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Myocardiial Protection Strategy Utilizing Retrograde Cardioplegia
Myocardial Protection Strategy Utilizing Retrograde Cardioplegia Item Type text; Electronic Thesis Authors Karbasi, Michael Publisher The University of Arizona. Rights Copyright © is held by the author. Digital access to this material is made possible by the College of Medicine - Phoenix, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author. Download date 25/09/2021 11:23:01 Link to Item http://hdl.handle.net/10150/281195 Myocardial Protection Strategy Utilizing Retrograde Cardioplegia for Neonatal Arterial Switch Operations Michael Karbasi1, John Nigro, M.D.2,3, Bradford Sanders, CCP,, MS2,3, Cyrus Kosar, MS4, Brigham C. Willis, M.D.1,2,3 1 University of Arizona, College of Medicine-Phoenix; 2Children’s Heart Center, Phoenix Children’s Hospital, Phoenix, AZ; 3Eller Congenital Heart Center at St. Joseph’s Hospital and Medical Center, Phoenix, AZ; and 4Institute for Aging Research in Affiliation with Harvard Medical School ABSTRACT RESULTS 30.0 Introduction: Myocardial protection strategies are a central component of neonatal arterial switch operations. Traditionally antegrade cardioplegia 25.0 through the aortic root has been the method of delivery, but use of retrograde cardioplegia via the coronary sinus has become the standard 20.0 of practice by many in the field. Methods: After obtaining IRB approval 15.0 Retrograde and informed consent, a retrospective chart review was done to assess Days Antegrade outcomes between 48 patients receiving antegrade (n= 5) and retrograde 10.0 (n= 43) cardioplegia during neonatal switch operations. Preoperative demographics and postoperative outcomes were compared between the 5.0 two groups and compared with historical studies. -
Congenital Heart Disease
GUEST EDITORIAL Congenital heart disease Pediatric Anesthesia is the only anesthesia journal ded- who developed hypoglycemia were infants. (9). Steven icated exclusively to perioperative issues in children and Nicolson take the opposite approach of ‘first do undergoing procedures under anesthesia and sedation. no harm’ (10). If we do not want ‘tight glycemic con- It is a privilege to be the guest editor of this special trol’ because of concern about hypoglycemic brain issue dedicated to the care of children with heart dis- injury, when should we start treating blood sugars? ease. The target audience is anesthetists who care for There are no clear answers based on neurological out- children with heart disease both during cardiac and comes in children. non-cardiac procedures. The latter takes on increasing Williams and Cohen (11) discuss the care of low importance as children with heart disease undergoing birth weight (LBW) infants and their outcomes. Pre- non-cardiac procedures appear to be at a higher risk maturity and LBW are independent risk factors for for cardiac arrest under anesthesia than those without adverse outcomes after cardiac surgery. Do the anes- heart disease (1). We hope the articles in this special thetics we use add to this insult? If prolonged exposure issue will provide guidelines for management and to volatile anesthetics is bad for the developing neona- spark discussions leading to the production of new tal brain, would avoiding them make for improved guidelines. outcomes? Wise-Faberowski and Loepke (12) review Over a decade ago Austin et al. (2) demonstrated the current research in search of a clear answer and the benefits of neurological monitoring during heart conclude that there isn’t one. -
The Conversion to Rastelli's Type Operation from Patrick-Mcgoon's
