomized Controlled Trials

2017 ◽  
Vol 29 (3) ◽  
pp. 301-310 ◽  
Author(s):  
Umberto Benedetto ◽  
Massimo Caputo ◽  
Gustavo Guida ◽  
Chiara Bucciarelli-Ducci ◽  
Jade Thai ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Cardiac Surgery ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Carbon Dioxide Insufflation ◽  
Randomized Controlled

scholarly journals Systemic effects of carbon dioxide insufflation technique for de-airing in left-sided cardiac surgery

2014 ◽  
Vol 147 (1) ◽  
pp. 295-300 ◽  
Author(s):  
Maya Landenhed ◽  
Faleh Al-Rashidi ◽  
Sten Blomquist ◽  
Peter Höglund ◽  
Leif Pierre ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Cardiac Surgery ◽  
Systemic Effects ◽  
Carbon Dioxide Insufflation

scholarly journals Prevalence of co-morbidities among adult patients presented for open heart surgery and the implication on convalescence period

2017 ◽  
Vol 4 (1) ◽  
pp. 1 ◽  
Author(s):  
Hayel Al Adwan ◽  
Ashraf Fadel ◽  
Yanal F. Al Naser ◽  
Abdallah Al Qaysi ◽  
Rami Qsous ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cardiac Surgery ◽  
Heart Surgery ◽  
Anesthetic Management ◽  
Open Heart Surgery ◽  
Left Ventricular ◽  
Adult Patients ◽  
Open Heart ◽  
Previous Myocardial Infarction ◽  
Icu Discharge

Background: Improvements in perioperative medical care, anesthetic management, surgical and myocardial protection techniques made cardiac surgery feasible in the high risk surgical patients. The aim of the study was to determine the prevalence of comorbidities in adult patients undergoing open heart surgery and to evaluate their implications on recovery profile.Methods: This randomized retrospective observational study of 100 adult patients presented for heart surgery for different pathologies took place at Queen Alia heart Institute in the period of time between February 2013 and June 2014. Patients' data was collected in forms, tabulated and retrospectively analyzed. Patients' demographics, co-morbidities and type of surgery were recorded. Risk stratification models (ASA-American Society of Anesthesiology and EUROSCORE 2- European system for cardiac operative risk evaluation) were used. Time of extubation, ICU discharge and hospital discharge was recorded with each patient.Results: Age of patients ranged from 18 to 77 years (mean±SD: 58±12). 83% of patients were male and 17% were female. 80 patients were presented for CABG and 20 patients for heart valve(s) surgery. BMI (body mass index, mean±SD) was 28.9±4.6 kg/m². The prevalence of smoking was 56% (6 times higher among males (64%), in comparison to females (12%). Hypertension was prevalent in 72% of patients; diabetes was present in 53%, respiratory disease in 30%, previous myocardial infarction in 23%, 37% of patients had left ventricular impairment, renal impairment in 6%, renal failure in 2% and previous stroke in 2%. EUROSCORE values ranged between 0.5 to 5.3 % (mean 1.4%). ASA grades ranged from 2 to 4 (85% of patients were grade 3). 5% of surgeries were emergent. Average operative time was 248±47 minutes (mean±SD). 30% of patients needed inotropic support and 6% needed intra-aortic balloon. Mean time in the intensive care was 43.2±28.8 hours (mean±SD).Conclusions: There is a high prevalence of co-morbidities in patients presented for cardiac surgery. Most common associated diseases were hypertension, obesity, smoking, previous myocardial infarction and diabetes; which are all well known risk factors of ischemic heart disease. Preoperative risk scoring is of paramount importance.

scholarly journals Impact of some intraoperative factors on wound infection in cardiac surgery

2021 ◽  
Vol 20 (1) ◽  
pp. 36-43
Author(s):  
A. V. Stepin
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Wound Infection ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Wound Infections ◽  
Open Heart ◽  
Postoperative Wound ◽  
Sternal Infection ◽  
Mammary Arteries

