Objective: The aim of this study was to test the hypothesis that normothermic cardiopulmonary bypass (CPB) is as effective as hypothermic CPB in terms of cardiac protection (cTnI level) and outcome in patients with valvular heart disease.
Design: Prospective randomized study.
Setting: A tertiary cardiothoracic referral center.
Participants: 140 patients who had valvular heart disease, with/without coronary artery disease, surgically treated under CPB.
Interventions: The patients were allocated randomly to undergo either hypothermic (temperature [T], 31 °C-32 °C) or normothermic CPB (T>36 °C).
Measurements And Main Results: The primary endpoint was the dynamics of troponin I. The secondary endpoints were ventilation time, the need for inotropic support, intensive care unit (ICU) and hospital stay durations, complications, and mortality. There were no significant intergroup differences in dynamics of troponin I. Ventilation time was significantly lower in the hypothermic group (6 (5-9) and 8 (5-12); p = 0.01).
Conclusions: Normothermic CPB in patients with valvular heart disease was as effective as hypothermic perfusion in terms of myocardial protection after the surgery assessed by cTnI release. The short ventilation duration in patients who underwent hypothermic CPB needs to be confirmed in a future investigation.
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http://dx.doi.org/10.1053/j.jvca.2013.03.009 | DOI Listing |
Pathogens
November 2024
Department of Cardiac Surgery, Centre Cardiologique du Nord, 93200 Saint-Denis, France.
Prosthetic valve endocarditis (PVE) is the medical term used to describe a focus of infection involving a valvular substitute within the heart. It is a significant concern in the field of cardiology, and the epidemiology of PVE has seen notable developments over the last five decades. The disease currently affects an older demographic and is becoming increasingly prevalent in patients with transcatheter-implanted valves.
View Article and Find Full Text PDFJ Clin Med
December 2024
Division of Cardiology, Department of Medicine, NewYork-Presbyterian Hospital-Weill Cornell Medicine, New York, NY 10021, USA.
Thrombosis is an important cause of morbidity and mortality worldwide. Pregnancy is a hypercoagulable state, and thrombotic complications in pregnancy are a major cause of maternal and fetal morbidity and mortality. Current guidelines support the selective use of aspirin, heparin, and warfarin in pregnant women.
View Article and Find Full Text PDFJ Clin Med
December 2024
Department of Cardiovascular Medicine, Chiba University, Chiba 260-8677, Japan.
: Extracellular volume (ECV) analysis using computed tomography is recognized as a potential method for diagnostic application. It is currently the only noninvasive method for quantitatively evaluating myocardial fibrosis in dialysis patients for whom gadolinium contrast agents are contraindicated. In this study, we assessed the utility of ECV measurement via CT in the left ventricular (LV) myocardium (LVM) to predict major adverse cardiac events (MACEs) in dialysis patients.
View Article and Find Full Text PDFBiomolecules
December 2024
Laboratory of Regenerative Biomedicine, Institute of Cytology, Russian Academy of Sciences, Saint-Petersburg 194064, Russia.
A significant role in the pathogenesis of CAVD is played by innate immunity cells, such as macrophages. In stenotic valves, macrophages have enhanced inflammatory activity, and the population's balance is shifted toward pro-inflammatory ones. Pro-inflammatory macrophages release cytokines, chemokines, and microRNA, which can directly affect the resident valvular cells and cause valve calcification.
View Article and Find Full Text PDFCirc Cardiovasc Imaging
January 2025
Division of Cardiology, Department of Medicine, University of California, San Francisco (L.C., S.D., D.B., J.J.T., Q.F., L.T., A.H.R., R.J., S.H., H.H.H., Z.H.T., N.B.S., F.N.D.).
Background: A subset of patients with mitral valve prolapse (MVP), a highly heritable condition, experience sudden cardiac arrest (SCA) or sudden cardiac death (SCD). However, the inheritance of phenotypic imaging features of arrhythmic MVP remains unknown.
Methods: We recruited 23 MVP probands, including 9 with SCA/SCD and 14 with frequent/complex ventricular ectopy.
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