General Thoracic and Cardiovascular Surgery (2019) 67:551–553 https://doi.org/10.1007/s11748-018-0942-x CASE REPORT The conversion to Rastelli’s type operation from Patrick-McGoon’s procedure of an adult with Taussig–Bing heart: a case report Keiichi Fujiwara1 · Kousuke Yoshizawa1 · Nobuhisa Ohno1 · Hisanori Sakazaki2 Received: 30 January 2018 / Accepted: 18 May 2018 / Published online: 11 June 2018 © The Japanese Association for Thoracic Surgery 2018 Abstract A 23-year-old female of Taussig–Bing heart with antero-posterior relation of the great arteries was underwent Patrick- McGoon’s intraventricular rerouting at 6 years old of age. The left ventricular outflow obstruction (peak pressure gradient of 100 mmHg) developed, and severe aortic valve regurgitation following bacterial endocarditis was noted. The conversion to Rastelli’s type operation and aortic valve replacement were performed successfully at 23 years old of age. She is doing well without any significant left or right ventricular outflow obstruction at 7 years postoperatively. Keywords Taussig–Bing heart · Intraventricular rerouting · Patrick-McGoon’s operation · Left ventricular outflow obstruction · Adult congenital heart disease Introduction Case Taussig–Bing heart is characterized by double-outlet right A 23-year-old female diagnosed of double outlet right ventricle with subpulmonary ventricular septal defect [1, 2]. ventricle with subpulmonary ventricular septal defect and Currently, the arterial switch procedure as anatomic repair, antero-posterior relation of the great arteries, was referred to connecting the left ventricle to aorta and the right ventricle our hospital for severe left ventricular outflow tract obstruc- to pulmonary artery, is a popular surgical management for tion following Patrick-McGoon’s intraventricular rerouting Taussig–Bing heart regardless of relation of the great arter- and moderate to severe aortic valve regurgitation following ies. -
Pediatric Radiology
2013 RSNA (Filtered Schedule) Sunday, December 01, 2013 10:30-12:00 PM • VSPD11 • Room: S100AB • Pediatric Radiology Series: Pediatric Neuroimaging I 10:45-12:15 PM • SPOI11 • Room: E353C • Oncodiagnosis Panel: Pediatric Sarcoma (An Interactive Session) 12:30-01:00 PM • CL-PDS-SUA • Room: S101AB • Pediatric Radiology - Sunday Posters and Exhibits (12:30pm - 1:00pm) 01:00-01:30 PM • CL-PDS-SUB • Room: S101AB • Pediatric Radiology - Sunday Posters and Exhibits (1:00pm - 1:30pm) 02:00-03:30 PM • VSPD12 • Room: S102AB • Pediatric Radiology Series: Pediatric Musculoskeletal Monday, December 02, 2013 08:30-10:00 AM • RC224 • Room: E353B • Mentored Case Approach to Pediatric Cardiovascular Disease 1: Vascular Disease (An Interactive Session) 08:30-12:00 PM • VSPD21 • Room: S102AB • Pediatric Radiology Series: Fetal - Neonatal Imaging 12:15-12:45 PM • CL-PDS-MOA • Room: S101AB • Pediatric Radiology - Monday Posters and Exhibits (12:15pm - 12:45pm) 12:45-01:15 PM • CL-PDS-MOB • Room: S101AB • Pediatric Radiology - Monday Posters and Exhibits (12:45pm - 1:15pm) 03:00-04:00 PM • SSE21 • Room: S102AB • Pediatric (Neuroimaging) Tuesday, December 03, 2013 08:30-10:00 AM • RC324 • Room: S402AB • Mentored Case Approach to Pediatric Cardiovascular Disease 2: Cardiac Disease (An Interactive Session) 08:30-12:00 PM • VSPD31 • Room: S102AB • Pediatric Radiology Series: Chest/Cardiovascular Imaging I 12:15-12:45 PM • CL-PDS-TUA • Room: S101AB • Pediatric Radiology - Tuesday Scientific Posters and Exhibits (12:15pm - 12:45pm) 12:45-01:15 PM • CL-PDS-TUB • -
Comparison of Del Nido Cardioplegia
ORIGINAL ARTICLE Braz J Cardiovasc Surg 2021;36(2):158-64 Comparison of Del Nido Cardioplegia and Blood Cardioplegia in Terms of Development of Postoperative Atrial Fibrillation in Patients Undergoing Isolated Coronary Artery Bypass Grafting Umut Serhat Sanrı1, MD; Kadir Kaan Özsin1, MD; Faruk Toktaş1, MD; Şenol Yavuz1, MD DOI: 10.21470/1678-9741-2020-0047 Abstract length of hospital stay remain significantly higher in the BC group Objective: Del Nido cardioplegia (DNC) has been used in (P=0.044, P<0.001, respectively). In addition, the aortic cross-clamp pediatric cardiac surgery for many years with a single dose time and the cardioplegia volume delivered were significantly application and its usage in adult cardiac surgery has been lower in the DNC group (P=0.042, P<0.001, respectively). In increasing in recent years, with results being published. In multivariate logistic regression analysis, only higher cardioplegia this study, we aimed to investigate the effect of DNC on the volume was determined as an independent predictor for PoAF development of postoperative atrial fibrillation (PoAF). development (OR 1.001; 95% CI 1.000-1.001; P=0.033). We did not Methods: In this retrospective observational comparative found difference between groups in terms of troponin T, inotropic study, 255 patients who underwent isolated on-pump coronary drug support, need for intraaortic balloon pump and mortality. artery bypass grafting, between January 2019 and November Conclusion: This study showed that DNC can be used safely 2019, were enrolled. The patients were divided into two groups: in adult coronary bypass surgery and PoAF development effect DNC (n=132) and blood cardioplegia (BC) (n=123). -
