scholarly journals Totally endoscopic resection of atrial myxoma: early results of 26 patients in E hospital

2021 ◽  
Vol 33 ◽  
pp. 38-43
Author(s):  
Nguyen Hoang Nam ◽  
Nguyen Cong Huu ◽  
Tran Thuy Nguyen ◽  
Hoang Van Trung ◽  
Do Duc Thinh ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Endoscopic Surgery ◽  
Atrial Myxoma ◽  
Thoracic Wall ◽  
Aortic Cross Clamp Time ◽  
Aortic Cross Clamp ◽  
Cardiopulmonary Bypass Time ◽  
Cross Clamp Time ◽  
Early Results ◽  
Postoperative Time

Objective: Myxoma is the most common form of non-malignant tumor that arises from connective tissue. Totally endoscopic surgery without robotic assistance can resect the entire atrial myxoma. This study aim to evaluate the early results of this surgical method. Methods: From January 2019 to April 2021, 26 patients (20 females, 6 males, mean age 49.5 ± 14.3) were diagnosed with atrial myxoma. All tumors of those patients were resected by totally endoscopic surgery. We evaluated the early outcome of this method based on the following criteria: mortality rates, conversion to open surgery, cardiopulmonary bypass time, aortic cross-clamp time, postoperative time. Results: Totally endoscopic surgery to resect atrial myxoma was successfully performed in all patients with surgical ports on the thoracic wall. The largest incision was not more than 1.5 cm in diameter. Mean cardiopulmonary bypass time was 134 ± 39 minutes, aortic cross-clamp time was 81.4 ± 26.4 minutes, mechanical ventilation time was 10.5 ± 4.6 hours, ICU length of stay was 2.1 ± 0.9 days, postoperative time was 6.9 ± 5.4 days. We had one case in which the excision of myxoma was performed contemporaneously with mitral valve annuloplasty. Conclusions: Initial outcomes of totally endoscopic surgery to resect atrial myxomas were satisfactory. However, to fully evaluate the effectiveness of this method, we need to conduct a long-term follow-up of these patients.

Comparison of outcomes of the use of Del Nido and St. Thomas cardioplegia in adult and paediatric cardiac surgery: a systematic review and meta-analysis

Perfusion ◽  
2020 ◽  
Vol 35 (8) ◽  
pp. 724-735 ◽  
Author(s):  
Ashlynn Ler ◽  
Faizus Sazzad ◽  
Geok Seen Ong ◽  
Theo Kofidis
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Relative Risk ◽  
Confidence Interval ◽  
Mean Difference ◽  
Aortic Cross Clamp Time ◽  
Aortic Cross Clamp ◽  
Cardiopulmonary Bypass Time ◽  
Paediatric Cardiac Surgery ◽  
Adult Cardiac Surgery

Background: In recent years, the use of del Nido cardioplegia, initially intended for paediatric cardiac surgery, has been extended to adult cardiac surgery in many institutions. Our aim was thus to compare the outcomes of the use of del Nido cardioplegia with that of conventional cardioplegia and discuss its role in both adult and paediatric cardiac surgery. Method: A systematic literature search was conducted in August 2019 on Medline (via PubMed), Embase and Cochrane electronic databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Any retrospective studies and randomised controlled trials that reported findings comparing the outcomes of the use of del Nido cardioplegia with that of St. Thomas cardioplegia were included. Results: We observed shorter aortic cross-clamp time (mean difference: −15.18, confidence interval: −27.21 to −3.15, p = 0.01) and cardiopulmonary bypass time (mean difference: −13.52, confidence interval: −20.64 to −6.39, p = 0.0002) associated with the use of del Nido cardioplegia in adult cardiac surgery as compared to St. Thomas cardioplegia. Defibrillation rates were significantly lower in patients who had been given del Nido cardioplegia, in both adult (relative risk: 0.28, confidence interval: 0.12 to 0.64, p = 0.003) and paediatric patients (relative risk: 0.25, confidence interval: 0.08 to 0.79, p = 0.02). Conclusion: Del Nido cardioplegia may be a viable alternative to the use of St. Thomas cardioplegia in both adult and paediatric patients, providing similar postoperative outcomes while also affording the additional advantage of shorter aortic cross-clamp time and cardiopulmonary bypass time (in adult cardiac surgery) and decreased rates of defibrillation (in both adult and paediatric cardiac surgery).

scholarly journals P0343 / #1255: ASSOCIATION BETWEEN PROLONGED CARDIOPULMONARY BYPASS AND AORTIC CROSS CLAMP TIME WITH EXTRACARDIAC OUTCOMES AFTER PEDIATRIC CARDIAC SURGERY.

