In a model of aortic cross-clamping, we studied the use of a multiparameter sensor for measurement of cerebrospinal fluid (CSF) PO(2), PCO(2), and pH during and after aortic cross-clamping. The present study addressed the above-mentioned alterations and their relation according to time intervals. In 31 pigs, a sensor was introduced into the intrathecal space and epidural laser Doppler was used to measure spinal cord blood flow (SCF). By placing the aortic clamp at different levels, three different spinal cord ischemia groups were obtained (mild, moderate, and severe). CSF variables with SCF were studied for 25%, 50%, and 100% changes according to baseline level. In the clamping period, SCF decreased 71.5%, 40.0%, and 33.3% in groups 1, 2, and 3, respectively. CSF O(2) tension reached 0 in group 1, decreased 74.8% in group 2, and was 12.7% in group 3. CSF CO(2) tension increased 247.2% and 202.0% in groups 1 and 2, respectively, but slightly increased in group 3. The maximum reaction time of CSF O(2) tension was about 16.7-26.9min, although this range was 34.5-49.8min in CSF CO(2) tension. We recognized that O(2) tension reacts faster than PCO(2) and pH. It is possible for O(2) tension to be used faster than produced CO(2) in the ischemic medium, although it is known that the diffusion rate of CO(2) is much higher. Spinal cord O(2) tension monitoring is an important method to detect ischemic changes.
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http://dx.doi.org/10.1016/j.avsg.2008.06.004 | DOI Listing |
J Cardiothorac Surg
January 2025
Department of Anesthesiology, Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, No. 123, Tianfei Lane, Mochou Road, Nanjing, Jiangsu, 210004, China.
Introduction: The study was to assess the myocardial protection effects of the histidine-tryptophan-ketoglutarate (HTK) solution and the 4:1 blood cardioplegia (BC) in patients with atrial fibrillation (AF) who were subjected to valvular replacement concomitant with the Cox maze III surgery.
Methods: A cohort of 148 individuals afflicted with AF, who received valve replacement surgery in conjunction with the Cox maze III procedure at our clinic within the period extending from 2015 to 2023, were enrolled. Subsequent to adjustment by propensity score matching (PSM), the patients were categorized into two distinct groups: the HTK group and the BC group.
J Cardiothorac Vasc Anesth
December 2024
Department of Cardiovascular Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. Electronic address:
Objectives: The myocardial-protective effect of del Nido cardioplegia solution was evaluated in adult patients undergoing prolonged aortic cross-clamping during cardiac surgery.
Design: Prospective cohort.
Setting: Single-center tertiary academic medical center.
Ann Vasc Dis
December 2024
Cardiovascular and Thoracic Center, Viet Duc University Hospital, Hanoi, Vietnam.
We evaluate the preliminary and intermediate-term results of Viet Duc modification of the frozen elephant trunk (FET) technique. During December 2019 and May 2023, 47 patients underwent surgery using our modification of the FET at Viet Duc University Hospital. The mean age of the patients was 56.
View Article and Find Full Text PDFJ Extra Corpor Technol
December 2024
Department of Clinical Engineering, Kitaharima Medical Center, 926-250, Ichiba-cho, Ono-shi, Hyogo, 675-1392, Japan.
We conducted a high-risk redo mitral valve replacement through a right mini-thoracotomy without rib spreading (redo-MICS MVR) under systemic hyperkalemia combined with circulatory arrest to circumvent complications associated with cardioplegia delivery. The patient, a 75-year-old man, had a predicted mortality rate of 20%. Initial antegrade cardioplegia successfully induced cardiac arrest, which was administered every 30 min.
View Article and Find Full Text PDFObjective: To evaluate the immediate outcomes and safety of simultaneous Maze procedure in patients with isolated and multivalvular heart disease via right-sided mini-thoracotomy.
Material And Methods: A retrospective analysis of postoperative outcomes included 21 patients with various valvular heart diseases and atrial septal defects with atrial fibrillation. All patients underwent heart valve surgery with cryoablation (left atrial, right atrial or biatrial «Maze» approach) via right-sided mini-thoracotomy.
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