Bentall Procedure: Quarter Century of Clinical Experiences of a Single
Benke et al. Journal of Cardiothoracic Surgery (2016) 11:19 DOI 10.1186/s13019-016-0418-y RESEARCHARTICLE Open Access Bentall procedure: quarter century of clinical experiences of a single surgeon Kálmán Benke1,3*, Bence Ágg1,3, Lilla Szabó1, Bálint Szilveszter1,4, Balázs Odler2, Miklós Pólos1, Chun Cao1, Pál Maurovich-Horvat1,4, Tamás Radovits1, Béla Merkely1 and Zoltán Szabolcs1,3 Abstract Background: We retrospectively analyzed 25 years of experiences with the button Bentall procedure in patients with aortic root pathologies. Even though this procedure has become widespread, there are only a few very long term follow-ups available in the clinical literature, especially regarding single surgeon results. Methods: Between 1988 and 2013, a total of 147 patients underwent the Bentall procedure by the same surgeon. Among them there were 62 patients with Marfan syndrome. At the time of the surgery the mean age was 46.5 ± 17.6 years. The impact of surgical experience on long-term survival was evaluated using a cumulative sum analysis chart. Results: The Kaplan-Meier estimated overall survival rates for the 147 patients were 91.8 ± 2.3 %, 84.3 ± 3.1 %, 76.3 ± 4.9 % and 59.5 ± 10.7 % at 1,5,10 and 20 years, respectively. Multivariate Cox regression analysis identified EuroSCORE II over 3 % (OR 4.245, 95 % CI, 1.739–10.364, p = 0.002), acute indication (OR 2.942, 95 % CI, 1.158–7.480, p = 0.023), use of deep hypothermic circulatory arrest (OR 3.267, 95 % CI, 1.283–8.323, p = 0.013), chronic kidney disease (OR 6.865, 95 % CI, 1.339–35.189, p = 0.021) and early complication (OR 3.134, 95 % CI, 1.246–7.883, p = 0.015) as significant risk factors for the late overall death. -
A Common Occurrence After Coronary Bypass Surgery
CORE Metadata, citation and similar papers at core.ac.uk Provided by Elsevier - Publisher Connector lACC Vol. 15, No.6 1261 May 1990:1261-9 Acute Myocardial Dysfunction and Recovery: A Common Occurrence After Coronary Bypass Surgery WARREN M. BREISBLATT, MD, FACC, KEITH L. STEIN, MD, CYNTHIA J. WOLFE, RN, WILLIAM P. FOLLANSBEE, MD, FACC, JOHN CAPOZZI, CNMT, JOHN M. ARMITAGE, MD, ROBERT L. HARDESTY, MD, FACC Pittsburgh, Pennsylvania To evaluate whether acute myocardial dysfunction was min after coronary bypass and showed complete recovery common in the early postoperative period, serial hemody• within 48 h. Left ventricular end-systolic and end-diastolic namic measurements and radionuclide evaluation of ven• volume index increased significantly postoperatively, but tricular function were performed before and after opera• recovery in left ventricular ejection fraction was mostly due tion in 24 patients undergoing elective coronary bypass to decreases in end-systolic volume index (50 ± 22 ml at surgery. All patients had uncomplicated surgery, and no trough and 32 ± 16 ml at recovery). Depressed myocardial patient sustained an intraoperative infarction. In 96% of function was independent of bypass time, number of grafts patients, significant depression in right and left ventricular placed, preoperative medications or core temperatures ejection fraction was seen postoperatively, reaching a nadir postoperatively. Postoperative therapy with pressors or at 262 ± 116 min after coronary bypass. Left ventricular inotropic agents delayed but did -
Balloon Aortic Valvuloplasty