2021 ◽  
Vol 22 (Supplement 1 3S) ◽  
pp. 183-183
Author(s):  
J.T. Salinas Alanis ◽  
N.C. Arias Pena ◽  
C.D. Hernandez Rosales ◽  
N.E. Guzman Delgado ◽  
M.E. Molina Garza
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Pediatric Cardiac Surgery ◽  
Aortic Cross Clamp Time ◽  
Aortic Cross Clamp ◽  
Cross Clamp Time

scholarly journals Correlation of Interleukin-8, Pediatric Logistic Organ Dysfunction score and factors associated with systemic inflammatory response after cardiopulmonary bypass in children who have undergone open-heart surgery

2010 ◽  
Vol 50 (4) ◽  
pp. 245
Author(s):  
Ririe F Malisie ◽  
Antonius H Pudjiadi ◽  
Fathema D Rachmat ◽  
Jusuf Rachmat
Keyword(s):  
Cardiopulmonary Bypass ◽  
Plasma Level ◽  
Inflammatory Response ◽  
Systemic Inflammatory Response ◽  
Aortic Cross Clamp Time ◽  
Aortic Cross Clamp ◽  
Factors Associated ◽  
Logistic Organ Dysfunction ◽  
Reperfusion Period ◽  
Pelod Score

Background Cardiopulmonary bypass (CPB) provides a complex set of non-physiologic circumstances, induces systemic release of pro-inflammatory cytokines and initiates systemic inflammatory response. IL-8 is an important activator of neutrophil with chemotactic effect and are proposed to be major mediator of inflammation. The majority of general intensive care unit scoring system does not adequately address the specific characteristics of cardiac surgery patients. None of the study had been published the validation of PELOD score setting in pediatric cardiac intensive care unit (CICU).Objectives To evaluate the correlation between interleukin-8 (IL-8), Pediatric Logistic Organ Dysfunction (PELOD) score and factors associated with systemic inflammatory response after bypass (SIRAB) in children undergone cardiopulmonary bypass surgery.Methods A quasi-experimental study was conducted on children who have undergone cardiac surgery requiring CPB. There were 21 eligible children, two were excluded. Blood samples from mixed vein and coronary sinus were taken before, during and after surgery. The plasma level of IL-8 analyzed at 3 time points: baseline (before) CPB, at reperfusion period and 3 hours after aortic cross clamp-off. Cumulative organ dysfunctions were analyzed by PELOD score.Results The plasma level of IL-8 highly increase at the reperfusion period. IL-8 plasma level correlated with bypass-time (r > 0.49, p=0.003) and aortic cross clamp-time (r > 0.55, P=.014). Moderate association between age and PELOD score (r > 0.47, P=0.041). The correlations were significant between age and mechanical ventilation time support (r > 0.47, P=0.03), age and length of stay in CICU (r > 0.44, P=0.05). No correlation between IL-8 plasma level and PELOD score.Conclusion There was no correlation between IL-8 plasma level and PELOD score. IL-8 plasma level correlated with aortic cross clamp-time in children who undergo cardiopulmonary bypass surgery.

scholarly journals Oxidative stress injury after on-pump cardiac surgery: Effects of aortic cross clamp time and type of surgery

Redox Report ◽  
2013 ◽  
Vol 18 (5) ◽  
pp. 193-199 ◽  
Author(s):  
José García-de-la-Asunción ◽  
Ernesto Pastor ◽  
Jaime Perez-Griera ◽  
Francisco Javier Belda ◽  
Tania Moreno ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Cardiac Surgery ◽  
Aortic Cross Clamp Time ◽  
Aortic Cross Clamp ◽  
Stress Injury ◽  
Cross Clamp Time ◽  
Oxidative Stress Injury ◽  
Type Of Surgery

scholarly journals Myocardial protection during elective coronary artery bypasses grafting by pretreatment with omega-3 polyunsaturated fatty acids

2013 ◽  
Vol 70 (5) ◽  
pp. 484-492 ◽  
Author(s):  
Milic Veljovic ◽  
Ana Popadic ◽  
Zoran Vukic ◽  
Radoje Ilic ◽  
Zoran Trifunovic ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Coronary Artery ◽  
Myocardial Protection ◽  
Oxygen Extraction ◽  
Controlled Study ◽  
Control Group ◽  
Omega 3 ◽  
Aortic Cross Clamp Time ◽  
Aortic Cross Clamp ◽  
Cross Clamp Time