Relevanc. Surgical Site Infection (SSI) after open heart surgery is a significant problem in clinical, social, and economic aspect which causes the need to identification of the preferred procedures for successful prevention of the SSI.Objectives. To determine risk of the SSI in cardiac surgery depending on complexity of intervention, using of cardiopulmonary bypass (CBP) and use of both internal mammary arteries (IMA).Methods. Prospective observations study from 2010 to 2019 in cardiac surgery department of the Ural Institute of Cardiology, where in total 4993 open heart surgery procedures were consecutively performed. All SSI cases were recorded up to 90 days after surgery. The analysis was performed to identify risk of cardiopulmonary bypass (CPB), bilateral IMA grafting and combined procedures on the risk of the postoperative wound infection.Results. During the investigation period, total 220 cases of the SSI (4,5%) have been registered of the 4993 patients undergoing open heart surgery. It included 42 cases of deep sternal infection (0,9%) and 178 cases of superficial infection (3,6%). The main pathogen identified was Staphylococcus epidermidis (56,4%). During the hospital period, 151 cases (66,5%) of SSI have been detected, with the median time to detection of the complication 6 days. The relative mortality risk in deep sternal infection group was 4,4 times higher than in the group without SSI (HR 4,6, 95 % CI 1,5-13,9, p=0,003624). CABG increases the relative risk of SSI in compare with non-CABG procedures (OR 3,086169; 95%CI 1,281 – 7,437), while the complexity of the operation (combined versus isolated interventions) does not significantly increase the risk (OR 0.972283; 95% CI: 0.696 - 1.359). The incidence of SSI in the group of in situ BIMA grafting was 8.8%, significantly increasing the likelihood of the SSI in compare to those with SIMA (OR 2.167983, 95% CI 1.463 - 3.212; p =0,000057). CBP significantly increases the risk of postoperative wound infections (OR 1.523890, 95% CI 1.149 - 2.022, p = 0.001742).Conclusions. Refusal of cardiopulmonary bypass, simultaneous procedures and bilateral coronary artery bypass does not allow completely to avoid postoperative wound infections. Nevertheless, the technical features of the preparations and use of grafts, including skeletonization, prevention of coagulation and the preference for sequential composite CABG, can reduce the risk associated with the type of the open heart surgery.

scholarly journals 83 The predictive role of neutrophil-to-lymphocyte ratio in post-operative cardiopulmonary bypass surgery

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Valentina Bucciarelli ◽  
Francesco Bianco ◽  
Annaclara Blasi ◽  
Martina Primavera ◽  
Baldinelli Alessandra ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Pediatric Patients ◽  
Septal Defect ◽  
Left Ventricular ◽  
Conduction System ◽  
Neutrophil To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Predictive Role

Abstract Aims Postoperative arrhythmias (POA) are a common complication after cardiac surgical repairs for congenital heart disease (CHD), representing a substantial source of morbidity, mortality, and prolonged total in-hospital stay, with an incidence of 7.5–48% in postoperative pediatric cardiac patients. The etiology is multifactorial, and it has been related to the direct surgical manipulation of the cardiac conduction system, to the local tissue inflammation in the myocardium adjacent to the conduction system and to the arrhythmogenic effects of cardiopulmonary bypass (CPB), inotropes, and electrolyte disturbances. Recently, the prognostic role of neutrophil-to-lymphocyte ratio (NLR), a novel inflammation marker, has been evaluated in pediatric patients after CPB surgery. To evaluate the predictive role of NLR in POA in a population of pediatric CHD patients after CPB. Methods and results We retrospectively collected perioperative clinical and laboratory data of 146 patients (age 8.27 ± 10.79 years; male gender: 60.8%) consecutively admitted to the cardiac surgery intensive care unit (ICU) of our institute after elective cardiac surgery with CPB in 2018. We grouped and analyzed our population over NLR tertiles evaluated at 24 h from CPB and types of POA: supraventricular (SVT) and junctional (JET). The prognostic value of NLR and its association with POA was analyzed. Diagnoses of 146 patients included atrial septal defect (n = 36), ventricular septal defect (n = 20), pulmonary atresia/stenosis (n = 10), tetralogy of Fallot (n = 20), endocardial cushion defect (n = 8), left ventricular outflow tract obstruction (n = 14), anomalous origin of coronary artery (n = 6), complex CHD (n = 13), interrupted/hypoplastic aortic arch (n = 12), anomalous pulmonary venous return (n = 3). The mean CPB time was 121.6 ± 84.6 min. The median ICU hospitalization was 48 h [Q1, Q3: 24, 96]. Twelve patients experienced POA: 6 SVT and 6 JET. The frequency of POA incremented over NLR-tertiles (P-Trend 0.017), while SVT onset was associated with higher values of NLR and C-reactive protein (P = 0.034 and P = 0.011, respectively). Patients in the second and third tertiles of NLR had a prolonged hospitalization (log-rank, P = 0.029), especially when associated with POA (log-rank, P = 0.012). At the multivariable analysis, higher age and NLR values were independently associated with SVT [OR per year 1.22; 95% CI (1.02, 1.25), P = 0.043 and OR per point 1.91; 95% CI (1.29, 2.82), P = 0.012, respectively], but not with JET. Conclusions 24-h post-CPB NLR can predict postoperative SVT in a population of pediatric CHD patients. Our data suggest that the NLR could be a useful, easy-to-obtain marker for postoperative outcome in pediatric patients who had undergone elective CPB.

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