Original Research Article Journal of Structural Heart Disease, May 2015, Received: December 8, 2014 Volume 1, Issue 1: 20-32 Accepted: December 15, 2014 Published online: May 2015 DOI: http://dx.doi.org/10.12945/j.jshd.2015.00009-14 Balloon Aortic Valvuloplasty Patient Selection and Technical Considerations Ted Feldman, MD, FESC, FACC, MSCAI*, Mohammad Sarraf, MD, Wes Pedersen, MD, FACC, FSCAI Evanston Hospital, NorthShore University Health System, Evanston, Illinois NOTE: This manuscript includes videos. Not all PDF readers support video. For desktop computers we recommend using Adobe Acrobat Reader. To view videos within a PDF on an iPad we recommend viewing in ezPDF Reader or PDF Expert. On desktop computers you may view videos full screen by clicking on a video, right click on the video, then choose Full Screen Multimedia. Abstract BAV occurs in the vast majority of patients. While in BAV has had resurgence in association with the dissem- many this clinical improvement is short-lived, a ma- ination of TAVR. The lack of clear mortality benefit from jority of patients feel improved symptoms for as long BAV does not translate to lack of efficacy as a palliative as 1 year [1]. The utility of this therapy as a palliative therapy. BAV remains a useful bridge to surgical AVR or TAVR, and for symptom relief in patients who are not treatment is seen best among patients, who truly candidates for either AVR approach. It is also useful as a have no other option [2]. For example, the extreme diagnostic test for patients with low gradient-low out- risk patient, who is a candidate for neither surgical put AS, and for those with mixed pulmonary and aortic nor transcatheter AVR may undergo BAV periodically valvular disease. -
Surgery for Acquired Heart Disease
View metadata, citation and similar papers at core.ac.uk brought to you byCORE provided by Elsevier - Publisher Connector SURGERY FOR ACQUIRED HEART DISEASE EARLY RESULTS WITH PARTIAL LEFT VENTRICULECTOMY Patrick M. McCarthy, MD a Objective: We sought to determine the role of partial left ventriculectomy in Randall C. Starling, MD b patients with dilated cardiomyopathy. Methods: Since May 1996 we have James Wong, MBBS, PhD b performed partial left ventriculectomy in 53 patients, primarily (94%) in Gregory M. Scalia, MBBS b heart transplant candidates. The mean age of the patients was 53 years Tiffany Buda, RN a Rita L. Vargo, MSN, RN a (range 17 to 72 years); 60% were in class IV and 40% in class III. Marlene Goormastic, MPH c Preoperatively, 51 patients were thought to have idiopathic dilated cardio- James D. Thomas, MD b myopathy, one familial cardiomyopathy, and one valvular cardiomyopathy. Nicholas G. Smedira, MD a As our experience accrued we increased the extent of left ventriculectomy James B. Young, MD b and more complex mitral valve repairs. For two patients mitral valve replacement was performed. For 51 patients the anterior and posterior mitral valve leaflets were approximated (Alfieri repair); 47 patients also had ring posterior annuloplasty. In 27 patients (5!%) one or both papillary muscles were divided, additional left ventricular wall was resected, and the papillary muscle heads were reimplanted. Results: Echocardiography showed a significant decrease in left ventricular dimensions after resection (8.3 cm to 5.8 cm), reduction in mitral regurgitation (2.8+ to 0), and increase in forward ejection fraction (15.7% to 32.7%). -
Coronary Artery Disease and Transcatheter Aortic Valve Replacement JACC State-Of-The-Art Review
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY VOL. 74, NO. 3, 2019 ª 2019 BY THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION PUBLISHED BY ELSEVIER THE PRESENT AND FUTURE JACC STATE-OF-THE-ART REVIEW Coronary Artery Disease and Transcatheter Aortic Valve Replacement JACC State-of-the-Art Review Laurent Faroux, MD, MSC, Leonardo Guimaraes, MD, Jérôme Wintzer-Wehekind, MD, Lucia Junquera, MD, Alfredo Nunes Ferreira-Neto, MD, David del Val, MD, Guillem Muntané-Carol, MD, Siamak Mohammadi, MD, Jean-Michel Paradis, MD, Josep Rodés-Cabau, MD ABSTRACT About one-half of transcatheter aortic valve replacement (TAVR) candidates have coronary artery disease (CAD), and controversial results have been reported regarding the effect of the presence and severity of CAD on clinical outcomes post-TAVR. In addition to coronary angiography, promising data has been recently reported on both the use of computed tomography angiography and the functional invasive assessment of coronary lesions in the work-up pre-TAVR. While waiting for the results of ongoing randomized trials, percutaneous revascularization of significant coronary lesions has been the routine strategy in TAVR candidates with CAD. Also, scarce data exists on the incidence, characteristics, and management of coronary events post-TAVR, and increasing interest exist on potential coronary access challenges in patients requiring coronary angiography/intervention post-TAVR. This review provides an updated overview of the current landscape of CAD in TAVR recipients, focusing on its prevalence, clinical impact, pre- and post-procedural evaluation and management, unresolved issues and future perspectives. (J Am Coll Cardiol 2019;74:362–72) © 2019 by the American College of Cardiology Foundation. -