Background/Aim. Despite recent advances in coronary artery bypass grafting (CABG), cardioplegic cardiac arrest and cardiopulmonary bypass (CPB) are still associated with myocardial injury. Accordingly, the efforts have been made lately to improve the outcome of CPB by glucose-insulinpotassium, adenosine, Ca2+-channel antagonists, L-arginine, N-acetylcysteine, coenzyme Q10, diazoxide, Na+/H+ exchange inhibitors, but with an unequal results. Since omega-3 polyunsatutated fatty acids (PUFAs) have shown remarkable cardioprotection in preclinical researches, the aim of our study was to check their effects in prevention of ischemia reperfusion injury in patients with CPB. Methods. This prospective, randomized, placebo-controlled study was performed with parallel groups. The patients undergoing elective CABG were randomized to receive preoperative intravenous omega-3 PUFAs infusion (n = 20) or the same volume of 0.9% saline solution infusion (n = 20). Blood samples were collected simultaneously from the radial artery and the coronary sinus before starting CPB and at 10, 20 and 30 min after the release of the aortic cross clamp. Lactate extraction/excretion and myocardial oxygen extraction were calculated and compared between the two groups. The levels of troponin I (TnT) and creatine kinase-myocardial band (CK-MB) were determined before starting CPB and 4 and 24 h postoperatively. Results. Demographic and operative characteristics, including CPB and aortic cross-clamp time, were similar between the two groups of patients. The level of lactate extraction 10 and 20 min after aortic cross-clamp time has shown negative values in the control group, but positive values in the PUFAs group with statistically significant differences (-19.6% vs 7.9%; p < 0.0001 and -19.9% vs 8.2%; p < 0.0008, respectively). The level of lactate extraction 30 minutes after reperfusion was not statistically different between the two groups (6.9% vs 4.2%; p < 0.54). Oxygen extraction in the PUFAs group was statistically significantly higher compared to the control group after 10, 20 and 30 min of reperfusion (35.5% vs 50.4%, p < 0.0004; 25.8 % vs 48.7%, p < 0.0001 and 25.8% vs 45.6%, p < 0.0002, respectively). The level of TnT, 4 and 24 h after CPB, was significantly higher in the control group compared to PUFAs group, with statistically significant differences (11.4 vs 6.6, p < 0.009 and 12.7 vs 5.9, p < 0.008, respectively). The level of CK-MB, 4 h after CPB, was significantly higher in the control group compared to PUFAs group (61.9 vs 37.7, p < 0.008), but its level, 24 h after CPB, was not statistically different between the two groups (58.9 vs 40.6, p < 0.051). Conclusion. Treatment with omega-3 PUFAs administered preoperatively promoted early metabolic recovery of the heart after elective CABG and improved myocardial protection. This study showed that omega-3 emulsion should not be considered only as a nutritional supplement but also as a clinically safe and potent cardioprotective adjunct during CPB.

Reduced aortic cross-clamp time in high-risk patients with abdominal aortic aneurysm

1986 ◽  
Vol 3 (5) ◽  
pp. 820-823 ◽  
Author(s):  
Richard T. Purdy ◽  
Frederick C. Beyer ◽  
William D. McCann ◽  
Ian D. Smith ◽  
Richard H. Mann
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
High Risk ◽  
Aortic Aneurysm ◽  
Aortic Cross Clamp Time ◽  
Aortic Cross Clamp ◽  
High Risk Patients ◽  
Cross Clamp Time ◽  
Abdominal Aortic ◽  
Risk Patients

scholarly journals Transannular Patch Repair of Tetralogy of Fallot With or Without Monocusp Valve Reconstruction: A Meta-analysis

2020 ◽  
Author(s):  
Xiaodong Wei ◽  
Tiange Li ◽  
Yunfei Ling ◽  
Zheng Chai ◽  
Zhongze Cao ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Length Of Stay ◽  
Tetralogy Of Fallot ◽  
Meta Analysis ◽  
Patch Repair ◽  
Perioperative Outcomes ◽  
Aortic Cross Clamp Time ◽  
Aortic Cross Clamp ◽  
Transannular Patch ◽  
Valve Reconstruction