Arterial Switch Operation Surgery Surgical Solutions to Complex Problems
Pediatric Cardiovascular Arterial Switch Operation Surgery Surgical Solutions to Complex Problems Tom R. Karl, MS, MD The arterial switch operation is appropriate treatment for most forms of transposition of Andrew Cochrane, FRACS the great arteries. In this review we analyze indications, techniques, and outcome for Christian P.R. Brizard, MD various subsets of patients with transposition of the great arteries, including those with an intact septum beyond 21 days of age, intramural coronary arteries, aortic arch ob- struction, the Taussig-Bing anomaly, discordant (corrected) transposition, transposition of the great arteries with left ventricular outflow tract obstruction, and univentricular hearts with transposition of the great arteries and subaortic stenosis. (Tex Heart Inst J 1997;24:322-33) T ransposition of the great arteries (TGA) is a prototypical lesion for pediat- ric cardiac surgeons, a lethal malformation that can often be converted (with a single operation) to a nearly normal heart. The arterial switch operation (ASO) has evolved to become the treatment of choice for most forms of TGA, and success with this operation has become a standard by which pediatric cardiac surgical units are judged. This is appropriate, because without expertise in neonatal anesthetic management, perfusion, intensive care, cardiology, and surgery, consistently good results are impossible to achieve. Surgical Anatomy of TGA In the broad sense, the term "TGA" describes any heart with a discordant ven- triculoatrial (VA) connection (aorta from right ventricle, pulmonary artery from left ventricle). The anatomic diagnosis is further defined by the intracardiac fea- tures. Most frequently, TGA is used to describe the solitus/concordant/discordant heart. -
Reduction Ventriculoplasty for Dilated Cardiomyopathy : the Batista Procedure Shahram Salemy Yale University
Yale University EliScholar – A Digital Platform for Scholarly Publishing at Yale Yale Medicine Thesis Digital Library School of Medicine 1999 Reduction ventriculoplasty for dilated cardiomyopathy : the Batista procedure Shahram Salemy Yale University Follow this and additional works at: http://elischolar.library.yale.edu/ymtdl Recommended Citation Salemy, Shahram, "Reduction ventriculoplasty for dilated cardiomyopathy : the Batista procedure" (1999). Yale Medicine Thesis Digital Library. 3123. http://elischolar.library.yale.edu/ymtdl/3123 This Open Access Thesis is brought to you for free and open access by the School of Medicine at EliScholar – A Digital Platform for Scholarly Publishing at Yale. It has been accepted for inclusion in Yale Medicine Thesis Digital Library by an authorized administrator of EliScholar – A Digital Platform for Scholarly Publishing at Yale. For more information, please contact [email protected]. SlDDCITOM VENTRICULOPIASTy FOR DILATED CARDIOMYOPATHY THE BATISTA PROCEDURE W«M * (e,yx»> ShaLramSalemy YALE DNIVERSriY YALE UNIVERSITY CUSHING/WHITNEY MEDICAL LIBRARY Permission to photocopy or microfilm processing of this thesis for the purpose of individual scholarly consultation or reference is hereby granted by the author. This permission is not to be interpreted as affecting publication of this work or otherwise placing it in the public domain, and the author reserves all rights of ownership guaranteed under common law protection of unpublished manuscripts. Signature of Author Date REDUCTION VENTRICULOPLASTY FOR DILATED CARDIOMYOPATHY: THE BATISTA PROCEDURE Shahram Salemy B.S., George Tellides M.D., Ph.D., and John A. Elefteriades M.D. February 5, 1999 r 113 f'Uh (e(e.cl 0 REDUCTION VENTRICULOPLASTY FOR DILATED CARDIOMYOPATHY: THE BATISTA PROCEDURE.