Abstract Background: Tetralogy of Fallot (TOF) is one of the most common cyanotic congenital heart diseases. Pulmonary regurgitation is the most common and severe comorbidity after transannular patch (TAP) repair of TOF patients. It has not been confirmed whether a TAP repair with monocusp valve reconstruction would benefit TOF patients in perioperative period compared to those without monocusp valve reconstruction. The purpose of the study is to review and analyze all clinical studies that have compared perioperative outcomes of TOF patients undergoing TAP repair with or without monocusp valve reconstruction and conduct a preferable surgery.Methods: Eligible studies were identified by searching the electronic databases. The primary outcome was perioperative mortality. Secondary outcomes included cardiopulmonary bypass time, aortic cross-clamp time, ventilation duration, ICU length of stay, hospital length of stay, and perioperative right ventricular outflow tract (RVOT) pressure gradient. The meta-analysis and forest plots were drawn using Review Manager 5.3. Statistically significant was considered when p-value ≤ 0.05. Results: Eight studies were included which consisted of 7 retrospective cohort study and 1 randomized controlled trial. The 8 studies formed a pool of 526 TOF patients in total, in which are 300 undergoing TAP repair with monocusp valve reconstruction (monocusp group) compared to 226 undergoing TAP repair without monocusp valve reconstruction (non-monocusp group). It demonstrated significant differences between two groups in perioperative cardiopulmonary bypass time (21.86, 95% CI 16.51-27.21), perioperative aortic cross-clamp time (11.20, 95% CI 1.06 - 21.34), mean length of ICU stay (-1.55, 95% CI -3.90 - -0.81), and the degree of perioperative PR (OR=0.02, 95% CI 0.00 - 0.15).Conclusion: Transannular patch repair with monocusp valve reconstruction seems to have significant advantages on some perioperative outcomes of TOF patients. Large, multicenter, randomized, prospective studies focusing on differences between TAP repair with and without monocusp valve reconstruction are needed.

What was the impact of the introduction of extracardiac completion for a single center performing total cavopulmonary connections?

2004 ◽  
Vol 14 (2) ◽  
pp. 140-147 ◽  
Author(s):  
Christian Schreiber ◽  
Martin Kostolny ◽  
Joachim Weipert ◽  
Klaus Holper ◽  
Manfred Vogt ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Statistical Significance ◽  
Multivariable Analysis ◽  
Total Cavopulmonary Connection ◽  
Cardiopulmonary Bypass Time ◽  
Cross Clamp Time ◽  
Significant Difference ◽  
The Mean ◽  
The Impact ◽  
Cavopulmonary Connection

Background:Creation of an extracardiac cavopulmonary connection has been proposed as a superior alternative to the lateral intracardiac tunnel for the completion of total cavopulmonary connection.Methods and results:We made a retrospective review of our experience with 125 patients undergoing a total cavopulmonary connection between June 1994 and January 2003. Our experience with the extracardiac connection for completion began in 1999. Since 1994, we have constructed an intracardiac tunnel in 50 patients, and an extracardiac connection in 75. Of the total number, 83 had undergone an earlier partial cavopulmonary connection. Additional intracardiac procedures were performed in 43 patients at time of completion, in 25 of those undergoing extracardiac completion, and in 18 of the patients having an intracardiac procedure. The mean size of the tube used for completion was 19 mm. The mean cross-clamp time for placement of the intracardiac tunnel was 77 min, with a median of 80.5 min, and a mean cardiopulmonary bypass time of 139 min, with a median of 131 min. For construction of the extracardiac connection, a mean cross-clamp time in 24 of the 75 patients was 54 min, with a median of 54 min. Mean cardiopulmonary bypass time for all the patients with an extracardiac connection was 100 min, with a median of 88 min. Reoperations were needed in 10 patients, 6 having intracardiac and 4 extracardiac procedures. Of these, 5 were early and 5 late, including one take down. None of the patients died after these interventions. Taken overall, 8 patients died, with 5 early deaths. In the multivariable analysis, cardiopulmonary bypass time of more than 120 min, atrioventricular valvar replacement, and banding of the pulmonary trunk prior to the total cavopulmonary connection, all reached statistical significance for early death, whereas only heterotaxy syndrome remained as the sole risk factor for late death. There was no significant difference in survival between the modifications used.Discussion:Whereas we could not identify any clinical superiority for the extracardiac approach in the short-term, the concept of extracardiac completion has helped to simplify the overall procedure. Longer follow-up will be required to elucidate any potential advantages.

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